Maternity services

It is expected that the large majority of people who contract COVID-19 will experience only mild or moderate cold/flu like symptoms. There is no evidence that pregnant women who get the infection are more at risk of serious complications than any other healthy individuals, however we are taking extra precautions to ensure all women who come into our services are kept as safe as possible.

We are following government guidance in terms of social distancing, protective personal equipment and isolation areas for those who need it. This ensures that those women who are unaffected are also kept safe and well.  To help us manage the spread of COVID-19, all staff will be wearing face mask and gloves and an apron for any contact. Please do not be alarmed, we are doing this to try and stop the spread of the virus into our department. Please help us by adhering to any safety recommendations given to you at the time of attendance.

The following changes have been made to maternity care provided by Epsom and St Helier hospitals:

Maternity advice line

The dedicated maternity advice line will continue to run as normal. A midwife is at the end of the phone 24 hours a day to answer any questions that you may have, and can be reached on 0300 123 5473

Early Pregnancy Assessment Unit

• No reassurance scans will be performed. Any woman experiencing acute bleeding prior to having a nuchal scan (12 week scan) will be seen via A&E. 

Booking appointment

• Our aim is still to complete the booking assessment by 10 weeks of pregnancy. The booking will be conducted over the phone with the exception of women requiring interpreting services or if vulnerability is previously identified. The routine booking bloods tests will be taken when you attend for your nuchal scan at 12 weeks.
• There is a phlebotomy clinic (blood testing) open on both sites from Monday to Friday. You will have your blood pressure, height, weight, BMI and urine check completed at the same time as your blood tests. The booking midwife will review your blood results and contact you if required.

Antenatal care

Scanning:

• The nuchal scan (12 week scan) will be scheduled as normal. Prior to the appointment (24 hours earlier), you will be contacted by phone to establish if you are symptomatic and/or self-isolating. If you are symptomatic or self- isolating, the appointment will either be re-booked or arrangements made for the quad test to be performed at 16 weeks.
• Anomaly scans (20 week scan) will be planned as normal. Prior to the appointment you will be contacted by phone to establish if you are symptomatic and/or self-isolating. If the anomaly scan is missed then it will be re-booked for you in two weeks.
• We currently have a strict visiting policy in place. No visitors are permitted for any outpatient or scan appointments, and you can only bring one dedicated person to accompany you when you give birth.  

Antenatal clinics:

• We now aim to conduct the majority of clinics over the phone or virtually where clinically safe to do so (with the exception of perinatal mental health). If you are attending maternal medicine, diabetes and pre-term birth clinics, these will be reviewed individually by the specialist clinician.
• Smoking cessation clinics have been cancelled and women who smoke will be offered  an extenral referral, where feasible. Carbon monoxide (CO) screening will not be performed due to infection prevention concerns. ?
• Women’s health counselling has been suspended and women will be referred to external agencies, eg Uplift, by their midwife if required
• Antenatal classes have been cancelled, and women who have been recruited for the Pregnancy Circles study will be amalgamated into a routine antenatal schedule. If you have anything you would like to discuss, this can be done with the midwife that contacts you or via the maternity advice line.

Antenatal appointments:

• The only appointments that will be conducted face-to-face are at 28, 34, 38 and 40 weeks. We will aim to conduct all other appointments over the phone, paying particular attention to fetal movements and any specific concerns you may have.
• All women who are low risk, will be offered a growth scan at 36-37 weeks of pregnancy, in the absence of the usual routine antenatal assessments.

Giving birth

If you think your labour has started, or you need to attend the hospital due to an emergency or concern about the baby, please call the maternity advice line on 0300 1235473.  A member of midwifery staff will advise you where and when to come in. Women should wait on the ground floor and not come straight to the delivery suite on either site. Two allocated staff members with personal protection (apron, mask and gloves) will receive the woman and her birth partner, fit them with a mask and bring them to delivery suite via the lift and take them directly to a single room. You will be given a surgical (non FFP3) face mask which should be worn until isolated. 

We have reviewed the situation around home births and now have assurance that both London and South East Coast Ambulance services are back to usual response times.  Our maternity staffing is currently also maintained at a safe level.  We are therefore pleased to be able to reinstate the home birth service at this time, with the following caveats:

• The woman and all members of her household are not displaying any signs of Covid-19 
• Only one birth partner is in attendance

We will review the situation twice daily to ensure the ambulance and staffing requirements continue to be manageable. 

Please remember only one birth partner will be permitted, who will need to comply with infection control procedures.  Your birth partner must not be showing any symptoms or have been diagnosed with COVID-19. 

Water births:

• With regret, we have had to withdraw the offer of a water birth at this time, due to the potential risk of cross-contamination to staff.

Postnatal 

• To minimise the risks of transmission, a six-hour discharge following birth will be completed on all low risk women.

Postnatal visiting pathway:

• Day 1 - telephone triage
• Day 5 - telephone triage prior to contact, and a plan made for appointment to see mother and baby and perform the Newborn Blood Spot (NBBS).  This will only be deferred if the mother is symptomatic. 
• Day 10 - telephone discharge. 

When you are contacted by telephone following the birth of your baby, please accurately and honestly answer the questions asked regarding any COVID-19 symptoms or anyone self-isolating in your household. This will allow us to make an appropriate care plan for you that will keep you, your baby and our staff as safe as possible. You can continue to call the maternity advice line at any time if you need any additional support or information.

Visiting 

To protect our staff and patients, there is a strict no-visiting policy in operation throughout the hospital at this time. Birth partners are exempt from this policy, when women are in active labour, but should follow government advice on social distancing. In light of the guidance that everyone should self-isolate at home and remain two meters apart when out, we have made the difficult decision to stop partners visiting the antenatal or postnatal wards or staying overnight.

We understand that this will be disappointing for you, and we will do our very best to ensure that you are transferred to the labour ward as early as possible and discharged home as soon as you are fit. Once home, you will continue to be supported by the community midwifery team and they will make contact with you by telephone the day following your discharge from hospital.

Please do not allow any other member of your household to attend the hospital at any time.

We remain committed to providing you with outstanding care and have dedicated staff working hard to ensure you have a safe and positive pregnancy and birth. Our maternity staff cannot work from home as we need to care for you and your baby throughout the antenatal, labour and postnatal period. Our first priority is in providing the best service we can for you, and we ask for your understanding of the challenging environment that we are working in. We trust that you will support us in our efforts to care for you as safely and efficiently as we can during this time.

Kathryn Hughes, Divisional Director for Women and Children’s Services

• Hazel Gleed, Deputy General Manager for Women and Children’s Services
• Mr Ramesh Ganapathy, Clinical Director for Obstetrics and Gynaecology
• Mr Haider Jan, Clinical Lead for Gynaecology
• Marion Louki, Director of Midwifery and Gynaecology Nursing (cross site)
• Miss Antoinette Johnson, Clinical Lead for Obstetrics
• Mr Mike Katesmark – Gynaecology Oncology Lead (Epsom)
• Mr Manish Maheshwari – Gynaecology Oncology Lead (St Helier)
• Dr Arun Kundu – Clinical Director for Paediatrics
• Dr Salim Yasin – Clinical Lead for Paediatrics (St Helier Hospital/QMHC)
• Dr Tim Marr/Dr Stephanie Kirk – Clinical Lead for Paediatrics (joint role, Epsom)
• Dr Aileen Alston – Quality Lead, Paediatrics (Trust-wide)
• Nadine Mitchell – Head of Nursing (Paediatrics and Neonatal)
• Louise Proffitt – Deputy Heald of Nursing for Neonates, Children and Young People
• Yasmin Ashrafi – Women’s health Service Manager
• Angie Molineaux – Assistant Service Manager for Women’s health
• Julia Sinclair – Paediatrics Service Manager
• Linda Mccallum – Assistant Serivce Manager for Paediatrics
• Wendy Millar, Quality Manager for Gynaecology
• Mary Shewell, Quality Manager for Paediatrics
• Margaret Mansfield – Lead Nurse for Safeguarding Children
• Carol Erzen, Directorate Co-ordinator
• Catherine Malins, Patient Experience - Paediatrics
• Mary Willocks, Inpatient and Antenatal Services - Epsom
• Margaret Flynn, Gynae Matron
• Louise Emmett, Consultant Midwife for Normality – Epsom based
• Julia Lidderdale, Consutant Midwife Public Health (cross site)
• Laura Rowe, Lead Midwife for Clinical Governance and Risk
• Emilie Lacquement, Lead Midwife for Inpatient Services (St Helier) (currently on maternity leave)
  • Covering for maternity leave (until summer 2019) - Suzanne Powroznyk
• Diane Weir, Maternity Transformation Lead
• Patience Ohikhena, Lead Midwife for Antenatal (St Helier) and Community (cross site) 
• Nicola Shepherd, Deputy Head of Midwifery (cross site, Epsom based)
• Michelle Knight, Lead for Normality (St Helier based)
• Sue Taylor, Infant Feeding Lead
• Infant Feeding Team (07975 232374 or email esth.infantfeedingteam2@nhs.net)
• Elizabeth Cullen, Named Midwife for Safeguarding
• Community Teams (Epsom): 
  Reception: 01372 736566
  Epsom and Ewell:  01372 6406/6410
  Banstead and Cobham: 01372 5140/6721
• Community Teams (St Helier) 020 8296 2990
• Home Birth Team:
  Maria Mill Shaw Home Birth Lead Midwife 07975 232101
  Pippa Davies 07828 224703 
  Nina Johnson 07975 232106
  Jill Pidler 07975 232102
  Visit our Home Birth Team Facebook page.

We also offer a number of complementary therapies at our Trust for our maternity patients. Please see the following leaflet for more information: Complementary therapies - information leaflet[pdf] 293KB

 

Below are a list of local and national support groups and other resources which may be of use to pregnant women and new families.

• Public Health England Screening tests for you and your baby [pdf] 4MB - explains the screening tests offered during and after pregnancy
• ARC (Antenatal Results and Choices) (opens in a new window) - a national charity helping parents and healthcare professionals through antenatal screening and its consequences
• DadPad - Dadpad is the essential guide for new dads, developed with the NHS. Download the app to your smartphone to get started!
• Down Syndrome Association (opens in a new window) - a national charity which aims is to help people with Down’s syndrome live full and rewarding lives.
  • Down Syndrome Association Looking forward to your baby leaflet [pdf] 2MB
• Positive about Down Syndrome (opens in a new window) - a website for parents and parents to be about Down syndrome
• Get on Downs (opens in a new window) - a parent lead support group in the London Borough of Sutton and surrounding areas. The support group meets weekly for coffee, chat and cake. Children of all ages are welcome to play with stimulating toys, in the sensory room or outdoors (weather permitting). They offer support and advice for new families, arrange useful speakers for informal discussions, social events, pamper sessions and spa days.
  • Get on Downs leaflet [pdf] 1MB
• SOFT (opens in a new window) - a support group for Trisomy 13 (Patau’s syndrome) and 18 (Edwards’ syndrome): 
• Shine (opens in a new window) - specialist advice and support for spina bifida and hydrocephalus
• Miscarriage Association (opens in a new window) - information about pregnancy loss and support
• Tamba (opens in a new window) - Twins and Multiple Births Association.