Coronavirus: Maternity advice says partners should attend birth

Pregnant women should continue to have a birthing partner with them during labour “unless this partner is symptomatic or unwell, irrespective of the woman’s Covid-19 status”, according to new guidance for maternity hospitals.

However, it says, it may not be possible, in some situations, for a partner to be present during delivery.

The guidance was issued on Friday by the Royal College of Physicians of Ireland (RCPI) Institute of Obstetricians and Gynaecologists on Covid-19 and maternity services.

According to the World Health Organisation (WHO), a positive childbirth experiences includes having a birthing partner of choice present during delivery.

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The guidance acknowledges this but says: “In situations where the woman has or is suspected to have Covid-19 infection there may be situations where regrettably this is not possible relating to PPE [personal protective equipment] availability, workforce gaps or unit configuration.

“Local policies may also apply for the partner to wear PPE, and to stay in the room for the duration of the labour or delivery.

“In emergency scenarios for Covid-19 positive women… it may not be feasible for the partner to attend the delivery in theatre.”

Women, the guidance states, with suspected or confirmed Covid-19 who are in labour should be placed in an isolation room with en suite facilities.

The guidance also states pregnant health care workers should be assigned to patients and duties that have reduced exposure to patients with, or suspected to have, the coronavirus.

Pregnant healthcare workers are described as an “at-risk group for Covid-19 infection” and as such should not be rostered to work on “Covid-specific units or wards”.

It said redeployment to lower risk duties should be considered and any pregnant staff with an underlying medical condition should discuss redeployment or working from home with their treating obstetrician.

No maternal deaths from the virus have been reported to date and pregnant women do not appear more likely to contract Covid-19 than the general population, according to the guidance which was issued on Friday.

But pregnancy “predisposes women to complications of viral infection” and “pregnant women are more likely to develop severe illness after infection with respiratory viruses”.

To date there is no data on first trimester infection. A rise in the risk of miscarriage in women affected by Covid-19 cannot be ruled out, however, as pregnant women who develop a fever, or who have a serious illness, in their first trimester of pregnancy are considered to have an increased risk of miscarriage.

Furthermore, in women affected by Sars for example, there was a higher pregnancy loss rate and more pregnancy complications were reported.

Mother to baby transmission of Covid-19 is now considered “probable”, the guidance states, but “the proportion of pregnancies affected and the significance to the neonate has yet to be determined”.

The guidance was written by Dr Keelin O’Donoghue, Consultant Obstetrician at Cork University Maternity Hospital (CUMH) and Principal Investigator at University College Cork’s (UCC) INFANT Research Centre; and Joye McKernan, National Perinatal Epidemiology Centre.