COVID-19 information for pregnant women and new mums

Having COVID-19 can be a worrying time, especially if you are pregnant or have a new baby. It is important that you are prepared to isolate at home if you or someone in your house tests positive for Covid 19. See detail information about preparation here.

Does COVID-19 affect my pregnancy?

Being pregnant increases your chances of becoming more unwell with COVID 19 than if you were not pregnant. You are also more at risk of having a pregnancy complication such as a blood clot or high blood pressure. Data from overseas tells us that you are less likely to become severely unwell with COVID-19 while pregnant if you have received all of the recommended vaccinations

You may be advised to have a blood thinner injection each day to reduce your risk of developing a blood clot. Keeping active and hydrated, even if you are isolating, is important to reduce the risk of blood clots in pregnancy. 

If you required care in hospital because of COVID-19 it may be recommended that you have an additional scan when you are well. Your LMC can provide a form for you.

What if I go into labour when I am Covid positive? 

If you give birth while you have COVID-19 you will still receive all the maternity care that you need. You may still be able to have your baby in a birthing centre, you should discuss this with your midwife. At Waikato Hospital Delivery Suite we are ready with a safe birthing room to care for you and your baby. It is still likely that you will have a normal birth but if you need any extra help like an epidural or a caesarean section this will also be provided.    

Once your labour starts contact your midwife as you usually would. When your labour is established your midwife will call the hospital or birthing centre to arrange for you to come in 

The staff caring for you will be wearing PPE and your support person will also be asked to wear a mask at all times. Both you and your support person are required to stay in the birth room at all times so that infection risk is kept to a minimum.   

In some cases it may be recommended to you that your baby’s heart rate be monitored continuously while you are in labour and advised that you have a drip inserted. All pain relief options are still available to you.

Will my baby get COVID 19? 

There is a very small risk that your baby will get COVID-19 from you while you are pregnant or giving birth. It is more likely that you will pass COVID-19 onto your baby after birth. At present newborn babies who get COVID-19 are not unwell. It is recommended that you maintain good hand hygiene and wear a mask when caring for your baby. If you are concerned about the health of your baby contact your midwife for advice.

Can I still breastfeed my baby?

Close contact and exclusive breastfeeding helps a baby to thrive. We recommend that you breastfeed your baby as this can pass on some immunity to your baby.

Who will check up on me?  

You may be contacted by your GP or their team to monitor your health during your isolation. Your Midwife will inform the doctors at the hospital who may also contact you.  

Generally during the time you’re isolating with COVID-19 your midwife will delay any routine appointments, urgent care will still be provided. Please continue to contact your midwife as you usually would. 

Some women may be asked to measure their oxygen saturations with a small device called a pulse oximeter.

What symptoms should I look out for? 

This checklist will help to monitor for important changes to your and your baby’s health when you have COVID-19. These changes may be early symptoms for preeclampsia or blood clot. The checklist will help your LMC or healthcare team decide if hospital assessment is needed.

◻ Headache or visual disturbances 
◻ Swelling in your hands feet or face
◻ Tummy pains or contractions 
◻ Vaginal bleeding or mucous discharge 
◻ Leg swelling or pain
◻ Changes in your babies movements
◻ Pain when breathing or breathing feels like hard work 

If you have been provided with a pulse oximeter or a blood pressure monitor also measure these. Oxygen and heart rate 3 times each day and blood pressure once each week – or as advised by your midwife 

◻ Heart rate is 110 or higher 
◻ Oxygen level is 94% or lower 
◻ Blood pressure is more than 140/90 

If you have ticked yes to any of the above checklist call your midwife immediately

If you are having difficulty breathing or chest pain call 111, ask for an ambulance and tell them you have COVID-19 and are pregnant. 

You can get your COVID-19 vaccination from GPs, some pharmacies and other healthcare providers and from Waikato DHB community mobile vaccination clinics.

For more information go to the Immunisation Advisory Centre.

We are in uncertain and unprecedented times, and everyone will respond differently to the impact of COVID-19. It’s important not only to look after your physical health but also your mental health.

It’s completely normal to be feeling a wide range of emotions, including being worried, anxious and scared. As we are all encouraged to socially distance, it is very important to stay connected with friends and whānau online or by phone.

• The Ministry of Health has a list of really good resources and contacts if you need mental health and wellbeing support.
• Perinatal Anxiety and Depression Aotearoa has a whole host of information about pregnancy and COVID-19, including dealing with uncertainty, building resilience, coping with stress and looking after your mental health.
• Depression.org.nz has information on coping with COVID-19.
• If you feel you need professional support for anxiety and distress, you can call or text 1737 to talk with a trained counsellor for free, 24 hours a day, 7 days a week.
• If you are currently getting help with your mental health, continue this – talk to your GP, counsellor, case worker or mental health team about how they can continue to support you over the phone, via email, text or video chat.
• Talk to a trained counsellor on the New Zealand Depression Helpline. Call 0800 111 757 or text 4202 to talk about how you are feeling or ask a question. 
• Pregnancy Counselling Services is an independent charitable trust offering free counselling service, emotional support, information and practical help. Call 0800 PREGNANT (0800 773 462) for free, or visit their website to find out more about support in pregnancy.
• Te Rōpū Whakakaupapa Urutā: National Māori Pandemic Group have information for whānau about COVID-19.

Keep attending your health care appointments and accessing health care when you need it

• It is important for you to have your antenatal and postnatal checks with your midwife now we are in the traffic light system your Midwifery care should follow the same schedule as before covid. Talk to you midwife about how this will happen.
• If you have a scan booked, it is safe for you to attend - COVID precautions are in place in all ultrasound facilities and in the hospital.
• If you have a hospital antenatal appointment, be assured COVID precautions are in place with social distancing, mandatory mask wearing and a separate system for those who are suspected of having COVID.
• If you have any urgent maternity care needs, the women’s health assessment (WAU) and delivery suites are open 24 hours a day, 7 days a week. Call your LMC to discuss your urgent care needs and she will arrange for your attendance at the hospital if this is required. If you cannot get in touch with your midwife, call WAU on 07 839 8899 so you can be assessed over the phone and we will make preparations for your arrival at WAU.
• Our staff are here to care for you and COVID precautions are in place to protect you.

Wearing a mask when going to essential services and taking exercise

Always wear a mask when you leave home to protect yourself. It is now mandatory to wear a mask when you are outside your home. Emerging strains of the virus have stronger transmission. The virus can be breathed in if you are in close proximity to someone who has the virus. 

• It is important to wear a mask even when you are out walking and getting fresh air.
• Protect yourself and wear a mask when you are using essential services like the supermarket or pharmacy.
• You will need to wear a mask if you are attending your maternity service appointments or scans.
• When you are in labour, you will not be required to wear a mask once you have settled into the birth room.

Having a smoke-free pregnancy and home 

Smoking impacts on the lungs of people who smoke and those breathing in secondhand smoke from other people smoking in their home or cars. If your lungs are weaker because of this and you get COVID-19, you could get more severely sick.

One of the best things you and/or your whānau can do for your health and your baby’s health is to stop smoking. Koia nā! Mō āke Tonu!

Waikato Once and For All stop smoking service can help. You can find out more and enrol for help on their website or ask your midwife or doctor to refer you to Hei manaaki ngā mama e hapū ana – Help for pregnant mums. The service is open during COVID-19 lockdowns and they are working in conjunction with the national Quitline team. They will support you by phone, text, email or video calling.

COVID-19 vaccination and pregnancy

• If you catch COVID-19 when you’re pregnant, you are more likely to become very unwell.
• If you’re not vaccinated, you are more likely to be admitted to the intensive care unit. There are also increased risks for babies. Babies are five times more likely to be born prematurely and require neonatal intensive care. 
• Data from the large number of pregnant people already vaccinated globally shows that there are no additional safety concerns with giving COVID-19 vaccines to pregnant people.
• You can have your vaccination at any stage of your pregnancy.
• Vaccinating during pregnancy may also help protect your baby as there is evidence that babies can get antibodies through the placenta that help protect them from COVID-19.
• If you have any questions or concerns, discuss them with your health care professional

Breastfeeding

• If you’re breastfeeding, as with all vaccines on the New Zealand Immunisation Schedule, there are no safety concerns about getting the Pfizer vaccine (also called Comirnaty).
• When you're vaccinated, your baby can be protected against COVID-19 through your breastmilk.

Trying for a baby

• If you’re planning a pregnancy, you and your partner can receive the Pfizer vaccine.
• The Pfizer vaccine will not affect your genes or fertility. The mRNA from the vaccine does not enter the nucleus of any cells, which is where your DNA is.

Drop into a community vaccination centre or book in advance through Book My Vaccine.nz or by phone on 0800 28 29 26 (8am to 8pm, 7 days a week).

For more information about the COVID-19 Vaccination

• Open this link to find out How the Pfizer vaccine works
• COVID-19 vaccine: Pregnancy and breastfeeding
• Open this link to Te Rōpū Whakakaupapa Urutā – the National Māori Pandemic Group.

We know that your pregnancy journey is a very important time for you and your whānau. We are working hard to ensure you, your whānau, our staff and other patients are safe while you are attending antenatal clinic appointments at Women's Health Clinic. As a result we have made some changes to how the service is run.

Appointments

• Appointments have been changed in response to COVID-19. This is to minimise face-to-face contact and to maximise safety. Depending on your condition and the reason for your referral to clinic, your appointment may be carried out over the phone. We will keep you informed about what will happen.
• If you require a scan/tests/monitoring or if you require an examination, you will need to attend clinic for your appointment – we will tell you.

Attending clinic for an appointment

• If you have tested positive for COVID-19 or unwell and have an appointment to attend clinic, please phone 07 589 6706 before your appointment so arrangements can be made for your safe care.
• Please wear a mask when you enter the building for your appointment. If you do not have a mask, one will be provided for you.
• You are welcome to bring one key support person to your appointment.  We ask that your support person also wears a mask and is well.  Please do not bring children with you.
• Please note the entrance to Women’s Health Clinic (B3) is close. All arrivals and exits must be via the Delivery Suite entrance (B2) and then down the stairs or via the lift to level B3.

In response to COVID-19, we have changed how Waikato DHB's diabetes service and clinics are run. We are limiting face-to-face contact in our diabetes outpatient clinics to ensure you and your whānau, our staff and other patients are safe while you are being cared for.

Women with Gestation Diabetes Mellitus (GDM)

• A routine blood test in early pregnancy may indicate you need further screening for gestation diabetes mellitus (GDM). This will take place between 24 and 28 weeks' pregnancy. Your lead maternity carer (LMC/midwife) will offer you a test for gestational diabetes, an oral glucose tolerance test (OGTT). This will confirm a diagnosis of GDM, which is becoming increasingly common in the population. If you are not diagnosed with GDM you will be informed and your LMC will continue to provide your care.
• If your OGTT is positive for GDM the Diabetes in Pregnancy team will contact you by phone and you will receive a detailed information pack, with meters for checking your blood glucose levels including detailed information and links to videos to support this. We will continue to support you to manage your health via phone and email.
• The Diabetes in Pregnancy team will provide clinical care to support you to manage your GDM along with the Obstetric team at the hospital, but your midwife will remain your lead maternity carer and continue to provide your midwifery care.
• You may also need to come to an antenatal clinic appointment in the hospital. See information in Antenatal clinic appointments section for more information about attending a clinic with the Obstetric team.

Women with Type 1 diabetes or Type 2 diabetes

• If you have type 1 or 2 diabetes you will be referred to the Diabetes in Pregnancy service as soon as you engage with an LMC, general practitioner (GP) or diabetes educator.  
• Women with type 1 diabetes will already be very familiar with diabetes management. The Diabetes in Pregnancy team encourages contact ASAP to allow for further advice and guidance on glycaemic control to account for the expected physiological changes in your pregnancy. You will receive a phone call from the diabetes clinical nurse specialist to discuss this and plan for ongoing care. The Diabetes in Pregnancy team will support you regularly via phone or email to manage your diabetes and gain control of your BGLs to promote optimal health for you and your developing baby, and to minimise the potential for complications in pregnancy related to your diabetes.
• If you have type 2 diabetes, you may already be familiar with diabetes management but will require further support and guidance from the Diabetes in Pregnancy team. For those who do not, you will receive a detailed information pack with equipment for checking your blood glucose levels (BGLs), detailed information and links to videos about managing type 2 diabetes in pregnancy. We will support you regularly via phone or email to manage your diabetes and gain control of your BGLs to promote optimal health for you and your developing baby, and to minimise the potential for complications in pregnancy related to your diabetes.
• Regular clinic appointments with the diabetes doctors will occur via phone or virtual consultations.
• You will be referred to the Obstetric team early in your pregnancy. See information in antenatal clinic appointments section for more information about attending the clinic for your obstetric appointment.
• You will require midwifery care for normal pregnancy, labour, birth and postnatal care. It is highly recommended you seek midwifery care early as midwife bookings fill fast.

We are working very hard to ensure the Women’s Assessment Unit (WAU) environment is safe for you, your baby, our staff and other patients. To do this, we have made some changes to how things work in WAU.

WAU is open 24 hours a day, 7 days a week for urgent care for pregnant women. However it is not a drop-in service or walk-in clinic.

• Your midwife (LMC) or doctor (GP) will contact WAU and arrange for you to attend and we will expect your arrival. If you need to be seen that day, but not urgently, the WAU team will discuss this with your LMC/GP and they will let you know about the best time to attend.
• If you have an urgent pregnancy-related issue - for example, bleeding or a change in your baby’s movements - and you cannot get hold of your LMC, ring 07 839 8899 so you can be assessed over the phone and we will make preparations for your arrival at WAU.
• If you have tested positive for COVID-19 or are awaiting results of a COVID-19 test, ask your LMC or GP to let WAU know or call WAU on 07 839 8899 so arrangements can be made for your safe care in WAU.
• Please wear a mask when you enter the building.
• Please arrive at B2 main reception. We ask that partners/support people do not park their car outside the B2 entrance while waiting for you. It is important this area is clear for women arriving in labour, and for women attending clinic or WAU and for mothers and newborn babies being picked up following their discharge from the ward.

Information for women who are planning to/or have been recommended to have their baby in Waikato Hospital.

We know the birth of your baby is a very important time for you and your whānau and you may be apprehensive about giving birth at this time. We are working very hard to ensure the delivery suite environment is safe for you, your baby and support person as well as our staff and other patients. To do this, we have made some changes to how things work in the delivery suite and the ward environment.

If the number of COVID-19 positive women increased significantly, there may be changes required to keep everyone safe. These changes may affect your preferred place of birth. Under certain circumstances it is possible that the Hospital Delivery Suite will only be available to women who are unwell or who have experienced complications with their pregnancy that require additional medical care. You can be assured that when birthing at a Primary Birth Unit, should your clinical situation change and additional care be necessary, your LMC Midwife and Birth Centre staff will arrange a timely transfer to Delivery Suite. While evidence is clear that a Primary Birth Unit is the safest environment for well women with uncomplicated pregnancies, we do understand how important women’s choice is, and this measure would only be undertaken if absolutely necessary.   

One of these changes may be that only unwell, or women with complications can birth in the hospital and to protect the wellbeing of well women with uncomplicated pregnancies the birth centres will care for you with your midwife

Please advise your LMC if you are feeling unwell with any COVID-19 symptoms or if you have tested positive for COVID-19 or are awaiting COVID-19 test results. Your LMC will need to let Delivery Suite know ahead of time before your labour starts and also when you go into labour (before you arrive at Delivery Suite). 

This will enable us to make preparations for your arrival and safe care during labour. 

If you are having a c-section

• If you are having a planned c-section, the hospital team will ring you the day before to check if you and your support person are well (have no COVID-19 symptoms). They will go over information for the next day. On the day, one support person can come into the hospital with you and wait in the Women’s Assessment Unit (WAU) with you while you await theatre. The same support person can remain with you in theatre and the post-operative care area and can accompany you to the ward.
• If you are having an emergency c-section, the support person that has been with you during labour or who arrived at the hospital with you can accompany you into theatre, depending on the level of the emergency. If they are unable to come into theatre, they will wait until they get the call that you are out of theatre and then join you until you are ready to go the ward.

If you are having an induction of labour (IOL)

• If you are having an induction of labour, the hospital team will ring you the day before to check if you and your support person are well (have no COVID-19 symptoms). They will go over the information for the next day.
• On the day of your IOL, arrive at B2 and report to WAU reception. From there you will go to the ward to commence your induction. Your support person can stay with you if they are well without any symptoms of Covid.

When you go into labour 

• When you go into labour ring your midwife (LMC), who will talk to you to assess what stage of labour you are in. Your LMC may also come and assess you at home. Your LMC will make arrangements to meet you in Delivery Suite.
• If you cannot contact your LMC and you feel that your labour is progressing, ring Delivery Suite on 07 839 8899 and they will assess you. If you need to come in straight away, they will make arrangements for your arrival.

Support people

• You are welcome to bring one support person with you to Delivery Suite.
• If you have other children at home, please arrange for a family member or trusted adult to care for your children while you come into Waikato Hospital with your partner.  
• Your support person will need to stay with you the whole time. For safety reasons they will not be able to leave Delivery Suite and return to the delivery room. You cannot have a second person “to take over for them”. Make sure your support person has drinks and snacks with them should they need them. Children are not allowed in Delivery Suite at this time.
• Do not bring a support person/partner to Delivery Suite with you if they have tested positive for COVID-19, are awaiting a COVID-19 test result or have symptoms of COVID-19, even if they are the baby’s father, as they need to be self-isolating. If they come into Delivery Suite it will put you, your baby, our staff and other patients at risk.

Following your baby’s birth

• After your baby has been born, and if you or you baby are clinically unwell, you will be admitted directly to the maternity ward from Delivery Suite to ensure you and/or your baby receive the obstetric/neonatal care needed.
• If you and your baby are well, we recommend you have your postnatal care at the birth centre of your choice as you will be in a private double room with your own en suite facilities and your partner can stay with you. This option is particularly for women who feel they will initially need more midwifery care and support.
• If you and your baby are well you also have the option of going directly home from Delivery Suite. Your LMC will visit you at home.

Information for women who are staying on the Waikato Hospital ward for clinical care while they are pregnant and for women who are staying on the ward with their baby following birth.

With COVID-19 circulating in the community, this can be a scary time for pregnant women or women who have just had a baby. We are working very hard to ensure the ward environment is safe for you, your baby, our staff and other patients. The layout of the ward does not enable social distancing if additional people such as visitors and support people come to the ward. To ensure women and babies are safe, we have made some changes to how things work.

Antenatal and postnatal women  

• You will be staying on ward E1 or E2.
• In line with hospital and national restrictions, you are able to have one key support person visit the ward during hospital visiting hours only. Children are not allowed on the ward.
• Waikato DHB has a free wifi service which will enable you to stay in contact with your loved ones, wider whānau and friends.
• All women will be screened for COVID-19 before admission to the ward.
• Women staying on the ward will continue to receive the same clinical care for their condition from our midwives, nurses and doctors who work on the ward. Additionally, women will be screened each day for symptoms of COVID-19.

When you are ready to be discharged from the ward you can phone your partner/support person to collect you.

Babies admitted to NICU can have one parent or caregiver visit each 24 hour period. This restriction is to keep NICU babies safe. Certain circumstances will be considered on discussion with the Charge Nurse of the NICU nursery. The parent or caregiver will need to wear a mask and follow hand hygiene infection control measures.

Visitors are not allowed to the NICU nursery at this time.

We know that the birth of your baby is a very important time for you and your whānau and you may be apprehensive about giving birth when COVID-19 is circulating in the community. Primary birth facilities are working very hard to ensure the birth centre environment is safe for you, your baby and your support person as well as staff and other women and babies in their care. This has meant changes to how things work in primary birth facilities.

When you go into labour  

• All Waikato primary birth facilities are open for labour and birth care provided you do not have a high suspicion of COVID-19, are awaiting a COVID-19 test result or have tested positive for COVID-19.
• Women and their support person/partner will be screened for COVID-19 when they arrive.
• Please do not arrive at a birth centre in labour before contacting your LMC first. Your LMC will talk to you to assess what stage of labour you are in. Your LMC may also come and assess you at home. Your LMC will make arrangements to meet you at the birth centre.
• You will need to arrive wearing a mask – you will be able to remove this once you have settled into the birthing room.

Support people in primary birth facilities during birth and for postnatal stay 

• Please contact your birth centre to find out about their current support person policy for labour and birth and their current visitor policy.
• Please ensure your support person staying with you for postnatal care has also packed a bag.
• Your support person(s) will need to arrive at the birth centre wearing a mask.
• If you have other children at home you can arrange for a family member or trusted adult to care for your children in your home while you come into the primary birthing facility with your partner.
• Please do not bring a support person/partner to the birth or for your postnatal care if they have a high suspicion of COVID-19, are awaiting a COVID-19 test result or have tested positive for COVID-19, even if they are the baby’s father, as they need to be self-isolating. If they come into the primary birthing facility it will put you, your baby, maternity staff and other women and babies at risk.
• The kitchen and common areas in primary birth facilities may be closed. Your support person will need to stay in the postnatal room with you. Please check with the primary birth facility or ask your LMC if food will be supplied to your partner staying with you during your postnatal stay or what the options are for bringing in food/purchasing food.

Visitors to primary birth centres during COVID-19

Please contact the primary birth facility where you will be staying to find out more about their visitor policy.