Publicado no Best Practice & Research Clinical Obstetrics & Gynaecology
2. Labour and birth
Dr Mary Ross-Davie (Director Royal College of Midwives)a1
Alison Brodrick (Consultant Midwife)b
- aRCM, 37 Frederick Street, Edinburgh, EH1 9NH, United Kingdom
- bSheffield Teaching Hospitals NHS Trust, United Kingdom
- cOxford University Hospitals NHS Foundation Trust, United Kingdom
- dWirral University Teaching Hospital, United Kingdom
- eUniversity Hospital Wishaw, McSherry, United Kingdom
Available online 31 March 2021.
- •Infection prevention and control in intrapartum care is a priority.
- •Women who become unwell with COVID-19 are at higher risk of iatrogenic preterm birth and have higher than normal rates of caesarean section.
- •Maintaining choice of place of birth, providing high quality care and support and pain relief should also remain a priority.
- •Care should be taken to enable women to have access to their partner or support person and remain with their newborn.
This chapter describes the national guidance for care during labour and childbirth in the United Kingdom during the COVID-19 pandemic. The content largely draws attention on the guidance developed by the Royal College of Obstetricians (RCOG) and the Royal College of Midwives (RCM), and specific guidance on infection prevention and control measures from Public Health England.
The key areas addressed are as follows:
- •Testing of pregnant women before and on admission for labour and birth
- •Overall approach to intrapartum care for women with and without symptoms of COVID-19
- •Timing, place, and type of birth considerations
- •Personal Protective Equipment (PPE) during labour and birth – for staff, women, and birth supporters
- •Use of birthing pools and waterbirth
- •Foetal monitoring
- •Immediate care of the newborn and support for breastfeeding.
The chapter refers to some of the ways in which the guidance was translated in practice.
The guidance was developed using a rapid analysis approach to emerging research and evidence, along with evidence from previous experiences of coronavirus combined with consensus expert opinion from all key professionals providing maternity care in the UK.
What is known
The UK RCOG/RCM COVID-19 guidance was widely accepted across the UK maternity services and also worldwide as a reliable and credible source of information to shape care during the pandemic.
What is not known
The full impact of the pandemic on the experiences and outcomes for babies and women of pregnancy, childbirth, and early parenting in the UK.
The impact of the new approaches to intrapartum care on experiences and outcomes for women, babies, and families.
The impact of the changes required to intrapartum care as a result of the pandemic on the professional care provided; in terms of pressure created by rapidly changing approaches to care and restrictions on the ability to provide normal levels of care.