Early pregnancy care during the coronavirus pandemic

This information is for you if you (or someone you love) are under 12 weeks pregnant (in your first trimester) and you have a problem or concern that may require care from an Early Pregnancy Assessment Unit. This information is based on guidelines written in collaboration with the Royal College of Obstetricians and Gynaecologists and the Association of Early Pregnancy Units on early pregnancy care during the pandemic. We will update this page as new information is published.

Updated 14/05/2020

Please note that the first part of this video was filmed before the coronavirus outbreak. The second section refers specifically to guidelines delivered after the outbreak. Please note that currently our advice line is not operating, but you can still contact us via email or our social channels. 

 

Because of the coronavirus pandemic, all hospitals are trying to reduce the number of people coming in for appointments. This will help limit the spread of the virus and take the pressure off NHS services, including maternity services.

This means that there will be some changes to early pregnancy care. It is completely understandable to feel a bit anxious about this. But be assured that, as always, maternity services will continue to provide essential care. So, you will be able to get an appointment if you really need one.

Do not hesitate to contact your local early pregnancy unit or GP if have any symptoms you are worried about, such as stomach pain or bleeding. 

What if I have any concerns in the early stages of my pregnancy during the coronavirus pandemic?

If you have any concerns about your pregnancy it's important to contact your GP, midwife or local early pregnancy unit straight away. Although it is not always the case, some symptoms, such as pelvic pain, cramping and/or bleeding during early pregnancy, are linked to ectopic pregnancy and miscarriage so they need to be investigated.

A telephone appointment will be arranged for you as soon as possible with your local early pregnancy unit to check your symptoms and to check whether you have symptoms of suspected or confirmed coronavirus to ensure you receive the safest care.

If you are bleeding very heavily or feel very unwell, you should contact your GP or NHS 111 for advice. If this is not possible, you should attend an accident and emergency department.

How will the coronavirus pandemic affect my care at an Early Pregnancy Unit (EPAU)?

An EPAU is a clinic run by nurses and doctors from the gynaecology department for women who are less than 12 weeks pregnant. Not all women will need care from an early pregnancy unit. If you have any concerns during the early stages of your pregnancy it is likely you will speak to a nurse or doctor from the EPAU who will discuss whether you need to be seen there.

EPAUs in hospitals will continue to provide care during the coronavirus pandemic. Where possible, this care will be given over the telephone. This will help to keep travel and hospital appointments to a minimum and promote social distancing of pregnant women.

What will happen if I have an existing appointment at an EPAU?

If you have an appointment scheduled at the EPAU, someone will contact you and let you know if you need to attend. Your appointment may be conducted over the telephone. Please do not miss any appointments without discussing this with a member of the team looking after you and your pregnancy first.

What will happen if I am self-isolating for suspected or confirmed coronavirus?

If you are self-isolating for suspected or confirmed coronavirus, your planned appointment may be delayed or may be conducted over the telephone. Someone will contact you to:

  • discuss your needs and to decide if your care and advice can be given over the telephone or whether it is necessary for you to attend the hospital/clinic.
  • ask you about any symptoms you or anyone in your household may have that might mean you are at risk of infection with coronavirus.

What if my hospital confirms that I need to attend my appointment at the EPAU?

If an urgent face to face appointment is necessary, you should travel by private transport where possible. You may be asked to come on your own for the safety of your household, other patients, and hospital staff. Unfortunately, hospitals are unable to allow children to attend with you during this time. You will be told about this.

What if I want to rearrange my appointment or book a new one at the EPAU?

You should call the EPAU if you wish to rearrange your appointment or make a new appointment. Someone will:

  • discuss your needs and decide if your care and advice can be given over the telephone or whether it is necessary for you to attend the hospital/clinic.
  • ask you about any symptoms you or anyone in your household may have that might mean you are at risk of infection with coronavirus.

Will I be able to have an ultrasound scan at the EPAU?

In some circumstances, some women will be offered an ultrasound scan as part of their care. This will depend on your individual history and current symptoms. You may be asked to come on your own for the safety of your household, other patients, and hospital staff. Unfortunately, hospitals are unable to allow children to attend with you during this time. You will be told about this.

What do I do if I think I’m having a miscarriage?

Call your hospital or nearest EPAU if you have any miscarriage symptoms, including vaginal bleeding or stomach pain. You will be seen and looked after.

Try to remember that these symptoms do not always mean you are having a miscarriage. But doctors will want to investigate, just in case.

Ectopic pregnancy

An ectopic pregnancy doesn't always cause symptoms. But if you do have symptoms, they tend to develop between the 4th and 12th week of pregnancy, and can include:

  • tummy pain low down (usually on 1 side but can affect both)
  • vaginal bleeding or a brown watery discharge
  • pain in the tip of your shoulder
  • discomfort when weeing or pooing. 

An ectopic pregnancy creates a potentially life-threatening situation for the mother, so it is very important that it is treated quickly

Do not hesitate to contact your local early pregnancy assessment unit or general practitioner if you have any symptoms you are worried about. If they think there is a potential problem, you will be seen and assessed.

What happens if I do miscarry?

If you miscarry early, it’s possible that the pregnancy will come away from the womb naturally and you won’t need any treatment. This is called a complete miscarriage.

But if you have a missed miscarriage or the pregnancy doesn’t come away completely (incomplete miscarriage) you usually have 3 options: expectant, medical or surgical management.

During this pandemic, women will be asked to try expected or medical management as an outpatient first.

Expectant management means waiting for the miscarriage to happen by itself naturally, without treatment. You don’t need to be at the hospital for expectant management. 

Medical management means taking medicine to help the pregnancy come away from the womb.

Surgical management means having surgery to remove the pregnancy using a suction device. Surgery will be available to you, but not as a first choice option.

You may be advised to have surgery immediately if you are bleeding heavily and continuously or there are signs of infection.

What do I do if I have nausea and vomiting?

Nausea (feeling sick) and vomiting in pregnancy, often known as morning sickness, is very common in early pregnancy. But if you are sick many times a day and you can’t keep fluids down, you may need extra care.

If you have nausea and vomiting in pregnancy in the first instance you may be offered advice over the phone and any treatment arranged without you needing to attend hospital. If your symptoms are very troublesome you will be offered outpatient treatment including  therapy (therapy that delivers fluids directly into a vein) and medication if necessary, rather than be admitted to hospital.

Call your local early pregnancy unit to general practitioner as soon as possible if you develop:

This can be a sign of a urinary tract infection and you will need treatment.

What does this mean for me?

Once again, it is important to emphasise that if you have any concerning symptoms in early pregnancy, you will be given an appointment and have access to the care you need.

Hospitals and early pregnancy units are stretched at the moment and limiting the spread of coronavirus is a priority. But you will get the help you need, if you need it.

If you have any concerns in early pregnancy, it’s important to still contact your GP or early pregnancy unit.

We're here to support you

Although we've had to temporarily close our support line as our midwives have moved to homeworking, our Tommy's midwives are still here to support you.

We are working hard to provide the best support and information we can during a time of extra anxiety and worry for pregnant women and their families.

Watch out for updates and contact us on the following platforms:

If you have non-urgent questions, we have developed Tommy's Midwife, a skill for Google Assistant and Amazon Alexa that answers many pregnancy queries, including some about COVID-19.

Read more about the Tommy's Midwife Alexa skill here

Read more

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