Will the coronavirus pandemic affect how I give birth?

Last updated: 21/08/2020

Please be assured that your maternity services are working around the clock to support your choice about where and how you give birth. But due to staffing and other possible concerns, some of these choices may not always be possible. 

Just as at any other time, you may need to be flexible with your birth plan and be prepared to do things differently from what you wanted. As well as possible concerns around coronavirus, sometimes things don’t go according to plan during pregnancy or labour. For example, certain facilities may not be available on the day or there may be complications. Your maternity team should involve you (or your birth partner if necessary) in any decisions that need to be made on the day to make sure your baby is delivered safely.

We understand how anxious many women are at the moment, so we have put together the following FAQs to help you understand the current guidance. We will update this page as and when new information becomes available.

Will my childbirth choices be affected by the coronavirus pandemic?

Like all areas of NHS care, maternity services have been affected by the pandemic but units are working to ensure services are provided in a way that is safe, with the levels of staff that are needed and the ability to provide emergency care where necessary.

In some areas of the UK, some Trusts and Boards have had to pause their home birth service or close their midwife-led unit. Most of these services have now been reinstated.

Can my birth partner stay with me if I'm being induced?

You should be able to have at least one birth partner with you while you have an induction where that is in a single room (e.g. on the maternity suite), if they don't have coronavirus symptoms. If the induction takes place in a bay on a main ward, your birth partner may not be able to come because it may not be possible to maintain the necessary social distancing measures.

We understand this must be a very worrying and anxious time if you are pregnant and your birth partner(s) cannot be with you while you are being induced. However, hospitals still need to limit the number of visitors during this time.

This guidance is in place to protect other pregnant women and babies and birth partners themselves, as well as maternity staff.

Please be assured that if your birth partner(s) is unable to be with you on a ward during your induction, this will not impact on your birth partner’s presence during labour and the birth, unless they are unwell with symptoms of coronavirus or have tested positive for coronavirus. At the point you go into active labour, you will be moved to your own room and at least one well birth partner will be able to join you.

Will I be able to have my birth partner with me during labour and birth?

Yes, you should be encouraged to have at least one well birth partner present with you during labour and birth. Your birth partner(s) must wear a mask in hospital.

Even if your birth partner is from another household, you should be supported to have them with you unless they are unwell with coronavirus symptoms or have tested positive for coronavirus.

Having at least one trusted birth partner present throughout labour is known to make a significant difference to the safety and wellbeing of women in childbirth.

If your birth partner has symptoms of coronavirus or has recently tested positive for coronavirus, we do not recommend they go into the maternity suite. This will keep you, other women and babies and the maternity staff same from the virus. 

In some hospitals and maternity units, restrictions on visiting remain in place. This may mean that birth partners or other supportive companions are not able to attend routine antenatal appointments, or stay with women on antenatal or postnatal wards. However, this should not impact on your birth partner’s presence during your labour and the birth, unless they are unwell with coronavirus symptoms or have tested positive for coronavirus.

Can my birth partner stay with me if I have a caesarean or instrumental birth that occurs in an operating theatre?

Around one in four women in the UK has a caesarean birth. A caesarean birth may be recommended as a planned (elective) procedure for medical reasons or as an emergency – for example, if doctors and midwives are concerned that your baby is not coping with labour and needs to be born immediately.

Around one in five women in the UK has an instrumental birth (ventouse or forceps). Some instrumental births may also be recommended to happen in an operating theatre to allow the maternity team to modify plans and do a caesarean section if necessary.

Most caesarean and instrumental births in theatre are carried out under spinal or epidural anaesthetic. This means you’ll be awake, but the lower part of your body is numb and you cannot feel any pain. In this situation, everything will be done by the clinical staff – midwives, doctors (obstetricians) and anaesthetists – to keep your birth partner with you.

Due to the coronavirus pandemic, staff in the operating theatre will be wearing enhanced personal protective equipment (PPE) to prevent the spread of infection, which will make it more difficult for them to communicate. To enable the clinicians to assist in the birth of your baby safely, it is very important your birth partner(s) follows the instructions from the maternity team carefully and quickly.

Occasionally, a general anaesthetic (where you are put to sleep) may be used, particularly if your baby needs to be born urgently. During this type of caesarean birth, even under usual circumstances (before the coronavirus pandemic), for safety reasons it is not possible for birth partners to be present during the birth.

While the maternity team will do all they can to ensure that your birth partner(s) is present for the birth, there will be some occasions when there is a need for an urgent emergency birth with epidural or spinal anaesthetic in which it will not be possible for your birth partner(s) to be present. This is because, during an emergency, operating theatres are more high-risk environments for the potential spread of coronavirus to anyone who is present.

If it is the case that your birth partner(s) will not be able to be present during the birth, your maternity team will discuss this with you and will do everything they can to ensure that your birth partner(s) can see you and your baby as soon as possible after the birth.

What about if I have suspected or confirmed coronavirus?

If you have suspected or confirmed coronavirus, you will not be able to have a home birth or give birth in a midwife-led unit. Instead, when you go into labour you will be advised to give birth in hospital on the delivery suite.

This will be the safest place for you and your baby. At the hospital, your baby will be monitored using continuous electronic fetal monitoring to check how they are throughout your labour. You will also have extra care from doctors, as well midwives.

Will my birth partner(s) be tested for coronavirus?

It is possible that your birth partner(s) may also be offered testing for coronavirus when you are admitted to hospital. Your maternity team will be able to advise you further.

Can I still give birth vaginally?

There is currently no evidence to suggest you cannot give birth vaginally if you have suspected or confirmed coronavirus. But if your breathing is very affected and your baby needs to be born urgently, a caesarean birth may be recommended.

It is not recommended that you give birth in a birthing pool in hospital if you have suspected or confirmed coronavirus. The virus can sometimes be found in faeces, so there is a possibility that it could contaminate the water and infect the baby. It may also be more difficult for healthcare staff to use suitable protection equipment during a water birth.

There is no evidence that women with suspected or confirmed coronavirus cannot have an epidural spinal block or gas and air. Find out more about your choices for pain relief in labour.

Will I be able to have my birth partner with me on the postnatal ward?

Visiting is now subject to local discretion by Trusts and other NHS bodies – please check with your maternity unit for their policy on visitors to the postnatal wards. It is important that any visitors follow guidance in hospitals about social distancing, wearing a face covering and regular handwashing.

Restrictions around visiting inpatients and accompanying outpatients are now being eased but this happening differently in the four nations of the UK - advice in Scotland, Wales and Northern Ireland has been updated recently. Some Trusts in England are permitting birth partners to the postnatal wards but there is not a consistent approach.

However, we are aware the NHS in England and other organisations are working with your local Trust so they can safely begin to reintroduce measures birth partners to stay with women on the postnatal ward.

We understand that not having a birth partner with you on the postnatal ward after you have given birth may be upsetting for you both but these restrictions are in place to reduce the risk of transmission of coronavirus to you, your baby, the maternity staff and birth partners themselves.

Please be reassured that during this time, midwifery, obstetric and support staff will do their best to support the needs of all women and the practical challenges of caring for newborn babies after birth. If visitors are permitted, it is important that they follow guidance in hospitals about social distancing, wearing a face covering and regular handwashing.

Will my baby be tested for coronavirus?

If you have confirmed or suspected coronavirus when the baby is born, doctors who specialise in the care of newborn babies (neonatal doctors) will examine your baby and advise you about their care, including whether they need testing.

Will I be able to stay with my baby/give skin-to-skin if I have coronavirus?

Yes, as standard practice, you will be kept together after birth if your baby doesn’t require care in the neonatal unit.

Some reports from China suggest women with confirmed coronavirus have been advised to separate from their baby for 14 days. However, this may have negative effects on feeding and bonding. A discussion between you and the doctors will weigh up the risks and benefits and care will be individualised for each baby.

This guidance may change as more is known about the virus.

Will I be able to breastfeed my baby? 

There is currently no evidence that the virus can be carried in breast milk. The current advice is that the benefits of breastfeeding outweigh potential risks of transmitting the virus. However, there is concern about the close contact between you and your baby, as you may share airborne droplets infected with the virus.

You can talk to your maternity team about the risks and benefits and any precautions that you can take.

When you or anyone else feeds your baby, the following precautions are recommended:

• Wash your hands before touching your baby, breast pump or bottles
• Try to avoid coughing or sneezing on your baby while feeding at the breast
• Consider wearing a face mask while breastfeeding, if available
• Follow recommendations for pump cleaning after each use
• Consider asking someone who is well to feed your expressed breast milk to your baby.

If you choose to feed your baby with formula or expressed milk, it is recommend that you follow strict adherence to sterilisation guidelines. If you are expressing breast milk in hospital, a dedicated breast pump should be used.

After the birth, is there any increased risk to me or my baby?

There is no evidence that women who have recently had a baby and are otherwise well are at increased risk of contracting coronavirus or of becoming seriously unwell. A recently pregnant woman’s immune system is regarded as normal unless she has other forms of infection or underlying illness.

Do not put off seeking medical advice if you have concerns about your baby’s health during the pandemic. Seek medical advice if your baby has any symptoms you may have concerns about. Find out more about bringing your baby home during the pandemic.

This guidance may change as knowledge evolves.

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:

• by email ([email protected])
• on Facebook 
• on Instagram
• on Twitter.

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