'Women don't stop having babies because of lockdown!': York Hospital midwife Debbie Scott

Nurses and midwives on the labour ward at York Hospital recognise that.

So when it comes to helping mums deliver that precious scrap of new, mewling life, they do it in full PPE: masks, gloves, eye protectors, gowns - the lot.

It’s not exactly ideal, admits Debbie Scott, York Hospital Trust’s acting maternity matron. Being all masked up tends to spoil the magic of the moment a bit, for mum and midwife alike.

But that’s the Covid pandemic for you: it is changing the way we do everything.

Mums understand, says Debbie. “We say to women ‘I’m smiling!’ And they say ‘we can see from your eyes that you are!’” In fact, she says, women are reassured that the maternity staff are all wearing PPE.

Debbie Scott

Protecting vulnerable pregnant women, mums and babies is top of the list of priorities for Debbie and her colleagues.

That’s why they have taken measures to reduce the risk of the coronavirus spreading.

Mums who are booked in for an elective Caesarean section are tested for the virus a couple of days before they are due to come in, like anyone else coming for a planned operation.

You can’t do that with most births, however. Babies aren’t known for being particularly punctual, so it just isn’t possible to test pregnant mums before they come into hospital to give birth - you never know quite when that is going to be.

Instead, mums who come into the labour ward are given an immediate Covid test then kept in isolation on a side bay until the result comes back.

Maternity staff have also, reluctantly, had to impose strict controls on visitors.

Partners are allowed to be with their spouses in the labour ward as they give birth. They will be temperature-tested and questioned about any symptoms beforehand, and they’ll be expected to wear PPE like everyone else.

Thereafter, they can visit mum and baby on the post-natal ward - but only by making a pre-booked appointment.

No other family members - grandmums or dads, aunts or uncles, or other children - are allowed.

That can be upsetting, Debbie admits - having a new baby is, after all, one of the most profound of all experiences, and one that mums naturally want to share.

“We understand that it is difficult,” she says. “But it is about keeping mums and babies safe.”

Inevitably, given the way the pandemic has been spreading, there are some pregnant women who do test positive for the virus.

For such mums-to-be, there is a dedicated isolation area on the labour ward - and also on the ante-natal ward. The maternity unit also has access to a Covid-dedicated operating theatre, if needed.

Debbie Scott in the maternity isolation area at York Hospital

Staff who visit those Covid-dedicated areas change their PPE and their clothes and have a shower before visiting other areas of the maternity unit to ensure there is no risk of the virus spreading.

Fortunately, there is no evidence that pregnant women are more likely to get seriously ill from coronavirus, Debbie says - and most Covid-positive mums-to-be show few or no symptoms. “They’re generally quite fit and healthy,” she says.

Even better, all the evidence so far suggests that if a mum-to-be has the virus, it is unlikely to cause any problems for her baby’s development. “There have been no reports of this so far,” Debbie says.

There is also no evidence to suggest that there is an increased risk of miscarriage if women develop Covid while they are pregnant.

Nevertheless, despite all this, pregnant women have been included in the list of people said to be at ‘moderate risk’ from the coronavirus.

The advice to all pregnant women, therefore, is to follow the latest government guidelines on social distancing - and to avoid anyone who has symptoms that might be due to coronavirus, Debbie says.

Women in their third trimester (ie more than 28 weeks’ pregnant) are advised to be particularly careful.

It is not about shielding, Debbie says - many pregnant women, for example, will still have to go to work. It is just about being careful and limiting the number of people you meet.

Maternity staff, too, have to take all possible precautions against the virus - both for the sake of their own health, and to prevent spreading the infection.

Hence the PPE, and the strict hygiene and clothes-changing regime for anyone who has been in a Covid isolation area.

Any staff who do develop any signs or symptoms that could suggest Covid, meanwhile, are sent home until they can be tested.

If they test positive, they have to self-isolate at home for ten days - or 14 days, if a family member has the virus.

Inevitably, that puts extra pressure on staff.

The maternity units in York and Scarborough have a full complement of staff - new midwives have just been recruited, as they always are at this time of year when a fresh wave of new midwives qualify, says Debbie.

It is also probably true to say that - PPE and increased hygiene measures aside - maternity units are perhaps less directly affected by the pandemic than some other areas of hospital activity, she admits.

Nevertheless, she and her colleagues remain constantly busy.

“Women don’t stop having babies just because there’s a lockdown on!” she says.

She and her colleagues in York and Scarborough deal, on average, with about 3,500 births a year.

That’s something like 10 a day on average - though nothing ever is average, she admits. One thing a midwife learns very quickly is that you never really know just when your services will be needed. “Babies come when they are ready, day or night!” she says

Maternity staff don’t just deal with mums when they come in to give birth, of course.

They look after them from early in the pregnancy, and continue to give care and support afterwards.

Again, to minimise unnecessary contact and reduce the risk of Covid spreading, some ante-natal care - discussion of delivery options, advice about preparing for feeding etc - is now done by telephone.

Mums-to-be do continue to come in for two scans during their pregnancy, however. One, at about 12 weeks, is to check on the baby’s growth. Mums are also given the choice of whether they want the baby to be screened for conditions such as Down’s Syndrome.

The second scan is at about 20 weeks - this time to monitor heart activity, and check that all the limbs and organs are developing properly.

Sadly, because of the Covid pandemic, partners are no longer allowed to attend with the mum-to-be at the first scan. They can, however, come along for the second scan. It is about finding a balance between allowing parents-to-be to enjoy the pregnancy - and ensuring everyone stays safe, Debbie says.

So how are maternity staff coping with the pandemic and a second lockdown?

“We are more tired than usual,” says Debbie, a 48-year-old mum of two who lives near York. “I think people generally are tired of Covid now - society is tired! It is hard for people, not seeing family and friends.

“But staff have been brilliant They have been really working hard, stepping up, adapting. Everybody has been pulling together.”

York Hospital Trust coronavirus update

At time of writing, there were 68 Covid-positive inpatients at York Hospital, up from 63 last week.

There were 64 Covid-positive inpatients at Scarborough, up from 52 the week before.

There had been 261 Covid-related deaths at the two hospitals since the pandemic began - 15 in the last seven days. At the moment, there are three Covid wards in York and four in Scarborough.