COVID-19: Maternity

Information for the maternity services sector

Last updated: 4 March 2022

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Health workers can download the Āwhina app to stay up-to-date on the latest information relevant to COVID-19 and the health and disability sector.


Information for community-based midwives

Guidance on reducing the spread of COVID-19 in home and community settings, and on protecting both pregnant and postnatal women/people, and their community-based Lead Maternity Carer midwives at different COVID-19 response settings.

At all COVID-19 Protection Framework settings (Green, Orange and Red)

Ask screening questions and do a risk assessment prior to any visit.

COVID-19 positive 

When screening questions or a risk assessment indicates a COVID-19 test is recommended, ask the person to get a COVID-19 test (if they haven't already done so). Defer in-person care if it is clinically safe to do so.

Wear the appropriate PPE for the situation. View the IPC guidance: COVID-19: Infection prevention and control recommendations for health and disability care workers

 

Clinical Guidance for managing COVID-19 positive pregnant women / people in the community

As New Zealand sees more cases of COVID-19 in our communities, the specific guidance has been updated to support the provision of safe and integrated maternity care.

The clinical care pathway provides guidance for clinicians when managing COVID-19 positive pregnant women / people in the community.

The ‘Care Framework for pregnant women and people isolating in the community for COVID-19’ (Care Framework) provides guidance for clinicians on the roles and responsibilities of health professionals when managing COVID -19 positive pregnant women / people.

The clinical care pathway and Care Framework have been updated to reflect the emerging evidence on the Omicron variant and its impacts on pregnancy.

The pathway and the care framework are intended to be used together.

More detailed information is available:

Where COVID-19 is not indicated

When the person does not have COVID-19 and screening questions do not indicate an increased risk, follow the guidance below for services at whichever Community Protection Framework setting you're working in.

Services at Green

At Green, there is limited community transmission and hospitalisations are at a manageable level. The health system is ready to respond – primary care, public health and hospitals.

Maternity services providers operate at full-service levels. This includes in-person care provision at ‘pre-COVID-19’ or ‘usual’ timings for routine assessments as the expected means of providing services and care.

Services at Orange

At Orange there is increasing community transmission with increasing pressure on the health system and increasing risk to at-risk populations. The health system is focusing resources but can manage – primary care, public health and hospitals.

Maternity services providers operate at full-service levels. This includes in-person care provision at ‘pre-COVID-19’ or ‘usual’ timings for routine assessments as the expected means of providing services and care. There is still the option for the provision of phone or video consultations with shorter in-person assessments if needed.

Services at Red

At Red, action is needed to support the health system, with the system potentially facing unsustainable numbers of hospitalisations. 

Maternity service providers continue to operate at full-service levels. This includes in-person care provision at ‘pre-COVID-19’ or ‘usual’ timings for routine assessments.. There is still the option for the provision of phone or video consultations with shorter in-person assessments if needed.


Occupational health guidance for vulnerable community-based self-employed midwives

Self-employed midwives claiming off the Section 88 Notice who fall into the ‘vulnerable’ category, can use this DHB developed occupational health advice to determine the areas in which it is safe for them to work. 

Information for radiologists on community-based maternity ultrasound scans

This document provides guidance on the prioritisation of clinically indicated maternity ultrasound scans undertaken in the community. This advice has been prepared by clinicians as a guide to assist in the prioritisation of maternity ultrasound scans during the Omicron outbreak. This guidance may be adapted to suit regional or local circumstances.


Advice for the use of Entonox in labour

Guidance to provide advice on the use of Nitrous oxide/Entonox for labour analgesia during the COVID-19 pandemic, with the aim of reducing the spread of COVID-19 from person to person in New Zealand. 


Recommendations for health professionals and whānau on handling of the whenua/placenta for COVID confirmed or probable people

‘Hara mai e tama, puritia te aka matua o te whenua’ – Come forth our child, we are bound by deep roots in this land/placenta.

The Ministry of Health acknowledges the rights of tangata whenua and encourages all health professionals to adhere to the principles of Te Tiriti o Waitangi. The Ministry of Health encourages health professionals to provide culturally safe care of the whenua/placenta along with evidence based best practice.

The cultural guidelines for Māori birthing customs can be found in the Turanga Kaupapa developed by Nga Maia o Aotearoa. The professional body of midwifery has adopted the Turanga Kaupapa in recognition of their obligations to Māori as tangata whenua and should be embedded throughout maternity care. (See New Zealand College of Midwives - Standards of Practice.)

This interim guidance is based on what is currently known about COVID-19 and the transmission of other viral respiratory infections. The Ministry of Health will update this interim guidance as needed, as additional information becomes available.

The purpose of this guidance is to provide advice on the handling of the whenua/placenta for COVID-19 confirmed or probable women during the COVID-19 pandemic. Clinical judgement and discussions with whānau should take place to support decision making. 

The likelihood of COVID-19 being transmitted from a whenua/placenta to whānau is remote but cannot be ruled out completely. 

If whānau are planning on keeping their whenua/placenta, the following is recommended: 

  • Thorough hand hygiene should be practiced at any time the whenua/placenta is being handled. 
  • Whenua/placenta to be placed into an ipu/container/leakproof bag. Consider biodegradable non-permeable bags to alleviate double handling of the whenua. 
  • After the whenua/placenta is placed in the first ipu/container/bag it should then be placed in a clean non-permeable bag while wearing clean gloves.  
  • Wash hands with soap for a minimum of 20 seconds and thoroughly dry them. Take special care not to touch your face throughout the handling of the container and/or whenua/placenta. 
  • Whenua to be taken from the place of birth as soon as possible following the birth by someone in the same household as the birthing woman. 
  • Consider burying the whenua/placenta in a large planter pot to be transplanted if travel restrictions are in place.
  • If your whenua/placenta is in a biodegradable ipu or bag it can be buried in that. If it is in a non-biodegradable container it is recommended to remove it from the container prior to burial. Ensure you practice hand hygiene after any handling of the whenua/placenta or ipu/container/bag. See link above for guidance. 
  • If the whenua/placenta is not buried in the container/bag then these must be disposed of immediately in a double plastic/bio-degradable bag. Wash your hands with soap for a minimum of 20 seconds and thoroughly dry them. Take special care not to touch your face throughout the handling of the container and/or whenua/placenta.

COVID-19 Community Response Framework

The COVID-19 Community Response Framework provides some guidance and considerations for primary care, community-based health services, residential care, community pharmacy, maternity, population health services and ambulance services.

The Framework has been updated following the introduction of the Government traffic light system on 3 December 2021. It recognises that 100 percent of the health workforce and almost 90 percent of the country are vaccinated against COVID-19.

It is important that health services continue to be delivered at all levels, with the least restrictions and in a safe environment. 

Find full details on the COVID-19 Community Response Framework page.

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