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Coronavirus (COVID-19) infection and early pregnancy: Information for women and families

This information relates to guidance for rationalising early pregnancy services in the evolving coronavirus (COVID-19) pandemic (Version 1.1 – 21 April) published by the Royal College of Obstetricians and Gynaecologists, the Association of Early Pregnancy Units and the charity Tommys.

This information is for you if you are early in your pregnancy and have a problem or concern which may require care from an Early Pregnancy Assessment Unit (EPAU/EPU). This may include bleeding, a history of previous early pregnancy loss or ectopic pregnancy. This information may also be helpful if you are a partner, relative or friend of a woman who is having a baby. We define early pregnancy as a pregnancy which is under 12 weeks, and this is calculated from the first day of your last period

This information has been produced to help you understand what changes there will be to your early pregnancy care during the coronavirus pandemic. It will help you to ensure you receive the care and advice you need during the early stages of your pregnancy.

For more information about coronavirus and pregnancy, visit the main Q&A.

The Royal College of Obstetricians and Gynaecologists (RCOG) provides this advice and guidance for your information purposes only. This information is not intended to meet your specific individual healthcare requirements and this information is not a clinical diagnostic service. If you are concerned about your health or healthcare requirements we strongly recommend that you speak to your clinician or other healthcare professional, as appropriate.

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

It is very important that if you have any concerns about yourself or your pregnancy at any time, you contact your GP, midwife or local early pregnancy unit straight away to discuss these. Some symptoms, such as pelvic pain, cramping and/or bleeding during early pregnancy, are linked to ectopic pregnancy and miscarriage. 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.

Q. How will COVID-19 effect my early pregnancy care?

We understand that it could be a stressful and anxious time if you are pregnant during the coronavirus pandemic. The NHS is working to ensure that you and your family are supported and cared for during these early stages of your pregnancy. This means that there may be some changes to how and where you attend any appointments you have, any other care you need during the first 12 weeks of pregnancy, and how safe care and support are given to you. You will be told about any changes by your local maternity service.

Q. Why are changes necessary during the coronavirus pandemic?

These changes are often referred to as “rationalising” or “modification” of services. They are a way of ensuring we deliver the best care without overloading our NHS services, which are crucial during the coronavirus outbreak. This helps us to:

  • reduce the number of people coming into hospitals where they may come into contact with other people and spread the virus
  • ensure staff are not overwhelmed and stretched too far by the additional strain on services. This could be due to staff sickness and self-isolation as well as the higher numbers of patients needing care and overnight hospital stays due to coronavirus.

This allows us to care for and protect you from coronavirus while also ensuring we protect our NHS staff and service.

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

An early pregnancy unit 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 Early Pregnancy Unit who will discuss whether you need to be seen there.

Early pregnancy units 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.

Q. What will happen if I have an existing appointment at an Early Pregnancy Unit?

If you have an appointment scheduled at the Early Pregnancy Unit, 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.

Q. 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.

Q. What if my hospital confirms that I need to attend my appointment at the Early Pregnancy Unit?

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.

Q. What if I want to rearrange my appointment or book a new one at the Early Pregnancy Unit?

You should call the Early Pregnancy Unit 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.

Q. Will I be able to have an ultrasound scan at the Early Pregnancy Unit during the coronavirus pandemic?

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.

Q. What will happen if I experience a miscarriage during the coronavirus pandemic?

We know that suffering a miscarriage can be a distressing experience for you, your partner and your family, both physically and mentally. We also recognise that social distancing from your extended family and friends at this time will be especially difficult.

Your care will depend on your individual circumstances but where possible hospital admission and surgery will be avoided to lower your overall exposure to coronavirus and ensure your family are able to be with you at home.

  • In most cases, it is likely that you will be asked to miscarry naturally (without any medication or surgery) at home with the support of your family. Your healthcare team will make arrangements with you for any follow up care and ensure you can contact them should you have any concerns during this time.
  • You may alternatively be offered medication to assist the process of miscarriage. You may be able to take this medication at home but sometimes it is necessary to attend a clinic at the hospital. This will be discussed with you. Your healthcare team will make arrangements with you to ensure your medical care is monitored safely.
  • Sometimes, attending hospital for surgery may be the safest option for you, even taking into account the risk of infection with coronavirus. Your healthcare team will discuss this with you.

Q. What if I am experiencing pregnancy related nausea and vomiting?

If you are experiencing nausea and vomiting in early pregnancy, you should inform your GP or Community Midwife, so that they can discuss and arrange the right care for you. This will most likely be done over the telephone to promote social distancing for pregnant women. Your care will depend on the level and impact of your symptoms.

You may be offered a prescription for anti-emetics (anti-sickness medicine). In some cases, you may need intravenous fluids (a drip). This will be arranged with you as safely as possible taking into account the coronvirus pandemic. It is unlikely you will be admitted to hospital overnight, unless your symptoms become more serious.

 

Key points

  • It is important to know that if you experience any health issues during early pregnancy that require you to be seen by a healthcare professional, an appointment at an early pregnancy unit will be offered and you will receive the care you need.
  • Whilst hospitals are trying to minimize people entering in order to reduce the spread of the coronavirus and to limit the impact on services, they are organised in such a way that they are able to provide all acute services.
  • If you have symptoms that may be associated with miscarriage or ectopic pregnancy, it is very important that you contact your GP, midwife or local early pregnancy unit as soon as possible. You will be able to speak with an experienced healthcare professional on the telephone who will be best placed to advise you as to whether a visit to the hospital during the coronavirus pandemic is necessary and to ensure you receive the care that you need.

 

Further information

You can find further information and support at the following organisations:

You can also find all the latest coronavirus guidance and information from the following websites: