As New Zealand sees more cases of COVID-19 in our communities, specific clinical guidance has been developed to support the provision of safe and integrated maternity care. The Care Framework for pregnant women and people isolating in the community for COVID-19 recognises that, depending on individual circumstances, most people who become COVID-19 positive will isolate in the community. This shift in approach sees LMCs becoming more involved in the care of COVID-19 positive pregnant women/people.
Circumstances may arise where it becomes appropriate due to the COVID-19 status of the woman/person, to provide antenatal or postnatal maternity care via a phone or video assessment. In most cases, these circumstances are expected to only be necessary for a short period of time. If it is not clinically appropriate for an LMC to provide in-person antenatal or postnatal maternity care to their registered client and they provide phone or video assessments instead, the Ministry can still count these visits in the total of requisite visits for a module of care. The relevant clinical circumstance must be documented and made available to auditors on request (as per clause CB2 of the Primary Maternity Services Notice 2021).
During Phases 2 and 3 of the Omicron response, critical workers (such as midwives) who are identified as close contacts of a COVID-19 case will be able to continue to work, as long as they return a negative rapid antigen test (RAT) prior to working each day of their isolation period.
From 28 February 2022, LMCs will only be able to claim under the Primary Maternity Services Notice 2021 for care of pregnant/birthing/postpartum women/ people and infants with actual, probable or suspected COVID-19 infection when they have continued to provide the care themselves.
If a woman/person requires a transfer of clinical responsibility for maternity care to secondary services due to risk stratification or severity of COVID-19 disease, a three-way consultation will take place to determine the involvement of the LMC, in accordance with the Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines). If the LMC does not remain involved in care provision, they will not be able to claim off the Primary Maternity Services Notice 2021 for care provided after their involvement has ceased.
If a midwife/LMC tests positive for COVID-19, they may claim for any births missed over the recovery/self-isolation period. LMCs are advised to contact the New Zealand College of Midwives on 0800MIDWIFE to arrange locum cover for the period of time they are required to self-isolate. The locum is paid from the locum service contract and the LMC claims the labour and birth module.