The purpose of this document is to provide guidance on preventing the spread of COVID-19 in home and community settings, and protecting both pregnant and postnatal women, and their community-based midwives.

This information sheet should be read in conjunction with information available at health.govt.nz/covid-19

How is COVID-19 spread?

COVID-19, like the flu, can be spread from person to person. When a person who has COVID-19 coughs, sneezes or talks, they may spread droplets containing the virus a short distance which quickly settle on surrounding surfaces.
You may get infected by the virus if you touch those surfaces or objects and then touch your mouth, nose oreyes. That’s why it’s really important to use good hygiene, regularly wash and thoroughly dry your hands, and use good sneeze/cough practice.

Who is more at risk of COVID-19?

• People who have conditions that compromise their immune systems or have compromised immune systems as a side effect of taking certain medications such as chemotherapy or other medications.
• People who have chronic medical conditions such as liver disease, heart disease, kidney disease diabetes mellitus, and lung disease or other long-term conditions.
• People with a disability and co-existing long-term conditions.
• People who have medical devices that enter the body (e.g. a catheter, tracheostomy, ileostomy, feeding tube).
• People with surgical or large open wounds.
• Frail older people.

Community-based midwifery care during the period of COVID-19 pandemic

Community-based midwifery care for pregnant, labouring and postnatal women and their babies should continue. Pregnant and postnatal women appear no more susceptible to the consequences of COVID-19 infection than the general population.

Basic hygiene measures are the most important way to stop the spread of infections, including COVID-19. We advise the following.

• Avoid close contact with people suffering from any acute respiratory infection.
• Frequent hand-washing and drying (or hand sanitiser), especially after direct contact with ill people or their environment.
• Keep hands away from face (eyes, nose and mouth).
• Everyone should practice cough etiquette (maintain distance, cover coughs and sneezes with elbow, disposable tissues or clothing and wash and dry hands).

Providing midwifery care to those in self-isolation after potential exposure to COVID-19

Extra precautions are needed to ensure midwives and the women receiving home visits are safe, particularly those who are more vulnerable to infection and severe illness.

Refer to Table 1: Advice for community-based midwives caring for women who are in self-isolation after potential COVID-19 exposure. This provides specific advice for care before and after 37w0d, during labour and birth and postnatally.

In general we recommend the following.

• Reschedule any non-urgent appointments until after the isolation period, if possible.
• Conduct non-physical assessments and pregnancy or parenting education over the phone or via video call.
• Phone ahead to ask the woman if she has any symptoms and if she does, avoid visiting and recommend she contact Healthline.
• Provide the woman in self-isolation with a surgical face mask to wear while you are visiting her at home.
• Ask others in the home who are in isolation to not be present in the room for the home visit.
• Minimise time spent undertaking the physical assessments.
• Cough or sneeze into your elbow or by covering your mouth and nose with tissues.
• Put used tissues in the bin or a bag immediately.
• Wash your hands for at least 20 seconds with soap and water and dry them thoroughly:

– before eating or handling food

– after using the toilet

– after coughing, sneezing or blowing your nose

– after caring for sick people

• If soap and water are not available, clean your hands with an alcohol-based hand sanitiser that has at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
• Avoid touching your eyes, nose or mouth if your hands are not clean.
• Avoid close contact with people who are unwell.
• Do not visit the pregnant or postnatal woman if you are feeling unwell.

Providing midwifery care to those who have COVID-19

Refer to Table 2: Advice for community-based midwives caring for women who have confirmed or suspected COVID-19. This provides specific advice for care before and after 37w0d, during labour and birth and postnatally.

Note:

• PPE includes: gloves, surgical face masks, disposable fluid resistant aprons, and eye protection.
• Practice safe removal and disposal of PPE by putting it in a bag in the bin immediately.
• Midwives who require PPE supplies for this situation can contact their local district health board.

Going to work

Community-based midwives must not go to work if they have:

• experienced cold or flu symptoms. Workers should be symptom free for 48 hours before returning to work
• returned from an overseas visit to any country in the last 14 days
• been in close contact with someone confirmed with COVID-19 in the last 14 days.

About COVID-19

COVID-19 presents with mild respiratory symptoms, including a cough and fever but, in some people, it can be more severe and can lead to pneumonia or breathing difficulties. More severe infections mainly occur in those with chronic health conditions or other co-morbidities. More information can be found on the Ministry of Health website health.govt.nz/covid-19

More information

For the latest advice, information and resources, go to health.govt.nz/covid-19 Call Healthline on 0800 358 5453. It operates 24 hours a day, seven days a week. If you have concerns about your health, speak to a doctor.