Kia ora koutou members,

1. In person attendance for care during Alert Levels 3 & 4
The College’s advice for community midwives includes guidance for the frequency of midwifery contacts during COVID-19 Alert Levels 3 and 4.  Midwives are encouraged to review Tables 2 & 3 of this document which set out a recommended frequency of in-person and telephone or virtual contacts.
The  Ministry of Health’s advice for community based midwives confirms that:

• for women who are not probable or confirmed COVID-19 cases, and do not meet the Clinical and Higher Index of Suspicion (HIS) criteria, Community-based midwifery care for pregnant, labouring and postnatal women and their babies should continue. This includes LMC attendance at labour and birth, in any setting.
• for women who are probable or confirmed COVID-19 cases, or meet the Clinical and Higher Index of Suspicion (HIS) criteria, urgent midwifery care for these women and their babies should continue, as well as necessary late pregnancy and postnatal in-person midwifery assessments.  Midwives are encouraged to liaise with local DHB services to determine the most suitable place for any in person assessment to occur. These assessments can occur in a community setting or DHB facility. With changes to visitor policies, women are not being discharged as early as they were in the previous lockdowns, and any DHB maternity services are at capacity and facing staffing issues.
• care for women in Labour and birth care who are confirmed COVID-19 cases, should be handed to the DHB.
• As set out in the Ministry of Health advice for women who meet HIS criteria and have not tested positive, care for labour and birth is discussed between LMC and DHB. This is not an automatic handover and will be dependent on the woman’s specific risk profile.

2. Childcare support and Alert Level Boundary crossing. The Ministry of Health has advised that it will be updating its website to include advice for pregnant women, clarifying that if an identified person who will be providing urgent child care during labour and birth needs to cross alert boundary levels, this is allowed. The person will need to state the reason they are crossing the boundary (urgent childcare for a birth). An exemption letter is not required to cross the boundary in this circumstance.