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Jenna Wall, Head of Midwifery at Northumbria Healthcare NHS Foundation Trust talks about her career as a midwife, and how COVID-19 has impacted the service she works in.

Monday, 02 November, 2020
How COVID-19 has impacted the way we deliver maternity care

I have been a practicing midwife for 18 years, beginning my career at Northumbria Healthcare NHS Foundation Trust in 1999 and subsequently working in various roles, including a move to The Newcastle Upon Tyne Hospitals, before I eventually returned to Northumbria last year.

I was overjoyed to make this move and it was great to see so many familiar faces. Many of my mentors from my days as a student midwife remain in post, too many to name, but I remain grateful for the firm foundations of midwifery skills they imparted in me.   It’s been great getting to know the teams, although it has to be said going into post as the Head of Midwifery just six months before a pandemic is the definition of hitting the ground running.

I think I speak on behalf of every midwife in my team, possibly within the region, when I say that COVID-19 is the most difficult time within which we have worked. In March we had to make the decision for the safety of all pregnant women and new babies within Northumbria to restrict visiting to just one designated birthing partner for emergency assessments on the Pregnancy Assessment Unit, during induction of labour and labour and postnatal care. This meant that our mums-to-be had to attend their planned antenatal appointments and scans unaccompanied. As a team we were aware of the upset this would cause and so immediately introduced a dedicated COVID maternity helpline manned by the matron team to answer any questions and perform individualised assessments to plan and support the women in our care, as well as suspending charges for scan photos to ensure all women could share these moments with their loved ones.  The decision to restrict visiting wasn’t taken lightly, and was in line with the restrictions that had to be placed across all of our hospitals, community settings and the region. That said, I made a commitment to review this decision on a frequent basis, considering all the risk factors such as infection rates and footfall as well as mental wellbeing and support structures needed for women during their antenatal appointments and in labour too, whilst working closely with the Maternity Voice Partnership (MVP), to understand the needs of women booked to have their babies in our care.

We were the first trust in the region to lift the restrictions and allow birthing partners to accompany mums to 12- and 20-week scans. On top of this, we have always allowed birthing partners to attend the Northumbria Hospital from induction right through to post-natal discharge. This is not because we are more lenient than others in the region, but because our state-of-the-art estate allows for it. With en-suite bathrooms in every room, and separate rooms instead of ward bays, our offering for women has always been premium, but has been a huge positive during the pandemic too. Each of our midwifery led units can accommodate partners throughout care during labour, and we were the only service in the region to maintain our homebirth and midwifery led unit delivery service throughout the pandemic, this was undoubtedly because of the dedication and flexibility of the staff who have always gone the extra mile to ensure all services can remain open.

This is just the activity that our mums-to-be see, they don’t see the additional work which has gone on in the background. We have introduced virtual MVP meetings, worked closely with the health psychology and perinatal mental health teams to support women and their families. Completed targeted work to support the most vulnerable women from a BAME background alongside the public health midwives and public health team, introduced virtual video consultations, home BP monitoring using cloud based technology along with new screening techniques for pre-eclampsia to support safety remotely, worked with our medical colleagues to introduce telephone consultations for high risk women and despite the pressures on the service we have maintained the ‘saving babies lives’ scanning bundle for high risk women as well as introducing a telemedicine clinic so some women with very complex pregnancies no longer need to attend appointments at the RVI as we host a joint virtual clinic with the Fetal Medicine team. The team haven’t taken their foot off the pedal and, despite the challenges over the last few months, with the support of the Digital Services and sonography team we’ve introduced a new scanning system and a preterm prevention clinic for high risk mums. COVID19 really hasn’t held us back.

Caring for mums with COVID19 was new to us all, and the use of PPE for routine labour care was initially a challenge, with this in mind we invested £50k and purchased an additional sim mom for the Birthing Centre to allow us to complete real time COVID19 scenarios and drills so the team were well prepared for any situation, to ensure that they, and the mums were safe.

The dedication of every member of the multidisciplinary team has been inspiring, they have provided compassionate and individualised care to every woman who has accessed our services and I’ve been inundated with messages from families who have been grateful for the care, and normality, the team have been able to bring to their maternity care, despite the challenges. I am grateful to them all, and so proud of our maternity service.

My message to pregnant women in Northumbria would be that yes, COVID-19 is here for the foreseeable future, but no that doesn’t mean that it should affect your choices and birth experience. We are doing everything we can to ensure that partners can share those special moments, and we will make sure that each and everyone of you has someone with you throughout labour and in those exciting moments afterwards too.

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