How might the swine flu affect maternity services?

In the UK, hospitals and health care organizations are planning for a projected shortage of midwives due to the projected swine flu pandemic. Some of the possible scenarios include suspending both home birth services and planned/elective cesareans, as well as cutting back on prenatal care and testing. From the Telegraph's Swine flu a threat to home births:

Hospitals are drawing up emergency plans for dealing with a shortage of midwives.

Home births would be refused and planned caesarean sections abandoned if there were not enough staff to carry them out safely.

Ante-natal tests to check the health of the expectant mother and check for foetal abnormalities could be delayed, or even stopped, under separate guidance being agreed by medical experts.

The Government has made planning assumptions that up to one in three people in Britain could become infected with the swine flu virus by the end of winter, putting huge strains on the NHS.

However, this does not necessarily mean a blanket moratorium on home births. While asking all women to birth in hospital makes sense from a staffing point of view, it also increases their risk of being exposed to the virus.

But Luton and Dunstable Hospital Foundation Trust said it hoped to keep its home birth service going, rather than adding to pressures on hospitals dealing with swine flu patients. A spokesman said that women who had booked caesarean sections might be asked if they would switch to a traditional birth, reserving slots for emergencies.

Belinda Phipps, from the National Childbirth Trust, said that during a pandemic, pregnant women were more likely to want a home birth, in order to keep away from hospitals.

Many women would be disappointed, she said, given that there are already not enough midwives to give a home birth to everyone who wanted one.

She said: “In a situation like this, what we would want to see is more women given home births.

“It would reduce the risk of cross-infection, but hospitals are between a rock and a hard place, because they are already short of midwives.”

Bringing more women into hospital would increase the risks of them contracting the virus, she said, but it was the only way to meet demand when there were more pregnant women than midwives available.