Tuesday, July 28, 2009

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.


  1. There needs to be a separate building for giving birth, which would be kept completely free of people coming in with swine flu. It's that simple. In major cities like London or New York, one hospital could handle swine flu and another hospital could handle birth. Some women will need the safety of a hospital; many women will not be comfortable giving birth at home; there may not be enough midwives to attend home births as well. Converting "hospital A" from having a maternity wing or floor into being solely maternity; while converting "hospital B" from having a maternity wing or floor into having none, and perhaps devoting the old maternity wing to confirmed swine flu cases would work. But of course, that's too simple an idea to ever catch on. :-)


  2. Talk about being between a rock and a hard place. Very interesting!

  3. But it's the flu. THE FLU. It's not more dangerous or more deadly than any OTHER flu. So, what, next winter they are going to suspend all the "extras" in fear of a pandemic? It's so FRUSTRATING to see how uneducated the public is...particularly when we're talking about POLICY MAKERS.

    I'm not suggesting there aren't risks...there are risks associated with EVERY strain of the flu, for crying out loud. But come ON people. This is just getting to hysteria for no reason. Seriously.

  4. Rebekah,
    You are right on. I am currently watching a report from the CDC on the national news. Currently one million Americans have contracted the H1N1 virus, with 1% of those people dying. Of the 1% of deaths, 6% of those were pregnant women. This is sad, not shocking, because the swine flu is not acting very much differently than seasonal flu. It does appear to be affecting younger people more however.
    I am curious as to how women coming to the hospital would increase their chances of getting the H1N1 virus, as compared to contracting it out in the community? Did Ms. Phipps offer an references to this point?

  5. Shoot, I would be even MORE inclined to stay home!

    I do agree with the other ladies that this is Very Much Ado About Nothing. It's not any worse than any other strain of flu. If I were very old or had HIV, I might be more worried, but I'm not.

  6. The expected midwife shortages over here (as if we weren't already in trouble!) are part of why I've hired an experienced doula for this autumn. Things were bad enough when I birthed two years ago in terms of staff shortages - I can't imagine what it'll be like now the birth rate has gone up (without a corresponding increase in midwives) AND with flu knocking out some of the staff...

    - UK mum

  7. and lets not forget that many hospitals are starting to talk about limiting to ONE support person during a "pandemic" ...sorry doulas, this includes us too, b/c we aren't PAID BY THE HOSPITAL, (this is an actual statement to ME when accompanying a client for preregistration). I asked what constituted a pandemic and the nurse told me that was to be determined by hospital staff. Hmm... sooo much power... :(


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