H1N1 and maternity care

Back in July I wrote about how the swine flu might affect maternity care. Health care organizations in the UK had expressed concerns about providing maternity care services if a large portion of the staff are unable to work due to the H1N1 virus. L&D nurse blogger At Your Cervix says the virus is already beginning to affect their staffing. Any health care worker (physician, nurse, PA, etc) with a confirmed or suspected H1N1 flu cannot come to work and must stay away from work for a certain amount of time. She writes:

We have one confirmed H1N1 case in one of the doctors. One confirmed in a nurse practitioner whose sister is a midwife on the unit. The NP's husband and young child also with confirmed H1N1. The midwife had very close contact with the young child. Just talked to a nurse on L&D who sounds like she probably has N1H1 too. Her symptoms just started.

And so the hospital pandemic begins............

Will they ever be in for a surprise when H1N1 and the other flu viruses start to really hit hard on the staff. There will be no one left to take care of the patients.

The SOCG, Canada's main obstetrical organization, has recently issued H1N1 guidelines for pregnant women (PDF). It strongly support both the seasonal and the H1N1 flu vaccines.

I'm curious to see what happens with health care services in general, and maternity care services specifically, if the H1N1 virus turns into a true pandemic. Although this strain of flu isn't particularly deadly, it is quite contagious and so might keep many people from being able to come to work. Since my husband is a university professor, he will be working in close contact with a demographic at high risk of getting the swine flu. We've never got the flu vaccine before, but I wonder if he might consider doing so this year since he works with an age group highly susceptible to the virus.

Read more ...

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.

Read more ...