Things are moving fast.
As you know I am a member of a number of professional bodies and my favourite (I really am an anglophile) is the Royal College of Obstetrics and Gynaecology in London (The RCOG). Just overnight The RCOG have published their latest Guidelines on Coronavirus and pregnancy. You can find this document at www.rcog.org.uk if you wish to read it in full. I will summarise the main points below:
- Good news. It appears (contrary to my first update) that the great majority of pregnant women who contract Coronavirus only suffer a mild illness although, as always, significant illness can occur.
- More good news. There is no change on some matters I reported earlier:
- The virus does not appear to cross the placenta and it does not cause fetal abnormalities. It may be associated with preterm birth but we think this is due to significant maternal illness or obstetric intervention rather than a direct effect of the virus,
- Having Coronavirus should not affect how you give birth or your care in labour although your partner and the staff looking after you will be wearing masks, gowns and gloves (kind of like the old days). You can have gas or an epidural for pain relief, and
- The virus is not excreted in breast milk so you can – and should – breastfeed if you wish.
- Even more good news. Some authorities (including some in China) have recommended separating newborn babies from infected mums for two weeks but The RCOG does not recommend this and I agree. Apart from feeding time your baby will need to be 1.5 m away and you will need to wear a mask while feeding (I suppose having Coronavirus is an excellent way of making sure you get a single room (or is it too soon for Coronavirus gags?)).
- The good news keeps coming. The RCOG has – most sensibly – recommended that all of your antenatal care – visits with me, ultrasound scans and lab tests – continue as usual because that stuff is important. As you know I have made a number of modifications to my schedule to allow for social distancing at my office and we are working to provide what care we can over the phone and by home visits. By sheer coincidence the paediatrician has moved out of my rooms so my (big) waiting room should be close to empty when you arrive. I do not recommend you visit a maternity – or any other – hospital for any reason that is not related to your own direct medical needs (or that of your baby). This includes birthing classes, preadmission visits or other non-essential visits. We are working to provide you with one on one (or one on two, if you know what I mean) antenatal classes with the midwives in my office.
Infection control, social distancing and – most importantly – the simple application of common sense are all really important. Just as I have a responsibility to you, you have a responsibility to me and my staff to help keep us healthy. Please:
- Practise Social Distancing and do not take any unnecessary trips or make unnecessary visits to places where people congregate. Put off your waxing, hairdressing, laser and massage appointments.
- Do not bring your mother, your older kids, your sister or your best friend with you to medical visits.
- Please DO NOT enter my consulting rooms if you have any known Coronavirus contact or you are unwell IN ANY WAY. This applies to your partner and family too. If unsure ring us.
The Bad News
This is just my opinion (we have moved on from the RCOG now) but we’re heading into difficult times. This is not helped by inconsistent messaging, incompetence (unloading three cruise ships within a few days) and a reluctance by those in power to properly shut things down (despite overseas experience strongly suggesting ultimately widespread shutdowns will be needed).
We will all need to stay strong.
Sue and I are only too aware of how fortunate we are compared to so many others. None of us really know what help various government interventions might have for businesses or individuals and on that score, we will need to wait and see. However, if you or your partner have lost your job as a result of this crisis and are having trouble paying bills please talk to me and we can work something out (as long as my lavish lifestyle is maintained, obviously).
I have two Twitter accounts (showing my age) – one is personal (@robert_buist) and one is my obstetric practice account that I use to interact mainly with colleagues overseas (@buist_rob). You’re welcome to follow these as I rant – oops, Tweet – about government inaction and the actions of morons (amongst other things, including tangling with Annabel Crabb about what is terrible these days) but you must not consider my Tweets to be medical advice. Oh, and I don’t recommend you tangle with Annabel Crabb (who is definitely NOT a moron).
And a big shout out to Liana Ravek and her team at Creative Clarity who post these updates and look after my website.
Be careful and do your best. None of us can eliminate risk but if we take sensible steps, we can reduce it.