Coronavirus and miscarriage: your care
On this page, we share information on how the Coronavirus (COVID-19) pandemic is affecting access to hospital services for those who are pregnant or experiencing a miscarriage, ectopic pregnancy or molar pregnancy, and for those awaiting investigations. But first, a note about Covid-19 vaccination and pregnancy.
Last updated: 17 August 2021
Covid-19 vaccination and pregnancy
The Chief Midwifery Officer for England, the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists are continuing to encourage pregnant women to get the Covid-19 vaccination to protect them and their babies. They are especially concerned about the number of unvaccinated pregnant women who have become severely ill with the virus and about the effects on their babies.
They know that this isn’t an easy decision for many pregnant women and their partners, so they have produced this helpful infographic about vaccination during pregnancy, as well as a video message from NHS England. Both provide useful information to help you make a decision if/when you are offered vaccination.
You will find more information from Public Health England here. NHS Inform Scotland has similar information, and a vaccination helpline, here. Information from Public Health Wales can be found here. And HSC Public Health Northern Ireland has information here.
While many restrictions due to COVID-19 have eased, the pandemic continues to have a significant impact on many lives and especially on access to healthcare. Even though overall rates of infection and hospitalisation with the virus are much lower than at the beginning of the year, they are still fluctuating due to new variants. There is also still a backlog of people awaiting hospital care for a range of conditions.
NHS England (and guidance from the other UK nations too) still encourages pregnant women to seek advice and care if they have or suspect they have problems with their pregnancy, but there are still some reductions and retrictions in some early pregnancy and maternity services. These can be very different across different hospitals and with continuing changes in levels of infection, staff sickness and geography, it can be truly difficult to know what to expect.
We hope the following information helps you to understand how the current situation might affect anyone who is pregnant or experiencing (or worried they might be experiencing) pregnancy loss.
Access to hospital services for people who are currently pregnant or experiencing a miscarriage, ectopic or molar pregnancy
Despite easing of many if not most retrictions, some early pregnancy and gynaecology units are still limiting the service they provide:
- to minimise the risk of exposure to the virus for people coming into a hospital environment
- to reduce the risk of spread within the hospital and
- because of reduced staff numbers caused by sickness, self-isolation and because of staff being moved to different departments, such as emergency care.
Wendy and Barry describe their experience of having a miscarriage during the coronavirus pandemic, with reduced access to hospital services. And you will find other people’s stories of loss during the pandemic here.
Information from the RCOG on early pregnancy care
The Royal College of Obstetricians and Gynaecologists (RCOG) has published a guide to early pregnancy services during the coronavirus pandemic. While it focuses mainly on women and couples in the first twelve weeks of pregnancy, it is equally helpful for anyone who is not yet booked with a midwife or an antenatal clinic.
They also have regularly updated information and guidance on pregnancy and Coronavirus at www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/.
Many hospitals are still having to limit the number of appointments for pregnancy scans and appointments, so women may be assessed over the phone before being advised whether or not they can be seen.
Until fairly recently, most hospitals have allowed only the woman being scanned or assessed to attend her appointment. Some allow use of a mobile or smartphone for part of the appointment so that the partner or other supporter can take part remotely but that will depend on the individual hospital’s policy. This has caused considerable upset both to women and their partners, as you can read in some of these stories.
NHS England, Scotland, Wales and Northern Ireland have all published guidance to support NHS Trusts and Boards in re-introducing visitors in pregnancy and maternity services. The RCOG notes that the guidance in England says pregnant women should be supported to have one person beside them “at all stages of her maternity journey” and attend appointments as long as the support partner is not showing any Covid-19 symptoms.
There are steps for hospitals to follow to allow this to happen safely, including risk assessments for Covid-19 transmission, managing layout and space and testing women and their support people.
This process is taking time as some hospitals will face practical challenges, especially where clinic and waiting areas are limited. But hopefully it will mean the gradual re-introduction of partners and other supporters during pregnancy appointments and care.
Hospitals are still limiting non-emergency surgical procedures under general anaesthetic. That means that women with a missed or incomplete miscarriage or a ‘blighted ovum’ or anembryonic pregnancy are more likely to be offered natural (expectant) or medical management of miscarriage at home rather than being treated in hospital. However, some units are now offering surgical management with local anaesthetic (an MVA) and this is likely to increase.
Ectopic pregnancy assessment and management
Ectopic pregnancy is a potentially life-threatening condition, so early assessment and treatment are crucial and access to care should remain as normal. See here for more information.
Molar pregnancy diagnosis and management
With fewer women having surgical management, it may take longer for some molar pregnancies to be diagnosed, so it’s very important to contact the hospital if a pregnancy tests is still positive 3 weeks after your loss. But once molar pregnancy has been diagnosed, care and follow-up will be as normal. You’ll find more information on our molar pregnancy pages, starting here.
If you are pregnant or currently experiencing a loss
If you need urgent advice regarding your pregnancy, you are encouraged to telephone your local Early Pregnancy Assessment Unit or Emergency Gynaecology Unit, or your midwife or antenatal clinic if you are already booked with them. It’s important to be as clear as possible about your symptoms or worries to help staff to assess your needs and advise on next steps. Please be assured that if you need emergency care for severe pain, very heavy vaginal bleeding, suspected ectopic pregnancy or other acute symptoms, then you will be assessed in person and seen accordingly.
If you are awaiting investigations following recurrent or second trimester miscarriage
Investigations into the possible causes of recurrent miscarriage or late loss were initially suspended in most hospitals, but some centres have reintroduced these over time. This may change again depending on local and national conditions and on the availability of specialist staff.
Information, guidance and support
The Royal College of Obstetricians and Gynaecologists (RCOG) has general up to date information and guidance on pregnancy and Coronavirus at www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/.
And of course, you can contact us at the Miscarriage Association for information and support. We don’t give medical advice but we can help you think through how best to manage at this time.
You can call us: 01924 200799 (Monday to Friday, 9 a.m. to 4 p.m.)
We know that picking up the phone and talking to someone you don’t know can sometimes be a scary experience. But we’ll do everything we can to make you feel comfortable, to listen and understand and to answer your questions to the best of our abilities.
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We talk about pregnancy loss and mental health here.