Hauora Tairāwhiti midwives both in the hospital and in the community have undertaken all precautions and the required training to ensure would-be mum's, newborn babies and their whanau remain safe during the Covid-19 lockdown.
"Everything was being put into place from the word go" said Hauora Tairāwhiti Director of Midwifery, Liz Lee Taylor.
"We went into lockdown immediately like everyone else on March 26.” This meant closing our doors to visitors and restricting the number of support people to just one ‘well’ support person who remained with their partner/wife from admission in labour or for induction of labour until going home postnatally with baby.
All midwives underwent the essential training on how to "don and doff" personal protection equipment, now known to most New Zealanders as PPE by Healthcare Assistant, Nikki Hewson, who is the units Infection Control representative.
All Lead Maternity Carers (LMCs) midwives were provided with PPE once they completed this training.
"If you don't get ‘don and doff” right that's where the risk is." "It is important the midwifery workforce protect themselves."
Currently, there are only eight Lead Maternity Carers in the district.
"This is a very small number to cover our vast geographical area”.
Questions to screen women and their support person were developed in line with the Ministry of Health guidelines but that was not an easy task as the ministry guidelines are "live" documents and often changed.
April proved to be a busy month even excluding the demands of a pandemic lockdown.
There were 66 births at the hospital's Puawai Aroha Maternity Unit evenly spread over most of the month.
There were some high acuity days but "nothing we haven't been able to manage."
Ms Lee Taylor said a room at the maternity unit has been converted into an isolation room and not used for any other purpose.
It has limited but essential equipment kept in the room to minimise the chance of contamination.
While antenatal clinics are held in outpatients, follow-ups for matters such as fetal monitoring and caesarean preparation, previously held in the maternity unit, are now carried out by a former midwife, who offered to help and re-instated her registration to provide this service.
The aim is to reduce exposure to different bubbles.
An obstetrician reviews all antenatal referrals and appointments. Those deemed to require a face-to-face meeting will still be seen but go through the screening process before entering the building. Others will receive a phone consultation at an arranged time.
"That's a big difference."
Pictured from left is: Iidil Merlini (Midwife Maternity), Carol Chan (Paediatrician), Hein Stander (Paediatrician), Kate Harris (Anaesthetic Technician), Carol Coetzee (Midwife Neonatal), Kelly Kartchner (Anaesthetist) and Michelle Goldsmith (Theatre Nurse)
Maternity staff have conducted simulation exercises of a woman with or suspected of having Covid-19 who then requires a caesarean birth."This has been repeated three or four times as we need to ensure we get it right to keep everyone safe."
The simulation is a multi-disciplinary exercise involving midwives, obstetricians, paediatricians, the neonatal nurse, theatre team and anaesthetists.
"We want everything to run smoothly with every eventuality carefully thought through.”
The maternity unit takes all the lockdown cautions with social distancing, restricted numbers in the office, precautions at the change of shifts and meal breaks.
LMCs have also been provided with office space in the maternity unit.
The maternity keeps its doors locked and an intercom system is used to screen woman and their support person before entry to the unit.
Staff don PPE if the woman at the door is suspected of having Covid-19.
The temperature of women and their one allowed support person is also taken to ensure they are well.
The support person stays in the maternity unit and cannot leave until the mother is discharged with her baby.
The support person is provided with food and access to showers. Again the aim is to prevent exposure to more bubbles.
Ms Lee Taylor said a maternity consumer survey is conducted each April.
A quick look at the feedback from this April looks good, she said.
Respondents seem to be very satisfied with the care they have received.
"They enjoyed quality time with their partner and their baby.”
But it has been more challenging for those with other children because they have been unable to enter the maternity unit.
"The hospital adapted to this need and introduced free WiFi which was offered to the mothers to help them communicate with family members at home during this lockdown."
The midwifery team has remained strong and positive during these challenging times to keep our mums and babies safe during their stay with us in Puawai Aroha maternity unit.
“2020 has also been designated by the World Health Organisation as ‘International Year of the Midwife’, we hope to be able to celebrate this later in the year and raise the profile of midwifery as a profession to think about joining.”
Thanks Gisborne Herald for this story for International Day of the midwife.
Thanks Biddy Robb for the photo