The Covid-19 pandemic has led to a variety of changes in the way that pregnant and labouring women receive medical treatment, including a reduction in the number of in-person antenatal visits and some alterations to the way the labour and birth process is handled in hospitals.
While most Dubai hospitals are still allowing all pain-relief options (apart from water births), it recently emerged that gas and air has been suspended as a pain relief option at Al Zahra hospital, which is one of Dubai’s major birth hospitals.
Gas and air (aka Entonox) is a combination of oxygen and nitrous oxide, and it is one of the most popular and non-invasive methods of pain relief during labour.
“Recent studies have shown that there might be a possibility that the gas might contribute to spreading the Covid - 19 virus,” says Dr Ghassan Lotfi , Head of Maternity Services at Al Zahra Hospital Dubai.
Al Zahra Hospital Dubai delivered its first baby born to a Covid-19 positive mother back in early May, but it is planning to stop accepting Covid-positive patients in the near future, says Dr Lotfi.
“As the hospital is becoming Covid -19 free, we expect to resume the practice [of allowing labouring patients to use gas and air as a form of pain relief] in the near future.”
The majority of other private hospitals in Dubai do allow women to use Entonox during labour, and the Royal College of Obstetricians and Gynaecologists’ latest advice (updated June 12 2020) has now reviewed its previous guidance to say that, “there is no evidence that Entonox is an aerosol-prone procedure, so there is no reason you cannot use this in labour.”
However, the guidance and hospital policies are changing rapidly during the pandemic, so it is crucial for pregnant women to keep abreast of their options and to keep in constant contact with their ob-gyn and the labour ward of their chosen hospital to ensure that they are aware of any change in policy.
Other changes to labour and birth because of Covid-19
- Water births have been suspended across the UAE. Dr George Michailidis, Consultant in Obstetrics & Gynaecology and Maternal & Fetal Medicine at Genesis Clinic says: “Due to the risk of cross infection or contamination and the difficulty of using appropriate PPE (Personal Protective Equipment) for the caring staff, water birth and labour in water are not recommended at the moment and most hospitals have stopped offering it.”
- Birth partners are limited to just one person for a natural birth at most hospitals, while some hospitals do not allow birth partners to accompany mothers at all. It’s worth double checking the policy at your chosen hospital, and ask what the policy is for birth partners at a natural birth, an elective C-section and in the case of an emergency C-section, as they may vary. For instance, at Mediclinic Parkview hospital your partner is allowed to accompany you during a c-section as long as you have regional anesthesia, but “If you are going to sleep for your C-section (not a usual practice) then your partner will wait for your outside the operating theatre” says Dr Jennifer Kasirsky, Consultant Obstetrician & Gynaecologist, Mediclinic Parkview Hospital.
- Staff will be in full Personal Protective Equipment gear when attending to you in labour. This means gowns, gloves, airborne protection (masks or respirators) and goggles or a face shield. Dr Jennifer Kasirsky, Consultant Obstetrician & Gynaecologist, Mediclinic Parkview Hospital says: “The World Health Organisation and other healthcare agencies deem delivery as a high-risk procedure for spread of Covid-19 and we need to take full precautions to protect our staff.
- You may be required to wear a face mask and your partner will need to wear one when staff are in the room. “If you are not Covid-positive, we encourage you but do not require that you, the patient, wear a mask during delivery – however, we know that this is quite cumbersome and are committed to your safety and comfort. We will require that your husband or birth partner wear a mask when out staff is in the room with you.”
- Visitors to you in hospital may be restricted or banned. “You should minimize the number of visitors to the hospital in order to minimize the risk of transmission of COVID19,” says Dr George of Genesis. “Birth photographers are not normally allowed now, and most units will not allow small children to visit. You should check with your hospital regarding visiting policies as they are subject to change at short notice as a response to the COVID19 pandemic evolution.”