By Dr Rebecca Fradkin, Clinical Editor, HealthPathways Melbourne. This article originally appeared in the HealthPathways Melbourne newsletter.
For expecting parents, the risk of COVID-19 can bring a great sense of anxiety, not just due to the fear of infection and its consequences. Isolation, financial difficulties and inability to access usual support systems are risk factors for mental illness and an increase in family violence. Whilst face to face consultations have been reduced during this time, it’s important that expecting families still feel connected to health care services, for their physical and mental wellbeing.
HealthPathways Melbourne has pathways to assist clinicians to ask about and support patients disclosing family violence.
Currently, although recognised as a vulnerable group, there is no evidence that pregnant women are more severely unwell if they develop the infection than the general population. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has advised on strategies to reduce the risk of exposure to infection.
With the reduction in face to face care, it is important that a comprehensive assessment has taken place early in pregnancy. For women having public hospital care, this assessment occurs in general practice.
The Antenatal Care – First Consult pathway can assist GPs to navigate this early assessment. Early identification of risk factors for mental illness, gestational diabetes, pre-eclampsia, fetal abnormalities and growth restriction can ensure early intervention and extra surveillance for pregnancies at risk.
When referring women for obstetric care it’s important to clearly document any reasons that identify patients as high risk or in need of early obstetric assessment. Be sure to include baseline blood pressure measurement in your referral to assist services to triage to the appropriate care level.
This review is a part of a larger review of the obstetrics suite that will include the upcoming statewide referral criteria for select obstetrics conditions due to begin this year.