Recommendations for antenatal referral for obstetric care in women with Covid-19

23 August 2021

A joint statement by RANZCOG and the New Zealand College of Midwives

General guidance for provision of maternity care during Covid-19

Maternity services continue to be an essential service during Covid-19, at all alert levels. Consider the following when providing maternity care.

  • Telephone consultations may provide easier and safer access than face to face care where appropriate.
  • All women should be screened for Ministry of Health Higher Index of Suspicion criteria for Covid-19 before every antenatal appointment.
  • Pregnant women are a priority group for COVID-19 vaccination, and should be routinely offered vaccination at any stage of pregnancy.
  • Women who are trying to become pregnant do not need to delay vaccination or avoid becoming pregnant after vaccination.

Referral for Pregnant women with confirmed Covid-19

Pregnant women who have confirmed Covid-19 should be referred for multi-disciplinary assessment following the local hospital/DHB referral guidelines for Covid-19 patients.

This is because pregnant women with Covid-19 have a higher risk of severe illness compared to non-pregnant women with Covid-19 of the same age. This includes an increased risk of:

  • hospitalisation
  • admission to an intensive care unit
  • invasive ventilation

Covid-19 during pregnancy also increases the risk of complications for the baby including a higher risk of stillbirth and of being born prematurely.

Usual referral criteria apply for women who do not have Covid-19.

As always, optimal care is achieved through collaboration with a strong focus on mother and baby. For circumstances that do not easily fit into these guidelines or standard referral guidelines, or where clinical judgement indicates cause for concern, referral to obstetric care should be made.

Labour and birth care

If a woman has recovered from Covid-19 prior to labour and birth, there is no need to refer for obstetric service for care, other than for usual obstetric referral criteria.

All women with confirmed Covid-19 at 37 weeks, or later, should be referred to the DHB maternity service for labour and birth care planning.

All women with confirmed Covid-19 at the onset of labour should be referred for hospital birth, and care transferred to the DHB. Women should be advised to make contact with the birthing suite and/or midwife before arrival.

Download this statement here



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