Coronavirus infection and pregnancy
Advice for pregnant women with suspected or confirmed coronavirus infection
Q. Will being in self-isolation for suspected or confirmed coronavirus affect where I give birth?
As a precautionary approach, pregnant women with suspected or confirmed
coronavirus when they go into labour are being advised to go to obstetric unit
for birth, where the baby can be monitored using continuous electronic fetal
monitoring, and your oxygen levels can be monitored hourly.
The continuous fetal monitoring is to check how your baby is coping with
labour. As continuous fetal monitoring can only take place in an obstetric
unit, where doctors and midwives are present, it is not currently recommended
that you give birth at home or in a midwife-led unit, where there would not be
doctor present and where this monitoring would not be possible.
We will keep this advice continually updated as new evidence emerges.
Maternity units everywhere are working around the clock right now to manage
additional pressures and facilitate women’s choices to the best of their
abilities.
There is currently no evidence to suggest you cannot give birth vaginally or
that you would be safer having a caesarean birth if you have suspected or
confirmed coronavirus, so your birth choices should be respected and followed
as closely as possible based on your wishes.
However, if you are unwell and your team feel that this suggests that your
baby needs to be born urgently, a caesarean birth may be recommended.
It is not recommended that you give birth in a birthing pool in hospital if
you have suspected or confirmed coronavirus, as the virus can sometimes be
found in faeces. This means it could contaminate the water, causing infection
to pass to the baby. It may also be more difficult for healthcare staff to use
adequate protection equipment during a water birth.
There is no evidence that women with suspected or confirmed coronavirus cannot
have an epidural or a spinal block. In our previous version of the guidance it
was suggested that the use of Entonox (gas and air) may increase
aerosolisation and spread of the virus, but a review of the evidence suggests
there is no evidence that Entonox is an aerosol-prone procedure, so there is
no reason you cannot use this in labour.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. Is there any advice for birth partners during the coronavirus pandemic?
We are asking you to follow the guidance below to keep yourself, your family,
other families and NHS staff as safe as possible during the pandemic:

During the coronavirus pandemic, all hospitals are restricting visitors, but there are exceptions for a birthing partner during active labour and birth.
Every woman should be able to have one birth partner stay with her through labour and birth, unless the birth occurs under a general anaesthetic.
To help prevent spread of coronavirus to other women, their babies and key front-line healthcare staff, it is very important that you do not attend the maternity unit if you have any symptoms of coronavirus or have had any in the previous 7 days.
If you are unwell, protect your family and NHS staff, and stay at home. To prepare for this, women and their current birth partner are being encouraged to think about an alternative birth partner, if required. This person does not need to be from the same household as you.
If you are supporting a woman during labour and birth, please be aware of the strict infection control procedures in place to prevent the spread of coronavirus to other pregnant women and their babies, as well as other people within the hospital and the maternity staff.
Please wash your hands regularly with soap and water and use hand sanitiser gel in clinical areas as available.
If you cough or sneeze, please cover your mouth with a tissue and dispose of it in a bin immediately.
Stay in the labour room with the woman you are supporting. Do not move (/walk) around the maternity unit unaccompanied – use the call bell if you require assistance.
If you are asked to a wear a mask or any personal protective equipment (PPE) during the labour or birth, it is very important. Please follow the instructions carefully, and take it off before you leave the clinical area.
If you are accompanying a woman to her birth in an operating theatre, please be aware that operating theatre staff will be wearing PPE and it may be more difficult for them to communicate with you:
A staff member will be allocated to support you; please carefully follow their instructions and approach them if you have any questions.
To enable the clinical staff to do their job, it is very important that you do not move around the operating theatre as you risk de-sterilising sterile areas and spreading the virus.
The maternity team will do everything they can to enable you to be present for the birth. However, if there is a particular safety concern, they may ask that you are not present in the operating theatre. If this is the case, the team should discuss this with you and explain their reasons unless it is an emergency.

We understand this is a stressful and anxious time for pregnant women and their families and we thank you for your cooperation during this time.
Please be assured that the maternity team will do all it can to provide information, guidance and support to you and the woman giving birth.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. What impact will coronavirus have on my pregnancy?
The NHS has made arrangements to ensure that women are supported and cared for
safely through pregnancy, birth and the period afterwards during this pandemic
when there will be extra pressures on healthcare services.
Maternity services are absolutely essential and the RCOG is helping units to
coordinate staff in maternity services, to ensure safe care is provided. This
includes reducing staff commitments outside maternity units, reducing any non-
essential work within Trusts and re-organising staffing.
Maternity units are increasingly providing consultations on the phone or by
video link, when this is appropriate, so you do not have to travel
unnecessarily to the hospital. However, some visits in person with a midwife
are essential and it is important for the wellbeing of you and your baby that
you attend these to have routine checks.
Visitor restrictions, including for women admitted to maternity services for
antenatal and postnatal care, are in place in most settings across the UK.
During this time, midwifery, obstetric and support staff will be able to
support the needs of all women and the practical challenges of caring for
newborns after birth.
Routine and planned gynaecology operations are being postponed and, in many
units, arrangements are being made for gynaecology doctors to work in the
maternity unit.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. Will I be able to have my birth partner with me if I am being induced?
A birth partner without symptoms may be able to attend your induction of
labour where that is in a single room (e.g. on the maternity suite) but not if
the induction takes place in a bay on a main ward, as it would not be possible
to achieve the necessary social distancing measures.
We understand this must be a very worrying and anxious time if you are
pregnant and your birth partner can’t be with you while you are being induced;
however, it is essential that we limit the number of visitors to hospitals
during this time.
This guidance is in place to protect other pregnant women and babies, and
birth partners themselves. Please be assured that if your birth partner is
unable to be with you on a ward during your induction, this will not impact on
your birth partner’s presence during labour and the birth, unless they are
unwell. At the point you go into active labour, you will be moved to your own
room and your birth partner will be able to join you.


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. What is the advice for pregnant women who are classed as extremely vulnerable or who are shielding on older children attending school/nursery/external childcare?
Some pregnant women with pre-existing severe medical illnesses have been
classed as extremely vulnerable and have been advised to
shield. You will have been
told this by your maternity team. The government advice is that children and
young people who live in a household with someone who is pregnant and
shielding (extremely vulnerable) should only attend school/nursery/external
childcare if stringent social distancing, and hand hygiene, can be adhered to
– and the child or young person is able to understand and follow those
instructions.
Practical advice for measures that may be helpful to adopt within a family are
now available within the shielding
guidance.


Coronavirus infection and pregnancy
Advice for all pregnant women on attending antenatal and postnatal care during the coronavirus pandemic
Q. Can I still attend my antenatal/postnatal care appointments?
Your antenatal and postnatal appointments remain an important part of your
maternity care to provide checks and screening on your health and your baby’s
health. A member of the maternity team looking after you may call you before
your appointment, or carry out an assessment at entrance of the
clinic/hospital, or both, to check whether you have any symptoms that are
suggestive of coronavirus, or if you meet the current ‘stay at home’
guidance.
If you are advised to attend an appointment by your local maternity team, this
is because the need for the appointment to help reduce the risk of
complications for you and your baby is greater than your risk of being exposed
to coronavirus.
If you are well, you should be able to attend your appointments. You may be
asked to attend alone to protect your household from the risk of coronavirus.
You will be told about this by your local maternity service.
If you are currently self-isolating with suspected or confirmed symptoms of
coronavirus, and you have an appointment scheduled in the coming days, you
should telephone your continuity team or community midwife, or local maternity
unit, to inform them.
Your upcoming appointment will be reviewed by the maternity team looking after
you and your baby. You will then be advised whether your appointment is urgent
and a home appointment is required, or whether your appointment can be safely
delayed for a period of 7 or 14 days until you are well.


Coronavirus infection and pregnancy
Advice for pregnant women with suspected or confirmed coronavirus infection
Q. Why would I be asked to self-isolate (as opposed to reducing social contact)?
You may be advised to self-isolate because:

You have symptoms of coronavirus, such as a high temperature or new, continuous cough, or loss or change in your sense of smell or taste
You have tested positive for coronavirus and you’ve been advised to recover at home
You have an elective caesarean birth or induction of labour planned and you have been asked to self-isolate prior to your admission to hospital


Coronavirus infection and pregnancy
Advice for pregnant women with suspected or confirmed coronavirus infection
Q. What do I do if I feel unwell or I’m worried about my baby during self-isolation?
Pregnant women who are self-isolating are advised not to attend maternity
units or A&E unless in need of urgent pregnancy or medical care.
If you have concerns about the wellbeing of yourself or your unborn baby
during your self-isolation period, contact your midwife or, out-of-hours, your
maternity team. They will provide further advice, including whether you need
to attend hospital.
If you are advised to go to the maternity unit or hospital, pregnant women are
asked to travel by private transport, or arrange hospital transport, and alert
the maternity unit reception once on site, before going into the hospital.


Coronavirus infection and pregnancy
Advice for pregnant women with suspected or confirmed coronavirus infection
Q. How will I be cared for after I have recovered from coronavirus?
If you have confirmed coronavirus infection, as a precautionary approach, an
ultrasound scan will be arranged at least 2 weeks after your recovery, to
check that your baby is well.
If you have recovered from coronavirus and tested negative for the virus
before you go into labour, where and how you give birth will not be affected
by your previous illness. Visitor numbers may be restricted to promote
recommended social distancing but your birth partner will be able to be with
you, provided they are not unwell.


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. What is the advice if I am in my first trimester/less than 12 weeks’ pregnant?
Even during the pandemic, it’s very important that if you have any concerns
about yourself or your pregnancy at any time, you contact your GP, midwife or
local early pregnancy unit straight
away to discuss them. Some symptoms, such as pelvic pain, cramping and/or
bleeding during early pregnancy, are linked to ectopic pregnancy and
miscarriage so you should seek urgent medical advice.
A telephone appointment will be arranged for you as soon as possible with your
local early pregnancy unit to check your symptoms. They will be able to advise
whether a visit to the hospital during the coronavirus pandemic is necessary,
and ensure you receive the care that you need.
Whilst hospitals are trying to minimise people entering in order to reduce the
spread of the coronavirus and to limit the impact on services, they are
organised in such a way that they are able to provide all acute services.
Find out more information on the changes to early pregnancy care
and what to expect during the coronavirus pandemic.


Coronavirus infection and pregnancy
Advice for all pregnant women on attending antenatal and postnatal care during the coronavirus pandemic
Q. How many antenatal appointments will I have?
You will have at least six face-to-face antenatal appointments in total. Where
possible, essential scans/tests and routine antenatal care will be offered
within a single appointment. This is to prevent multiple journeys and visits
to clinics/hospital, and will involve contact with as few staff as possible to
prevent the spread of coronavirus to you, your family and other patients.
This may mean that your initial ‘booking in’ appointment will take place at
the same time as your 12-week (dating) scan.
You should be asked about your mental health at every appointment, whether in
person or via phone/video.
In the third trimester, you should be asked about your baby’s movements at
every appointment, whether in person or via phone/video.
All pregnant women should be provided with
information about group B
streptococcus (GBS) in pregnancy and newborn babies.
Sometimes, you may need additional antenatal appointments and medical care.
This will depend on your individual medical needs. These appointments may be
carried out over the phone or via video, provided a physical examination or
test is not required. This will enable partners and other family/household
members to join you for support and allow social distancing to protect you and
your baby from coronavirus.
This may include:

Appointments with a specialist doctor
Extra blood tests
Support for your mental health
Discussion of plans for birth
Local provision of antenatal/parent education classes, infant feeding support and information on safe sleeping, pelvic floor exercises and birth choices


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. Will my birth partner be able to stay with me if I have a caesarean or instrumental birth that occurs in an operating theatre?
We fully support women having their birth partners with them during labour and
birth, unless they are unwell, when an alternative well birth partner can
attend.
Around one in four women in the UK has a caesarean birth. A caesarean may be
recommended as a planned (elective) procedure for medical reasons or as an
emergency – for example, if doctors and midwives are concerned that your baby
is not coping with labour and needs to be born immediately.
Furthermore, around one in five women in the UK has an instrumental birth
(ventouse or forceps). Some of these types of birth may also be recommended to
occur in an operating theatre in order to allow the maternity team to modify
plans and undertake a caesarean birth if necessary.
Most caesareans and instrumental births in theatre are carried out under
spinal or epidural anaesthetic, which means you’ll be awake, but the lower
part of your body is numb and you cannot feel any pain. In this situation,
everything will be done by the clinical staff – midwives, obstetricians and
anaesthetists – to keep your birth partner with you.
Due to the coronavirus pandemic, staff in the operating theatre will be
wearing enhanced personal protective equipment (PPE) to prevent the spread of
infection, which will make it more difficult for them to communicate. To
enable the clinicians to assist in the birth of your baby safely, it’s really
important your birth partner follows the instructions from the maternity team
carefully and quickly.
Occasionally, a general anaesthetic (where you’re put to sleep) may be used,
particularly if your baby needs to be born urgently. During this type of
caesarean birth, even under more usual circumstances, for safety reasons it is
not possible for the birth partner to be present during the birth.
While the maternity team will do all they can to ensure that your birth
partner is present for the birth, there will be some occasions when there is a
need for an urgent emergency birth with epidural or spinal anaesthetic, and it
will not be possible for your birth partner to be present. This is because,
during an emergency, operating theatres are more high-risk environments in
terms of potential spread of coronavirus to everyone who is present.
If it is the case that your birth partner will not be able to be present
during the birth, your maternity team will explain this to you and will do
everything they can to ensure that your birth partner can see you and your
baby as soon as possible after the birth.


Coronavirus infection and pregnancy
Advice for all pregnant women on attending antenatal and postnatal care during the coronavirus pandemic
Q. Why are changes to antenatal and postnatal care necessary during the coronavirus pandemic?
These changes are a way of ensuring we deliver the best care without
overloading our NHS services, which are crucial during the coronavirus
pandemic. This helps us to:

Reduce the number of people coming into hospitals where they may come into contact with other people and spread the virus
Ensure staff are not overwhelmed and stretched too far by the additional strain on services, which could be due to staff sickness and self-isolation as well as the higher numbers of patients needing care and overnight hospital stays due to coronavirus

This allows us to care for you and protect you from coronavirus while also
ensuring we protect our NHS staff and services.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. Will I be able to have my birth partner with me during labour and birth?
Yes, you should be encouraged to have a birth partner present with you during
labour and birth. Having a trusted birth partner present throughout labour is
known to make a significant difference to the safety and wellbeing of women in
childbirth.
If your birth partner has symptoms of coronavirus, they will not be allowed to
go into the maternity suite, to safeguard the health of the woman, other women
and babies, and the maternity staff supporting you.
In most hospitals and maternity units, there are now restrictions on visitors
which might mean that birth partners or other supportive people are not able
to attend routine antenatal appointments, or stay with women on antenatal or
postnatal wards. However, this should not impact on your birth partner’s
presence during your labour and the birth, unless they are unwell.


Coronavirus infection and pregnancy
Advice for pregnant women with suspected or confirmed coronavirus infection
Q. Can I still attend my antenatal appointments if I am in self-isolation?
You should contact your midwife or antenatal clinic to inform them that you
are currently in self-isolation for possible/confirmed coronavirus and ask for
advice on going to routine antenatal appointments.
It is likely that routine antenatal appointments will be delayed until
isolation ends. If your midwife or doctor advises that your appointment cannot
wait, the necessary arrangements will be made for you to be seen. For example,
you may be asked to attend at a different time, or in a different clinic, to
protect others.


Coronavirus infection and pregnancy
Advice for all pregnant women on attending antenatal and postnatal care during the coronavirus pandemic
Q. What should I do if I develop a fever or temperature, or both, when I am pregnant?
If you develop a temperature or a cough, or both, in pregnancy, you can use
the NHS 111 or NHS 24 website to obtain advice about isolation, which you
should follow in line with current regulations. However, please also be alert
to the other possible causes of fever in pregnancy. In particular, these
include urine infections (cystitis) and waters breaking. If you have any
burning or discomfort when passing urine, or any unusual vaginal discharge, or
have any concerns about your baby’s movements, contact your maternity
provider, who will be able to provide further advice.


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. What effect does coronavirus have on pregnant women?
All available evidence suggests that pregnant women are at no greater risk of
becoming seriously unwell than other healthy adults if they develop
coronavirus. The large majority of pregnant women experience only mild or
moderate cold/flu-like symptoms. Cough, fever, shortness of breath, headache
and loss or change to your sense of smell or taste are other relevant
symptoms.
If you think you may have symptoms of coronavirus you should use the NHS 111
online service for information, or NHS 24 if in Scotland. If you develop more
severe symptoms or your recovery is delayed, this may be a sign that you are
developing a more significant chest infection that requires specialised care.
If you feel your symptoms are worsening or if you are not getting better, you
should contact your maternity care team, your GP, or use the NHS 111 online
service / NHS 24 for further information and advice. In an emergency, call
999.
While pregnant women are at no greater risk of becoming seriously unwell than
other healthy adults, a small proportion of pregnant women with coronavirus
have required admission to hospital for treatment.
In the UK, information about all pregnant women requiring admission to
hospital with coronavirus is recorded in a registry called the UK Obstetric
Surveillance System (UKOSS). The first
report from this study included information about the
outcomes of 427 pregnant women admitted to hospital with coronavirus and their
babies during the pandemic, and was published on 11 May. While most women in
the study required only ward treatment and were discharged home well, around
one in ten women required intensive care, and sadly five women with
coronavirus died, although it is currently unclear if coronavirus was the
cause of their death. The study found that the majority of women who did
become severely ill were in their third trimester of pregnancy, emphasising
the importance of social distancing from 28 weeks of pregnancy.
The study also found that pregnant women from black, Asian and minority ethnic
(BAME) backgrounds were more likely than other women to be admitted to
hospital for coronavirus. Pregnant women over the age of 35, those who were
overweight or obese, and those who had pre-existing medical problems, such as
high blood pressure and diabetes, were also at higher risk of developing
severe illness.


Coronavirus infection and pregnancy
Advice for pregnant women with suspected or confirmed coronavirus infection
Q. What should I do if I’m asked to self-isolate?
Pregnant women who have been advised to self-isolate should stay indoors and
avoid contact with others for 7 days. If you live with other people, they
should stay at home for at least 14 days, to avoid spreading the infection
outside the home.
The NHS guidance on self-isolation currently recommends people should:

Not go to school, work, NHS settings or public areas
Not use public transport
Stay at home and not allow visitors
Open windows to ventilate rooms
Separate themselves from other members of their household as far as possible, using their own towels, crockery and utensils and eating at different times
Use friends, family or delivery services to run errands, but advise them to leave items outside.

You may wish to consider online fitness routines to keep active, such as
pregnancy yoga or Pilates.


Coronavirus infection and pregnancy
Advice for all pregnant women on attending antenatal and postnatal care during the coronavirus pandemic
Q. Will I be able to bring someone with me to scans?
In most hospitals and maternity units, there are now restrictions on visitors
which might mean that birth partners or other supportive people are not able
to attend routine antenatal appointments, including scans, with you.
We encourage units to allow women to share the ultrasound scan experience with
their partner (or other family members and friends) by saving a short
10–30-second video clip of the baby at the end of the dating scan and/or
anomaly scan.
In the current pandemic situation, when women attend alone, virtual attendance
by partners or companions with online video calls, or the filming of the
dating scan and/or anomaly scan, is not recommended. While we understand this
may be disappointing, virtual attendance can be distracting to the sonographer
and prevent them from doing their job effectively.
We understand it may be upsetting if you are asked to come alone to a scan,
but this measure has been put in place to protect maternity staff, other women
and babies, and you and your family from the risk of infection. Scans are an
essential part of pregnancy care and it is important that you continue to
attend them for your and your baby’s wellbeing.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. What is an antibody test – will I have this?
You may also have heard about antibody testing for coronavirus. This is a
blood test that can show whether you have previously come into contact with
the virus or not. It does this by detecting antibodies, which your body
produces if you have had coronavirus. This is called an immune response.
At present, this type of test is only being offered to NHS staff and some
individuals across the UK. It is hoped the results of these tests will help us
to understand how immunity to coronavirus works as we do not yet know how the
antibodies develop and how long immunity lasts for. Therefore, we do not
currently recommend that results from antibody tests are used when caring for
pregnant women.


Coronavirus infection and pregnancy
Advice for women with suspected or confirmed coronavirus infection who have recently given birth
Q. Will I be able to breastfeed my baby if I have suspected or confirmed coronavirus?
Yes. There is no evidence showing that the virus can be carried or passed on
in breastmilk. The well-recognised benefits of breastfeeding and the
protection it offers to babies outweigh any potential risks of transmission of
coronavirus through breastmilk. Provided your baby is well and doesn’t require
care in the neonatal unit, you will stay together after you have given birth
so skin-to-skin and breastfeeding can be initiated and supported if you
choose.
The main risk of breastfeeding is close contact between you and your baby, as
if you cough or sneeze, this could contain droplets which are infected with
the virus, leading to infection of the baby after birth.
A discussion about the risks and benefits of breastfeeding should take place
between you and your family and your maternity team. This guidance may change
as knowledge evolves.
When you or anyone else feeds your baby, the following precautions are
recommended:

Wash your hands before touching your baby, breast pump or bottles
Try to avoid coughing or sneezing on your baby while feeding at the breast
Consider wearing a face mask while breastfeeding, if available
Follow recommendations for pump cleaning after each use
Consider asking someone who is well to feed your expressed breast milk to your baby.

If you choose to feed your baby with formula or expressed milk, it is
recommend that you follow strict adherence to sterilisation
guidelines. If you are expressing breast milk in hospital, a dedicated breast
pump should be used. Further information on infant feeding during the
coronavirus pandemic is available from
Unicef.


Coronavirus infection and pregnancy
Advice for women with suspected or confirmed coronavirus infection who have recently given birth
Q. After the birth, is there any increased risk to me or my baby?
There is no evidence that women who have recently had a baby and are otherwise
well are at increased risk of contracting coronavirus or of becoming seriously
unwell. A recently pregnant woman’s immune system is regarded as normal unless
she has other forms of infection or underlying illness. You should however
remain well-nourished with a balanced diet, take mild exercise as you feel fit
and ensure social distancing guidance is followed. Children, including
newborns, do not appear to be at high risk of becoming seriously unwell with
the virus. However, close observation of hygiene, as always, is important and
particularly with family members resident in the house. Anyone who enters the
home should take standard hygiene precautions, including washing their hands,
and be careful about handling your baby if they have symptoms of any illness
including the coronavirus.
It is important that your baby is feeding well and gaining weight, and if you
have any concerns, please contact your midwife. Once restrictions are lifted,
we would caution against large family gatherings to celebrate your baby’s
arrival until more is known about the spread of the virus in the community.
Do not put off seeking medical advice if you have concerns about your baby’s
health during the pandemic. Seek medical advice if your baby has a fever,
lethargy, irritability, poor feeding or any other symptoms you may have
concerns about.


Coronavirus infection and pregnancy
Advice for women with suspected or confirmed coronavirus infection who have recently given birth
Q. Will I be able to stay with my baby/give skin-to-skin if I have suspected or confirmed coronavirus?
Yes, if that is your choice. Provided your baby is well and doesn’t require
care in the neonatal unit, you will stay together after you have given birth.
In some other countries, women with confirmed coronavirus have been advised to
separate from their baby for 14 days. However, this may have potential
negative effects on feeding and bonding.
A discussion about the risks and benefits should take place between you and
your family and the doctors caring for your baby (neonatologists) to
individualise care for your baby. This guidance may change as knowledge
evolves.


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. What effect will coronavirus have on my baby if I am diagnosed with the infection?
As this is a very new virus, we are just beginning to learn about it. There is
no evidence to suggest an increased risk of miscarriage.
Emerging evidence suggests that transmission from a woman to her baby during
pregnancy or birth (vertical transmission) is probable. It is important to
emphasise that in all reported cases of newborn babies developing coronavirus
very soon after birth, the babies were well.
Given current evidence, it is considered unlikely that if you have the virus
it would cause problems with your baby’s development, and none have been
observed currently.
Across the world, emerging reports suggest some babies have been born
prematurely to women who were very unwell with coronavirus. It is unclear
whether coronavirus caused these premature births, or whether it was
recommended that their babies were born early for the benefit of the women’s
health and to enable them to recover.
In the recent UK study of 427 pregnant women with
coronavirus published on 11 May, the data reported outcomes for babies who
were born to women with coronavirus severe enough that the woman required
hospital admission. Although almost one in five were born prematurely and were
admitted to a neonatal unit, fewer than 20 babies were born very prematurely
(when the women were less than 32 weeks’ pregnant). One in 20 babies born (12
babies in total) had a positive test for coronavirus, but only half of these
babies – 6 babies - had a positive test immediately after birth, suggesting
that transmission of the coronavirus infection from a woman to her baby is
low. The number of babies born at term (37 weeks or later) to women who had
tested positive for coronavirus that required neonatal care was similar to the
number of babies born to women without the virus – about 1 in 10.


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. What is the advice for pregnant women with older children attending school/nursery/external childcare?
Pregnant women were placed in the vulnerable category by the Chief Medical
Officer on 16 March as a precaution during the coronavirus pandemic. The
government‘s guidance on schools and early years settings
advises that: children and young people who live with
someone who is pregnant (vulnerable) can attend school and early years
settings. See the next question for information about pregnant women who are
classed as extremely vulnerable.
All pregnant women are advised to follow government guidance on staying alert
and safe (social
distancing). Pregnant women
are at no greater risk of contracting coronavirus or becoming seriously unwell
than other healthy adults. However, there are additional concerns for pregnant
women in the third trimester. This is based on the challenges in caring for
women who are heavily pregnant, and the risk of the baby needing to be born
early for the woman’s wellbeing.
A recent report from a UK study showed that so far all pregnant women who
became seriously unwell with coronavirus were in the third trimester. This
emphasises the importance of more stringently practicing social distancing
from 28 weeks of pregnancy.
If you choose to take your children to school/nursery/external childcare, you
should ensure you practice social distancing – stay two meters away from
teachers/carers and other parents and do not go inside the building. If this
is difficult, then consider staggering your child’s drop off and pick up
times. Remember to wash your hands when you return home and ensure that your
children wash their hands when they leave the childcare setting. Alcohol gel
can be used if they cannot wash their hands with soap and water.
If you are concerned about the choice of returning to school or other
childcare settings based on the risk to children attending, helpful
information is available from the
RCPCH.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. Who should care for my other children when I go into hospital for labour and birth?
Government guidelines recommend that guidelines on social distancing should be
followed by everybody in the UK wherever possible. It is reasonable to leave
the home when you need to do so for a medical reason (i.e. attending a clinic
appointment or attending the maternity unit to have your baby). It is
important that you are supported by a well birth partner when attending the
maternity unit for the birth of the baby; however, your other children must
not go with you into the maternity unit. If this means that there is nobody
else available at home to care for your other children, then it is necessary
for the children to be cared for by another close family member or friend.
Please discuss this with the chosen person in advance. When choosing another
person to care for your children in this situation, please do not ask somebody
who is vulnerable to the severe effects of coronavirus (e.g. people over the
age of 70, other pregnant women or individuals with significant medical
problems). Also, please make a back-up plan, in the case the person you had
planned to ask is self-isolating because either they, or someone else in their
home, are unwell with coronavirus when you need them.


Coronavirus infection and pregnancy
Advice for all pregnant women on attending antenatal and postnatal care during the coronavirus pandemic
Q. Who should I contact about my antenatal and postnatal care appointments?
If you have been allocated a local health continuity team or a named
community midwife
You should continue to contact your continuity team or community midwife by
telephone to discuss any questions or concerns you might have and to check on
arrangements for all scheduled and future appointments.
If you have not been allocated a local health continuity team or a named
community midwife
You should contact your GP surgery or local maternity unit in order to be
connected to an appropriate continuity team or named community midwife so you
can discuss any questions or concerns you might have and to check on
arrangements for all scheduled and future appointments. If you are unsure when
your next appointment is you should make contact as above to help us care for
you.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. Will my birth partner be tested for coronavirus?
It is possible that your birth partner may also be offered testing for
coronavirus when you are admitted to hospital. Your maternity team will be
able to advise you further.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. Will my childbirth choices be affected by the coronavirus pandemic?
We understand this must be a stressful and anxious time if you are pregnant
and due to give birth in the coming months. Maternity units everywhere are
working around the clock right now to manage additional pressures and
facilitate women’s choices.
Like all areas of NHS care, maternity services will be affected by the
pandemic but units are working to ensure services are provided in a way that
is safe, with the levels of staff that are needed and the ability to provide
emergency care where necessary.
If you have chosen to give birth at home or in a midwife-led unit that is not
co-located with an obstetric unit, it is worth noting that these services rely
on the availability of ambulance services to allow for rapid transfer to
hospital, and the right number of staff to keep you safe. If these are not in
place, it is possible that your Trust or Board may not be able to provide
these services.


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. What research is being done to monitor the impact of coronavirus on pregnant women and their babies?
The UK is conducting near-real-time surveillance (observation) of women who
are hospitalised and test positive for coronavirus during pregnancy, through
well-established systems already used by all maternity units – this is the UK
Obstetric Surveillance System (UKOSS).
Imperial College London are also running a surveillance programme (PAN-
COVID) to monitor pregnancy and neonatal outcomes for
women with coronavirus.
The COVID-19 Symptom Study app has been
developed by King’s College London and health science company ZOE. Members of
the public, including pregnant women, can use this app to report on their
health during the coronavirus pandemic.
We will update our information if and as soon as there is any change in the
evidence.


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. Are some pregnant women more at risk of becoming seriously unwell from coronavirus than others?
Data from the UKOSS study of 427 pregnant women in
May 2020 found the majority of women who have become severely ill were in
their third trimester of pregnancy, emphasising the importance of social
distancing from 28 weeks of pregnancy.
The study also found pregnant women from black, Asian and minority ethnic
(BAME) backgrounds are more likely than other women to be admitted to hospital
for coronavirus. Pregnant women over the age of 35, those who are overweight
or obese, and those women who have pre-existing medical problems, such as high
blood pressure and diabetes, also appear to be at higher risk of developing
severe illness.
All pregnant women are advised to follow government guidance on staying alert
and safe (social
distancing). If you develop
coronavirus you are still most likely to have no symptoms or a mild illness
from which you will make a full recovery. It is important that all pregnant
women who develop more severe symptoms or whose recovery is delayed should
seek help, particularly if you are at higher risk of becoming seriously unwell
and being admitted to hospital.
Healthcare professionals are also being advised that women known to be at
higher risk should be told at each contact that they may be at risk of
complications of coronavirus, and advised to seek help early if they become
concerned about their health or that of their baby.
The increased risk to pregnant women from a BAME background will mean that
your maternity team may book you additional appointments, or refer you to a
doctor or specialist clinic should there be any concerns about your health or
your baby’s.
The Royal College of Midwives has developed new
guidance for midwives and
maternity support workers to ensure that they are aware of the increased risks
for BAME women and can pass on relevant advice and
support to the women in their care.


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. What can I do to reduce my risk of catching coronavirus?
The most important thing to do is to follow government
guidance. For pregnant
women and the rest of their households, this includes:

Wash your hands regularly
Use a tissue when you or anyone in your family coughs or sneezes, discard it and wash your hands
Avoid contact with someone who is displaying symptoms of coronavirus (these symptoms include high temperature and/or new and continuous cough)
Avoid non-essential use of public transport when possible
Work from home, when possible
Avoid large and small gatherings in public spaces, noting that pubs, restaurants, leisure centres and similar venues are currently shut as infections spread easily in closed spaces where people gather together
Avoid gatherings with friends and family; keep in touch using remote technology such as phone, internet and social media
Use telephone or online services to contact your GP or other essential services


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. Should I plan a pregnancy during the coronavirus pandemic?
Becoming pregnant during the coronavirus pandemic is a matter of personal
choice.
The Faculty of Sexual and Reproductive Healthcare (FSRH) recommend that when
considering a pregnancy, women and their partners consider the risks of
coronavirus transmission associated with routine contacts with healthcare
professionals during pregnancy, particularly if pregnancy complications may
necessitate frequent hospital attendance.
For more information, see the FSRH clinical statement: Information to support
management of individuals requesting to discontinue contraception to plan a
pregnancy during the Covid-19 outbreak.


Coronavirus infection and pregnancy
Advice for all pregnant women on attending antenatal and postnatal care during the coronavirus pandemic
Q. How many postnatal appointments will I have?
Your postnatal care will be individualised to meet your needs and those of
your baby. You should have at least three postnatal appointments with your
local continuity team or community midwife. These will take place once you
have been discharged from hospital: on your first full day at home, then on
day 5 and day 10. These appointments may be a mixture of face-to-face care at
home or in a clinic, and telephone consultations, where this is appropriate.
After your postnatal appointment on day 10, your care will be transferred to
your local health visiting team. You will be given information about this.


Coronavirus infection and pregnancy
Occupational health guidance for pregnant women who work in a public-facing role
Q. What is the advice for pregnant healthcare workers after 28 weeks’ gestation, or with an underlying health condition?
If you are in your third trimester (more than 28 weeks’ pregnant), or have an
underlying health condition – such as heart or lung disease – we strongly
recommend you avoid direct patient contact. It is better to work from home
where possible, avoid contact with anyone with symptoms of coronavirus, and
significantly reduce unnecessary social
contact.
Data from the UKOSS study of 427 pregnant women in
May 2020 found the majority of women who have become severely ill were in
their third trimester of pregnancy, emphasising the importance of social
distancing from 28 weeks of pregnancy.
We encourage employers to seek opportunities for pregnant healthcare workers
in their third trimester to work flexibly in a different capacity, to avoid
roles where they are working directly with patients.
Whatever gestation of your pregnancy, you should discuss your individual
circumstances with your local Occupational Health department.
The evidence base for this new virus is growing rapidly and, as and when new
information emerges, the government and professional bodies will update the
guidance.
Maternity Action has published FAQs around rights and benefits during
pregnancy and maternity
leave which you may find
helpful.


Coronavirus infection and pregnancy
Advice for women with suspected or confirmed coronavirus infection who have recently given birth
Q. Will my baby be tested for coronavirus?
If you have confirmed or suspected coronavirus when the baby is born, doctors
who specialise in the care of newborn babies (neonatal doctors) will examine
your baby and advise you about their care, including whether they need
testing.


Coronavirus infection and pregnancy
Advice for pregnant women with suspected or confirmed coronavirus infection
Q. What happens if I go into labour during my self-isolation period?
If you go into labour during self-isolation, you should call your maternity
unit for advice, and inform them that you have suspected or confirmed
coronavirus infection.
If you have mild symptoms, you will be encouraged to remain at home (self-
isolating) in early labour, as usual practice.
Your maternity team have been advised on ways to ensure that you and your baby
receive safe, quality care, respecting your birth choices as closely as
possible.
When you and your maternity team decide you need to attend the maternity unit,
general recommendations about hospital attendance will apply:

You will be advised to attend hospital via private transport where possible, or call 111/999 for advice, as appropriate
You will be met at the maternity unit entrance and provided with a surgical face mask, which will need to stay on until you are isolated in a suitable room


Coronavirus infection and pregnancy
General information and advice for all pregnant women during the coronavirus pandemic
Q. I am pregnant – what do I need to do?
As a precaution, you should follow government advice about social distancing,
stay away from public places and avoid anyone who has symptoms suggestive of
coronavirus. It is still considered necessary for pregnant women to go out for
essentials, such as food shopping, exercise and to attend antenatal
appointments.
If you are in your third trimester (more than 28 weeks’ pregnant) you should
be particularly attentive to social distancing and minimise any contact with
others.
All pregnant women should follow the Public Health England advice:

Guidance on social distancing for all vulnerable people including pregnant women
Guidance for individuals and households with possible coronavirus infection

On 24 March, additional
‘shielding’ measures
were announced for people defined on medical grounds to be at very high risk
of severe illness from coronavirus, including pregnant women with significant
heart disease (congenital or acquired). If you are pregnant and have
significant heart disease, it is strongly recommended that you follow these
shielding measures to keep yourself safe.


Coronavirus infection and pregnancy
Information for all pregnant women about childbirth choices and birth partners during the coronavirus pandemic
Q. Will I be able to have my birth partner with me on the postnatal ward?
To ensure compliance with social distancing measures and prevent the spread of
coronavirus, visitor restrictions are in place across all hospital wards,
including antenatal and postnatal wards. We understand it may be upsetting not
having your birth partner with you on the postnatal ward after you have given
birth, but these restrictions are in place to reduce the risk of transmission
of coronavirus to you, your baby, the maternity staff and birth partners
themselves. Please be reassured that during this time, midwifery, obstetric
and support staff will do their best to support the needs for all women and
the practical challenges of caring for newborns after birth.


Coronavirus infection and pregnancy
Advice for all pregnant women on attending antenatal and postnatal care during the coronavirus pandemic
Q. How will the coronavirus pandemic affect my routine antenatal and postnatal appointments?
We understand that it could be a stressful and anxious time if you are
pregnant or have recently given birth during the coronavirus pandemic. The NHS
is working to ensure that you, your baby and your family are supported and
cared for during these uncertain times. This means that there may be some
changes to how, when and where you attend essential routine appointments and
how safe care and support are given to you. You will be told about any changes
by your local maternity service.
Antenatal and postnatal care is based on years of evidence to keep you and
your baby safe in pregnancy and birth, and beyond. Antenatal and postnatal
care should therefore be regarded as essential and you should be encouraged to
attend, despite being advised to engage with social distancing measures.
Your local maternity team may reduce routine appointments, provide more home
visits or deliver some care and support over the phone or by video to reduce
the number of times you need to travel and attend hospital/clinics. You will
be informed of any changes to your care in advance.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Does someone with a paediatric first aid certificate still need to be on site?
The requirements in the EYFS on paediatric first aid certification have been
modified and statutory guidance on
EYFS has been published setting out what this means.
The existing requirement remains in place where children aged 0 to 24 months
are on site. Paragraph 3.25 and Annex A of the EYFS set out the requirements,
including that ‘at least one person who has a current paediatric first aid
(PFA) certificate must be on the premises and available at all times when
children are present, and must accompany children on outings.’ The existing
requirements also remain unchanged for childminders, as they are already
required to have full PFA certification.
The requirement is modified where children aged 2 to 5 are on site (with no
children aged below 24 months) to a best endeavours duty to have someone with
a full PFA certificate on site. If all steps set out in the guidance have been
exhausted and settings cannot meet the PFA requirement, they must carry out a
written risk assessment and ensure that someone with a current First Aid at
Work or emergency PFA certificate is on site at all times. New entrants (level
2 and 3) will not need to have completed a full PFA course within their first
3 months in order to be counted in staff to child ratios.
[EYFS]: early years foundation stage
  [PFA]: paediatric first aid


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Prioritising children
What should happen to vulnerable children if their provider is closed?
Where the setting which vulnerable children usually attend is closed, the
setting should notify the local authority (and social worker, where relevant)
that these vulnerable children need alternative provision. Settings should
work with the families of vulnerable children and local authorities (and
social workers, where relevant) to support this.
Where a setting has closed, and a child moves to a different early years
setting, the closed provider should do whatever it reasonably can to provide
the receiving setting with any relevant welfare and child protection
information. The receiving setting should be aware of the reason the child is
vulnerable and any arrangements in place to support them. As a minimum, the
receiving setting should, as appropriate, have access to a vulnerable child’s
EHC plan, child in need plan, child protection plan or, for looked-after
children, their personal education plan, and know who the child’s social
worker is (and, for looked-after children, who the responsible virtual school
head is).
The transfer of necessary information should ideally happen before a child
arrives at the new setting and, where that is not possible, as soon as
reasonably practicable. Any exchanges of information will ideally happen
between the designated safeguarding leads (or deputies), and/or between
special educational needs co-ordinators/named individual with oversight of
special educational needs provision for children with EHC plans.
Whilst providers must continue to have appropriate regard to data protection
and General Data Protection Regulation GDPR, they do not prevent the sharing
of information for the purposes of keeping children safe. For more information
please read the Department for Education’s guidance: Information sharing
advice for practitioners providing safeguarding services to children, young
people, parents and carers
guidance.
*[EHC]: education, health and care


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Responsibilities
Are childcare settings expected to share resources?
The priority is to ensure children of critical workers, and vulnerable
children, can access provision. Local authorities should work with settings to
manage local demand and should coordinate support from other settings in the
area. Settings are expected to be flexible and work together where required.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
What if a setting has a large number of vulnerable or critical worker children?
Since the aim of closures is to slow the spread of coronavirus, settings may
wish to make arrangements with other settings to reduce the number of children
in their care, if a large number of children are eligible to attend.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Will schools assess children against the EYFS profile this academic year?
The Secretary of State for Education has announced that there will be no exams
or assessments in schools this summer. This includes no assessment of children
in reception year against the early learning goals that form the EYFS profile.
This also means no moderation by local authorities.
*[EYFS]: early years foundation stage


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Childminders
Can childminders work with other childminders to look after more priority children together?
To align with the government’s position on nannies, we are updating our
guidance for early years settings to confirm that paid childcare can be
provided to the children of one household from Wednesday 13 May 2020. This
includes childminders, who may choose to look after the children of one
household, if they are not already looking after vulnerable children or those
of critical workers. From 1 June 2020, childminders can look after children of
all ages, in line with their current Ofsted registration, and within usual
limits on the number of children they can care for
Yes – up to 3 childminders (or a mix of up to 3 childminders and assistants)
can work together in the same domestic premises. However, if more than 3
childminders work together they will need to apply to Ofsted to register
childcare on domestic premises.
If registered to deliver childcare on domestic premises, 4 or more
childminders (or a mix of 4 or more childminders and assistants) can work
together in the same domestic premises, which would enable them to care for
larger groups of children and still meet ratio requirements. Further details
of requirements for childminders and childcare on domestic premises is
available.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
Will children attend their usual childcare setting?
Our priority is ensuring sufficient childcare for vulnerable children and
children of critical workers. We are asking settings to stay open to do this,
but we acknowledge this may not always be possible.
Where a setting is unable to stay open, local authorities will work with local
settings to determine the best way to support vulnerable children and the
children of critical workers.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Funding
What will happen to funding for free childcare places during this period of disruption?
On 17 March 2020, the Chancellor confirmed that the government would continue
to pay local authorities for free early years entitlement places for 2-, 3-
and 4-year-olds.
We have published guidance on the use of free early education entitlements
funding setting out
how local authorities can use their free entitlement funding differently,
redistributing it - in exceptional cases and only when all other options have
been exhausted - in order to secure childcare for the children of critical
workers, and for vulnerable children, where their usual arrangements are no
longer possible.
Local authorities will need to ensure there are sufficient childcare places at
this time, and to redistribute funding across settings accordingly – in a
clearly focused and targeted way. This ability to redistribute free
entitlement funding in exceptional circumstances will enable local authorities
to ensure that critical workers, including NHS staff, are able to access
childcare where they need it. Any setting which sees their early entitlement
funding reduced, in order to fund childcare places elsewhere, will be able to
increase the proportion of their salary bill eligible for the Coronavirus Job
Retention Scheme in line with DfE’s guidance on financial support for
education, early years and children’s social
care on access to the scheme.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Funding
Are settings covered by their insurance during this period of disruption?
Business interruption insurance
For childcare providers which have a policy that covers government-ordered
closure and unspecified notifiable diseases, the government’s social
distancing instructions are sufficient to allow businesses to make a claim
against their insurance, provided the other terms and conditions in their
policy are met.
Public liability insurance
For childcare providers with public liability insurance, the Association of
British Insurers’ members continue to offer cover to settings, whether open or
closed, with no change to terms and conditions to existing policies.
Providers should check their terms and conditions with their insurance
company.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
What happens if staff need to renew their paediatric first aid certificates?
If PFA certificate requalification training is prevented for reasons
associated directly with coronavirus, or by complying with related government
advice, the validity of current certificates can be extended by up to 3
months. This applies to certificates expiring on or after 16 March 2020.
*[PFA]: paediatric first aid


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Funding
I am not a critical worker and my child isn’t vulnerable. Do I still need to apply or reconfirm for the 30 hours entitlement if I’m not currently accessing a place?
We encourage all eligible parents to continue to apply for, and reconfirm,
their 30 hours entitlement, even when childcare settings remain closed to all
but vulnerable children and children of critical workers. This will ensure a
smooth transition back into childcare when settings fully reopen.


Guidance Actions for early years and childcare providers during the coronavirus outbreak

What arrangements do settings need to make about meals for children attending the setting?
Where maintained nursery schools are open for children of critical workers,
and vulnerable children, they should continue to provide free school meals to
children who would normally receive them.
In all other settings where free school meals do not apply, settings may
charge for meals in line with national entitlements guidance. As per existing
guidance, they should consider the impact of charges on disadvantaged
families.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
What if a member of staff already has an enhanced DBS check but is moving temporarily to another early years setting?
Where members of the early years and childcare workforce are already engaging
in regulated activity and already have the appropriate DBS check, there is no
expectation that a new DBS check should be obtained for them to temporarily
move to another setting to support the care of children.
The onus remains on the receiving setting to satisfy themselves that someone
in their setting has had the required checks, including by seeking assurance
from the current employer rather than requiring new checks.
*[DBS]: Disclosure and Barring Service


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Prioritising children
How do we identify which children are the children of critical workers?
Childcare settings should speak with parents or carers to identify who
requires a place.
If it proves necessary, settings can ask for simple evidence that the parent
in question is a critical worker, such as their work ID badge or payslip.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
Are childcare settings expected to stay open if only one vulnerable or critical worker child attends?
If providing suitable care for a child is not possible, we ask that
arrangements are made to merge provision with other settings, in consultation
with the local authority.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Responsibilities
Can provision be shared across local authority areas?
If a childcare setting is unable to open, local authorities should try to
coordinate provision for children who meet the criteria in other settings in
their area. If this is not possible, local authorities should consider working
with neighbouring local authorities while keeping in mind the impact on
children.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
Should settings offer longer opening hours to care for the children of critical workers?
Settings should try to be as flexible as possible for critical workers who
work shifts or atypical hours.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Prioritising children
How are vulnerable children defined?
The government encourages vulnerable children and young people to attend
educational settings, unless they have underlying health conditions that put
them at severe risk.
During the coronavirus outbreak, vulnerable children are defined as those who:

are assessed as being in need under section 17 of the Children Act 1989, including children who have a child in need plan, a child protection plan or who are a looked after child
have an education, health and care (EHC) plan, and it is determined, following risk assessment, that their needs can be as safely or more safely met in the educational environment
have been assessed as otherwise vulnerable by educational providers or local authorities (including children’s social care services), and who are therefore in need of continued educational provision. This might include children on the edge of receiving support from children’s social care services, adopted children, those who are young carers, and those living in temporary accommodation
and others at the provider’s and local authority’s discretion

Vulnerable children’s attendance is encouraged, where it is appropriate for
them. A brief summary of attendance expectations, across the different groups
of vulnerable children and young people, is as follows:

for vulnerable children who have a social worker, attendance is encouraged where this is appropriate in line with the advice set out by Public Health England
for vulnerable children who have an Education Health and Care (EHC) plan, attendance is encouraged where it is determined, following risk assessment, that their needs can be as safely, or more safely, met in the educational environment
for vulnerable children who are deemed otherwise vulnerable, at the childcare setting, school or local authority’s discretion, attendance is encouraged where this is appropriate

Educational providers, local authorities, social workers, parents/carers, and
other relevant professionals (where applicable), should work together closely
to consider factors, such as the balance of risk, including health
vulnerabilities, family circumstances, risks outside the home, and the child
or young person’s assessed special educational needs. Further detail on
supporting vulnerable children is set out in Supporting vulnerable children
and young people during the coronavirus (COVID-19)
outbreak.
*[EHC]: education, health and care


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
How can settings continue to offer care if staff are sick or self-isolating?
Childcare settings who are experiencing staff shortages should work with their
local authority to identify how appropriate provision can be put in place.
They can pool staff with another setting, or take on qualified and Disclosure
and Barring Service (DBS) checked staff from other educational settings
(including local registered childminders) which have been closed, or invite
local registered childminders to work with them at the setting. Registered
childminders can already do this under the 50/50 registration flexibility they
have.
Settings must obtain criminal records checks for new members of staff,
including volunteers. If an application has been made but the DBS disclosure
has not arrived, new staff and volunteers can still care for children as long
they are supervised by someone who has a DBS check. Under no circumstances can
an unchecked member of staff be left alone with children.
*[DBS]: Disclosure and Barring Service


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Can settings take on new staff (including volunteers) even if a Disclosure and Barring Service (DBS) check has not been completed?
The requirements set out at paragraph 3.11 of the EYFS remain in place.
Settings must obtain criminal records checks for new members of staff
including volunteers. If an application has been made but the DBS disclosure
has not arrived, new staff and volunteers can still care for children as long
they are supervised by someone who has a DBS check. Under no circumstances can
an unchecked member of staff be left alone with children.
Where new staff are recruited, or new volunteers enter the childcare setting,
they should continue to be provided with a safeguarding induction.
[EYFS]: early years foundation stage
  [DBS]: Disclosure and Barring Service


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Childminders
Will early years entitlement funding continue for childminders?
To align with the government’s position on nannies, we are updating our
guidance for early years settings to confirm that paid childcare can be
provided to the children of one household from Wednesday 13 May 2020. This
includes childminders, who may choose to look after the children of one
household, if they are not already looking after vulnerable children or those
of critical workers. From 1 June 2020, childminders can look after children of
all ages, in line with their current Ofsted registration, and within usual
limits on the number of children they can care for
On 17 March 2020, the Chancellor confirmed the government would continue to
pay local authorities for free early years entitlement places for 2-, 3- and
4-year-olds,
We have published guidance on the use of free early education entitlements
funding setting out
how local authorities can use their free entitlement funding differently,
redistributing it – in exceptional cases and in a clearly focussed and
targeted way – in order to secure childcare for the children of critical
workers, and for vulnerable children, where their usual arrangements are no
longer possible.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Funding
Can childcare settings continue to charge parents during coronavirus-related closures?
We are working hard to mitigate the impacts of coronavirus (COVID-19) on all
parts of our society, including individuals and businesses. We expect
nurseries to comply with the law and take a reasonable and proportionate
approach to parents’ fees, in light of these unprecedented circumstances, and
to communicate any arrangements clearly with them.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Funding
How do early years settings access the Coronavirus Job Retention Scheme (CJRS)?
The CJRS scheme opened for applications on 20 April and guidance on how to
access the scheme can be found at Claim for wages through the Coronavirus Job
Retention Scheme. Early years providers remain eligible for
the CJRS while continuing to receive early entitlement funding via local
authorities.
The CJRS guidance, published by HM Revenue and Customs on
26 March, states that where employers receive public funding for staff costs,
and that funding is continuing, we expect employers to use that money to
continue to pay staff in the usual fashion - and correspondingly not furlough
them. This also applies to non-public sector employers who receive public
funding for staff costs. Employers should not be able to receive public
funding for staff cost and furlough payments for the same staff.
On 17 April, DfE published guidance setting out how the CJRS and early
entitlement funding
interacts, confirming that early years
settings can access the CJRS to cover up to the proportion of its pay bill
which could be considered to have been paid for from that provider’s private
income.
A private provider should only furlough employees, and therefore seek support
through the CJRS, if they meet the following conditions:

the employee works in an area of business where services are temporarily not required and where their salary is not covered by public funding
the employee would otherwise be made redundant or laid off
the employee is not involved in delivering provision that has already been funded (free entitlement funding)
(where appropriate) the employee is not required to deliver provision for a child of a critical worker and/or vulnerable child
the grant from the CJRS would not duplicate other public grants received, and would not lead to financial reserves being created

If it is difficult to distinguish whether staff are funded through free
entitlement or private income for the purposes of meeting the first 3
conditions as listed above, then an early years provider can access the CJRS
to cover up to the proportion of its paybill which could be considered to have
been paid for from that provider’s private income.
*[CJRS]: Coronavirus Job Retention Scheme


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Childminders
Are childminders eligible for the Self-employment Income Support Scheme?
To align with the government’s position on nannies, we are updating our
guidance for early years settings to confirm that paid childcare can be
provided to the children of one household from Wednesday 13 May 2020. This
includes childminders, who may choose to look after the children of one
household, if they are not already looking after vulnerable children or those
of critical workers. From 1 June 2020, childminders can look after children of
all ages, in line with their current Ofsted registration, and within usual
limits on the number of children they can care for
Eligibility for the scheme is based on employment structures and not
professions. You can apply if you are self-employed, or a member of a
partnership, and have lost profits due to coronavirus, as well as meeting
further eligibility criteria. HM
Revenue and Customs will contact individuals who are eligible and invite them
to apply online.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Prioritising children
Can childcare practitioners send their children to schools and childcare settings?
Childcare practitioners are critical to the coronavirus response. Critical
workers are encouraged to send their children to school or childcare settings.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Do other aspects of safeguarding requirements remain the same?
All other aspects of the safeguarding and welfare section of the EYFS still
apply, including requirements relating to child protection arrangements.
Providers should consider whether any refresh or review is needed of their
child protection arrangements, policy and procedures, in light of the
coronavirus outbreak.
Settings must continue to have a practitioner designated to take lead
responsibility for safeguarding. It is acceptable for the safeguarding lead
not to be based on-site if this is not practical, for example they may be
working from home, or be based at another setting, as long as they are still
available to provide support, advice and guidance to staff. It is important
that all childcare staff and volunteers have access to a trained designated
safeguarding lead or deputy, and know on any given day who that person is and
how to speak to them.
*[EYFS]: early years foundation stage


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Funding
Is there any flexibility for parents who have missed the deadline for 30 hours codes?
Local authorities also have the ability to relax the validity dates on 30
hours codes where critical worker parents were ordinarily eligible and
expecting to take up a 30 hours childcare place between 1 April 2020 and 31
August 2020, but have missed the reconfirmation/application deadline of 31
March 2020. This will enable children to take up their places in the summer
term.
We are therefore asking local authorities and childcare providers who are
approached by the parents of vulnerable children, or critical workersm who
have missed the 31 March 2020 deadline, to accept their codes, having first
checked the child’s date of birth to ensure summer term eligibility. To be
eligible for a summer term 30 hours place the child must have turned 3 before
1 April 2020.
At this time, only the children of critical workers and children who are
vulnerable, are able to access childcare. A list of children prioritised for
education provision can be found in guidance on Critical workers who can
access schools or educational
settings. We have asked all
early years settings to prepare for wider opening from 1 June 2020, and will
update the guidance on 30 hours in due course.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Funding
Can parents continue to claim their 30 hours free early education entitlement?
We are making some temporary changes to the 30 hours free entitlement so that
all eligible parents, including critical workers, are not disadvantaged during
the coronavirus outbreak.
Specifically, parents who will not meet the minimum income threshold (16 hours
per week at National Minimum/Living Wage) due to lower earnings as a direct
result of coronavirus will be treated as meeting that test during the
outbreak. This will apply only to parents who need to apply for, or reconfirm,
their 30 hours place during the outbreak this year.
Subject to parliamentary approval of a temporary amendment to the 30 hours
free childcare regulations, we intend to allow critical workers who exceed the
maximum income threshold (£100k per year), due to increased hours as a direct
result of the coronavirus outbreak, to remain eligible for 30 hours for the
current tax year.
These are temporary changes in response to the coronavirus outbreak which will
be reviewed as the situation develops.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Prioritising children
If childcare settings are open for children of critical workers and vulnerable children, can they accept other children if they have enough staff and space?
No. At this time, settings should only care for children of critical workers
and vulnerable children.
If a childminder is not looking after vulnerable children, or the children of
critical workers, they can provide childcare for the children of one household
who are not critical workers or vulnerable children.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Prioritising children
Is it necessary to prioritise children?
The first aim of the partial closure of educational settings has been to
reduce the overall population of children and families moving around local
areas, as far as possible, in order to reduce the number of social
interactions, and thus flatten the upward curve of the coronavirus outbreak.
The second aim is to continue to care for priority children – those who are
vulnerable, or whose parents are critical to the coronavirus response, so that
they can continue to work.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Does the Early Years Foundation Stage still apply?
The Early Years Foundation Stage (EYFS) statutory
framework sets the standards that schools and childcare settings
must meet for the learning, development and care of children from birth to 5
years old.
We have amended legislation to allow for the temporary disapplying and
modifying of a number of requirements within the EYFS, giving settings
flexibility to respond to changes in workforce availability and potential
fluctuations in demand while ensuring children are kept safe. These temporary
changes came into force on 24 April 2020.
Full details of the amendments can be found in the guidance on early years
foundation stage statutory framework
(EYFS), which also includes details about how the temporary
arrangements will be brought to an end. Settings and local authorities should
fully familiarise themselves with these changes to ensure they understand the
flexibilities available to them and are meeting the modified requirements,
especially in relation to paediatric first aid, during the coronavirus
outbreak.
*[EYFS]: early years foundation stage


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Is it still a requirement for early years settings to have a separate baby room for children under the age of 2 during this period of disruption?
The EYFS requirement to have a separate baby room is a safety issue for the
protection of very young children particularly when they are asleep. Paragraph
3.59 of the EYFS already allows for the mixing of children when this is
appropriate. If the layout of the premises does not allow for a separate ‘baby
room’ with its own door, a suitable area may be partitioned off to provide
safety for younger children.
*[EYFS]: early years foundation stage


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Childminders
When can childminders reopen to more children?
To align with the government’s position on nannies, we are updating our
guidance for early years settings to confirm that paid childcare can be
provided to the children of one household from Wednesday 13 May 2020. This
includes childminders, who may choose to look after the children of one
household, if they are not already looking after vulnerable children or those
of critical workers. From 1 June 2020, childminders can look after children of
all ages, in line with their current Ofsted registration, and within usual
limits on the number of children they can care for
To align with the government’s position on nannies, we are updating our
guidance for early years settings to confirm that paid childcare can be
provided to the children of one household from Wednesday 13 May 2020. This
includes childminders, who may choose to look after the children of one
household if they are not already looking after vulnerable children or those
of critical workers. From 1 June 2020, childminders can look after children of
all ages, in line with their current Ofsted registration, and within usual
limits on the number of children they can care for.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Ofsted
What is Ofsted doing about unregistered provision?
Ofsted is aware that these are extremely worrying times for both settings and
parents. However, the health, safety and well-being of children is our first
consideration, and government continues to expect childcare to take place only
within registered settings.
Ofsted will consider legal enforcement action against those who set up
unregistered childcare, in line with their duties as a regulator. This is in
order to keep children as safe as possible in these difficult times.
See Ofsted’s response to coronavirus
(COVID-19) for more information.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Can settings vary staff to child ratios and qualifications?
Paragraph 3.30 of the EYFS states:
‘Exceptionally, and where the quality of care and safety and security of
children is maintained, changes to the ratios may be made.’
We consider the extent of the coronavirus outbreak to be an exceptional
temporary circumstance in which the staff to child ratios set out in the EYFS
can be changed if necessary. However, childcare settings or schools remain
responsible for ensuring the safety and security of children in their care.
Amendments made to regulations from 24 April allow further exceptions to be
made to the qualification level that staff hold in order to be counted in the
ratio requirements. Settings should use reasonable endeavours to ensure that
at least half of staff (excluding the manager) hold at least a full and
relevant level 2 qualification to meet staff to child ratio requirements, but
this is not a legal requirement.
In nursery classes in maintained schools, caring for children aged 3 and over,
reasonable endeavours should be used to ensure that at least one member of
staff is a school teacher. Where this is not possible, there must be at least
one member of staff for every 8 children, with at least one member of staff
who holds at least a full and relevant level 3 qualification. Providers should
use their reasonable endeavours to ensure that at least half of other staff
hold at least a full and relevant level 2 qualification.
Further detail is set out in Early Years Foundation Stage: disapplications
and modifications for early years provision open during the coronavirus
(COVID-19) outbreak.
*[EYFS]: early years foundation stage


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
What are the expectations on settings regarding staying in touch with parents whose child is at home?
We recognise that many settings have already shared resources for children who
are at home and are grateful for this. We encourage them to continue working
with parents to ensure children can continue to learn at home.
The Department for Education’s Hungry Little
Minds campaign features tips and
practical activities that parents can do at home with children to support
their early learning. There are many simple ways to help children learn and it
does not have to feel like ‘learning’. Having everyday conversations, make-
believe play and reading together all make a big difference to children’s
development. Settings can also direct parents to the BBC’s Tiny Happy
People.
Settings should work with local authorities to monitor the welfare of
vulnerable children who are not attending provision, and other children they
might wish to keep in touch with, for safeguarding purposes.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Childminders
Can childminders get involved in supporting the continuation of provision for priority children?
To align with the government’s position on nannies, we are updating our
guidance for early years settings to confirm that paid childcare can be
provided to the children of one household from Wednesday 13 May 2020. This
includes childminders, who may choose to look after the children of one
household, if they are not already looking after vulnerable children or those
of critical workers. From 1 June 2020, childminders can look after children of
all ages, in line with their current Ofsted registration, and within usual
limits on the number of children they can care for
Childminders can continue to look after vulnerable children and children of
critical workers.
In addition, under existing registration arrangements, childminders can work
for up to 50% of the time on non-domestic premises.
Childminders who do not already have approval to work up to 50% of their time
on non-domestic premises will need to seek approval from Ofsted, after seeking
initial support from their local authority. If childminders have the capacity,
and there is a local need, they could help support with staff shortages in
centre-based childcare provision.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
Are early years staff eligible for coronavirus testing?
Yes. The government announced that all essential workers, and members of their
households who are showing symptoms of coronavirus, can be tested. This list
of essential workers includes early years staff.
For further information, please read guidance on coronavirus (COVID-19)
getting tested.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
Are early years and childcare settings opening on the 25 May 2020 bank holiday?
Early years and childcare settings should decide, in consultation with the
parents of children who are currently attending settings, whether it is
necessary for them to continue to look after critical workers’ children and
vulnerable children on Monday 25 May 2020.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Funding
What additional business support is available to childcare settings during this period of disruption?
The government has announced a package of
support for workers and
businesses which will benefit childcare settings.

the Chancellor has announced that private childcare settings will be eligible for a business rates holiday for one year - that means non-local authority providers of childcare (registered with Ofsted and providing EYFS) will pay no business rates in 2020 to 2021
nurseries in receipt of small business rate relief or rural rate relief will benefit from small business grant funding of £10,000
nurseries, which were already eligible for a charitable status relief, will also pay no business rates at all in 2020 to 2021
some settings operate from shared spaces which may now benefit from a 100% rates relief. We strongly encourage those shared spaces to reflect any business rates saving in their rent charges
the Coronavirus Job Retention Scheme means that, for employees who are not working but kept on payroll, the government will contribute 80% of each worker’s wages of up to £2,500, backdated to 1 March 2020. Further guidance provides details on how early years providers with a mixture of public and private funding should access the scheme
the Self-employment Income Support Scheme for those who are self-employed or members of a partnership and have lost profits due to coronavirus. The scheme allows individuals to claim a taxable grant worth 80% of trading profits up to a maximum of £2,500 per month for 3 months. HMRC will contact individuals who are eligible and invite them to apply online
for the self-employed (including childminders), the minimum income floor will also be temporarily relaxed, meaning Universal Credit can be accessed at a rate to match statutory sick pay (SSP)
the Business Interruption Loan Scheme will now be interest-free for 12 months, an increase from 6
VAT payments due with VAT returns between now and the end June 2020 will be deferred. UK VAT registered businesses will not need make those payments until March 2021
the Secretary of State for Business announced on 28 March 2020 that he will make changes to enable UK companies undergoing a rescue or restructure process to continue trading to help them avoid insolvency. This includes temporarily suspending wrongful trading provisions retrospectively from 1 March 2020 for 3 months for company directors so they can keep their business going without the threat of personal liability
working tax credit has been increased by £1,000 a year
the government has also announced a £20 per week increase to the Universal Credit standard allowance and Working Tax Credit basic element, and an increase in the Local Housing Allowance rates for Universal Credit and Housing Benefit claimants so that it covers the cheapest third of local rents

*[EYFS]: early years foundation stage


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Prioritising children
Should settings only offer places to children where both their parents are critical workers, alongside children of single-parent critical workers?
Children with at least one parent or carer who is critical to the coronavirus
response can attend a setting if required.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
What needs to happen if a child is attending a different setting than usual?
Important information should be provided by the parent or carer to the setting
on day one, including emergency contact details, dietary requirements and
medical needs to safeguard the health, safety and welfare of the child.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
Do early years and childcare settings need personal protective equipment (PPE)?
The majority of staff in education settings will not require PPE beyond what
they would normally need for their work, even if they are not always able to
maintain a distance of 2 metres from others. PPE is only needed in a very
small number of cases including:

children, young people and students whose care routinely already involves the use of PPE due to their intimate care needs should continue to receive their care in the same way
if a child, young person, or other learner, becomes unwell with symptoms of coronavirus while in their setting and needs direct personal care until they can return home. A face mask should be worn by the supervising adult if a distance of 2 metres cannot be maintained. If contact with the child or young person is necessary, then gloves, an apron and a face mask should be worn by the supervising adult. If a risk assessment determines that there is a risk of splashing to the eyes, for example from coughing, spitting, or vomiting, then eye protection should also be worn

Read further guidance on safe working in
settings.
*[PPE]: personal protective equipment


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Responsibilities
What are childcare settings responsible for?
Childcare settings are responsible for safeguarding and caring for children
who attend the settings as set out in the early years foundation stage
statutory (EYFS) framework and Working together to safeguard
children.
At this time, settings should try to remain open to care for children who are
vulnerable or whose parents are critical to the coronavirus response. However,
we understand that it may not be possible for all settings to remain open at
this time. Childcare settings should work with local authorities to agree the
provision needed locally to support the needs identified. Settings should take
steps to prepare for welcoming back more children from 1 June 2020, including
to reopen if they had previously closed.
*[EYFS]: early years foundation stage


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Do settings need to meet the learning and development requirements in sections 1 and 2 of the EYFS?
Following the amendments to the EYFS from 24 April, early years settings only
need to use reasonable endeavours to deliver the learning and development
requirements set out in the EYFS. We understand that these are exceptional
circumstances and the priority at this time is keeping children safe and well
cared for. As far as possible, children should also benefit from a broad range
of educational opportunities.
*[EYFS]: early years foundation stage


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Early Years Foundation Stage
Will settings be required to undertake the progress check at age 2?
Settings will not be required to undertake the progress check at age 2 during
the coronavirus outbreak.


Guidance Actions for early years and childcare providers during the coronavirus outbreak
Considerations for settings that are open during this period
Will it be mandatory for all registered childcare settings to remain open in some form?
We understand that some settings may be unable to stay open, especially if
they are experiencing severe staff shortages due to self-isolation and
sickness. Local authorities will work with local settings to determine the
best way to ensure sufficient childcare for vulnerable children and the
children of critical workers.


Guidance Actions for schools during the coronavirus outbreak
Preparing for the wider opening of education settings from 1 June
Can schools operate a staggered return or a rota system for pupils returning from 1 June?
Schools should not plan on the basis of a rota system for pupils returning
from 1 June, either daily or weekly. We are asking schools to welcome back
eligible pupils full-time, and do not expect schools to implement flexible
approaches, such as rota systems.


Guidance Actions for schools during the coronavirus outbreak
What arrangements should schools and local authorities maintain throughout the remainder of May?
Schools and early years settings in some areas are operating in ‘hubs’ - for example, groups of schools/settings operating at a single site. Is this permitted?
We are asking schools to remain open for children of critical workers and
vulnerable children where they can, but we understand that some may be unable
to do so especially if they are experiencing severe staff shortages.
Local authorities should therefore work with maintained, academy and
independent schools to identify temporary places for any children affected
whilst their normal schools are closed.
With significantly reduced pupil numbers, and risks of understaffing due to
illness, we understand that shared provision through multi-school or early
years hubs and clusters is an option being considered in some areas. In some
cases, arrangements are already in place.
Please see guidance on Using clusters and hubs to maintain provision in
educational settings.