We read with interest the excellent editorial ‘Postnatal care: new NICE guideline for the “Cinderella service”’.1 GPs’ involvement in the care of women in the perinatal period has never been so important as currently, during the COVID-19 pandemic.
Pregnant women affected by COVID-19 are at higher risk of developing serious complications,2 especially women of Black, Asian, and minority ethnic backgrounds, and those with underlying medical conditions.3 MBRRACE-UK reported that the maternal mortality rate due to COVID-19 was 2.4 per 100 000 between 1 March 2020 and 31 March 2021.4 In a recent study, only 28.7% of 1328 pregnant women had received at least one dose of the COVID-19 vaccine, with the majority of women who declined the vaccine expressing concerns about safety as a reason for declining.5 Up to 31 August 2021 in England, 81 000 pregnant women were reported to have received at least one dose of the COVID-19 vaccine. Given that around 600 000 women give birth each year, this is likely to represent a similarly small proportion of women.6
Initially when the UK COVID-19 vaccination programme commenced, only pregnant women at highest risk were eligible; this position later changed when the Joint Committee on Vaccination and Immunisation advised that all pregnant women should be offered the Pfizer or Moderna vaccines.2 This policy change and conflicting advice received by pregnant women contributed to vaccine hesitancy in these women.7
The GP’s role in vaccinating pregnant women cannot be overemphasised. GPs frequently discuss the risks and benefits of COVID-19 vaccination with their patients, including pregnant women. Through the call and recall system, GPs can identify unvaccinated pregnant women, invite them to book their vaccination, and direct them to useful resources (Box 1).
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The majority of pregnant women admitted to hospital with symptomatic COVID-19 remain unvaccinated.8 COVID-19 vaccine uptake in the pregnant population can and must be improved. Proactive GPs can be instrumental in this process and need to be recognised for their positive influence on maternal and infant health. UK health care needs GPs empowered to be involved in policy and research in this area as the pandemic continues.
- © British Journal of General Practice 2021