Maternal and child health nurses have been providing universal, equitable and free health support to Victorian families for more than one hundred years. Because of the COVID-19 pandemic and the associated risks of infection, on 23 March 2020, the service began providing this support to families via telephone consultations.
These were difficult times for families, especially where there were mental health concerns, family violence, financial hardship, and isolation. Our enhanced maternal and child health team, which provides additional support to families, also moved their consults to the telephone but continued outreach visits for families by going for long walks in local parks.
This was particularly helpful for women experiencing family violence. Walking together when only one other person was permitted, excluded the offending partner. The conversations shared, the support offered, the networking with other family violence services while out in the ‘fresh air’ was invaluable. The enhanced nurses became the fittest on our teams!
Telehealth video calls proved to be a user-friendly way of conducting virtual face-to-face consultations. They also made developmental screening easier for older children and babies who could now ‘see’ the maternal child health nurse as well. A favourite game for eight-month-olds was to play peek-a-boo by dropping off the screen and then reappearing suddenly! A great game for this age group and lots of fun for the nurse and families too.
With increased government support, other services extended into the virtual space. Families were able to access free counselling as needed and engage with early intervention services from their homes, something they appreciated despite the combined challenges of home-schooling older children.
Zoom became an enabler. We used it to engage with child protection and attend case or care conferences with workers and families. Families with complex needs were able to click into a meeting from their home base and instantly be involved in the conversations about their care needs with their maternal child health nurse present as well.
Victoria experienced a baby boom during the COVID-19 pandemic, placing additional pressure on public midwifery services. Many maternal child health nurses volunteered to work in maternity services to support their midwifery colleagues. They also helped out in other local council areas where the baby boom and the increasing number of midwives on leave with COVID was most acute.
As the months progressed, we were able to reintroduce short face-to-face appointments back at a few centres for babies up to eight weeks of age. These were staffed by nurses who volunteered to work in this way, knowing the increased risk of exposure to COVID-19 they would face despite wearing full PPE. We allocated fifteen minutes for each visit, with a gap of fifteen minutes between visits so we could disinfect the surfaces in the consulting rooms. Families appreciated this opportunity and readily agreed to mask up and attend alone with their babies. We later complemented this service with an online breast-feeding support service.
We also provided an outreach service to families who were confirmed COVID-positive. This team would schedule their visits at the end of their consulting day to limit the risk of COVID transmission. They would attend in full PPE and limit the visit to fifteen minutes with the remaining consultation via telehealth.
Despite our collective fears, by working with the community to adapt and meet the challenges presented by the COVID-19 pandemic we were able to continue providing a comprehensive maternal and child health service across Victoria.
Because of the changes we made, we now have increased flexibility in our service delivery, with some of our families still preferring a telehealth consult. We have also developed closer working relationships with other council maternal and child health services and improved networking with a range of other service providers. We are proud of the efforts we made to get through COVID and maintain the service for families.