A woman's pregnant belly in a striped shirt and grey cardigan

Letter to the president of The Royal College of Obstetricians and Gynaecologists

29th April 2020


Mr. Edward Morris


The Royal College of Obstetricians and Gynaecologists

10 –18 Union Street




Dear Mr. Morris,


Further to our previous correspondence dated 29.03.2020 and 27.04.2020, we write again regarding the 28-week delineation of the risks to pregnant workers, as set out in the RCOG occupational guidance for pregnant healthcare workers.


We welcome your recent revisions to the occupational guidance (versions 3.0 and 3.1) and the steps you have taken to emphasise the role of risk assessments in the workplace for pregnant healthcare workers. We also appreciate that issues surrounding suspension and pay are not in your remit and we have written to the Secretary of State for Health and Social Care separately on this matter. However, we know that NHS trusts as well as private healthcare providers continue to defer to the 28-week distinction in your occupational guidance, and are insisting that there is no risk to pregnant women before this point.


We’re sure you are aware of the recent study by researchers at Baylor College of Medicine and Texas Children’s Hospital into the effects of COVID-19 on pregnant women, published this week in The American Journal of Obstetrics & Gynecology. As you will know this was a study of nine cases of COVID-19 in pregnant women; seven of these women sadly died, one remains critically ill and another has since recovered. 


While we appreciate the limitations of this study, we are deeply concerned that of the seven deaths recorded in this surveillance, two of the women were at 24 weeks gestation. In both cases, their babies also died. We note that another case study of 28+0 weeks gestation had displayed symptoms for 14 days prior to her hospitalisation. Sadly, that patient and her twins also passed away. These three cases are notable in that each woman contracted the coronavirus prior to the 28-week mark.


Regardless of the small sample of this study, it does clearly indicate that pregnant women under 28 weeks gestation are at risk of severe illness and death if infected with the coronavirus. Our own research has found that 25% of pregnant NHS workers are still coming into contact with patients that could have COVID-19. In many of these cases, it is the RCOG guidance on the 28-week distinction that is cited by employers who want these women to keep working. In light of the cases mentioned in this study, we call on you to urgently review your guidance so that it better reflects the risk to pregnant women of all gestations. 


Yours faithfully,


Joeli Brearley

CEO, Pregnant Then Screwed


Lauren Currie, OBE

Chair, Pregnant Then Screwed


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