Pregnant women sometimes test positive even though they are asymptomatic as outpatients, so it is necessary to screen all pregnant women universally by polymerase chain reaction for SARS-CoV-2, the virus that causes COVID-19. [1] [2] [3] We now, as a challenge, intend to conduct a screening test for every pregnant woman on admission to distinguish between positives and negatives and examine what management policy is preferable ( Fig. 1) . Even if the result is negative, it may be desirable to discontinue the pregnant woman's and family's health check-up and perform online medical treatment by telephone, including cases who have a history of overseas travel or if a pregnant woman is associated with close contacts with infectious patients, or asymptomatic COVID-19 positive pregnant women. In addition, in the female positive cases, the necessity of hospital management is classified according to the presence or absence of respiratory disorders (Fig. 1) . When perinatal care is required, management in a negative pressure room will be adopted if possible, and the delivery management policy will be adopted at the optimal time. 4 The delivery mode will be caesarean section, unless labour progresses rapidly. This is to prioritise maternal and child care, and the health care of our medical workers.
We believe that if such a maternal medical system, hopefully accompanied with highly sensitive anti-SARS-CoV-2 antibody and virus antigen tests, can be constructed, it will be very useful for the safe management of medical facilities and workers. Postpartum, rapid mother-child separation of COVID-19 positive women is needed as soon as possible and synthetic milk is better for the infant in order to prevent neonatal infection of COVID-19. To prevent the collapse of the medical care system, comprehensive management of medical facilities and workers is now urgently required around the world.
Mayumi Sugiura-Ogasawara The following five key themes were identified and agreed upon by the researchers.
Obstetricians expressed their strong desire to maintain connection with their patients using technology such as video conferencing.
They found the inability to have physical contact with patients (e.g. holding a patient's hand) meant they were not able to effectively express empathy. Doctors also valued contact with family members, colleagues and the wider medical community.
Personalised, timely communication from specialist medical bodies was universally appreciated.
ety about contracting COVID-19, all specialists interviewed were continuing clinical work even in the presence of pre-existing risk factors. Their over-riding concerns were for their family members and patients.
Responding to variation in practice and response: Where doctors encountered unexplained variation in practice, they questioned the validity of decision-making bodies. The differing screening procedures and variations in guidelines for personal protective equipment were two issues that were raised as causes for
anxiety. An open, consultative approach from executives with acknowledgement of the gaps in evidence generated confidence among participants.
Workflow adaptations: Doctors described in detail some of the practices they had adopted to comply with distancing guidelines, including reduced work hours, limited face to face contact with patients, avoiding physical contact with colleagues and having time allocated between appointments for regular cleaning.
about the future viability of private practice as well as the consequent increased burden on the public health system and discussed role of Telehealth in post-pandemic times.
In summary, our pilot study suggested that the Victorian obstetric workforce has adapted to the COVID-19 challenges. While doctors dealt with a variety of anxieties, they had a strong sense of belonging to a shared community of practice. As clinicians, doctors wanted to maintain a reassuring connection with their patients. Collegial relationships were critical to allay fears regarding lack of evidence in a rapidly evolving situation and to inform practice change. Healthcare leaders and specialist medical societies played an important role in supporting doctors at the frontline.
While our study was limited to private practitioners in Victoria, a larger study exploring perspectives of maternity care providers and recipients across Australia could provide valuable information for future practice. 