COVID-19

COVID-19 Update/ FAQ

What is COVID-19?

COVID-19 is a novel (meaning it is new or never been seen before) virus infection in the family of coronaviruses that causes significant respiratory disease in many infected individuals. This virus is transmitted primarily through contact with infected respiratory droplets. This can occur through direct airborne transmission (proximity to someone who is infected who coughs or sneezes, and you breathe the droplets in), physical contact with infected individuals (touching a person who is has viral droplets on them), or items/surfaces on which the live virus may have landed (touching surfaces on which an infected individual has coughed or sneezed, or a surface that someone has inadvertently moved the virus to). This viral infection is thought to affect pregnant individuals only because they are at an increased risk for respiratory infections by nature of pregnancy status. At present time, pregnant people are not in a significantly vulnerable risk group nor are they becoming sicker than other groups nor are they experiencing increased severity or symptoms compared to other people who are in a more vulnerable risk group. Due to the possibility of rapid decline in any infected individual to severe pneumonia/acute respiratory distress syndrome, it is recommended to take a conservative attitude regarding our pregnant population even though the risk for increased morbidity and/mortality is relatively low.

The virus can live in aerosol form for up to 3 hours, and infected individuals may spread the droplets into the air without being symptomatic. The virus has a different life span on different surfaces, so each may need special treatment or consideration:

Virus Survival

Aerosol – 3 hours
Surfaces
1. Copper – 4 hours
2. Plastic or metal – 3 days
3. Paper/Cardboard – 24 hours
4. Fabrics – 3 days

Sanitary Precautions

Frequent hand washing, and sanitizing
Avoid close contact with people who are sick.
Social distancing (ONLY leaving your home for essential reasons, ie; to get groceries, care for a loved one, health care related trips)
Limiting travel, especially to affected regions
Limiting contact with any individual who may have had contact with any individual who has traveled to an affected area or who may otherwise be infected
Avoid touching your eyes, nose, and mouth.
Stay home when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect high touch objects and surfaces (things you or people in your home touch frequently such as knobs, handles and light switches) using a regular household cleaning spray or wipe, and frequent laundering of high touch fabrics and clothing
Practice should institute pandemic protocols to prevent spread and protect community

What does this means for pregnancy?

This virus epidemic is hard on everyone. If you are pregnant, first off remain calm. Pregnancy does not place anyone in a high risk group for contracting OR for poor outcomes if you become infected. It does however, carry the risk of pneumonia and respiratory compromise if you become seriously ill, which CAN have an affect on pregnancy and the fetus.

Social distancing is important for everyone right now, to reduce the amount of people who are becoming infected and spreading the virus. This aids in controlling HOW QUICKLY the virus spreads and the overwhelm on our public health systems.

What does this means for birth?

Currently, most hospitals are only allowing the partner of the laboring person into the birth space. This means that doulas and other family members will not be admitted. Planning to labor at home with a doula or a monitrice (a provider who is trained to monitor you and baby during labor) may be a good option to ensure you have adequate support for labor, and know when to head to the hospital, thereby reducing the amount of time you, your partner and your baby are in the hospital. You may also consider asking for early discharge, which further reduces your chances of exposure.

If you are planning a birth center or home birth your provider's protocols may change significantly during this time to protect you, your family, their other families and themselves.

What does this means for newborns?

Newborns are in a vulnerable risk group, just based on their immature immune system and rapidly changing respiratory system at birth. Healthy newborns born to a healthy individual should have no problems. Newborns are susceptible to infections from the hospital environment and personnel. Minimizing your exposure to people, places and things where the virus may be active are imperative for your newborns health.

At this time there is mixed recommendations regarding separating newborns from infected parents. The current recommendations do however suggest that breastfeeding is the absolute best intervention to keep baby healthy.

What does this means for nursing baby?

Offering your milk to your baby is not only recommended it is encouraged. If you become sick, you can still nurse your baby by practicing extreme precautions to not pass the virus to baby. At this time there has been no virus detectable in breast milk. If you were not planning to breastfeed, for whatever reason, you might want to consider offering baby your milk, for the duration of this epidemic. You can always change your plan when everyone is healthy.

Re-lactation is also an option for people who may have a young baby and who is not nursing currently. We have specialists on staff who can help you decide if this is an option for you.

Can I change my birthing care plan?

In some cases yes. Midwives are mobilizing all over the country to lean in and provide care for low risk individulals who are due during this uncertain time. In some areas hospitals are recommending birthing people to either transfer to a facility that is better suited for caring for healthy people, or coming into L&D in late active labor, to reduce exposure. While both of these are emergency stop gap measures to keep people in labor and babies low risk, it is not ideal.

If you are committed to a low intervention birth with a midwife, you have options. We also can offer telehealth visits for prenatal care, which can then be transferred back to your preferred provider after the social distancing practices are relaxed.

Are you accepting late transfers of care?

The short answer is YES. The longer answer is that there is a strict criteria that must be met in order to qualify for a late transfer to care for our homebirth practice. You MUST be low risk, you must have already been having prenatal care, and you must agree to practice social distancing protocols stringently. We are not offering discounted fees for late to care, because the amount of attention and work that goes into preparing for a homebirth with a late transfer is still exponential.

As always we offer a cash pay discount, for people who's insurance will not cover homebirth, and set up generous, affordable payment plans. If you feel like you may want to transfer to our practice, inquiring sooner rather than later is encouraged, as our calendar is filling up.