Answers for maternal health and COVID-19.
In response to the growing threat of COVID-19 and it’s recent pandemic status, we at SimplyBorn would like to provide pregnant clients and their families with reliable information as it pertains to COVID-19 and the childbearing year. If you are pregnant we anticipate you are concerned about COVID-19 for yourself, baby, and your family. Please be advised, the CDC is the most reliable outlet for new information and developments relating to COVID-19.
If you have questions or concerns please direct them to our simplyborn@yahoo.com email, or call for further information. Please note this is educational information, and you can access SimplyBorn policy changes through our clinic staff.
Basic hygiene practices to remember:
Wash your hands often, with soap and water (normal soap is adequate) for minimum of 20 seconds (Sing happy birthday while washing.)
Avoid touching eyes, nose, mouth, face with unwashed hands
Cover your nose and mouth with a tissue when coughing or sneezing
Avoid handshakes
Avoid contact with sick individuals
STAY HOME WHEN YOU ARE SICK
Limit social interactions, large groups of people, and work from home when possible
Regularly clean and disinfect frequently touched surfaces (doorknobs, cellphones, keyboards, light switches)
Access services as much as possible online and via phone
Symptoms to be aware of:
Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.
The following symptoms may appear 2-14 days after exposure.*
Fever
Cough
Shortness of breath
For more information regarding symptoms and more serious symptoms to be aware of utilize the CDC website: https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html
Things to consider…
Should you go to the clinic/office for visits
It is your right to inquire with your healthcare provider what measures they are implementing to contain transmission of illness, including COVID-19. If you have COVID-19, or cold or flu symptoms, call the office before you go in to your appointment. Let them know you are sick and they will provide further instruction for the health and safety of all clients and staff. Aggressive containment is an appropriate public health measure to slow the pandemic spread of COVID-19.
Working with an out of hospital midwife, and planning an out of hospital birth does NOT eliminate risk of contracting illness including COVID-19. Holistic care is often considered lower risk, and less “sterile” in terms of public health measures; while in some respects this can be proven true, that is not a smart way of thinking when you are trying to prevent the spread of infection to yourself or to others.
We realize that healthcare is a unique service which often requires in-person interaction and physical contact. Midwifery is no different in this and we do require clients to have physical assessments regularly to assess maternal and fetal wellbeing through pregnancy. However, whenever possible we do recommend telemedicine for low-risk, non-urgent client needs and assessment. With this in mind SimplyBorn may reduce clinic location appointments in the foreseeable future to protect the health of clients and staff. Please reference our COVID-19 policy guidelines for further information.
Birthing location considerations
SimplyBorn has already been contacted several times by prospective clients considering out of hospital birth amidst fears of COVID-19 exposure in hospital.
Hospitals are equipped and have implemented public health protective measures to protect patients during the COVID-19 pandemic. These measures are for the patient’s safety and are not put in place to be intentionally limiting of the patient's personal birth desires.
At this time there is no medical reason to avoid hospital birth due to COVID-19. However, women are encouraged to labor at home as long as possible to reduce exposure risk. Women who have been diagnosed with COVID-19 should birth in hospital, in order to have access to higher level care as needed.
Maternal health
With the limited available data, as this is a new viral infection, data shows that women tend to get less severe presentations of COVID-19 than their male counterparts. This includes pregnant women. Generally pregnant women are more susceptible to respiratory infections and comorbidities as a result of immunosuppression. Research and data developments are moving quickly, but at this time pregnant women do not appear to be at higher risk of severe disease from COVID-19.
Newborn health
Studies are inconclusive whether maternal fever from COVID-19 increases risk of birth defects in babies. Adequate supplementation of folate (minimum 400 mg) during early pregnancy can prove a protective and supportive measure in proper fetal development in the first trimester.
At this time there is no evidence linking COVID-19 to increased rates of miscarriage or stillbirth; while other Coronavirus such as SARS or MERS did. There is no data indicating vertical transmission or infection of baby during labour or birth. COVID-19 has not been detected in amniotic fluid, cord blood, or breastmilk.
Breastfeeding
At this time COVID-19 has not been detected in breast milk, This means it is relatively safe for an infected, or symptomatic mother to breastfeed her newborn if she takes adequate precautions. The primary concern in breastfeeding is hand hygiene and transmission from respiratory droplets.
These precautions are: wash hands thoroughly before each feeding and interaction with baby, wear a face mask when interacting with baby, do not kiss baby, follow proper breast pump cleaning recommendations, and consider having a different healthy individual feed baby with expressed milk in a bottle.
What to do if you think you may be sick
Remember that risks for maternal and newborn health are currently low for those infected with COVID-19. If you become symptomatic, or have reason to believe you have COVID-19, call your midwife or OB to inform them. If you need to be tested or seen by a medical provider, remember to call the facility before you arrive to allow them to provide instruction and prepare their facilities. This is to protect staff, and other pregnant clients/patients.
The CDC has provided excellent resources and insight as well: https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html
Steps to follow for getting tested
First contact your primary care physician, if they are unable to assist with immediate testing and you live in Kent County, call the Kent County Health Department at (616) 632-7228. Please note, both primary care physician offices and the Kent County Health Department are being flooded with calls. Exercise patience and know they are available to support the efforts for testing and containment.
For more information regarding testing in your State:
https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html
References:
MDHHS, COVID-19 Recommendations
Government of Canada, www.gc.ca
