Our Plan of Care during these difficult times ~by Your Midwives on 04/18/20
We have updated our previously sent out supply list as well as our practice protocols and have added some resources to share (please see below). We also wanted to share some thoughts with you as our communities continue social distancing and precautions surrounding COVID-19.
Your midwives are doing all we can to keep ourselves as exposure-free as possible to ensure our health for your birth. We will not attend births if we have any signs of sickness. We feel fortunate to have a team of midwives in our practice, for many reasons, but especially now in case any of us were to be ill. We wanted to update you in regards to who is specifically involved in our team of midwives. We are happy to announce that Acadia Gantz, who some of you have met as one of our back-up birth assistants, will be joining our team full-time. Brenda and Lindsay are currently the two primary midwives you’ll get to know at prenatal visits. Acadia will start attending virtual prenatal visits with Lindsay and Brenda starting May 19th, so that you can get to know her. Robin and Jodie are on-call on a part-time basis, and one of them may be the second midwife at your birth along with one of the other midwives you know well.
These are unchartered times, yet our aim continues of providing excellent, comprehensive personalized care to our clients, while supporting the sustainability and well-being of our midwives. We believe this allows us to continue to provide excellent care to our clients that is both safe and reliable. We are keeping our practice small so we can provide such care.
We hope you are all taking virus precautions that are very important at this time, such as:
· Social Distancing (meaning, staying home other than necessary outings. When around non-immediate family members/housemates, staying 6 feet or more away from them. This also includes no kid play dates.)
· Sanitizing appropriately and washing hands for at least 20 seconds every time you come inside and before and after eating or touching your face, eyes or nose.
· Eating well and staying hydrated
· Sleeping peacefully
· Enjoying being home with your family!
As you know…
· We use impeccable hygiene practices like handwashing at the beginning and end of every client encounter, use of gloves when indicated and disinfectant on surfaces and things that touch clients, like stethoscopes, fetoscopes, blood pressure cuffs, etc. between each client. We will be using masks, as available, and changing our garments immediately after working with anyone in person. We will do everything we can to slow down transmission of any virus.
· Births cannot be rescheduled. If a midwife and family suspects COVID-19 in their home at the onset of labor, we will discuss a plan with the family.
· In order to keep our clients and ourselves healthy, and help slow the spread of Covid-19, our practice is now implementing the use of phone/video conference visits with a plan to do physical exams at another time. We can use home blood pressure monitoring and other tools, whenever possible, to fulfill the physical exam components of our visits. As you know, the majority of our visits is talking. We have the ability to do Facetime and Zoom. We need to inform you that these are not HIPPA compliant. If you feel like HIPPA is important to you in this respect, we can make other arrangements. We feel this precaution will also keep your midwives healthy to be able to continue to attend home births. Since it is possible to have multiple participants on these calls, sometimes you will see more than one midwife at your telehealth visit.
*As the concern of this virus continues we are updating our prenatal plan to include a short hands-on portion of our visit around the 36-week mark, with additional visits as needed on a case-by-case basis for labs, or fetal palpation checks. We will call or video conference from our cars and then meet you for a brief one-on-one home visit. If the weather is nice we might ask to meet outside. We will use your home prenatal tools (see resources list) to keep ours clean and safe to use at births. We ask that this visit be limited to just our pregnant client, partner and the midwife to limit close interactions with the rest of the family. Post partum and newborn visits will either be in person or virtual, depending on the needs at the time and will be scheduled with this determination after the baby is born. The 24-48 hour postpartum visit will always include a hands-on portion in order to provide newborn screening.
*Clients who have COVID-19 when they go into labor will not be eligible for home birth. We are in contact with Maternal Fetal Medicine and they are able to facilitate a direct transport for any of our clients who are ill, either for their birth or if they need hospital care prior to birth. MMC offers a video tour of the Labor and Delivery on their website. Please let us know if you are interested in a virtual tour of the hospital.
*Remember to support your immune system in all the ways you know how. We suggest including Vit C, Vit D, and Zinc. Elderberry is known to be antiviral and best used a preventative. Hydration, sleep, relaxation, fresh air and laughter are all supportive to the immune system.
*Two articles recently published in the Bangor Daily News regarding the current increase in interested for homebirth and how Maine midwives are adjusting their practices:
*We ask that folks purchase or borrow from us if available, the following home prenatal tools.
Automatic Blood Pressure Cuff
Finger pulse oximeter
Centimeter tape measure
Doppler and gel
*Here is a great article by former midwife, now doctor, Aviva Romm on what we know about COVID-19, pregnancy, immune boosting, etc.
She is offering a free class online class for those who are interested.
*Information from the CDC on COVID and pregnancy/breastfeeding. https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancy-breastfeeding.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fspecific-groups%2Fpregnancy-faq.html
*Information from the CDC that guides care of clients at home with COVID: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html
Sending love and health to all of you,
(Brenda, Lindsay, Robin, Jodie and Acadia)
This recommendation is effective April 18, 2020. We will re-evaluate this as new information becomes available and update/communicate at that time.