We want to keep you informed on how the COVID-19 pandemic is affecting midwifery care. As the information is rapidly evolving from day to day, please check back to this site for changes as we will be updating it as relevant information becomes available. Please be assured that your midwives are working tirelessly to keep well informed and up to date on the evolving developments and recommendations and will continue to do so.
The safety and wellbeing of you and your growing baby remains our number one priority. For this reason, we are making important adjustments to how we provide care to help limit the spread of infection in the coming months.
We recognize that pregnancy and early postpartum is already a vulnerable time for people and this is especially heightened during a pandemic. If you have concerns or questions about how our changes to care are impacting you or your pregnancy please discuss with your midwife. We recognize safety is not only physical, but also emotional and wish to provide you with the same quality of individualized, supportive care even though it looks a little different from the way you are used to receiving midwifery care. We appreciate that this is a challenging time for all and thank you for your patience and understanding.
UPDATED MAY 22, 2020
Covid-19 & Pregnancy
*Pregnant people are not more susceptible to Covid-19 than other people. Social distancing (only going out for required errands, fresh air and maintaining 2m distance between people) and frequent handwashing will significantly reduce your risk of getting the virus.
*Symptoms of Covid-19 often include fever or chills, extreme fatigue, new or worsening cough, shortness of breath. If you have any of these symptoms, please DO NOT come to clinic. Instead email the clinic so we can reschedule your appointments and you can discuss with your midwife.
*Rarer symptoms of Covid-19 can also include muscle ache/fatigue, headache, runny nose, sore throat, diarrhea, vomiting, lack of smell and loss of appetite. If you feel you have new onset of the above symptoms that are not related to seasonal allergies, or typical pregnancy symptoms or you are unsure, please email the clinic so that a midwife can speak with you before you come in to clinic.
Severe symptoms – what should I do?
*If your condition worsens, and you are unable to breathe effectively or have a fever that cannot be treated with Tylenol, please present to the emergency department at Vancouver General Hospital or St. Paul’s Hospital, let them know your symptoms immediately so they can give you a mask and place you safely away from other patients. If you need urgent care, you can call 911.
Mild/flu-like symptoms – What should I do?
*Pregnant patients with mild COVID 19+ symptoms should be kept at home in self-isolation. Most people will only experience mild or moderate cold/flu like symptoms. You should not have visitors if experiencing symptoms.
*If you are ill, you should self-isolate (do not go out) until 10 days after the first symptoms appear and anyone in your household who does not have symptoms should self-isolate for 14 days after you had your first symptoms. All people in BC with symptoms of Covid-19 can now be tested. Please contact 811 or your midwife for further information.
*If you are still unsure what to do please use the self-check on the Covid-19 Thrive app
WORK ABSENCE & EMPLOYMENT INSURANCE
As per instructions from the Minister of Health and the Provincial Medical Officer of Health, you will not need a note to miss work if you have symptoms: https://news.gov.bc.ca/releases/2020HLTH0077-000484
People in quarantine (including those who are not sick and those whose workplace is closed to enforce social distancing), can apply for Employment Insurance Medical Leave. You do not need a medical certificate from your midwife:
Prenatal, Labour, Birth & Post-Partum Care
*Visit schedule: Based on current recommendations from the BC Centre for Disease Control we have adjusted our visit schedule as follows:
– First trimester (10-12wks) by phone/virtual,
– Second trimester (20wks in person and 26wks by phone/virtual)
– Third trimester (30wks virtual or in person, 34 virtual or in person, 36 in person, 38 in person, 39-optional by phone, 40 in person, 41wks by phone or in person as needed).
If you need more appointments for medical reasons, your midwife will book those for you.
*You will be given instructions regarding a phone/video portion of your visit that will be sent out in your appointment reminder. In most cases, your visit will start by phone at the scheduled time. We ask you to be in the parking lot downstairs for this portion of your visit, and then you will come upstairs to the clinic for a quick in-person assessment at the end of the visit to take blood pressure and do a belly check.
*Please come alone to your appointment whenever possible.
*Please wash your hands with soap and warm water and dry with paper towel on arriving at the clinic.
*While our washroom will be available, please consider using your own washroom prior to your visit.
*It is STRONGLY recommended that you follow current public health guidelines for you and your family at this time. We expect that all families will be practicing social/physical distancing.
BC WOMEN’S HOSPITAL
*Currently no Entonox (laughing gas) available
*Labour support is limited to one person in addition to a certified doula (SEE BELOW)
*Your labour support person cannot have symptoms of Covid-19. If your partner/support person develops symptoms of Covid-19 they will be asked to leave and self-isolate at home. In this case, you would be able to have another non-symptomatic person join you for support.
*No visitors to the hospital postpartum
*Waterbirth is not currently available, although water immersion in labour is still an option.
*Your midwife will remain the primary care person in labour and birth and will be present at your labour and birth if you require a vacuum, forceps or Caesarean section.
Applies to births at BC Women’s Hospital, although many points apply to home birth as well.
*The doula must have recognized doula certification prior to the COVID-19 pandemic declaration, and must provide proof of this when arriving at hospital.
*The doula will only provide support during the period of labour and delivery and only for vaginal births. Doulas will not be permitted to visit in post-partum, or to attend deliveries in the OR.
*The doula must wear clean scrubs, clean shoes/booties upon arrival at hospital.
*The doula will be screened at entry and must be asymptomatic when they provide support. If they become symptomatic during the admission they will be asked to leave by maternity staff. If the patient is suspect or COVID+ the doula will not be allowed to participate as part of the care team due to risk of exposure.
*The doula will wear appropriate PPE while in the delivery room.
*Available currently as per usual considerations.
*RMs unable to provide home birth if anyone in the home is unwell with COVID-19 symptoms (whether confirmed or clinical) or has been told to self-isolate. In this case, hospital birth is recommended to provide a safer environment for both your midwifery team and you and your baby in the unlikely event of any complications related to Covid-19.
*Waterbirth is not recommended, although water immersion in labour is still an option. We recommend you do not rent birth tubs as it is impossible to guarantee that the virus could not be transported from one home to another via the tub.
*As always, there will be one midwife attending your labour at home, and another midwife will arrive for the birth. Midwives attending home births will following guidelines for use of personal protective equipment at home births.
POSTPARTUM VISITS *In person visits will be as follows: One visit within the first 48 hours after birth. One additional visit within the first week. One visit between 4-6wks in the clinic for discharge. We will attempt to do all other postpartum visits by phone or ‘virtually’, however we will consider further in-person visits for urgent clinical concerns.
RMs are unable to provide home visits if anyone in the household is unwell with COVID-19 symptoms (whether confirmed or clinical) or has been told to self-isolate and/or quarantine.