COVID19

UPDATES

COVID-19: UPDATES, INFORMATION, & RESOURCES

Below is information about COVID-19, including changes we’ve made to our clinic as a result of Coronavirus, changes made at St Paul's and BC Women's, current best practice guidelines, and additional resources. We will try to keep this page as up-to-date as we can. As always, the health and safety of our clients is at the top of our minds as we contemplate best practice during this time.

  1. WHAT DO DO IF YOU BELIEVE YOU MAY HAVE COVID19

  2. BLOOM-SPECIFIC COVID-19 UPDATES

  3. GENERAL PREGNANCY, LABOUR AND DELIVERY, AND POSTPARTUM GUIDELINES REGARDING COVID-19

 

WHAT DO DO IF YOU BELIEVE YOU MAY HAVE COVID19


Please be aware of symptoms of COVID-19: 

  • a fever (temperature >38.0 C) and/or flu-like symptoms

  • respiratory related issues (coughing, shortness of breath or difficulty breathing, coughing up blood)

  • GI symptoms

  • Wondering if you need to swab or self-isolate for COVID-19? Take this quiz: COVID-19 Self-Assessment Tool

If you are experiencing any of these symptoms:

  • Please STAY HOME and call 8-1-1 (nursing hotline) and await their instructions. Please inform 811 that you are pregnant. You will speak to a nurse and be triaged to a testing centre if indicated.

  • Call the pager to inform your midwives you are symptomatic and to make them aware of the follow up plan public health instructs.

  • Do NOT come into clinic- As per the BCCDC recommendations, anyone who is symptomatic will not be seen in clinic. Should you need to reschedule your appointment due to illness please do so by emailing info@bloommidwives.com

  • Anyone who is symptomatic & needing urgent obstetrical assessment will be assessed at their planned birthing hospital (BC Women's or St Paul's).

BLOOM-SPECIFIC COVID-19 UPDATES

OUR CLINIC:

We have made the following changes to our clinic to protect the safety and wellbeing of our Bloom families and our entire community by reducing volume of non-essential calls and visits. Please note in working to achieve this, we appreciate all efforts and flexibility for families to adhere to and support these strategies.

Prenatal and Postpartum Clinic Visits:

  • Intake visits and visits before 14 weeks of pregnancy will be done over the phone.

  • Non-essential visits will be done by phone. If your visit has been switched to a phone appointment, your Midwife will be in-touch with you to notify you 24-72hrs before your visit.

  • Routine prenatal and postpartum visits will be shorter to ensure we have time to clean all equipment between clients and to prevent overlap between clients in our office.   

  • If your clinic visit will be in person, we kindly ask that clients please come to appointments on their own and do not bring partners, children or family members into the clinic. You are welcome to call your support people into your visit by phone.

  • Please note that we are more than happy to speak over the phone in order to answer any questions and further discuss any topics raised during visits. Our top priority is your health and safety, but by limiting face-to-face exposure we do not in any way want to limit your ability to ask questions and our ability to ensure we are providing you all the information you need to navigate your pregnancy.

  • ​ Safety in the Waiting Room – If you have an in clinic appointment, you may be asked to wait in your car or outside. We would also like to remind you to please use hand sanitizer as you enter the clinic.

  • If your visit has been switched to a phone appointment, your Midwife will call you at the same time your appointment is booked. You do not need to do anything except make sure you are by your phone at the time of your appointment (please change your phone settings to accept "unidentified callers" as the call may come from a "blocked caller ID").

  • We are reducing our in-person visit frequency. To guide this decision, we are using the World Health Organization guidelines recommending the optimal number of prenatal appointments for a positive outcome. This includes:

    • One visit in first trimester (or shortly there after)

    • Two visits in the second trimester (around 20 and 26 weeks)

    • Frequent visits in the third trimesters (30, 34, 36, 38, 40, 41 weeks)

    • Postpartum visits: hospital or home visits as needed during your first week postpartum. Follow-up clinic visits at 3 & 6 weeks postpartum.

  • We have also significantly modified the setup of and cleaning frequency of our clinic to minimize the chance of exposure for all. Equipment and furniture in the clinic room are being sanitized between every client, and all high-traffic areas are being wiped down with antiviral solution frequently throughout the day. We have removed all toys, books, cups & tea/water station, and unnecessary furniture. 

  • Please do NOT come to the clinic if you are sick with a cold, cough or flu-like symptoms. We will be required to ask you to leave.

  • In addition, our prenatal and breastfeeding classes, and baby drop ins are CANCELLED until further notice.

BIRTHING AT ST PAUL'S OR BC WOMEN'S HOSPITALS

For the health and safety of all hospital patients, at both hospitals labour and delivery has instituted the following changes:

  • Only 1 support person is allowed to attend each labouring person. Unfortunately, that currently includes doulas. This means you may have your partner or your doula, but not both. It must be the same person for the entire duration of the L&D stay.

  • No friends and family are allowed in the waiting area on L&D, or to visit in the postpartum.

  • No Nitrous Oxide (laughing gas) will be provided on L&D

 

HOME BIRTH

  • We ask you to limit the amount of extra support persons at home, however doulas are welcome as part of the home birth support team.

 

POSTPARTUM HOME VISITS

  • We are happy to continue to provide postpartum home visits during the first 7-10 days at home. We will call prior to the visit to answer any questions so that we can keep our visits briefer to limit any possible exposures. 

  • If anyone in your home has COVID-19 or is in quarantine for possible exposure, we will not be able to offer home birth or home visits – this is to protect all our clients.

 

OUR MOA

Erin will be primarily working from home. However, she will be regularly checking the phone and emails during the day to ensure we are able to respond promptly to any client phone calls. If you need any documents from or 

POTENTIAL CHANGES TO YOUR MIDWIFE TEAM

Your Bloom midwives and the other midwives of Vancouver work as a team and help each other in times of need. We prioritize continuity of care for our clients, and strive to provide your known care providers to you whenever possible. If one of your Bloom midwives becomes aware of an exposure or becomes ill and must self-quarantine and stop working, you may receive care from another midwife in our Vancouver Community in order to protect your health. 

GENERAL PREGNANCY, LABOUR AND DELIVERY, AND POSTPARTUM GUIDELINES REGARDING COVID-19

The 3 leading organizations for Obstetrics and Gynecology have recently published Covid-19 practice advisories. You can read them here:

The Society of Obstetricians and Gynecologists of Canada

The American College of Obstetricians and Gynecologists

The Royal College of Obstetricians and Gynecologists

These are the key highlights from all 3 of these key organizations:

PREGNANCY

  • Pregnant people should be considered an at-risk population due to physiologic and immunologic changes in pregnancy

  • Covid-19 transmission to the baby in pregnancy seems unlikely. There has been a single case report of possible transmission in pregnancy. Again, there is very limited data.

  • As there is no evidence your baby can get infected while in the uterus it is currently considered unlikely that there will be congenital effects of the virus on your baby’s development.

  • To date, there is currently no conclusive data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19. Case reports from early pregnancy studies with SARS and MERS reported pregnancy losses but did not demonstrate a convincing relationship between infection and increased risk of miscarriage or second trimester loss.

  • As with SARS and MERS and drawing upon our knowledge of other respiratory illnesses in pregnancy, adverse outcomes are likely to be strongly correlated with degree of illness – most pregnant people who contract Covid-19 will experience only mild or moderate cold/flu like symptoms.

  • If you are immunocompromised, have asthma or lung disease, diabetes, renal disease, or chronic illness, be extra vigilant in pregnancy with hand hygiene and Social Distancing.

  • If you do have the Covid-19 virus in pregnancy it is recommended you have an ultrasound 14 days following the resolution of acute illness.

  • There might be a greater risk of the baby’s growth being restricted in the uterus and being born smaller than usual – based on data from other coronaviruses (e.g. two-thirds of pregnancies with SARS were affected by small intrauterine growth). Therefore, pregnant people with Covid-19 should be have an ultrasound to monitor for growth restriction in the baby.

 

LABOUR & DELIVERY

  • In two case series in China, including a total of 18 pregnant persons infected with COVID-19 and 19 babies (one set of twins), there were 8 reported cases of fetal compromise. Given this relatively high rate of fetal compromise, continuous electronic fetal monitoring in labour is currently recommended for all persons with COVID-19.

 

POSTPARTUM

  • There is no evidence that the virus has been found in the breast milk of people infected with Covid-19. The primary concern is whether an infected mother can transmit the virus through infective airborne droplets during the period of breastfeeding. A mother with confirmed Covid-19 or who is symptomatic with flu like symptoms should take all possible precautions to avoid spreading the virus to the infant, including washing hands before touching the infant and wearing a face mask, if possible, while breastfeeding. In the light of the current evidence, it is advised that the benefits of breastfeeding outweigh any potential risks of transmission of the virus through breastmilk.

  • All babies born to COVID-19 positive mothers should have appropriate close monitoring and early involvement of neonatal care, where necessary. Babies born to people testing positive for COVID-19 will need follow-up and ongoing check-ups after discharge from the hospital.

OTHER TIPS & INFORMATION

As a reminder, the best way to protect ourselves and our community from COVID-19 are straightforward:

  • Hand-washing – Wash your hands with soap and water for at least 20 seconds before and after touching your face, before eating, and after using the washroom. This is the best way to prevent transmission of any virus. If a sink is not available, the next best option is hand sanitizer with 60% alcohol content.

  • Avoid touching your face if possible. COVID-19 and other viruses are spread through coughing and sneezing, but also by touching surfaces that the virus is living on and then touching your eyes, nose, or mouth. 

  • Cough or sneeze into a tissue and dispose immediately.  Alternatively, folks can cough or sneeze into their sleeve.

  • Social Distancing—As much as reasonably possible, keep two arms-lengths (one yours, one the other person) apart from others.

 For additional information on COVID-19, please see the following websites:

 

  • Sick notes for employers: 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.

  • Service Canada-applying for EI for Covid-19 related work closures or quarantine

  • Travel advisory notice: The B.C.’s Provincial Health Officer is still advising no non-essential travel outside of Canada, including to the United States. Anyone choosing to travel will be required to self-isolate for 14 days upon return. 

  • School closures: This is a great piece for all the parents out there who may be home with their kids and Social Distancing:  How to prepare for extended school closings – and not lose your mind.

  • Anxiety and coping with the COVID outbreak: Many of you may feel overwhelmed with the rapidly changing news reports about the spread of COVID. 

    • You can read more about coping strategies herehere, and here

    • Many local counsellors offer remote consults (including our Bloom Perinatal Clinical Counsellor, Monica Pearson) – get in touch if you feel you need more support. 

    • Many people successfully use Mindfulness-based stress reduction to manage anxiety. 

    • Simplify your life as much as possible, and do what makes you feel healthy and happy (within the limits of social distancing!). Think about other strategies that have worked for you in the past to help you manage stress and anxiety, and try to adapt them to the current situation. 

Thank you for your understanding during this time. We recognize that this is a changing situation, and our guidelines may change to reflect best practice recommendations as they continue to evolve. Please do not hesitate to call or email our Bloom office you have any concerns.

Sincerely, your Bloom Midwifery Team

We would like to acknowledge that the land on which we provide care is the unceded territory of the Coast Salish Peoples, including the territories of the xʷməθkwəy̓əm (Musqueam), Skwxwú7mesh (Squamish), Stó:lō and Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh) Nations.

 

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