Pregnancy and COVID-19: Your Questions Answered by Mon Health

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Doctors at Mon Health Obstetrics and Gynecology, help answer important questions on how Mon Health is taking specific actions to ensure both you and your baby’s safety during the pandemic.

We understand that these are unprecedented times and many of our pregnant patients are scared about how this pandemic will affect their pregnancy and delivery experience. Your safety is our top priority. We are committed to keeping pregnant patients informed about what this means for them and to help, we’ve answered some common questions below.

Which pregnancy visits are deemed essential?

In accordance with ACOG and CDC recommendations, we are rescheduling all non-essential visits in our office which limits exposure from members of the public who could be infected but not yet showing symptoms. However, essential visits for pregnant patients will include:

  • New OB visits
  • 20-week visit with anatomy ultrasound
  • 28-week visit which will include labs for gestational diabetes screening, as well as rhogam and tdap vaccination, if needed
  • 36-week visit with GBS education and swab collection, delivery consent and pre-registration for the hospital

Non-essential OB visits are any visit that does not require an exam, labs or procedures. We are excited to now offer telemedicine options to our patients.

Will I be screened prior to my visit and if so, how?

Mon Health System is screening all patients prior to visits in two ways:

  1. A phone call is made to patients prior to their visit to screen for symptoms, possible exposures, and travel history.
  2. Upon arrival, patients are screened again in the lobby before entering the clinic with a questionnaire inquiring about symptoms, recent travel, whether they work in or have visited a long-term care facility like a nursing home, and whether they have known possible exposures.

Any patient who screens positive will not be seen in the clinic but will be directed to either self-isolate at home and call their physician or redirected for testing for COVID-19 if they meet CDC testing criteria.

How do I enter the hospital with COVID-19 restrictions in place?

There are two entrances currently being used: Main Entrance and ER Entrance.

  • During the day, patients going to labor and delivery should enter through the front door at the main entrance. Both the patient and their visitor will be screened in the same manner as the clinic visits and will be directed to wear a mask to help prevent exposures prior to traveling to the Labor and Delivery unit.
  • At night when the front door is locked, patients will enter through the emergency department entrance after applying a mask to help prevent exposures. You will then travel to Labor and Delivery.

How will updated visitation restrictions impact my pregnancy?

There are currently no visitors allowed in the clinic to reduce exposures to our patients. That said, we understand that pregnancy is a special time for you and your family and the below exceptions are in place for you:

  • You are permitted to use FaceTime or Skype during ultrasounds.
  • For Labor and Delivery, you can have one support person present with you during your entire hospital stay. That person will not be able to leave the hospital or the unit to prevent potential exposures.
  • There is currently no outside food delivery which can cause unnecessary exposure risks. The patient and support person will be fed by our cafeteria in disposable packaging and disposable wrapped utensils.
  • You will able to share the good news of your birth with family and friends via FaceTime or Skype.

Is Labor and Delivery isolated from ill patients?

Yes. It has its own OR that will be used for surgical procedures, if necessary, so the labor patients won’t be traveling through the hospital to avoid potential exposures.

  • Ill patients are housed in special units far away from Labor and Delivery.
  • Newborns room with their parents so they will not be exposed to other infants or other patients.
  • Personnel caring for ill patients in other units will not be working in Labor and Delivery to prevent contamination and exposures to other patients.
  • Care providers treating ill patients will wear proper personal protective equipment (PPE) and the areas will be cleaned by CDC-recommended procedures, as well as UV lights, to decontaminate the ill-patient rooms and surfaces.

What cleaning procedures are in place at the offices or hospitals?

Based on recommendations from the CDC, Mon Health System is working diligently to clean and disinfect all offices and patient-areas.

In the offices:

  • All surfaces in rooms are wiped down with CDC-approved cleaning wipes.
  • Staff are washing their hands for at least 20 seconds and using hand sanitizer that contains at least 60% alcohol.
  • All equipment used, such as dopplers to get fetal heart tones are wiped down or washed with soap and water between every patient.

At the hospital:

  • The same procedures are done as well as UV light sterilization and HEPA filtration of any rooms that ill patients have been in.
  • COVID-19 affected patients are housed in their own wing that is remote from Labor and Delivery and has their own elevator so that other patients are not exposed or contaminated.

Why are non-emergent surgical procedures delayed?

  1. There is currently a national blood shortage due to people not donating blood. Blood may be necessary for some surgeries that cause blood loss and not having available blood puts patients at more risk.
  2. It is also done to conserve supplies that will be needed to take care of ill patients if a surge should occur at the hospital. Operating rooms are equipped with ventilators that may be required for ill COVID-19 patients in a surge.
  3. Inserting a breathing tube during surgery aerosolizes virus particles and could infect all OR staff, so it also helps to ensure that we have healthy healthcare workers to take care of you when you need it.

Should I consider a home birth to avoid being at the hospital?

Fear not, we have taken every safeguard to protect our pregnant patients. We understand that this is an unprecedented time with COVID-19, but do not recommend home birth for the following reasons:

  • Although home births are associated with fewer interventions, it is also associated with a more than twofold increased risk of perinatal death (1-2 in 1,000) and a threefold increased risk of neonatal seizures or serious neurological dysfunction (0.4-0.6 in 1,000).
  • Women with fetal malpresentation (like breech or other malpresentation), multiple gestations, and history of prior cesarean delivery are absolute contraindications to home birth.
  • Of first-time mothers attempting home birth, up to 37% transfer to a hospital, largely because the baby is unable to move through the birth canal.
  • If you require transfer to a hospital, the time needed to transfer delays care and may be detrimental to yours and your baby’s health. Most of the reasons for these transfers are lack of progression of labor, fetal distress, need for pain relief, hypertension, bleeding, and fetal malposition.
  • Homebirth providers also do not typically collaborate with doctors in hospitals. If the hospital staff and providers at the hospital are not familiar with you and do not have medical records of your prenatal care, this could further delay or otherwise impact your care.

Due to these reasons, The American College of Obstetricians and Gynecologists (ACOG) does not recommend home birth. ACOG believes that the safest place for you to give birth is still a hospital, hospital-based birth center, or accredited freestanding birth center.

Every woman has the right to choose where she will give birth, but it is important to not take any risks that might put you or your newborn’s health in danger, especially during the COVID-19 pandemic. Talk with your OBGYN or other healthcare professional about your birth plan and any concerns you may have.

What can I do to help stop the spread of Coronavirus?

The best thing you can do to help us fight the Coronavirus is to stay home. We recommend following the governor’s mandatory stay-at-home order unless you must leave for approved essential reasons such as essential pregnancy visits. Other CDC-recommendations include:

  • Social distancing
  • Washing your hands for at least 20 seconds with soap and water
  • Using hand sanitizer with at least 60% alcohol
  • Coughing and sneezing into your elbow
  • Frequently disinfecting surfaces
  • Remembering to not touch your face

To learn more, please visit MonHealth.com/Coronavirus.