Practice Updates and Policies
Information and recommendations are changing quickly. My priority is keeping everyone as safe and healthy as possible, while sacrificing as little as possible of the attentive, individualized, and compassionate care and interpersonal trust that defines the practice of midwifery. This information is current as of 3/24/2020 and will be updated as needed.
CHANGES FOR LABOR AND BIRTH
At this time, Gig Harbor Midwifery does not have a specific limitation on persons in attendance at your delivery, except they must be healthy with no known recent exposures. For deliveries at The Birthing Inn, only support people who are physically in the room will be allowed for the time being (no family allowed to wait in the waiting room). We strongly encourage limiting people present to those who live with you and your birth team. Please weigh the value of additional support people being present against the possibility that they may have been exposed and be latent carriers of the virus causing Covid 19. These individuals would be capable of transmitting the virus to you, your family, and your birth team without knowing they were sick. The decision regarding who to invite to your birth is ultimately your own.
Our birth team will continue to consist of 3 members, as I believe that this is the fewest safe number of trained attendants at a birth. However the goal will be to get an assistant there late in the process and delegate charting and cleaning to her, so that only two of us are providing hands on care unless an emergency arises.
We will be changing clothes immediately prior to entering your home (or the birth center), sanitizing hands, and wearing surgical face masks. If you request that we do not wear the masks we will take them off. The masks are for your protection and are only minimally effective at protecting the wearer. Also expect that we will take a little extra time leaving your home to re-sanitize and repack equipment prior to placing it in my car, and to change or layer our clothing before returning home to our own families.
CHANGES FOR PRENATAL CARE
We're working hard to reduce exposure in prenatal clinic by spacing out in person visits and offering some telemedicine and home visits. Please help us out by arriving to clinic on time and planning on a 45 minute or less visit to give us time after your visit to completely clean the clinic space and remove any toys or items your kids may have touched (these will be sanitized before being returned to the clinic space). As always we will wash, sanitize, or glove our hands immediately prior to any physical contact with our clients.
Please make sure to check for a text message and/or email within a couple of days of your appointments to discuss whether you would like a virtual visit instead of an office visit. Home visits are an option for families who are having transportation difficulties or are sick with something that is known not to be Covid-19, and continue to be routine for postpartum care. We can discuss what is most appropriate for you when we confirm your appointment.
Consider not bringing your children to appointments for the time being. Healthy kids are not particularly susceptible to complications of Covid-19, but they make great asymptomatic carriers, and most kids are not the best at washing their hands, not touching their faces, or avoiding spreading germs in general. If they do come, please help us out by NOT putting away toys - we'll pick them up and clean them when your family leaves.
I'm now offering virtual visits on a HIPAA compliant video conferencing platform, which clients can access using a phone or computer with internet access and video/audio capability. Eligible visits include consultations, mid-pregnancy visits that do not involve labwork, some types of straightforward problem visits, and uncomplicated lactation visits.
The following appointments still need to be held in person: initial visits, most visits at 36 weeks and beyond, and any appointment with lab work. When we do virtual visits we can miss important information that we may have obtained through abdominal palpation, blood pressure checks, or other hands-on clinical activities that are routinely done during an in-person visit. The excellent outcomes that midwifery care can achieve are in large part attributable to the personal connections we have with our clients and our careful attention to what you tell us, but we also rely on the skill of our hands and our evaluations based on the numbers and measurements we collect.
Postpartum care will mostly proceed as usual, with the exception of 1-2 week visits being home visits rather than clinic visits. Many lactation visits can be conducted virtually, so expect that if you have a lactation concern I may offer a virtual appointment. 3-5 day visits may also be conducted virtually if all is going well at the 24 hour visit and we are able to leave you a scale to take baby's weight.
If you begin labor in Gig Harbor Midwifery care but a hospital transfer is needed, we will continue to accompany clients to the hospital but cannot guarantee that we will be allowed to remain with you. Area hospitals are restricting support people and generally will ALSO allow a midwife or a doula, but this is not uniform. We will make sure your receiving providers understand what is happening and have your records even if we cannot continue to stay with you.
Let me know if you need confirmation of pregnancy or birth for an employer or to qualify for leave or aid.
If you or your household has experienced a decrease in income (and absolutely if you have lost insurance coverage), please apply for Washington Pregnancy Medical here: https://www.hca.wa.gov/health-care-services-supports/apple-health-medicaid-coverage/pregnant-women
If you have questions about unemployment: https://esd.wa.gov/newsroom/covid-19
For resources if you're having difficulty paying bills/mortgage/rent: https://dfi.wa.gov/coronavirus/financial-resources
STAY SAFE AND HEALTHY EVERYONE!!