Maternity Care and COVID-19

I have working and searching tirelessly to know how to best help my clients and the community during this current crisis. I follow many doula and birth worker groups on social media and I have been soaking up all of the statistics and knowledge that I can! Here is a summary of what I have learned and prepared.

For a summary of this post check out my podcast episode on this topic!

1. World Health Organization: COVID-19

WHO Recommendations for Breastfeeding and COVID-19

” 1. Practice respiratory hygiene, including during feeding. If you have respiratory symptoms such as being short of breath, use a medical mask when near your child.

2. Wash your hands thoroughly with soap or sanitizer before and after contact with your child.

3. Routinely clean and disinfect any surfaces you touch.

4. If you are severely ill with COVID-19 or suffer from other complications that prevent you from caring for your infant or continuing direct breastfeeding, express milk to safely provide breastmilk to your infant.

5. If you are too unwell to breastfeed or express breastmilk, you should explore the possibility of re-lactation (restarting breastfeeding after a gap), wet nursing (another woman breastfeeding or caring for your child), or using donor human milk. Which approach to use will depend on cultural context acceptability to you, and service availability. “

2. Center for Disease Control: COVID-19

  • “Mother-to-child transmission of coronavirus during pregnancy is unlikely, but after birth a newborn is susceptible to person-to-person spread.
  • A very small number of babies have tested positive for the virus shortly after birth. However, it is unknown if these babies got the virus before or after birth.
  • The virus has not been detected in amniotic fluid, breastmilk, or other maternal samples.” -CDC
  • Breast milk provides protection against many illnesses and is the best source of nutrition for most infants.
  • You, along with your family and healthcare providers, should decide whether and how to start or continue breastfeeding
  • In limited studies, COVID-19 has not been detected in breast milk; however we do not know for sure whether mothers with COVID-19 can spread the virus via breast milk.
  • If you are sick and choose to direct breastfeed:
    • Wear a facemask and wash your hands before each feeding.
  • If the you are sick and choose to express breast milk:
    • Express breast milk to establish and maintain milk supply.
    • A dedicated breast pump should be provided.
    • Wash hands before touching any pump or bottle parts and before expressing breast milk.
    • Follow recommendations for proper pump cleaning after each use, cleaning all parts that come into contact with breast milk.
    • If possible, consider having someone who is well feed the expressed breast milk to the infant.” -CDC
*Notice that the CDC is recommending that separation be discussed, not mandated or forced. And that is in cases of confirmed cases of the mother having contracted of COVID-19.

3. Other Resources: COVID-19

  • Birth Class on YouTube by Evidence Based Birth. This free birth class during COVD-19 is full of helpful tips and resources!
  • Find resources for Texas and COVID-19 here!
  • The form below can go with your birth plan to the place you are going to give birth. It is for families that choose to refuse separation from their infants.

4. Doula Services:

Doulas are being limited at births because of COVID-19 in many birth settings. However there is much evidence to refute these policies.

  • In Dallas County’s ruling on essential workers “Certified Doulas” are listed under “Essential Healthcare Operations”. The are listed as such in the same category as hospitals, blood banks and more!
  • “AWHONN recognizes that doula services contribute to the woman’s preparation for and support during childbirth and opposes hospital policies that restrict the presence of a doula during a woman’s active labor.
  • “Doulas are not visitors and should not be blocked from caring for patients in the antepartum, intrapartum and postpartum period. Most doulas have been contracted by patients weeks to months ahead of time and have established provider relationships. They are recognized by AWHONN and ACOG as essential personnel and part of the maternity care team,” said AWHONN member Nancy Travis, MS, BSN, RN, BC, CPN, CBC, Florida Section Chair.
  • AWHONN supports doulas as partners in care and acknowledges their ability to provide physical, emotional, and partner support to women. AWHONN opposes hospital policies that restrict the presence of a doula in the inpatient setting during an infectious disease outbreak. Read more about AWHONN’s position on continuous labor support for every woman here.”
  • “Continuous support during labour may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labour, and decreased caesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score and negative feelings about childbirth experiences.”(2017, Bohren et al.)”

5. Voices of Eve: COVID-19

I have developed my own resources for helping through this crisis!

  • I have also dropped the cost of my online childbirth class down to $10 a year for the duration of the crisis! Online Childbirth Class
  • I have also doubled my efforts to get a few other resources out that have been on my to do list but now with everything going on I want them done asap!
  • One of them is my Live Podcast! Join the event here to follow! During this podcast you can have your questions answered in real time!
  • I have also begun working on creating an online Homeschool curriculum that I am hoping to release soon! Until then I am uploading fun home activities regularly on my website. Homeschool Resources
  • I created an account on doxy.me which is a HIPAA compliant video conferencing app to ensure that I will be able to communicate with my clients via video at any birthing place! And here is the link to my waiting room on Doxy.
  • I added a page to my website that covers my ministry. There you can see all who have been helped, what my plans for the future are, and how you can be a part of that ministry! Ministry Page

This has been a difficult time for many of us and we have all faced challenges we might not have faced before. But I have found new vigor in my ministry. Because the mission statement of my ministry is “Empowering birth services for everyone”. Everyone has become bigger and more diverse. It has given me an extra hungry for the work I love and I am so excited to see all that God will do through it!

Here is my Podcast on this topic!

Cheers!

Abbey Barnosky

Birth, Postpartum, Bereavement, and Sibling Doula, Breastfeeding Educator, Post Abortion Counselor, Photographer, and Artisan in Fort Worth Texas.

vociesofeve@yahoo.com

(304)203-6688

April 16, 2020

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