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The Labor & Delivery Experience in the Time of COVID-19: A Podcast for Pregnant Moms and Partners
Avery Fisher, Certified Nurse Midwife, discusses labor & delivery in the time of COVID-19.
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Learn more about Avery Fisher, CNM
Avery Fisher, CNM
Avery discovered a passion for reproductive health and midwifery as a volunteer doula in rural Maine, drawn to midwifery’s focus on patient-centered, evidence-based care. Avery earned a bachelor’s and a master’s in nursing from Oregon Health & Science University, and is a board-certified nurse midwife. Clinical interests include LGBTQ reproductive health, family planning, adolescent and well-patient gynecology, obstetrics, and vaginal birth after cesarean. When not in the office or on labor and delivery, Avery can be found exploring Boston with wife Lorna and spending time with family in coastal Maine.Learn more about Avery Fisher, CNM
Transcription:
The Labor & Delivery Experience in the Time of COVID-19: A Podcast for Pregnant Moms and Partners
Caitlin Whyte: Pregnancy is supposed to be a time of joy and excitement, buying little baby clothes, getting a room set up, creating a birth plan with your doctor. But as we hear daily updates on COVID-19 and constant reminders to wash our hands, being pregnant during this time could feel a little overwhelming. What are some extra precautions that pregnant people and their partners can take to stay safe and healthy during this pandemic? Joining us today to answer some of these questions is Avery Fisher, Certified Nurse Midwife with AFA OB GYN and Emerson Hospital. This is Healthworks Here. I'm your host, Caitlin Whyte. Avery, I'm sure this is one of the most common questions on unexpecting mother’s minds with lockdowns and visitors being reduced or even not allowed in many hospitals. Will visitors be allowed on labor and delivery and postpartum?
Avery Fisher: That is a really good question and something most of our patients are asking us. You're right about that. So our current visitor policy, you can find it on the main page of the Emerson website. I think there's been a lot in the media about no visitors at hospitals. So Emerson's general policy right now is that no visitors are allowed at the hospital except in certain circumstances. So that would be in the case of pediatric patients, end of life care, as well as labor and delivery. So our policy specifically right now on labor and delivery is that patients are allowed to have one asymptomatic support person for the duration of labor delivery and the postpartum stay. So for the whole hospitalization, this person is not going to be able to leave the hospital and return during the stay and must be the same support person for the whole time. So this has been a pretty difficult policy for a lot of folks. It does mean a big change in their birth preferences for a lot of people who may have had additional support, people planned for their delivery, including doulas, maybe additional family members or other support people, other friends. And then those folks will not now be allowed onto the delivery room or postpartum floors. So we are just asking folks to understand that this is for the safety and protection of all of our patients, their families, Emerson's hospital staff. We can't make any exceptions to this visitor policy, but you can always discuss concerns regarding support during labor and delivery with your providers at either a scheduled in person or telemedicine appointment. And FaceTime is a wonderful tool and anybody that folks love and want to have in their delivery room is welcome to FaceTime and this is the same policy that all Boston area hospitals have adopted at the time of this recording. So it's going to be very similar across all of Massachusetts moving forward,
Host: What is the recommendation for visitors once patients and their babies leave the hospital and go home?
Avery Fisher: At this time we are recommending strict social distancing, so that does mean that if at all possible family and friends should not be visiting unfortunately and that patient's and their babies should not be going to visit family and friends. If you're visiting with family and friends outdoors only, we recommend that to be safe just to make sure that patients are at least six feet away from anyone who does not live in the home with them. And this can be really distressing for families at such a happy time because so patients are looking forward to going home and introducing their new addition to their families, to their friends and to their families. And this is just not something we're recommending right now to prevent the spread of the COVID-19 virus.
Host: So if a mother, God forbid, is diagnosed with COVID-19 during pregnancy, is there a risk to her baby?
Avery Fisher: The good thing is that even though pregnant patients by nature have compromised immune systems and it's why we recommend vaccines during pregnancy, like the flu shot, preliminary data that we have available does suggest that pregnant women are not at a higher risk of getting COVID-19 than non-pregnant people. And we do not believe that COVID-19 can be transmitted to babies during pregnancy. So that is at least good news for folks who are concerned about their health of themselves and their babies in pregnancy.
Host: And how are the labor and delivery and postpartum departments protecting patients and babies during this outbreak?
Avery Fisher: That's a great question. So we do have a designated negative pressure room on our postpartum unit and just yesterday transitioned one of our labor and delivery rooms to a negative pressure room as well. Negative pressure is a type of isolation technique used in hospitals to decrease cross contamination from room to room. So these rooms will be used for any patients with either suspected or known COVID-19 all of our staff, including doctors, midwives, nurses, techs, labor and delivery, postpartum, everyone is trained in the appropriate use of precautions for caring for patients with known COVID-19, suspected COVID-19, or any other respiratory illness. So the appropriate use of gowns, masks, gloves when caring for any patient with a suspected infection. While there has been a lot in the media recently about hospitals running out of basic protective equipment like gloves and masks, Emerson has an appropriate supply right now to cope with any known COVID-19 patients. So we are not at the point at Emerson Hospital's labor and delivery right now where we are running out of supplies.
Host: Will the COVID-19 pandemic change options for pain management during labor?
Avery Fisher: So a lot of our patients do ask a lot of questions about pain management. Generally the hospital does have in room showers, use of injectable medications like morphine and of course epidurals.
Host: So what happens if I, you know, was signed up for childbirth classes or CPR classes, all this stuff you do before hand. Are there any online options for these groups?
Avery Fisher: So unfortunately Emerson is not able to offer any online childbirth classes at this time. The Emerson website does have a virtual tour that patients can take of the unit if they are unable to attend previous tour in person. There is going to be an online website called motherly MOTHER.LY that is going to offer upcoming online childbirth classes. They're not available yet, but they will have free online classes for their scheduled C-section class and unmedicated childbirth class, a standard childbirth class, and a refresher class for experienced parents or patients attempting vaginal birth after a C-section. So hopefully there will be some really great childbirth Ed options available online for free. The American Red Cross is also offering an online child and infant CPR class, and we are also encouraging all of our patients to take advantage of any postpartum support group that they may have previously been trying to join. Many of these are working online.
The best resource out here in the Metro West area is called First Connections. You can find them online at www.JRI.org, that's JRI.org all of First Connections postpartum groups including their new mom group, their emotional wellbeing after baby group, and all their new dads groups will be moving to an online format using a conference app called zoom. So patients can email their program director whose information is available on the website, but her name is Mary Beilman, MBeilman, beilman@jri.org to get information about times and sign up for these support groups so that moms can still join them online. There's also a parental support line available 24 seven for postpartum through Parents Helping Parents. They have online support groups, weekly information at parentshelpingparents.org or over the phone at +1 800-632-8188. So that is a great resource for folks after they've gotten home from the hospital who feel like they need additional support.
Host: So Avery, as we're wrapping up here, you know everyone's kind of freaked out by this COVID-19 outbreak, but I'm sure adding on being pregnant or your partner being pregnant during this time is just another layer of anxiety. What would you say to expecting mothers and their families on how to cope during this time?
Avery Fisher: Yeah, so this is a very anxiety provoking time for patients and their families. It's a time of fear of uncertainty at what is typically a time that people are very joyous bringing their babies and new life into the world. And so I wish I had an answer for every question for every patient who has a concern, I don't, but we are here. We are always going to be here to take care of patients and their families as they navigate this very uncertain time. And if they have any questions they are always welcome to call us and ask.
Host: Well Avery, I'll let you get back to the moms, but we appreciate your time and reassurance during all of this uncertainty. That was Avery Fisher, Certified Nurse Midwife with AFA OB GYN and Emerson Hospital. Thank you for listening to the Healthworks Here Podcast. Subscribe to this podcast on your favorite podcast source, including Apple podcasts, Google Play Music, and Spotify. I'm your host, Caitlin Whyte. Thanks for listening and remember to wash your hands.
The Labor & Delivery Experience in the Time of COVID-19: A Podcast for Pregnant Moms and Partners
Caitlin Whyte: Pregnancy is supposed to be a time of joy and excitement, buying little baby clothes, getting a room set up, creating a birth plan with your doctor. But as we hear daily updates on COVID-19 and constant reminders to wash our hands, being pregnant during this time could feel a little overwhelming. What are some extra precautions that pregnant people and their partners can take to stay safe and healthy during this pandemic? Joining us today to answer some of these questions is Avery Fisher, Certified Nurse Midwife with AFA OB GYN and Emerson Hospital. This is Healthworks Here. I'm your host, Caitlin Whyte. Avery, I'm sure this is one of the most common questions on unexpecting mother’s minds with lockdowns and visitors being reduced or even not allowed in many hospitals. Will visitors be allowed on labor and delivery and postpartum?
Avery Fisher: That is a really good question and something most of our patients are asking us. You're right about that. So our current visitor policy, you can find it on the main page of the Emerson website. I think there's been a lot in the media about no visitors at hospitals. So Emerson's general policy right now is that no visitors are allowed at the hospital except in certain circumstances. So that would be in the case of pediatric patients, end of life care, as well as labor and delivery. So our policy specifically right now on labor and delivery is that patients are allowed to have one asymptomatic support person for the duration of labor delivery and the postpartum stay. So for the whole hospitalization, this person is not going to be able to leave the hospital and return during the stay and must be the same support person for the whole time. So this has been a pretty difficult policy for a lot of folks. It does mean a big change in their birth preferences for a lot of people who may have had additional support, people planned for their delivery, including doulas, maybe additional family members or other support people, other friends. And then those folks will not now be allowed onto the delivery room or postpartum floors. So we are just asking folks to understand that this is for the safety and protection of all of our patients, their families, Emerson's hospital staff. We can't make any exceptions to this visitor policy, but you can always discuss concerns regarding support during labor and delivery with your providers at either a scheduled in person or telemedicine appointment. And FaceTime is a wonderful tool and anybody that folks love and want to have in their delivery room is welcome to FaceTime and this is the same policy that all Boston area hospitals have adopted at the time of this recording. So it's going to be very similar across all of Massachusetts moving forward,
Host: What is the recommendation for visitors once patients and their babies leave the hospital and go home?
Avery Fisher: At this time we are recommending strict social distancing, so that does mean that if at all possible family and friends should not be visiting unfortunately and that patient's and their babies should not be going to visit family and friends. If you're visiting with family and friends outdoors only, we recommend that to be safe just to make sure that patients are at least six feet away from anyone who does not live in the home with them. And this can be really distressing for families at such a happy time because so patients are looking forward to going home and introducing their new addition to their families, to their friends and to their families. And this is just not something we're recommending right now to prevent the spread of the COVID-19 virus.
Host: So if a mother, God forbid, is diagnosed with COVID-19 during pregnancy, is there a risk to her baby?
Avery Fisher: The good thing is that even though pregnant patients by nature have compromised immune systems and it's why we recommend vaccines during pregnancy, like the flu shot, preliminary data that we have available does suggest that pregnant women are not at a higher risk of getting COVID-19 than non-pregnant people. And we do not believe that COVID-19 can be transmitted to babies during pregnancy. So that is at least good news for folks who are concerned about their health of themselves and their babies in pregnancy.
Host: And how are the labor and delivery and postpartum departments protecting patients and babies during this outbreak?
Avery Fisher: That's a great question. So we do have a designated negative pressure room on our postpartum unit and just yesterday transitioned one of our labor and delivery rooms to a negative pressure room as well. Negative pressure is a type of isolation technique used in hospitals to decrease cross contamination from room to room. So these rooms will be used for any patients with either suspected or known COVID-19 all of our staff, including doctors, midwives, nurses, techs, labor and delivery, postpartum, everyone is trained in the appropriate use of precautions for caring for patients with known COVID-19, suspected COVID-19, or any other respiratory illness. So the appropriate use of gowns, masks, gloves when caring for any patient with a suspected infection. While there has been a lot in the media recently about hospitals running out of basic protective equipment like gloves and masks, Emerson has an appropriate supply right now to cope with any known COVID-19 patients. So we are not at the point at Emerson Hospital's labor and delivery right now where we are running out of supplies.
Host: Will the COVID-19 pandemic change options for pain management during labor?
Avery Fisher: So a lot of our patients do ask a lot of questions about pain management. Generally the hospital does have in room showers, use of injectable medications like morphine and of course epidurals.
Host: So what happens if I, you know, was signed up for childbirth classes or CPR classes, all this stuff you do before hand. Are there any online options for these groups?
Avery Fisher: So unfortunately Emerson is not able to offer any online childbirth classes at this time. The Emerson website does have a virtual tour that patients can take of the unit if they are unable to attend previous tour in person. There is going to be an online website called motherly MOTHER.LY that is going to offer upcoming online childbirth classes. They're not available yet, but they will have free online classes for their scheduled C-section class and unmedicated childbirth class, a standard childbirth class, and a refresher class for experienced parents or patients attempting vaginal birth after a C-section. So hopefully there will be some really great childbirth Ed options available online for free. The American Red Cross is also offering an online child and infant CPR class, and we are also encouraging all of our patients to take advantage of any postpartum support group that they may have previously been trying to join. Many of these are working online.
The best resource out here in the Metro West area is called First Connections. You can find them online at www.JRI.org, that's JRI.org all of First Connections postpartum groups including their new mom group, their emotional wellbeing after baby group, and all their new dads groups will be moving to an online format using a conference app called zoom. So patients can email their program director whose information is available on the website, but her name is Mary Beilman, MBeilman, beilman@jri.org to get information about times and sign up for these support groups so that moms can still join them online. There's also a parental support line available 24 seven for postpartum through Parents Helping Parents. They have online support groups, weekly information at parentshelpingparents.org or over the phone at +1 800-632-8188. So that is a great resource for folks after they've gotten home from the hospital who feel like they need additional support.
Host: So Avery, as we're wrapping up here, you know everyone's kind of freaked out by this COVID-19 outbreak, but I'm sure adding on being pregnant or your partner being pregnant during this time is just another layer of anxiety. What would you say to expecting mothers and their families on how to cope during this time?
Avery Fisher: Yeah, so this is a very anxiety provoking time for patients and their families. It's a time of fear of uncertainty at what is typically a time that people are very joyous bringing their babies and new life into the world. And so I wish I had an answer for every question for every patient who has a concern, I don't, but we are here. We are always going to be here to take care of patients and their families as they navigate this very uncertain time. And if they have any questions they are always welcome to call us and ask.
Host: Well Avery, I'll let you get back to the moms, but we appreciate your time and reassurance during all of this uncertainty. That was Avery Fisher, Certified Nurse Midwife with AFA OB GYN and Emerson Hospital. Thank you for listening to the Healthworks Here Podcast. Subscribe to this podcast on your favorite podcast source, including Apple podcasts, Google Play Music, and Spotify. I'm your host, Caitlin Whyte. Thanks for listening and remember to wash your hands.