Winter and spring certainly have brought much change and uncertainty for all of us. Our world on the North Shore and elsewhere is different.
We are happy to say that Vera and team continue to welcome clients into a partnership of care, despite now needing to live with COVID pandemic processes as a part of daily life.
Initial changes were mindful coughing, sneezing and handwashing. Then came PPE. Our gratitude to Sew with Claire – Northshore Handmade PPE and Sons of Vancouver Distillery that provided us PPE and hand sanitizer in the initial stages of the pandemic, when there was no supplies available. . We have been inspired by people’s kindness, as well as the caring and go with the flow spirit that this pandemic has evoked.
We encourage all to be mindful to focus on hand hygiene, avoiding touching our faces, self-care that is having wholesome nutrition, exercise, fresh air and sleep. It is also important to find positive ways of dealing with stress and to stay at home, isolating when feeling unwell.
These actions, consciously chosen and enacted on a daily basis, boost our immune systems, help to keep our bodies, minds, as well as our pregnancies healthy. In addition, to also contributing toward keeping folk around us healthy.
We are grateful for Dr Bonnie Henry’s compassionate guidance, as we all strive to do our best to be kind, safe and stay well. We are also fortunate to live and work in the municipality of North Vancouver City that has had a focus on supporting family wellness long before COVID began.
-Changes that have taken place in the provision of prenatal and postpartum care:
Clients can expect more remote video conference or telephone visits than in-person visits. We have a secure videoconference platform for virtual visits.
We do enjoy remotely seeing clients relaxing in their homes, meeting partners this way, as well as seeing their children, or 4-legged family members. Remote visits also provide us a chance that we appreciate, of being able to smile and be seen without a mask. Test requisitions and forms are now emailed to clients after their remote visit.
Wherever an in-person visit takes place (office, home or hospital), clients can also expect their midwife to hand wash, wear mask, googles and gloves and at the time of birth, to also wear a gown.
In preparation for home visits, we ask that clients have a designated hand-cleaning area in their homes that midwives can use, where we will find clean soap and towels for hand washing, and sanitizer to wipe surfaces.
When coming to Quayside Village Co-housing, where MCNS office is located, we have designated hand cleaning areas. In-person visits are spaced out to allow for cleaning equipment and surfaces between clients.
Due to physical distancing requirements, we ask that only pregnant persons and postpartum persons with their babies attend MCNS Quayside Village office appointments. Partners and other family members are asked to stay at home. They can be telephoned into the visits. As soon as this requirement can change, we will be happy to let folk know and to welcome all family members to our clients appointments.
On arrival at Quayside Village, we ask that clients wash their hands. A cell phone and gear to change a baby can be brought into the office in a clear plastic bag. At the end of a visit, before leaving clients are reminded to wash their hands once more.
During an office visit, clients can wear a mask, if they choose. When choosing to wear a mask, we ask folk to be conscious to avoid touching their faces. When we touch our face, whither wearing a mask or not, it is important to remember to sanitize our hands to avoid contaminating surfaces.
Before attending in-person prenatal or postpartum appointments, we ask everyone to go through a self-assessment. If you are feeling unwell, to stay away and instead reschedule a remote visit, or alternate in-person that you can be assessed. Page your midwives in this circumstance. Remember to wear a mask and hand wash, if you are seen in person when feeling unwell.
Besides preventing the spread of COVID, these actions put into practice, could reduce the spread of colds, flues and other respiratory viruses.
To self-assess for COVID specific symptoms, make use of BC’s self-assessment tool before leaving your home. https://bc.thrive.health
– Changes that have taken place around labour, birth and postpartum care:
Useful information and links about COVID pregnancy and newborn care can be found on the government of Canada site https://www.canada.ca/en/public-health/services/publications/diseases-conditions/pregnancy-advise-mothers.html
Pregnant people are advised NOT to come to hospital unless they are in need of urgent obstetric or medical care. Those with symptoms should self-isolate at home. However, if these symptoms are in the 3rd trimester, they should be swabbed for Covid-19 and influenza. When symptomatic request a call from a midwife to discuss next steps. Assessment and testing can be done at Lower Lonsdale Urgent Primary Care Center http://www.vch.ca/about-us/news/news-releases/urgent-and-primary-care-centre-opens-in-north-vancouver
– Labour and Birth:
We continue to encourage women to remain home in early labour, if they are coping well.
Only one close support person may accompany a client in labour. This can be a partner OR family member. Support persons are not allowed in and out of hospital, so clients are advised to bring food and snacks along with their personal belongings.
A professional doula is allowed to accompany a pregnant person and family members too, as long as they have ID and have DONA certification, or DSA membership.
When women are in active labour, upon arrival at LGH please present at the 15th street entrance during the DAY: 8:00am – 8:30pm and go the admissions window to be admitted. At NIGHT between 8:30pm – 8:00am, please enter through the Emergency Room Entrance on Sr. Georges. From ER, go up to the 3rd floor to Labour and Delivery. This is where midwife will meet a client.
Any client who is Covid-19 +positive when in labour will need to deliver in hospital. Home Birth is NOT recommended. As increased surveillance of a woman and baby’s wellbeing during labour is needed.
-Home Birth for non-infected women is still an option. However, clients need to meet specific criteria for Home Births during this pandemic that can be discussed during visits.
In addition to hand washing and PPE, Covid initiated changes to home and office equipment to make for easy cleaning and protection of self and others shown in collage above.
Vera is trusting that she can soon get used to her new progressive prescription safety glasses, so that she no longer has to wear a shield or put googles over her glasses.
A reminder to everyone. All clients regardless of their place of birth intentions, must register at Lions Gate Hospital. LGH registration processes are now facilitated by email.
Pleased be assured that IT IS SAFE to deliver at LGH. The Labour, Delivery and Postpartum Units at Lions Gate Hospital continue to offer exceptional, uninterrupted care. Clients are supported by an amazing and dedicated team of midwives, nurses, GPs, obstetricians, paediatricians and when needed anaesthetists. Extra measures have been put in place to protect labouring mothers and their newborns.
-Postpartum changes:
Visitors have been limited at all hospitals throughout Canada. At this time no visitors [other than the support person who accompanied a client in labour] are allowed, except in special circumstances.
If a new parent is Covid-19 +positive, keeping parent and baby together is recommended. Parents that are Covid +positive are asked to wear a mask and to utilize strict hand washing protocol for breastfeeding and/or skin to skin.
Breastfeeding is encouraged, because the protective effect of breastfeeding is particularly strong against infectious diseases through directly transferring antibodies and other important immune factors to the baby.
If a mother is Covid-19+positive, baby will be tested for COVID-19 after delivery. No isolation of infant from mother is necessary, unless clinically indicated.
Where appropriate, early discharge of all parents and babies is recommended and facilitated.
Midwives see clients the first week at home. Visits thereafter are a mixture of remote and in-person appointments. Type of visit is decided upon by individual client need and using our College of Midwives of BC suggested COVID appointment schedule.
WORK ABSENCE & EMPLOYMENT INSURANCE
Pregnant women can work during Covid and are encouraged like everyone else to stay home and isolate if they are unwell. As per instructions from the Minister of Health and the Provincial Medical Officer of Health, clients will not need a note to miss work if they have symptoms: https://news.gov.bc.ca/releases/2020HLTH0077-000484
People in quarantine (including those who are not sick and those whose workplace is closed to enforce social distancing), can apply for Employment Insurance Medical Leave. No medical certificate from a doctor or midwife is needed:
https://www.canada.ca/en/employment-social-development/corporate/notices/coronavirus.html
Related pregnancy, labor, breastfeeding and parenting services, for example, counselling, doula care, physio and massage therapy and/or childbirth, breastfeeding and parenting education have also had changes to their services due to COVID and provide details on their websites.
We encourage clients to go to MCNS website resource pages for information, as we do our best to find relevant, local and/or useful links https://midwiferycare.ca/resources/
Emotional health:
COVID-19 takes its toll on all of us … staying home, physically distancing and wearing personal protective equipment, managing with less income… it’s important we look after our emotional health. Below find a few links that may be helpful.
FOR ADULTS
Anxiety Canada
https://www.anxietycanada.com/articles/what-to-do-if-you-are-anxious-or-worried-about-coronavirus-covid-19/
Work on living in the moment, finding inner peace and little joys in your life, like taking mindful deep breaths and smelling the fragrance of a flower, or appreciating the beauty of nature.
Train your mind to sleep more, stress less and live better.
Remember we are all in this extraordinary time together and while we cannot choose these curveballs, we can choose our response. Calm has inspirational sayings that can be useful reminders https://www.instagram.com/calm/?hl=en
Mindful living stress reduction and counseling services
http://mindful-living.ca/
Mindfulness–Based Stress Reduction (MBSR) with Dr. Kasim Al-Masha
http://www.mbsrbc.ca/pages/classes.htm
Family Services North Shore
https://www.familyservices.bc.ca
FOR KIDS
Talking to your kids about coronavirus and physically distancing
https://www.forbes.com/sites/tarahaelle/2020/03/18/talking-to-your-kids-about-coronavirus-and-social-distancing/#45a594d32c15
Below find a few suggestions of activities to do together, while isolating at home.
I visited 18 countries today – how about you?
https://www.messynessychic.com/2020/03/19/i-visited-18-countries-today-how-about-you/
20 things to do at home instead of banging your head against a wall
https://www.messynessychic.com/2020/03/12/hobbies-at-home/
Pluto the Dog’s Message to Kids – we are following Pluto!
https://www.youtube.com/watch?v=eiBYw3bDFro
Cats teach kids how the virus spreads
https://twitter.com/ziyatong/status/1240303392188248070
Children Stuck at Home Can Still Explore the Zoo or Aquarium. Some Penguins Could, Too.
https://www.nytimes.com/2020/03/18/us/coronavirus-zoos-webcams.html
Please remember as BC moves into Phase 3 of our COVID pandemic that everyone needs to remain mindful of how we are feeling; isolating when we feel unwell, continuing with sanitizing our hands, physically distancing and wearing our masks when we are in crowded spaces inside or outside.