Having your baby in the time of COVID-19

Below is what you can expect if you are having your baby at Kingston Health Sciences Center

 

How can I protect myself from COVID-19 while I’m pregnant?

Pregnant mothers should follow the same advice as everyone else – washing hands often with soap and water or using alcohol-based hand sanitizer, practicing social distancing and avoid touching your face.

 

What should I do if I think I have COVID-19 and I am pregnant?

If you are pregnant and showing symptoms (cough, new onset shortness of breath, fever), have travelled in the last 14 days or have been in close contact with someone who has tested positive for COVID-19, don’t hesitate to use a self-assessment tool (https://covid-19.ontario.ca/self-assessment/#q0), visit the Community Assessment Centre or contact your local Public Health Unit (https://www.publichealthontario.ca/).

 

Can I still take a prenatal tour?

All hospitals, including KGH, have suspended all in-person prenatal tours for the time being. Please download the Having a Baby at KHSC booklet (https://kingstonhsc.ca/obstetrical-care/having-your-baby-kgh) for more information.

 

What will my prenatal care be like during the COVID-19 pandemic?

Regardless of who looks after you during the pregnancy, maternity care is essential.  The frequency and process of maternity care has been developed over many decades in order to reduce and/or early identification of complications in the mother or the baby. Whatever your personal situation please consider the following:

• It is important that you keep in contact with your maternity care provider and continue clinic and virtual (telephone) check-ups.

• If you have symptoms of COVID-19, please inform your care provider and they will identify where to go for testing and arrange the right time and place for your clinical visits.

• There may be a reduction in the number of actual clinic or phone visits that you have. This will be communicated with you and will be done as safely as possible. If you are not sure of your next appointment, contact your care provider to sort that out.

 

Is it still safe to come to the hospital to have my baby?

Yes, it is still safe to come to the hospital to have your baby. We have taken many steps to protect all of patients in the hospital, including mothers and babies, and staff. All patients, support people and hospital staff are screened and asked to use hand sanitizer when they enter the hospital.

If you are showing symptoms (cough, new onset shortness of breath, fever) or have tested positive for COVID-19, call ahead to inform us.  Patients who test positive or are awaiting test results will be asked to wear a mask throughout their stay including during their labour and delivery.

Is it safe to come to my ultrasound or clinic appointments?

Yes, it is still safe to come to KGH for your appointments. We have made an effort to triage and reschedule, or offer clinic appointments virtually or by phone whenever possible. If your appointment has not been rescheduled, you can still attend as you normally would as we still need to periodically check your blood pressure, measure the size of your uterus and listen to baby’s heartbeat.  

When you come to the clinic for an appointment or fetal assessment unit for an ultrasound, you should use the hand sanitizer prior to entering. When you leave the room and when you leave the hospital you should once again be using the hand sanitizer provided. We thoroughly wipe down the beds and equipment (ie: Ultrasound probes, fetal doptones, etc) after each visit.

Support people are not allowed in the obstetrics clinic (Armstrong 5) or in the ultrasound area (Fetal Assessment Unit) during the pandemic.

 

Can I still bring a support person to my delivery? Can this person stay overnight in the hospital with me?

Laboring mothers are permitted to bring one support partner with them for the delivery and to stay with them as long as they are in the hospital. This person must pass the screening at the main entrance, meaning they must not be showing any symptoms (cough, fever, new onset shortness of breath) and have no recent travel history. It is very important to answer these questions honestly in order to help protect other women and their babies and our staff. 

Support people who screen positive will not be allowed in to the hospital. It is extremely important to not lie about your symptoms at screening; you would put other women, babies and staff at risk.

These recommendations may change if you are infected by COVID-19 and/or we have a significant increase in activity of the infection in our community requiring us to take more precautions for all patients and staff. These decisions are extremely difficult to make but if needed, are made to protect the most people possible.

 

Can I bring my midwife or doula with me?

Midwives are registered members of the care team and are not considered visitors. If you are under the care of a midwife, you may still bring one support person to the hospital with you. 

If you are seeking support from a doula you are welcome to bring them as your support person, but remember they will be the only support person you are permitted during your stay. Your support person cannot tag-team with someone else either during labour or postpartum on the ward; only one support person is allowed during your entire stay in the hospital and they are not permitted to come and go from the hospital as they please.

 

What if I need a cesarean section (C-section)?

Because of heightened infection prevention measures, support persons are not permitted to be in the operating room during C-sections.  Patients who are COVID-19 positive or at-risk of being positive will have their C-section in the main Operating Room.

Partners will be able to stay with their infant on the Labour & Delivery unit until the mother is out of the operating room.

 

What if I need to be induced?

All inductions are being done in hospital. We are no longer doing cervical ripening outside of the hospital in order to limit women/support person coming into/out of the hospital. Once your induction has started, you must remain in the hospital.

 

What pain therapies are available?

We are unable to provide nitrous oxide or any form of water therapy including water births, immersion or showers for laboring women during the pandemic. This is because these are all practices that could spread the virus to others.

Other pain therapies are still available. If you are interested, we advise that you speak to your care team to discuss which of these options are best for you.

 

For more information about COVID-19 at KHSC Kingston General Hospital site, visit www.kingstonHSC.ca/COVID-19.

For other hospitals, please check their website for hospital specific practices.

 

FAQ’s for COVID-19 positive mothers

 

What do we know about COVID-19 and pregnancy?

There is no evidence that COVID-19 causes birth defects.

Healthy pregnant women are not more likely to get infected with COVID-19 than healthy non-pregnant women, and are not at higher risk of a severe infection requiring ventilation compared to non-pregnant women.

Smoking or vaping appears to be associated with worse outcomes if you’re infected with COVID-19. Everyone, pregnant women included, need to stop smoking or vaping. Consult your health care provider for smoking cessation options available to you.

There is only limited data on pregnancy outcome when the infection is in the first and early second trimester, but these reports don’t identify a higher risk of miscarriage or spontaneous preterm labour. Regardless, if you get sick you and your baby will be monitored closely during and after your illness.

The evidence suggests that the chance of baby being exposed to the virus during pregnancy is very small, if at all. Therefore, if you are COVID-19 positive at the time of delivery, your baby is not likely to be born sick. However, the health care providers looking after your baby may decide to test the baby sometime after birth.

 

I have tested positive for COVID-19. What will my prenatal care be like?

• If you are COVID-19 positive you should discuss with your care provider when you should go to Labour & Delivery at the hospital. This should occur if you were to progressively get sicker because of shortness of breath or if you were unable to stay hydrated. Please enter through the Emergency room of your local hospital.
• If you develop a fever you should be using acetaminophen (ie. Tylenol) to help control it; nonsteroidal anti-inflammatory medications (ie. Advil) should be avoided in pregnancy and should probably be avoided in COVID-19 positive patients.
• Self isolation and social distancing to minimize community spread to your family and others.
• For any clinic or ultrasound appointments, contact your maternity care provider – we will instruct you on how to safely come to your appointments or schedule them virtually if possible.

 

I have tested positive for COVID-19 and I am going to be delivering soon, what can I expect?

If you are COVID-19 positive and normally would have your care by a midwife or your family doctor, you will be transferred to an obstetrician for care during labour and delivery. Your midwife or family doctor may still provide postpartum care for you and/or your baby while in the hospital and after discharge home.

If you are COVID-19 positive your care will be different in order to protect you, your baby and the staff caring for you.

COVID-19 positive women will be required to wear a mask during their entire labour and delivery (including pushing) and to use hand sanitizer frequently in order to protect their baby, their partner and the health care staff. Asymptomatic partners must also wear masks all the time and use hand sanitizer frequently.  We recognize that this adds extra stress to your delivery and postpartum course; we will all be there to help you.

Delayed cord clamping and skin-to-skin contact is still practiced with COVID-19 positive mothers who are wearing a face mask and have washed their hands.

 

I have tested positive for COVID-19 – what will my care after delivery be like?

Mothers will need to continue wearing a mask after delivery, during their stay in the hospital and at home in order to protect the baby. You can continue to use the same mask that was used in hospital as long as it is not wet or visibly soiled.

The baby’s bassinette should be kept at least 2 meters from the mother's bed; ideally a physical barrier such as a curtain should be used. This should also be the case at home, not just at the hospital.

COVID-19 positive mothers or partners should always wear a mask and wash their hands before touching the baby; regardless of whether it’s to feed, change a diaper or just interact.

Before anyone touches the baby, they must wash their hands. Nobody should be kissing the baby. Even though it is a very exciting time, families should still practice social distancing and not have friends or family over to see the baby and celebrate.

There are some reports that even after a period of improvement, COVID-19 positive patients can have a rapid deterioration. As such, we would plan a further 24-48 hours of observation in hospital for mothers who are COVID-19 positive before discharge home after delivery. Even then there may be frequent phone follow-ups to check in.

KFL&A has a public health phone line (6135491154) and Facebook page (Child & Babytalk in KFL&A) https://www.kflaph.ca/en/clinics-and-classes/Child-and-Babytalk-Drop-Ins.aspx which is operating Monday to Friday, 8:30 a.m. to 4:30 p.m. These are serviced by a public health Registered Nurse, who can answer questions regarding infant nutrition, breastfeeding, pregnancy, newborn care and mental health including screening. This line can also connect families to services, including Health Babies, Health Children (HBHC).

 The Breastfeeding Clinics are operating Monday to Friday, in the afternoons, in Kingston only. Breastfeeding mothers can speak with a Lactation Consultant on the phone (613-549-1154) and can still be seen face to face after proper screening for COVID 19.

The HBHC program continues and parents will be signed up prior to discharge from hospital.

There is new parenting email program – families who sign up receive timely emails that corresponds to their baby’s age, currently goes to 18 months but is in development to go further into the early years. The HBHC screener and the nurses on the post partum floor will facilitate this for you.