As hospitals around Maine intensify their focus to care for patients who have tested positive for coronavirus, women’s health departments have had to make adjustments to keep their doctors, nurses and expectant mothers safe.
Dr. Bill Bradfield, chairman of the Department of Women’s and Children’s Services and lead physician at Northern Light Women’s Health at Inland Hospital in Waterville, said in an email recently that safety is the hospital’s primary concern when it comes to pregnant women. He said they should follow the same protocols that everyone has been instructed to: wash hands, maintain a social distance and observe sneezing or coughing etiquette. Courtesy of Northern Light Inland Hospital
Doctors heading up obstetric and gynecology departments at hospitals in Skowhegan, Augusta and Waterville emphasize that what the general population is doing to ward off coronavirus infection are the same practices that pregnant women should employ: washing hands, maintaining social distance and observing coughing and sneezing etiquette. In addition, those hospitals have taken steps to minimize contact among staff and patients to maintain safe environments for all concerned.
Redington-Fairview General Hospital in Skowhegan has made several adjustments, according to Dr. Abigail Masterman, the chairwoman of the maternal center, including spacing out routine visits for pregnant women and children to coordinate with routine labs, ultrasounds and immunizations.
The hospital is scheduling follow up visits with patients by phone or Telehealth video when possible and is paying close attention to ensuring that outpatient office and hospital spaces are also clean and sanitized.
Group meetings, classes and nonurgent visits and procedures are also being rescheduled or postponed at the hospital, Masterman said in an email.
At MaineGeneral in Augusta, Dr. Melissa Collard, medical director of obstetrics and gynecology and chairwoman of the OB department, said that office visits have been reduced so that only prenatal and urgent gynecology visits are scheduled in order to reduce the number of contacts among patients and staff. Additionally, only one visitor is allowed with patients at prenatal visits.
Collard said doctors are doing more phone calls with patients who need checkups but prefer not to come to the hospital.
“We used to have grandparents and siblings attend,” Collard said in an email. “We are also not allowing children in the office or on labor and delivery.”
Before the onset of the pandemic, there were no restrictions on hours or the number of visitors to new moms and babies.
At Inland Hospital, Dr. William Bradfield, chairman of the Department of Women’s and Children’s Services and lead physician at Northern Light Women’s Health, said that, like the other two hospitals, elective surgeries and nonemergency patient office visits have been canceled or postponed. Group meetings such as childbirth education classes and Tree of Hope Postpartum Support groups have also been postponed.
Telemedicine is also being used on a much more frequent basis, he said.
“There is no doubt that it is a difficult time to be delivering in the midst of the COVID-19 crisis,” Bradfield said in an email. “But just like every other day, we are focused on safety for all above all else … It is what’s best to protect our patients, staff and community until we can turn the curve of this pandemic.”
Each doctor expressed that there is limited data about the effects of COVID-19 in pregnancy and newborns or infants.
“This data suggests that pregnant women are not more likely to contract COVID-19 and that the clinical symptoms in pregnancy are consistent with those seen in nonpregnant patients,” Masterman said.
Each of the three doctors pointed out that there are few reports of mothers having tested positive for the virus, that there does not appear to be any transmission of the virus from an infected pregnant mother to the infant in the womb, nor is there evidence of transmission via breastmilk.
“We have seen in the past that pregnant women were at a higher risk for complications from other infections, such as influenza and the SARS and MERS, but information is limited,” Collard said. “The biggest concern is that if a pregnant woman contracts COVID-19 at the end of her pregnancy and goes into labor, the recommendation by the CDC is to separate mother and baby to reduce transmission.”
If this is not acceptable, Collard said there at least needs to be a 6-foot distance during hospitalization, which can affect bonding. Before coronavirus, hospitals recommended skin-to-skin contact quickly after birth between moms and babies.
Collard said that at MaineGeneral, the labor and delivery units have two designated rooms for COVID-19 positive patients.
“We have processes in place to care for a laboring mom and then the newborn,” Collard said.
“The advice given to pregnant women is essentially the same as the advice given to nonpregnant patients in terms of social distancing, hand hygiene and coughing/sneezing etiquette,” Bradfield said. “At this time, there are no extra precautions that a new or expecting mother would need to take other than what we all need to do.”
Bradfield also said that there is no evidence to prove that pregnant women who have tested positive face an increased risk of miscarriages or congenital anomalies.
As more information becomes available, the doctors assure patients that they will continue to work within CDC guidelines and keep their patients and staffs as safe as possible.
“As the epidemic of COVID-19 increases across all 50 states and regions, medical systems are creating plans to provide the best and safest care to those infected and to patients with other acute and chronic illnesses,” Masterman said.
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