C-19 Updates in our Local Birth & Postpartum Care

Here’s a list of updates for the RGH Labour/Birth Unit and Mother/Baby Units. These are significant. Anything is subject to change. 
 
Some tips for navigating this journey without your extra support people:  
  1. Article: How to Set Up your Birth Room (i.e. What Your Doula Would Normally Do!)
  2. Easing Labour Pain: An online 2-hr class this weekend (Sunday at 1:30) that teaches partners how to provide hands-on birth-support, comfort, and decrease labour pain.
  3. If anyone’s looking for online prenatal classes or virtual hospital tours, check out my site. I teach all the sessions live but online so you can ask questions.

I’ve been keeping in touch with the good people managing the units at RGH. 𝐇𝐞𝐫𝐞’𝐬 𝐚𝗻 𝘂𝗽𝗱𝗮𝘁𝗲 𝗼𝗳 𝐑𝐆𝐇 𝐋𝐚𝐛𝐨𝐮𝐫/𝐁𝐢𝐫𝐭𝐡 𝐔𝐧𝐢𝐭 𝐚𝐧𝐝 𝐌𝐨𝐭𝐡𝐞𝐫/𝐁𝐚𝐛𝐲 𝐔𝐧𝐢𝐭𝐬, 𝐝𝐮𝐞 𝐭𝐨 𝐂-𝟏𝟗.
Any of these may change.

Highlights & What’s New

◆ The health region is not on the same timeline as the SK gov’t. Restrictions are still in place at health care facilities. Only ONE support person for the entire process, from admission to discharge. i.e. whoever attends the birth also stays in MBU. No swapping. No visitors.

◆ Labouring women do not need to wear a mask IF they pass screening.

◆ Partners/support persons will be provided with a mask at the entry doors. It can only be removed once they’re in their own birth or mother-baby room. (Bring a big paperclip or string if you want to save sore ears.) Check out these tips for saving your ears from mask-pain.

◆ You’ll see staff wearing masks throughout your stay.

◆ There was a news report that pregnant women in SK will undergo testing for C-19, but that has not trickled down to local practice at this time.

◆ Everyone is screened at the doors; ER screening includes temperature. Staff is aware of allergy season and will screen appropriately.

◆ Bring in only what you would normally bring for your birth. Partner will be given a band so they can go to car later for extras and car-seat. You are still allowed to bring your pillow, clothing etc – whatever you need for comfort.

◆ Nitrous-oxide (“laughing”) gas is available for pain management.

◆ If you or baby are at high-risk for birth complications, you may be asked to use an epidural during labour to avoid the need for a general anaesthetic in case of an urgent/stat caesarean. Best to discuss this with your OB ahead of time so you can learn your options and make a plan.

◆ No one in Regina area is renting birth pools. Midwives are not loaning theirs out. If you have your own then waterbirth at home is still an option.

◆ Food outlets in RGH are open for take-out. You may meet someone at the main doors for food delivery.

◆ Breastfeeding is still being supported at RGH.

◆ There are plans and protocols in place so that mother-baby can stay together if mom is at risk or has symptoms of C-19 in the immediate postpartum.

◆ Even though some community restrictions are being lifted, great care should be taken with newborns once the family is home. Physical distancing and being only with members of the same household are still recommended. Anyone who enters the house can bring in pathogens/bugs.

Other things still happening from previous update:

𝐏𝐫𝐞𝐧𝐚𝐭𝐚𝐥 𝐂𝐚𝐫𝐞
● Pregnant women attend appointments, diagnostics (ultrasound, lab) solo. Routine appointments might be done over the phone or spaced out. High-risk and special circumstances will still get the extra care they need.
● Midwifery offices are doing the discussion part of the consult by phone and then a quick in-person appointment for the hands-on part. They prefer pregnant patients attend alone but will allow partners. No other family members/friends/support are allowed.
● Anyone under midwifery or GP care who tests positive for C-19 at any point in their pregnant, birth or postpartum will be immediately transferred to OB care.
● If you’re an early-bird you may be asked to wait in your car until your appointment time.

𝐀𝐧𝐭𝐞𝐧𝐚𝐭𝐚𝐥 𝐂𝐚𝐫𝐞 (𝐋𝐚𝐛𝐨𝐮𝐫, 𝐁𝐢𝐫𝐭𝐡)
The previous section, plus:
● Hospital is locked-down. No visitors except for compassionate visits (no, meeting a cute new babe does not count).
● Everyone entering RGH at ER, main entry and 15th St Admitting door will be screened for C-19 risk factors.
● Doors that don’t have an admitting desk are locked tight; security will not let anyone in. That includes the convenient door just below the MBU.
● Galleys (the kitchenettes) in the units are closed to patients/support person. There is no access to the microwaves, kettles, food, water-ice machines. There is no access to the fridges and freezers, except for the small ones in your room.
● Food Services is limiting snack delivery. Bring your own snacks and food! Maybe a little kettle if you like to make hot drinks. There’s a small fridge in every LBU & MBU room.
● Labouring woman and support person are both screened before entering the LBU. If the support person doesn’t pass screening, they will not be allowed in either unit. An alternate may be invited, who must pass screening and plan to stay for the duration of the admission. If the labouring woman doesn’t pass screening then her and her partner will be put into an isolation room for the birth and postpartum, and not allowed to leave the room for any reason. Food will be delivered by RGH food services.
● Early discharge is being offered as an option for those that are healthy and feel comfortable with newborn care. That means to go home a few hours after your birth instead of staying 24-36 hours.
● Women getting a cervidil induction will be monitored and then sent home to wait for labour to start, as per usual, then rescreened at RGH doors and LBU doors upon return.
● People who show up too early in labour will be sent home, as usual, then rescreened at RGH doors and LBU doors upon return.
● There will be no in-hospital water-birth for midwifery clients. The installed bath-tub is available for comfort in labour.
● Support people are allowed at homebirths but must be screened. If anyone in the home (residents or support people) doesn’t pass screening, then the birth must be transferred to RGH. In that case, the one support person rule applies. Home birthers – screen your people before they come over!
● Screening questions:
1. Have you or anyone in your home been out of the country and returned to Canada prior to March 6th?
2. Have you or anyone in your home been out of the country and returned to Canada March 6th or after?
3. Are you, or someone in your home feeling sick? If yes, what are your symptoms?
4. Have you or anyone in your home been directed to self-isolate? If yes, by who? What date?

𝐏𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐂𝐚𝐫𝐞
Previous 2 sections, plus:
● Families are being asked to stay in their room as much as possible.
● Partners may not visit any other patient areas.
● Food trays are being provided for new moms in the MBU.
● Breastfeeding class in the unit is still running but only birth mother and baby attend (no partners) and only up to 3 participants.
● Midwives and public health nurses are still providing postpartum home-visits. Some may be done by phone or video, depending on your needs.

Home Birth Supply List

Prepare Your Home Before 37 weeks:

  1. Midwife & doula contact info entered into cell-phones.
  2. A contact page on your fridge or pinned to a wall, easy to find, in case we have to call for fast help. (Trust me – brain-freeze is a thing!)  Please print, fill out and post this Homebirth Contact Form, or add the extra info to the page your midwives provide and ask you to post.
  3. Other “Important Phone Numbers” list on your fridge.
  4. Some cleared surfaces for equipment set-up.
  5. Plan for birth-attendant parking.
  6. Outside lights working, house # visible at night (may require a temporary # to be put up).
  7. Clear a path to door and through halls in case we have to quickly run in equipment for set up or quickly depart.
  8. Child-care plan (unless they’re attending birth; MW & doulas can offer tips).
  9. Pet-care plan – pets with teeth / claws absolutely need to be locked up or sent elsewhere as even the most gentle animal can become over-protective and stressed while mama’s in labour.
  10. If you’d like candles then please use only beeswax or battery-candles. The rest are toxic and can give your support people headaches.
  11. Get your bed “birth-ready” – make bed in this order (from bare mattress): extra mattress pad, sheets for after the birth, then a plastic liner/sheet or water-proof mattress pad, a regular mattress pad if you’re using a plastic sheet (optional but nice, because plastic gets hot and sticky; an extra flannel sheet works too), “birth” sheets, blankets & pillow cases that can be used for birth.  Have pillow cases and blankets for after the birth nearby.  Note: if you don’t wish to sleep with plastic in the days/weeks before birth, please have all this ready near bed so someone can quickly make the bed during labour.
    Note: Waterproof plastic liner/sheets can be a clear shower curtain liner or plastic drop-sheet (like a thin tarp). Mattress stores sell nice waterproof mattress pads that feel like normal bedding.
  12. If you’re planning a water birth then ensure hot water temperature is turned up
  13. Birth-Kit from MW (if she provides this; otherwise purchase and assemble yourself):
    – Package of 10 or more large absorbent under-pads / “blue pads”
    – Peri-bottle for postpartum perineal care (one per washroom)
    – 4 -6 pair disposable mesh underwear
  14. If you have a guest-room, it’s nice to have it ready for birth-attendants, just in case.
  15. Extra bits if you’re planning a water birth:
    Note: I am a water birth expert and can offer all kinds of guidance if there are issues with any of this, but we need to know ahead of time!
    – Purchase / rent birth pool (unless your bath-tub is appropriate) and all related supplies.
    – Determine where and when to set up the pool.
    – Tarp to protect the floor. Padding under the tarp is nice.
    – Hot water temperature is turned up.
    – Ensure the hose for filling the birth pool fits one of your taps and reaches your pool. Seriously, you can not imagine how often this isn’t done and foils waterbirth plans! Do not just assume it all fits. If the hose won’t connect then you’ll need an adapter or extra pump; ask me.

Birth Containers

Please prepare in plastic tubs or reserved laundry baskets; boxes work in a pinch.

 1) Dryer Items
These items will be warmed in the dryer prior to birth.  Place in a separate bag or container, stored near dryer or with Birth Container). Washed and ready for use; will get soiled or stained so consider Thrift Store purchases.

  • 6 towels (make it 8-10 for waterbirth!)
  • 6 receiving blankets
  • 2 hats for baby
  • 3 flannel sheets/blankets for mother (4 for for waterbirth)

2) Other Linen
This is in addition to the Dryer Items above.  This linen is kept in a separate container please, near birth-spacee e.g. in bedroom, by birth-pool.  Washed and ready for use; will get soiled or stained so consider Thrift Store purchases.

  • Newborn outfit incl. diaper, undershirt, sleeper, socks, hat and blankets
  • Nighty / PJs for mother
  • Set of sheets to fit bed
  • 1-2 flannel sheets/light blankets for waterbirth
  • 6 old washcloths, old diapers, etc. for hot compresses
  • 10 washcloths for mother comfort
  • 6 towels; make it 12 minimum for waterbirth!
  • 10 cloths/rags for clean-up after

3) Other Items
Keep this in a container close to or in birth-space.
Note: There may be some repeats from the Birth Bag Suggestions list, which you’re encouraged to check out for some great ideas of things you can use at home, hospital or birth centre.

  • Large plastic sheet to protect bedding – e.g. drop sheet or plastic shower curtain liner (see above for how to prepare your bed for birth)
  • 4 large, strong garbage bags (2 for garbage, plus replacements)
  • Large laundry bin or an additional large strong garbage bag to collect soiled linens
  • 1 large roll paper towel (please – no matter how much you love Mother Earth
  • Plastic ice cream pail or other suitable container with lid for placenta
  • Flashlight with new batteries
  • Large pkg. maxi pads, extra long (the bigger, thicker the pad the better). Avoid pads with a “dry-weave” topping as they can be irritating to your perineum
  • Small bottle of peroxide – best thing ever to clean blood from surfaces and fabrics
  • Flexible straws
  • Cookie sheet or other large firm portable surface
  • Bottle of hydrogen peroxide (cleans blood stains)
  • Digital thermometer
  • Q-tips, in case of care of umbilical cord
  • (optional) Small unopened bottle of food-grade oil e.g. coconut for crowning
  • (optional) Large saucepan or Crockpot for heating compresses and oils

4) Waterbirth
Your pool should have come with a supply list.  Please ask if you need more info.  If you’re lucky enough to have a big comfy built-in tub, the only extra thing you’ll need is a floating thermometer and a small fish-net or sieve.

Nourishment

Think about lots of healthy foods and drinks (Labour-Drinks) you and your family might enjoy during and after labour and birth, and stock up.  HINT– birth attendants LOVE tea and snacks too! 😉

Make a few trays of ice-cubes (can keep cubes in a zip-lock).