How COVID19 will change your Doula & Encapsulation Care
Updated: Mar 17, 2020
Dear Our Families,
Due to recent events, we know that this may be a stressful time for you and your family. Please read the following statement to understand how doula care moving forward will change to protect you, your health amid COVID19, birthing options, and policies may be changing. Below is also information regarding this virus during pregnancy, in children, and safe prevention methods.
Topics addressed: Changes to your appointments, Doulas in the hospital setting, Placenta Encapsulation Protocols, Alternative Birthing Options, COVID19 while pregnant, COVID19 and children, Prevention of COVID19, Resources for COVID19 and pregnancy.
Your appointments with us:
Licensing And Regulatory Affairs (LARA), has put out a statement to all workplaces to limit non-essential travel and to use virtual points of contact whenever possible. Due to this requirement, Rachel and I have agreed that all interviews and prenatal appointments should be held virtually until the State of Emergency is lifted. We will be able to offer 40 minute appointments via Zoom. We understand that you may want to utilize more time with us, and are willing to add in additional prenatal appointments with you as necessary.
Due to our inability to do hands-on teaching with you during this time, we strongly advise that you download the Parents Class and Daily Essentials from www.spinningbabies.com/shop. Please be VERY familiar with these positions and techniques. If you have any question on if you are doing them properly, please reach out and we can schedule a virtual time to review your technique.
Rachel and I feel that due to our work within the hospitals on the day of your birth, this is the best way to protect you and your family, along with our families, during this time. Please be advised that even if we are not sick, we may still wear masks during your labor should the alert be heightened even further. Again, while this removes a level of comfort for all of us, this is in the best interest of you and your family. Rachel and I also have other safety measures in place, such as specific birthing clothing to put on immediately prior to your birth, and washed immediately afterwards to minimize risk of exposure or cross-contamination. Our movements throughout the hospital will likely be limited by policy, to your room only. Please be mindful that we are human and may rest when you rest, need to refuel ourselves, and use the restroom - all times we may have traditionally stepped out of the room.
As for your postpartum visit, should you feel the need for additional support after your birth in regards to your postpartum visit, we will also be hosting these virtually. However, we understand this may require a more hands-on visit at times and we are willing to be flexible if there is a NEED.
Lactation services will be screened for NEED as well. There is a significant amount of support and information that can aid your journey in breastfeeding and be given virtually. If you are screened out of an in-home visit, you may be provided virtual support for $75. If you are screened and it is determined that you do require an in-home assessment, the standard fee of $150 will apply. In the instance of a home visit, we ask that our contact be limited to the nursing parent and the nursing child only. All siblings and other household members should be in another area of your home.
Doulas in the Hospital Setting:
Currently, hospitals are changing protocols in regards to support staff. We are working tirelessly to contact your individual hospital for you to stay abreast on their policies. Policies are changing hour to hour at this point.
3/13/20- Visitors strictly to 2, Royal Oak begins doula ban and moves to 1 visitor. The advocacy begins!
3/15/20- Doulas banned from most hospitals that consider doulas "visitors" and moves visitor count to 1. U of M, St Joes Ann Arbor, and ABC still accepting doulas. Petition started to approve doulas.
3/16/20- Organizations call in all political connections possible and Governor Whitmer releases Executive Order approving partners AND doulas in Labor and Delivery units in Michigan
3/17/20- Contacting all area hospitals to update visitor policies.
Information prior to 3/17/20 applicable to other states:
The American College of Obstretics and Gynecology (ACOG) and the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) agree that Doula care is a professional personnel member essential to the birth team.
In addition, the CDC (Centers for Disease Control and Prevention) has stated in its most recent (March 10) recommendations for infection control, "If restriction of all visitors is implemented, facilities can consider exceptions based on end-of-life situations or when a visitor is essential for the patient’s emotional well-being and care" (emphasis added) [link to statement].
We invite you to speak to your providers regarding their policy and make the value of our role known to your staff. You are your best advocate! We have been professionally retained for services by you! The same way you are professionally retaining your medical provider and hospital. Some clients may even choose to go as far as getting a letter of support from their provider to bring to their birth, changing birthing locations to where they know their doula will be allowed, or you may have to accept the small risk of being unable to have doula support.
Rachel and I have worked for years building positive relationships with providers and hospitals to have a great relationship, and hope that this will be the time it pays off. Should hospital policies not allow our presence, and there is no flexibility, we will work with you providing virtual care throughout your labor as best as possible. We do NOT anticipate this need, and we do expect that our professional role will be respected. We will keep you informed of any concerns regarding our ability to care for you during labor, and come up with an individual plan for you should there be any concerns.
Placenta Encapsulation Protocol Changes:
Current evidence shows that transmission of COVID19 is not being transmitted to babies. Even if this virus did pass to babies or amniotic fluids, our proper temperature treatments of your placenta would deactivate this virus. It is still safe to encapsulate your placenta. What is changing is the fact that visitors are being limited to the hospitals. Considering that we are doing our best to limit our exposures to hospitals for the sake of transmission risk, and /our families, we are now requiring that partners/visitors bring the placenta to us in the hospital parking lot so we can avoid entering the hospital. Traditionally, we came to your labor room for your convenience, but this is not currently a possibility, nor is it in the best interest of ourselves, our families, and the community.
What You Need To Do:
Save this picture to your phone.
Show your nurse this picture for proper storage. All products shown are available at the hospital.
Replace ice as it melts
Once it is time for pick up, dump water from bucket so that only ice is in the basin, put entire basin in a hospital belongings bag or biohazard bag and knot closed. You may choose to bring a medium sized cooler if you'd like, but this is not required.
Have your partner/visitor bring the placenta to your encapsulator at the entrance doors once the encapsulator or courier has announced their arrival. We will notify you when we are on our way for pick up to coordinate that exchange.
Please have the following information available for us:
1. GBS status: positive or negative, if positive did you receive adequate treatment? Inadequate treatment requires placenta to be steamed prior to processing
2. Did birthing person or baby have any signs of fever or infection related to labor or birth? If so, it is unsafe to process this placenta
3. Was there meconium in waters prior to birth? If so, this requires placenta to be steamed prior to processing
For drop off of your capsules, we will be doing door deliveries. Typically we may have entered your home and discussed protocols with you or your birth, however we are now limited home visits. Guidelines for consumption are on the bottle of your capsules, and should you have further questions or concerns, we are ALWAYS a phone call away.
Our sanitation protocols have ALWAYS accounted for coronaviruses, amongst other viral and bacterial treatment. We will continue to provide sanitary and safe processing for our clients.
After Birthing in a Hospital
Some of our families are choosing to quarantine themselves for 2 weeks after birth, due to their recent exposure to a hospital setting. Please prepare your loved ones for this should you choose to follow quarantine guidelines to protect your parents and loved ones. We also ask that should you choose to quarantine, that you set yourself up for success without family support. This may include taking an online breastfeeding class to prepare yourself for smoother breastfeeding experience which leads to easier healing and recovery, frozen meals prepared, diapers stocked, and any other household functions smoothed out prior to birth.
Alternative Birthing Options:
Some families have reached out to us regarding leaving the hospital setting for birth, especially due to the fact that homebirth midwives provide postpartum care for you and baby and you'll get to avoid doctor's offices. If this is something you are interested in, here are some resources for you and some basic information regarding costs. If this is even a blip on your radar, please always have your most up to date prenatal records with you!
Nine Short Months Birth Center: Preparing now and ready for influx of transfers from hospital settings. They have significantly reduced this cost to fill this need. If you contact them and provide your insurance information they will verify any benefits you may be eligible for. Require a $1500 non-refundable deposit for a laboring, support, staff, and center fee. Should your birth happen in the birth center, there is a $2000 remaining balance OR they will accept what your insurance is willing to pay if you are eligible for coverage. You can have your prenatal records faxed to (248)306-9966
Cynthia Jackson and Mosaic Midwifery: Currently preparing for an influx of transfers from hospital settings. Costs and payment plans TBD. You may contact Cynthia at SacredRoseBirthingServices.com for more information
Stacia Proefrock: Has one availability for May and one for June. Fee for transferred care is $3200 for payment by 6 weeks postpartum. $3700 if you require a longer payment plan. HSA, FSA, and credit card are accepted.
Other Certified Professional Midwives to reach out to are Courtenay Grabowski, Nicole White, Goldie Parker, Jenny Zaner, Amy Lechtenburg, Helen Eggertson, & Amanda Howell.
University of Michigan: Has a separate hospital care center for women and children (Women's Von Voigtlander Center) and will be lower risk for cross-contamination if you are concerned but still want to be in a hospital setting.
For more resources regarding COVID19 during the perinatal period, please visit http://nationalperinatal.org/COVID-19 for the latest, evidence based reports.
Our goal is to help flatten the curve of this viral infection due to our privilege to be able to restrict our movements. Preventative measures such as these will help prevent the spread of this virus. We are willing to work within our government's requests for the health and safety of our community. We are willing to appear as if we are over-reacting in the larger picture. The appearance of "over-reaction" is a best case scenario for our community, it means that taking preventative measures worked. Please understand that we work within hospital settings and WANT to reduce YOUR risk!
Please reach out to us, should you have any further questions.
With love and care,
Margaret Rodeghier and Rachel Mackay