CORONAVIRUS

* BE SAFE * BE KIND *

*PHYSICAL DISTANCING * CLEAN YOUR HANDS FREQUENTLY *

*REPORT EXPOSURE/SYMPTOMS TO YOUR MIDWIFE*

*WEAR A MASK WHEN UNABLE TO DISTANCE (previously optional)*


IF YOU THINK YOU HAVE CORONAVIRUS OR HAVE BEEN EXPOSED:

UP-TO-DATE PREGNANCY INFORMATION ABOUT CORONAVIRUS

www.bccdc.ca/health-professionals/clinical-resources/coronavirus-care/clinical-care/pregnancy


CARE AT POMEGRANATE DURING CORONAVIRUS

UPDATED 26 May 2020 –

The midwives and staff at Pomegranate continue to work overtime to plan and manage our pandemic response. Our priority is to reduce the risk to you, your family and community, as well as our midwives, our staff, our hospital colleagues, and all of our extended circle of family and community. More than ever, our three teams are working as one large team to maintain a high level of service to all clients. In addition, the midwives and administrators of BC Women’s, St. Paul’s and Burnaby Hospital have joined forces to support each other and all of our clients.

PRENATAL CARE

We have taken extensive measures to minimize potential exposure for our clients who are receiving care from us in our clinic. Our two-pronged approach includes both extensive sanitizing and minimizing contacts – clients, staff, midwives, support staff, etc.

Until further notice, all in-clinic appointments are  being scheduled in an adapted manner to reduce the number of people in the clinic. Since the bulk of our clinical care tends to involve discussions on various topics, we will be scheduling visits in two parts – the first  on the phone or Zoom to allow time for questions, review of labs, informed choice discussions, etc; the second part will be in the clinic, generally 5-10minutes in length, for physical assessments as necessary. If there is no need for clinical assessment, then your full appointment may be by phone or Zoom.

PHONE or ZOOM APPOINTMENTS:

  • Phone appointments will happen before your clinic appointments.
  • PLEASE keep an eye or your phone when you are expecting us to call.
  • PLEASE have your list of questions ready and near your phone, as there is no extra time to catch up during the in-clinic appointments.
  • PLEASE feel free to put us on speakerphone if you want to involve your partner.
  • Most lab requisitions, handouts, prescriptions, records releases, etc, will be emailed or faxed. Make sure to check your junk mail regularly when you are expecting an email from us.
  • Testing and specialist referrals are being limited to those deemed essential, although many specialists are now available by phone or Zoom.

IN-CLINIC APPOINTMENTS:

  • PLEASE have a thermometer at home and take your temperature before your visits
  • PLEASE attend your appointment alone, with your partner, or with one other person from your household. We usually love to meet your families and friends but currently we request that you bring no more than one support person to your visit.
  • PLEASE don’t arrive early for your appointment
  • PLEASE wear a mask to your appointment. Anyone who comes with you should also wear a mask, as well as keep distanced from the midwife while in the clinic room.
  • PLEASE clean your hands on entering the clinic (and before exiting)
  • PLEASE remove and discard any gloves you are wearing, and then sanitize your hands immediately. This is to prevent contamination within the office of anything you may touch while here. Ensure you have a new pair with you for when you leave.
  • ****PLEASE do not come to our clinic if you think that you – or any of your close contacts – have possibly been exposed. Page your midwife, who will help you figure out whether you or they need testing, and how we can still provide appropriate midwifery care to you in the meantime. Arriving to the office sick may result in a shutdown of the entire clinic.****
  • PLEASE return any borrowed books at your next appointment. Our lending library is closed at this time for outgoing books.
  • Our Free Store exchange is also closed at this time.

POSTPARTUM CARE

Most postpartum visits will be done in your home, except for your final visit. We highly recommend that families consider self-isolation for the first 14 days: we always recommend that postpartum families do not leave home for at least one week, and now we are requesting that you avoid visitors for two weeks. Especially grandparents, as they are in a higher risk category. Two weeks of nothing but sleeping, eating and learning how to breastfeed will help you heal quickly and build your immune system! It will also help your midwives ensure that they are safe with you, and not tracking any contagion to another family.

*May 2020 update: Over the past two months of pandemic restrictions, there has been a dramatic improvement in breastfeeding success with our clients! We largely attribute this to the pandemic restrictions, which have eliminated the large number of distractions in the first two weeks that interfere with establishing a good breastfeeding relationship. Even the joyful interactions with family and friends are enough, apparently. Once coronavirus restrictions are lifted, we will be still strongly advising new parents to focus on cocooning for those first precious weeks.*

We will be using hand sanitizer before entering your home. Please provide the following for us to use after arrival (located near the bathroom or kitchen sink is helpful):

  • Paper towels
  • Liquid soap

Part of postpartum care is keeping an eye on baby’s weight gain (or lack of). Usually we bring a scale to your home, but thanks to coronavirus, a number of our clients have purchased scales to weigh their babies themselves. Feel free to ask us about this option.

 

ALLIED HEALTHCARE TEAM

As of mid-May, we are happy to say that our pelvic floor physiotherapist and massage therapist are back to working in the clinic. Appointments can be booked at  www.fullcirclephysiotherapy.com

 

COMMUNICATING WITH OUR OFFICE ADMIN

Our administrators are working from home.

CALLING THE OFFICE (604-255-5556 extension 0)

  • Phone calls may now come through as “anonymous”, “unknown” or “no caller ID”.
  • Administrative phone hours will be reduced. Please feel free to leave a message on the office voicemail. We will be checking messages 2-3 times during the day and returning calls as promptly as possible, typically within 1-2 business days. As always, if you’ve not heard from us, we are not ignoring you! Please call us back as we may not have received your message or may not have heard it well enough to call you back.

EMAIL FROM THE OFFICE

  • Help us to stay in touch efficiently, by keeping your phone number(s) and email up-to-date with our office.
  • We will be emailing quite a bit more than usual during this time, typically to send you handouts or lab requisitions. Emails often go to junk/spam folders, so please check them frequently if you are expecting an email from us.

FAXING/EMAILING PAPERWORK TO THE OFFICE (office@pomegranate-midwives.com)

  • Occasionally you may need to send paperwork to us, such as a records release that you have just signed – if you don’t have access to a fax machine, an excellent iPhone app is Genius Scan, with which you can scan and email paperwork. Just know that it has limits on confidentiality, as with all email.

PAGING YOUR MIDWIVES

  • PLEASE page your midwife about possible exposures/illness for you or any close contacts. We will help you figure out whether you or they need testing, as well as how we can still provide appropriate midwifery care to you in the meantime.
  • PLEASE be patient. As you can imagine, we are receiving a much larger than average call volume, all at the same time as we are working overtime to keep up-to-date with coronavirus information, provide extra testing, source extra supplies, and maintain extra cleanliness, etc. Our midwives are doing their best to answer all messages in a timely manner. Please make sure to leave a detailed message including the nature of your call, so that we can triage calls appropriately. Unfortunately, less urgent calls may have to wait a number of hours, but you should receive a call back within 24 hours.

*Please note that lab and ultrasounds results will not be called to you, unless there are clinical concerns to be addressed. We will not be able to call you with non-clinical information such as the sex of your baby.*

  • If you have My EHealth, be aware that some test results can be flagged as abnormal because normal values are often based on non-pregnancy norms, and in some cases, male norms. We will call you if there is anything concerning with your labwork.

CARE IN THE HOSPITAL

www.bcwomens.ca/health-info/coronavirus-information-for-patients

  • Your partner or another companion is welcome, of course. If they have signs of illness or are known to be coronavirus positive, then they will have to leave.
  • At this time, certified* doulas are also allowed for labor support. If your doula is unable to work, please let us know so that we can quickly refer you to someone else who is available. (*Certified by the DSA – ask your doula, most have this certification or can apply easily.)
  • Nitrous oxide (laughing gas) is not available for pain relief
  • If you are at low risk of having coronavirus, then your careproviders will use all the usual precautions to prevent infection, PLUS full protective gear for the delivery (gowns, gloves, face masks and eye protection).
  • If you are coronavirus positive, or have symptoms suspicious of coronavirus:
    • In addition to us, you will have a lot of experts on your team keeping you and your baby as healthy as possible: we will involve the obstetrical team and the infectious disease specialists. We will recommend extra monitoring during labor. Everyone on your team will be wearing full protective gear for the whole labor. If you have not been swabbed yet, it will happen on arrival at the hospital.
    • Fever is a common side-effect of epidurals, but also of coronavirus. Even if it is likely that you have developed a fever due to your epidural, we will not be able to rule out coronavirus, thus you will get a viral swab and the team will don full protective gear for the rest of your labor as a precaution.
    • If you need to deliver in the operating room (generally, this means caesarean), then only necessary medical personnel will be allowed. Unfortunately, this likely means the obstetrician, the surgical nurses, and the pediatrician only – no partner or midwife.
  • There is no cordblood collection at this time.
  • Postpartum visitors – one adult support person is welcome. No visitors, not even siblings, not even in the waiting room, sorry.
  • Parking is free at all hospitals.

CARE IN YOUR HOME: Labor care, Homebirth, Postpartum visits

*We are continuing to attend low-risk clients at home*

As with previous pandemics, we are receiving additional requests for homebirth. As always, we are always happy to discuss the benefits and risks of your planned place of birth, but we encourage people to avoid making choices out of fear. Our hospitals continue to be safe places to give birth, and every effort is being made to provide appropriate support in hospital. If you want to do more research about your options, check out the BIRTH section on our Resources page.


Unfortunately, at this time we can only offer homebirths to current clients, since we are fully booked. If you would like to be on our waitlist anyways, feel free to send in an intake form.


POMEGRANATE ONLINE

MENTAL HEALTH CARE: TAKE CARE OF YOURSELF AND YOUR RELATIONSHIP

Tanya Podlozniuk, Registered Clinical Counsellor with expertise in pregnancy and postpartum, including loss

*Appointments by Zoom, don’t wait until coronavirus is over to access mental health support!

 

PELVIC FLOOR STRENGTHENING & TREATMENT

Jodie Pulsifer, Registered Physiotherapist with expertise in pregnancy and postpartum

*Appointments by Telehealth and in-person (starting end of May), a key piece of helping your body prepare for/recover after birth

 

CHILDBIRTH PREPARATION CLASSES:

HYPNOMAMMAS with Jenn Lasek

CHILDBEARING SOCIETY

 

POSTPARTUM DROP-IN GROUP:

Our well-loved Friday drop-in group is up and running on Zoom. Check Facebook updates on how to join, times, etc.

 

HOMEBIRTH INFO SESSION, WATERBIRTH INFO SESSION:

NOW ONLINE: If you are interested in finding out more about homebirth or waterbirth, join in on one of our Info Sessions, currently being done on Zoom. Check Facebook for dates and times.

 

IN OUR COMMUNITY

VILLAGE ACUPUNCTURE – A favorite local business who has treated 100s of Pom clients, needs support to stay afloat! They have figured out how to provide service at a distance – mailing you the necessary acu-buttons, then providing private Zoom appointments to guide you through applying them.

HASTINGS SUNRISE WALK-IN CLINIC – Both in-clinic and virtual appointments

LONDON DRUGS, SHOPPERS DRUGMART – Free prescription delivery on weekdays

LIFELABS – Info on booking appointments, changes to protocols and/or operating hours/closures

ULTRASOUNDS   *Obstetrical ultrasounds are considered an essential service and will continue to be booked*

Contact the ultrasound clinic directly before your appointment to learn if they have made changes to their policy regarding bringing an adult companion to join you.


POMEGRANATE RESTART PLAN

PHASE 1

ESSENTIAL SERVICE: Goal restricting traffic through the clinic to 30%

MARCH – mid MAY Finished. May be necessary to return here during second wave.

PHASE 2

CAREFUL RESTART: Goal 40% contacts

mid MAY – JUNE

 

NEW:


PHASE 3

CAREFUL RESTART: Goal 50% contacts

JUNE

 

NEW:

  • Partner or one support person from same household welcome at visits
  • Resume doing Paps & IUDs.
  • Registered Clinical Counsellor working in clinic.
  • Library book recall: please return your books at your next visit.
  • Increased prevention efforts due to increased traffic in the clinic plus many clients expanding their bubbles and returning to work, including increased frequency of cleaning.

PHASE 3-A

CAREFUL RESTART: Goal 50-60% contacts

JULY-AUG

 

NEW:

  • MOAs gradually increase hours in clinic, starting with one day per week.
  • Papapalooza event for outstanding Paps

PHASE 3-B

CAREFUL RESTART: Goal 60% contacts

SEPT? NEW:

  • Resumption of longer clinic visits instead of split into phone+in-person. Some visits still virtual (phone/Zoom) only.
  • Resumption of postpartum visits in clinic after the first week.
  • Reopen lending library to outgoing books.
  • Resumption of small classes.

PHASE 4

TBC Dependent on wide vaccination, community immunity, broad successful treatments …

 

 

 

 

 

 

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