* BE SAFE * BE KIND * BE BRAVE *
IF YOU HAVE CORONAVIRUS SYMPTOMS OR THINK YOU HAVE BEEN EXPOSED:
Testing is available for all, even with mild symptoms:
UP-TO-DATE PREGNANCY INFORMATION ABOUT CORONAVIRUS
DECISION-MAKING TOOL ABOUT CORONAVIRUS VACCINATION IN PREGNANCY
BC WOMEN’S HOSPITAL – COVID-19 INFORMATION FOR PATIENTS
CARE AT POMEGRANATE DURING CORONAVIRUS
UPDATED March 2021 –
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.
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 (including between client visits), and minimizing exposure by minimizing contacts (clients, staff, midwives, support staff, etc), shortening in-person visits, wearing masks, etc.
Until further notice, all in-clinic appointments are being scheduled in an adapted manner to reduce the number of people in the clinic. Generally we will be following the World Health Organization recommendations for scheduling prenatal care, as published by the BC Centre for Disease Control. 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 in-person assessment, or this has been done in some other manner (e.g. at an ultrasound clinic), then your full appointment may be by phone or Zoom.
VIRTUAL (PHONE or ZOOM) APPOINTMENTS:
- Virtual appointments will happen before your in-clinic appointments, in most cases.
- PLEASE keep an eye or your phone when you are expecting us to call.
- Zoom appointments will be sent a link in the morning of, or the day before, your appointment.
- PLEASE have your list of questions ready and nearby, 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/Telehealth.
- PLEASE expect that we will ask you Covid-screening questions, and may reschedule your in-person appointment if necessary to minimize risk to those in the clinic.
- PLEASE have a thermometer at home and take your temperature before your visits
- PLEASE attend your appointment alone, 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.
- ***NEW: updated guidelines require all people in healthcare settings, including patients and support people, to wear medical masks (not cloth). If you don’t have one, we will supply you with one.
- 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. Arriving to the office sick may result in a shutdown of the entire clinic.
- *NEW* If you are Covid-positive, or are awaiting Covid test results, we can still provide in-person care, but it will be necessary to make careful plans with your midwife and the clinic to minimize exposure to anyone else. Page the midwife oncall for your team to discuss and arrange.
- Both our Free Store exchange and our Library are closed at this time.
***Nov2020*** Until current emergency guidelines are lifted, visitors are restricted to your core bubble, i.e. your immediate household.
In order to minimize traffic in the clinic, most postpartum visits will be done in your home, except for your final visit. Please see the Care In Your Home section below for specifics about how to improve safety for everyone.
How to survive pandemic restrictions in the immediate postpartum:
- Plan ahead to cocoon for 1-2weeks minimum – Over the past many 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. We have always advised new parents to cocoon for the first precious week, but now we are strongly advising that people take this to a new level by self-isolating completely for minimum one week.
- No visitors AT ALL until your baby is over a week old.
- No leaving the house for either parent, until your baby is over a week old, except for medically necessary appointments.
- Given the above point, make sure to plan ahead for food in the first week(s).
- Consider buying a baby scale – 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 (cost $45-$100, depending on the model). Feel free to ask us about this option.
- After the initial cocoon period:
- Plan other ways for family to meet your baby, by making sure that family members are set up to use Facetime/Zoom/etc.
- If you want your family to visit in-person after the first week or two, they should consider quarantining for 14 days before visiting you. Even if they are unlikely to bring coronavirus into your household, be aware that you may be the infectious one, which is especially dangerous for older adults such as grandparents.
- After one week, local outdoor adventures (i.e. short walks), while wearing masks, are okay.
- Plan ways to get avoid social isolation; take advantage of the many online resources for connecting to your new postpartum community, such as the many postpartum groups on Zoom (including Pomegranate’s).
- Plan a virtual ceremony or social media welcoming. For example, Tsow Tun Le Lum Resolution Health Support Workers offer prayers and virtual smudges on Facebook.
- Plan a celebration or ceremony to officially welcome your baby after restrictions are lifted
ALLIED HEALTHCARE TEAM
As of mid-May, we are happy to say that both our pelvic floor Physiotherapist and our 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 mostly 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 (email@example.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
- Your partner OR one other support person is welcome. If they have signs of illness, are known to be coronavirus positive, or have pending test results, then they will have to leave.
- *NEW* all patients and support people are required to wear medical masks everywhere in the hospital. Women in labor can choose to remove their mask once in their labor room. [NOTE: each hospital may have slightly different protocols, which may change quickly with increases/decreases in local outbreaks.]
- 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 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.
- BC Women’s cordblood banking program has restarted as of June 1st. You can sign up at Canadian Blood Services www.blood.ca/cordblood
- Postpartum visitors – one adult support person is welcome. No visitors, not even siblings, not even in the waiting room, sorry.
CARE IN YOUR HOME: Labor care, Homebirth, Postpartum visits
*We are continuing to attend low-risk clients at home. To be clear, this excludes anyone who has coronavirus, has pending test results, or has current symptoms; or has a household member who is positive, has pending results, or has current symptoms. *
Your midwife will be wearing a mask and using hand sanitizer before entering your home. To keep yourselves, ourselves and the rest of our clients as safe as possible:
- We will be attempting to keep in-person contact for clinical visits to under 15 minutes, wherever possible, by talking to you on the phone before we arrive. Please be prepared to ask the bulk of your questions at this time.
- Please minimize the number of people in the space where the visit will take place. Same for home labor.
- All adults in the space should be wearing masks, as well as age-appropriate children.
- Please consider cleaning high-touch areas both before and after our visit: doorknobs, sink faucets, etc.
- Please provide the following for us to use on arrival (located near the bathroom or kitchen sink is helpful):
- Paper towels or clean hand towels
- Liquid soap
SPECIFICALLY REGARDING HOMEBIRTH:
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.
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!
Other mental health resources in our community:
www.keltyskey.com – self-help for anxiety and mental health, free online therapy for Vancouver Coastal region
postpartum.org phone and text support, online peer support groups
IF YOUR HOME ISN’T SAFE
Battered Women’s Support Services – hotline, online resources, info and support, safety planning
WAVAW Rape Crisis Centre – 24/7 crisis line, trauma-informed counseling and support, hospital accompaniment
If you are in immediate danger:
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
POSTPARTUM DROP-IN GROUP:
FRIDAYS at 11:00 – Our well-loved Pomegranate Postpartum 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
REACH COMMUNITY HEALTH CLINIC – Flu shots, Covid testing (by appointment)
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
*on pause until current emergency restrictions lifted*
ESSENTIAL SERVICE: Goal restricting traffic through the clinic to 30%
|MARCH – mid MAY
||May be necessary to return here during second wave.
CAREFUL RESTART: Goal 40% contacts
|mid MAY – JUNE
||Massage therapist and pelvic floor physiotherapist working in clinic. Appointments can be booked at www.fullcirclephysiotherapy.com
CAREFUL RESTART: Goal 50% contacts
- Partner or one support person from same household welcome at visits
- Resume doing Paps & IUDs.
- 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.
CAREFUL RESTART: Goal 50-60% contacts
- MOAs gradually increase hours in clinic, starting with one day per week.
CAREFUL RESTART: Goal 60% contacts
- MOAs continue to gradually increase hours in clinic.
- Move from only two midwives offering clinic hours at one time, to three midwives.
||Dependent on wide vaccination, community immunity, broad successful treatments …
- Reopen library for browsing. Allowing clients to wait in lobby before appointments.
- Resume classes in clinic.