Dr. Debra Wright, Medical Director of Maternity Services at UC Davis Health, discusses pregnancy, delivery and postpartum care during the novel coronavirus (COVID-19) pandemic. Dr. Wright explains the new precautions taken in the hospital and answers questions from current and future patients in this Facebook Live interview.
I'm Pamela Wu. And with me today virtually is Dr Deborah, right? She is the medical director of maternity services at U. C Davis Health. Today we're going to be discussing delivery and postpartum care at UC Davis Health during this cove in 19 pandemic. If you have questions today, please feel free to post them in the comments, and we'll do our best to answer them toward the end of discussion. Doctor. Right, Thank you for being with us. Thank you for having me now. Labor and delivery, of course, is already extremely daunting. For expectant moms, there's so much to think about. And, of course, the Kobe 19 pandemic has added additional challenges. What is being done to protect these patients from Kobe? 19. Well, certainly many changes have made since the beginning of this pandemic. All of our patients, actually all of the doctors, nurses, patients, visitors are screened at the entry of the hospital as a first line, both with screening questions and temperatures being taken. Everybody who enters the hospital must wear a mask, including doctors, nurses, employees, patients and visitors. Once patients get up to our labor and delivery suite, they are again screened with, uh, questions that might be consistent with having co vid um, all of our patients who are admitted to labor and delivery are tested for Cove in 19 so that we can better care for the moms and the baby's once they arrived and again, patients, doctors, nurses, everybody is wearing masks and then more recently, face shields to help protect everybody. So when you say that expectant moms, those who are being admitted to deliver are being tested, they're receiving the nasal swab. They they are so patients that we know are coming, maybe for a scheduled induction or for a scheduled cesarean section. They will have their co vid test a couple of days before there admission date. But anybody else has it after they arrived and about how quickly are those tests turned around? Um, there turn around less than a day. It's usually about half a day way. Get the results back. That's fantastic that at our facility were able to turn them around as quickly as we can for the protection of both patients and staff. Are we screening moms and support people? A swell Yes, So the support people are screened via questions but they're not. Have Koven test done? And what happens if someone tests positive upon admission to the hospital? Well, fortunately, in our in our population are asymptomatic pregnant patients, um, who are coming for labor and delivery or other present pregnancy complaints. We haven't had anybody be positive who did not have symptoms. So I think that's very reassuring in our patient population in Sacramento. Um, I think we're very fortunate in that sense, and that also provides an extra feeling of safety. I think for all of us we have had a few patients who presented with symptoms consistent with, um covert who are not in the labor and delivery pop process. And they are kept in on different floors where we're able to care for them to not have them be in close proximity to our pregnant patients. You mentioned a little earlier in the conversation the use of PPE personal protective equipment, and I'm sure that a lot of expectant moms who are coming in are wondering what they need to wear, what their support people will need to wear and what the staff is going to wear. Could you discuss those for us? Certainly. It is definitely a little bit of a different time. Their doctors and their nurses will all have a mask on, and then either a face shield or goggles or glasses or some I protection eso. It's a little bit different in the sense that hard to see the face of people. But it is what we believe. The safest for our employees and for patients is, well, patients and their support. People are also asked to wear masks at all times, even patients who have tested positive. We're asking to wear a mask on but really is for their protection. Yeah, for their protection and the protection of everyone around them as well. Have any moms asked if their newborn babies they're going to be tested for Kobe? 19 moms have definitely asked. So we so if the mom is negative, then the baby would not be tested. So we do have plans in place. So if a mom was co vid positive and delivered her baby, I think those babies are will be tested. And what about the audiology and blood tests for babies after delivery of those still happening? Those are all still happening. We're really doing our very best to provide the same standard of care that we always have provided. But just adding these extra precautions to protect everybody. We are discussing labor and delivery during the cove in 19 Pandemic with Dr Deborah. Right. If you have any questions, please feel free to post them in the comments, and we're going to answer them toward the end of the discussion. In fact, before we even went life, we received a number of questions via our social media channels, and I have a few of them right here. These are questions that came from our social media followers. Dr Right, What is the current visitor policy? And do you expect this to change any time soon? Our current visitor policy actually has just recently changed based upon the mandates from the state. But all of our patients are allowed to have one support person during their hospital admission. And so that is And of course, I mean, the situation is changing. Like you said, we have to respond to what are our regulators? Tell us, um, to dio. But that is the current policy right now. 11 support person it is. We were actually unique and that we had allowed people to have to support people during their labor and their delivery. But in compliance with the state, we have now limited that toe one that one person, though, does need to be the same person for the whole, for the whole stay. Unfortunately, we can't allow on exchange of visitors. So there's one designated person for the hospital, of course. Okay, so that actually answers the next question, which was whether the support person can switch with someone else. So it needs to be one designated person for safety. Okay, Yeah. The next question asks whether you're separating babies and moms of mom tests positive. So we have We have a plan in place that involves, um, share decision making with the mom and with the pediatric team and the OBE team. Um, fortunately, current data doesn't show a, um the significant risk of the baby getting cove it just by the labor and delivery process on getting the baby from the mom in the uterus. So that is good and reassuring news for everybody way Offer to plans which are made in conjunction with the with the parents or the support people on that involves the most conservative would be that the baby is immediately separated, um, from the mom and taken to another room and provided care there. Um, the other alternative is that we could do physical distancing eso the baby would be 6 ft away from the mom in an isil. It, um, possibly even with a curtain to separate the mom from the baby. And then another person can provide care for the baby and these air. All are these plans that you had to put in place yet or these were just these air just plans that you have at the ready, right? So far, we haven't had to use those plans. But we have, ah, great team of doctors and nurses that involve r o B G Y n physicians are doctors in the neonatal intensive carrying it are pediatricians. So we have come up with a plan. So that way feel prepared, you know, Unfortunately, that also involves things like routinely we do, um, delayed court clamping on the mom's chest. If the mom had co vid, we would still do delayed cord clamping, But that would be in the doctor's arms. And not, um, we wouldn't have the baby beyond the moms chest. So we've had to make some arrangements or some plans that deviate a little bit from what would we like to do for the baby's protection, right? Obviously out of the ordinary, but like you said so important to be prepared so that when it happens, you know exactly what you're going to do for the safety of all patients. Both mom and newborn. Exactly. Exactly. The next question asks if a mom is tested upon arrival, does it mean that Mom might have toe labor in a mask until the test results come back? So if the mom does not have symptoms and her tests are pending, we treat her as if she did not have co bid. Um, but right now we're asking everybody to wear masks regardless, moms, their support people and all of the doctors and nurses. So we are encouraging that we do understand sometimes when you're laboring or pushing the mass not might not be able to be on every second, so we do try and accommodate that if if it is incredibly uncomfortable. But that is our preference. Sure, safety as much as possible for everyone in the room. Exactly. The next question asks if a significant other is symptomatic. Is there another way that U. C. Davis can include them in the birth? Since they can't be there? Are moms allowed Thio You say video or FaceTime or other technology in that situation? Yes, you know, as you said, unfortunately, if somebody has symptoms, we can't allow them in the hospital. But we do allow FaceTime or resume. Whatever media source they choose to use is absolutely fine. Will support persons be able to provide skin to skin contact with the baby? Yes, they can. And that would absolutely be encouraged. That's great. It's so important to and so meaningful for for everyone involved. Our next audience question asks when we are released from the hospital. What precautions do you recommend that we take? So I think I'm assuming that means somebody who doesn't have co vid Andi. I think the precautions would be the same as we are all doing right now. Um, which would be to lim limit outings to what we need to do is possible. I'm sure keeping the baby in in the home as much as possible, except for doctors appointments, um, wearing masks and using precautions when we're out in the world and washing. Of course, I think Probably no significant changes from what we've all been doing for these last months. With the exception of keeping the baby in the house, I think as much as possible. And I can absolutely understand the anxiety. When you know you read a question like this, it z daunting to have a new baby to begin with, especially if you're a first time parent. And now with the virus. I'm sure parents are wondering, Should I be doing something differently? Is there something really important that I don't know? Yeah, it's a really scary time. Labor and delivery. Having a baby is always something that women, um, worry about and are anxious about. And this is a really surreal time. You know, things none of us would have imagined that we would be ever even suggesting to a patient, you know, limiting the number of people in rooms or being masked and face shield when we see patients. Um, but I think all of these are precautions that are really necessary in this time and that we need to be really careful to be safe for everybody. The next question, I'm sure, is one that you've been getting a lot. That is, since we can't tour the hospital in person, Do you have a virtual tour of labor and delivery that we can take? We do on the on the UC Davis O B G y n website, there is a virtual tour of labor and delivery. And then finally, I know that this is such a Superfund perk that all of our labor and delivery patients enjoy. Are you still doing the celebratory mommy meals after delivery? We are still providing the meals toe the mom and her support person. For those who are watching and don't know those celebratory meals are amazing. Um, they roll in a cart. It's like room service. You get a really delicious dinner with champagne flutes to toast with sparkling apple cider. It's really fun, and it makes the whole experience. It's just sort of the icing on the cake to make things really special on a very special day. Yeah, I'm thankful we're still able to offer that. Absolutely, This next question asks. Are postpartum rooms single or shared post part of rooms are single. People like to hear that. I'm sure, Yes, I think I think I'll dio. Yeah, people enjoy their privacy. And plus, these days, it's it's safer to with, you know, with what we're talking about exactly. Dr. Right? Do you have any closing comments? Anything I didn't ask that you want to touch on or things that you just really want perspective patients to know. I think mostly I wanna offer reassurance that the hospital is ah, safe place. I think many people are hesitant to seek health care and to go to clinic and goto hospitals out of fear of being exposed to Cove in. But we have a neck Solent group of people that meet frequently stay up on the latest evidence and literature and really do our very best to ensure that the care is, um is safe at U. C. Davis. I want everybody to feel reassured, and I believe that it's safer to be in the hospital than to be, um, of waiting the hospital, especially in a time of, you know, pregnancy, labor and delivery, and maintaining prenatal care and regular visit and delivery in the hospital, I think is really important, and I want people to know that it's safe. It's such an important message. Is someone who, you know, works at a health care facility. I, too, can tell our audience members that there is so much care that is going into the preparation for our patients to keep them and their loved ones safe as well. So thank you so much for that message, Dr Right. Thanks for being with us. We really appreciate your time and information today. Thank you. Thank you for having me and next to those of you in the audience for joining us for this u C. Davis helped Facebook live. If you have more questions, you can still post them in the compliments. And we will get them to Dr right so that she can give you some replies and we encourage you to share this post. If you have family and friends who would enjoy learning from it for the most up to date information on Kobe 19 had to health dot u c Davis dot e D u slash coronavirus. Thanks for being with us. Yeah,