Due date approaching? Here’s what to do | Norton Healthcare Louisville, Ky.

What to expect and do if your due date is approaching

COVID-19 has upended lives. If you’re pregnant, you may wonder: Is it safe to give birth in a hospital? Is home birth an option? Here’s what you should know to stay safe.

Pregnancy can be an exciting and challenging time no matter when you’re due. However, if your due date is approaching during a global pandemic, you may have a lot of questions. Should I change my birth plan? Is it safe to give birth in a hospital? Here’s what you can do to keep yourself and baby safer before, during and after delivery.

Social distancing for expectant moms and labor and delivery partners

According to the Centers for Disease Control and Prevention (CDC), pregnant women and babies are not a high-risk population for COVID-19. However, women should take precautions to stay as safe as they can, including staying in the house and avoiding public places, maintaining the social distancing and good hand hygiene that are recommended by local and state governments.

In addition to the expectant moms, significant others who will be present in the labor and delivery room should really limit, if at all possible, their time outside of the home. They should work from home if at all possible and stay home with the expectant mother.

“This is especially important during that last two or three weeks leading up to delivery,” said Jennifer C. Evans, M.D., MPH, system vice president, women’s and pediatric services for Norton Healthcare. “The time of delivery is unpredictable, certainly, and a lot of specialists nationwide are really starting to talk about that three weeks preceding the due date.”

Norton Healthcare currently allows one support person to accompany a woman giving birth in a hospital, as well as a properly credentialed doula if desired.

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What to do about prenatal and postnatal checks?

When pregnant women come to Norton Healthcare providers’ offices, we bring them in and take them straight back to the exam room. Obstetrics patients can have one visitor at the second-trimester ultrasound. Otherwise, for the safety of everyone involved, only patients will be allowed at appointments. While we understand this is not preferable, it is in the best interest of everyone. We encourage expectant mothers to use FaceTime or other video conferencing tools to allow a significant other to be involved. If you require support during your visit, please contact your provider’s office before your appointment. You will be asked to complete a health screening before you are seen. All patients in an outpatient setting must wear either a surgical mask or cloth face covering; we highly encourage you to arrive wearing a mask. Learn more about what we’re doing to keep you safer.

Not all expectant moms or significant others can stay at home due to their careers or personal situations. What should they do to protect themselves?

“If mom works in a high-traffic business such as a grocery store, I would recommend wearing a mask, along with constant hand hygiene or wearing gloves to protect herself as much as possible,” Dr. Evans said. “Certainly, she could ask to be in an area that’s less public-facing whenever possible so that there isn’t that contact face to face. Face shields are being used in a lot of businesses now, and I think that we’ll see more of that in the future.”

How safe is it to have a baby in a hospital?

“I feel that moms should feel secure coming into the hospital,” Dr. Evans said. “All employees are screened, wear masks, and take precautions to be safer. We have significantly changed our visitor policies to keep patients and caregivers safer. Certainly, there are COVID-19 patients in the hospital, but not necessarily in labor and delivery. Somebody could be positive in labor and delivery, but we isolate them, and we also do that in the postpartum area.”

Mothers can choose to have a test for COVID-19 when they are admitted for delivery. For mothers who test positive for the coronavirus, protocols will be followed to protect the baby.

“The current CDC guidelines are recommending that we request that they be separated,” Dr. Evans said. “So mom is in one room and baby in another, but mom’s given that option. If she prefers to have her baby in the room with her, we recommend that they stay at least 6 feet apart. We usually have a screen between them. They can breastfeed. We would recommend that they express milk through a breast pump. If they choose to breastfeed directly with baby next to them, we have the mom wear a mask to help prevent transmission to the neonate.”

If you’re concerned about staying in the hospital after giving birth, talk to you OB/GYN or midwife.

“Typically, after a vaginal delivery, babies go home in two days and then after a C-section usually three to four days,” Dr. Evans said. “Occasionally, we’re seeing some moms who say, ‘Hey, I’m ready to go. Nothing’s holding baby up. Can I go ahead and be discharged sooner?’ So as long as mom and baby are doing well and the pediatrician and neonatal specialist, whoever’s seeing the baby, agrees, then we can usually work that out, if they want an earlier discharge. But once again, safety of mom and baby are of utmost importance, and we will do everything to protect both.”

If I’m social distancing, should I just consider a home birth?

According to the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG) and American Heart Association, hospitals and accredited birth centers remain the safest settings for births in the U.S. Both AAP and ACOG state that home birth is associated with maternal and infant complications, including a twofold to threefold increase in infant death and increased rates of neonatal seizures and low Apgar scores.

Should you consider a home birth, there are guidelines from ACOG and AAP for pregnancies that are considered the best candidates for at-home birth. Women are considered eligible for home births if:

  • They have no preexisting conditions or conditions that develop during a pregnancy, including diabetes or preeclampsia.
  • The woman is carrying only one fetus.
  • They are at least 37 weeks pregnant and less than 41 to 42 completed weeks of pregnancy.
  • They are carrying the baby in the cephalic position (head-first presentation).
  • Labor is spontaneous or induced as an outpatient.
  • They have not previously had a cesarean section (C-section).
  • They have not been transferred from another referring hospital.

ACOG states that if these criteria are not met, a planned home birth clearly is associated with a higher risk of infant death. The AAP states that two care providers should be present at a home birth — at least one should have the primary responsibility for the newborn, with the appropriate training, skills and equipment to perform full resuscitation of the infant according to the Neonatal Resuscitation Program.

Additionally, according to the CDC, all pregnant women should be screened at 35 to 37 weeks’ gestation for group B streptococcus. Women with strep who are having home births should be given an antibiotic at home at least four hours before delivery.

If you are concerned about the coronavirus and giving birth in a hospital, talk to your OB/GYN or midwife.

Baby is healthy at home. How do you continue to keep your newborn safer?

“It’s really important that once mom takes her newborn baby home that they close their house to visitors,” Dr. Evans said. “Everyone’s anxious to see the baby and hug the new baby and kiss them and everything else, but that’s the last thing that we want, right now, is for people to be brought into the house. So really just staying at home and following the public health guidelines are the things to do. We definitely don’t want the kids to become infected.”

Note: Do not put a mask on a child under age 2.


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