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M.A.M.A.S., Inc. Practice Plan During COVID-19 Pandemic

Updated 10/27/2021

It is the aim of all of us here at M.A.M.A.S., Inc. to provide you with safe, personalized, client-centered care, and to continue creating community in this strange and confusing time of social distancing.  We will continue to be in contact at our usual intervals, but while some of our visits will continue to be individual in-person visits in our office or your home (after 36 weeks), others will be group or individual virtual visits using Zoom, and some will be a combination of a virtual visit for the talking portion of the visit with a brief hands-on in-person visit.  These visits will take place in the following locations:

~ Individual visits will be with alternating midwives in our home office.

~ Home visits will be at your house starting at 36 weeks and happening weekly until your baby is born.

~ Group Visits will be on Zoom, often followed either by virtual belly-checks done with your equipment, or by in-person belly checks with one of the midwives at our office.

~ Type of Visit can change if there is any concern about your health, or unforeseen need for an in-person visit (for instance, if you need a lab test for a problem such as UTI or yeast infection)

Infection Control 

Midwife office visits (individual visit):

Our office is in a private home, with separate entrance and bathroom, which we will use for individual visits, disinfecting all high-touch surfaces and our equipment before and between visits, according to current CDC recommendations.

We ask that you text us from your car to let us know you have arrived.  We will text you back when we have finished disinfecting and preparing the space for you.  Please STAY IN YOUR CAR until you receive the text saying it’s okay to come in.

Home visit:

Before our scheduled appointment time, please go through your space and disinfect all high touch areas.  Start at the front door and walk through to a main level kitchen or bathroom, disinfecting surfaces (bookshelves, tables, doorknobs-inside and out, and light switches), toilet handle, faucet, etc.  Please provide a fresh washcloth or paper towel for drying hands, and some wipes or a washcloth and Clorox solution to wipe our equipment before we leave.  We will leave shoes and outerwear at the door, wash hands on arrival and again before we leave.

 

Birth:

When you go into labor, please have your support person disinfect the house as instructed for home visits, including surfaces on the same level as the birthing room. Based on current recommendations at the time of your birth, we will don personal protective equipment while in your home. Currently, this means only masks, and gloves for the birth (which is what we wore pre-pandemic).

In the “before times” we were happy to follow the birthing person all over the house, kitchen, living room, bedroom—wherever.  However, during this pandemic, to the extent possible, please prepare ONE room for your birth and sanitize it well, and the midwives will try to stay just in that room, the bathroom, and the kitchen, unless everyone in the house has been fully-vaccinated. In addition, all other support people (family, friends, or doulas) will remain outside the home in order to decrease exposure risk for the midwives and the birthing person (they can happily join virtually) unless: 

  • They have quarantined with the family for 2 weeks and tested negative for covid-19

OR

  • Are fully covid-vaccinated (any type), 2 weeks past their last dose, and tested negative for Covid-19 within 72 hours of coming to the home

 

Birth tub:

M.A.M.A.S. is happy to support water births when the requirements below are met:

Requirements:

  • Antibody testing at 38wks (unless fully vaccinted) and viral test at testing center with negative results.
  • A plastic sheet should be available to cover the pool after use.
  • Support person is responsible for pool clean-up after midwives leave.
  •  Tub used will be the client’s bathroom tub, purchased by client specifically for first time use, or rented from a M.A.M.A.S-approved source.
  • Add 2 tablespoons of bleach to the water an hour before use to sanitize the water and evaporate within that hour. (per Waterbirth International recommendations)

Testing:

In the interest of providing the best possible care, we require covid antibody testing in each trimester unless you are fully vaccinated against Covid-19.  If you have a mild case of Covid-19 not requiring hospitalization prior to 32 weeks gestation we require consultation with our consulting MFM & will discuss in partnership with you the safest option of birth location. If you have covid antibodies or a positive nasal swab after 32 weeks gestation, current data suggest that the safest location for your birth is the hospital and we will facilitate your transfer to the GW midwives or a provider of your choosing.

Even if you are fully-vaccinated, we advise extra caution in the last few weeks of pregnancy, with a swab test at 38 weeks and then quarantining as much as possible for the remainder of your pregnancy.

We encourage all our clients and the other people in their homes to follow the current CDC and White House Guidelines about social distancing.

  • Avoid going out unnecessarily, and avoid inviting others into your home.
  • Avoid groups of more than 10 people and stay 6 feet from anyone.
  • If you must go out, wear a mask, and when you return home wash hands for at least 20 seconds with soap and hot water, when you get home. And also clean your mask!

 

THINGS THE MIDWIVES CONTINUE TO DO:

The midwives would love to see you and exchange hugs as has been our “normal” for so long, and we will continue to be WITH you in new and different ways while respecting the need for social distancing.  Some things have to change, but not everything.  We can continue to:

  • Offer our respect for the birthing person at the center of care
  • Find ways to create community in new paradigms
  • Hold the space for physiologic birth and breastfeeding
  • Offer our calm and loving presence along with our desire to help
  • Offer our patience and fortitude.
  • Be available by phone 24/7 to discuss any questions or concerns you may have. If you find yourself thinking, “should I call the midwife?” The answer is always YES.

THINGS THAT YOU CAN CONTINUE DOING:

  • Get good sleep
  • Drink plenty of water
  • Eat a well-balanced diet with lots of fresh fruits and vegetables and minimize processed foods.
  • Reduce stress by creating and maintaining self-care practices.
  • Consider following the recommendations of Aviva Romm to help maintain your immune system: (Zinc 30mg/day, Vitamin D 4000 IU/day, Vitamin C 1000mg/day, echinacea tincture 2.5 mL (1 dropperful) 3x/day. Be sure your prenatal vitamin has 400mcg of folic acid as it’s shown to be protective in case of maternal fever.

Love,

Máiri, Emily, and Leslie