COVID-19: Are you prepared to serve your clients?

As of this writing, there are more than 1200 confirmed cases of COVID-19 infection and dozens of deaths reported deaths in the United States. The ‘Pandemic’ threshold has been reached. The COVID – 19 virus has spread to 111 countries around the world and community spread is increasing. A week ago, it was possible that you were pondering if this was going to really impact you personally. Today, I’m sure you are recognizing that for some time, anyway, our lives are going to be organized in one way or another around this pandemic.

This novel virus appears to have a high level of transmission, and a significantly higher rate of fatality overall than Influenza types A or B. Health care systems are bracing for a pandemic. While businesses and schools prepare for lockdown, what happens for those who care for others? If you’re caring for expectant or new families, what do you need to know?

How is COVID-19 presenting in pregnant persons or young infants?

Public health officials remain hopeful that pregnant persons, infants, and young children appear to be least severely impacted by this strain of the Coronavirus, epidemiologists generally define pregnant persons as “key at-risk” populations (Qiuo,2020). That’s a fair concern, given how H1N1 presented in 2009, and the SARS related outcome from 2004.

Lactation as Protective

It is anticipated that COVID-19 will replicate the patterns of transmission identified with previous novel virus’, such as SARS, and that as such, vertical in-utero transmission between parent and neonate is unlikely, and that antibodies in human milk will provide protection to newborns and infants. Breast /chest feeding may be even more critical in providing immunity during outbreaks.

Family Preparedness

In our practice, we’re providing resources for families to prepare, and are anticipating a few possible scenarios:

• Family supports are less likely to be able to safely travel, and grandparents may end up being at greater risk than their adult children
• Health care systems are becoming taxed and medical centers will likely see an increase in hospital-acquired infections. Staff shortages may make non-medical supports, such as doulas more important than ever.
• Families may opt to attend childbirth classes in more protected settings, opting for small or one:one private classes in community hubs, rather than hospital-based classes. We’ve offered online classes and enlisted strict policies for educators, doulas to refrain from duty if they have any symptoms or any exposures to those who may be ill or had any contact with PUI.

Preparing as a Doula, Lactation Consultant, or Perinatal Educator

As infectious disease specialists continue to study the impacts for population groups, health care personnel are receiving guidance to best care for infected persons, to create isolation protocols and other containment practices, to protect staff from infection and to organize emergency response plans. For providers who work outside of hospital or clinic settings, particularly in private practice, there is a need for accurate information and the establishment of transmission –specific protocols.

As doula, perinatal educators, LCs in private practice, are excluded from centralized information sharing, providers of reproductive health support services need access to best practice guidelines. If you’re caring for families in this way, how are you going to be responding?

How are you answering questions from your clients? Do you have accurate and up-to-date information? What ethical and scope of practice issues might arise? When should you exclude yourself from the care of families? Can you travel? What if there is a lockdown in your community? What should change about your home-based routine for care? How can you manage your own health, manage stress and support your immunity?

Italy has been on lockdown for 2 days now, and experts have projected that the U.S will be about 10 days behind Italy in progression and that without clear action and skillful response, the consequences here could be much worse. Babies will continue to be born, even as health care systems become overburdened.

Let’s together do what we can to do what we do best: keeping families informed, supported, healthy and well.

Our COVID-19: Best Practices for Lactation Consultants, Doulas & Perinatal Educators will provide a synthesis of up-to-date position statements to guide the care of lactating parents and their children and key briefing for those in position to provide health education and advocacy or other non-medical support services. Sign up today and get access to the online, self-paced course.  Pre-registration offer ends 3/16.