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Berkshire OB-GYN caregivers aim to arm moms-to-be with vital info

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Being pregnant, preparing to welcome a new life into the world and coordinating prenatal care can be stressful for any mom-to-be; now, try doing it during a global pandemic.

"We're definitely getting a lot of concerned phone calls," said Dr. Lauren Slater, division director of OB-GYN for Berkshire Faculty Services and vice chairwoman of the OB-GYN department for Berkshire Medical Center.

According to Slater and Dr. Andrew Beckwith, of Barrington OB-GYN, who delivers at Fairview Hospital in Great Barrington, women are calling with concerns about the health of their unborn babies and themselves, and are especially concerned about rumors that they might have to deliver alone, without a partner.

Because there is so little known about the coronavirus' effect on pregnant women at this stage of the epidemic, there is a lot of misinformation, or little information, available to expectant mothers.

Slater and Beckwith answered some questions and dispelled some rumors going around regarding prenatal care at their practices, hospital protocol and what pregnant women should know regarding COVID-19.

True or false?

Due to COVID-19, women have to give birth without a partner in the room.

False

Slater and Beckwith confirmed that each of their respective Berkshire County hospitals, Berkshire Medical Center and Fairview Hospital, do not have that protocol in place.

"There is a lot of worry that we could reach a point, perhaps, that we enact a visitors policy so draconian that no one is permitted in the delivery room, and that is making a lot of women anxious," Beckwith said. "I just don't see that happening here."

Slater agreed that the rumors of women being asked to birth alone in Berkshire County are "just not true."

But, both hospitals have begun restricting visitors to one per mother, and are asked to go through the same screening process as their partner for COVID-19 symptoms or exposure.

"We are allowing just one person [with the birthing mother]," Slater said. "We want our mothers to feel supported, but we also have to make the environment safe for them and safe for the staff."

Rumors regarding the possibility of mothers birthing alone started when some hospitals in New York City began enacting the policy in response to the outbreak. New York Gov. Andrew Cuomo overruled those individual hospitals and soon will issue an executive order stating that women are allowed to have one visitor.

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But, that hasn't stopped some women living in New York from calling Fairview Hospital and Barrington OB-GYN close to their due dates to request if they can deliver their babies in Great Barrington, for fear of having to go it alone in New York, according to Beckwith.

"We've had a huge influx of patients asking us to take care of them," he said. "Many people have fled the city, and others not quite as dramatic, have reached out to us for care. It's unusual to get so many patients due so soon suddenly requesting to deliver with us. We've had more than our normal monthly deliveries asking to transfer to us just last week. It's pretty profound."

Prenatal care is limited because of COVID-19.

False

Both doctors stressed that the same level of prenatal care is being given to expectant mothers; it just might look a little different.

OB-GYNs at Community Health Programs and Berkshire Health Systems are using technology to check in on their patients to limit face-to-face contact when appropriate.

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"We are basically reviewing every patient visit in advance to determine whether, with each visit, there is any possibility it can be undertaken without person-to-person contact," Beckwith said. "Whenever it's appropriate, and not any risk to the patient, we're doing Zoom visits, telephone visits and having the patient check their own weight, blood pressure if possible."

Slater said that, at BMC, they are doing every other visit face-to-face, with telephone calls in between. Both doctors stressed that high-risk pregnancies still are being treated in person.

In Great Barrington, they are also doing what Beckwith called "parking lot care," where patients meet doctors and nurses in the parking lot to have their blood pressure checked and listen to the baby's heartbeat.

While this is all new, Beckwith said these are recommended patient care protocols that have been put in place for years by the different governing medical societies for times like this.

"Everything we're doing is not renegade," he said. "We're using previously published data and protocol for ways to adapt."

Pregnant women are at a higher risk for developing severe COVID-19 symptoms.

Maybe

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As of right now, both doctors agree there isn't enough data to give a conclusive answer as to how the virus affects pregnant women and the fetus.

"What we know from the limited data is that there doesn't appear to be vertical transmission in third trimester," Slater said, referring to cases in which the expectant mother becomes infected. "It doesn't seem like the virus passes from the placenta or the amniotic fluid; you get a healthy baby. As far as what the virus does the first or second trimester, we're just seeing that for first time."

According to the American College of Obstetricians and Gynecologists, "Current reports show that pregnant women do not have more severe symptoms than the general public. But researchers are still learning how the illness affects pregnant women. Doctors urge pregnant women to take the same steps as the general public to avoid coronavirus."

At BMC, Slater said its mother-baby ward is preparing for the possibility of having a mother come in testing positive for COVID-19 and having to separate mother and baby right after delivery to keep the baby from being further exposed to the virus.

"The recommendation is for the mother to pump breast milk; it can still be given to the baby [if separated]," she said. "We obviously haven't been in that scenario yet, but we're thinking through it just in case; maybe using iPads if patients are separated to try to give them the feeling they are there with their baby."

Women are changing their birthing plans.

True

Many women are requesting their doctors get them in and out of the hospital as fast as possible, both doctors confirmed.

"Patients are asking to go home earlier, for a more rapid discharge," Slater said. "When appropriate, and mom and baby are healthy and stable, we get them home to quarantine."

But, Slater wants mothers to know the hospital is still a safe place for them to be. The mother-baby unit staffing is level at BMC, there have been no furloughs and Slater feels they have the medical equipment they need to safely care for their patients.

"I still feel strongly that the hospital is a safe place for them to come," she said. "We've taken great precautions to care for our unit and our staff to make it safe for them come."

Beckwith agreed, and also wants expectant mothers to know doctors are here for them.

"We're acutely aware of their fears and concerns," he said. "We're working around the clock to learn what we need to know to handle everything that comes our way. We're not going to turn our backs on anybody for fear of the unknown. We're going to do everything we can to provide the best care possible."


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