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COVID-19 Resources For Pregnancy, Birth and Breastfeeding

As parents you likely have many questions about how COVID-19 could affect you and your baby, as well as what you might experience giving birth and breastfeeding. We want to acknowledge how stressful and confusing it is during this time.

What scientists know about COVID-19 is changing every day, and what is true today may be understood differently tomorrow. We hope that what you find here can support your understanding, and facilitate personal decisions, and conversations with your healthcare professionals.

Please understand that these resources are not comprehensive. They are also not medical recommendations, which should come directly from your healthcare providers.

To learn more about making informed choices that support your family’s values and belief systems, consider taking our Informed Choices workshop, and view the Informed Choices links expanding box below.

COVID-19 Information + Resources for Pregnancy, Birth + Breastfeeding

How might this virus affect my pregnancy?
How might this affect my birth?
  • Scientists are trying to learn many things about how COVID-19 may impact birth, including whether COVID-19 increases risk for preterm birth. 
  • In the time of COVID-19, many aspects of the physiologic process in birth shouldn’t change. “Physiologic” refers to the body’s evolutionary “knowledge” of how to birth. Similarly, most of the standard ways your practitioners and hospitals support you in birth will not change. You may notice a heightened use of protective gear. and the presence of your birth supports and visitors may be decreased or eliminated. (See below)
  • We do know that stress levels effect labor and birth hormone production, so in this time, reaching out for as much support as you can and developing personal practices that help you manage stress can be supportive of decreased intervention and complication risks in birth as, well as your overall health.
  • Limiting duration of stay in the hospital may help to limit exposure risk. To support this:
    • labor at home as long as possible (in communication with your provider and if they feel it is safe).
    • Consider what will help you feel more supported and safe, be it the choice of your birth location, your provider, your support people, birth education, etc.
    • Consider using doula support, which is known to decrease rates of intervention and cesarean sections, which may help limit hospital stay.
  • Some families choose homebirth for a variety of reasons. This may limit possible exposure to the virus, however, homebirth providers are able to take on a limited number of families, and depend on the following to keep families as safe as possible:
    • extended pre-planning for homebirth
    • supporting pregnancy health through regular counseling
    • developing a strong understanding of birthing parent’s health and psycho-emotional health history
    • learning about birthing families beliefs and traditions
  • Hospital policies and provider precautions may change the experience and planning for your birth. It is best to be in close contact with your provider to learn how things are changing at your birth facility. For example, most hospitals are changing visitor policies and some are limiting access to certain alternative pain management options such as nitrous oxide and birthing tubs.
  • It is important to note that there can be different approaches for immediate postpartum for birthing people who have tested positive, or are suspected positive for COVID-19.
    • CDC Recommendations / Guidelines
    • World Health Organization Guidelines
    • It is advisable to find out ahead what your hospital’s policy is on infant/parent unity or separation.
    • If the policy is immediate separation (not currently supported by scientific evidence) and your preference is unity– you may choose to explore tools for advocating for your patient rights to informed consent and refusal.
    • In this case, we recommend printing out, or having easily accessible on a phone, the CDC and WHO guidelines to share with your provider ahead, and to bring with you in labor.
How might this affect my baby?
  • Current research suggests that babies do not contract COVID-19 in utero, nor via breastmilk. There is some risk of exposure through an infected parent’s respiratory droplets, but breastmilk does provide some antibodies and is a good general immune support for baby. 
  • There is some research that shows a correlation between COVID-19 positive mothers and pre-term birth, but the numbers are not conclusive and the research is not clear enough to determine the COVID-19 as the cause
  • Read more about COVID-19 considerations for breastfeeding and newborn care here:
  • It is important to note that there are two conflicting guidelines for immediate postpartum for birthing people who have tested positive, or are suspected positive for COVID-19.
    • The United States based organizations CDC + ACOG recommend that people with confirmed or suspected COVID-19 be separated from their newborns to prevent infection.
    • In contrast, the World Health Organization and RGOC recommend that newborn babies and their COVID-19 positive parents still remain skin-to-skin immediately after birth and immediately initiate breastfeeding. The COVID-19 positive parent will be encouraged to practice very careful handwashing and may be asked to wear a mask. Some US hospitals are following the CDC guidelines, and others the WHO.
    • It is advisable to find out ahead what your hospital’s policy is on infant/parent unity or separation.
    • If the policy is immediate separation–and your preference is unity– you may choose to explore tools for advocating for your patient rights to informed consent and refusal.
    • In this case, we recommend printing out, or having easily accessible on a phone, the WHO guidelines to share with your provider ahead, and to bring with you in labor. Found under “Can I hold and touch my newborn baby if I have COVID-19?”
    • We also recommend you bring in a copy of the CDC’s Interim Considerations for Infection Prevention and Control of Coronavirus. . .. in Obstetric Health Care Settings, and in the Mother Baby Contact section, highlight: “If colocation (sometimes referred to as “rooming in”) of the newborn with his/her ill mother in the same hospital room occurs in accordance with the mother’s wishes or is unavoidable due to facility limitations, facilities should consider implementing measures to reduce exposure of the newborn to the virus that causes COVID-19.”
      • This mention of “in accordance with the mother’s wishes,” may help you advocate to avoid separation, if that is your choice/preference.
How might this affect my support in labor?
  • Hospitals across the nation are restricting visitor access, and sometimes doula support. Please contact your provider for the best details. Not currently in Rhode Island, but in some states even primary birth support is currently restricted from attending the birth.
    • There is no scientific evidence that supports restricting primary birth support from being present at the birth, and many believe this is inhumane and ill-considered policy.
    • The CDC and WHO do not advocate for restricting the primary support persons presence (if they live with or are in regular contact with the birthing person).
  • In an effort to contribute to the safety of our clients, healthcare workers, communities, and families, Open Circle has adopted a primarily remote doula support format.
    • We are regularly assessing whether in person support can be provided.
      • based on evolving policy and research
      • based on a family’s specific health history
      • based on the availability of healthy doulas
    • We believe that with the technology we have available we can still provide comprehensive perinatal support remotely during pregnancy, birth and postpartum, while still observing safe social distancing.  

 

What are my rights? What is informed consent + refusal?

• You have the legal and ethical right to say “yes” or “no” to any action, procedure or advice of your practitioner or medical staff at your place of birth and during appointments.
• It is your right to not be threatened, coerced or manipulated into any decision.
• Finding a practitioner who listens and communicates respectfully and utilizing a tool called the B.R.A.I.N acronym can help you better understand recommendations and decide what is and is not right for your body and your baby.

Below you will find a number of quotes affirming your rights: 

“Pregnancy is not an exception to the principle that a decisionally capable patient has the right to refuse treatment, even treatment needed to maintain life. Therefore, a decisionally capable pregnant woman’s decision to refuse recommended medical or surgical interventions should be respected.
-American College of Obstetricians and Gynecologists, “Refusal of Medically Recommended Treatment During Pregnancy” (2016)

”Informed consent is a basic policy on both ethics and law that physicians must honor, unless the patient is unconscious or otherwise incapable of consenting and harm from failure to treat is imminent.”
-American Medical Association, “Informed Consent” (2006)

“A fundamental tenant of contemporary medial ethics is the requirement of informed consent, including the right. . .to refuse medical treatment.”
American College of Obstetricians and Gynecologists, “Maternal Decision Making, Ethics and the Law” (2005)

“The Freedom to accept or refuse recommended medical treatment has legal las well as ethical foundations. In the obstetric setting, recognize that a competent pregnant woman is the appropriate decision maker for the fetus that she is carrying.”
American College of Obstetricians and Gynecologists, “Ethical Decision Making in Obstetrics and Gynecology” (2007)

‘The use of coercion is not only ethically impermissible, but also medially inadvisable because of the realities of prognostic uncertainty and the limitations of medical knowledge. As such, it is never acceptable for obstetrician-gynecologists to attempt to influence patients toward a clinical decision using coercion. Obstetrician-gynecologists are discouraged in the strongest possible terms from the use of duress, manipulation, coercion, physical force or threats, including threats to involve the courts or child protective services, to motivate women toward a specific clinical decision.’
American College of Obstetricians and Gynecologists, “Refusal of Medically Recommended Treatment During Pregnancy” (2016)

How can I reduce pregnancy exposure to COVID-19
  • Practice physical distancing and good hand hygiene
  • Call before all your prenatal appointments, some may be able to be done at home or via telemedicine 
  • Practice immune support measures: hydrate, nourish rest and sleep, eat as healthfully as possible. Enjoy ginger, garlic, and dark leafy greens.
  • Get easy gentle exercise, fresh air, and sunlight daily (walks, gentle yoga etc.)
  • Consider taking news and social-media breaks. While it is important to stay informed, monitoring the news too regularly can cause extra stress. 
  • Reach out to friends, mental health professionals, and to your doula (if applicable) when you are feeling overwhelmed or upset.
  • Physical distancing doesn’t have to mean social isolation — we rely on social connection for health — find creative ways to connect with loved ones.
  • Practice mindfulness and meditation through online classes, apps, groups and moment to moment personal attention to breath and self-compassion.
I'm pregnant and I tested positive; what should I do?
  • Call your provider immediately to discuss, they may wish to see you or tell you to remain at home.
  • Your provider will offer you guidance on how to track your symptoms for safety, and how to limit loved ones exposure.
How can I support my and my baby's health + manage stress during this time?
  • Access support from Loved Ones / Community
  • Nourish your body through healthy nutrition
  • Engage in movement practices daily — walking, home dance party, yoga, fitness classes
  • Prioritize sleep and rest
  • Learn and practice self-compassion exercises, including meditation and breath awareness practices, among many others
  • Seek supportive and healthy touch from loved ones or bodyworkers
  • Utilize trained mental health support
  • Go outside for the supportive medicine of nature — sunlight, fresh air, visual beauty, contact with water and earth. . . .

 

Local Resources for Families Suffering Health, Relationship and Financial Insecurities due to COVID-19
(currently being updated)

Prematurity

Mothers’ Milk Bank Northeast:
milkbankne.org
377 Elliot St,
Newton Upper Falls,
MA 02464 
617-527-6263
info@milkbankne.org 

Project Sweet Peas
RI Based NICU Support Group
info@projectsweetpeas.com

Self Care in the NICU
Hands to Hold: Fragile Babies. Family Support.
handtohold.org
Toll-Free: 855-424-6428
Parent Support ext. 1
Online Store ext. 3

SPIN: Supporting Premature Infant Nutrition
UC San Diego Health

Breastfeeding Your Premature Infant:
KellyMom.com

The Journal of Pediatrics:
Study about human milk based fortifier for NICU babies.

RI Parenting Support Programs

Family Visiting Program – Department of Health
This program provides in-home support for any pregnant parent up to age three in Rhode Island
Family Visiting Webpage
401-222-5960

Women, Infant, and Child (WIC) Services – Department of Health
This program provides nutritional support to pregnant women and children up to age five.
WIC Services
401-222-5960

Supplemental Nutrition Assistance Program (SNAP) – Department of Health
Provides low-income individuals and families with the resources to purchase food
Program Information
Family Visiting Webpage
401-222-5960

Home Energy Assistance Program (HEAP) – Department of Health
The Home Energy Assistance Program (HEAP) helps income eligible families pay their heating bills.
Program Info

Rhode Island Community Food Banks
The Rhode Island Community Food Bank distributes food to people in need.
Find a Local Pantry
(401) 942-6325

Temporary Disability / Caregiver Insurance – Rhode Island Department of Labor & Training
www.dlt.ri.gov/tdi/
(401) 462-8420

Recovery & Addiction Services

Parent Support Network of Rhode Island
The Parent Support Network (PSN) is an organization of families supporting families with children, youth, and young adults who experience or are at risk for serious behavioral, emotional, and/or mental health challenges.
https://www.psnri.org/
401-467-6855

Sexual & Domestic Violence Resources

RI Coalition Against Domestic Violence
24-Hour Support Line: 1-800-494-8100
http://www.ricadv.org

Sojourner House
Housing, support Groups, shelters and education services
http://www.sojournerri.org/
24-hour helpline: 401-765-3232

Day One
Treatment, intervention, education, advocacy, and prevention services for sexual assault or abuse to Rhode Islanders of all ages.
https://www.dayoneri.org/
24-hour hotline: 1-800-494-8100

 

Community Resources for Families Who Have Experienced Pregnancy or Infant Loss

RI Based Bereavement Doula Services:

Ada Johnson
Hawthorn Grief Care
https://hawthorngriefcare.com
(510) 590-1231

Emerald Ortiz
Bereavement Doula
emdoula28@gmail.com
(508) 740-1519

Jenn Fantasia
Still Birth Certified Bereavement Doula
Crunchymamadoula@gmail.com
(401) 524-7562

Agroterra Birth Bereavement
http://www.agroterrabirth.com/pregnancy-infant-loss/

The Tiny Miracles Foundation Bereavement Support Services
https://ttmf.org/find-support/after-a-loss/
info@ttmf.org

Counseling & Therapy Referral Database:
Zen Care Rhode Island
Find vetted therapists filtered by specialty, insurance billing, geographic location, and training.
https://www.zencare.co/rhode-island/therapists/

RI Family Support Groups:
Providence Loss Support Group
Peer-facilitated, for anyone who has experienced loss through miscarriage, stillbirth, or the death of an infant.
First Tuesday of the month at Providence Community Acupuncture (please enter through the back door)
Contact: Ada Johnson
infantlossri@gmail.com
(510) 590-1231

Greater Providence Chapter of The Compassionate Friends (TCF)
A national, nonprofit support organization that offers friendship, understanding, and hope to families who are grieving the death of a child of any age, from any cause.
http://www.tcfprovidence.com/
Lucille: 401-231-9229, lcvalliere49@gmail.com   
Sheila: 401-272-6267,  capasso25@verizon.net

Newport Hospital – Infant Death Support Group
For those who have lost an infant through SIDS, miscarriage, stillbirth or early infant death.
Meets every 4th Wednesday in the McClarin Living Room.
Newport Hospital,
20 Powel Ave, Newport, RI 02840
(401) 845-1114

Miscarriage, Infant Death & Stillbirth (M.I.S.) Group
Meets the first and third Wednesdays of the month at 7:00 p.m.
Ronald McDonald House
, 45 Gay Street, Providence
(401) 274-1122, extension 44049
http://www.mispals.org/

Pregnancy After Loss (P.A.L.S.) Support Group
This support group is for women who are pregnant following a loss and would like to share their fears and concerns with other women.
Meets the second Wednesday of each month at 7 pm
Ronald McDonald House, 45 Gay Street, Providence
(401) 274-1122, ext. 44049
http://www.mispals.org/

Support for Children / Siblings:
www.friendsway.org

Photography:
Agroterra Birth Bereavement
http://www.agroterrabirth.com/pregnancy-infant-loss/

Now I Lay Me Down to Sleep Bereavement Photography
https://www.nowilaymedowntosleep.org/find-a-photog/