At the Quality Institute, we just released recommendations to guide pregnant individuals and their caregivers through the unprecedented times we’re living in right now. We answered a request from the State and The Nicholson Foundation and created a Work Group comprised of maternal and child health experts in New Jersey.
The result is Recommendations of the New Jersey Perinatal Care During COVID-19 Work Group. I’m now asking all of our members to download and share this far-reaching and important document. It’s available here.
We brought together neonatologists, obstetricians, doulas, midwives, labor and delivery nurses, social workers — who all worked swiftly and diligently to come up with creative solutions to support pregnant patients during this global pandemic. The comprehensive, twenty-eight page document provides specific and clear guidance aimed at ensuring that all pregnant individuals obtain safe and equitable care despite the social distancing and infection controls necessary to reduce the spread of the novel coronavirus.
About 100,000 babies are born each year in New Jersey and childbirth is the most common diagnosis for a hospital stay. With the pandemic causing a shortage of hospital beds and creating other challenges, the Work Group created goals and procedures to enable patients and their families to have the best outcomes — as well as a birth experience that best aligns with their preferences and values.
The recommendations will help all pregnant patients understand how childbirth protocols have changed during the prenatal and postpartum period as well as during labor and delivery. The recommendations also were created to align with the work of Nurture NJ, which seeks to reduce maternal mortality in New Jersey by 50 percent and to eliminate racial disparities in birth outcomes.
The Work Group members developed creative and innovation solutions to support pregnant individuals while also keeping them and their health care providers safe. The recommendations focus on safety and accommodations to support pregnant individuals and guide health care providers and facilities in areas such as:
- Safety and accommodations during prenatal visits
- Advance communications to patients on changes in protocols for arriving at the hospital to deliver
- Protocols for COVID-19 testing of pregnant individuals
- Ways to support patients through labor and delivery when there are limitations on the number of support persons that can be with them in person
- Protocols for suspected or confirmed COVID-19 patients
- Lactation advice for COVID-19 positive patients
- Consideration of resources and supports needed postpartum when hospital discharges may occur more quickly and access to supplies and food can be more challenging due to the statewide health emergency
The document recognizes that vulnerable pregnant populations, such as individuals of color, those with low-incomes, or individuals with a disability, mental health illness, limited health care access, or underlying medical condition, faced an increased risk of maternal mortality and other pregnancy-related complications even before COVID-19. The recommendations outline the need for additional resources and individualized care to support patients and infants under these circumstances.
The Appendix to the recommendations includes information by health insurer to new or modified resources due to COVID-19; links to national sources of information and best practices; on-going trials and studies that patients and providers are encouraged to enroll in; as well as short and longer-term policy topics for further consideration to advance and improve perinatal care, especially in light of the pandemic. The creation of the Work Group and the recommendations report was generously supported by The Nicholson Foundation.
We hope that the recommendations will be widely adopted throughout the state and used to reduce anxiety and uncertainty for parents-to-be.
Pregnancy and childbirth can bring joy, of course, but also some apprehension, even in normal times. The pandemic adds a new level of uncertainty. This document is intended to let people understand what their care will look like and to understand what will happen during each step of pregnancy and childbirth. We hope that you will support us in sharing the recommendations report and partner with us in keeping expectant patients and their caregivers safe while having a patient centered, equitable birth experience.