COVID-19 OB & Hospital Policies?

KLS123

After speaking with a few expecting/recently delivered friends and family I had a whole list of questions to ask my care provider to understand the "new normal" of what to expect for my care and delivery in the times of COVID compared to what I experienced with my first delivery in 2018. I thought it may be helpful to list those out here for others to think about and talk to their OBs. 
Feel free to add any additional items that I haven't thought about and I will edit this post and update the list as helpful thoughts/concerns are added.
If you would like to copy and paste the Questions with the answers you receive from your provider that would give everyone good context as to what all is going on out there and how their hospital policies may change depending on how their local case counts are. It would be helpful to add if the area you live is currently in a high risk area with rising case counts or if you are located in an area that has stabilized currently to give context.

*This thread is not a place to debate the validity of COVID policies or share your politicized opinion on the state of the pandemic, there are pleeenty of other corners of the interwebs to air your grievances about that. Let's just compare notes so we can be better prepared on what to anticipate. Please and thank you!

Prenatal Care/OBs Office Questions:

• Am I allowed a support partner at prenatal visits?
• Are you offering virtual prenatal check ups?
• If I get COVID, what is the care procedure regarding my pregnancy?
• If I get COVID, will I have to transfer my prenatal care to a high risk care provider?
• Are you currently seeing patients in this office that test positive for COVID?
• If a COVID vaccine becomes available during my pregnancy, will I be eligible to get it as a pregnant woman?

Labor & Delivery Questions:

• Am I allowed a support person for Labor and Delivery? How many?
• Am I allowed a Doula for Labor and Delivery?
• Am I allowed visitors aside from my support person?
• Am I or my support person allowed to leave the hospital room?
• Will I be tested for COVID close to delivery? When? The day of or prior?
• Will my support person be tested for COVID when we arrive for L&D?
• If they are positive, will they be denied entry and I have to labor alone?
• Do I have to Labor with a mask on?
• Does my support person have to keep a mask on?
• In the event of a C-section, will my partner be allowed in the operating room?
• Are there COVID patients in the same facility that I will be delivering?
• If yes, are there shared staff between L&D and the COVID patients (nurses, janitors, food providers, etc)

Post-Delivery Questions:

• If I test positive for COVID when I deliver, will you separate me from my baby?
• If my baby has to go to the NICU, will I be allowed to visit? Will my support partner?
• Am I allowed to have outside food delivered during recovery?
• Am I allowed visitors during recovery?
• Will I stay the traditional 2 day post delivery (3 day for C section)? Or are you trying to discharge early?
• Will my support person be allowed to leave and return?
• If a COVID vaccine becomes available, will my newborn child be eligible to get it?

KLS123

I am located in a high risk, rising case count county in Texas.

Prenatal Care/OBs Office Questions:

• Am I allowed a support partner at prenatal visits? No, not even for the anatomy scan. You are allowed to Facetime your partner for prenatal visits but not during ultrasounds.
• Are you offering virtual prenatal check ups? Yes, for visits that an ultrasound, blood draw or something of that nature isn't needed, they want to see me every other visit in person if possible. 
• If I get COVID, what is the care procedure regarding my pregnancy? Try to stay home, try and get a blood pressure and blood oxygen reader to DIY monitor vital signs, the OB will call and check up on me everyday to make sure no further care is needed.
• If I get COVID, will I have to transfer my prenatal care to a high risk care provider? Only if I end up hospitalized and on critical care (aka ventilator)
• Are you currently seeing patients in this office that test positive for COVID? Yes, if they are positive and need additional care than what they have at home, they will come into the office. 
• If a COVID vaccine becomes available during my pregnancy, will I be eligible to get it as a pregnant woman? No, they will not likely have been able to run adequate testing on pregnant people between now and February.

Labor & Delivery Questions:

• Am I allowed a support person for Labor and Delivery? How many? Yes, only 1 person. Has to be the same person the whole time.
• Am I allowed a Doula for Labor and Delivery? No, not unless that is your 1 designated person that is with you the whole time.
• Am I allowed visitors aside from my support person? No. No visitors whatsoever.
• Am I or my support person allowed to leave the hospital room? No, if you leave the room you can't go back in.
• Will I be tested for COVID close to delivery? When? The day of or prior? Yes, current policy to do a rapid response test when you arrive in labor. As a person with a history of precipitous labor and may not get the test results back before I deliver, I may be eligible the get the test ahead of time. For reference my sister went in at 39 weeks to get tested prior to labor starting (at a different hospital).
• Will my support person be tested for COVID when we arrive for L&D? Yes
• If they are positive, will they be denied entry and I have to labor alone? Yes, they will be denied entry and I would be alone.
• Do I have to Labor with a mask on? Yes, until the rapid response test comes back negative, in which case I am allowed to remove the face maks.
• Does my support person have to keep a mask on? Yes.
• In the event of a C-section, will my partner be allowed in the operating room? No, I would be alone.
• Are there COVID patients in the same facility that I will be delivering? Yes
• If yes, are there shared staff between L&D and the COVID patients (nurses, janitors, food providers, etc) No

Post-Delivery Questions:

• If I test positive for COVID when I deliver, will you separate me from my baby? Yes, current hospital policy would be to separate mother and baby. I am allowed to reject that decision "against medical advice" but there could be possible ramifications of child protective services being called in if you refuse to go with hospital policy to separate from the baby.
• If my baby has to go to the NICU, will I be allowed to visit? Will my support partner? Current policy is only one designated parent is allowed to visit the NICU, you are not allowed to trade off.
• Am I allowed to have outside food delivered during recovery? No
• Am I allowed visitors during recovery? No
• Will I stay the traditional 2 day post delivery (3 day for C section)? Or are you trying to discharge early? They are attempting to discharge patients early is possible.
• Will my support person be allowed to leave and return? No
• If a COVID vaccine becomes available, will my newborn child be eligible to get it? No, they will not likely have been able to run adequate testing on babies between now and February.

Yiggle09

Very good list of questions but you are not legally allowed to be told if your OB office is caring for patients who have covid.  That is against HIPAA. Also if you deliver in a hospital you can guarantee there are covid patients in the facility. Least likely to have covid patients would be birthing centers that specialize only in caring for the birth. Also scary as it may be but a home birth if you are very concerned.
I can tell you from my personal experience that OB staff and DRs would have no reason to be caring for general covid patients BUT they would share many places within the hospital such as cafeterias.
My entire hospital is required to wear masks employees and patients 100 percent. If you do not have your own one will be provided for you and you must wear it anytime someone else is in the room with you. I have had two friends give birth during this covid era and many of their photos are wearing masks at the hospital.
As to if they'll test you I couldn't say for certain. In our area they are doing temperature screening at the door. I assume if you develop a fever sortness of breath etc while in the hospital they would test you. We are only allowing the support person in the hospital no other visitors at this time. Hopefully this was ok to post here as it's not an addiction  to the question thread you were intending to start.

KLS123

@Yiggle09 ah yes, certainly HIPAA would prevent some straightforward answers but I was trying to get a feel for my exposure levels in the OB office. She explained a scenarios where there would or wouldn't be COVID positive patients in their offices which was helpful.
Some of the other questions regarding exposure in the L&D setting were because they are located in a "wellness women's hospital" that's specific to birthing/OBGYN care and adjacent to a children'ts hospital so the women's hospital doesn't treat any kind of infectious disease type situations. BUT there would possibly be COVID positive patients delivering babies there at any given time.
They are also doing required masks, temp screening and risk questionnaires at the door at my location as well.

mdfarmchick

This is also not an addition or a specific answer to the questions thread you have started here, but my OB’s office has told me that things are changing quickly in care as things change with this whole situation so I personally don’t know that asking these questions before third trimester would necessarily be informative because things change daily/weekly. 

As far as my OB’s office, I would assume if they had a patient that was COVID positive and they needed care, they would be seen and extra precautions would be taken on top of their rigorous extra cleaning they are doing now.

Currently I am allowed to bring one adult with me to all appointments as long as they do not have a fever.

Nothing about this pregnancy is normal for me personally, other than how we got pregnant so virtual appointments would not be an option for me due to my high risk status. 

chichiphin

**dirty lurker** - HIPAA doesn't prevent a practice/hospital from telling you if they have a patient population test positive. source: I am a privacy officer for a large university/health system. 

Yiggle09

@chichiphin thanks you for the clarification. I've been told not to discuss the covid population if we are asked by anyone. I thought it was a HIPAA thing. Perhaps it's a PR or mental prophylactic thing. I cant imagine being the unwitting "source" from a newspaper saying we have this many or whatnot. 

chichiphin

@Yiggle09 now that I absolutely believe - PR is a big deal! or if you're an OB practice of like, 5 people and they all know each other and affirming there is a covid case would make it easy to guess who it is... when our hospital had it's first ICU case it was SUPER locked down because you could piece together news articles etc and figure out who it was. 

WildMagelet

@chichiphin - I was going to say the same thing. I work as a Compliance Officer in a residential facility and our number of positive & recovered COVID-19 cases for both residents and staff are public information, we're just not allowed to say who. 

birdiejo

This is a comprehensive list! My OB answered most of these questions without me having to ask in the first appointment but also talked about how we really don’t know what it’ll be like come February. 

juliebeannn

*lucking from March 2021 BMB* Thank you for the comprehensive list of question! This is really helpful!

cmoon3

Here's a question to add for post delivery:  If a vaccine becomes available, will it be safe/recommended for nursing mothers?

Yiggle09

@juliebeannn is there a march one yet? I keep checking

juliebeannn

@Yiggle09 It's up and running on the web but for some reason, it still won't show up on the app.
https://forums.thebump.com/categories/march-2021-moms