On April 22, 2020, UW Medicine, together with the Whole U at the University of Washington, jointly hosted a webinar to address pregnancy, labor and delivery in this time of the novel coronavirus. The presentation included insights from four OB-GYN faculty members: moderator Deborah Blue, CNM, MSN; Suchi Chandrasekaran, MD; Alisa Kachikis, MD; and Anna Shope, MD. You may view the recording on YouTube. In addition to the topics covered in the webinar, we have compiled resources and a Q&A addressing chatroom questions for the COVID-19 situation in late April 2020. If you have an individual health concern and would like to talk with one of our UW Medicine providers, book an appointment here. The COVID-19 situation is rapidly evolving, and we expect to adjust and adapt our system’s response according to new circumstances. If you have coronavirus-related questions, please call our information line at 206.529.2885 or see UW Medicine’s COVID-19 information page. Helpful UW Medicine resources: Guidelines for essential and urgent women’s healthcare during the COVID-19 pandemic UW Medicine coronavirus updates for patients — patient safety, care and services, visitor policy UW research study on COVID-19 and pregnancy TeleOB Program information In the news: This Wasn't My Plan: How Coronavirus is Affecting Pregnancy, Labor, Delivery and New Parenthood Pregnant Women Adapt to Changes as They Navigate a Pandemic Pregnant? Here’s What You Should Know About the Coronavirus How to You Deliver a Baby During a Pandemic? Seattle-Area Women's Healthcare Pro-viders Answer Questions About Birth During the Coronavirus Frequently asked questions about care and services How safe is the hospital setting for labor and delivery? Delivering your baby at a UW Medicine hospital is very safe. Since the novel coronavirus was first detected in the U.S., we have been very fortunate that through April 25, 2020, UW Medicine hospitals have seen, in total, only a handful of COVID-positive pregnant patients. The clinics and hospitals in the UW Medicine system are among the safest in the nation. We offer a rapid screening test that takes only 90 minutes; universal masking and daily symptom attestation requirement for employees; and a visitor policy that protects everyone, particularly pregnant patients and babies. We are taking every precaution to offer the safest healthcare to our expecting families. How can I transfer my care to UW Medicine? If you are not a current patient but would like to transfer your care to UW Medicine, call 206.520.5000. New and existing appointments may be by phone or video (telehealth). Where can I get more information about your telehealth programs? You can get information about our TeleOB Program and our general telehealth programs on the UW Medicine website. If you are a UW Medicine patient, please let your provider know you are interested. Since Labor and Delivery tours are not available in person, how can I get questions answered about items I can bring in on my birthing day (e.g., a birthing ball, chair or bar; scents; postpar-tum care items; etc.)? Virtual birth center tours are available online. Room views of our Labor and Delivery suites are also available: UW Medical Center – Montlake UW Medical Center – Northwest Valley Medical Center All birthing suites in Labor and Delivery are private and have their own bathroom with whirl-pool tubs. Most rooms have a small refrigerator and a TV. All rooms have wireless internet access and a couch with linens for your support person. Birthing accessories include a birthing ball, peanut ball, mirror and squatting bar. Although we have everything you will need during your stay, we encourage you to bring other personal items with you to support the experience you would like to have. For example, if you would like to have music playing during your labor, please bring something to support that (most patients find their phones and/or a small speaker sufficient). Please note that at this time we are not allowing people to go in and out of the hospital, so make sure to bring everything when checking in. You will need to bring photo IDs for both you and your support person as well as a car seat for your baby and clothing for everyone to go home in. For more detailed answers, please speak with your provider. Ideas of what to bring are available in the patient education booklet “Pregnancy and Giving Birth” (which you should have received at the start of your prenatal care). How accurate is the 90-minute COVID-19 screening test? Have there been any false positives? The rapid screening test developed by UW Department of Laboratory Medicine is one of the most accurate in the country, with a false negative rate of less than 2%. You should feel very reassured if you test negative. There have not been any false positives. If we have recovered from an illness and are not sure if it was COVID-19, what do we tell our care team when we are admitted to labor and delivery? Tell your care team any symptoms you have experienced in the past six weeks. We are testing any pregnant patient within 72 hours of admittance for labor and delivery. UW Medicine is working on an antibody test and hope to make it available as soon as possible. If all laboring women are now being tested for COVID-19 upon admittance to labor and delivery, will a patient's partner be banned from the delivery room while the patient's COVID-19 test is pending? If I go into spontaneous labor and have not been tested Assuming that you have no suspicious symptoms, you are permitted one support person until your swab test results come back. If your COVID-19 test is negative, you can continue to have a support person with you. What are the lessons learned from those coming into Labor and Delivery who have tested positive? Were they practicing physical distancing? Were they still going into the workplace? Do they have a partner who is an essential worker, etc.? We have had only a handful of COVID-positive cases in total across all our hospital campuses’ pregnant patients. They were tested when they presented with symptoms; the circumstances of their individual cases are confidential. UW Medicine is now testing all patients on admission to the hospital, including all patients admitted to the labor and delivery floor. We continue to encourage all individuals, including pregnant patients, to practice physical distancing and rigorous hand hygiene. If a pregnant patient tests positive for COVID-19, are accompanying partners tested or will they automatically be separated? Will a newborn be separated from the pregnant patient? If a pregnant patient tests COVID-positive, we would test their partner. As we learn more about the novel coronavirus, we expect recommendations to evolve, and we will adjust to new information. Currently we recommend minimizing COVID-19 exposure of the newborn to a COVID-positive parent. As far as co-location, in the event that a pregnant patient tests COVID-positive, this would lead to a conversation between the pediatric team and OB providers, and involve joint decision-making with the family. How does the hospital protect the pregnant patient during the glucose screening test? During a glucose screening test, the pregnant patient would need to remove their mask to drink from the cup. This should only take up to five minutes. A clinical staff member, wearing their mask, would walk in just to give the patient that cup before departing the room. What would you advise for a birth plan when the couple has other children at home? Would it be okay to introduce a grandparent or caregiver to care for the other children? If the grandparent or caregiver is traveling from another area, consider the rate of viral infection in that area and make decisions taking geographical considerations into account. When considering an extended family situation for child care, continue to take every precaution, such as hand washing or using an alcohol-based sanitizer, not touching your face, practicing social distancing from others outside the home and using frequent disinfectants around the home. I have heard that COVID-19 attacks hemoglobin or affects it in some way. Is it possible that women, particularly pregnant women who supplement with prenatal vitamins containing iron, are protected against complications from an attack on hemoglobin? Prenatal vitamins themselves do not protect against a complication like COVID-19, but they are part of a standard recommendation for prenatal care. COVID-19 contraction can lead to a lot of laboratory abnormalities. It can mimic the complications for preeclampsia. In more advanced stages of COVID-19, it is not unusual to see abnormalities in the lab, but it’s a systemic response, not an attack on hemoglobin. Will antibody tests be available upon delivery for both pregnant patient and baby? Probably not in the situation of labor and delivery, unless antibody tests become universally applied at UW Medicine. Antibody tests are more likely to be used in situations like workforce re-entry. However, like a lot of situations throughout the pandemic, this is a moving target. If a vaccine is developed, would it be given to pregnant women early on? Or would we wait until further testing is done? The answer would depend on the situation and the kind of vaccine that becomes available. Many vaccines are safe in pregnancy. Are there any guidelines for pregnant women about which type of mask is best and is there a maximum duration they should be worn to not affect the baby? The Centers for Disease Control and Prevention (CDC) recommends that some type of mask, whether cloth, paper, etc., be worn over the face when outside of the home. The type of mask is a personal choice and we do not have any specific mask recommendation. If the pregnant woman is well oxygenated, the baby will be fine. Do asymptomatic patients in labor need to wear a mask while their COVID-19 test is pending? If so, can they wear their own cloth mask or must they wear a hospital medical mask? Currently, UW Medicine has a universal masking policy. Everyone entering the hospital must wear a mask (of their choice), therefore asymptomatic patients awaiting COVID-19 test results will need to wear a mask in labor. All staff at UW Medicine will be masked when in clinical areas to help protect you and themselves from asymptomatic spread. Once the baby is born, can COVID-19 be transmitted directly from an infected person via contact to the infant? If so, how will this affect the infant? Have there been any cases in infants reported? Once a vaccine is available, at what age will the infant Our pediatrics experts at the UW School of Medicine will address these questions at the next webinar on Newborn Care and COVID-19. Please check back for the date. Visitation Policy for Childbirth (C-section or Vaginal Birth) As of April 2, 2020, UW Medicine Montlake and Northwest campuses will restrict to ONE healthy support person to stay during labor, delivery, and the postpartum stay. The support person and mom will stay together until the family is discharged home together. Support people will not be able to leave and come back to the hospital; your support person must be at least 16 years old. To maintain social distancing for your safety and that of others, we will not be able to permit walking in the hallways. However, you can continue to move around in your room and call out for food and drinks. Our staff will bring these items directly to your room. We ask that you plan in advanced to arrange care of other children, family members, and pets, etc. so that you and your support person can stay together and focus on your birth and new baby. Please bring everything you will need for your stay, including an infant car seat and favorite food items. This was a difficult decision for the leadership team to make. We previously allowed 2 support individuals (partner and doula) during labor as we recognized the support and crucial role that doulas play in the care of our birthing parents. However, the data has become compelling that part of the fight against this pandemic is limiting exposure in order to decrease the number of new cases. Doing so will help keep our current healthy families healthy and allow us to focus on providing all the resources available to our most critically ill patients. We will continue to screen EVERYONE coming to the hospital for symptoms of COVID-19. Symptoms may include fever, body aches, sore throat, cough, shortness of breath, sudden loss of taste and/or smell. We appreciate that these policies may present some hardships for you, but we trust that you understand that our sole intent is to keep you, your baby, family, and community as safe as possible. We are incredibly inspired by the hard work of our colleagues in the healthcare field right now and the outpouring of support from the whole community. We are all in this together, and we will get through this together. Please talk to your provider about your questions and concerns so you can address them together. To see all of UW Medicine’s information related to COVID-19 please check out uwmedicine.org/coronavirus.