Hello Tuesday! Another bonus post today! I was able to listen to this webinar this morning because I didn’t called into work last night (thank you Jesus). I love that kind of 24 hour shift. I attended a beautiful birth in the morning of one of my favorite families, then had a fairly uneventful rest of the shift!

I also finished a few books while on break from graduate school. If you’re needing a great book recommendation to pass some time at home, I have to recommend Daisy Jones and the Six! It was the second best book I’ve read this year. I finished it and immediately went to see if someone was making it a series (thank you Amazon for purchasing the rights…Amazon actually purchased the rights to produce the show even before the book was published!). Okay, enough. It’s fantastic – buy it today! I also read Atul Gwande’s The Checklist Manifesto – this one was so good I added it to the BOOKS page as a recommendation for anyone in healthcare!

Let’s get to the recap…

On April 2, 2020, ACNM released a webinar hosted by ACNM President Susan Stone, President-Elect Cathy Collins-Fulea, and Vice President Carol Howe. The video is posted below. This webinar wasn’t as well put together as the previous ones but it was meant to be a Q+A with the leaders (and there were a few sound hiccups…).

I’ve done a few recaps to date and I think the recaps are so important to pass along to any mama, pregnant women, midwife, or midwife student.

It is vital for the midwifery profession to stand together during the pandemic. Despite the fact that many of us are at home (when we aren’t catching babies), I can’t think of a more important time to communicate with other midwives across the country and the world.

There webinar is about an hour long but my recap is below (tl:dr):

• Susan Stone spoke about trying to avoid catastrophic thinking (the rabbit hole you go down thinking about everything that could go wrong).
• Some methods of coping discussed for mental health:
  • Going for a daily walk
  • Limiting the news (trying not to watch the COVID-19 numbers)
  • Prayer and digging into the wellspring of faith
• One member posed the question: What is the impact to midwifery students?
  • About 50% of clinical sites were closed to students at the start of the pandemic.
  • The accessibility of these sites in the future is unknown at this time.
• Personal protective equipment (PPE)
  • New evidence that masks should be worn during all patient contact
  • Multiple people discussed how their sites were handling this new recommendation
  • Many people do not have enough PPE at their sites and some sites are asking providers to provide their own PPE
• How do we “come home from work?”
  • After a shift as a healthcare provider on the front line, how are we supposed to come back into our own homes?
  • There’s no guidance….
  • As a group what does everyone recommend?
    • Taking off all clothes in the garage
    • Placing clothes directly into the washing machine
    • Taking a shower immediately
  • Concerns were voiced about asymptomatic individuals – removing clothes and taking a shower doesn’t prevent an asymptomatic individual from transmitting the virus
  • Brief mention of this study: Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. The study was published March 17, 2020 in the New England Journal of Medicine examined SARS-CoV-2 in five different experimental conditions. The study found:
    • On plastic and stainless steel, the virus can live for up to 72 hours (median half life for stainless steel estimated 5.6 hours and for plastic 6.8 hours)
    • On copper, the virus can live up for 4 hours
    • On paper or cardboard, the virus can live up for 24 hours (the study notes that these results were somewhat variable and this timeline should be interpreted with caution)
• What is the average return on COVID-19 test results?
  • The group said 2 to 6 days is the average
• Labor support was discussed…
  • Midwives disagree on whether support persons should be allowed for laboring women (especially in the instances where the support person is COVID-19 positive)
  • Susan Stone brought up a good point: the hospital staff isn’t necessarily a form of good support for the patient if the hospital staff is already stressed from the pandemic (this is a great point).
  • Also discussed: it is unethical to abandon a laboring women.
• Postpartum telephone calls
  • To increase support to women, a phone call to women in their early postpartum courses may improve gaps during this recovery period
• The Annual ACNM meeting…the meeting will take place virtually!
• Can we really move birth into outpatient surgery settings?
  • Lisa Paine recommended guidance from ACNM ASAP on birth in an atypical birth setting. She stressed this guidance is imperative for when (not if) midwives face a change in place of birth.
• Membership at ACNM
  • Some midwives voiced frustration about the high cost of ACNM membership
  • Some individuals asked for ACNM to open membership at a lower cost, or to allow more midwives to join the organization
• Are cesarean sections recommended for COVID-19 pregnant mamas?
  • No, the evidence does not support delivering mamas early (note: I haven’t seen this evidence yet but suspect that is true; the same is often seen in cases of mamas with influenza)

My thoughts…

• Students are most definitely impacted and the repercussions of a pandemic during their training is going to have it’s own host of difficulties. We must help students get back into clinicals safely and appropriately, and help them to complete their training.
• What is the health care system going to look like on the back side of the pandemic? This is a questions I have heard many people ask over the past few weeks. Even my husband and I ask this questions on a regular basis to each other. Things will be different – I’m just not sure how.
• Susan Stone was really interested in the lack of PPE; she even said it would make a good NPR story. That probable wasn’t the most appropriate comment in my humble opinion. She also stated ACOG “does not want to get on that bandwagon” in regards to the topic of home birth. That is a well known standpoint of ACOG. However, as a profession, we must speak respectfully of our colleagues while simultaneously upholding the practice of home birth. ACOG and ACNM must come together in order for maternal and child health to improve in our country.
• Postpartum visits! At my practice, we implemented the 2 week postpartum visit in early 2019. The patients seem to really benefit from the extra visit and it is an opportune time to address breastfeeding, milestones, lochia, contraception and screen/manage postpartum mood disorders. Our uncomplicated patients are completing their 2 week and 8 week postpartum visits by phone. I think we could do even better – what if a provider or nurse reached out to a patient at 2 weeks, 4 weeks and 8 weeks postpartum? How would that improve postpartum outcomes? Just some thoughts 🙂

Hope you enjoyed the recap! I am really excited ACNM is going to have a virtual meeting. That may be even better – then I can attend presentations in my PJs and with unlimited coffee.

I’ve also been updating the RESOURCES page with COVID resources as they cross my path. Check those out if you’re interested.

Also found this gem on Kellymom.com…great little picture on infant feeding tips!

Stay safe out there! Has anyone made a homemade mask yet? We’re headed that way up here in Alaska….

Jamie

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