What to expect when you’re expecting: The pandemic version

A guide for pregnant patients in Ottawa in the time of Coronavirus

*** Last updated: November 3, 2020 ***

“These are strange times” is something we’ve been hearing a lot lately. Stranger still when you’re growing a tiny human. My name is Jillian Bardsley and I am family doctor who practices low-risk Obstetrics and delivers at The Ottawa Hospital – General Campus. I decided to write this blog post to help give expectant moms some factual information on their risks with regards to COVID-19, as well as some idea about what to expect about their appointments and time in the hospital.

Going to the hospital in the time of Coronavirus

First things, first: Hospital registration

Please call ahead to register. A good time is the 32 week mark. Unfortunately, there has been some misdirection from the staff at the admitting department about whether an in-person visit is necessary for registration. I have confirmed several times with the powers that be that you do NOT need to go to the hospital in-person to register.

Call the Admitting Department Monday to Friday from 8am – 4 pm at the hospital where you are having your baby.

  • Civic Campus - 613-798-5555 ext 13599
  • General Campus 613-737-8200

Have the following pieces of information ready:

  • Name, address, date of birth
  • Name of prenatal care provider, name of your usual family physician
  • Next of kin information
  • Health Card number and any Supplementary insurance for semi private or private.

The Ottawa Hospital does not do birthing unit tours at the best of times, so you’re out of luck on that front. If you have questions about what’s available at the hospital for labouring women, please ask your prenatal care provider.

Not sure if you’re in labour or have a question about something that’s happening after 20 weeks?

Call the hospital and speak to the Obstetrics triage nurse at the hospital where you will be delivering. She will give you instructions about what to do and tell you if you need to come in. Available 24/7!

  • Civic Campus 613-761-5112
  • General Campus 613-737-8012

Many first time mums come to the hospital in early labour and are told to walk around for a few hours because their cervix is not yet dilated enough for admission. I would recommend waiting at home until you are having painful contractions (and I mean, you can’t walk, you can’t talk) that last a minute, every 4 minutes for an hour. You don’t want to be waiting around the hospital if you don’t need to be.

An important resource for the most up to date information is the The Ottawa Hospital Department of Obstetrics, Gynecology, and Newborn Care Website. They also have videos of a virtual tour for both the General Campus and the Civic Campus.

Now actually going to the hospital.... dun dun dunn!

This really won’t be as scary as it might seem. I feel safer at the hospital than I do at the grocery store.

The Ottawa Hospital Hospital Birthing Units will continue to update their visitor policies. I have attached the link here.

If the link dies, please search ‘TOH Visiting Hours.’ Once at that page, go down to ‘Exceptional visits’ and click the link blue link at the bottom of the pink box.

Take home points:

If you are sick, had a COVID-exposure, please let your nurse know as soon as your arrive. Please wear a mask.

I would highly recommend that you have a back-up support person for your labour.

Support persons must be completely well (no viral symptoms), not have had any COVID-exposures and not have travelled outside the country.

Doulas being allowed in the hospital will wax and wane depending on the outbreak level in Ottawa. Check the link above on visitors for an update on the current situation.

You will be asked to wear a mask during your entire admission (you can take it off to eat and drink). Your support person will also be asked to wear a mask. You may use a cloth mask or we can give you a surgical one.

Once you are fully dilated and pushing (lots of huffing and puffing there!), you will be asked to wear a surgical mask to protect our workers. These offer more protection than cloth masks and from experience, they seem to stay on a lot better too! Personally, I actually find them easier to breathe in.

13% of women who had no fever or cough at admission to Labour and Delivery at New York Presbyterian Hospital were positive on their COVID swabs. While New York has a much larger epidemic than Ottawa, this highlights the importance of ‘asymptomatic spread.’ Globally, 1 in 20 asymptomatic women who show up at Labour and Delivery will actually have COVID.

If you develop a fever while in labour and your doctor thinks that this is most likely not related to COVID-19 (for example, if you develop a womb infection called ‘chorioamnionitis’), your chosen support person will remain with you until after your baby is born and on the post-partum unit. Only if your doctor is concerned that you have developed COVID while in hospital will your original support person have to leave. A new support person who does not live with you and who have you have not had contact with for 14 days, will be able to come and help you with the baby on the postpartum ward until you are discharged. They will be given gloves, a mask and a protective hospital gown and be asked to try to stay 6 feet away from you but will be able to hold, feed, change and rock your baby while you rest (basically, whatever you need them to do).

Babies born to mothers with a cough or even with proven COVID-19 will not be separated from you unless you, as a parent, think that it is safest if someone else cares for them. If you choose to keep your baby with you, you will be asked to wear a mask and wash your hands well prior to holding and handling your baby. One exception is that if your baby needs to be admitted to NICU and you have COVID, you and any household contacts will not be able to enter the NICU (but your back up support person can!) so that we can keep the other babies safe. For more information, refer to this note from the NICU team at TOH on your options for baby care if you have any cold symptoms, fever or confirmed COVID. If you do not have COVID or COVID symptoms, you will be able to come and go from the NICU nursery.

A few notes on pain management:

Nitrous oxide (laughing gas) will not be an option during the COVID outbreak

If the hospital gets busy with sick patients, anaesthesia may not be able to come as quickly (or at all) for your epidural. Take a deep breath now and in labour. You will get through it. I am always amazed at how well women who were planning on an epidural do when for whatever reason (their platelets are too low, labour is going to fast, or anaesthesia is tied up with an emergency) they are not able to get one.

On both a personal and professional level, I highly recommend having a plan for coping with natural labour prior to showing up at the hospital. Don’t be that lady who researched strollers for days but isn’t aware of how labour progresses and doesn’t have an approach to dealing with labour pains. Knowledge is power! I highly recommend the book “Birth Partner” for all pregnant women (despite the title saying it’s for someone else). “Hypnobirthing” is another good one.

If you have COVID-19, you may be encouraged to get an epidural on the earlier side if anaesthesia is available. This is because if stuff really hits the fan and we need to get your baby out ASAP via C-section, if you don’t have an epidural, you will need to get a general anaesthetic which comes with intubation (a breathing tube). As you can imagine, inserting a breathing tube generates a lot of aerosolized spit and germs, which puts your health care providers at greater risk. We are trying to avoid that situation.

Going Home

To minimize your exposure to health care workers, and because home is always nice (especially during a pandemic!), we are doing our best to get mummies and babies out of the hospital as soon as possible. My personal target is around the 12 hour post (vaginal) delivery mark. Women who have Caesarean sections used to stay for about 48 hours. My understanding is that is also been reduced to about 24 hours, if your obstetrician thinks that is safe for you.

Necessary tests can be done at the Monarch clinics. This will get you out of the hospital and back to your usual environment faster. Babies born to mothers with respiratory symptoms or with proven/suspected COVID will have their first few doctor’s appointments at the new Monarch C+ Clinic that will hopefully be up and running at the General by April 1st. Hats off to the Monarch staff and Dr. Dave Millar, family doctor extraordinaire, for making sure our system takes good care of these families!

Many if not most family doctors are continuing to see newborns in person. If your family doctor or paediatrician is not seeing live patients during the pandemic (ie. they are just doing phone/video visits), talk to the staff at Monarch or the hospital. There is a list of family doctors in the city who are still open for business and who have volunteered to see these ‘orphaned’ babies during the important few weeks and months after birth.

Additional resources from TOH:

For your convenience I have collected some of the pertinent information about policies during COVID from The Ottawa Hospital. As this is a developing and changing situation, policies may change over time. TOH may publish updated policies on their website.

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