Response of an Obstetric Unit during the Coronavirus Disease of 2019 (COVID-19) Pandemic: Experiences from a Tertiary Care Center

Abstract

Objective To describe our experiences in preparing our obstetric unit in Westchester County, New York, during the COVID-19 (coronavirus disease of 2019) pandemic. We focus on describing our timeline, continuously evolving actions, observations, and challenges. Methods With guidance from the New York State Department of Health (NYSDOH), our institutional epidemiologist, and key multidisciplinary faculty members, we evaluated emerging national data as well as expert opinions to identify issues and challenges to create action plans. Results We created and modified policies for our patients presenting for obstetrical care on the labor and delivery unit to accommodate their unique needs during this pandemic. Conclusion The COVID-19 pandemic has posed many unique challenges. Balancing communication, risks of infection to providers, patient autonomy and rights, and resources for testing and personal protective equipment were among the valuable lessons learnt. We have shared our experiences and described our observations and challenges in Westchester County, New York.

Effects of the Covid-19 Pandemic on Maternity Staff in 2020 – A Scoping Review

“…Maternity staff felt burdened by the need to act contrary to evidence-based breastfeeding support [30]. Throughout the world there were reports that hospitals prematurely discharged women who had given birth [4,24,30,35], even when maternity staff had reduced home visits or where postpartum visits were uncommon [4,33,42]. These changes and challenges directly affect the staff.…”

“…They also developed simulation exercises for time-critical emergencies [24]. Socalled "do cers" were made responsible for ensuring staff adhered to the rules and hospitals installed mirrors so staff could check to see if protective clothing tted properly [5,35]. Protective clothing makes the environment safer for both hospital patients and maternity staff [21].…”

“…There were 1,344 delivery rooms in the USA: 90.2% had adequate testing capacities; 84.3% tested all pregnant women [30]. Later on, rules about wearing protective clothing depended on the results of PCR tests and symptoms indicating an infection with Covid-19, and took into account the lack of protective clothing or the discomfort of staff who wore it [21,35,37]. Insu cient protective clothing and inadequate testing capacity posed particular challenges to communal hospitals [29,31,36].…”

“…Over the course of 2020, bans on visits were eased as respiratory masks, PCR tests, and quick tests become more available [27] but practices varied. Some maternity hospitals in New York checked accompanying persons for clinical symptoms [27] and barred anyone with a ≥38°C temperature or other potential Covid-19 symptoms [21,27,35]. Some hospitals allowed people who had tested positive for Covid-19 a week before, did not have a temperature within the last 72 hours to attend a birth [21].…”

Effects of the Covid-19 pandemic on maternity staff in 2020 – a scoping review

“…They also developed simulation exercises for time-critical emergencies [24]. So-called "do cers" were made responsible for ensuring staff adhered to the rules and hospitals installed mirrors so staff could check to see if protective clothing tted properly [5,35]. Protective clothing makes the environment safer for both hospital patients and maternity staff [21].…”