Mountain Midwifery Care, Hamilton, Ontario

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COVID-19 UPDATES

July 25, 2020:

 

Updated Letter to clients from Mountain Midwifery Care

 

Dear Clients of Mountain Midwifery Care,

 

We wanted to update you about a few small changes about clinic scheduling and midwifery care during the pandemic. Two things have changed since our last update: first that Hamilton is now in Stage 3 of reopening, and second, that Hamilton has mandated the use of masks in indoor public places. We are hopeful that the widespread use of masks will keep the new case numbers low as people are more active in the community. Please call ahead to change your appointment if you do not pass the screening questions at the end of this letter. If you are sick and worried about your symptoms, please page your midwife.

 

Updates:

 

MASKS:

Please wear a mask to your clinic appointments. Our clinic rooms are not very big, and it is not possible to adequately socially distance during a physical assessment.

 

CLINIC SCHEDULE:

All visits from 26 weeks onward will be in-person at the clinic. The clinic schedule is listed below (page 2). Please continue to wait in your car until your midwife calls you up so that we can limit the number of people in the clinic at one time.

 

SUPPORT PEOPLE AT VISITS:

We continue to follow the recommendation of our building and the hospital to limit the number of people coming in and out of our clinic. We understand that this can be difficult, and trust us, we miss meeting your partners and other children as well!

We truly appreciate the effort everyone has made to come to visits alone.

If you feel that having a partner attend with you is necessary, please ensure that they are wearing a mask and that they pass the screening questions at the end of this letter. Another consideration is to have your partner join the visit on speaker phone or video call.

 

PRENATAL VISITS

Week 10 – Initial visit – Telephone visit. We can review your health history and

organize lab work and ultrasounds. Please plan for 1 hour.

 

Week 16 – First in-person visit. We will complete your physical exam and listen to the fetal heart rate. Any labs that haven’t been done yet can be done at this time.

 

Week 20 – Telephone visit. We will review all lab work done to date and also review the results of your 18-20 week ultrasound.

 

All visits after 20 weeks will be in-person at the clinic. All in-person visits will include a blood pressure check, a symphysis-fundal height measurement, and a check of the fetal heart rate.

 

Week 26 – We will offer a requisition for gestational diabetes testing and give you the pre-registration package from the hospital. We will discuss the Tdap vaccine.

 

Week 30 – We will review lab work, discuss fetal movements, and discuss signs and symptoms of preterm labour.

 

Week 34 – We will monitor for fetal growth and discuss birth plans.

 

Week 36 – We will offer a GBS swab. We will discuss when to page in labour and

review your birth preferences.

 

Week 38 – At this visit we will offer a cervical exam.

 

Week 39 – We will offer a cervical exam and stretch and sweep. Week 40 – Visit similar to week 39.

 

Week 41 – We will discuss the need for induction of labour and organize this as required.

 

First Week: Home visits every 2-4 days. Please remind other household members to

socially distance and/or wear a mask during these appointments.

 

2 Weeks: Clinic visit. Please wait in the car until we call you up to ensure the clinic room is clean and ready for your visit.

 

4-6 Weeks: Clinic visit (final visit). If you require a pap test, this service is now happening again as per the Cancer Care Ontario recommendations.

 

You can always reach us by the pager number for urgent concerns.

 

Thank you so much for your patience and understanding. We look forward to getting to know you throughout your pregnancy and birth as it is such a meaningful time in your life.

 

Sincerely,

 

All the midwives at Mountain Midwifery Care

 

 

 

June 9, 2020:

 

Dear Clients of Mountain Midwifery Care,

 

It is hard to believe that over two months have passed since our last update letter.  In that time, many babies have been born, and many new clients have arrived to start their prenatal care. Wearing masks and protective clothing while we work has become normal, though we are looking forward to the day when we can interact without them.

 

As more businesses open and the weather turns to summer, we see that people are out more and that the streets are not as empty as they were. Many people are becoming more comfortable with wearing masks while they are out in a public place such as the grocery store. Keeping our distance from others and avoiding hugs and handshakes has become normal.

 

At the clinic, Diane is back at her desk and now has a plexiglass shield. We continue to keep the waiting room empty by calling you up to the clinic once we are ready to see you and asking you to come alone to your visits if possible. Please let us know if you have any barriers that would keep you from waiting in your car. We have been able to maintain a good supply of hand sanitizer, cleaning products, and personal protective equipment throughout the months of the pandemic. We are also finding that completing some of our visits by phone has been a good way to limit unnecessary exposure.

 

Our schedule of visits remains the same as outlined in the March 23rd update.

 

Many of you have worn a mask to your visits, and we appreciate this very much. The medical mask that we wear helps to protect both of us, but if you wear a mask, even a cloth mask, the risk of exposure for everyone is reduced even more. Since the corona virus that causes Covid-19 can be spread by infected but asymptomatic individuals, using masks is now recommended to prevent spread of the virus. For this reason, we request that you wear a mask for your visits.

 

In Ontario, the number of new cases has hovered around 300-400 for the last few weeks and is showing a gradual decline this week. As restrictions are lifted, we must all remain careful in our interactions.

 

Together we will get through this!

 

From all of us at Mountain Midwifery Care

 

Updated Letter to clients from Mountain Midwifery Care

 

March 23, 2020:

 

Dear Clients of Mountain Midwifery Care,

 

Thank you for your patience as we try to provide the best care possible during this time. The College of Midwives of Ontario and the Ontario Ministry of Health have mandated that we only provide essential care at this time. We have made a few small changes to our clinic plan in order to limit in-person interactions.

 

 For scheduled in-person visits, your midwife will call you at your appointment time. Please wait in your car. We will start the visit over the phone to answer questions and check in on your current health. For the last 10 minutes, you can come up to the clinic for a brief in-person assessment.

 

If you are using public transit or if you don’t have access to a cell phone, please let us know when we are in touch to plan your appointment.

 

PRENATAL VISITS

 

Week 10 – Initial visit  – Telephone visit.  We can review your health history and organize lab work and ultrasounds need to be arranged. Please plan for 1 hour.

 

Week 16 – In person visit. We will listen to the fetal heart rate, take your blood pressure. Any labs that haven’t been done yet can be done at this time.

 

Week 20 – Telephone visit. We will review all lab work done to date and also review the results of your 18-20 week ultrasound.

 

Week 26 – In person visit. We will measure your symphysis-fundal height. We will check your blood pressure and the fetal heart rate. We will give you a requisition for gestational diabetes testing and give you the pre-registration package from the hospital.

 

Week 30 – Telephone visit. We will review lab work, discuss fetal movements, and discuss signs and symptoms of preterm labour.

 

Week 34 – In person visit.  We will measure, listen to fetal heart rate, and take your blood pressure.

 

Week 37 – In person visit.  We will measure, listen to fetal heart rate, and take your blood pressure. We will offer a GBS swab.

 

Week 39 – In person visit. We will offer a cervical exam and stretch and sweep. We will measure, listen to fetal heart rate, and take your blood pressure.

 

Week 40 – In person visit similar to week 39.

 

 Week 41 – In person visit if needed.  We will discuss the need for induction of labour, and organize this as required.

 

POSTPARTUM VISITS

 

First Week: Two home visits

 

 2 Weeks: Clinic visit. Call from the car/parking lot for discussion, then bring up baby for a weight check.

 

 4-6 Weeks: Clinic visit (final visit) . Call from the car/parking lot for discussion, then bring up baby for a weight check. Pap tests will be delayed unless there is a pressing reason to have one done.

 

You can still reach us by the pager number for urgent concerns.

 

We hope you are all keeping well both mentally and physically during this unprecedented time!

 

From all of us at Mountain Midwifery Care

 

Updated Letter to clients from Mountain Midwifery Care

 

March 22, 2020:

 

To reduce community transmission of Covid-19 while still providing safe care, we recently received guidance from the Ontario Ministry of Health and the Association of Midwives asking we carry out some of our prenatal and
post-partum visits over the phone.  If, during the phone visit, we feel an in-person visit is needed, we will arrange one. We will also have shorter in-person visits, and ask that you come to your visits alone if possible.

 

Updated Letter from Obstetrical Care Providers - St. Joseph's Health Care Hamilton

 

March 16, 2020:

 

Letter from Obstetrical Care Providers - St. Joseph's Health Care Hamilton

 

March 15, 2020:

 

Dear Clients of Mountain Midwifery Care,

 

We’d like to take this opportunity to communicate with you about plans we have made to continue to provide safe care during the COVID-19 Pandemic.

 

Your health and our health are the top priority at this time. The midwives will follow all employee health guidelines regarding self-isolation if they are at risk of COVID-19 or screen positive. This may mean that your visit or birth will be attended by a different midwife.

 

If you develop symptoms of COVID-19 such as fever, cough, and shortness of breath, please follow the advice of Hamilton Public Health and call the COVID-19 Hotline at 905-546-2424 ext. 7970 to see if you qualify for testing. Do not attend your clinic appointment but call ahead and we will discuss what to do next.

 

In-person clinic visits:

Starting this week, we will follow what other midwifery and physician clinics are doing and limit the risk of exposure by having you come to clinic less often. To guide this decision, we are using the World Health Organization (WHO) guidelines on the number of prenatal appointments for a positive outcome. This includes: One visit in the first trimester (we will book initial appointments for 10 weeks), two visits in the second trimester at 20 and 26 weeks, and then more frequent visits in the third trimester at 30, 34, 36, 38, 39 and 40 weeks.

 

Phone Assessments:

We can achieve a lot over the phone including answering your questions, informing you about relevant topics related to pregnancy and birth, arranging ultrasounds, sending prescriptions to the pharmacy, and ordering bloodwork. We will plan to book phone appointments at 15-16 weeks to bridge the gap between 10 and 20 weeks and to ensure that all laboratory and ultrasound reports have been explained. If you would prefer a phone assessment over an in-person visit for any of your other scheduled visits, please let us know.

 

Our clinic space:

On Monday March 16 we will be removing all the toys and magazines from the waiting room to reduce the number of objects that are touched, and to make cleaning easier.

We will continue to wipe off surfaces in the clinic room in between clients, and, as always, wash our hands or use hand sanitizer in between clients. We ask that you also use hand sanitizer when you arrive for your appointment. Please limit the number of people who come to the clinic for your appointment. We would appreciate children remaining home if possible.

 

Our Hospital, St. Joseph’s Healthcare Hamilton:

The Birthing Unit is equipped with the items required to care for pregnant women with COVID-19. The isolation room has a special filter, and all health care professionals will use personal protective equipment such as a gown, mask, gloves, and face shield to provide care. If a pregnant person develops more severe symptoms, her care could be moved to another area of the hospital in close consultation with other physicians.

The hospital has initiated strict visitor limitations. You may have one person with you during your birth and postpartum stay. That person may be with you at any time of the day or night. Children, including siblings of the new baby, are not allowed to visit the hospital at this time.

 

Home Births:

We will continue to offer choice of birthplace. Home birth can be a great way to keep mothers and babies out of the hospital, however, we need to be certain that every person requesting a home birth is a good candidate for home birth (ie. low risk of complications). If any household members are sick or have screened positive for COVID-19, midwives will not be able to attend you at home and will request that the birth occurs in the hospital where there is a supply of masks and gowns.

 

Continuing Updates:

There are changes happening every day as the pandemic is evolving. We are hopeful that the measures taken by the Canadian government to reduce travel, close schools, and cancel large events will slow the spread of COVID-19 and allow the healthcare system to properly care for those who need it. We will do our best to keep you up-to-date as time goes on.

 

We know it can be stressful to deal with situations like this, especially while you are pregnant or have a new baby at home. Our hope is that you remain healthy and calm in the weeks ahead.

 

Sincerely,

 

All of us at Mountain Midwifery Care

 

Appendix

 

Summary of things that you can do at this time:

• Practice social distancing – avoid crowded places and unnecessary travel.

• Wash your hands, try not to touch your face, and reconsider hugging and handshaking

• Avoid contact with sick people and stay home when you are sick. Cough or sneeze into your shoulder or arm.

• If possible, come on your own to your clinic appointments to avoid extra people in our waiting room.

• On arrival to our clinic, clean your hands with hand sanitizer.

 

Resources:

 

Hamilton Public Health COVID-19 Hotline: 905-546-2424 ext. 7970

 

https://www.hamilton.ca/public-health/health-topics/novel-coronavirus-covid-19

 

Public Health Ontario

https://www.publichealthontario.ca/en/diseases-and-conditions/infectious-diseases/respiratory-diseases/novel-coronavirus

 

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Monday: 9:00am - 5:00pm

Tuesday: 9:00am - 5:00pm

Wednesday: 9:00am - 5:00pm

Thursday: 9:00am - 5:00pm

Friday: 9:00am - 4:00pm

 

Mountain Midwifery Care

849 Upper Wentworth St., Suite 409

(Beside Lime Ridge Mall)

Hamilton, Ontario

L9A 5H4

phone: 905-296-3665

fax: 289-426-3226

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