Review of Hospital Policies on L&D
Good evening ! Some updates on the visitor policies and new data on testing at Hoag!
#1 One support person for the each patient on delivery, antepartum, and postpartum. The same person. The person should be wearing a mask whenever any hospital staff is in the room. They are allowed to come and go from the hospital if needed, but encouraged to stay the entire visit.
#2 All scheduled Cesareans and Induction of labor patients should have COVID test 3-5 days prior to admission, and they should self-quarantine until their admission.
#3 If the baby is admitted to the NICU and the patient has tested positive, they will not be allowed but can name a surrogate who has not been exposed until the 14 days are completed. In the case of NICU admissions, one support person will be allowed into the NICU and for twins, two support persons.
#4 All patients admitted in labor or for other reasons will be offered COVID-19 rapid testing. As of this week, 96 patients who were asymptomatic were offered testing. 76 of them tested, 1 tested positive, 1 patient later developed symptoms and was tested positive but was not initially tested. 7 patients declined mostly because they were worried about being separated from the baby, but please see the attached letter and my previous posts. The idea behind testing asymptomatic patients is to protect the baby and protect the hospital staff.
What will happen if my test is negative?
If your test results are negative, you can remove your mask while in your room for comfort during the labor process. We will continue to use standard safeguards (staff will continue to mask and wear eye shields, and request that you and your support person mask in the presence of a health care provider) in the small chance the test was a false negative.
What will happen if my test is positive?
If your test results are positive, we will use appropriate personal protective equipment (PPE) when entering your room. We can also help you make decisions about reducing exposure to your baby and alterations for breastfeeding. Current guidelines suggest separation of the mother and baby may help protect your baby from infection however, you may choose to have your baby room-in and stay with you.
If you decide on complete separation, you stay in one room and the baby stays in a separate room. Visitation of the infant will not be allowed by either a positive mother or their significant other, as they will be presumed to be positive. iPads are available if you wish to view your baby on a live camera. Staff will provide you with frequent updates on your baby and will fully educate you on discharge instructions and how to care for baby at home using standard safety precautions
If you decide to room-in with your baby, your baby will be placed in an isolette 6 feet away from you in the room. Staff will provide safety instructions (hand washing, wearing a mask, etc.) so that you may safely continue to breastfeed, or pump and hold your baby. Your designated support person must also remain in the room and wear their mask for the duration of your stay to help you care for your newborn. Staff will provide discharge instructions and how to care for baby at home using standard safety precautions.
One of our newborn physicians or your pediatrician will review your options, as you share in the decisions regarding infant care and breastfeeding. Other workup will be discussed with you regarding recommended changes for you and your baby’s care.
Will I be able to have a support person with me during my hospital stay?
Prior to the COVID-19 pandemic we encouraged our delivering mothers to involve as many loved ones in the process as they felt comfortable. Currently, we are limiting involvement to a single support person who is carefully screened with questions and temperature measurement upon entering the hospital. This individual, chosen by the you, will be asked to minimize travel outside of the room and must always wear a mask inside the facility, including in your room.
In the event you test positive for COVID-19, your support person will be presumed positive and will be asked to remain in the room with you for the duration of your stay. We will be happy to provide meal trays and beverages for your support person.
If the support person is symptomatic or is known COVID-19 positive, they will not be permitted to enter the hospital and must stay home until after the isolation period.
In the event you need to deliver via cesarean section and you require, or may possibly require, intubation for general anesthesia we will not be able to permit a support person in the operating room.
What other changes will I be expected to perform?
Social distancing, respiratory etiquette, and hand hygiene are the most effective methods of reducing transmission. Please be sure to wear your mask and maintaining a six-foot distance when staff and physicians/midwives are present in your room. Additionally, when you are checking into the hospital (or being discharged) you will be required to wear your mask in hallways and other areas.
What will happen if I decline to have testing?
If you have no symptoms and decline testing, we presume you are negative. We will continue to use standard safeguards including asking you to wear a mask during your stay. Your newborn would still need routine evaluation for this infection as a part of standard care.
Will I have a repeat test?
If, during your stay with us, you develop symptoms suggestive of COVID-19, we may recommend repeat testing since there is an incubation period after exposure that occurs before the virus can be detected. Otherwise the test will not be repeated.
In other news, shout out to our very own Hoag ER Dr. Alcouloumre who got mentioned in the LA times for his blog/ Facebook posts. Science is science, reading on google is not science. And for all our patients suffering from conditions such as endometriosis I am so sorry that those so-called "America's Frontline Doctors" made it to the national spotlight. Frankly, it is so embarrassing that women's health has been trivialized and politicized even further. Keep your politics out of our exam room!
Continue to stay safe and vigilant, we are making some progress after our big spike in early July. Social distance, masking, and washing your hands! Avoid crowded restaurants, but support them with take out! I appreciate your all for reading this!