Let me just say this: I'm angry.
Almost one year ago, I sent email, letters and created social media posts surrounding the care and safety of pregnant families. One year. No action. Not a single response from one doctor, one CEO, one Health Minister, one Premier. No differences. No change. And I am angry.
The solutions are so incredibly simple. Birth needs to be filled with joy and free from fear. Parents need to feel respected, heard and part of the experience. The rate of interventions needs to be low and the rate of birth experience satisfaction needs to be high. Children need this from their parents from a basic biological perspective.
The current model of care had its problems prior to the pandemic and now, more than ever, this new environment supports high anxiety births with little opportunity for change.
Did hear about the mother in BC who gave birth by caesarean while in a coma with complications due to COVID-19?
While caring for the COVID positive pregnant patients is still unfolding, there are some basic things that should have happened for this parent, the partner and the newborn for both the short and long term well-being of this family. Easy things. Simple things. Things I would have suggested. But no one asked me.
Did you see the post on social media from the postpartum parent who was not allowed to bring her newborn to her six week check up?
There is just so much wrong with this. Wait times for a check up sometimes goes beyond sixty minutes. Never mind, breastfeeding on demand - many parents feel a great deal of anxiety being separated from their infants. Some parents will skip the check up and mistake abnormal signs in a physical recovery for normal because they don't know what they don't know. This can lead to both short and long term health problems.
Has any obstetrician or their staff ever caught cues of something being amiss with a baby? If you don't see the parent and child together, you are only assessing half of the dyad.
Virtual care for pregnant patients has the potential to have life threatening issues for both parent and child missed.
IUGR, significant blood pressure changes, diabetes, PUPPPs, eating disorders are just a few of the things that can be missed by TeleHealth. In person care is needed for all pregnant patients.
Did you know that in Toronto, many pediatric cases are being redirected from hospital to the Hospital for Sick Children?
If we can have an entire hospital devoted to the care of children, surely, we can have more centres devoted to birth. Three freestanding birth centres exist in the Province of Ontario. Yes. Three. In the entire, vast Province. While it may not be feasible to build centres, at this point, there is feasibility in converting areas of motels, hotels and utilizing military hospitals for only birthing services. Mobile military hospitals can be utilized and there are so many options available to enhance the environment.
For example, in South Simcoe County, births could all be moved the Base Borden hospital. In Alliston, the Mary McGill centre could be revamped, quickly, efficiently and inexpensively to house a birth centre. Integrated health teams could be utilized to maximize efficiency. This model has been studied for decades. Ask me about it, some time.
Rapid C19 testing is becoming more readily available.
Your birth team can all be tested so birthers can be mask free in labour. They can be in water (if desired), with adequate support and enhanced comfort measures utilized.
Pregnant patients need in-person, health checks in a clean, sanitized and non-medical environment. Pregnant patients and their choice of support people need the freedom from restrictions to birth their children in an environment conducive to physical, emotional and spiritual safety. That's it. And it's not a lot to ask.