Pregnancy Care during Covid

Pregnancy care during Covid:

We know a lot of you are seeing way less of your maternity care provider than you usually would in “normal” times and you may be wondering... Is this safe?  What should I be watching for?  

So let's take a few minutes and go through what the recommendations are and what you can be doing to keep yourself and your baby safe!!!

Schedule of Visits:

Normally we would see you every four weeks until 28 weeks, every two weeks until 36 weeks and weekly until your cute baby is delivered.  During the times of Covid, we are still checking in with you this often, but some of these will be done by phone or by video chat! Our clinic, Grow Health, has adapted the following schedule as per the recommendations of our governing bodies and the World Health Organization. 

Visit 1: Phone/Video: 8-10 weeks. Get to know each other! This is usually a chit chat visit learning a little bit about each other.  We review your medical history, talk about any previous deliveries you have had and any issues that came up during a previous pregnancy, if applicable.  We also review your family history.  We tell you about our clinic, and how it works, we discuss what testing and monitoring we do during a “normal or low risk” pregnancy.  We get you set up for regular screening bloodwork and a dating ultrasound.  We generally do this sometime between 8-10 weeks of gestation (based on the first day of your last menstrual period). We also just check in and see how you’re feeling, what questions you might have that we can answer, etc. 

Visit 2: In Person: 10-12 weeks This is a complete physical exam including listening to your heart and lungs, doing a breast exam as well as pap test and internal exam as needed.  We review your bloodwork and ultrasound and listen to your baby with the doppler.  This is an in person visit (hard to do a pap over video!!).  

Visit 3 & 4: Phone/Video: 16 weeks and 20 weeks (after your ultrasound!). These phone appointments review how you are feeling and answer any questions.  We also get your ultrasound around 20 weeks which looks at how your baby is developing and where your placenta is.  We review this over the phone.  Of course if there are any concerns that we feel need to be addressed in person we’ll arrange to see you face to face. 

Visit 5: In person - we want to see you a bit more regularly after 24 weeks to monitor how your baby is growing (by measuring from your pubic bone to the top of your uterus) and checking your blood pressure.  

Visit 6: Phone/Video 28 weeks: This visit is when we talk about fetal movement and how to make sure your baby is doing well...ie how you can monitor your baby at home!  Just making sure your baby is moving regularly and how to learn what movement is ‘normal’ for your baby! Each baby has their own movement pattern, which becomes more consistent after 28 weeks.  10 movements in 2 hours is normal.  If you feel your baby is a bit more quiet than normally, then sit down, put your feet up, have a glass of water and a snack and really focus on your baby! You should feel 10 movements in 2 hours, if not we would like to hear from you! If those movements happen in the first 20 minutes...great! Get up and be on your way, if it takes longer, not to worry, as babies sleep just like us...as long as you are getting those movements...we are happy! 

Visits 7 & 8: These occur on weeks 32 and 34, and we will alternate seeing you in person and doing a phone/video check in.  If you have a history of high blood pressure or other concerns, we may ask you to purchase a blood pressure cuff to monitor your blood pressure during these times and report back to us! Most extended benefit plans will cover a blood pressure cuff, so get a prescription from us if you need one!   Also we want you to be keeping an eye on your baby’s movements.  

Visit 9: 36 weeks - In person.  This is the visit where we do your GBS swab, and check to make sure that baby is in the right position (i.e head down!).  We will also make a plan with you for the weekly visits we do and whether any of those can be done on phone/video, or if they need to be done in person. 

Visits 10+: 37-41- In person/Video: You and your care provider will make a plan around how these videos take place. It depends on a few things, mostly if there have been complications in your pregnancy including baby’s growth, blood pressure, etc. 

So as you can see, we will still be keeping a close eye on you and your baby, and we certainly want to have discussions with you about any concerns you have.  If you need to be seen for something...we are still here for you!  Make sure you reach out to us with anything you need to know or are worried about! 

Testing during Pregnancy: 

We’ve talked a bit about this, but we still need to do our regular screening for bloodwork and ultrasounds in pregnancy.  These include: 

• Bloodwork with your first visit
• Ultrasound before 12 ish weeks
• Ultrasound around 20 weeks
• Bloodwork between 26-28 weeks (Gestational diabetes screen, iron etc)
• GBS swab at 36 weeks
• Monitoring of your pregnancy if high risk, or if you go over your due date. 

Some pregnancies will require more monitoring than this, and you will be informed by your caregiver as to what needs to be done! 

What Do I do to make sure my baby is healthy?

This doesn’t change just because we are in the time of Covid.  

1. Eat nutritious food
2. Exercise regularly (yes walking 30-45 min 3-4 days a week is great exercise!)
3. Take care of your mental health - meditate, talking to friends/families
4. Monitor fetal movement after 28 weeks
5. Monitor your blood pressure at home, if asked to do so by your care provider
6. Doppler - up to you if you want to purchase one to listen to your baby, once your baby starts moving (approximately 20 weeks) then you can monitor well being by fetal movement. 
7. Symptoms: keep an eye on your symptoms, ask your care provider about them if you are worried.  If there is something we ask you to look out for...and you have it...let us know right away!  You will be told specifically what to look for! 

What about my Newborn?

Obviously we need to make sure your newborn is doing well, so we will individualize this to you and your baby!  Generally speaking we will see your baby within one week of delivery to make sure all is well.  We will do a weight check and a full physical exam.  Over the next 6-8 weeks we will do a combination of phone and in person visits depending on how the two of you are doing. 

Some places also have public health that are following babies as well, and we try not to duplicate visits, so this will also influence how often you are seeing your primary care provider. 

Monitoring you Baby: 

Things we need you to keep an eye on over the first 6-8 weeks with your baby are:

• Feeding every 3-4 hours from start to start until they are gaining weight consistently.
• At Least 5-7 wet diapers a day (after the first week). 
• Having increasing periods of wakefulness and alertness over time (they will be only lasting 30-60 minutes at the start. 

If your baby is not doing these things, please contact your care provider! 

Recap: 

• We will still touch base with you as frequently as pre-Covid, we will just do it in a different way!
• We are still here for you if you have questions or concerns...please reach out. 
• We will tell you if there are specific things you need to do to monitor your pregnancy (ie if you are more high risk)
• We will closely monitor your newborn over the first few weeks
• You will monitor your pregnancy and newborn and call us if you have concerns! 

We know these are trying times and isolation and limited in person help may make the newborn days more challenging than you may have anticipated. Please know we want to hear from you if you’re struggling with sleep, mood, bonding with baby etc. We’re here. For you.

Check out our Essentials Packing List for you, your partner and newborn for the hospital Here!

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