Last updated: May 15, 2020
This webpage provides the most current information on impacts of the Novel Coronavirus on Birthingway College and our responses to those impacts. This is a time of extraordinary change and uncertainty, and thus of potential stress, fear, and panic. Birth workers are, by the nature of our work, resilient and experienced with unexpected and stressful situations. Yet the place we find ourselves today is unlike anything the world has seen in a long while. By staying informed, staying calm, and doing what needs to be done, we will survive and come through stronger and in a different, and hopefully better, world.
Current Status of the College
Birthingway College continues to operate; we have no plans to “close” the school, change the academic calendar, or revise deadlines at this time. We will forge ahead more or less as usual.
The College is well positioned for the current “shelter at home” environment. Beginning January 1, 2020, the College implemented a decentralized administrative structure, with our staff working from home and minimal in-person meetings. This will continue indefinitely.
At this time, all in-person coursework is completed. We have no plans to offer additional regular courses in the future. We are instating a moratorium on all in-person meetings and will instead plan to meet via phone or online platforms .
Per Oregon Governor Kate Brown’s recent Executive Order, all colleges and universities are prohibited from in-person instruction from March 21 through June 13, 2020, unless extended or terminated earlier.
For students who are planning to graduate soon, we have developed new processes for facilitating LD&D testing and Oral Examinations virtually. You can find more details about virtual testing for LD&D Examinations here: LD&D Virtual Testing
Commencement is currently planned for June 25 at Zenger Farms. However, this is subject to change depending upon the status of the pandemic.
In future, a limited number of individualized alternative format courses of no more than two students and a teacher will be offered to meet the graduation requirements of students.
For additional information about Birthingway’s policies, please view our Student Handbook and Catalog.
Financial Impacts and Birthingway
Concerning financial aid, the US Department of Education has decided to temporarily waive interest on federal student loans and suspend loan repayments. For more information:
Delivering on President Trump’s Promise, Secretary DeVos Suspends Federal Student Loan Payments, Waives Interest During National Emergency
Coronavirus and Forbearance Info for Students, Borrowers, and Parents
Birthingway was recently granted funding through the HEERF CARES Act, which included funds for Emergency Financial Aid Grants for students. Read our statement on that funding here: HEERF CARES Act Update.
Working with Clients – Midwifery Students
While novel coronavirus is not blood borne, it is highly contagious via respiratory droplets, so precautions are strongly recommended when providing care.
Current recommendations are NOT to provide care to anyone experiencing respiratory symptoms, even mild ones. If a client is having symptoms of COVID-19, they should contact their primary care provider so that the provider can assess whether in-person treatment is necessary and a referral to the hospital is warranted.
Preceptors and students should not provide services to clients if the provider or students have any symptoms of potential infection with coronavirus, even mild ones!
Preceptors and students should follow the recommendations in the Protecting Your Health section below, as well as all CDC recommendations, with emphasis on frequent and thorough hand washing. You should not attend a birth at home or at a birth center with someone who has symptoms of COVID-19 because midwives do not have adequate personal protective equipment (PPE).
The Oregon Midwifery Council (OMC) has shared a very informative resource on coronavirus, with information specific to midwives and community birth: Midwives and COVID-19.
They released another update on April 9 with information specific to midwives working in Oregon, including current COVID projections, information on handling requests from the media, and guidance on using and acquiring appropriate PPE: OMC Email Update-April 9, 2020
Guidance from OMC related to midwives wearing masks :
Community Midwives, Masks, and COVID-19
We all want clear and accurate information about how to protect our clients and ourselves from COVID-19 in the midst of medical supply shortages. Here is the best information that we have for home birth and birth center midwives as of 3/30/2020.
- We should assume that we, our clients, and their support people could be asymptomatic carriers of COVID-19
- It can be protective for midwives to wear masks during all client contact during this outbreak, primarily to protect our clients from us as potential vectors (virus carriers who could transmit the disease), and secondarily to protect ourselves
- We specifically recommend that midwives wear masks at births
- N-95 masks are most effective against transmission of COVID-19 but they should be reserved for health care providers who are working with COVID-19 patients as there is a shortage and those most at-risk need to be prioritized
- Surgical masks do reduce the risk of transmission of viruses and are preferred over cloth masks for midwives at this time
- There is limited evidence on the effectiveness of cloth masks to reduce transmission of viruses but we recommend them if a surgical mask is not available as they do provide some protection (especially in terms of our clients’ exposure from us)
- Cloth masks should be washed and dried after each use
- Cloth masks should be removed if the fabric becomes moist
- Please note that the 2015 MacIntyre et al. study of the use of cloth masks in Vietnam that has been circulating does not provide any useful information because the study design is deeply flawed (major unmeasured variation in mask use in control group, incredibly wide confidence interval, etc)
- No one is claiming that cloth masks are more protective than surgical masks but there is evidence that cloth masks are more protective than no mask.
Please see the CDC page on Strategies for Optimizing the Supply of Facemasks for more information: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html
Chughtai, A. A., Seale, H., & MacIntyre, C. R. (2013). Use of cloth masks in the practice of infection control—evidence and policy gaps. Int J Infect Control, 9(3).
Rengasamy, S., Eimer, B., & Shaffer, R. E. (2010). Simple respiratory protection—evaluation of the filtration performance of cloth masks and common fabric materials against 20–1000 nm size particles. Annals of occupational hygiene, 54(7), 789-798.
MacIntyre, C. R., Seale, H., Dung, T. C., Hien, N. T., Nga, P. T., Chughtai, A. A., … & Wang, Q. (2015). A cluster randomised trial of cloth masks compared with medical masks in healthcare workers. BMJ open, 5(4), e006577.
In an effort to protect clients and practitioners, many midwifery practices are performing prenantal and postpartum assessments virtually. Birthingway has decided that students in clinical training may count these visits toward completion of clinical training credit hours. On April 17, NARM released their decision to allow two virtual clinicals to apply to the Continuity of Care clinicals for each Continuity of Care Client. If you are a student whom this policy pertains to, please carefully review their statement for more information: NARM Policy on Virtual Clinical Experiences.
Working with Clients – Doula Students
Doulas provide emotional, physical, and educational support to childbearing women during labor and birth (Labor Doulas), and after the birth (Postpartum Doulas). They are not “guests,” they are professionals and a part of the health care team providing services at a time of great need. As such, they should be allowed into the birthplace to care for asymptomatic clients and, as long as sufficient personal protective equipment (PPE) is available, to care for symptomatic clients. See the AWHONN Position on Doulas below.
The Oregon Doula Association has also released a statement on access to doulas during the COVID-19 outbreak.
Doulas should not provide services to clients if the doula has any symptoms of potential infection with coronavirus, even mild ones!
In the absence of client symptoms, all student doulas should follow the recommendations in the Protecting Your Health section below, as well as all CDC recommendations, with emphasis on frequent and thorough hand washing.
Labor Doulas should not attend a birth with someone who has symptoms of COVID-19 unless adequate PPE is available.
Postpartum doulas should not provide postpartum care to someone who has symptoms of COVID-19, or if a family member has symptoms, as appropriate PPE is not available to them.
We understand that some hospitals are requesting that doulas provide confirmation of training or certification. If you need Birthingway to re-issue your certification or workshop certificate of completion, you can submit a request here: Doula Certificate Re-Issue Request.
AWHONN Position on Doulas
The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) Position on Doulas with Patients During COVID-19, published March 11, 2020, states:
AWHONN recognizes that doula services contribute to the woman’s preparation for and support during childbirth and opposes hospital policies that restrict the presence of a doula during a woman’s active labor.
“Doulas are not visitors and should not be blocked from caring for patients in the antepartum, intrapartum and postpartum period. Most doulas have been contracted by patients weeks to months ahead of time and have established provider relationships. They are recognized by AWHONN and ACOG as essential personnel and part of the maternity care team,” said AWHONN member Nancy Travis, MS, BSN, RN, BC, CPN, CBC, Florida Section Chair.
AWHONN supports doulas as partners in care and acknowledges their ability to provide physical, emotional, and partner support to women. AWHONN opposes hospital policies that restrict the presence of a doula in the inpatient setting during an infectious disease outbreak. Read more about AWHONN’s position on continuous labor support for every woman here.
For additional information, please see this list of COVID-19 resources for doulas, which is updated frequently.
Understanding the Impact of Exposure
This is a new virus for humans to cope with, which means that we have no immunity developed yet. It is not “just like the flu,” being both more contagious and more deadly than influenza.
While it is currently most dangerous for the vulnerable – the elderly, immune compromised, those with preexisting health conditions, smokers and vapers – as the disease spreads, serious illness and death rise among lower risk populations. Being young is not a protection!
What we know at this time is that asymptomatic people CAN and DO spread the virus. That is why social distancing and staying home as much as possible is such an effective tool for limiting spread to manageable levels.
For a great article and graphic explaining how important social distancing is and how the virus can spread, see this simulator from the Washington Post.
Protecting Your Health
Birthingway College strongly recommends that our community members follow health department guidelines to minimize risk of infection and of transmitting the virus, including:
- Cover your nose and mouth with a cloth face cover when around others—this is a new CDC recommendation as of April 3, 2020: Recommendations for Cloth Face Covers
- Homemade, cloth masks are not known to be effective in protecting the wearer against infection by a sick person. However, if worn by a sick person, they may reduce the spread of COVID-19, especially in situations where it’s difficult to maintain six feet of distance. Asymptomatic carriers can and do spread the virus, so act with the assumption that you may be a carrier when in public.
- Social distancing is still the most effective way to prevent the spread of COVID-19. Wearing a mask should not be seen as a replacement for social distancing.
- Practice social distancing – isolate at home as much as possible except for essential trips and keep at least six feet from other individuals.
- Frequent and thorough hand washing with soap and water for at least 20 seconds. Wash your hands as if you’ve touched a jalapeno!
- If soap and water are not available, use an alcohol-based hand sanitizer (at least 60% alcohol)
- Avoid touching your face, eyes, nose, and mouth
- Avoid close contact with people who are sick
- Cover all coughs and sneezes; throw away tissue if used even once
- Clean and disinfect all frequently touched objects and surfaces, especially hard surfaces such as metal and plastic. For a guide to effective disinfectants, please see List N: Disinfectants for Use Against SARS-CoV-2
- Watch for symptoms of COVID-19:
- Shortness of breath or difficulty breathing
- Repeated shaking with chills
- Muscle pain
- Sore throat
- New loss of taste or smell
- Precautions to take if you have symptoms of COVID-19: CDC-What to do if you are sick
- Stay home and monitor your symptoms. Only leave your home to get medical care.
- Call for medical assistance if you have: a fever of 100.4F / 38C or higher, a persistent cough, or trouble breathing. Call ahead before going to a doctor’s office or hospital emergency room, and avoid contact with others.
- Separate yourself from other people and pets in your home.
Birthingway encourages our students, staff, faculty, and other community members to monitor and follow recommendations on the CDC website, as well as local and state health departments; see Resources below.
This is a time of unprecedented uncertainty and disruption, with significant repercussions for our daily lives as well as livelihoods. Many of us are experiencing concern over our own health and the health of our loved ones, the stress of losing income, or having children suddenly and unexpectedly home from school. Not to mention the demands of providing care as perinatal practitioners during a pandemic.
It is perfectly normal to experience grief, anxiety, and fear as we find ways to cope with this new reality. Now, more than ever, it is important to reach out for the support you need. Below are some resources we have compiled in the hope that they might assist you in protecting your wellbeing during this time.
Student Support Groups: Birthingway is facilitating virtual support groups for enrolled doula and midwifery students on a regular basis. This is an opportunity to let us know what’s alive for you during this crisis, to ask questions, and to share strategies. Please look for invitations to these meetings in your Birthingway email.
Mental and Emotional Health
- COVID-19 Battle Kit from Beyond My Battle: compilation of self-care resources
- Care for Your Coronavirus Anxiety: resources addressing a variety of possible stressors
- Lines for Life: crisis line that has developed a list of resources to find support for food, housing, and utilities, among others
- CDC-Managing Stress and Anxiety
- Coronavirus: Mental Health Coping Strategies: guidance and resources from NAMI
- Irresistible Podcast: Coronavirus Wisdom from a Social Justice Lens: podcast episode with resource list at bottom of page
- Marion County numbers for mental health outreach
- Adult Behavioral Health program: 503-588-5351
- Crisis Services: 503-585-4949
- Common Hotline Phone Numbers: List of hotline phone numbers within the US
Safety from Domestic Violence and Intimate Partner Abuse
- Call to Safety (Formerly Portland Women’s Crisis Line): 503-235-5333
- National Domestic Violence Hotline: 1-800-799-SAFE
- Multnomah County Crisis Line: 503-988-4888
Employment, Food, Housing, and Utility Assistance
- State of Oregon COVID-19 resource page for workers and employers
- COVID-19 Emergency Relief Resources for PDX: A very comprehensive list of resources for people in and near Portland, compiled by Congressman Earl Blumenauer
- United Way COVID-19 Response and Recovery Fund: Community economic relief fund for help with bills, rent, and food
This is a small sampling of the resources available to you—please contact us at firstname.lastname@example.org if there are resources you think we should add.
Birth Justice and Advocacy During COVID-19
Pregnant people are particularly impacted by the COVID-19 pandemic, especially those who are already marginalized by racism, economic inequality, immigration and documentation status, and other systemic injustices. This moment presents unique opportunities to surface and address long-standing inequities—advocacy for birth justice is needed now more than ever.
Below are some resources to assist practitioners and other advocates with advancing this cause in their practices.
Birth Rights: A resource for every day people to defend human rights during labor and birth
Tracking mistreatment, abuse, and obstetric violence during the COVID-19 pandemic
Challenges facing pregnant and birthing people during COVID-19
Opportunity for a paradigm shift in maternity care: guiding principles for getting the most out of COVID-19
Compilation of resources on COVID-19 and Birth Justice from Elephant Circle
Here is some of the latest and most credible information on COVID-19.
For regular updates and advice on prevention, treatment, and recovery, go to:
- Centers for Disease Control (CDC): www.cdc.gov
- Oregon Health Authority (OHA): www.oregon/oha
- Oregon Public Broadcasting (OPB): www.opb.org
- New York Times free coronavirus coverage
- Washington Post outbreak simulator
- Oregon Health Authority COVID-19 Updates
- The Oregonian-Coronavirus at a Glance
- Institute for Health Metrics and Evaluation (IHME) COVID-19 Projections
If you don’t have access to the Internet, call:
- Public Health Departments in the Tri-County area:
- Washington County: 503-846-3594
- Multnomah County: 503-988-3674
- Clackamas County: 503-742-5300
- Public Health Department in Clark County, WA: 360-397-8000
- Your doctor’s office or health clinic
- 211 for general questions
For the latest coronavirus summary, see the CDC website: cdc.gov/coronavirus/index.html
For factsheets you can share with your community and clients: https://www.cdc.gov/coronavirus/2019-ncov/communication/factsheets.html
For guidance specific to healthcare professionals: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html
For information specific to pregnant, birthing, and postpartum people:
CDC-Pregnancy and Breastfeeding
WHO Q&A on COVID-19, pregnancy, childbirth, and breastfeeding
Evidence Based Birth COVID-19 Resource Page
Aviva Romm MD-COVID-19, Pregnancy and Breastfeeding: What We Know is Reassuring
Infographic on COVID-19 and Breastfeeding Precautions
COVID-19 Resource List from MANA: A very comprehensive list of resources for providers and consumers of midwifery care
For guidelines from professional organizations:
ACOG Practice Advisory
SOGC Committee Opinion (Canada)
RCOG Guidance (UK)
International Lactation Consultant Association Resources
OMC Guidance on Midwives and COVID-19
OMC Update-April 9, 2020
A guide from the Royal College of Midwives in the UK on Coronavirus (COVID-19) Infection in Pregnancy
AWHONN Position on Doulas
Oregon Doula Association Position on Doula Access
Other useful information
Some info about temporary exceptions to HIPPA to allow for more telemedicine visits. Good info about which platforms are and aren’t okay to use: Notification of Enforcement Discretion for telehealth remote communications during the COVID-19 nationwide public health emergency
Some states have temporary suspensions or modifications of licensing laws in place to make it easier for essential healthcare workers to enter the workforce. Please see this article for more information: COVID-19: Occupational Licensing During Public Emergencies
HIVE Continuing Education COVID-19 info page: https://www.hivece.com/pages/covid-19-Q-and-A
News from NARM about testing and recertification in light of closures due to COVID-19: Response to NARM Examination Site Closures
List of web resources for parents and communities from Prevent Child Abuse America: https://preventchildabuse.org/coronavirus-resources/
The National Association of Certified Professional Midwives (NACPM) is offering access to the recording of their webinar Coronavirus: Midwives on the Front Line, featuring Aviva Romm.
The slides and recording for the CDC Clinician Outreach and Communication Activity (COCA) Call that occurred March 12 are available here. The topics include infection prevention and control measures in obstetric healthcare settings and resources available to care for newborns. Though it is geared toward a hospital setting, those who attended report some useful information applicable to community birth, transfers, etc. and slide 6 of the PDF has many helpful resources.