Birthingway Update on Novel Coronavirus and COVID-19

Last updated: March 24, 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.

The most recent updates to this page will be indicated in purple.


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 for Winter Term 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 April 28, 2020, unless extended or terminated earlier.

For students who are planning to graduate soon, we are considering ways to provide LD & D testing and the oral integration exam in an online format.

Commencement is currently planned for June 25 at Zenger Farms. However, this is subject to change depending upon the status of the pandemic.

Course remediation deadlines remain the same – six weeks after the last class day or after the last assignment is due, whichever comes last. Whenever possible, remediations should be completed via on-line exchange of information, for instance by using the Google Classroom, and should only be completed in person if absolutely necessary.

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.

Registration for Clinical Training Credits and Research Projects will follow the usual deadlines and policies.

Registration for Spring Term will continue as planned:

Spring 2020 Midwifery Student Registration Timeline
March 16, 2020 Registration Materials Available Registration materials will be sent to your Birthingway email address.
ONE WEEK LATER
March 23, 2020 Registration Begins Start turning in your registrations!
ONE WEEK TO COMPLETE TERM REGISTRATION
March 30, 2020, 5:30 PM Registration Ends Deadline to register for the term. Registrations that are not completed by this deadline will be subject to a $75 late fee
TWO WEEKS LATER
April 13, 2020 First day of Spring 2020 Term Deadline to register for Research Project and submit Course Add Forms for Alternative Format Courses
ONE WEEK LATER
April 20, 2020, 4:30 PM Enrollment Confirmation Deadline Deadline to register for the term-you will be withdrawn from your program if you have not registered by this date.

Deadline to use financial aid to register for credits.

Spring 2020 Doula Student Registration Timeline
March 16, 2020 Registration Materials Available The link to register for the term online will be sent to your Birthingway email address.
FOUR WEEKS LATER
April 13, 2020
5:30 PM
Registration Deadline
First Day of Spring Term
Registrations received after this deadline will be subject to a $25 Late Registration Fee
ONE WEEK LATER
April 20, 2020
4:30 PM
Enrollment Confirmation Deadline Deadline to register for the term-you will be withdrawn from your program if you have not registered by this date.

For additional information about Birthingway’s policies, please view our Student Handbook and Catalog.


Financial Impacts and Birthingway

We know this is a time of financial hardship for many, as businesses close and employees are laid off. If you are unable to pay your registration fees for this term due to circumstances related to the coronavirus pandemic, please reach out to your Program Coordinator to discuss your situation and options. Birthingway is creating several new registration options for Spring Term to provide flexibility in light of these unique and challenging circumstances.  If the coronavirus pandemic is impacting your ability to pay for registration this term, please contact your Program Coordinator as soon as possible.

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

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).

Use of gloves for routine care (such as taking blood pressures and abdominal palpation) is not currently recommended when working with healthy clients without symptoms of the virus. Of course, do follow the usual universal precautions.

Individual preceptors may create more stringent requirements for their practices.

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

Additionally, OMC released the following guidelines on March 20 on how to protect yourself and clients from possible exposure: 

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

References

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.

For links to other information about working with clients, see Resources below.


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.

Use of gloves for routine doula care is not currently recommended when working with healthy clients without symptoms of the virus. Of course, do follow the usual universal precautions.

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.

For insight into possible death rates from the virus, see this article from the New York Times: Could Coronavirus Cause as Many Deaths as Cancer in the US?


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:

  • 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
  • Practice social distancing – at least six feet from another individual.
  • No gatherings of more than ten people.
  • 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
  • Avoid unnecessary excursions and isolate at home as much as possible. This is especially essential if you are sick or have known exposure to the virus.
  • If you are not seriously ill, stay home and monitor your symptoms. Call for medical assistance if you have:
    • A fever of 100.4F / 38C or higher
    • A persistent cough
    • Trouble breathing

Call ahead before going to a doctor’s office or hospital emergency room, and avoid contact with others.

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.


Find Support

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 weekly 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

Safety from Domestic Violence and Intimate Partner Abuse

Employment, Food, Housing, and Utility Assistance

This is a small sampling of the resources available to you—please contact us at info@birthingway.edu if there are resources you think we should add.

Resources

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:

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 

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
A new 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

HIVE Continuing Education COVID-19 info page: https://www.hivece.com/pages/covid-19-Q-and-A

Information from NARM about testing and recertification in light of closures due to COVID-19: Notice to all CPM Applicants and Candidates for Recertification

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.