Last updated: April 13, 2022
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 continues to conduct all instructional and administrative activities remotely. At this time, all in-person coursework is completed and we have no plans to offer additional regular courses in the future.
Financial Impacts and Birthingway
Concerning financial aid, the US Department of Education decided on March 20, 2020 to temporarily waive interest on federal student loans and suspend loan repayments. This provision was extended through August 31, 2022. You can find more information about these provisions on the Federal Student Aid Website: Coronavirus and Forebearance
Birthingway was also granted funding through the HEERF CARES Act, which included funds for Emergency Financial Aid Grants for students. You can find more information about that funding below:
- HEERF CARES Act Update
- HEERF Institutional Grant Budget Expenditure Report-Quarter Ending September 30, 2020
- HEERF Institutional Grant Budget Expenditure Report-Quarter Ending December 31, 2020
- HEERF Institutional Grant Budget Expenditure Report-Quarter Ending March 31, 2021
- HEERF Institutional Grant Budget Expenditure Report-Quarter Ending June 30, 2021
- HEERF Institutional Grant Budget Expenditure Report-Quarter Ending September 30, 2021
- HEERF Institutional Grant Budget Expenditure Report-Quarter 3-Ending September 30, 2021-REVISED
- HEERF Institutional Grant Budget Expenditure Report-Quarter 4-Ending December 31, 2021
- HEERF Institutional Grant Budget Expenditure Report-Quarter 1-Ending March 31, 2022
- HEERF Institutional Grant Budget Expenditure Report-Quarter 2-Ending July 8, 2022
Working with Clients – Midwifery Students
Health and Safety
As of September 30, 2021, all healthcare providers in the State of Oregon, including students, must either be fully vaccinated or undergo weekly testing for COVID. Other states may have similar requirements.
While vaccination does greatly decrease your risk of serious illness or death from the virus, it is still possible to contract and spread COVID as a vaccinated individual. While Oregon’s statewide indoor mask mandate expired on March 12, 2022, use of masks is still required in settings where healthcare is provided. Wearing masks indoors, physically distancing, and avoiding large and/or tightly spaced groups are still effective ways to lower your risk of contracting and spreading COVID. Vaccinated and asymptomatic people CAN and DO spread the virus.
While novel coronavirus is not blood borne, it is highly contagious via respiratory droplets, so precautions are necessary 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) is sending regular updates on COVID-19 with information and guidance specific to midwives and community birth in Oregon:
- March 17, 2020: Midwives and COVID-19.
- March 30, 2020: Midwives, Masks, and COVID-19-guidance on using and acquiring appropriate PPE
- June 8, 2020: Updates on hospital transfers, current COVID cases, and new research on outdoor transmission of COVID
As of June 1, 2021, “NARM will no longer allow virtual clinicals to apply to the Continuity of Care clinical requirements for CPM candidates which they previously allowed. For each Continuity of Care Client between March 1, 2020 and June 1, 2021: one prenatal in the final trimester and one postpartum done anytime between 24 hours and six weeks post birth. Guidelines for documentation are available at narm.org.” All other clinical requirements for NARM certification remain unchanged.
Currently, Birthingway WILL ALLOW students to count virtual prenatal and postpartum appointments as direct client care for Clinical Training Credits (CTC) IF they are a full participant in the appointment. All labor, birth, and immediate postpartum care must be provided in person for the experience to count for either NARM or Birthingway graduation requirements.
While we do not expect this will be a problem for students in the Portland metro area, many students are finding it difficult to find in-person NRP courses. For this reason, NARM will accept the verification of passing the NRP Essentials (Lessons 1-4) exam without the hands-on class until January 1, 2023. The CPR requirement is still in effect and requires the full course (must include BLS if taking only NRP Essentials 1-4). You can find more information about this policy change at narm.org.
Working with Clients – Doula Students
Health and Safety
As of September 30, 2021, all healthcare providers in the State of Oregon, including students, must either be fully vaccinated or undergo weekly testing for COVID. Other states may have similar requirements. Additionally, as of March 12, 2022, many localities are lifting public health regulations such as mask mandates; however, healthcare facilities will continue to require use of masks and other required PPE.
All hospitals and many out-of-hospital birthing locations in the area expect doulas and other healthcare providers to be fully vaccinated; however, hospital policies vary around checking vaccination status for all individuals. It is your responsibility to verify the doula and visitor policies at your client’s planned place of birth well in advance of their due date. Choosing to remain unvaccinated will prohibit you from providing in-person care in many birthing settings in the area.
As a doula, you are ethically obligated to truthfully share your COVID vaccination status with clients or care providers who ask for this information. We strongly recommend vaccination in order to prevent the spread of COVID and to ensure you are able to serve clients at their chosen birthing location.
While vaccination does greatly decrease your risk of serious illness or death from the virus, it is still possible to contract and spread the virus as a vaccinated individual. Wearing a mask, physically distancing, and avoiding crowds and poorly ventilated spaces are still effective ways to prevent transmission.
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. We have also created support guidelines specifically for labor and postpartum doulas on caring for clients during the COVID-19 Pandemic:
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.
Access to Doulas during the COVID-19 Pandemic
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.
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 are just beginning to develop immunity. 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 have increased even 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, masking, and staying home as much as possible are such effective tools 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:
- Follow CDC guidelines regarding COVID-19 vaccination and booster shots
- Practice social distancing
- Cover your nose and mouth with a mask when indoors and around others
- Oregon’s indoor mask mandate expired on March 12, 2022; however, masks are still required in healthcare settings and remain an effective way to reduce the risk of exposure to the virus for yourself and others.
- In order to be effective, masks must fit snugly without gaps around the nose, mouth, and chin, and should be made of a high filtration material. See CDC guidance on Masks and Respirators.
- 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 continue 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 well being during this time.
Please don’t hesitate to reach out to a Birthingway staff member for support. You can reach us by emailing email@example.com
Mental and Emotional Health
- 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
- 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
- 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 inequities. 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
- State and Local COVID-19 Response Information
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 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-Breastfeeding and Caring for Newborns if You Have COVID-19
WHO Q&A on COVID-19, pregnancy, childbirth, and breastfeeding
Evidence Based Birth COVID-19 Resource Page
Infographic on COVID-19 and Breastfeeding Precautions
Guidance for pregnant people on COVID-19 and pregnancy from the Royal College of Obstetricians and Gynaecologists
For guidelines from professional organizations:
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
Guidance from the Royal College of Obstetricians and Gynaecologists on Coronavirus (COVID-19) infection and pregnancy
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
News from NARM:
- Testing and recertification in light of closures due to COVID-19: Response to NARM Examination Site Closures
- NARM Policy on Virtual Clinical Experiences
- CPR and NRP Policy Update-May 2021
- Update on Meeting NRP Requirement-March 2022
List of web resources for parents and communities from Prevent Child Abuse America.
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.