WBWC
COVID-19 Practice Guidelines
Last updated May 15, 2020
WBWC STRONGLY encourages social distancing. Please stay home if your job is not an essential occupation.
During this time, WBWC remains open and still invites new patients to contact us if you are in need of care. WBWC is converting as many visits as possible into a telemedicine format to minimize potential viral exposure to our patients and staff members.
Phone calls are being answered, and messages checked remotely by Front Desk Staff. We encourage you to leave messages and ask for your patience as we return calls.
New This Week:
WBWC is still offering essential primary care services including IUD and Nexplanon insertions/removals, contraceptive and family planning consultations, and acute needs such as evaluation of infections, pain, and medication management. WBWC is still offering water births and many of our classes and community services are available online. Please call our office with questions, or to schedule an appointment.
Critical exams, labs, & screenings are still occurring IN PERSON. This includes periodic wellness checks for maternity patients (see section below). The availability for ultrasounds and scans of any kind will largely be based on evaluation of urgency, as well as what types of screening centers are currently open. Please schedule a telemedicine visit to determine your need for in-person care.
Our providers stress the importance of utilizing telemedicine while we adapt to life with COVID-19. WBWC is currently abiding by the recommendations from the CDC and the WHO, while also collaborating closely with our partners at UNC to develop best practices. We understand that this may feel very different to some of our patients, and we promise to work with you while we all adjust.
Our nurses and midwives are committed to a gold standard of care that is centered on building relationships. WBWC’s model of care takes the time and space to engage in conversations with you. Hearing from you regarding your life, well-being, concerns, and how you are feeling inside your body is crucial, because numbers and measurements can never tell the whole story. Providers and patients alike have found that we are still able to accomplish this in the telemedicine format, sometimes to an even greater degree because physical exams are occurring in a separate visit. This arrangement lets us spend the full visit hearing from you, and deeply informs our recommendations. You are, and always have been, the expert on your own body & care. WBWC is here to help you interpret your body’s signals and develop personalized care plans that meet your individual needs.
_______________________________________________________________________________________
Masks at WBWC:
WBWC encourages all of our patients to wear masks in public, even if you feel well. Wearing masks at your in-person clinic visits is required, and ALL family members and support teams attending births MUST wear a mask.
**At this time WBWC is NOT requiring laboring patients to wear masks**
Patients and supporters of WBWC have shared a mother-load of love, and we will now be able to gift re-usable cloth masks to all scheduled in-person patients upon entry. WBWC is so grateful for the out-pouring of donated, hand-sewn masks that are helping to protect our community. All masks have been washed in hot water, and should be washed in hot water between uses.
The masks we have to give do not contain extra filters. Unfortunately, COVID-19 is very small, and even with additional filters masks may not offer full protection. WBWC still strongly recommends social distancing even while wearing a mask.
What to expect from telemedicine:
Patients are able to access their telemedicine visit through their patient portal or email.
After clicking your link, you will be sent to your virtual waiting room. Your provider will start the visit, and you will become visible to each other on –screen.
If you call with a concern, we will schedule a telemedicine visit with one of our providers, usually on the same day. After talking with you, the provider will help decide whether an in-office appointment is needed.
What to Expect in the Clinic:
***WBWC is now asking patients to come to in-person visits alone***
PLEASE DO NOT BRING CHILDREN OR PARTNERS TO APPOINTMENTS
The exception to this will be newly postpartum couples attending their in-clinic follow ups and lactation visits. We do however, welcome partners and support individuals to accompany patients virtually by phone or video to in-clinic appointments, and are encouraged to attend all routine prenatal telemedicine appointments.
- Social Distancing: Waiting room chairs are arranged in a manner that is conducive to patients maintaining at least six feet of distance from other patients. We have also scheduled fewer co-occurring in-person visits, and you may be the only person in the waiting room. If there are other people in the lobby, please respect at least 6 feet of distance.
- Administrative staff and other support staff will be absent. Please just have a seat, and wait patiently in the lobby.
- Your midwife or nurse will greet you, collect your vital signs, and show you to your exam room.
- WBWC takes EVERYONE’S health seriously, so all clinical staff will be wearing scrubs, a scrub cap, and a mask FOR EVERY VISIT.
- It is intentional to have the bare minimum of WBWC staff in the building.
Primary Care Patients:
WBWC is the Primary Care provider for a lot of folx. If you were scheduled for a visit to evaluate your chronic health condition like depression, thyroid disease, or high blood pressure, call us to schedule a telemedicine visit. We can touch base and figure out how to proceed together. If an in-office visit is needed, we’ve got you.
Contraceptive Visits:
We know that contraceptive healthcare is ESSENTIAL healthcare. We want to make sure that people have access to the contraceptive method of their choice. Some methods can be safely started after a telemedicine visit with a provider, while other methods like IUDs, Nexplanon devices, and diaphragms, will require an in-office visit. WBWC will make it work, just reach out to us to get started.
GYN Visits:
Right now, routine GYN care (think about your annual breast/ chest exam, thyroid check, listening to your heart and lungs, et cetera) is NOT considered to be an “essential visit”. If you have a GYN problem or concern, it is possible that it can be addressed via telemedicine. If not, we will schedule you in-office after your telemedicine visit. Let’s talk.
Pregnant People:
We are still taking new patients. Pregnant clients will still come to the office periodically for in-person visits. First time intake appointments will now be broken into 2 separate visits: 1 teaching telemedicine visit, and 1 in-person exam. All except initial intake labs will be drawn in office.
The following appointments will take place In-Person: Intake Exam, 28 week, 32 week, 36 week, 38 week, 40 week, and Postpartum visits. In-between these in-office visits, clients will have regular telemedicine visits with a provider. Your provider will still go over all the usual teaching, while also continuing to address questions, concerns, and pregnancy symptoms. Additional office visits may be necessary depending on the individual’s circumstances.
WBWC recommends pregnant patients get a blood pressure cuff, so that vitals can be monitored at home. Medicaid and private insurers have both announced they will be covering blood pressure cuffs for pregnant individuals. WBWC would love to write you a prescription for a BP cuff so that insurance might cover the costs. Let your midwife or nurse know if you are interested.
Community Prenatal Care (CPC):
CPC participants will still gather for virtual CPC with their group using Zoom. CPC members will follow the same in-office visit schedule described above to receive their essential in-person checks. Zoom links will be sent out to group members via email a few days prior to your next scheduled CPC meeting. Group facilitators will reach out to you via email regarding changes or updates to group.
Births:
Support people for birthing families are still welcome at WBWC. Partners, children, and doulas may still attend WBWC labors and births. All support people will be required to wear a mask while at WBWC. When you call us because you are in labor, you will be asked about your health, as well as the health of any potential visitors. When a birthing family/team arrives at the Birth Center, all individuals will be asked a series of screening questions. Temperatures of all family/team members will also be taken. If ANY member of the birthing person’s support team, including partner, has a fever, they will not be permitted to stay at the birth center with the birthing person. Once cleared for entry, WBWC asks that for everyone’s safety, that all accompanying persons stay in the birthing room. We are not able to open the common area with the exception of coming out for food or drink.
In order to minimize exposure to patients and staff, uncomplicated labors and deliveries will aim to discharge from the birth center at ~4 hours postpartum.
Home Visits:
Sadly, we are not currently able to provide in-home visits to our families. Instead, we ask that the birthing person and their infant to come to the WBWC clinic for evaluation on the day that they would otherwise be due for their home visit. We will welcome partners to join at this visit. All routine newborn screenings will be completed at this visit (metabolic screen, hearing screen, critical congenital heart disease screen).
Postpartum Visits:
Postpartum individuals and couples (birthing person and infant) may still be seen at their 2 week and 6 week postpartum visit in the office. A midwife will reach out and decide together with you whether your visit should be in-person or via telemedicine. If you are asked to come in for a 2wk postpartum with your infant, we will also welcome partners to join at this visit.
In-person 2 week Postpartum visits will be offered on Mondays/Thursdays, while the 6 week postpartum visits will be available on Wednesdays/Fridays. This will help us limit in-office exposure. Again, if the birthing person’s postpartum course is uncomplicated, and the baby has had a recent weight check, the in-office postpartum visits may not be necessary, and will be substituted by telemedicine.
Lactation:
For the time being, lactation visits will primarily be telemedicine. Limited in-person visits will be available, and circumstances will be assessed on a case by case basis. Please reach out to schedule a telemedicine visit, and we can determine your need for an in-person evaluation. Partners will be permitted at in-person lactation visits.
Lactation telemedicine visits will last ~90min. The following are helpful tips for a successful visit:
Connect with a device that can be moved around for the best camera angle.
Have a support person nearby to assist with the camera while feeding
Make sure that baby is hungry so consultants can observe a proper feeding session
You may be asked to pick up a specialized scale at the WBWC Boutique (curbside pickup) to document baby weights during the visit.
For a comprehensive list of breastfeeding resources during COVID-19 we invite you to visit our friends at the NC Breastfeeding Coalition. ncbfc.org
If an in-person visit is deemed appropriate, you will receive a set of instructions by email prior to the visit to guide you. As with the rest of the clinic, Lactation Consultants will be wearing protective equipment, and allowing time between visits to thoroughly clean our space. We again ask that you limit the number of people who come to the visit, and please schedule at a time when siblings can be left at home. *Please bring your own pillow to your in-person lactation visit.*
Boutique:
WBWC Boutique remains open for curbside pick-up, as well as phone & online orders. Calls and curbsides are available Monday-Friday 9am-4pm and online orders can be placed at anytime. Please do not hesitate to reach out with questions
919-537-7055; boutique@ncbirthcenter.org
Classes:
Classes offered through the WBWC website are still available virtually. If you have registered for a class you will receive instructions from your facilitator via email prior to the class with group information. If you would like to register for one of our classes please visit www.ncbirthcenter.org/classes for more information.
Staff Illness Protocol:
WBWC has a plan if one of our staff members gets sick, and active steps are being taken to keep everyone healthy. We are taking precautions such as social distancing, holding virtual meetings, tours, and classes, and requiring all staff to wear face masks, hair coverings and scrubs if they are on site. However, if a staff member were to become sick, we will ensure they get appropriate testing, and expect them to impose a self-quarantine until results are back and/or symptoms have resolved. WBWC’s dedicated team of nurses and midwives are incredibly vigilant for even vague signs of illness, and back-up staff has been arranged should the need arise.
Support Opportunities:
WBWC appreciates our donors, now more than ever. Contributions to WBWC are fully tax deductible to the fullest extent of the law. If you have been thinking about ways to support your community please consider becoming a WBWC sustainer. All contributions are helpful, so to show your support of the midwifery-model of care please visit: https://ncbirthcenter.kindful.com/ to make an easy one-time or on-going donation.
A Note to our Sponsors:
You may be aware that Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act on March 27, 2020. Included in this legislation were several provisions that may change your charitable donations this year. Please consider the following:
- You can now deduct your gift to WBWC, even if you take the standard deduction. The CARES Act allows for up to $300 per taxpayer ($600 for a married couple) in an above-the-line deduction for charitable gifts made in 2020 and claimed on taxes in 2021. This means that you can lower your income tax bill by giving to WBWC today, even if you take the standard deduction on your taxes.
- If you itemize deductions, there are new charitable deduction limits. The CARES Act increases the existing cap on charitable cash contributions for those who itemize, raising it from 60% of adjusted gross income to 100% in 2020.
As a nonprofit, WBWC would like to deeply thank all our contributors. You are our lifeblood and we are eternally grateful for your sponsorship.
WBWC understands that these changes to your treatment plan can be difficult to take in. Please stay well during these unprecedented times, and do not hesitate to reach out to us if you have any questions or concerns. We are here with you; we are here for you, with care and love.
The WBWC Staff
Your Health. Your Birth. Our Commitment.