Updated: May 14, 2020
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Dear Clients of The Midwives Clinic of East York–Don Mills,
We are writing to give you an update and outline changes we have made at our clinic in response to COVID-19 Pandemic. The health of everyone is our top priority at this time. The midwives will follow all Public Health guidelines regarding self-isolation if they are at risk of COVID-19 or screen positive. This means that your prenatal visits, birth, postpartum visits may be attended by a midwife that is not part of your team.
*New Information*Worrying if you have CoVID-19?
Have you developed the common symptoms of COVID-19 such as fever (over 37.8C), new or worsening cough, and/or difficulty breathing? Do you have any of these other symptoms; sore throat, difficulty swallowing, loss of taste or smell and upset stomach: with new or worsening nausea, vomiting, diarrhea and stomach pain? Do you have any of these atypical symptoms such as conjunctivitis, chills, headache, unexplained fatigue? Also consider if you have a runny nose, sneezing and nasal congestion in the absence of an underlying reason for these symptoms such as seasonal allergies, post nasal drip etc.
You can review the Ministry of Health CoVID-19 Reference Document for Symptoms here. Please reach out to your midwife and/or call the testing centre at Michael Garron Hospital at 416-469-6858 to see if you qualify for testing. Do not attend your clinic appointment but keep us updated by calling the clinic or in urgent situations please page us.
In-person clinic visits and OTN/Internet visits:
Your midwives will be wearing masks to reduce the spread of COVID-19 for all your in-person visits. As of April 20th we will be starting Ontario Telemedicine Network (OTN) visits which will mean you can meet with your midwife in a secure way over the internet. Your midwife will let you know before your visit if it will be in-person visit or by using this platform. We can achieve a lot over the phone including answering your questions, discussing relevant topics related to pregnancy and birth, arranging ultrasounds and other testing and sending prescriptions and reviewing completed lab work. If there are other appointments that you would like to do by phone or OTN, please let us know.
We are using the World Health Organization (WHO) guidelines on the number of prenatal appointments for a positive outcome. We will offer a virtual appointment for initial visits at 8-10 weeks, clinic appointments at 12-14 weeks, 20, 26 30, 34, 36, 38, 40 and 41 weeks. The visits on weeks 37 and 39 will be determined with your midwife if they will be in person or by phone. If your initial visit is greater than 12 weeks, it will take place in the clinic. The in-person portion of your visit will be 10-15 minutes and then the remainder of your appointment will be done by phone.
The postpartum visit schedule includes a home or hospital visit between day 1 and day 2. You midwife will call on day 3 and see you again on day 4/5. If everything is well, you will return to the clinic on day 10. There will be one or two additional clinic visits, if needed, between weeks 3 and 6.
Our clinic space:
We have removed all the toys and we ask you not to touch the lending library books in the waiting room to reduce the number of objects that are touched and to make cleaning easier.
We will continue to wipe off surfaces in our clinic rooms and wash our hands or use hand sanitizer in between clients. We ask that you also use hand sanitizer when you arrive for your appointment that is available at the front desk. For the time being we will be restricting other family members from coming into clinic visits. All pregnant clients will have a 15 minute in person appointment followed by a phone appointment with family members as needed.
Michael Garron Hospital:
The birthing unit is equipped with items (PPE) required to care for pregnant people with COVID-19. All people entering the hospital will be screened for CoVID-19. You can only enter the Coxwell Ave entrance when going to Labour and Delivery regardless of time of day. If you are less than 20 weeks gestation and require emergency services you will go to the emergency entrance and seek care there. Labouring clients can have 1 support person for the duration of their stay, this person is not interchangeable with another. All other appointments at the hospital can have one person accompanying you. Children under the age of 16 will not be able to visit the hospital at this time.
It’s currently recommended that people who are CoVID-19 positive or People Under Investigation (PUI) for CoVID-19 should have external fetal monitoring and epidural for their labours. This is due to the many uncertainties during the labouring process with people who are ill. Your midwife will discuss these recommendations with you if you become positive or have symptoms of CoVID-19. All people who are either CoVID-19 positive or a PUI will be placed in a single room for the entirety of their stay.
Due to the growing number of CoVID-19 cases in the Toronto shelter system our hospital will be initially isolating clients who live in a shelter. What does that look like? When you talk to your midwife on the phone they will screen you for symptoms of CoVID-19. When you arrive at the hospital you will be admitted directly into a room instead of being assessed in triage.
All of our clients will register at the hospital, regardless of planned place of birth. You can register by faxing your registration forms before 30 weeks, the forms can be retrieved here. If you do not have access to a fax machine bring your forms to your next in-person visit and we will fax them for you.
The breast/chest feeding resources for new parents is limited at this time due to the shutting down of all non essential services at MGH. You can find resources online here.
Home Births and Postpartum Home Visits:
Your midwife will be wearing the appropriate PPE when in your home. When we visit we ask that you provide paper towel in the bathroom or kitchen so we can dry our hands off after hand washing. When we visit we hope that family members who are in contact with our midwives will be wearing masks and keep social distancing measures whenever possible.
We continue to offer out-of-hospital births both at the TBC and home. This is a great way to keep clients and babies out of the hospital. As always, we need to be certain that every person requesting an out-of-hospital birth is a good candidate. If any household members are sick or have screened positive for COVID-19, midwives will not be able to attend you at home and will request that the birth occurs in the hospital where there is a supply of masks and gowns.
Getting Information that’s relevant to you!
We are committed to giving you the best possible update information. We will change this page when new information becomes available. There are also these links to read:
We will send regular emails as things change, update our website: themidwivesclinic.ca, and have regular postings on our social media platforms. You can follow @themidwivesclinic on Instagram, Twitter and The Midwives Clinic of East York-Don Mills on Facebook for updates.
We know these are stressful times. We hope you all are able to feel our continued support and reach out if you have concerns. Most of all we hope that you and your families remain healthy in the coming weeks.
Your Midwives at The Midwives’ Clinic of East York-Don Mills
The Midwives’ Clinic is accepting new clients who want a midwife in Toronto during pregnancy, labour and birth and the first 6 weeks after your baby is born. Our midwives can attend your birth at home, at the Michael Garron Hospital or at the Toronto Birth Centre; the midwives will give you information to make decisions that are right for you and your family. One of your midwives will always be on call for urgent concerns 24 hours a day, 7 days a week. You will be cared for by well-trained, sensitive female caregivers that respect individual needs of the families in our community. Cultural sensitivity is an important aspect of the care your midwives will provide.
Midwives are fully funded by the Ministry of Health and Long Term Care and offer complete care for you and your newborn baby; you do not need to see a family doctor or an obstetrician in addition to your midwives. If complications arise, our midwives will consult with the appropriate specialists such as obstetricians, pediatricians and lactation consultants.
Our hearts are hurting today. twitter.com/world_midwives…