COVID-19 policy and FAQ

General

 

What to do if I am experiencing COVID-19 related symptoms?

  • Stay at home in case of a cold or nosecongestion, a runny nose, sneezing, sore throat, coughing, raise of temperature or fever and schedule a PCR-test.

  • Avoid any social contact. This also includes having visitors over or visit other people and doing groceries. Only call the general practitioner if the symptoms worsen over time (more than 38 degrees fever and shortness of breath) and if you require medical assistance.

  • If you start feeling better and haven’t experienced any symptoms for at least 24 hours, you are cured. This also means that you shouldn’t be able to infect other people.

Can I get infected with the virus if I touch furniture or surfaces?

A virus always needs a person or animal to ‘stay alive’ and to multiply. Outside of the body a virus can only survive for a short while. This also depends of the type of surface, the temperature and the humudity. The virus is more likely to survive longer on hard/slippery surfaces like plastic, metal and glass and less on porous surfaces such as paper and cardboard.

 

The risk that you will get infected by touching a product or surface is not too high, but it could happen. The virus particles will diminish exponentially outside of the body. We do recommend washing your hands frequently. A surface that could be infected is easily cleaned with a regular (anti-bacterial) cleaning product.

What if it is no longer possible to contain the virus?

We (ROAZ and midwives Almere) will do ANYTHING to provide the necessary care. There are a lot of emergency protocols to make sure this remains possible (depending on each circumstance). This could affect the freedom of choice regarding care, for example we could be forced to cancel the non-medical ultrasounds or the location of childbirth in the most extreme scenario. We feel it is very important to keep this freedom of choice for as long as possible.

Am I at risk if I have to have blood tests taken in the hospitals and are there other options?

The Flevoziekenhuis is divided into clean and ‘red’ zones. The laboratory is situated in the clean zone. Furthermore, only people that essentially have to be there are allowed and screened at entry. This minimalizes the risk a lot. This policy will be adjusted daily by the hospital.

Is my pet susceptible for the virus and can it transfer the virus to people?

There are indications that pets play a role in the spreading of the virus. As a precautionary measure we advise people that are infected with the virus to avoid contact with their pets as much as possible. That means, no petting, hugging, kissing or having your pet lick you. If you are in home isolation because of an infection, you can stay in a different room and should not let your pet inside. Roommates can take care of the pets until you have recovered.

Is it still wise to get a whooping cough vaccination?

Despite the virus the appointments scheduled for the 22-weeks vaccination will still be done. It is important to get this vaccination, but you should keep the following rules in mind:

  • Visit the consultation agency alone (no partner or kids)

  • If you are experiencing symptoms of nose congestion or a cold (sneezing, runny nose), sore throat or fever we advise you to stay at home and reschedule your appointment after you have been symptomfree for at least 24 hours.

  • In case any of your family members have a fever you should also stay at home and reschedule your appointment after the familymember has been symptomfree for at least 24 hours.

I would like to reschedule, is this possible?

That is definitely possible. We would like to discuss this, so we can be sure not to reschedule when it is medically not advised.

I have a desire to start a family, is it possible to try and get pregnant during this pandemic?

There has been no negative advice on this topic thusfar.

Can I get tested if I am experiencing symptoms that match the virus? And if so, when is the best time to get tested?

Nowadays the national policy is to get tested if you are experiencing slight symptoms that match the virus. If you have visited a ‘red’ or ‘orange’ area you should go into quarantine for 10 days. Let us know if this is the case. Pregnant women experience mild symptoms at most and are advised to stay home and take rest until they get well again. Sometimes we can reschedule your appointments or have a consultation by phone.

 

If in any case your symptoms worsen and you are experiencing high fever and shortness of breath, always contact your general practitioner, midwife or OB/GYN. If there is a possible virus infection suspicion while you are in the hospital or giving birth a PCR-test will be taken.

I have had the virus and am symptomfree again, am I now being checked by different doctors?

At this stage there is no indication that the risks are higher for you, so you can stay in the care of the same healthcare workers you have been seeing until now.

Which measures are taken in the practice?

The number of physical contact moments are limited as much as possible and they are being kept as brief as possible. We also use gloves and mouth masks. Lastly, all surfaces that are used/touched will be desinfected frequently.

Pregnancy

 

Is the virus more dangerous in case of pregnancy?

Probably not. However, this is a new virus and the longterm effects are still not known – this also is the case for pregnancies. We do know that the virus cannot be transferred via the placenta. If you are pregnant and infected with COVID-19 we will schedule some extra consultations just to be sure. After the birth you can start breastfeeding as usual, but you will get instructions regarding proper hygiene during feeding, so you do not transfer the virus to the baby in this process.

Am I more susceptible to the virus if I am pregnant?

There is no indication that a pregnant women is more susceptible than anyone else, but as this is a new virus, we do not know any of the long term effects at this point.

As I am in an essential profession and do not want to get infected; can the midwife give my employer a statement so I do not have to go to work?

This is not up to us, you should contact the health and safety officer at work or check RIVM.nl for more information.

Will I still be checked properly during this period?

Definitely. No necessary consultations will be cancelled, however some consultations may be done by telephone if possible. We will have regular contact and if there is any reason to do extra research we will make sure this is scheduled as soon as possible.

National emergency policy:

Intake: physical (also by telephone)
10-12 wks: physical term ultrasound
Counseling (explanation about consultations): by telephone
16 wks: physical 15 minute check
20 wks: physical SER ultrasound
24 wks: physical/by telephone 15 minute check
27 wks: physical 15 minute check
31 wks: physical 15 minute check
33 wks: physical/by telephone 15 minute check
35 wks: physical 15 minute check
37 wks: physical 15 minute check
39 wks: physical 15 minute check
40 wks: physical 15 minute check
41 wks: physical 15 minute check

 

Important to know: If you have scheduled a physical check, please come to the practice alone. If necessary you can bring 1 extra person.

What can I expect during my consultation/check?

The normal procedure is measuring your blood pressure, feeling your belly and listening to the heart of the baby. After you leave, the room will be sanitized before the next patient can enter.

Can my partner come with me for the consultations/checks?

Currently, you can still take 1 person to most consultation or checks. To keep providing great care, we have to do our best to not get the midwives and OB/GYN staff infected. This may mean that it is not always possible to take your partner, so we advise pregnant women to come alone as much as possible. Your midwife or OB/GYN will explain the specifications suitable for your situation, if necessary.

Should I still contact the practice if I am experiencing inconveniences or when I am worried?

Definitely. Lately, we have been experiencing that pregnant women do not call as often as they used to, because they assume we are too busy or they might be anxious to be sent to the hospital. There is no need to have these worries, we still urge you to call whenever you are in need of information. If you are feeling less movement in your belly, experience painful Braxton-Hicks contractions, have bloodloss or any other thing that might worry you. We need to know these things so we can assess whether medical actions should or should not be taken.

When do I have to reschedule my physical consultation/check?

In case you are experiencing COVID-19 related symptoms, such as nose congestions, a cold, runny nose, sneezing, sore throat, raise of temperature or fever. If you are arriving from an ‘orange’ or ‘red’ area, we advise you to call and not to come to the practice. You should quarantine for 10 days.

Which protective gear will the midwife wear during consultation, labor and after childbirth?

This policy can change daily due to the way the pandemic evolves or diminishes. Currently, we will always wear gloves. In case you are experiencing symptoms (coughing, sneezing, nose congestion, sore throat or fever) and a consultation is essential, it is possible that the midwife has to refer you to the hospital without having physically checked you.

Can I infect the baby during pregnancy if I have the virus?

In the medical magazine The Lancet a study appeared with nine pregnant women that were infected with COVID-19. In this study the amniotic fluid, breastfeeding and blood in the embillical chord were included and tested. The most important (temporary) conclusion of this study is that it appears that the virus cannot be transferred through the womb (no vertical transmission).
Bron: The Lancet – What are the risks of COVID-19 infection in pregnant women?

When will the information evening start again?

We are currently using an online version of the information evening. Please send us an email if you would like to see this video. The course on location will not start before national policies can give us a green light regarding safety.

Childbirth

 

Will it still be possible for me to give birth at home?

Yes, this is currently still possible. For a safe home birth, there are a few rules that need to be taken into account to make sure the midwives present will not get infected themselves. There must be ambulances available to, in case of complications, get you to the hospital as soon as possible. Therefore, as long as there are enough midwives and ambulances available a home birth is still an option.

What if this changes?

All midwives in Almere and Lelystad and the OB/GYN staff of the Flevoziekenhuis are extremely well-prepared for this situation. We will make sure that you will be able to choose a home birth for as long as possible if this is your wish. In the worst case we will have to let you know that the option is no longer available, but we will let you know in advance as much as possible and in that case you will be able to safely give birth in the Flevoziekenhuis.

 

This way we are sure that there will always be enough healthcare workers to take care of you and your baby. In case a home birth cannot be organized anymore because of the pandemic (for example due to shortage of beds/healthcare workers.ambulances), the health insurance will reimburse you for your own financial contribution.

Is it still safe to go to the hospital if pregnant?

Definitely. In the Flevoziekenhuis a separate department has been made for pregnant women with symptoms that are COVID-19 related. This means they will not be able to infect other pregnant women or the healthcare staff. Whether you are experiencing symptoms or not: we can assure you that you will get the best care we can provide.

Is there a chance that my partner cannot be present during the birth?

No. Because the moment of childbirth is such an important moment in your lives, we will always make an exception for this. If you or your partner are experiencing COVID-19 related symptons, we will make sure you will be treated in the separate department in the Flevoziekenhuis. The healthcare staff will be wearing protective gear to prevent them to get infected themselves to make sure they can carry on with their work and help other pregnant women in need of care.

Is there a possibility that I will have to choose for a homebirth, because the hospital does not have beds available?

No. We have expanded the number of delivery rooms in the Flevoziekenhuis to ensure we have enough space for any woman that wants to give birth at the hospital. It is very unlikely that all these rooms will be occupied when you need to give birth. Because of the separate department for pregnant women that have COVID-19 related symptoms, you do not have a higher risk of getting infected at the hospital.

Should my partner wear protective gear during the birth?

If both of you do not have fever, this is not necessary.

Can my doula as well as my partner be present during the birth?

Along with your partner, another person may be at the birth. This applies to a birth at home as well as a birth at the hospital.

Can I give birth in a bath (specially designed for giving birth)?

Yes, this is possible.

Are there any risks for premature babies?

Even though there are strict guidelines, we have no insights yet, because this is a new virus and no longterm effects are known.

Is stripping necessary so I can give birth sooner?

There is no medical indication to give birth sooner at this point. If inducing the labor is essential, we will do an internal check and determine which procedure should be followed to make sure you do not have to visit the hospital more often than absolutely necessary.

After childbirth

 

 

Can I still breastfeed if I have COVID-19 related symptoms?

Yes, there has been research to check whether the virus can be transmitted through the breastmilk. This is not the case. We do recommend breastfeeding while wearing a mouth mask and take extra hygienic precautions (washing your hands before touching the baby or your breasts, use your own breast pump or a bottle and clean the breast pump after use). You can infect the baby with the virus if it is near you, so we can also advise to use the breast pump and then have someone without symptoms feed the baby with a bottle.

Can my parents visit the baby?

The national policy is to have limited visitors over, please contact your midwife to check the current status.

What precautionary measures can I take?

The most important rules you and visitors can follow to minimize the risk of infection is:

  • Washing your hands frequently

  • Cough and sneeze on the inside of your elbow

  • Use paper handkerchiefs

  • Do not shake hands with anyone

 

The above precautions are for all viruses that can cause flu and colds. Do not have people over that are ill, in any case after giving birth.

What are the risks for a newborn?

COVID-19 can be transmitted through bodily contact, so it is very important to stick to all the mentioned hygiene rules.

Will newborns get tested for the virus?

Not unless there is a medical indication to.

Do I need to take any precautions with my older children and the newborn?

The family can be together as usual. In case one of the family members has symptoms we advise the following:

  • Try to enter the room of the family member with the symptoms as little as possible.

  • Try to have as little contact with the family member as possible, so definitely no hugging, kissing or sex.

  • Do not use the same dishes or cutlery as the family member.

  • Do not use the toothbrush of the family member.

  • If possible use a different toilet and bathroom. If this is not possible, try to clean the areas as much as possible and open the windows every day for at least 30 minutes.

In conclusion

We understand that these uncertain times can be particularly difficult for you and your partner. It is therefore important to know that you can ask us about questions that may be on your mind. Our midwives are at your disposal and we can be reached 7 days a week, 24 hours a day.

 

Despite everything, we wish you a beautiful, lovely pregnancy and birth.