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Dar a Luz Birth & Health Center Position Statement and Policies Regarding COVID-19

As you are all aware, the novel coronavirus or COVID-19 has moved from an international virus to national and now local. As of March 14, 2020, New Mexico has 10 presumptive positive cases (meaning they have tested positive in NM and are awaiting verification from the CDC). All of those people either were exposed during travel or were in close contact with someone else who tested positive. At this time, none of the cases are in children or pregnant people in NM. 

Dar a Luz is taking this virus very seriously as well as the recommendations of social distancing/isolation to keep our mothers and newborns safe. However, because of the nature of our work and the commitment to the safety of our clients and their families, we have come up with the following policies that will take effect immediately and will stay in effect until experts declare that the risk is mitigated. These policies may change as the situation of the pandemic shifts.  1. If you are sick or think you are getting sick OR if you have traveled within the last 14 days: you need to cancel your appointment until further notice. If you have a fever >100.4˚F (38˚C) along with a cough/shortness of breath, you may not come into the birth center at all and will be referred to the NM Department of Health for COVID-19 testing. These symptoms are considered the main testing criteria and are based on symptoms of severe illness. Those with mild symptoms of a cold or flu-like illness are requested to stay at home for 14 days but at this time are not being tested through the Department of Health. You may call the midwife on call or RN triage line for further information and instructions. 2. Clinic visits and appointments: starting Monday March 16, 2020, we will be limiting in-person clinic visits to already scheduled new OB clients, clients who are needing their diabetes labs (around 28 weeks), clients who are 36 weeks or further in their pregnancy, and all mother/baby appointments. Additional clients who have certain problems or a higher risk pregnancy will also be seen. Clients that are currently scheduled will be contacted by a midwife for further instructions. Please do not call the midwife on call regarding your appointment. If you fall into this category, you may bring no more than two people with you to an appointment who are not sick and who have not been sick in the last 14 days and who have not traveled in the past 14 days. All clients and their guests will be screened for fever in the lobby with an axillary thermometer before they can be allowed into the center. Any person with a fever will be asked to leave the building and we will help determine if you need testing as stated above.
a. Telehealth appointments: pregnant clients who are already scheduled for an appointment in the next three weeks who do not meet the above requirements can either be scheduled further out or can have an appointment with a midwife via video. We are working on what platform we will be using for this. 
 b. Postponed visits: non-pregnant clients will be rescheduled at this time. There will be some opportunity for clients with certain gynecologic problems to be seen via telehealth communication as well. We understand this is a hardship but we have to reserve our resources for our pregnant and mother/baby clients. We will be contacting all clients over the weekend for appointments that are scheduled the week of March 16-20th. 3. Birth: the center is open as normal for clients in labor. You will still call the midwife on call for labor triage and you will be screened over the phone for history of illness. Once you arrive at the center, you and your labor partner(s) will be screened for fever in the lobby with a thermometer. Anyone with a fever will not be permitted to enter and if it is the laboring client, we will need to transfer to the hospital immediately. 
4. Home visits: unfortunately, we will be suspending ALL home visits for the time being. Mother/baby dyads will be required to come to the center for their 24-36 hour visit after birth as well as the regular interval of mother/baby appointments (typically 3 days, 2 weeks and 4 weeks after birth). We apologize for the inconvenience. 
5. Classes: all in-person classes in the birth center are suspended. Instructors are working to create video classes that will be live on the Zoom platform. You will still be required to attend the class via phone or video for all required classes. Please check your email often for instructions. If you have not received instructions on how to attend a class, please email your instructor. 

6. Support Groups: all cancelled until further notice. 
7. Doula teas, community partner classes and gatherings: all cancelled until further notice. 

8. New client tour and orientations: March 14th and 21st in-person tours are postponed. We are working on a virtual tour and orientation so families may attend from home. Please note that we are already on a waitlist for due dates between April 1st and June 30th. 

9. Staff: we will be decreasing the number of employees working at the center to one midwife, one nurse and 1-2 administrative support persons. All other employees will be working from home and available to clients via phone and video. Dar a Luz employees who are working at the center, including clinical and administrative personnel, will be screened for fever in the lobby with a thermometer every day as they arrive for work. Any staff member found to have a fever will be sent home and isolated for 14 days. Staff who think they are getting sick or who are sick will not be allowed to come to work. Staff are requested not to shake hands with clients and their guests and will only touch you for whatever examination is required for your care. Staff members will wash their hands before and after touching a client and as needed in between clients. 
10. Cleaning: we have increased our sanitation between clients and throughout the day in hopes of decreasing any risk of contracting the virus from surfaces. This includes using maximum strength wipes and disinfectants on all surfaces throughout the day. Toys in the lobby and other waiting areas have been removed. Pens will be disinfected throughout the day. Hand sanitizer is available throughout the center.
11. Children: while children appear to not be as affected by COVID-19, we are asking that you leave your children at home if you have an appointment at the center. We understand that children are home since all schools are closed. If you are able to have any child care, we ask that you do so. If your child/ren is/are sick, you will NOT be able to bring them into the birth center and your appointment will be rescheduled for another time or via telehealth. 
12. Milk Depot: at this time, we can still accept milk from donors who donate to the Denver Milk Bank. We cannot accept milk from informal donors at this time and will not be able to accommodate informal milk sharing.  

We understand that these are strict measures and they impact not only our clients but our staff and entire organization. Our goal is always to be proactive instead of reactive and we hope these measures that increase social distancing will keep our birth center free of COVID-19 and operating as close to usual as possible so that we can continue to offer safe out-of-hospital birth. Dar a Luz staff are healthy, organized, optimistic and ready to take action and make changes as needed. Please continue to check our website and social media (Facebook and Instagram) for updates on these policies. 

Phone numbers for clients include: 

Main: 505.924.2229

Tracy (front desk), extension 0

Registered nurse/triage line, extension 5

Midwife on call (established clients ONLY), extension 8

If you have further questions or concerns that have not been answered in this policy, you may call me directly using extension 2. 

Abigail Lanin Eaves, CNM

Executive Director

For More Information Please Visit:

Information from the NM Department of Health 
http://cv.nmhealth.org/

Information from the CDC
https://www.cdc.gov/coronavirus/2019-ncov/index.html

Defining mild, moderate, severe symptoms:
https://www.npr.org/sections/goatsandsoda/2020/03/13/814691018/coronavirus-symptoms-defining-mild-moderate-and-severe

Nine charts that explain the coronavirus
https://www.vox.com/future-perfect/2020/3/12/21172040/coronavirus-covid-19-virus-charts?fbclid=IwAR34YBJhXPiMSYN9M7xpOXWEX1ac84q4fEBpvG2L75EociLcUSzVrDXBOmI

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