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As the epidemiology of COVID-19 evolves, obstetric care providers and obstetric anesthesiologists must thoughtfully consider routine aspects of inpatient obstetric management and discuss alterations in practice to optimize the safety of our patients and staff. Hospitals should begin collaborations with others in their health region to optimize testing and clinical management protocols for pregnant and postpartum women in their geographic area. These recommendations are not proscriptive and may not apply in your clinical setting. They are intended to introduce concepts to be considered in each setting and give examples of current practices in place. This guidance will be updated as additional data and information emerge. Systems-Level Responses Level of CareBroader health systems and networks should coordinate to identify each hospital's capacity and plans for transferring care as needed to meet both maternal and fetal needs. Communication should frequently occur, as hospital capacities may change rapidly. Cohorting and Other Strategies for Exposure MitigationOne public health intervention to reduce exposure risk is cohorting-co-locating patients who are persons under investigation (PUI) and women who test positive for SARS-CoV2 into a restricted area of the hospital. While not all facilities are able to create an independent obstetrics COVID-19 unit, attempts should be made to designate specific locations for the purposes of containment, which will limit the exposure of unaffected patients and staff.

(Obstet Gynecol. 2020;00:1–4) Due to the current coronavirus disease 2019 (COVID-19) pandemic, many obstetric units across North America have implemented social distancing policies, including modified visitation, to minimize exposure to the virus. Unfortunately, these policies may have unintended consequences stemming from reduced labor support and increased maternal stress. This commentary offers recommendations to combat isolation and improve birth outcomes while continuing to mitigate the risk of infection posed by COVID-19.