The care of pregnant women during the COVID-19 pandemic – response of a large health system in metropolitan New York

Rochelson, Burton; Nimaroff, Michael; Combs, Adriann; Schwartz, Benjamin; Meirowitz, Natalie; Vohra, Nidhi; Klein, Victor R.; Santandreu, Orlando; Kramer, Mitchell; Mootabar, Navid; Serur, Eli; Spiryda, Lisa Beth; Berlin, Scott; Chervenak, Frank A.

doi:10.1515/jpm-2020-0175

Cited by 30 publications

(56 citation statements)

References 2 publications

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“…Of note, early postpartum discharge was implemented at Lenox Hill Hospital on March 12th in anticipation of COVID-19 cases, followed by similar practice in the other hospitals, while an official system-wide policy for implementation was in effect on April 1st. Our guidelines suggested discharge home the day after uncomplicated vaginal deliveries and 2 days after uncomplicated cesarean deliveries using maternal criteria checklists to assure that each patient had no medical conditions or complications requiring longer stay [4]. Due to pediatric considerations and newborn testing requirements, postpartum discharge prior to 1 day was not feasible.…”

Section: Methodsmentioning

confidence: 99%

“…As a result, hospitals within the New York metropolitan area saw a sudden influx of pregnant and nonpregnant patients with complications related to the novel coronavirus disease (COVID-19) [2]. In the face of this a public health emergency, significant changes in patient care were urgently needed in order to optimize care for obstetrical patients, accommodate the high influx of non-obstetrical COVID-19 admissions requiring increased hospital resources, as well as to decrease the potential exposure of both patients and medical staff in the hospital [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…We therefore implemented early discharge of low risk puerperium patients following uncomplicated vaginal and cesarean deliveries, with the intention of reducing potential exposure of patients and medical staff to SARS-CoV-2, facilitate lower patient census to decrease crowding in postpartum units, and accommodate the surging need for beds for nonpregnant patients hospitalized with COVID-19 [4]. Our objective in this study was to demonstrate that implementation of early postpartum discharge was successful in shortening hospital length of stay (LOS) among low-risk obstetrical patients following uncomplicated vaginal or caesarean delivery during the COVID-19 pandemic in New York.…”

Section: Introductionmentioning

confidence: 99%

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Early postpartum discharge during the COVID-19 pandemic

Bornstein

Gulersen

Husk

et al. 2020

Journal of Perinatal Medicine

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ObjectivesTo report our experience with early postpartum discharge to decrease hospital length of stay among low-risk puerperium patients in a large obstetrical service during the COVID-19 pandemic in New York.MethodsRetrospective analysis of all uncomplicated postpartum women in seven obstetrical units within a large health system between December 8th, 2019 and June 20th, 2020. Women were stratified into two groups based on date of delivery in relation to the start of the COVID-19 pandemic in New York (Mid-March 2020); those delivering before or during the COVID-19 pandemic. We compared hospital length of stay, defined as time interval from delivery to discharge in hours, between the two groups and correlated it with the number of COVID-19 admissions to our hospitals. Statistical analysis included use of Wilcoxon rank sum test and Chi-squared test with significance defined as p-value<0.05.ResultsOf the 11,770 patients included, 5,893 (50.1%) delivered prior to and 5,877 (49.9%) delivered during the COVID-19 pandemic. We detected substantial shortening in postpartum hospital length of stay after vaginal delivery (34 vs. 48 h, p≤0.0001) and cesarean delivery (51 vs. 74 h, p≤0.0001) during the COVID-19 pandemic.ConclusionsWe report successful implementation of early postpartum discharge for low-risk patients resulting in a significantly shorter hospital stay during the COVID-19 pandemic in New York. The impact of this strategy on resource utilization, patient satisfaction and adverse outcomes requires further study.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early postpartum discharge during the COVID-19 pandemic

Bornstein

Gulersen

Husk

et al. 2020

Journal of Perinatal Medicine

Self Cite

View full text Add to dashboard Cite

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“…During the pandemic process, telemedicine and telenursing applications have been used to meet the need for healthcare throughout the world, and skills in this area have been developed (ACOG, 2020;Nanda et al, 2020). Especially in pregnancy and postpartum follow-up and care, telehealth programs have been created, widely used (Dashraath et al, 2020;Rochelson et al, 2020). Besides, a study has shown that telehealth applications are applicable in providing prenatal care (Aziz et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Use of Mobile Applications by Pregnant Women and Levels of Pregnancy Distress During the COVID-19 (Coronavirus) Pandemic

Şat

Sözbir

2021

Matern Child Health J

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Objective Pregnancy and postpartum periods require continuity in care and counseling. During the pandemic process, telemedicine and telenursing applications have been used to meet the need for healthcare throughout the world, and skills in this area have been developed. This study aimed to identify the use of mobile applications by pregnant women in receiving health information, counseling, and healthcare during the COVID-19 pandemic and their distress levels during pregnancy. Methods This research was a descriptive cross-sectional study. The study was designed as an online survey administered between August 2020 and November 2020 via a questionnaire and the Tilburg Pregnancy Distress Scale (TPDS). A total of 376 women agreed to participate in the study. Women were included if they were literate, had a gestational age of ≥ 12th weeks, and accommodated within the Republic of Turkey's boundaries. Results A total of 77.9% of participants reported using pregnancy-related mobile applications during the pandemic. The mean total Tilburg Pregnancy Distress Scale score was 24.09, and 37.2% of the participants were found to be at risk for high distress according to the cut-off point. There was a significant difference between the change in receiving health services and the anxiety about coronavirus transmission and the Tilburg Pregnancy Distress Scale total score. (p ≤ 0.05). Conclusions This study helped understand the pandemic's impact on pregnancy distress and usage of mobile health applications by pregnant women during the pandemic. Also, our results indicate that a decrease in pregnant women receiving health services during this period. Mobile health applications appear to be usable for prenatal follow-ups because mobile applications are common among pregnant women during the COVID-19 pandemic.

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“…After the national call for selfisolation in the UK in March 2020, staff dropped out when they were infected and also as a precautionary measure after they came in contact with a Covid-19 patients [20]. In New York, a general 14-day quarantine was imposed on all staff members who spent longer than 10 minutes within 2 meters of a Covid-19-positive patient [21]. This strict regulation was later mitigated after wearing protective masks was required [21].…”

Section: Main Topic: Structural and Organizational Challenges A Staff Shortage And Restructuringmentioning

confidence: 99%

Effects of the Covid-19 pandemic on maternity staff in 2020 – a scoping review

Schmitt

Mattern

Cignacco

et al. 2021

Preprint

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In the spring of 2020, the SARS-CoV-2 virus caused the Covid-19 pandemic, bringing with it drastic changes and challenges for health systems and medical staff. Among the affected were obstetricians and midwives, whose close physical contact with pregnant women, women who recently gave birth, and their children was indispensable. In the obstetric setting, births cannot be postponed, and maternity staff had to adapt to assure obstetric safety while balancing evidence-based standards with the new challenges posed by the pandemic. This scoping review gives a comprehensive overview of the effecs the Covid-19 pandemic had on maternity staff. We followed the evidence-based approach described by Arksey & O’Malley: we searched several databases for English and German articles published between January 2020 and January 2021 that discussed or touched upon the effects the pandemic had on maternity staff in OECD countries and China. We found that structural challenges caused by the crisis and its subjective effects on maternity staff fell into two main topic areas. Structural challenges (the first main topic) were divided into five subtopics: staff shortages and restructuring; personal protective equipment and tests; switching to virtual communication; handling women with a positive SARS-CoV-2 infection; and excluding accompanying persons. The pandemic also strongly affected the staff’s mental health (the second main topic.) Attempting to meet challenges posed by the pandemic while afraid of contamination, suffering overwork and exhaustion, and struggling to resolve ethical-moral dilemmas had severe negative subjective effects. Several studies indicated increased depression, anxiety, stress levels, and risk of post-traumatic stress symptoms, although the crisis also generated strong occupational solidarity. Care for pregnant, birthing, and breast-feeding women cannot be interrupted, even during a pandemic crisis that requires social distancing. Maternity staff sometimes had to abandon normal standards of obstetric care and were confronted with enormous challenges and structural adjustments that did not leave them unscathed: their mental health suffered considerably. Researchers should study maternity staff’s experiences during the pandemic to prepare recommendations that will protect staff during future epidemics.

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The care of pregnant women during the COVID-19 pandemic – response of a large health system in metropolitan New York

Cited by 30 publications

References 2 publications

Early postpartum discharge during the COVID-19 pandemic

Early postpartum discharge during the COVID-19 pandemic

Use of Mobile Applications by Pregnant Women and Levels of Pregnancy Distress During the COVID-19 (Coronavirus) Pandemic

Effects of the Covid-19 pandemic on maternity staff in 2020 – a scoping review

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