About 100,000 babies are born each year in New Jersey and childbirth is the most common diagnosis for a hospital stay. The COVID-19 pandemic has raised concerns about pregnant patients entering hospitals, especially at a time of ongoing shortages of Personal Protection Equipment and lack of access to testing. At the request of the state of New Jersey and several foundations, the New Jersey Health Care Quality Institute recently brought together neonatologists, obstetricians, doulas, midwives, labor and delivery nurses, social workers, and others to create comprehensive recommendations for pregnant individuals during the pandemic.
Recommendations from the New Jersey Perinatal Care During COVID-19 Work Group includes actions and procedures for clinical teams to take to enable patients and their families to have the best outcomes — as well as a birth that reflects their preferences and values. While aligned with the work of Nurture NJ, which seeks to reduce maternal mortality in New Jersey by 50 percent and to eliminate racial disparities in birth outcomes, these recommendations place a special emphasis on keeping pregnant individuals and their health care providers safe in the following areas:
- Safety and accommodations during prenatal visits
- How to keep patients apprised of changes in protocols, including when arriving at the birthing facility to deliver
- Protocols for COVID-19 testing of pregnant individuals
- Ways to support patients through labor and delivery when there are limitations on the number of support persons who can be with them in-person
- Protocols for suspected or confirmed COVID-19 patients
- Breastfeeding advice for suspected or confirmed COVID-19 patients
- Consideration of resources and support needed postpartum when hospital discharges may occur more quickly and access to supplies and food can be more challenging
The recommendations recognize that vulnerable pregnant populations, such as individuals of color, those with low-incomes, or individuals with disabilities, mental health illness, limited health care access, or underlying medical conditions, face an increased risk of maternal mortality and other pregnancy-related complications even before COVID-19. The recommendations also outline the need for additional resources and individualized care to support patients and infants under these unprecedented circumstances.
The report also includes short-term and long-term recommendations for all states to consider in order to further improve maternal and child health during and beyond the pandemic. It also provides links and resources that patients may need at each stage of pregnancy, especially now that a lot of care will be delivered through telehealth.
With state health departments around the nation stretched thin as they work to reduce spread of coronavirus, Regional Health Improvement Organizations, like the Quality Institute, can play a key role supporting state governments during the pandemic. These organizations work to improve health care quality and affordability, and to improve the health of populations. They can be the catalyst bringing together all players involved in an area of health, including people who do not routinely engage with each other.
At the Quality Institute, we want to work with our state and partners to keep improving maternal and child health — even in the face of the pandemic. We can’t let the pandemic slow the important work to enable every child to have the best start in life. The creation of the Work Group and the recommendations report was supported by The Nicholson Foundation.
The recommendations are a living document that the Quality Institute is updating as new information about the virus and additional resources and guidance become available. We’ll update with information about support groups — and additional resources from the state government or health insurers that support patients, their families, or the clinicians serving them. We encourage you to access the recommendations in the report and share them within your communities.