How doctors are creatively adapting prenatal care during COVID-19 crisis

A little creativity goes a long way in supporting moms-to-be during the coronavirus pandemic.

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/ Source: TODAY
By Meghan Holohan

For her 37-week prenatal exam, Alisha Natvig drove up to the curb outside her doctor’s office and opened her door. Dr. Regina Cho came to the car with a blood pressure cuff and a fetal heart monitor to check Natvig's blood pressure and the baby’s heartbeat.

“It took less than five minutes,” Natvig, 35 of Minneapolis, told TODAY Parents. “It really was minimal contact, only as needed to do the vitals and check on the baby. But the rest of the conversation was done at a safe distance. It was nice to have that reassurance of being able to check on my baby without having the additional risks of being exposed to germs.”

While pregnant with her third child during the coronavirus pandemic, Alisha Natvig has appreciated that she can participate in curbside prenatal check-ups, which protect her from being exposed to extra people. LeAnne Johansen Photography

The COVID-19 pandemic has caused doctors’ offices and hospitals to change how they see patients with many turning to telehealth. But providing obstetric care to women often requires a hands-on approach and practices across the countries are adapting to meet these needs.

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“We have pretty quickly evolved into doing virtual visits for a lot of patients, but we realized that … really there are certain parts of prenatal care you can't virtualize,” Cho told TODAY Parents. “Pregnancy-related care is in the personal touch, the reassurance and the counseling. It's also hearing the heart beat and knowing that the baby is doing OK.”

The curbside appointments — which take place during visits that don’t require bloodwork or an ultrasound — allow doctors to perform the hands-on care and the counseling without exposing the patients to too many risks.

Dr. Regina Cho and her colleagues have been offering curbside appointments to women who need prenatal exams but do not need bloodwork or an ultrasound. Patients love that they get to hear their babies' heartbeats without going into an office and being exposed to more germs. Courtesy of Laura Garland

“Patients are nervous and anxious but especially pregnant patients are very anxious right now about going into public places,” Cho said. "We were trying to...come up with ways to creatively protect our patients.”

Sara Reardon, a physical therapist at NOLA Pelvic Health, has been providing telehealth to her patients for treatments that do not require hands-on manipulation. While she taught an in-person birthing class, the spread of the novel coronavirus meant she had to take the course online.

“I have a pelvic model that I use,” she told TODAY Parents. “Parents can get coached on strategy, perineal massage, breathing, birthing position, labor.”

She shows them how the muscles engage and work in labor and teaches stretches, too. She’s noticed demand has grown now that the classes are online.

“This is a great way to reach a lot more women in one hour, 150 people from all over the world purchased this course,” said Reardon, who shares facts about pelvic floor health on her Instagram account, the Vagina Whisperer. “It’s a lot more convenient and a lot less expensive and more accessible to people who would not otherwise be able to go. The benefits are great.”

Doctors across the country have turned to telemedicine and creative solutions to provide prenatal care to pregnant women during the coronavirus pandemic. Courtesy of Laura Garland

Pampers is also offering online childbirth education classes, which covers everything from nutrition, to body changes to postpartum care.

Telehealth makes it easier for women to access important services without putting their own health at risk. And, it eases expectant moms’ worries.

“There's a lot of anxiety in pregnancy normally — like all the responsibility of making a human — and then you add a pandemic on top,” Dr. Jane van Dis, medical director of Maven Clinic, which offers a variety of telehealth services to women, told TODAY Parents. “A lot of women are thankful that they can have these telehealth visits.”

Maven offers virtual doulas, midwives, nutritionists, physical therapists and mental health professionals, she added. Van Dis thinks these appointments help women feel supported during a time of great uncertainty.

“The telehealth visits sometimes last a little bit longer and hopefully they have more time to discuss any concerns that they have," she said.

Doctors at Magee Womens Hospital in Pittsburgh have also transitioned to virtual appointments for many of their pregnant patients when they don’t need bloodwork or an ultrasound. They’ve mailed out hundreds of blood pressure cuffs so expectant moms can check their blood pressure when on video calls with their doctors.

“We trying to make whatever element of prenatal care can be performed at a distance to be performed at a distance,” Dr. Hyagriv Simhan, division director of maternal-fetal medicine and medical director of obstetrical services at Magee, told TODAY Parents. “Much of prenatal care is education and counseling and talking and looking and listening and that’s relatively easily facilitated by an electronic medium.”

The hospital just launched tele-lactation services, where a lactation consultant video conferences with a new moms.

“The lactation consultant is here in a secure room and able to watch them breastfeed and give advice or just talk through any of their concerns,” Beth Quinn, a program director at Magee, told TODAY Parents. “They can show us exactly what's going on and we can advise and that’s something patients are going to really like.”