No separation for birthing people and newborns at MD hospitals during COVID-19 pandemic

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Effective immediately, Frederick Health Hospital (FHH) is requiring COVID-19 testing of all birthing people prior to or upon entry to the labor and delivery unit and is treating all people as a person under investigation (PUI) for COVID-19 until a negative test determines otherwise.  If a patient is classified as a PUI or as COVID-19 positive, FHH is separating birthing people from their newborn baby at birth by placing the newborn in a “isolette in the mother’s room” and PUI and/or “Positive mother, spouse will wear a mask and will not touch the newborn if the newborn is out of the isolette”. If a COVID-19 test is declined, FHH is treating the birthing person as a PUI and will separate them from their newborn baby as specified above. FHH is also prohibiting “direct breastfeeding” of the newborn for any PUI or COVID-19 positive patients. These policies go against the Patient Bill of Rights and are not evidence based, are unnecessarily traumatizing to birthing families and are an incredible misuse of hospital resources and staff. Similar policies are being enforced at hospitals across the State of Maryland.

Furthermore, these policies are not in line with the clinical advice of the Center for Disease Control (CDC) and The World Health Organization (WHO). In a publication released on May 26, 2020 by the WHO, they state: “Separation causes cumulative harms, including disrupting breastfeeding and limiting its protection against infectious disease, which has disproportionate impacts on vulnerable infants. Separation also presumes the replaceability of breastfeeding – a risk that is magnified in emergencies. Moreover, separation does not ensure lower viral exposure during hospitalizations and post‐discharge, and contributes to the burden on overwhelmed health systems. Finally, separation magnifies maternal health consequences of insufficient breastfeeding and compounds trauma in communities who have experienced long‐standing inequities and violence, including family separation. Taken together, separating PUI/confirmed SARS‐CoV‐2 positive mothers and their infants may lead to excess preventable illnesses and deaths among infants and women around the world”. The CDC advises that the decision of separation should be a collaborative choice made between provider and birthing person and ultimately the birthing person should choose: “…the risks and benefits of temporary separation of the mother from her baby should be discussed with the mother by the healthcare team, and decisions about temporary separation should be made in accordance with the mother’s wishes”. Additionally, The WHO advises that “Mothers and infants should be enabled to remain together and practise skin-to-skin contact, kangaroo mother care and to remain together and to practise rooming-in throughout the day and night, especially immediately after birth during establishment of breastfeeding, whether they or their infants have suspected, probable, or confirmed COVID-19”. 

To reiterate, these types of threatening, non-evidence based policies are detrimental to the bonding experience of the birthing person and their newborn and will negatively affect breastfeeding outcomes. These policies have the potential to increase preventable illness and death in infants and birthing people and will disproportionately be used against birthing people of color and those of marginalized communities.

While it is understood that the COVID-19 situation is constantly changing and there are many unknowns, we demand that FHH and other any other Maryland hospital who may be enforcing similar separation policies, follow the guidance of leading, reputable health organizations like the CDC and WHO. This separation policy places unnecessary stress and trauma on birthing people and health care workers, uses large amounts of critical PPE, and increases risk of infection of the newborn as they are exposed to a greater number of care givers and are prevented from potentially receiving crucial SARS‐CoV‐2 antibodies found in breastmilk. The signatures on this petition urge FHH and all Maryland hospitals to implement common sense policies based on CDC and WHO guidelines, including immediate skin to skin after birth, direct breastfeeding within the first hour of birth and rooming in with newborn. These can be completed safely for PUI and COVID-19 positive patients by wearing proper PPE and following heightened hand washing hygiene. The decision of physical separation of birthing person and newborn is one that should be made jointly between patient and provider without threatening policies or medical coercion.  

Respectfully Signed,

The Birthing Circle Board of Directors