NYSDOH COVID-19 & Maternal Equity Webinar - Shared screen with speaker view
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The NYSDOH COVID-19 Tracker is available here: https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Map?%3Aembed=yes&%3Atoolbar=no&%3Atabs=n
Dr. Kacica: For the age-related death numbers/proportions, are there denominators available within each age group for total test-positives?
yep, loe that tshirt - have it on now
Marilyn Kacica, MD, MPH
Dr Glantz, for each of the tables or graphs, there are links to the underlying data that is available
Good afternoon what is the name of the literature and authors please thank you
Resources list save lives too!
I will like to have more information for clinical pastoral education program.
White Fragility is one and the other is How to be an Anti-Rascist
Ms. Grant mentioned two books:
Shout out from Ithaca, NY * What efforts are being made to finalize the DOH Freestanding Birth Center Regulations and when will the application process open?* Who is the best contact person at the NYSDOH for community midwives.
"White Fragility" by Robin DiAngelo and "How to Be An AntiRacist" by Ibram X. Kendi
Very interested in the Durham's Stress Free Zone Program , have you just started in one location, can we mirror this in other communities
Birth center application is on track to be released by June 15th
would like to see how stress free zone is established - what does it include
Could you please share a link to the application or contact person for questions?
Sorry everyone, that was my 11 month old!
How To Be An Antiracist By Ibram X. Kendi
White Fragility by Robin Diangelo
That's a beautiful thing for Mothers Rev Holt! (hi from St. Lawrence Health System in St. Lawrence County)
Many Ob's (including my office) we are doing Televisits - we created a list of items my patients have to procure and we conduct virtual visits. They still need labs and certain ultrasounds done - and we coordinate their visits with those visits so we minimize need to leave home. Problem with some patients that want birth center is they are too high risk or have had insufficient prenatal care. It is so important if possible to get women in early for that first visit and do risk assessment. Also stress that hospitals have taken great measures to be safe. Sometimes being Outside of Hospital is more dangerous (we have seen babies born with COVID and if they were home this would have potentially been challenging to get prompt care)
thank everyone for the books response
Private practices have been open as far as I have heard from my colleagues. Hospital affiliated clinics have closed perhaps or furloughed employees
Some labs are able to go to the home to draw bloodwork. But they will not do GCT or GTT
How can community health workers support prenatal patients?
Pregnants should be made aware of changing protocols prior to their arrival at the facility.This includes providing patients with information on:● Who to contact when they are in labor or have any concerns.● What to expect when they arrive at the facility.● Protocols for their support person, including where the support person shouldwait during the patient’s triage and the need to stay with the patient for theduration of the admission● Personal Protective Equipment (PPE) protocols for the patient, their supportperson, and staff (i.e. expectations regarding when to wear a mask)
need to also get providers to ask “ have I answered all your questions”
"What other questions do you have for me?" assumes they have questions and welcomes them asking!
@Dulce that is so true, had my first visit this week, and it was totally different, and i wasnt prepared with the expectations
Thanks to those who answered the book questions...I was originally on full screen. Much more to share when the time is right but these two books are a good start ...There are others that are specific to the CARE of WOC that are very necessary for this unpacking and undergirding of increasing consciousness to take place
hospitals have all sent to their providers the guidelines for admissions. Each has their own. Perhaps the NYS DOH can collect that information on their site for people to access in the community. I believe they are all collecting oropharyngeal swabs on admission. Only partner and doula are allowed. and once inside they cannot come in and out.
all are attempting early discharge as well.
as a high risk pregnant woman, I was most worried about how will I continue to be cared for due to receiving care for pre term labor
who explains to women that they should get or have blood pressure equipment/cuff - I have HBP, I didnt even think about buying one. are we checking to make sure that its affordable
Family Centered Care still is paramount!
To Denise Wyatt - or can the cuffs be covered by health insurance
Trust in the healthcare system needs to be earned, especially for black birthing people!
I have instilled a program in my practice lending dopplers, measuring tapes, BP cuffs, urine dip sticks for virtual visits for low risk normal pregnancies. This has been really great. It’s empowering for women to learn about their pregnant bodies and self assess.
thats excellent Lisa
I think bridging the communication gap between hospital and the community would definitely be supported if the NYSDOH, once again funds the Perinatal Forums that previously existed between RPCs and Community based organizations. That will allow for cohesive, regional collaborations that address many of the equity issues that are being discussed today.
the provider should do the counseling - pregnancy is such a dynamic time and that's why getting early care - or even prepregnancy care is the ideal - so we can fix the things we can, so we can plan out the care together, so we can see what resources will be needed - things change quickly - the goal at the end of the day is a healthy mother and baby going home together. Sometimes it ends up going left turn - but then we adapt - but we communicate.
Fetal Heat Dopplerhttps://www.amazon.com/SweetieSong-EZD-100ST-Pocket-Doppler-Monitor/dp/B07DVX2L22/ref=sr_1_21?dchild=1&keywords=fetal+heart+doppler&qid=1590943672&sr=8-21How to find your baby’s heartbeat with Doppler video:https://www.neevababy.com/pages/instructiontape measurehttps://www.amazon.com/Measure-Flexible-Measurement-Centimetre-60-inch%EF%BC%88White%EF%BC%89/dp/B07MT89MCW/ref=sr_1_4?dchild=1&keywords=tape+measure&qid=1590943744&rnid=2941120011&s=arts-crafts&sr=1-4How to measure fundal height:https://www.open.edu/openlearncreate/mod/oucontent/view.php?id=40&printable=1Blood pressure monitor:https://www.amazon.com/Pressure-Monitor-Bluetooth-Storesup-Readings/dp/B07RYBKNC2/ref=sr_1_10?dchild=1&keywords=blood+pressure+monitor+home&qid=1590944231&refinements=p_89%3AOmron%2Cp_85%3A2470955011&rnid=2470954011&rps=1&sr=8-10Scale:https://www.amazon.com/Letsfit-Bathroom-Technology-Precision-Measurements/dp/B07L2XBK5V/ref=sr_1_1_sspa?crid=ISEWPOAWBBOA&dchild=1&keywords=scales+for+body+weight&
Great to hear
has anyone had issues getting equipment like blood pressure cuffs etc covered by insurance?
NYS Medicaid issued coverage guidelines for Automatic Blood Pressure Monitor, online at https://www.emedny.org/ProviderManuals/communications/provider_communication_automatic_blood_pressure_monitors-6-3-20.pdf
Re: Perinatal Forums - And strategize on concrete deliverables which reflect true integrated partnership between the perinatal networks and/or other relevant CBOs focused on community perinatal services.
congratulations to the healthy baby
did Stacy have a preconception visit before the next pregnancy?
I think Obstetrician–gynecologists and other obstetric care clinicians should continue to provide medically necessary prenatal care, referrals, and consultations.Obstetric care clinicians should be prepared to explain the rationale for any change in prenatal care or delivery scheduling, emphasizing that these modifications have been made in order to limit the risk of exposure to the virus for the mother and the fetus or infant.It is recommended that the patient–physician discussion regarding a plan for alternate prenatal care in the setting of the COVID-19 pandemic be documented in the medical record.
The other consideration for Covid deliveries is the inability for these parents of newborns to have support the early days post discharge if the support didn't live in their house. there's an increase risk for PMAD.
The best learning and understand comes from hear those lived experiences , and taking the focus off us the healthcare provider but on them, thanks for sharing that story
The information shared today is very powerful and important for healthcare providers to hear.
Yes, are there any stories of newborn care and/or postpartum depression under conditions of physical/social distancing?
That is true Cheryl
We may need to think about developing a set of questions that providers, community health workers, doulas, and other ask the women and parents they serve so we can gather the info and adjust the system accordingly.
And the exacerbation of existing MH symptoms for mothers experiencing an isolated birth
Yes, we do need to be mindful of the impact of delivering during the pandemic and the psychological impact on all family members. MH stress is even higher than typical and needs to be constantly assessed for and supported through
I am agree with that suggestion Cheryl because as a CHW I noticed most pregnant do not ask question that will improve the healthy pregnancy
and we need to make sure that it is not just during COVID, but post-COVID to make sure all of the residual complications and rollover - that supports are there with resources
Thank you everyone! We are stronger together! Sending LOVE to ALL!
Yes this trauma will have LONG lasting implications
Now that is good!!
we are doing virtual childbirth classes, lactation, newborn care - virtual anything we can with Nurse Jackie - 40 yrs of experience at Woodhull, NYP Downtown (former Beekman, NYDH). She is wonderful
there needs to be a systematic response for care across the board... just as we’ve decided that everyone wear a mask to enter stores... we need to have an established gold standard across the board and funds to do so.
We Community Health Workers are very supportive we advocate, educate to help improve their lifestyle and outcome we help them connect to proper health care options. Provide informational counseling with educational materials, social support and translate information for clients.
Yes Sandra Bueno, we are very supportive
How do we build that virtual support when parents are home for frequent check ins and late or early in the day contacts when their baby won't stop crying and they need help/support and family can't get there because of quarantine......and worse when they don't have family
Well said, Helena!
we need to expand that village - full of "Aunties" that can give advice and support
When the public system became desegregated, the govt stopped investing in these institutions
this was intentional
you are right Cheryl
Connect patients to local Federally Qualified Health Centers
Cheryl- what about a call in number for the patients and then setting up a virtual appoint ment for that day?
We just need to take from this situation and work to ensure that "circle of support" can be available when you can't be there in person.
continuity of care is important - fragmentation is not optimal. FQHC's are fine - but if their providers don't deliver the patients - then those connections are lost. Ideal is continuity - connectedness.
Tami - Sounds like a good idea......something to flesh out. Maybe even a 24 hr service to include both trained clinical and non-clinical (CHWs, Doulas, etc) persons covering a wide variety of issues...….May also just be someone to talk to to get the strength to keep on,.
Linnette Vargasa Gonzalez
As a community health worker, I make sure mom has her birth plan with her. Asking her doctor/OB any questions that concern them. Making sure they have the support before they go in the hospital and when they arrive home. Connecting them with the resources when they leave such as our Bilingual Baby Café La Taza Materna in Sullivan County for breastfeeding support. Birthing classes, safe sleep webinars and breastfeeding basics classes. Letting moms know where they can call for post partum depression, parenting classes, connecting them with health insurance and pediatricians, WIC, mental health, nutrition, and helping them with some baby needs such as a pack and play, clothes, education on safe sleep and more. As a community health worker its having someone to hear you, to listen. Many women who have no one their at home for the support when they go home. Delivering alone. And preemies that can only receive that one parent visit. Preparing them for the before and after. Support as much as you can.
My hospital also gives families an infant safety kit at discharge with diapers, masks, clothes , wipes and many other items. Many of our patients are undocumented.
i think its great that some of your hospitals are trying to provide services to clients, however, we really need to make sure there is connection to community based organziations, who provide alot of the SDOH services for women and families. changing the healthcare system as it stands now and valuing what partnership with each of the touching points of the women.
My daughter delivered 4/15 in Baltimore, and I worked hard to create a remote experience that would take the place of my ability to be there with her right after birth. That also included being available for every little question whatever time of day. Also making frequent check in calls with video chats affirming what she and her husband were doing.
Thank you Linnette--
Patient are screened by our social work team and referred to Community Based organizations as well as homecare. Post-discharge calls were also made.
Relationships are key
Some of the COVID-19 grants may be able to assist with avoiding homelessness, through paying back rent, etc.
Re. Holt's comments are even more important given the current jobs report which has the WH admin arguing that we are "back" and nothing more needs to be done as the unemployment rate was reported to decrease and it's only 20M unemployed rather than 40M.
Iman Judith Jones
Thank you everyone!!
This was a wealth of information
Awesome discussion! Thanks so much, panelists and Dr. Crear-Perry!
thank you everyone!!! this was truly wonderful
Great panel thank you everyone
thank you to all panelists for a wonderful discussion
The recording of this webinar will be posted on our website, www.NYSPQC.org.
Feel free to contact us at NYSPQC@health.ny.gov.
Thank you everyone for your time and participation!
thank you for inviting me and to hear my experience, stay safe and have a great day everyone💕
Thank you for the opportunity to participate.
last polling question - staff being treated equitable by whom?
Thank you for putting this timely program together.
Thank you, Sherae! Your story is so important. Enjoy your baby!
Thank you so much! This was so informative and though/action-provoking!
Thank you so much. The focus on patient perspective was valuable and powerful.
Thank you for this, Sherae you were amazing!
Thank you for putting this together. We can't overstate the importance of this topic.
Joy DeGruy I believe
Thank you to all who shared. This has been very helpful
Thank you to all our panel members!
Thank you everyone who contributed and made this webinar possible.