Region I Update (Jan-Jun 2020)

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The experience of many of the Region I midwives during the first half of 2020 is intertwined with the COVID-19 pandemic – the trauma of risking sickness for midwives and their families due to lack of PPE, of handling an sudden onset of potentially sick and frightened people in labor, of seeing temporary morgues outside hospitals, or of preparing for an onslaught of cases, whether or not they materialized.

New York: New York City midwives heroically rose to provide excellent care under difficult circumstances, aided by midwife Kimm Sun, who started “Masks for Midwives” and coordinated donating PPE for many NYC midwives. Especially hard-hit were those midwives at hospitals that became centers for COVID-19 patients, such as Elmhurst Hospital, as well as those in neighborhoods where Black and Brown people suffered a higher incidence of infection compared to white New Yorkers. Thank you, NYC midwives, for persevering under such stressful conditions. New York’s COVID-19 Maternity Task Force initiated an expedited process to create the licensure application for midwifery-led birth centers, and its Postpartum Task Force has begun work to address maternal mortality rates and racial disparities evidenced beyond the previously prescribed six-week postpartum period. Midwives were represented on both these task forces.

Massachusetts: Eastern Massachusetts was hit hard in the early months of the pandemic but has steadily recovered, and cases in Massachusetts remain low overall. Western Massachusetts faced significant shortages of PPE in rural areas, but overcame this challenge and is now well-supplied. Holyoke’s women’s health practice, including a long-standing midwifery team, permanently closed this summer, which is a great loss to western MA and Latinx people in particular. The affiliate stands in solidarity with the Black Lives Matter movement and has initiated education and training to address racism and antiracism within the affiliate. MA House Bill, “An act to increase access to nurse-midwifery services,” which would provide equal reimbursement for CNMs, did not pass, but the affiliate will re-introduce it in the next session. Affiliate President Mary Paterno was inducted as an ACNM Fellow at the 2020 Annual Meeting and won the Kitty Ernst Award.

Vermont: Vermont’s governor moved quickly to a “stay home, stay safe” advisory, which kept the case count low. There was an early bump in homebirths – motivated by fear of the virus, not belief in out-of-hospital birth. Practices have increased telehealth and Zoom visits, and stopped testing all L&D admissions to conserve supplies, only with indications now including increased risk of NICU admission. At the University of Vermont Medical Center (UVM), patients can now bring two supports on L&D, but no visitors on postpartum. A new practice has opened and a longtime negative environment for midwives at the Central VT Medical Center has improved.

Maine: In March, the Maine Affiliate began holding weekly “support group” Zoom meeting to support each other and share information. The affiliate is accomplishing many of its goals for the year, including establishing a student mentoring process and updating the affiliate website. One member created a survey to update practice information and is improving and updating the website. The affiliate discussed working to establish a midwifery educational program in Maine, but
that initiative has been sidelined until they know more about how the pandemic will play out and how the state health care system will evolve in the next year.

Connecticut: Affiliate Vice President Stephanie Welsh sent out a survey to see how Connecticut midwives were impacted by the pandemic. Initially, many CNMs in the state were furloughed. Prior to the recommendation of universal masking, co-president Ariel Herron and student midwife Sarah Thayer were featured on NBC Connecticut in the article, “Nurses Making Homemade Masks To Help With Protective Gear Shortage.”

Rhode Island: The Rhode Island Affiliate is revising its bylaws to create a leadership board instead of officers. The affiliate has been working to connect with local chapters of the American College of Obstetricians and Gynecologists (ACOG) and Association of Women’s Health, Obstetric and Neonatal Nurses (AHWONN) and to attract more members.

New Hampshire: Northern New England “nailed it” – the local rate of asymptomatic carriage is 1% or less. No existing practices have been negatively impacted, and home birth midwives have seen an increase in births. A new free-standing birth center in Lebanon had construction delays, but construction is now underway again.