Limitations on Birth Support People During the COVID-19 Pandemic: A Presentation by the ACNM Ethics Committee

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Probably every midwife still in clinical practice has a COVID-19 horror story to tell. These past two years, we have seen our organization’s listservs light up with requests for help and guidance on crucial obstacles focusing on pregnancy, birth, postpartum, and lactation areas.

Many of the issues were centered around hospitals restricting the presence of support members, such as partners, family, and doulas. With this in mind and supporting the theme of the 2021 ACNM Annual Meeting, “Dismantling Racism in Midwifery,” the ACNM Ethics Committee analyzed the power dynamics between prenatal care providers and patients of color. An “ethical and social justice” lens was used to examine the challenges of providing a safe, respectful, and culturally appropriate response during the global pandemic. During the annual meeting, our panel will present a diverse perspective to guide our midwife colleagues in the ethical dilemma of developing and implementing policies.

We will open with epidemiological and transmission background information on COVID-19 and how this developed into a rationale for limiting all types of labor support. Next, we will examine some of the issues and literature. Then, we will use our ACNM Code of Ethics and the bioethical principles of beneficence, non-malfeasance, autonomy, and justice, and how these panel members apply them to balance the needs of patients, providers, institutions, and the public. The literature is rich in citing early HIV and Ebola work and its fear-based decision making, leading to disparities and racism, affecting Black, Indigenous, and other people of color.

We opened a case study to help guide a focused discussion about situations in the Antepartum, IntraPartum, and Postpartum arenas. The panel will discuss working through the many obstacles they have faced and how they addressed them. Panel members will also describe how they experienced changes in office visits, ultrasounds, labor support, use of doulas, family members not able to be present at the birth, lactation support, culturally relevant postpartum care, and more. Please join us for what we are sure will be a lively and contemporary discussion.

The panel includes Helena Grant, NYU Langone Hospital, New York; Michelle Drew, Executive Director Ubuntu Black Family Health Collective, Wilmington Delaware; and Ana Delgado, Clinical Professor, UCSF Department of Obstetrics, Zuckerberg San Francisco General Hospital.

Join us at the ACNM 66th Annual Meeting, held virtually May 23-25, 2021, to learn more.

This presentation was brought to you by:

Ira Kantrowitz-Gordon,Meghan Eagen-Torkko and Michael McCann on behalf of the ACNM Ethics Committee