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Healthwise Maui

Q: Why can’t you move labor and delivery out of the hospital to a separate facility? Wouldn’t that be safer?

Dr. Jennifer Mathieu, OB-GYN, Maui Lani Physicians & Surgeons: The safest place for delivery is still the hospital. In the hospital we have well-established protocols, all the equipment we need, and staff ready to respond to emergencies.

It’s simply not feasible to set up a separate out-of-hospital obstetrical unit. One reason is our size: unlike a major city hospital, Maui Memorial isn’t large enough to set up separate administrative and clinical staff for a dedicated, off-site childbirth unit.

More importantly, a separate OB unit would not reduce the risk of COVID-19 exposure. Other hospitals around the country have tried to separate COVID-19 and non-COVID-19 patients. In these cases, they still ended up with COVID-19 patients in their “clean” facilities because of asymptomatic spread.

What does reduce the risk of infection are the things we are currently doing. This includes screening all labor and delivery patients at the ER entrance with a temperature and risk assessment for COVID-19 symptoms. Once screened, the patient and her partner, wearing masks, are transferred directly to the OB unit for routine care. The OB unit itself is a closed unit, which means nobody passes through the floor from other areas without prior clearance.

Every laboring mother is given a rapid COVID-19 test upon admission to reduce the chance of asymptomatic spread. All staff members wear full PPE, including masks and eye protection, and wash their hands frequently to protect themselves and patients.

Suspected or confirmed COVID-19 patients are brought to a special isolation room for labor, delivery and postpartum care. The room is quarantined to keep non-COVID-19 patients safe. COVID-19 patients have a dedicated nurse who only cares for that patient during their shift to further reduce the risk of spreading infection.

In addition, we are currently not allowing visitors after the baby is born. Every laboring mother can have one support person who will stay with her through labor, delivery and postpartum care. This minimizes the risk of introducing infection from the community.

We understand that this pandemic may cause additional anxiety for moms-to-be, on top of an already exciting but anxious life event, so we’ve created a Virtual Maternity Tour. This tour will show you what to expect when you come to the hospital to give birth. The tour walks you through admission, delivery and postpartum recovery to help make your delivery day as smooth and stress-free as possible.

You can view the virtual tour at mauihealth.org/maternity.

Q: Do labor and delivery nurses “float” to other units in the hospital?

Dr. Jennifer Mathieu, OB-GYN, Maui Lani Physicians & Surgeons: Nurses in labor and delivery typically do not move between units. However, if an OB staff member is floated, they will typically not return to take care of OB patients for the remainder of their shift, and they never float to a COVID unit.

If physicians and health care providers do care for nonobstetric patients they take extra precautions before returning to OB care including changing scrubs and showering, if necessary.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on the first and third Thursdays of the month. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.

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