We are writing to provide you with further updates regarding our response to the current COVID 19 Pandemic. We first would like to thank all of you for being patient as we adapt to these changing circumstances. This is a trying time for everyone and we know our pregnant clients and clients with newborns are especially concerned at this time. The good news is that so far the outcomes for pregnant women and their babies are generally good.

Yesterday Ontario’s Chief Medical Officer released a medical directive to all regulated health professionals in the province. This directive is aimed at conserving our health resources in this time of great demand and require that “all non-essential and elective services be ceased or reduced to minimal levels”.

How this directive impacts our clients

Clinic Visits

As in discussed in our previous communication, Midwives of Brampton & Halton Hills has reduced the frequency of in-person prenatal visits to the minimum recommended where it is medically appropriate. For most low risk pregnancies this means 8 prenatal visits through your care. These visits will be at approximately the following weeks in pregnancy:

Initial interviews will be conducted remotely.

1st Visit at 10-12 weeks

16 weeks

18-20 weeks

28 weeks

34 weeks

36 weeks

38 weeks

40 weeks

41 weeks

Your midwife will notify you if you need more frequent visits for any medical reason.

As per our previous communication the in-person portion of your visit will consist of blood pressure and belly checks (measuring belly and listening to baby) only. Your midwife will arrange to have any relevant discussions remotely either before or after your in-person visit. Please see procedure for remote visits below.

Postpartum Visits

Visits in the 6 weeks following the birth will be similarly limited to comply with this directive. For most clients you and your baby will be seen for in-person visits as follows:

2 visits in the first week after birth (a visit in the first 48hrs and one visit between days 3-7)

5-6 weeks clinic discharge visit appointment

Your midwife may offer a remote visit at 3-4 weeks after birth or at any time between these visits as needed.

The in-person portion of the visit will consist only of medical checks (Blood Pressure, belly check & baby check including listening to heart and lungs and weighing).

All discussions will happen using the doxy.me software discussed below.

In order for us to continue to be able to offer visits in our clients’ homes we will be asking the active screening questions of you and anyone in your home prior to entering. Please notify your midwives as soon as possible if you, or someone in your home is on self-isolation and/or has a suspected or confirmed case of COVID-19. We also strongly recommend that you limit any visitors during this time.

Remote Visits

Your midwives can do a lot remotely! We can discuss important issues/decisions during the pregnancy and we can even help you with breastfeeding concerns.

To enhance these remote visits we will be using software called Doxy.me which will allow the midwife to text or video call you on your phone or tablet. We have chosen this software as it is compliant with privacy requirements and allows us to have face to face discussions with our clients

We will be using this for:

1) Discussion portion of prenatal appointments

2) To do active screening prior to clients entering the clinic

3) To do active screening prior to entering your home for a home assessment or postpartum visit

How it works

1) Your midwife will send you a text message inviting you to meet her in the secure virtual waiting room. The text will say “Hello, this is Team X- join me for a secure video meeting” and include the link.

2) All you need to do is click on the link and check in by entering your name.

3) Your midwife will begin the session when she is ready.

Please note:

The only thing you require for this is a device connected to the internet. You may be asked by your device to enable camera and microphone depending on your device settings. If you do not have access to a smart phone or tablet please let us know and we will make alternative arrangements.

Choice of Birthplace

Currently there is no change to our options for place of birth. However, as this situation evolves and more information is provided we may need to make changes to planned place of birth depending on available resources at any location and the ability of the midwives to provide safe care to our clients. We will do our best to update you in advance if this occurs but there may be circumstances where you are asked to go to a different location for your birth than planned. It may also be possible should our midwives need to be self-isolating, that a midwife other than your team’s midwife will conduct your appointments or attend to you in labour. We ask that clients be understanding of the limitations of resources during this time and trust that we are doing everything within our power to maintain quality midwifery care for everyone.

Support People/Visitors at Home & Hospital Births

Both Brampton Civic Hospital and Georgetown Hospital have limited clients to having only 1 support person in the hospital. This person will be screened and receive an identification bracelet, no other visitors or support people will be allowed in labour and delivery or on the postpartum ward. These rules are strictly enforced at this time.

For planned home births we are asking that you similarly limit additional people to as few as absolutely necessary at your birth in order to reduce the risk of exposure to you, your baby and your midwives.

We thank all our clients in advance for your continued understanding and compliance during this time. We will continue to update you as more information becomes available.


Midwives of Brampton & Halton Hills