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Labor and Delivery Visitor Policies During the COVID-19 PandemicBalancing Risks and Benefits

Educational Objective
To understand how to adjust labor and delivery visitor policies to protect patients from COVID-19 infection in a compassionate manner
1 Credit CME

In times of a pandemic, the primary responsibility of health care professionals shifts from maximizing the best interests of individual patients to prioritizing the health of the community. Given the surge of patients with the novel coronavirus disease 2019 (COVID-19), their clinical needs, and thus, resource utilization, the ongoing pandemic has amplified the duty of physicians to responsibly steward health care resources. Additionally, the well-being of health care professionals, both as scarce resources and as members of the community, must be safeguarded. Given this shift in ethical and clinical goals, policies have been implemented to limit the number of visitors accompanying patients in virtually all clinical settings. Such policies stem from balancing the benefits to the individual patient with the duty to reduce infectious exposures to visitors, other patients, the community, and the health care team. Notable exceptions to many of these policies exist for visitors for children, persons with disabilities, end-of-life care, and labor and delivery units.

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Article Information

Corresponding Author: Kavita Shah Arora, MD, MBE, MS, 2500 MetroHealth Dr, Cleveland, OH 44109 (kavita.shah.arora@gmail.com).

Published Online: May 22, 2020. doi:10.1001/jama.2020.7563

Conflict of Interest Disclosures: Dr Arora reported that she serves as vice chair of the American College of Obstetricians and Gynecologists' Ethics Committee and is funded by the Clinical and Translational Science Collaborative of Cleveland, grant KL2TR0002547 from the National Center for Advancing Translational Sciences component of the National Institutes of Health and National Institutes of Health roadmap for Medical Research. No other disclosures were reported.

Disclaimer: This article is solely the responsibility of the authors and does not necessarily represent the official views of the American College of Obstetricians and Gynecologists or the National Institutes of Health.

References
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Centers for Disease Control and Prevention. Considerations for inpatient obstetric healthcare settings. Published April 4, 2020. Accessed April 22, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html#anchor_1582067966715
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American College of Obstetricians and Gynecologists. COVID-19 FAQs for obstetricians-gynecologists, obstetrics. Published March 23, 2020. Accessed April 22, 2020. https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics
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Caron  C , Van Syckle  K . Some pregnant women in New York City will have to deliver babies alone. New York Times. March 24, 2020. Accessed April 7, 2020. https://www.nytimes.com/2020/03/24/parenting/coronavirus-labor-birth.html
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New York Department of Health. Pregnancy and COVID-19 resources for health care providers. Published March 21, 2020. Accessed April 7, 2020. https://coronavirus.health.ny.gov/system/files/documents/2020/03/covid-19pregnancyguidanceforproviders3.21.20.pdf
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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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