Public health organization guidelines aligning to promote bonding between newborn and birthing parent
Recently, the Center for Disease Control (CDC) updated their COVID-19 birth guidelines to soften recommendations around mom-baby contact and separation. The CDC now recommends that if a birth parent is confirmed or suspected to be COVID-19 positive health care providers should engage in shared decision making with the patient around the best course of care for their baby. Before April 4, the CDC recommended birthing professionals consider separating newborns if their birthing parent tested positive for COVID-19 or was a patient under investigation, even though the risk of transmission to and clinical severity of COVID-19 in newborns is still unclear.
This change encourages providers to better consider all the known benefits of skin-to-skin contact and the patient’s desire and ability to breastfeed with the birthing patients before making a determination on behalf of the patient about whether to separate the newborn. The CDC is now better aligned with the World Health Organization’s (WHO) birth guidelines which, from early on, emphasized shared decision making, the importance of skin-to-skin contact, and the use of proper hygiene precautions when keeping a mom and baby together.
What about birth equity?
We know that access to a safe and happy birth are not distributed equally across the population. Although the WHO, and now CDC, emphasize shared decision making between the birthing person and their provider, neither guideline emphasizes equity-based care. It’s important to remember that equity is not equality. Equity allows everyone to receive the services needed to thrive whereas equality affords everyone the same services, regardless of need.
For example, while the CDC and WHO do not call for limiting support people to one or none, the guidelines do not mention that people of color are more likely to experience discrimination in a health care setting and therefore are more likely to benefit from additional support people to serve as their advocates.
It is important to remember that we have a history of race and discrimination in our country and state, which has led to disproportionate health outcomes. Unless we stop to listen to those most impacted and think intentionally about equity, those disparities will only get worse. We strongly encourage the state, advocates for health and birthing, as well as health care providers, to examine equity issues during the pandemic and prioritize community-informed solutions.