RCP e-News October 2020

RCP is Open for Business - The Reproductive Care Program of Nova Scotia (RCP) continues to provide assistance and support. RCP staff members are working from home as much as possible but will respond to your questions as usual. Currently, e-mail and our contact us page are the most efficient ways to reach us. Please take care of yourselves and your family during this challenging time.

COVID-19 Resources for Nova Scotia Health Care Providers – RCP has complied a number of resources and information for NS care providers. The full list of resources can be found on the RCP website COVID-19 page.

Virtual Education Coming Soon – RCP is working towards developing/expanding our current online education offerings. Stay tuned in the coming months for more information related to this.

World Breastfeeding Week - RCP celebrated World Breastfeeding Week Oct 1 - 7 with important messages from the Breastfeeding Committee for Canada and the Baby-Friendly Initiative. Check it out here.

Nova Scotia’s 2020-2021 Flu Campaign - In preparation for the 2020-2021 Influenza season RCP has posted several resources developed by the NS Department of Health and Wellness to guide care providers. As in previous years, all Nova Scotians aged 6 months and older will be eligible to receive the influenza vaccine. However, it is of utmost importance that those individuals at high risk for influenza related complications or hospitalizations, including pregnant women and individuals capable of transmitting influenza to others, be immunized. In addition, this year, to reduce the risk of severe illness that could potentially arise from co-infection with COVID-19 and influenza, people at high risk of COVID-19 related illness and those people capable of transmitting influenza to those at high risk of severe illness related to COVID-19 are particularly recommended to receive the influenza vaccine this fall. See the RCP website to access information regarding these resources.

COVID-19 Alert App - COVID Alert is a free exposure notification app. The app lets you know if you may have been exposed to COVID-19.You can also use the app to let others know if you test positive without sharing any personal information. Learn more and download the app here.

Coming Soon - COVID-19 and Pregnancy: Maternal and Newborn Care Bulletin #4 - In conjunction with the IWK Health Centre and the Nova Scotia Health, RCP will be releasing the next bulletin to share current information and provide guidance about care for pregnant and childbearing persons and newborns in Nova Scotia during the COVID-19 pandemic. The bulletin will be updated as new information becomes available. The direct link to the PDF can be found on the RCP website.

Postpartum Resource Needs Assessment - The Public Health Agency of Canada is looking to develop a new postpartum health resource for parents. If you work with pregnant women, postpartum families or parents of a newborn your help is requested to complete a short needs assessment using this link. This information will help in the development of the resource. The survey is open until November 8, 2020.

Please share the survey link with your colleagues/stakeholders who work with pregnant and postpartum families. Thank you for taking the time to help the Public Health Agency of Canada in the development of this important resource.

Canadian Perinatal Care Providers Survey: Assessing the Gaps in Canadian Perinatal Mental Health Services - This survey is being conducted by the Canadian Perinatal Mental Health Collaborative (CPMHC) to better understand gaps in perinatal mental health services for pregnant people and their partners. The research will develop an understanding of the services currently available and highlight where additional services are needed. Heath care practitioners who deal directly with perinatal mental health populations are asked to participate. To participate go to the CPMHC website.

Trial of Labour after Cesarean (TOLAC) Birth during the COVID-19 Pandemic – SOGC has developed a statement related to TOLAC birth during the pandemic. Key messages from the statement include:

That TOLAC is safe and the risk of uterine rupture is not increased by COVID-19 infection. While the risk of vertical transmission of COVID-19 is extremely low pregnant women should continue to minimize their exposure to COVID-19 by strictly adhering to preventive measures.
Pregnant women should be supported in their choice for TOLAC if there are no known contraindication to labour and vaginal birth.

Joint Statement Re: Epidurals and Autism - The Canadian Anesthesiologists’ Society (CAS) along with the Canadian Pediatric Anesthesia Society (CPAS), a sub-section of CAS, the Society of Obstetricians and Gynaecologists of Canada (SOGC), and the Canadian Paediatric Society (CPS) developed a joint statement in response to the findings of the study - “Association Between Epidural Analgesia During Labor and Risk of Autism Spectrum Disorders in Offspring,” published on October 12^th, 2020 in JAMA Pediatrics. The position statement identifies that a true relationship between epidural pain relief and autism spectrum disorder can not been ascertained due to multiple study limitations.

Updated Statement Re: Access to Contraception – SOGC has developed an updated statement regarding how Pandemic conditions have accelerated the need for universal subsidized and barrier-free access to contraception for all Canadians.

New Choosing Wisely Recommendations - SOGC has released 3 new Choosing Wisely recommendations in obstetrics and gynaecology. These three new recommendations are in addition to the previously released obstetrics and gynaecology list. The new recommendations include:

Don’t remove ovaries in premenopausal women without strong clinical indications.
Don’t do a caesarean delivery for the sole indication of failure of progress in labour in the latent phase of labour for a woman at term with a singleton fetus and cephalic presentation.
Don’t give antenatal corticosteroid therapy unless the pregnant woman meets the gestational age criteria and the risk of delivery within the next 7 days is very high.

See the full list of 12 Tests and Treatments to Question in Obstetrics and Gynaecology that includes rationales and references for each recommendation. Feel free to share broadly and thank you for your continued engagement in the Choosing Wisely Canada campaign.

Cannabis Update:

Research: Associations Between Prenatal Cannabis Exposure and Childhood Outcomes: Results From the ABCD Study - This cross-sectional analysis of 11 489 children (655 exposed to cannabis prenatally) found that prenatal cannabis exposure after maternal knowledge of pregnancy was associated with greater psychopathology during middle childhood, even after accounting for potentially confounding variables. When including potentially confounding covariates, exposure after maternal knowledge of pregnancy remained associated with greater PLEs and externalizing, attention, thought, and social problems. Exposure only prior to maternal knowledge of pregnancy did not differ from no exposure on any outcomes when considering potentially confounding variables. For the full artcile see here.

Cannabis Knowledge Hub - The Cannabis Knowledge Exchange Hub at the Centre for Addiction and Mental Health’s (CAMH) provides a credible source for cannabis information, including evidence-based information on the non-medical use of cannabis. CAMH is committed to ensuring that the information psoted to the hub is current, accurate and relevant. New resources will also be posted as it is released.

Recent Publications of Interest – Several publications have been recently released and are now available for your review. The titles with links have been provided below for your information and reading enjoyment:

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If you have any questions or comments, please contact the RCP office at rcp@iwk.nshealth.ca.

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