Standard Precautions for Homebirth Midwives
Standard Precautions assumes that all blood & body fluids are potiential sources for infections regardless of the status of the source individual. As midwives, we do not like the idea of treating all women as potentially diseased objects; however, as health care providers, we are aware of the prevalence of Hepatitis B (HBV), HIV and other blood born pathogens. One reason some families choose to deliver outside of the hospital is to avoid the sterile atmosphere that can interfere from the sense that birth is a normal, natural event. A midwife can use Standard Precautions without compromising the family comfort and choices for their birth.
While many practices routinely screen for HBV and HIV, do not let a negative test reading lull you into a false sense of security. It takes time from exposure to show positive on tests. That is why it is important to avoid direct contact with all body fluids. At homebirths it is difficult to avoid contact with blood or body products. Midwives sit on women's beds to deliver the babies, women bleed on us; their water breaks in our faces; we hold the bowl while they vomit. However there are some simple things you can do at home to minimize your risks:
1. Always Wear Gloves. In addition to the birth and direct contact client contact, use gloves when cleaning up postpartum, doing laundry, washing instruments, examining the placenta, and whenever changing chux or peri pads. Wash hands before and after gloves are removed.
2. Wear Protective Eyewear. Antisplash goggles are best, or regular glasses. If you don't need glasses, buy ones with clear lenses. They can protect your eyes from splashing blood, as well as from unexpected water bag breaks.
3. Wear Protectiving Clothing. Disposal plastic aprons can be ordered in your birth kits, or wear a heavy birthing apron over your clothes for births, doing laundry or whenever you may be exposed with a spraying or droplets of body fluids.
4. Be Careful with Sharps. To prevent injuries caused by needles, or other sharp instruments or devices during procedures; when cleaning used instruments; during disposal of used needles; and when handling sharp instruments after procedures. To prevent needlestick injuries, needles should not be recapped, purposely bent or broken by hand, removed from disposable syringes, or otherwise manipulated by hand. Disposable syringes and needles, scalpel blades, and other sharp items should be placed in puncture-resistant containers for disposal after use; the puncture-resistant containers should be located as close as practical to the use area.
5. Practice Proper Handling of Laboratory Specimens. Asssume all blood and body fluids are infectious.
6. If contaminated with blood or other body fluids: hands and other skin surfaces should be washed immediately with a disinfectant soap and warm water. Hands should be washed immediately after gloves are removed.
7. Dispose Properly of BioHazards. Placentas, or chux pads that drip any body fluids are considered biohazards: learn your local regulations for proper disposal.
adapted from CDC guidelines by Daphne Singingtree, CPM
Free to copy and reproduce if credited.