We understand that recent events regarding access to women’s healthcare may be causing concern.
We want to reassure you that we at Bedford Commons highly value and will continue to support patient autonomy, reproductive health, and the patient-clinician relationship.
We also want you to be reassured that at this time there are no changes or new limitations to access to reproductive health care in the state of New Hampshire.
We are pleased to share that due to low community transmission rates in our area, we are no longer restricting visitors to our office. Like always, children accompanying you to your visits need to be supervised at all times. In addition, for ultrasound visits, we have space only to accommodate one adult visitor in addition to the patient. We look forward to seeing you!
We continue to follow CDC and NH state guidance regarding COVID-19 precautions. Bedford Commons OBGYN continues to require masks for all patients and team members. If you have any questions or concerns, please reach out to our office.
With rising COVID19 cases in New Hampshire, we are getting calls daily from our patients reporting a positive COVID-19 test. We are here to support you with the latest information about pregnancy and COVID19. We know that you are worried and have lot’s of questions. We are updating this information as new guidance becomes available.
If you think you may have symptoms of COVID19, you should be tested. Symptoms include: cough, fever, shortness of breath, headache, cold-like symptoms, sore throat, or loss or change to your sense of smell or taste. There are many options for testing including at-home test kits (only should be done if you are symptomatic), state test sites, and pharmacies. For a full list of testing sites, click here. New Hampshire is also offering free COVID19 test kits. To get your test kit, follow this link.
If you test positive for COVID-19, please call us during office hours at 603-668-8400 to let us know. For the safety of our patients and team members, your next visit will be scheduled at least 10 days from the date of your positive test. We are also happy to convert your scheduled visit to a telehealth visit to check-in with you. You should isolate from others and stay at home for 10 days. If you live with unvaccinated family members, try to isolate yourself from them. If you are unable to isolate yourself, those family members also need to quarantine – they will need to quarantine for 20 days. If you do need to leave your house for medical care, please be sure to wear a mask and call your healthcare provider before you arrive to notify them of your positive COVID-19 test result.
Most cases of COVID-19 are mild and can be managed at home with getting plenty of fluids and rest, as well as using medication to reduce a fever. It is safe to treat a fever in pregnancy with Tylenol (Acetaminophen) 1000mg every eight hours. In addition, make sure you’re staying hydrated by drinking a lot of water. If you are fully vaccinated for COVID-19, your risk of severe illness is significantly less than those who are not vaccinated.
Primary care providers are well versed in the symptoms of COVID-19 and recommendations for treatment. We would encourage you to reach out to your primary care provider for additional recommendations. Because pregnancy is considered to be a high risk condition for COVID-19, your primary care provider may recommend that you receive monoclonal antibodies. Monoclonal antibody treatments are recommended by the Centers for Disease Control (CDC) and the American College of Obstetricians and Gynecologists (ACOG) for treatment of pregnant people with mild to moderate COVID-19 who are at risk for complications from COVID-19. There is a limited supply of monoclonal antibodies so we are relying on insight from your primary care provider as to whether you should receive monoclonal antibodies based on your symptoms. Although monoclonal antibodies have not been specifically evaluated in pregnancy, preliminary data suggests that monoclonal antibody treatment is safe in pregnancy. Orders for monoclonal antibodies need to come from your primary care provider.
If you feel like your symptoms are worsening, please reach out to your primary care provider for additional recommendations. Watch for emergency warning signs for COVID-19 which may indicate more severe illness including difficulty breathing, confusion, persistent pain or pressure in the chest, or pale, gray, or blue-colored skin, lips or nail beds. If you have any of these signs, seek emergency medical care immediately.
According to the data available from the CDC and ACOG, people with COVID-19 during pregnancy are more likely to experience preterm birth (delivering the baby earlier than 37 weeks) and stillbirth and might be more likely to have other pregnancy complications compared to people without COVID-19 during pregnancy. Unfortunately, there are not any specific ways to prevent these risks once someone tests positive for COVID-19 other than monitoring for symptoms. Due to a risk of pre-eclampsia (high blood pressures in pregnancy), if you are less than 28 weeks pregnant, you should begin taking low dose aspirin (81mg) daily starting at 12 weeks of pregnancy, if you have not already been instructed to take aspirin. If you’re more than 28 weeks pregnant, you do not need to start aspirin. If you’ve already been on it, continue taking your aspirin until you deliver.
If you were hospitalized with COVID-19, we will schedule non-stress tests to monitor your baby’s well-being twice weekly starting at 32 weeks (and at least 14 days after you were diagnosed with COVID-19) and an ultrasound to check your baby’s growth. Please reach out to our office with any symptoms of preterm labor which include: Regular, frequent contractions or tightening of your belly, leaking fluid like your water might have broke, worsening lower back pain, and a sensation of significant lower pelvic pressure.
If you have not already received your COVID-19 vaccine or booster, once you are feeling better and it’s been at least 14 days since you were diagnosed with COVID-19, please get vaccinated. Even if you have already had COVID-19, vaccination is still the best way to protect you and your baby.
We hope you feel better soon. Again, please be sure to seek emergency medical help if you are having any severe symptoms of COVID-19.
For more information, please visit: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html
Travel During Pregnancy
In most cases, pregnant women can travel safely until close to their due dates. Please discuss your travel plans with your OB-GYN for specific recommendations. Some considerations:
COVID
Delay travel until you are fully vaccinated. If you are not fully vaccinated and must travel, follow the CDC guidelines at www.cdc.gov.
Risk of Blood Clots
DVT (deep venous thrombosis) is a condition in which a blood clot forms in the veins, usually in the leg. DVT can lead to a dangerous condition called pulmonary embolism. This is when a blood clot travels to the lungs. Research shows that any type of travel lasting 4 hours or more—whether by car, train, bus, or plane—doubles the risk of DVT. Being pregnant is an extra risk factor for DVT. If you are planning a long trip, take the following steps to reduce your risk of DVT:
Travel by Plane
Zika
As COVID-19 continues to be a concern in the United States, we want to remind our patients what we are doing to make sure you have a safe experience in our office. We have received very positive feedback from our patients who have been to our office recently and we continue to make changes regularly.
Here is a little about what we are doing:
Our goal as a practice is to continue to provide you with exceptional care while keeping you safe. We are all in this together.
For our OB patients and families:
Bedford Commons OB-GYN has adopted an alternative schedule for obstetric visits in our office based off guidance from the American College of Obstetricians and Gynecologists (ACOG) to limit your exposure risk to COVID-19. Instead of seeing our obstetric patients every four weeks through the end of the second trimester, most visits were scheduled 6-8 weeks apart. Starting in the third trimester, we were seeing our patients every 2-4 weeks depending on risk factors.
As we have watched the COVID-19 pandemic unfold, it is clear that we will be coexisting with COVID-19 for the months ahead. Several of our patients have asked if we will be continuing the alternative schedule for obstetric care or if we will resume the “normal” frequency of visits. For at least the next few months, we plan on continuing to see our OB patients at a more spaced out interval. Here’s what a typical visit schedule might look like:
At Bedford Commons OB-GYN, we believe that every woman is an individual. It’s important to us that you feel comfortable and confident in the care you are receiving. Although we feel that it is safe to continue more spaced out OB visits, we know that some of our patients would feel more reassured seeing us a little more often. If you would like to see us more frequently, just let us know at your visit. Additionally, some of our patients have risk factors or concerns that may necessitate additional visits. We will let you know if we need to see you more often.
As of January 3, 2022, one adult visitor may accompany you to your ultrasounds; visitors will not be permitted at office visits. We know what an important journey pregnancy is for an expecting family but for the safety of all of our patients, we can only permit one visitor at ultrasound visits only. We hope to again return to having visitors for routine visits but need to see a reduction in COVID-19 positive cases in NH.
Some of our patients have also been asking about the safety of the COVID-19 vaccine in pregnancy. We strongly encourage all of our patients to receive the COVID-19 vaccine, especially those who are pregnant. Pregnancy significantly increases the risks associated with COVID-19 illness and vaccination is the best way to protect you and your baby. Click here for more information.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.
Disclaimer
This Good Faith Estimate shows the costs of items and services that are
reasonably expected for your health care needs for an item or service. The
estimate is based on information known at the time the estimate was created.
The Good Faith Estimate does not include any unknown or unexpected costs
that may arise during treatment. You could be charged more if complications or
special circumstances occur. If this happens, federal law allows you to dispute
(appeal) the bill.
If you are billed for more than this Good Faith Estimate, you have
the right to dispute the bill.
You may contact the health care provider or facility listed to let them know the
billed charges are higher than the Good Faith Estimate. You can ask them to
update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask
if there is financial assistance available.
You may also start a dispute resolution process with the U.S. Department of
Health and Human Services (HHS). If you choose to use the dispute resolution
process, you must start the dispute process within 120 calendar days (about 4
months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your
dispute agrees with you, you will have to pay the price on this Good Faith
Estimate. If the agency disagrees with you and agrees with the health care
provider or facility, you will have to pay the higher amount.
To learn more and get a form to start the process, go to
www.cms.gov/nosurprises/consumers or call 1-800-985-3059.
For questions or more information about your right to a Good Faith Estimate
or the dispute process, visit www.cms.gov/nosurprises/consumers or call
1-800-985-3059.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 515-223-5466 to request a Good Faith Estimate.
As you probably are aware, we are seeing a dramatic surge in COVID-19 cases. After two years of providing healthcare in this new environment, many of us are exhausted; we are sure you are exhausted too.
This is our special request – please get vaccinated.
With the rising COVID-19 cases in New Hampshire, we unfortunately have seen some of the sad outcomes that can occur with COVID-19. We have witnessed firsthand the devastating effects of severe COVID-19 in pregnancy, seeing our patients hospitalized, some required ICU care, long term oxygen supplementation, and all of whom were in fear of harm to their baby. Compared to those who aren’t pregnant, pregnant women infected by COVID-19 with symptoms are 3 times more likely to need ICU care, 2 to 3 times more likely to need advanced life support and have a 70% increased risk of death. Severe COVID-19 can also cause issues for babies including a 60% increased risk of very premature birth, extended stays in the neonatal ICU, and risk of stillbirth. All major medical organizations and we, your doctors, feel that COVID-19 vaccination in pregnancy is very safe and critically important because pregnancy is considered a high-risk condition for severe illness with COVID-19.
If you’re pregnant, get vaccinated as soon as possible. We get calls daily from unvaccinated pregnant women who recently tested positive for COVID-19, asking us how they can prevent complications from COVID-19. Unfortunately, there really isn’t anything that can be done once someone has COVID-19 other than monitor symptoms and treat a fever. The only way to prevent complications from COVID-19 is vaccination.
If you’re not pregnant, make sure you get a COVID-19 vaccine and talk to friends and family members who are pregnant and encourage them to get vaccinated. If you’re already vaccinated, thank you. Be sure to also get your booster dose.
We know that everyone is really tired of this. Please do your part and get vaccinated.
We care deeply about you so please, let’s work together to keep each other safe.
The short answer is YES. As of November 29th, 2021, the U.S. Centers for Disease Control and Prevention (CDC) recommends that everyone ages 18 and older should get a booster dose.
If you received Pfizer-BioNTech or Moderna vaccines: You should get a booster at least 6 months after completing your primary COVID-19 vaccination series.
If you received the Janssen (J&J) vaccine: You should get a booster 2 months after completing your primary COVID-19 vaccination.
Which booster should you get?
You may choose which COVID-19 vaccine you receive as a booster shot. Some people may prefer the vaccine type that they originally received, and others may prefer to get a different booster. CDC’s recommendations now allow for this type of mix and max dosing for booster shots.
For any adults 18 years old or older who completed their primary Pfizer-BioNTech or Moderna vaccine series at least 6 months ago OR received the Janssen (J&J) vaccine at least 2 months ago, a booster dose of the COVID-19 vaccine is recommened.
Where can I get a booster? Although we are not giving COVID19 boosters at Bedford Commons OBGYN, if you are eligible for a booster dose, you can schedule an appointment at any retail pharmacy or can inquire about an additional dose through your primary care provider office. Find a vaccine location by clicking here: https://www.vaccines.gov/. If you haven’t gotten a flu shot this year, consider getting the flu vaccination along with your COVID19 booster. Both can be given on the same day.
What about boosters in pregnancy? We strongly recommend that our pregnant patients receive the COVID-19 vaccine and also strongly recommend the COVID-19 booster for our pregnant patients who qualify. For more information about the COVID19 vaccine and pregnancy, click here.