Pregnancy in the age of coronavirus
The new coronavirus is causing major concern around the world, including in the U.S., where there are more than 890,000 cases confirmed, according to Johns Hopkins University. (Keep in mind that these numbers were accurate at the time this article was written.)
According to studies, for as much as 80% of the population, the symptoms should be mild, but its effects seem to be particularly more aggressive in the elderly and immunocompromised, which is a group that could include pregnant women. (Even though there are no signs yet that this is the case.)
The thought of labor and delivery can be stressful enough during pregnancy in normal conditions (especially if it’s your first child). In this age of coronavirus, however, future mothers have an extra layer of uncertainty and concern. Pregnant women have no idea how the virus might affect the health of the fetus to potentially having to give birth alone. Two major hospital systems in New York City, which is known as the epicenter of COVID-19, initially had policies that prohibited spouses and birth partners to get into the delivery room, and even hospital, in some cases.
However, these policies were soon reversed in an executive order by New York Governor Andrew Cuomo.
Unfortunately, not much information is yet known about how coronavirus affects pregnancy. We’ve talked to pregnant women and asked them to share their hopes and fears regarding giving birth in this age of COVID-19, and what it feels like being pregnant during the coronavirus pandemic.
For coronavirus, “the effects are still unknown in the first trimester, regarding birth defects, but there hasn’t been a large increase seen in miscarriages, though data is sparse,” says Felice Gersh, MD, ob/GYN, founder/director of the Integrative Medical Group of Irvine, in California and author of PCOS SOS Fertility Fast Track. “Later in the pregnancy, there may be heightened risks for preterm delivery, growth restriction, placental abruptions, and more C-sections.”
“No infants born to mothers with COVID-19 have tested positive for the COVID-19 virus,” according to the Centers for Disease Control and Prevention (CDC). “In these cases, which are a small number, the virus was not found in samples of amniotic fluid or breastmilk.”
“Hospitals around the country are implementing changes in response to the COVID-19 pandemic,” says Diana Spalding, certified nurse-midwife, pediatric nurse, and author of forthcoming The Motherly Guide to Becoming Mama. “The most profound is likely the change to support teams, but other possible changes might be more extensive questioning upon admission to assess individual risk, and people wearing masks and [personal protective equipment] PPE.”
Additionally, any hospitals around the world are now only allowing one support person in the room, with no other visitors, while some women are even delivering their babies wearing masks or having unplanned C-sections, with their birth plans out the window.
“Paying attention to the mental health of new mothers is essential—new moms are vulnerable as it is, but this pandemic makes them even more so,” says Spalding. “This feels like such an isolating experience to go through, but new mothers need to know they are so deeply held, and not alone.”
So much is changing every day
“This is a nightmare and I can’t imagine a worse time to be pregnant,” confesses Lauren Wellbank, a mother of two who is 39 weeks pregnant. “Everything is so unprecedented, and things are changing every day, I feel like I can’t catch my breath. I feel like I’m in a suspended state of horror because every time I turn around something else crazy is happening.”
Wellbank explains that her doctors will take temperatures every six hours for the duration of her stay at the hospital. “If they become elevated at any time, they may separate us from the baby.”
“I’m actually less worried about catching the virus than I am about something happening because the hospital is short-staffed or because their new policies and procedures are reactionary instead of being well thought out,” she says. “I heard a story last night about a new mom in north Jersey having her baby taken away from her because she experienced an unexpected uterine rupture and they were afraid that was a sign that she had COVID-19. I simply cannot imagine someone taking my newborn from me during such a crucial time.”
“My birth plan has sprouted wings and flown out the nearest window. Absolutely nothing looks the way it did two months ago when I filled it out. The only thing that is still the same is that I’d like to avoid an epidural. At this point that has more to do with not wanting extra people in the delivery room with me and less to do with my original concerns that stem from prior bad experience.”
Still, she’s still very optimistic. “I’m still very hopeful that things won’t be as bad as I’m afraid they will be. Childbirth, no matter how many times you’ve done it, is unpredictable. Even without a pandemic, there would be things for me to stress about. I’m way less worried about how much pain I’ll be in and more worried about everything else that is happening.”
She is also grateful for her OB/GYN. “I would be remiss if I didn’t mention how great my OB and her staff have been. I was having a panic attack in the exam room today while I was waiting for her to come in and talk to me about an induction (they are currently asking all their patients to schedule an induction as soon as is reasonable to avoid having people deliver during our estimated “peak”). I was literally in tears by the time she walked in and by the time we finished the exam I felt a million times better. I now feel more confident in my choice to continue with a hospital birth.”
All women are now hoping that their partner can be there during delivery
“There’s a lot going through my mind experiencing all of this,” says 30 weeks pregnant Lisa Kullman, mother to a 3-year-old girl. “We struggled for three years to get pregnant with our daughter and ended up doing IVF. I always said if we can get through that, we could get through anything: being pregnant and giving birth was nothing compared to struggling to get pregnant and the IVF process. This pandemic is really testing that statement.”
As her baby’s birth approaches and coronavirus cases continue to spread, Lisa has now realized the pandemic will affect her delivery. “At first, I think I assumed that the pandemic would be ‘over’ by the time I needed to start preparing for our second child. That this was not going to be something that even affected this pregnancy at all. Things we took for granted with our daughter, like being able to run to the store or ordering whatever we needed online and having it be available, are proving to be very different this time. Just today I looked at diapers on Amazon and the delivery date was in May!”
She’s trying to stay calm, but it’s difficult. “I keep saying to myself ‘you still have 10 weeks.’ I went to my OB appointment today and everyone was wearing masks and the reality of the situation hit me like a ton of bricks. I knew in my head the doctor would be wearing a mask but experiencing the appointment like that really affected me. I got into my car and cried. I thought about how that could be how it is when I got to the hospital when I give birth, everyone in masks, maybe even me. Not allowed to leave my room…it’s scary.”
The biggest fear that most women have, is that her partner might not be allowed into the delivery room. “This is my biggest anxiety about giving birth, not having my husband with me. He was my advocate during the birth of my daughter. I had some complications after giving birth that I needed him there for so that idea of him not being there is terrifying.”
Moreover, Kullman still has her sense of humor and tries to make the best out of this situation. “My husband keeps reminding me that I’m pretty lucky to be spending my third trimester working from home wearing comfortable clothes. I’m saving money on maternity clothes that’s for sure! I’m also trying to enjoy the massive increase in family time while it’s just the 3 of us: my husband, daughter, and me. I have more time to prepare for our baby’s arrival not commuting to the office daily, so all of that are some silver linings.”
Looking forward to a source of joy in dark times
“I did not choose or plan to be pregnant during a once-in-a-century global pandemic,” says 36-weeks-pregnant Natalie Aldern Kennedy, mother of one child. “I feel that the health crisis has added yet another layer of uncertainty to pregnancy. This makes me more anxious than I otherwise would be: having one more, very big, thing to worry about.”
Kennedy is not as worried about labor itself, considering that she has been through it previously with her older son, but she is definitely nervous that her husband won’t be allowed into the delivery room. “This is my main worry. As of right now, partners are allowed in the delivery room, but not allowed in other parts of the hospital. However, because of the current rules in place at the national level, we don’t have childcare for our two-year-old so there is a good chance my husband will have to stay home with him, even if partners are allowed. I expected that my husband would be with me, and I assumed that I would be able to request an epidural if I wanted. Both of those things are now up in the air because of hospital rules on visitors/partners, as well as the canceling of ‘non-essential’ appointments, which I would need to be pre-approved for the epidural.”
She also said that her hospital is small and specializes in maternity and non-infectious diseases, so she’s not worried about coronavirus patients being there. “I am more concerned that despite our best efforts, my newborn may be exposed at some point. There is so little known about how the virus impacts children this young.”
If finds comfort in the future. “The baby is a great source of hope herself. While we are anxious about the future that awaits her, we cannot wait to meet her. We feel continuously worn down by the bad news and the tragedies that other families are grappling with, but we hope that this new life can be a source of joy for others as well as we face these dark times.”
Being extra vigilant about social distancing
“Being pregnant has made the pandemic a lot scarier,” says Whitney Sandoval, 36 weeks pregnant with her second pregnancy and third child. “Although so far, most of the information coming out about women who are pregnant and babies being born is positive, there isn’t clear information on the ramifications of catching COVID-19 while pregnant.”
She fears to catch the virus, for a variety of reasons. “I’m worried about what it would mean if I caught it in terms of my family and the birth experience. I have two toddlers and can’t imagine having to isolate from them for two weeks. If I caught the virus, I would have to birth without my partner. I haven’t allowed myself to look at what happens after delivery if the mother is positive for COVID-19 when she delivers. Would I still get to see my baby? Would I have to be quarantined from him too? My biggest anxiety is that I’ll contract COVID-19 within a two-week window of my delivery.” (If you’re worried about infecting your family, here’s how you can stop the spread of coronavirus at home.)
“This week, I sat down and made a series of birth plans to be mentally prepared if I get COVID-19, if someone in my family gets COVID-19, if we get transferred to a hospital, and if my husband can’t be in the delivery room.” Both Sandoval and her husband have been strictly social distancing for more than two weeks and plan to keep it up. “We’re hopeful neither of us nor our children will get COVID-19 and we won’t have to worry about who in our family can and cannot be there. I am hopeful nothing too crazy will change in the next four weeks.”
“My pregnancy anxiety has been pretty high, and the pandemic is only increasing it. But, I have been trying really hard to focus on the positives,” Sandoval says, trying to stay upbeat.
More time to focus on the baby’s arrival
“My first child arrived at 36 weeks and I’m considered high risk for going early again, so I’m being monitored pretty closely,” explains Kate Wehr, 30 weeks pregnant with four children. “With this virus, I did suggest a home birth the other night—there have been several in our families—but my husband isn’t on board with that idea at all. Since we had complications last time, that’s understandable.”
Wehr is aware of the possibility of being alone during labor and delivery or postpartum. “I’m concerned they won’t allow my partner in the room or my children to visit after. I just saw an article saying the CDC is recommending separating newborns from their mothers as a precautionary measure. That’s horrible! I can’t see supporting that in a non-life threatening situation.” (The CDC recommends considering a temporary separation if the mother has COVID-19 but the decision is made on a case-by-case basis and is meant to protect the baby from infection.) And while Wehr knows pregnancy lowers the immune system, she’s most worried about those around her catching the virus. “The thought of my family or baby getting sick worries me more.”
“I’m hoping quarantine will be lifted before I’m due, and that we’ll be able to make it close to our due date this time. I have four older children, so we really can’t be without childcare when the baby comes. Eventually, we’ll all have to go back to work, too. But we are in a much better position to handle this than most. My heart goes out to all the moms who just had their babies or will in the next few weeks. I at least have some hope that the worst of this will have blown over before it’s our turn.”
Due to a shelter-in-place in order in Montana, she is home with four children out of school. “It’s certainly disrupting our normal schedules, but having all the usual extracurriculars and commitments canceled also frees us up to focus on family time and on getting our household more prepared for the new baby.” As a result, Wehr and her husband are making the most of sheltering. “We’re trying to use this period to adjust our priorities as a family and take advantage of the opportunity to declutter our home and minds. This is unexpected downtime to rearrange the nursery, deal with a paperwork backlog, prep freezer meals, deep clean—all of those things that expectant families find themselves rushing to address in the last trimester.”
Planning for a home birth and happy about it
“Right now I’m trying to stay as calm as possible and maintain as much normalcy as I can for my two kids, but we haven’t left the house in several weeks and it’s really disappointing not to be able to spend time with friends or relax and enjoy the baby kicks without fears about what’s to come,” says Julia Pelly, 21 weeks pregnant with two children.
She is very worried about getting infected by the virus. “With my previous births, I was most concerned with avoiding intervention and having healthy, happy babies. Now I’m worried about being ill at the time of my birth and separated from my newborn. I’m also worried about getting sick before she’s due and having to be hospitalized or going into early labor.” (Psst, here’s the truth about giving birth that no one tells you.)
She has her fears. “I am very worried that he or my kids might be sick and we would have to make the difficult choice for them not to be present. I am so worried about catching coronavirus that my children and I have not left the house in weeks and my husband has only left to go to the grocery store. I’ve heard that it can be associated with early labor and that really scares me.”
“We’ve been planning a home birth since I became pregnant, but now I’m extra glad that I won’t be going to the hospital! I am sticking by my plan to birth at home with my husband, my midwife, and my children. Homebirth is safe and knowing that I’ll avoid the hospital when they might have active cases of coronavirus is one of my primary comforts with this plan. I’m finding that I’m counting the days and really looking forward to getting my girl here but I’m also glad she’s safe and sound inside for now!”