As the COVID-19 outbreak lingers, U.S. hospitals are imposing visitor limitations in maternity wards. Pregnant women everywhere are bracing themselves.
Healthcare systems are trying to curb transmission of the new coronavirus by restricting nonessential visitors, despite support people being crucial to a woman’s health and well-being during and immediately following childbirth.
NewYork-Presbyterian hospitals briefly suspended all visitors, leading some women to worry whether prohibiting support people during labor and delivery will become a widespread practice.
Fortunately on March 28, New York Governor Andrew Cuomo signed an executive order requiring statewide hospitals to allow a woman to have a partner present in the labor and delivery room.
While this guarantees New York women have that right for now, other states have not yet made the same guarantee. For women with a partner, a doula, and others planning to support her, difficult decisions may need to be made.
During my first labor and delivery, I was induced due to preeclampsia, a potentially fatal pregnancy complication characterized by high blood pressure.
Because I had severe preeclampsia, my doctors gave me a drug called magnesium sulfate during my delivery and for 24 hours after my daughter was born. The drug left me feeling extremely disoriented and groggy.
Feeling ill already, I spent a really long time pushing my daughter into the world and was not in the mental state to make any type of decision for myself. Fortunately, my husband was present as well as an extremely kindhearted nurse.
The connection I formed with that nurse turned out to be my saving grace. She came back to visit me on her day off while a doctor I had never met was getting ready to discharge me, even though I still felt very sick.
The nurse took one look at me and said, “Oh no, honey, you’re not going home today.” She immediately hunted down the doctor and told them to keep me in the hospital.
Within an hour of this happening, I collapsed while trying to use the bathroom. A vitals check showed my blood pressure had skyrocketed again, prompting another round of magnesium sulfate. I credit that nurse who advocated on my behalf for saving me from something much worse.
My second delivery involved another set of extreme circumstances. I was pregnant with monochorionic/diamniotic (mono/di) twins, a type of identical twins that share a placenta but not an amniotic sac.
At my 32-week ultrasound, we found out that Baby A had passed away and Baby B was at risk of complications related to his twin’s death. When I went into labor at 32 weeks and 5 days, I delivered via emergency C-section. The doctors barely showed me my son before he was whisked away to neonatal intensive care.
When I met my son’s brisk, cold doctor, it was clear she lacked compassion for our difficult set of circumstances. She espoused a very specific infant care ideology: do what was best for the baby no matter the opinions and needs of anyone else in the family. She made that very clear when we told her we were planning to formula-feed our son.
It didn’t matter to the doctor that I needed to start taking a medication necessary for a kidney condition which is contraindicated for breastfeeding, or that I never made milk after my daughter’s birth. The neonatologist stayed in my hospital room while I was still coming out of the anesthesia and berated me, telling me my remaining son was in grave danger if we formula-fed him.
She kept going despite the fact I was sobbing openly and asking her repeatedly to stop. Despite my requests for time to think and for her to leave, she would not. My husband had to step in and ask her to go. Only then did she leave my room in a huff.
While I understand the doctor’s concern that breast milk provides much needed nutrients and protections for preemie babies, breastfeeding would have also delayed my ability to manage my kidney issue. We can’t provide for babies while ignoring the mother — both patients deserve care and consideration.
Had my husband not been present, I get the feeling the doctor would have stayed despite my protests. Had she stayed, I don’t even want to think about the effects she would have had on my mental and physical health.
Her verbal assault tipped me over the edge toward developing postpartum depression and anxiety. Had she convinced me to attempt to breastfeed, I would have stayed off medication needed to manage a kidney disease longer, which could have had physical consequences for me.
My stories are not outliers; many women experience difficult birth scenarios. Having a partner, family member, or doula present during labor to provide comfort and advocate for the mother’s health and well-being can often prevent unnecessary trauma and make labor run more smoothly.
Unfortunately, the current public health crisis posed by COVID-19 may make this an impossibility for some. Even still, there are ways to make sure moms have the support they need when in labor.
I’ve spoken to expectant moms and a perinatal mental health specialist to find out how you can prepare yourself for a hospital stay that may look very different from what you had been expecting due. These tips can help you prepare:
Consider other ways to get support
While you might be planning on having your husband and your mom or your best friend with you while you labor, know that hospitals across the country have changed their policies and are limiting visitors.
As expectant mom Jennie Rice says, “We are now only allowed one support person in the room. The hospital allows five normally. Additional children, family and friends are not allowed in the hospital. I’m concerned that the hospital will once again change restrictions and I will no longer be allowed that one support person, my husband, in the labor room with me.”
Cara Koslow, MS, a licensed professional counselor from Scranton, Pennsylvania, who’s certified in perinatal mental health says, “I encourage women to consider other alternatives of support for labor and delivery. Virtual support and video conferencing might be good alternatives. Having family members write letters or give you mementos to take to the hospital may also be a way to help you feel closer to them during labor and postpartum.”
Have flexible expectations
Koslow says if you’re struggling with anxiety over giving birth in light of COVID-19 and the changing restrictions, it can help to think through a few possible labor scenarios prior to birth. Considering a couple different ways your birth experience may play out can help you set realistic expectations for the big day.
With everything changing so much right now, Koslow says, “Don’t focus so much on, ‘This is exactly how I want it to go,’ but focus more on, ‘This is what I need.’”
Letting go of certain wants prior to birth can help temper your expectations. This means you may have to give up the idea of having your partner, a birth photographer, and your friend as part of your delivery. However, you can prioritize your partner seeing the birth in person and connecting to others via a video call.
Communicate with providers
Part of being prepared is staying informed about your provider’s current policies. Pregnant mom Jennie Rice has been calling her hospital daily to stay up to date on any changes being made in the maternity unit. In the rapidly evolving healthcare situation, many offices and hospitals have been changing procedures quickly. Communicating with your doctor’s office and your hospital can help your expectations stay current.
Additionally, having an open and honest conversation with your doctor can help. While your doctor may not have all the answers in this unprecedented time, voicing any concerns you may have over potential changes before your system will allow you the time to communicate before you are giving birth.
Make connections with the nurses
Koslow says seeking connection with your labor and delivery nurse is so important for women who will be giving birth in the time of COVID-19. Koslow says, “Nurses are really on the front line in the delivery room and can help advocate for a laboring mom.”
My own experience supports Koslow’s statement. Making a connection with my labor and delivery nurse prevented me from falling through the cracks of my hospital system.
To make a good connection, labor and delivery nurse Jillian S. suggests that a laboring mom can help foster connection by putting her trust in her nurse. “Let the nurse [me] help you. Be open to what I am saying. Listen to what I’m saying. Do what I’m asking you to do.”
Be ready to advocate for yourself
Koslow also suggests moms to get comfortable advocating for themselves. With fewer people on hand to support a new mom, you should be ready and able to voice your concerns.
According to Koslow, “A lot of women feel like they aren’t able to be their own advocate. Doctors and nurses are more in the power situation in labor and delivery since they see birth every day. Women don’t know what to expect and don’t realize they have the right to speak up, but they do. Even if you don’t feel like you are being heard, keep speaking up and expressing what you need until you are heard. The squeaky wheel gets oil.”
Remember these policies are keeping you and baby safe
Some expectant mothers actually find relief in the new policy changes. As expectant mom Michele M. says, “I’m happy they won’t be letting everyone into the hospitals given that not everyone is following social distancing guidelines well. It makes me feel a bit safer going into delivery.”
Feeling as if you are working towards safeguarding your health and the health of your baby by abiding by policies can help you feel more in control in this uncertain time.
Don’t be afraid to ask for help
If you find yourself increasingly or unmanageably anxious or fearful prior to birth due to COVID-19, it’s OK to ask for help. Koslow recommends talking to a therapist to help you manage your anxiety. She specifically suggests looking for a therapist certified for perinatal mental health.
Pregnant women seeking extra support can turn to Postpartum Support International for a list of therapists with experience in perinatal mental healthcare and other resources.
This is a rapidly evolving situation. Koslow says, “Right now, we just have to take things day by day. We need to remember what we have control over right now and focus on that.”
Jenna Fletcher is a freelance writer and content creator. She writes extensively about health and wellness, parenting, and lifestyles. In a past life, Jenna worked as certified personal trainer, Pilates and group fitness instructor, and dance teacher. She holds a bachelor’s degree from Muhlenberg College.