Birth at the Beginning of the Pandemic
Late March 2020 was a frightening time to have a baby in New York City. Rates of COVID-19 were beginning to rise in a horrifying crescendo, and area hospitals had just announced that, in order to slow coronavirus spread, mothers would deliver their babies alone, without a partner.
For Lindsay Schoenfeld, this was distressing news. Schoenfeld, 36, had stopped working at her job in corporate finance in order to care for her 3-year-old as she approached the very end of her pregnancy; her babysitter could no longer come to work because of the city’s shelter-in-place order.
When her obstetrician suggested she be induced on her due date, March 23 — the first day of no-partner births — Schoenfeld felt a sense of grim resignation.
In the labor and delivery room, she was aware that the hospital staff were under tremendous stress, even as they went out of their way to make her feel supported. She had been tested for COVID-19 on admission, but the result (negative) wouldn’t be known until late the following day, so she suspected the staff was worried she was infected.
She tried to breathe deep through a mask and face shield while her contractions came fast and hard. She FaceTimed her husband. “I could hear in his voice that he was so demoralized,” she remembers. “He didn’t know how to help me.” As her son was born, her husband watched on his cell phone, snapping a screenshot as Schoenfeld cut the umbilical cord.
She knows she was lucky, but it’s hard for her to look at that picture now.
Since that day early in the lockdown, the impact of COVID-19 on pregnancy and birth has not so much improved as stabilized. Most hospitals now allow at least one support person for someone in labor who has tested negative for COVID-19, and some allow a partner during ultrasounds. But in many hospitals, pregnant people who have tested positive cannot bring a partner for prenatal care or for the birth.
Other precautions now in widespread use to prevent the spread of the coronavirus during pregnancy and childbirth include increased reliance on telehealth for prenatal care as well as new hospital protocols that include rapid COVID-19 testing upon admission, universal masking, and physical distancing of patients from each other.
Changes to standard care and visitation policies vary from region to region and hospital to hospital. That’s in line with the official guidance from the American College of Obstetricians and Gynecologists, which suggests certain pandemic-aware modifications for prenatal and birthing care, but notes that specific decisions should be made by individual facilities on the basis of the local infection rate and the resources and space the facility has available.
Birth With a COVID-19 Diagnosis
Some parents have found creative ways to work within these new COVID-19 restrictions. Beth Browning, 26, a real estate agent and bartender from Grapevine, Texas, was shocked to discover that both she and her boyfriend tested positive for COVID-19 shortly before she was induced, on June 19. Both felt like they had minor allergies, nothing more. Browning’s boyfriend manages a restaurant; they believe he was exposed at work, but going without a paycheck wasn’t an option.
The diagnosis meant that Browning’s boyfriend couldn’t be present for the birth of his child — at least, not inside the hospital. He and her 7-year-old daughter from a previous relationship put on masks and set up lawn chairs outside the window of her first-floor labor and delivery room. They opened the window a crack to pass snacks back and forth while Browning was in labor and the whole family was together, in a way, when their baby boy was born.
Throughout her stay, Browning was cared for in a single room with the door closed — common hospital protocol for mothers with COVID-19. Healthcare workers clad in PPE (personal protective equipment) entered only when necessary.
Browning’s biggest worry was that her baby might be taken away from her until she tested negative. But her obstetrician reassured her that this practice is no longer considered necessary or beneficial; mothers can choose to have their babies cared for in the nursery for the duration of the hospital stay, but that is of limited use if the mother and baby will be going home together in a day or so.
Instead, Browning’s obstetrician advised her to wear a mask when breastfeeding or cuddling, and to wash her hands a lot.