How COVID-19 has changed life for local expecting mothers
by Aja Hannah
With COVID-19 changing the landscape of the medical field, pregnant women may be feeling especially down at this time. Baby showers, pregnancy portraits, and baby shopping trips have been cancelled due to restrictions on gathering sizes. While some families have adapted with online registries and “drive-thru” baby showers, others have postponed it all.
Pregnancy has almost become a second thought against the backdrop of COVID-19; the shopping restrictions, the stay-at-home orders, the massive lay-offs, social distancing and ever changing news. At least, that is how it is for me at 35 weeks pregnant.
I’m due in May with our second child. Things were already different. We didn’t have a baby shower planned, but we were going to buy a second vehicle. Now we aren’t going anywhere, so there is no point. We were going to get pregnancy portraits done since we did them for our first pregnancy. Forget about that.
This has translated to me not being the primary grocery shopper and being told to stay home whenever an errand needs to be run. At first, it was a nice relief, but now certain brands or flavors of things aren’t being bought which trips up my pregnancy cravings. Not to mention the cabin fever.
But all these issues are minor when compared to the most striking changes in the medical field. Everything from routine OBGYN visits to the delivery to the postpartum stay has changed and continues to require me to be open to change.
Most OBGYN offices in Summit County have expanded their tele-health appointments for patients or have postponed routine checkups altogether. For pregnant women, this can increase their stress. They want to know their babies are healthy and developing properly, especially first-time moms.
In many cases across the country, OBGYN offices are still open for those who are high-risk or having an emergency, but staff has been reduced.
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At Cleveland Clinic offices, OBGYNs are not seeing new pregnant patients until after the first scheduled ultrasound around 12 weeks — unless of course there is concern about the mother or baby. They are still scheduling patients when it is a necessary appointment that involves a possible complication, bloodwork, or ultrasounds. This keeps pregnant women out of the office and minimizes the risk of catching coronavirus.
The office is also recommending low-risk pregnant patients forgo in-person visits if they have access to a blood pressure cuff and doppler (to monitor the baby’s heart rate) at home. Patients who have this equipment now have the option of telehealth check-ups. But these items can be expensive and, with so many people laid off or working reduced hours, affordability flies out the window.
Like many other pregnant women, I do not have access to this equipment, so I have to go into the office every other week. While it all feels a little dystopian and disconcerting, all the precautions these offices are taking are somewhat reassuring.
Patients are typically greeted with a series of screening questions; these questions have increased and changed as information on the virus becomes available. The nurses running the doors used to just have a bottle of hand sanitizer. Now there are marks on the floor designating the six-foot distance. Patients still get a squirt of sanitizer, but now the nurses are wearing masks and gloves. Patients’ temperatures are also taken using a forehead scanner that does not touch the patient.
Many offices won’t let in partners or children, although the latter can be a serious issue for single pregnant moms.
Even with all this, I still worry about going in and contracting COVID-19 somehow, like riding on the elevator or using the office’s bathroom.
Tessa King, a soon-to-be mother of five, is due in June and she sees a doctor at Associates of Akron. She has a high-risk pregnancy and cannot be seen from home. She has experienced the same changes at her office and said, “It really doesn’t bother me. I’m extremely high-risk this time, so any extra precautions to stay healthy are fine with me. I go twice a week to the doctors from 20 weeks on.”
When I see my doctor, she stands at the opposite side of the room and is mostly hands-off except to measure my bump and take the baby’s heart rate. She doesn’t even log on to the computer if she doesn’t need to. The appointments are short and to the point, and I am sent on my way.
While many women in online forums have talked about giving birth at home because of COVID-19, there are women that do not have that option or still feel it is safer to give birth at the hospital. I will be giving birth at the hospital because I have to have a c-section.
I will most likely be headed to Cleveland Clinic Hillcrest hospital when the time comes because that is where I have given birth before. Hillcrest also has private NICU rooms in case something goes wrong, the baby is too early, or the baby contracts COVID-19. But not everyone wants to do that long trek while in labor or forgo having their OBGYN with them at the time of delivery.
In Akron, there are two major hospitals that do deliveries: Summa Akron City and Cleveland Clinic Akron General. The birthing wings of these hospitals are separated from the rest of the hospital. Still, pregnant women are worried about even going into the hospital and contracting the virus.
Tessa has given birth several times at Akron City and will be going there again for her latest baby. “I am high risk and have a very, very low immune system right now. I worry I could somehow come in contact with the virus and get very sick.”
The hospitals have several layers of precautions. They question and take the temperature of everyone entering the hospital. Staff and visitors have reduced to only the essential people. Akron City hospital is currently allowing only one visitor for labor and delivery, but that visitor is restricted by a “come and stay” policy, meaning they cannot leave the hospital once they have entered. That means no returning home to feed dogs, change clothes, or put children to bed.
Depending on the spread of the illness, this could be further limited to no visitors or support persons for labor and delivery. First-time mom and educator Carolyn A. Spivak Colbow, gave birth March 27. At that time, only her husband was allowed with her, but he could still leave the hospital and return if his temperature was okay.
If we do not have someone else to watch our kids, women like me and Tessa have to go through surgery and recovery alone. If something happens to us, who is our advocate? Where is our support? But on the other hand, getting someone else to watch our kids means putting someone else or our kids at risk by introducing a third party. Has that person quarantined properly? If it is a grandparent, are we risking their health?
“I worry about having an extended stay all alone as my boyfriend has to be home with our other children,” says Tessa. She will also miss being able to have visitors. “This will be the only baby my other children won’t be able to meet right away. That’s really hard on them, so it’s saddening to me.”
Bethany Pyper, a postpartum nurse at Akron General, reports that the single visitor/support person is still allowed to come and go, but will have their temperature taken each time they return to the hospital. She says the hospital also still has its lactation staff and newborn photographers.
Despite being part of the same Cleveland Clinic system, Fairview and Hillcrest hospital report that they are following “come and stay” procedures.
Nurses have been picking up the slack and offering support to postpartum parents since there are limited visitors. “[We are] definitely connecting more [to patients] through conversation. These mommas are usually processing their birth experience by talking with their visiting friends and family so we are aware of the importance of them sharing those stories. Also, we are helping take care of the baby more because a lot of times the extra visitors are helping with diaper changes and holding the baby while [patients] shower and stuff. We are being conscientious that they have much less physical support than they might if COVID-19 wasn’t an issue,” says Bethany.
To minimize exposure and possible contraction of the virus, hospitals are also allowing patients to be discharged early if possible. For vaginal births, stable women and babies can leave as early as the next day. For c-sections, stable patients are staying two days rather than three. Bethany clarifies that “this is an ongoing conversation between the patient’s doctor, pediatrician for the baby, nurses, and the patient. We aren’t forcing people to leave or even ‘encouraging’ them to leave sooner than they feel comfortable. But doctors are definitely trying to be aware that we want to cut down the exposure to these patients if they aren’t benefiting from the average length of stay.”
As information on COVID-19 develops and the number of cases change, restrictions in hospitals and offices may be lifted or increased.
Aja Hannah is a writer, traveler, and mama. She believes in the Oxford comma, cheap flights, and a daily dose of chocolate.