by Casey Newman
As coronavirus continues to spread, hospitals all over the country are implementing policies to protect the health of patients and employees. Some hospitals have even extended their restrictions to pregnant and birthing people, demanding everything from mandatory epidurals to forcing the laboring person to give birth without a support person — all in the name of allegedly stopping the spread of COVID-19.
Forcing people to give birth alone is inhumane. Requiring interventions to be performed on birthing people all in the name of “safety” is inhumane.
If you’re going to give birth during the pandemic or know someone who is, you’re likely experiencing a lot of anxiety over how your labor and delivery will play out. Regardless of your hospital’s visitor policy, world and national health authorities all agree on one thing: People giving birth deserve to have a support person present.
To help you ease some of your fears — and influence change — here’s what some of the top health organizations say about giving birth during COVID-19.
The World Health Organization (WHO): WHO states that all people giving birth — whether they have COVID-19 or not — have the right to:
- Respect and dignity
- A companion of choice
- Pain relief
- Clear communication from maternity staff
- Mobility in labor and birth position of choice
WHO also notes that a positive COVID-19 diagnosis does not automatically mean a pregnant person needs a c-section.
The Centers for Disease Control and Prevention (CDC): Like WHO, the CDC says a birthing person should have a support person present if they so choose. The CDC also encourages the use of video technology to allow others to “visit” the person in labor or after birth.
An important note here: The CDC notes that an infant born to a suspected positive coronavirus case is NOT considered to have the virus. However, an infant born to a confirmed positive patient IS considered suspected to have the virus.
The determination to separate a parent and baby should only be made on a case-by-case basis. And it should include shared decision-making between the parent and their medical team.
WHO recommends that a baby born to a COVID-19 positive parent be allowed to breastfeed, share a room and be held.
American College of Obstetricians and Gynecologists (ACOG): ACOG doesn’t take a stance on birthing rights during the COVID-19 pandemic, instead suggesting clinicians and hospitals follow the CDC’s guidance and implement visitor restrictions as they see necessary.
Many pregnant people have considered having a home birth in the wake of the restrictions and requirements that now come with giving birth during a pandemic. ACOG has said it believes the safest place for people to give birth is in a hospital. It does point out that your baby may need to be separated from you if you are sick, despite evidence from WHO claiming otherwise.
As for COVID-19 affecting pregnancy, ACOG notes that some pregnant women with confirmed COVID-19 cases have given birth prematurely, but it is unclear if the virus caused preterm labor. Researchers have also found a few cases where coronavirus has been passed to a fetus, but ACOG notes, this seems to be rare.
American Academy of Pediatrics (AAP): Previous guidance from AAP recommended separating COVID positive parents from their newborns. However, as more data and information has become available, AAP now recommends that newborns remain in-room with a COVID positive parent unless that parent is too ill to properly care for the baby.
If you are COVID-positive when you give birth and your baby is not, AAP recommends you wear a mask and wash your hands before holding your infant. It’s also recommended that any support people or family members visiting you or your baby also wear a mask and wash hands before holding your baby.
Like WHO, AAP says a COVID parent can breastfeed a newborn, but when doing so should wear a mask.
AAP also recommends babies born to COVID-positive parents be bathed immediately after birth to remove any viral strains. If you have coronavirus and your baby needs to stay in the NICU, it’s recommended that you don’t visit them in the NICU until you are no longer ill.
What Other Organizations are Doing: New York has been the hardest hit. As such, the New York State Department of Health advised all hospitals to ban nearly all visitors. Many hospitals in the state included this visitor ban for support people during labor and delivery. However, days later Gov. Andrew Cuomo released an order requiring all hospitals to allow at least one support person for labor and delivery.
The American College of Nurse-Midwives advocates for the presence of support people during labor, saying: “Institutional decisions that limit the ability of a laboring person to have access to desired support people of their choosing, including doulas, can be difficult for midwives and families to comprehend and seems inconsistent with optimal care.”
The American Academy of Pediatrics (AAP) notes that the separation of an infant from an infected parent minimizes the potential risk for infection. The organization notes that the benefits of separation may be greater for mothers who are seriously ill and that discussion of possible separation should be discussed with the mother beforehand.
What You Can Expect at Local Hospitals: The Cleveland Clinic’s COVID-19 visitor policy allows one visitor during labor. Masks are recommended for patients and required for any accompanying visitors. Summa also allows one support person during labor and postpartum. All patients and visitors are required to wear masks while at Summa. Visitors also must stay in the patient’s room outside of using the restroom or cafeteria.
So what can you do as a pregnant person or someone who loves one? If your hospital is enforcing the “no visitors” rule for labor and delivery, point them to guidance provided by WHO and CDC. If you’re able, consider changing where you plan to give birth either at a different hospital, a birth center or your home.
Casey Newman is a mother of two who depends on wine to get her through bath and bed times. She is a maternal and women’s health advocate who volunteers with several birth and maternal rights organizations and has spoken to Congress members about issues affecting moms.