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When my husband and I saw those two pink lines on the pregnancy test back in August 2019, it was pure, unadulterated joy. After all, we’d been trying for over three years, enduring four miscarriages and two D&Cs in our quest to give our nearly 5-year-old daughter a sibling. It was, literally, a dream come true.
Fast-forward eight months, and it’s less like a dream and more a waking nightmare. I’m currently 38 weeks pregnant, and I am due to give birth at the height of the coronavirus pandemic — the very same week my state’s hospital system is anticipated to be at an overwhelmed tipping point. (And we’re one of the lucky ones: California was among the earlier to states to issue a statewide shelter-in-place and appears to be successfully flattening the curve.)
For most, the idea of being at the hospital right now — surrounded by coughing patients and doctors/nurses forced to wear items like bandanas due to a lack of personal protective equipment — is something to be avoided at all costs. So the idea that I am guaranteed to be in the hospital in a matter of days — and with my precious newborn baby, no less — fills me with an overwhelming sense of dread and panic.
But that dread is simply the tip of the iceberg. There are so many unknowns surrounding labor and delivery right now, to the point where even my Ivy League-educated, exceedingly competent OB-GYN can’t definitively answer basic questions. Will I be required to wear a mask during labor? (Signs point to yes.) If I have a simple cough but no other symptoms, will my husband be banned from the hospital? (Probably yes on that count, too.) Will my husband be kicked out after labor and denied the chance to bond with our newborn? (Almost certainly.) Can we proceed with my induction next week, as scheduled? (The jury’s still out.) The situation seems to be changing weekly. and it's one reason why pregnant people right now need to be in constant communication with their healthcare providers regarding any changes to their birth plans.
With all the unknowns, it’s no wonder pregnant people are anxious. “Pregnant women are extremely vulnerable," says Stephanie Newman Ph.D., a clinical psychotherapist, visiting scholar/clinical supervisor at Columbia University, and author of Barbarians at the PTA. "They worry, first about delivering healthy babies, and also about whether they will rise to the occasion and become the loving caretakers they hope to be. What looks like baseline anxiety about performing basic maternal tasks can go through the roof as pregnant women face a pandemic that stresses our healthcare system and leaves everyone unable to predict the future or control most aspects of daily living."
“The question is no longer ‘Will I be a good enough mother?’ but ‘Will I be able to ensure my baby is healthy and protected — and my family survives?’” she adds.
In the best of times, childbirth is not just scary but can be genuinely dangerous: The United States is the only developed country where maternal mortality rates are rising rather than falling, with the rate more than doubling from 10.3 per 100,000 live births in 1991 to 23.8 in 2014. Those numbers are even scarier for black women, who are three to four times more likely to die in childbirth than white women.
At first, the news around pregnancy and coronavirus seemed promising. While pregnant people are technically considered immunosuppressed, based on numbers from China, it was initially thought that babies were not at much risk from coronavirus. The Centers for Disease Control (CDC) hasn’t yet reported adverse pregnancy outcomes in pregnant people with COVID-19, but does note that related coronaviruses such as SARS-CoV and MERS-CoV have caused pregnancy loss, including miscarriage and stillbirth. However, just this week, it was reported that a 1-day-old infant died from coronavirus-related complications in Louisiana, while a 6-week-old baby who tested positive for the virus died recently in Connecticut. Obviously, there’s much we still don’t know, and that frightens me.
I’m not alone with those fears. Pregnant people around the country are struggling with uncertainty, especially regarding hospital L&D regulations, which are constantly changing and leave the expectant unable to make birthing plans in advance. Following the news that two major hospital systems in New York would be banning support partners and spouses from labor and delivery, an online petition to safeguard the right of laboring people to have support present circulated that gathered more than 600,000 supporters. The decree was reversed a few days later following an executive order by Governor Andrew Cuomo, but not before some women had to endure childbirth alone.
“I am just taking it day by day,” says Lorrane Bardarson, nine months pregnant in Seward, Alaska. Married to a doctor serving in the military, Bardarson understands the work being done by healthcare professionals behind the scenes, but she’s anxious about transmission. “There is a massive shortage of Personal Protective Equipment in hospitals, so I am definitely concerned about personal transmission from providers.”
She’s also sad that her husband may not meet their baby for weeks or even months. “As a physician, he is more at-risk that most," she says. "It is likely that he will be exposed to COVID patients and he will have to quarantine away from us until this is under control. There is a very real possibility that he won’t hold our baby for the first several months of this pandemic. That is not something that anyone can prepare for, especially him.”
“As a first-time expecting mother, I am anxious — period,” agrees Ashley Jepma Rogosheske, who is 38 weeks pregnant in Minneapolis. “Being separated from my husband or baby due to this infection is my biggest fear, which drives my decisions to stay safe and inside. It has been said that pregnancy is an emotional roller coaster, but being pregnant and due to deliver any day during the heart of this is unlike anything you can prepare for. What to Expect When You're Expecting definitely does not have a chapter on a pandemic.”
To further complicate matters, pregnancy, labor & delivery, and postpartum are already highly emotionally-charged and difficult, each with their own unique challenges. I experienced postpartum depression following my daughter’s birth and worry it will be exacerbated by a problematic delivery. The fear that I might be separated from my daughter after she’s born because of coronavirus also keeps me up at night. Will she be scarred forever, denied that precious postpartum bonding?
“One of the most concerning issues a brand-new mom could face is the possibility that, if she is infected with this novel coronavirus, her baby may be separated from her and placed in isolation in the nursery,” says Felice Gersh, M.D., Irvine, California-based OB/GYN, founder/director of the Integrative Medical Group of Irvine, in Irvine, CA and author of PCOS SOS Fertility Fast Track. “If this should happen, there can be long-lasting emotional impacts on the babies and moms, but awareness of this has helped improve such outcomes. Even when initially separated, close bonding can occur and mom and baby can still form a loving unit, even if delayed.”
Dr. Gersh explains that, even in the NICU, staff often play soothing music to babies and hold them while feeding them, adding that moms can still express milk. “So far there is no evidence of transmission of the infection through breast milk," she says. "And it’s important to recognize the resilience of humans: the mom and her baby.”
“If it happens that you and your baby must be separated for a couple of weeks, know you can still love your baby with all of your heart and your baby will love you back," Dr. Gersh adds. "Make a recording of you singing and talking to your baby. There is no question that the birthing experience, which is typically filled with varied emotions, and always including some degree of worry, will be made far more anxiety provoking by the COVID-19 pandemic — but your baby will get through this, and so will you."
Katie Unverferth, M.D., a Santa Monica-based psychiatrist specializing in women’s mental health, agrees. “Pregnant women would do well to focus on what is within their control, maximize virtual social connections, and have a contingency plan for less-than-ideal scenarios," she says. "Mothers and babies are remarkably resilient — giving birth even under atypical circumstances can still be a positive and empowering experience.”
I take these words to heart, praying they will be true. For months, my 5-year-old has been excited about the arrival of her new sister, drawing photos of the two of them hand-in-hand, hugging my belly, and talking about how she already loves her baby more than anybody. She had a “plan.” She’d come to the hospital all dressed up with Daddy, be the first person to hold her little sister, and would have one of the yummy postpartum fruit smoothies that my hospital is famous for amongst local moms.
When my husband and I finally told her that plans had changed because of “the sickie” that had already so uprooted our lives — she wouldn’t be able to come to the hospital at all, she wouldn’t be able to meet her sister for at least a day or two, she’d only be seeing the baby over via FaceTime once she finally arrived — my daughter’s face fell. She then let out a primal scream of anguish and burst into tears, running to hide under the dining room table with a stuffed animal. I finally coaxed her out by offering to make banana bread together.
At a time when people are dying, the frustrations of an overly empathetic 5-year-old might seem like small potatoes, but as a mother, it’s just another checkbox in the already lengthy “Is Coronavirus going to scar my child forever?” column.
When I allow my worries off leash, really indulge them at two in the morning when pregnancy insomnia takes over, here’s where it gets dark. While it would be incomprehensibly traumatic, I could survive birthing alone, or even being temporarily quarantined from my newborn for her health. My biggest fear is that something fatal will happen during the delivery, and — because she has the virus — my baby will be whisked away from me before I can so much as see her, let alone hold her. Taken forever, as if she never existed.
Six months ago, I would have shrugged off an improbable scenario like that. Now, with the news reporting wave after wave of people dying alone, families denied the chance to say goodbye, bodies piling up in refrigerated trucks, it feels … though unlikely, something no longer impossible, either.
“Like any big transitions during this period of uncertainty and change, pregnant mothers can best manage their anxiety by shifting expectations, redefining priorities, and focusing one day at a time,” says Amber Trueblood, licensed marriage and family therapist, MBA, mother of four, and author of Stretch Marks. “Focusing on the dynamics you can control and experiencing gratitude for what you do have in your life will allow you to be more flexible and emotionally prepared for whatever comes your way.”
I can’t control the strange, unimaginable circumstances of my newborn’s birth. I have no control over whether either of us will catch something at the hospital, whether my kindergartner will shrug off the sadness the way children so often do, whether I will be forced to push wearing a mask, whether postpartum depression will rear its ugly head once again.
So I focus on the silver linings, rather than the fears.
I focus on spending as much time with my daughter as possible in these last couple of weeks as a family of three: stopping mid-work-email, no matter what, when she says, “Mama? Let’s play!” Snuggling with her longer at bedtime (nearly a full hour last night) rather than capping it at ten minutes so my husband and I can race downstairs to watch more Ozark and temporarily let the outside world fade away. I focus on banana bread, on nightly baths in lavender Epsom salts, on family tea parties that we never seemed to have time for before.
I’m lucky enough to finally have a baby in my belly that I’ve spent years praying for. I’m privileged to have a two-income household, with excellent insurance, a roof over our heads, and one of the best hospitals in the state less than half a mile away. And despite my family’s fears — financial, health, personal — I’m fortunate to realize that, all things considered, we will probably be okay when this all shakes out. I know that not everybody in our country can say the same right now, certainly not the first responders and healthcare workers putting their lives on the line on a daily basis.
After focusing for so long on what it seems like I can control, I've given up that illusion. Now, I'm simply praying for the best with my daughter’s birth. Taking it one surreal day at a time. And never taking my health or my family for granted again.
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