Unlike her first pregnancy, Hilary Robinson knew what she was doing when she gave birth to her second child on April 19. What she didn't know was if she would be bringing her newest son, Memphis, into the world on her own.
Hospitals around the country have implemented strict visitation policies in order to prevent the spread of COVID-19. Although labor and delivery is an exception — one coronavirus-free visitor is allowed — many expectant mothers fear their partner or loved one won't be able to join them at the hospital bedside.
Another major concern is that newborns whose mothers have suspected or confirmed COVID-19 will be separated at birth to prevent mom from infecting her baby, as recommended by the American Academy of Pediatrics and other leading medical organizations.
"There were points before I had my son that I wondered if my husband was even going to be able to be there, if they were even going to let me hold my child," Robinson said. "If that's going to happen, then I just want to stay home and have my baby."
Dr. Patricia McLelland, an OB-GYN at Galen Medical Group, is the medical director for women's services at Erlanger East Hospital. She said it's understandable for women to feel anxious about childbirth during the pandemic, which is why she wants them to know what to expect so that they're not afraid.
While the coronavirus has definitely changed protocols, McLelland said that health care leaders understood from the beginning of the outbreak that childbirth and the postpartum period had to be a focus, because unlike some other procedures, it can't be postponed. That's why hospitals have gone to great lengths to ensure safety, staffing, equipment and supplies, she said.
"We know that the number of women who are due right now hasn't changed," McLelland said. "Those of us who do this are committed to making this still be one of the best days of your life. I want all moms to feel empowered and know we've got their back."
Dr. David Barker, an OB-GYN at OBGYN Centre of Excellence who delivers babies at Parkridge East Hospital and Erlanger's main campus, said preparing patients mentally has become an even bigger part of his job in the COVID-19 era.
"We're having to talk to every patient who has a level of fear and worry and meet them where they are," Barker said.
Early in the pandemic, he said his pregnant patients were most concerned about safety, then it was whether they could have their partner in the room.
"The new fear is that if the mom is coronavirus positive that the mom will be separated from baby at birth," Barker said. "The potential risk is there. It's real. Fortunately, I have not seen a COVID patient, but the reality is we probably will."
Mother-to-child transmission of coronavirus during pregnancy is unlikely, but after birth a newborn is susceptible to person-to-person spread, according to the U.S. Centers for Disease Control and Prevention. CDC guidelines state that the decision of whether to separate a mother with known or suspected COVID-19 from her infant should be made between the mother and the health care team on a case-by-case basis.
"A very small number of babies have tested positive for the virus shortly after birth. However, it is unknown if these babies got the virus before or after birth. The virus has not been detected in amniotic fluid, breastmilk or other maternal samples," the CDC website states.
McLelland said social distancing is important for everyone, but especially pregnant women and the people who are close to them. Moms, their partner and a few backup people need to strictly adhere to social distancing in the weeks leading up to the delivery date so they're not infected at the time of birth.
"The good news is social distancing really does work," she said, emphasizing that moms definitely need "their person" during childbirth.
"You need that person to be with you throughout that process so that they have a much better idea how to take care of you," McLelland said, and the same social distancing guidelines apply after childbirth, too.
"Normally, we don't think twice about calling a friend and asking them to bring you five things from Target," she said. "Now, you have to find those one or two people that will stay quarantined and do social distancing well so you have somebody that can come to your house and bring you stuff."
Robinson said that at first she was sad when she learned her family and oldest son wouldn't be able to meet Memphis in the hospital. Her mom still hasn't held him, because she was worried she may have been exposed to the coronavirus at work.
But ultimately, Robinson said Memphis' birth was a good experience.
"I had a lot of people praying for me, and I ended up just having a peace about it," she said. "It was actually kind of relieving in some ways not having to deal with a bunch of company."
Barker said he's seen the positives of the strict visitation policy play out in his own patients.
"There's a great unity that comes there and a bonding that occurs, because you don't have uncle Joe bringing a box of donuts just because there's social pressure to see the baby," he said.
Robinson recommends that moms communicate with their providers, mentally prepare as much as possible before their delivery day and don't be afraid to ask for what you need or want.
"I just had wonderful nurses that were so supportive, and really, I had the birth experience I wanted. It's even better than my first one in a way," she said.
She also cautions people against making rash decisions out of fear.
"I definitely think that there's different information out there that can kind of scare you. It will be OK as long as the baby and you are healthy and safe, and it seems like that's what the concern was with my nurses, too," Robinson said. "Even though it was during this time, it was a good experience, and it's kind of an interesting one. I can tell my son and grandkids how it happened, and other people during this time. It's a time in history that he was born."
Contact Elizabeth Fite at firstname.lastname@example.org.