Giving Birth During the Pandemic
The Covid-19 pandemic has forced hospitals to completely upend their systems to accommodate the influx of patients. Every department has had to change protocols and limit supplies, while still accepting the same amount of patients. Nowhere is this more true than in the maternity ward. The process of giving birth can be stressful and overwhelming during normal times, and the pandemic has added another level of worry. I decided to delve into this topic and talked to two nurses, one who works in Labor and Delivery and the other in Postpartum, to get an idea of what it is like to give birth during a pandemic.
1st nurse: Labor and Delivery
Me: Would you say that giving birth is more stressful than it was before the pandemic? If so, how much?
Nurse: Yes, it’s definitely more stressful. There are more testing and more steps that need to be taken when couples come in. We’re also limiting visitors. Only one person can be with the mom for the whole process. When they walk into the hospital, partners have to wait in the lobby and new mothers are alone. If they are staying, the partner can come in the labor room, but can’t leave. Everyone involved must be tested! There is definitely more stress because we do not know if the patients will test positive.
Me: If it is a high-risk pregnancy, is it more stressful?
Nurse: It is going to be stressful for anyone who is compromised and high risk. They have to get check-ins more often, exposing themselves to the virus more times. Those with more health risk factors are more at risk, especially diabetics.
Me: Is their a separate protocol if a mother has tested positive for Coronavirus?
Nurse: They are allowed to have a partner with them, but the partner has to leave after the birth. The way we nurses enter a room is different: we wear the personal protective equipment (PPE) that we would wear on the COVID floor, but we have to throw the gear out the minute we leave the room, which is pretty wasteful.
Me: New York passed a law saying one person could be with a woman when she is giving birth. Has that made your job more or less difficult?
Nurse: The rules change practically every day. At first, the dad could stay in the room regardless. However, with the worry of asymptomatic spreaders, everyone was eventually required to be tested, and the dad mandated to leave after labor. This executive order complicated things and put everyone in the unit at risk, but it is good to have a family support system for mom. Otherwise, it falls on the nurses who already have a lot on their plate.
Me: Have the birth wards been heavily affected by the virus in terms of staffing and equipment?
Nurse: We have lost a lot of beds, and two induction rooms were taken for COVID-19 patients. We also lost our antepartum floor and had to double up postpartum patients. Patients have also been discharged earlier. A natural birth will be discharged after 24 hours if the mom is healthy, and a c-section will be discharged after about 48 hours later if mom is healthy.
Me: Is it possible for an infant to contract the virus in the womb?
Nurse: We don’t know yet, but there have been cases of infants contracting viruses. Things are changing so fast that we can’t really tell.
Me: Do you have any advice for families who are about to welcome an infant?
Nurse: Have patience and be flexible. Your labor will not be what you expected and everything we do is for yours', ours, and babies’ safety. It’s not an “Instagram” labor, but what matters is that you and the baby come out alive. Be honest with your caretakers, let go of your expectations of labor, and be considerate to others.
2nd Nurse Postpartum, Labor and Delivery
Me: What is the biggest change on the postpartum floor?
Nurse: No visitors were allowed at first, and moms had to endure labor alone, which was very stressful. This lasted about two weeks, and then we changed our policy because people were going to other hospitals or giving birth at home. After an at-home birth, they had to come to the hospital, and about 50% needed to stay overnight because of complications. As of May, partners could stay in the room during labor, but later they had to leave. The baby stays with the mom who has to do everything by herself because there is no nursery. Safety is decreased because staffers have to do more work per patient. The Women’s Health Organization (WHO) wants the hospital to be baby-friendly, which means moms and babies are never separated. Moms are typically very tired, and a c-section patient can’t even stand, so the risk of falls increased. Later we changed the policy to have one person help through labor, delivery, and postpartum, which alleviated the risk of falls. The support person has to have their temperature taken every 12 hours and wear a mask. Every mom has to be swabbed no matter what. We can no longer hold classes to teach moms how to care for their babies because they need to be discharged sooner.
Me: Is there fear that a newborn could contract the virus?
Nurse: We haven’t had any positive tests from babies, even those with moms who tested positive. We have to teach mothers how to handle visitors at home because there’s more worry about catching the virus at home than at the hospital.
Me: What is the protocol if a mom has tested positive for the Covid-19?
Nurse: If a mom tests positive she is isolated, and her baby is kept 6 feet apart, which negatively impacts bonding. These moms can’t breastfeed unless they’re wearing a mask and gloves, and can’t have skin to skin contact with the baby. At the hospital, one nurse takes care of all of the COVID patients so there’s no cross-care.
Me: Is there a stricter protocol with high-risk patients than with non-risk ones?
Nurse: Nope, everyone is treated the same because everyone is screened for COVID.
Me: Has the postpartum department lost resources because of the pandemic?
Nurse: Yes, because of the influx of patients we have lost wheelchairs, beds, and IV poles. This was a problem even when we didn’t have many patients. We didn’t have a pump for IV’S so we had to eyeball the correct amount of fluid by counting the drops.
Me: What is the best advice you could give to new moms at this time?
Nurse: Embrace the rules, because they are for you and the baby’s safety. Enjoy the time you have to form a bond with your child, don’t be scared to go to the hospital, and wash your hands. If you have other questions, call the unit and we will answer.