Giving Birth During the COVID-19 Pandemic
Being pregnant and giving birth during the COVID-19 pandemic raises a lot of new challenges, fears, and questions for families. Perhaps one of the hardest parts of this is that we are still learning. At Women’s Health Connecticut we are constantly adapting our recommendations to keep you, your baby, and your family safe. Please know that you and your baby are our top priority and we are doing everything we can to ease any anxiety. To answer some of your questions about giving birth during the COVID-19 pandemic, we spoke to Dr. Tracy Brennan, a Women’s Health Connecticut Medical Director and Stephanie Welsh, CNM, DNP, of Mansfield Ob/Gyn Associates.
What advice would you give to pregnant women who may be feeling stressed given the current climate?
Stephanie Welsh, CNM, DNP (SW): In general, we are trying to reassure women that it does not appear that pregnant women are at higher risk of contracting or becoming seriously ill from COVID-19 than the general population. There are also no known pregnancy complications or risks to infants born to mothers who test positive. However, we are urging everyone to follow COVID-19 health recommendations to keep themselves safe as there is so much that is unknown about the virus. In addition to those health precautions, we are asking pregnant women to practice self-care by exercising and eating healthy.
What are the hospital policies in Connecticut regarding COVID-19?
Dr. Tracy Brennan (TB): This situation is extremely fluid and healthcare providers and hospital administrators are in constant communication to evaluate hospital policies to provide the highest level of safety for hospital personnel and patients. Currently, Hartford Healthcare facilities are still allowing a single support person in the delivery room. Hartford Healthcare is committed to continuing this policy.
Who is allowed in the delivery room?
SW: Right now, hospitals in the area are allowing one support person in a delivery room. There are studies to support that women do better and have a more positive birthing experience when they have a person with them. It is a very difficult situation; I don’t fault hospitals for instituting a no visitor policy because this is an unprecedented time. There is so much unknown about the virus, and hospitals are trying to keep patient and hospital staff members safe.
What can pregnant women expect when they go to the hospital to deliver during COVID-19?
TB: Women should realize that the hospital is a safe place. Everyone involved in their care is committed to protecting their safety and the safety of their newborn child. When they go to the hospital, they should prepare to see that their provider and nurse caring for them are wearing masks and gloves. Pregnant women should wash their hands often with soap and water for at least 20 seconds. They should avoid touching their eyes/nose and mouth. As they prepare for delivery maintain a healthy lifestyle to keep their immune system strong, like eating healthy meals, exercise regularly, get plenty of sleep, and avoiding alcohol and drugs.
I also recommend not taking a lot of personal items with you to the hospital, don’t wear jewelry or watches. When you return home after delivery wash the clothes you wore to the hospital in hot water immediately and disinfect anything you brought with you.
If you are symptomatic with a cough, fever or congestion notify your healthcare team IMMEDIATELY. They will discuss special considerations for your hospital care and breastfeeding plan.
Can women change their birth plan to a home birth instead of going to the hospital? Is that something you would advise?
SW: We don’t recommend that women who are planning to give birth in a hospital to change their plan and give birth at home because of COVID-19. For homebirths, you need to have a certified midwife and to have a very low-risk pregnancy. Unfortunately, we don’t have the infrastructure to make those changes, there are not enough midwives to make that transition.
How are prenatal checkups changing?
SW: We are moving to fewer in-office visits for obstetric patients, which is really supported by evidence that low-risk pregnancies don’t need as many. We can prescribe a blood pressure cuff for women to pick up at the pharmacy so they can monitor their blood pressure at home. We are doing telemedicine visits, and it is going quite well. There are many kinds of visits that we don’t need to touch someone to render care. I would say 90 percent of the time in prenatal checkups is spent answering and asking questions, and making sure everyone is comfortable and healthy.
TB: There is an effort to provide care via telecommunication whenever possible. If you do need to go to your doctor’s office minimize touching door handles and office equipment and countertops. Remember your doctor’s staff is sanitizing surfaces on a regular basis, several times daily. Wash your hands with soap and water once in the office and immediately upon returning home. Change and wash your clothes immediately in hot water.
How long can a woman expect to be in the hospital after giving birth?
SW: Typically, we discharge 48 hours after vaginal birth, and 72 hours after a cesarean section. We do offer early discharge for women at 24 hours, which women have been taking. We do recommend that women use telemedicine visits postpartum, so we can monitor them.
What if a pregnant woman has tested positive for COVID-19, what can she expect at the hospital?
TB: She will be asked to wear a mask throughout her hospitalization. She may be temporarily separated from her infant, to protect the baby from contracting the virus. But the infant can still be breastfed by having someone who is healthy feed the baby with the mother’s expressed breast milk.
SW: A woman who is not critically ill should be in a negative pressure room, which is a room in a hospital used to contain airborne contaminants within the room. Everyone caring for her will be geared up in PPE (personal protective equipment), other than that everything is the same. Women who are critically ill would be transported to a tertiary facility that is equipped to care for critically ill women in labor. Because someone can transmit COVID-19 without symptoms, everyone in our unit wears a mask, including patients and their support people. Health care personnel use PPE during every birth.
What precautions can a new family take after giving birth to protect themselves and their newborn during the pandemic?
SW: I advise to really practice social distancing and to follow the health recommendations that are in place now. It is critically important for women approaching their due dates to really avoid getting sick. I think in general; we all need to take this seriously and follow the recommendations, but to also not let this consume our thoughts. It’s very easy to become anxious and that has an effect on all of our health.
Women’s Health Connecticut is here for you and your ObGyn needs during this time, if you have an urgent question regarding your health, please call your provider’s office. Here are more resources and information regarding COVID-19.