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A doctor performs an ultrasound scan on a pregnant woman
AP Photo/Teresa Crawford
Preserving some normalcy.
CALM AMID THE STORM

Hospitals are fighting to preserve the joy of childbirth during Covid-19

Annabelle Timsit
By Annabelle Timsit

Geopolitics reporter

From our Obsession

Being Human

We’ve never been as connected, or as isolated.

The world may be in the middle of an unprecedented crisis, but people are still having babies.

With 250 babies born every minute, it’s safe to assume that more than 12 million new lives have started since the world locked down about five weeks ago. And while many anxious parents probably wish they could delay the birth of their child until Covid-19 recedes, that’s not an option. So hospitals, medical bodies, and labor and delivery staff have adapted their practices to allow women to give birth as safely as possible in the middle of this pandemic.

While the rules may vary in different countries, they all share the same goal, said Clare Livingstone, a midwife and professional policy advisor at the UK Royal College of Midwives: “Keep things as normal as possible.” But stories from around the world show that’s not always possible, especially in cases where mothers test positive for the novel coronavirus.

“We were in this one alone”

Sarah Golding’s water broke around 3 am on the night of April 7, 10 days before her due date. She and her husband, Jarrett, immediately drove to the Kaiser Permanente West Los Angeles Medical Center. As they describe it, the hospital looked “eerie.” They were greeted at the door by staff in personal protective equipment (PPE) who took their temperature and swabbed Sarah’s nose to test her for Covid-19. She tested negative, and was processed and admitted alone into the maternity ward. Jarrett was eventually allowed to join her in the delivery room, where she gave birth to a healthy baby boy, Beau.

Three years ago, Sarah gave birth to another baby; this time around, the experience was a little different. Midwives and nurses in the delivery room wore what essentially looked like hazmat suits, and diligently washed their hands any time they touched anything. “You know when you’re a kid and you play like the floor is lava?,” asked Jarrett. “That’s kind of what it felt like.” The hospital limited every woman to one birth partner in order to prevent contagion, so the couple’s doula couldn’t be in the room with them. “We were in this one alone,” he said.

Delivering a child is stressful in the best of times; these preventative measures, while necessary for the safety of both the mother and the healthcare staff, can add to the anxiety. That’s why midwives and ob-gyns are doing their best to keep the experience of childbirth as predictable as possible, in order to meet babies’ needs and preserve mothers’ mental health.

Study after study has shown that the first few hours of a baby’s life are vital for their development; during this time, mothers and babies need each other to be well. That’s why hospitals recommend that, if the mother is healthy, she should be given unlimited time for skin-to-skin contact with her newborn. Most also recommend breastfeeding when possible, because it boosts babies’ immune systems, protects them from some infections, and in many countries, is a better source of nutrition than the alternative—poor-quality formula.

Physical closeness allows mothers and newborns to form an attachment that is the foundation for healthy development and mothers’ mental health. When mothers experience high levels of anxiety, or even depression, research has shown that their children have worse outcomes. “Trying to maintain some level of normalcy for these women, and making it a positive experience, has repercussions on both the mom and the baby,” says Juliette Prust, an ob-gyn at Ob-Gyn Associates in Maryland. She says she has seen more depression and anxiety in her pregnant patients during this time, which she suspects is “because women are feeling so isolated.”

Separation anxiety

When mothers test positive for Covid-19, that need for closeness can turn into a threat. Currently, there’s no evidence that the novel coronavirus can be transmitted through breast milk. But it is spread through droplets, and when a mom holds her newborn to her chest or breast, the risk of contagion increases. That’s why many hospitals have asked Covid-positive mothers to wear masks around their infants.

Some have gone further, and physically separated mothers who have severe Covid-19 symptoms from their newborns. Piyarat Sumritpradit is an ob-gyn and assistant director of the Praram 9 Hospital in Bangkok, Thailand. There, the protocol is to erect a plastic curtain between mom and baby to enforce physical distancing and prevent infections.

In the US, every hospital has a different policy, says Prust, who delivers babies at Holy Cross Hospital in Silver Spring, Maryland. She has received guidance to separate mothers who have severe symptoms from their newborns until discharge if possible. Mothers are still encouraged to pump breast milk, but another family member or nurse feeds the baby using a bottle.

Not everyone believes that’s the right thing to do. In the UK, the Royal College of Obstetricians and Gynecologists (RCOG) has specifically recommended against separating mothers from their newborns. Scientists know that the bond between a parent and a child is vital, and that even in bad circumstances, a child is better off with a parent who loves and cares for them. That’s especially true for newborns, which is why RCOG warns in its guidance that “routine precautionary separation of a woman and a healthy baby should not be undertaken lightly, given the potential detrimental effects on feeding and bonding.”

Get us out

A rather uncomfortable Covid-19 swab test and some scary-looking PPE aside, there was very little difference in the care Sarah Golding received after giving birth to Beau, says her husband Jarrett. A nurse weighed and measured Beau, tested him for vital signs, and encouraged skin-to-skin contact and breastfeeding.

One thing felt different: The first time he and his wife had a baby, Jarrett jokes, “we were like, ‘please don’t send us home, help us, we don’t know what we’re doing.’” This time, “we were just like ‘get us out.’” The couple is isolating at home with their children, in case they caught the virus at the hospital.

Childbirth will inevitably feel different for many women. They might not have the support network of family and friends they would usually have. They can’t bond with other new parents in community settings like family cafés or parent groups. It’s only natural that many would feel more isolated and anxious—after all, many of us who are not pregnant feel the same way, and we’re not hormonal and sleep-deprived.

Still, says Prust, the step-by-step process of childbirth “has probably changed less than what most people on the outside would have thought.” And if midwives, obstetricians, nurses, and pediatricians have anything to say about it, giving birth to a child will still be a joyful experience.

“You’re coming to us for the most important experience of your life,” says Prust. “We want you to still be able to enjoy [it].”

Read more from our series on Rewiring Childhood. This reporting is part of a series supported by a grant from the Bernard van Leer Foundation. The author’s views are not necessarily those of the Bernard van Leer Foundation.

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