By Leana Wen, MD, as told to Jennifer Clopton
As an emergency physician, public health professor, and former health commissioner of Baltimore, I feel very comfortable in healthcare settings. But I just gave birth to my second child, Isabelle, during this pandemic and I can tell you – everything felt strange given the COVID-19 crisis.
Delivering a baby during this pandemic put me on the other side of the healthcare equation at a very challenging time, and as a public health expert, I feel compelled to help other expectant moms navigating this experience. So here are a few things I learned about what to expect when you are expecting to deliver a baby during this crisis.
Prepare for the uncertainty
There’s so much uncertainty associated with childbirth, even during normal times – and that is exponentially amplified right now. Heading into the hospital during the coronavirus pandemic, you really have no idea what is coming your way because there is so much stress and demand on hospitals and healthcare providers. On top of that, hospital guidelines are changing on a daily basis in regards to protective equipment for providers, visitor plans, and more. All of this adds a new level of complexity and uncertainty to an already anxiety-producing experience.
When my first child was born, my worries centered on finding the right car seat, crib, and lactation support group – those concerns paled in comparison to what was weighing on my mind this time around. My recurring nightmare was developing coronavirus symptoms that would separate me from my baby girl right after delivery. I also worried that my husband might not be allowed into the delivery with me. An even worse fear was my newborn contracting the virus. Thankfully, none of these scenarios happened, but preparing for those possibilities and mapping out our ‘what if’ plans provided a little bit of calm and control in a challenging situation.
Because of my training as an emergency room physician, I always think of the worst-case scenario for everything. I recommend that everyone prepare for the ‘what if’. So, prepare for the unexpected to happen. Make a birth plan, knowing that it could change. Bring a list that includes your past medical history, medications, and contact information of your doctor and your partner. That way, when you head to the hospital, you can handle things alone in case you may have to see a new doctor or the person who normally advocates for you isn’t allowed to be with you.
Understand that interactions with your provider will feel different
I had very caring and exceptionally competent people taking care of me, but our interactions were definitely different from the first time I delivered a baby in the same hospital two and a half years ago. This time there was a sense of anxiety – on both sides – throughout the patient/provider experience, and it changed things. We were all worried about and for each other. Everyone knew they could be a carrier and pass the virus on to others, and in a unit with pregnant women and babies that is especially worrisome.
Just before I was admitted to the hospital where I delivered, one doctor and one nurse on the birthing unit were diagnosed with COVID-19. Some of their colleagues were in quarantine. That was disconcerting for all of us. I often thought how worried the nurses and doctors still working must be about their ill colleagues, on top of wondering if they were going to be next to test positive. I worried about that too.
As a patient, I found that I never fully relaxed with my providers. I noticed every time they brushed against my bed sheet or touched me. I worried if nurses were getting too close to me, fearing they could infect me – and that I could be a carrier and potentially infect them. It used to be normal to hold a nurse’s hand during labor and delivery, but I felt uncomfortable doing that this time.
Then there’s the issue of masks. At the hospital I was at, all providers were required to wear them all the time. They were each issued one to wear for an entire week, and as the days went on, you could see their masks fraying and itching them. I often wondered if they felt safe. I worried for my doctor and nurse.
You also don’t realize how weird it is to never see the faces of the people taking care of you during that kind of vulnerable experience until you live through it. The truth is, it is a bit disconcerting. My nurse and I talked about how odd it will be if we ever run into each other in the future. Despite her helping me through such a significant moment in my life, I wouldn’t recognize her. Medicine is such a deeply personal profession, and this is a departure from how it is normally practiced.
Again, all you can do about this is go into the experience knowing that this is how it has to be. I also felt compelled to express my gratitude to my providers whenever possible. I knew how much they were trying and how hard it must have been for them, and yet they were coming to work to care for patients including me and my baby, and I felt incredibly grateful for that.
You have to relinquish control and that can be uncomfortable
There were many moments as a patient that I had to surrender control and trust that the hospital had the necessary protocols in place to keep the baby and me safe. Despite knowing that, those moments were still difficult.
For example, when my daughter was only a few hours old, she needed mandatory newborn screening tests in a different part of the hospital. For obvious reasons, hospital policy no longer allows parents to travel to other units with their babies. Newborns can’t safely be put in any protective gear, so I had to simply wrap Isabelle in a blanket and hand her off to a nurse in full protective equipment who carried her down halls and in and out of elevators to get the necessary tests. I felt extremely anxious about this – who knew the exposures my baby could have had during this time – but that’s how it has to be right now. This is the best way to do it to keep everyone safe.
Set realistic expectations for social support
The lack of in-person social support is challenging when you first come home. We’re so used to celebrating a new baby with family and friends, and those interactions provide a much-needed emotional boost to tired mothers – especially those struggling with postpartum depression. I don’t have that, but even so, it is disappointing and sad to all involved when you can’t welcome a new baby.
I think the most you can do about this is remind yourself and others that you just won’t be able to interact as you had hoped. Set expectations in advance for everyone – let them know that it is going to be different and come up with new ways to find joy and celebration in this time. In my case, nobody has been by the house yet to visit Isabelle, but we’ve had lots of video chats and are certainly planning in-person visits for whenever it’s safe for all involved.
I share all of this because I think it’s important that parents realize that welcoming your child into the world during a pandemic isn’t likely to look exactly as you imagined. That may lead to some challenging moments for you and your loved ones. But the important thing to remember is this: While the coronavirus is forcing us to make many changes in how we act and interact with others to keep us all safe, it does not take away the joy of parenthood. I can tell you with 100% certainty that even in the midst of this kind of crisis, meeting your child for the first time is still as magical and wonderful as ever.
Dr. Leana Wen is a visiting professor of health policy and management at George Washington University School of Public Health. She is an emergency physician and the former Health Commissioner for Baltimore. Learn more about her at her website and connect with her on Twitter.