On Saturday, New York Gov. Andrew Cuomo (D) overruled a new and controversial policy adopted by several New York City hospitals barring pregnant women from having a support person in the room with them during labor and delivery to protect against COVID-19.
“In no hospital in New York will a woman be forced to be alone when she gives birth,” Cuomo tweeted.
But as COVID-19 spreads in New York and elsewhere, similar policies might well pop up. Hospitals in other states have informed patients it is a possibility. And other policies also are changing. Women who planned to labor with a doula may not be able to. Prenatal visits are being canceled or moved online. Things are quickly evolving, which can add significant stress for pregnant women and their partners.
Feeling unnerved by the uncertainty around having a baby? Here are some logistical and emotional coping strategies that may help during the coronavirus pandemic.
Talk to your provider about the nitty-gritty of their policies — as they are right now.
Again, birth policies are changing constantly, and can vary wildly even between neighboring institutions. Now is the time to have an in-depth conversation with your OB-GYN or midwife about what their policies are right now. That’s always a good idea, but right now it’s particularly important to be specific.
“When people understand what to expect, it helps take the fear away,” Amy Johnson-Grass, president of the American Association of Birth Centers, told HuffPost.
“Ask, ‘Can you run through what it looks like when I come into the hospital or wherever you’re delivering?’” said Johnson-Grass. “What does the process look like. Will I stop at the front desk? Will I be assigned a room? Will I have one nurse?”
Obviously, your care provider will be talking to you about any big policy changes around things like scheduled C-sections. But you might want to ask about other aspects of birth that have changed specifically as a result of the pandemic. Do they have any specific guidance around laboring at home before you head to the hospital — and how might that have changed? Have any of the policies around, say, laboring in a tub or shower changed? What about other forms of pain management? (Johnson-Grass said she has heard that some hospitals are relying on anesthesiologists to help COVID-19 patients, which could affect how and when they give epidurals, for example.)
Johnson-Grass also urged pregnant women, and their partners, to look into birth education classes if you haven’t. Simply spending some time online reading a bit more about what happens to the body during labor and delivery can help you feel more prepared.
Create a very specific technology plan.
If you have a smartphone or a tablet or a laptop (or any combination thereof), now is the time to think about how they can help you before, during and after birth.
Many doulas, for example, have begun working with clients virtually rather than providing in-person support. So they can provide support while you’re in labor, even if they’re not physically in the room.
Of course, technology becomes even more important if you find yourself delivering somewhere with a policy that doesn’t allow a support person.
“The best thing would be for them to have their support person on a video call, so they could at least hear their voice and reassuring words,” said Rachel Goldstein, owner of the New York City-based Astoria Doula Collective.
So ask yourself: What devices will you use? Do you have some kind of stand, or could you get one? If not, where would you set up a laptop or tablet? Do you have chargers packed in your go-bag? Will you have WiFi, or how will you get online?
Of course, many women simply do not have devices readily available to them, which means they’ll be totally reliant on their care providers to offer support. But if you do have the resources, having a technology plan could be really helpful.
Know you can always explore other options — but safety is paramount.
If you are concerned about your current childbirth plans, you could look into transferring to a new provider or practice. Johnson-Grass said requests for consults at her birth center in Minnesota have skyrocketed recently. And media reports have speculated for weeks that more women are looking into home birth, for example.
But switching care providers during pregnancy can be challenging, even under less extraordinary circumstances. Many care providers have policies about accepting new patients — and those policies are in flux as COVID-19 disrupts many birth plans. You’ll have to consider issues like insurance, transferring records, and more. It is also essential to understand the potential risks associated with home birth. The American College of Obstetricians and Gynecologists considers hospitals and accredited birth centers the safest options.
“Yes, many policies and procedures have changed,” Johnson-Grass said. “But safety is the number one most important factor to consider.”
Use these strategies to remind yourself that you’re not alone.
Labor and delivery aren’t the only things changing because of COVID-19. Social distancing now means that many women won’t have friends or family around to meet the baby soon after birth, or to lend an all-important helping hand during the postpartum period. In addition to having a clear plan about how to connect via technology before, during, and after birth, it can help women stay calm and centered if they plan to surround themselves with comforting items.
Goldstein suggested women might thinking about bringing a photo, visual cues, or some other tangible item with them when they head into labor.
“I once had a client who held her grandmother’s rosary through most of her labor and found great strength in that,” Goldstein said. “Someone else suggested bringing your partner’s favorite shirt or something like that to help them feel more present.”
Personalized playlists with songs that really mean something to you can also help. Those touches aren’t silly or superfluous in these serious, frightening times; they can help anchor you, even momentarily.
If you do find yourself laboring alone — or sitting in a recovery room, wishing that your mom could be there with you, for example — it could help to think of the women who have done this before you. Think of grandmothers and mothers you know who’ve delivered on their own, Goldstein said. Maybe think of military spouses. Draw some strength from them.
Then remember that your care providers will do whatever they can to help you through this.
“They are doing their best to be present,” Goldstein said, “given the extraordinary circumstances.”
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