Pandemic Babies: Pregnancy and birth in the COVID era
The day before Kerry Cole went into the hospital to give birth to her first baby, the governor declared a State of Emergency. It was March 10, 2020, and a global health crisis was just at the brink, but still, to Cole, coronavirus felt like a vague threat.
But just days later, everything was different. By the time Cole’s son, William, was a week old, the world had completely shut down.
“Looking back, it’s funny how naive we were,” said Cole, who lives in Sturbridge and works as Vice President of Admissions at American International College. “At that time most people were naive about COVID, even in hospitals. Few wore masks with normal interactions (that changed about 7-10 days post Will being born). At the time, we allowed family to come visit, once. Our parents came up after we got home for one visit each.”
The magnitude of a global pandemic began to unfold just as the Coles brought home their newborn baby. Suddenly, visits with grandparents felt unsafe, planned excursions as a family of three were out of the question, and the world outside their home felt threatening.
Cole spent her maternity leave in strict quarantine, staging her own newborn photos on her front porch and replacing impromptu family visits with weekly Zoom meetings. The isolation put more strain on what’s already a stressful time for postpartum women.
“I think the hardest part about being a first-time mom during the pandemic was the fact that you couldn’t ask for help. Even with little things,” she said.
Bringing home a newborn is always an adjustment, but the pandemic has made it unusually complex for new parents like Cole. The joy of a baby has been tinged with the sadness of not being able to share the experience with extended family and friends in person, and happiness has been tainted by fear of a virus looming beyond their own four walls.
For Cole, it brought on a sense of panic.
“Things we took advantage of, like seemingly endless supplies of toilet paper, formula and diapers became hard to find,” she said. “I had expected ups and downs during maternity leave, but I never anticipated that I would be worried about providing the basic necessities for my baby. As a planner, I took it hard. I felt guilty that I couldn’t predict this. But honestly, who would have predicted a pandemic? No one taught us that in our baby 101 classes.”
Birth plans don’t always go as planned
It’s not just those first weeks at home with a baby that have changed for moms in the coronavirus era. Labor and delivery protocols have been upturned, as well.
Early on in the pandemic, representatives from hospitals in Central and Western Massachusetts and Eastern Connecticut gathered to outline policies, said Dr. Michele Sinopoli, an OBGYN and Medical Director at Saint Vincent Hospital in Worcester.
“We quickly realized in the region we needed to be aligned with other hospitals; that it would be helpful early on to have consistent messages on what to expect,” she said.
In the tightened labor and delivery policies at regional hospitals, women are tested for COVID just prior to or on admission, and are allowed only one support person with them.
If a woman tests positive for the coronavirus, her support person can stay with her unless she has a cesarean delivery.
In most cases, babies can room-in with mothers with COVID-19, according to the most recent guidelines from the American Academy of Pediatrics. But, the AAP recommends the mother maintain a reasonable distance from her infant when possible and wear a mask when providing hands-on care. The guidance also recommends that mothers with COVID-19 breastfeed after appropriate hand hygiene or express milk for the newborn, depending on the circumstances.
Post-birth visitors are extremely limited at local hospitals, and patients and visitors are asked to wear a mask at all times, unless eating.
Worried that the guidelines could impact the birth she wanted, Myjorie Phillipe, of Harvard, almost didn’t have her third baby, Grace, in a hospital back in June.
“There was a lot of unknown. Especially being Black I always fear the worst when I’m pregnant because Black die at a higher rate during their pregnancy,” she said.
Because of COVID, Phillipe’s choice of pain management, nitrous oxide, was unavailable when she delivered at Emerson Hospital in Concord. She ended up having an unmedicated birth, which was not her plan. (Editor’s note: nitrous oxide is again available to women in labor and delivery at Emerson.)
“With my previous pregnancies I was able to have the birth plan I wanted and not have to worry about last minute changes,” Phillipe said. “Having a baby during a pandemic is definitely different than my other two children.”
Dr. Sinopoli said hospital staff is acutely aware of the challenges women giving birth in the COVID world face. They’ve provided FaceTime in the delivery room, or positioned patients near windows to show off the baby to visitors outside, she said. At Saint Vincent, they’ve also implemented a new postpartum depression screening before discharge, knowing that many new moms could feel isolated once they go home.
“We don’t want women to be scared -- they’re not alone. I think in the current situation, we’re even more in tune to the fact that patients really need us,” she said.
What to expecting when you’re expecting in a pandemic
Six months since COVID-19 was declared a global pandemic, scores of women have spent all or most of their pregnancies in this new normal. That’s meant canceled baby showers, and masked, solo doctors’ appointments. Even birthing classes and hospital tours are being held virtually.
“Best word to describe it is depressing,” said Brittany Morgan, of Auburn, who was expecting twin girls when she spoke to baystateparent in early August. “My boyfriend hasn’t been allowed to an appointment since I was 12 weeks pregnant and I feel very alone at times during this pregnancy.”
A self-proclaimed “gym rat,” Morgan, a 911 dispatcher, was also forced to quit her workout routine when COVID closed down businesses in March. She felt “sad and robbed,” she said of being pregnant during a pandemic.
“I felt like my experience, especially one with twins, has been stolen by the isolation of COVID,” she said.
But taking every precaution to stay healthy while pregnant is important for moms-to-be. While current data suggest that pregnant women, newborns, and children are not at highest risk for COVID-19 deaths, pregnant women might be at an increased risk for severe illness from COVID-19 compared to non-pregnant women. And in July, physicians in France published a case study that strongly suggests a newborn caught the coronavirus before birth from his mother via the placenta.
“It’s worth it to take extra precautions,” Dr. Sinopoli said of women who are expecting. “You don’t want to have the disease at all, but especially when you’re pregnant.”
The silver lining
Five months after welcoming her son, Cole has been able to reflect on the experience of being a new mom in the midst of a global health crisis. It hasn’t been what she expected life with a newborn would be, but it hasn’t been all bad.
“We got to spend the first 4.5 months at home with our son. We got to see him roll over for the first time. We heard his first laugh. We spent every lunch with him, listening to him babble in his bouncy seat. We got to have coffee with him and take breaks from work to sing silly songs on toddler radio. We got extra snuggles,” she said. “The pandemic and the restrictions that come with it are hard to swallow. However, the bond that my husband and I have with our son, in part due to the pandemic, is one that I wouldn’t trade for the world. We are a stronger couple and family because of it.”