At DC Metro Maternity, it’s been our job to guide clients through changes brought about by COVID-19. We’ve worked to address each situation individually for our labor clients.
Throughout the first few weeks of the virus’ impact on the DC Metro area, hospital labor and delivery staff, like the rest of us, were attempting to learn what exactly they were dealing with, and how best to protect their patients and their staff, while adapting to our new reality.
There were a lot of changes very quickly. It was hard to keep up!
Thankfully the dust is settling a bit, and doctors, nurses and midwives have begun to settle into this strange new normal. One of those doctors, Dr. Laurena White of the Eudimonia Center, took some time to talk to us at DCMM, and give us advice for her patients, our clients, and families in general.
*the interview below is edited for clarity
Dr. White, can you give us some guidance on what the general environment is like in labor and delivery units during the COVID-19 pandemic?
Dr. White: There have been places around the country where it looks and/ or feels like a warzone, and the sacrifices that physicians are making were way outside of normal. Life as we know it changed abruptly, with a great deal of misinformation along the way. It’s been hard to know what information to trust and what we know changes rapidly. The staff is there day in and day out, and there may be an atmosphere of fear and it may be a situation that they’re watching devolve.
Unfortunately, there’s been no universal standard for what should be going on across the country, state, or even within a county. The mixed messaging that patients and clients are receiving is because there’s no uniformity from hospital to hospital.
Some of the guidelines could be considered draconian (for instance, the women who’ve been required to give birth alone). Measures have been taken to limit family members, loved ones, and doulas. I’ve been at a couple of deliveries with just laboring mom and nurse. That’s a huge part of how things are changing. It can be harsh, but I can understand it from a safety perspective.
As more testing is being done, there are more diagnoses of coronavirus. The sheltering in place orders that most of us are under are helping. But there are so many people still moving around with the mindset of not being sick who are still having parties and moving, and providers are at risk.
As providers, no matter what, we’re trying to give accurate information. We want to be calm so we don’t add fuel to a gas fire.
Thank you for that perspective. I think that it’s been frustrating (to be candid) for expectant families and doulas. But I’m also sensitive that you all are being asked to go above and beyond right now.
What can families expect when going into the hospital to have their baby during the COVID-19 pandemic?
Expect screening questions and a temperature check. As a visitor, if you have a fever you may not be able to enter. The person in labor will get settled first prior to the support person being able to join.
If you’re at a hospital where there is full personal protective equipment (PPE), expect to see staff in PPE. There are variations (mask, eye protection, sometimes full gown covers, gloves).
There may be fewer labor and delivery nurses. For the most part, no more than 2 nurses would be in a room.
You may request a mask or bring your own to wear. You may not be offered one depending on the resource situation (there is a shortage). At this point, laboring mothers may not be required to wear a mask in some hospitals but may be requested to at others. And partners should wear a mask. You should protect yourself, knowing that labor and delivery staff has been in the hospital for days at a time.
Once a visitor is in the room, anticipate that there are limits to ins and outs, because everyone is working to keep exposure minimal, and keeping everyone who came in safe.
Painting that picture for us helps. We’ve been calling hospitals for labor clients and childbirth education students, and gathering information about what they can expect as well. It seems like one of the main things that COVID has taken away is that sense of safety.
If someone is pregnant and experiences symptoms they think could be COVID-19, what should they do?
Right now, if you wouldn’t go to the emergency room before COVID-19, don’t. But track your symptoms & document.
Are you experiencing fever, body aches, coughing, shortness of breath? Are things getting worse? Could it be the flu or allergies? Make sure to inform your medical provider, and talk to your doula. Your provider can provide the referral for testing.
What prenatal appointments are being moved to virtual/telehealth? Which ones should clients expect to still have in person?
How far along in pregnancy you are will determine this. For example, you may only have a telehealth visit utnil the week 12 ultrasound. Any appointment for bloodwork or a hands-on procedure like glucose screening or urinalysis, a PAP smear or Group B Strep testing will be in person. But ultrasounds to find out the sex, for instance, might be limited.
There are other ways to assess fetal growth and development & the health of your pregnancy, so you may have fewer in-person visits because it’s not considered necessary and essential.
When you do go in, you may have longer appointments since you haven’t been seen in person previously. Write your questions down so that the appointment can be more focused- we know that you may have more questions. Use the time and ask what you need to, even if something happened 1 time 2 weeks- write it down and keep a journal with you.
And remember, you can still call your provider at any point in time- they’d prefer that you call than not (so that you can be put at ease).
On the day of, I recommend staying home as long as possible. Avoid being in the hospital until it’s time to give birth.
What do doctors want their patients to know right now?
BREATHE and do your best to stay in the moment. Spiraling out of control right now won’t help.
We’re all in this together, and we all have different roles. Remember that we’re all doing the best that we can. Everyone handles stress differently, and every day is high stress now. Every person around you is stressed too- doctors and nurses don’t know more than anyone else right now. Uncertainty is still the only thing that we’re sure of , and we don’t want to put you in harm’s way.
Call your hospital ahead of time and check up daily starting at 38 weeks so that you know the standard. Things change within 24 hours, and sometimes without publicized notification.
Also, try to manage your expectations. It’s a transition. Cultivating a little bit more love is the best we can all do.
Dr. Laurena White and the other providers are still open and seeing patients at the Eudimonia Center. Both patients and providers are required to wear a mask during appointments.
If you’re looking for more information on preparing for birth, take a live online childbirth class with DC Metro Maternity.
