Pandemic poses new challenges for pregnant and postpartum moms

BIRMINGHAM, Ala. (WBRC) - “Pregnant in a pandemic” is not the phrase any expecting mom had envisioned as a caption to their baby bump photos or printed on a maternity shirt, but it has been the reality for many women around the world.

Pregnancy is often a season where expectant mothers reach out to their friends, community and own moms for advice and support. But women who are pregnant during the coronavirus pandemic are facing many questions for the first time, without the experience of others to lean on.

Those questions range from “How do I keep from catching the coronavirus while pregnant? Can my husband be in the labor and delivery room with me?” to “When can the grandparents meet our baby?” and “How long until I can let someone else hold our newborn?”

Olivia Amin-Bashier is a nurse at a Birmingham-area hospital and she gave birth to a daughter, Mina, in late April. As a pregnant healthcare worker, she was considered a high risk. And although her floor wasn’t accepting COVID-19 patients, she was exposed to a coworker who tested positive for the coronavirus and subsequently she had to be tested as well.

Amin-Bashier breathed a sigh of relief when her test came back negative, but decided to take her maternity leave early, around 37 weeks pregnant, to avoid any further risk of exposure.

“For me emotionally, that was the hardest part because I wanted to work up until I went into labor, just being active during the pregnancy, and not going stir crazy at home. And financially it’s taken a hit to go out early,” she said.

She wore a mask to her doctor’s appointments, going in alone except for a final ultrasound where her husband Allafi was allowed to join her. Like many hospitals around the U.S., her hospital allowed only one support person for each mother in labor and delivery.

Amin-Bashier said originally she wanted one of her sisters to be her doula, but because of the limit, only her husband was allowed to be with her as she gave birth.

Midwife: Pandemic brings a ‘whole new learning curve’

Princeton Baptist Medical Center is the only hospital in Birmingham currently allowing both a support person and a doula at delivery, because they consider a doula to be a part of the medical team.

Certified nurse midwife Sheila Lopez has been working at the Simon-Williamson Clinic at Princeton for four years. In pre-pandemic times, she preferred to enter a laboring mom’s room quietly, trying to be as unobtrusive as possible.

Now, she dons an N-95 mask covered by a cloth mask, gloves, a gown and a face shield. When she gears up, she said she feels “like a Storm Trooper.” All the added layers of protection can get very hot, especially when worn for hours at a time.

“I literally walk out and have to change clothes because I’m drenched,” Lopez said.

Her clinic has stopped seeing gynecological patients for annual visits, but those will resume on June 1, with social distancing measures in place.

“It’s been a whole new learning curve for sure, a whole new normal,” she said.

Her clinic has stopped offering group prenatal care due to the virus, which is something she and other staff members have been missing.

Princeton has also started testing all patients who have a scheduled procedure (such as a C-section or induction) for COVID-19 because they can get test results back in six hours.

If a pregnant woman does test positive for COVID-19, she would be moved to a room furthest away from the main nursing station and everyone would be required to wear N-95 masks, including her support person.

Lopez says it hasn’t happened at her clinic yet, but if a mother who tested positive for the virus gives birth, a pediatrician would offer counseling and discuss the options for how best to care for the newborn baby.

Options would include the mother wearing a mask, washing her hands regularly, and using some type of barrier screen except when breastfeeding, or allowing the baby to be cared for in a NICU to prevent further exposure. She said pediatricians would help parents assess the risk on a case-by-case basis.

Lopez said most of the research is still so new that they’re still not sure what the risk of exposure to COVID-19 is for pregnant women and newborns. Most of the current data is from pregnant women in their third trimester and shows a minimal risk to moms and babies, which is different from many other respiratory illnesses.

Virus adds fear, stress for new parents

Pregnant and postpartum moms face new fears all the time, but carrying a child while worrying about the coronavirus can add a whole new level of stress.

Reagan Luebe gave birth to her daughter Ruth in early May in Athens, Georgia. She said initially it was scary to be pregnant while the coronavirus was spreading in the U.S.

“The unknown of the impact of the disease on infants and the unknown of what the hospital restrictions would be the day she arrived. Having both of those things kind of ironed out was really helpful,” Luebe said.

“After New York said mothers were allowed one support person it put me at ease that other states would probably follow. There are always safety things to think through with a newborn but it’s been interesting thinking through them in light of the pandemic,” she added.

Like many women caring for newborns recently, she and her husband have had to change their plans for when their family members could meet their daughter. They asked anyone who wanted to be in their home and hold their baby to quarantine for a full 14 days, which has impacted which relatives can come visit.

“Another way I’ve seen it impact us celebrating her arrival is simply trying to figure out how to make the decisions on who is around her and when. And for how long do we have certain parameters in place? How long do we keep them narrow and when do we broaden them some?” she questioned.

“On the other side, having so much time as the three of us has been very sweet,” she said. Since her husband is working from home, he’s able to sit with Ruth and hold her even while he’s working.

Luebe said they’ve also been creative in how to let people outside of their immediate family “meet” their daughter.

“This has looked like taking lots of videos and pictures and sending them out to friends and family,” she said.

Olivia Amin-Bashier said the pandemic brought a fear factor to her pregnancy and postpartum life that wouldn’t normally have been there.

“It did take away some of the excitement of being able to have people come over and meet her and hold her. I’m starting to feel that now that we’ve been home several weeks and not been able to see people,” Amin-Bashier said.

Olivia and her husband Allafi, a teacher for Birmingham City Schools, are adjusting to parenthood without the physical presence of family members.

But relatives and friends are showing love in the ways they can: she’s been talking “all day long about baby stuff” with her sister in Colorado over the Marco Polo app; her mom dropped off a huge delivery from Sam’s Club, and friends have come to sit in lawn chairs in her cul-de-sac—admiring her new baby from a safe distance of 6 feet.

Amin-Bashier says one of the upsides to spending so much time at home lately is getting to know her neighbors.

“I will say, we’re new in this neighborhood, and our neighbors have been incredible. We walk every day, and every single person in our cul-de-sac, around seven different households, gave us gifts,” she said.

One of the hardest parts is figuring out who she and her husband will allow to hold their baby, especially when there aren’t many guidelines to go by.

“I can’t help but feel that paranoia, that’s what I’m struggling with the most, is that ever going to go away? Am I ever going to be comfortable with someone holding my baby?” she wonders.

Midwife urges pregnant, postpartum women to remain cautious

Midwife Sheila Lopez says pregnant and postpartum women should be more cautious than the general public as restrictions start to lift across the U.S.

“We don’t know long-term what the risk to moms and babies are. We know pregnancy decreases our immune system and babies have a weak immune system,” she said.

Lopez said there’s usually a recommendation of keeping the baby at home and away from large groups of people for at least six weeks, but with the coronavirus pandemic, she’d recommend trying to shelter at home as much as possible until the virus decreases.

Lopez also recommends those caring for the baby to wash their hands frequently, wear a mask when in public and limit their exposure to public areas or large groups of people. She encourages parents of newborns to speak to their pediatrician about the risks when it comes to making decisions about who can be around their baby, for how long and at what age.

“The grandparent question is the hardest because obviously everyone wants to meet their grandchild. But at the same time the asymptotic rate is there, babies can be carriers, parents can be carriers, and grandparents are at greater risk” because of their age, Lopez said.

While it may an emotionally difficult decision to keep grandparents from meeting or holding a new baby, Lopez says the pandemic will eventually be over, and the babies won’t remember that they weren’t held. But there could be serious repercussions if a grandparent did contract the virus, especially if they are older or have a compromised immune system.

Resources for pregnant and postpartum moms

Midwife Sheila Lopez recommends parents reach out to their baby’s pediatrician with their questions and concerns, since pediatricians will be studying the latest data on babies and the coronavirus.

She also recommends the website Evidence-Based Birth, founded by a nurse researcher and nursing professor. Parents can also check the CDC guidelines and the American Academy of Pediatrics.

Reagan Leube said Evidence-Based Birth and The Birth Hour podcast were both helpful for her during her pregnancy.

Olivia Amin-Bashier said the Moms on Call book (written by two nurses) has been informative as she cares for her newborn, and she also appreciated the article “Pregnant in a Pandemic: Coping and Hoping” by Betsy Childs Howard.

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