The uncertainties of having a baby during a pandemic
Early Tuesday morning, as news everywhere focused on the global calamity called the coronavirus, a girl named Isabella emerged into the world.
She arrived black-haired, 8 pounds, healthy and loved. A lucky girl.
Isabella is the first child of my 31-year-old niece Meredith, who felt lucky too. Forget for the moment that her husband just lost his job as a bar manager, becoming another economic casualty of COVID-19. What mattered this week was that she’d delivered a healthy baby during a pandemic.
Isabella was induced at 39 weeks — a little early — and the timing was an unexpected blessing in an unstable world. When Meredith arrived at the hospital, pregnant women were still allowed two visitors. By the next day, because of coronavirus precautions, the limit was one, and Meredith knew that soon, as has happened in New York, it might be none. Lucky.
“It was a weird feeling,” she texted me later, meaning weird to feel glad that she’d had to go to the hospital when she did, which allowed her to get in and out “before things get any crazier.”
Meredith lives in Oregon, and I offer her story as just one example of what’s happening all over the country: women having babies, or preparing to, during a time of coronavirus siege and economic convulsions.
“Birthing moms are really left behind in this conversation,” said Melissa Simon, an obstetrician/gynecologist at Northwestern Medicine Prentice Women’s Hospital. “They’re the only ones who are healthy who have to come to the hospital. It makes the stress level go up.”
At Prentice, as at other hospitals in Chicago, procedures for pregnant women keep adapting to the pandemic. As of Friday, laboring mothers were allowed only one visitor, and that person had to be screened for COVID-like symptoms. The designated visitor can’t be replaced. In other words, your mother can’t be there for a while and then make way for your partner or a doula.
“A lot of moms are coming to me talking about fear and anxiety,” Simon said. “This anxiety is normal for any mom, but right now during this COVID outbreak, the anxiety and fear are heightened.”
She tries to reassure them: You are not alone. This, too, shall pass. You will have a good life with your family. Reach out for help if you need it.
Being or feeling alone during childbirth is one anxiety. Another is the virus itself, whose effects on women and their pregnancies remain murky. At Prentice, as at other hospitals, women with COVID-19 or the flu — or with symptoms — are being treated separately from women without. They’re also being treated by separate health care teams to avoid transferring infections.
These sudden new anxieties around pregnancy and childbirth come in different forms.
Kara Goldman, an assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, is also seeing a lot of anxious patients. She’s a fertility specialist. For now, fertility treatments are suspended.
“The general feeling among patients is overwhelming uncertainty,” she said. “If they can’t get pregnant now, when will be safe for them to get pregnant? If they’ve been trying for a long time and don’t have access to fertility treatments, when will that access be available? For older patients, does waiting mean they’ll lose the opportunity to conceive entirely?”
The day we talked, she had been seeing cancer patients. She mentioned she’d worn a mask. Then she added, “We have to keep our masks stashed away now because they were disappearing quickly.”
Goldman worries about the lack of protective gear for all medical workers in this crisis. She worries about something else as well, and she echoes Melissa Simon when she says it, more than once: It’s still safer to have a baby in the hospital than at home.
For many women, the stresses involved with pregnancy are compounded by the new economic distress. Simon hears stories of women or their spouses losing their jobs, of pregnant women quitting because they can’t work from home.
“This COVID virus is really accentuating disparities,” she said. “Many of my patients are publicly insured and they are having a hard time. They are the ones on the front lines — working in the grocery stores, helping do the Prime and Instacart deliveries. The women I take care of are on the front lines of this virus, just like I am, and it breaks my heart. The disadvantaged are even more disadvantaged. We all have to think about what we have relative to one other right now.”
My niece Meredith is taking that approach. She left her job running her own one-person nail salon early this year to take care of herself while waiting for her baby, so she, as well as her husband, Travis, is out of work. She still feels lucky. Travis can collect unemployment and hopes to get his job back. Public health insurance has replaced the insurance he lost when he was laid off. They have parents who can help.
Her main regret for the moment is that family members have had to cancel trips to come visit Isabella, a girl born into a generation that will be shaped by a pandemic.
“That’s all part of her birth story now,” Meredith texted me from the hospital, “which is pretty weird! Hoping it makes for a good story later.”