A recurrent anxiety terror keeps flashing intrusively through my head: I’m in the throes of labor, surrounded by masked strangers, and I don’t recognize a single face around me. This vision began three weeks ago, when I first realized that this pandemic was rearranging my pregnancy into a constellation of uncertainty. Already navigating the uncharted waters of my first pregnancy, I now feel completely adrift.
The changes have already started. Last week, I went to the hospital alone for an anatomy scan, an ultrasound that can detect a number of abnormalities from heart defects to spina bifida. Up until the day of my appointment, I was excited that my husband would hold my hand as we watched our baby squirm around on the screen. Instead, that morning the nurse called to let me know non-patients wouldn’t be allowed to enter the hospital.
Somewhere between the NBA calling off its season, the WHO declaring a pandemic and the frightening reports out of Italy, most of America seemed to catch on to the gravity of Covid-19. But among pregnant women, the threat has been a topic for months. In private online subreddits and Facebook groups, we collectively watched the early headlines from China and attempted to divine what it might mean for us. “Today I Cried” posts morphed from sarcastically funny (“my husband ate the rest of my Ben & Jerry’s”) to genuine and troubling. As the threat of contagion, and its broader ramifications, grew, mild annoyances (like the grocery store getting ransacked of my go-to pregnancy treat, Annie’s Shells & White Cheddar) gave way to real fear.
Last week, women began to report on pregnancy subreddits that their obstetrician’s offices had transitioned all routine appointments to virtual telemedicine checkups, eliminating the peace of mind that can come from hearing your baby’s heartbeat on a fetal doppler. Others had their anatomy scans delayed, forcing women to wait an indefinite length of time to find out whether their babies were progressing healthily (and, depending on the state, eliminating the option of terminating for medical reasons). The birthing and breastfeeding classes at my hospital were canceled. I’ve never given birth, or breastfed, or cared for a newborn before – for me, these were critical resources I’d counted on to help me navigate all of this.
As hospitals began tightening the restrictions on how many visitors could accompany patients in the delivery room, women had to decide whether their doulas or their spouse would be with them during birth. Then, over the weekend, a hospital in New York announced that they would no longer allow any non-patients whatsoever: women will give birth without birthing partners or support people at all. Mount Sinai Health System has also put a similar policy in place and as the outbreak worsens, other hospitals are likely to follow suit.
With hospitals and doctors’ offices adopting different policies individually, and news about the pandemic’s effects changing by the hour, I felt little clarity on what all of this meant for myself and other pregnant women. I contacted Denise Jamieson, chair of Emory University’s department of obstetrics and gynecology. She helped formulate the clinical guidelines for the American College of Obstetricians and Gynecologists on pregnancy as it relates to Covid-19 based on the (admittedly scant) data researchers have collected so far. A former CDC officer, Jamieson has studied the impacts of outbreaks like Sars and West Nile on pregnancy for decades.
“Though we know that pregnant women can get ill from Covid just like everybody else, we don’t have evidence at this point that pregnant women are more severely affected than the general population,” Jamieson told me. Unlike viruses such as Zika, Covid doesn’t appear to increase the risk of severe birth defects, either. On the other hand, Jamieson adds, any woman severely ill late in her pregnancy could have an increased risk of pre-term labor and delivery. “But again, we just don’t have enough information at this point.”
Beyond this being so unprecedented that even experts don’t have answers, what fuels my anxiety is the threat of hospitals becoming so overburdened that by the time I’m delivering, I’m in the care of a skeleton crew of exhausted healthcare workers who can’t even access the basic supplies they need to proceed with safe medical procedures. To top it off, I may be bringing a newborn into an environment that is overrun with infected patients.
Thoughts like this are what’s driving more women to consider home births. The other day, I checked in via text with a friend in California who is due in May. At a doctor’s appointment last week, her husband asked the nurse what happens if the hospital runs out of beds. The nurse dismissed the question, assuring them such a scenario would never happen. “I’m sure she didn’t intend to make us feel silly for asking, but that was the tone,” my friend told me. “Literally two days later, that scenario was the news.”
Home birth – a prospect my friend hadn’t at all seriously entertained previously – started to seem like the only option.
Sarah Gormley, a doula based in Atlanta, has fielded various concerns from her clients in recent weeks. “We’re all exploring worst-case scenarios,” she said, explaining that doulas are now organizing and advocating for hospitals to recognize them as “essential personnel”, not just visitors. Then again, she adds, there is a moral calculus to be made: is it the civically responsible, ethical choice for a doula to stay home, rather than insist on being present in hospital environments? She doesn’t know the answer. She added, “But I can’t imagine getting a call from one of my clients and saying no.”
Personally, I can’t yet imagine transitioning to a home birth. Some friends have asked whether I’d consider switching to a birthing center (a non-hospital environment for giving birth), but that would preclude any option for medical interventions, like an epidural, and I’m not sure I’m ready for that.
Just a few weeks ago, I wasn’t considering hiring a doula for my pregnancy, but that has since changed. I’m not even sure whether one would be allowed to come with me to my birthing hospital. But navigating all of this uncertainty without someone to hold my hand and tell me what to do seems unfeasible for me right now. The prospect of giving birth and learning to care for an infant is already daunting to me; if I can have someone by my side who has coached women through it, that might be my best hope for staying grounded through this. Even if the hand-holding and coaching has to happen strictly via FaceTime.
In my online groups, women are trading advice for throwing “virtual baby showers” on Zoom, and compiling links to online webinars about breastfeeding and YouTube prenatal “classes” to help replace those canceled birthing classes. We comfort each other by echoing a refrain that feels like a well-worn talisman: women have been doing this for thousands of years, through war and plague, starvation and social upheaval. And in a moment devoid of any answers, trusting in that is a feat quite a lot like pregnancy itself: marching, however blindly, toward something beyond ourselves.
