Pregnancy, delivery and postpartum during Covid: What to expect and how to find support

Written by: Claire Zawa

Pregnancy during Covid

Photo by Daniel Reche from Pexels
 

For those growing a family during the Covid-19 global pandemic, there may be additional concerns, worries or fears on your mind. While we continue to learn more about Covid, pregnancy has not been proven to be a contributing factor for increased vulnerability to the virus. However, prenatal care, labor and delivery, and post-birth care will look different from the pre-Covid era. Here's a guide on what to expect when you're expecting during this pandemic. 

Pregnancy
Each health care provider—obstetrician, family physician or midwife—will always bring their own training, past experiences and approaches to prenatal care. During the pandemic, each practice will have its own policies and procedures around medical prenatal visits during Covid. Establish a partnership with your provider—ask them your questions about what to expect for your pregnancy care.   

In the Chicago area, most providers and practices have substituted some of the standard in-person appointments with telehealth visits. If you are experiencing a low-risk pregnancy, this should be just fine for you and your baby. If you or your baby have any high-risk factors or complications, your provider will be working with you directly to provide the most appropriate medical prenatal care. 

For an in-person visit, expect to be asked screening questions upon arrival and to have your temperature checked. If you are experiencing any symptoms, call your provider’s office before going in to see them. Until testing is more widely available, don’t expect to be tested during routine prenatal visits.

One of the most significant changes in prenatal care is that your partner may not be able to join you at most or any of the routine visits, though they may be able to attend an ultrasound appointment. You can minimize potential disappointment by finding out in advance whether your partner can come in with you. If not, ask if you can have them on the phone or a web call during the appointment or if they can give you a recording of baby’s heartbeat to share.

What if you test positive during pregnancy?
Your provider is going to tell you what they recommend, based on what trimester you are in and what else may be going on with your pregnancy. As always, ask your questions so you understand the recommendations and what options you may have.

Final weeks of pregnancy
Talk about what options will or will not be available to you at the birth location. Have this conversation by the 36th week of pregnancy, because most babies, on their own, will arrive between 37–42 weeks. Do you have a strong preference for elements of your birth experience? Knowing what is possible may help you feel more prepared when your labor begins.

In addition to your provider, you can check out Birth Guide Chicago’s COVID-19 page for updates on local hospital policies and support people. Having the support of a labor support doula—in-person or virtually—can also be an invaluable resource for navigating pregnancy and birth. 

Labor and delivery
If you are planning to give birth at a hospital, here are some things to be prepared for:

  • Most providers are recommending that you stay home for as long as you are able to manage the sensations of labor before you come to the hospital or birth location. Even if you are planning for or decide you want an epidural, the longer you stay at home the shorter your hospital stay will be.
  • You will be given a Covid test in triage, in addition to the standard triage/admitting procedures. If you test negative, then things will likely proceed as they would in non-Covid times. 
  • If you are having a scheduled induction or Cesarean, you will likely take a Covid test a few days prior. 
  • There will be a limit of one to two people who can be with you. Some hospitals have limited it to one, others are allowing a partner and doula. Whomever your support person is, they will not be given a Covid test at the birth location. They should expect to be masked the entire time, and they will need to stay in the room with you. (Partners, pack extra snacks and clothes!) 
  • Each location has different policies on whether the mom-to-be will be required to wear a mask, regardless of the result of Covid test. 
  • Expect all hospital staff to be masked and gloved when interacting with you. 

What if you test positive for Covid when in labor? 
Expect to have additional measures put into place to keep staff safe while ensuring your safety and baby’s safety. You can talk with your provider in advance about the specific practices of your birth location. Because this is a new virus, there is still much we don’t know. The specifics of what your care will look like during labor, delivery and postpartum, as well as baby’s care, vary by birth location. But expect to be placed in a special room, to potentially have no partner/doula allowed in with you, and for all staff to be wearing PPE. 

Postpartum
Visitors will likely be limited to the partner and possibly the doula. Friends, family members and older children will have to wait to see you and baby once you are home.

Most hospitals are discharging new moms and babies after 24 hours for a vaginal birth and three days for Cesarean birth. Discharge remains dependent upon Mom being cleared by her provider and baby being cleared by the pediatrician to go home. Breastfeeding/chest-feeding is safe and recommended! 

When can friends and family visit? Pediatrician recommendations on who and when non-household members come into your circle vary, but generally the baby’s 2-month vaccination appointment can be considered a time marker. You will need to assess the risks and benefits for yourself and your family to determine when you are ready for visitors. There is no one set time that it will feel right for every new family.

During pregnancy and the first year of parenting, the only constant is change. How we each respond to change is personal but doesn’t need to be isolating. There are many resources that are accessible during Covid: childbirth education and preparation classes have moved online, and so have many pregnant and new parent support groups (check out NPN's New Moms Groups). Therapy and other mental health services have been made easier to access through most insurance companies and with telehealth. Labor support and postpartum doulas, as well as lactation consultants (IBCLCs), continue to offer in-person and virtual care.  

Pregnancy and postpartum during Covid may be different but you can still find plenty of support. I hope your new baby brings you joy during this uncertain time!

Claire Zawa is the Care Manager at Birthways Inc in Chicago. She teaches mindfulness-based childbirth and parenting classes and provides doula services. At Birthways, we strive to provide an exceptional experience. It is important to us that we make your journey as a parent safer, kinder, supported and less stressful. For more than 23 years, we have been helping families to thrive as they welcome their babies. 

Posted on September 24, 2020 at 10:54 AM