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What to expect when you’re expecting – COVID-style

“No one has really seen me pregnant,” said Jenny, who is due in early June. “The whole visible part of my pregnancy has been in lock down. That’s been harder for me than I expected it to be. Not being able to share the experience with my sister who’s pregnant, or my other sister, or my sister-in-law who has kids, or my mom.”

In the age of COVID-19, pregnancy comes with equal parts happiness and loss.

In many cases, husbands have not been able to share in the thrill of seeing ultrasounds or hearing heartbeats. To limit exposure to COVID-19, expectant mothers are having to attend doctor visits alone. In some cases, fathers aren’t even allowed in the delivery room.

“My cousin, who is due the week after me, is having a C-section and as of now, her husband won’t be allowed in the delivery room,” Jenny said. “I never wanted a C-section but now I really don’t want a C-section!”

Her sister, Nicki, declared, “All this social distancing is the pits!”

Nicki, who is due the first week of May, was able to have her baby shower at the end of February, allowing her friends and family to share in the joy of welcoming her daughter into the world.

“When you think about showers … not being able to celebrate … is just bizarre. You don’t realize how much you had expectations in your head; you don’t realize that’s an important part of being pregnant until you don’t have it,” Jenny said.

While obstetricians can’t change the world in which their patients are expecting, they are trying to ensure that the quality of care does not diminish.

“We’re using virtual visits and continuing to educate patients about what they can do to remain safe and have excellent prenatal care,” explained Dr. Maggie Marcrander, a Mercy Cinic obstetrician. “Virtual visits help a lot, allowing patients to have that face-to-face, even if they’re not coming in [to the office]. I think patients appreciate not coming in but also getting excellent care.”

Marcrander said tele-medicine hasn’t really been used locally in obstetrics but physicians are finding that it is a very helpful tool.

Marcrander said local obstetricians are working with the recommendations of the American College of OB/GYN and The Society for Maternal-Fetal Medicine.

“They are suggesting that in low-risk populations there are visits that you can either do through the telephone or with video visits in place of some in-person visits,” she said. “And do that very safely.”

“Before the COVID-19 pandemic, we did not use tele-health in the generalist’s office. The high-risk doctors would use it to reach to patients in outlying areas, but my partner, Dr. Rosen, and I have talked about how this might change how we see our patients post COVID-19. It’s something to think about it.”

Ashley, who is expecting in early September, had her March visit with her Mercy obstetrician via video conferencing.

“I talked to the nurse first and then I talked to my doctor. She was very understanding about my anxiety surrounding working from home, home-schooling and being at high-risk for coronavirus,” Ashley said. “She was reassuring and also very thorough.”

But Ashley’s next visit in late April can’t be conducted by video chat.

“I’m having an ultrasound so I have to go in,” she explained. “I’m worried that Adam [her partner] won’t be able to go with me and that he’ll miss out on this.”

Adam, likewise, does not want to miss out on his first child’s ultrasound.

“At Mercy, while we feel like the fewest number of people at a visit is very important during the COVID crisis, we understand that our pregnant patients are going to need a support person. So during times of ultrasound, for example, the patient would just check with her doctor to see if she can have her support person with her at that time,” Marcrander said.

Even before the COVID crisis, Marcrander said patients whose partners were unable to attend a doctor visit might use their cellphones to record the baby’s heartbeat or video tape an ultrasound appointment. There are options to help everyone feel connected.

With fewer visitors allowed on the maternity floor, Marcrander said, “It certainly is quieter on the labor and delivery.”

“What we’re also noticing is that some patients are wanting to leave the hospital sooner after delivery,” Marcrander said. “We do like to keep the baby at least 24 hours but we can support those earlier discharges if that’s what the patient wants and we feel clinically that they’re safe.”

Once home, the new families have to be quarantined for two weeks.

“That’s hard, too,” Nicki said. “I want everybody to meet her and it could be a while.

Also, I keep thinking that I will come home, my mom will be accessible, I will learn things from her, I don’t know how to do anything, and now she can’t come. There will be a lot of Zoom consultations.”

Like her sister, Jenny feels a bit lost, but Marcrander said the best advice gets back to basics.

“Right now, the most important advice for expectant mothers is social distancing and good hand washing,” Marcrander said. “Keep in contact with your doctor if you’re anxious so they can help walk you through what your worries are and try to enjoy being pregnant during this time of COVID. We don’t want our patients to miss out on the wonderful miracle of life.”

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