Delivering During a Pandemic; Hospitals Remain the Safest Choice
Expectant mothers, especially those who’ll be delivering their first baby, already have plenty of questions and fears. Now, the reality they’ll be bringing new life into the world during the COVID-19 pandemic is adding to anxiety levels.
Dr. Melinda Feely, an OSF HealthCare Family Medicine physician who specializes in obstetrics, says fear of contracting COVID-19 is prompting some pregnant women to explore delivering at home, when they would not have considered that option previously. Dr. Feely points to results of research published in February by the American College of Obstetricians and Gynecology which found births were significantly safer using midwives in a hospital setting versus a home delivery.
“Hospital delivery is three times safer than a home delivery. There are so many complications that can happen during birth that minutes and seconds matter so we can ensure a safe birth for that infant and for mom,” Dr. Feely stressed.
OSF HealthCare Chief Medical Officer Dr. Ralph Velazquez says hospital birthing centers are separate from where COVID-19 patients are cared for and it’s helpful to remember that nurses and physicians working in designated labor and delivery areas are not mingling with other units which might have COVID-19 positive patients, including pregnant women. In addition, he emphasizes new safety protocols make the hospital the best place to give birth.
“If you choose to deliver at home, has everyone in that house been screened, had their temperature checked and answered all the questions before they were there? Is your home as clean as the hospital is? Are you using the same cleansers a hospital is using?” he asked.
In addition, Dr Velazquez suggested there are other considerations. “Is the person coming in to help with the delivery been screened with a temperature check? Do you know the last place they were before they got to your house for delivery and that that place had no one with COVID?”
For the safety of caregivers and patients, visitors are limited to one support person who will be in the labor and delivery birthing suite. However, Dr. Feely says OSF HealthCare is allowing others to be included virtually.
“We have loosened restrictions allowing FaceTime and videoing during that laboring process so you can have your support people with you, even remotely.” She added, “We try to promote letting you help us guide your birth plan so you just need to let us know what you want during your labor and delivery process and as long as things are safe and going well for mom and baby, we can go ahead and honor those.”
COVID-19 testing is recommended but not required within 72 hours of scheduled C-sections. Women are asked to consult their doctor. A test for the novel coronavirus is not required for vaginal deliveries because of uncertain nature of the timing since babies come when they’re ready.
Masks will be required for mothers-to-be and their support person as they enter the hospital but will not be required in the birthing suite unless the mother is positive for COVID-19. In that case, the delivery would occur in a separate, negative air pressure operating room, which would prevent the potential spread of the virus. The care team would wear N95 masks and face shields while mom and her support person are masked throughout labor and delivery.
With vaginal deliveries, the surgeon or nurse midwife and other caregivers will be wearing surgical masks and face shields.
Updated CDC guidelines say the risks and benefits of separating a COVID-positive mom from her baby should be discussed and separation should not be considered the first or only option. Early research suggests the novel coronavirus doesn’t appear to pass from mother to fetus in the womb and that pregnant women are at no higher risk for contracting the virus if they take recommended precautions.
Dr. Feely says close, skin-to-skin contact is important for bonding post-delivery but should be done cautiously. Once the baby is home, she recommends direct contact only with people living in the home.
“You just want to continue your good hand hygiene and if you’re going to the store, making sure you’re coming home and washing up and wearing your mask when you’re out at the store.” she stressed.
Even though virtual visits and window visitors aren’t the same as the typical welcome home for most babies, Dr. Feely says preventing transmission to an infant after delivery is critically important. That kind of isolation can also impact a new mom’s mental health. Changes in hormone levels, lack of sleep and stress contribute to postpartum depression and Dr. Feely says the lifestyle restrictions brought on by the novel coronavirus pandemic are an added stressor.
“Make sure you’re reaching out to your social support even if it is remotely -- that’s important; staying in touch with your family and reaching out with questions to you physicians and other care providers. We’re all here for you,” she advised.
For any questions, moms to be can also call the 24/7, OSF COVID-19 Nurse Hotline at 833-OSF-know (833-673-5669).
The Circle by OSF is a free mobile app that supports women through pregnancy, motherhood and beyond.
Here are the complete CDC guidelines for pregnant women including information about breastfeeding and caring for babies and young children.