What to expect when you're expecting during COVID-19

Apr 29, 2020

Catholic Health is reassuring moms-to-be that the hospital is the safest place to deliver their child in this era of COVID-19.

COVID-19 has compounded the emotions experienced when a baby is due, so much so that the governor has established a Maternity Task Force to make recommendations. Those are expected as soon as this week. Catholic Health Chief Clinical Officer Dr. Hans Cassagnol said his biggest concern is that when people get frazzled or scared of a process, they will take shortcuts.

"The biggest thing I think everyone needs to get out of the task force is, number one, every single process that we have in place for a mom that's going to go through labor and delivery really needs to be based on the science of safety and infection control, and making sure we have the best possible outcome for two individuals: the newborn and the mom," Cassagnol said.

Fearful of contracting of the virus, many moms-to-be have been looking into home births. Catholic Health OB/GYN Services Chair Dr. Anthony Pivarunas said he has been noticing moms in labor are also "waiting too long" to go to the hospital. He assures the hospital is the safest place to deliver a baby because they are prepared for any possible complication.

"We drill all the time for every single possible complication and they have all the necessary equipment and professionals, basically, just waiting, standing by in case they're needed," he said. "Hopefully, when you're driving a car, you don't need your air bag to go off, but if you do have an accident, the air bag deploys as soon as something happens."

He said Catholic Health also screens all staff, patients and support people for the coronavirus throughout the hospital stay.

"All of our moms, if they have a scheduled delivery, such as a casearean section or induction of labor, they are going to have a test two days ahead of their scheduled delivery," Piverunas said. "And if they come in in labor, they are going to be screened with one of our rapid tests, which happens right when they come in."

He said a rapid test takes 45 minutes for a result. If a woman tests positive for the virus, as has happened "a few times," additional precautions are taken. Piverunas said one newborn also tested positive, but nationally, babies seem to tolerate the virus "very well" and without the complications seen in adults.

"The CDC has recommended possibly separating the baby from the mother after birth, but at Sisters Hospital, Mercy Hospital and Mount St. Mary's, we do what's called a shared decisionmaking model," he said. "We tell you what are the risks, how to reduce the risks of transmission to your baby, and even if you test positive, you choose whether the baby is going to stay in the room you're in or go to the nursery."

Cassagnol said COVID-19 also adds to the cost of delivery, mostly because of the personal protective equipment needed and the testing conducted.

"Another thing we haven't mentioned is the significant mental energy required just to operate within the COVID-19 setting," Cassagnol said. "There's so much that's still unknown about COVID-19. So I think that in itself, I don't think that we could put a cost on that, but it's definitely significant."

Piverunas said women also should not fear having to go through delivery alone. One support person is allowed during the delivery process, whether that is a partner, midwife, dula or someone else.

"Some downstate hospitals have eliminated any support person," he said. "That's the worst experience I can imagine, to come to the hospial and not have someone you trust and care by your side. We've never had that policy to not allow a support person."

He said that support person will have to stay in the mother's hospital room until discharged, but that will give the couple time to learn about the other things COVID-19 has changed about motherhood, like breastfeeding. Piverunas recommends mothers wash with soap and water before breastfeeding, but said there is no evidence COVID-19 can be passed through breast milk to a nursing child.

In nine months, Piverunas said he expects a "tremendous number of births" because of COVID-19.