Giving birth during coronavirus: 'Something has been stolen from us'
Parents welcoming babies into the world during the strange chaos of COVID-19 face an unusual new set of challenges and fears.
Danielle just turned two weeks old, and she still hasn't been hugged by her grandparents.
They've come close. After Danielle was released from the hospital, alongside her parents Andrew and Joanne, her grandparents on the father's side visited the house. They didn't come close to Danielle, or cradle her. Instead, they stood on the deck. Just to be safe. Given the need for social distancing -- and the added vulnerability of the elderly to the virus -- it was probably the right call.
Danielle is a baby born into the strange chaos of the most widespread pandemic since the Spanish flu.
(Some names in this story have been changed for privacy reasons.)
It's March 2020, and COVID-19 has the entire world on lockdown as cases continue soaring upward. Almost every country affected has put restrictions in place to stop the disease from spreading. In the US, many states are fully locked down. In Italy, where conditions are dire, humans are essentially under house arrest. In Spain, the military disinfects the care homes of the elderly, often discovering corpses in the process. Life as we know it has changed.
Hospitals, especially maternity wards, are far from immune. In the past few weeks, processes put in place to protect patients and staff have changed dramatically.
In Australia, expectant mothers are usually allowed two support people in the delivery room -- maybe a partner and a parent. Now they're only allowed one. Doors that were once open to visitors are now locked. Literally locked.
These changes make perfect sense in the current climate. Hospitals more than any other institution are required to protect at-risk segments of the population. That includes pregnant women and newborns.
"It's weird. There are strictly no visitors allowed in the hospital," says Jason, who recently became a father for the second time. "Partners only. They've stopped doing all their usual classes to help new parents learn how to live with a baby."
The changes have been difficult for some.
"The impact of those restrictions during labor is going to be very traumatic for many women," says Marie Heath, a spokesperson for Midwives Australia, a not-for-profit organization that represents midwives across the country.
If anything, midwives say, these restrictions -- and the resulting anxieties of expecting parents -- are about to get worse.
Heath says Danielle's grandparents were lucky to even stand in the same house as their grandchild.
The clock
Childbirth was a blur for Joanne. She remembers the pain. She remembers being handed her baby, her first, seconds after delivery. Above all she remembers the clock.
An oversized digital clock, with ominous red digits, steadily ticking forward. During labor, in an attempt to regulate her breathing, Joanne focused steadily on that clock, a clock she was familiar with. A clock used in emergency wards throughout Australia. Joanne recognized it because she, herself, is a doctor.
Working a doctor's punishing hours contributed to what was an extremely challenging pregnancy.
"It was hard," Joanne says. "I wasn't super well for most of it."
Joanne suffered from morning sickness for the majority of her pregnancy and was eventually diagnosed with preeclampsia, a pregnancy complication characterized by high blood pressure and potential organ damage that usually appears at around 20 weeks. ("Ironically that was the point at which I actually started enjoying pregnancy," jokes Joanne. "That's when I started to feel better.")
Being a doctor in an emergency ward and being pregnant is incredibly difficult.
"You often don't get time to eat, you don't get time to go to the toilet," Joanne says. "On top of that we have regular patients with infections I wanted to avoid, like toxoplasmosis or listeriosis or measles."
By comparison, Joanne's labor was relatively straightforward. Her husband, Andrew, says it was "like starting in the final act."
"Officially it lasted one hour and one minute," says Joanne.
Coronavirus updates
Because she's a doctor, there were moments during labor when, compared with most patients, Joanne was more acutely aware of the situation. She could hear her baby's heart rate slowing down through the monitor and understood the consequences of that before midwives told her to go go go.
Almost immediately after giving birth, Joanne was rushed to theater complaining of a "pain worse than childbirth." A 2-hour-old Danielle was placed in the hands of Andrew, husband and now father. He had no family, no additional support person to help guide him through his first terrifying hours of parenthood.
"This is my baby," Andrew remembers thinking. "This is what we're here for."
Locking the doors
Joanne's preeclampsia diagnosis meant she had to visit the hospital frequently.
In the beginning, coronavirus precautions were minimal. There were already reports of panic buying, of toilet paper shortages, all the precursors of the impending chaos. But in the hospital not too much had changed.
In under a week, policies tightened dramatically. The changes made sense, but for an expectant mother like Joanne, anxious about the impending birth of her daughter, they were tough to witness.
"Within four days it went from no real restrictions to the doors being locked on the wards," she says.
Andrew remembers being constantly checked by hospital staff for ID and the wristband he was asked to wear at all times.
Now that she's been discharged and is back at home, the days since Danielle's birth have been difficult for Joanne and Andrew. Panic buying in supermarkets made buying some of the necessities required for parenting a newborn child difficult. They needed formula, diapers, a breast pump. Andrew had to visit three separate supermarkets to get everything they needed.
"I wandered around in a daze, trying to buy the things we didn't realize we needed," Andrew says. Everyone was acting normally, and Andrew remembers getting frustrated at customers standing so close to him in the queue.
"I felt like if I said anything I might have lost it," he remembers. "I'd gone from hospital mode, washing my hands with sanitizer every time I went through a door. Now I was in the real world where people weren't respecting that."
Because of interstate lockdowns and rules around social distancing, no family members -- outside of the grandparents standing at a safe distance from the deck -- have properly met Danielle for the first time.
"I sometimes feel like something has been stolen from us," says Joanne.
"The normal experience just isn't going to happen. I won't be able to go and meet other new mums for coffee, I can't take the baby to meet friends and family like you're supposed to do."
The halls are quieter
Jason, who welcomed his second daughter, Amelia, into the world this week, had a slightly different experience. That's to be expected of a parent going through this process for a second time. Been there, done that. He's less worried about family members not being able to visit, for example. If anything, he welcomes the respite.
But he was also acutely aware of the differences between his first daughter's birth and the second's.
"The halls are far quieter than they were two years ago," he says.
Jason's daughter has had, in his words, a "bumpy start" as a result of hypoglycemia and jaundice. That's resulted in a three-day stay in the special care nursery.
Wandering around the halls feels different this time around.
"People are understandably staying their distance from one another," says Jason. "I feel like an errant cough or sneeze in this place will get me shot. I tried so hard to stifle a sneeze today that I pulled a muscle in my neck."
But Jason's optimistic about the future. He was more stressed after the birth of his first daughter, he says. He stressed endlessly about climate change back then and wonders if the response to the coronavirus crisis will be a net positive in the years to come.
Either way, the future Jason expected for both his children has now irrevocably changed.
"Right now it's hard to clearly imagine what her future might look like. I hope to raise her to be invested in that future and never take it for granted."
Escalation
One week after giving birth, Joanne and Danielle have already had a home visit from a midwife, but Joanne is worried additional restrictions will result in future visits being canceled.
Marie Heath from Midwives Australia says visits should continue to go ahead, but have been restricted to 15 minutes. A representative from NSW Health confirmed midwives are required to perform risk assessments, to determine if anyone in the house has been sick. If someone is sick, midwives can consider "alternative methods of conducting, such as via telephone or video call if appropriate."
"Colleagues I know that work in the system are very fearful, particularly because there's really not a lot of direction around how things might happen," Heath says.
There's a sense among midwives that women preparing to give birth in the coming weeks, who have a more concrete understanding of COVID-19 and its global impact, will suffer more stress and anxiety compared with women like Joanne, who gave birth in the midst of the initial confusion and chaos.
As a result of quarantines and social distancing, Heath is concerned about increases in domestic violence. She believes we're just beginning to see the impact of lockdown on the mental state of women preparing to give birth.
"It's going to get worse before it gets better," she says. "It's going to escalate the level of isolation that women are going to have to cope with and with that comes anxiety.
In an attempt to reassure pregnant women, Dr. Vijay Roach, president of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, posted a video on Vimeo, providing advice to help soothe some of those anxieties.
"We need to remember that pregnant women are at higher risk of developing anxiety and depression," he explained. "This can apply to your partner as well. Look after yourself. Be gentle to yourself. And, if you have symptoms of anxiety or depression, talk to your health care provider and get the appropriate care."
Some important facts he also wanted to relay: Pregnant women with COVID-19 usually display only minor symptoms and don't pass the virus on to the baby. There's no evidence the virus will harm the baby or cause any abnormalities.
"I want to reassure you," he said, "that the most likely thing that will happen is you and your baby will be well."
The future
Joanne was planning to take a whole year of maternity leave, but expects she'll now have to go back to work much sooner.
First, because Andrew, her husband, works in retail, and retail is one of the worst-hit industries by the coronavirus pandemic. Second, because Joanne is a doctor in a world that desperately needs doctors.
"I'll feel guilty if I go back to work early and leave Danielle at home, but I'll feel guilty if I don't go back and work."
Andrew is unsure of his job situation. Retail sales at his store dropped 20% almost immediately as a result of the coronavirus, and continue to drop. He'd initially planned to take a month of paternity leave, but was asked to cut that short by two weeks. He doesn't know if this is a good sign or a bad sign.
"We planned a future," says Joanne, "but now that future is dramatically different."
But everyone's healthy and they're together in the chaos. Ultimately, says Andrew, that's all that matters.
"We don't know how this plays out. We just have to do what makes sense and get through it. Some of it's going to feel weird, some of it has felt weird, but we've got her.
"We'll find a way to make it work."