McKenzie Redmond thought this spring would be a time to get together and celebrate as she awaits the birth of her first child, a boy.
But with the growing outbreak of new coronavirus, the Pasadena resident is spending her time at home. She canceled her April baby shower. She doesn’t know who will be allowed with her when she goes to deliver.
“When it’s your first, you imagine everyone celebrating with you,” said the 23-year-old hairstylist, due in July.
As the pandemic disrupts daily life for Americans, expecting parents are dealing with anxieties they never thought they would face, from new restrictions on hospital visitors to fears of getting sick or exposing a newborn to the virus.
In Maryland and elsewhere, the outbreak is changing the way prenatal care is delivered, with many patients attending appointments remotely through video chat. Expecting mothers face hard choices about who accompanies them in the delivery room.
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Redmond said she planned for her mother and sister to be with her in addition to her husband. Her hospital now allows one visitor in labor and delivery, but she doesn’t know what the rules might look like come summer. The outbreak has brought other stress, too: With salons shut down as non-essential businesses, she was laid off a few weeks ago.
In New York City, a hot spot of the U.S. outbreak, some hospitals last month banned anyone from accompanying women during labor and delivery, including fathers. But this past weekend, in response to such bans, New York Gov. Andrew Cuomo issued an executive order saying that hospitals there must allow one support person for patients giving birth.
Still, news of those restrictions has shaken some local women as the pandemic intensifies in Maryland.
“My biggest fear is having to deliver alone,” said 27-year-old Melana Reed of Reisterstown, due with a baby girl in July.
This has been a time of “a lot of scary unknowns," said Reed, who has been working from home as a service coordinator for people with disabilities. She, too, canceled her baby shower and doesn’t know when it will be safe to hold a “welcome party” for her daughter. Her boyfriend used to come to every appointment with her, but now visitors aren’t allowed for doctor’s visits.
”It’s a traumatic experience being pregnant during this time," said Reed, adding that she’s been especially anxious because she previously suffered a miscarriage.
In the Baltimore area, many hospitals are allowing only one visitor in labor and delivery.
“Unfortunately for families, it may be very difficult choosing who that is,” said Dr. Robert Atlas, chair of obstetrics and gynecology at Mercy Medical Center in Baltimore, which previously allowed up to five visitors in the delivery room. “It is a trying time, to be sure."
Atlas emphasized that these restrictions aim to protect “patient safety, staff safety, doctor safety."
So far, there has been limited research on pregnancy and coronavirus, Atlas said.
“Our biggest problem is there’s not a lot of information on this specific virus to guide us,” he said.
The U.S. Centers for Disease Control and Prevention says scientists do not know if pregnant women have a greater risk of getting the virus than the general population, or if mothers can pass the virus to their baby during pregnancy or delivery.
For now, local hospitals say they are trying to protect both staff and patients by using telemedicine and finding other ways to reduce the number of visits for prenatal care. For instance, some are arranging for women to take home blood-pressure machines for self-monitoring. High blood pressure can pose risks for mothers and babies during pregnancy.
At Johns Hopkins Medicine, providers are spacing out the number of in-person visits and conducting video chats for certain appointments, said Dr. Jeanne Sheffield, director of the maternal-fetal medicine division. The system has “decreased substantially" the number of gynecological patients coming to see a doctor, so there are far fewer people in the waiting rooms.
For pregnant patients who need extra monitoring because of conditions such as hypertension or diabetes, they can electronically message their providers their blood pressure or blood sugar readings.
"We’re able to do a lot more remote monitoring than we could before,” Sheffield said.
On a recent visit to her nurse-midwife’s office, Perry Hall resident Tara Rasmussen said she walked in and most of the furniture was gone, with chairs spaced well apart.
The pandemic-related restrictions have complicated plans for those who want to have a doula — a companion who provides support and comfort during childbirth. Some hospitals, like Hopkins, are allowing a visitor in addition to a doula in labor and delivery. Others are allowing one visitor only.
Rasmussen, due in June, had planned to have a doula, but if her hospital’s current rules remain in place, she won’t.
Rasmussen, 38, works from home as a legal operations program manager. Her husband is a full-time student and their 4-year-old son’s day care is closed because of the outbreak.
Like “most other women that are in my situation, it’s just figuring it out day-by-day,” she said. “And trying to take deep breaths.”
Doulas “are available to our clients 24/7” and that hasn’t changed with the pandemic, said Carling Sothoron of the Baltimore Doula Project, a volunteer-run organization that provides services on a sliding scale based on income. But now such support may come over the phone or FaceTime.
“We are still very much with them the entire time, it’s just not in person,” Sothoron said.
Doulas also are offering virtual classes and online support sessions, said Andrea Williams-Muhammad, a doula and co-chair of the Reproductive Health Equity Alliance of Maryland.
The American College of Obstetricians and Gynecologists has found that evidence suggests that "in addition to regular nursing care, continuous one-to-one emotional support” from someone such as a doula is linked to better outcomes for women in labor.
Williams-Muhammad called the new policies restricting visitors especially concerning given racial disparities in maternal mortality.
Last year, the CDC reported that black, American Indian, and Alaska Native women are two to three times more likely to die from a pregnancy-related complication than white women.
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A support person can help advocate for a woman during labor, said Williams-Muhammad, who is also program coordinator for the Baltimore Community Doula Program, which provides free services to families in the city.
“The potential of not having a chosen partner there only adds to that mom’s stress,” she said, adding that she is concerned that drastic visitor restrictions could result in families having unassisted home births without the support they may need.
Joanne Motino Bailey directs the University of Michigan Nurse-Midwifery Service. She’s trying to assure parents-to-be that “no matter how the birth unfolds, whatever the environment looks like, it does not take away form the sacred experience of welcoming this baby into the world."
“The folks that are close to giving birth are really anxious about what the birth experience will be like,” Bailey said.
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For some families, the pandemic also is changing the experience of bringing a new baby home.
When Arielle Seidler gave birth at Sinai Hospital in March, her husband was the only visitor allowed throughout her stay. She said doctors told them not to have any visitors around their baby girl once home. So, while her parents live “basically around the corner,” they haven’t been able to help out or visit their first grandchild.
“That part’s been really tough,” said Seidler, 31, an addiction therapist who lives in Mount Washington.
She feels grateful for the support of her daughter’s pediatrician, whom she recently texted with close to midnight when she was worried.
“That’s been amazing," she said. And “a couple people have dropped stuff off, like extra diapers.”
Redmond, the Pasadena resident, said it’s especially difficult to cope with the uncertainty of the situation — she doesn’t know what things will look like this summer, when she’s due. It’s also hard to pull away from constant stream of news about the virus, she said.
“All I can do is pray,” she said.