Emergency room physicians such as myself are adept at operating under demanding circumstances, but nothing could have prepared me for the onslaught of COVID-19. Especially because with a baby due in two months, I am not only protecting my life and the lives of those I serve — I am protecting my unborn child.
Every day, I walk into the hospital knowing that I am not alone. When I feel my baby kick while at work, it’s a sharp reminder of the responsibilities I hold both as a front line provider and a mother. In addition to my baby girl on the way, I have an 18-month old daughter at home. I am constantly preoccupied not only by my increased risk, but also the thought of my future child being born prematurely into a hospital full of very sick people, potentially with limited resources.
The stress of being a pregnant mother on the front lines of the COVID-19 crisis can be overwhelming. Simple activities such as drinking enough water on a shift are more difficult as I am constantly wearing a mask or a respirator. Every day is a constant battle between my duty to patients and protecting my children at all costs. My plan now is to be as present and careful as possible until I reach a point that the risk is too great.
In addition to protecting myself at work by remaining diligent with my personal protective equipment, I also have to think about if a health emergency does arise. I am helping my patients navigate this process by thinking about goals of care, what they would want done in a health crisis. I urge them to have honest and frank conversations with their families. As visitor access becomes increasingly restricted and our medical facilities and providers are overwhelmed with patients, advance care plans give patients a voice in their care, even if a times comes when they are unable to communicate with caregivers. These directives also help ER physicians like me make care decisions quickly, which allows us to provide expeditious, quality care when it matters most.
I am having to make these tough decisions for myself as well. The current crisis prompted me to sit down with my husband and tell him what is most important in my life, what I would want done if I were to become sick and how to protect our baby if I was critically ill. These are difficult conversations but must happen ahead of time and are something people of all ages should consider, especially as we combat this pandemic.
As a practicing physician, and as an expectant mother, I see every day how crucial this kind of planning is for my work and for my own health and well-being. For myself and my patients, I recommended going to CDC.gov to find state specific plans, or a free, online platform such as MyDirectives.com to create an advance care plan that can be easily and securely updated to keep everyone on the same page.
While the situation that I and my pregnant colleagues are in is unique, to simply be pregnant in this global crisis is a challenge in and of itself. Many mothers will not be able to have their loved ones beside them when they deliver. Hospitals have already banned visitors from sitting in on ultrasounds and checkups. Though this is for the best, it is still another tragic loss amid this pandemic. I hope these mothers know that the doctors and nurses caring for them understand the fears and anxiety surrounding pregnancy and labor, especially in this time of crisis.
Mothers like myself are strong, and we will survive bringing new life into this world, even during a pandemic, with strength and courage. Despite the many challenges coronavirus has brought on, it has not negatively impacted how I feel about my profession. I have been struck by the tenacity, compassion and community that has emerged as a result of us dropping everything to save fellow human beings.
People often ask me what it is like to work in an emergency room, and I tell them I see the extremes of human nature. We witness people in their lowest and most vulnerable moments but are also present for the beauty and infectious energy of hope, love and resilience. I am beyond blessed to have the love and support from family and friends who remind me that they are praying for me and that they are so proud of the work I am doing.
Dr. Elizabeth P. Clayborne is an adjunct assistant professor of emergency medicine at the University of Maryland School of Medicine. She works at UM Prince George’s Hospital Center. You can follow her on Twitter at @DrElizPC.