“What matters in life is not what happens to you but what you remember and how you remember it.” –Gabriel García Márquez

Birth in the Time of Coronavirus

“You’re not going to like this but I want to send you over today” were my doctor’s words at my last OB appointment on March 16^th before my son was born. I walked in on Monday and delivered on Tuesday, March 17, 2020 at 3:45am. That Thursday, we came home with our baby. I’m so excited to share the story of how our son, Brody, came into our lives. Brody was born in the middle of a global pandemic and a day after social distancing orders were in effect. As the country was slowing down and everything was coming to a close, my son came into our world and and brought immense joy in the middle of unprecedented fear. The anticipation of his birth was riddled with questions as Julian and I tried to navigate giving birth in the time of coronavirus. As a pharmacist and him being an anesthesiologist, we had access to more information than most but we were still terrified. I hope our experience provides some clarity as you make your own seemingly impossible decisions.

Of note, I gave birth right at the beginning of social distancing and procedures are more strict now than they were weeks ago.

Pregnant during a global pandemic

When we found out we were pregnant with our third child, I could have never predicted the pandemic circumstances in which he would ultimately be born. My priorities towards the end of my pregnancy quickly became protecting myself and my baby while pregnant and avoiding exposure to coronavirus in the hospital or during an office visits. At the time, data was still limited but thanks to scientists publishing case studies and retrospective reviews, we have more information coming out on a daily basis.

Pregnancy and birth never goes as planned but with COVID-19, everything felt amplified, as though one wrong decision could have a devastating downstream effect. As a mother, you are already so protective of your unborn baby, doing anything you possibly can to protect the life inside of you. A global pandemic increases that instinct exponentially. I worried every time I went to one of my appointments if I was exposing myself to COVID-19. I washed and sanitized my hands incessantly and tried not to touch anything I didn’t have to, including my face. The stakes felt impossibly high every time I left the house. Although, a silver lining in all of this is that I finally had the motivation to stop biting my nails.

With every doctor’s appointment, I was asked if I had been out of the country in the past two weeks and if I had any flu-like symptoms. There were minimal people in the office at the time as physicians had already started scaling back appointments. As I write this post a month later, doctors have drastically decreased in-person visits and have been relying on telemedicine. In fact, my 6-week postpartum appointment will be via telemedicine. There were still so many unknowns a few weeks ago, many of which remain today. In an effort to support expectant mothers, New York State has launched a COVID-19 Maternity Task Force to evaluate the effects of COVID-19 on pregnancy and to advocate for pregnant mothers. One of the goals of the task force is to examine the need for additional birthing centers as a safe alternative to strained hospital systems. More birthing centers means women without coronavirus can deliver their babies without exposing themselves to the virus, ultimately improving health outcomes.

We set a date

Our due date was April 4th so we were still a few weeks away from meeting our baby. That all changed when I had an OB visit on Monday, March 16th. For about two weeks, my blood pressure was elevated and trending upwards, leading to a diagnosis of preeclampsia. I was seeing my OB on a weekly basis in addition to getting two non-stress tests weekly and frequent blood work for monitoring.

Although I was feeling great, the numbers were writing a different narrative. Because my blood pressure readings were slowly creeping up and I had proteinuria (protein in the urine), my OB felt that getting induced was the best course of action for me and my baby and Julian and I agreed with her. Initially, I was disappointed at the idea of delivering early. I wanted to wait as long as possible to give my baby time to grow.  However, our circumstances had changed and we understood that we needed to deviate from the original plan. We set a date of Wednesday, March 18^th for the induction.

With the coronavirus being classified as a global pandemic and daily news escalating in severity and concern, we started to feel grateful for the opportunity to deliver early. I never thought I would feel happy to have preeclampsia. This was right in the beginning of the first week of social distancing. We were beginning to see the effects of the virus around us – empty streets, healthcare professionals wearing more PPE, extensive hand-washing and a general anxiety among the population. Coronavirus was all anyone was talking about, rightfully so. I was 37 weeks and 3 days along and felt comfortable delivering at that point given the chaos surrounding us.

This is happening, today.

Back to Monday, the 16^th. I was set to deliver in two days but that was all about to change. My blood work was back and my proteinuria had worsened. My blood pressure was also steadily increasing. For a time, I had attributed the higher numbers to hectic mornings trying to get the kids to school on time but that was clearly no longer the case. My doctor said that I would need to get induced that day and waiting was no longer a possibility. I remember her exact words were, “you’re not going to like this but I want to send you over today.”

Julian happened to be with me at the doctor’s office that day because he was post-call after two days of working 7pm – 7am shifts, ironically doing epidurals in labor & delivery at another hospital. Because of coronavirus precautions, he wasn’t able to come into the room with me when I was speaking to my doctor. I walked out into the waiting room and saw him sitting on the row of chairs closest to the entrance. He looked up at me, waiting for the latest update. “We’re having the baby today,” I told him. He started smiling and said, “good, that’s what we wanted.” His excitement made me feel slightly better but inside I was panicking. I thought I had time. In my mind, I had two days to get my bag packed, prepare my two big kids, do the last load of laundry at home, change our sheets, and establish a sense of order in what I remembered to be a very disorderly newborn period in the past.

Between coronavirus, preeclampsia, and giving birth, it felt like everything was happening too quickly. I started to feel like my world was spiraling. At that time, I didn’t feel prepared to have a baby that day but our baby was on his own timeline. I leaned into Julian and allowed myself to be wrapped up in his arms. For a moment, I needed to feel safe.

I should note that we were relying on our two older children (four- and two-years-old) to be in school that week. We found out the night before that their preschool would be closed for the next two weeks, the beginning of social distancing. Not wanting to bring them to the doctor’s appointment, we dropped them off at my brother- and sister-in-law’s house, thinking they would be there for a few hours. Upon hearing that I would be delivering that day, I thought about my kids and not being able to see them for the next 3 or 4 days. What if something happened to me? What if the last conversation I had with them would be me dropping them off quickly as I rushed to get to my doctor’s appointment on time?

As a steady stream of questions circulated through my mind, I closed my eyes while remaining in Julian’s embrace. I tuned out all the what-ifs and thought about one thing only. This is the day my baby would be born. My protective nature (also known as my control issues) kicked in and J and I made some decisions. We would go home first so I could shower and get my things together. Then, we would stop by to say bye to our kids. It was important for me to see them before undergoing an experience as monumental as giving birth. I needed to see my family. We were fortunate in that our kids were able to stay with my brother- and sister-in-law for a few days. Our parents were quarantined themselves and as much as they wanted to help, they weren’t able to because of coronavirus.

Looking back, I’m so happy we took the time to hug our kids tight and tell them that their baby sibling was coming. At that point, we didn’t know the gender and referred to the baby as “baby heart.” The kids were excited, their cousins were thrilled and it was a beautiful family moment that I desperately craved. A little familiarity was what I needed to feel like everything was going to be okay.

Stay tuned for part two (the delivery, a changing visitor policy, and complications) coming soon. By soon, I mean, as soon as my infant sleeps for more than one hour consecutively).