For Devina Lalla, expecting a baby in the midst of a coronavirus pandemic raises new challenges and questions, and sparks waves of anxiety. It also had Lalla considering what would otherwise be unthinkable for her — a home birth.
Lalla quickly dropped the idea after learning rubbing alcohol, considered an essential for delivery at home, is on back order for months.
“Being pregnant for the first time can be stressful anyway,” said Lalla of east Cobb County, who is due July 4. “But this is uncharted territory for what it means for moms and their babies.”
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Pregnant women, along with their partners, are on high alert and hunkering down at home to reduce the risk of possible exposure to the highly contagious coronavirus. They are forced to come to terms with difficult circumstances surrounding their pregnancies, such as skipping some appointments or doing them via video chat. Metro Atlanta hospitals, including Northside, Piedmont and Emory, are severely restricting visitors and allowing women in labor and delivery to have only one support person accompany them. If they bring their spouse, they cannot bring anyone else, including their doula. And more restrictions may be on the way as the new coronavirus quickly spreads, now surpassing 2,000 confirmed cases in the state.
All the while, it’s not known how the coronavirus affects pregnancy. The American College of Obstetricians and Gynecologists says “very little is known” about COVID-19 — the disease caused by the coronavirus — and its effect on pregnant women and infants.
While most people with COVID-19 suffer mild to moderate symptoms, adults over 60 and those with underlying health conditions such as heart disease or diabetes appear to be at greater risk. While pregnant women are at a higher risk from other viral respiratory infections, including influenza, it’s unknown whether they have a greater chance of getting sick or experiencing more serious illness than the average person from this new coronavirus, according to the U.S. Centers for Disease Control and Prevention.
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Dr. Albert Scott Jr., an Atlanta OB-GYN and founder of DeKalb Women’s Specialists, advises pregnant women to take the same precautions as everyone else: washing hands thoroughly, practicing social distancing, avoiding people who may have COVID-19, not touching faces and routinely cleaning frequently touched surfaces at home.
Scott, who is president of the Georgia OB-GYN Society and also part of Gov. Brian Kemp’s State Coronavirus Task Force, said several measures are in place at OB-GYN clinics and hospitals to help reduce the spread of the coronavirus. Patients in labor are evaluated and admitted to special rooms. He said suspected COVID-19 patients are evaluated in an isolated area in the emergency department and admitted only to designated floors.
He said many OB-GYN offices are discouraging non-urgent patients from visiting and requiring pregnant patients to come alone to those visits to reduce potential exposure. Some practices, he said, are seeing patients only at critical times in the pregnancy — 28, 36 and 39 weeks — and then using telemedicine for virtual visits in between.
Dr. Stephanie Grogan, the chief of OB-GYN at Northside Hospital, said the hospital’s OB-GYN practices have increased precautions, which include only allowing one entrance into the labor and delivery department, screening patients and their support people for any symptoms of the coronavirus, and disinfecting and sanitizing hospital rooms at a high level.
Any woman in labor who arrives at Northside with symptoms of COVID-19 is isolated in an area separate from other women in labor. Grogan declined to comment on the number of pregnant women at Northside with suspected coronavirus.
"This is uncharted territory for what it means for moms and their babies." —Devina Lalla, expecting a baby
Northside and other hospitals have also recently stopped allowing visitors, including parents, to visit newborns in neonatal intensive care units to prevent the transmission of COVID-19. Many of the hospitals, including Northside, are giving parents IPads to connect to their babies through video interactions.
Grogan encourages pregnant women worried about giving birth during the pandemic to talk to their doctors. She also urges them to take steps to ease stress, such as going on a walk or doing a yoga class at home.
“Everybody is anxious right now, pregnant or not,” she said. “It’s certainly normal to be anxious, and I understand this additional layer of anxiety.”
Grogan said while she understands women may be feeling more concerned these days about giving birth in a hospital, she cautioned against changing delivery plans based on COVID-19.
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“Even with the COVID-19 pandemic, delivering a baby in a hospital is still, by far, the safest option,” she said.
Grogan said there’s been no decline in the number of babies delivered at Northside.
For Elysia Douglas, an Atlanta doula, the outbreak has forced her to stop all in-person visits with clients.
“We just have to make the best of a not-so-great situation,” she said. “I would hate to be the person asymptomatic and be spreading it to a client and not finding about it until later or that anyone in the hospital could be exposed because of me. In the end, it’s more important to keep you and me safe and healthy than risk exposure.”
Douglas, who has been a doula for more than 100 women and their partners, said she will compensate for what is lost through virtual support.
“As humans, we have five senses, and when one is taken away, the others are heightened,” Douglas said. “If I am not there personally, I will beef up emotional support and communicate very effectively.”
Douglas has started doing trial runs using video chat with her clients, including Scott and Elizabeth Meachum, who is pregnant with twins and due in late April.
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Shweta Kanetkar, a research scientist at Georgia Tech and due with her second child, a boy, in early August, said she’s trying to stick to a routine and stay positive. The Smyrna woman enjoys spending more time with her 3-year-old daughter, Arya. She’s also started daily meditation.
“We are taking each day as it comes,” she said, “and I’m trying not to psyche myself out too much by keeping up to date with major headlines but not reading about the coronavirus too much.”
Kanetkar, who is 35, said she’s noticed her husband, Yatin Kanetkar, is more protective. He does all the grocery shopping and wipes down everything, including cans, in the garage first before bringing anything inside the house.
Meanwhile, Lalla, who is 32 and is a professor at Savannah College of Art and Design, said preparing for the birth of her first child during a public health crisis has forced her and her husband to focus on what really matters. That means dropping plans to leave the house to shop for curtains, plants and baby-friendly artwork, and getting the nursery ready.
“I would have been freaking out about not having a nursery done in time a few months ago,” she said. “But right now, if we can have a safe delivery, not get sick, (have) a bassinet and few changes of clothes and diapers at home, everything else is gravy.”
Two of New York City’s leading hospital networks, New York-Presbyterian and Mount Sinai Health System, announced earlier this month that they would prohibit all visitors from the delivery room to protect mothers and their babies, and help slow the spread of the coronavirus.
Representatives here said it’s hard to predict whether local hospitals would have to follow suit.
“We don’t want to deny a support person for obvious reasons,” Grogan said. “But we have to see how things progress in Atlanta and are we able to manage our numbers and not become the next New York. Our plan is to continue with our current guidelines, but we know things are evolving and can change.”
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