How Will COVID-19 Affect My Pregnancy, Delivery, And New Baby?

Being pregnancy and the prospect of giving birth can be worrisome for many expecting couples even under the best of circumstances. Today, subhan’Allah, we are living in a pandemic, but pregnant women still need to visit with their obstetricians to monitor their health and that of their baby, babies need to be delivered, and newborns and their mothers need to be tended to.

So how do we navigate our way through this new and uncertain terrain?

We reached out to Afra Said, an experienced birthing expert who works as a labor and postpartum doula and coach, to address some of the valid concerns that many expecting couples may have. Afra has very generously provided answers to your questions related to your pandemic pregnancy.

Having an insider’s perspective and advice on how to navigate your pregnancy during this unprecedented time is incredibly valuable. Learning from others who have gone through their labor and delivery is also very helpful.

Ayesha Rab was entering her ninth month of pregnancy with her third baby when things started shutting down in her hometown of Orlando, Florida. Around the same time, many doctors offices were scaling back their appointments to urgent-only and shifted to telemedicine.

“I was around 36 weeks when Covid-19 shut everything down in Orlando. During this time I had twice weekly OB appointments. My doctor had very limited appointments available and those that were considered high risk, which I was, were given priority. They were very strict about not allowing anyone else in at the appointments, which meant I had to schedule my appointments around my husband’s work schedule so he could watch the girls. He also was not able to come with me to our last ultrasound. This being our last baby, we were both disappointed we could not experience this moment together and share it with the girls as well.”

Her labor and delivery looked drastically different from her previous experiences with her two girls.

“By the time I went into labor, the hospital had strict guidelines in place. I was really worried and anxious that my husband would not be allowed in with me, but Alhumdulillah they allowed one support person.  When we arrived at the hospital, our temperatures were checked at the door and we were handed masks. You can imagine how fun this process was while dealing with contractions! We were asked to keep the masks on for a time, but after we got to our private room, they relaxed on that guideline a bit. We were also assured that they had strict guidelines in place for Labor & Delivery, and it was essentially on lockdown to ensure no possible exposure. While they did allow one support person in the room, no other visitors, including kids, were allowed. I was a bit disappointed the girls could not come to see their baby brother right away as were they. Because of this, we asked to be discharged after 24 hours so we could get home as soon as possible.”

So what does that mean in terms of support?

The pandemic shutdown has meant that kids and a lot of husbands are now at home instead of at school and work, so Alhamdulillah there is the blessing of having a routine that’s a little more relaxed. With a new baby in the house and two older kids to take care of, however, it can be overwhelming to be back to a newborn’s routine, and even experienced mamas like Ayesha need all the help they can get.

“I was fortunate my parents made it to Orlando prior to delivery to help with the girls. That was something that had given me anxiety leading up to my due date. Was it safe for my parents to come? What if they get exposed to the virus on their way? Is it safe for the kids? Is it safe for the baby to be around other people? Because of my concerns, my parents drove from Dallas to Orlando, 16 hours straight, stopping only for gas. They were concerned about being exposed as well. I am so lucky that they were able to do this and they made it in time. Having them here gave me peace of mind that the girls would be in good hands while I was at the hospital. While in the hospital, everyone was great and supportive knowing this was a unique time to be having a baby. The lactation specialist didn’t hesitate to help when we had issues and the nurses were great every step of the way. I don’t feel that I lacked support of any kind due to Covid and for that I am very grateful.”

With a recent uptick in coronavirus cases in several states, it’s clear that COVID-19 isn’t going anywhere soon. Ayesha shares her advice to those couples who are currently expecting, and are anxious and worried about the safety of their babies and themselves.

“I know hospital guidelines are changing daily due to Covid-19 and this can be anxiety inducing for new and expecting moms. My advice for expecting moms is to believe in your strength. You can do this! I would also advise to speak with the hospital ahead of time so you know what to expect. My nurses were so amazing and understanding every step of the way. Also, I know the possibility of not having your partner with you during this time is stressful, but trust that Allah has a plan and He is with you and will give you the strength you need.”

Should I Skip My Prenatal or Postpartum Care Appointment?

It’s important to attend prenatal and postpartum care appointments, although care providers might cancel or postpone visits, or conduct the visit over the phone or video. I know of many sisters who have had virtual appointments unless there is a medical concern which needs an in-person visit.

What extra precautions are you taking in your interactions with expecting and post-partum sisters?

Most doulas are offering virtual support at the moment unless the parents are comfortable and would like in-home support during labor. Unless someone is sick or showing symptoms, support can be provided as long as precautions like using hand hygiene according to CDC guidelines and covering their mouth and nose with a medical mask or cloth face covering.

Is it preferable to deliver at home rather than face the risk of exposure at the hospital, and what are the mask requirements for women in labor?

It is not preferable necessarily, it really depends on the mother and their insurance and the availability/affordability of a midwife. For example in my area a home birth costs around $5000 and that’s quite difficult for a lot of couples to make that switch midway during pregnancy. However, if it is feasible, it is most definitely a better option mainly for safety and the comfort of the mother. There is nothing like birthing in your place of comfort. If a Doula or midwife were to support you in your home they would take the precautions of washing hands, wearing a mask at all times and sanitizing. Of course if the mother has complications that need medical intervention she would need to deliver at a hospital.

I understand that you have had limited exposure in assisting women with their labor and delivery during COVID so far. Is this because of the restrictions currently in place in hospitals for the number of people in the delivery room?

Yes it is due to the restrictions in the hospital limiting the support to one person. Things are changing now slowly however, but initially it was really difficult even for the husband to be there throughout labor.

If I test positive for COVID, does that mean that there is an increased likelihood of preterm labor?

There is currently no evidence that the virus causes birth defects or increases the risk of miscarriage. Always check Evidence Based Birth for up to date information on studies as they release information every few days.

If I test positive for COVID, what precautions can I take to protect my unborn baby/newborn? Should I breastfeed?

According to a study published by Evidence Based birth, newborn infection is uncommon and rarely causes symptoms. In this study, the rate of infection was not increased when the baby was born vaginally, breastfed/chestfed, or had contact with the infected birther. According to the authors, “Newborn infants can be infected in the first few hours of life, but as very few are severely affected it is likely that the benefits of contact with the mother and the ability to breastfeed outweigh the potential benefits of separation.”

How long should I wait before introducing my newborn to relatives and friends?

What’s common at the moment is once mom and baby are clear & discharged, unless the family was already living in the same home, it is advisable to wait out the 2 week period of isolation for both parties before visitation.

The U.S. Centers for Disease Control (CDC) continues to recommend social distancing for everyone which means staying home or staying at least 6 feet away from people who do not live in your home. In situations where you can’t practice social distancing (grocery shopping, for example), the CDC recommends wearing a cloth face covering.

However with friends, I would say this is at the parents discretion . Depending on your individual risk perception, you could decide to consider your newborn a vulnerable member of the household and take the additional precautions outlined by the CDC. 

If you decide to bring the baby into contact with people from outside of the household (grandparents, for example), then you can consider taking precautions such as using face masks (not for children under age two) and keeping physical distance. So much about this virus is unknown down to the testing (you could have COVID with absolutely no symptoms and still test positive many weeks later).

Alhamdullilah though with technology, it is possible for visitation from a distance with video calls, photos, etc. It is important to consider everyone’s health just like we would when someone has a flu and visits.

What other advice can you offer to me and other expecting parents?

With all these new changes and the fears around contracting the virus, it is natural that anxiety is at an all time high. Trusting in Allah that everything will be OK is important, and of course making lots of dua’a. From many of the sisters who have delivered (friends or clients), there were no negative stories (what we expect from the pandemic) and so it’s important to keep reminding yourself that the hospitals are also taking precautions for your safety & believe in your ability to also have a good experience despite the anxiety and isolation. 

Whilst in labor it is important to advocate for yourself as a mother (i.e. demanding your spouse or support person be next to you at all times unless its necessary for him to step out of the room). Other things you can do to make the experience smoother is hiring a virtual doula, and creating a postpartum plan for your recovery and the support of your postpartum mental health. 

We are living in strange isolating times which is why I can’t emphasize enough the importance  of new mothers having systems in place so that they can be supported through postpartum recovery both emotionally and physically. Whether it’s through meal drop offs, virtual doula support, checking in, or in-person doula postpartum support (lots of self care, vaginal steaming, belly binding, virtual mothers circles etc).