~ Updated August 1, 2020
Back in March, new policies and procedures for prenatal care and labor & delivery were literally being devised and implemented on the fly. Months later, things have “normalized” (HAH) a little bit, but many particulars still remain in flux — and so do variations in practice depending on where you live. As information about COVID-19 continues to evolve, hospitals and practices across the country are still revising and updating their protocols regularly.
The sad reality is labor and delivery today is entirely different from what anyone would have expected, and it probably will be for a quite a while, on account of COVID-19. We’re sorry — it’s so sh*tty. (Although, you may be in a better place now compared to several weeks/months earlier, when things were escalating rapidly.)
Every state and hospital is tackling things differently — there is no blanket protocol right now. And without sufficient data, everyone is being overly cautious.
- As much as is possible, regularly-scheduled prenatal check-ups are being conducted virtually, via telehealth appointments;
- Some offices are having women take their own vitals and measurements at home for virtual appointments;
- Many locations are holding clinic visits only for necessarily in-person tests and screenings, such as ultrasounds and lab work (and are enforcing careful physical distancing measures for any such appointments as well as trying to consolidate those visits for as few encounters as possible — many places are also conducting temperature checks first thing);
- The Society for Maternal-Fetal Medicine recommends that no support persons or visitors be allowed to accompany women for in-person prenatal appointments;
- Some practices have cut certain nonessential prenatal appointments entirely;
- Prenatal education and childbirth classes have moved to the cybersphere.
Here’s the University of Michigan’s visual graphic depicting the changes in care there:
→ See also: Coronavirus: Children and Pregnant Women
- Many hospitals are barring L&D wards (maternity wards) to protect women and babies from exposure to COVID-19;
- Although NYC hospitals initially barred any visitors during L&D, that policy was reversed after a few days, and the overwhelming trend since has been to allow one (asymptomatic) individual to accompany a mother (*this is likely what most women will encounter);
- L&D wards are still reserved for that purpose — you can still expect to have space for your birth, as you would normally;
- More hospitals are working to test all women admitted for labor and delivery automatically, and in many places, COVID-positive mothers are delivering in separate sections of the maternity ward;
- Some OB teams are dividing their health care personnel between inpatient and outpatient to help minimize exposure;
- Postpartum visitors are also being restricted, in both number and movement (they can’t come and go);
- ***If you test positive for COVID-19, the most current recommendation from the CDC and ACOG is that you and your health care providers seriously consider mother-infant separation (in different rooms) for 14 days (if testing is unavailable) — this would literally be so heartbreaking, but we want you know about this possibility in case you end up in this boat. Since testing is more widely available now, hopefully you won’t;
- If you are not COVID-19 positive, your doctor/hospital may be more open to your going home sooner, which has been reported by most moms who recently delivered.
BTW, most health authorities — including practicing midwives and nurse-midwives — are not recommending changing your plans to have a home birth (especially at the last minute).
Here’s Heather’s live Q&A with her mom, Dr. Dianne, from March 21st, 2020 (which already feels like a lightyear ago…), but many of the points are still relevant, including what’s happening for prenatal care:
We wish you the best of luck as you embark upon your new journey during this challenging and unprecedented time. Once you’ve welcomed your new baby, read on for more resources to get you through the postpartum phase. Deep breath, mama.
See also: Emily Oster on Delivering Alone
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