“My OB basically told me she would prefer that I not even go to the grocery store,” says Sedler. “I have always had mild anxiety, but I had been surprisingly not anxious for the first half of my pregnancy. I’m trying to keep that mindset, but it feels impossible. Just last week, I was annoyed that we couldn’t book a pre-baby trip to Hawaii and now I can’t even go to Publix,” she says.
The practice of prenatal care is also changing—rapidly. Doctor’s offices and hospitals, especially in hard-hit areas, are canceling [medical appointments, procedures, and surgeries deemed “nonessential,” “elective,” or “routine.”. “We have overhauled our office policies: every patient gets a phone screening prior to their visit, asking about SARS-CoV-2/COVID-19 symptoms. We have cancelled all elective surgeries in line with the guidelines from the surgeon general and the joint statement put out by [major ob/gyn societies],” Jaclyn Friedman, M.D., a practice physician in gynecology in Atlanta, tells SELF. That means they have canceled the vast majority of office visits and surgeries, she explains, adding that the doctors in the practice are also decreasing how many hours they spend in the office.
“We want to minimize all contact—patient to patient, patient to staff, patient to provider—to decrease the risk of transmission of this virus,” Dr. Friedman says. Some hospitals are also canceling maternity ward tours, a rite of passage for many parents choosing where to deliver. However, which category prenatal office visits and ultrasounds fall into can be inconsistent and confusing from practice to practice.
Harya Tarekegn, who is 17 weeks along in New York City, says her OB group has canceled all her “routine” visits to minimize exposure risks. “The only reason my next appointment isn’t canceled is because it’s a full-body scan, so it is not considered routine,” she tells SELF. For those offices carrying on with appointments, the protocols have changed. Dr. Sedler says at her last appointment, “there were signs all over the office, including on the front door, instructing patients on what to do if they had any symptoms, and they were Cloroxing the checkout desk when I went [in]”— a constant reminder that a health care office is actually the most vulnerable place a pregnant woman might be going. Ob/gyn offices are also strictly limiting who can enter. “In the past we have encouraged grandma to come in to listen with our patient to the baby’s heart rate, as well as siblings and partners, but we are now trying to minimize the attendance of other folks,” Mary Jane Minkin, M.D., a clinical professor of obstetrics & gynecology at Yale University and founder of MadameOvary.com, tells SELF.
This change in visitor policy is happening most intensely at hospitals. Many hospitals have reduced their visitation policy to just the partner of the person in labor, while the entire New York City private hospital system has banned any people in the delivery room with laboring people, including spouses, and other hospitals are beginning to follow suit.
“I’ve felt sick over it,” Liza Maltz, a birth doula and the founder of BirthYourOwnWay doula services in New York City, tells SELF. “[To have] no one is horrible.” These changes, while ostensibly for public health, may be really challenging for laboring women: [surveys have found that having support in labor improves how a woman views her experience.
“We understand that addressing this public health crisis has required hospitals to implement additional infection prevention control protocol, as well as other procedures to maximize the capacity for patient care and safety,” Christopher Zahn, M.D., vice president of practice activities at the American College of Obstetricians and Gynecologists, tells SELF in a statement. “We also recognize that these measures can have a significant impact on a laboring mother’s support in the delivery room. Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by a partner or support personnel such as a doula is associated with improved outcomes for women in labor. As hospitals move forward with measures and policies in the face of this crisis, ACOG urges them to consider innovative solutions and localized, collaborative approaches that ensure laboring patients have the support and stability they need through this chaotic and stressful time,” he says.