No more baby showers, no dads beaming proudly during ultrasounds, no grandmas swooping in to help out. Pregnancy and childbirth are changing in the age of the coronavirus. For Loudoun moms-to-be, it’s a time of hopefulness and anticipation mixed with serious anxiety and changing expectations. For some women, giving birth during a pandemic means adapting to new hospital protocols, while others are shaking up their birth plans entirely and having babies at home.
In the midst of the COVID-19 crisis, Inova Loudoun Hospital is moving its Birthing Inn to its new north tower building staring April 13. The hospital is giving the maternity wing a two-week head start in the move before other services move in. Inova has also made dramatic changes to visitation policies in response to the pandemic, allowing only one partner or significant person during delivery with no other visitors allowed.
COVID concerns are causing some Loudoun women to avoid the hospital altogether, opting to give birth at home or at a non-hospital birth center. Certified Nurse Midwife Hilary Biesecker, founder of Loudoun Homebirth & Healthcare, has seen a dramatic uptick in calls from women interested in giving birth at home. In some cases, Biesecker and her partner certified nurse midwide Heather Swartz are able to accommodate women switching to a homebirth just weeks before their scheduled delivery date.
And while safety concerns about COVID-19 come into play, one of the most-cited reasons women are making changes is the limit on companions during delivery.
“Now people are calling and saying, ‘I’ve never had an unmedicated birth before, and I didn’t necessarily plan on it, but we don’t want to go to the hospital. We’re concerned about COVID-19. We’re concerned because we were told our doula can’t be present,’” Biesecker said.
While Biesecker underscored that homebirth isn’t the best option for all pregnant women, and her practice has turned down women for whom she doesn’t feel it’s appropriate, the COVID crisis is raising awareness about the benefits of homebirth for low-risk women.
“There are a lot of people who are doing their research and it wasn’t on their radar before,” she said. “It is a pivot point for normal out-of-hospital birth or community birth. That’s another reason why I think it’s so important that we are treating appropriate-risk women at home because our data has always supported that home is a great environment for a low-risk woman.”
And COVID is also changing how Biesecker does business, putting a damper on the warm and fuzzy side of midwifery in the age of social distancing.
“We’re having to redo all of our normal policies and protocols. It’s so contradictory to how I would practice. I’m such a hugger—it’s that going into the home and having the siblings around, having a cup of tea with them,” she said. “We have to make sure that we’re keeping moms safe and babies safe and our own families safe.”
One of Biesecker’s new clients is a first-time mother-to-be who lives in Brambleton and asked to remain anonymous. The mother had planned an unmedicated birth with midwives and a doula at a hospital in Fairfax County. But with her former midwives’ blessing, she shifted to a homebirth with Loudoun Homebirth & Healthcare for her baby due in early May. She said she made the decision in a single day in late March at 35 weeks pregnant. She initially made the change because she wanted to keep her full support team, including a birth doula, in place. But as she moves forward with her pregnancy, she’s embracing her choice to give birth outside of a hospital setting.
“Pregnancy and labor is something that, especially for the first child, is very unknown. I wanted my team to be strong and give me support,” she said. “I would have had to decide between my doula and my husband or my mom and I need all three with me for different reasons. … Labor has a lot to do with how you feel at the moment. … With the situation going on, the hospital wouldn’t be a comfortable place for me to be right now”
Her low-risk status, her philosophy and her plans for an unmedicated birth all made the transition relatively easy.
“It’s really personal and it’s very dependent on your lifestyle and how you believe things should be going. … I believe this is something natural. …That made it easier for me,” she said.
While some women are shaking up plans, many Loudoun women are sticking with hospital births but bracing for a raft of COVID-related changes and disappointments. In addition to the planned move to a new building April 13, Inova Loudoun has made significant changes in protocol, allowing just one support person and no additional visitors.
Daphne Holliday of Leesburg, who is scheduled to deliver at Inova Loudoun in late May, will have her husband Kevin at her side but is adjusting to the fact that she won’t have her mother present for the birth of her first child. Holliday is also grappling with the disappointment that her grandmother won’t be able to fly in from Guatemala to visit her newborn great-grandchild, as initially planned. Holliday’s mother-in-law is battling cancer, and concerns for the new grandmother’s safety will also keep her away for the foreseeable future.
“She can’t even meet him until we don’t know when,” Holliday said.
And as the pregnancy moves forward, traditional milestones and celebrations are falling by the wayside. The couple has canceled planned baby showers, and Kevin is no longer allowed to be present at doctors’ appointments and ultrasounds, after making every appointment before new protocols were put in place.
For Holliday, the challenge is staying positive and keeping stress at bay in the face of anxiety-provoking news items.
“I try my best and try not to get emotional about it. … It’s just the way things have to go,” she said. “We’re trying to take it day by day and live in the now.”
Another Loudoun woman, who asked that her name not be used, is confronting the possibility that her husband may have to support her delivery via FaceTime. The couple has a young daughter at home and plans for out-of-state grandparents to come to town for childcare have fallen through because of COVID concerns.
“I’m more sad for my husband than for me. For him not to be able to see his son until I’m discharged from the hospital is pretty painful,” she said. “This is a situation where we don’t have any control and so we just have to go with it and hope that everything will work out the way it’s supposed to.”
She is planning to deliver at Inova Loudoun in early May and is trying to stay positive as so many of the joyful rituals associated with pregnancy disappear.
“I think most pregnant women are going through a grieving process and mourning the fact that our pregnancies are not what we thought that they would be—being afraid of going to doctors appointments, having fewer doctors, appointments, not being able to bring family in to ultrasounds because rules have changed, baby showers being canceled,” she said. “It really was supposed to be this joyful thing, and it will be once he’s here. But there’s so much stress and anxiety leading up to it about the delivery.”
Instead of scheduled traditional newborn photos, her photographer will do a porch photo of the new family of four from a distance. Her family is Jewish, and they’ve canceled a planned bris celebration for their son. Instead of a celebratory gathering with friends and family, they’ll hold a private ceremony with their family of four and a physician mohel.
For Tara Lussier, a longtime doula who launched her online birth education and consulting platform Arrow Birth in 2019, the shift to virtual services has been timely with the onset of a global pandemic. Lussier has been flooded with calls from women for a range of services, including help in deciding whether to move from a hospital setting to a homebirth or a birth center.
“An uptick is an understatement,” Lussier said. “We’ve been busier than we’ve ever been. People can’t take in-person childbirth education classes. … We’re helping people navigate where it is that they feel safest to give birth and what’s appropriate for them.”
Lussier has also been getting requests for virtual doula services as women adapt to the one-companion rule by requesting doula services via FaceTime or another online platform while in the hospital. Lussier’s company includes 22 consultants, including midwives, doulas, sleep consultants, lactation consultants, licensed clinical social worker therapists and postpartum doulas to provide support after the baby is born.
“It’s really important to pay attention to mental health especially during this time and especially during the perinatal period,” she said. “Those mighty folks who are giving birth during this period—bless them because it’s a really hard time right now.”
For more information on Loudoun Homebirth & Healthcare, go to loudounhomebirth.com.
For more information on Arrow Birth and to read Tara Lussier’s blog posts on pregnancy and childbirth during COVID-19, go to arrowbirth.com.
For more information on Inova Loudoun Hospital Birthing Inn’s move April 13 and safety protocols, go to inova.org.