Many routine medical procedures have been postponed or rescheduled due to the ongoing coronavirus pandemic, but there is one common medical condition that cannot be put off so easily – pregnancy.
So, hospitals in Mid-Missouri have had to determine the best ways to keep moms, babies and staff safe, as well as reduce anxiety for expectant mothers.
Jordan Parshall is a new mom in Columbia, and she said that every year on her birthday, her parents tell the story of the day she was born.
“But it's kind of funny because none of it is written down. They don't actually remember the exact same way. Every year can be a little bit different,” Parshall said .
She said she loves this family tradition, and she’s excited to recount the story of her newborn son, Otto’s, birth to him in the years to come because “every birthday, he's gonna hear the story of how he was born into a pandemic.”
Jordan said there was a lot of anxiety for her and her husband, Joe, as the due date approached and more information came out about COVID-19.
“So, I made a deal with my mom where if there was news, she would tell me,” Parshall said. “But I was not gonna look for that myself because I kind of just needed to be able to stay positive and healthy.”
Jordan said that throughout the last few weeks of her pregnancy, her OB/GYN worked with her, answered all her questions, screened her and her husband for COVID-19 before admitting them to hospital for labor – and baby Otto was safely delivered on April 16th.
Keeping Mothers and Babies Safe
Dr. Melissa Terry, the Associate Chief of General Obstetrics and Gynecology at Women’s and Children’s Hospital, said that the hospital has been communicating with Boone Hospital, and finetuning recommendations from the CDC and the WHO to meet the needs of expectant mothers in Mid-Missouri since the early days of the pandemic.
“Pregnancy has an end date, we can't put off taking care of pregnant patients. Eventually they will have to come to the hospital for delivery,” Terry said. “So, we were trying to, to balance the patient's fear with the, the dependability of being able to schedule it delivery and then be able to go home.”
The hospital has moved many prenatal check-ups – at 16, 24 and 32 weeks – to telehealth visits, and the hospital is currently recommending that expectant mothers isolate at home, as much as possible, starting at 37 weeks.
Though Terry recognized this is not feasible for all families. “Frankly, I don't know very many patients who can self-isolate for two weeks,” Terry said.
But this isolation minimizes the risk of infection, so COVID-19 testing can be done at 38 weeks, and ideally a scheduled induction can be done at 39 weeks.
She added that the hospital has increased their capacity or scheduled procedures.
“So, rather than waiting for labor to happen, we are doing more elective inductions to, I guess, limit the risk that mom would be exposed to coronavirus while she's still pregnant,” Terry said. “The thought process behind that is to decrease the risk of separation of moms and babies after delivery.”
Terry stressed that separation is entirely voluntary and no mothers will be forced to separate from their child, but the current professional guidelines are: separation, if the mother tests positive for COVID-19.
But, as more is learned about the disease, other options are becoming available – like “rooming in.”
That’s according to Dr. Matthew Borgmeyer, the Medical Director of Labor & Delivery and Obstetrics & Gynecology at Boone Hospital. He said this newer option of “rooming in” keeps a COVID-positive Mom in the room with her baby and breastfeeding, as long as Mom wears a mask, follows good hand and chest hygiene and, ideally, is asymptomatic.
This allows for boding and breastfeeding, which according to the CDC is relatively low risk.
“We do not know for sure if mothers with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggest this is not likely.”
Borgmeyer added that this pandemic has been difficult for new mothers when it comes to anxiety and mental health, so having more options has been a relief.
“The thought that we can potentially keep Moms and babies together has been very well received by the moms who are worried about this,” Borgmeyer said.
Keeping Staff Safe
Both Borgmeyer and Terry say that expectant mothers in our area should feel safe, as the case count remains low. They also pointed to other safety policies, like improved personal protective equipment for staff, a one visitor policy, required masks for all visitors, as well screenings and temperature checks at the door of the hospitals.
Borgmeyer said this level of precaution is, of course, to protect new mothers and infants, but is also about keeping staff safe, healthy and able to come to work. He added that this has been a priority of the hospital since day one since labor is, as he calls it, “messy.”
“We had to figure out the physical limitations on labor and delivery, like where are we going to put the patients? And how are we going to screen those patients if they are positive? What kind of personal protective equipment do we need?” Borgmeyer said. “So, I think that was the initial challenge. just figuring out what we can do to prevent a problem.”
He noted, much like Dr. Terry, that pregnancy and birth are not health procedures that can be put off, and so it is imperative that there is adequate staffing in labor & delivery units.
Back at Jordan Parshall’s home, she said one of the positive things about social distancing is that the family is spending lots of time with new baby Otto. Their dog, Alfred, loves to lick his toes and Otto calms down when he dances with his Dad.
She adds all of the precautions and safety procedures made her feel comfortable and safe while giving birth to Otto. So much so, that while they were there, “we probably didn't even really think about the pandemic was going on because we were just focused on our baby and people taking care of us worried about everything else.”