When you envisioned giving birth, you probably didn’t imagine doing so in the middle of a global pandemic.
But that’s the reality many birthing people are facing as the fight to reduce the spread of the novel coronavirus marches on without an end in sight.
Since hospitals are hotbeds for the disease, many parents-to-be have to comply with protocols that feel like their worst fears come true.
- You’re only allowed to bring in one support person, and that person is not allowed to leave the premises or they risk not being allowed back in.
- No visitors are allowed.
- You and your support person have to stay in your room and wear masks the entire time.
- If you have a baby who needs to go to the NICU, only one person can be with them.
Giving birth as a Black woman already comes with a unique set of stresses. So while these rules are in place for everyone’s safety, it’s hard not to feel like coronavirus is yet another battle Black moms have to fight. (Especially since the virus is striking our communities the hardest.)
But you can have an empowered, positive, and beautiful birth in a hospital during coronavirus. (And beyond!)
“There are many things that are going to be thrown at you,” says Dr. Kiesha Benn, an OB-GYN in New Hyde Park, New York. “It’s the way you react that will ultimately determine your experience.”
Here are 11 tips to help you react with confidence and knowledge, instead of fear and anxiety, and to help you have the birthing experience you deserve in this new reality.
1. CHOOSE THE TYPE OF DELIVERY YOU’RE HAVING AND COMMIT TO IT.
There are some pregnant women who are thinking about having home births or delivering in birthing centers to avoid the stress of giving birth in a hospital.
Being on the fence about where you’re going to deliver will only add to your anxiety. Instead, do some research, decide where you’re going to deliver once and for all, and own it. There are a lot of decisions to make and conversations to have based on your choice, and there’s no need to complicate matters by wondering “What if…?” as you get closer and closer to your due date.
“Every woman has the right to deliver where they want to deliver as long as they know the risks and the benefits, and are able to make an educated decision,” says Dr. Ruth Arumala, an OB-GYN based in Mansfield, Texas. “However ACOG [the American College of Obstetricians-Gynecologists] proposes the safest place to deliver is either a hospital or an accredited birth center.”
Keep in mind that home birth is not a cure-all, and not everyone is a good candidate for it. And given the unpredictable nature of birth, there is no guarantee that you or your baby won’t need to go to the hospital anyway.
If you do decide not to deliver in a hospital, you have to do your due diligence, Dr. Kiesha stresses. Research your new healthcare providers, get your medical records, and be transparent about complications and your medical history.
And don’t change your birth plan without letting your original provider know what you’re doing.
“This is when mistakes happen,” Dr. Kiesha says of leaving your primary doctor in the dark. “We feel that people are going to judge us based on our decision and so we don’t say anything… and then when something deleterious happens it’s ‘Why didn’t I [tell them]?’”
Whatever you decide, make sure you’re making the decision from an informed space. (If you’ve chosen a home birth, check back for an upcoming article on having a home birth during coronavirus.
2. FIND A PROVIDER YOU TRUST.
Note: Since this guide is focused on giving birth in hospitals during the coronavirus pandemic, advice will be catered to that moving forward.
There is no better time than now to evaluate how you really truly feel about your doctor. Do you feel comfortable asking them questions? Do they listen to you? Do you have an easy rapport?
If your answers to those questions are “no, nope, nah,” change providers to find someone you do trust.
“The beginning of advocacy often is having conversations before you’re in labor with your provider…and changing facilities or providers as soon as you can if it doesn’t look like that place or those people are going to be supportive,” says Anayah Sangodele-Ayoka, a certified nurse midwife who works out of hospitals in the DMV-area.
Sometimes doctors give their patients evidence-based facts, but if their bedside manner leaves something to be desired, the women in their care are less inclined to hear them. This can contribute to the bad experiences many Black women report facing in the healthcare system. So it helps to have someone you trust in your corner.
“If you trust your provider,” Dr. Ruth says, “if there’s a poor outcome, you know it was not because of a lack of trying. And I hate to say this, but all skinfolk ain’t kinfolk. You gotta pick somebody that you actually trust…and that you can see this person going above and beyond for you.”
If you’re unable to change providers, consider working with a seasoned doula so you’ll have someone available to advocate for you, Dr. Ruth adds.
“Can they [FaceTime] you at a reduced rate now so if somebody tells you that you need a c-section, you can find out, ‘Well, do I need a c-section because my baby’s heart rate is dropping? Do I need a c-section because I’ve been laboring, my bag of water has been ruptured for X amount of time, and now we’re scared of infection? …Or am I being c-sectioned because my provider needs to go home and sleep or needs to take care of other patients?’ That [the] doula can help you sort,” she says.
3. START ASKING QUESTIONS.
A lot of labor and delivery anxiety during coronavirus stems from the fear of the unknown. Try to get clarity on as much as you can and go over your questions with your doctor. (Afraid you’ll forget what you want to ask? “Write the questions down because pregnancy brain is real,” says Dr. Ruth.)
“A woman who has knowledge is empowered,” Dr. Kiesha says. “A woman who doesn’t doesn’t know if she’s not being treated fairly.”
“At your next prenatal visit, [ask] ‘What is being done differently because of coronavirus?’” Anayah advises. “There should be specific answers about that, like, ‘We’re going to test you for coronavirus when you come, and if you have it, this is what’s going to happen.’ Patients should be asking those questions so they can also know what to expect or [to] push back.”
Giving birth during coronavirus is a situation only made more difficult by going in blind. Familiarize yourself with your hospital’s protocols. (These are constantly changing and are different from hospital to hospital, say Drs. Kiesha and Ruth, so stay on top of them.)
Will they be testing you for coronavirus as soon as you come in? Will you be separated from your partner and baby after delivering? Will you be able to walk around the maternity floor? How long will you be in the hospital after delivery or surgery? (Many places are keeping vaginal delivery moms for 24 hours, and C-sections for 48 hours.) Will you have to go to a separate facility after birth? What happens if you or your support person test positive for coronavirus?
When you know what to expect, you’ll be able to emotionally prepare for it.
4. BUILD IN SOME EMOTIONAL SUPPORT.
Give yourself grace and try not to beat yourself up about the way your pregnancy will look, says Dr. Kiesha.
“Don’t compare. Don’t compare to your previous pregnancies,” she says. “Don’t compare to what’s happening to other people in other parts of the state, because different areas have different burdens of disease.”
No mom who has given birth before social distancing and coronavirus will understand exactly how you’re feeling right now. That’s why you want to build a community of support with other moms like you. Join mom groups on Facebook or apps like Peanut and see if there’s anyone you can relate to on the platform. (You may be able to find someone in a breastfeeding support group, too.)
If you already have a therapist, lean on them for support right now. And if you’ve been thinking about finding one, why wait? A therapist can help you navigate all the feelings you’re having about giving birth during coronavirus. Therapy for Black Girls and Psychology Today have directories to help you find a therapist suited to the task.
And check with your provider about on-site mental health support you can receive while you’re at the hospital.
5. TAKE CARE OF YOUR PHYSICAL HEALTH.
One of the reasons why Black maternal and infant mortality rates are so devastatingly high is because Black women often have a higher likelihood of experiencing many poor health disparities and pre-existing conditions—diabetes, obesity, high blood pressure, etc.—than their white counterparts. (Why? Short answer: systemic racism.)
These comorbidities can complicate delivery and recovery, so work with your trusted provider to make sure you’re taking care of your health as best you can from home.
“Make sure you’re at baseline [health] so that you can be able to have an immune system that can actually fight this virus” if exposed to it, she says.
6. LEARN ABOUT CHILD BIRTH.
Some hospitals and health-care professionals are encouraging expecting moms to labor at home before they come to the hospital to reduce the amount of time spent in the hospital.
“We want you to labor for not as long as possible but at the very least come in active labor,” explains Anayah. “When you come in active labor, you are less likely to need certain kinds of interventions or have them put upon you unnecessarily.”
What is active labor? What are the different stages of labor? If you’re not sure, take childbirth education classes. (There are many available online, or you can read books like Nurtureby Erica Chidi Cohen, The Motherly Guide to Becoming Mama or What to Expect When You’re Expecting.)
And whether you’re partnered or single, your support person should take them, too, Anayah says. If you’re partnered, it’s not just about them being there for the birth of their child. They need to be aware of what’s happening (and what should be happening) to better advocate for you.
7. KEEP ASKING QUESTIONS AND MAKE PEACE WITH AN EVOLVING BIRTH PLAN.
Your birth plan will have to evolve with the coronavirus, but that doesn’t mean everything is off the table.
“If you are choosing to…give birth in the hospital or you have to…really own that and not be resigned like, ‘Ok, well, now that I have to be in the hospital, I guess I’m just going to have an epidural and lay in the bed and wait for this thing to happen,’” says Anayah.
Stay in regular communication with your provider and voice your questions and concerns as well as your wishes to see what’s viable.
“’Will I have skin to skin? Will I be able to have delayed cord clamping? Am I still able to collect cord blood? Am I going to be able to keep my placenta?’—all of those things that you have in your ‘birth plan’ that might end up being irrelevant should be discussed with your provider before you go to the hospital,” says Dr. Ruth.
“And when you get to the hospital, I would whip it out again and discuss with the nurse because things change so rapidly with this virus,” she adds. “I would encourage everyone to adapt as you can because a lot of this is out of your provider’s and your current nurse’s control.”
You’ll also need to communicate all of this to your support person, Anayah says.
“If you’re really going to be leaning on that person I think it’s going to be important to have a conversation ahead of time to say, ‘You’re going to be my main person! So I really need you to be ok with rubbing my feet, feeding me, helping me drink things, helping me get up and move’—letting them know that there’s going to be a big responsibility since they are the only one who can come with you from the outside,” she says.
While you should feel comfortable asking the hospital staff for support as well, your support person needs to know that they’re your fail-safe option.
8. TAKE ADDITIONAL PRECAUTIONS TO PROTECT YOURSELF AND YOUR SUPPORT PERSON FROM CORONAVIRUS.
You and your support person should be following all the protocols for good health right now. Dr. Ruth advises everyone to:
- wash their hands for 30 seconds,
- use hand sanitizer that has 75% alcohol instead of the CDC recommended 60% (“The viral capsule is 100% denatured at 75% alcohol,” she explains),
- keep practicing socially distancing,
- limit the amount of time spent out and about, and
- wipe down surfaces multiple times with antibacterial wipes or a solution of bleach and water. “Especially if you have other children who may not stick to the hygiene rules,” she says.
If your partner is not socially distancing or taking the virus seriously, talk to your doctor and doula to have them impress the importance of following the rules.
“If they’re not socially isolating ipso facto you’re not socially isolating,” Dr. Ruth says.
Hospitals and care providers are taking precautions to reduce the likelihood of infection by wearing personal protective equipment and providing that to birthing people and their supporters. But you can take additional steps as well when you’re packing your hospital bag and once you’re there.
Pediatric nurse Leah Marie Noble and her husband welcomed their daughter Mia Grace Robinson on March 29, 2020. They both wore N95 masks to the hospital, and Leah brought her own sheets and pillows. Her suggestion to moms giving birth now?
“Bring your own cleaning products, wipe down your beds, wipe down where your support person is going to be sleeping,” Leah says. “Make sure everything is in a plastic bag and that you wash all those things as soon as you get into the house, because you just don’t know what type of germs that you’re bringing in. It’s not just coronavirus that’s out there; there are other viruses in the hospital that we need to look out for.”
9. MAKE YOUR ROOM FEEL SAFE.
“Put the effort and energy into personalizing the birth space as you would before,” says Anayah. “Bring in a cheap bluetooth speaker to have your music or playlist, bring your aromatherapy… Try to figure out all you can do to make the space feel energetically like a space that you would want to be in.”
That includes bringing in your loved ones. You can bring a phone, laptop, or tablet into your room to talk to your doula, mom, sister, whoever you wish could be in the room with you physically but can’t.
“I hate to say ‘Livestream your birth,’” Anayah says, “but for a certain part of it, when it’s getting very difficult, maybe you do want to have your mom or your sister on FaceTime to joke with you.”
10. ADVOCATE FOR YOURSELF!
Now that you’re ready to give birth, your self-advocacy work continues. Don’t assume that everyone is on the same page as you—even with these conversations, things may have changed.
“When you arrive to labor and delivery, you go over [your birth plan] with them,” says Dr. Kiesha. “Even if they tell you ‘Look, we can’t meet any of these [things],’ at least you’ve expressed it.”
“People need to remember that they are consumers in hospitals,” says Anayah. “Yes, it’s an institution, but it’s not a prison. You are not to be subjected to whatever somebody wants to do to you just because you showed up at that facility to give birth.
“[If] there is something big going on or somebody’s trying to change the plan, you always want to know why so that you can know, ‘Is it legit or am I being pushed into something out of someone else’s comfort or discomfort?’” she continues. “So some great questions to ask [are] ‘What if we don’t? What if we wait? Am I or my baby in danger?’ and actually hearing what is being said about that.”
Along with having your support person and your doula on your side, see if you can rally your nurses as well.
“If your goal is an unmedicated birth, you want to say, ‘I really want to have an unmedicated birth. Can you help me do that? Can you help me with position changes? I don’t want an epidural and I really would like for you to help me try all the different comfort measures that you know of or that any of the other nurses know of to help me do that,” Anayah advises.
If that person can’t, ask if you can have a different nurse.
“Get somebody who’s going to help support you in the birth experience that you were trying to have,” Anayah says.
11. FIND THE BEAUTY IN YOUR EXPERIENCE.
At the end of the day, everyone’s health and safety are the most important things. All of these steps you’ve taken to ensure your and your baby’s health are some of the first choices and acts of love you’ve made for your child. Now you get to see the fruit of your literal labor: your baby! Bask in that—it may not have happened the way you envisioned when you first found out you were pregnant, but they’re here. And it’s a beautiful thing.
New mom Leah was sure she would have to have a c-section, and was surprised when her doctor said “‘Ok, let’s have a baby. We’re going to practice pushing,’” she recalls.
“It was the most amazing feeling to know that I birthed this baby. The process of being able to push your baby out and then for them to lay her on your chest as soon as she comes out—her face was beautiful—it was honestly amazing,” Leah says. “I have the video of the ugly cry and everything. My husband cut the cord. The nurse actually took my husband’s phone and videotaped him cutting the cord. It was really nice.”
Dr. Ruth has delivered thousands of babies, but she says she “saw most possibly the most beautiful delivery right in the midst of this pandemic.”
“[It] came from the appreciation of the partner,” she explains. “He bust out crying at the end of the delivery and held her. Most dads, once the baby’s out, they go over to the baby and forget all about the mom. And he took his time and showed her his appreciation because he knows what she went through to carry this pregnancy through.
“There are still very, very beautiful moments that happen even in such a time like this,” Dr. Ruth continues. “The experience of bringing a life into this world will always be exciting, but it can still be precious and unmatched in this time of chaos.”
You got this. Yes, coronavirus is scary. Yes, being a Black woman giving birth can be scary. But let those fears power your mission to have the best possible birth experience you can have given these unprecedented circumstances.
* This article originally appeared on https://www.matermea.com/