Who Is and Is Not Allowed in the Delivery Room During the Coronavirus Pandemic
COVID-19 is changing the way hospitals handle labor and delivery. Here's what you need to know if your due date is approaching.
It's a stressful time for everyone right now—the COVID-19 numbers are increasing here in the U.S. and abroad, cities are locking down, people are staying in—but for those who are pregnant and close to their estimated due date, panic might be close to setting in. In order to protect both parents, newborns, and other vulnerable patients and staff, hospital rules for who is allowed into the delivery room during labor are changing rapidly.
How Are Labor and Delivery Rules Changing?
Many hospitals have announced visitor restrictions and many now only allow one support person to be present during labor and delivery and throughout the postpartum hospital stay. This is leaving many mothers in the lurch when it comes to their family members, doulas, and birth photographers.
NewYork-Presbyterian hospitals recently made headlines after instituting a ban on partners in labor and delivery rooms despite World Health Organization recommendations that a companion be present during labor and birth. But the hospital reversed its position after a state order from New York Governor Andrew Cuomo went into effect, requiring that hospitals allow one support person in the delivery room during labor and immediately postpartum.
“Women will not be forced to be alone when they are giving birth,” Melissa DeRosa, Cuomo's secretary and chairwoman of New York State Council on Women and Girls, posted on Twitter over the weekend. "Not in New York. Not now, not ever."
First-time New York City mom-to-be Raina Fieland watched her March 15 due date pass and then watched her March 24 induction date grow closer as the COVID-19 crisis became more and more dire. She started having contractions on March 22, and when she called her doctor at NewYork-Presbyterian, she was told that their visitor policy was in the process of being changed and partners were no longer allowed.
"Leaving for the hospital to give birth to your first baby then being told on the way, with no notice, that my husband, Brandon, would not be allowed in, was obviously devastating and I cried the whole car ride," she says. Luckily, since the policy hadn't gone into effect yet, Fieland was able to have her husband by her side during a difficult labor and her C-section, but he was required to leave two hours after their son's birth.
Mitchell Kramer, M.D., chief of obstetrics and gynecology at Huntington Hospital—part of the Northwell Health network in Long Island, New York—says his staff is working hard to ensure everyone is kept safe. "Our hospital is protecting patients and staff from cross-contamination by using any and all protective measures," says Dr. Kramer. "We are assuming patients are infected and have them and the significant other wear masks."
"Patients that have any symptoms are being treated as Patients Under Investigation (PUI) and are under isolation precautions and staff are wearing appropriate personal protective equipment (PPE) until proven otherwise," Dr. Kramer explains. In addition, obstetric patients must enter the facility through a dedicated maternity entrance and movement by patients and significant others through the hospital is limited for social distancing purposes.
What About My Hospital?
While sweeping changes in visitation policies have occurred in hospitals across the country, the only way to be sure about the policies at the hospital where you'll deliver is to ask directly. Either contact the labor and delivery unit or reach out to the doctor or midwife who will be attending your birth. At Huntington, Dr. Kramer says their policy has changed. "These are extraordinary times requiring extraordinary measures, and despite the recommendations and guidelines by other health organizations, many institutions are going that extra mile to protect those that are under their care," he explains. "At Northwell Health, we are continuing to allow a significant other to accompany a laboring patient for humane reasons and we feel that with the precautions we are taking we can do it safely for all." While a significant other or birth partner is allowed to visit, most other visitors to Northwell facilities are not allowed.
NewYork-Presbyterian is requiring anyone admitted to the labor and delivery unit to be tested for COVID-19 whether they have symptoms or not. While this isn't standard practice in other hospitals at this time, as the pandemic continues it might become more widespread. However, Dr. Kramer says that's not likely to happen until quick-result tests are widely available.
"Right now the likelihood of implementing across the board COVID-19 testing for all laboring patients is not viable due to the need to reserve testing for symptomatic patients to conserve supplies," he says. "Also, with a turnaround time of more than 24 hours, it is not very useful in asymptomatic patients. When rapid testing is available for general use, where we can get results in 2 to 3 hours, that would be useful for laboring patients."
Things are changing rapidly as COVID-19 spreads and hospitals are doing what they can to support people in labor. If your due date is approaching, be sure to discuss contingencies with your provider so you know what to expect when you arrive at the hospital. And you can always discuss testing protocols with your provider if you have concerns.
As for Fieland, she and her baby boy, Jett, are healthy and at home; she was discharged just 40 hours after her C-section. This is compared to the usual three to four days of hospital recovery—she was told by her nurses it would be safer to leave the hospital as soon as possible. "After just experiencing this, my advice for women giving birth alone in the next couple of weeks is to remember how strong you are," she says. "There is a light at the end of the tunnel—a bundle of joy and the reunion will be that much sweeter."