In this week's blog, I am honored and delighted to share an exclusive interview with a special family friend: Dr. Tatiana Araujodua. She is an Obstetrician and Gynecologist who works in Chicago and was gracious to answer my 'what's it like delivering during COVID-19?' inquiries. Thank you, Tati!
1. What differences have you seen between pre-pandemic labor and delivery Moms and Moms who give birth during COVID-19?
Moms giving birth during COVID-19 are definitely more anxious and stressed than Moms pre-pandemic on labor and delivery. I still see that they are excited to welcome their new family member but along with all the worries most "new" moms have, they are now burdened with COVID-19. In particular, they feel anxious or disappointed at not being able to have their entire support system allowed to be with them. Most hospitals during COVID-19 have enforced strict visitor policies. At my hospital for example, General Medicine patients are not allowed ANY visitors; moms on Labor and Delivery are allowed only ONE visit and that person must stay with them through the entire hospitalization without in and out entry.
2. Have any of your patients tested positive for COVID-19 before giving birth?
Yes, I have definitely seen moms who have tested positive before giving birth. Through this entire process since the pandemic started we have adjusted our policies. At first, the babies needed to be separated from the mom immediately once born, now per American College of Obstetrics and Gynecology (ACOG,) there are different options to offer and you can read more about them in their FAQ 511: Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A message for Patients. Last updated July 14, 2020.
If you room together—Your baby may stay in your room if you decide this is best, or if your hospital or birth center does not have separate space for your baby to stay. Rooming together may help you bond with your baby and help you start breastfeeding. You should wash your hands before touching your baby. You also should use a face mask or covering when holding your baby, including during feeding. Do not put a mask or covering over the baby’s face. The staff may keep the baby’s crib at least 6 feet away from you. The staff also may use a clear plastic crib that is enclosed and kept at an even temperature.
If you choose temporary separation—Your baby may stay in a different room if you decide this is best. Your health care team may be more likely to encourage this if you are very sick or your baby is at a high risk of getting very sick. If you and your baby are separated and you plan to breastfeed, you can ask for a breast pump and use it to express (pump) milk. This will provide milk for someone who is not sick to bottle-feed your baby. Pumping also may help you maintain your milk supply for when you begin breastfeeding.
3. (If yes) what was that process like for them, you, and their newborn baby?
The patient would be placed in a special isolation room in a specific location on the Labor and Delivery unit. All mom's are required to wear masks; except during pushing if they cannot help it. The staff on the other hand including the physicians are required to wear additional PPE (Protective personal equipment). As I mentioned earlier, when the pandemic first started the babies would be separated from the mothers and placed in a special isolation unit and tested twice, 24 hours apart. If negative, a social worker would assist the mom and family releasing the baby to a negative family member to help care for the baby while the mother "self-quarantined" at home for 14 days. Now, though recommendations do allow properly educated mothers to room together with their baby if they choose. Special precautions include wearing a mask when the holding baby and wiping the breast very clean every time prior to breastfeeding.
4. Expecting Moms and Dads will likely have to wear masks. Do you have any tips on how to make wearing masks for extended periods of time more comfortable?
Trust me, I feel your pain on this. I have worked 24 hour shifts and this is probably the hardest part of my day. Choose masks that don't hurt your ears or cause your glasses to fog up. I have found the best ones are masks that can bend at the nose (nasal bridge in order to avoid that.)
5. Do you have a favorite labor and delivery story (pre pandemic or during) to share?
Definitely a hard question for me as I have several happy, joyous Labor and Delivery moments but most recently one memory I can recall off the top of my head... I was performing a routine scheduled Cesarean delivery on a patient (pre-pandemic) and her husband was also in the OR with us. Towards the end of the case we usually ask our surgical assistant for a wet sterile towel to wipe the incision just prior to closing it. The way we normally ask for this is "sloppy wet please" and as I said that the husband stood up and asked "who me?" thinking we had asked for a "kiss"... or so I'm guessing!
6. Hahahaha. OMG! What do you wish more patients knew about being pregnant during the pandemic?
Honestly, mothers who are close to delivery seem to be the most understanding of all types of patients during the pandemic. They come across as patient and very tentative to what is going on around them. I wish other more general patients were as understanding as my "mom" patients. 7. If you could tell your patients to remember one thing during the labor and delivery process, what would it be?
Keep your mind on the end goal!!! (as you are going through your labor pains or pushing and feeling exhausted,) I promise it is always worth it in the end!