Samantha Roxas recently relocated to Los Angeles from San Francisco, and is expecting her first child in July. “Even before the pandemic really hit, there was a shortage of OBGYNs accepting new patients,” she says. Fearing that any new doctor she found here may be reassigned should the COVID-19 pandemic worsen, Roxas chose to seek care from a midwife instead, adding that there are “more midwives on call, and it’s a more intimate experience.”
For Roxas and other expectant mothers, this pandemic—to say nothing of the looming recession—has blindsided them with a host of unplanned-for decisions and unexpected anxieties.
“There’s a natural sense of anxiety over having a baby,” says Ashley, an expectant mother who spoke to Los Angeles and asked to remain anonymous (Ashley is a pseudonym). “Then, to layer another level of uncertainty about what the conditions will be like at the hospital, and whether [my partner] will be there, or how this will affect care, if at all, is unsettling,” she continues.
Ashley is due to give birth to her first child later this month at Ronald Reagan UCLA Medical Center in Westwood, but was informed by her doctors two weeks ago that she would only be able to bring one visitor into the delivery room with her. Ashley chose her husband and had to let her doula go. Heading into her next checkup this week, she fears the restrictions will tighten further and that she may have to deliver alone, as some hospitals in New York City are currently mandating.
“The visitor policy for every hospital has been changing,” says Dr. Aparna Sridhar, associate clinical professor of Obstetrics and Gynecology at the UCLA David Geffen School of Medicine. While UCLA is currently limiting visitor policy to one support partner—whether a spouse, doula, or otherwise—doctors have been encouraging patients to utilize virtual options like Zoom, FaceTime, or other platforms. “We understand that it’s hard for patients, but for their safety we have to make certain rules and we are encouraging women to have people there virtually, both during childbirth and post-delivery.”
In fact, beyond delivery, OBGYNs have been using telemedicine when possible to limit exposure risk for mothers. “Our in-person visits are reserved for those patients that need to be seen for their best care, and are as safe as possible with screening, masks, and gloves where appropriate,” explains Dr. Brent Gray, an OBGYN and vice president of Medical Affairs for Maternal and Child Health at PIH Health. He further clarified that delivery timing will not change due to COVID-19, but that “hospital stays have decreased as patients want to get home as early as it is safe.”
The shift to these impersonal visits, as well as the lack of certainty surrounding partners in the delivery room, has led some mothers to choose delivering at a birth center rather than a hospital.
“People often ask, ‘How many people can I have with me at the birth?’ and our answer: is as many as you can fit in the room,” Delia Camp, administrative director of the Del Mar Birth Center in South Pasadena, says. However, while birth centers are looser with visitor policy and provide a more comfortable setting than a maternity ward, it should be noted that they cannot perform emergency surgeries, and no doctor is present to oversee the delivery. “Part of having a baby in a birth center requires that a mother be low-risk: she’s got to be expecting only one baby, the baby needs to be head down (we don’t deliver breech babies), she cannot have high blood pressure, and she cannot have gestational diabetes that requires medication,” Camp explains. Yet even with these restrictions, the Del Mar Birth Center has booked out through April and is quickly filling up for May. “The phones are ringing off the hook since the middle of March,” Camp described.
The postpartum months have also been complicated by COVID-19. Ashton Stronks, a first-time mother due in late June, worries that her in-laws may not be able to visit their new grandchild for weeks. “Both of [my husband’s parents] are out of state,” Stronks says. “My doctor told me the other day that if you have family flying in, they would need to land and then self-isolate for two weeks somewhere” before meeting the infant. As for her own parents and other family members based locally, Stronks has instructed them to monitor for any flu-like symptoms and start self-isolating at least two weeks out from her due date.
Roxas is also feeling the effects of these post-delivery precautions. “I’m Filipino, and, traditionally, you have your mom or your grandma stay with you for the first month straight,” she said. “To think that we’re going to be new parents by ourselves during the first two weeks, month, however long it is, is not something that we had obviously planned for.”
“The fact of the matter is, I did a bunch of planning, I hired a doula, I did all this stuff, and then all my plans have gone out the window,” Ashley concluded of the mounting list of effects this pandemic has wrought over daily life in the final month of her pregnancy. “So, I don’t really see a point in trying to plan or prepare myself because this kid is going to come whenever she’s going to come and whatever situation I’m in. If I try to create some kind of plan B, that will have to go out the window anyway. So, there’s really no point.”