Savannah Horton is 33 weeks pregnant with high blood pressure, but she only has seen her doctor three times during her pregnancy. The Santa Rosa, Calif., mother of four last saw her OB-GYN—and her unborn daughter via ultrasound—at the end of January, two days after California’s first confirmed coronavirus case was announced. Since then, the doctor has either canceled Horton’s prenatal appointments or conducted them over the phone.
The COVID-19 pandemic has upended routine prenatal care and childbirth practices as doctors and hospitals try to implement social distancing and limit the spread of the disease.
Horton has a history of gestational hypertension, a form of high blood pressure during pregnancy that poses dangerous risks for mothers and babies. She delivered her second and third babies early to avoid complications. Horton’s mom, a postpartum nurse, grew worried when the doctor kept canceling her daughter’s prenatal appointments. During one nursing shift, she called Horton in to check her vitals. Her blood pressure was high, so she spent four hours in the labor and delivery ward where nurses confirmed she had hypertension and low iron levels.
Since then, Horton, an orthopedic trauma nurse, has monitored her blood pressure and will continue to do so until her next appointment in three weeks. During labor and delivery, she is allowed one support person, her husband, Greg, but no hospital visitors. She expects a shorter hospital stay, but the shelter-in-place mandate will limit childcare and postpartum support.
“It’s bittersweet,” Horton said. “I feel a lot worse for first-time mothers.”
Early reports indicate the new coronavirus does not disproportionately affect pregnant women. Expectant mothers who have contracted it have mostly experienced mild symptoms and recovered. And it rarely crosses through a mother’s placenta to infect her unborn baby, according to Dr. Jeff Wright, a maternal-fetal medicine specialist and board member for the American Association of Pro-life OB-GYNs. Pregnant women with preexisting health conditions are at the greatest risk, he said.
Wright’s Wilmington, N.C., practice is following strict safety protocols, including wearing face masks donated from a local nail salon, “trimming, not cutting” services where possible, and, most importantly, calming mothers’ fears
“Most women we see are more concerned with making sure their baby is OK than they are ensuring they don’t contract the virus,” he said.
Many are especially concerned about going to the hospital. Shelly Shaw, a neonatal intensive care nurse at two Sonoma County, Calif., hospitals, said women are waiting longer into their labor progression to come in. Hospitals screen any patients or support people with COVID-19 symptoms, but she said some mothers still worry about needlessly being separated from their babies. “I get why hospitals are scary for people right now,” Shaw said, “but there is also a lot of misinformation.”
Wright said Wilmington-area midwives have seen increasing demand for home births, and he expects that to grow. Sonoma County’s Santa Rosa Birth Center reported a 25 percent increase last month in women inquiring about home births and requesting to change their hospital birth plans. The center typically assists with 12 to 15 births a month, but last month it had 20. Its capacity is 24.
Marisa Stack, who is 38-weeks pregnant with twin girls, was scheduled for induced labor on Friday. Since she is considered high risk, her doctor didn’t cancel any of her appointments. Stack has been careful lately about what she reads and listens to, knowing she is susceptible to fear. “[The pandemic] is a good testament to our faith and trust in the Lord,” she said. “I know He’s got these babies in His hands.”