Pandemic increasing stress for pregnant women

The coronavirus outbreak is adding stress and disruption for many local pregnant women, who are now limited to one support person in the hospital during birth and navigating other challenges from Ohio’s “stay at home” order.

The Greater Dayton Area Hospital Association member hospitals changed their policy to only have one healthy support person during labor and delivery. No visitors under 18 years of age will be permitted.

The safety restrictions were issued in March as hospitals work to keep the respiratory virus contained from spreading to staff, patients and visitors. Hospital officials have struggled to tell who is and who isn’t infectious given the shortage of tests and that people can be infectious without having tell-tale symptoms. The challenge has been compounded as hospitals run tight on protective supplies like masks and gowns.

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But babies keep coming in all circumstances, which has left local women trying to navigate the obstacles.

This includes Linsey Griffith, who is 38 weeks pregnant as a surrogate and is also a practicing doula in the region. Griffith said she would under typical circumstances have the future parents, her husband and a doula all attend the birth.

It’s not a moment that parents can get back when the outbreak subsides. As Griffith put it, “you can only have your first child once.”

“I’m livid and I’m terrified. And I’m somebody who teaches childbirth education and supports women through birth on a daily basis. If I’m mad and I’m scared, how do first time moms feel?” Griffith said.

The visitor restrictions could mean giving birth without the doula a pregnant woman had worked with throughout her pregnancy to provide emotional, physical and educational support before, during and after the birthing experience, according to Hope Lane, researcher with Cleveland-based Center for Community Solutions, who wrote a paper outlining challenges with birth and the outbreak.

“This can present a huge obstacle for families who were relying on their guidance, especially since in-person birthing and parenting classes are cancelled until further notice,” Lane said.

Griffith said her practice, which is certified and insured, would be able to supply their own personal protective equipment as needed if they were allowed to attend births at the hospitals. She said doulas have advocated to be recognized as non-clinical professional support.

“We are professionals. It’s not a hobby,” Griffith said.

Disrupted community

Certified Nurse Midwife Kitty Lowry-Collins, with Five Rivers Health Centers/Center for Women’s Health, said she’s been telling patients they should have a back up — and to call her if they need to — in case they come to the hospital to give birth but their partner doesn’t pass the health screening being done on all visitors.

One of the local efforts that’s been successful in helping more babies live to their first birthdays has been the local CenteringPregnancy groups that bring pregnant women together in peer groups for support, but those groups can’t gather anymore in-person, she said. They’ve tried to meet up long distance but that hasn’t worked for everyone.

“I think that’s what helps with the overall infant mortality rate decreasing because we do try and have that community connection and being able to rely on others. Now we’ve taken that away,”Lowry-Collins said.

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She said they’ve seen a remarkable increase in depression in recent weeks. The hospitals have tablets now so patients can do video chat with family in delivery, which she said helps, but the situation is still hard.

“Most of them are very scared. The only thing that we can do is there’s just mountains of information coming every day and we all try to keep up with it and try to advise our patients the best we can,” she said.

Nan-C Vann , Maternal and Infant Vitality Task Force project manager with Public Health – Dayton & Montgomery County, said last week at the daily local briefing on the pandemic that there's currently no evidence that COVID-19 adversely affects pregnancy or passes from mom to babies during pregnancy or deliveries. She encouraged women to talk with their health care provider as the best point of contact and to get information from credible resources, like mceveryonereachone.org.

For women whose birth plans included having another support person in the room for labor delivery, Vann said “please check with your health care provider or birthing facility to learn about alternatives to in-person support,” adding that there’s technology like video conferencing and telephone support.

Vann said she understands that pregnant women might be hesitant to give birth at a hospital. But she said the professionals at hospitals and birthing centers have the necessary equipment to anticipate every need and are taking extra precautions during the pandemic.

The social distancing could have particular burdens on low-income women.

Lane said that while abandoning baby shower plans in the name of social distancing may seem small in the grand scheme of things, for many low-income families, a baby shower is a crucial event. It may be the first time a family is able to get baby essentials, like diapers, onesies and bottles before birth.

Challenges after baby is born

There are also challenges families have to navigate after their new baby is born.

Many grocery stores have been struggling to keep diapers in stock. Families who participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) which provides supplemental foods such as formula, health care referrals and nutrition education for low-income pregnant and postpartum women, may find that disrupted supply chains cause many WIC-approved foods to be out of stock longer than usual, Lane said.

“Due to this, it’s crucial that the federal government waive requirements that WIC retailers’ stock specific food products, and a specific amount of those products, to be certified by the WIC program,” Lane said.

Dina Thurman, pediatric nurse practitioner, with Dayton Children’s Hospital division of child advocacy, said it’s going to be important to use technology to connect to family and friends. But none of those options can give you a break when your infant won’t stop crying.

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Thurman, who wrote a blog post for Dayton parents dealing with postpartum emotions, said that crying, including long periods of inconsolable crying, is normal infant behavior and crying may increase during the first 6 to 8 weeks of life. But just because it’s normal doesn’t mean it’s not frustrating. In fact, crying is a major trigger for most physical abuse and death from physical abuse for infants and young children, Thurman said. Add to the stress that having a new baby brings, the financial and health concerns right now, and you have a potentially dangerous situation, she said.

Try calming your crying baby by gently rocking, offering a pacifier, singing or talking softly, taking a walk with a stroller, or going for a drive in the car.

You can focus on calming yourself down if feeling frustrated or upset and it is OK to lay a crying baby down in a safe place while you walk away to calm yourself down, checking on the baby every 5 to 10 minutes, she said.

Call a friend, family member, neighbor, or parent helpline to ask for help virtually.

“If you find yourself feeling stressed, lonely or frustrated, remember the quote ‘this too shall pass’ for both COVID-19 and infancy. It won’t always be this way, take one day at a time, and recognize when you are stressed so you are never in a position hurt your baby,” Thurman said.


Help and resources for new parents

• The Ohio Department of Health announced a free 24/7 Statewide Breastfeeding Hotline available to mothers, fathers, and caregivers across Ohio, staffed with trained lactation professionals. The hotline is available at 1-888-588-3423.

• National Parent Helpline is available at 1-855-427-2736 is available Monday through Friday to provide emotional support and referrals (in English and Spanish).

• Public Health - Dayton & Montgomery County's Maternal & Infant Vitality Task Force has more information about resources and service changes due to COVID-19 at mceveryonereachone.org

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