The first two pregnancies were nothing like this.
Abby Deckard thought she knew what being pregnant with her third child would be like. By her 34th week of pregnancy, the Greenwood resident said it had gone pretty much as expected.
That is, until the spread of COVID-19 upended every aspect of daily life.
"I’m not worrying about things I worried about with my other pregnancies as much, but it’s just been replaced by this," Deckard said. "I worry about what would happen if I got (COVID-19) or what would happen with my baby? How would I take care of my baby?"
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For women like Deckard, the unique challenges of pregnancy have been amplified during the conoravirus crisis. Doctor’s appointments have been canceled or come with layers of added precaution, plans have been put in place to protect against the disease during delivery and the normal anxieties about having a child have been intensified with the presence of the deadly virus.
Local health officials are working to ensure that moms-to-be and their babies receive all the necessary care, with added emphasis on efforts to stop the spread of coronavirus. But they admit that it’s a challenge.
"This is unchartered territory for sure. I think patients are understandably very nervous and scared. This should be an exciting time in their life and the lives of their partners and families, and it’s not typical of what they expected," said Dr. Indy Lane, Community Health Network obstetrician-gynecologist and women’s product line executive physician. "We need to acknowledge that this is unexpected and this isn’t what we planned for patients, but we’re still dedicated to creating an exceptional experience for them."
As COVID-19 cases have grown throughout central Indiana, area hospitals and physicians have had to make major adjustments to prepare for coronavirus patients while continuing to serve those with other health needs.
Franciscan Health, on the southside of Indianapolis, has set up two dedicated respiratory illness clinics where all patients with some kind of respiratory distress including, potentially, COVID-19, would go to be evaluated and treated, said Dr. Paul Driscoll, medical director for Franciscan Physician Network Central Indiana. That enables the hospital to preserve protective equipment and keep potentially infectious patients out of most offices, concentrating them in those dedicated respiratory spaces, Driscoll said.
Doing so allows other practices to continue taking care of the ongoing needs of their patients. That includes women who are pregnant, Driscoll said.
"What those physicians are doing is bringing in pregnant moms in the mornings, when they won’t be seeing any other sick patients until later in the day," Driscoll said.
In her role as a registered nurse with Goodwill’s Nurse-Family Partnership, Heather Lett is used to answering anxious questions about pregnancy. The program pairs moms-to-be with registered nurses for ongoing home visits, aimed at supporting mothers and families prior to birth and through the first two years of their child’s life.
But the coronavirus crisis has added a new dimension to the concerns and fears that Lett’s clients have.
"Moms who are going to the hospitals to have their babies are wondering if they can bring someone with them, what it’s going to be like there. We’re just trying to reassure them that they’re going to be taken care of," said Lett, a Franklin-based nurse serving Johnson County. "It’s scary, being pregnant or a brand-new mom in this. So we’re video chatting, doing phone calls, sometimes doing extra calls, just to be there for them."
The Nurse-Family Partnership has transitioned to video chats and visits, which has required some adjustments for Lett and other nurses. But it also provides more opportunities to meet with clients, answer questions and calm their concerns.
"Our goal is always to be very supportive, and we didn’t want that to change. We’ve kind of ramped it up for those who are in a little more need of things now, whether that’s from mental health things, how do we help them locate another job, diapers, formula, things like that," Lett said. "We’re trying to stay in regular contact, and (a) little more frequently if that’s needed. Just a lot of education if they have questions."
According to the Centers for Disease Control and Prevention, it is unknown at this point what the effect of COVID-19 has on pregnant women. The limited data they have is unclear whether pregnant women have a greater risk of contracting the virus, or if the disease can be passed from mothers to fetuses or newborn babies.
"There is a lot that we still don’t know about COVID-19, so we try to stress that the changes we’re making, though they seem to be made on a daily basis, are all meant to create a safe experience for patients, their babies and staff," Lane said.
No infants born to mothers with COVID-19 have tested positive for the virus. In these cases, which are a small number, the virus was not found in samples of amniotic fluid or breastmilk, according to the CDC.
That unknown adds another dimension of anxiety during pregnancy, Deckard said.
"So far, all of the information they have is that it doesn’t hurt the baby, but they don’t really know. It just makes it worse," she said.
Deckard has also been thinking about when she delivers her baby in the next month or so. She anticipates that visitors won’t be allowed to see her after she gives birth.
"That’ll be really different because with both of my boys, my parents and my husband’s parents were all there. My mother was there when I delivered both of my boys, and I’m fairly positive that won’t happen this time," she said.
Not being able to have visitors with them at delivery is one of the major concerns patients at Community Health has, Lane said. Women are worried that their mothers or their sisters or their best friends are not going to be at their side during this monumental life moment.
Restrictions at Community Health Network facilities limit patients to have one support person with them.
"That support person can be anybody that person wants. But it does have to be just one individual. So I think there’s a lot of anxiety and disappointment around that," Lane said.
Deckard has been receiving care from her doctors at Southside OBGYN on Franciscan Health’s Indianapolis campus. Though Southside OBGYN has rescheduled all non-essential appointments at the office and started using telemedicine when possible, Deckard hasn’t missed a visit with her doctor.
But, the experience of going to the doctor’s office has been radically different. Before she goes, she has to be screened to be sure that she doesn’t have a fever or any other COVID-19 symptoms.
She can’t bring anyone else with her. No other patients are around, and only limited nurses and other staff are working.
"It’s just different," she said. "It’s pretty much empty."
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What is the risk to pregnancy women of getting COVID-19?
We do not currently know if pregnant women have a greater chance of getting sick from COVID-19 than the general public nor whether they are more likely to have serious illness as a result. Pregnant women experience changes in their bodies that may increase their risk of some infections.
With viruses from the same family as COVID-19, and other viral respiratory infections, such as influenza, women have had a higher risk of developing severe illness. It is always important for pregnant women to protect themselves from illnesses.
Can COVID-19 be passed from a mother to a fetus or infant?
We still do not know if a pregnant woman with COVID-19 can pass the virus that causes the disease to her fetus or baby during pregnancy or delivery. No infants born to mothers with COVID-19 have tested positive for the virus. In these cases, which are a small number, the virus was not found in samples of amniotic fluid or breastmilk.
How can pregnant women protect themselves from getting COVID-19?
Pregnant women should do the same things as the general public to avoid infection. You can help stop the spread of COVID-19 by taking these actions:
- Cover your cough (using your elbow is a good technique).
- Avoid people who are sick.
- Clean your hands often using soap and water or alcohol-based hand sanitizer.
Information from the Centers for Disease Control. For more information, go to www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html
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