As Ohio and Kentucky begin easing restrictions and reopening their economies, one of the first sectors each state let expand in terms of operating capacity was health care. Because citizens were able to flatten the curve, hospitals weren’t overwhelmed with COVID-19 patients. And medical facilities were able to resume outpatient and invasive surgeries, diagnostics and more.
But for both states, the lifting of restrictions came with caveats including COVID-19 screening for patients prior to entry and visitation limits. (Kentucky is allowing patients to have a single visitor at the discretion of the health care facility starting May 13.)
But one sector of health care that has allowed visitors — or, a single visitor, rather — during lockdown has been labor and delivery.
“Right now for all the hospitals, even in this Phase One of loosening up the restrictions, at least at TriHealth, we are still not allowing any visitors except in maternity,” said Dr. Kristin Coppage, Department Chair for Obstetrics and Gynecology at Good Samaritan, during an interview in early May. “And maternity is allowed to have one person per birth…It could be whomever the patient would want, but they can’t be switched out. Meaning the person who comes with you from the time you get admitted is the person that stays the entire time.”
The only time a maternity patient cannot have a visitor at Good Samaritan is if she is admitted to the ICU.
And these restrictions — in place to keep both patients and hospital staff safe — have been one of many that pregnant women are experiencing during the pandemic. For example, Coppage says each patient who enters the hospital is screened for COVID-19 before they arrive, when they arrive and everyone — mom, designated visitor, hospital staff — wears masks.
“(We are) actually starting universal COVID (testing) on all of our patients that present to labor and delivery,” Coppage says.
Good Samaritan has also created a maternity COVID unit “to decrease any risk of transmission among team members or patients,” Coppage says. And if a mom is COVID positive, Coppage says hospitals across the region are starting to use a shared decision-making model to help patients decide whether they want to co-room with their newborns or be separated from them. “We go through the risks and benefits of each and we let the patient decide what they would like to do,” she says.
But these changes and news stories — like those about women diagnosed with COVID-19 giving birth while in a medically induced coma — can up the anxiety level for anyone about to have a child.
“I think just in general, there’s heightened anxiety right now. And all moms are very anxious about delivering in the hospital and not knowing what to expect,” Coppage says. “I feel at TriHealth, we’ve done a very good job to educate our moms and to prepare them for what to expect and to let them know that we’re there for them, that we are here to take care of them and keep them safe. (Good Samaritan is) one of the busiest maternity hospitals in the Greater Cincinnati region and so we have taken care of both COVID positive patients and COVID negative moms for delivery. And I think everyone so far has had a successful outcome. And that just shows me that all the planning that we’ve been doing on a daily basis for the last six weeks has really been worth it, that we are able to have successful outcomes even in this very strange time that we’re living in.”
We spoke with three Greater Cincinnati women who have either recently given birth or are about to about their experience with pregnancy during the pandemic.
It should be noted that all of these women have access to health care and have what could be considered typical pregnancies.
Caitlin Burnett
Caitlin Burnett will be a first-time mom with a due date in mid-June. She and her husband, Barry Williams, have been planning for a family and recently had to adjust their birth plan to accommodate for COVID-19 restrictions. Burnett will now be doing a home birth, attended by two certified professional midwives, after the natural birth center at Mercy Health West — their original hospital choice — was dismantled to accommodate gynecological and obstetric surgery recovery (it has since been put back in place, Burnett says). Burnett says the change prompted her decision to “look really seriously at home birth” to make sure the support system she wanted was able to attend the birth, and to reduce the risk of exposure to COVID in a hospital setting. (Disclosure: Barry and Caitlin are both friends of mine.)
CityBeat: What is it like being pregnant right now?
Caitlin Burnett: I find that it’s this really weird moment where you are both extremely vulnerable — like your body is not functioning how it has functioned for your entire life, and you don’t know what it’s going to do or what it needs because it’s all new and it’s all directed by hormones that just take over. So, in that way, it’s kind of a uniquely vulnerable time. But then, on the other hand, your body is literally manufacturing a brand-new organ and putting together the building blocks of life. And, regardless of what you’re thinking or feeling, it is figuring out how to produce a human. It’s just this incredible, weird feeling to be both totally out of control and then doing something entirely new that you have no idea how to do but is going to happen anyways.
The pandemic just kind of increases that feeling of vulnerability because you don’t know what would happen if you were to get sick. And then it definitely completely upended our birth plan.
CB: Has there been concern about — if you were going to do labor and delivery still at a hospital — about Barry not being able to go to the hospital?
CB: That was one of our big concerns. One of the initial triggers for us to consider a home birth even before they dismantled the natural birth option that we wanted to use was that they are cutting back really drastically on support people, so they wouldn’t allow our doulas in. And at this point, as a first-time pregnant person, having doulas there to support me and tell me what’s going on and make the tendency for hospital births to be really medicalized less likely was really important. So once they were not allowed, we kind of had a moment of figuring out what that meant and what we wanted to do, because having advocates who don’t want to push medical options was really important. And I think it’s also really still changing, literally week by week. So we had looked at another hospital that at that point had still been allowing doulas, but by the time we called back the next week, they were in the same camp.
And with COVID, if Barry was to be sick, they would not let him in. And then the other moment that was extra terrifying was that our OB (obstetrician) warned us that if either of us were (COVID) positive, the baby would be isolated from us for the first 14 days of his life. Like we could not touch, care for, bring that baby home for two weeks, which I just can’t even imagine.
CB: Was it difficult for you to find doulas to attend the home birth? Have you heard (whether or not) this is an option that a lot of other people are moving to?
CB: We had the doulas way before COVID hit…and they helped walk us through like hospitals versus a birth center versus a home birth. And they ultimately connected us with the midwives — they are called certified professional midwives as opposed to certified nurse midwives; nurse midwives are in the hospital, professional midwives do home births. They connected us with a couple of different folks to interview and they are being really selective right now because they’re getting a lot of calls. But I think we had the benefit of from the very beginning planning for a natural birth.
CB: Are the midwives relaying any information to you guys about their own precautions for COVID or what happens if Barry was sick at the house?
CB: I know they come with their own PPE — they’ll be masked even at home. But, you know, we haven’t asked that. I think we are just being super cautious about isolation and not taking any chances.
CB: Do you have any concerns about (the midwives) being in other people’s homes and then coming to your house?
CB: I’m trying to trust that their contact with folks is limited enough. They won’t be in a hospital setting with like, hundreds of people walking around touching everything, breathing — they’ll be in more limited settings where it’s just three or four people or two or three people. And they are using precautions. But they are connected to a network, so if our two midwives couldn’t personally be there, I trust that they’d find good colleagues to send us.
CB: When you guys are doing the home birth and the midwives are there, if something is happening that they can’t handle, do they direct you to a hospital?
CB: They do something called parallel care where they provide care in tandem with nurse midwives and our OB. So, if all else fails, and something goes catastrophically wrong, we still have the care of the medical OB and nurse practice. And we’re still registered at the hospital that we were originally planning on. But the interesting thing that I’ve found out in all this research and writing is that catastrophic stuff for home birth is really not common at all because home births are typically a self-selected group of healthy people who have zero complications who are really closely monitored.
CB: Obviously, the world has drastically changed in the eight/nine months you’ve been pregnant. What is your general overview of this experience? And have you been talking to other pregnant people or people who have given birth?
CB: No, that’s been the other part of this whole crisis: The isolation has hit pretty hard because all the stuff that you’d expect from like a first-time pregnancy of getting to go to birthing classes, getting to do a hospital tour, where you meet other people at the same stage of life and form relationships and connect, all that is canceled. So, that’s been one of that aspects that’s been difficult because there’s a whole lot of excitement for us, like we’re thrilled to welcome this little human and see what he’s like and see him grow and learn about the world. But there’s also an element of grief, like all the stuff that we thought you were going to get to do — celebrating, building a community — all that is canceled, so I’ve definitely been going between just being really upset to really angry, and I think now I’m finally at acceptance. Except when I see the stupid people who are out there without a mask walking too close and touching me. Then I go back to the anger stage of the cycles of grief.
CB: As your friend, personally, I think it’s hard for us because I don’t want to get anywhere near you because I don’t want to do anything (that could harm you).
CB: I know. I think even my parents are struggling with that. And I think postpartum is going to be weird and isolating, like extra isolating, besides the fact that I’ll be walking around in adult diapers for several weeks — people conveniently forget to leave that out of the story.
We had hoped that maybe my mom would be able to come and support us, even if it’s just hanging out with the dogs and helping to clean and make sure that we’re eating, but with all of this stuff, it’s just too much of a risk. So we’re really kind of bracing to be on our own in a way that we didn’t expect.
CB: Now, how’s your OB? Do they have constantly updating advice for you guys? Or have they been able to at least provide some support or information?
CB: They do provide information. The weird part has been, first of all, Barry can’t go with me (to the doctor) now. Like, he’s not allowed in the building. It is only me. And I have to be wearing the mask, which when you have a baby pressing against your lungs and your lungs are literally functioning worse because of the hormone percentage, breathing is really just crappy. So he hasn’t gotten to hear the baby’s heartbeat in a while. And I think it’s worse for folks who are getting pregnant now. I can’t imagine what it would have been like to be in that ultrasound room alone for the first time — to see the baby and to see the heartbeat and to know that everything’s OK. It’s just heartbreaking.
Then, especially in this phase of late pregnancy, they typically want to see you every two weeks or every week. But because the risk is so great, they moved to telehealth. And so we have video check-ins, but as an anxious person not having that chance for them to actually take my blood pressure or look at my weight or measure my belly, listen to the baby, all those reassuring routines are kind of out the door because we’re literally on a Zoom call in the dining room.
I think they’re trying to be flexible and provide information but it’s also fast changing. I think it’s really hard for them — they don’t know what the hospital will look like next week. Or, you know, if we see a spike if maybe it will be no support people, period, in the delivery room like it was in New York for a while. I think they’re navigating the crisis right along with us.
Andi Ploehs
Andi Ploehs, a local graphic designer and artist, just had her second child, Sage, at the beginning of April. CityBeat has spoken with Ploehs several times about pregnancy and her fertility journey. She is the mind behind a.p. loves design and after unsuccessfully attempting to conceive a child on their own for several years, Ploehs and her husband, John, began seeking medical assistance in their quest to become parents. As a result, Ploehs began designing a line of greeting cards specifically aimed toward other women experiencing fertility issues and also has started to bring to light conversations about infertility and pregnancy struggles. She gave birth to her first child, Xavier, in 2018.
CityBeat: How did your pregnancy with Sage differ this time around — specifically in regards to any changes or adaptations for COVID-19?
Andi Ploehs: Thank goodness we were in the last few weeks of my pregnancy when COVID-19 really hit the area. However, my doctor’s office immediately changed several policies including going to appointments alone. I couldn’t even enter the office building without stopping at a station in the lobby where I was asked several questions related to the virus, and a temperature check.
CB: Did you have to adjust your birth plan, if there can ever truly be a “plan”? What was the process like?
AP: We used the same birth plan we used for our son, but of course plans change — especially when you’re in the moment. Once we started to get word of other cities using other parts of the hospital to treat patients, I got very nervous that there would be this influx of patients and that I would have to deliver in the ER. I wasn’t told I would be delivering in the ER, but I was told that no one really knew what to expect since it was new to everyone. After that conversation, we started to entertain the idea of a home birth and even reached out to a doula we knew, but the thought of something going wrong and not being at the hospital didn’t ease any of my nervousness so we axed that idea.
CB: Were members of your family or your support system allowed to be there for the birth?
AP: I was allowed to have one person with me, so my husband was there, of course. But we both had to again answer questions related to the virus, our whereabouts and had our temp checked before we could even leave the hospital lobby. We decided to semi-quarantine weeks before I was induced to ensure no one got sick.
CB: Many people have family members or friends help postpartum. With quarantine/isolation orders in effect, did that impact any of what you had expected your postpartum experience to be like?
AP: My mother lives in Georgia and the plan was for her to be at my side when I delivered along with my husband. She’s a non-Hodgkin’s lymphoma survivor and is considered high risk so she wasn’t allowed to travel for the birth. With our son, she stayed and helped for two months, so it’s very strange not to have her here. We have an awesome support system and rely a lot on grandparents. The ones living here have been able to see our daughter six feet away, from the car, but honestly, I don’t know when my mom will be able to meet her granddaughter. It kills me inside, but I need to do all I can to make sure my family stays healthy.
CB: Have you had any additional concerns with a newborn now in a world with a novel virus? Are you approaching anything differently beyond CDC recommendations for sanitization and social distancing?
AP: Honestly, we would’ve been living a very similar life with a newborn even if there wasn’t a pandemic. We like to stay put for the first month or so, and are very particular about folks coming around, especially if they don’t have the flu shot, etc. One huge change from my last delivery was our time in the hospital post-delivery. They usually want momma and baby to stay 48 hours with a natural delivery, but because of the pandemic, my husband and I decided we didn’t want to stay in the hospital longer than 24 hours if all went well, which it did.
I’m accepting this as our new temporary normal but not our permanent one. I don’t want my son to remember wearing a mask to go outside or not being able to give his grammy a hug because we don’t want to put her or ourselves at risk. But we are definitely following the CDC guidelines for sanitizing and social distancing. I can’t wait for the grandparents to finally be able to hold their granddaughter and grandson when this is all over.
CB: Do you have anything you want people to know about pregnancy or pregnant women or newborns during the time of COVID-19, or any advice?
AP: I was terrified weeks leading up to my delivery. I was listening to too many outlets and started to freak myself out. I had to block out media, social media outlets, and even some people. I did a lot of praying, and had to trust myself and the health care workers. I also had to trust that it would all work out, and reminded myself that I couldn’t get stressed because I had a baby girl still inside me that needed her momma to stay calm. I want mommas to remember we are tough and that this too shall pass. I never imagined I would be living through a pandemic let alone giving birth during one.
Karla Weisenberger
Karla Weisenberger is a small business owner and musician who is about to be a first-time mom with her partner, Pete. She operates Karla Louise Bridal Designs and Accessories in Covington, and plays in Folk group Stitches & Seams. Her due date is at the end of May and she did not have health insurance for herself until she found out she was pregnant.
CityBeat: When you got pregnant, there was not a pandemic, and now there is. How has the pandemic affected your experience of being pregnant? How has it affected your birth plan?
Karla Weisenberger: When it first happened, the first thing that they did was close the schools and I really felt like nobody was reacting quick enough. My doctor’s office wasn’t really doing anything different and I called them and I was like, “I’m not coming in.” At this point, I was supposed to be there every two weeks or every week for my third-trimester check-ups. You don’t have people checking people. You don’t have people requiring masks. It’s like sick people and regular people can be in the same room at the same time. So my doctor was like, “OK, Karla, we understand what you’re saying. If you want to take this week off, that’s fine.”
And then three weeks went by, and (my doctor) was like, you really need to come in. I’m like, “Well tell me what you’ve done to like change the situation to make sure that I’m not going to be sick when I go there.” So the first thing they did was started screening people at the door — you would pull up in your car and someone would meet you at your car and then they would ask you a bunch of questions. And then they would still let you go into the waiting room. I was the only person at this time wearing a mask and wearing gloves.
So that was probably five weeks in (to the pandemic) and I still felt very uncomfortable in all of my appointments. And then they’re like, “OK, it’s getting to be the end of your pregnancy, we need you to come in every week.” And I’ve also had some minor complications, so they’re trying to keep a closer eye on me than they normally would. So now when I go, I’m greeted at my car, or they have a little pop-up tent if it’s raining, and they take my temperature, they asked me those same questions. And I wait in my car until my appointment.
I also go to the hospital once a week to have a non-stress test and an ultrasound just because of the minor complications that I’ve had. So right now, for the last three weeks, I go to the hospital on Tuesdays and I go to the doctor on Thursdays.
When I get (to St. Elizabeth Edgewood), they immediately put a mask on me. They sanitize my hands and they, like, spray me down, and then they take my temperature. Then they asked me the same questions that the doctor’s office does, and if I pass all that, they send me to the next station. They’ve done a good job where they have little circles that you’re supposed to stand in so you know how far apart you’re supposed to be when speaking to anybody.
CB: So you’re going to the hospital once a week for a check-in?
KW: Basically they put these monitors on my belly and they just listen to her heart rate and every time she moves, I click a button. They’re tracking her movement, they’re tracking her heart rate, they’re tracking her growth and they’re basically just making sure that all of her organs are up to date, all of my organs are doing good. I’ve had some issues with my placenta. I had a tear in my placenta early on in December and they’ve just been monitoring it, making sure it hasn’t gotten worse. I have really bad swelling in my feet. And my heart rate’s been pretty good, but if my blood pressure were to go up, they would tell me that I have preeclampsia, which is dangerous for both me and the baby.
CB: Are any of your doctors worried that is making you more susceptible to a COVID-19 infection?
KW: Not necessarily because of the conditions that I have. They have said because I’m pregnant in general, that I am more susceptible…They don’t want me coming in contact with anybody because they just don’t know.
CB: So as of right now, do you guys have a birth plan in place?
KW: We’re going to go to St. Elizabeth — I’m already pre-registered at St. Elizabeth. I’m going to wait as long as possible and do most of my laboring at home. It’s going to take me five minutes to get to the hospital.
CB: Are there any kind of restrictions in terms of the amount of visitors you guys can have or who’s allowed to go with you?
KW: So only Pete is allowed with me — my mom, the grandparents, nobody’s allowed in the waiting room at all. And once Pete is in that room with me, he is on lockdown with me. So anything he needs, he has to have in that room. That does mean that they are giving us a refrigerator now, which is crazy. And they’ve been like, “Bring snacks because nobody can bring you snacks now or after the kid comes.” And after the kid is born, it’s only going to be Pete and I who are allowed to hold her. They don’t know how long it’s going to be before they’re like, “Yes. Your child can be held by somebody in the family.”
CB: Now have they said anything to you about whether they are going to test both of you guys for COVID before you go in to the hospital again?
KW: As of right now, we show up at the hospital and I’m tested; Pete is not. They assume that if I have it, then Pete has it. And if I have it, then I leave St. Elizabeth Edgewood, where I’m planning on giving birth, and I go to the COVID unit over in Fort Thomas, which they don’t have a birthing center set up — it’s literally the COVID hospital where I would have to give birth.
CB: Did you guys have any plans for postpartum stuff that has changed?
KW: Since they are telling us that nobody’s allowed to see her, nobody’s coming to help us — like we’re totally on our own. And we don’t know how long that’s going to be. And so, for someone like me who has suffered from depression in the past, knowing that your body goes through a lot of highs, and I’m not saying that I think I’m going to have postpartum depression, but I’m not saying that that’s not going to happen either. So I’ve been very much in contact with my doctors and been like, “Hey, I want to notice the symptoms and the signs,” you know?
I have to make sure that my brain is in the best possible way to care for this kid and that, we, as a team can do this just the two of us. And so that being said, we’ve also been like, OK, developmentally, we all know that kids thrive from extra physical contact and extra love and hugs and all the things. So we’ve been trying to research how can the two of us give her the same comfort and love that a family would normally give her?
CB: How are you handling being a small business owner with maternity leave?
KW: This whole thing messes with my financial situation majorly because I had all these brides lined up and spring is my wedding season. This was like my moment to make all the money I needed to make sure I could take those six weeks, eight weeks, whatever I needed to do. Because of that, I am not real sure exactly. And I haven’t qualified for any of the small business loans or the payment protection.
With (the baby) not having an immune system, knowing that she’s not able to be held by anybody, I’m not planning on taking clients until they tell me that it’s safe for her to see anyone. Meaning, if I go out to my job, and I take on a client, that person could have it and then I could bring it home to my kid. And I have ordered one of those laser thermometers and I know that when I do eventually open, (the clients) are going to wear masks, I’m going to wear a mask and limit it to one person in the shop at one time. We’re still going to be social distancing, but I have to touch them — I have to fit their dress to them.
I don’t know when I’m going reopen, I really don’t. And I also don’t know what that means for my space. My landlord’s being super cool right now, but she’s got a mortgage and she’s got things that she’s going to have to do. I don’t know what that means for the future of my shop. I’m doing my best to be as cool as possible about it.
Interviews have been edited for clarity and space
This article appears in May 6 – Jun 14, 2020.
