How the Coronavirus is Forcing New Guidelines in the Delivery Room - COVID-19 Clinical Trial
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How the Coronavirus is Forcing New Guidelines in the Delivery Room

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    Most women would agree that childbirth is one of the single most exhilarating and terrifying experiences of a lifetime. It’s a pivotal moment, one that women want to share with partners, grandparents, and other important loved ones. But the rapidly spreading coronavirus pandemic has forced hospitals to adopt unprecedented measures to keep mothers, newborns, and healthcare workers safe. 

    Lack of Data Regarding COVID-19, Pregnancy, and Childbirth Causes Uncertainty 

    As medical experts seek to understand the behavior of COVID-19 and protect vulnerable populations, the link between the virus and pregnancy is still poorly understood. The existing evidence doesn’t suggest that pregnant women are more likely to contract the virus, but far more research is needed to confirm this. 

    A very limited amount of research shows childbirth and breastfeeding cannot transmit COVID-19, but doctors are still uncertain. “The reality is we don’t have a lot of data related to outcomes in pregnancy in women who have COVID-19 or their risk of contracting COVID-19,” explained Maureen Phipps, CEO of American College of Obstetricians and Gynecologists. 

    This has left expectant parents feeling frightened, overwhelmed, and anxious. “As you can imagine, our phones are ringing off the hook from folks that have questions about coronavirus and pregnancy,” said Dr. Jeffrey Ecker, Chief of Obstetrics and Gynecology at Massachusetts General Hospital in Boston. 

    Hospitals Err on the Side of Caution By Minimizing Visitors During Labor and Delivery 

    Without reliable data to inform their actions, hospitals around the country find themselves making a difficult decision: continue to allow visitors during childbirth and risk the spread of COVID-19, or deprive women of their support systems to minimize the threat. 

    Many hospitals, including Mass General and UCLA Health, have temporarily changed their guidelines to allow only one visitor into the delivery room during childbirth. Dr. Maya Zapata, an OB/GYN at UCLA Health, explains the reasoning: “In the setting of the coronavirus, we are trying to limit the risk for the patient, her baby, her support person, her family, our staff and the public in general.” 

    Other hospitals in the hardest hit areas, especially New Jersey and New York, feel the need to take more drastic measures. Two of the country’s largest hospital systems, New York- Presbyterian and Mount Sinai Health System, are both based in New York City on the front lines of treating a huge wave of COVID-19 patients. Toward the end of March, both hospitals banned all visitors. This left hundreds of pregnant women to give birth without a support person, using FaceTime and Skype to stay connected with their families. 

    On March 28, Governor Cuomo of New York responded to these hospital policies by tweeting, “In no hospital in New York will a woman be forced to be alone when she gives birth. Not now, not ever.” He then signed an executor directive allowing all women in the state to have one visitor during childbirth. The order cites the health department, which “considers one support person essential to patient care throughout labor, delivery, and the immediate postpartum period.” 

    Pregnancy and Childbirth Guidelines Continue to Evolve 

    As the coronavirus situation changes daily, it remains to be seen whether other hard-hit states like New Jersey and California will follow New York’s lead and require hospitals to allow one healthy visitor. 

    Many other policies are also continually shifting, including obstetricians who are choosing to reduce the number of appointments their pregnant patients are required to have. In-office visits are widely being replaced with phone calls and videoconferences. Some hospitals are even offering to induce labor at 39 weeks to allow pregnant women to get in and out of the hospital before the worst surge of COVID-19 hits. 


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