Jenna Larrew was thrilled, if slightly nervous, when she learned in March she was pregnant for the first time. The Michigan native had recently relocated to Lakeway, outside Austin, far from friends and family, and thought the blistering heat of a Texas summer would be her biggest adjustment.
But just one month later?
“I feel like I’m pregnant during the apocalypse,” Larrew said.
When Texans first began testing positive for the novel coronavirus, Larrew was immediately vigilant. As an older, first-time mother, her pregnancy is considered high risk. So the 39-year-old and her husband wasted no time arming themselves against infection, carefully scrubbing down each grocery item and staying isolated at home.
Larrew hopes society will be somewhat normal again when the baby arrives in November. But in the meantime, pregnancy milestones that are typically celebrations — the first ultrasound, the frequent check-ups — are tinged with worry in the rapidly changing face of a pandemic.
“It’s a scary time to be pregnant,” Larrew said. “And it’s already nerve-wracking as it is.”
For pregnant Texans, fear of COVID-19, the disease caused by the virus, has upended carefully laid plans for obstetrician visits and labor schedules. Many expectant mothers now worry about giving birth during a peak in the public health crisis, fearing hospitals will limit access or lack necessary medical supplies.
Meanwhile, Texas hospitals, either slammed with an influx of COVID-19 patients or preparing for more, are restricting visitors to labor and delivery wards in an attempt to contain spread, giving rise to rumors that women may soon have to give birth alone.
Medical experts have largely discounted these rumors and are advising hospitals to allow visitor access during labor and delivery, more so than for other procedures. Last week, the American College of Obstetricians and Gynecologists reassured patients that hospitals and birth centers “remain safe places to give birth in the United States.” In a statement, the organization said the emotional support provided by a partner or support personnel, such as a doula, can improve delivery outcomes.
George Macones, an OB-GYN and the chair of the women’s health department at the University of Texas at Austin’s Dell Medical School, echoed those guidelines. While it makes sense to limit hospital access in general, there is a much higher threshold for hospitals to consider restricting all visitors to maternity wards, he said. Macones has not yet heard of any such policy at a Texas hospital.
“I think there are already a lot of protections you can put into place to try and limit potential spread,” Macones said. “Most people recognize that the birth of a child is such a momentous event in life that there needs to be a little more flexibility around labor and delivery than something more routine.”
Much of the fear in the state stems from a recent ban on all visitors by two hospital networks in New York, NewYork-Presbyterian and Mt. Sinai. In mid-March, the hospitals announced a short-lived moratorium on spouses, partners, family members or outside support people, according to The New York Times, a move they told patients was in their best interest.
The policy lasted a week, during which time some women gave birth alone and others fled the city, until New York Gov. Andrew Cuomo signed an executive order overturning the ban. The office of Texas Gov. Greg Abbott could not be reached for comment about how the state might respond to similar hospital bans here.
Across Texas, Facebook groups for pregnant women started buzzing with outrage, their members wondering if something similar could happen to them. Julie Shaddox, a 34-year-old Dallas resident, said she panicked briefly after seeing posts stirring speculation that no-visitor policies could happen here.
Her hospital, Baylor University Medical Center in Dallas, is only allowing one visitor during labor and delivery. That should allow her husband to be with her in the delivery room, unless something changes before June. But Shaddox is also paying for a doula from a local birth center, someone she was anticipating also bringing into delivery with her before the coronavirus pandemic. The doula, though, does not count as essential under the hospital’s current rules.
What concern Shaddox most are the painstakingly mapped parts of her pregnancy that are now beyond her control. Her baby is due in June, less than three months away. Because she is low risk, her provider has recommended she have fewer in-person appointments, use an at-home blood pressure cuff to self-monitor abnormalities, and check in with a doctor every six weeks instead of biweekly.
“Intellectually, I can understand that a lot of people think it's better that I have fewer appointments right now. But I still feel alarmed about this,” Shaddox said. “You Google ‘what to expect in your third trimester,’ and it says ‘have an appointment every two weeks.’ Nope, not during a global pandemic.”
Macones said he’s seen in-person obstetrician visits slashed almost in half, with nearly 50% of appointments at Dell Medical School moved online for now. Expectant mothers are asked to alternate their visits to limit exposure to hospitals. So far, this seems to be working, he said.
“My own experience is that telemedicine visits are going great and we’re not missing much,” Macones said.
But it still remains to be seen if pregnancy outcomes improve or worsen after this, he added.
The lack of information about coronavirus and pregnancy is spurring a lot of uncertainty. Researchers’ best guess is that pregnant women are not at any increased risk, Macones said. The Centers for Disease Control and Prevention cautions pregnant women to be wary about coming in contact with the virus.
For Elise Stephens, another first-time expectant mother struggling with the pandemic, the already stressful situation is worsened by financial constraints.
Stephens, 30, was laid off from her job in technology sales few weeks ago. Her husband works in the oil industry and has already seen his hours and paycheck cut, Stephens said. She’s spent the last few weeks scavenging for baby wipes and diapers, both of which seem to be in short supply, and she’s worried about stockpiling the necessary essentials with no extra money.
“If I had all the money in the world, I wouldn’t be worried,” Stephens said. “But as a regular person, not being able to afford everything I need for my child is a huge worry.”
Stephens, 30, is six months pregnant. The idea that no one knows what the next three months could hold is terrifying, she said.
The hospital she plans to deliver in, UT Health Tyler, has also implemented a one-visitor-only policy. But Stephens’ fear that she might have to deliver alone is still top of mind.
“It’s important to me to have the father of my child in the room by my side, especially as a first-time mom not knowing what to expect in the hospital,” Stephens said. “If I have to be alone in a room for 20 hours by myself, I have no clue what I’d do. Right now, it can feel like you’re doing this thing alone.”
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