One of my favorite parts of my job as a doula and childbirth educator is helping parents make a birth plan. This is not for the reason you’d expect though! I like birth plans for the exercise. The process of researching all your options, thinking through your preferences, making contingencies…that all helps you have a more empowered birth, because you feel prepared. COVID has thrown a wrench in things though, and my experience is that people feel less prepared than ever for their births. There is so much uncertainty, especially in hospital settings, about what will be allowed and not allowed, what the birth space will be like, who can attend your birth as a support person, etc. This is not helped by the fact that most hospitals aren’t doing tours and it’s difficult to get someone on the phone to answer your questions. I’m going to let you in on a little secret though…this is still YOUR birth and YOUR body, even during COVID! So, let’s dive into what to expect for birth during COVID-19.
No Tours or Virtual-Only Tours
To limit exposure and the number of people walking around the hospital, most have moved to virtual-only hospital tours or no tour at all. This makes it really difficult to imagine how you want your birth to feel. It also doesn’t give you a chance to ask your logistical questions, like “where do I go when I’m in labor?” and “what do I need to pack?” Your provider might be able to answer these questions for you, but I also recommend putting in a call to the OB Patient Navigator (or equivalent job title) at your hospital. Their job is to make sure you feel prepared and comfortable leading up to and during your big day! They’re also the person you want to speak to if you have any issues with your care while you’re in the hospital. They can help answer your questions and they might even have resources (like private tours) available for you that aren’t advertised to the general public.
Most hospitals require that you submit to a COVID test before coming in to labor and delivery. If you are planning an induction or cesarean, you may be encouraged to come in the day before your planned delivery to have your test run. If you show up to the hospital already in labor, you will be tested in OB triage.
In the event of a positive test, your partner will be sent home and you will have to labor on your own. Truthfully, I haven’t seen this happen in person, but this is the current policy. Also, if you refuse the COVID testing prior to admission, you will be treated as COVID positive and will need to labor alone, according to hospital policy.
The first difference I see is that you will be expected to wear a mask during your labor. Every hospital has different policies surrounding this, but the thing I see across the board is that providers would like for both the birthing person and their partner to have masks on any time staff is in your room. Now, that being said, labor is not the most comfortable experience ever, so sometimes you really just can’t wear a mask. If you’re vomiting, having trouble catching your breath, eating/drinking, or pushing, you will not need to keep your mask on, especially when it is impossible to do so.
The other thing to note about masks is that all of your providers will be wearing them at all times. The nurses, doctors, anesthesiologists, technicians, and anyone else that comes into your room will be wearing a mask. This can be difficult in a birth experience, especially when you’re looking to the faces of your care providers to help bring you comfort and reassurance during the process. If you cannot understand your provider because the mask is muffling their voice, be sure to ask them to repeat themselves so you can make informed decisions about your care plan.
Limited Support People
Gone are the days when you could have your partner, mom, sister, grandma, doula, birth photographer, and anyone else you wanted with you during your birth. Most hospitals at this point are allowing one support person (such as your partner, sister, mom, etc.) and a certified doula, since they are considered a birth professional. Usually the hospital requires that the doula show some form of identification, as well as proof of their certification. Partners are typically not allowed to switch out with anyone else during the course of the birth.
Mostly Confined to Room
In addition to the limited support people, you are typically confined to your Labor & Delivery room as soon as you are admitted. There is not much opportunity for walking around the hospital, or even the L&D unit, to encourage labor and cope with contractions, so you’ll have to get creative with the space and tools you have in your room! Depending on your hospital’s policy, support people may be able to leave the unit for food and come back, but they are discouraged from leaving the hospital and coming back in during the duration of your labor. Please clarify with your specific hospital what the policies are at the time, so you can be sure to pack and be prepared for any scenario.
Even with all of these added policies and precautions, there is no reason to think that your birth cannot still be whatever experience you want it to be. I recommend watching hospital birth videos, making a birth plan, and writing a packing list of comfort items and snacks that you’ll want from home in order to create a space where you feel comfortable and calm. Talk with your provider about your questions and concerns and make sure to get answers that you are satisfied with. Ultimately, this is your experience, and you deserve to feel informed, confident, and supported.