I got tested for Covid-19 at 37 weeks pregnant.
This last week was by far the most stressful and anxiety-ridden I have experienced since the beginning of the pandemic. Spoiler alert: I tested negative! My next-door neighbor, Allie, who is one of my best friends and whose family was our ONLY social contact since social distancing, was tested and declared positive for Covid-19. It started with her husband. He got tested on Monday and found out on Tuesday that he was positive. Since Allie and I are both pregnant, we were both able to get tested that night (driving separately, of course!) and receive results a day or two later through the expedited State testing.
I have to say that until that night, I truly did not understand the full scope of risk that our healthcare workers are taking for us. I was blown away, beyond thankful, that these nurses and doctors were risking their health and safety for me, a stranger, and treating me with such gentleness and respect while doing so. Thank you Respiratory Clinic of the Wyoming Medical Center - your staff was so kind and sympathetic to my situation, which was as such:
My nurse informed me of all the different scenarios regarding my exposure to Covid-19. Best case scenario - were I to test negative, my family and I would have to remain in isolation for two weeks, as we were all exposed and could be carriers of the virus. Generally, that would not have been a problem, assuming that my midwife, who was also tested, would test be negative. I could continue with my planned home birth and just have to remain without any contact for two weeks.
Worst case - I test positive and continue to test positive. In that situation, the nurse told me that I would be required to give birth at the hospital, my baby and I would be separated at birth until I had tested negative twice, and if Zach had been tested positive, he wouldn't have been let into the delivery room with me. This was honestly my worst nightmare, as birth is one of my passions and as I have been so hopeful and excited for this home birth. I could imagine giving birth without Zach (agonizing though that would be), but being separated immediately from my baby - I hated that idea. The nurse who tested me explained all of this with great care and sympathy for the agony of the possibility of being separated from my baby after birth. However, I still felt defeated and anxious. How could I not?
I had to wait a day and a half for my results, which I understand is not very long, but it seemed like an eternity to me. I was beyond overwhelmed, but in the Lord's grace, the few weeks leading up to these days had been rich regarding my intimacy with Christ. He has been giving me a greater hunger for His Word and for prayer, and because of that, it felt easier and more natural to keep myself in prayer during these few hours where I was bombarded with such a scary and unknown future.
Though I realize I am prone to hyperbole and dramatic speech, I do not want to come across as trite in this post. I understand that in the grand scheme of this pandemic, my life has changed very little compared to some of you around the world. I have not suffered even close to the same degree as someone having lost a loved one. But this is still my journey, and I wanted to process this scary time myself and with you. I wanted to share some of the ways my mindset has changed as well as some of the research that I have found regarding pregnancy during this pandemic, whether you have tested positive for Covid-19 or not.
This pandemic has impacted the whole world in various ways. In a way, we are obviously more isolated, but in many ways, we are more united as a world. We are all humans, all being asked to sacrifice our preferences in various ways, all somewhat nervous about the unknown of the future. This scare has softened my heart immensely and given me such compassion for the high-risk populations around us. It has given me a deep burden to pray for all of our healthcare workers, not just the ones I know personally. It has given me a mindset of sacrificing my desires for the community. I desperately want to be at the park with my kids or having playdates with their friends or even rebelling against the government and forgoing this social-distancing. But I mustn't - I must choose empathy over apathy, obedience over rebellion, love over selfishness. For the sake of our community, to honor our healthcare workers, to respect our governmental authorities, I am choosing to abide by the regulations put in place. Do not get me wrong - I love the general attitude of Wyomingites and our fierce independence and value of personal liberty. However, the time we are living in right now is different, and we must consider people around us above ourselves. Not only is this morally the answer, this is one of Christ's urges to us all - to lay down our lives for another. These are the things Covid-19 has given me, a more sympathetic and compassionate perspective, one that requires self-sacrifice.
As I mentioned, I tested negative for the virus! I am beyond thankful, so relieved. My midwife also tested negative, so we will continue my home birth as planned. I am praying (please join me!) that Allie will have two negative tests and can join my birth as well as my doula; although I am mentally preparing myself for the possibility that she will not be there. This birth will still be much different from my original plan. I was hoping for my older two kids to be away from our house, being babysat by friends while I labor calmly and quietly at home. I no longer feel comfortable asking that of anyone. That might mean that Zach will be with them instead of me while I give birth. I was so excited for my sister-in-law to come stay with us and help. She can't come now. Neither can either of our moms. What I thought would be a month full family coming into our homes to welcome our third baby will be more alone than I ever imagined. This is how Covid-19 is affecting me. I know it's affected you all, in various ways. It has taken things from me, but it's also given me things too, as I mentioned earlier.
And now, here is some of the research that I found and might be helpful for you, especially if you are pregnant, regardless of where you will give birth, or if you have a risk of exposure to Covid-19 (you can also find these resources on my website):
Though many hospitals are mandating routine separation of babies with mothers testing positive, this is not necessarily the recommendation by the World Health Organization (WHO), who suggest taking an assessment case-by-case, and the Royal College of Obstetricians & Gynaecologists (RCOG), UNICEF and the Society of Obstetricians and Gynaecologists in Canada, who all recommend not separating mothers and babies routinely. Both WHO and RCOG suggests breastfeeding and skin-to-skin contact to help a newborn thrive, in terms of feeding, temperature, and regulating glucose levels, not to mention the many benefits of skin-to-skin bonding. While caring for baby the mama should wear a face mask, practice excellent hand and breast hygiene, and routinely disinfect items and areas that she has touched. Consider both the risks and benefits of separation of baby, if you are positive or exposed to Covid-19. If you do wish to remain with your baby, see the first website link I have listed, as they have a legal waiver that you can sign and take with you to the hospital. Other organizations, however, including the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine, are recommending routine separation of babies whose mothers are positive for the virus. The CDC is now recommending assessing the risks and benefits of such separation to be determined case-by-case. If you are tested positive and must be separated from your baby for either this reason or others, there are many ways to accommodate for you and baby. In that case, pumping equipment should be sterilized before and after use, mother should be at least six feet away from baby, and the mother must exhibit two negative tests before she is confirmed to be non-contagious.
Many states are allowing doulas in the birthing room, alongside the partner, and many organizations are urging hospitals to consider doulas as "medically necessary." See the second and third links below for more information.
Research is being done to determine whether mothers who have tested positive for Covid-19 can transmit the virus vertically while the baby is in the womb. So far, there have been no cases where the newborn has been tested positive for COVID19 even when the mother is positive; however, that does not negate the possibility. There is no evidence indicating the virus can be found in or transmitted through breastmilk, so hygienic breastfeeding is still recommended.
Some medical practitioners are advising against waterbirth, as there is a potential that the virus can be transmitted through fecal matter, in which case the baby may be exposed if the mother releases stools while pushing in the tub. This is a risk, but there are preventative measures that can be taken if waterbirth is still appealing. Certified Nurse Midwife and waterbirth expert Barbara Harper states, "All the research shows that water reduces the rate of infection in all three participants – mother, baby and provider - and in some cases makes contaminants non-viable" (March 20, 2020). She has done extensive research and has years and years of experience attending waterbirths. Harper says that there are two main contraindications to birthing in water: if the mother has a fever (this is the case regardless of Covid-19 risk) and if the midwife/obstetrician is uncomfortable with waterbirth. Otherwise, waterbirth may decrease risk of transmission of this virus. There has been no form of Covid-19 detected in drinking water yet, likely due to the cleaning and chlorination of the water, which would render any virus coming from the mother inactive. In addition, you can safely add two tablespoons of household bleach the pool while filling in a well-ventilated area. Make sure to wait one hour before allowing the mother to enter. She has accumulated many research findings regarding neonatal safety and birthing in water (see fourth link below).
The CDC now recommends that everyone in a public setting should wear a face mask, as it has been found that asymptomatic persons can carry the virus. Many hospitals are also requiring doulas, partners, and even the birthing mother to wear face masks. If the mask inhibits breathing and pushing efficacy, the mother is generally recommended to take off the mask.
Websites to visit:
https://evidencebasedbirth.com/covid19/ - so much information regarding pregnancy and Covid-19, including a free online birthing course, access to virtual doulas, and the most recent evidence regarding transmission of the infection to babies
https://birthmonopoly.com/covid-19/ - shares your rights and different states' policies regarding people allowed in the delivery rooms
https://www.dona.org/covid-19-and-doulas/ - information and suggestions on allowing a doula to be present at your birth
https://waterbirth.org/wp-content/uploads/2020/03/Keeping-Waterbirth-Safe-During-COVID-19.pdf - facts and recommendations regarding waterbirth during Covid-19 pandemic
https://www.babycenter.com/0_coronavirus-covid-19-pregnancy-faqs-medical-experts-answer-y_40007006.bc#articlesection3 - FAQ regarding pregnancy and Covid-19
https://www.pregnancycovid19.com - resources for pregnancy if you are exposed or tested positive for Covid-19
And now I wait for my baby to be born, hoping and praying that she or he will come when my other kids are sleeping, praying for Allie to be able to attend, praying that nothing will necessitate a transfer to the hospital. Of course I feel more at ease with my test returning negative, but I want to continue trusting in the Lord's good plan for me, for my babies, for our world, during this crazy time. I hope that these resources are helpful. I have been and will continue to update my "Favorite Resources" page with the newest evidence and information regarding Covid-19 and pregnancy.
Photo taken from DukeHealth