Between social distancing, lockdowns, and shelter-in-place orders, the ongoing coronavirus outbreak has caused serious disruptions to nearly everyone's life. Birth plans of many parents-to-be have, of course, also been impacted. In New York City, however, expectant parents are facing new concerns as NewYork-Presbyterian hospitals have banned birthing partners from delivery rooms due to the novel coronavirus, COVID-19.
As the number of confirmed coronavirus cases continues to grow, NewYork-Presbyterian, a network of 13 cooperating hospitals, moved to bar all visitors for adult patients, including birthing partners and support persons for laboring mothers. "At this time, no visitors including birthing partners and support persons are permitted for obstetric patients," NewYork-Presbyterian said over the weekend in a series of updated visitor guidelines issued in response to the ongoing COVID-19 outbreak. "We understand that this will be difficult for our patients and their loved ones, but we believe that this is a necessary step to promote the safety of our new mothers and children."
The policy, which went into effect Monday, stands in contrast to recent coronavirus guidelines issued by public health officials. Both the New York Department of Health and the World Health Organization (WHO) have recommended that patients admitted for childbirth be allowed one support person during the extent of their care and stay. Romper has reached out to NewYork-Presbyterian for comment.
"For labor and delivery, the Department considers one support person essential to patient care throughout labor, delivery, and the immediate postpartum period," guidelines for treating obstetrics patients during the coronavirus outbreak issued by the New York Department of Health read. "This person can be the patient's spouse, partner, sibling, doula, or another person they choose. This person will be the only support person allowed to be present during the obstetrical patient's inpatient care." Designated support persons will be screened for symptoms of coronavirus and cannot be sick or have recently been sick.
WHO has also noted that pregnant patients are entitled to "a safe and positive childbirth experience," even during the ongoing global coronavirus pandemic. This includes "having a companion of choice present during delivery."
NewYork-Presbyterian's new policy was met with criticism and concern when announced over social media. "This is not the right decision," one person tweeted. "I will be a new mother in 2 months and will have to change our plans if this is the case. You cannot expect mothers to do this for the first time completely alone. Test ahead of time - this is not a solution."
Christopher Zahn, MD, vice president of Practice Activities for the American College of Obstetricians and Gynecologists (ACOG) tells Romper that while the association understands the COVID-19 outbreak has required health care providers "to implement additional infection prevention control protocol, as well as other procedures to maximize the capacity for patient care and safety," it's urging hospitals, in general, "to consider innovative solutions and localized, collaborative approaches that ensure laboring patients have the support and stability they need through this chaotic and stressful time."
"We understand that these are extraordinary times and that hospitals are working hard to maintain a safe environment for all their patients with enhanced infection control measures," Zahn says, adding that "in addition to regular nursing care, continuous one-to-one emotional support provided by a partner or support personnel such as a doula is associated with improved outcomes for women in labor."
Lindsey Meehleis, certified professional midwife in California, tells Romper she anticipates that barring birthing partners from delivery rooms could lead to more interventions during labor as well as higher C-section rates. "We know that women labor very well when they are supported," she says.
As of Monday morning, a Change.org petition urging NewYork-Presbyterian to reconsider its ban on birthing partners had garnered more than 70,800 signatures. It argued that leaving patients to labor alone would "substantially" increase their risks. "Not only can partners and spouses provide physical and emotional comfort during labor and postpartum, they are also essential in alerting staff when something has gone wrong and the laboring patient cannot notify nurses themselves, like in the event of an eclamptic seizure or a fainting episode," it read.
Fears of catching COVID-19, concerns about medical supply shortages in overtaxed hospitals, and anxieties about visitor limitations during care, have already spurred a number of expectant parents to look into changing their birth plans amid the coronavirus outbreak in favor of home delivery.
While many hospitals across the country have opted to limit or restrict visitors during the ongoing coronavirus pandemic, most appear to have made exemptions for maternity and postpartum patients. In New York, for example, Mount Sinai Hospitals and NYC Health + Hospitals allow obstetrics patients to have a healthy visitor. In California, another state seeing a high number of confirmed coronavirus cases, Sutter Health and Kaiser Permanente have also made exceptions for birthing partners.
Zahn also referred to the Centers for Disease Control and Prevention's infection control guidance on managing visitor access, which states that health care facilities can consider making exceptions on visitor restrictions when someone is "essential for the patient’s emotional well-being and care," including "essential support persons for women in labor (e.g., spouse, partner)." Zahn tells Romper "labor support can be particularly critical for women who already face health care disparities and other barriers to care."
If you think you’re showing symptoms of coronavirus, which include fever, shortness of breath, and cough, call your doctor before going to get tested. If you’re anxious about the virus’s spread in your community, visit the CDC for up-to-date information and resources, or seek out mental health support. You can find all of Romper’s parents + coronavirus coverage here, and Bustle’s constantly updated, general “what to know about coronavirus” here.
Christopher Zahn, MD, Vice President of Practice Activities at the American College of Obstetricians and Gynecologists
Lindsey Meehleis, certified professional midwife at OC Midwifery.
Editor's Note: This article has been updated to include quotes from the ACOG's Dr. Christoper Zahn and certified professional midwife Lindsey Meehleis.