Giving Birth In A Pandemic Can Be Isolating. It Doesn't Have To Be

Monique Cowan, a doula in L.A. County, photographed outside of her home, where she now does most of her work remotely. (Chava Sanchez/LAist)

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Even in normal times, there are plenty of stressors for expectant moms. Now add to that the concerns over giving birth in the time of coronavirus.

Experts don't know the full effect of the virus on pregnancy and babies — although studies have shown the disease can spread from mothers to infants.

As of May 11, babies were born to 29 women in Los Angeles County known to have COVID-19, but none of the newborns have tested positive for the virus. Overall, 134 pregnant women have tested positive for COVID-19 in L.A. County.

But the pandemic is changing the process of birth for all pregnant women.


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Jadah Parks Chatterjee is a maternal and child health nurse at an L.A. County hospital where fewer people are coming with questions before their due dates and are instead spending more time on the phone with their doctors.

"I think that the only concern with that is not all health-care spaces are created equally," Chatterjee said. "If you're not able to be heard, or if you're not able to really articulate what you're feeling, then therein lies the concern."

DOULAS GO VIRTUAL

Alhambra couple Sheila Thomas and Charles Lyles knew the birth of their second child would be different because of coronavirus.

For example, their hospital would now only allow one support person in the delivery room.

"My mom, she did not care that it was COVID time," Thomas said, laughing. "She was going to try to break down the hospital door to get to me, but I convinced her to stay home."

During a routine prenatal visit on May 7, several days before her due date, a doctor told Thomas her amniotic fluid was low and labor would be induced that day.

"And then I flipped out," Thomas said. "(I said), let me call the doula who can listen to what it is you're saying, and then tell me later when my mind is clear."

Doula work relies heavily on in-person relationships, but most of Monique Cowan's work has now moved online and she has had to readjust how she works with her clients. (Chava Sanchez/LAist)

They dialed Monique Cowan. She's been supporting people before, during and after birth for almost a decade, and almost always helping in person.

Now, she coaches clients on the phone while pacing her Hawaiian Gardens apartment, her voice shifting between a command and a whisper, with the occasional moan.

"I'm mirroring my client and their energy," Cowan said. If it's too late at night, she takes the calls from her car to keep from disturbing her family and neighbors.

Cowan connected with Thomas through an L.A. County Department of Public Health program that pairs African American moms with free doula services.

[Related: What Do Doulas Do — And How Can I Find One In LA?]

Nationwide, there are disproportionately high rates of black maternal and infant deaths.

In L.A. County, African American moms are four times more likely than white moms to die of complications related pregnancy and childbirth and African American babies are three times more likely to die before their first birthday than white babies.

While she understands why hospitals are limiting the number of people in the room, Cowan worries that doula services might diminish or disappear if they're shut out of delivery rooms for too long.

LESS SUPPORT, MORE STRESS

Since the onset of the coronavirus, Cowan said families' fears of childbirth complications have gotten worse.

"Feeling like you're going to be by yourself in a hospital where, you know, you're already hearing stories and statistics about black women not being treated well is very scary and anxiety-inducing," Cowan said.

She's not the only one who's noticed the increased stress. Researchers like Darby Saxbe, an associate professor of psychology at the University of Southern California, are studying how soon-to-be parents are coping during the pandemic.

Hezekiah, 1, and newborn brother Ezra Lyles. (Courtesy of Charles Lyles)

"We know that stress during pregnancy can have potentially profound effects on infant and child development, from looking at smaller birth weights or more risk of preterm birth," Saxbe said.

Saxbe has investigated the transition to parenthood for years. When she compares recent surveys of more than 700 pregnant women and their partners in L.A. to her existing research, she sees more signs of depression and anxiety. The study is still recruiting participants.

"People are feeling like they're getting less support from their families and from their community networks," Saxbe said. "I thought that these differences were really, really striking considering that the pandemic's only been going on for a relatively short time."

That stress doesn't always go away after the baby is born. Postpartum Support International reports 10% of people develop anxiety after birth.

Sheila Thomas, a licensed clinical psychologist, said she sought out a doula because she was among those who experienced postpartum anxiety when her first son was born.

"When it hit me last year, I didn't even know that's what was happening to me," Thomas said.

Her mind raced with uncontrolled thoughts:

"I'm the only one who could keep this baby alive. Nobody else will be able to keep this baby alive. So that means that I have to stay awake — all the time. I cannot sleep. There will be no sleeping because I'm the only one. All other people, they might let him die. For real. They probably want him to die."

"Honestly, like it goes that bad," Thomas said.

She reached a tipping point while preparing to take her son for a walk one day. An intense feeling of dread washed over her — "an asthma attack mixed with you have to throw up. And then my mind was just like, 'Danger, danger, don't go outside.'"

BUILDING A NETWORK AND A GREAT BIRTH PLAYLIST

Doula Monique Cowan listens while client Sheila Thomas dances during a prep session conducted on FaceTime. (Courtesy of Monique Cowan)

Charles Lyles drove home for supplies —including frozen Snickers, veggie sticks and gummy bears — while his Thomas prepared for labor.

"I was just worried that I wouldn't be able to advocate for myself, to be able to say no to stuff that I don't want and ask for stuff that I do want," she said.

Her birth plan asked that the hospital staff get her permission before touching her body and performing procedures.

The plan also called for music.

Thomas had planned to listen to a playlist of '90s R&B, but in the moment the song that felt right was Juvenile's "Back That Thang Up," the uncensored version.

Thomas danced in her light blue hospital gown, IV trailing from her left hand, and Cowan laughed with them over FaceTime.

When the pain intensified, Cowan guided Lyles as he used his hands to massage his wife's sacrum and glute muscles.

"She inspired me to do it, to help her out, which helped me feel like I was actually being useful," Lyles said.

Their son Ezra was born at 9:36 p.m. on May 7, about an hour after the hospital room dance party.

Cowan continues to check in over text messages and phone calls. Lyles is finding ways to help out, like bottle-feeding Ezra previously pumped breast milk so Thomas can nap.

The network of support surrounding Thomas includes her husband, family, a therapist, public health programs, and her doula, who, for now, is a text message or phone call away.

"I still have thoughts like I'm the only one that can keep them alive, but now I can say that's unrealistic," Thomas said. "There's other people here."

RESOURCES

Jadah Parks Chatterjee is a maternal and child health nurse. (Courtesy Jadah Parks Chatterjee)

TIPS FROM OUR INTERVIEWEES FOR PREGNANT PEOPLE

"Get as much help as possible that you are allowed to and want to take. Raising the child is very hard, especially giving birth. There's so much to it. You really do need a village to raise a child and a doula is a village."

Charles Lyles, father

"Be mindful that other people are also stressed."

— Sheila Thomas, mother

"It's not always as simple as just going to the hospital and pushing a baby out. Make sure that you know what you want. Make sure that you know how to ask for it."

— Monique Cowan, doula

"I really would like to see my families drinking more water, more water, more water and taking the time they need in order to stretch their muscles ... get up and move around."

— Jadah Parks Chatterjee, nurse and lactation consultant, parent educator