Giving birth during the coronavirus pandemic
(Editor's note: The following is an entry from the author's blog. We've republished it – with minor tweaks – with Krista's permission. Visit Krista's blog to learn more about her motherhood journey.)
My son Lawin Elias was born on Black Saturday, April 11.
This is my first birth so I had no idea what lay ahead. My family and friends’ experiences were so varied that I had no benchmark of what an “ideal” birth scenario would be. All I was hoping for was that it would be a safe, smooth, and joyful experience for us.
When I hit my third trimester in February, I started preparing in earnest for my delivery. I assembled our hospital bags, researched on birth plans and what my preferences would be, and discussed with my OB which hospital would be our best choice.
Then the coronavirus reached Manila. I would give birth during a global pandemic. My due date would arrive during a nationwide lockdown.
Even without the enhanced community quarantine (ECQ), one birthing goal took precedence over everything else: reducing or totally eliminating our risk of exposure to the coronavirus.
Since the ECQ is still in place for a few more days (with the possibility of being extended even further), I thought I’d share what it was like to give birth during community quarantine.
Disclaimer: This isn’t meant to call out anyone. In fact, I commend the medical professionals we worked with for doing their best to give me the safest possible experience during my birth.
What I wish to highlight is how the coronavirus affects our expectations of what a birthing environment should be. Hopefully, my account could help other due parents out there in making new decisions in light of the circumstances. This pandemic isn’t going away anytime soon, after all.
We delayed going to the hospital as much as possible. My irregular contractions started on the morning of April 10 — my husband Ranie’s birthday. By then, I was already having “bloody show” for a few days, so we were really expecting to give birth anytime soon.
By afternoon, my contractions were starting to hurt and occur ten to twenty minutes apart. But my OB told me via Viber to try to wait it out until the day after if I can still manage the pain, in order reduce my stay in the hospital and therefore minimize any risk of exposure to the virus.
But by evening, my contractions started coming in much closer. They were getting more painful. After a hurried dinner (we didn’t even get to eat dessert), we grabbed our bags and my brother-in-law drove us to the hospital, where I was brought to the ER right away. I was expecting to go through a COVID-19 screening/Q&A per my OB’s advise, but this didn’t happen.
I spent active labor in the maternity ward. From the ER, I was wheeled into a 4-bed ward with one other patient (who I felt so sorry for, and you’ll see why later) — a woman with ovarian cancer who was undergoing a chemotherapy session the next day. We weren’t informed why, but the labor room was not available on the eve of my delivery. There were also no private rooms available (perhaps allocated to PUIs and PUMs already? It wasn’t clear).
After settling in, we were told that we were still waiting for my OB and anaesthesologist to get back to them re: their ETA or further instructions; in the meantime, all I could do is wait and try to relax. I was 3 cm dilated and the resident on duty informed me that I’ll probably be ready to give birth early the next day.
I was not ready for the pain of the real contractions. Some say it’s like a huge need to poop, others say it’s like having period cramps, just a little more intense. For me it was NOT just a little more intense. I was told to relax, to breathe through my mouth, and no matter how I felt, NOT to push — but waves of acute pain took over my body one after the other and no amount of mental conditioning or breathing could make it hurt less. It felt like I was being gutted out and pulled apart over and over again for hours (actually closer to just around six).
I don’t know if I was just being dramatic or I simply have a low pain threshold. In my case, it was the most painful thing I’ve ever experienced.
I didn’t receive an epidural. More advice from mommy friends: if offered a pain-eliminating epidural, I shouldn’t hesitate to say yes, though one possible downside is that it might make my labor longer and prolong our efforts to push the baby out. In my comprehensive birth plan (which ended up never leaving our black file folder, haha), I indicated that I wished to decide when the epidural would be administered.
I never got to exercise my right to choose pain management. Under normal circumstances I could have probably been given the damn epidural already, with all the screaming I was doing. And I did already ask for it – but with no word from the anes... no dice. I think I was given a powerful painkiller via drip at some point, but it hardly helped. (My poor wardmate probably did not get any sleep, bless her soul and I hope her chemo was successful.)
Ranie wasn’t allowed in the OR but was beside me throughout my labor, guiding me to breathe, keeping me conscious, and just grabbing my hand every time a contraction arrived (which, at one point, happened every two minutes). Later on, he said he felt scared because I was screaming like hell, talking gibberish, and already rolling my eyes towards the back of my head. I know I can be dramatic, but I want to clarify that I was NOT being dramatic about how painful it was!
We got the baby out in three pushes. By 3 am on April 11, I was finally 8-9 cm dilated and the baby’s head was crowning. I was brought into the OR, but we still had to wait a little longer. I couldn’t discern who was moving around me as everyone was wearing PPEs. At this point, I could feel baby really heaving out, but I was told by someone – rather sternly, yet again – to not push just yet.
Around 6 am, my OB and anaesthesologist finally arrived. I was so ready (and seriously delirious from the pain). I think I was given a local anaesthesia. We did three pushes, with my OB doing the counting and giving me the go signal to puuuush. That part was easy.
I became aware of the baby that was placed on my chest. (Wait why does his head resemble a Dorito?) And… I passed out.
My baby spent his first hours in the NICU... I woke up with fuzzy vision in a tiled room beside a row of beds filled with folded surgical suits. Someone (still in a PPE) approached me and said I was in the recovery room (?) and that my baby has been placed in the NICU. This, they said, was part of protocol to reduce babies’ exposure to possible carriers.
They also told me that since I had Gestational Diabetes, my baby might have to stay a little longer there for his blood sugar tests as they can’t do it in the maternity ward. My husband has already viewed him and was out buying formula for his second feed. But they said they would bring him to me for his first feed shortly.
…and drank formula for his 2nd feed. HOLD UP. NICU? Formula? 2nd feed? They just gently explained that they because of the protocols, I can’t just go to the NICU to feed my baby and unless I can express some milk in the next four hours, they’ll have to give him some formula while stays in the NICU for his sugar tests.
My chosen hospital strictly follows DOH’s guidelines on breastfeeding, but again, reducing exposure trumped all existing protocols.
I was tired and I wanted to see my baby already so I just said OK and I’ll try to express anyway (spoiler alert, I didn’t). Fortunately we were able to reinitiate breastfeeding by the third feed and so far, one week in, we’re still doing it!
I’m not sure if we got to do skin to skin in the OR because I passed out, but our recovery room meeting was brief. I was allowed to feed Lawin for only 30 minutes before he was wheeled out again. I didn’t even get to see his face properly because my vision and general mental state was still so foggy.
But it was still something else, seeing your baby first time.
Thankfully, everything, save for the blood sugar monitoring was normal. His head was a little tapered, they said, because he had spent so much time being crowned. He also went out stargazer style — face up instead of down. He had a cord coil, too. But we still managed to get him out vaginally, and pretty quickly. That effort was part the team’s skills, part my pain-induced willpower to get it over and done with at that point, and part Lawin’s fighting spirit.
We haven’t done newborn screening yet. While I was in the OR and recovery room, Ranie was busy doing all the paperwork and being briefed by the staff. He was informed that Lawin couldn’t do the required newborn testing just yet because the kits weren’t available (due to the ongoing lockdown). We’ll have to call and follow up on its availability. I hope we get to do this sooner rather than later.
Our post-delivery visits happened via Viber. Our OB and Pedia, as well as my diabetologist for my GD, were not allowed to do post-birth rounds in person. Instead, we received our discharge instructions via call, email, and Viber. Thankfully, everything was normal (even our blood sugars! Yay!) so this wasn’t a big deal. Our next check-ups will happen after the quarantine, or until further notice.
We didn’t have visitors. Obviously, we weren’t allowed to have visitors (nor did we want to risk it). Yet we still got food and even milk tea delivered thanks to kind family and friends. It was just us three for our first 24 hours together. We shared our first moments and celebrated with our loved ones via Facebook Messenger and Viber.
Even if the quarantine expires by the end of April, I don’t think we’d be exposing Lawin to too much people just yet. We’ve barely begun mass testing and there’s just too much risk out there… so meet-ups and tito and tita selfies will have to be put off just a little bit longer.
We safely brought Lawin into the world and that’s all that matters. When the hospitals started filling up with COVID-positive patients, I did consider giving birth in a maternity clinic instead. But I didn’t want to deal with a new set of professionals and unfamiliar facilities too close to my due date.
I also had GDM and it was my first pregnancy so I wanted to be in an environment that I was thoroughly oriented in and familiar with, with people (like my OB) I already know and trust. At the end of the day, I’m just grateful that the hospital staff and our delivery team took care of us the best they could, despite the limitations and circumstances of being in a nationwide lockdown and dealing with a pandemic.
That said, I would also recommend in these times a maternity clinic for women who still have time to modify their birth plans. Again, reducing risk to exposure is the most important detail while we deal with COVID-19.
So that's it! Whew, this became longer than I expected (typed it out through phone and laptop over the course of several breaks from feeding or changing Lawin. Such is my life for now). I know it’s nerve-wracking enough to be pregnant, what more to be one during COVID-19!
So if any mommy who stumbles upon this has any questions, you can reach me on Instagram or Facebook. I hope missing out on a few minutes of nap time would prove useful for other mommies out there who will also be giving birth soon. – Rappler.com