Some pregnant women are moving up their due dates over COVID-19 concerns
Being pregnant is hard enough under normal circumstances, but during a global pandemic it can be terrifying. Parents-to-be are trying to navigate new labor and delivery regulations (including ones that limit visitors) while trying to minimize their risk — and their growing family’s risk — of contracting COVID-19 in the hospital. Now there’s another layer to consider: trying to give birth early.
A growing number of patients and doctors are considering earlier deliveries in an attempt to control the birth process more tightly or to get ahead of the coronavirus.
Anna Titchnell is one of them. The Maryland mom just welcomed her second child, a daughter, via induction. While an induction was already in the cards because of her having a high-risk pregnancy, Titchnell tells Yahoo Life that she asked if she could be induced on the earlier side, at 39 weeks — a time during pregnancy that’s generally recognized as safe — as the pandemic got worse in the United States.
“I didn’t want the situation [in my area] to get worse and have to endure some of the horror stories I had heard in my online birth-month group,” she says. Among other stories she had heard was that one mom was separated from her newborn for two weeks because she tested positive for COVID-19 but had no symptoms and that another new mom was separated from her baby for three days while she waited for her test results to come back after she developed a low-grade fever. “The stories completely broke my heart for the mothers,” Titchnell says.
Despite her concerns, Titchnell says her doctor wasn’t comfortable with an earlier induction “since everything was looking good with the pregnancy, and the situation in my county wasn’t escalating as rapidly as neighboring areas.” Still, Tichnell says she was “really concerned that the rules for support persons would change and [her husband] Jeff wouldn’t be able to be with me during labor and delivery.” Ultimately, Titchnell was induced earlier than her due date but at a slightly later time than she hoped.
“I asked to be released as soon as it was deemed safe for me and baby,” she says. “I didn’t want to be in the hospital any longer than I had to because I was concerned about possible exposure.” Titchnell and her new daughter ended up being released 25 hours after birth.
New Jersey mom Kate Farley also asked to have the delivery date for her third child moved up due to COVID-19 concerns. Farley tells Yahoo Life that she struggled with anxiety over the pandemic as her due date approached. “My request for an earlier delivery was totally me driving the bus and trying to get in as early as possible while still being safe for my baby,” Farley says.
Farley eventually was able to persuade her doctor to deliver her daughter earlier than planned. “I feel like it was the right decision,” she says. “My baby was healthy, everything was fine, and I had her the week right before the peak of the virus in my area. I saw it coming, and I was glad that we were in and out before it started.”
Why is this happening?
It’s not entirely clear, but this seems to be a middle ground between fears surrounding delivering in a hospital while the virus is raging in a particular area and doing a home birth, which some pregnant women are considering right now. If a woman wants to deliver in a hospital setting but is nervous about her COVID-19 risk, trying to deliver before the virus reaches its peak may be a solution.
It’s too early in the pandemic for data on this trend, but doctors say they’re seeing it too. “I’m noticing it more from the patient than the doctor side,” Dr. Jamie Lipeles, founder of Marina Ob/Gyn in Marina Del Rey, Calif., tells Yahoo Life. But it may depend on the area, she says.
Dr. Michael Cackovic, a maternal-fetal medicine physician at the Ohio State University Wexner Medical Center, tells Yahoo Life that he is hearing this “a lot” from colleagues across the country and that it seems to be a fifty-fifty split between patient requests and doctor recommendations. “Some doctors are offering to induce early to try to get ahead of the virus,” he says. “Some are even doing unnecessary C-sections.”
And again, location seems to matter. “For certain cities, this can be a way to control the hospital efficiencies based on peak times, bed availability and also supplies for the staff and health care providers,” Dr. Jessica Shepherd, based in Texas, tells Yahoo Life. “Hospitals are making sure the providers have N95 masks, negative pressure rooms for COVID-positive patients and also protocol for how to handle newborns whose mothers are COVID-positive.”
One of the thoughts behind an early delivery is to try to have women in and out of the hospital before it experiences a surge in COVID-19 patients, women’s health expert Dr. Jennifer Wider tells Yahoo Life. “In certain areas in the country where there are surges already, this wouldn't be feasible, but in others, some doctors recommended it,” she says.
Some doctors say this could be counterproductive, though.
While the American College of Obstetricians and Gynecologists (ACOG) hasn’t issued guidance on elective inductions in the age of COVID-19, it does have general recommendations around the practice. Elective inductions are not recommended before 39 weeks, ACOG says, and the organization points out that inductions don’t always work. In those cases, another induction may be needed, or a mom might have to have a C-section. The C-section risk is “greatly increased” for a first-time mom, especially if her cervix is not ready for labor, ACOG says.
The length of time an induction can take is concerning, Cackovic says. “You can have a prolonged induction process where a patient is in the hospital for two or three days,” he says. “You’re trying to get the patient in and out of the hospital quickly, but this can be counterproductive.”
However, Cackovic says, if a woman has already had children before and her body appears to be ready to give birth, the induction process may be fairly fast. “A woman who’s in her third pregnancy and is 4 centimeters dilated — it’s a no-brainer for induction,” he says.
Overall, Wider urges moms-to-be to have an open, honest conversation with their doctors about their fears and concerns, as well as the current COVID-19 situation in their area. “Discuss, discuss, discuss with your health care provider,” she says.
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.
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