How B.C.'s expectant mothers are dealing with added anxiety of the COVID-19 pandemic

Lerato Chondoma hasn't stopped crying for more than a week. Her C-section delivery at B.C. Women's Hospital in Vancouver is booked for the last week in April and her list of worries grows by the day.

As a single parent of a five-year-old, and soon a newborn, she worries about managing postpartum recovery in isolation with two children. Her mum, who had planned to fly in to help, is stuck at home in Lesotho because of travel restrictions related to the COVID-19 pandemic.

"Will I fall asleep and not hear my child? Or will I miss something because I'm too tired? I really worry about those first couple of days and hours being alone,"said Chondoma, a UBC researcher who lives in Vancouver.

The hospital itself is also a worry these days. Chondoma worries her baby could be exposed to COVID-19. She worries that she could bring the virus home to her asthmatic son.

She is not the only expectant mother with worries.

Birth doulas in B.C. are reporting increased anxiety among their third trimester clients as they grapple with the prospect of bringing new life into hospitals the public is being told to avoid for safety reasons.

The rise of home birthing

Some pregnant women, like Nathalia Gama, who are planning a low-risk, vaginal birth, are choosing to skip the hospital altogether.

After discussing the possibility with her midwife and her doula, Gama, who lives in Vancouver, took the last-minute decision to switch from hospital to home birth when COVID-19 concerns ramped up in late March.

There is some evidence Gama will not be alone in her choice this year, and B.C. midwives are preparing.

Marella Falat of Westside Midwives said in an email her practice in Vancouver has seen a 25-50 per cent increase in inquiries about home birthing in recent weeks. Falat has heard from midwives in other practices that they are seeing a similar jump in queries.

Another surge is likely during this pandemic, said Louise Aerts of the B.C. College of Midwives, who said the 2003 SARS outbreak saw a rise in home births in Canada.

New hospital precautions

However, most deliveries will still occur in hospitals this year.

Giving birth is the No. 1 reason for hospitalization in Canada and health authorities are taking extra measures to reduce the risk of exposure to COVID-19 during labour and delivery.

Here's what to expect if you're expecting in B.C.this spring:

• Screening: People in labour and their support people will be screened at the entrance of all B.C. hospitals for symptoms of the virus and support people may not be admitted if they are symptomatic.
• Reduced visitation: For maternity in-patients, one support person plus one registered doula will be admitted. No other visitors are allowed into hospitals after delivery.
• No nitrous oxide: Most hospitals are no longer offering this pain management option during labour.
• No baths or showers: Some hospitals, including all Interior Health labour wards, are not allowing showers or baths during labour. In other health authority areas,bathtubs will be available at the discretion of hospital management. St Paul's Hospital in Vancouveris allowing bathtub use.
• Possible early discharge: The B.C. Centre for Disease Control recommends discharging parents and babies as soon as medically appropriate to reduce the risk of exposure. Interior Health and Island Health authorities have confirmed they are releasing maternity patients as soon as it is safe to do so.

Mental health toll

Alongside these practical changes, birth doula Rebekah Nathan is reminding her clients at Eventide Birth to consider their mental health.

Nathan has spent more than two decades advising birthing families to plan for increased, in-person support from loved ones. Now she's helping families grapple with the possibility of labouring alone and returning home alone.

"Generally, birth is happening in a community," she said. "Now it's potentially going to be with people wearing masks and people you don't know ... there's a sadness for people."

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