Elena 
It seems that every aspect of American Life has changed drastically over the past three weeks. What once seemed highly unlikely and almost impossible is now happening every day and at least for the moment, most Americans are going along with the orders and regulations.
It seems those changes are about to extend into maternity wards and affect laboring moms and their families. This week the CDC came out with recommendations that hospitals prohibit anyone from being with a mom delivering a baby. The idea is to reduce the number of potential carriers in the hospital to protect the staff and the other patients. A few hospitals in New York implemented this recommendation and were soundly chastised for it. Others are only allowing one person with the new mom. That could be her husband or partner, but not her husband and her mother, or even a professional doula. Additionally, if mom shows any signs of a viral infection (fever, cough, body aches, cough, sneeze) she can be separated from her newborn.
It’s worth mentioning that the World Health Organization DOES NOT recommend separating the mother-baby unit.
Although this seems preposterous to our modern sensibilities, this used to be the norm in this country. When my mother gave birth to my sister, she was left alone in the hospital without any family or friends in attendance. She was strapped to a gurney and put out with the infamous ‘Twilight sleep.” When she woke up, they told her she had a baby girl, who was being taken care of in the hospital nursery. After a few days, they were both discharged home together. This was the norm back in 1960.
So what if a first-time mom has to go into a hospital to deliver her baby today all by herself? How can she manage it? What can she expect?
If my daughter or daughter-in-law was having a baby in the next two months, this would be my best advice.
1. Educate yourself. Hospitals probably aren’t even allowing tours right now because they aren’t letting visitors in to reduce the infection risk. So be sure to talk to your doctor or midwife about what’s available at the hospital.
Can you walk in labor? Will you have to be in bed most of the time? Do they use birthing balls? Is there a tub? What’s the requirement for an IV? Hep Lock?
Then read, read, read. Here is my must-read childbirth bibliography.
2. Don’t get to the hospital too soon. First-time labors usually last a long time. Ask your mom or your sisters what their labors were like. Were they fast? or slow? That might give you some idea of what to expect timewise. Stay at home as long as possible and walk, rest, or do light household chores if you like. When contractions are strong (they demand your attention and you have to breathe through them) and regular, then it’s time to get to the hospital.
If you get there and you are only one or two centimeters, and if they will allow it, you can leave and come back later. But with new coronavirus policies in place they might not let you leave, so call ahead to see if your dilation can just be checked without requiring you to stay.
3. If you have to do this alone, without your spouse, mom, professional doula, or other-support person, just know this –
You can do it!
If you think of it as a cross between an athletic event and a mind game, you can do this and be your own support person.
During labor play this game. When a contraction comes on, try to keep every bit of stress and tightness out of your body. Try to be really relaxed. If the nurse wants to help you she can help by touching your hand or leg, or any part where there is tension to remind you to be loose and relaxed. You can do this sitting up or standing, on a birthing ball or in a tub. Do what makes YOU feel the best.
Also, keep your jaw loose and open. You can’t tighten up your pelvis and birth canal if your jaw is loose. Try it. It’s hard. Keep your mouth slightly open, loosen your jaw. Make a low hum or moan too but keep the pitch low. That will also help your contractions to open your cervix because it’s helping to keep you out of your own way.
Remember when you feel tired, exhausted, and overwhelmed, you’re probably in transition and it won’t be long before you’ll be able to push.
4. For pushing, one of the best on-screen examples of this recently is the Handmaid’s Tale. It’s instructive. June isn’t confined in her bed. She’s moving around to positions that make sense for her and her body. She’s loud, because the effort she is making is huge. And she’s focused on what her body is doing. Demand that for yourself. It’s okay to push on your back with your legs in stirrups, but if you feel more comfortable on hands and knees, or squatting, then do it. Standing squats open the pelvis to its maximal dimension and might be the most effective way to get the power out of your push.
5. Keep your baby with you as much as possible. Your colostrum will give the baby extra protection and having the nursing baby with you will help to bring your milk in faster. It is possible, after a short rest, making sure that your bleeding is under control and the baby is okay, to leave the hospital in under day. It would be the best for a healthy mom and baby to be sequestered at home safely instead of exposed to potential pathogens in the hospital.
6. I don’t know what the Cesarean rate is going to be during this Covid-19 scare. I haven’t seen statistics, but I have a hunch the rate of Cesareans might go down because they want to limit unnecessary medical procedures. With a 30% Cesarean rate, we can be pretty sure there were a lot of medically unnecessary procedures. On the other hand, they might go up because providers feel comfortable with caring for a postoperative mom as opposed to a mom having a vaginal birth. With moms feeling unsupported, there might also be a hike in cesareans. It will be interesting to see the stats for that when this is over.
If you do get a Cesarean, ask for an abdominal binder soon after surgery. The binder will support your post-surgical abdomen and allow you to use both of your hands instead of holding your painful abdomen with one and handling the baby with the other. This is helpful if you are breastfeeding or bottle-feeding. And again, as soon as you can possibly get cleared, get out of the hospital to recover at home.
Remember your body was built for this. If you prepare your mind and spirit as thoroughly as you prepared your body for birth, you’ll get through this. And what a story to tell the baby about his or her birth in the years to come!
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