6 things one labor & delivery nurse wants you to know about delivering during a pandemic

Let’s face it, the world as we know it is a scary place right now. We’re told to stay home with a stockpile of food and toilet paper, wear masks and stay away from loved ones or else we may get ourselves or someone we love very, very sick. For many, the stay at home order is inconvenient, for a lot, it’s devastating for their financial well being, and for pregnant mothers, it’s all that plus terrifying, upsetting, and downright unfair.

For mothers nearing their due date, I want to personally say my heart breaks for you. Giving birth is a life changing experience that is a bit scary even in “normal” times. Throwing a pandemic in the mix certainly adds unneeded stress, anxiety and fear to what should be an exciting and joyful time. I know this isn’t what you planned, but please know so many people are rooting for you and think you’re very, very brave.

In an effort to ease the worry of expectant mothers, I caught up with my friend Jessica, a BSN, RN working in the OB, Postpartum unit at a South Florida hospital through these unprecedented times. During our chat, I asked her some questions that many expectant mothers have concerns about. It’s important to note that these answers stand true for the hospital she works at, but are a good reference overall. Since I personally gave birth during a different time, I polled a few friends that are currently pregnant, and most of these questions came directly from them.

1. Are the birthing person or support person required to BYOM (Bring your own mask?) Will the mother be required to wear a mask at all times, even during labor? 

Currently, literally everyone is wearing a mask 24/7. I can only speak for our hospital, but we currently have enough PPE to provide to the mom and support person. We all know it is very hard to breathe during labor, let alone with a mask on so all we can do is recommend it. Do all moms continue to wear the mask? No, but that is her choice to refuse our recommendations. You have the right to refuse any medical treatment at any time.

2. What are the main differences in the L&D ward now vs. prior to Covid

Our OB unit is great because the entire floor (L&D, Postpartum, and NICU) is locked and not really connected to the rest of the hospital. Its always been very secure and strict with allowing visitors even before Covid. Currently, we (and Pediatrics) allow only 1 visitor, whereas the rest of the hospital allows none. Besides more PPE and only 1 visitor, our nurses still provide the same compassion and care to our patients.

3. Are new moms getting tested for Covid-19? If so, is it only if they’re showing symptoms?

We are screening both moms and fathers/support person. No one is tested unless they show symptoms.

4. Some expectant mothers have heard rumors that due to Covid 19, mothers will be discharged from the hospital just hours after delivery. Do you know if there is any truth behind this?

There is no truth to that at my hospital and I have not heard that in others. I think that is completely unrealistic and utterly unsafe. Most mothers havent even recovered enough to even get out of bed, let alone go home and take care of herself and her newborn.

That is the exact reason for the postpartum unit. To continue to take care of a mother and her baby. Most complications can happen 24-48 hours later. I do not foresee a discharge that quickly ever happening.

5. Do you feel that first time moms are at any disadvantage receiving some of the support new mothers usually receive at the hospital? For example, visits with lactation support?

We are still allowing lactation specialists to visit mothers. They are a part of our staff, and we believe breastfeeding is so important, so they are still seeing families.
I do think its unfair to the mothers who want/need a doula. I personally didnt use one during my birth, but I know the unbelievable support they provide for some mothers, that no one else can provide. So currently, our policy is only 1 support person allowed. Which usually is the father.

What is your message as a L&D nurse to birthing persons during this time?

We always want and – more importantly- need a mom to be flexible with her birth plan. We will respect every decision a mother makes and will educate as much as we can to help her make an informed decision. Things change hourly and even by the minute, things that are out of our control. Just be open and flexible. We will try our best to still make it the best experience possible. Come with the idea in your head of a safe delivery and happy healthy mom & baby.

Also, since there is only the dad allowed in the delivery room, make sure to give another nurse your phone/camera to take pictures! We love capturing the beautiful miracle and even more so now with no help from family or photographers.

The takeaway here, is your labor and delivery nurses will be there to support you through the most monumental moment of your life, just as they always would. They may have a little more PPE on, but know that they are smiling underneath that mask and ready to help you become a mom, or a mom again!

You got this mama!

 

 

 

 

Preeclampsia, a get to the hospital now story

As I have mentioned in previous posts, the last few weeks of pregnancy were not fun for me. I was wildly uncomfortable and full of anxious nerves. Each day seemed to last a week and I felt like I was trapped in my own body with symptoms getting more uncomfortable by the day. And to my poor husband, I apologize. I know I was not pleasant to be around.

Around week 36 of my pregnancy, I started having what I called “vision spells,” where out of nowhere I would start seeing stars or “auras” and lose almost all vision in one eye and only be able to see out of my peripheral in the other. It would last about 20-30 minutes and then dissipate. The first time it happened, we were at the Olive Garden—leave me alone, I had a craving for breadsticks—and I couldn’t read the menu. I was trying not to freak out and cause a scene amongst the crowd enjoying their unlimited soup, salad and breadsticks, but I was truly frightened.

Visual disturbances are a symptom of preeclampsia—a serious pregnancy complication that affects roughly 5% of pregnancies, that is often characterized by high blood pressure and protein in the urine, that if left untreated can lead to very serious and even fatal complications to both mom and baby. Other symptoms of preeclampsia include swelling, headache, nausea and shortness of breath, which to be honest are all symptoms of a normal pregnancy too, so don’t freak out mamas. When I saw my doctor for my 36-week checkup, I talked to her about the scary visual disturbance that had happened, and just as I began to talk about it, it happened again. Right there in her office… I mean, that never happens! (You know… Like when you’re driving around for months with a check engine light on, but as you pull into the dealership it turns off?) I started crying—the usual at that point in pregnancy—but honestly, I was really freaked out. I mean, I was having temporary bouts of blindness, that’s scary AF.

I did not have high blood pressure or protein in my urine to indicate preeclampsia, so they sent me to the lab to see if there was anything else going on with my bloodwork that could make sense of the vision spells I was having. The bloodwork showed that my blood platelets were low. They weren’t low enough to worry at that point, but they wanted to check again in a few days to monitor. Blood platelets are what helps blood in the body clot, which is very important during childbirth, because, well, there is so. much. blood. during childbirth. I had bloodwork done 2 more times before my 37-week appointment and continued to have the visual disturbances off and on every day or so. I had also stopped driving at that point because the visual issues happened randomly and without warning.

On the morning of my 37-week checkup, I still had no typical signs of preeclampsia (high BP + protein in urine) but my doctor ordered a rush panel as my platelets had continued to drop over that week, and she wanted to test one more time. She explained to me that she would call as soon as the panels came back, but if my blood platelets had dropped again, it would be cause for induction.

Now, as much as I did not want to be pregnant anymore, this was frightening. Pregnancy is considered full term at 37 weeks, but I did not see this one coming. I was sure I’d be an overdue mama. I called my husband at work and told him what had transpired at the appointment, but told him not to worry, and that I was pretty sure if I were to get induced, it would probably be scheduled for later in the week. When the doctor called a few hours later, she informed me that she didn’t like what she was seeing, that my platelets had continued to drop, and now my liver levels were elevated as well. She then said she felt it was time to end the pregnancy.

Wait. What?

The phrase “end the pregnancy” hit me like a ton of bricks, well, it was more like I ran into a brick wall and got slapped into reality real quick.

With a shaky voice, I asked, “Okay, when?”

Her response, “Now. I’ve already sent your charts over and spoken to the doctor on call. They’re waiting for you. You’ll be induced tonight. You’re in good hands.”

Even though she delivered that news calmly and in the most reassuring way, it left me trembling.

She explained that although I don’t have the typical symptoms of preeclampsia, sometimes it presents itself in strange ways. She classified it as “atypical preeclampsia” which is typical of me to get a rare pregnancy complication and then make it even more rare by not even getting the standard, run-of-the mill preeclampsia.

Suddenly, I wasn’t allowed to whine about being uncomfortable and pregnant anymore. My placenta previa-turned low-lying placenta seemed like the most minor of issues, even though just a month or so prior it had me very worried. If I would have known this would have transpired the night before, I might have laid off the theatrics of sobbing for an hour after I realized I had lost a button to my duvet cover. (Pregnancy hormones and nerves will really make ya loco, y’all). But I felt guilty. Like I had somehow willed the universe into giving me a scary complication so that I could have the baby sooner, and now we were both at risk. It was a real “be careful what you wish for” moment for me.

I had now been slapped with a scary diagnosis and it was go-time, I didn’t have too much time to think about it honestly. I called my husband and let him know he needed to get home ASAP. Luckily, we had packed our hospital bags two weeks prior so we were ready to go, but we hadn’t put the car seat in yet as it had been snowing non-stop. He rushed home, and with the help of YouTube got the car seat installed, grabbed our bags and we headed to the hospital. We began calling and texting friends and family to let them know what was going on and shortly after we arrived, we were admitted. To be honest, even though I was shaking violently, I was oddly calm. I knew I had a job to do, and that the best treatment for preeclampsia was delivery of the baby. I knew we were in good hands and we were going to meet our little boy soon. This wasn’t at all how I had expected things to go, but pregnancy is weird like that. It was very surreal that what had started as a routine 37-week prenatal appointment landed me in the hospital, but there we were.

As I got changed into what would be the backless gown I’d wear for the next three days, I couldn’t help but notice my husband pacing around the room. We were going to be parents soon. This was it. This was how our story started and how my pregnancy ended. No dramatic water breaking in public, rush to the hospital story. No middle of the night “I think I’m in labor” moment. My labor would be started artificially, here in this room, by a doctor I was about to get to know very well.

I watched the monitor that was tracking the baby’s heartbeat as I waited for the doctor to come and begin the induction. I listened to the beeping of the machine and looked away winching as the nurse placed the IV in my arm. My phone buzzed with text after text, call after call from family and friends sending their “you got this” messages and well wishes. When the doctor walked in with a full cart of medical devices, I knew this would be the moment that started it all, my life was about to change forever.