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Some Pregnant Women Who Can Afford to Are Fleeing New York City Some Pregnant Women Who Can Afford to Are Fleeing New York City
(2 months later)
The plane leaving New York was nearly empty.The plane leaving New York was nearly empty.
Ariella Tabick, one of a handful of passengers flying to Colorado on Thursday evening, was 31 weeks pregnant, and the idea of giving birth at a hospital in New York City had started to feel too risky. So Tabick, a special education kindergarten teacher, and her husband and 2-year-old son left their apartment in Manhattan to stay with her parents in a suburb of Denver.Ariella Tabick, one of a handful of passengers flying to Colorado on Thursday evening, was 31 weeks pregnant, and the idea of giving birth at a hospital in New York City had started to feel too risky. So Tabick, a special education kindergarten teacher, and her husband and 2-year-old son left their apartment in Manhattan to stay with her parents in a suburb of Denver.
She knew it was the right decision for her family, she said. But after the flight took off, she began to cry.She knew it was the right decision for her family, she said. But after the flight took off, she began to cry.
“I felt so sad to leave my home,” she said. “It’s where all my friends are, and I feel like I’m leaving them behind in the trenches because I had an easy out.”“I felt so sad to leave my home,” she said. “It’s where all my friends are, and I feel like I’m leaving them behind in the trenches because I had an easy out.”
In a matter of weeks, New York has become a hot spot for the new coronavirus, leaving some pregnant women anxious about their upcoming deliveries as doctors and nurses fall ill, protective gear disappears and the hospital system becomes so strained that emergency rooms are running out of lifesaving equipment like ventilators. Choosing to leave the state and to give birth in areas with less besieged hospitals and fewer coronavirus cases has become an appealing option for those who can afford to do so.In a matter of weeks, New York has become a hot spot for the new coronavirus, leaving some pregnant women anxious about their upcoming deliveries as doctors and nurses fall ill, protective gear disappears and the hospital system becomes so strained that emergency rooms are running out of lifesaving equipment like ventilators. Choosing to leave the state and to give birth in areas with less besieged hospitals and fewer coronavirus cases has become an appealing option for those who can afford to do so.
“I’d rather be in a less burdened hospital system if I can,” Tabick, 31, said.“I’d rather be in a less burdened hospital system if I can,” Tabick, 31, said.
Early last week, two major hospital systems, NewYork-Presbyterian and Mount Sinai, instituted a ban on support persons in the labor and delivery rooms, which many expectant parents, midwives and doulas vocally opposed. On Saturday, Gov. Andrew M. Cuomo signed an executive order requiring hospitals to allow support persons in the delivery room and during the immediate postpartum period. But that change hasn’t fully alleviated pregnant women’s concerns.Early last week, two major hospital systems, NewYork-Presbyterian and Mount Sinai, instituted a ban on support persons in the labor and delivery rooms, which many expectant parents, midwives and doulas vocally opposed. On Saturday, Gov. Andrew M. Cuomo signed an executive order requiring hospitals to allow support persons in the delivery room and during the immediate postpartum period. But that change hasn’t fully alleviated pregnant women’s concerns.
Right now there are more than 75,000 coronavirus cases in New York State and over 1,500 deaths. In Colorado, where Tabick will give birth, the numbers are far different: 2,990 known cases and 68 deaths.Right now there are more than 75,000 coronavirus cases in New York State and over 1,500 deaths. In Colorado, where Tabick will give birth, the numbers are far different: 2,990 known cases and 68 deaths.
After she arrived in Colorado, Tabick said she felt as if she had traveled back in time to the way New York was several weeks ago, when you could still find disinfectant wipes, economy packs of diapers and Amazon Fresh delivery slots.After she arrived in Colorado, Tabick said she felt as if she had traveled back in time to the way New York was several weeks ago, when you could still find disinfectant wipes, economy packs of diapers and Amazon Fresh delivery slots.
And because she’ll be living with her family, she and her husband will have child care during those first exhausting, hazy months with their newborn. Tabick, who said she might need a second cesarean section, is already anticipating a reprisal of the postpartum depression and anxiety that she experienced after her first pregnancy.And because she’ll be living with her family, she and her husband will have child care during those first exhausting, hazy months with their newborn. Tabick, who said she might need a second cesarean section, is already anticipating a reprisal of the postpartum depression and anxiety that she experienced after her first pregnancy.
Choosing to go elsewhere, however, is economically prohibitive for most expectant mothers in New York. Leaving aside the cost of a flight or car rental, not everyone has family in another state with spacious, free lodging. Many women still have jobs and family connections in New York, as well as rent or mortgage payments they must meet.Choosing to go elsewhere, however, is economically prohibitive for most expectant mothers in New York. Leaving aside the cost of a flight or car rental, not everyone has family in another state with spacious, free lodging. Many women still have jobs and family connections in New York, as well as rent or mortgage payments they must meet.
And for lower-income families, leaving isn’t even a consideration, said Eugenia Montesinos, the co-chairwoman of NYC Midwives, a professional association.And for lower-income families, leaving isn’t even a consideration, said Eugenia Montesinos, the co-chairwoman of NYC Midwives, a professional association.
“They don’t even think about that,” said Montesinos, who sees women at NYC Health + Hospitals/Metropolitan, a city hospital in East Harlem. “They’re going to be thinking about: ‘How am I going to pay my rent? How am I going to get something to eat?’”“They don’t even think about that,” said Montesinos, who sees women at NYC Health + Hospitals/Metropolitan, a city hospital in East Harlem. “They’re going to be thinking about: ‘How am I going to pay my rent? How am I going to get something to eat?’”
While some ob-gyns have been supportive of their patients’ decisions to leave the New York area, there are risks involved in traveling, especially late in a pregnancy. Public health experts recommend avoiding nonessential travel to reduce your potential exposure to the virus and the risk of inadvertently infecting others.While some ob-gyns have been supportive of their patients’ decisions to leave the New York area, there are risks involved in traveling, especially late in a pregnancy. Public health experts recommend avoiding nonessential travel to reduce your potential exposure to the virus and the risk of inadvertently infecting others.
“Delivering in a system that has provided you with all your prenatal care and knows you is more optimal,” said Dr. Mary E. D’Alton, the chief obstetrician and gynecologist at the NewYork-Presbyterian/Columbia University Medical Center in Manhattan. “We now have probably the best firsthand information about Covid and how obstetric patients are responding to this virus, and quite honestly, other centers in the United States are looking to us to give guidance on what we are doing.”“Delivering in a system that has provided you with all your prenatal care and knows you is more optimal,” said Dr. Mary E. D’Alton, the chief obstetrician and gynecologist at the NewYork-Presbyterian/Columbia University Medical Center in Manhattan. “We now have probably the best firsthand information about Covid and how obstetric patients are responding to this virus, and quite honestly, other centers in the United States are looking to us to give guidance on what we are doing.”
She estimated that fewer than 5 percent of the pregnant patients in her practice have left.She estimated that fewer than 5 percent of the pregnant patients in her practice have left.
And there’s no guarantee that another area won’t eventually see a surge in coronavirus cases, she added.And there’s no guarantee that another area won’t eventually see a surge in coronavirus cases, she added.
The American College of Obstetricians and Gynecologists said in a statement on Monday that pregnant women in America should feel comfortable delivering babies in any licensed and accredited U.S. hospital.The American College of Obstetricians and Gynecologists said in a statement on Monday that pregnant women in America should feel comfortable delivering babies in any licensed and accredited U.S. hospital.
The organization also advised women — especially those in Covid-19 hot spots — to discuss any concerns with their doctors.The organization also advised women — especially those in Covid-19 hot spots — to discuss any concerns with their doctors.
Alice Anigacz, 31, who lives in Crown Heights, Brooklyn, is due in July and is planning to have her baby at Mount Sinai West in Manhattan. Her doctor recommended that she remain in New York.Alice Anigacz, 31, who lives in Crown Heights, Brooklyn, is due in July and is planning to have her baby at Mount Sinai West in Manhattan. Her doctor recommended that she remain in New York.
“There are the unknown unknowns” about traveling elsewhere, she said, “like, is coronavirus going to hit hard there in a few weeks?”“There are the unknown unknowns” about traveling elsewhere, she said, “like, is coronavirus going to hit hard there in a few weeks?”
To avoid traveling into Manhattan, Anigacz has been performing basic tests at home, like monitoring her blood glucose levels to help determine her risk for gestational diabetes.To avoid traveling into Manhattan, Anigacz has been performing basic tests at home, like monitoring her blood glucose levels to help determine her risk for gestational diabetes.
Even though there is no official medical guidance suggesting that pregnant women ought to leave New York City, Efe Osaren, a doula who lives in Brooklyn, said she is advising her clients to deliver elsewhere if they can travel somewhere by car.Even though there is no official medical guidance suggesting that pregnant women ought to leave New York City, Efe Osaren, a doula who lives in Brooklyn, said she is advising her clients to deliver elsewhere if they can travel somewhere by car.
“I just predict that the hospitals are going to be so overwhelmed as well as we may lose a lot of staff due to the virus,” Osaren said. “If you have the privilege and the funds to go to a place where there’s not as many people, I suggest it.”“I just predict that the hospitals are going to be so overwhelmed as well as we may lose a lot of staff due to the virus,” Osaren said. “If you have the privilege and the funds to go to a place where there’s not as many people, I suggest it.”
That’s exactly what Lauren Profis, 28, did last week: She and her husband rented a car and drove from New York City to Atlanta to stay in her childhood home. Like Tabick, Profis found an ob-gyn through a family connection. Although she is only 20 weeks pregnant, Profis realized she needed to leave New York City after being too afraid to travel to the hospital for an ultrasound when she started having unexplained stomach pain.That’s exactly what Lauren Profis, 28, did last week: She and her husband rented a car and drove from New York City to Atlanta to stay in her childhood home. Like Tabick, Profis found an ob-gyn through a family connection. Although she is only 20 weeks pregnant, Profis realized she needed to leave New York City after being too afraid to travel to the hospital for an ultrasound when she started having unexplained stomach pain.
The pain has subsided and she’s feeling fine now, she said. She is following up with her new doctor in Atlanta.The pain has subsided and she’s feeling fine now, she said. She is following up with her new doctor in Atlanta.
Relocating and changing providers is not always so simple.Relocating and changing providers is not always so simple.
“There are a lot of hospitals that are in the easy commuting distance from New York City that aren’t actually accepting any transfers of any kind,” said Dr. Kelly Culwell, an ob-gyn in San Diego. “I think that even if women are trying to find ways to deliver outside of New York City, I think that they’re going to find a challenge.”“There are a lot of hospitals that are in the easy commuting distance from New York City that aren’t actually accepting any transfers of any kind,” said Dr. Kelly Culwell, an ob-gyn in San Diego. “I think that even if women are trying to find ways to deliver outside of New York City, I think that they’re going to find a challenge.”
Allison Lamberth, 27, who is due in early April, drove her to parents’ home in Pennsylvania with her husband and 17-month-old son on March 15 after she asked her ob-gyn how bad things were expected to get in New York City.Allison Lamberth, 27, who is due in early April, drove her to parents’ home in Pennsylvania with her husband and 17-month-old son on March 15 after she asked her ob-gyn how bad things were expected to get in New York City.
Updated June 1, 2020
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
The answer, she said, “wasn’t very reassuring.”The answer, she said, “wasn’t very reassuring.”
She called two different birthing centers, which wouldn’t take her as a new patient because she was too far along in her pregnancy, but finally found a hospital that would accept her. She was asked to self-quarantine and wait 14 days before coming in for her first appointment.She called two different birthing centers, which wouldn’t take her as a new patient because she was too far along in her pregnancy, but finally found a hospital that would accept her. She was asked to self-quarantine and wait 14 days before coming in for her first appointment.
Although President Trump has backed away from evoking a strict quarantine of the New York region, the Centers for Disease Control and Prevention issued an advisory Saturday night urging residents of New York, New Jersey and Connecticut to “refrain from nonessential domestic travel for 14 days effective immediately.”Although President Trump has backed away from evoking a strict quarantine of the New York region, the Centers for Disease Control and Prevention issued an advisory Saturday night urging residents of New York, New Jersey and Connecticut to “refrain from nonessential domestic travel for 14 days effective immediately.”
Alexandra Schinasi, 34, who lives in Manhattan with her husband and two children, is 35 weeks pregnant and had hoped to travel to Geneva, where her family lives, but then Switzerland closed its borders to anyone who is not a Swiss citizen. That meant her husband and children were barred from entering the country. It was a similar situation in Israel, where her husband’s family lives. In the end, she had to accept that she would be giving birth in New York City in May.Alexandra Schinasi, 34, who lives in Manhattan with her husband and two children, is 35 weeks pregnant and had hoped to travel to Geneva, where her family lives, but then Switzerland closed its borders to anyone who is not a Swiss citizen. That meant her husband and children were barred from entering the country. It was a similar situation in Israel, where her husband’s family lives. In the end, she had to accept that she would be giving birth in New York City in May.
“I went through a range of emotions in the last week,” Schinasi said. “It started with a lot of anxiety and fear and sadness. Then I kind of came to terms with it, it in a way.”“I went through a range of emotions in the last week,” Schinasi said. “It started with a lot of anxiety and fear and sadness. Then I kind of came to terms with it, it in a way.”
India Browne, 34, who was formerly an ensemble dancer in “The Lion King” on Broadway, is six months pregnant and due in July. She has been unemployed since the theaters closed in the middle of March. Work has also slowed for her husband, who is employed in real estate.India Browne, 34, who was formerly an ensemble dancer in “The Lion King” on Broadway, is six months pregnant and due in July. She has been unemployed since the theaters closed in the middle of March. Work has also slowed for her husband, who is employed in real estate.
Browne said her first instinct was to leave New York City to stay with family in Georgia, but it felt too dangerous to drive or fly. She was also concerned about having undiagnosed Covid-19 and potentially infecting her family or the larger community.Browne said her first instinct was to leave New York City to stay with family in Georgia, but it felt too dangerous to drive or fly. She was also concerned about having undiagnosed Covid-19 and potentially infecting her family or the larger community.
“To leave town, for me, is very selfish,” she said, adding that the impulse is also understandable.“To leave town, for me, is very selfish,” she said, adding that the impulse is also understandable.
She and her husband ultimately decided to stay and give birth at Brooklyn Methodist Hospital.She and her husband ultimately decided to stay and give birth at Brooklyn Methodist Hospital.
“If the entire nation is going to get back on track, we all have to cooperate,” she said. “We can’t just take things into our own hands and just try to take care of just our family unit.”“If the entire nation is going to get back on track, we all have to cooperate,” she said. “We can’t just take things into our own hands and just try to take care of just our family unit.”
For those who are staying, either because they wish to remain in the city or because they do not have another option, Dr. Daniel F. Roshan, the director of Rosh Maternal & Fetal Medicine in New York City, urged pregnant patients to speak with their doctor if they have continuing concerns or anxieties.For those who are staying, either because they wish to remain in the city or because they do not have another option, Dr. Daniel F. Roshan, the director of Rosh Maternal & Fetal Medicine in New York City, urged pregnant patients to speak with their doctor if they have continuing concerns or anxieties.
“We are dealing with a crisis,” he said. “I think the best thing we can do is not to panic and keep calm.”“We are dealing with a crisis,” he said. “I think the best thing we can do is not to panic and keep calm.”