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Pregnant and Scared of ‘Covid Hospitals,’ They’re Giving Birth at Home Pregnant and Scared of ‘Covid Hospitals,’ They’re Giving Birth at Home
(about 1 month later)
With less than three weeks to go until her baby was due, Aziza Hasanova packed her bags and prepared for what she expected to be a relatively smooth delivery at a Brooklyn outpost of one of New York City’s leading hospitals.With less than three weeks to go until her baby was due, Aziza Hasanova packed her bags and prepared for what she expected to be a relatively smooth delivery at a Brooklyn outpost of one of New York City’s leading hospitals.
But as the coronavirus pandemic swept across the city, all her planning was suddenly thrown into disarray.But as the coronavirus pandemic swept across the city, all her planning was suddenly thrown into disarray.
When she was 38 weeks pregnant, the hospital, N.Y.U. Langone in Brooklyn, canceled her last checkup, and Ms. Hasanova said a clerk at the hospital discouraged her from coming in because of the risks of being exposed to the surging number of patients infected with coronavirus.When she was 38 weeks pregnant, the hospital, N.Y.U. Langone in Brooklyn, canceled her last checkup, and Ms. Hasanova said a clerk at the hospital discouraged her from coming in because of the risks of being exposed to the surging number of patients infected with coronavirus.
Ms. Hasanova, who lives in Midwood, Brooklyn, grew anxious.Ms. Hasanova, who lives in Midwood, Brooklyn, grew anxious.
“I was really scared just to go to the hospital because for pregnant women it’s very risky getting the virus,” Ms. Hasanova said.“I was really scared just to go to the hospital because for pregnant women it’s very risky getting the virus,” Ms. Hasanova said.
The solution she landed on seemed the only option so late in her pregnancy: giving birth at home. Luckily, she found an available midwife.The solution she landed on seemed the only option so late in her pregnancy: giving birth at home. Luckily, she found an available midwife.
As the pandemic has battered hospitals across New York and other parts of the country, there has been a sharp increase in demand for midwives who can deliver babies at home or in facilities that are not part of the traditional health care system.As the pandemic has battered hospitals across New York and other parts of the country, there has been a sharp increase in demand for midwives who can deliver babies at home or in facilities that are not part of the traditional health care system.
“People are reconsidering their birth plans and doing whatever they need to avoid hospitals,’’ said Sarita Bennett, president of the Midwives Alliance of North America.“People are reconsidering their birth plans and doing whatever they need to avoid hospitals,’’ said Sarita Bennett, president of the Midwives Alliance of North America.
Jeanette Breen, a midwife for over three decades who delivered Ms. Hasanova’s baby, described her business as “a whirlwind of activity. We’re getting late transfers.’’Jeanette Breen, a midwife for over three decades who delivered Ms. Hasanova’s baby, described her business as “a whirlwind of activity. We’re getting late transfers.’’
“They don’t want to be involved with Covid and they would feel much safer at home,’’ she added.“They don’t want to be involved with Covid and they would feel much safer at home,’’ she added.
Ms. Breen, who is based on Long Island, said she helped eight women deliver in the first three months of this year. But in April, she has had more than 25 inquiries, she said, nearly all of them women who had initially planned hospital deliveries with doctors.Ms. Breen, who is based on Long Island, said she helped eight women deliver in the first three months of this year. But in April, she has had more than 25 inquiries, she said, nearly all of them women who had initially planned hospital deliveries with doctors.
“It’s not that they don’t want to be in hospitals; it’s that they don’t want to be in a Covid hospital,” said a midwife in a recent Zoom meeting of New York City midwives.“It’s not that they don’t want to be in hospitals; it’s that they don’t want to be in a Covid hospital,” said a midwife in a recent Zoom meeting of New York City midwives.
On Monday, the Cuomo administration announced the creation of a panel to find ways to quickly authorize free standing birthing centers as alternatives to hospitals.On Monday, the Cuomo administration announced the creation of a panel to find ways to quickly authorize free standing birthing centers as alternatives to hospitals.
“Birth centers can serve as a safe alternative for low-risk pregnancies — relieving the strain on hospitals and providing a supportive environment for mothers during an already stressful time,’’ said Melissa DeRosa, the top aide to Gov. Andrew M. Cuomo.“Birth centers can serve as a safe alternative for low-risk pregnancies — relieving the strain on hospitals and providing a supportive environment for mothers during an already stressful time,’’ said Melissa DeRosa, the top aide to Gov. Andrew M. Cuomo.
N.Y.U. Langone, in a statement about Ms. Hasanova’s assertions, said it had adopted practices to keep pregnant women safe and has “continued to provide uninterrupted services to mothers scheduled to deliver at the hospital.’’N.Y.U. Langone, in a statement about Ms. Hasanova’s assertions, said it had adopted practices to keep pregnant women safe and has “continued to provide uninterrupted services to mothers scheduled to deliver at the hospital.’’
“It is unfortunate, as it seems, that in the case of this family, this was not the message they received,” the hospital said.“It is unfortunate, as it seems, that in the case of this family, this was not the message they received,” the hospital said.
Some hospitals have been so overwhelmed that gynecologists and obstetricians have been diverted to treat coronavirus patients, said Dr. Michael Nimaroff, an obstetrician-gynecologist and senior vice president at Northwell Health, New York’s largest health care provider.Some hospitals have been so overwhelmed that gynecologists and obstetricians have been diverted to treat coronavirus patients, said Dr. Michael Nimaroff, an obstetrician-gynecologist and senior vice president at Northwell Health, New York’s largest health care provider.
Women fear being infected in hospitals, though the greater risk appears to be that they might have asymptomatic Covid-19 and infect hospital staff.Women fear being infected in hospitals, though the greater risk appears to be that they might have asymptomatic Covid-19 and infect hospital staff.
Some expectant mothers have tested positive after delivering in hospitals, and some midwives, many of whom work in hospitals, have fallen sick too.Some expectant mothers have tested positive after delivering in hospitals, and some midwives, many of whom work in hospitals, have fallen sick too.
According to a study published in the New England Journal of Medicine, 88 percent of expectant women who tested positive for the virus at NewYork-Presbyterian Allen Hospital and Columbia University Irving Medical Center between March 22 and April 4 were asymptomatic when they arrived at the facilities.According to a study published in the New England Journal of Medicine, 88 percent of expectant women who tested positive for the virus at NewYork-Presbyterian Allen Hospital and Columbia University Irving Medical Center between March 22 and April 4 were asymptomatic when they arrived at the facilities.
Meghan Perez, 35, a hairstylist on Long Island, is 26 weeks pregnant and decided on a home birth after originally planning to deliver at Stony Brook University Hospital.Meghan Perez, 35, a hairstylist on Long Island, is 26 weeks pregnant and decided on a home birth after originally planning to deliver at Stony Brook University Hospital.
“One night when things were getting more serious and overwhelmed at our hospital, my husband said to me, ‘Let’s do a home birth,’” she said.“One night when things were getting more serious and overwhelmed at our hospital, my husband said to me, ‘Let’s do a home birth,’” she said.
The couple reached out to a private midwifery practice and were among 15 couples interviewed on the same day. The practice, Gaia Midwives, has been inundated with calls and is now booked until September.The couple reached out to a private midwifery practice and were among 15 couples interviewed on the same day. The practice, Gaia Midwives, has been inundated with calls and is now booked until September.
“When we were notified that they would take us on under their care, I felt like I was accepted to the college of my choice,” Ms. Perez said.“When we were notified that they would take us on under their care, I felt like I was accepted to the college of my choice,” Ms. Perez said.
Before the health crisis Ms. Perez said she had briefly entertained the idea of a home birth but never thought of it seriously.Before the health crisis Ms. Perez said she had briefly entertained the idea of a home birth but never thought of it seriously.
Now, the pandemic “has changed labor and delivery as we once knew it.”Now, the pandemic “has changed labor and delivery as we once knew it.”
Some hospitals are making changes in response to the concerns of pregnant women and to protect their own staff.Some hospitals are making changes in response to the concerns of pregnant women and to protect their own staff.
Northwell Health, New York’s largest health care provider with obstetric units at 10 hospitals, said it was testing expectant mothers for the virus before they are admitted.Northwell Health, New York’s largest health care provider with obstetric units at 10 hospitals, said it was testing expectant mothers for the virus before they are admitted.
A mother who is infected but asymptomatic would be kept six feet away from her newborn except for breastfeeding. A mother showing symptoms would almost immediately be isolated from her child, said Dr. Nimaroff. “Unfortunately, the mom can’t bond with the baby,” he said.A mother who is infected but asymptomatic would be kept six feet away from her newborn except for breastfeeding. A mother showing symptoms would almost immediately be isolated from her child, said Dr. Nimaroff. “Unfortunately, the mom can’t bond with the baby,” he said.
“There are a number of pregnant patients who have certainly developed the infection and many patients do test positive,” he added. “Some obviously are very sick from corona.”“There are a number of pregnant patients who have certainly developed the infection and many patients do test positive,” he added. “Some obviously are very sick from corona.”
But, Dr. Nimaroff said, the hospital “is still a safe space to have a baby.”But, Dr. Nimaroff said, the hospital “is still a safe space to have a baby.”
In New York State, there are roughly 1,150 certified nurse-midwives, according to state figures. Most work in hospitals; a smaller number specialize in home births.In New York State, there are roughly 1,150 certified nurse-midwives, according to state figures. Most work in hospitals; a smaller number specialize in home births.
Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
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.)
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.
Only three-quarters of the states allow licenses for midwives to practice out-of-hospital deliveries. Some states, like West Virginia and Georgia, do not offer licenses, making midwifery essentially illegal. Other states, like New York, place restrictive rules on home births, including a requirement that midwives have a written practice agreement with a doctor or hospital.Only three-quarters of the states allow licenses for midwives to practice out-of-hospital deliveries. Some states, like West Virginia and Georgia, do not offer licenses, making midwifery essentially illegal. Other states, like New York, place restrictive rules on home births, including a requirement that midwives have a written practice agreement with a doctor or hospital.
Pedro Frisneda, deputy press secretary at the New York City Department of Health, cautioned against making changes to birth plans late in pregnancy. “The hospital birthing experience may not be what was expected, but the care provided will be safe and of the utmost quality,” he said.Pedro Frisneda, deputy press secretary at the New York City Department of Health, cautioned against making changes to birth plans late in pregnancy. “The hospital birthing experience may not be what was expected, but the care provided will be safe and of the utmost quality,” he said.
And in some cases women planning to deliver at home have ended up needing to go a hospital anyway because births were not progressing properly, a process that could be more fraught now given slower ambulance response times.And in some cases women planning to deliver at home have ended up needing to go a hospital anyway because births were not progressing properly, a process that could be more fraught now given slower ambulance response times.
But the risks have not dissuaded nervous expectant mothers from upending their original plans.But the risks have not dissuaded nervous expectant mothers from upending their original plans.
Trinisha Williams, director of midwifery at the Brooklyn Birthing Center, one of three free-standing birthing centers in New York, said the facility had received about 15 inquiries per week before the pandemic. Last week, it received 200 calls.Trinisha Williams, director of midwifery at the Brooklyn Birthing Center, one of three free-standing birthing centers in New York, said the facility had received about 15 inquiries per week before the pandemic. Last week, it received 200 calls.
“We are overflooded,” she said, adding that the center is planning to soon open a second site in Manhattan.“We are overflooded,” she said, adding that the center is planning to soon open a second site in Manhattan.
Midwives deliver babies as naturally as possible, without the aid of doctors or drugs unless there is an emergency. Women considered low risk are the most appropriate candidates.Midwives deliver babies as naturally as possible, without the aid of doctors or drugs unless there is an emergency. Women considered low risk are the most appropriate candidates.
“I’m having women call saying, ‘I want a C-section here,’” Ms. Williams said. “But we don’t do that.”“I’m having women call saying, ‘I want a C-section here,’” Ms. Williams said. “But we don’t do that.”
Another factor driving some women toward home births are new rules barring partners from being with mothers after they give birth, meaning women face recovery time alone.Another factor driving some women toward home births are new rules barring partners from being with mothers after they give birth, meaning women face recovery time alone.
That is why Jacqueline Aiello, 33, whose due date is in July, decided to switch from a hospital delivery at Mount Sinai South Nassau to the Brooklyn Birthing Center.That is why Jacqueline Aiello, 33, whose due date is in July, decided to switch from a hospital delivery at Mount Sinai South Nassau to the Brooklyn Birthing Center.
She wanted to be close to her family. “I’m hopeful of bringing a baby in a safe environment and not worry about germs and the harms that Covid is bringing to the hospital,” she said.She wanted to be close to her family. “I’m hopeful of bringing a baby in a safe environment and not worry about germs and the harms that Covid is bringing to the hospital,” she said.
There are no guarantees that birthing centers or home births offer full protection from infection. The Brooklyn Birthing Center said it was testing clients, but midwives who perform home births do not necessarily get tested or require that their patients do so.There are no guarantees that birthing centers or home births offer full protection from infection. The Brooklyn Birthing Center said it was testing clients, but midwives who perform home births do not necessarily get tested or require that their patients do so.
“Of course I wash my hands, but I don’t wear a mask,” Ms. Breen said. “That is not part of my belief system.’’“Of course I wash my hands, but I don’t wear a mask,” Ms. Breen said. “That is not part of my belief system.’’
On April 5, Ms. Breen rushed to Ms. Hasanova’s home where she helped Ms. Hasanova place light blue waterproof pads on her bed and two shower curtains under the bedding set. Ms. Hasanova dimmed the lights, breathed and started reciting a prayer.On April 5, Ms. Breen rushed to Ms. Hasanova’s home where she helped Ms. Hasanova place light blue waterproof pads on her bed and two shower curtains under the bedding set. Ms. Hasanova dimmed the lights, breathed and started reciting a prayer.
At around 11 p.m., she gave birth to Abdurrahim, a healthy boy weighing 9.04 pounds.At around 11 p.m., she gave birth to Abdurrahim, a healthy boy weighing 9.04 pounds.