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December marks nine months since the first coronavirus case was recorded in Philadelphia. Nine months of watching case counts rise and fall, and experiencing ever-shifting levels of shutdown and loss.
What else in human life takes nine months?
Yes, amid a deadly pandemic, plenty of people are creating new lives — and the cognitive dissonance is a once-in-a-century experience. Despite the massive industry built up around parenting advice, there’s no playbook for this.
“We were all living in such uncertainty,” said Roxy Trudeau of West Philly, a 39-year-old who welcomed her first child last month. “Back in March, we had to make decisions based on projections and guesses [about] what life in October would look like when we were due.”
Would doctor’s visits carry risk? Would hospitals be over-full?
For first-time parents, COVID life is the only version of pregnancy they know. That doesn’t make it any easier.
Trudeau’s prenatal yoga class and new parent group meetings were canceled. Some expectant mothers hosted drive-by baby showers. Telemedicine has become the maternity care norm. When South Philly’s Marie DiFeliciantonio felt stir crazy in the months leading up to son’s December birth, she couldn’t break up the monotony by leaving the house.
Every decision has been filled with uncertainty, said DiFeliciantonio, 38. At one point in her pregnancy, she started getting migraines, and debated whether or not the issue merited an in-person visit.
“I don’t know what’s normal or what’s not,” DiFeliciantonio said. “Really, my option from the jump was telehealth.”
Most local hospitals scaled back in-person maternity visits tremendously — from 10 to 12 check-ups over nine months to just four or five total visits, said Dr. Vincenzo Berghella, director of Jefferson’s division of maternal fetal medicine.
The few doctor’s appointments that do happen prohibit anyone other than the patient, stripping their partners of the opportunity to see ultrasound and hear their baby’s heartbeat live.
Manayunk resident Rebeca Cruz-Esteves, 32, whose first child arrives any day, tried to include her fiance in those check-ups via video call.
“I would drive and drop her off, and she would FaceTime me from inside the doctor’s office so I could see sonograms and get the virtual experience,” said fiance Clay Stiles. “That was pretty much as close as I could get.”
If things go wrong, it’s even scarier.
Cruz-Esteves became anemic during her pregnancy. It was terrifying, she said, to visit the emergency room as she watched the city’s COVID count rise. She had to get infusions, and take extra care in a ward with immunocompromised cancer patients.
Bo Zhao, a 38-year-old who lives in Center City, found out she was pregnant with her second child in August. She miscarried after 11 weeks, never once making it to an in-person appointment, since all the initial prenatal visits were moved to a virtual setting.
“I’m lucky in that I do have a good group of female friends,” Zhao said. “Some of them have experienced miscarriages, and they were able to help me get through it and deal with it.”
Enforcing face masks during birth — and separating babies from positive moms
Hospital workers say the new normal is eerie.
“The waiting rooms are empty at this point,” said Dr. Tiffany Montgomery, a labor and delivery nurse at Einstein Hospital, instead of full of people celebrating new life with gifts and hugs. “And a lot of patients are on FaceTime. It’s really strange.”
She’s also noticing many more induced pregnancies than she’s used to. While uncertainty persists in almost every other facet of their life, it seems to her some expecting parents are comforted by the opportunity to schedule their births.
One of the hardest parts for Montgomery? While in labor, as new mothers strain to push out 7 to 10 pounds of life, they’re expected to wear a face mask.
“I feel like a prison warden sometimes,” Montgomery said. “How do you tell somebody who’s in labor, who’s experiencing the pain of transition to seven, eight centimeters, that they have to keep a mask on their face.”
She knows it’s necessary for safety, however — especially when expectant moms test positive.
Berghella, of Jefferson’s division of maternal fetal medicine, has seen positive COVID tests in between 2% to 8% of mothers actively going into labor. They’re almost always asymptomatic, he said.
Protocols call for the new moms to be kept on the opposite side of the hallway from patients who test negative. In some hospitals, their newborns have to be kept separate as well.
“It goes against everything we know about how to properly care for birthing people,” said nurse Montgomery. “We don’t like to break them up. … People have this picture in their mind of the perfect birth story. That’s disrupted because of COVID.”
The hospital-in-a-pandemic idea was so scary for Trudeau, of West Philly, that she opted for a home birth with a midwife.
Along with the hardships, a few silver linings have popped up.
Lack of new-parent FOMO is one, said South Philly’s DiFeliciantonio. With everyone expected to stay in and events canceled, there’s not much she worries about missing.
“If you’re going to be at home with a baby, at least everybody else is at home too,” she said. “Let me get through this infant stage while everyone’s here anyway.”
The flexibility to work from home also allowed many expecting parents more time with supportive partners. It was especially helpful during Cruz-Esteves’ first trimester morning sickness, said the Manayunk resident.
In the days leading up to the birth of her first child, she felt grateful for 2020.
“I know a lot of people like, ‘Wow, I wish I got pregnant during a different time,'” Cruz-Esteves said. “But with so much sorrow in the world, to bring life into the world, it’s really a blessing.”