FORT MYERS, Fla. – Tonia Doffing, at 30 weeks pregnant, joked to her husband, “If it gets bad enough, we’re just going to pull up a YouTube tutorial and get this baby out ourselves.”
She had read that some hospitals might bar support people during delivery — most hospitals are allowing at least one. But the sarcasm was a testament to dizzying, disorienting changes for pregnant women in the age of COVID-19.
The 22-year-old had weighed transferring to a birthing center only to spend 90 minutes on the phone with her insurance to learn they wouldn’t cover most of it. Her baby showers had been canceled. She hadn’t set foot in a grocery store in a month.
“I did not expect to feel this kind of isolation until postpartum,” said Doffing, who lives just south of Fort Myers in Estero. “This has been good preparation for motherhood. It truly does show you, no matter how much you plan ahead, there’s just some things in life you cannot really control.”
Hospital and prenatal visit rules seem to change daily. Certain baby supplies can be scarce. New moms have turned to anxiety medication. Florida midwives offering alternatives to the gloom-and-doom around hospitals have been deluged with inquiries.
Even Florida’s governor has felt the unease of welcoming a baby into a pandemic.
“It’s surreal being in a hospital during this time,” said Gov. Ron DeSantis at a March 30 news conference, the same day his wife, Casey, announced their third child’s birth. He did not enter the delivery room to save protective gear, he said.
Midwives are trying to accommodate women — who must be low risk for complications — if they wish to transfer care. Yet with fewer than 200 licensed and practicing midwives in the state, some have already hit capacity for the spring.
“We’re getting calls every day,” said Dawn Meier, a licensed midwife and owner of the Family Birth Center of Naples, the only center of its kind in the region. “We’re pretty maxed out for the next couple of months.”
Pregnant women are at-risk as the COVID-19 pandemic seeps across the globe, the Centers for Disease Control and Prevention says. But much is unknown about how the virus impacts pregnant women and newborns.
A sliver of good news: No infants born to mothers with the coronavirus are known to have tested positive for it. According to state Department of Health data released Sunday (April 5), two infants in Collier County have tested positive. It was unknown how they contracted the virus or if the birth mothers were infected.
Yet despite the transformation of hospitals into virus battlegrounds, there are plenty of obstetricians and birthing nurses staffed for labor and delivery, Florida healthcare leaders say.
“You may see nurses dressed in crazy garb right now, but we’re there. … We are prepared and ready for you,” said Nancy Travis, director of women’s services at Cape Coral Hospital of Lee Health. “Nobody’s going to give birth alone.”
'DO YOU KNOW HOW MANY TIMES I PEE IN THE DAY? I NEED TOILET PAPER!’
Along with the barrage of unknowns, little is going as planned for pregnant women, who are also losing crucial in-person supports.
Women have been required to attend prenatal visits alone or via telehealth. Restrictions at hospitals are fluid. Hospital officials can’t promise they won’t be forced to go down to zero support people. Well-orchestrated plans must be scrapped. Forget Grandma and Grandpa visiting. Forget the Instagram-ready professional photography session.
Good luck finding wipes.
Panicked people can lack compassion.
A very pregnant Cindy Pierre saw this when the 5-foot-4 Naples resident reached for the last package of toilet paper. A man swooped in, grabbed it and took off.
“Even worse, he already had two packs in his cart,” said Pierre, 33. “I was like, ‘Do you know how many times I pee in the day? I need toilet paper!’”
She and others have found solace at home through prayer or meditation and steering clear of social media and sensationalized what-if reports for pregnant women.
“Pregnant women are some of the only people on earth with something to celebrate right now, and these babies will bring joy and light in a very dark time,” texted Caitie Eck, 36, of Fort Myers. “I wish more people would focus on that instead of instilling fear.”
Eck has a C-section set for April 16. Until then, she’s focused on coordinating Lee County’s response to COVID-19 in her emergency management position.
With her first birth, also by C-section, Eck stayed in the hospital a week.
This time, her plan is “to get in and get out,” she said.
“Now, every day I’m in the hospital, I’m drawing resources that are very, very limited. I work so hard to find the solution every day that I don’t want to be part of the problem.”
‘WE’RE TAKING ELDERBERRY SERUM LIKE IT'S GOING OUT OF STYLE.'
Midwives across the state are seeing more and more women contacting them who want to transfer to their care late in their pregnancies, after 28 weeks, as women worry about COVID-19 in hospitals and losing access to partners, said Amanda Mann, executive director of the Florida School of Traditional Midwifery in Gainesville.
The three-year program expects 15 students to graduate in August and is providing distance education to them so they can finish on time.
Demand for midwives is starting to exceed capacity, Mann said. “Generally, the care we provide is so individualized that it’s very hard to scale up rapidly for what we do.”
For instance, Meier caps her Naples birth center at eight women due a month. Empathetic to pandemic worries, she has upped it to 10.
As the only midwife there, she’s focused on keeping her patients healthy as well as herself and her staff. “We’re taking elderberry serum like it’s going out of style.”
Midwives are wary of overextending.
“We cannot have a drop in providers because we already don’t have enough providers,” said Audrey Luck, president of Midwives Association of Florida, which counts 200-plus members.
Yet they cautioned women from choosing an out-of-hospital birth solely out of fear.
“If you initially chose a hospital because you believed it to be the safest location to give birth, then the hospital is likely still the safest place for you,” according to a post on the site of Magnolia Birth House, which offers midwifery care in North Miami Beach.
Women who had already opted for an out-of-hospital setting felt reaffirmed.
“I truly feel it was the safest place right now to have a baby,” said Judith Martin, 28, who gave birth in late March at the Family Birth Center of Naples.
Pandemic or not, home birth is not a decision a woman takes lightly, said Dawn Rogula, a licensed midwife in Southwest Florida for two decades.
“Not everybody’s asking for a home birth, I can promise you that.”
TOUGH CHOICE: WHO GETS TO BE AT THE BIRTH?
For women giving birth in a hospital, many face a choice: doula or partner?
Amy Lynn Kucharski, a certified doula serving Southwest Florida, quickly adapted to virtual support for a couple when their hospital system dropped to one support person.
“I was like, ‘OK, let’s figure this out.’”
This meant preparing the couple more prior to labor and texting with the father during the labor and childbirth at the hospital to ensure the mother was getting proper care and movement.
Once the baby arrives, many women have prepared for the anxiety to linger.
Kami Greer, 34, of Naples, spoke openly with her obstetrician. She was at risk for postpartum depression. Her anxiety spiked with every report on the pandemic. They developed a plan to start Zoloft the day after her daughter was born in March.
“I will say the first week was really difficult,” said Greer, a pediatric nurse and nursing instructor. Turning off phone notifications and staying off social media helped, as did the Zoloft and the Xanax she later started for anxiety. “You feel the fog lift.”
She hopes other mothers of newborns reach for help too.
“Every emotion they’re feeling right now is completely justified,” she said. “Moms have to become a tribe for each other.”