Late last August, Cassie and Jason Krajewski received the news that they were going to have a baby, their first. They’d been trying for a year and welcomed the news of Cassie’s pregnancy with a combination of disbelief and excitement.
Their feelings have grown a lot more complicated since.
The Littleton couple’s baby is due April 26 and will enter a world gripped by a pandemic and full of uncertainty.
“It’s not a celebratory time,” Krajewski said. “It’s just not what you expect to happen … It just doesn’t feel exciting in the same way because you’re so isolated.”
She’s been worried about the birth itself, about her health and the health of her child and about the effects of isolation at a time when family and friends are typically on hand and ready to help. And, on top of all that, Jason was furloughed from his job as a biomedical engineer on March 20.
“It was a shock to have both those happen at the same time, not only losing my job, but then also this big question mark of how is the rest of the pregnancy gonna go,” Jason said. “Nobody really could answer how smoothly or how bumpy things would go so it was just a world of unknown for both of us.”
The coronavirus pandemic has caused a wide range of anxiety, uncertainty and fear for people during one of the most momentous times of their lives: pregnancy and childbirth. Last year, about 63,000 babies a year were born in Colorado, and pregnancies and births during this time of physical separation and high risk of contagion have left some families without the expected support and celebrations they had counted upon.
“We’re all having conversations with all our clients about following hand-washing protocols and following the social-distancing protocols as much as they possibly can,” says Julia Amend, a certified midwife and registered nurse from Englewood who owns Generations Midwifery. “…But the most worry and anxiety that I’ve seen is still around the concept of connectedness. During pregnancy, people need connectedness even more than they do on a regular basis.”
The health implications of the virus itself are also at the forefront of some pregnant people’s minds given their compromised immune systems and the uncertainty of the effects of COVID-19 on themselves and their newborns. Some families are even looking to avoid hospitals altogether, Amend said, and are investigating home-birth options.
“I have — and most midwives in the city that I know of have — also seen an uptick in inquiries,” she said. “The latest I’ve had somebody contact me interested in a home birth was 35 weeks, but I’ve also had people calling in their first trimester.”
Amend says she approaches all with open arms, but she also wants people to be educated about home births and to be making the decision for the right reasons.
“I don’t want this to be a last resort for anyone because we do tend to face a higher transport rate when people are coming to us with the only reason being fear of the other options,” she said. “We also want people to acknowledge what the other benefits of home birth can be aside from hopefully protection against infection.”
Dr. Kelly Moore is an OB-GYN affiliated with Rose Medical Center, which is screening people who enter the hospital and has a separate entrance specifically for obstetrical patients. Moore said coronavirus did not seem to be adversely affecting pregnant women more frequently than the general population. She did, however, still insist they take extra caution and pay attention if symptoms such as fever arise.
“We do know their immune system isn’t as strong,” Moore said. “We’re also telling them if they have a fever, to immediately initiate Tylenol to decrease – especially in the first trimester – high fever because high fever in the first trimester can have adverse pregnancy outcomes.”
According to the Centers for Disease Control and Prevention’s website, there are still many unknowns regarding the effects of COVID-19 on pregnant people.
“We do not currently know if pregnant people have a greater chance of getting sick from COVID-19 than the general public nor whether they are more likely to have serious illness as a result,” the CDC website states. “Pregnant people have changes in their bodies that may increase their risk of some infections. Pregnant people have had a higher risk of severe illness when infected with viruses from the same family as COVID-19 and other viral respiratory infections, such as influenza.”
The website also states: “Based on available information, pregnant people seem to have the same risk as adults who are not pregnant.” It also recommends breastfeeding as the best source of nutrition for newborns, saying that “the virus has not been detected in amniotic fluid, breastmilk, or other maternal samples.” However, the CDC cautions, “we do not know for sure whether mothers with COVID-19 can spread the virus via breast milk.”
Glorianna Schinagl said she is not too worried about coronavirus. Schinagl is about 21 weeks pregnant with twins. She lives with her husband and two little girls in Denver. Although she has a positive outlook, Schinagl admits her body could be handling the pandemic in a separate manner.
“Our [pregnant] bodies handle stress differently,” she said. “While I’m telling you ‘Yeah, I’m not worried about it,’ I’m sure my internal body is probably having a totally different chemical reaction.”
Likewise, Brittany Moroney Werner, who is due May 20 and lives in Centennial with her husband, said she was not too worried about herself, but that her doctor wants her to do everything in her power to stay safe, so she is being extra cautious.
“It’d be terrible to find out in a month that [COVID-19] does affect the baby or it does affect the mother,” Werner said. “There’s no room or reason to take any risk.”
Some families are also worried they might be separated from the baby if mom tests positive for COVID-19. The CDC does not explicitly recommend separating a mother with confirmed COVID-19 and the newborn explaining that, “the determination of whether or not to separate a mother with known or suspected COVID-19 and her infant should be made on a case-by-case basis using shared decision-making between the mother and the clinical team.”
Separation is a big concern for Denver-area resident Nadia Brewster, who is about 34 weeks pregnant with her first child.
“What if I did get the virus and then I couldn’t actually be near my baby?” Brewster said. “That initial stage of being with your baby after they’re born is so important for their development.”
She is also worried she might have to deliver alone. She believes giving birth without her husband would change their relationship.
“It’d be so weird if he, for 48 hours, was at home watching Netflix and then I just came home after the most traumatic experience and was, like, ‘Here’s our kid,’ ” Brewster said. “We would be on completely different pages as far as our understanding of what just happened to bring this kid into the world.”
Brewster’s fears are not far-fetched. Some hospitals in New York were forcing pregnant people to deliver alone because of health concerns amid the pandemic, but New York responded with an executive order allowing partners in delivery rooms despite the coronavirus risk.
At Rose Medical Center, the policy is to allow one support person for every pregnant person. “I think it would be exceedingly unlikely that we would limit the patient to coming in by themselves without their partner, however, obviously we can’t predict the future, and if the pandemic got severely worse, that would theoretically be a possibility,” Dr. Moore said.
A doula is also allowed if that doula is affiliated with the hospital, she added. The role of a doula is to provide support for a pregnant person during pregnancy, labor, birth and postpartum. They typically do not have formal obstetric training.
But a one-support-person policy means the Krajewskis cannot have their doula with them during labor and delivery at UC Health Highlands Ranch. Krajewski’s doula, Brittany Kochar, considers this a “violation of birth rights.”
Kochar argues that hospitals should allow all doulas because they could help decrease the use of precious PPE, or personal protective equipment, as well as the risk of infection.
“If a doula is staying in there the whole time, these laboring clients… they’re not gonna feel the need to call the nurse as much with questions,” she said. “They’re gonna have the support with them constantly so the nurses don’t have to come in and out with a new pair of gloves and a new mask, new whatever, every single time.”
Krajewski said she specifically wanted to work with a doula for that additional support “and someone who could give me some real education and empowerment to have the birth experience go my way. I know having her involved in the labor and delivery room would be just another peace of mind that we don’t really have right now.”
With all the uncertainty of the moment, Krajewski and her husband are trying to find joy and excitement in their pregancy, she said. Both sides of the family live in Michigan and they planned to fly in to help before and after delivery. That’s canceled. So are the baby showers.
“The big part of one of the baby showers was to get all the people together that I think is our support system here,” Krajewski said. “While we still have those people in our life, it’s just very different.”
Krajewski knows she is not the only one having to adapt during the coronavirus pandemic. Births, weddings, funerals, so many important life events can no longer be celebrated with the same rituals and sense of community. People will adapt for now and, she says, once we have gotten through this, society will have to process all the grief in a time of healing.