Arianna Thompson had big plans for her pregnancy. A photoshoot. Two baby showers – one in South Bend, Indiana, where she lives, and one with family in Chicago.
Everything has been cancelled.
“Every first-time mom gets a baby shower. That’s just not right,” Thompson says. “But then I was like, ‘Well, it's better safe than sorry.’”
Like most people, Thompson now spends her days inside, unless she has to go to the store to stock up on diapers. Her last in-person appointment with her midwife was more than a month ago.
“I’m just counting down the days at this point,” she says. “I’m like, 30 more days.”
Thirty days until Thompson gives birth to a girl she’s naming Heaven Noelle. Thompson found out she was pregnant last August, three days after her 24th birthday. And she had typical first-time mom worries.
“Your body is going to do so many new things, so you don't really know what’s the outcome going to be,” Thompson said. “So I was more so nervous about, like, gestational diabetes and preeclampsia.”
A month from her due date, she has very different worries.
Thompson is giving birth as cases of COVID-19 could surge in Indiana. Now, she’s worried about what happens if she gets sick, or if her fiancé gets sick. What if something happens to baby Heaven and they have to stay in the hospital surrounded by sick people? Her childbirth class was cancelled, so she’s not sure what to expect during labor.
“I'm going in like a deer in headlights,” Thompson says.
There are still a lot of unknowns when it comes to COVID-19 and pregnancy. Pregnant women are at higher risk for complications from respiratory viruses like the flu. But there’s not enough data to say if the same is true for COVID-19. Guidelines to keep pregnant women healthy are the same as for people who aren’t pregnant.
That means social distancing. And that’s hard for people like Kelli Brien. Brien is Thompson’s doula and the founder of Mahogany Maternity, a birth service based in South Bend that offers childbirth classes and breastfeeding support.
Being a doula is hands-on work. Brien builds trust with her clients by spending time with them in person. That hasn’t been possible for weeks. Future parents she normally would meet in their homes she now sees through video calls. The birth classes Brien teaches are also virtual.
“We practice going through contractions together, you know, mock contractions,” Brien explains. “And I'm watching how she holds her body. I'm watching how she tenses ... and how she furrows her brow. So I'll do things like a very slight, gentle touch on her forehead and ask her to release her eyebrows. So not being able to actually go and practice that physically … that can be tricky.”
Brien asks parents-to-be to repeat instructions back to her, so they know what to do if she can’t be with them. Many hospitals have restricted patient visitors to limit the spread of COVID-19, and that means women who planned to have a doula and their partner with them during labor may not have that support.
And that’s what Thompson is most afraid of – that she won’t be able to have Kelli and her fiancé with her.
“That’s one thing that I can't do,” Thompson says. “Because essentially, there's no comfort zone.”
Things are even more complicated because Thompson is black. While there isn’t much known about how COVID-19 affects pregnancy, it’s well established that infant and maternal mortality rates in the U.S. are worse for black women. Black women are more than three times as likely to die in childbirth as white women, according to a report released this year by the federal Government Accountability Office.
“The issues that we're having come from lack of quality care and not being listened to. So it’s more of a risk for us not to have someone there,” says Brien, who is also black. “It raises a lot of concern for the safety of moms, not just physically but emotionally as well, when she doesn't have that support available.”
That puts physicians like Dr. Brownsyne Tucker Edmonds in a difficult spot. She’s an obstetrician-gynecologist and researcher at the Indiana University School of Medicine. She knows there is a history of institutional racism and bias in health care, and her black patients may feel uncomfortable in the hospital. And research shows having support from family and a doula can lead to more successful births, including lower rates of cesarean delivery and higher rates of breastfeeding.
“Obviously these are things that under any normal circumstance we would want people to be able to share with their loved ones,” she says. “This is a hard moment to have this totally unanticipated set of circumstances that create a lot of upheaval.”
But Tucker Edmonds says OB-GYNs have to balance patient fears with overall safety, especially while there are shortages of personal protective equipment for doctors, patients and visitors.
“In a moment where there is a fair amount of anxiety and fear because of the efforts to raise public awareness about maternal mortality ... to now be faced with these restrictions where you're going into that space that's not necessarily a trusted space … That is something that just adds another layer, that just makes this more complicated,” she says.
Thompson will give birth using a midwife at Memorial Hospital in South Bend. The plan is for her fiancé and doula to be there – as long as hospital rules don’t change.
Meanwhile, family from Chicago who planned to visit postponed their trip. Thompson says they’re upset they won’t see her growing belly, but they know staying away will keep her and her baby safe. They joke it will make a great story one day.
“She made it through a pandemic,” Thompson says with a laugh. “That'll be something you get to tell her when she gets older.”
They’re planning a baby-cue – a barbecue celebrating Heaven's birth – for this summer.
This is a rapidly evolving story, and we are working hard to bring you the most up-to-date information. However, we recommend checking the websites of the Centers for Disease Control and Prevention or your state health department for the latest guidelines to stay healthy.
This story was produced by Side Effects Public Media, a news collaborative covering public health.