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The unfortunate backlash of government and institutional policies regarding covid-19 have affected countless individuals in the United States since the pandemic began. Suicide, drug abuse, and prescriptions of depression medication are on the rise, hinting at the turmoil many Americans are facing. With the focus on preventing the spread of coronavirus, which has a mortality rate similar to that seen in a severe flu season, birthing mothers and their newborns are another group facing unintended consequences from ill-advised policies established by government administrators and hospital bureaucracies.
Birthing in the US
Even before covid, the United States suffered from one of the highest mother mortality rates among first-world nations, where more than five times the number of mothers pass away due to birth and pregnancy complications than in Italy and Denmark. Compared to the United Kingdom, approximately two and a half more moms die, according to statistics from 2015.1
The mortality rate is unfortunately growing; 13.3 deaths per 100,000 live births occurred in 2008, only to then increase to 17.4 per 100,000 births in 2018.2 A point of interest is that certain groups, namely black mothers, face a mortality rate close to four times that of their white counterparts, with the difference becoming more distinct over time.3 Recently the New York City public was reminded of this reality when Black Lives Matter protesters stood outside the Bedford-Stuyvesant Hospital, where hopeful new mother Sha-Asia Washington controversially passed away at the young age of twenty-six.4
Understanding the reasons for the disparity in birth outcomes among women residing in the US compared to those in Europe is difficult given the problems with statistical reporting. However, one notable phenomenon is that typically, one in three women give birth via cesarean compared to the WHO-recommended rate of 10–15 percent.5 While c-sections may be necessary medical interventions in many instances, the procedure tends to be associated with other risks, including surgical error, trauma to a woman’s organs, increased risk of hemorrhaging and infection, and permanent injury or death.6
New mothers, whether giving birth vaginally or through cesarean, may also face traumatic birth experiences resulting from modern medical care or negligent health practitioners. This may cause mothers to experience difficulty in bonding with their babies and can sometimes cause postpartum depression or anxiety. While recovery from birth is never easy, the birth experience itself may have long-lasting effects on both mother and baby, even if physically they are both “okay.”
Hospital Procedures during Covid
Given the reality of the prospective birth outcomes that mothers face, informed consent and a support team are crucial. Sadly, the response to coronavirus by hospitals in the pursuit of increasing safety measures may not be made with the mother in mind.
Across the country, mothers are restricted from having visitors attend the birth or may be limited to only one individual.7 Similarly, OBGYN offices tend to restrict regular maternal visits to the patient only. Given the fact that the birth partner probably lives with the patient, there is generally no increased risk from including the additional individual (who tends to be a patient’s parent or the child’s father). This restriction also tends to limit birth and well-visit attendance by a mother’s paid birth representative, her doula. Doulas are part of a mother’s support system, with the purpose of ensuring a positive pregnancy and birth experience while also helping a mother avoid unnecessary medical interventions.
These changes have had extremely personal impacts on mothers. Stories have surfaced on social media about mothers being informed of imminent miscarriage during pregnancy visits, where they received the news alone. Others have had traumatic births due to not having their full birth team or doula, leading to potentially unnecessary cesareans, which can be both physically and emotionally difficult to recover from.
Further, many hospitals have required mothers to wear masks while in labor, which restricts oxygen during a physically taxing activity which often lasts for many hours. This stipulation is problematic given the care that birthing mothers who are in pain or have faced previous abuse need, as face masks during such an ordeal can cause trauma. Similarly, other hospitals may require mothers to birth on their backs as an attempt to reduce virus exposure, but may instead increase pain and birth complications for mothers (and increase the likelihood of cesarean).
The sad reality is that most of these procedures are unnecessary given that many hospitals already screen incoming patients and that OBGYN offices often ask mothers to be tested for coronavirus prior to their expected due date. For mothers who do test positive a suggested ritual has been to separate them from their babies postdelivery. This practice may have long-term emotional and psychological effects on patients, without any substantial benefits. For mothers who desire to breastfeed, separation from their infants may decrease their ability to breastfeed successfully, a practice that is important if covid is considered a problem.8
Stop Hurting Mothers and Babies
During a pandemic, hospitals’ responses are crucial to ensuring greater quality of life during such a time as a new life entering the world. Where unscientific practices hold, the long-term personal effects will last after covid-19 becomes a memory. The trauma may be psychological, physical, or emotional when joy and peace should be the primary goal. Where applicable, the citizenry should demand that hospitals and their legislators change these practices, especially if they believe mothers’ lives matter, black lives matter, and infants’ lives matter.
For moms in the pandemic, you have patient rights, such as not being separated from your baby, not having to wear a mask while laboring, nor being forced into a back-lying position if it’s not your desire. Mothers have the right to informed consent for any medication or intervention being administered. Whichever preferences you hold to pursue the best birth experience possible, include them in your birth plan and choose a birth partner who will provide support. If applicable, you may generally change your OBGYN or hospital/birth center of delivery prior to giving birth. Some low-risk mothers have even opted for nurse midwife–assisted home births during the pandemic. Lastly, know that you are important and so incredibly strong.
- 1Nina Martin and Renee Montagne, “U.S. Has the Worst Rate of Maternal Deaths in the Developed World,” NPR (website), May 12, 2017.
- 2Ina May Gaskin, Ina May’s Guide to Childbirth (New York: Bantam Books, 2003), pp. 274–75; Gaby Galvin, “The U.S. Has a Maternal Mortality Rate Again. Here’s Why That Matters,” U.S. News and World Report, Jan. 30, 2020.
- 3Galvin, “The U.S. Has a Maternal Mortality Rate Again. Here’s Why That Matters.”
- 4Rose Adams, “Protesters Slam Bed-Stuy Hospital after Black Woman Dies during Childbirth,” Brooklyn Paper, July 9, 2020.
- 5Wealth Health Organization Department of Reproductive Health and Research, WHO Statement on Caesarean Section Rates (World Health Organization, 2015), p. 1.
- 6Gaskin, Ina May’s Guide to Childbirth, pp. 288–89
- 7Joyce Slaton, “Labor and Delivery during Coronavirus (COVID-19): What Pregnant Women Need to Know,” Baby Center, June 28, 2020.
- 8Alyson Sulaski, “AAP Updates Guidance on Newborns Whose Mothers Have Suspected or Confirmed COVID-19,” AAP News, American Academy of Pediatrics, May 21, 2020.
