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Women giving birth at two leading New York City hospital networks are being told they must labor without spouses, partners or doulas by their side — leaving the expectant mothers anxious and frightened about their upcoming deliveries.
The New York City hospital network NewYork-Presbyterian on Monday instituted one of the most restrictive visitor policies in the country for women giving birth, barring spouses, partners and other family members or outside support people, such as doulas, from the delivery room — a rule it said would help protect mothers and children during the coronavirus outbreak.
And on Monday night, Mt. Sinai Health System announced it would also bar partners and other visitors from its labor and delivery rooms, beginning on Tuesday.
“We do not take this decision lightly, but these are unprecedented times that require unprecedented steps to protect our patients, their families and their new babies,” Lucia Lee, a spokeswoman for Mt. Sinai, said in a statement.
The new rules at NewYork-Presbyterian network, where about 15,000 infants are delivered each year, started two days after the New York State Department of Health issued guidance stating that one support person could be in the delivery room during the coronavirus outbreak because a support person was “essential to patient care throughout labor, delivery and the immediate postpartum period.”
The state said the support person must be asymptomatic for Covid-19 and should be screened for any symptoms, with their temperature checked before they enter the labor and delivery floor.
Pregnant women here say they are increasingly on edge as they prepare to deliver a baby in a region that has become the epicenter of the coronavirus outbreak in the United States at a time when very little is known about how the disease affects an expectant mother or her unborn child.
“I have so much anxiety now and literally have not stopped crying after hearing that my husband can’t be with me,” said Samantha Moshen, 37, who is due in early June and plans to deliver at the Weill Cornell Medical Center, part of the NewYork-Presbyterian Hospital system. “I haven’t been able to sleep. I’ve just been a mess.”
Moshen, a prekindergarten teacher in Manhattan, said she nearly underwent an emergency C-section with the birth of her first child, a boy who is now 4, and the experience has made her fearful that something may go wrong during her second delivery.
“I was so scared — I had no idea what to do,” she said, recalling how her heart rate suddenly dropped along with her son’s during her first birth, prompting a team of doctors to rush into the room. She ended up delivering vaginally.
NewYork-Presbyterian announced on Sunday that it would be instituting the new rules, saying they were “a necessary step to promote patient safety.”
Although some doctors and hospitals told patients that they could have virtual visits from loved ones or doulas via technology like FaceTime, that offered little comfort to Moshen, who said she wanted her husband physically in the room with her.
Other women echoed the same sentiment.
“Nothing beats having the support and the love and the touch of the person you care about, that you’re creating this new family with,” said Laura Halzack, 38, who is nearly 36 weeks pregnant and will also be delivering at the Weill Cornell Medical Center.
“I grew up in a generation of women where having a partner with you is a big part of everyone’s birth story,” said Halzack, a dance teacher who also works in development for an arts organization. “That’s a moment that doesn’t happen again.”
Elsewhere in New York City, hospitals are taking a different approach, though the situation is fluid and may change rapidly. So far, N.Y.U. Langone is still allowing one support person to be in the delivery room, Deborah Haffeman, a media relations manager for the hospital, said Monday.
New York City Health and Hospitals, the city’s public hospital system, said they would allow one support person to be in the room with the patient, as long as that person is asymptomatic for Covid-19, according to Christopher Miller, a spokesman for New York City Health and Hospitals.
In other parts of the country, hospital policies have become increasingly restrictive, with hospitals reducing the number of visitors to just one person.
At UCSF Health, which on Sunday started a nationwide registry of pregnant women with suspected or confirmed Covid-19, one visitor is permitted in the labor and delivery rooms. And in Washington State, where 110 people have died from the virus, women delivering at U.W. Medicine are allowed one partner (or family member) and one support person, such as a midwife or a doula, said Dr. Catherine M. Albright, an ob-gyn at the U.W. Medical Center.
“I think there would be, especially in Washington State, a very big backlash to not allowing a support person for women in labor,” Dr. Albright said.
According to the American College of Obstetricians and Gynecologists, continuous one-to-one emotional support from someone like a doula or a relative is associated with improved outcomes for women in labor. Benefits include a lower likelihood of cesarean section, increased patient satisfaction and a shorter duration of labor.
Jo Song, who is 40 weeks pregnant and lives in New York City, had considered traveling to another state to give birth, even going so far as to reserve a rental car, she said. But after speaking Monday with her doctor at Mt. Sinai West, she and her husband have decided to stay.
Her husband, Paul Ahn, who jokingly refers to himself as a moula, or male-doula, said he was still grieving that he would miss the birth experience.
“I completely understand the policy and it makes sense,” he said. “As a dad and partner, there’s not much I could do to support my wife in the pregnancy process, and being there in labor is one of the few things that I could do, and I guess I’m just sad that I’m not able to do it.”
Bailey Nolan, 34, is having a baby girl in July and was planning to give birth at Brooklyn Methodist Hospital, part of the NewYork-Presbyterian Hospital network. She said she spent all of Monday on the phone with family members and insurance providers trying to figure out what to do.
Her plan is to drive to Philadelphia, where she has a cousin who is an obstetrician. When she is ready to deliver, they will go to the emergency room there. She said a representative for her insurance company told her that it would be difficult to switch providers and suggested this was her best option.
“I haven’t had the best experience in hospitals, and I am not going to deliver alone,” she said. “If something happens, if there is some kind of emergency, I need someone who knows me to help make decisions in a time of stress.”
She believes it is irresponsible to put women in this position.
“It is not the 1950s, you can’t just expect them to go in and sedate them and push out a baby, and then they come home and dad is there smoking a cigar,” she said. “That is not our reality anymore.”
Jesse Pournaras, a doula based in New York City, created a petition asking Gov. Andrew M. Cuomo to review the no-partners policy. The petition has received more than 200,000 signatures since it was launched.
Pournaras, who spends hours in the hospital with her clients, is concerned that the policy could increase complications for women giving birth. She fears that nurses, who are already overburdened, will not be able to fully monitor potential emergencies.
“I think it is deeply dangerous to have women laboring alone,” she said. “Yes, there are call bells and monitors, but that does not replace having someone in the room 100 percent of the time.”
She is also concerned these policies will have a greater impact on women of color.
“We see that, generally, black women are less believed when they are expressing pain or discomfort,” she said. “They receive less face to face time with care providers and nurses.”
Some women are considering the idea of home births in response to the new policies.
Susan Rannestad, a licensed midwife, said the number of calls she received for midwife services had soared since the new policy was announced.
But she warned against women deciding at the last minute to give birth at home, which she said required months of education, planning and preparation.
“I am concerned that they are not prepared,” Rannestad said. “Home birth is not like going to Walmart and buying a new blanket for your bed.”
“My clients plan their births like they plan their weddings, and the people who are calling now don’t get it,” she said.
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