Pandemic changes typical procedures throughout pregnancy, delivery
While a number of doctor’s appointments and elective procedures have been delayed during the pandemic, babies don’t stop being born.
And for pregnant mothers, the changes in procedures — and changes in reality as we once knew it to be — presents some unique challenges.
Over the course of March, April, May and June, 132 babies were delivered at UCHealth Yampa Valley Medical Center.
At the UCHealth Women’s Care Clinic, the changes also impacted the postponing of regular check-ups for all women — and anything that fell into the category of routine care.
But of course, pregnant women, especially those in the higher risk category, still required regular care.
For pregnancies that were not high risk, the typical first in-person visit and ultrasound at eight weeks was pushed back to twelve weeks, with a telehealth visit conducted at eight weeks.
Instead of seeing the woman once a month in the earlier months and every two weeks after 28 weeks, the in-person visits were staggered with telehealth visits. At 36 weeks, the women were seen weekly, as would have been the normal schedule.
One of the primary elements about those visits, described certified nurse midwife Elizabeth Kilmer-Sterling, is the ability to hear the baby’s heartbeat and measure the mom’s growth. “Those are the things that help us identify concerns,” she said. “It gives parents reassurance as well.” Kilmer-Sterling works at the UCHealth Women’s Care Clinics in Steamboat Springs and Craig.
She said it will be interesting to see if new user-friendly, cost-effective technology develops to allows for at-home heartbeat monitoring by moms.
Still, there was a lot that could be done virtually, Kilmer-Sterling explained. And that education piece was huge. They could help mom identify things like what was normal movement for the baby, and when something was abnormal.
However for moms with risk factors, in-person visits continued as often as needed.
Until about June, mothers also weren’t allowed to have anyone accompany them on their regular visits.
That part was hard, said Kolby Sumskis, who gave birth to her little girl, Kyle, on May 6.
Her partner, Casey, couldn’t join her at the last ultrasound, and “we were equally the parents — we had been doing everything together.”
Kilmer-Sterling noted that it often isn’t until the third trimester that dads truly start to “understand the reality the baby does really exist and is going to be a life changing event.”
Many moms did have partners or other family members who joined them on those ultrasounds over Skype or FaceTime. There were also moms who refused to come without their partners, she said.
Then when Sumskis’ water broke, about seven weeks early, her mother drove her to the hospital, but she had to walk into the hospital alone.
“I got through the front door and said, ‘I need to go to labor and delivery.’ They asked if I had an appointment,” Sumskis explained. She had to convince them she was in labor before being admitted.
She was then given a COVID-19 test, and no one came into her room until the results came back.
In the earlier weeks of the pandemic, Kilmer-Sterling said, there was careful rationing of personal protective equipment, and only moms who were symptomatic or had known exposure were tested.
It was a bit weird for everyone to always be in masks, Sumskis said. “It was impersonal to not see smiles on peoples faces. I wouldn’t have been able to pick the nurses out of a lineup. Everyone was so nice, but it was hard to see any facial expressions.”
Kilmer-Sterling said it’s been weird for them, too, to wear so much additional gear. And hot.
“We don’t like it, but we understand,” she said. And, going into the winter months, it’s likely to continue to be the new norm, she added.
The loneliness really set in after she gave birth, Sumskis said, and after she got home.
Each mom was allowed to have one visitor accompany her during labor, which for Sumskis was her partner.
But her mom, who lives in Steamboat and with whom she is very close, couldn’t be there to meet the baby after the delivery.
And that wasn’t for just a few days. Because Kyle was so premature, the family spent 20 days in the Neonatal Intensive Care Unit.
She was a healthy baby, Sumskis said, but needed time to learn to do the three crucial things simultaneously: suck, swallow and breathe.
Sumski’s mom — “who helps with everything” — didn’t get to see the baby for almost a month.
Kilmer-Sterling said she saw a number of families stand outside the emergency exit or outside the room’s window, getting a glimpse of the baby from a short distance. “And there was a lot of Skyping,” she said.
Overall, she said the new moms coped fairly well, all things considered.
“We live in a society where it’s expected to have visitors at birth — and a party-like atmosphere,” Kilmer-Sterling said.
But on the other hand, she noted, there were some moms who felt some relief at having the time to rest, recover and adapt, and not have to entertain guests.
Sterling-Kilmer encouraged friends and family to do other things to help out the new mom — like a load of laundry or planning meals for when they arrived home.
Another difference in procedure was an effort to get moms and babies home as quickly as possible after delivery, she said.
Of course for Sumskis, that wasn’t an option.
Sumskis and her partner were required to wear masks every time they held their own baby.
Spending all that time in the labor and delivery wing, Sumskis watched a number of things unfold.
There was the COVID-19 wing, which shrunk at one point. And at one point, there was a COVID-19 scare regarding a baby who had come from Denver and was having respiratory issues.
Sumskis remembers observing it all, “sitting there behind the thin curtain breast feeding. And just sobbing.” It was a false alarm, but added a layer of anxiety and fear, she said. And there were the hormonal changes she was experiencing.
Kilmer-Sterling said that one of the biggest concerns is for the moms going home. “They are at such a high risk of developing mood disorders,” she explained.
And amidst a pandemic, they were going home to a much more isolated environment. “Women are very socialized beings,” she said. “They talk about things and share things.” She encouraged her new moms to keep themselves busy and stay connected over technology.
Once Sumskis and her partner and new baby finally did go home, it was indeed still a bit lonely.
They were very cautious at first about visitors and allowing others to hold the baby.
But once Kyle reached her actual due date of June 25, “We lightened up a little. We felt ready to socialize more. And started seeing more and more friends. But I also have to trust my friends are educated and being safe,” Sumskis said.
And today? Kyle is doing “amazing — above and beyond.”
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The statistics are not good. Cases of sexually transmitted infections are surging, and young people are taking the brunt of this troubling trend.