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Speaker 1: Hi everyone, I'm Katie Curic, and welcome to next question today,

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Speaker 1: Giving birth and the time of coronavirus. When I walked

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Speaker 1: into the hospital, the hallways are eerily quiet. One mother

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Speaker 1: surreal experience of going it alone. You saw the doctors,

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Speaker 1: you saw security guards, and you saw cleaning staff just

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Speaker 1: really kind of giving you a nod of you got this,

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Speaker 1: but in a really powerful, yet somber and scary way. Later,

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Speaker 1: we'll check in with obstetricians in two different New York

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Speaker 1: hospitals to understand some of the biggest challenges they face

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Speaker 1: and keeping pregnant mothers safe amid COVID nineteen. When I

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Speaker 1: tell a patient that her COVID nineteen tests came back positive,

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Speaker 1: she's terrified and there's a lot of avoidance of wanting

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Speaker 1: to know the answer to that. Um So, I think

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Speaker 1: it's the biggest challenge we have is to let our

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Speaker 1: patients know that it's okay to come seek care. But first,

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Speaker 1: my next question, how do you have a baby during

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Speaker 1: a pandemic? Alicia Biggs had already given birth once nearly

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Speaker 1: two years ago, to a baby girl named Olivia, and

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Speaker 1: beyond the excitement of planning for their second child, to

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Speaker 1: take place at the same hospital and with the same doctor.

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Speaker 1: Alicia and her husband Patrick were really looking forward to

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Speaker 1: a few crucial things being different this time around. I

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Speaker 1: really wanted my my mom in the room. She wasn't

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Speaker 1: in the room for the first pregnancy, and you know,

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Speaker 1: I really wanted her there for for this one. She's

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Speaker 1: my best friend, and and just um thought the more

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Speaker 1: of the merrier for this one. And then another thing

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Speaker 1: that we thought would be really nice and special that

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Speaker 1: was a little different was in my first pregnancy, in

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Speaker 1: my delivery, I had a very healthy baby, but she

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Speaker 1: needed to go to the nick you at first. So

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Speaker 1: that initial time where you're you spend with your with

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Speaker 1: your newborn, I'm kind of on your chest, and just

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Speaker 1: with your husband and with your family and just really

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Speaker 1: relishing in the moment of what just happened. We didn't

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Speaker 1: really get because she was sent into the nick you

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Speaker 1: so fast. So we were hoping and crossing our fingers

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Speaker 1: for an easy and healthy delivery where we could have,

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Speaker 1: you know, shared that moment that people talk about all

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Speaker 1: the time. Because of the complications of Alicia's first birth

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Speaker 1: and the already large size of her second baby, Alicia's

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Speaker 1: doctor planned to have her induced on Marchy, one week

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Speaker 1: before her due date, at New York Presbyterian Hospital in Manhattan.

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Speaker 1: But as that date neared, cases of the coronavirus were

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Speaker 1: growing at alarming rates across New York City, which was

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Speaker 1: already the epicenter of the virus, and hospitals were being

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Speaker 1: forced to make some very tough decisions to prevent the

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Speaker 1: virus from spreading. The week before, we had heard looming

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Speaker 1: messages from people saying, you know, the hospitals down to

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Speaker 1: usually you can have two attendees with you, they moved

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Speaker 1: it down to one. So that means the plans changed

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Speaker 1: for my mother. But they, you know, everybody was really

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Speaker 1: messaging me saying, oh, they'll never you know, not let

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Speaker 1: your your spouse in or your they'll you always have

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Speaker 1: one person. So I kind of put it out of

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Speaker 1: my mind that was never going to happen to me.

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Speaker 1: And the Sunday prior to the delivery, so about three

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Speaker 1: days before I got a call from my doctor she said,

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Speaker 1: I have good news and I have bad news. The

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Speaker 1: good news is there's a full staff in labor and delivery,

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Speaker 1: which which really just level sets you as to what

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Speaker 1: is good news. Anymore. The bad news isn't going to

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Speaker 1: have to break it to you that you can no

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Speaker 1: longer have your husband in the room. Those are some

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Speaker 1: of the most difficult phone calls I've had to make.

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Speaker 1: Dr Alan of Brownstein is Alicia's obstetrician. When she found

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Speaker 1: out the news that New York Presbyterian Hospital had to

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Speaker 1: institute severe restrictions due to the coronavirus and was no

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Speaker 1: longer allowing any partners, family member, or outside support into

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Speaker 1: the hospital at all, much less the delivery rooms, she

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Speaker 1: immediately called her patients. They were long phone calls. I

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Speaker 1: would sit there with them. I I feel horribly that

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Speaker 1: they were not able to have that person with them,

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Speaker 1: and how upsetting disappointing that was, and they were obviously disappointed.

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Speaker 1: Um and that was not an easy conversation to have,

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Speaker 1: although I do feel like they did understand the reasons

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Speaker 1: why it was being done and how severe things had

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Speaker 1: become for the hospital to make that decision that they

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Speaker 1: couldn't have somebody there. And I would say, I'm going

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Speaker 1: to do everything I can to make this a great

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Speaker 1: experience for you, despite the fact that your husband's not

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Speaker 1: going to be there. I said, make sure you have

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Speaker 1: your laptop, your phone fired up charged. Don't forget to

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Speaker 1: bring your charge to the hospital so if it dies

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Speaker 1: during the delivery, you can still you know, charge it

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Speaker 1: up and have your husband there. You can have him

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Speaker 1: on the laptop, on FaceTime, on Zoom, on any platform

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Speaker 1: so that you can feel like he's with you as

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Speaker 1: much as possible. For Alicia, the news was devastating. I

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Speaker 1: just cried to her on the phone, Um, and she

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Speaker 1: was just unwavering in her support, saying, you you can

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Speaker 1: do this, and where you're going to do this together

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Speaker 1: and you will not be alone because I Am going

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Speaker 1: to be there the entire time and it's you know,

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Speaker 1: it's you and me and we will figure out a

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Speaker 1: way to get through this. And she said take a

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Speaker 1: day to to just figure yourself out. Patrick, where you

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Speaker 1: crushed when you heard the news, I was. I was

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Speaker 1: totally heartbroken that Sunday and Monday. It was incredibly difficult,

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Speaker 1: um and sad. But then there was a shift that

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Speaker 1: happened on kind of Monday into Tuesday before she gave

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Speaker 1: birth on Wednesday, where it was this, you know, this

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Speaker 1: was our new reality and we will we'll get through

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Speaker 1: this together as much as possible. I took a day

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Speaker 1: to be very emotional to you know, really just understand

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Speaker 1: what was going on, and then I, um, I was

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Speaker 1: a swimmer by background, uh, and really just tried to

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Speaker 1: use the tools that I had available to me, you know, mentally,

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Speaker 1: and really then said, okay, here's a day where you

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Speaker 1: get to decide how you're going to move forward, and

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Speaker 1: then really treated it as a swimming um and a

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Speaker 1: swim race, right, It's a you know, swimming is a

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Speaker 1: very individual, an individual sport that's surrounded by teammates who

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Speaker 1: support you. I met my husband while swimming, and he understands,

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Speaker 1: you know, the nuances of how I am of of

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Speaker 1: when I get into that mode. So we spent the

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Speaker 1: next days just preparing and kind of getting into that zone.

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Speaker 1: On Wednesday, March, in the darkness of the early dawn,

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Speaker 1: Patrick drove Alicia to New York Presbyterian Hospital and watched

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Speaker 1: from the car as she walked in alone. When I

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Speaker 1: walked into the hospital, the hallways are are eerily quiet

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Speaker 1: because no one needs, you know, should be walking hallways

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Speaker 1: unless they really have to. So I had my bag

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Speaker 1: and it was clear with my bump where I was going,

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Speaker 1: um and you saw the doctors, you saw security guards,

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Speaker 1: and you saw cleaning staff just really kind of giving

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Speaker 1: you a nod of you got this, but in a

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Speaker 1: really powerful yet somber and scary way. And when you

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Speaker 1: when you go immediately to sit down to check in,

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Speaker 1: they give you a mask and they need to treat

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Speaker 1: you as though you have COVID, um as though you

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Speaker 1: have the virus, and they test you immediately when you

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Speaker 1: get into the room, and then you we I didn't

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Speaker 1: know results for twelve hours after that. Um, So your

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Speaker 1: tense because you're having a baby, but you're you're also

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Speaker 1: just tense because you don't know if you have COVID.

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Speaker 1: You don't know if the nurses around you might have,

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Speaker 1: you know, gotten it. So you're everybody's you know, protecting

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Speaker 1: themselves for the greater benefit of everybody, right, But it's

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Speaker 1: just really scary. So I didn't find out until right

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Speaker 1: before I pushed that I had tested negative, which I

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Speaker 1: was just you know, very tense about and you know,

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Speaker 1: continue to tell Pat what if I have I was

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Speaker 1: I was getting more stressed about having COVID than I

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Speaker 1: was about delivering the baby. Um At first, the whole

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Speaker 1: thing sounds ridiculously stressful. Just hearing you talk about it,

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Speaker 1: it's making me feel anxious. Yeah, no, it was. It

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Speaker 1: was anxious. It was, it was. It was really anxious.

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Speaker 1: I mean some of the you know, beautiful things that

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Speaker 1: had come out of it was you know, um, just

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Speaker 1: understanding what the nurses are and the doctors are putting

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Speaker 1: them how they're putting themselves out there to make you

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Speaker 1: feel comfortable. So they you know, I walked in and

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Speaker 1: they said they gave me a letter, a handwritten letter

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Speaker 1: signed by all the nurses saying you're not alone, and

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Speaker 1: you're going to prove to yourself how strong we already

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Speaker 1: know you are, and we're here for every step of

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Speaker 1: the way. And you know, everything was just so powerful

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Speaker 1: that you're you're emotional and you're crying, but because you're

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Speaker 1: you know, partially sad, partially scared, but partially you know,

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Speaker 1: you're empowered to to get through this, and you just

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Speaker 1: have one choice and you have to just get to

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Speaker 1: the other side and decide, you know, I can either

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Speaker 1: I need to make this a positive experience. So I

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Speaker 1: um and they did a great job for me too,

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Speaker 1: because the way we had it set up was I

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Speaker 1: had an iPad A. Alicia had an iPad and we

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Speaker 1: basically space time uninterrupted for thirteen hours, and so she

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Speaker 1: had it on a little table with her that could

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Speaker 1: move UM, and the nurses and the doctors talked to

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Speaker 1: me as if I was in the room the entire time.

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Speaker 1: They're saying, Okay, we're gonna do this. We're doing this, um,

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Speaker 1: you know, here going to take her medicine up to

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Speaker 1: this level. So they did a very um amaze job

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Speaker 1: of making me feel a part of the entire process,

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Speaker 1: even though I was They're virtually on an iPad, Alicia,

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Speaker 1: I wanted to go back and ask you about the delivery.

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Speaker 1: Did the doctors and nurses look like they were dressed

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Speaker 1: for some kind of chemical spill? I mean, was that

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Speaker 1: a strange experience for you versus seeing their faces? Right?

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Speaker 1: It was? You know, they're in there in full there

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Speaker 1: in masks. They're also in a shield. Um, they're in

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Speaker 1: full gloves. You know, you can it's it's hard to

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Speaker 1: to necessarily get out their demeanor, you know, other than

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Speaker 1: verbally and and really through their eyes. So you had

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Speaker 1: it was that's what made it so scary until I

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Speaker 1: knew that I had tested negative for COVID. It was.

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Speaker 1: It was a really scary time, which I think helped

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Speaker 1: with you know, the handwritten letter and just really trying

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Speaker 1: to read people's eye contact. And but it was a

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Speaker 1: unique experience, and luckily I had a doctor who had

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Speaker 1: been my doctor this entire time through you know, my

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Speaker 1: first birth and also all my appointments of my second birth,

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Speaker 1: and her comfort. You know, at one point I got quite,

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Speaker 1: you know, just I just lost, I got my my

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Speaker 1: emotions got the better of me, and I you know,

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Speaker 1: I just was crying because this was all just a lot,

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Speaker 1: and you know, she came in and you know, gave

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Speaker 1: me that look of we we had we're going to

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Speaker 1: do this and we're going to get through this, and

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Speaker 1: you know, you're you're tough, and you just we're going

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Speaker 1: to be tough together. And so that was really nice.

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Speaker 1: And so I tried to make it also, you know,

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Speaker 1: a lighter experience in in terms of they also saw

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Speaker 1: how petrified I was so trying to combat that. I

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Speaker 1: brought in plastic wrapped COVID approved sweat bands so that

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Speaker 1: they could undo them, um and so that you know,

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Speaker 1: the nurses and the doctor when we were you know,

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Speaker 1: going through labor could could see that I was this,

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Speaker 1: you know, this can be fun and this is a

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Speaker 1: you know, bring it back to that, this is an

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Speaker 1: amazing experience. So we all did wear sweatbands during the delivery.

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Speaker 1: Dr Brownstein, what was it like for you helping Alicia.

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Speaker 1: Luckily it was her second child, so she wasn't you know,

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Speaker 1: it wasn't her first rodeo, but it still must have

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Speaker 1: been pretty stressful. Can you describe what that delivery was like? Right? Well,

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Speaker 1: she had her husband on the laptop the entire time.

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Speaker 1: I felt like he was there. I had regular conversations

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Speaker 1: with her throughout the entire labor process, and I would

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Speaker 1: just talk directly to him. Um. We tried to make

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Speaker 1: him as included as possible and just feel like he

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Speaker 1: was just another person in the in the room. She

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Speaker 1: was very funny. She said, you know, usually, you know,

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Speaker 1: Patrick is here with me, and last delivery we had

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Speaker 1: him were the headband for it, and we were both

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Speaker 1: wearing the headband together, and she whipped out these brand

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Speaker 1: new headbands for me and the nurse and she said,

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Speaker 1: would you be willing to please by or these headbands?

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Speaker 1: It makes me feel like Patrick is here and in

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Speaker 1: the room, and we always like absolutely so the nurse

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Speaker 1: and I were wearing our matching headbands along with Alicia

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Speaker 1: and going through the whole process and pushing them. We

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Speaker 1: got pictures of us all with our headbands on, and

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Speaker 1: it just made it more fun and inclusive, and Patrick

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Speaker 1: felt like he was there and we were just trying

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Speaker 1: to be as importive and as there for her as

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Speaker 1: you could possibly be. How long were you in labor, Alicia?

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Speaker 1: So I was in labor for about thirteen hours. The

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Speaker 1: labor and delivery part was went by really fast because

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Speaker 1: you had all of the support of the of of everybody,

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Speaker 1: and you know it's building up to this one moment

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Speaker 1: and then you know the post. The post twenty four

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Speaker 1: hours and forty eight hours after is I think the

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Speaker 1: hardest part too, where you just feel loneliness and being

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Speaker 1: scared because you're sitting with your you're sitting alone with

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Speaker 1: your thoughts and um, you have a roommate, but everyone's

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Speaker 1: really scared to to, you know, even talk to each other. Yeah,

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Speaker 1: So it's just it's it's an interesting environment. What was

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Speaker 1: it like for you, Pat to see your son on

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Speaker 1: that iPad screen? It was surreal for sure. I mean

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Speaker 1: it was, you know, again, not what you had anticipated. Um, so,

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Speaker 1: you know, after he was born, they bring them over

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Speaker 1: to the heating table to do measurements and all those things,

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Speaker 1: and so they picked up the iPad and brought me

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Speaker 1: over there. So they made me feel the entire time

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Speaker 1: like I was part of the process. And then the

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Speaker 1: picking up at the hospital the next day, it was

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Speaker 1: very special to just you know, Alicia was on the

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Speaker 1: wheelchair with Jack with a blanket over her, and so

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Speaker 1: she had the blanket over him basically until she got

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Speaker 1: to the car and then, um, you know, to see

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Speaker 1: him for the first time and to hold him and

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Speaker 1: to put him in the car seat. That would be

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Speaker 1: a moment that will have kind of etched in my

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Speaker 1: brain forever, that first time medium outside the hospital Alicia

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Speaker 1: and patted. Just a few days after you had to

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Speaker 1: go through this, Governor Cuomo announced an executive order that

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Speaker 1: rescinded these restrictions so that hospitals in New York allowed

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Speaker 1: women to have one support partner present during their births.

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Speaker 1: So did you feel like, gosh, uh, why the heck

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Speaker 1: did I end up in this window? I did think

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Speaker 1: it was funny timing. I'm hoping I have, we have

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Speaker 1: some delayed good karma hanging over us in the future.

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Speaker 1: But I was, I was, you know, being a second

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Speaker 1: time mother. I was happy that it was me who

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Speaker 1: has had the benefit and you know, the fortune to

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Speaker 1: have a delivery with my husband, and during times like this,

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Speaker 1: it makes you realize just you know, what's important, and

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Speaker 1: I was happy to take that place for someone other

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Speaker 1: than a first time mom, because that's a really it's

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Speaker 1: it's scary, it's lonely, and you know, doing it when

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Speaker 1: you have no idea what's going on once you give

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Speaker 1: birth is just frightening. So I'm I'm really glad that

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Speaker 1: it happened to me versus some of my other close

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Speaker 1: friends who were um first time mom's delivering very shortly

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Speaker 1: after that, and luckily was the band was lifted. Congratulations

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Speaker 1: to Alicia and Patrick Biggs, to big sister Olivia, and

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Speaker 1: of course too little Jack Biggs, who will have one

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Speaker 1: hell of a birth story to tell when we come back.

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Speaker 1: Dr Alana Brownstein on what we know so far about

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Speaker 1: pregnancy and COVID nineteen. One of the many things we

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Speaker 1: don't yet know about COVID nineteen is how the virus

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Speaker 1: affects pregnant women and their babies, So we wanted to

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Speaker 1: talk to a few obstetricians about what they are seeing

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Speaker 1: as well as how their hospitals and pregnant patients are

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Speaker 1: experiencing all this. We started New York Presbyterian Hospital with

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Speaker 1: Dr Alana Brownstein, the o B we heard from at

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Speaker 1: the beginning of the episode. A few things to note

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Speaker 1: about New York Presbyterian Hospital. It is massive, with multiple

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Speaker 1: campuses across the New York metropolitan area. It's also one

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Speaker 1: of the most prominent hospitals, ranked number five in the country.

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Speaker 1: Dr Brownstein delivers out of the hospital's location on the

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Speaker 1: Upper East Side of Manhattan, a community that's overwhelmingly white

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Speaker 1: and ensured. Dr Brownstein answers a few medical questions first

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Speaker 1: and then walks us through what labor and delivery looks

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Speaker 1: like right now where she practices. What physiological changes and

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Speaker 1: biological changes occurred during pregnants that could in fact make

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Speaker 1: pregnant women more susceptible to certain viruses if not COVID nineteen,

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Speaker 1: it's too soon to tell, but can you explain what

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Speaker 1: happens to women that could put them at greater risks?

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Speaker 1: So we know that pregnant women are at a relative

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Speaker 1: immune suppressed state um in parts so that the the

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Speaker 1: mother's body can accept to feed us in their body

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Speaker 1: which is not their own cells. So we know that

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Speaker 1: it is decreased in certain ways like that. We also

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Speaker 1: know that certainly any bodies that they have can be

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Speaker 1: in lower tighters just because of the plasma volume expansion

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Speaker 1: that happens naturally in pregnancy. So it is theoretical possible

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Speaker 1: that your immune systems decrease could make you more susceptible

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Speaker 1: to certain viruses and make that disease much worse in

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Speaker 1: pregnancy than not. We just need more time to know

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Speaker 1: iff that's the case for COVID nineteen or not. But

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Speaker 1: in Layman's terms, you're saying that the expansion of the

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Speaker 1: baby can decrease lung capacity just because it's pushing up

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Speaker 1: on the lungs right, So later in pregnancy, especially where

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Speaker 1: there's a whole fetus in the in that cavity, it

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Speaker 1: can make it difficult for the lungs or expand more,

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Speaker 1: which also sometimes can make it more difficult to know

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Speaker 1: who has it or not. Because when you talk about

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Speaker 1: some of the symptoms of COVID nineteen and you talk

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Speaker 1: about respiratory changes, well, feeling short of breath is a

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Speaker 1: very common symptom of normal pregnancy, So that can make

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Speaker 1: it a little bit more challenging to figure out what

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Speaker 1: it is because your respiratory rate is faster, and certainly

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Speaker 1: you feel more breathless. It's harder to um take a

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Speaker 1: deep breath, and it's harder to feel like your lungs

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Speaker 1: are fully expanding because of that fetus in that area.

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Speaker 1: What happens when a pregnant woman comes in now to

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Speaker 1: your hospital is she immediately tested for COVID nineteen. So

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Speaker 1: any woman that is coming onto the unit gets a

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Speaker 1: mask right away. Um. If the patient is admitted to

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Speaker 1: the hospital, then she is immediately tested. If somebody comes

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Speaker 1: in and is not admitted, then they are not tested

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Speaker 1: for For example, if a woman thinks that her water

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Speaker 1: broke and she's coming in and she's evaluated and it

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Speaker 1: turns out that her water didn't break, she's sent out.

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Speaker 1: We don't test that person for COVID. If the patient

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Speaker 1: is admitted for whatever reason it is, whether it's labor,

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Speaker 1: preternal labor, any other condition going on obstetrically, that patient

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Speaker 1: is tested for COVID. It does take a few hours

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Speaker 1: before we get the test back, So we essentially just

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Speaker 1: treat everybody like they're positive UM, and then anything obstetrically

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Speaker 1: is done as it normally would be. If she's in labor,

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Speaker 1: we're managing her labor. She wants pay medicine, she gets

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Speaker 1: pay medicine. That part doesn't change. It's really more of

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Speaker 1: UM whether or not she is positive in what that

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Speaker 1: means for her, the delivery and for the baby afterwards.

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Speaker 1: But everybody on the unit has a mask on. We're

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Speaker 1: wearing gloves for everybody, and that's the same across the board.

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Speaker 1: If we know if somebody who might be positive UM,

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Speaker 1: we try to call ahead to the hot spook. I

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Speaker 1: know I have a patient that's coming in that either

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Speaker 1: I suspect as positive, I know is positive, or any

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Speaker 1: inkling of that. We make sure we call ahead, We

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Speaker 1: have a room waiting for them, and we make sure

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Speaker 1: that they are isolated. What kinds of concerns are raised?

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Speaker 1: Dr Brownstein if pregnant woman about to give birth test positive,

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Speaker 1: other than protecting the staff members, is there any risk

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Speaker 1: to her baby? Is their risk to her in terms

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Speaker 1: of the delivery, etcetera. So for the delivery part, we

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Speaker 1: deliver them as we would regardless of their COVID status,

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Speaker 1: meaning if they are going to have a vaginal delivery,

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Speaker 1: they can have a vaginal delivery. If they're going to

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Speaker 1: have a c section, they can. For the baby, the

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Speaker 1: concern is we want to make sure that it doesn't

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Speaker 1: get transmitted to the baby. So currently it does not

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Speaker 1: appear that there's vertical transmission, meaning that the baby would

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Speaker 1: get the virus just from being inside the mom um.

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Speaker 1: So it's thought that for the actual delivery process they

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Speaker 1: can deliver as they normally would. It's more of a

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Speaker 1: question for postpartum. The babies are not taken away from

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Speaker 1: the moms, so that's the question. I get a lot,

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Speaker 1: is my baby taken away from me? If I'm positive.

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Speaker 1: We generally don't take the baby away from the mom.

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Speaker 1: The mom the baby can still be with the mother,

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Speaker 1: but we do try to make sure that the mom

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Speaker 1: is wearing a mass mom's wearing gloves. We're not having

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Speaker 1: that direct contact that that baby might get it from

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Speaker 1: the mother. After the delivery, you're not concerned that the

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Speaker 1: baby could become infected out of utera. So we are

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Speaker 1: and not necessarily just during that delivery, but we're concerned

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Speaker 1: with contact with the mom afterwards that even the mom

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Speaker 1: just holding the baby. You know, the first thing you

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Speaker 1: want to do is when you get your newborn is

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Speaker 1: hold it tight, kiss at snugglet be very close to it.

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Speaker 1: But all of those things, the baby could get COVID

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Speaker 1: from that. So generally what they're trying to do is

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Speaker 1: have the baby be with the mom, but still maintain

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Speaker 1: that distancing, so being six freed away. If the mom

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Speaker 1: chooses to breastfeed, then the mom can breastfeed. However, we

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00:23:00,240 --> 00:23:02,399
Speaker 1: try to wash the breast off. We try to make

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Speaker 1: sure the mom has washed our hands. We want to

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Speaker 1: make sure there's the mom is wearing a mass the

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Speaker 1: entire time so she's not breathing directly on it or

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Speaker 1: the other optionism mom can express breast milk and then

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Speaker 1: somebody else can feed the baby the breast milk if

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Speaker 1: they want to do it that way, because there is

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Speaker 1: a concern that it could be transmitted to the baby,

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Speaker 1: not in utero, but afterwards just having the contact with

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Speaker 1: the mother, so we do try to limit that contact.

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Speaker 1: But it's not like the mom can't be in the

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Speaker 1: same room as the baby. I think that concern of

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Speaker 1: having your baby physically taken away from you to another room.

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Speaker 1: That is very concerning. What about having mothers give birth

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Speaker 1: prematurely or early because of their COVID symptoms and concerns

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Speaker 1: about their health and potentially the baby's health. So there

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Speaker 1: are some situations or the mom just are so sick

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Speaker 1: that they have to do that. We generally try to

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Speaker 1: hold off on doing that if we could, just for

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Speaker 1: the baby's health. UM, We'll try to get the baby

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Speaker 1: at least to either like thirty two or thirty four

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Speaker 1: weeks ges station if we have to do that, because

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Speaker 1: there's such significant morbidity UM for the baby before that

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Speaker 1: gestational age. But there are situations where moms are that

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Speaker 1: sick that they do have to convert over and decide

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Speaker 1: to deliver the baby early for the moms health. What

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Speaker 1: about during pregnancy? I was getting a lot of questions,

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Speaker 1: and I'm not a doctor with pregnant women very concerned

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Speaker 1: if they got COVID ninety obviously for themselves, but very

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Speaker 1: concerned about the health of their babies developmentally. What do

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00:24:32,000 --> 00:24:35,879
Speaker 1: we know about that? Great questions? So very little, only

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00:24:35,960 --> 00:24:38,640
Speaker 1: that again it's so early that we don't have patients

433
00:24:38,640 --> 00:24:40,760
Speaker 1: that have had it very early in the pregnancy and

434
00:24:40,800 --> 00:24:43,440
Speaker 1: then carried food a term. Yet, just because it hasn't

435
00:24:43,440 --> 00:24:46,119
Speaker 1: been around that long so far, it seems that there

436
00:24:46,200 --> 00:24:49,560
Speaker 1: might be a high risk for preterm delivery. UM, we

437
00:24:49,640 --> 00:24:51,880
Speaker 1: are concerned about whether or not there could be an

438
00:24:51,880 --> 00:24:56,359
Speaker 1: increased risk of either miscarriage or congenital adormalities. But we

439
00:24:56,440 --> 00:24:59,679
Speaker 1: haven't seen that yet. UM, it's certainly a concern, and

440
00:24:59,760 --> 00:25:03,119
Speaker 1: we're we're getting our huge registry of pregnant women to

441
00:25:03,160 --> 00:25:06,400
Speaker 1: see something that we can follow out over time. It's

442
00:25:06,440 --> 00:25:08,800
Speaker 1: just too early to know. We're also concerned about the

443
00:25:08,800 --> 00:25:10,840
Speaker 1: growth of the baby, so we want to make sure

444
00:25:10,840 --> 00:25:13,760
Speaker 1: if the mom is infected as the baby growing well,

445
00:25:14,040 --> 00:25:17,320
Speaker 1: so they have to have ways to monitor that as well.

446
00:25:17,640 --> 00:25:20,800
Speaker 1: We haven't seen it yet, but again only because those

447
00:25:20,800 --> 00:25:23,920
Speaker 1: are things that take while to actually develop into see

448
00:25:24,000 --> 00:25:26,840
Speaker 1: and it just hasn't been amount enough to see. I

449
00:25:26,880 --> 00:25:31,040
Speaker 1: wanted to ask you about maternal mortality. We did two

450
00:25:31,080 --> 00:25:36,080
Speaker 1: episodes on maternal mortality, which we're holding for later, but

451
00:25:36,160 --> 00:25:40,119
Speaker 1: it's very concerning. There are something like seven hundred to

452
00:25:40,240 --> 00:25:45,640
Speaker 1: nine women dying from pregnancy or childbirth every single year

453
00:25:45,640 --> 00:25:48,960
Speaker 1: in this country. Not to mention the fifty thousand women

454
00:25:49,000 --> 00:25:53,119
Speaker 1: every year who almost die. So how concerned are you

455
00:25:53,160 --> 00:25:58,520
Speaker 1: about the impact of COVID nineteen on this skyrocketing maternal

456
00:25:58,600 --> 00:26:02,560
Speaker 1: mortality rate. I think it goes back to we need

457
00:26:02,640 --> 00:26:05,360
Speaker 1: to make sure that our patients have access, that they

458
00:26:05,400 --> 00:26:07,840
Speaker 1: can be seen, that they can get to a hospital

459
00:26:07,880 --> 00:26:10,320
Speaker 1: that can care for them, because that is going to

460
00:26:10,359 --> 00:26:13,040
Speaker 1: make the difference of how they do and how their

461
00:26:13,080 --> 00:26:16,359
Speaker 1: their babies do. And it's very concerning, and this is

462
00:26:16,400 --> 00:26:19,800
Speaker 1: just one more, one more layer of things that can

463
00:26:19,840 --> 00:26:21,640
Speaker 1: make it harder for those women to get the good

464
00:26:21,680 --> 00:26:25,119
Speaker 1: care that they need. The doctors we spoke to for

465
00:26:25,240 --> 00:26:29,360
Speaker 1: our maternal mortality Episodes also said it can be crucial

466
00:26:29,400 --> 00:26:32,240
Speaker 1: to have support for the mother. There's not only before

467
00:26:32,240 --> 00:26:36,600
Speaker 1: and during the pregnancy, but afterwards, since so many complications

468
00:26:36,640 --> 00:26:40,400
Speaker 1: can happen after the baby is born and hospitals are

469
00:26:40,440 --> 00:26:43,600
Speaker 1: so focused on the health of the baby. What are

470
00:26:43,600 --> 00:26:46,159
Speaker 1: your thoughts there, But there's a lot of things that

471
00:26:46,200 --> 00:26:49,560
Speaker 1: can happen postpartum um. It's not over once that baby

472
00:26:49,560 --> 00:26:54,080
Speaker 1: comes out. You know, people can have um bleeding issues postpartum.

473
00:26:54,160 --> 00:26:56,920
Speaker 1: You can get pre aclamps to a blood pressure issues

474
00:26:57,240 --> 00:27:00,199
Speaker 1: postpartum um. There's a lot of things that if you

475
00:27:00,240 --> 00:27:03,200
Speaker 1: don't have somebody who one knows about it you can

476
00:27:03,200 --> 00:27:05,480
Speaker 1: help take care of you. And three recognizing and get

477
00:27:05,520 --> 00:27:09,280
Speaker 1: you to your hospital can be major issues. UM and

478
00:27:09,320 --> 00:27:11,560
Speaker 1: I think that is a huge problem having that support.

479
00:27:11,760 --> 00:27:14,120
Speaker 1: It doesn't end once that baby comes out. It really

480
00:27:14,160 --> 00:27:17,120
Speaker 1: goes into the whole hours partum care period as well.

481
00:27:17,320 --> 00:27:21,320
Speaker 1: Can tell a medicine be helpful in that regard for

482
00:27:21,440 --> 00:27:24,199
Speaker 1: women who have given birth but may not have as

483
00:27:24,280 --> 00:27:29,120
Speaker 1: much access to top medical care. I think that we're

484
00:27:29,160 --> 00:27:31,560
Speaker 1: seeing the role that telemedicine can play. I think it's

485
00:27:31,640 --> 00:27:35,159
Speaker 1: really been shot into the spotlight with everything going on

486
00:27:35,200 --> 00:27:37,639
Speaker 1: here where we're trying to keep people at home. UM,

487
00:27:37,720 --> 00:27:39,680
Speaker 1: there are a lot of things that you can assess

488
00:27:39,800 --> 00:27:43,320
Speaker 1: over the telemedicine visits. You can't do everything, but you

489
00:27:43,359 --> 00:27:46,119
Speaker 1: can see the patient, you know. I'll have visits with

490
00:27:46,160 --> 00:27:48,520
Speaker 1: my patients who all have them show me their own decision,

491
00:27:48,720 --> 00:27:50,919
Speaker 1: you know, have you know, show me what that bleeding

492
00:27:51,040 --> 00:27:53,919
Speaker 1: is looking like. I have patients get blood pressure monitors

493
00:27:53,960 --> 00:27:56,920
Speaker 1: at home. I have them take their bloo pressure at home,

494
00:27:57,240 --> 00:27:59,240
Speaker 1: show me what it shows like, show me what that

495
00:27:59,320 --> 00:28:02,040
Speaker 1: number is, and then I can try to do an

496
00:28:02,080 --> 00:28:04,600
Speaker 1: assessment whether that's somebody who needs to come in, or

497
00:28:04,600 --> 00:28:06,720
Speaker 1: whether that's something I can just speak to them at home.

498
00:28:06,840 --> 00:28:09,840
Speaker 1: So it certainly can help, especially in this day and

499
00:28:09,880 --> 00:28:12,560
Speaker 1: age or trying to not have people come in. I

500
00:28:12,600 --> 00:28:14,280
Speaker 1: think there is a lot of information you can get

501
00:28:14,280 --> 00:28:19,040
Speaker 1: with a telemedicine visit. What's your advice, Dr Brownstein for

502
00:28:19,960 --> 00:28:23,760
Speaker 1: pregnant women right now, with no end in sight, what

503
00:28:23,920 --> 00:28:27,800
Speaker 1: would you tell your patients that might help pregnant women everywhere?

504
00:28:28,320 --> 00:28:30,600
Speaker 1: I think the most important thing is what we're telling

505
00:28:30,760 --> 00:28:34,200
Speaker 1: all people right now, which is make sure that you're

506
00:28:34,280 --> 00:28:38,360
Speaker 1: practicing the social distancing, make sure you're performing hand hygiene

507
00:28:38,800 --> 00:28:41,600
Speaker 1: where we're a mask, we're a protective gear. If you're

508
00:28:41,600 --> 00:28:45,240
Speaker 1: going out, try to distance yourself from everybody. Um, those

509
00:28:45,240 --> 00:28:48,600
Speaker 1: are the things that seem to be working. And I

510
00:28:48,640 --> 00:28:52,360
Speaker 1: feel like for the pregnant patients, especially where there's already

511
00:28:52,480 --> 00:28:55,360
Speaker 1: a high anxiety and a concern about this pregnancy, to

512
00:28:55,440 --> 00:28:57,320
Speaker 1: try to protect themselves as much as they can, This

513
00:28:57,400 --> 00:28:59,960
Speaker 1: is a great time to kind of stay inside corn

514
00:29:00,000 --> 00:29:02,120
Speaker 1: teen and keep your distance from people as much as

515
00:29:02,120 --> 00:29:04,400
Speaker 1: you can for your own protection and for that of

516
00:29:04,480 --> 00:29:12,560
Speaker 1: your baby as well. Just across the East River from

517
00:29:12,680 --> 00:29:17,160
Speaker 1: Dr Brownstein is the Elmhurst Hospital Center in Queens, a

518
00:29:17,280 --> 00:29:21,000
Speaker 1: public hospital that has about five hundred and forty beds

519
00:29:21,400 --> 00:29:27,880
Speaker 1: to New York Presbyterians hundred plus. It's located in Jackson Heights, Queens,

520
00:29:27,920 --> 00:29:31,479
Speaker 1: which is the most ethnically diverse neighborhood in the country.

521
00:29:32,120 --> 00:29:35,120
Speaker 1: It's a very underserved community and the community right now

522
00:29:35,480 --> 00:29:37,520
Speaker 1: is being hit very, very hard by the COVID epidemic.

523
00:29:37,960 --> 00:29:42,160
Speaker 1: Dr Tracy bone Hemmerdinger is the chief of Obstetrics at Elmhurst.

524
00:29:42,440 --> 00:29:45,920
Speaker 1: The population that we generally see at Elmhurst is mixed

525
00:29:45,920 --> 00:29:51,760
Speaker 1: community of new immigrants. UM. We see all different ethnic backgrounds. UM.

526
00:29:51,880 --> 00:29:55,440
Speaker 1: The number one language spoken is Spanish, followed I think

527
00:29:55,520 --> 00:29:59,320
Speaker 1: very closely by Bengali UM. And I think that a

528
00:29:59,320 --> 00:30:01,200
Speaker 1: lot of the patient is that we see fall into

529
00:30:01,240 --> 00:30:05,360
Speaker 1: the category of people who can't social distance because they

530
00:30:05,400 --> 00:30:08,000
Speaker 1: live with large numbers of people in their homes, people

531
00:30:08,000 --> 00:30:10,320
Speaker 1: who are responsible for caring for not only many children,

532
00:30:10,360 --> 00:30:13,560
Speaker 1: but also their parents and their extended family UH. And and

533
00:30:13,320 --> 00:30:17,800
Speaker 1: and people whose jobs are either domestic workers or you know,

534
00:30:18,000 --> 00:30:20,800
Speaker 1: people whose jobs and livelihood may be cut off completely

535
00:30:20,840 --> 00:30:24,800
Speaker 1: and not have any access to their regular daily needs.

536
00:30:25,040 --> 00:30:26,960
Speaker 1: And so I think that that puts them at significant

537
00:30:27,040 --> 00:30:29,720
Speaker 1: risk for any illness. Elm Hurst has been called the

538
00:30:29,760 --> 00:30:34,320
Speaker 1: epicenter of the epicenter of coronavirus cases, the ground zero

539
00:30:34,440 --> 00:30:37,720
Speaker 1: of the epidemic. The fact is Elmer's was one of

540
00:30:37,720 --> 00:30:41,520
Speaker 1: the first hospitals hit by corona and it was hit hard.

541
00:30:42,000 --> 00:30:44,600
Speaker 1: Elmhurst runs at capacity, so I believe it was running

542
00:30:45,880 --> 00:30:49,560
Speaker 1: capacity before the epidemic, and so that's why it became

543
00:30:49,600 --> 00:30:51,720
Speaker 1: so difficult, because we needed to figure out ways to

544
00:30:51,760 --> 00:30:54,040
Speaker 1: structurally change our hospital to be able to take care

545
00:30:54,080 --> 00:30:56,760
Speaker 1: of all of our patients. The very beginning of this,

546
00:30:56,840 --> 00:30:59,200
Speaker 1: nobody really knew what was going on and what was happening.

547
00:30:59,720 --> 00:31:02,080
Speaker 1: We got at a lot of patients presented and they

548
00:31:02,120 --> 00:31:04,280
Speaker 1: didn't know what they were supposed to say or do.

549
00:31:04,400 --> 00:31:06,040
Speaker 1: We didn't know what we're supposed to say or do.

550
00:31:06,600 --> 00:31:09,560
Speaker 1: The recommendations from the CDC and from the New York

551
00:31:09,640 --> 00:31:12,880
Speaker 1: City officials and the New York State officials were changing

552
00:31:12,920 --> 00:31:14,880
Speaker 1: every couple of hours, and I would come up with

553
00:31:14,960 --> 00:31:16,560
Speaker 1: some kind of a protocol and then it would have

554
00:31:16,600 --> 00:31:19,960
Speaker 1: to be changed. And it was very frustrating and difficult

555
00:31:20,160 --> 00:31:22,480
Speaker 1: on both sides. On the patient side, and not even

556
00:31:22,480 --> 00:31:24,520
Speaker 1: just the patient side. The family members of the patients,

557
00:31:24,600 --> 00:31:27,880
Speaker 1: especially for pregnant women, which is what I deal with UM.

558
00:31:28,000 --> 00:31:29,920
Speaker 1: And now I would say we're a few weeks into it.

559
00:31:30,000 --> 00:31:32,480
Speaker 1: We really got this down and we know how to

560
00:31:32,480 --> 00:31:34,600
Speaker 1: manage it. And I think that a lot of our

561
00:31:34,600 --> 00:31:37,200
Speaker 1: patients initially were very afraid to come to the hospital,

562
00:31:37,560 --> 00:31:40,040
Speaker 1: especially because of all the news the elm Hurst Hospital

563
00:31:40,080 --> 00:31:42,160
Speaker 1: has been on the news because we've gotten hit so hard.

564
00:31:42,480 --> 00:31:45,320
Speaker 1: And now, UM, I think they feel more comfortable. Are

565
00:31:45,320 --> 00:31:47,080
Speaker 1: our senses is starting to come up. Our patients are

566
00:31:47,080 --> 00:31:49,760
Speaker 1: more comfortable coming in, and our outcomes are very good.

567
00:31:50,080 --> 00:31:53,440
Speaker 1: Dr Bones says half the battle was working out the logistics.

568
00:31:53,760 --> 00:31:55,960
Speaker 1: There was a lot the hospital had to figure out

569
00:31:56,120 --> 00:31:59,800
Speaker 1: and figure out fast when it came to managing incoming

570
00:32:00,040 --> 00:32:05,360
Speaker 1: COVID or suspected COVID cases. With exceptions like labor delivery

571
00:32:05,400 --> 00:32:11,000
Speaker 1: and postpartum. Elmhurst is now almost entirely devoted to COVID care.

572
00:32:11,640 --> 00:32:13,440
Speaker 1: The physical space was something we had to figure out

573
00:32:13,480 --> 00:32:15,280
Speaker 1: how to use and our staff as well. So we

574
00:32:15,360 --> 00:32:18,480
Speaker 1: have a triage area that has seven beds for triage,

575
00:32:18,480 --> 00:32:20,160
Speaker 1: and we had to put up a wall so that

576
00:32:20,200 --> 00:32:22,680
Speaker 1: we could have COVID patients on one side. And non

577
00:32:22,680 --> 00:32:24,240
Speaker 1: COOVID patients on another side. And then we had to

578
00:32:24,280 --> 00:32:26,240
Speaker 1: do the same thing in our post anesthesia care unit

579
00:32:26,280 --> 00:32:27,880
Speaker 1: after c sections, we had to put up a wall

580
00:32:28,200 --> 00:32:30,440
Speaker 1: to separate an area where we could put COVID patients

581
00:32:30,520 --> 00:32:34,560
Speaker 1: or suspected COVID patients and non COVID patients, um, you know,

582
00:32:34,600 --> 00:32:36,800
Speaker 1: and then who could go into those rooms versus who

583
00:32:36,800 --> 00:32:38,640
Speaker 1: can who has to go into an isolation room someone

584
00:32:38,720 --> 00:32:41,120
Speaker 1: actively coughing with a high fever, whether or not we

585
00:32:41,160 --> 00:32:44,480
Speaker 1: have a positive test that patients probably should be isolated, UM,

586
00:32:44,520 --> 00:32:46,680
Speaker 1: and so figuring out where we can put those people

587
00:32:46,720 --> 00:32:50,080
Speaker 1: and not overrun our our service. And obviously staff has

588
00:32:50,080 --> 00:32:54,160
Speaker 1: been affected. UH, nurses and doctors and resident doctors have

589
00:32:54,360 --> 00:32:58,360
Speaker 1: all been hit, and we've had many many providers get

590
00:32:58,360 --> 00:33:02,360
Speaker 1: sick and be out for sometime, and so that puts

591
00:33:02,400 --> 00:33:07,080
Speaker 1: a strain on everything, UM. And so streamlining the system

592
00:33:07,160 --> 00:33:10,560
Speaker 1: has to deal with figuring out which staff you have

593
00:33:10,640 --> 00:33:12,800
Speaker 1: when and making sure that you have enough staff at

594
00:33:12,800 --> 00:33:15,000
Speaker 1: all times. Obviously, many of us would love to go

595
00:33:15,080 --> 00:33:17,240
Speaker 1: help our colleagues in the emergency department or in the

596
00:33:17,360 --> 00:33:19,240
Speaker 1: medicine I see you, but you have to make sure

597
00:33:19,240 --> 00:33:22,520
Speaker 1: you're able to cover everything. And you know, since we're

598
00:33:22,560 --> 00:33:24,800
Speaker 1: pretty much the only service in the hospital left that's

599
00:33:24,840 --> 00:33:26,680
Speaker 1: non COVID, we want to make sure we're covering our

600
00:33:26,680 --> 00:33:29,760
Speaker 1: patients well with experienced physicians and nurses who know how

601
00:33:29,840 --> 00:33:32,440
Speaker 1: to handle will be When it comes to how this

602
00:33:32,600 --> 00:33:36,320
Speaker 1: virus effects pregnant women, Dr Bones says, there are still

603
00:33:36,360 --> 00:33:39,920
Speaker 1: a lot of unknowns, but also a few key and

604
00:33:40,160 --> 00:33:44,640
Speaker 1: positive takeaways. The course and pregnant women seems to be

605
00:33:44,800 --> 00:33:47,000
Speaker 1: not any worse than it would be for non pregnant women,

606
00:33:47,000 --> 00:33:48,760
Speaker 1: which is a very good thing and for and for men.

607
00:33:49,320 --> 00:33:51,880
Speaker 1: Women tend to be doing a lot better with the

608
00:33:51,880 --> 00:33:54,960
Speaker 1: disease than men. Um so that's a positive thing for

609
00:33:55,000 --> 00:33:58,920
Speaker 1: women as well. Uh, we are noticing that are the

610
00:33:58,960 --> 00:34:02,680
Speaker 1: transmission from from pregnant woman to her fetus seems to

611
00:34:02,680 --> 00:34:05,640
Speaker 1: be almost zero. It's not a d zero, but it's

612
00:34:05,680 --> 00:34:08,080
Speaker 1: it's almost zero. So that's a very very good thing

613
00:34:08,080 --> 00:34:11,759
Speaker 1: as well. Um And the one thing we've learned, I

614
00:34:11,760 --> 00:34:13,279
Speaker 1: think that a lot of people in this hospital and

615
00:34:13,280 --> 00:34:15,560
Speaker 1: in the country have learned, is a lot of people

616
00:34:15,560 --> 00:34:18,520
Speaker 1: are infected with CODE. We learned that by testing, So

617
00:34:18,560 --> 00:34:20,880
Speaker 1: we're testing every single patient now that gets admitted to

618
00:34:20,880 --> 00:34:24,520
Speaker 1: the hospital on our floor, and we've noted many, many

619
00:34:24,560 --> 00:34:28,640
Speaker 1: patients who are positive and completely asymptomatic, and some of

620
00:34:28,680 --> 00:34:30,920
Speaker 1: them become symptomatical later, and some of them never do.

621
00:34:31,680 --> 00:34:34,279
Speaker 1: The other thing Dr Bone has learned is you don't

622
00:34:34,280 --> 00:34:37,480
Speaker 1: know what to expect when it comes to this new virus,

623
00:34:37,560 --> 00:34:40,680
Speaker 1: which makes her job all the more difficult. You've got

624
00:34:40,680 --> 00:34:43,440
Speaker 1: to be really cautious because I've seen and again this

625
00:34:43,480 --> 00:34:45,839
Speaker 1: is anecdotal, but I've seen it go both ways. I mean,

626
00:34:45,880 --> 00:34:48,799
Speaker 1: we had one super sick pregnant woman who ended up

627
00:34:48,800 --> 00:34:51,080
Speaker 1: going into the I See You and was very close

628
00:34:51,080 --> 00:34:54,000
Speaker 1: to being intubated, and then we as a group interdisciplinary

629
00:34:54,120 --> 00:34:58,440
Speaker 1: between high risk obstetrics and I See You and pediatrics,

630
00:34:58,440 --> 00:35:00,520
Speaker 1: decided that it would probably be better for her health

631
00:35:00,760 --> 00:35:04,160
Speaker 1: to deliver, and we delivered her her baby by C section,

632
00:35:04,239 --> 00:35:08,440
Speaker 1: and she miraculously got better after she was delivered, and

633
00:35:08,480 --> 00:35:10,720
Speaker 1: she didn't require intubation, and I actually had the privilege

634
00:35:10,760 --> 00:35:13,880
Speaker 1: of sending her home on Sunday. Uh flip side, I

635
00:35:13,920 --> 00:35:16,480
Speaker 1: had another patient last week who came in for an

636
00:35:16,600 --> 00:35:21,040
Speaker 1: uncomplicated scheduled C section and did wonderful, no problems at all,

637
00:35:21,080 --> 00:35:24,000
Speaker 1: totally healthy. As I mentioned earlier, we swabbed everybody when

638
00:35:24,000 --> 00:35:26,239
Speaker 1: they first come into the hospital, and it was taking

639
00:35:26,239 --> 00:35:28,360
Speaker 1: about twenty four or four hours to get the results

640
00:35:28,360 --> 00:35:30,560
Speaker 1: back at that point, so we didn't have her results.

641
00:35:30,920 --> 00:35:33,520
Speaker 1: And then on post operative day one, about a day

642
00:35:33,520 --> 00:35:35,279
Speaker 1: after she had her surgery, all of a sudden, she

643
00:35:35,360 --> 00:35:38,719
Speaker 1: decompensated and got very very ill, also requiring oxygen and

644
00:35:38,840 --> 00:35:40,920
Speaker 1: I see you care. And then her test came back

645
00:35:40,960 --> 00:35:44,719
Speaker 1: positive from days before when she was asymptomatic. So it's

646
00:35:44,880 --> 00:35:47,759
Speaker 1: very hard, I think, to to figure out who's gonna

647
00:35:47,800 --> 00:35:50,279
Speaker 1: go which way and when, and that's what makes it

648
00:35:50,320 --> 00:35:53,960
Speaker 1: so difficult to care for the patient. Before COVID hit,

649
00:35:54,080 --> 00:35:58,799
Speaker 1: Elmhurst was very involved with the maternal mortality crisis, particularly

650
00:35:58,840 --> 00:36:02,200
Speaker 1: the racial despaired these that see so many more black

651
00:36:02,239 --> 00:36:06,560
Speaker 1: and brown women dying due to pregnancy or childbirth, and

652
00:36:06,719 --> 00:36:11,840
Speaker 1: Dr Bone notes that COVID nineteen is underscoring that same disparity.

653
00:36:12,120 --> 00:36:15,880
Speaker 1: I think that black women, and I think that UM

654
00:36:16,000 --> 00:36:19,080
Speaker 1: underserved women in general are being hit harder and men

655
00:36:19,160 --> 00:36:22,560
Speaker 1: are being hit harder by this UM. Whether that's because

656
00:36:22,560 --> 00:36:27,920
Speaker 1: they have underlying illness or just there there decreased access

657
00:36:27,960 --> 00:36:30,720
Speaker 1: to care, I think it's probably a combination of both.

658
00:36:30,719 --> 00:36:34,000
Speaker 1: And I don't think that COVID nineteen is going to

659
00:36:34,040 --> 00:36:37,799
Speaker 1: be different than anything else. Uh, COVID nineteen doesn't discriminate,

660
00:36:37,840 --> 00:36:40,640
Speaker 1: meaning anybody is eligible forgetting it. But I do think

661
00:36:40,760 --> 00:36:42,920
Speaker 1: that we're going to see more of this in the

662
00:36:42,960 --> 00:36:45,520
Speaker 1: same populations that we see more of other illnesses because

663
00:36:45,560 --> 00:36:48,800
Speaker 1: of access to care, and because of limited resources and

664
00:36:48,800 --> 00:36:50,880
Speaker 1: and all of the other problems that go along without

665
00:36:51,600 --> 00:36:55,000
Speaker 1: As for right now, the biggest obstacle Dr Bone and

666
00:36:55,040 --> 00:36:59,360
Speaker 1: her team at Elmhurst face is misinformation. Their fear around

667
00:36:59,360 --> 00:37:02,720
Speaker 1: COVID and the fear of contracting it has kept many

668
00:37:02,760 --> 00:37:06,160
Speaker 1: pregnant women from coming in to get the care they

669
00:37:06,200 --> 00:37:08,839
Speaker 1: may desperately need. We want to take care of our

670
00:37:08,880 --> 00:37:11,560
Speaker 1: our patients as we always do, and they're so afraid,

671
00:37:11,960 --> 00:37:13,720
Speaker 1: and they're just so afraid to come into the hospital.

672
00:37:13,760 --> 00:37:15,440
Speaker 1: They're so afraid of what's going to happen to them

673
00:37:15,440 --> 00:37:18,000
Speaker 1: where they're babies. They're afraid of infecting other family members

674
00:37:18,560 --> 00:37:22,120
Speaker 1: um and they're afraid, like everybody else is, of of

675
00:37:22,239 --> 00:37:24,600
Speaker 1: having it. You know, when I tell a patient that

676
00:37:24,640 --> 00:37:28,680
Speaker 1: her COVID nineteen tests came back positive, she's terrified. And

677
00:37:29,320 --> 00:37:31,000
Speaker 1: there's a lot of avoidance of wanting to know the

678
00:37:31,000 --> 00:37:34,520
Speaker 1: answer to that. UM, So, I think it's the biggest

679
00:37:34,840 --> 00:37:37,000
Speaker 1: challenge we have is to let our patients know that

680
00:37:37,080 --> 00:37:39,480
Speaker 1: it's okay to come seek care. It's more important for

681
00:37:39,520 --> 00:37:41,319
Speaker 1: you and your your health and your baby's health to

682
00:37:41,360 --> 00:37:43,080
Speaker 1: come seek care, and that we know what we're doing

683
00:37:43,360 --> 00:37:44,960
Speaker 1: and we're going to take care of you and this

684
00:37:45,040 --> 00:37:47,120
Speaker 1: is all gonna be okay. And I think our patients

685
00:37:47,160 --> 00:37:49,279
Speaker 1: are grateful for that and they're starting to come round.

686
00:37:52,360 --> 00:37:56,400
Speaker 1: I have learned that people tend to come together in

687
00:37:56,400 --> 00:38:01,200
Speaker 1: a crisis, and that's a very good thing. Um. I

688
00:38:01,280 --> 00:38:04,319
Speaker 1: run the department, and at times running a department like

689
00:38:04,360 --> 00:38:08,640
Speaker 1: this is difficult. And when this hit, I didn't have

690
00:38:08,719 --> 00:38:11,600
Speaker 1: to ask anything more than once. And I haven't heard

691
00:38:11,600 --> 00:38:14,839
Speaker 1: a know at all. Everybody has stepped up. We've had

692
00:38:15,080 --> 00:38:19,120
Speaker 1: co workers outsick, everybody checks on them every day. UM.

693
00:38:19,160 --> 00:38:22,200
Speaker 1: It's just people do come together. And I think it's important,

694
00:38:22,280 --> 00:38:25,360
Speaker 1: especially in the climate in this country now, to recognize

695
00:38:25,400 --> 00:38:28,640
Speaker 1: that that at in a crisis, America is going to

696
00:38:28,719 --> 00:38:36,480
Speaker 1: come together. Dr Tracy bone Hemmerdinger, the chief of Obstetrics

697
00:38:36,520 --> 00:38:42,960
Speaker 1: at Elmer's Hospital in Queens, New York. Up next for

698
00:38:43,080 --> 00:38:46,160
Speaker 1: all those pregnant women out there and their partners some

699
00:38:46,239 --> 00:38:49,640
Speaker 1: tips on how to feel safe and empowered during these

700
00:38:49,719 --> 00:39:06,480
Speaker 1: uncertain times. Giving birth during a pandemic is no doubt

701
00:39:06,680 --> 00:39:10,480
Speaker 1: a very stressful event, so for those pregnant women and

702
00:39:10,560 --> 00:39:13,400
Speaker 1: their family or partners, we wanted to leave you with

703
00:39:13,480 --> 00:39:16,879
Speaker 1: some tips for how to reduce anxiety and feel not

704
00:39:17,000 --> 00:39:20,920
Speaker 1: only safe but empowered. So the role of the doula

705
00:39:21,160 --> 00:39:26,000
Speaker 1: is to offer continuous support. Chantal Troub, who is originally

706
00:39:26,080 --> 00:39:28,839
Speaker 1: from Cape Town, South Africa, if you couldn't tell by

707
00:39:28,840 --> 00:39:32,160
Speaker 1: her accent, has been an active birth duela in New

708
00:39:32,239 --> 00:39:35,400
Speaker 1: York City for nearly twenty years, which means she has

709
00:39:35,440 --> 00:39:39,239
Speaker 1: supported a lot of women through some very intimate and

710
00:39:39,480 --> 00:39:44,040
Speaker 1: often difficult life changing moments. That's around seven hundred eight

711
00:39:44,080 --> 00:39:48,680
Speaker 1: hundred plus births. Now Dulas are commonly thought of as

712
00:39:48,760 --> 00:39:53,759
Speaker 1: birth coaches, someone who provides emotional and informational support, but

713
00:39:53,880 --> 00:39:58,160
Speaker 1: also and often crucially, a lot of physical support, things

714
00:39:58,200 --> 00:40:03,600
Speaker 1: like massage or counter pressure to alleviate back pain during contractions,

715
00:40:03,719 --> 00:40:07,320
Speaker 1: or even moving mothers into a more comfortable birthing position.

716
00:40:08,120 --> 00:40:11,480
Speaker 1: But with physical support out of the question and severe

717
00:40:11,480 --> 00:40:14,480
Speaker 1: restrictions on the number of people who can accompany women

718
00:40:14,520 --> 00:40:18,040
Speaker 1: through labor. Seantalas had to figure out how to do

719
00:40:18,080 --> 00:40:21,480
Speaker 1: it all virtually. This is not the same as being

720
00:40:21,520 --> 00:40:24,719
Speaker 1: in the room with someone. But the one aspect that

721
00:40:24,760 --> 00:40:28,520
Speaker 1: I've had to adjust is how do I support my

722
00:40:28,600 --> 00:40:32,439
Speaker 1: client without using my hands. Everything else is the same.

723
00:40:32,800 --> 00:40:36,279
Speaker 1: Once they're in labor, I set up my computer or

724
00:40:36,280 --> 00:40:39,239
Speaker 1: my laptop or my phone, and I in the day,

725
00:40:39,320 --> 00:40:43,760
Speaker 1: I'm here in my living room on FaceTime, face to face,

726
00:40:44,719 --> 00:40:50,839
Speaker 1: using my voice and my gestures to help them and

727
00:40:50,880 --> 00:40:55,680
Speaker 1: to be able to give them cues of connection and safety.

728
00:40:56,280 --> 00:40:59,200
Speaker 1: When it became like the nighttime or things got much

729
00:40:59,239 --> 00:41:01,920
Speaker 1: more intent, I would hold up in my bedroom with

730
00:41:02,000 --> 00:41:05,680
Speaker 1: my phone and my I pad, keeping the room dark.

731
00:41:05,719 --> 00:41:08,080
Speaker 1: If their room was dark, I would only turn up

732
00:41:08,120 --> 00:41:10,440
Speaker 1: my lights on if their lights were on, so that

733
00:41:10,520 --> 00:41:13,440
Speaker 1: I could keep the same ambiance in my home as

734
00:41:13,480 --> 00:41:16,600
Speaker 1: in theirs. And again I would give them solid support

735
00:41:17,239 --> 00:41:22,239
Speaker 1: face to face and using my voice and using my gestures.

736
00:41:22,360 --> 00:41:27,000
Speaker 1: And so far it has worked really well. I was

737
00:41:27,200 --> 00:41:30,719
Speaker 1: actually for someone who was not technical savvy at all.

738
00:41:31,800 --> 00:41:35,200
Speaker 1: I have been so pleasantly surprised how well this has

739
00:41:35,239 --> 00:41:39,520
Speaker 1: worked under these circumstances. First, Chantal share some advice for

740
00:41:39,520 --> 00:41:44,320
Speaker 1: those supporting their pregnant partners. So a woman in labor

741
00:41:45,160 --> 00:41:50,800
Speaker 1: really needs to feel safe and protected to be able

742
00:41:50,880 --> 00:41:54,799
Speaker 1: to let go and open up, to be able to

743
00:41:54,920 --> 00:42:01,080
Speaker 1: let her baby out. So feeling safe and feeling supported

744
00:42:01,440 --> 00:42:12,360
Speaker 1: and feeling protected is essential. So for the partner to understand,

745
00:42:12,800 --> 00:42:18,759
Speaker 1: how can we adjust in this time to create safety

746
00:42:20,040 --> 00:42:24,080
Speaker 1: at the times where clearly we are feeling a lot

747
00:42:24,120 --> 00:42:30,720
Speaker 1: of fear and anxiety about this disease and about feeling

748
00:42:30,800 --> 00:42:34,080
Speaker 1: supported in the ways that we think we may have needed.

749
00:42:34,880 --> 00:42:41,760
Speaker 1: So we want to relate on and almost primitive level.

750
00:42:42,000 --> 00:42:46,400
Speaker 1: We want to be able to communicate cues of safety

751
00:42:46,719 --> 00:42:53,200
Speaker 1: using face to face facial expressions, using our voice, our

752
00:42:53,400 --> 00:42:58,799
Speaker 1: tone of our voice, and then our gestures and our postures.

753
00:42:58,880 --> 00:43:04,600
Speaker 1: So whether we're supporting virtually or in person. Now this

754
00:43:04,960 --> 00:43:09,600
Speaker 1: may change place to place because changes are happening daily.

755
00:43:10,160 --> 00:43:13,239
Speaker 1: But as of now, our partners are required to wear

756
00:43:13,280 --> 00:43:16,600
Speaker 1: a mask the whole time while they are in the

757
00:43:16,680 --> 00:43:20,440
Speaker 1: laboring room until they leave. And so when your mouth

758
00:43:20,600 --> 00:43:24,600
Speaker 1: is covered by a mask, you have to learn to

759
00:43:24,719 --> 00:43:28,680
Speaker 1: communicate with your eyes. And so you want to learn

760
00:43:28,719 --> 00:43:33,560
Speaker 1: to smile, for example, so big that your eyes smile.

761
00:43:34,960 --> 00:43:37,600
Speaker 1: You want to be able to use the tone of

762
00:43:37,680 --> 00:43:41,319
Speaker 1: your voice and the gesture of your hands. So if

763
00:43:41,320 --> 00:43:47,880
Speaker 1: you're able to be in person, then touch is key.

764
00:43:47,960 --> 00:43:50,520
Speaker 1: You want to touch the mother, You want to hold

765
00:43:50,680 --> 00:43:55,200
Speaker 1: the mother, You want to massage the mother, give counter pressure,

766
00:43:57,000 --> 00:43:59,480
Speaker 1: you want to stay close. And this is a lot

767
00:43:59,520 --> 00:44:03,719
Speaker 1: of RuSHA on the support person, especially if you weren't

768
00:44:03,719 --> 00:44:06,719
Speaker 1: planning to be the main support person. It takes a

769
00:44:06,760 --> 00:44:14,479
Speaker 1: lot of focus and stamina to be present and pay

770
00:44:14,520 --> 00:44:18,840
Speaker 1: attention for a long period of time. We want to

771
00:44:19,680 --> 00:44:23,640
Speaker 1: one communicate face to face. We also want to really

772
00:44:24,640 --> 00:44:28,360
Speaker 1: tune in and learn how to listen. We want to

773
00:44:29,239 --> 00:44:34,000
Speaker 1: listen to what the mom is saying, hear how she's sounding,

774
00:44:35,440 --> 00:44:39,920
Speaker 1: understand her concerns, and to be able to support that.

775
00:44:40,080 --> 00:44:43,680
Speaker 1: So that takes a lot of focus and emotional presence,

776
00:44:44,160 --> 00:44:48,400
Speaker 1: and we want to prepare for that. So here's a

777
00:44:48,480 --> 00:44:51,640
Speaker 1: tip that I've suggested to some of my clients is

778
00:44:52,040 --> 00:44:55,360
Speaker 1: on the mask, you can either maybe draw a smile

779
00:44:55,719 --> 00:45:00,000
Speaker 1: on your mask, or maybe take a photograph of yourself

780
00:45:00,360 --> 00:45:04,840
Speaker 1: smiling and pun that onto your shirt, or even take

781
00:45:04,960 --> 00:45:11,480
Speaker 1: pictures of your honeymoon or a happy time together, or

782
00:45:11,960 --> 00:45:16,239
Speaker 1: your pet or your puppy or your favorite beach location,

783
00:45:16,480 --> 00:45:20,040
Speaker 1: print them out and then take them onto the walls

784
00:45:20,600 --> 00:45:26,040
Speaker 1: so you can surround yourself with moments of feeling safe

785
00:45:26,280 --> 00:45:29,960
Speaker 1: and at peace and joyful and happy. As for the

786
00:45:30,040 --> 00:45:33,799
Speaker 1: moms out there, Chantal's first tip is to understand the

787
00:45:33,880 --> 00:45:37,799
Speaker 1: new ambiance of the hospital. She says, it's important to

788
00:45:37,960 --> 00:45:42,800
Speaker 1: mentally prepare for what labor and delivery look like right now.

789
00:45:43,560 --> 00:45:45,600
Speaker 1: What you have to get used to seeing it is

790
00:45:45,640 --> 00:45:50,000
Speaker 1: pretty much like a hazmatted vibe. Everybody is wearing overalls

791
00:45:50,120 --> 00:45:53,680
Speaker 1: or gowns. Everybody, all the medical staff or even the

792
00:45:53,719 --> 00:45:58,680
Speaker 1: housekeeping are wearing a mask. Their head is covered and

793
00:45:58,760 --> 00:46:04,080
Speaker 1: they either wearing goals or a shield. So it's pretty

794
00:46:04,120 --> 00:46:09,520
Speaker 1: surreal and something to adjust mentally for. The Other thing

795
00:46:09,560 --> 00:46:12,000
Speaker 1: that I would really like you to prepare for is

796
00:46:12,040 --> 00:46:15,000
Speaker 1: that at some point during your hospital will stay, you

797
00:46:15,160 --> 00:46:18,239
Speaker 1: will be wearing a mask, whether that may only be

798
00:46:18,520 --> 00:46:24,839
Speaker 1: entriage or if you happen to test COVID positive, And

799
00:46:24,960 --> 00:46:28,239
Speaker 1: that's another adjustment to get used to just laboring with

800
00:46:28,320 --> 00:46:31,400
Speaker 1: a mask. So I encourage you to just try a

801
00:46:31,520 --> 00:46:35,600
Speaker 1: mask and use that communicating with someone. What does that

802
00:46:36,080 --> 00:46:40,279
Speaker 1: I feel like to communicate? How does that change? And

803
00:46:40,320 --> 00:46:43,800
Speaker 1: then how does that change when you're needing to breathe

804
00:46:43,880 --> 00:46:48,680
Speaker 1: and maybe breathing quite hard. So try you know, exercising

805
00:46:48,719 --> 00:46:52,160
Speaker 1: with a mask. Try marching in one spot with a

806
00:46:52,239 --> 00:46:55,440
Speaker 1: mask and notice, you know, how does that feel. It

807
00:46:55,480 --> 00:46:58,120
Speaker 1: takes some getting used to and I want you to

808
00:46:58,320 --> 00:47:00,840
Speaker 1: already know what that feels like before you go in,

809
00:47:01,680 --> 00:47:05,240
Speaker 1: once you have some expectation of what your birth experience. Maybe,

810
00:47:05,360 --> 00:47:08,520
Speaker 1: like Shantal says, the next step is to learn the

811
00:47:08,600 --> 00:47:13,680
Speaker 1: coping mechanisms now for calming the nervous system at any time.

812
00:47:14,480 --> 00:47:17,400
Speaker 1: One of the ways to regulate our nervous system is

813
00:47:17,480 --> 00:47:22,120
Speaker 1: to start developing a breathing practice. The breath is the

814
00:47:22,239 --> 00:47:26,040
Speaker 1: way into common our nervous system. The breath is the

815
00:47:26,120 --> 00:47:31,160
Speaker 1: way to manage in contractions. So developing a breathing practice

816
00:47:31,320 --> 00:47:36,000
Speaker 1: now is so helpful for now, for labor, for when

817
00:47:36,040 --> 00:47:41,279
Speaker 1: the baby cries postpartum. One breathing practice that is incredibly

818
00:47:41,320 --> 00:47:45,279
Speaker 1: helpful is a simple belly breath. You can place your

819
00:47:45,280 --> 00:47:48,560
Speaker 1: hands on your belly and take a deep breath in

820
00:47:49,200 --> 00:47:55,640
Speaker 1: full your belly and take a slow breath out, deep

821
00:47:56,120 --> 00:48:05,480
Speaker 1: full belly breaths, long slow exhales, so in hell, breathe

822
00:48:05,480 --> 00:48:16,120
Speaker 1: into your belly into your baby. Excel in calms the

823
00:48:16,200 --> 00:48:20,200
Speaker 1: nervous system. So when we take an inhale, we bring

824
00:48:20,200 --> 00:48:24,279
Speaker 1: an oxygen to our baby, to all our organs, even

825
00:48:24,320 --> 00:48:29,560
Speaker 1: the public floor, And when we excel it allows us

826
00:48:29,600 --> 00:48:36,080
Speaker 1: to feel safe, to feel open, to feel calm. Chantal

827
00:48:36,200 --> 00:48:39,600
Speaker 1: also suggests when those feelings of fear or anxiety do

828
00:48:39,719 --> 00:48:43,319
Speaker 1: bubble up, to not push them aside, but actually experience

829
00:48:43,400 --> 00:48:46,800
Speaker 1: them and then move on. We don't want to feel

830
00:48:46,800 --> 00:48:50,200
Speaker 1: those feelings. Were very good about squashing them down or

831
00:48:50,239 --> 00:48:55,319
Speaker 1: pushing them away, or scrolling on Facebook or going and

832
00:48:55,360 --> 00:49:00,319
Speaker 1: doing something. But to be able to manage those feel ends,

833
00:49:01,160 --> 00:49:03,919
Speaker 1: we want to be able to allow them to be there.

834
00:49:05,120 --> 00:49:07,880
Speaker 1: If we allow them to be there and con sit

835
00:49:08,040 --> 00:49:12,240
Speaker 1: with them, they usually only lost just a few minutes.

836
00:49:13,120 --> 00:49:18,320
Speaker 1: So allow yourself to be with the feeling, feel the feeling,

837
00:49:19,800 --> 00:49:22,840
Speaker 1: and let it pass. Now it may come up again

838
00:49:22,920 --> 00:49:26,200
Speaker 1: soon after, So we want to develop a practice of

839
00:49:26,280 --> 00:49:31,439
Speaker 1: being able to stay with the feelings, acknowledge them, name them,

840
00:49:31,480 --> 00:49:34,440
Speaker 1: and feeling scared. Right now, I'm really anxious about the

841
00:49:34,440 --> 00:49:37,680
Speaker 1: way this may go. That's okay. We can feel them,

842
00:49:38,080 --> 00:49:42,960
Speaker 1: don't push them away. It's important to be able to

843
00:49:43,000 --> 00:49:47,200
Speaker 1: sit with them and breathe through them. We have a

844
00:49:47,280 --> 00:49:50,120
Speaker 1: moment in this time to actually recognize them for what

845
00:49:50,200 --> 00:49:55,000
Speaker 1: they are and transform them and move ourselves more to

846
00:49:55,560 --> 00:49:59,040
Speaker 1: how can we feel safe? What makes me feel safe

847
00:49:59,120 --> 00:50:02,680
Speaker 1: right now? Does being in a quiet room make me

848
00:50:02,760 --> 00:50:06,720
Speaker 1: feel safe? Does having someone look at me and smile

849
00:50:06,760 --> 00:50:11,200
Speaker 1: at me make me feel safe? Does have just me

850
00:50:11,600 --> 00:50:15,200
Speaker 1: hugging my puppy right now make me feel safe? What

851
00:50:15,360 --> 00:50:18,400
Speaker 1: makes us feel safe? Let's explore that so that we

852
00:50:18,440 --> 00:50:23,200
Speaker 1: can find ways to use that and support us in labor.

853
00:50:23,360 --> 00:50:26,279
Speaker 1: So the more that we learn about what makes us

854
00:50:26,440 --> 00:50:29,640
Speaker 1: feel safe, then we can ask for what we need

855
00:50:29,800 --> 00:50:32,120
Speaker 1: or set that up for the time that we have

856
00:50:32,200 --> 00:50:35,239
Speaker 1: to go to the hospital when all else fails, when

857
00:50:35,239 --> 00:50:39,120
Speaker 1: the breathing exercises don't do the trick, or you've acknowledged

858
00:50:39,160 --> 00:50:42,440
Speaker 1: all those feelings to no avail, She says, take a

859
00:50:42,480 --> 00:50:45,200
Speaker 1: moment to connect with what's behind all of this in

860
00:50:45,239 --> 00:50:52,040
Speaker 1: the first place. And lastly, don't forget you're having a baby.

861
00:50:52,200 --> 00:50:55,960
Speaker 1: It's a very important time to connect to your baby.

862
00:50:56,080 --> 00:50:58,920
Speaker 1: Take the time to talk to your baby, Take the

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00:50:58,960 --> 00:51:01,880
Speaker 1: time to sing to your baby. I have some of

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00:51:01,920 --> 00:51:05,920
Speaker 1: my clients uh either singing lullabys to their babies or

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00:51:06,080 --> 00:51:08,440
Speaker 1: making up a lullaby. If you don't know, this is

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00:51:08,480 --> 00:51:10,760
Speaker 1: something that you can do on your own to your baby,

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00:51:11,280 --> 00:51:14,080
Speaker 1: or spouse or partner can join in where you both

868
00:51:14,160 --> 00:51:16,759
Speaker 1: talk to the baby or sing to the baby. But

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00:51:17,000 --> 00:51:19,759
Speaker 1: talk to your baby right now and be honest with

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00:51:19,800 --> 00:51:22,800
Speaker 1: your baby. You can tell your baby, I'm feeling really

871
00:51:22,840 --> 00:51:26,920
Speaker 1: scared right now. I'm worried about how it's gonna be

872
00:51:27,160 --> 00:51:30,239
Speaker 1: bringing you into the world. Right now. Your baby can

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00:51:30,400 --> 00:51:34,200
Speaker 1: sense your anxiety, so it's okay to communicate to your

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00:51:34,200 --> 00:51:37,120
Speaker 1: baby how you're feeling and how you're going to be

875
00:51:37,239 --> 00:51:40,040
Speaker 1: protecting your baby. How are you going to do everything

876
00:51:40,080 --> 00:51:42,520
Speaker 1: you can to bring the baby into a safe world.

877
00:51:42,800 --> 00:51:45,320
Speaker 1: To talk to your baby now, talk to your baby

878
00:51:45,560 --> 00:51:49,960
Speaker 1: during labor, and talk to your baby postpardon. And if

879
00:51:50,080 --> 00:51:53,680
Speaker 1: your baby needs to be separated from you for any reason,

880
00:51:54,280 --> 00:51:58,239
Speaker 1: then keep talking to your baby, whether it's energetically or

881
00:51:58,280 --> 00:52:01,239
Speaker 1: when you are reunited with baby. You can say I'm

882
00:52:01,360 --> 00:52:03,920
Speaker 1: so sorry that we had to be separated. I was

883
00:52:04,320 --> 00:52:07,600
Speaker 1: so sad to be separated, but I'm so happy to

884
00:52:07,680 --> 00:52:11,799
Speaker 1: be reunited with you now and express that to your baby,

885
00:52:11,800 --> 00:52:14,760
Speaker 1: because your baby does sense the way that you're feeling.

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00:52:21,239 --> 00:52:25,560
Speaker 1: That was Shantal Trout Adula assisting moms and families in

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00:52:25,560 --> 00:52:28,680
Speaker 1: the New York region. Shantala is put together a guide

888
00:52:28,680 --> 00:52:32,360
Speaker 1: exclusively for Next Question listeners that goes over some of

889
00:52:32,400 --> 00:52:35,840
Speaker 1: these tips for preparing moms and their partners for giving

890
00:52:35,880 --> 00:52:40,160
Speaker 1: birth during the coronavirus pandemic. You can download that at

891
00:52:40,200 --> 00:52:44,320
Speaker 1: Shantal Trout that's c H A and T A L

892
00:52:44,840 --> 00:52:48,799
Speaker 1: t R a UB dot com. And while you're there,

893
00:52:48,880 --> 00:52:52,880
Speaker 1: you can also check out her virtual workshops, including Birthing Strong,

894
00:52:53,239 --> 00:52:57,000
Speaker 1: which she designed specifically for helping women who are due

895
00:52:57,120 --> 00:53:05,120
Speaker 1: during this pandemic. And that does it for this episode

896
00:53:05,120 --> 00:53:08,399
Speaker 1: of Next Question. Stay tuned for next week's show, when

897
00:53:08,400 --> 00:53:11,960
Speaker 1: we'll be releasing our special two part series on America's

898
00:53:12,239 --> 00:53:18,400
Speaker 1: maternal mortality crisis that's coming up April. And for the

899
00:53:18,440 --> 00:53:21,799
Speaker 1: most up to date information on the coronavirus, make sure

900
00:53:21,840 --> 00:53:25,680
Speaker 1: to check out the CDC and the World Health Organization websites.

901
00:53:26,200 --> 00:53:29,239
Speaker 1: You can also subscribe to my morning newsletter wake Up Call,

902
00:53:29,560 --> 00:53:33,400
Speaker 1: where we're diligently compiling the day's most pressing news. You

903
00:53:33,440 --> 00:53:36,760
Speaker 1: can do that by going to Katie Correct dot com.

904
00:53:36,880 --> 00:53:39,720
Speaker 1: Until next time and my Next Question, I'm Katie Couric,

905
00:53:40,000 --> 00:53:42,760
Speaker 1: thank you all so much for listening, and stay safe

906
00:53:42,840 --> 00:53:52,960
Speaker 1: and healthy out there. Next Question with Katie Couric is

907
00:53:53,000 --> 00:53:55,600
Speaker 1: a production of I Heart Radio and Katie Curreic Media.

908
00:53:56,160 --> 00:53:59,680
Speaker 1: The executive producers are Katie Kurk, Courtney Litz, and Tyler Klang.

909
00:54:00,000 --> 00:54:03,719
Speaker 1: The supervising producer is Lauren Hansen. Our show producer is

910
00:54:03,800 --> 00:54:08,800
Speaker 1: Bethan Macaluso. The associate producers are Emily Pinto and Derek Clements.

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00:54:09,440 --> 00:54:14,040
Speaker 1: Editing by Derrek Clements, Dylan Fagan and Lowell Berlante, Mixing

912
00:54:14,120 --> 00:54:18,759
Speaker 1: by Dylan Fagin. Our researcher is Gabriel Loser. For more

913
00:54:18,800 --> 00:54:21,919
Speaker 1: information on today's episode, go to Katie Curik dot com

914
00:54:22,080 --> 00:54:25,000
Speaker 1: and follow us on Twitter and Instagram at Katie Currich.

915
00:54:28,719 --> 00:54:31,040
Speaker 1: For more podcasts for My Heart Radio, visit the I

916
00:54:31,160 --> 00:54:34,200
Speaker 1: Heart Radio app, Apple podcast, or wherever you listen to

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00:54:34,239 --> 00:54:35,080
Speaker 1: your favorite shows.