Speaker 1: Hi everyone, I'm Katie Curic, and welcome to next question today,
Speaker 1: Giving birth and the time of coronavirus. When I walked
Speaker 1: into the hospital, the hallways are eerily quiet. One mother
Speaker 1: surreal experience of going it alone. You saw the doctors,
Speaker 1: you saw security guards, and you saw cleaning staff just
Speaker 1: really kind of giving you a nod of you got this,
Speaker 1: but in a really powerful, yet somber and scary way. Later,
Speaker 1: we'll check in with obstetricians in two different New York
Speaker 1: hospitals to understand some of the biggest challenges they face
Speaker 1: and keeping pregnant mothers safe amid COVID nineteen. When I
Speaker 1: tell a patient that her COVID nineteen tests came back positive,
Speaker 1: she's terrified and there's a lot of avoidance of wanting
Speaker 1: to know the answer to that. Um So, I think
Speaker 1: it's the biggest challenge we have is to let our
Speaker 1: patients know that it's okay to come seek care. But first,
Speaker 1: my next question, how do you have a baby during
Speaker 1: a pandemic? Alicia Biggs had already given birth once nearly
Speaker 1: two years ago, to a baby girl named Olivia, and
Speaker 1: beyond the excitement of planning for their second child, to
Speaker 1: take place at the same hospital and with the same doctor.
Speaker 1: Alicia and her husband Patrick were really looking forward to
Speaker 1: a few crucial things being different this time around. I
Speaker 1: really wanted my my mom in the room. She wasn't
Speaker 1: in the room for the first pregnancy, and you know,
Speaker 1: I really wanted her there for for this one. She's
Speaker 1: my best friend, and and just um thought the more
Speaker 1: of the merrier for this one. And then another thing
Speaker 1: that we thought would be really nice and special that
Speaker 1: was a little different was in my first pregnancy, in
Speaker 1: my delivery, I had a very healthy baby, but she
Speaker 1: needed to go to the nick you at first. So
Speaker 1: that initial time where you're you spend with your with
Speaker 1: your newborn, I'm kind of on your chest, and just
Speaker 1: with your husband and with your family and just really
Speaker 1: relishing in the moment of what just happened. We didn't
Speaker 1: really get because she was sent into the nick you
Speaker 1: so fast. So we were hoping and crossing our fingers
Speaker 1: for an easy and healthy delivery where we could have,
Speaker 1: you know, shared that moment that people talk about all
Speaker 1: the time. Because of the complications of Alicia's first birth
Speaker 1: and the already large size of her second baby, Alicia's
Speaker 1: doctor planned to have her induced on Marchy, one week
Speaker 1: before her due date, at New York Presbyterian Hospital in Manhattan.
Speaker 1: But as that date neared, cases of the coronavirus were
Speaker 1: growing at alarming rates across New York City, which was
Speaker 1: already the epicenter of the virus, and hospitals were being
Speaker 1: forced to make some very tough decisions to prevent the
Speaker 1: virus from spreading. The week before, we had heard looming
Speaker 1: messages from people saying, you know, the hospitals down to
Speaker 1: usually you can have two attendees with you, they moved
Speaker 1: it down to one. So that means the plans changed
Speaker 1: for my mother. But they, you know, everybody was really
Speaker 1: messaging me saying, oh, they'll never you know, not let
Speaker 1: your your spouse in or your they'll you always have
Speaker 1: one person. So I kind of put it out of
Speaker 1: my mind that was never going to happen to me.
Speaker 1: And the Sunday prior to the delivery, so about three
Speaker 1: days before I got a call from my doctor she said,
Speaker 1: I have good news and I have bad news. The
Speaker 1: good news is there's a full staff in labor and delivery,
Speaker 1: which which really just level sets you as to what
Speaker 1: is good news. Anymore. The bad news isn't going to
Speaker 1: have to break it to you that you can no
Speaker 1: longer have your husband in the room. Those are some
Speaker 1: of the most difficult phone calls I've had to make.
Speaker 1: Dr Alan of Brownstein is Alicia's obstetrician. When she found
Speaker 1: out the news that New York Presbyterian Hospital had to
Speaker 1: institute severe restrictions due to the coronavirus and was no
Speaker 1: longer allowing any partners, family member, or outside support into
Speaker 1: the hospital at all, much less the delivery rooms, she
Speaker 1: immediately called her patients. They were long phone calls. I
Speaker 1: would sit there with them. I I feel horribly that
Speaker 1: they were not able to have that person with them,
Speaker 1: and how upsetting disappointing that was, and they were obviously disappointed.
Speaker 1: Um and that was not an easy conversation to have,
Speaker 1: although I do feel like they did understand the reasons
Speaker 1: why it was being done and how severe things had
Speaker 1: become for the hospital to make that decision that they
Speaker 1: couldn't have somebody there. And I would say, I'm going
Speaker 1: to do everything I can to make this a great
Speaker 1: experience for you, despite the fact that your husband's not
Speaker 1: going to be there. I said, make sure you have
Speaker 1: your laptop, your phone fired up charged. Don't forget to
Speaker 1: bring your charge to the hospital so if it dies
Speaker 1: during the delivery, you can still you know, charge it
Speaker 1: up and have your husband there. You can have him
Speaker 1: on the laptop, on FaceTime, on Zoom, on any platform
Speaker 1: so that you can feel like he's with you as
Speaker 1: much as possible. For Alicia, the news was devastating. I
Speaker 1: just cried to her on the phone, Um, and she
Speaker 1: was just unwavering in her support, saying, you you can
Speaker 1: do this, and where you're going to do this together
Speaker 1: and you will not be alone because I Am going
Speaker 1: to be there the entire time and it's you know,
Speaker 1: it's you and me and we will figure out a
Speaker 1: way to get through this. And she said take a
Speaker 1: day to to just figure yourself out. Patrick, where you
Speaker 1: crushed when you heard the news, I was. I was
Speaker 1: totally heartbroken that Sunday and Monday. It was incredibly difficult,
Speaker 1: um and sad. But then there was a shift that
Speaker 1: happened on kind of Monday into Tuesday before she gave
Speaker 1: birth on Wednesday, where it was this, you know, this
Speaker 1: was our new reality and we will we'll get through
Speaker 1: this together as much as possible. I took a day
Speaker 1: to be very emotional to you know, really just understand
Speaker 1: what was going on, and then I, um, I was
Speaker 1: a swimmer by background, uh, and really just tried to
Speaker 1: use the tools that I had available to me, you know, mentally,
Speaker 1: and really then said, okay, here's a day where you
Speaker 1: get to decide how you're going to move forward, and
Speaker 1: then really treated it as a swimming um and a
Speaker 1: swim race, right, It's a you know, swimming is a
Speaker 1: very individual, an individual sport that's surrounded by teammates who
Speaker 1: support you. I met my husband while swimming, and he understands,
Speaker 1: you know, the nuances of how I am of of
Speaker 1: when I get into that mode. So we spent the
Speaker 1: next days just preparing and kind of getting into that zone.
Speaker 1: On Wednesday, March, in the darkness of the early dawn,
Speaker 1: Patrick drove Alicia to New York Presbyterian Hospital and watched
Speaker 1: from the car as she walked in alone. When I
Speaker 1: walked into the hospital, the hallways are are eerily quiet
Speaker 1: because no one needs, you know, should be walking hallways
Speaker 1: unless they really have to. So I had my bag
Speaker 1: and it was clear with my bump where I was going,
Speaker 1: um and you saw the doctors, you saw security guards,
Speaker 1: and you saw cleaning staff just really kind of giving
Speaker 1: you a nod of you got this, but in a
Speaker 1: really powerful yet somber and scary way. And when you
Speaker 1: when you go immediately to sit down to check in,
Speaker 1: they give you a mask and they need to treat
Speaker 1: you as though you have COVID, um as though you
Speaker 1: have the virus, and they test you immediately when you
Speaker 1: get into the room, and then you we I didn't
Speaker 1: know results for twelve hours after that. Um, So your
Speaker 1: tense because you're having a baby, but you're you're also
Speaker 1: just tense because you don't know if you have COVID.
Speaker 1: You don't know if the nurses around you might have,
Speaker 1: you know, gotten it. So you're everybody's you know, protecting
Speaker 1: themselves for the greater benefit of everybody, right, But it's
Speaker 1: just really scary. So I didn't find out until right
Speaker 1: before I pushed that I had tested negative, which I
Speaker 1: was just you know, very tense about and you know,
Speaker 1: continue to tell Pat what if I have I was
Speaker 1: I was getting more stressed about having COVID than I
Speaker 1: was about delivering the baby. Um At first, the whole
Speaker 1: thing sounds ridiculously stressful. Just hearing you talk about it,
Speaker 1: it's making me feel anxious. Yeah, no, it was. It
Speaker 1: was anxious. It was, it was. It was really anxious.
Speaker 1: I mean some of the you know, beautiful things that
Speaker 1: had come out of it was you know, um, just
Speaker 1: understanding what the nurses are and the doctors are putting
Speaker 1: them how they're putting themselves out there to make you
Speaker 1: feel comfortable. So they you know, I walked in and
Speaker 1: they said they gave me a letter, a handwritten letter
Speaker 1: signed by all the nurses saying you're not alone, and
Speaker 1: you're going to prove to yourself how strong we already
Speaker 1: know you are, and we're here for every step of
Speaker 1: the way. And you know, everything was just so powerful
Speaker 1: that you're you're emotional and you're crying, but because you're
Speaker 1: you know, partially sad, partially scared, but partially you know,
Speaker 1: you're empowered to to get through this, and you just
Speaker 1: have one choice and you have to just get to
Speaker 1: the other side and decide, you know, I can either
Speaker 1: I need to make this a positive experience. So I
Speaker 1: um and they did a great job for me too,
Speaker 1: because the way we had it set up was I
Speaker 1: had an iPad A. Alicia had an iPad and we
Speaker 1: basically space time uninterrupted for thirteen hours, and so she
Speaker 1: had it on a little table with her that could
Speaker 1: move UM, and the nurses and the doctors talked to
Speaker 1: me as if I was in the room the entire time.
Speaker 1: They're saying, Okay, we're gonna do this. We're doing this, um,
Speaker 1: you know, here going to take her medicine up to
Speaker 1: this level. So they did a very um amaze job
Speaker 1: of making me feel a part of the entire process,
Speaker 1: even though I was They're virtually on an iPad, Alicia,
Speaker 1: I wanted to go back and ask you about the delivery.
Speaker 1: Did the doctors and nurses look like they were dressed
Speaker 1: for some kind of chemical spill? I mean, was that
Speaker 1: a strange experience for you versus seeing their faces? Right?
Speaker 1: It was? You know, they're in there in full there
Speaker 1: in masks. They're also in a shield. Um, they're in
Speaker 1: full gloves. You know, you can it's it's hard to
Speaker 1: to necessarily get out their demeanor, you know, other than
Speaker 1: verbally and and really through their eyes. So you had
Speaker 1: it was that's what made it so scary until I
Speaker 1: knew that I had tested negative for COVID. It was.
Speaker 1: It was a really scary time, which I think helped
Speaker 1: with you know, the handwritten letter and just really trying
Speaker 1: to read people's eye contact. And but it was a
Speaker 1: unique experience, and luckily I had a doctor who had
Speaker 1: been my doctor this entire time through you know, my
Speaker 1: first birth and also all my appointments of my second birth,
Speaker 1: and her comfort. You know, at one point I got quite,
Speaker 1: you know, just I just lost, I got my my
Speaker 1: emotions got the better of me, and I you know,
Speaker 1: I just was crying because this was all just a lot,
Speaker 1: and you know, she came in and you know, gave
Speaker 1: me that look of we we had we're going to
Speaker 1: do this and we're going to get through this, and
Speaker 1: you know, you're you're tough, and you just we're going
Speaker 1: to be tough together. And so that was really nice.
Speaker 1: And so I tried to make it also, you know,
Speaker 1: a lighter experience in in terms of they also saw
Speaker 1: how petrified I was so trying to combat that. I
Speaker 1: brought in plastic wrapped COVID approved sweat bands so that
Speaker 1: they could undo them, um and so that you know,
Speaker 1: the nurses and the doctor when we were you know,
Speaker 1: going through labor could could see that I was this,
Speaker 1: you know, this can be fun and this is a
Speaker 1: you know, bring it back to that, this is an
Speaker 1: amazing experience. So we all did wear sweatbands during the delivery.
Speaker 1: Dr Brownstein, what was it like for you helping Alicia.
Speaker 1: Luckily it was her second child, so she wasn't you know,
Speaker 1: it wasn't her first rodeo, but it still must have
Speaker 1: been pretty stressful. Can you describe what that delivery was like? Right? Well,
Speaker 1: she had her husband on the laptop the entire time.
Speaker 1: I felt like he was there. I had regular conversations
Speaker 1: with her throughout the entire labor process, and I would
Speaker 1: just talk directly to him. Um. We tried to make
Speaker 1: him as included as possible and just feel like he
Speaker 1: was just another person in the in the room. She
Speaker 1: was very funny. She said, you know, usually, you know,
Speaker 1: Patrick is here with me, and last delivery we had
Speaker 1: him were the headband for it, and we were both
Speaker 1: wearing the headband together, and she whipped out these brand
Speaker 1: new headbands for me and the nurse and she said,
Speaker 1: would you be willing to please by or these headbands?
Speaker 1: It makes me feel like Patrick is here and in
Speaker 1: the room, and we always like absolutely so the nurse
Speaker 1: and I were wearing our matching headbands along with Alicia
Speaker 1: and going through the whole process and pushing them. We
Speaker 1: got pictures of us all with our headbands on, and
Speaker 1: it just made it more fun and inclusive, and Patrick
Speaker 1: felt like he was there and we were just trying
Speaker 1: to be as importive and as there for her as
Speaker 1: you could possibly be. How long were you in labor, Alicia?
Speaker 1: So I was in labor for about thirteen hours. The
Speaker 1: labor and delivery part was went by really fast because
Speaker 1: you had all of the support of the of of everybody,
Speaker 1: and you know it's building up to this one moment
Speaker 1: and then you know the post. The post twenty four
Speaker 1: hours and forty eight hours after is I think the
Speaker 1: hardest part too, where you just feel loneliness and being
Speaker 1: scared because you're sitting with your you're sitting alone with
Speaker 1: your thoughts and um, you have a roommate, but everyone's
Speaker 1: really scared to to, you know, even talk to each other. Yeah,
Speaker 1: So it's just it's it's an interesting environment. What was
Speaker 1: it like for you, Pat to see your son on
Speaker 1: that iPad screen? It was surreal for sure. I mean
Speaker 1: it was, you know, again, not what you had anticipated. Um, so,
Speaker 1: you know, after he was born, they bring them over
Speaker 1: to the heating table to do measurements and all those things,
Speaker 1: and so they picked up the iPad and brought me
Speaker 1: over there. So they made me feel the entire time
Speaker 1: like I was part of the process. And then the
Speaker 1: picking up at the hospital the next day, it was
Speaker 1: very special to just you know, Alicia was on the
Speaker 1: wheelchair with Jack with a blanket over her, and so
Speaker 1: she had the blanket over him basically until she got
Speaker 1: to the car and then, um, you know, to see
Speaker 1: him for the first time and to hold him and
Speaker 1: to put him in the car seat. That would be
Speaker 1: a moment that will have kind of etched in my
Speaker 1: brain forever, that first time medium outside the hospital Alicia
Speaker 1: and patted. Just a few days after you had to
Speaker 1: go through this, Governor Cuomo announced an executive order that
Speaker 1: rescinded these restrictions so that hospitals in New York allowed
Speaker 1: women to have one support partner present during their births.
Speaker 1: So did you feel like, gosh, uh, why the heck
Speaker 1: did I end up in this window? I did think
Speaker 1: it was funny timing. I'm hoping I have, we have
Speaker 1: some delayed good karma hanging over us in the future.
Speaker 1: But I was, I was, you know, being a second
Speaker 1: time mother. I was happy that it was me who
Speaker 1: has had the benefit and you know, the fortune to
Speaker 1: have a delivery with my husband, and during times like this,
Speaker 1: it makes you realize just you know, what's important, and
Speaker 1: I was happy to take that place for someone other
Speaker 1: than a first time mom, because that's a really it's
Speaker 1: it's scary, it's lonely, and you know, doing it when
Speaker 1: you have no idea what's going on once you give
Speaker 1: birth is just frightening. So I'm I'm really glad that
Speaker 1: it happened to me versus some of my other close
Speaker 1: friends who were um first time mom's delivering very shortly
Speaker 1: after that, and luckily was the band was lifted. Congratulations
Speaker 1: to Alicia and Patrick Biggs, to big sister Olivia, and
Speaker 1: of course too little Jack Biggs, who will have one
Speaker 1: hell of a birth story to tell when we come back.
Speaker 1: Dr Alana Brownstein on what we know so far about
Speaker 1: pregnancy and COVID nineteen. One of the many things we
Speaker 1: don't yet know about COVID nineteen is how the virus
Speaker 1: affects pregnant women and their babies, So we wanted to
Speaker 1: talk to a few obstetricians about what they are seeing
Speaker 1: as well as how their hospitals and pregnant patients are
Speaker 1: experiencing all this. We started New York Presbyterian Hospital with
Speaker 1: Dr Alana Brownstein, the o B we heard from at
Speaker 1: the beginning of the episode. A few things to note
Speaker 1: about New York Presbyterian Hospital. It is massive, with multiple
Speaker 1: campuses across the New York metropolitan area. It's also one
Speaker 1: of the most prominent hospitals, ranked number five in the country.
Speaker 1: Dr Brownstein delivers out of the hospital's location on the
Speaker 1: Upper East Side of Manhattan, a community that's overwhelmingly white
Speaker 1: and ensured. Dr Brownstein answers a few medical questions first
Speaker 1: and then walks us through what labor and delivery looks
Speaker 1: like right now where she practices. What physiological changes and
Speaker 1: biological changes occurred during pregnants that could in fact make
Speaker 1: pregnant women more susceptible to certain viruses if not COVID nineteen,
Speaker 1: it's too soon to tell, but can you explain what
Speaker 1: happens to women that could put them at greater risks?
Speaker 1: So we know that pregnant women are at a relative
Speaker 1: immune suppressed state um in parts so that the the
Speaker 1: mother's body can accept to feed us in their body
Speaker 1: which is not their own cells. So we know that
Speaker 1: it is decreased in certain ways like that. We also
Speaker 1: know that certainly any bodies that they have can be
Speaker 1: in lower tighters just because of the plasma volume expansion
Speaker 1: that happens naturally in pregnancy. So it is theoretical possible
Speaker 1: that your immune systems decrease could make you more susceptible
Speaker 1: to certain viruses and make that disease much worse in
Speaker 1: pregnancy than not. We just need more time to know
Speaker 1: iff that's the case for COVID nineteen or not. But
Speaker 1: in Layman's terms, you're saying that the expansion of the
Speaker 1: baby can decrease lung capacity just because it's pushing up
Speaker 1: on the lungs right, So later in pregnancy, especially where
Speaker 1: there's a whole fetus in the in that cavity, it
Speaker 1: can make it difficult for the lungs or expand more,
Speaker 1: which also sometimes can make it more difficult to know
Speaker 1: who has it or not. Because when you talk about
Speaker 1: some of the symptoms of COVID nineteen and you talk
Speaker 1: about respiratory changes, well, feeling short of breath is a
Speaker 1: very common symptom of normal pregnancy, So that can make
Speaker 1: it a little bit more challenging to figure out what
Speaker 1: it is because your respiratory rate is faster, and certainly
Speaker 1: you feel more breathless. It's harder to um take a
Speaker 1: deep breath, and it's harder to feel like your lungs
Speaker 1: are fully expanding because of that fetus in that area.
Speaker 1: What happens when a pregnant woman comes in now to
Speaker 1: your hospital is she immediately tested for COVID nineteen. So
Speaker 1: any woman that is coming onto the unit gets a
Speaker 1: mask right away. Um. If the patient is admitted to
Speaker 1: the hospital, then she is immediately tested. If somebody comes
Speaker 1: in and is not admitted, then they are not tested
Speaker 1: for For example, if a woman thinks that her water
Speaker 1: broke and she's coming in and she's evaluated and it
Speaker 1: turns out that her water didn't break, she's sent out.
Speaker 1: We don't test that person for COVID. If the patient
Speaker 1: is admitted for whatever reason it is, whether it's labor,
Speaker 1: preternal labor, any other condition going on obstetrically, that patient
Speaker 1: is tested for COVID. It does take a few hours
Speaker 1: before we get the test back, So we essentially just
Speaker 1: treat everybody like they're positive UM, and then anything obstetrically
Speaker 1: is done as it normally would be. If she's in labor,
Speaker 1: we're managing her labor. She wants pay medicine, she gets
Speaker 1: pay medicine. That part doesn't change. It's really more of
Speaker 1: UM whether or not she is positive in what that
Speaker 1: means for her, the delivery and for the baby afterwards.
Speaker 1: But everybody on the unit has a mask on. We're
Speaker 1: wearing gloves for everybody, and that's the same across the board.
Speaker 1: If we know if somebody who might be positive UM,
Speaker 1: we try to call ahead to the hot spook. I
Speaker 1: know I have a patient that's coming in that either
Speaker 1: I suspect as positive, I know is positive, or any
Speaker 1: inkling of that. We make sure we call ahead, We
Speaker 1: have a room waiting for them, and we make sure
Speaker 1: that they are isolated. What kinds of concerns are raised?
Speaker 1: Dr Brownstein if pregnant woman about to give birth test positive,
Speaker 1: other than protecting the staff members, is there any risk
Speaker 1: to her baby? Is their risk to her in terms
Speaker 1: of the delivery, etcetera. So for the delivery part, we
Speaker 1: deliver them as we would regardless of their COVID status,
Speaker 1: meaning if they are going to have a vaginal delivery,
Speaker 1: they can have a vaginal delivery. If they're going to
Speaker 1: have a c section, they can. For the baby, the
Speaker 1: concern is we want to make sure that it doesn't
Speaker 1: get transmitted to the baby. So currently it does not
Speaker 1: appear that there's vertical transmission, meaning that the baby would
Speaker 1: get the virus just from being inside the mom um.
Speaker 1: So it's thought that for the actual delivery process they
Speaker 1: can deliver as they normally would. It's more of a
Speaker 1: question for postpartum. The babies are not taken away from
Speaker 1: the moms, so that's the question. I get a lot,
Speaker 1: is my baby taken away from me? If I'm positive.
Speaker 1: We generally don't take the baby away from the mom.
Speaker 1: The mom the baby can still be with the mother,
Speaker 1: but we do try to make sure that the mom
Speaker 1: is wearing a mass mom's wearing gloves. We're not having
Speaker 1: that direct contact that that baby might get it from
Speaker 1: the mother. After the delivery, you're not concerned that the
Speaker 1: baby could become infected out of utera. So we are
Speaker 1: and not necessarily just during that delivery, but we're concerned
Speaker 1: with contact with the mom afterwards that even the mom
Speaker 1: just holding the baby. You know, the first thing you
Speaker 1: want to do is when you get your newborn is
Speaker 1: hold it tight, kiss at snugglet be very close to it.
Speaker 1: But all of those things, the baby could get COVID
Speaker 1: from that. So generally what they're trying to do is
Speaker 1: have the baby be with the mom, but still maintain
Speaker 1: that distancing, so being six freed away. If the mom
Speaker 1: chooses to breastfeed, then the mom can breastfeed. However, we
Speaker 1: try to wash the breast off. We try to make
Speaker 1: sure the mom has washed our hands. We want to
Speaker 1: make sure there's the mom is wearing a mass the
Speaker 1: entire time so she's not breathing directly on it or
Speaker 1: the other optionism mom can express breast milk and then
Speaker 1: somebody else can feed the baby the breast milk if
Speaker 1: they want to do it that way, because there is
Speaker 1: a concern that it could be transmitted to the baby,
Speaker 1: not in utero, but afterwards just having the contact with
Speaker 1: the mother, so we do try to limit that contact.
Speaker 1: But it's not like the mom can't be in the
Speaker 1: same room as the baby. I think that concern of
Speaker 1: having your baby physically taken away from you to another room.
Speaker 1: That is very concerning. What about having mothers give birth
Speaker 1: prematurely or early because of their COVID symptoms and concerns
Speaker 1: about their health and potentially the baby's health. So there
Speaker 1: are some situations or the mom just are so sick
Speaker 1: that they have to do that. We generally try to
Speaker 1: hold off on doing that if we could, just for
Speaker 1: the baby's health. UM, We'll try to get the baby
Speaker 1: at least to either like thirty two or thirty four
Speaker 1: weeks ges station if we have to do that, because
Speaker 1: there's such significant morbidity UM for the baby before that
Speaker 1: gestational age. But there are situations where moms are that
Speaker 1: sick that they do have to convert over and decide
Speaker 1: to deliver the baby early for the moms health. What
Speaker 1: about during pregnancy? I was getting a lot of questions,
Speaker 1: and I'm not a doctor with pregnant women very concerned
Speaker 1: if they got COVID ninety obviously for themselves, but very
Speaker 1: concerned about the health of their babies developmentally. What do
Speaker 1: we know about that? Great questions? So very little, only
Speaker 1: that again it's so early that we don't have patients
Speaker 1: that have had it very early in the pregnancy and
Speaker 1: then carried food a term. Yet, just because it hasn't
Speaker 1: been around that long so far, it seems that there
Speaker 1: might be a high risk for preterm delivery. UM, we
Speaker 1: are concerned about whether or not there could be an
Speaker 1: increased risk of either miscarriage or congenital adormalities. But we
Speaker 1: haven't seen that yet. UM, it's certainly a concern, and
Speaker 1: we're we're getting our huge registry of pregnant women to
Speaker 1: see something that we can follow out over time. It's
Speaker 1: just too early to know. We're also concerned about the
Speaker 1: growth of the baby, so we want to make sure
Speaker 1: if the mom is infected as the baby growing well,
Speaker 1: so they have to have ways to monitor that as well.
Speaker 1: We haven't seen it yet, but again only because those
Speaker 1: are things that take while to actually develop into see
Speaker 1: and it just hasn't been amount enough to see. I
Speaker 1: wanted to ask you about maternal mortality. We did two
Speaker 1: episodes on maternal mortality, which we're holding for later, but
Speaker 1: it's very concerning. There are something like seven hundred to
Speaker 1: nine women dying from pregnancy or childbirth every single year
Speaker 1: in this country. Not to mention the fifty thousand women
Speaker 1: every year who almost die. So how concerned are you
Speaker 1: about the impact of COVID nineteen on this skyrocketing maternal
Speaker 1: mortality rate. I think it goes back to we need
Speaker 1: to make sure that our patients have access, that they
Speaker 1: can be seen, that they can get to a hospital
Speaker 1: that can care for them, because that is going to
Speaker 1: make the difference of how they do and how their
Speaker 1: their babies do. And it's very concerning, and this is
Speaker 1: just one more, one more layer of things that can
Speaker 1: make it harder for those women to get the good
Speaker 1: care that they need. The doctors we spoke to for
Speaker 1: our maternal mortality Episodes also said it can be crucial
Speaker 1: to have support for the mother. There's not only before
Speaker 1: and during the pregnancy, but afterwards, since so many complications
Speaker 1: can happen after the baby is born and hospitals are
Speaker 1: so focused on the health of the baby. What are
Speaker 1: your thoughts there, But there's a lot of things that
Speaker 1: can happen postpartum um. It's not over once that baby
Speaker 1: comes out. You know, people can have um bleeding issues postpartum.
Speaker 1: You can get pre aclamps to a blood pressure issues
Speaker 1: postpartum um. There's a lot of things that if you
Speaker 1: don't have somebody who one knows about it you can
Speaker 1: help take care of you. And three recognizing and get
Speaker 1: you to your hospital can be major issues. UM and
Speaker 1: I think that is a huge problem having that support.
Speaker 1: It doesn't end once that baby comes out. It really
Speaker 1: goes into the whole hours partum care period as well.
Speaker 1: Can tell a medicine be helpful in that regard for
Speaker 1: women who have given birth but may not have as
Speaker 1: much access to top medical care. I think that we're
Speaker 1: seeing the role that telemedicine can play. I think it's
Speaker 1: really been shot into the spotlight with everything going on
Speaker 1: here where we're trying to keep people at home. UM,
Speaker 1: there are a lot of things that you can assess
Speaker 1: over the telemedicine visits. You can't do everything, but you
Speaker 1: can see the patient, you know. I'll have visits with
Speaker 1: my patients who all have them show me their own decision,
Speaker 1: you know, have you know, show me what that bleeding
Speaker 1: is looking like. I have patients get blood pressure monitors
Speaker 1: at home. I have them take their bloo pressure at home,
Speaker 1: show me what it shows like, show me what that
Speaker 1: number is, and then I can try to do an
Speaker 1: assessment whether that's somebody who needs to come in, or
Speaker 1: whether that's something I can just speak to them at home.
Speaker 1: So it certainly can help, especially in this day and
Speaker 1: age or trying to not have people come in. I
Speaker 1: think there is a lot of information you can get
Speaker 1: with a telemedicine visit. What's your advice, Dr Brownstein for
Speaker 1: pregnant women right now, with no end in sight, what
Speaker 1: would you tell your patients that might help pregnant women everywhere?
Speaker 1: I think the most important thing is what we're telling
Speaker 1: all people right now, which is make sure that you're
Speaker 1: practicing the social distancing, make sure you're performing hand hygiene
Speaker 1: where we're a mask, we're a protective gear. If you're
Speaker 1: going out, try to distance yourself from everybody. Um, those
Speaker 1: are the things that seem to be working. And I
Speaker 1: feel like for the pregnant patients, especially where there's already
Speaker 1: a high anxiety and a concern about this pregnancy, to
Speaker 1: try to protect themselves as much as they can, This
Speaker 1: is a great time to kind of stay inside corn
Speaker 1: teen and keep your distance from people as much as
Speaker 1: you can for your own protection and for that of
Speaker 1: your baby as well. Just across the East River from
Speaker 1: Dr Brownstein is the Elmhurst Hospital Center in Queens, a
Speaker 1: public hospital that has about five hundred and forty beds
Speaker 1: to New York Presbyterians hundred plus. It's located in Jackson Heights, Queens,
Speaker 1: which is the most ethnically diverse neighborhood in the country.
Speaker 1: It's a very underserved community and the community right now
Speaker 1: is being hit very, very hard by the COVID epidemic.
Speaker 1: Dr Tracy bone Hemmerdinger is the chief of Obstetrics at Elmhurst.
Speaker 1: The population that we generally see at Elmhurst is mixed
Speaker 1: community of new immigrants. UM. We see all different ethnic backgrounds. UM.
Speaker 1: The number one language spoken is Spanish, followed I think
Speaker 1: very closely by Bengali UM. And I think that a
Speaker 1: lot of the patient is that we see fall into
Speaker 1: the category of people who can't social distance because they
Speaker 1: live with large numbers of people in their homes, people
Speaker 1: who are responsible for caring for not only many children,
Speaker 1: but also their parents and their extended family UH. And and
Speaker 1: and people whose jobs are either domestic workers or you know,
Speaker 1: people whose jobs and livelihood may be cut off completely
Speaker 1: and not have any access to their regular daily needs.
Speaker 1: And so I think that that puts them at significant
Speaker 1: risk for any illness. Elm Hurst has been called the
Speaker 1: epicenter of the epicenter of coronavirus cases, the ground zero
Speaker 1: of the epidemic. The fact is Elmer's was one of
Speaker 1: the first hospitals hit by corona and it was hit hard.
Speaker 1: Elmhurst runs at capacity, so I believe it was running
Speaker 1: capacity before the epidemic, and so that's why it became
Speaker 1: so difficult, because we needed to figure out ways to
Speaker 1: structurally change our hospital to be able to take care
Speaker 1: of all of our patients. The very beginning of this,
Speaker 1: nobody really knew what was going on and what was happening.
Speaker 1: We got at a lot of patients presented and they
Speaker 1: didn't know what they were supposed to say or do.
Speaker 1: We didn't know what we're supposed to say or do.
Speaker 1: The recommendations from the CDC and from the New York
Speaker 1: City officials and the New York State officials were changing
Speaker 1: every couple of hours, and I would come up with
Speaker 1: some kind of a protocol and then it would have
Speaker 1: to be changed. And it was very frustrating and difficult
Speaker 1: on both sides. On the patient side, and not even
Speaker 1: just the patient side. The family members of the patients,
Speaker 1: especially for pregnant women, which is what I deal with UM.
Speaker 1: And now I would say we're a few weeks into it.
Speaker 1: We really got this down and we know how to
Speaker 1: manage it. And I think that a lot of our
Speaker 1: patients initially were very afraid to come to the hospital,
Speaker 1: especially because of all the news the elm Hurst Hospital
Speaker 1: has been on the news because we've gotten hit so hard.
Speaker 1: And now, UM, I think they feel more comfortable. Are
Speaker 1: our senses is starting to come up. Our patients are
Speaker 1: more comfortable coming in, and our outcomes are very good.
Speaker 1: Dr Bones says half the battle was working out the logistics.
Speaker 1: There was a lot the hospital had to figure out
Speaker 1: and figure out fast when it came to managing incoming
Speaker 1: COVID or suspected COVID cases. With exceptions like labor delivery
Speaker 1: and postpartum. Elmhurst is now almost entirely devoted to COVID care.
Speaker 1: The physical space was something we had to figure out
Speaker 1: how to use and our staff as well. So we
Speaker 1: have a triage area that has seven beds for triage,
Speaker 1: and we had to put up a wall so that
Speaker 1: we could have COVID patients on one side. And non
Speaker 1: COOVID patients on another side. And then we had to
Speaker 1: do the same thing in our post anesthesia care unit
Speaker 1: after c sections, we had to put up a wall
Speaker 1: to separate an area where we could put COVID patients
Speaker 1: or suspected COVID patients and non COVID patients, um, you know,
Speaker 1: and then who could go into those rooms versus who
Speaker 1: can who has to go into an isolation room someone
Speaker 1: actively coughing with a high fever, whether or not we
Speaker 1: have a positive test that patients probably should be isolated, UM,
Speaker 1: and so figuring out where we can put those people
Speaker 1: and not overrun our our service. And obviously staff has
Speaker 1: been affected. UH, nurses and doctors and resident doctors have
Speaker 1: all been hit, and we've had many many providers get
Speaker 1: sick and be out for sometime, and so that puts
Speaker 1: a strain on everything, UM. And so streamlining the system
Speaker 1: has to deal with figuring out which staff you have
Speaker 1: when and making sure that you have enough staff at
Speaker 1: all times. Obviously, many of us would love to go
Speaker 1: help our colleagues in the emergency department or in the
Speaker 1: medicine I see you, but you have to make sure
Speaker 1: you're able to cover everything. And you know, since we're
Speaker 1: pretty much the only service in the hospital left that's
Speaker 1: non COVID, we want to make sure we're covering our
Speaker 1: patients well with experienced physicians and nurses who know how
Speaker 1: to handle will be When it comes to how this
Speaker 1: virus effects pregnant women, Dr Bones says, there are still
Speaker 1: a lot of unknowns, but also a few key and
Speaker 1: positive takeaways. The course and pregnant women seems to be
Speaker 1: not any worse than it would be for non pregnant women,
Speaker 1: which is a very good thing and for and for men.
Speaker 1: Women tend to be doing a lot better with the
Speaker 1: disease than men. Um so that's a positive thing for
Speaker 1: women as well. Uh, we are noticing that are the
Speaker 1: transmission from from pregnant woman to her fetus seems to
Speaker 1: be almost zero. It's not a d zero, but it's
Speaker 1: it's almost zero. So that's a very very good thing
Speaker 1: as well. Um And the one thing we've learned, I
Speaker 1: think that a lot of people in this hospital and
Speaker 1: in the country have learned, is a lot of people
Speaker 1: are infected with CODE. We learned that by testing, So
Speaker 1: we're testing every single patient now that gets admitted to
Speaker 1: the hospital on our floor, and we've noted many, many
Speaker 1: patients who are positive and completely asymptomatic, and some of
Speaker 1: them become symptomatical later, and some of them never do.
Speaker 1: The other thing Dr Bone has learned is you don't
Speaker 1: know what to expect when it comes to this new virus,
Speaker 1: which makes her job all the more difficult. You've got
Speaker 1: to be really cautious because I've seen and again this
Speaker 1: is anecdotal, but I've seen it go both ways. I mean,
Speaker 1: we had one super sick pregnant woman who ended up
Speaker 1: going into the I See You and was very close
Speaker 1: to being intubated, and then we as a group interdisciplinary
Speaker 1: between high risk obstetrics and I See You and pediatrics,
Speaker 1: decided that it would probably be better for her health
Speaker 1: to deliver, and we delivered her her baby by C section,
Speaker 1: and she miraculously got better after she was delivered, and
Speaker 1: she didn't require intubation, and I actually had the privilege
Speaker 1: of sending her home on Sunday. Uh flip side, I
Speaker 1: had another patient last week who came in for an
Speaker 1: uncomplicated scheduled C section and did wonderful, no problems at all,
Speaker 1: totally healthy. As I mentioned earlier, we swabbed everybody when
Speaker 1: they first come into the hospital, and it was taking
Speaker 1: about twenty four or four hours to get the results
Speaker 1: back at that point, so we didn't have her results.
Speaker 1: And then on post operative day one, about a day
Speaker 1: after she had her surgery, all of a sudden, she
Speaker 1: decompensated and got very very ill, also requiring oxygen and
Speaker 1: I see you care. And then her test came back
Speaker 1: positive from days before when she was asymptomatic. So it's
Speaker 1: very hard, I think, to to figure out who's gonna
Speaker 1: go which way and when, and that's what makes it
Speaker 1: so difficult to care for the patient. Before COVID hit,
Speaker 1: Elmhurst was very involved with the maternal mortality crisis, particularly
Speaker 1: the racial despaired these that see so many more black
Speaker 1: and brown women dying due to pregnancy or childbirth, and
Speaker 1: Dr Bone notes that COVID nineteen is underscoring that same disparity.
Speaker 1: I think that black women, and I think that UM
Speaker 1: underserved women in general are being hit harder and men
Speaker 1: are being hit harder by this UM. Whether that's because
Speaker 1: they have underlying illness or just there there decreased access
Speaker 1: to care, I think it's probably a combination of both.
Speaker 1: And I don't think that COVID nineteen is going to
Speaker 1: be different than anything else. Uh, COVID nineteen doesn't discriminate,
Speaker 1: meaning anybody is eligible forgetting it. But I do think
Speaker 1: that we're going to see more of this in the
Speaker 1: same populations that we see more of other illnesses because
Speaker 1: of access to care, and because of limited resources and
Speaker 1: and all of the other problems that go along without
Speaker 1: As for right now, the biggest obstacle Dr Bone and
Speaker 1: her team at Elmhurst face is misinformation. Their fear around
Speaker 1: COVID and the fear of contracting it has kept many
Speaker 1: pregnant women from coming in to get the care they
Speaker 1: may desperately need. We want to take care of our
Speaker 1: our patients as we always do, and they're so afraid,
Speaker 1: and they're just so afraid to come into the hospital.
Speaker 1: They're so afraid of what's going to happen to them
Speaker 1: where they're babies. They're afraid of infecting other family members
Speaker 1: um and they're afraid, like everybody else is, of of
Speaker 1: having it. You know, when I tell a patient that
Speaker 1: her COVID nineteen tests came back positive, she's terrified. And
Speaker 1: there's a lot of avoidance of wanting to know the
Speaker 1: answer to that. UM, So, I think it's the biggest
Speaker 1: challenge we have is to let our patients know that
Speaker 1: it's okay to come seek care. It's more important for
Speaker 1: you and your your health and your baby's health to
Speaker 1: come seek care, and that we know what we're doing
Speaker 1: and we're going to take care of you and this
Speaker 1: is all gonna be okay. And I think our patients
Speaker 1: are grateful for that and they're starting to come round.
Speaker 1: I have learned that people tend to come together in
Speaker 1: a crisis, and that's a very good thing. Um. I
Speaker 1: run the department, and at times running a department like
Speaker 1: this is difficult. And when this hit, I didn't have
Speaker 1: to ask anything more than once. And I haven't heard
Speaker 1: a know at all. Everybody has stepped up. We've had
Speaker 1: co workers outsick, everybody checks on them every day. UM.
Speaker 1: It's just people do come together. And I think it's important,
Speaker 1: especially in the climate in this country now, to recognize
Speaker 1: that that at in a crisis, America is going to
Speaker 1: come together. Dr Tracy bone Hemmerdinger, the chief of Obstetrics
Speaker 1: at Elmer's Hospital in Queens, New York. Up next for
Speaker 1: all those pregnant women out there and their partners some
Speaker 1: tips on how to feel safe and empowered during these
Speaker 1: uncertain times. Giving birth during a pandemic is no doubt
Speaker 1: a very stressful event, so for those pregnant women and
Speaker 1: their family or partners, we wanted to leave you with
Speaker 1: some tips for how to reduce anxiety and feel not
Speaker 1: only safe but empowered. So the role of the doula
Speaker 1: is to offer continuous support. Chantal Troub, who is originally
Speaker 1: from Cape Town, South Africa, if you couldn't tell by
Speaker 1: her accent, has been an active birth duela in New
Speaker 1: York City for nearly twenty years, which means she has
Speaker 1: supported a lot of women through some very intimate and
Speaker 1: often difficult life changing moments. That's around seven hundred eight
Speaker 1: hundred plus births. Now Dulas are commonly thought of as
Speaker 1: birth coaches, someone who provides emotional and informational support, but
Speaker 1: also and often crucially, a lot of physical support, things
Speaker 1: like massage or counter pressure to alleviate back pain during contractions,
Speaker 1: or even moving mothers into a more comfortable birthing position.
Speaker 1: But with physical support out of the question and severe
Speaker 1: restrictions on the number of people who can accompany women
Speaker 1: through labor. Seantalas had to figure out how to do
Speaker 1: it all virtually. This is not the same as being
Speaker 1: in the room with someone. But the one aspect that
Speaker 1: I've had to adjust is how do I support my
Speaker 1: client without using my hands. Everything else is the same.
Speaker 1: Once they're in labor, I set up my computer or
Speaker 1: my laptop or my phone, and I in the day,
Speaker 1: I'm here in my living room on FaceTime, face to face,
Speaker 1: using my voice and my gestures to help them and
Speaker 1: to be able to give them cues of connection and safety.
Speaker 1: When it became like the nighttime or things got much
Speaker 1: more intent, I would hold up in my bedroom with
Speaker 1: my phone and my I pad, keeping the room dark.
Speaker 1: If their room was dark, I would only turn up
Speaker 1: my lights on if their lights were on, so that
Speaker 1: I could keep the same ambiance in my home as
Speaker 1: in theirs. And again I would give them solid support
Speaker 1: face to face and using my voice and using my gestures.
Speaker 1: And so far it has worked really well. I was
Speaker 1: actually for someone who was not technical savvy at all.
Speaker 1: I have been so pleasantly surprised how well this has
Speaker 1: worked under these circumstances. First, Chantal share some advice for
Speaker 1: those supporting their pregnant partners. So a woman in labor
Speaker 1: really needs to feel safe and protected to be able
Speaker 1: to let go and open up, to be able to
Speaker 1: let her baby out. So feeling safe and feeling supported
Speaker 1: and feeling protected is essential. So for the partner to understand,
Speaker 1: how can we adjust in this time to create safety
Speaker 1: at the times where clearly we are feeling a lot
Speaker 1: of fear and anxiety about this disease and about feeling
Speaker 1: supported in the ways that we think we may have needed.
Speaker 1: So we want to relate on and almost primitive level.
Speaker 1: We want to be able to communicate cues of safety
Speaker 1: using face to face facial expressions, using our voice, our
Speaker 1: tone of our voice, and then our gestures and our postures.
Speaker 1: So whether we're supporting virtually or in person. Now this
Speaker 1: may change place to place because changes are happening daily.
Speaker 1: But as of now, our partners are required to wear
Speaker 1: a mask the whole time while they are in the
Speaker 1: laboring room until they leave. And so when your mouth
Speaker 1: is covered by a mask, you have to learn to
Speaker 1: communicate with your eyes. And so you want to learn
Speaker 1: to smile, for example, so big that your eyes smile.
Speaker 1: You want to be able to use the tone of
Speaker 1: your voice and the gesture of your hands. So if
Speaker 1: you're able to be in person, then touch is key.
Speaker 1: You want to touch the mother, You want to hold
Speaker 1: the mother, You want to massage the mother, give counter pressure,
Speaker 1: you want to stay close. And this is a lot
Speaker 1: of RuSHA on the support person, especially if you weren't
Speaker 1: planning to be the main support person. It takes a
Speaker 1: lot of focus and stamina to be present and pay
Speaker 1: attention for a long period of time. We want to
Speaker 1: one communicate face to face. We also want to really
Speaker 1: tune in and learn how to listen. We want to
Speaker 1: listen to what the mom is saying, hear how she's sounding,
Speaker 1: understand her concerns, and to be able to support that.
Speaker 1: So that takes a lot of focus and emotional presence,
Speaker 1: and we want to prepare for that. So here's a
Speaker 1: tip that I've suggested to some of my clients is
Speaker 1: on the mask, you can either maybe draw a smile
Speaker 1: on your mask, or maybe take a photograph of yourself
Speaker 1: smiling and pun that onto your shirt, or even take
Speaker 1: pictures of your honeymoon or a happy time together, or
Speaker 1: your pet or your puppy or your favorite beach location,
Speaker 1: print them out and then take them onto the walls
Speaker 1: so you can surround yourself with moments of feeling safe
Speaker 1: and at peace and joyful and happy. As for the
Speaker 1: moms out there, Chantal's first tip is to understand the
Speaker 1: new ambiance of the hospital. She says, it's important to
Speaker 1: mentally prepare for what labor and delivery look like right now.
Speaker 1: What you have to get used to seeing it is
Speaker 1: pretty much like a hazmatted vibe. Everybody is wearing overalls
Speaker 1: or gowns. Everybody, all the medical staff or even the
Speaker 1: housekeeping are wearing a mask. Their head is covered and
Speaker 1: they either wearing goals or a shield. So it's pretty
Speaker 1: surreal and something to adjust mentally for. The Other thing
Speaker 1: that I would really like you to prepare for is
Speaker 1: that at some point during your hospital will stay, you
Speaker 1: will be wearing a mask, whether that may only be
Speaker 1: entriage or if you happen to test COVID positive, And
Speaker 1: that's another adjustment to get used to just laboring with
Speaker 1: a mask. So I encourage you to just try a
Speaker 1: mask and use that communicating with someone. What does that
Speaker 1: I feel like to communicate? How does that change? And
Speaker 1: then how does that change when you're needing to breathe
Speaker 1: and maybe breathing quite hard. So try you know, exercising
Speaker 1: with a mask. Try marching in one spot with a
Speaker 1: mask and notice, you know, how does that feel. It
Speaker 1: takes some getting used to and I want you to
Speaker 1: already know what that feels like before you go in,
Speaker 1: once you have some expectation of what your birth experience. Maybe,
Speaker 1: like Shantal says, the next step is to learn the
Speaker 1: coping mechanisms now for calming the nervous system at any time.
Speaker 1: One of the ways to regulate our nervous system is
Speaker 1: to start developing a breathing practice. The breath is the
Speaker 1: way into common our nervous system. The breath is the
Speaker 1: way to manage in contractions. So developing a breathing practice
Speaker 1: now is so helpful for now, for labor, for when
Speaker 1: the baby cries postpartum. One breathing practice that is incredibly
Speaker 1: helpful is a simple belly breath. You can place your
Speaker 1: hands on your belly and take a deep breath in
Speaker 1: full your belly and take a slow breath out, deep
Speaker 1: full belly breaths, long slow exhales, so in hell, breathe
Speaker 1: into your belly into your baby. Excel in calms the
Speaker 1: nervous system. So when we take an inhale, we bring
Speaker 1: an oxygen to our baby, to all our organs, even
Speaker 1: the public floor, And when we excel it allows us
Speaker 1: to feel safe, to feel open, to feel calm. Chantal
Speaker 1: also suggests when those feelings of fear or anxiety do
Speaker 1: bubble up, to not push them aside, but actually experience
Speaker 1: them and then move on. We don't want to feel
Speaker 1: those feelings. Were very good about squashing them down or
Speaker 1: pushing them away, or scrolling on Facebook or going and
Speaker 1: doing something. But to be able to manage those feel ends,
Speaker 1: we want to be able to allow them to be there.
Speaker 1: If we allow them to be there and con sit
Speaker 1: with them, they usually only lost just a few minutes.
Speaker 1: So allow yourself to be with the feeling, feel the feeling,
Speaker 1: and let it pass. Now it may come up again
Speaker 1: soon after, So we want to develop a practice of
Speaker 1: being able to stay with the feelings, acknowledge them, name them,
Speaker 1: and feeling scared. Right now, I'm really anxious about the
Speaker 1: way this may go. That's okay. We can feel them,
Speaker 1: don't push them away. It's important to be able to
Speaker 1: sit with them and breathe through them. We have a
Speaker 1: moment in this time to actually recognize them for what
Speaker 1: they are and transform them and move ourselves more to
Speaker 1: how can we feel safe? What makes me feel safe
Speaker 1: right now? Does being in a quiet room make me
Speaker 1: feel safe? Does having someone look at me and smile
Speaker 1: at me make me feel safe? Does have just me
Speaker 1: hugging my puppy right now make me feel safe? What
Speaker 1: makes us feel safe? Let's explore that so that we
Speaker 1: can find ways to use that and support us in labor.
Speaker 1: So the more that we learn about what makes us
Speaker 1: feel safe, then we can ask for what we need
Speaker 1: or set that up for the time that we have
Speaker 1: to go to the hospital when all else fails, when
Speaker 1: the breathing exercises don't do the trick, or you've acknowledged
Speaker 1: all those feelings to no avail, She says, take a
Speaker 1: moment to connect with what's behind all of this in
Speaker 1: the first place. And lastly, don't forget you're having a baby.
Speaker 1: It's a very important time to connect to your baby.
Speaker 1: Take the time to talk to your baby, Take the
Speaker 1: time to sing to your baby. I have some of
Speaker 1: my clients uh either singing lullabys to their babies or
Speaker 1: making up a lullaby. If you don't know, this is
Speaker 1: something that you can do on your own to your baby,
Speaker 1: or spouse or partner can join in where you both
Speaker 1: talk to the baby or sing to the baby. But
Speaker 1: talk to your baby right now and be honest with
Speaker 1: your baby. You can tell your baby, I'm feeling really
Speaker 1: scared right now. I'm worried about how it's gonna be
Speaker 1: bringing you into the world. Right now. Your baby can
Speaker 1: sense your anxiety, so it's okay to communicate to your
Speaker 1: baby how you're feeling and how you're going to be
Speaker 1: protecting your baby. How are you going to do everything
Speaker 1: you can to bring the baby into a safe world.
Speaker 1: To talk to your baby now, talk to your baby
Speaker 1: during labor, and talk to your baby postpardon. And if
Speaker 1: your baby needs to be separated from you for any reason,
Speaker 1: then keep talking to your baby, whether it's energetically or
Speaker 1: when you are reunited with baby. You can say I'm
Speaker 1: so sorry that we had to be separated. I was
Speaker 1: so sad to be separated, but I'm so happy to
Speaker 1: be reunited with you now and express that to your baby,
Speaker 1: because your baby does sense the way that you're feeling.
Speaker 1: That was Shantal Trout Adula assisting moms and families in
Speaker 1: the New York region. Shantala is put together a guide
Speaker 1: exclusively for Next Question listeners that goes over some of
Speaker 1: these tips for preparing moms and their partners for giving
Speaker 1: birth during the coronavirus pandemic. You can download that at
Speaker 1: Shantal Trout that's c H A and T A L
Speaker 1: t R a UB dot com. And while you're there,
Speaker 1: you can also check out her virtual workshops, including Birthing Strong,
Speaker 1: which she designed specifically for helping women who are due
Speaker 1: during this pandemic. And that does it for this episode
Speaker 1: of Next Question. Stay tuned for next week's show, when
Speaker 1: we'll be releasing our special two part series on America's
Speaker 1: maternal mortality crisis that's coming up April. And for the
Speaker 1: most up to date information on the coronavirus, make sure
Speaker 1: to check out the CDC and the World Health Organization websites.
Speaker 1: You can also subscribe to my morning newsletter wake Up Call,
Speaker 1: where we're diligently compiling the day's most pressing news. You
Speaker 1: can do that by going to Katie Correct dot com.
Speaker 1: Until next time and my Next Question, I'm Katie Couric,
Speaker 1: thank you all so much for listening, and stay safe
Speaker 1: and healthy out there. Next Question with Katie Couric is
Speaker 1: a production of I Heart Radio and Katie Curreic Media.
Speaker 1: The executive producers are Katie Kurk, Courtney Litz, and Tyler Klang.
Speaker 1: The supervising producer is Lauren Hansen. Our show producer is
Speaker 1: Bethan Macaluso. The associate producers are Emily Pinto and Derek Clements.
Speaker 1: Editing by Derrek Clements, Dylan Fagan and Lowell Berlante, Mixing
Speaker 1: by Dylan Fagin. Our researcher is Gabriel Loser. For more
Speaker 1: information on today's episode, go to Katie Curik dot com
Speaker 1: and follow us on Twitter and Instagram at Katie Currich.
Speaker 1: For more podcasts for My Heart Radio, visit the I
Speaker 1: Heart Radio app, Apple podcast, or wherever you listen to
Speaker 1: your favorite shows.