If anyone knows about the dangers and concerns of giving birth during the coronavirus pandemic, it’s Dr. Leana Wen.
The emergency physician and former health commissioner for Baltimore has been a leading voice in public health and a frequent national commentator on coronavirus. She was also one the first experts to express deep concern that Americans weren’t taking social distancing recommendations seriously enough.
Wen, who on Friday gave birth a healthy 7-pound, 2-ounce baby girl, Isabelle Wen Walker at Mercy Medical Center in Baltimore, detailed her pregnancy and delivery journey in a video diary for “Morning Joe” and Know Your Value.
Like many near-term pregnant women during the height of the coronavirus pandemic, Wen too had a host of worrisome, previously unimaginable questions. Would her partner be allowed in the delivery room? Would she be induced early if hospital capacity became an issue? Would her newborn be safe in the hospital after birth?
Here’s a look at Wen’s thoughts, concerns and observations:
Sunday, 3/29: Will the hospitals be too crowded?
5:00 p.m.: “My baby is due on Tuesday, although there is no sign of her quite appearing yet.
I've been thinking a lot about how different this time is from when I was about to give birth to my son two-and-half years ago, and I was thinking about...how to install the car seat and whether I would get help for breastfeeding. And this time, I'm thinking a lot about whether I should be inducing labor so that I can go in before hospitals get too crowded. And I worry about whether my husband would even be allowed to come with me when I give birth.
…There’s just a lot in the next few days that I don’t quite know how to prepare for or anticipate. I mean, I packed my hospital bag, my husband is packing his, we're getting our son ready so that we know where he's gonna go when I go into labor. But we don’t know what's gonna happen when I actually get into the hospital. Last time, I walked around a lot in a way to try to induce labor, but I know I'm not going to be able to that this time. Again, I don’t whether I'm going to induce labor if the baby doesn't come in the next few days. I think that uncertainty that so many of us who are pregnant … so many of us with medical conditions that have to be treated will be thinking about.”
Monday, 3/30: A mandatory stay-at-home order is issued
5:00 p.m.: "...Gov. Larry Hogan has just issued a mandatory stay-at-home shelter-in-place order, which is about time. It's definitely the right thing to do but it does also make me wonder what information is he seeing from the perspective of our hospitals and hospital capacity, that's making it necessary? It's the right public health measure but another illustration of the changing and very rapidly evolving times that we're in."
Wednesday, 4/1: ‘I really, really want to deliver this baby’
Before 9:00 a.m.: "So I'm about to drive to the hospital … I have my routine OB appointment, so my husband can't come with me because of the no visitor policy and we'll see. I mean I really, really want to deliver this baby. I am concerned as I've talked about, about hospital overcrowding. But I also think about, what if the baby gets sick and I don't want to have to take the baby in during the first 28 days when her immune system will be really weak and going in to a hospital that's battling COVID-19. So for all these reasons I'm hoping that I'll be ready to deliver so I'll keep you posted."
9 a.m.: "So I just got to my hospital...And it feels totally different. It's a weekday, but there are barely any people here. There's a ‘no visitors’ sign. I got my temperature checked as I entered, I got asked a list of questions, was asked to use hand sanitizer and I'm about to walk into my OB's office."
9:30 a.m.: "So I just got my cervix checked, and I'm a bit dilated but not enough and actually the labor ward is full and so induction is not going to look possible so I'm discussing the options with my OB shortly. But it looks like I'm gonna be headed home and we'll just keep on waiting."
Friday, 4/3: A healthy baby, but ‘I am worried about exposure’
4:45 a.m.: "... I've called the hospital, and they actually have a bed available. So I'm all packed virtually and we've had our bags packed actually for a few weeks now. We're gonna go, and I called ahead of time. Sebastian, my husband, is able to come. He's the only person allowed, and they can only have one person so they can't rotate in and out … We are packed, we are ready. I never thought I'd be so excited to have a hospital bed available but here it is, and we'll see how this day unfolds.
… I've been trying to reach my pediatrician to ask about when we should be bringing the new baby when she arrives to the pediatrician. Technically, it's supposed to be the day after. So, the day after you go home and be discharged, you're supposed to bring the new baby to a newborn visit. But the problem is I am worried about exposure. I actually don't know what the policies are at the pediatrician's office and while I want her to get checked out, I also want to limit exposure to potentially COVID-19 in the office. And so, it's just another one of the things that we have to be thinking about now that I certainly was not thinking about the last time around."
11:40 a.m.: "...I'm definitely a lot more uncomfortable, and I'm actually just finishing a contraction now. But my water broke, I am now five centimeters dilated, which is all good ... Things are getting more intense. I found out that we actually have two dedicated anesthesia people who are today, and that they're dedicated to OB anesthesia. Our hospital doesn't have a lot of COVID patients yet, but I do worry about if I were in a hospital that had anesthesiologists that were intubating COVID patients, maybe they wouldn't be so available to do routine care … Things that are not as emergent s intubations for respiratory arrest. But anyway, things are definitely getting more intense here."
3:00 p.m.: "…As you can see, I've actually delivered the baby. Things went really fast and ... I'm just really happy that she came out. Her name is Isabelle and she's 7 lbs 2 oz … She is now feeding, and we're doing skin to skin. This really went about as well as I could have hoped for. Everybody's healthy, I feel fine ... and I just can't quite believe it all happened."
6:30 p.m.: "We are now obsessed with the idea of trying to leave as soon as possible...The providers are wonderful here, we love the hospital, but we are worried about exposure. I actually tried to see if we could leave tonight but I think that in and out in less than 12 hours just didn't make a lot of people comfortable, and she hasn't actually gotten examined by a pediatrician yet. But I am just worried about how much exposure everybody has and because of lack of testing we just really don't know. We'll probably end up staying the night, and I want to leave as early as possible tomorrow morning."
Saturday, 4/4: We want to leave the hospital as soon as possible
3 p.m.: “We hopefully are going home soon depending on what happens with Isabelle's newborn examination. So, she's upstairs in the newborn nursery -- can't go with her for fear of exposure, and she's specifically getting a bilirubin level that's tested 24 hours after her birth. Now if it's borderline, we would actually stay in the hospital because the idea of going to a follow-up appt in a lab, a public lab tomorrow, just would increase the exposure for her. Which again is one more difference that we're experiencing in these times. So that fingers crossed we'll be able to leave shortly if her levels are good.
… I've also been talking the whole day on and off with our lactation consultant, the one that our hospital provides. She was a lifesaver last time with [my older child] Eli because she just helped us identify all these issues with feeding that actually led to him not having to get treatment for increased bilirubin and jaundice. You know, I'm so thankful to have her here, and she's a woman who is older, has chronic medical conditions, and I guess some people could consider her non-essential. But she is still here. She's working every day, and I just think about the lives that she is changing while she's putting herself on the line. Like so many other frontline providers are."
4 p.m.: “The great news is that we are going home, so Isabelle's bilirubin was just fine, not borderline. So, we don't need to go for repeat testing. We do have a pediatrician's appointment set up for Monday, but we're gonna go home. We are packed up, we're gonna go home and then pick up Eli [who will] meet his baby sister for the first time. We're just really grateful for the care that we received here from just some incredible people …. and thankful to be bringing back...someone who brings us so much joy in this crazy time."