When you imagined the day (or night) you give birth, you probably didn’t envision it would be in the midst of a pandemic.
Parents-to-be have extra concerns and challenges because of coronavirus disease 2019 (COVID-19), but rest assured that your medical team is prepared to deliver your baby safely.
Some of what you planned for might not be possible anymore, such as having more than one support person, but doctors, nurses and the rest of your medical team are committed to a positive, safe experience for mom and baby.
Before the big day comes, it might help to get a sense of who will be in the room with you at various times during labor, especially because they will be in PPE (personal protective equipment) and might be hard to see. Rest assured, there are dedicated, experienced professionals under those gowns and masks who are happy to be caring for you at this special moment.
Labor and Delivery Nurse
When you’re in labor, you’ll call your provider, who will tell you whether it’s time to go to the hospital. Once you’ve checked in to the labor and delivery department, you’ll meet your labor and delivery nurse. Consider this nurse your biggest ally: If you need something, he or she is there for you.
“This is the person who will be with you the most, and is your primary nurse,” says obstetrician Philip Deibel, MD, who delivers babies at UNC REX Healthcare in Raleigh, NC.
Your labor and delivery nurse is the link between you and your doctor or midwife. He or she will provide updates to your healthcare provider as needed. The nurse will ensure that you and the baby are doing OK by monitoring vital signs, such as heart rate and blood pressure, measuring your contractions and possibly conducting vaginal exams to help monitor labor progress. This person also will be with you during birth to assist your healthcare provider—and you—during delivery.
Keep in mind that you may end up with a different nurse if your nurse goes on a lunch break or you are in labor during a shift change (nurses typically work 12-hour shifts).
Doctor or Midwife
Your baby could be delivered by an obstetrician-gynecologist, a family medicine physician or a midwife. This may or may not be the person you have seen in the office during your prenatal visits. It will depend on who is on call when you deliver.
Your doctor or midwife will periodically check on you during the labor process and then will return when the nurse lets him or her know that it is time for delivery.
You may also want the support of a doula during your delivery. Doulas are trained professionals who offer physical, emotional and informational support to women before, during and shortly after childbirth. Doulas work closely with the labor and delivery team to help you have a positive birth experience.
You might decide you want an epidural to help you manage the pain of contractions and delivery. An epidural is medication, administered with a needle by an anesthesiologist, that blocks pain in a particular region of the body. In this case, your epidural will decrease feeling in the lower half of your body. Once you have an epidural, you are not able to leave your bed because of this reduced sensation, and you will need a catheter to empty your bladder.
Your anesthesiologist will return during delivery to check the level of numbness in your lower body to be sure it is high enough for delivery or surgery, if you end up needing a cesarean section.
If you don’t want an epidural, you can get pain medication through an IV or an inhaled gas called nitrous oxide. If you prefer to deliver without medication, your labor nurse and partner may help you walk around to help manage your pain.
As you get closer to delivering your baby, a second nurse will join your labor and delivery team. This nurse will take care of the baby as soon as he or she is born.
“One nurse focuses on mom while the other takes care of baby,” Dr. Deibel says.
Your baby’s nurse will clean off your baby and take his or her vital signs. Your baby’s nurse may be the first one to help educate you on newborn care and to help you try to breastfeed your baby.
Sometimes your labor and delivery team may need to call in other specialists to help care for you or your baby. For example, if you need a C-section, an assistant surgeon may join your doctor.
“If there is anything concerning that may require extra help, then a nursery team will be present for the delivery,” Dr. Deibel says.
This team usually includes a respiratory therapist and a pediatrician, neonatal intensivist or neonatologist. Usually this team is called in before the birth to be available to help mom or baby as needed.
“If the baby comes out and looks great, they just leave,” Dr. Deibel says.
But they are on hand to help with at-risk newborns if the need arises.
If you deliver at an academic medical center that trains nurses and doctors, you may have medical students, nursing students or residents in the room during delivery. (Depending on the hospital, this may not be permitted during the COVID-19 pandemic.) Ask about your facility’s policy for students at birth.
“You don’t have to allow them, or you could say it’s OK,” Dr. Deibel says. “That’s up to the patient.”
If you need a primary care provider, obstetrician or midwife, you can find one near you.