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Giving Birth During Covid19: Protocols and Possible Interventions

Coronavirus continues to be a threat to the American public. Because of this, giving birth during covid19 in a hospital or a healthcare setting has many expecting parents feeling more anxious than usual. To help parents feel more confident and in control, common labor and delivery interventions are detailed below including coronavirus protocols. If interventions happen, parents and support people will know exactly what’s happening and why. Knowing the facts help us make informed decisions, and this blog Giving Birth During Covid19: Protocols and Possible Interventions can help you be prepared.

We will continue to update this blog as more information becomes available. 

newborn twins born during covid

Whether opting for a natural birth or an epidural, it can be helpful to understand the basics of medicines that may be administered during labor. Knowing the terms doctors and nurses use , and understanding the effects of potential interventions can help parents can feel comfortable. Decision making can happen quickly, especially if there are unexpected changes.

Below is an overview of medications, protocols and interventions that may be used during labor and birth.

Giving Birth During Covid19: Protocols and Possible Interventions

As coronavirus continues, many hospitals are now implementing stricter rules on their maternity floors. Each hospital is different so it’s important to understand your hospital or birthing center’s specific procedures but we do know that in almost every hospital, everyone should be prepared to wear masks even during labor.

Many hospitals are also implementing either a 1 visitor rule, meaning that birth moms can have 1 designated person supporting them through labor and delivery. The support person cannot change through mother’s entire stay in hospital. If it’ your sister who brought you to the hospital, it must be your sister who stays as your “plus 1” during all of labor and delivery. The support person can come and go, but cannot change.  Generally, no children under 18 are allowed to visit at all during this time.

One thing to remember is that maternity wards are typically in a completely different, secured section of the hospital to minimize exposure risk of coronavirus and other illnesses to families and newborns. Coronavirus protocols are in place to protect families in a place that is considered safe to begin with. Epidurals, Anesthesia and Spinal Blocks

  • An epidural is the local anesthesia administered just outside the membrane that surrounds your spinal cord and spinal fluid. Epidurals are the most common pain relief for laboring mothers. While there are differing opinions on the effect epidurals have on baby, they are overwhelmingly considered safe for baby’s health. There are reports of babies born to moms who have had epidurals taking longer to get into position for birth, since the epidural also travels to the baby through the umbilical cord.

Temporary side effects of epidurals are heavy shivering, a ringing of the ears, backache, nausea or difficulty urinating. These are also considered harmless to mom and baby. Because they are used to dull the intense sensations of labor, an epidural may also slow contractions.

  • Spinal Block– A spinal block is a type of regional anesthesia, where the body is numb from the belly down. This is the intervention used for c-section birth since it means that mother cannot move, or feel any sensation.
  • General Anesthesia Use of general anesthesia is extremely rare, but we’re including the term so parents will know the difference between general and regional anesthesia. General anesthesia means being completely asleep. (An example of when general anesthesia would be appropriate is if birth needed to be induced due to a traumatic car accident- again, very rare). Regional anesthesia again, is being numb in just one area (region).

Because the body is numb from the belly down with anesthesia, a Foley catheter will be inserted into the bladder to drain urine.

Giving Birth During Covid19: Protocols and Possible Interventions

Oxygen

Oxygen, administered through an oxygen mask to laboring moms helps mother deliver oxygen to baby. The oxygen mask might be given if baby’s heart rate is dropping due to fetal distress during labor. This can be scary but the good news is that giving oxygen is common and has no adverse effects.

Pitocin

Pitocin is a synthetic version a natural hormone called Oxytocin. It’s a stimulant commonly given to induce or strengthen contractions. It may be given after an epidural because the epidural has slowed labor. It may also be given after birth to ensure mother does not hemorrhage to help the uterus contract back to its non-laboring state. Pitocin is generally considered safe,, potentially causing unnecessary problems during labor and early breastfeeding.

Common side effects of Pitocin may include nausea, stomach pain and runny nose or sinus pain. Rare side effects may include confusion, slurred speech and headache. The doctor must be notified immediately if any of these are present.

When Pitocin is administered, Labor & Delivery nurses watch to be sure that contractions are not occurring too severely or too frequently. These types of contractions can cause uterine rupture, meaning that the uterus tears creating a danger to both mother and baby. There is typically a 1:1 nurse to mom ratio when Pitocin is administered. This ensures the laboring mom and baby are safe and monitored correctly.

Giving Birth During Covid19: Protocols and Possible Interventions – Pain Management

  • Percocet is the most common medication given to help mothers with pain management after delivery. It is an opioid. Most opioids are not advised for nursing newborns, so when possible, sticking to NSAIDs like ibuprofen (Advil or Motrin) for pain relief is preferred.

For a cesarean or difficult vaginal birth, Percocet is appropriate to help with the high level of pain.

If the goal is to nurse right away, the best thing to do is to nurse before Percocet is administered. If it’s decided that nursing on demand is okay on Percocet, the main thing to do is to watch baby for marked drowsiness. For a full term, healthy baby there will be side effects like sleepiness, but no lasting effects.

You may also choose to pump while Percocet is in your system and save the milk. Baby’s 6 months or older can drink the pumped milk without any danger. Once baby is past the newborn phase, the effects of opioids decrease.

If early formula supplementation is chosen so that opiods don’t travel to baby, it is still extremely possible to still have an exclusive breastfeeding relationship.

Blood Pressure Control and Gestational Hypertension

Preeclampsia, also sometimes called toxemia, is high-blood pressure in pregnant women. It can become very dangerous and even fatal if left untreated. Treatment for preeclampsia is administration of Magnesium Sulphate, also called “Mag.” Mag keeps Preeclampsia from advancing to Eclampsia, which manifests as seizures. If given magnesium sulphate it’s perfectly normal if birthing moms feel too sick to nurse right away.

Hypertension meds like Procardia or Labetalol are beta-blockers that may be prescribed to keep blood pressure down. These do not affect nursing of healthy full-term newborns.

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This blog was written under the direction of present and former Let Mommy Sleep Labor & Delivery and NICU Registered Nurses. As always though, the primary care physician and L&D staff are the authority on care.

Advice for New Parents from Author Kristina Schnack Kotlus

Advice for New Parents from Author Kristina Schnack Kotlus, author of I Quit: Facing Cancer with Faith, Family and Friends. Written by a brain cancer survivor, I Quit provides strength and encouragement to individuals struggling with cancer from the perspective of someone who has experienced it firsthand. Candidly sharing her experiences with chemo, radiation, and doctors, Kotlus outlines how her faith and family directed her cancer journey, and how she maintained a positive attitude in the midst unfortunate circumstances.

Advice for New Parents from Author Kristina Schnack Kotlus
Advice for New Parents from Author Kristina Schnack Kotlus

I Quit: Facing Cancer with Faith, Family and Friends encourages patients with a positive Christian message to choose joy and choose peace in the midst of cancer’s turmoil. Filled with raw, honest emotion balanced with humorous anecdotes and encouraging words of wisdom, I Quit features themes of determination and resilience that will inspire those diagnosed with cancer to keep fighting, and push through their diagnosis. 

Given her unique perspective, we asked the author her advice for new and expecting parents.

Having been through so many unpredictable ups and downs, what’s your advice to expecting and brand new parents just starting their family journeys?

I am going to give you two:

First, you will NEVER regret the time you spend with your babies, so don’t let anyone tell you that you should feel bad if you take an extra week before you go back to work or if you work from home every time their daycare is closed. I opted to stay home with my children, and am still home with them because we homeschool, and looking at possibly not making it out of brain surgery alive, I regretted many things, but my time with them was not one.

Second, listen, stuff happens, and as a parent one of your jobs is to provide your children with as much stability as possible, even if you can’t be there.

Get a will. Select the people that will take your child if the unthinkable happens, and make sure you ask them if they’re willing to do it. Our will has so many if/then statements that we have 5 people listed to take our kids in order of who we want first. Saving for the future is important, but make sure you have a saving for now- try to get to 3-6 months of living expenses saved up so that if you are sick or injured, or your child is, you won’t have to panic. I know that’s hard, and you don’t have to do it TODAY, just start working towards that goal. 

Curious to know your thoughts on coronavirus, having literally faced down cancer twice…what do you think of the public response?

They typically estimate 1,735,350 new cases of cancer will be diagnosed in the United States and 609,640 people will die from the disease each year, but despite the likelihood of that, I don’t really see people in a frenzy to get checked or change their lifestyle if they are smokers, etc. But the big thing for me is that my whole approach is to chose faith over fear, so I really want to encourage people to do what they CAN do, like wash their hands, or make arrangements to stay home if their immune system is compromised, and then let go of the future outcome.

Your fear and worry cannot change what will happen, so let that part go- which is all part of my “I Quit” philosophy. Also, stop hoarding the toilet paper, because we’re going to run out soon!

More about Advice for New Parents from author Kristina Schnack Kotlus

Kristina Schnack Kotlus is a brain cancer survivor. She has a degree in Comparative Religion from George Mason University by way of Holy Cross College. She was baptized a Lutheran, currently attends an Assemblies of God church, and is married to a non-practicing Jew. Her writing has been published in numerous local magazines and newspapers. Kristina was recognized as Blogger of the Year in Northern Virginia, 40 Under 40 in Northern Virginia, and an Influential Woman in Prince William County. She currently resides in Manassas, Virginia, with her husband and three children, who she homeschools.

If you are a blogger, author or expert with a perspective on newborn care or parenting to share with our audience, please let us know!

Q&A for Postpartum Workers During Covid19: the CARES Act, Essential Work and Unemployment

Newborn care providers and other 1099 care workers such as postpartum doulas who have lost work due to covid19 are now able to file for unemployment benefits. The temporary change is part of the $2.2 trillion stimulus package titled Coronavirus Aid, Relief, and Economic Security or CARES act.  Caregivers are also eligible for stimulus checks if they earn less than $99,000 per year and can both file for unemployment and receive a stimulus check; it doesn’t have to be one or the other.  Q&A for Postpartum Workers During Covid19: the CARES Act, Essential Work and Unemployment details are below.

Here is the basic information for doulas, night nannies and other newborn care providers: 

Postpartum Workers During Covid19

STIMULUS CHECKS – Who Will Get One and How Much Will They Be?

  • As long as you have a Social Security number, filed taxes in 2018 or 2019 and meet the income requirements of less than $99k, you will receive a check.  
  • Green card holders will not receive checks. Only immigrants with valid Social Security numbers and people who qualify as resident aliens will receive the checks.
  • The amount is a maximum $1200 per adult and $500 per dependent. The amount is determined by how much you’ve earned in the past (less earnings = higher check amount).
  • You will receive a check if you made less than $99,000 last year or you and your partner together made less than $198,000.
  • Your taxes must have been filed in 2018 and/or 2019.
  • Checks will be generated automatically. You do not have to do anything to receive a check.

UNEMPLOYMENT BENEFITS – Can I get them even though I’m a private contractor?

Even though you may be 1099 private contractor, you are eligible for unemployment 24 hours after your final shift/work time has ended.  Here is everything you need to know about how to file for unemployment benefits. Don’t forget that you need to file every week that you’re not working.  According to the new laws specific to covid19 and unemployment, the unemployment benefit is a flat $600. However some state websites are reporting different numbers so you’ll want to get the exact number from your state’s unemployment office.  

Here is what we know:

DC RESIDENTS:Use this website to file for unemployment: does.dc.gov 

Maximum weekly amount: $444 per week for 26 weeks

MARYLAND RESIDENTS:Use this website to file for unemployment: https://www.dllr.state.md.us/employment/uicovidfaqs.shtml

Maximum weekly amount: $430

Maximum weekly amount: $378 per week for 26 weeks

Postpartum Workers During Covid19  – AM I AN ESSENTIAL EMPLOYEE?

Postpartum support professionals, and others in baby and childcare are not mentioned as essential workers in the guidance provided by the Dept. of Homeland Security.  While there is certainly an argument to be made that yours are indeed essential services, there’s no clear guidance. Services could fall under the category of “therapeutic care” if a case needed to be made. If you are still working in a state with a stay at home order, it’s a good idea to travel to and from work with doctors’ orders or other written notification of services.   

We hope everyone stays safe and cozy at home and we look forward to getting back to work when this is all over! If we can help families or workers in the meantime, let us know.

Grow a Kitchen Scrap Garden!

You don’t need lots of room to garden and you don’t need to spend money on seeds! You can grow your own groceries and Grow a Kitchen Scrap Garden!

With coronavirus keeping us all at home, most of us are racking our brains to come up with new homeschool activities, new foods and ways to minimize waste without breaking the bank.  With all that in mind, here’s how you can make your own garden just from kitchen scraps. You don’t even need real pots because used plastic containers will do! Best of all…we promise it works!

Grow a Kitchen Scrap Garden! 

Celery Stumps

  • Just cut off the stump and place it in about ¼ inch of water…any small dish or bowl will do.
  • If you have toothpicks place 4 toothpicks in the bottom to suspend the celery over the bowl but have the root still touching the water.
  • Celery will start to grow in about 2-3 days! Once it’s too big for your bowl, just pop it in the ground. No special soil is needed, and the celery will come back each year.  It’s usually best to start seeds indoors just to be sure they’re staying warm enough in the early weeks.

Tomatoes

  • Cut open a tomato and squish the seeds out onto a dish or paper towel. Rinse the seeds in a little cup and then place the seeds on a paper towel to dry them.
  • Let them stay on a windowsill or other safe place for a day or 2, to be sure they are completely dry.
  • Put the seeds in a little pot or the ground about ½ inch under the dirt. Any pot or soil will do!  

Potatoes

  • If you have small potatoes, cut them in half and place in the ground about 1 ½ inches below the surface. Make sure they’re fully covered and that the eyes are facing up toward the sun.
  • If you have large potatoes or sweet potatoes, cut them into 5 or 6 pieces around the eyes. Don’t cut through the eyes because the eye is basically the root or the “seed” that makes new potatoes.
  • In about 6 weeks you’ll see hearty green stems with little yellow flowers come up from the ground where you planted the potato. They kind of look like weeds but they are the signal that your potato is almost ready! When you see the flowers, it will be tempting to pull the potato up but don’t! Leave them in the ground for another 2-4 weeks or longer and they’ll be ready. The longer you leave them in, the bigger they get and the more you’ll have!  

Root Vegetables like ginger, onions, scallions or radishes

  • This one’s easy – just cut the root and let it sit in water (hanging is better but not the end of the world if you can’t)
  • You’re veggie will grow from there….you can put it in the ground or leave it in the bowl for as long as it grows.

Dirt, Soil and Containers

It’s fine if you use whatever is around your house and neighborhood.  These veggies are hearty and not fragile. If you want to fortify your soil though, simply mix in some used coffee grinds…just like with humans, coffee perks up seeds and roots!

If you don’t have a pot, that’s okay too! Just cut the top off your milk carton or any plastic container, making sure an adult cuts a few holes in the bottom to let out excess water.

Looking for more activities? Here are Toys Siblings Can Play with Together!

Chicago Area Resources for New Moms and Dads

updated June, 2 2024– The Chicago night doulas and baby nurses of Let Mommy Sleep have complied a list of helpful Chicago Area Resources for New Moms and Dads. We are not just a night nanny agency, but a postpartum overnight infant care provider that cares for the whole family. With the amount of national and statewide programs online, searching for postpartum support after your newborn arrives can be overwhelming.

Chicago Area Resources for New Moms and Dads
Chicago mom with toddler and newborn

Chicago Area Resources for New Moms and Dads

  • Postpartum Mental Health Support:  Perinatal Mood and Anxiety Disorders (PMAD’s) are the most common complication of pregnancy, with one in 7 mothers experience postpartum depression. Morever, fathers and partners can also experience postpartum issues, called Paternal Post Natal Depression. Early intervention is proven to be key in helping your mental health.

Postpartum Support International (PSI), Illinois Chapters has free postpartum and postnatal support meetings at 11 area medical centers, hospitals and private facilities. Meetings are held throughout Chicago and the suburbs.

  • Crisis Support – If you’re in need of immediate care, contact the National Maternal Mental Health Hotline via text or phone at 1-833-TLC-MAMA.
  • Twins, Triplets and Higher Order Multiples: If you’re expecting more than 1 baby at a time, twins and multiples clubs are a fantastic source of advice from “been there, done that” parents.  Multiples of Illinois, (also known as the Illinois Organization of Mothers of Twins) has Local chapters in Cook County, DuPage, Kane, Lake, Peoria Counties. There is a club for you now matter what town you live in!

Parents of Multiples groups also have referral lists of night nannies, baby nurses and postpartum doulas specializing in the care of twins.

  • Breastfeeding Support:  Perhaps the best known resource for nursing help is La Leche League International (LLL). That reputation is well earned as LLL has been helping moms and consulting with medical professionals since 1956.

La Leche League of Illinois offers in-person meetings, breastfeeding cafes and virtual support. They have email and phone support, and in person meetings open to all who are nursing, feeding human milk or support nursing. Meetings are led by accredited Leaders who are also experienced breastfeeding parents.

Whether you are in the immediate postnatal phase of nursing or later in your breastfeeding journey, LLL is one of the best Chicago area resources for new moms and dads.

Social Support

  • Dad’s Support Groups: Chicago Dads Group is a place for Chicagoland dads to form networks of friends. There are also resources to become the best fathers they can be. Not only do they have Meetup events but they also have a blog.
  • Chicago MOMS Club– Find your fellow neighborhood parents with newborns, infants and toddlers the same age as your own kids! Mothers Offering Mothers Support is a non-profit designed to help stay at home parents and nannies meet friends in the neighborhood for free and low-cost social events.
  • Every Mom Chicago – Non- profit organization that connects expectant mothers in underserved communities with the material and support resources for the critical (and challenging) early weeks of parenthood. Every Mom Chicago provides new baby kits with newborn, postpartum, and breastfeeding essentials.

Chicago Area Resources for New Moms and Dads – Postpartum Doulas and Night Nurses

Our team of certified newborn care providers and postpartum doulas offer you evidence-based feeding and baby sleep support. We can visit before your baby arrives to help you get prepared and confident, in addition to helping when you’re just home from the hospital with your newborn.

Our team serves: Grayslake, Libertyville, Lake Zurich, Vernon Hills, Buffalo Grove, Wheeling, Palatine, Barrington, Arlington Heights, Des Plains, Park Ridge, Morton Grove, Wheaton, Naperville, Downers Grove, Elmhurst, Oak Brook, Hoffman Estates, Lombard, Carol Stream, Hinsdale, Western Springs, Winfield, Deerfield, Northbrook, Northfield, Glenview, Evanston, Wilmette, Kenilworth, Winnetka, Highland Park, Lake Forest, Lake Bluff, Deer Park, Oak Park, River Forest, Lincoln Park, Lake View, Logan Square, Edgewater, Rogers Park, Lincolnwood, Bucktown, Uptown, Downtown, Lincoln Square, Wicker Park, West Loop, South Loop, The Loop, Streeterville, River North, Old Town, Gold Coast, Mayfair, Andersonville, Ravenswood, Irving Park, Glen Ellyn, Glencoe, La Grange and Schaumburg 

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