How to Have a Positive and Confident Hospital Birth during COVID-19

While giving birth has always included many unknowns for expectant parents, COVID-19 has created more questions and confusion for many parents-to-be. Educating yourself about what to expect during labor in the pandemic will help you feel more positive, confident, and ready to bring your baby to this world. This may not be what you envisioned, but you can do this! These COVID-19 birthing tips will support you in having the best hospital birth possible given the uncertain circumstances.

What should I do to prepare before labor during COVID?

• Get comfortable wearing a mask indoors and for long periods of time. Almost all people in labor will be required to wear throughout their entire labor. Wear your mask periodically throughout the day during your pregnancy, especially while doing light exercise to get used to wearing a face covering. 
• Take a childbirth class. Learning about birth will teach you the stages of labor, when to go to the place of birth, a variety of pain-coping techniques and the risks and benefits of various medical support or interventions which could become necessary during labor. Childbirth class can increase your confidence and feelings of preparedness. 
• Pack your labor bag with these additions for COVID times. In case your partner tests positive for COVID or your doula is suddenly not allowed in, extra things in your bag will allow you to connect virtually when needed. 
  • Mask or face covering (you may be issued one by the hospital once you settle into your room) 
  • Laptop and laptop charger (if using a virtual doula)
  • Tripod or adjustable cell phone arm to allow ease in virtual communications.
  • Phone charger and extra charger
  • Sanitizing wipes
  • Hand Sanitizer
  • Toiletries that you can throw out
  • Food and drink you may want for labor or after.
  • Just in case your partner or doula tests positive for COVID.
    • Pre-record your partner talking to you
    • Bring something that smells like your partner
    • Partner or family member can write a supportive and empowering note to you to tuck into your bag
• Learn the current COVID protocols of your place of birth and your midwife or doctor. Protocols change frequently, so around 34 weeks of pregnancy is a good time to begin asking questions and learning what to expect when you arrive. Ask what your hospital or birth center’s protocol is about skin-to-skin if you test positive. The CDC recommends that birthing parents be kept with babies in most instances when they test COVID positive and encourages nursing.  
• Consider hiring a doula. Doulas provide emotional, physical and information support to laboring parents and their partners. Doulas decrease the likelihood of having a cesarean birth, increase peoples’ satisfaction with their birth experience, decrease the likelihood of having postpartum depression and increase the likelihood of successful nursing. They are not only your advocate and your support throughout labor, they also help with prenatal preparation and birth planning through prenatal education. A doula who has worked at your hospital can give you a lay of the land, since you cannot visit your hospital in person currently. During birth they will use or show comfort measures throughout labor. They can demonstrate pain management skills and do guided imagery or relaxation. Virtual doulas can do a lot of this remotely. Make sure to talk to your care provider ahead of time about incorporating virtual support. 

When to call your doctor and doula/when to leave for the hospital? 

• Call your doula. Call them when you first go into labor so they can provide early emotional and physical support, guidance, tips and more. 
• Unless you are high risk, staying home is preferable and suggested by most care providers in the early stages of labor, especially during COVID. 
  • Your care provider will indicate when they want to be called toward the end of your pregnancy. Some want to hear from you when you go into labor; others will ask that you call when your contractions are a certain distance apart.
  • Your midwife or doctor will tell you when they want you to come into the hospital or birth center during labor.
  • Your childbirth class will teach you how to recognize the signs of labor and how to assess how far along you are through timing of contractions and assessing your labor behaviors.
• Most care providers suggest that you come in active labor which is defined as about 6cm by the American College of Obstetricians and Gynecologists (ACOG) or when contractions are lasting at least one minute long and are approximately 3-5 minutes apart (measuring from the beginning of the first contraction to the beginning of the next contraction). Typically the birthing parent should also be unable to effectively talk during a contraction because all their concentration is going toward managing the sensations of labor.
• Getting to the hospital.
  • If you have a car, your partner or family member can drive you. 
  • Some car services offer transport for people in labor. Try to find a service which is fully sanitizing the car between rides. 

What happens once I arrive at the hospital? 

• What to expect: 
  • You’ll walk in wearing a face covering. 
  • Someone may offer a wheelchair. Unless you wish to sit in it, most laboring parents prefer to walk (walking helps facilitate labor).
  • Wash your hands for 20 seconds when you get to the maternity floor. 
  • The birthing parent will take a COVID test (and possibly the partner and/or doula).
  • You’ll be assessed in triage (vaginal exam, fetal monitoring, etc) or will be directed right to your labor and delivery room where this assessment will take place. 

• Some items and techniques to help you  feel calmer and more comfortable and cope with the sensations of labor
  • Hair comb. Squeeze a hair comb in your palm to create mini-sensations which compete with your cervix-opening sensations, diminishing the pain or sensations of your contractions.
  • Tennis ball. Place a tennis ball behind your back to give yourself lower back relief when in hospital bed or use under your foot while standing.
  • Music. Listening to music can shift how a person perceives their pain in labor (and in life). Music is known to help people relax, reduce anxiety and create distraction.
  • Aromatherapy. Lavender is calming, peppermint is energizing, and lemon can help with nausea. Many people find scent to relieve stress, reduce pain and make labor more manageable. 
  • Fake candles. Dim lighting can help you feel safer and calmer in labor. 
  • Get more tools and tips to cope with labor in our ebook here. 

• Questions to ask your care providers during labor. These questions will help you feel empowered when trying to make a decision if a medical procedure is suggested to you.
  • Is the baby ok?
  • Am I ok?
  • If the answer to both above is yes, can I have more time to think about it?

We hope these tips will help you have a confident and positive hospital birth. If you’re experiencing persistent worry or anxiety, check in with a mental health provider who focuses on pregnancy and postpartum. Even one session can help. You are not alone.