Anna Jackman was six months pregnant whenhit. The 36-year-old Long Islander has made plans to welcome her first child. Preparing the delivery plan for her sister and husband, the catheter prepared for her, the delivery plan for her hope. She told CBS News: “As a black woman, I have natural concerns.” “Will I be pressured on certain things? Will I be protected?”
But this pandemic undermines Jackman’s plan, just like thousands of pregnant women across the United States. Jackman is worried about contracting the virus, but she is also worried that the burden of the virus will impair the care she receives during pregnancy and childbirth. After spending several months considering the potential worst-case scenario, Jackman delivered the baby in June.
She said: “Before I went to the hospital, I told my husband,̵
Compared with other industrialized countries, the maternal mortality rate in the United States is incredibly high: In 2018, there were 17.4 maternal deaths per 100,000 live births. In comparison, there are 9 mother deaths per 100,000 live births in the UK, 7 in Canada and 5 in Japan. .
The CDC estimates that 60% of these deaths are preventable. The data also shows clear racial differences: Black women are three to four times more likely to die from pregnancy and childbirth than white women.
Black families and black people have long been committed to making pregnancy and childbirth safe and happy. But will a pandemic put them at higher risk?
New York City Health and Hospital/Northern Center Obstetrician and Gynecologist Dr. Heather Irobunda said: “Many reasons for the higher maternal mortality rate in black communities and the higher incidence of COVID-19 in black communities are the same.” Bronx “These The core of the cause comes from systemic racism, which leads to a higher incidence of underlying diseases, such as hypertension or diabetes, which not only increases the risk of death from COVID-19, but also increases pregnancy-related deaths.”
“In addition, people are also worried about hidden prejudice and its impact on medical services, especially among black mothers.”
Doctors worry that patients will “fall into a crack” between virtual visits. Expectant parents worry about contracting COVID, giving birth alone and raising their newborn in isolation. Will these factors lead to more preventable deaths?
“Frustrated having to be alone”
Stefani is a 30-year-old man from North Carolina. He gave birth to identical twin boys on April 22. Stefani asked for identification only by her name.
She said: “My husband dated me every time until I was about 30 weeks away, when I was told that he would no longer be with me because of the virus infection.” “Have to think alone, even if I become bigger, It is also very difficult for me to walk alone, which is really frustrating, and having to go through a longer date and test without him is really lonely.”
Stefani said that some of her OB-GYN clinic’s rotation providers did not thoroughly explain the matter and eliminated worrying symptoms such as high blood pressure and severe leg swelling. During her 34-week appointment, a doctor took Stefani directly to the hospital after checking her charts and symptoms. She was diagnosed with severe preeclampsia, which was induced on the same day. When her husband gave birth to twins by caesarean section, her husband was present. Her family is now safely together, but Stefani said she is still mourning the childbirth and recovery she had hoped for-affected by family and support.
She said: “I have been emphasizing how to keep the twins alive throughout my pregnancy.” “When the pandemic takes away any opportunity for my family to help, I cry almost every day.”
“I always worry about my patients”
Shifting in-person appointments to telemedicine visits will affect communication between patients and doctors. Carol Major, an obstetrician and obstetrician in Orange, California, said: “I have been worrying about my patients.” Major specializes in high-risk pregnancy and monitors health conditions. (Such as high blood pressure, diabetes and mental illness) mothers.
Major asks patients to do what they can at home, such as testing blood sugar levels or blood pressure. She said: “But it’s not the same as seeing them with your own eyes, because sometimes when you know them, you only have a feeling for a person.” “Sometimes I think,’They don’t look right.’ I I’m worried that I won’t be able to appreciate this on the phone.”
For families who cannot use telemedicine services, they worry that signing COVID-19 may prevent them from seeking medical services completely. Dr. Charlene Collier, an obstetrician and gynecologist in Jackson, Mississippi, said this is likely to affect rural families who live a few hours from their nearest provider. She said: “We don’t know how many people didn’t come in there or missed appointments because of this.” She knew that patients would worry about changing hospital policies, such as requiring mothers to give birth alone or separating mothers from babies. She said: “Women are worried that they have no symptoms of COVID and will be separated from their babies.
The anxiety and fear of childbirth during COVID also affect the family’s mental health. Saleemah McNeil, a reproductive psychotherapist at the Oshun Family Center in Philadelphia and a childbirth method, told CBS News: “Customers are feeling more and more stressed and more isolated. I feel condolences for the envisaged childbirth.” In addition, the parents felt cut off from their wider support network. McNeill said that during the pandemic, her practice received so many consultations about postpartum emotional disorder support that they hired more therapists to meet the needs of the community.
“I was not there at the time”
Due to the pandemic, some mothers have to give birth without a partner or supporter. Jawanza Keita and his fiancee Amelia welcomed their third child on April 5. Amelia, an educator in Philadelphia, only asked to call her by name. She told CBS News that the OB appointment felt “a bit impersonal” and pointed out that it is difficult to really establish contact with blocked providers. She said: “Out of the obvious concern for health and safety, the appointment is straightforward in nature, a fact, and does not exceed the time required to complete all questions, exams and procedures.”
The hospital guidelines allow a support person to be with Amelia, but if Keita is with her, others will have to care for their 5- and 3-year-old children and may expose them to COVID. When Amelia gave birth alone, they made the difficult decision to keep Keita with the child. The two communicated via video. He said: “I can only see the white walls and ceiling of the room on the camera screen.” He heard the baby’s first cry on the phone.
After childbirth, Amelia experienced severe postpartum hemorrhage-“The blood clot flowing through is larger than the nurse’s palm”. At the other end, when the medical staff manually cleaned the uterus and solved the problem, Keita felt helpless. He said: “I am full of uncertainty.” “Under normal circumstances, I feel that people who are sick or under treatment should have a champion. A champion can help ensure clear communication, compassion, and good decision-making. But I am not here. There. I can neither protect nor defend her.”
“We are trying to answer many questions”
Doctors are not yet sure how COVID-19 will affect the number of mothers and babies who have died. But they do know that the pandemic has made the birth and recovery of many families more terrifying and more lonely. COVID-19 has a disproportionate impact on people of color, and it is likely to affect black maternal mortality.
“We tried to answer a lot of questions,” Collier said. “Maybe, a year from now, maybe we can do this. But it’s still unfolding.”