By Virginia Breen, originally published in THE CITY.
Anxious first-time mom-to-be Keri Lynn Patton spent two hours awaiting transfer to a labor and delivery area of New York-Presbyterian Brooklyn Methodist Hospital without her husband, Dave.
“I was totally alone and they were so short staffed,” said Patton, 32. “But since I was in a triage area and technically not in a delivery room, Dave wasn’t allowed.”
Once she gave birth on April 9 to their 9-pound, 9-ounce daughter Freya Rose via Cesarean section, the hospital booted Dave out after two hours.
“I had to have faith that the hospital would take care of my wife and child and it wasn’t right that I couldn’t be there to advocate for them,” Dave Patton added. “Having our first baby is already stressful and this policy is making it worse.”
The Patton’s childbirth ordeal mirrors many couples’ experience amid changing and inconsistent maternity policies due to the coronavirus pandemic.
Advocates charge hospitals are still not fully complying with Gov. Andrew Cuomo’s executive order allowing a partner to be present during childbirth — leaving pregnant women to navigate often overcrowded and understaffed hospital settings alone for much of the time.
“Many New York hospitals are complying with certain aspects of the executive order, but not others, because it was somewhat vague and has allowed for a wide range of interpretations,” said Jessica Pournaras, a city-based doula who started a change.org petition to demand the state clarify Cuomo’s order to ensure partners are allowed to accompany mothers through the entire postpartum hospital stay.
Pournaras reported hearing from “dozens, at least” of pregnant women whose partners were denied access either during early labor or shortly after delivery. The petition asks those aware of hospitals removing support after birth to file a complaint with the state Department of Health.
The state DOH did not return requests for comment, but top Cuomo aide Melissa DeRosa and the state Council on Women and Girls announced earlier this week the creation of a COVID-19 maternity task force to address a number of issues surrounding childbirth during the pandemic.
A lack of uniformity in maternity policy has led to “mass confusion and chaos among pregnant people and their families over the past several weeks,” Pournaras told THE CITY.
Her petition, which had more than 21,500 signatures by Wednesday, follows Cuomo’s March 21 executive order backing up a state Department of Health directive that required hospitals to allow one support person in labor and delivery settings. The order also allows two designated support persons in pediatric settings, provided that only one is present at a time.
Cuomo’s move came in response to the decision by some hospitals, including Mount Sinai and New York-Presbyterian’s network, to ban support persons from labor and delivery rooms because of coronavirus concerns.
The policy sparked a surge in inquiries for home deliveries, local doulas and midwives said.
The state’s health advisory reversed the ban, but noted that support persons accompanying labor and delivery and pediatric patients “must be asymptomatic for COVID-19 and must not be a suspect or recently confirmed case.”
In addition, hospital staff must screen the support person for symptoms and take their temperature every 12 hours.
Despite the seeming clarity of the directive — which put words like “requires” and “must” in boldface — some hospitals continue to bar partners either during early labor or immediately after birth.
‘I Was Totally Alone’
Patton called Methodist’s decision to limit her husband’s access frightening and risky.
“I was coming off the drugs, slightly incoherent and bound to the bed, but Dave still had to leave,” she said. “It was heart-wrenching. I was so exhausted but you feel like you are the only one there to protect this little person.
“At one point, I dozed off feeding her for probably a few seconds, but was like, ‘Oh, dear, how long was I asleep?’ The situation created so many dangers and I feel like it just didn’t need to be that way.”
Her husband, meanwhile, said he was “lonely at home and nervous.”
After only 40 hours at Methodist — at least eight hours before her recommended discharge and against the advice of her baby’s pediatrician, Patton said — she left the hospital to return home.
“They wanted me to stay and do some blood tests and light therapy for the baby because she was a little jaundiced,” Patton said. “But I was like, “when are we getting out of here?’ I was just so exhausted.”
Patton stressed that the medical staff, particularly the nurses, “took extra care and were so amazing. The hospital bigwigs make it seem as though this is something they need to do to protect the patients and their staff, but that was not the vibe I got from any of them.”
Pournaras said the policies at Methodist seemed to be common across the New York-Presbyterian healthcare system.
New York-Presbyterian did not respond to a request for comment, other than with an email saying, “Please be aware that due to the volume of requests we are receiving, our response might be delayed.”
Support Important Throughout
Brooklyn’s public Woodhull Hospital, part of the Health and Hospitals Corporation’s network, would only allow partners to join a birthing woman once her cervix had dilated six centimeters, Pournaras said.
“That means many women who go in for inductions are left to labor alone for hours,” Pournaras said. “Labor is hard work that certainly begins long before a woman reaches six centimeters.”
The hospital did not address the specifics of Pournaras’ criticism, but emailed a statement reading, “NYC Health + Hospitals’ priority remains the safety of all patients during the unprecedented COVID-19 pandemic.
“Consistent with NYS Department of Health guidance, the system allows a support person to be with a patient when they are in labor, during delivery, and in the immediate postpartum period. Our goal is to continue to provide a respectful and safe birthing experience for all of our patients.”
At Mount Sinai Health System hospitals, partners were also permitted only for delivery and the immediate postpartum period, Pournaras said.
Mount Sinai did not respond to a request for comment.
Research shows that continuous one-on-one emotional support provided by a partner or doula is tied to better birth outcomes like shorter labors.
Pournaras pointed out that a large number of maternal deaths happen because of postpartum complications, including hemorrhage, pulmonary embolism and infection. Being without a partner in a room with a newborn to care for increases the risk of these complications going unnoticed, she added.
Last week, The New England Journal of Medicine published a letter from a team of city doctors noting the results of a COVID-19 screening given to 215 pregnant women admitted to two private Manhattan hospitals — New York–Presbyterian Allen Hospital and Columbia University Irving Medical Center — for delivery from March 22 to April 4.
About 15% of those women tested positive for the virus, though most never showed any symptoms before being discharged.
Maternity Task Force Planned
Some new mothers try to push off going to the hospital for as long as possible, according to doula Laura Vladimirova, who is the director of the women’s center at the Jewish Community House of Bensonhurst.
Many mothers are also being separated from their babies right after birth until their COVID-19 tests come back, Vladimirova said.
The state’s proposed maternity task force, meanwhile, is looking into adding dedicated birthing centers to provide mothers a safe alternative to stressed hospitals amid the pandemic. The group is supposed to make recommendations to Cuomo by the end of the week.
The task force also will work with Regional Perinatal Centers to review literature and make recommendations on the impact of COVID-19 on pregnancy.
“This pandemic strained our hospital system in a way no one could have ever imagined, and while New York leads in ensuring laboring mothers were able to have a healthy partner, friend or family member with them during childbirth we can and should explore additional ways to make the experience less stressful,” DeRosa said Monday.
“Birth centers can serve as a safe alternative for low-risk pregnancies — relieving the strain on hospitals and providing a supportive environment for mothers during an already stressful time.
Pournaras remained hopeful that the state would clarify the directive to hospitals.
“We cannot continue to sacrifice birth, reproductive and human rights in the face of this crisis,” she said.
“Postpartum patients need support now. They need continuous loving support from their birth partner–from the time they enter the hospital, till the time they leave the hospital with their baby in their arms. Anything less than this is dangerous and inadequate.”