I thought it would be hard to top Los Angeles shutting off water and electricity to businesses that fail to comply with their orders in terms of ridiculous and mean-spirited coronavirus policies, but NYC-area hospitals have found a way to out-do the crazy.
Imagine being cheated out of the opportunity to watch your child being born. Imagine being a woman having to give birth all alone.
Now, if you are a woman giving birth at some of NYC’s largest hospital systems, that’s the position you are in. Your husband does not get to be in the room with you to watch his child being born. And if your baby lands in the NICU, the father can meet the baby when it is released. Droves of NYC expectant mothers are defying the city’s shelter-in-place orders to drive to other states to give birth or calling midwives to learn about having babies at home. (Incidentally, there are not many midwives in NYC because health regulators have shut them down.)
Remember this story when someone tells you how great socialized medicine and concentrated decision-making in health care would be.
Last Saturday, Spencer Pitman and his wife Sarah received an upsetting call from their OB-GYN. The Long Island City couple, both in their 30s, were expecting their first child, with a due date of Monday, March 23rd. Like many expecting couples, they had heard that hospital policies were in flux amid the COVID-19 pandemic. Last Wednesday, following an advisory from the state Health department, New York hospitals said they would now allow only one individual to accompany a woman about to give birth. The move was part of a broader effort by hospitals to tighten general visitation policies in response to the threat of coronavirus.
Now, their doctor warned them of an even more dramatic change at the hospital where they were set to deliver: Beginning on Sunday, NewYork-Presbyterian, one of the biggest hospital networks in New York City, women going into labor would no longer be allowed to have any individual, including partners, accompany them into the hospital. “She told us, ‘If you don’t get in tonight, you won’t be able to be together,'” Pitman recalled.
That night, at around 10:30 p.m., the couple checked into the NewYork-Presbyterian Weill Cornell Medical Center on the Upper East Side. Not long after they were admitted, Pitman saw devastated couples who were informed about the new policy.
His wife Sarah was induced. The following afternoon, she gave birth to their daughter, Davis Wilder Pitman.
But after some skin-to-skin contact with his newborn, he was forced to leave. The hospital was no longer allowing visitors in the maternity ward.
Although parting from his daughter and wife was wrenchingly difficult, he still felt grateful. “We got some middle ground,” he said.
In New York, the coronavirus pandemic is threatening to upend one of the sacred rites of passage for expecting couples. For women in labor, a shared experience means having an individual who can assist and comfort them, while for partners, it means being able to witness the birth of their child. Even amid the coronavirus pandemic, the World Health Organization has upheld this tradition, recommending that women should have a “companion of choice” during delivery. Similarly, under the state Department of Health’s guidelines to hospitals dated March 21st, the state considers one support person “essential to patient care throughout labor, delivery, and the immediate postpartum period.”
“This was a knee-jerk reaction to an immediate issue with no consideration with the longterm ramification of putting an entire generation of people through traumatic birthing experiences,” said Jesse Pournaras, a New York City doula who immediately started an online petition against the policy. It has garnered more than 260,000 signatures. Doulas were one of the first groups to be impacted by new set of visitor restrictions at hospitals.
NewYork-Presbyterian did not respond to a request for an interview.
Asked about the new restrictions at NewYork Presbyterian on Monday, Mayor Bill de Blasio said, “I’d like to understand that better. I’m unclear what the rational is.” De Blasio said that while he understood the concerns about the spread of coronavirus, “At the same time, we’re talking about an irreplaceable life moment.”
The changes on Sunday at NewYork-Presbyterian, which has four major labor delivery hospitals in New York City and is one of the most well-regarded for maternity and infant care, immediately struck fear that other hospitals would soon follow suit.
Jenny Werbell, 38, said she immediately called Lenox Hill hospital after reading about what had happened at NewYork-Presbyterian on the Park Slope Parents message board.
“What if Iʼm going to be alone in this?” she immediately wondered. She is due on April 2nd. Her pregnancy care had already been disrupted, with her doctor deciding to cancel a final sonogram in an effort to limit her potential exposure to the virus in the hospital.
To her relief, Lenox Hill, which is part of the Northwell Health system, has said it is allowing one support person for delivering women.
But how long that rule will still be in effect is a question. As of Tuesday, Mount Sinai Health System also said they would exclude all hospital visitors, including partners of women in delivery. The city’s public hospitals, known as New York City Health and Hospitals, said they would allow one support person to be in the room with the patient but that person must wearing a surgical mask and must not be symptomatic.
The website for NYU Langone Health, another major hospital, states that one support person is permitted.
Amid the changes, some women and couples are exploring options they would have not normally considered.
Pournaras said that among her clients, some were arranging to give birth out of state. One couple is driving as far as Bloomington, Indiana.
By law, no hospital can turn away a patient. “It’s an option,” she said. “It’s just not an ideal option.”
Gessica Lesser, who is set to give birth to her first child in late May at NewYork-Presbyterian Lower Manhattan hospital, said she has considered going to a hospital in Syracuse where her husband’s family lives. She has also thought about doing a home birth. But she later found out that the globally common practice is not covered by their insurance plan, which is provided by Aetna.
Tanya Wills, a midwife who runs Manhattan Birth, said her office had fielded as many as 20 calls since Sunday. She said she has had to use a prerecorded message saying that they are not taking any new clients. Overall, she said the sudden demand for midwives outstrips the local supply. “In this town, we simply don’t have enough of us,” she said. According to a 2018 New York Times story, there are only about 35 midwives in the city.
She also noted that many of the women seeking out midwives right now are not the right candidates for home births because they have little knowledge of the philosophy behind it and all that it entails. She has some women ask her if they could receive epidurals. (The answer is no.)
Willis and others have pointed out that the coronavirus crisis has laid bare the scant birthing choices for women in New York City. Lesser, for example, noted that her friend in London said that home births were quite common in that city. In 2014, Britain’s national health service recommended that healthy women have their babies at home, or in a birth center, with a midwife rather than in a hospital. Here in the U.S. nearly 20,000 babies in the United States were born at free-standing birth centers in 2016, a rise of 83 percent increase over the last decade. Texas alone has more than 70 birthing centers.
Meanwhile, in part due to licensing restrictions, New York state has only three birthing centers: the Birthing Center of Buffalo, the Brooklyn Birthing Center and the Birthing Center of New York. Unlike hospitals, birthing centers provide a homelike, low-intervention environment. They have basic equipment and a plan to transfer to women to a hospital if the need arises.
Shortly after his wife gave birth to twins, Shaun Smith was allowed into the neonatal intensive care unit at NewYork-Presbyterian Brooklyn Methodist Hospital to see his babies during their first few days there. He had to wash his hands at the entrance and sanitize them periodically within the unit. Like the Pitmans, the Smiths’s baby was delivered right before the rules changed.
Smith later reflected that had his wife given birth after the new rules, “I would have had to drive her to the hospital and leave her at the door. It would break my heart. It would be so emotionally defeating for me to not be a part of that process that we were planning for for months.”
But on Sunday morning, he was told only mothers would be permitted going forward. He now won’t be able to visit his babies until they come home in a couple of weeks.