Doctors and doulas help pregnant women manage COVID-19 concerns

ARLINGTON, Va. (CNS) -- Eight weeks before Samuel Aiden Pelletier was born by cesarean section April 29, 2020, he was oblivious to the fact that his mother was pregnant as a pandemic swept the globe.
Nestled under Andie Pelletier's heart, he might have noticed a more rapid beat when his mom learned about the shutdowns, found out her delivery hospital was changing, or when she got her pre-delivery COVID-19 test.
He did not know that his firefighter father was now the family's only grocery shopper or that his siblings' neighborhood play dates were canceled indefinitely, all in an effort to keep him and his mom safe and healthy.
"Pregnancy does not take days off," said Dr. John Bruchalski, founder of Tepeyac OB/GYN and Divine Mercy Care in Fairfax, Virginia, which describes itself as a pro-life faith based obstetrics and gynecology practice.
"It was as if an invisible earthquake hit," he said about working in the pandemic. "Nothing seemed to change around us, but everything changed within us. The fear factor went up astronomically. We didn't know how contagious it was. Patients did not want to leave their (homes)."
Tepeyac provides health care services to families of all incomes who want a pro-life approach to pregnancy. Bruchalski said the clinic closed for a week and a half in March 2020 at the onset of the pandemic. It reopened to low-risk patients, implemented cleaning and social distancing procedures and arranged house calls for high-risk patients.
"With COVID, it is an inflammatory response," Bruchalski told the Arlington Catholic Herald, newspaper of the Diocese of Arlington. "Most women do very well, although other hospitals might be getting higher-risk cases. We just watch the baby early, like a high-risk pregnancy, and act early."
In one case, the clinic's staff decided to induce a woman who was more than 39 weeks pregnant because she tested positive for the coronavirus.
During a COVID-19-positive delivery, the medical team wears full protective coverings and after the delivery, the baby remains with the mother, Bruchalski said.
While Tepeyac has come a long way since the pandemic's early days, it continues to see the effects of that anxiety.
"Some of the moms developed high blood pressure and diabetes," Bruchalski said. He said women were not coming to their appointments, which meant they weren't being monitored throughout their pregnancy.
For many other expectant mothers, the ever-changing hospital policies were another source of worry. Jennifer Woodhead, a doula and owner of a Mother's Perspective Doula Services in Fredericksburg, Virginia, noticed that many women were worried about contracting COVID-19 while in the hospitals and sought out birth centers or home births.
Doulas provide continuous physical and emotional support to pregnant women before, during and shortly after childbirth.
"The midwives were completely booked," Woodhead said. When hospitals limited support persons, she and other doulas shifted to add virtual support.
One client, Cynthia Dement, signed up for in-hospital support in mid-2020 when hospitals were starting to allow doulas and one other support person into delivery rooms.
However, with the COVID-19 spike after Christmas, Mary Washington Hospital in Fredericksburg reverted to the one-person limit.
In January, Dement texted her doula, Beverly Bouchard, when she went into labor. At the hospital, Bouchard was able to give Dement's husband support over the phone by talking him through different ways to position his wife during labor. After three difficult hours, she delivered her baby girl, Blair, at 2:30 a.m. Jan. 26.
"Obviously, physical support is super important, but even just having that extra person there virtually was so valuable to us," Dement said.
While the development of COVID-19 vaccines has given hope to many that the return to normalcy is in sight, some pregnant women have questions about the vaccine.
Bruchalski said that the Tepeyac staff is encouraged by the results of a small study published in the American Journal of OBGYN that showed pregnant women who received the Moderna and Pfizer vaccines are producing large amounts of antibodies and passing them on to their babies through umbilical cord blood and breast milk.
Pregnant women reported the same level of side effects as women who were not pregnant, the study found.
"With that said, this study is a very small sample size and will need to be repeated," Bruchalski said.
Tepeyac, he said, encourages its patients to choose whether to receive the vaccine based on their medical history, and the latest information and guidelines.