Pregnant women in Sonoma County filled with hope, fear amid coronavirus pandemic
Brenna and Jim Paustenbach have been trying to get pregnant for years. When the pair found out they were due in August, they were over the moon. Jim Paustenbach calls his unborn child “Baby P.”
So when the couple went to a prenatal appointment on March 30 to learn the baby's gender, their excitement was palpable. But Jim Paustenbach was prevented from entering the building, even though he was wearing gloves and a mask like he had routinely donned for doctors' visits with his wife. The disappointment was searing.
“We expected my husband could go with me. It's a big moment,” Brenna Paustenbach said. “We got there and they turned him away at the door.”
It is a scene repeated over and over in Sonoma County, where 12 babies are born every day, on average.
Kaiser Permanente, like many health care providers in Sonoma County, is now limiting the number of people it sees in medical settings in order to limit the spread of the coronavirus. Pregnancy care and delivery protocols are changing at a dizzying pace.
Pregnant women are classified among high-risk populations susceptible to the pandemic, but research is scant on how the virus and the associated respiratory disease COVID-19 affect pregnant women or their unborn children. That uncertainty, in a time when many parents-to-be are already feeling excited and anxious, makes this generation of pregnancies especially emotional.
Brenna Paustenbach, an administrator who works at a biopharmaceutical company in San Rafael and lives in Rohnert Park, feels it all. And the self-described studier and planner, who has researched every step in her 40-week pregnancy journey, knows the safety protocols put in place by health care providers make sense during a historic pandemic. But the emotional wallop of leaving her husband outside on the day they were to learn the sex of their unborn child? It was too much.
“I cried for a lot of the appointment,” she said.
So the quick-thinking technician offered to print out the sonogram, slip it into an envelope and seal it so the Paustenbachs could open it together.
“She could tell I was really emotional,” she said.
Brenna Paustenbach brought the sealed envelope to the car where her husband was waiting for her. They didn't wait.
“We took a selfie in the parking lot, with our masks and our gloves on,” she said. “We'll never forget it.”
“We're having a girl,” she said.
Questions, no answers
While pregnant women are considered a high-risk population, the Centers for Disease Control reports that it is not known whether expectant moms are at a greater risk of contracting COVID-19 or of getting more seriously ill if they do become infected. The disease is too new, the sample size too small.
“That is a big question,” said Dr. Erin Lund, maternity care director at the Sutter Santa Rosa Family Medicine Residency Program and a family physician with Santa Rosa Community Health.
“We are not seeing rates of complication in pregnant women that makes us think that (it's more dangerous) compared to SARS and compared to flu, but it might be because the data is not great still,” she said. “I don't think anyone is comfortable saying, ‘No definitely you are not at higher risk.'?”
And that is a difficult spot to be in as a physician.
“I think we always want to provide factual, up-to-date, evidence-based recommendations and it's really hard to do that when the evidence is literally coming in different every day,” she said. “Just today I got another email on labor and delivery guidelines for COVID. It just came out. We're trying to read all this and keep up with this and see what is different, knowing that what this says today and we are telling our patients today could be different from what we are telling our patients a week from now. We just don't know everything there is to know.”
Lund understands the frustrations of her fellow professionals who do not have all of the answers about a new virus. But she also understands the desires of an expectant mother seeking as much information as possible to keep herself and her baby safe: Lund is almost six months pregnant with her second child.
The CDC has also not determined if the health of the baby is put at risk during either pregnancy or delivery if the mother tests positive for COVID-19. The virus has not been found in amniotic fluid or breast milk.
Still, health care providers have largely modified their schedules for patient visits, moving many to phone or video conferences to lessen the chance an expectant mother could be exposed to the virus in a hospital or clinical setting.
Appointments that were four weeks apart are now held six to eight weeks apart, and information that can only be gleaned in person is being folded into a single visit, to the extent possible.