Upset about having to wear a mask during labour

[Peridotty]

I am upset about having to wear a surgical mask during labour and my husband has to as well! :( We are in the US.
I won't be able to see my husband's face the whole time or expression when the baby is born! It's our first. I don't think I can take it off at all during the time I am in hospital. Upset about potentially having photos taken with baby with mask on and also the fact that the first thing baby will see are our masked faces :(

@mathanxiety there’s good evidence that women massively benefit from having a known birth partner. I know perhaps in the past (and currently in other places and cultures) it would be other females such as mothers/sisters/friends who would be a woman’s support. I think the cultural shift is really interesting and definitely worth considering as it seems to have become the ‘done’ thing to do with having the father present.

Call me a cynic and very old fashioned, but the idea that men are necessary to childbirth is a very new one, and the presence of men in labour and delivery and maternity wards in general isn't the unqualified boon to women it is made out to be.

Depends on the woman and her partner, surely? Mine was definitely a giant boon to me in the aftermath of my first labour. We were in a private room with its own bathroom though, so didn't inconvenience anyone else.

That's the crux of it though - one woman's comfort is the woman in the next bed's almighty pain in the arse, who can cause a great deal of unnecessary trauma at a time when trauma can have very serious side effects.

There are a lot of very disrespectful and entitled people sitting on their arses and making utter nuisances of themselves in maternity hospitals and wards up and down the country at any given time. The only way to make sure that everyone's needs is met is to provide private rooms for everyone.

Even a semi private room doesn't guarantee a peaceful labour or post natal experience. The mother of my room mate/grandmother of the newborn baby in a shared room smoked a cigarette in the en suite shower/loo the day after DD1 was born. I pitied the poor baby heading home with them all including the new mother.

Is the money available to make sure women and their babies get the best possible combination of support they feel they need while not infringing on anyone else's rights or denying anyone else their privacy or comfort or quiet rest? I doubt it.

The question of what women need at their time of delivery isn't answered solely by the inclusion of birthing partners or visiting by family members. Centering a discussion on this can actually push the needs of women to one side, and the focus on the inclusion of men transforms childbirth from an experience in which women are centered (for once in our lives) into a spectacle put on for partners and anyone else who wants to enjoy the show, risking outrage when that privilege is denied for any reason including very sensible ones, and risking distraction from the real solutions to issues women face when they go to hospital to give birth. The issues are problems that can only be solved by spending money on maternity services.

The issues are problems that can only be solved by spending money on maternity services.

Yes. I doubt that will happen though, and many hospitals seen to use partners to make up for staffing shortages. Under the current staffing levels, I think partners are a massive help to most women.

yup, so doctors have confirmed that I have to wear a mask during labour as long as I have a member of staff in the same room as me.
and I will also be tested for COVID 19 when I get admitted!

yup, so doctors have confirmed that I have to wear a mask during labour as long as I have a member of staff in the same room as me.

Send them out then. There's no need for them 90% of the time.

If she is delivering in a US hospital there will most likely be someone monitoring her in her room at all times, MrsTerryPratchett.

It's very reassuring that you will be tested for covid 19, Peridotty. Will your H be tested too?

Have they weighed up the risks and benefits for forcing all labouring women to wear masks? I just imagine a lot of women may find it very uncomfortable and potentially distressing during that moment. Plus with all the contact and additional bodily fluids present in a birth, how much protection is a mask really offering?

Does the USA not have the same human rights as over here? Rights regarding consent and autonomy mean women have to agree and give permission for all procedures/interventions/observations/basically anything that happens to them.

Yes @happyhappyhour it's highly intrusive to force this upon women.

Plus if they are being tested for corona and the tests come back negative then what is the point?

Technically I’m supposed to be wearing a mask at all times. But I suppose if no staff is with me, they wouldn’t know if I pulled it down. And I confirmed that even if I tested negative I still had to wear one!!! Which is so unfair!! My husband will not be tested, only me.
I am unaware of any other countries imposing this rule. Wish the staff could just protect themselves and leave me unmasked! I would be negative anyway so no risk to them!

It is horribly unfair, OP, but from what I've heard, medical treatment in America for labouring women is pretty dehumanising and the whole process is overly medicalised, so I'm not at all surprised. Any chance of getting a midwife to your house instead?

The trouble with rights is that everyone has them, @happyhappyhour. And there are a variety of them. In this unusual time, rights are being prioritised.

Peridotty, if you somehow manage to get a false negative on your test and infect a staff member, that person could go on to infect others and/or have to stop work, leaving the maternity service understaffed, which would infringe on the right of others to a safe delivery attended by qualified staff. So wearing a mask could make a difference to a lot of other women and their birthing partners and babies.

I feel they should be testing your husband too. If not then testing you is a bit of a waste, but presumably they are only testing everyone being admitted as a patient, which rules out individuals who are technically visitors even if they could be there for a prolonged length of time. I assume they are going to make him wear a mask.

If you test positive then it's possible the staff will wear N95 respirator masks and not the common or garden masks people wear to the grocery store, plus all the other protective gear that goes with covid 19.

Depending on your hospital, they may do two tests to rule out false first results. Testing positive will result in you and the LO being allotted a covid room. Testing you also makes it possible to educate you about care for the baby when you get home in the event of a positive result. You will be advised to wear a mask while breastfeeding and to observe very strict hygiene practices. You may be advised to let someone other than yourself do all baby care apart from breastfeeding. You may even be advised to pump and have someone else do the feeding.

As to risk/benefit analysis of various policies - testing of admitted patients is based on experience from NYC where about 13% of obstetric admissions tested positive despite being asymptomatic. There is a real risk to the whole system of obstetric healthcare breaking down if staff are unwittingly exposed or if they are unable to access the N95 respirator masks and other gold standard PPE or don't believe they need all of that. Ordinary masks protect others, not the wearer, but the N95 respirator masks protect the wearer. All staff masks are worn to protect you too. Masks if worn by everyone in any given environment have proven effective in containing transmission - it is an evidence based policy.

Home birth isn't really a thing in the US for many reasons, including cost. Some insurers won't cover a planned home birth. The OP's home state allows planned home births with midwife assistance but only about 500 families per year avail of home midwife services, according to stats. This number has probably risen for 2020 thanks to covid 19 and if women experience positive outcomes it may continue to rise in years to come.

It isn't easy at all to switch to another HCP late in pregnancy in the US. Generally a woman sees the same provider or that provider's colleagues in an OB or midwife practice all through pregnancy and one of those providers will also attend the delivery. A good relationship is often developed during the pre natal visits and women can be reluctant to give someone new a whirl at the last minute. MW practices are in some cases accepting new last-minute patients but the cost of about $3,500 which might not be covered by health insurance could be prohibitive. You would also owe your former HCP the cost of your pre natal visits but that would most likely be covered by your insurance.

from what I've heard, medical treatment in America for labouring women is pretty dehumanising and the whole process is overly medicalised,
I have had five babies in the US and that is a massive generalisation and exaggeration.

I have had five babies in the US and that is a massive generalisation and exaggeration.

I don't know, I think life in general is overly medicalised in the US, based on posts from forums by people who live there. Routine blood tests of toddlers at paediatric appointments for no reason, mandatory (in some states) insertion of antibiotic eye ointment into the eyes of newborns, restricting food and fluids during labour, one third of births being by c section (though we're catching up on you there)...

everymothercounts.org/giving-birth-in-america/

Link above also reckons it's over-medicalised.

As for dehumanising, maybe I've just heard the bad stories. After all, the good ones aren't as interesting and get shared less.

My DCs never had any routine blood tests at pediatric appointments. They did a skin prick test for TB (no BCG vaccinations in the US afaik).

I was screened for Group B strep as are the majority of pregnant women, something that isn't routinely done in the UK but should be as GBS can lead to sepsis, pneumonia, or meningitis in a newborn. Some routine tests make a lot of sense.

evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/
(Grrrr - very annoying use of the phrase 'pregnant people').
Reason to use AB eyedrops.
Maternal chlamydia is the most common cause of conjunctivitis which can cause blindness in babies, though herpes can also cause it, as well as a range of bacteria commonly found in hospital and home settings with the carriers showing no symptoms.
Basically, it is done because it works and it is incredibly cheap and practical and spares babies treatment after a diagnosis, which might include hospitalisation. It is wrong to assume parents would seek medical attention for a baby showing signs of conjunctivitis in time to prevent a lifelong problem with vision.
Colostrum in the eye works pretty well too.
As long as treatment is started immediately, the condition that causes blindness can be treated. A 'wait and see' approach means that babies least likely to receive medical attention would be the ones to suffer most.
However, the US seems to be moving toward a wait and see approach.

Restriction of food during active labour is done in order to prevent aspiration complications if a crash caesarian is needed. More and more anesthiology is done by nurse anesthesiologists in the US, under the supervision of a MD or DO anesthesiologist. I would personally vastly prefer a doctor over a NA and would do anything to reduce risk to myself even if that risk was very small. In many hospitals you do not get to choose who will be administering the anesthesia or dealing with problems if they arise.
Stomach function slows at the start of labour, and quite honestly, I personally do not know how women would manage to even think about food during active labour. This of course could be only my own personal experience and not universal.
Clear fluids or ice chips have not been an issue at any time during labour afaik. Many women will have an IV and saline fluids during labour anyway, with water to keep your mouth from going dry.

I wasn't hungry at all during labour but recall feeling ravenous after delivery each time and receiving a delicious sandwich and a hot drink once I was settled in my room if at night or between meals, or a regularly scheduled meal (the one ordered by the previous occupant of my bed) if mealtime wasn't too far off.

I may have been lucky to experience childbirth in a hospital renowned for the quality of nursing care, which imo is the make or break element of hospitalisation.

I agree though that there are massive problems in US healthcare including maternity care. The racial disparities in childbirth outcomes are horrific. The cost is horrific. The idea that healthcare isn't a human right but a commodity to be bought keeps me from applying for US citizenship. I couldn't put my hand over my heart and swear allegiance to a country where that is considered a reasonable or even a rational proposition.

I don’t know a huge amount about maternity care in the US but I’d always assumed it was a lot more ‘medicalised’ with higher intervention rates (but worse outcomes with maternal deaths and still births etc)

My 2nd pregnancy was low-risk and I chose to birth at hospital, I had a midwife rather than a doctor (although drs were of course nearby should they be needed) and there was a lot of choice with a birthing pool available, various pain relief inc epidural, I was encouraged to move around (there were mats and birthing balls) and also give birth in whatever position I felt most comfortable in. My immediate thought of US care would it would be a lot more ‘flat on back in bed with legs up in stirrups, epidural, team of drs’ even for low-risk such as myself. That may be very wrong though.

Yes, that would be a picture from probably 30-40 years ago but not today.

I had one epidural, with DC1. I can't say it made all that much difference (and I had four subsequent deliveries without pain relief to compare it to).

You can get walking epidurals now, and gas and air is making a comeback. Birthing balls, pools, etc were all available but on a first come first served basis and used as means to attract customers as far back as 25 years ago in the hospital I delivered 4/5 of my DCs. I was 10 minutes late for the fancy birthing suite with DC3 but I did get to stay in the same nice room with pristine ensuite bathroom from admission to discharge that time, with DC with me continuously. The one thing that really, really bothered me in that hospital was the policy of putting newborns in the nursery for 'observation' for a few hours after delivery. This was not necessary, and a very stressful intervention.

I had episiotomies, which quite honestly sound and look far more horrible than they actually are. When a doctor or MW does them frequently they get a lot of practice in stitching you up again very neatly. I would personally prefer one over an uncontrolled tear.

Teams of doctors - can go either way.
I delivered in a teaching hospital four times and had roomfuls of doctors twice, with my consent (I could have declined) to observe and learn. One resident got her hand crunched as I delivered DS (ventouse, very big baby, hence the roomful of students learning to use the vacuum) and she unwisely offered her hand to hold . I had one doctor/nurse team twice and my midwife and her student once. The teaching hospital I delivered in had a policy of keeping your own nurse with you at all times, so the nurse you were allocated when you were first admitted stayed with you until the end of her shift, then the next one was yours for her shift, etc. I only ever got one nurse I didn't like. Nursing care is the make or break factor in maternity care imo.

For complicated deliveries - preterm, multiple birth, maternal risk factors - you might have more HCPs in a delivery room, including neonatology staff, respiratory therapist, etc. Your chances of a CS depend on your doctor's expertise, your own underlying conditions, and other factors.

Higher intervention rates are partly due to higher litigation rates. OB/gyns are the specialty most likely to be sued for poor outcomes, with neurosurgeons a close second, afaik. They are also due to high rates of maternal risk factors - obesity, high blood pressure, T2 diabetes, asthma, kidney issues, older first time mothers. However, there is also a culture of intervention that comes from (imo) male attempts to keep women from being central to the process of childbirth, with a hero-doctor narrative informing how the doctor sees his role. As more and more women enter the field of obstetrics it will be interesting to see if the culture changes.

Remind me gain how much each of those births cost?

I had my baby a few days ago!!!

The experience was actually AMAZING! I am so glad I gave birth in the US. It was far better than I thought it would be. I stayed for 2 nights and 3 days (insurance paid for this). Husband and I had private rooms. Didn’t see any other patients whilst there (everyone in their own private rooms). We could choose what we wanted from a very extensive menu of items three times a day. Meals were amazing (I had salmon, burgers, fish, whatever I wanted), one to one with the nurses, paediatricians, obgyn doctors, lactation experts. They came round to do checks on us and gave us advice all the time. Whenever we rang the buzzer they would come within 5 mins!!! When I asked for an epidural two anaesthetists arrived next to me within 1 minute. I had ZERO pain after that. I didn’t feel anything and it was so blissful. I am low risk and healthy but I had my obgyn doctor all to myself and 3 midwives to help deliver my baby. Two pushes and she was out!! It was amazing.

Yes I had to wear a mask during labour but that was no problem at all !! I felt nothing after the epidural and was able to breathe as normal.

I didn’t bother with the mask when alone in the room with husband and baby and only whipped it on when talking to nurses or doctors who came in for checks.

We also got a TON of freebies to take home. Our insurance provided us with an automatic breast pump, we got nappies, nappy cream, nipple cream, peribottle, sitz bath, sanitary towels, ice packs and loads more. We ended up with 7 extra bags of stuff to take home!!!

All in all, it was an amazing experience and even a little bit like a staycation. I was so worked up and worried about masks, tearing, forceps etc as a FTM. You don’t hear many positive birth stories and wish there were more.

Great to hear you had a good experience, OP! Congratulations on the birth of your baby.

That sounds great! Congratulations on your lovely baby girl

They really do send you hone in style from American hospitals . Don't lose that peribottle - what an unlikely godsend. Hope you find the ice packs as useful as I did.

Your description of gorgeous hospital food brings me back . my Dsis thought I had lost my mind as I waxed eloquent about my hospital meals..

Glad it went well OP.
Enjoy your dc.
When USA healthcare works it can be excellent.