Ashlee Williamson, who is expecting a baby girl in three to four weeks, may have to give birth without her husband or family members by her side.
The threat and spread of the coronavirus has left multiple questions hanging for Williamson, a Pahrump resident with one daughter at home, and countless other women about to give birth, both in Southern Nevada and around the globe.
Williamson's pregnancy is considered high risk. She has multiple sclerosis and fibromyalgia. She suffers from seizures. MS treatments have left her immune system compromised.
Her doctors also have diagnosed her with placenta previa, where the baby's placenta covers part of her uterus. It's a condition that could cause serious bleeding during labor and childbirth.
“The placenta previa does kind of put me at a different level of high risk,” Williamson acknowledges.
When she does give birth this time around, it will be by cesarean section.
The onset of the coronavirus pandemic means that some women's birthing plans have had to change. Williamson’s health issues mean she may need to give birth with no one in the delivery room except for medical professionals. The fewer people in attendance, the smaller the possibility that she is infected by the coronavirus.
“There’s a good chance that my husband might not be able to be there for the C-section, depending on how bad the hospital looks in three to four weeks’ time,” she said.
Shadaba Asad, director of infectious disease at University Medical Center and a member of the governor’s medical advisory team, said hospitals were working to keep expectant mothers and their babies safe during the pandemic.
“Procedures have changed, and probably each hospital has a slightly different procedure,” she said.
A partner will be allowed to accompany the expectant mother at UMC, Asad said.
As with all patients arriving at UMC, expectant mothers are screened for coronavirus symptoms.
“If the patient happens to be COVID-19 positive, then things are a little different. She would still deliver at UMC and the procedure of the delivery would be no different … but infection control practices would be a little different,” Asad said. "Her physicians would take all the precautions necessary to prevent transmission of infection (to the infant).”
Many hospitals are restricting the number of visitors a patient can have during their hospital stay, whether in the delivery room or once the baby is delivered.
Jennifer McDonnell, director of communications for MountainView Hospital, said the hospital was limiting expectant mothers to one visitor, both in labor and delivery and mother-child units.
“We understand this is a hardship on families wanting to celebrate the birth of their baby, but we are working to keep our patients, newborns and community safe,” McDonnell said via email.
Dignity Health, which operates several hospitals in the Las Vegas Valley including two with birthing centers, its St. Rose Dominican San Martin Campus and St. Rose Dominican Siena Campus, is also limiting patients in labor and delivery to one adult visitor at a time. Overnight stays for the designated visitor will be allowed, said Gordon Absher, a spokesperson for Dignity Health.
Absher said that visitors would be asked a series of screening questions to assess risk for the coronavirus. Any visitor with a fever of 100.4 or higher will not be allowed into the hospital.
McDonnell, at MountainView, also said any expectant mothers with coronavirus symptoms should notify the obstetric unit before their arrival so the hospital could take precautions.
“Any mother with a confirmed case or who is symptomatic will be supported in taking possible precautions to avoid spreading the virus to her infant,” she said.
At UMC, any patients with COVID-19 infection would be under strict isolation with dedicated staff, Asad said. Pregnant women, she said, do no worse or better with the disease than others.
“We know that, immunologically, certain changes do occur during pregnancy that do in fact make pregnant women more susceptible to, at least, certain, viral respiratory infections,” she said. “As of now we do not know or haven’t seen anything that would suggest pregnant women are either more susceptible to infection due to COVID-19 or have more adverse outcomes when they do contract COVID-19 during pregnancy.”
It’s not currently known whether a mother infected with COVID-19 can pass it along to her baby during birth. The relatively short time the virus has been on the scene, Asad said, means that some questions have not been answered yet.
“There’s still a lot we don’t know about this virus, and we still don’t know if a pregnant woman can actually pass this virus to the unborn child during pregnancy or delivery,” she said.
Asad said, however, that the virus had not been isolated in samples of amniotic fluid or breastmilk, which she called encouraging.
“The few (newborns) who have had the infection acquired it after birth due to interaction with their mothers rather than having been born with the infection,” she said.
After birth, Asad said, mothers will be able to breastfeed their children. If a mother has COVID-19, Asad said they should wear a mask and wash their hands before and after breastfeeding.
Williamson’s neurologist advised her a few weeks ago to cancel any baby showers and start quarantining due to her health issues. Her family, some of whom have health issues of their own, were understanding that they would not be able to see the birth, she said.
“As long as we’re home safe and everything goes properly, I know my family can wait to see her," Williamson said. "And, hey, FaceTime’s a thing."
She said she was appreciative of her doctors at Summerlin Hospital Medical Center, who have been reassuring and calming her about what is planned as a three- to four-day hospitalization associated with her giving birth.
“I am extremely nervous to be in the hospital, just because obviously that’s where all the sick people are,” Williamson said.
She said women in this same situation should reach out to their doctors and be open about their concerns.
“Even when I called Summerlin about a week ago, just as a nervous parent giving birth … they completely reassured me that everything was very, very safe.”