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Planning for a Cardiologist-Assisted Delivery in the Pandemic

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Marie K,

“There was enough to distract me that it only got bad at night when everything would wind down, and then it would hit me like, oh, my gosh! I’m having a baby who will need surgery, possibly at birth, but definitely within the first four months of life.”

Marie preparing for a cardiologist-assisted deliveryChristmas time brought bad news. She was twenty-weeks pregnant, but the 20-week ultrasound showed that her son was going to have heart complications. He had a right aortic arch with a vascular ring. The esophagus and trachea should be going to the left of the heart. Instead, it was going through part of the heart. There was a real danger that the vascular ring would cause difficulty breathing and swallowing. As a result, his birth was to be a cardiologist-assisted delivery.

Special procedures were going to be needed at delivery. There would have to be a cardiologist following and immediate oxygen tracking after the birth to make sure that their son was breathing well enough on his own. But there was no way to determine how severely constricting the vascular ring was going to be until her son was born. And her son would certainly need surgery during the first year of his life. Thinking of the future filled Marie with anxiety.

Then Covid-19 came and made her fears even more intense.

The possibility of passing the virus onto her son was terrifying. There was a total lack of research of how Covid affected babies in utero.

Everything had to be done so carefully. Due to the pandemic, her weekly check-ups were intense. There was a back door only for OB patients. She’d go in and have an immediate temperature check. But the visit was done alone, which was one of the hardest things for her. She would have wished to have some emotional support for the visits, but nobody was allowed to come with her, not her husband and not her kids. 

The last month before her baby was due was the most stressful. She feared the Covid test that she would have to take at birth. She feared being positive and having to decide whether to separate from her baby or not. She was more anxious about the test than the actual birth. She wasn’t symptomatic, but the fear persisted.

There wasn’t much risk for her. Marie, at that time, was working from home. She is a speech language pathologist working at a school for moderate to severely cognitively-impaired children. She was meeting her students and their families online. Her kids were also at home, but her husband was still working outside. That was a problem.

Her husband worked in retail selling cell phones, and in some kind of ass-backward way, selling cell phones was deemed an essential business. In his store, he was in close contact with many people, and he wasn’t able to start paternity leave as early as she would have liked, which worried her. 

For the last bit of her pregnancy, Marie’s husband actually moved into a hotel room so that if he contracted the virus he wouldn’t pass it on. So, during the last month, the most fear-invoking month, she was apart from him. She was trying to stay healthy for the cardiologist-assisted delivery of her son.

“Without counseling, I probably wouldn’t have made it through the experience without a lot more crying. I needed some mental health support.”

Marie had therapy sessions to work on her anxiety. Her mother came and stayed with Marie to help with her two kids while she was working. Marie worked straight up until she had the baby.

“There was enough to distract me that it only got bad at night when everything would wind down, and then it would hit me like, oh, my gosh! I’m having a baby who will need surgery, possibly at birth, but definitely within the first four months of life.”

Her husband took paternity leave two weeks before their expected due date, and during that time he stayed isolated in his hotel. Marie and her kids talked to her husband every night via Skype. 

Everybody thought they were crazy to stay separated. A lot of people were giving them flak, particularly those who didn’t believe that the pandemic was real. Marie felt that was the hardest part. There were people she trusted and cared about, even family members, who would tell her she was crazy and overreacting and say that they were going to come and see the baby when he was born. The social pressure from the community was hard to take. 

Marie’s baby came as scheduled at the end of May.

Upon arrival at the triaged OB unit, Marie had a Covid test. Her husband stayed in the hospital parking garage waiting anxiously. The plan was that if she tested positive, he would take the baby while she isolated for two weeks. The rapid test came back twenty minutes later, and fortunately, it was negative. He was then able to join her, and he stayed with her for the entire time.

She’s had kids before. Nothing about labor was out of the ordinary except for wearing the mask, which she had to wear for the entire time. It wasn’t hard to breathe. It was annoying to breathe through it during labor, but she didn’t fight it. Everything else was normal. Getting the epidural was normal. The hospital policies seemed normal. The only thing different was the extra PPE that everybody came in with.

“I’d actually say out of my three deliveries, it was the most calm and I felt the most relaxed, even though it was the most intense one.”

There was additional monitoring with the birth as a result of the cardiologist-assisted delivery. Marie delivered at a specialized hospital connected to the children’s hospital, so if anything had been needed, they wouldn’t need to take a helicopter ride. They did an echocardiogram and a CT scan before they left the hospital, just to confirm everything. Then they scheduled her son’s surgery for the end of the year.

After cardiologist-assisted delivery Marie and sonMarie and her son were discharged at twenty hours after the birth.

Since that time, Marie’s baby has had monthly appointments with his pediatrician, three cardiology appointments, and another CT scan. She’s been assured that her baby will be clear until the pre-op appointment at the end of the year.

She’s gotten into a groove. Pediatrician appointments all had to be in the morning because the afternoons are reserved for sick appointments. There are definitely extra screening precautions. Her baby has his temperature taken with every appointment, but everything seems routine now.

These days, Marie is practicing risk management. She only goes to places where people take things seriously. She’s isolating herself as much as she can. She has groceries delivered to her door. She’s been teaching a virtual summer school. It’s hard having a baby in the pandemic. She can’t share her son with everyone the way she would normally. Instead of having her baby meet 80 people, her baby is limited to two family members. 

Eventually, she has to rejoin society, though. She’s scheduled to begin in-person teaching at the end of the month. Her students need her, and she misses them. She will be wearing a badger shield and a mask. Her husband has already started working.

Marie’s son’s surgery date is coming closer. She’s comfortable with the surgical team who will be working on him. She fears the possibility of another spike of Covid cases once school starts. She worries about whether the hotels will be open next to the hospital. If they are not, she thinks about the hour and a half trip to the hospital every day, and then there is the anxiety about the surgery itself. 

“I think I have more anxiety about handing him over to a surgeon and knowing what’s coming [after the surgery] rather than delivering, knowing that he might be just fine… I feel like I need my husband more for surgery than I did for birth.”

Read another delivery story with how a newborn son fought for life in the NICU. Or watch more stories on fuconomy’s youtube channel.