Akshata and baby

A Physician’s COVID-19 Birth Story

My Covid-19 birth story. My husband and I moved from Ohio to New York in the summer of 2019. Being native and lifelong Clevelanders, leaving our hometown where both our families lived wasn’t an easy decision. However, we both shared a desire to live in NYC and once we made up our minds, we fervently looked forward to carving out a life in the city. We were fortunate enough to secure jobs and took the leap — and LOVED it.

We found the magic of the city to be unmatched and we became accustomed to our fast life here. In the fall, I found out that I was pregnant with our first. Though raising a baby in the city would pose unique challenges, we loved the idea of our daughter being born and raised here. We spent the scarce free time our jobs afforded us doing baby research and preparing our home for her arrival. We were overjoyed. Little did we suspect how much our New York City experience would change.

Though news outlets were occasionally discussing the highly infectious virus plaguing China, even as a physician, I remained blissfully ignorant to the potential threat it posed to us in the United States. It seemed so geographically and theoretically far away. I genuinely hoped it would be “just a really bad flu.”

It became evident very quickly that this was not something that would remain out of sight and out of mind for much longer. We began discussing the novel coronavirus at our weekly department meetings as early as January.  I remember asking one of our hospital’s Infectious Disease and Epidemiology specialists if the virus posed a threat to pregnant women if it did in fact hit the United States. The answer was what I dreaded, but expected: no one knows. 

March 1st was the date the first person in New York City tested positive for COVID-19. The briefings changed. Now we were learning what to do for suspected COVID-19 cases. Slowly, the suspected COVID-19 cases in our hospitals started to rise. And before long, there were confirmed positives. The pandemic was here.

I didn’t think much of taking care of these patients while pregnant. While it is humbling to hear people’s appreciation for healthcare workers, it doesn’t FEEL like heroic work when you’re doing it. It’s just work. Plus, I felt safe behind the PPE. It was my co-workers and boss who worried about my well-being and assigned me non-COVID patients and took COVID patients onto their own services. Despite mixed feelings for the lopsided risk to them, I was grateful for the precautions for my unborn daughter.

But then, the inevitable happened in my Covid-19 birth story.

As I rounded on one of my patients admitted for non-COVID reasons, I noted that he had experienced fevers overnight and described to me a new onset of shortness of breath since that morning. I suspected what this might be and ordered a swab accordingly. He was switched to a non-shared room and as I suspected, the swab returned positive for COVID-19. Notably, I was not wearing PPE while seeing him as he was not under suspicion and therefore not under isolation precautions. Now that I had been exposed, my only option was to wait and watch for my own symptoms.

I returned to work the next day. The number of COVID-19 cases in the hospital had exponentially risen just overnight. I again rounded on my exclusively non-COVID list. That afternoon, I received a call from my OB’s office, recommending that all their patients in healthcare settings abstain from doing work requiring direct patient contact. With heavy apprehension about what I would do if I couldn’t work, I told my boss about my phone call. She sent me home right away. 

As it so happened, that was my husband’s first day working from home as well. I got home and told him what happened and that I’d do what I could to help my co-workers remotely. As I began to internalize what was going on, I was flooded with countless emotions. Anxiety about my recent exposure to a COVID positive patient. Fear about the implications it would have on my unborn daughter if I were to contract the virus. Shame that we were on the brink of a pandemic and that despite my training, I seemed to be fleeing the frontlines.

Apprehension for what lay in store for my selfless coworkers as the virus would inevitably ravage the globe. Uncertainty about what taking a leave of absence during my pregnancy would mean for my maternity leave when my baby actually arrived. The only positive emotion was the hint of relief I felt knowing that my unconsenting daughter would not be on the battleground during this war against COVID-19. And thus began a complicated several month-long journey of navigating this labyrinth of emotions.

Six days into staying home, it started. I felt suddenly short of breath. I was 27 weeks pregnant. It had to be my uterus, right? That’s a thing. But does it usually come on so quickly? I’m sure it can. The next day was worse. My body ached. I couldn’t get out of bed; I had no strength in my limbs.  My breathing was worse. I felt short of breath just sitting on the couch and my OB, who gave me a hotline number to call to see if I qualified to take a test. I called and I did qualify. Despite my symptoms and pregnancy status, I felt guilt utilizing a test while there was a limited supply.  The earliest slot was in seven days; I secured my spot. 

My husband escorted me to my appointment. After my swab and before I left the room, the nurse had to sit me down again and repeat my vitals because I had a bout of lightheadedness and palpitations. Fortunately my oxygenation was OK and my husband took me home. The next day, I received the positive result. For the first time in my pregnancy, my stomach sank with dread. I kept telling myself everything would be fine, baby girl would be fine. But I had no scientific basis for this and for the first time the control freak in me was sent into a tailspin of horrifying possibilities. 
Fortunately, I had a mild course of illness. Though my symptoms of shortness of breath and weakness lasted about three weeks, I never had low oxygen levels. I had to delay my upcoming OB appointment while I was acutely ill, but when it was finally safe to go to an appointment in person, I was reassured that my baby girl was doing just fine.

The remainder of my pregnancy, I still remained on edge, my mind often drifting to invasive thoughts of all the potential unknown complications COVID-19 could have caused to my baby that we simply couldn’t detect. It was an uneasiness I knew would not abate until I held my baby in my arms and I could see her for myself. My daughter arrived on June 16, 2020. She came two and a half weeks early and was a little smaller than expected. The delivery wasn’t the smoothest. Despite being in labor for 24 hours, my contractions weren’t getting closer together. I required augmentation with pitocin. The process was stressful for her. Her heart rate was slowing down significantly and often. She had to be delivered by forceps. But she was finally here. And thanks to my incredible delivery team, she was healthy.

Even though the scariest scenario many pregnant women could imagine during the pandemic had become my reality, it didn’t completely minimize the other difficulties the pandemic had inflicted on so many. I still felt heavy over the “little” things. I felt sadness in having to cancel my baby shower (though I had a beautiful and thoughtful virtual one). Selfishly, I wanted to waddle around the town with my husband during my third trimester. I wanted to get a prenatal massage. And a mani/pedi before delivery. Most of my friends didn’t see me when I was extremely pregnant. And it pained me most that my mother didn’t see my pregnant body from 16 weeks onward. I had to push through contractions with a mask on.

Our family and friends couldn’t rush to the hospital in an excited frenzy when we were told we were being admitted for labor. My parents and my husband’s parents had to carefully plan quarantine and travel to see us in succession rather than coming all at once. We have had no visitors at our home to meet our baby girl. And even though our family and friends have been generous and thoughtful with their gifts and warm wishes, only a handful of immediate family members (with careful planning, quarantining and testing) have held my daughter to this day. 

I went back to work after four months at home. It felt good to be back amongst my peers and get my hands dirty in this fight. The COVID cases are rising in our hospital day by day. People are doing better, partly because of some known treatments we can start early on in the disease course and partly because of the horrific number of lives this virus has already claimed. It is difficult to work, especially in PPE, but it is a privilege to be entrusted with people’s lives in this way. When I come home from the hospital, I run straight to the shower before greeting my daughter and husband. It is the highlight of my day.

I was honored to be prioritized into the first tier of staff at my hospital to receive the COVID-19 vaccine. On my drive back home after receiving the shot, I broke down into tears. That there is a glimmer of light at the end of this tunnel is surreal.  My story is not unique at all, in fact, it is probably painfully common. Despite the disparities and schisms that have arisen in this past year, there is far more we can probably say that we have in common. And as a result of having endured this harrowing chapter of human existence together, I’m hopeful that there will be a tolerant and more inclusive future to come.

Written by: Akshata Pandit, Mother + Board Certified Internist

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