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Doctors and doulas help pregnant women deal with COVID-19 concerns

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Eight weeks before Samuel Aiden Pelletier was born by cesarean section April 29, 2020, he was oblivious to the fact that his mother was pregnant as a pandemic swept the globe. Nestled under Andie Pelletier’s heart, he might have noticed a more rapid beat when his mom learned about the shutdowns, found out her delivery hospital in Haymarket was changing to Prince William Hospital in Manassas, or when she got her pre-delivery COVID-19 test. He did not know that his firefighter dad was now the family’s only grocery shopper or that his siblings’ neighborhood play dates were canceled indefinitely, all in an effort to keep him and his mom safe and healthy. 

"Pregnancy does not take days off," said Dr. John Bruchalski, founder of Tepeyac OB/GYN and Divine Mercy Care in Fairfax. "It was as if an invisible earthquake hit. Nothing seemed to change around us but everything changed within us. The fear factor went up astronomically. We didn’t know how contagious it was. Patients did not want to leave their (homes)."

Tepeyac provides health care services to families of all incomes who want a pro-life approach to pregnancy. According to Bruchalski, the clinic responded to the pandemic by shutting down the office for a week and a half in March. It then reopened to low-risk patients, implemented cleaning and social distancing procedures, and arranged house calls for high-risk patients. 

Some of those high-risk patients were between 20 and 40 women who contracted COVID-19. 

"With COVID, it is an inflammatory response," said Bruchalski. "Most women do very well although other hospitals might be getting higher-risk cases. We just watch the baby early, like a high-risk pregnancy, and act early," he said, citing a recent example where the clinic induced a woman at 39 and a half weeks because she tested positive for COVID-19.

During a COVID-19-positive delivery, the medical team wears full protective coverings and after the delivery, the baby remains with the mother, according to Bruchalski. 

While they have come a long way since the early days of the pandemic, Tepeyac is still seeing the effects of that anxiety.

"Some of the moms developed high blood pressure and diabetes," said Bruchalski. "They were not coming to their appointments. As a result, we saw a rise in … issues because of the lack of monitoring."

For many other expectant mothers, the ever-changing hospital policies were another source of worry. Jennifer Woodhead, a doula and owner of a Mother's Perspective Doula Services in Fredericksburg, noticed many women were worried about catching COVID-19 while in the hospitals and sought out birth centers or home births.

"The midwives were completely booked," said Woodhead. When hospitals limited support persons, she and other doulas shifted to add virtual support offerings, built on extensive early education and real-time communication during delivery.

One client, Cynthia Dement, signed up for in-hospital support in mid-2020 when hospitals were starting to allow doulas and one other support person into delivery rooms. However, with the COVID-19 spike after Christmas, Mary Washington Hospital in Fredericksburg reverted to the one-person limit. In January, Dement texted her doula, Beverly Bouchard, when she went into labor. At the hospital, Bouchard was able to give Dement's husband support over the phone by talking him through different ways to position his wife during labor. After three difficult hours, she delivered her baby girl, Blair, at 2:30 a.m. Jan. 26.

"Obviously physical support is super important, but even just having that extra person there virtually was so valuable to us," said Dement.

While the development of COVID-19 vaccines has given hope to many that the return to normalcy is in sight, some pregnant women have questions about the vaccine.

"All of us at Tepeyac are encouraged by the latest small study in our American Journal of OBGYN showing that moms who received the Moderna and Pfizer vaccines are making a large amount of antibodies to the virus; passing on those antibodies to their babies in their umbilical cord blood and in their breast milk, and are having no higher incidence of side effects than nonpregnant women," said Bruchalski. "With that said, this study is a very small sample size and will need to be repeated."

Bruchalski suggested that when deciding to take the vaccine, Tepeyac encourages its patients to choose what is best for them based on their medical history, and the latest information and guidelines. With or without the vaccine, he said the clinic will continue to care for patients. 

Frances Silva, a religion teacher at Saint John Paul the Great Catholic High School in Potomac Shores, married her husband, Nick, in July and now they are expecting a baby girl, Miriam Ruth, in May.

"This is our first so we don’t have anything to compare it to," said Silva. "We were really surprised how seamless it has been with Tepeyac, which is pretty amazing. You go in quickly, find the form, wear masks."

Since their jobs still take them outside the home, they depend on limited contacts and general best practices within the state mandates to keep safe. While there is still so much uncertainty, new parents like Frances and Nick are optimistic.

"You can’t put life on hold," said Silva. "You have to take what you've been given and make the best of it."

Kassock is a freelancer in Fredericksburg.

© Arlington Catholic Herald 2021