During even the most routine pregnancies, anxiety often runs high. So, understandably, pregnant mothers and expectant families likely have increased concerns about labor and delivery during the COVID-19 pandemic. The team at Massachusetts General Hospital is ready to care for mothers and families and address their concerns. In addressing worries that some have about coming to the hospital for delivery, clinicians at Mass General, in line with the position of the American College of Obstetricians and Gynecologists, believe that hospitals remain the safest places to give birth.

“Coming to Mass General for maternity care remains incredibly safe for patients, and we have preserved all the essential components of a normal, family-oriented birth experience,” says Bill Barth, MD, vice chair of obstetrics at Mass General. “Our Maternity and Newborn Service, for both normal and high-risk patients, remains one of the premier destinations for childbirth in New England, even during the COVID-19 pandemic.”

The care team within the Department of Obstetrics and Gynecology—including obstetricians, nurses and nurse-midwives, infectious disease experts, maternal-fetal medicine specialists, obstetric anesthesiologists, pediatricians and neonatologists—is taking all necessary precautions to ensure that mothers and babies who come into the hospital leave safe and healthy.

Giving Birth at Mass General

Every month, around 350 babies are born at Mass General, and that number has held steady during the pandemic. Maternity care remains a top priority for the hospital and there has been no break in the continuity in care. As ever, the Department of OB/GYN collaborates closely with other departments and specialists within the hospital to provide expert care, in unusual cases when complexities arise.

“The primary advantage to giving birth in the hospital is the availability of resources to provide safe delivery for both the mother and the baby regardless of the circumstances that arise,” says Michele A. O'Hara, DNP, RN, NE-BC, nursing director at Mass General.

To prepare for possible circumstances and complications brought by COVID-19 infections, prior to the pandemic, the OB/GYN team had almost daily contact with the Centers for Disease Control (CDC), professional organizations and COVID-19 experts around the country to ensure that services could preserve the highest standards of safety for patients, families and hospital employees.

Though available research argues that pregnant women do not appear to be at a higher risk of severe disease related to COVID-19 than the general population, the Mass General team is very prepared to care for all who are pregnant and infected.

“Given the extraordinary resources available,” says Dr. Barth, “we have been able to care for some of the most seriously ill mothers struggling with COVID-19. Through multidisciplinary intensive care, including ICU care with ventilators, we have been able to provide safe delivery for mothers with severe COVID-19. Several mothers who required ICU care during pregnancy have come off ventilators and are now at home recuperating and their children are doing great.”

Precautions for COVID-19

While the in-patient care model has not changed, to assure the health and safety of all patients, the care team has adopted universal precautions as described below caring for all patients, and all have trained in additional, important infection control measures.

“We wear appropriate personal protective equipment (PPE), such as N95 or procedure masks, goggles or face masks, gowns and gloves as clinically indicated,” says O’Hara.

Additionally, the visitor policy was adapted to further protect patients. Expectant mothers are limited to one visitor, but the care team aids in digital and teleconnection to families when possible and appropriate.

“Although limiting visitors was a difficult decision, we felt that was important. Fortunately for OB patients (as compared to most others admitted to the hospital) we still allow the presence of a partner, spouse or support person because that is so important to families and such a vital part of giving birth and caring for the newborn,” says Dr. Barth.

Healthy mothers and newborns can expect to go home a little early, typically the day after delivery if everything is routine. Otherwise, maternity care remains the same as during usual times.

Virtual Visits and Looking to the Future

While maternity care within the hospital remains the same, there has been a change to prenatal care that now includes more options for virtual visits over the phone and using technologies like Zoom. And many of these new options for patients are likely to remain where appropriate once the pandemic has run its course.

“Virtual visits may be one of the silver linings to come out of the COVID-19 pandemic,” says Dr. Barth. “Patients seem to love them, and it has had a dramatic effect on our wait times.”

As with any new challenge, the COVID-19 pandemic was met with uncertainty at first, but Dr. Barth says this has given way to the hope and confidence that Mass General has been able to meet the challenges.

“I get the sense that most of the providers and staff feel a sense of gratitude at this time,” he says. “Gratitude for our colleagues and their expertise, gratitude for our support staff and hospital leadership and, most of all, gratitude for the extraordinary faith our patients have placed in us during this time. To have mothers and families place that faith and trust in you during such a time is an honor, but also a huge responsibility. I think I can speak for us as a service and an organization that as each day passes, we gain confidence that we are meeting responsibility.”

“I’m incredibly proud of our faculty and staff as well as our patients and communities for adapting to the unexpected circumstances COVID-19,” says Jeffrey Ecker, MD, chief of Obstetrics and Gynecology and a practicing high-risk obstetrician. “We’ve worked hard to preserve the wonder and joy of childbirth even as we do everything necessary to assure the health of mothers and babies. For most families this will mean a very similar experience to that which was the norm before the pandemic. For those few with COVID-19 illnesses who need extra care, we are more than prepared to help and can use the many resources of Mass General to deliver best outcomes in those cases too.”