The Isolation And Sacrifice Of Pandemic Pregnancy : Consider This from NPR Three women come together to talk about the isolation and sacrifice that comes with being pregnant during the pandemic.

Those women: Irène Mathieu, a pediatrician in Charlottesville, Virginia; Elizabeth Baron, a mental health counselor in New York City; and Ashley Falcon, a fashion stylist who moved from Florida to New York in the early stages of the pandemic.

Economist Hannes Schwandt predicts the pandemic will coincide with a drop in birth rates.

In participating regions, you'll also hear from local journalists about what's happening in your community.

Email us at considerthis@npr.org.

Pregnant In A Pandemic: 'COVID Couldn't Rob Us Of Everything'

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AUDIE CORNISH, HOST:

This will sound dark, but there was this moment last year when things were feeling pretty crazy - with the politics, the pandemic, the economy - and I wondered, why would anyone bring a child into this?

It's 6:30 in the morning on March 17, 2020. My baby is due April 2.

That anyone was about to be me.

And I was just lying here with my eyes open.

I was nine months pregnant and watching TV, watching government officials like Dr. Anthony Fauci on the news.

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ANTHONY FAUCI: People need to understand that things will get worse before they get better.

CORNISH: That wasn't helping. And by the time I went into labor a few days later...

It's 10:20 a.m., and I'm in early labor.

...And finally went to the hospital, it was like there was a new layer of uncertainty over everything.

OK, so just so I'm clear - in the two, three hours that we've been waiting, they have changed the policy for labor and delivery to only the parents only, no support person or visitors. And for the NICU, only one person - visitor.

UNIDENTIFIED PERSON #1: I believe so, yeah.

CORNISH: And they had a COVID simulation/drill.

UNIDENTIFIED PERSON #1: Yes.

CORNISH: That's not even since this morning. That's, like, in the last three hours.

I'd seen a small team of medical workers practice running a resident in on a stretcher, trying to cut down the amount of time it would take to get a potential COVID patient down the hall. I watched med techs roll plastic-covered neonatal incubators into an isolated room for intensive care. I overheard nurses asking what kind of PPE they would have and how much. The layers of uncertainty seemed to pile up by the hour.

UNIDENTIFIED PERSON #2: I know. I bothered you. You did so many things. The picture looks great.

CORNISH: In the end, it was fine. My baby was born healthy, 7 pounds, 9 ounces. But CONSIDER THIS - the uncertainties around giving birth in a pandemic, it didn't end in 2020. We're going to hear from people who are going through it now.

From NPR, I'm Audie Cornish. It's Wednesday, March 17.

It's CONSIDER THIS FROM NPR. At the beginning of the pandemic, when the idea of being quarantined was still a novel thing, there was speculation that all this time trapped indoors could lead to a baby boom.

HANNES SCHWANDT: So I think like what people had in mind were, like, these episodes of like, you know, a blackout somewhere in Italy and then they, nine months later, have a baby boom or, like, Barcelona won against Madrid and then the baby boom, those kind of things.

CORNISH: But economist Hannes Schwandt was skeptical.

SCHWANDT: What typically happens when we have a society-wide, you know, recessions or, you know, dramatic events that involve a lot of uncertainty is that we see that people have fewer kids and not more kids.

CORNISH: Schwandt is a professor at Northwestern School of Education and Social Policy. He says there is usually a dip in births during economic recessions. It's part of what he refers to as the unromantic side of fertility, acknowledging that kids are expensive and that people, even subconsciously, understand it as a decision with financial consequences. And the day-to-day stress of a recession can change the course of family planning.

SCHWANDT: It's not that they say, oh no, I can't have kids because I don't have a job. No, it's, like, people are stressed about not having a job. They are searching for a job, which takes time.

CORNISH: As we know, this pandemic hasn't impacted everyone equally. Some people have been able to work from home, which has meant more flexibility. And Schwandt says that could mean having a kid now is actually easier. But the reality is we don't know exactly what has been happening, not yet, because economists like Schwandt are still waiting on the fertility data that the Centers for Disease Control and Prevention keep track of.

SCHWANDT: At the moment, whether women are pregnant, that's a very private thing, right? It's not that the government keeps track of conceptions or something like that, right? So we have to be a little bit patient here.

CORNISH: But Schwandt predicts, overall, we'll see a decrease in births, although there will be pockets of people - those who haven't taken an economic hit - where we're likely to see the opposite.

SCHWANDT: So I think in those groups, there will probably be a small baby boom.

CORNISH: Can I ask you if you have kids?

SCHWANDT: So actually, we have a four-month-old, which means we contribute to the fertility during the pandemic. But also, if you do the math, he was conceived before the pandemic. So, you know...

CORNISH: Congratulations.

SCHWANDT: Thank you. Thank you very much.

CORNISH: So you won't be in the data you'll be looking for (laughter).

SCHWANDT: Exactly. Not really.

CORNISH: Hannes Schwandt, professor at Northwestern School of Education and Social Policy.

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CORNISH: The data are one thing, but then there's the actual real-life experience of getting pregnant during a pandemic.

IRENE MATHIEU: I definitely paused. I put it off for several more months than we initially anticipated.

CORNISH: Irene Mathieu is a pediatrician in Charlottesville, Va. She's also 26 weeks pregnant with her first child. She and her husband had planned for 2020 to be their year for a while.

MATHIEU: When we got to the fall, I felt a little bit more comfortable about understanding my personal risk level.

ELIZABETH BARON: You think you're a regular pregnant person with no risk factors, and all of a sudden, you as a group are considered a high-risk population.

CORNISH: Elizabeth Baron, a mental health counselor in New York City, was pregnant at the start of the pandemic, and she had her first baby at the end of March 2020.

BARON: The decision-making fatigue and the importance of keeping everyone safe, balancing also the desire to share this newborn baby and this experience I think is a really, really, really difficult process.

CORNISH: And Baron says New York City felt really lonely and scary in those early days with the streets eerily empty. Ashley Falcon moved from the city to Florida around that time. She's a fashion stylist who's now seven months pregnant.

ASHLEY FALCON: When we drove out of the city, I was in tears. It was just empty. You wouldn't see a human. It was - I mean, it was really, really insane.

CORNISH: I got these three women together to talk about what pregnancy has been like during this time - the isolation, the decisions that they've been faced with that no one could have anticipated, not the least of which has been the COVID vaccine. We know pregnant women have a higher risk of becoming severely ill from the virus, but there's also uncertainty about how the vaccine could affect people who are pregnant and their babies. I asked Irene Mathieu, a pediatrician, why she decided to get it.

MATHIEU: You know, it was a really tough decision. I spent several weeks thinking really carefully about this, talking to friends and family and really reaching out to other health care providers, some of whom were also pregnant. And ultimately, for me, it was a risk-benefit analysis like we do in medicine all the time. And I felt that my personal risk, both in terms of being a pregnant person - so that puts me at high-risk - and then also being a health care worker and having a higher exposure level every day - both of those put me in a high-risk category.

CORNISH: When you had doubts, what were they?

MATHIEU: You know, I felt like this is something new. And the MRNA vaccine is using a new technology. The MRNA piece of that is something we haven't seen deployed at a large population scale. And so my doubt was that I don't know what impact this is going to have on me or on my unborn baby. But from the science that I read about it, there was no way that I could fathom it could actually have a material impact.

BARON: I want to second Irene there that I also am double vaccinated, and my partner is halfway there. And at this point, it's important to call out that there has been ever-changing communication and information on the risk factor. But to your point, Irene, about the risk-benefit analysis, I'm having that conversation daily with my patients now. And it is interesting that OB-GYNs and midwives are still sort of - some - like, of course, I can't overgeneralize - tend to not be as clear about their recommendations, whereas, you know, people are really trying to find information from their pediatricians and their colleagues and their friends or mental health providers, anyone who has clear information. And now there is more data. It's not as limited anymore about antibodies and what this means for pregnant women through the placenta - right? - in the event she gets the vaccine.

CORNISH: Ashley, I want to let you jump in here. Since you're the person who doesn't have a medical degree, you will not be judged for whatever your decision is around this. But what have your thoughts been about the vaccine?

FALCON: So here is something that I think is pretty fascinating about this conversation. As someone who doesn't have sort of the medical background and perhaps the access that the other two ladies have, I have chosen not to have the vaccine. Now, it's not to say that if I wasn't pregnant, I would have been the first one in the line. Granted, I'm much younger, and, you know, I'm not necessarily the first priority, but I'm all for it.

And what I've done as a result is I've been on this campaign to get everyone around me vaccinated. I was OK with the risk factor for myself. I was just talking to someone yesterday, saying, like, well, I wonder if I should get it immediately after having the baby. Can I even get it immediately after having the baby? If I'm breastfeeding, does that affect the baby? And it's not to say that I blame anyone in the medical profession 'cause we're all playing catch-up, and we still have no idea what's going on here. I mean, we have a better idea...

CORNISH: Right. But typically, when you're pregnant, you're like, should I have coffee? So you're (laughter)...

FALCON: Yeah. Like, I need pretty concrete answers. This is the life of, like, my first - you know what I mean? Like, I'm like, I can't have a - well, it probably won't do anything.

CORNISH: Let me ask another question. I'm going to start with Irene on this. What do you think you've learned throughout this time in terms of, you know, advice you think you would be able to offer expecting parents in the pandemic?

MATHIEU: I think that, you know, I've learned about myself. I don't know how translatable this is to other people - but that I can tolerate a higher level of uncertainty than maybe I gave myself credit for prior to this pandemic. In terms of advice to other parents, it's hard to say because this is my first child, so I don't know what it's like to actually have a kid and have gone through the kind of year that we had. But I would say in general, whether you're a pregnant person or a parent, be kind to yourself, be gentle to yourself and don't be too hard on yourself.

I think as a culture, we have a tendency to be very judgmental and say, this is the right way to do things and this is the wrong way. And I think what this pandemic has shown us, which Ashley so eloquently pointed out, is that when you have a situation where there's constantly changing data and new information and really there isn't a hard and fast correct answer, it's OK to just let people make the decision that feels the best for them and feels the safest for them.

CORNISH: Ashley, what advice can you offer to other people who are expecting or going to be expecting or making a decision to be expecting?

FALCON: I wouldn't change the choices that we've made. I think going into it with a little more understanding of - like, my spouse hasn't been able to be there for sonograms, which - we're very close, so that was something that felt really difficult to not have him next to me - so just knowing a bit of what you're getting into. But like, I can't remember who said it, but, you know, we've gone through so many other things as a history, as humanity. And sort of the show must go on. To me, it's like, COVID couldn't rob us of everything. You know, at a certain point, we had to hedge our bets and make choices and sort of move forward.

I would just say if you and your partner, you know, are in a strong relationship and you feel like you can weather anything together, then you should do it because I wouldn't change anything. I would do this all over again. But I think you just have to really actively talk to each other about how you're feeling and what those appointments would be like on your own and just really kind of knowing what you're getting into a bit more.

CORNISH: And I want to bring in Elizabeth here. You're a mental health counselor. That's why I have you last (laughter). And you've already had your baby. So what's your advice?

BARON: I cannot tell you how often I'm speaking daily with patients about what it means to be a good enough mom right now and to not have a perfectly clean house and to not put out a cheese platter when a caregiver comes to help - right? - just these feelings that I have to be good enough.

But what I wanted to share about my birth story and what I've learned and then my advice is, I think my birth story and this experience of being a pregnant and post-partum mom represents my personal sort of bravery and suffering all at the same time. So I'll use a personal anecdote here. During my birth experience, I had to keep telling myself, I am strong, I am brave and I miss my husband at the same time, right? I'm excited to meet this baby, and I'm terrified and angry about COVID.

So today, I feel both grateful and disappointed in many, many, you know, moments during the day when I see something on social media about another baby welcomed with a partner. But I have to make room for both, and I want moms - new and expecting moms out there to also make space for these two opposing things that can exist at the same time because I think it allows and gives permission to have some self-compassion in moments where you might be feeling guilty or might be feeling unable to sort of say, hey, I'm really struggling.

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CORNISH: That was Elizabeth Baron in New York, Ashley Falcon in Florida and Irene Mathieu in Virginia.

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CORNISH: You're listening to CONSIDER THIS FROM NPR. I'm Audie Cornish.

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