Pregnancy and giving birth can come with a wide range of joys, challenges, and fears. People who are giving birth during the current COVID-19 pandemic are also navigating unexpected circumstances and added uncertainty that may increase their chances of experiencing a traumatic birth.

As COVID-19 spreads in the United States, public health officials continue to urge people to help flatten the curve by staying home and following other restrictions. The idea is to slow the spread of the disease such that infections are spaced further apart. This reduces the strain on hospitals and other health resources, lowering the death rate from COVID-19. But some strategies to slow the spread of COVID-19 may negatively impact people who are giving birth.

Several hospitals around the country have announced their plan to restrict visitors during childbirth, and in some cases even to eliminate visitors altogether. Citing the public health emergency, hospitals in San Francisco have banned all visitors during childbirth, including spouses. Numerous hospitals have banned doulas. Two New York hospitals also temporarily forbade visitors, until Governor Andrew Cuomo issued an executive order clarifying a pregnant person’s right to support during labor. psychological help to people

COVID-19 is still new, with few large, reliable studies on its long or short-term consequences. Researchers aren’t sure how it affects pregnant people, whether it increases the risk of birth complications, or what risks it might pose to a newborn.

Giving birth in this uncertain climate can be terrifying—even with support during labor and beyond. For those without support, the uncertainty and fear coupled with isolation and birth trauma may trigger posttraumatic stress (PTSD), trouble bonding with their newborn(s), postpartum depression, or intense fear.

Long before COVID-19 entered the United States, the American maternity care system posed limitations. The U.S. has the highest maternal mortality rate in the wealthy world. Americans have seen maternal mortality skyrocket as other nations dropped their rate to nearly zero. An American woman giving birth today is more likely to die than her mother was 25 years ago. The states with the highest maternal mortality, such as Georgia, have higher death rates than dozens of other nations, including some war-ravaged countries.

Maternal mortality is just part of the picture. There can also be a problem of a lack of quality, compassionate care. Some pregnant people report abuse and even assault in the delivery room. One survey found that 87% of birth workers have witnessed obstetric violence, including sexual assaults and other forms of physical violence.

Now, birthing people enter this potentially flawed system as healthcare workers are more stressed, afraid, and overworked than ever. And in some cases, they are entering this system without a support person.

Researchers do not yet know how COVID-19 might affect pregnancy. This uncertainty may increase stress for pregnant people.

Pregnancy can affect a person’s immune response and respiratory system, so pregnant people might be more vulnerable to the disease. So far, however, no research indicates higher rates of coronavirus among expectant parents.

One small study suggests that vertical transmission—which happens when a mother transmits a virus to her baby in utero—is unlikely. The same study also analyzed samples from six Chinese women with the virus. Researchers did not find any signs of the virus in milk. However, these studies are small and preliminary.

Many hospitals now suggest that pregnant people diagnosed with COVID-19 be separated from their babies. Birth advocates have pushed back, arguing that a baby is much more likely to catch the virus in a busy hospital nursery than from an appropriately cautious parent.