Pregnancy in the Age of COVID-19
March 29th 2020. Since January, there are over 100,000 COVID-19 cases and over 2,000 deaths from this illness in the U.S. and New York is now officially the epicenter of the disease with over 50,000 cases reported since March 26th 2020. I’m 16.5 weeks pregnant and I’m also a clinical psychologist. To say this is a unique period in my life would be an understatement.
Collectively, this is a unique period of time in everyone’s life across the globe as this virus has uprooted society in almost all countries across the world. Non-essential businesses have been closed for just over a week now in N.Y. and I have been at home and have not left my house in 18 days unless to take a walk around our neighborhood. Since the insidious and quick spread of the disease in N.Y., I have been working exclusively from home, seeing patients virtually through phone and video telehealth sessions. I work part time at Northwell Health, a major hospital in N.Y. at an outpatient clinic located in Queens, N.Y. I have patients there who are from the community as well as the health system that include medical assistants, nurses and medical residents, all currently working on the front lines of this disease. I also work part time at a local practice in Westchester and I have my own small private practice consisting of patients with a ranging scale of anxiety disorders. During the first week of the lockdown here in N.Y., every one of my sessions that week consisted of a discussion around COVID-19 and how their individual lives were being affected and changed by this epidemic. The amount of fear and anxiety they were currently experiencing, as well as the level of uncertainty that remains prevalent in everyone’s thoughts and feelings was unbelievably tangible. Uncertainty and fear are generally part of feelings of anxiety, but this epidemic has since highlighted either existing fears or exacerbated ones that may have been dormant, coped with by the ability to distract ourselves with activities outside of our homes. We are all practicing social distancing, not attending regular functions like birthday parties or weddings, trying to figure out the best time to grocery shop and purchase goods we need for the week, making sure we have enough soap and disinfectant to wipe down any item we receive from the outside world. While others have to still go to work, in hospitals and clinics that are directly in contact with individuals who are sick and positive from this disease, all wearing masks and gloves and washing their hands um-teen times a day to ensure essential hygiene principles and reduce the spread of the disease.
To say that being a psychologist during this time is difficult would also be an understatement. Medical professionals and our own government still do not have answers as to how long this disease and outbreak will last, what the health consequences are for individuals who get sick, if this disease will only occur once or instead occur 2-3 times a year as long as we don’t have a vaccination, and what I have been most concerned with, the long term consequences of getting this disease while pregnant or if your newborn gets contracted with it. Data is incredibly limited at this stage and there are no definitive answers to any of these questions.
Uncertainty is difficult for many reasons and for most people. It is uncomfortable and can make us feel powerless and hopeless in a time when we are longing for direction. In my clinical experience, many of my patients who experience anxiety disorders tend to cope with thoughts and feelings of uncertainty with distraction, or by engaging in negative behaviors that temporarily alleviate the feelings of uncertainty or anxiety. It’s not to say that those of us who aren’t clinically diagnosed with an anxiety disorder are any better at coping with these feelings either. Human nature is to want and seek answers. We feel lost without an anchor, leaving us with little to hold on to, easily spiraling into negative thought patterns and feelings that feel like they will never dissipate or settle. So, what’s the solution in a time of extreme uncertainty and anxiety?
If you notice, the title of this article is ‘Pregnancy in the age of COVID-19’ and yet what I have been speaking of is the collective and communal experience of anxiety and uncertainty during this outbreak. This is my first pregnancy and to be brutally honest, I have been fearful of being pregnant for most of my adult life and I only realized why after I became pregnant. It all had to do with uncertainty and lack of control. The unbelievable lesson I have experienced while being pregnant, with or without COVID-19 is this: surrender to what is and learn to trust the process because that is how you get through it and remain grounded. It is essentially the same process that is described in the serenity prayer, “grant me the serenity to accept the things I cannot change and the courage to change the things I can.” We must learn to tolerate and accept the uncertainty in our lives and focus on the aspects that we are able to modify. What does this look like in practice during the COVID-19 outbreak? Here are some examples. As we listen to the directives and stay home, adapt and create spaces in your home to help you develop a routine. I advise to stay physically active by taking walks around your neighborhood or working out at home using various Apps you can download to your phone or computer. It doesn’t require much but spending 30 minutes a few times a week allows us to stay physically and mentally healthy. Start a meditation practice. Stillness is the ultimate teacher in how to learn how to create distance between your thoughts and your feelings. It is important that we are not constantly consuming the news, engaging in work at all hours of the day or mindlessly scrolling on our phones. Times away from ‘doing’ and learning how to be with yourself will give you gift of learning how to tolerate difficult feelings and thoughts and learn that you don’t have to do anything with them except give them the space to exist. Talk to your friends and family via phone and video. It is important we stay connected to our community, it is what helps us stay calm and thrive. Spend time playing. You can read, dance, paint, cook, play some board games, spend more time with your kids or your dog, the point is to focus on activities you may have not “had time for” in the past. Let’s learn how to be present and happy in our own homes with ourselves and our loved ones around us. And finally, if you feel yourself undoubtedly worried and anxious during periods of your day and week, create space for that to exist as well. You can mourn things that you aren’t able to engage in right now. I’m mourning the loss of having to spend any “real time” with my family and close friends as I grow into and experience my own pregnancy. It’s ok to be sad if you had to cancel a trip or reschedule your wedding. There’s going to be loss during this time, don’t push it away and keep distracting from it.
As difficult as this time is, let’s learn how to slow down, how to be present with ourselves and not continually distract ourselves to help make us “feel better.” Anxiety isn’t inherently bad. It’s a signal that states to us that something important and potentially threatening is happening. Our brains evolved to make us pay attention to it and see what we can do in order to manage it and make it better. Create the space to feel and experience whatever it is that you are experiencing and let’s help each other through these difficult experiences. We are never alone. It’s only our anxious thoughts that make us feel that way sometimes. There will be a day when we will no longer need to be on lockdown and quarantined, where we can hug our friends and our families again without the fear of contagion and the unknown, and that will be such a beautiful day. Such a beautiful day indeed.
