Lauren Cascone is a Newtown mom of two young boys Jake (age 3.5) and Ryan (age 22 months). She is also a registered nurse at White Plains Hospital on the Labor & Delivery floor. Lauren has been in Labor & Delivery for 9 years and is extremely passionate about helping women and their support partners navigate pregnancy & birth. She’s even gone on to earn her Master’s Degree in Nursing Education and holds certifications in in-patient obstetrics, as a certified childbirth educator and a certified lactation counselor. She’s taken that passion and turned into a small business – Strong as a Mother – and has adjusted her business model to now include virtual support & classes during this unprecedented time. I talked to Lauren recently about how the labor & delivery process is shifting during the COVID-19 crisis. Our hope is to provide insight and support to all the pregnant mamas reading this..
Hi Lauren! Thank you so much for taking the time to speak with me. Can you tell me a little bit about your background as a L&D nurse?
It’s my pleasure! I’ve been a registered nurse on a labor unit for a little over 9 years now. My unit delivers about 1800 babies annually. When I started out as a new graduate nurse, I knew this area of nursing was where I was destined to be, so I guess you could say that I pretty much work my dream job.
You’re a nurse in Westchester and as far as I know, your hospital did not make the shift to not allowing birth partners in the delivery room. Can you elaborate on why certain hospitals wanted to make that change?
That’s correct. Our facility did not make the change to prohibiting one support person to remain with the laboring patient on our unit (or c-section patient) for the duration of their stay. With that said, stringent efforts are being made to reduce risk of spreading the COVID-19 virus. We are not taking this lightly. I think some NYC hospitals were very concerned about risking unnecessary exposures of birthing people and newborns to the virus, and with rates in NYC and surrounding areas suddenly skyrocketing, they felt that it was the correct, though completely heartbreaking approach.
Earlier this week, Governor Cuomo reversed that directive, issuing an executive order for support partners to be allowed in L&D. We know that the World Health Organization (WHO) advises against barring support partners and fortunately in Connecticut, we have not seen any hospitals do this. What are the additional precautions Labor & Delivery units are taking to ensure the safety of the expectant person, birth partner, child, and staff?
I believe that order reversal was a win for the rights of the birthing persons. I continue to hope that CT will continue to allow one continuous support person to attend labor and birth and abide by the guidelines WHO has set forth. I also hope that doulas, lactation counselors, and other support people can find ways to utilize technology via Face-Time and other virtual consults to also help support the laboring person.
I can not speak to individual facility’s policies, but where I work, both the birthing person and their support person are given face masks upon entry to the hospital. Once they arrive at our labor unit they are temperature checked and screened with a series of questions for potential virus exposure. If the support person screens positive to any of the questions they are immediately sent home, and if the birthing person answers positive, they are put on immediate isolation and tested for the COVID-19 virus. If both are negative for the screening, then they stay together in a private room, masked. The support person is given a gown to cover their street clothes, and the support person is not to leave the hospital for the duration of the stay. If they leave the building, they can not re-enter our division again.
Hospitals may have differing policies on whether to separate babies from mothers who test positive for the virus. Where I work, a mother who tests positive for the virus is separated from her baby who is also put on isolation precautions.
Our entire clinical staff practices with N-95 masks on from the second we enter the building. We are also all temperature checked upon entry to the hospital at the beginning of our shift. We practice strict hand hygiene in and out of all patient rooms and during patient encounters. Our support staff such as our unit clerks, dietary staff, and housekeeping staff, for example, all wear simple face masks as well.
The other thing changing is the fact that you can no longer take a tour of the hospital or any birth preparation classes. This is for obvious reasons, but can make things particularly daunting for first time mothers. What advice do you have for all the moms who will not be able to tour their hospital or take a birth preparation class?
Yes! See if there are any virtual tours that you can access through your hospital’s website. Sometimes there are. Or there may be some photos of the rooms, along with information about the amenities that the hospital will provide you during your stay. It’s very helpful to know that information in advance so that you avoid overpacking. My other piece of advice is to see if you could take a live streamed birth class, or speak with an educator from your hospital. There are also a number of great free educational videos from websites like baby center. They’re certainly not going to take the place of having the prep with a live person that you can ask questions to, but they can certainly help keep your mind at ease.
I want to talk a little bit about the classes you offer through Strong as a Mother. Like most other small businesses, you are no longer able to offer in-person classes. Can you tell me a bit about the virtual classes you’ll be offering until things return to normal?
I have two online eClasses available for purchase on my website www.strongasamother.net. I’ve utilized some great evidence based material from a company called Injoy. It’s the same company I use to help me teach my live classes. Both online classes are self-paced and accessible for 270 days after course activation. They include videos, animations, quizzes, and read along audio, plus a number of tools that one can access. My childbirth preparation eClass covers essential information on labor and more, and highlights ways partners can help throughout the process. You’ll also get a sense of what labor is really like as you watch several birth stories. My breastfeeding eClass covers all the breastfeeding essentials such as how breastfeeding works, how to breastfeed, how to know baby’s getting enough milk, and more. Both classes include a private virtual consult with me once you’ve completed the online component so we can dive deep into any questions you have or material you want more clarification on.
Finally, as a mother and a nurse, I want to ask you one last question. I know that as a first time mom, I had a lot of pre-conceived notions about how my childbirth experience with Isabelle would go. What advice can you offer to women on this? I know how disappointing it can be to not have a doula during labor or even family visiting in the hospital.
I think it’s a really good idea to have a birth plan or some sort of template of how you hope your birthing experience will be. I would recommend reviewing this plan with your OB-GYN or midwife team during your 3rd trimester prenatal appointments so that you are on the same page, and bring it with you to the labor unit to discuss with your nurse and the provider on call for that day. The birth plan is not set in stone, and may need to be flexible, but it really helps to know what your wishes are. Emergencies can arise. Sometimes we do need to act immediately to ensure your safety and your baby’s. Ultimately, it helps to educate yourself on the labor and birth process to be best prepared for it. One of the most important things I explain during my birth classes is teaching my clients what informed consent is for anything being suggested during their birth experience. I ensure that they know that they have every right to know what the risks, benefits and alternatives are before consenting to something that wasn’t originally part of the plan.
It can definitely be disappointing to not have your doula during labor or not have your family visit. Thank goodness we live in a time that allows for virtual ways of meeting up and video calling them. I know many doulas in particular are ramping up their availability to be there for virtual consults during labor and birth!