Months into the pandemic, many Americans are still being forced to make significant changes in their lives. That includes pregnant women, who face an entirely new set of challenges. And for some, it means changing their birth plan.
"You just realize that you do need support. Pregnancy does bring out a lot of emotions, it's an emotional roller coaster," said Celeste Saunders, a first-time mother, who's now 36 weeks pregnant.
Due to COVID-19 safety protocols, she was alone for each pregnancy milestone at doctor's visits.
"After I found out, for one, my mom couldn't possibly make it because of the risks. I wanted to make sure I did have the support," said Saunders.
She began researching childbirth options outside of the hospital, eventually settling on a birthing center with a medically-trained midwife and a doula for physical and emotional support.
"I think I interviewed about 10 doulas," Saunders recalled. "Instantly, Jennifer was the sweetest, and we were on the same page with things."
"Every pregnancy is different, every mother is different, so it's not a cookie-cutter answer. It can be a very overwhelming experience," said certified birth doula Jennifer Cole, owner of Destiny Doula Services.
She says in the San Diego area there's been an uptick of women inquiring about childbirth outside the hospital. Back in May, the New York Homebirth Collective wrote an open letter in response to the increased interest in home birth.
"There's definitely options out there. It's just a matter about knowing about them," said Cole.
Cole will be allowed to join Celeste and her husband when they have their baby in the birthing center.
"Since the whole transition from a regular hospital to the birthing center, I haven't really thought about what if my parents can't come, X, Y, and Z, because the support is that much greater," said Saunders.
Because many hospitals are only allowing one support person, Cole's gone virtual with many clients, FaceTiming them during childbirth.
"Like school, it's not the same as being in the classroom, but it's better than nothing at all," said Elliott Main, MD.
An obstetrician, Dr. Main leads the California Maternal Quality Care Collaborative (CMQCC), an organization created to improve health outcomes for mothers and babies. He's also a Professor of Obstetrics and Gynecology at Stanford University.
"It's a scary time because particularly in the beginning of the pandemic, there were so many unknowns," said Dr. Main.
Mothers initially faced the possibility of being quarantined from their baby if they tested positive for COVID-19, but Main says researchers have learned babies are rarely infected. Main says the quarantining protocol is no longer being recommended; he instead encourages mothers to continue good hand hygiene and wear a face covering at home.
His organization will study the pandemic's impact on childbirth, looking at maternal outcomes and whether it increases the number of planned C-sections or births outside the hospital.
"I think the important thing about COVID-19 is that we're moving from a time of fear to a time of better understanding," said Main.
"My message to somebody struggling is it's all going to be great. Your body knows what to do. Trust your body and you have choices, and don't forget that you do," said Cole.
She's happy to see more women are learning they have childbirth options.
"Having more options right now is empowering," said Saunders.
Expecting mothers can search online for doulas in their area through nonprofits like Dona International.
Some cities and hospitals also offer volunteer doula support for low-income women.