Last Tuesday, Greg Davidson and his wife showed up at 6 a.m. at Mount Sinai Hospital on the Upper East Side for a planned C-section that would bring their first child into the world.
The couple knew that the coronavirus crisis had created a stressful environment for doctors, and that hospitals had imposed restrictions on visitors. But after Mount Sinai and NewYork-Presbyterian sought to ban partners from maternity wards last month, they were relieved to see Governor Andrew Cuomo sign an executive order that required all hospitals to allow one person to support a woman throughout labor and delivery.
Giving them added assurance was the fact that the hospital had tested the two of them for the virus the day before. Both tests turned out negative.
At the lobby, the two were met by a security guard.
"He said to my wife, you need to go upstairs," Davidson said, while he was instructed to stand by until she was admitted.
What he thought would be a perfunctory wait turned out to be three excruciating hours of standing outside the hospital building. Because of precautions, the guard told him he could not stay in the lobby. He was even unable to use the bathroom.
During that time, Davidson, who runs Lalo, a company that makes products for babies and toddlers, tweeted about the experience.
When the time finally came, he found himself whisked into an operating room where he found wife sobbing and about to undergo surgery. After their baby was born, he got to hold his son while doctors finished performing stitches on his wife. But he would have to leave soon after, he was told. He could not accompany his wife into the recovery unit.
Afterwards, he got in his car and drove home, in disbelief that he had just become a father.
"It almost felt like a dream," he said, adding, "It was totally surreal. This isn't what anyone expected."
Despite the governor's order, some New York City couples are still having to endure often lengthy and painful separations. The order specifies that women are entitled to "one support person who does not have a fever at the time of labor/delivery to be present." But as many are learning, the rules are unclear for women with planned C-sections who do not undergo labor.
On Monday, another expectant father tweeted that he too was forced to wait outside Mount Sinai as his wife was being prepped for a planned C-section.
A spokesperson for Mount Sinai said in a statement that the hospital follows "the strict guidelines" of Centers for Disease Control and Prevention and the Department of Health.
"However, we are doing everything humanly possible to prioritize the safety and health of expectant mothers, partners, baby and staff," the statement added. "This is the greatest humanitarian crisis in a century, and we are all in this together.”
Some hospitals are also applying their own standards of when labor begins. Jesse Pournaras, a New York City doula who started an online petition to get the state to issue its current order, said that she has heard about inconsistent rules from parents and midwives across the city. She said at Woodhull, a city-run hospital in Brooklyn, partners are not being allowed into the hospital until the woman is six centimeters dilated.
"It’s truly the wild, wild West out there," she said. "There’s no clear consistent practices in place."
Although Cuomo's March order does not say anything about postpartum support, on April 8th the state Department of Health issued guidance to hospitals stating that a "support person is essential throughout labor, delivery, and the immediate postpartum period."
But in an effort to provide leeway for hospitals, the guidance added that "the Department is mindful that patient care needs may restrict the times during which a support person may be present."
Many hospitals, including Mount Sinai and New York-Presbyterian, have prohibited support individuals from accompanying women into postpartum areas, thereby limiting any time to the labor and delivery areas.
Stephanie Guzman, a spokesperson for New York City's Health and Hospitals Corporation, which runs the public hospitals, denied that the city hospital system had any dilation requirement.
She said a support person is allowed to be with a patient when they are in labor, during delivery, and in the immediate postpartum period. For an uncomplicated vaginal delivery, the postpartum period in the labor and delivery units is about one to two hours. Those patients who have had an epidural may stay longer. Other cases may be decided on an individualized basis.
Support individuals, however, are not allowed into the postpartum unit.
As a result of such restrictions, Pournaras has now launched a second petition, this time calling on the state to order hospitals to allow support individuals into postpartum and recovery units. She has amassed over 20,000 signatures to date.
Especially for women who have had C-sections, help is critical. Immediately after birth, many women are confined to bed with a catheter. After the anesthesia wears off, the pain can be intense. Even during normal times, women often have to nurse and care for their babies with relatively little help from hospital staff.
"I can think of no other major surgery where we expect patients to be completely alone and take care of another dependent," she said.
The Cuomo administration has been cognizant of the difficulties pregnant women are facing. On Monday, Melissa DeRosa, the secretary to the governor, announced the creation of a COVID-19 maternity task force on safe alternatives to hospital births.
But those options, either home births or birthing centers, are not for every woman.
Tanya Wills, a midwife who runs Manhattan Birth, told Gothamist last month that many of the women seeking midwives are not the right candidates for home births, which does not use drugs or epidurals.
"There's a philosophy behind home births," she said. Women who are the right candidates are those who are "committed to doing births at home and all it entails."
Pournaras said that the issue for hospitals boils down to priorities. She pointed to NYU Langone in Manhattan and Lenox Hill, which have both continued to allow partners and support individuals throughout the crisis.
"Fundamentally these two hospitals believe in families and are patient-centered," she said.
Davidson said that from the start, there were problems in communications. Neither of them knew exactly when he would be let inside the hospital. After he was forced to leave, he said his wife was largely left to take care of their newborn by herself because of short staffing. On both nights she was at the hospital, the nursery was closed.
"It’s not that we don't understand the stress that hospitals are under," he said, adding that they were appreciative of several of the nurses as well as their doctor.
But he added, "If that’s the case then they should be able to give enough support for the patient, and that was not happening."
This story has been updated to include a statement from New York City's Health and Hospitals Corporation.