My prenatal visits had become uneventful, reduced to preemptively reporting no new symptoms and concluding with the sounds of a normal fetal heart rate and manual confirmation of the expected fundal height for gestational age. Though I had a healthy case of the new mom jitters and was rapidly accelerating into full on nesting mode, I was incredibly grateful for an uncomplicated pregnancy. I frequently envisioned what our new life would be like, and these thoughts were warmly filled with family and friends. After all, that was why we had moved back to Michigan.
As a physician, I was occasionally (and in retrospect, naively) fielding questions about the novel coronavirus, largely minimizing its potential for any substantial harm in the U.S., drawing comparisons to influenza. By March, however, cases started infiltrating local hospitals. It was when I received a phone call from the OB clinic asking if I would be willing to convert my last prenatal visit to telehealth I realized the postpartum period I envisioned was becoming less and less certain.
Labor and delivery was unlike the L&D I had witnessed and partaken in as a medical student. I was admitted for an induction prior to estimated delivery date in anticipation of the hospital being at or beyond capacity. Masked nurses came and went as their shifts changed. I both appreciated their support and guidance and feared the frequent encounters. There were no medical students as they were not yet back to clinical rotations. Given I was not in labor on presentation, labor was prolonged and full of interventions, making the experience feel far more medicalized than I imagined it would be.
Once Gabby entered the new and ever-changing world, my protective instincts kicked in. Despite the literature, albeit small at the time, suggesting COVID was a disease that largely affected adults in morbid and mortal ways, I irrationally feared her getting sick. Even more, I feared my husband or I getting sick and being unable to care for her. And so we advocated for the quickest discharge possible, eager to show we were ready to take care of Gabby at home.
The postpartum period was filled with the usual physical aches and pains, lack of sleep, innumerable diaper changes, toils and troubles of breastfeeding, and solicited as well as unsolicited advice about how to care for a newborn. Weeks passed by, and then months and before I knew it Gabby was no longer a newborn. With the exception of a handful of masked mostly outdoor visits to my parents’ house and a delayed visit from my in-laws after quarantine-ing and testing for COVID, this period was largely spent at home with just nuclear family. There was the occasional excursion to pick up groceries curbside that got the adrenaline rushing.
Though there were times early on after my husband’s paternity leave ended I selfishly longed for the presence of another person to watch Gabby while I slept or relieve me of one meal or diaper change, these feelings could easily be put into perspective and pacified. Likewise the disappointment for Gabby’s grandparents felt far more forgivable than the risk of them getting sick.
The most difficult emotions to grapple with were, and continue to be, more existential. As a physician, I struggled to accept my ongoing decision to not be a frontline provider in the midst of a pandemic when my colleagues, many also with young children, were tirelessly working to care for sick patients. I watched as they struggled to balance long hours, emotional exhaustion, fear of exposures, and uncertainties surrounding daycare and school. There were multiple rounds of testing and quarantining as well as stretching thin and shuffling to meet childcare needs. I worried as they talked about reusing personal protective equipment, packing into tight work spaces, and volunteering to care for patients with COVID on the wards and in intensive care units. And while I will always feel thankful for Gabby’s happy and healthy infancy, the pangs of guilt for exploiting privilege and prioritizing my own family over others are becoming chronic. Only time will tell if they will go dormant with an occasional flare or become smoldering.
Dr. Karmo is a mother, internist and writer based in Ann Arbor, Michigan. Her interests include psychosomatic medicine, endocrinology, women's health and end-of-life care. She trained at the University of Pittsburgh in internal medicine and currently does locums tenens a few hours a month when she's not busy raising her daughter with her very supportive husband, who is also a physician. She is also a champion of social justice causes, including black lives matter, refugee rights, LGBTQ rights and equal rights for women.