Brianna Tipping stands on her porch to evade falling snow on Monday, March 30. Tipping is 30 weeks pregnant with her second child. Credit: Staff Photo/Nina Mahaleris

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Anna Howard had hoped to have her mother and fiance in the delivery room when she gives birth to her first baby, due in less than a week.

That may no longer be possible, as hospitals have tightened restrictions on visitors in the delivery room as one of many responses to stop the spread of COVID-19, the illness caused by the novel coronavirus.

[Our COVID-19 tracker contains the most recent information on Maine cases by county]

“We don’t know, day to day, if it’s gonna change,” said Howard, who lives in Gray. “I feel like a month ago, I wasn’t that worried.”

Whether a pregnant woman, her fetus or a newborn child are more at risk for COVID-19 infection than the general population is not known, the Maine Centers for Disease Control and Prevention said on its website.

But Mainers preparing to give birth during a global pandemic are trying to take control of a situation that falls more out of their hands every day.

They juggle a myriad of new fears — including coming into contact with infected people inside hospitals, adding to the stress on medical professionals and new and evolving restrictions to slow the spread of the virus. Many are adapting to unusual relationships with their OB/GYNs and birthing professionals, while others are opting for home birth, avoiding hospitals entirely.

Maine’s major hospitals have not yet banned spouses and birthing partners from delivery rooms but some have laid down a one-visitor-per-patient rule to prevent an outbreak.

Some are prohibiting children from visiting pregnant patients entirely.

Two New York City hospitals last week prohibited all but medical staff from labor and delivery rooms — a measure that would have forced pregnant patients to give birth without their spouses or birthing partners present. New York ordered all public health facilities in the state to allow one support person in the room with a patient who is giving birth, as long as that person doesn’t have a fever.

Grandparents and siblings could be affected by Maine’s new restrictions as well.

“It’s bizarre, the idea of not being able to introduce my newborn to my daughter [at the hospital],” said Brianna Tipping, an Orono mother who is in the third trimester with her second child.

Hospitals are under tremendous pressure. Social distancing efforts have prompted many of them to move specialized care facilities to different floors or buildings, and reassign doctors and nurses to strict protocols.

The increased attention on flattening the curve of the coronavirus has stretched the capacity for care, some patients said.

Kasey McBlais, a Buckfield woman set to deliver her second child by C-section in July, said it was difficult to receive the routine health care she has come to expect from her doctors. These days, they have “corona blinders” on.

After three weeks of complaining about symptoms from home — doctors told her they were trying to reduce in-person visits — she finally demanded a test for strep throat. It came back positive.

“Everything is taking a backburner to COVID-19 — which I understand, but life still goes on. People still have other ailments,” McBlais said.

Cough, fever and fatigue are the most common symptoms for COVID-19. But a typical pregnancy can include these and all sorts of minor irritations.

“Some of the things you normally experience with pregnancy include shortness of breath” — another usual symptom — said Jen Little, an Auburn mother expecting her third child in July. “I’ve had to learn to check in with myself in a different kind of way.”

The possibility of exposing their newborns or family members to the coronavirus has led some to reconsider their birthing plans altogether.

“All of a sudden it’s not making sense [for people] to go into a building with a bunch of sick people when they are going to give birth,” said Heidi Fillmore, a certified professional midwife who founded the Birthwise Midwifery School in Bridgton in 1994.

Since COVID-19 reached Maine, requests for her services have skyrocketed. Fillmore — who is one of 27 certified midwives statewide — typically delivers about four home births a month, she said, with a birthing team of two students.

Last week alone, she reported six new inquiries from people looking to switch from a hospital birth with an OB/GYN to a home birth with a midwife.

Switching healthy pregnancies to midwifery care also reduces the strain on the financial side of the health care system, Fillmore said.

Christine Yentes, a longtime midwife and founder of Holly No. 7, a birth center in Bangor, said she’s been getting many requests from people who are newly considering home births. The center has established its own rules to limit exposure, such as prohibiting children from birthing rooms and banning visitors during and after birth.

They’re also leaving mothers with a scale and sling to weigh the baby themselves and report the numbers back to providers who can then monitor the baby’s health from afar, after the first postpartum check-in at home.

Dawn Caron, a labor and delivery nurse at Northern Light Eastern Maine Medical Center, said that while the hospitals’ actions may feel extreme, it’s the right call. “We felt like this was very necessary. There is a possibility that it will get even worse.”

Early reports on the virus’ spread in China suggested that kids are only mildly infected, adding that it was “relatively rare” for them to get the disease. A more recent study published by the American Academy of Pediatrics found that kids of all ages appeared susceptible to the disease, and a small percentage of infants can become seriously ill if infected.

Caron worries that soon-to-be parents may not be honest about their exposure to the coronavirus during a screening, out of fear of missing their child’s birth — a decision that would put everyone in the hospital at risk, she said.

“It’s horrible [to miss the birth of your child but] it’s even more scary to think about missing an entire lifetime.”

Maine’s expectant parents are trying to adapt to the evolving crisis as their due dates approach and the world around them changes day by day. But the pandemic has left them less certain than ever before.

“It’s possible that I might have to give birth alone, which is terrifying,” Tipping said. “We’re kind of in a new normal. It’s not a comfortable place to be.”