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No Guests Allowed

Before COVID-19, partners were able to attend prenatal appointments with pregnant patients. Now patients are left to navigate prenatal care solo.

May 22, 2020

Lauren Harkawik
Andrew Malone // Flickr

found out I was pregnant just before my state went into lockdown due to COVID-19. A week later, when my OB called to confirm my seven-week ultrasound appointment, the receptionist had a message for me.

“Please come to the appointment alone. No guests are allowed.”

“Guest” is the word that has now been used in several interactions with my OB to convey to me that my partner is not allowed to attend my appointments. This is markedly different from my first pregnancy, five years ago, when he was by my side for everything.

Though I felt bad for my partner that he wouldn’t get to experience things like seeing our baby’s heartbeat for the first time, and, later, hearing it for the first time, at first I saw this as an inconvenience more than anything else. Then I went to my 12-week appointment.

Toward the end of my 12-week appointment, the nurse-midwife said she was going to listen for the baby’s heartbeat on the doppler. She struggled, for about 15 minutes, to find it. As I felt my stress level rising, I closed my eyes and gripped the sides of the table I was laying on. Eventually, she gave up, and said she needed to go find a doctor who could perform an ultrasound. As soon as she left the room, I found myself feeling very alone and fearing two things. First, that my baby was gone. Second, that I would be tasked with breaking that news to my partner.

I think I was alone for about 10 minutes. It felt like hours. But then a doctor came in with an ultrasound machine, and she found my baby right away — healthy, moving, and with a robust heartbeat. In the CliffsNotes version I told my partner, I got to lead with that. “Everything is fine, the baby looks healthy,” I started. “It was a stressful appointment, though.”

For him, the good news came first. For me, it hadn’t.

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I’m now preparing myself for a 20-week anatomy scan for what is, because of my age, considered a high-risk pregnancy. It will be an in-depth look into my baby’s organs, followed by a consultation with a doctor who will explain what they find. I’ve had an anatomy scan for a not-high-risk pregnancy before, and I know that even if there is nothing wrong, there will be a lot of information thrown at me. I’ve been told I cannot bring any “guests.” That means that our baby will have one less parent in the room to absorb the important information the doctor shares, and one less parent in the room to ask questions. And if I am told that something scary, heartbreaking, or otherwise upsetting is happening inside my body, I will face that news alone.

Not all pregnant patients have partners or want partners involved in their care. However, many do. There has been reporting, and action, about potential trauma and danger caused by early-COVID-era decisions to ban partners from the delivery room — policies that have largely since been reversed. However, as we wade further into this time, it’s imperative that doctors, midwives, and other care providers are aware of the emotional impact of forcing partnered women to endure prenatal care alone. Frankly, it isn’t being talked about enough.

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A few days after my solo 12-week experience, I found myself having a lot of trouble processing the emotions and fear I’d felt in that room and the creeping suspicion that had I not been alone, it would not have been as traumatic as it was. Feeling like I needed to know I wasn’t the only one that felt this way, I posted on a message board for pregnant women to see if anyone else was feeling the way I was.

Over 40 women replied.

For me, their collective responses represent a powerful tapestry of the emotions that partnered pregnant women are experiencing as they forge into prenatal care alone. In the sampling of that tapestry below, I’ve kept their identities anonymous to protect their privacy. Each response is from a different mom in a range of ages, ethnicities, and geographical locations.

“I’m not a guest.”

“I have an appointment on Monday and they said no guests again in my text reminder. I told my boyfriend and he said, ‘I’m not a guest. I’m the father.’ I feel so bad. I don’t want him to miss out on anything. Especially with this being the first.”

“I couldn’t function that day, let alone tell him.”

“I had a miscarriage last June, and my husband was able to go to the first appointment at six weeks where we had a heartbeat. At 11 weeks, we went for an early than planned scan and found out the baby didn’t make it past the seven-week mark. I was so glad he was at that scan. I couldn’t function that day, let alone tell him. We are now pregnant again and I go in on Wednesday, at 13 weeks, for another scan. He had to miss the first scan at seven weeks, and I’m terrified going for this scan alone.”

“My heart hurts.”

“The only ultrasound my husband has ever been to was last fall when they told us there was no heartbeat and our baby stopped growing at 13 weeks. Not only am I terrified of having to go through that alone next Tuesday with my ultrasound, my heart hurts for him not getting to see his baby in real time with me.”

“The joy of pregnancy is nonexistent for me.”

“This is our first baby and I want to share joys with my husband. My first appointment has been pushed to 13 weeks for me and I feel like calling a delay to 16 weeks in hopes that my husband could be with me. With what is happening in the world, the joy of pregnancy is nonexistent for me.”

“I was so anxious and scared.”

“This is my second pregnancy and a few weeks ago, there was a scare, and I had to wait over an hour for an ultrasound by myself. I was so anxious and scared I’d have to give bad news to my husband.”

“I cried through the entire ultrasound.”

“The day of our ultrasound and first appointment was the day they implemented the policy at my doctor. We didn’t have any notice, and when we arrived, they told my husband that he couldn’t come upstairs with me. It’s our first baby, and we were both devastated. I cried through the entire ultrasound.”

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Many of the women who responded to the post said their OB offices have policies against the use of video or photography during appointments and ultrasounds. Some said their offices are easing their restrictions and are also allowing FaceTime chats during appointments to ease anxiety and isolation felt by mothers and the left-out feelings of their partners. However, this isn’t the case for all.

“I had my first ultrasound scheduled this morning and stupidly was under the assumption that they would of course allow me to FaceTime my husband so he could also hear the heartbeat for the first time and see the baby for the first time,” replied one mom. “They told me in the room that they weren’t allowing it. I just started bawling.”

The availability of technology is even affecting medical decisions for some. One mom said she paid for an elective ultrasound from a private company in order to have her partner there.

“I had an elective ultrasound yesterday at a private ultrasound clinic to determine gender at 14 weeks,” she said. “The main reason we decided to do this is because my husband wouldn’t be able to come with me and my anatomy scan with my doctor.”

Another mom is changing practices so her partner can FaceTime into appointments.

“My clinic is still not budging on the FaceTime and video thing, and my partner feels really left out,” wrote one mom. “We are set to move to midwifery care mid-month because as of now they are allowing more flexibility in video and FaceTime, and they seem to be poised to allow support persons in some appointments by late summer.”

Of course, changing practices or paying for an elective ultrasound is not possible for everyone. In rural settings, there may be no alternative practice to switch to. Elective ultrasounds cost between $100 and $300, which may be out of a viable price range for low- or middle-income families. Even if FaceTime or video is allowed in the ultrasound room, one has to have the technology to do it. Therefore, whether or not video is allowed, policies against allowing partners into the room disproportionately disadvantage low- and middle-income patients.

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This isn’t a big deal for everyone. Some moms replied to my post and said they never had their partners attend appointments anyway, so, what’s the big deal? “I think you should just try to be more positive,” wrote one mom.

That isn’t helpful advice. Whether or not I have a sunny outlook isn’t the issue. The issue is that for me, a pregnant person who feels very vulnerable and anxious about what is happening inside my body, having my partner in the room with me is important enough that not having that option available is causing me emotional distress.

Prenatal care can be scary and heartbreaking at some impasses, and joyful at others. Almost every patient I’ve ever spoken to about pregnancy has described moments of happiness and moments of feeling raw and exposed. If a parent-to-be feels that they are too anxious to go into those situations alone, they should be listened to.

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