At Home Places Magazine Summer 2021

WELL+BEING

Pregnancy and the Pandemic

Stories of three local health-care professionals who cared for COVID patients while pregnant

written by JANET HEIM

Navigating the COVID-19 pandemic has been a challenge, for sure. Imagine caring for coronavirus patients in the midst of your own pregnancy. The following stories are unique, but all three of these women faced anxiety and fears while being selfless professionals who put their patients’ care first.

Lindsay Stein, a registered nurse at Meritus Medical Center, holds a photo of her son Kieran. Stein was pregnant during the COVID-19 pandemic and gave birth to her son in November.

COLLEEN MCGRATH

Lindsay Stein, MSN, RN

Lindsay Stein has been clinical manager of the Emergency Department at Meritus Medical Center near Hagerstown since early March. After struggling with infertility and going through in vitro fertilization (IVF), Stein, 31, learned she was pregnant on March 4, 2020.

While pregnant, and during the bulk of the pandemic response, she was clinical manager of the Intermediate Care Unit, which became a COVID-19 unit the day she learned she was pregnant. “It was definitely amazing news,” Stein said of her pregnancy. Yet the change at work added a layer of uncertainty. “It was nerve-wracking and anxious at the same time. We didn’t know how contagious the virus was, the side effects ... There was a lot of wariness.”

Also of concern was how COVID-19 might affect the development of her baby in utero. At the start of her pregnancy, the Frederick, Md., resident was also working in the ER at another facility as a bedside nurse. Stein decided to quit that job and work only at Meritus, where, as a manager, she was not working directly with patients, yet inspiring her team.

“I told my staff this is the Olympics of health care. This is why we went into this field. There was a lot of pride, confidence and courage,” she said.

She went into labor on her lunch break and gave birth to a boy, Kieran, on Nov. 5, 2020, at Greater Baltimore Medical Center in Towson, Md. The only time Stein took off was after her son’s birth.

Dr. Liz Otto gave birth to her second son, Ethan Joseph, in June 2020.

SUBMITTED PHOTOS

Dr. Liz Otto

Dr. Elizabeth “Liz” Otto was more than five months pregnant with her second child when the pandemic started. The medical director of the hospitalist program at Meritus Medical Center, she delivered her second son in June 2020 at University of Maryland Hospital in Baltimore.

At 40, Otto’s was considered a high-risk pregnancy, and she delivered by caesarean section after a two-week quarantine. Otto admitted to some trepidation early on, but felt confident in the safety protocols and protection of personal protective equipment(PPE) to keep her and her staff safe.

“I felt, as the leader of the group, I had to lead by example, so I suited up,” Otto said. “I led the charge, which made it easier for my team members, if I was willing to do it while pregnant. I think it went over well. It helped ease everyone’s nerves.”

Despite her confidence, Otto confided she expected to get the virus while working full time with coronavirus patients. “I just prayed,” Otto said. Those prayers were answered, and she was reminded of her purpose. The general consensus between Otto and several friends who were also pregnant was that they chose acute clinical work to answer “that calling. Wanting to be there for patients took precedence over concern for our own health,” Otto said.

Dr. Laura Toso

At Capital Women’s Care in Hagerstown, Laura Toso, a Fellow of The American Congress of Obstetricians and Gynecologists, was one of five providers in the practice — three doctors and two midwives — who were pregnant during the pandemic. She was surprised when she found out she was pregnant with her sixth child in March 2020. Toso gave birth to son Giovanni in January 2021 at Meritus Medical Center.

Toso, 42, is Italian and has family in the Lombardy area of Italy. The Hagerstown resident has two sisters there who also are medical professionals. Italy was hit hard by the virus — before the U.S. — and Toso knew what was coming. For her, one of the most striking things was how she and her colleagues grew and changed as a group through the pandemic, wanting to provide the best possible care for their patients.

“Our patients were going through a lot of uncertainty and anxiety,” Toso said.

The staff’s regular meetings “sparked creativity and flexibility” as they adapted to the constantly changing protocols. Care was provided through virtual visits, and plans were put in place for safeguarding the office, dividing the staff into sections in the event ent one of them got COVID-19, allowing just that section to close down.

Toso noted that t as a physician, the need for physical isolation is the opposite of the way they’re used to working with patients, yet virtual visits were key to providing reassuring care during the pandemic. The staff also worked to minimize the pregnant colleagues’ exposure to coronavirus patients. Thankfully, the patients with the virus only had mild symptoms and some of them delivered their babies while still infected.

“It was a huge awakening for a lot in health care. There was a lot of desire to be present, be there and care,” said Toso, whose Catholic faith, education and family provided a strong foundation for how she navigated the pandemic and her pregnancy.

Changes to prenatal visits and labor & delivery

COVID-19 safety measures called for prenatal visits to be limited to the expectant mother but were shared by FaceTime or phone, and ultrasounds were recorded to DVDs to share later.

Husbands and partners were allowed to be present during labor.

Stein said her mother was “heartbroken” that she wasn’t able to be in the delivery room when Kieran was born. No visitors were allowed in the hospital or once the family came home, which was another tough hurdle.

Otto’s family in Hawaii and Toso’s family in Italy had yet to meet their newborns as of early May.

The power of PPE, protocols and vaccines

Stein, Otto and Toso praised the power of PPE and other protocols for keeping them coronavirus-free through the pandemic and their pregnancies, but it wasn’t easy. They wore N95 masks, face shields, gowns and gloves, which were even hotter while pregnant; practiced social distancing; washed or sanitized hands frequently; and isolated from family and friends outside their immediate household for a year.

Stein and Otto admitted they felt safer at work than going to the grocery store. After work, the health-care professionals shared a similar ritual, which included removing their shoes before entering their homes, showering before interacting with family and washing their work clothes after each shift.

As soon as it was safe for them to do so, each of the women was vaccinated, another step in prioritizing their health and that of their families and patients.

“It liberated us. It was a weight off our shoulders,” said Otto, a strong advocate for vaccinations.

Some personal reflections

Brandon Stein is a Maryland state trooper who had several scares when co-workers tested positive for COVID-10. Throughout Lindsay Stein’s pregnancy, though, both stayed healthy and were vaccinated as soon as they could be.

Vince Rusbosin, a teacher in Carroll County (Md.) Public Schools, taught online from the family’s Mount Airy, Md., home. He was able to care for their 3-year-old son, whose day-care center was closed due to the pandemic, allowing Liz Otto to continue her service. She said they couldn’t leave their son with her in-laws, who lived next door, for fear of infecting them.

In March 2021, the day Toso’s husband, Andrew Capobiano, was supposed to get his first coronavirus vaccine, he was exposed to the virus at a funeral, tested positive and had to be isolated at home while he recovered. Toso’s other children range in age from 3 to 13 years old. The family had just gotten a puppy, not expecting to have another baby.

Many of the hospitalists at Meritus have family in India and are concerned for their health as COVID-19 cases started spiking in April and May. From what they’re hearing from India, it is much worse than what’s been reported in the news.