As many of you who follow me know, I am pregnant with twins (35 weeks and 3 days when I am writing this) and I am preparing to give birth during the COVID-19 crisis. I personally know many people who are in this same situation, in Japan and abroad.
In Tokyo, the vast majority of hospitals have began restricting visitors as of April 6th, 2020. This means that birthing mothers will not be able to have their partners, doulas, or family members with them at the hospital when they give birth or afterward. This is devastating news for everyone, especially considering we are not currently in a lockdown in Japan. The countries who have limited support people for birthing women, such as Italy, are in a complete lockdown. This is in stark contrast to the situation in Tokyo where the majority of people are continuing to use public transportation to go to work on a daily basis and families are still gathering within close proximity to each other in local parks.
However, whether or not these policies are fair or make sense is not the topic of this blog post. There is a high chance that these hospital visitation policies will not change anytime soon, so many pregnant mothers are preparing to give birth within these restrictions. I’ve compiled some advice both from my doula, community members, and my own research of ways to prepare for this unfortunate situation.
Talk to your current caregiver about their rules and your options
Every hospital has different rules regarding visitations. Some hospitals, like mine, are denying all visitors until further notice, including the husband/partner. This rule applies from the time you arrive at the hospital to when you leave, including all of labor time at the hospital, the actual birth, and the days of recovery afterward. There are no visiting hours available during recovery and your partner will not be able to see you or the baby until you are discharged and heading home. In contrast, there are a couple of hospitals still allowing the partner during labor, either for the entire time or for a short period during the actual birth. Since there is such a difference between hospital policies, you should check with your specific caregiver to find out what to expect.
Once you know your caregiver’s policies, you can assess your options. Basically you will need to decide whether to stay with your current caregiver or to try to transfer to a new one. You may want to make a pros and cons list of both in order to decide what to do.
If you want to know more about how I came to my decision to stay with my current caregiver, you can read about it in my third trimester update post.
Adapt your birth plan to include remote support
Hospitals may not be allowing in person support, but they should still allow video communication with your birth support team. This could be a constant video connection with your partner or doula during labor and delivery so they can encourage you. Since you will be in labor and birthing a baby, you may want to have some sort of stand for your phone or computer so you can be hands free. You may also want to ask your caregiver if the hospital/clinic has wifi access because this may affect how often you want to use remote communication. For example, my hospital (Aiiku Hospital) does not have wifi so I will be using the data on my phone for all communication. I will be ready to add more data to my phone plan if necessary.
Prepare mentally and emotionally
This may seem obvious, but preparing your mind is even more important if you are going to give birth alone. This will look different for everyone. Some people may want to practice meditation, write out all their feelings in a journal, talk to friends and family in order to process the situation, among other techniques. One useful technique I found in Cynthia Gabriel’s book, Natural Hospital Birth is to cry if you can. That’s it! For some of us this is probably something already happening frequently (especially if you are in the third trimester!) but crying can be an incredible emotional release. In our case, crying can also be a way of grieving the birth experience you wanted to have even before you have it. Don’t be afraid to let all of your emotions out.
The same thing actually goes for during labor. One of my favorite pieces of advice from the book above has to do with how to handle a labor plateau. A labor plateau is when your contractions slow or things are not progressing as fast as you or your caregiver hoped. This is VERY common and not something to worry about, however caregivers often are tempted to suggest interventions at this time. Gabriel recommends you to do a few things before an intervention, eat, move, and cry. Sometimes labor slows down because you are tired. Eating a bit, such as a honey stick or even some applesauce, can give you the energy boost you need to get through the plateau. Moving, or changing position, can also help your body progress. Even if you have an epidural, the nurses should be able to help you change position in the bed. And again, cry! It’s amazing how our bodies respond to our mind. If you are feeling fearful of birth or upset for any reason, this can cause your contractions to slow because your body doesn’t want you to be in a vulnerable state in a dangerous situation. Being in the hospital is not dangerous necessarily, but your reptilian brain doesn’t know that. All it knows is you feel fear/anxiety. Having a good cry and letting out all of your emotions can be incredibly impactful during labor.
Repack your hospital bag
Since many of us will be at the hospital alone for the duration of the stay, what you bring with you initially will have more significance. Some hospitals are allowing family members to drop things off at the hospital nurse’s station for you as you need it so they can bring it to you, and some are not. Others have a cafe/store where you can buy necessary items. It’s important to think if you will be comfortable leaving your baby in the nursery during recovery so you can go to the cafe or store to buy things. Also, if you are having a more difficult recovery, you may not feel comfortable walking to another floor to get the things you need. If you are not comfortable with this or are unsure of how you will feel, you may want to consider bringing many extra snacks, water, and ensuring you have all the postpartum essentials you need. You can read what I packed in my hospital bag here.
Since you will also be alone during recovery, you may find yourself with some extra time or simply less interaction than you would if your partner was there with you. Downloading some movies, TV shows, or packing a book (remember you may or may not have wifi access!) can be a good way to pass the time while breastfeeding. If baby is sleeping however, I would recommend you to sleep as much as possible!
Gather your postpartum support team
If you can’t have your support team with you during the birth, you absolutely need it during the postpartum period. Life with a newborn is difficult enough in the best of times (although it’s of course beautiful as well!) so preparing your support is very important. If possible, try to make arrangements with your partner or another family member to be home with you once you come home with baby. The length of leave someone can take will vary, but any amount of time spent at home together will not only make up for the time you didn’t get in the hospital but also give you some peace of mind that you aren’t doing everything yourself.
Another option is to hire or at least be in contact with a postpartum doula. Stephanie Kawai offers these services, you can find out more here. Although many in-person services are limited right now with the current situation, there are still options for remote support.
Your postpartum support team also includes your mama community! In my opinion, Facebook is the most active platform for these communities so it’s worth joining if you don’t have an account already. Having an online community of people going through the same thing can go a long way to helping you prepare and process your birth experience. It can be very comforting to know you aren’t alone in this. I will link several FB groups here that you may want to join (note that some have specific joining instructions).
Tokyo Pregnancy Group
Tokyo Mothers Group
Tokyo 2020 Spring Babies Group (if you are due or had a baby anytime between March-June 2020) If you are due at a different time, there is probably already a group made. Search Tokyo Pregnancy Group for more info.
Prepare to advocate for yourself and your baby while in recovery
Without a support person with you, it can be difficult to stand strong in opposition to the advice of nurses and doctors, whether it be during the birth or in the recovery period. The thing is, often times medical staff tend to have quite varying opinions. One tip suggested in Natural Hospital Birth is to ask your caregiver to “give you an hour” if they suggest an intervention. Sometimes a bit more time is all you need to get through a labor plateau, speed up contractions, or get on top of your emotions. If the situation requires immediate action, your caregiver is likely to tell you so. However, many interventions are suggested preemptively and waiting an hour is not harmful to you or baby but can possibly avoid an intervention you didn’t want. Also keep in mind that there may be a time during labor where you are no longer able to make conscious decisions about what happens and you will need to trust your caregiver. This is absolutely okay.
An aspect of postpartum you may have more control over is breastfeeding while in the hospital. One nurse may suggest a certain position or technique, and the one who comes in at the next shift may tell you you’re doing it all wrong. So frustrating! The best thing you can do is to educate yourself as much as possible about breastfeeding before hand so you can at least know what advice to accept and which to ignore. This is also where your postpartum support team comes in! If you ever have any questions, please message a lactation coach or doula for advice. I am available to answer questions through any online means (contact me here), and there are many other breastfeeding support options you may look into. Prior to giving birth, you will also want to ask your caregiver what the policies are regarding breastfeeding at their clinic/hospital. Some hospitals separate mothers and babies more often than others, so you want to know what to expect.
For more on how to prepare for breastfeeding during pregnancy, check out this post and this post.
I hope we can all stand strong and support one another during this time. If you ever need support, please reach out! We are all in this together.
My Motherhood Tokyo 
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