Driving home one early summer morning, Dr. Ebony Carter’s mind was consumed with fear: Should she go home and risk the safety of her husband and three small girls?
Carter is a high-risk obstetrician at Barnes Jewish Hospital’s Women and Infants Center. Driving home that morning, she recalled the previous night when a pregnant woman came into the emergency room. Her entire team, which included interns and residents, helped deliver a breech baby.
Afterward, Carter learned that half the patients they had cared for that week, including the latest one, had tested positive for the coronavirus. “I was mortified for all of us,” Carter recalled. “We’d all worn masks the entire time, but not adequate PPE for that level of exposure. We were all there as she huffed and puffed and blew the baby out, while an invisible cloud of COVID rained over us.”
Until Carter received results from her test, she said she was super stressed. Due to the pandemic, her kids were home all day, mostly with their father, who was able to work from home.
Carter’s husband, Dedric Carter, has asthma, she has an immune deficiency. The thought of bringing the dreaded disease into their household was almost too much for her to bear. Fortunately, neither Carter nor her team contracted the disease. Still, the stress of the event and the constant caution related to her profession has taken its toll.
“A lot of hospitals say you cannot come and get our services until you have a negative COVID test. Well, labor and delivery is not such a place,” Carter explained. “No matter who you are, we’re going to take care of you.” Carter is not alone. A survey by Mental Health America, from June-through-September, found that 93% of health care workers experience stress, with between 75 to 86 percent reporting feelings of anxiety, frustration, exhaustion, burnout and being overwhelmed.
Even though she’s “hyper vigilant” about the disease, Carter said she’s blessed. She still has a job when so many other Americans have lost theirs. She also cherishes her role as a practitioner, comforter, counselor and confidant to pregnant women who often find themselves alone during one of the most critical times of their lives. To illustrate, she recalled a story about her first delivery. It was in the early 2000s when she was doing her OB-GYN rotation at Duke University. There, she met a young woman about to give birth who was all alone.
Carter spent the entire day with the woman talking about her life. She realized she was the only support system the woman had. When it came time to deliver, the woman told the medical team she wanted Carter to deliver her baby, which she did for the first time.
That experience underscored Carter’s belief in talking and listening to patients. This year when the hospital rolled out its universal COVID testing policies for labor and deliveries, Carter assumed every patient would be thrilled to be tested.
At that time, in early May, testing was still not routine. She and her colleagues were shocked at the number of patients who refused the test. “Disproportionately, the patients who said “no” were black women,” Carter said. “I think they were terrified that they would be alone or separated from their babies.” Carter said her team quickly “tweaked” their approach. Instead of asking patients if they wanted to be tested, they started asking why they wouldn’t want a test.
The answers ranged from being separated from their babies to fears of being treated differently by health care workers. The team decided to tell patients they were offering the tests to everyone, not just pregnant mothers, to protect patients, babies, mothers, and the staff.
By providing this reassurance, and promising that patients would not be penalized if they did test positive, Carter said the acceptance levels, even among black women, quickly rose to the mid-to-upper 90 percent range.
It’s a valuable lesson Carter said she will use when trying to convince people, especially her wary, black patients, to get vaccinated against the virus.
“I feel like my job is really to educate. I will be getting my vaccine. And I am the first to admit there are things that we do not know about it,” Carter said. “But, if we take what we can from the literature of patients who weren’t pregnant, it appears that it provides at least 95% protection from getting those severe infections that we know pregnant women are at higher risk of contracting.”
Like with the testing trials, Carter believes she can have success with her patients by sharing her personal experience as a practitioner and candid information about the risks of taking or not taking the vaccine.
“I have seen COVID up front and personal. We’ve had pregnant patients who were healthy one day then knocking on death’s door the next. “It’s nothing to mess with. I will take my vaccine over the prospect of messing with COVID any day.”
Sylvester Brown Jr. is The St. Louis American’s inaugural Deaconess COVID Fellow