Fleeing coronavirus in NYC, pregnant women head to Philly area but struggle to find prenatal care

Hope Halliday’s daughter — pregnant with her second child — arrived from Brooklyn last week with her husband and 4-year-old son. The young family sought refuge at Halliday’s home in Delaware County as coronavirus overruns hospitals in the New York City metropolitan area.

“We came down here in hopes of finding a place to have the baby that was safe,” said Halliday’s daughter, who is 42 and 7½ months pregnant.

But she has struggled to find prenatal care. Every OB-GYN practice she called in the Philadelphia region turned her away. Office managers said they weren’t taking any new patients from New York, the national epicenter of the virus.

“I basically can’t get in with anyone,” she said Tuesday night from her mother’s house in Media. “I understand that our name is mud as New Yorkers right now and that everyone is scared of this virus, but there’s other ways to deal with it besides that. It seems unethical to blanketly state that we are not going to try to help you at all."

Halliday’s daughter declined to allow The Inquirer to use her name because her husband was afraid that speaking out would make it harder for them to find an obstetrician. The couple have talked to an Abington doctor who may accept her as a patient. They also may go back to New York, she said Thursday.

She is part of an influx of pregnant women who have fled New York to hunker down with relatives and friends in the Philadelphia region, where the virus has yet to hit its peak.

Joseph M. Gobern, chair of the department of obstetrics and gynecology at Main Line Health, said the uptick of pregnant women from New York seeking care from practitioners across his system’s four hospitals began about seven to 10 days ago.

“We had a number of inquiries by phone of patients who were transferring or intending to transfer their care out of New York,” Gobern said Thursday. “So that’s when we decided to determine what is the best guidance that we have from both our public health state and local officials to ensure the safety of these patients, our staff and our [current] patients as well.”

Gobern said he quickly sent guidelines to obstetricians within Main Line Health, advising them that any new patients from New York or other hard-hit coronavirus areas must self-quarantine for 14 days prior to an in-person visit. He advised the same for their support partner, who will be allowed to stay with the mom during labor and delivery, as long as they are properly screened and symptom-free.

Expectant moms began seeking refuge last month after two major New York City hospital networks — New York-Presbyterian and Mount Sinai — banned partners from accompanying women in labor during births. The ban, which was intended to stop the spread of COVID-19, sparked public outcry and stories of women sobbing as their partners dropped them off at hospital lobby doors.

» HELP US REPORT: Are you a health care worker, medical provider, government worker, patient, frontline worker or other expert? We want to hear from you.

Gov. Andrew Cuomo overturned the ban by executive order March 28, but then President Donald Trump said he was considering a quarantine for the entire New York City-metro area. Although Trump decided against doing so, his words prompted more pregnant women to migrate out of the area.

The fear among some pregnant women of giving birth at hospitals swamped with highly contagious COVID-19 patients and faced with drastic staff shortages and an alarming lack of personal protective equipment (PPE) has also kindled additional interest in home births, according to Ray Rachlin, a certified professional midwife and owner of Refuge Midwifery in West Philadelphia.

“I’ve never in my life experienced the amount of calls and emails that I have in the last few weeks,” Rachlin said Wednesday. “I’ve had five interviews today — three of them due in the next six weeks. It’s unprecedented."

Just this week, Rachlin said she took on a new client from New York City who is already halfway through her pregnancy.

“There’s this feeling among the folks from New York that this is not going to end anytime soon and this feeling of not wanting to go back,” Rachlin said. “I do think it’s very hard to access prenatal care right now.”

Halliday’s daughter said she initially tried to get an appointment with Scott Bailey, an OB-GYN with Main Line Health in Wynnewood, but was told the practice wasn’t taking any New York transfers. Main Line Health spokesperson Bridget Therriault, echoing Gobern, said its providers will take transfers, with the caveat that they self-quarantine for 14 days prior to coming in.

“Depending on what the volume is with that particular practice, it may differ a little bit, but generally speaking, as a health system, we are certainly going to care for anybody that is in our region and needs that care," Therriault said Wednesday.

Halliday’s daughter said she also called Penn Medicine Ob/Gyn Associates at the Hospital of the University of Pennsylvania. The woman who answered the phone said the practice was not accepting patient transfers from COVID-19 hot spots. She called another Penn Medicine obstetrician’s office and got the same answer.

In response to an inquiry from The Inquirer, Deborah Driscoll, a physician and senior vice president for the Clinical Practices of the University of Pennsylvania, wrote in an email, “As COVID-19 cases increase across the United States, we understand that pregnant women may seek alternative arrangements for prenatal care and the birth of their babies.”

“At Penn Medicine, we are mindful of our obligation to safely care for obstetrical patients already receiving care in our health system, and to maintain capacity for critically ill pregnant patients, including those with COVID-19 complications, and other high-risk pregnancies requiring medically necessary transfers,” Driscoll said. “For that reason, we have developed guidance for our obstetricians to evaluate requests for transfers of care by women in their third trimester of pregnancy.”

A Penn Medicine spokesperson declined to provide a reporter with a copy of virus-related guidance distributed to its obstetricians.

Robert Field, a professor of law and health management at Drexel University, said hospitals and doctors are not legally required to take new patients from different states.

“Legally, a doctor is within their rights to not take a new patient, as long as it’s not for a discriminatory reason — it’s not because of their race or their religion, or disability,” Field said. “Ethically, it’s a little bit murkier. You could say they have an obligation to be available, but I suppose the response could be that she could pose a threat to other patients.”