“Shizzle is about to get real here,” a MU Health Care doctor posted March 22 in a private Facebook group.

Ednita Murray read the post and started to run through the mental calculations. She was at that point 23 weeks pregnant with her second child, a boy. The post details the number of visitors that women will be allowed to have during delivery – one. It describes where that visitor will be allowed – the patient’s room. Not the gift shop. Not the cafeteria.

“Pack some sandwiches,” it said.

Her due date isn’t until July. Although she would prefer her husband come with her for the birth of their son, she doesn’t feel comfortable leaving their daughter with someone who may unintentionally bring COVID-19 into their home.

“Now, because we are limiting exposure on everything, it’s like ‘Hmmm what’s going to happen?’” Murray said.

Murray is a registered nurse, so her medical background gives her some clarity on what’s to come. But there is something surreal in facing birth alone in 2020.

“In the ‘40s and ‘50s fathers weren’t part of the birthing process,” Murray said. “When you think about it that way it’s like, oh my gosh we’re going back 50 years.”

It’s a lot to consider, especially when considering all the other challenges involved with being a mother during a pandemic. Things like keeping Amazon boxes out of reach from her 10-month old for fear COVID-19 might be lingering on the packaging.

But it’s not just her family Murray is thinking about. Her friend Hannah Richards is pregnant too.

“We are super close,” Murray said. “She is a first-time mom and not medically trained.”

The choices Murray and Richards now face sum up many of the ways COVID-19 is affecting mothers' birth plans amid the ongoing COVID-19 outbreak. As of Wednesday there were 78 known cases of COVID-19 in Boone County and 3,539 statewide. It’s still unknown how contracting the illness could affect an unborn child, but that’s not necessarily what Richards is worried about.

“I’m not really afraid of getting coronavirus,” Richards said. “It’s just all the stipulations and things that they’re placing at the hospitals and stuff now.”

Richards is 32 weeks pregnant. Her plan was to have a low-intervention birth at Boone Hospital with her husband and doula present.

“That’s out of question now unless things change,” she said.

She’ll still be able to have a low-intervention birth if she chooses, but her doula won’t be there.

“I don’t want to go through a birth without my husband,” Richards said.

Doulas offer birth coaching. Their services are often used during a natural birth to help mothers cope with the pain without intervention.

“I can’t imagine it must be really tough for them to decide that,” Katy Miller, a former doula and practicing local midwife, said. “Certainly, you want your partner with you … but the baby’s other parent might not have the skills and expertise to provide the support you’re needing. It’s a big load to carry.”

Boone Hospital, like MU Health Care, is also limiting visitors to its facility. It’s a move that hospitals are taking across the country. Some private hospitals in New York City went so far as to bar all visitors, even to labor and delivery patients, before Gov. Andrew Cuomo signed an executive order guaranteeing mothers at least one support person. The idea is the fewer people in the hospital, the smaller the risk of accidental transmission.

“That is very unusual because we are very patient- and family-centered. We usually let people have as many visitors as is feasible,” Dr. Melissa Terry said. Terry practices obstetrics at Women’s and Children’s Hospital in Columbia.

But it’s not just who will be able to attend the birth that’s worrying expecting mothers. It’s where the birth will take place. With so many unknowns about how the virus spreads and how susceptible pregnant women are to the disease, many pregnant women now find themselves wary of their hospital.

“I don’t want patients to have that opinion of our facilities,” Terry said. “I have reassured them about our safety practices and the way we are putting patient safety and workers safety as the priority.”

Still, some women are considering their options.

“I think if women can have a home birth, now is the time to do it,” Murray said.

The Washington Post reported that many expecting mothers were doing just that. Locally, Miller said she received eight inquiries within a week. She usually receives one or two.

“It has really quadrupled and I actually have one of the newer practices in the area,” she said. “(Other midwives) have seen it even more so.”

Terry says that while every woman has the right to decide where she is going to give birth, the American College of Obstetricians and Gynecologists recommends giving birth in a hospital or certified birthing center.

As for Murray, her pregnancy is considered high risk. She hemorrhaged during the birth of her first child and is now at a double risk of hemorrhage for the second, so a home birth is out of the question. It’s not out of the question for Richards, though.

“In New York they (were) not even allowing husbands,” Richards said. “If that is the case, I would want to look for somebody to have a home birth.”

Richards is one of 11 children, all of which were born at home. But there is a complicating factor for her. She lives in Boonville, 45 minutes away from the nearest hospital.

“It kind of just gives me peace of mind to have my baby at the hospital,” she said.

She’s not ruled out a home birth yet, but for now, she is hoping she’ll be able to give birth as planned.

“It’s kind of just a waiting game,” she said. “It may all be passed by then, but at the same time it may not be.”

It’s not any easy game to play, especially considering that raising a newborn during a pandemic raises its own set of challenges.

Murray, for one, takes solace in knowing that even if she does have to give birth alone, it’s nothing women haven’t done before. And if they can do it, so can she.