When she held the baby in her arms, layers of personal protective equipment separated Gila Zarbiv from the newborn. As Zarbiv passed the tiny baby into the mother’s waiting arms, both women wept. But it was the mother’s uncontrollable shaking and primal wails that stayed with Zarbiv, explained the Pittsburgh-born Israeli midwife.
In the sea of COVID-19 related stories, delivering a stillborn in the midst of a global pandemic is a small but “significant” piece of a much larger tale, as “this is something that might not necessarily be thought of, but there’s really a lot of isolation. There’s a lot of loneliness,” said Zarbiv.
“People are mourning alone and dying alone and birthing alone. How do we help people get through that loneliness? That’s what this is about. How do we stay together while being so far apart?”
Birth’s complexity has long consumed the midwife’s thoughts. After growing up in Squirrel Hill and attending Hillel Academy of Pittsburgh, Zarbiv (née Kanal) moved to Israel in 2007, shortly following graduation from Yeshiva University. Her decision to emigrate was influenced by reading Ruth Gruber’s “Raquela, a Woman of Israel” as a child. She decided that like the book’s protagonist, Raquela Prywes, she too would further the Jewish state by aiding the births of children there.
After arriving in Israel, Zarbiv enrolled at the Henrietta Szold Hadassah-Hebrew University School of Nursing, and during her first week met her future husband, a medical student, in the lobby of Hadassah hospital. The two “locked eyes” and were married later that year.
The couple now share four children, ages 10, 8, 6 and 4, and reside in Katamon, a Jerusalem neighborhood, but, like work, parenting has presented new obstacles during the pandemic, she explained.
In former days, when Zarbiv and her husband, an oncologist, returned home from the hospital, the kids would “run into our arms like some sort of Disney movie, and there would be hugging and kissing.” Now, the parents find themselves almost madly directing their children away from the door. Clothes are discarded in the hallway, bleach is sprayed nearly everywhere and showers are feverishly taken.
“We scrub ourselves till we’re raw, and then we hug them,” said Zarbiv.
The pre-pandemic normalcy of family life has vanished, and for the kids “it’s very hard that Ima and Abba are not in the same house at the same time,” she continued. “Whenever he’s working I’m home, and whenever I’m home he’s working. That’s hard for them because it wasn’t always like that.”
Prior to COVID-19 upending so much familiarity, Zarbiv’s shifts at Hadassah’s Ein Kerem hospital often overlapped with her children’s schooling. That’s now changed. She’s still going in thrice weekly for 10-hour scheduled periods, but the nature of the work has altered greatly.
“Technically everything is different,” she said.
At the onset of the pandemic, protocols needed to be written and a specialized ward established.
“We had to determine how the midwives are going to deliver these women in a way that is safe, but also feasible.” Doing so “isn’t easy, it’s complicated.”
Creating a safe environment with limited viral exposure produces a potentially isolating space, and with midwives in Israel serving largely as they do in Europe, as the primary medical professional during low-risk pregnancies, it’s not uncommon for an otherwise healthy mother and midwife to be together but divorced from other personnel for hours, explained Zarbiv.
“Of course there’s always people who are available to help, but generally it’s just you and her,” she said.
Based on current design, when a COVID-positive mother, or one suspected of the virus, arrives for care, she is taken to a designated room with a single bed. Typically one midwife works inside the area and another outside the door. Given Zarbiv’s age, 35, and the fact that she’s the head midwife for infectious disease prevention, the former Pittsburgher often handles the interior slot: “I wouldn’t want a midwife who’s in her 60s to be there. I kind of feel a sense of responsibility that people who are at less risk should take that role.”
Gowned in ample personal protective equipment, the medical professionals discuss patient care in an approved fashion.
“If I need fluids, the midwife outside gives me fluids,” said Zarbiv. If the mother “starts to become unstable, or the fetus is becoming unstable, then you ask the midwife outside to call for help.”
The process can require considerable physical exertion.
“It’s very stressful as a midwife because you actually have to run,” she explained. “If we get a call from an ambulance and they say, ‘I have a woman who’s pushing,’ you have to go. Run, run, run, and it takes minutes to get dressed. Then you have to go inside and it’s challenging. It’s definitely challenging.”
Birth under normal circumstances generates significant emotion, but during this period of the coronavirus crisis it is almost impossible to comprehend all of the factors at play, explained Zarbiv.
For example, several hours after a quarantined patient was transported by Magen David Adom to Hadassah Hospital Ein Kerem, she delivered a healthy boy. After testing revealed that the mother was COVID-positive, she was transferred to a new unit while the baby was isolated, according to hospital representatives. Throughout the period, staff ensured that the mother and child could be together as best as possible by facilitating “frequent photos and phone calls.”
Zarbiv has worked with multiple COVID-positive or COVID-suspected mothers in recent weeks who’ve undergone similarly trying situations.
These women have demonstrated unmistakable strength and almost incomprehensible resolve, she explained.
“I think that these women are heroes. They are incredibly courageous. They’re facing these periods of isolation and separation with tremendous autonomy and grace and dignity, and they don’t dissolve in a panic. Yeah, there’s a lot of crying. We cry a lot. I’m crying right now.”
In general, however, “there’s just this dignity and quiet calm, and I really admire that,” Zarbiv said. “I think that’s an attribute to women: the ability to do things with quiet, with poise, with dignity. It amazes me. What they’re able to do is magical. Women are magical, I think. That’s really the bottom line.” PJC
Adam Reinherz can be reached at email@example.com.