Weighing Home Birth During Coronavirus
Our daily social distance strolls through the neighborhood have been a source of joy during these uncertain times. My son, beaming with pride, is learning how to ride a bike on our desolate streets. The Teddy Bear Hunt and beautiful Spring flowers blooming have made for vibrant games of ‘I Spy’. As I told my son on one of our recent walks, the Spring air and transition of seasons reminds me of when I was pregnant with him. I smile looking back on my daily walks as I tried to ‘walk (or waddle) him out’. It was a time of joy and peace as we waited in gleeful anticipation to meet him. Those pregnant during this pandemic are going to have a different story to tell their kids. One that is completely out of their control and laced with fear, anxiety and uncertainty.
Sure, I had fears when I was pregnant. Mainly, how would this watermelon-sized being make its way through a hole that allegedly expands to the size of a bagel? Would I even have the option of an epidural considering I have Harrington metal rods in my back? Would I need a C-section? Would I be able to breastfeed? Will my baby be healthy? These fears were enough to face. As we approach Mother’s Day, I can’t help but empathize with the challenging realities pregnant people are facing during Coronavirus.
If they contract Coronavirus, will they give birth in a medically induced coma or be separated from their baby at birth?
Will they have to take a COVID-19 test before being admitted?
Will hospitals request them to use an epidural, even if it’s not part of their birth plan?
Will their partner be allowed to be present for the birth of their child (the no visitor policy enforced by New York Presbyterian hospital has since been revoked)?
Will the operating rooms be available (and safe) in the case of a C-section?
If their infant is exposed in the hospital, how would the baby’s weak immunity stand up to Coronavirus?
Should they consider a home birth?
One Midwife in Sacramento has received an increased number of calls from potential home birth clients. “People wanted to secure me just in case the hospital said they couldn’t have their partner there or that they would be separated from the baby,” said Tel Viehmann Cunningfolk, LM, CPM at Taproot Midwifery.
While the largest group of people calling were those who had previously considered home birth, many of the new inquiries received weren’t their typical client. “Some had wanted a home birth, but their partners didn’t,” said Tel. “People who interviewed me months ago and decided on a hospital birth, called me back. But a large chunk of folks were those who never considered home births or even unmedicated births. We can’t offer epidurals or narcotics. That’s a big shift for some people.”
Pain management options for home birth patients include massage, the opportunity to labor in the bath or shower, guided breathing exercises and techniques to shift the pelvis and create space and time for the baby to make its descent. Nitrous oxide, which is historically an option, is not currently recommended because it can aerosolize the virus. Most hospitals and birth centers in Sacramento no longer offer water birth due to the risk of exposing the infant to COVID-19.
For expecting mothers weighing their options, a home birth may provide less exposure to Coronavirus. “If everyone is social distancing and we’re just going from house to house delivering babies, it’s not more risky than hospital care [in regards to exposure to Coronavirus],” they said.
A home birth allows the patient to have more control over who is permitted in the labor and delivery rooms. Whereas, a hospital has the added disruptions of doctors and nurses coming and going. A home birth support team helps the expecting mother from the onset of labor, through delivery and postnatal care. In a hospital, the mother and infant are introduced to new medical staff each rotation of a shift change.
While the risk of exposure to Coronavirus is present regardless, Taproot Midwifery is taking extra precautions amidst Coronavirus. “We’re wearing N95 masks and gloves throughout labor and birth,” said Tel. “We’re conducting health screening before any in-person appointments or delivery. And we’re hoping that we’ll soon have access to the COVID-19 antibody test to detect asymptomatic carriers.”
Since Coronavirus, Taproot Midwifery has decreased in-person appointments opting for Zoom. “We’re doing some virtual appointments, but still able to offer highly individualized care and maintain continuity of care,” said Tel. Their team is now teaching pregnant mothers how to monitor their health and their babies.
Taproot Midwifery allows laboring mothers to have their partner plus one other person in the room. “Before the pandemic, I had a birth with grandparents, siblings, and the whole family,” said Tel. “If I had that birth today, it wouldn't be the same experience for the family.” Their clients are opting to virtually include loved ones in birth experiences through Zoom or FaceTime.
For those considering home births, Tel has some advice for you: “Interview a midwife as soon as possible. The depth of trust and how well we know our clients plays into the safety. It has been much easier for people coming in within three months before their due date versus three weeks.” Tel also suggests you have your medical records in hand if you’re further along than 28 weeks. Take a childbirth education class to arm yourself with actual skills to help you get through an unmedicated labor outside the hospital.
“This pandemic has been hard on so many levels for my pregnant clients,” said Tel. The decisions pregnant people are weighing right now are astronomical.
Despite uncertain circumstances, expecting mothers have the most precious gift of all awaiting them: bringing a new life into this world. Giving birth during a pandemic will certainly prove to be a unique birth story. As Mother’s Day approaches, don’t let #HerStory be forgotten. I hope these firsthand stories provide solace to expecting mothers everywhere.
Shelly, Huntington Beach
Due Date: September with 1st child
Occupation: Labor and delivery nurse
Coronavirus is making me reconsider a hospital birth, for sure. I had plans to hire a doula and have a friend in the room. But our hospital is only allowing one birth partner. I think about that a lot right now, who would I choose if i can only have one person? If I can't have the support system to get me through labor, I will likely have to get an epidural. Should I deliver at home? Hopefully I won't have to make that choice.
I’ve been looking into different options for delivery and called several birthing centers. One local birth center was making women sign waivers that they would agree to have an epidural (upon transfer from birth center to hospital). It defeats the whole purpose of a birth center. What control pregnant women have, is being stripped from them.
I’m 43 and a high risk pregnancy. I’ve seen everything that goes wrong. I know too much. The thought of a home birth terrifies me. If everything goes smoothly with my pregnancy and there are no complications, I will consider a home birth so I can have a support team there for me.
I went through seven years of infertility to have this baby. I stopped going to baby showers years ago because it was too hard. I worked so hard to get here, and I really want this baby shower. But I may not be able to.
As far as cravings, that’s the hardest part for me right now. I still have morning sickness and don’t know what I feel like eating. I’m not grocery shopping at all and am fortunate that my neighbor is going every two weeks. So I’m often stuck eating what’s available in my pantry.
My parents usually visit every few months. Not being able to see them is so difficult. They aren’t able to experience my pregnancy with me.
“I can’t just sit on the couch like everyone else who is under stay at home mandates. I have to go to work and worry about getting coronavirus. It’s not the joyful pregnancy I envisioned. ”
Kristen, Los Angeles
Due Date: May 28 with 2nd child
Occupation: Working full-time from home with a toddler
My husband is an orthopedic surgeon. Although he’s isolated from the front lines, he interacts with people who are exposed. He received an email that if the situation gets worse, all bets are off and he’ll be asked to work in the ER with COVID-19 patients. Despite having a pregnant wife and toddler at home. And this is across the board. I’m a member of a Facebook group of 900 women married to orthopedic surgeons. It doesn’t matter that he’s an orthopedic surgeon. They’ve all been told they may have to go into a new specialty where exposure is much higher. I don’t know of any institution that is taking into account doctors who have small children or pregnant wives at home.
My husband just finished a two week rotation at the hospital. When he’s at the hospital, he’s quarantined away from us. We stayed one week with my parents and one week with his parents. He shopped for us and dropped off groceries so we didn’t have to leave the house. But we never got within 12 feet of him during this time. He would say hi to our daughter through the window. We were all crying, it was a disaster.
He goes back to the hospital from the beginning of May until the middle of May. We don’t plan to live away from him during that time, unless he has known exposure. We’ve chosen to be with him because if I go into labor, we don’t want to be quarantined from him during that time. It’s possible he gets Coronavirus, I go into labor and he can’t be there with me to welcome our son into the world. It’s not ideal but we don’t have another choice.
We never considered a home birth before. My husband is a doctor who believes in all the benefits of Western medicine; knowledgeable staff, medication and equipment. We know how quickly things can go south. I know people who have lost babies or have come close to losing them during home births. That being said, we talked about home birth as an option because the situation was looking really dire. We discussed what it would take to make me comfortable enough to have a home birth. Which is the first time that entered my mind.
“At this point, a home birth is not something I’m considering. I would probably go to a COVID-ridden hospital by myself over having a home birth. I don’t think it’s going to be as scary as I imagine it could be with how things are progressing in Southern California.”
Christina, Bend
Fertility Status: Miscarried, trying to conceive
Occupation: Unemployed due to Coronavirus
I was pregnant when all of this started, so I’ve weighed the fears of being pregnant during a pandemic. I’m old, I just miscarried. My biological clock is more definite than this pandemic. For sure, I only have a certain amount of time to try to conceive. The fact is, I may not even be able to have another baby. I’m not going to stop trying because I want another baby and I want the best chances of that. If I conceive now, I still have 10 months for research on Coronavirus to improve.
Even though I lost my job and my husband’s hours were reduced, I’m not concerned about the financial burden a child brings. There’s probably no way I would be as poor as I was when I raised my son. I’ve been through a lot in my life. I had a kid in much worse conditions, and we were fine.
“I understand it’s a serious thing that’s happening. But I also think there’s always going to be something (a reason to not have kids).”
Jennifer, Sacramento
Due Date: June 23 with 1st child
Occupation: Working full-time from home
It took us a long time to get pregnant, with medical intervention, and it’s like a mean joke to now be going through this. I’m so happy to be pregnant but it’s definitely not at all what I envisioned for this time in our lives. Coronavirus has really changed the experience.
Coronavirus has impacted so many things like my baby shower, not being able to go home to visit my family across the country, more difficulty and lag time sourcing products and getting the baby’s room ready, a general sense of anxiety that detracts what I had hoped would be a really exciting time in our lives, different hospital and OB regulations that are changing every day, and most importantly knowing my family won’t be here to greet our baby and to help us adjust to our new family.
We’ve definitely considered a home birth. I’ve always been curious about it and when New York stopped allowing partners in the delivery room, I freaked out and started to look into it more seriously. Home birth is currently a backup option for us. Ultimately, I feel more comfortable being at the hospital.
“It’s basically one giant grieving process. I’ve been through all the emotions (denial, sadness, anger) but ultimately keep trying to focus on how happy and lucky we are to welcome our baby into our lives.”
Amanda, Davis
Due Date: May 18 with 3rd child
Occupation: SAHM
Of course I am worried [about giving birth during a pandemic]. Isn't that a part of being a mom in the first place? Joking aside, yes, my anxiety is higher. As a former Hospital Administrator, I trust in the Sutter healthcare system and feel more reassured each time I visit. I am more worried about having a newborn baby being exposed to Coronavirus.
I considered a home birth. I called MILC (Midtown Lactation Consultants), who I have worked with for both of my children during 4th trimester for lactation support. They were wonderful and I wanted to learn about their new birthing center. However, after being given a virtual tour and exploring this as an option, both my husband and I felt more anxious going this route. I come from a family of healthcare practitioners. I have my Masters in Public Health. I ran hospital units and multiple clinical departments. My trust lies in traditional hospital services and I had to have this discussion with MILC in order to fully realize this sentiment. Had California not mitigated COVID-19 in such a timely manner, I believe I would have reconsidered a home birth. However, I feel that our hospitals will not hit a surge that we cannot handle because of the mitigation efforts employed early on.
Sadly my mom will not be able to be present at my delivery this time around as she has been for my first two children. She is my best friend, aside from my husband. However, it calms me to know my two boys will be in loving hands with their grandparents at home.
“It’s all a mind game in how you perceive it. Sure there are additional fears to consider. But I’m choosing to keep my eye on the prize and can’t wait to welcome our daughter into the world.”
Resources for Pregnant Women
Study shows pregnant women may be more likely to be asymptomatic carriers
If you’re pregnant and experiencing anxiety about your childbirth, please consider finding a virtual therapist who can help you process these emotions.
Join a Facebook Group in your area for mothers or pregnant women to find people facing the same tough choices. These can be a great resource for programs available in your area.
