Birth During the Covid-19 Pandemic and Out of Hospital Births

It’s Getting Very Real.

Unless you were around during World War II, none of us have seen or experienced anything quite like what we’re going through right now. Even then, the world wasn’t as global as it is today–the domino effect throughout nations didn’t happen the way it does now.

Covid-19 is on every news feed and all over social media. The word, “pandemic,” hasn’t been used since 2009’s H1N1 flu–but that flu strain didn’t cause the kind of things we’re seeing today: schools are closed, gatherings are shut down, stay-at-home orders are in effect, mandatory quarantines, self-quarantines and even the National Guard has been deployed. Jobs are being lost, we’ve hit 20% unemployment, and a financial crisis looks imminent. It’s happening in multiple nations all throughout the world.

This virus is starting to affect the people we know. And even if you don’t know someone personally, there are public figures and celebrities starting to test positive. Those affected are beginning to be the people we love — it’s getting very real.

The anxiety, questions, unknowns, and fear are like a thick cloud, and we’re all waiting — wondering when the hell it’s going to pass so we can feel the sunshine again. When can that sweet sunshine on our faces and all of the sickness, sadness, worry, death, fear, gloom, lack of human interaction, and keeping a 6-foot radius of space around you at all times — stop. We all want it to.

Flatten the Curve

You’ve probably heard of the bell graph of infections overlapped onto the line of hospital capacity. If we can flatten the curve and space out when people get sick, it helps with the amount of hospital space, equipment, and staff we have available to care for those who need it most. We’re showing our love for others in our community by socially distancing or quarantining ourselves. We’re expressing our devotion to our friends, family, and neighborhoods by staying away from them during this time.

We’re showing our love for others in our community by socially distancing or quarantining ourselves.

The devastation of this virus wasn’t taken seriously in many different nations (including our own), and now Italy’s hospitals are almost at capacity. They’ve said they’re going to have to start turning away patients that are 80-years old or older, deciding who gets a ventilator, and making the hard choices of who doesn’t. Hospitals aren’t performing non-essential surgeries. This is a reality of what could happen in the US, and it makes us want to do all we can to flatten the curve.

Birth During a Pandemic

And what about birth? What if you’re about to have a baby? Most births (about 98%) occur in the hospital. A hospital can be a fine place to give birth (some are better than others, of course), but it’s also where sick people go for care. It’s a place where there will probably be Covid-19 patients at some time in the future, if not currently (depending on where you live). That isn’t a sentence to instill fear (that’s the last thing in the world I want to do), but it is a strong possibility and the trend that’s been predicted by people who have much more knowledge in that area than I do. And if our nation starts to look like Italy, there just simply won’t be the capacity for all birthing people in the coming months.

Pregnancy, labor, and birth are not sicknesses.

You are not sick. You’re bringing a beautiful human into the world. Normally, the surgical and maternity wards are strictly off limits to those that are contagious. But this virus is stealthy and has overtaken hospitals’ capacities. Many staff have gotten sick or are asymptomatic but can possibly still spread it. Recently, there have been maternity wards completely shut down due to labor and delivery nurses testing positive for Covid-19.

It’s because of those things, that birth center and home births are starting to be seriously considered, even by those who would never have entertained them as an option before.

“A friend just contacted me and was concerned about birthing her baby in a hospital during this pandemic. She simply said she wished she was brave enough to have a home birth.”

And she is. But in our society, it’s seen as something only extreme parents do, or you need to be an ultra-hippy to have a home birth or birth at a center. People think it’s dangerous. But the truth is, all kinds of people choose home births, for many different reasons. And evidence supports this choice for low-risk birthing folks (And then there’s also patriarchy).

What’s the Evidence Really?

Even WebMD’s description and advice on home birth is written in a fearful and manipulative way that uses old (and not completely factual) data to say that yes, they are an option, but there’s a fairly substantial increase in complications that can happen to both the mother and the baby. It’s not the only site that has that type of language.

But only part of WebMD’s statement is true, and then — only to a degree. Approximately 37 percent of first births are transferred from a home birth to a hospital for non-progression. Which has the potential to turn into an issue if it occurred for a long period of time, but most often it isn’t an emergency and simply means a first-time mom might need a little extra help. There are interventions that birth centers and home birth providers won’t do. Non-progression isn’t exclusive to home births though; it happens all the time in hospitals as well. Skilled midwives know how to determine when a transfer is necessary and it’s safe to do.

When compared to hospital birth, there are no additional complications for the birthing parent and there were no differences found in the health of babies born. A study in 2012 (with 16,924 births) and another review of multiple studies published in 2019 (with over 500,000 births that were intended to occur at home with a skilled medical professional), found that home births were just as safe as births planned for the hospital. Not only that, but with home birth there are less medical interventions including surgical birth, episiotomies, epidurals, and other pain medications. Also, birthing people often feel more comfortable in their own environment or in the family-type of environment of a birthing center.

Home Births are Safe

You don’t have to put on a brave face to have a home birth because, with the right birth team, it’s a very safe option. And during this unpredictable time in healthcare — it may be a safer and healthier route because your home or a birth center isn’t where sick people are entering or being treated. And the safety of home birth is well backed up by research. But only if you're ready. If the idea of giving birth at home strikes fear in your heart, it's probably not the safest place for you to give birth. Feeling safe is important to the birth process.

Emme Corbeil, a Certified Professional Midwife that serves the Minneapolis and St. Paul areas, spoke with us concerning birth during the Covid-19 pandemic. She stated;

“Now is the time to consider community birth! Home birth and birth center birth is an excellent option for healthy low-risk birthing people who are experiencing a normal pregnancy. During this current pandemic, community birth is essential to minimizing transmission, maintaining health, and efficiently using our medical resources. Community midwives who practice in homes and birth centers know how to help people birth safely out of the hospital setting, care for newly postpartum people and their newborns and provide all the testing and evaluation of the new baby and birthing person. At this uncertain time when our hospital systems will be inundated with very sick and highly contagious patients let your community midwife keep you safe at home.”

Home Births Can Be Affordable

There might be financial concerns that make you think it isn’t an option, but many midwives work with insurance companies to the best of their ability to help with payment. However, if insurance doesn’t cover the cost of a home or birth center birth, you might not see too much of a difference to your bottom line, because the cost can be close to many insurance deductibles you would normally pay. Also, many midwives can work out payment plans with you in order to accommodate your budget and make it an affordable option.

There are Birth Centers too

Birth Centers follow the same midwifery care model as a home birth, but you’re at a facility that usually feels like a home, even spa-like — soft and quiet — and it’s not attached to a hospital. Birth Centers have several birth rooms and a bigger staff of Midwives and Birth Attendants (Registered Nurses) that see you through prenatal visits, birth, and postpartum.

Why Having an Out of Hospital Birth is Helping Yourself and Others

There are about 10k births every day in the US. Hospitals will more than likely not have the beds they need for the surge of Covid-19 patients that are expected. There are some mathematical models that estimate we could overload our hospital and healthcare system by the first week in May 2020.

So far, the hospital policies around birth are changing — rapidly and sometimes by the hour. There have been changes to many hospital’s visitor policies that have extended to essential birth support such as doulas. Many are not being allowed at the birth; only one other person is allowed with the birthing person (often the partner, friend or family support), and they’re required to leave immediately after the birth. Women are also being induced early in order to get births “in” while the hospital has capacity. Induction is one of the common medical interventions that lead to 60% of unplanned surgical Cesarean births and could drastically change your plans for birth.

The midwifery model that tends to support births at home or in a birth center and sometimes a hospital, has a much lower rate of Cesarean births. We’re talking low–single digits versus 20-30% in a traditional hospital setting. They’re welcoming to doulas and partners because they understand the importance of having those people by your side. They are also fully equipped, medically trained, and knowledgeable in all areas concerning pregnancy, birth, postpartum, and newborns.

So, while a Home Birth or Birth Center might not have been a consideration before, you might find yourself having a much calmer, grounded and joyful experience going that route rather than a hospital during this time in our history (or any time for that matter). Hospitals in Minnesota are starting to cancel postpartum visits — and that’s a trend with all outpatient appointments spreading across the country. Midwives are currently stating that they plan to check up on you at home or the center in the following days and weeks after your baby is born.  

Options to Empower You

In all of this, we want to encourage you not to lose sight of the beautiful miracle inside of you and the hope of new birth… the sweet beginning of new life. We sincerely care about your health and safety and want to see your little one come into this world in an environment that’s full of all the joy that should be, and we want you to feel completely at peace with the birthing location you choose, whether that’s a hospital, birth center, or your home. We know that having a baby is life-changing and can maybe feel overwhelming, especially with all the uncertainty in our world right now. We want to empower you by presenting options. You have a voice in how your little one makes their way into your arms.

We’ll Get Through This

Stay safe and healthy — we’ll get through this. We’re here for you. Seriously, we are cataloging the availability of home birth and birth center availability across the country. And we have resources for you to search midwives, birth centers, doulas, and lactation consultants that have availability in-home (with protective measures) and with virtual appointments as well. Many of these professionals have recently lost much of their work and income since hospitals have strictly limited much of the birth support team and visitors during a birth and their passion and expertise is to support birthing people.

We wish you peace and love around the arrival of your little one. Knowledge is power. You are powerful. And you’re not alone. You've got this.

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