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Planned a hospital birth but now thinking about home birth because of COVID-19?
These are uncertain, and frankly scary times, as our world deals with COVID-19, the illness caused by the CORONA virus. We are recognizing that birthing people, especially, are fearful and anxious about the future and how it pertains to the health and safety of them and their baby on the day of delivery. We have communicated our policy changes to our clients including moving much of our prenatal support to video options, and at this time will continue to provide in person support to clients on the day they give birth, as long as hospital policy allows.
We have had many conversations with our doula clients about their concerns for birthing in the hospital. Some of our clients and prospective clients have reached out with questions about home birth options in the DMV.
We acknowledge that homebirth is not for everyone including those considered high risk. It is only a safe option for low risk patients. We acknowledge that we will support our clients choice for the safest birth possible, wherever that choice may be! In typical times the vast majority of our clients choose hospital births and we provide doula support at all the area hospitals. These are not typical times.
As some of our physical support may decrease, we are working to increase the emotional support and information we can offer clients as they come to us with questions about options, in particular about where to give birth.
This article from the Daily Beast published on March 16, 2020 tells us more about how Pregnant Women Turn to Home Birth to Escape Virus.
Our clients have expressed concerns that hospitals are ground zero for this virus.
They are telling us their hospitals are making recommendations for preterm or early term (36 or 37 week) induction or elective cesarean in order to avoid being in the hospital in a few weeks. They are telling us that their doctors are recommending formula feeding and separation of them and their baby for confirmed or suspected cases of COVID-19 (per the ACOG Practice Advisory Novel Coronavirus: Covid-19) as the CDC does not know if COVID-19 poses a risk to pregnant people and their newborn babies, although with limited research COVID-19 is not detected in breastmilk. This is different from the World Health Organization's recommendations which says to keep the mother/baby dyad together and continue breastfeeding, as the little evidence we have does not look like the virus passes through breastmilk.
Our clients are also saying in some cases their partner and/or doula may not be permitted to be in the hospital with them, or if permitted, are not allowed to leave and return, (like in the case of caring for older children.) They are telling us that their doctors are planning to release them from the hospital ASAP if there are no complications. They are saying they will likely cancel their 6 week follow up visits if there are no complications.
In a country where the maternal and infant moratality rates are already awful compared to the rest of the developed world, and birthing is particularily dangerous for people of color, black and indiginous individuals, these changes may result in an increase in physical health complications and increased perinatal mood disorders like depression and anxiety. These are drastic differences in the type of care these families expected to receive earlier in their pregnancy and from what the World Health Organization recommends for a positive pregnancy experience.
Doulas do not make medical decisions for clients. What we will do is help them use their B.R.A.I.N, which is an acronym for
Benefits, Risks, Alternatives, Intuition, and do Nothing.
We believe that if clients want to know about their alternatives it is in our scope of practice to provide them with that information. As Diana Korte and Roberta M. Scaer, wrote in the Book Good, Safe Birth “If I don’t know my options I don’t have any.”
Pregnancy, Home Birth, & COVID-19 (Coronavirus):
A SAFE ALTERNATIVE DURING A PANDEMIC
“In a true epidemic/pandemic, we can expect medical facilities to be pushed past their capacities as they care for those stricken by the disease, especially those who need intensive care. Hospitals will become epicenters of virus habitat, their beds full, and their staff overworked. The already low resources of the maternity care units will be stretched even further making the hospital birth setting riskier and not just in terms of contagion. It only makes sense for out of hospital birth to become the safer choice for the majority of people in a crisis like this.”
2020 is the World Health Organization's year of the Nurse and Midwife. Perhaps this comes just in time to help more families have a safer birth in the midst of a pandemic.
Doulas of Capitol Hill owner, Emily Smith, spoke with local Certified Professional Midwife Ryann Morales of Del Ray Birth Collective to learn what she’s doing to accommodate late transfers to her home birth practice. Ryann says on the Del Ray Birth Collective Facebook page, “I am extending my discounted pandemic rates to anybody, regardless of when they are due. It seems we will be needing home birth more and more as time goes on. Happy to be collaborating with Samantha Sewell and Becky Banks to provide great midwifery care!” Ryann told Emily of Doulas of Capitol Hill that she and other local midwives are working together to have supplies and backup protocols, in case they get sick. That to her that is the most important thing for which they are making preparations. Ryann shared that the intimacy of the practice helps people to feel safe. They don’t walk in [to the office] at the same time and don’t have to sit in the waiting room. Also, differently from local area hospitals the birthing person can have any support person who is healthy. Ryann says, “homebirth is always a safe option but right now it’s an even safer option. It’s a great way to practice socially distance, flatten the curve, and reduce the load on hospitals. Right now in this country we’re still classifying pregnant women as low risk but in the UK they are saying they are high risk and recommend more extreme isolation.”
From Ryann’s website: HOME BIRTH AS A SAFE & AFFORDABLE OPTION DURING COVID-19
“Many pregnant people and their families are concerned about the current COVID-19 pandemic and how it will affect their plans to give birth in hospital. To make home birth an affordable and safe option for all birthing families, I am collaborating with two other local licensed midwives, Becky Banks and Sam Sewell. We formulated a comprehensive plan to accept late-to-care transfers for families wishing to birth their babies at home in order to avoid the risk of coming into contact with COVID-19. Additionally, as the virus continues to spread throughout the DMV we expect local hospitals to be overburdened with sick patients, furthering the logic for those with low-risk pregnancies to stay home and birth their babies with experienced, out of hospital providers such as Certified Professional Midwives (CPMs). “
“CPMs are experts in out-of-hospital care. We can order labs and ultrasounds, give prenatal care, give clinical care during labor and birth, and provide postpartum and newborn care for up to 6 weeks. We have our own instruments for clinical care and practice Universal Precautions as it pertains to sterility and disease prevention. We are an untapped resource ready to serve our community in this time of need and uncertainty. “
This article is meant to be informative for families considering home birth as a safe alternative for low risk people to birthing in the hospital and must not be construed as medical advice. For the purpose of this informative article, we did not discuss unassisted birth, which is homebirth without a health care provider such as a doctor or midwife. Doulas of Capitol Hill will not provide doula support for clients planning an unassisted homebirth, as we are not medical professionals and our professional liability insurance does not allow it.