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As Hospitals Become Overloaded, People Consider Home Births

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Natalie Burnside had always planned on giving birth to her third child at Amita Health Adventist Medical Center surrounded by her family, her midwives, and her doula. But just like everything else that the coronavirus has disrupted, it’s also uprooted her birth plans.

“We decided to change plans as of last week,” Burnside says. “Things are too unknown, and we feel confident that our home will be a better option.”

The Chicago-area woman isn’t the only one moving her birthing plans to her house relatively last-minute. As hospitals scramble to assist those with COVID-19, those who are getting ready to deliver are questioning whether those hospitals are the safest places for them right now.

Over the past four days, Robin Ross, a doula and hypnobirthing instructor with Blissful Births & Babies, says she’s had at least three different families contact her because they’re thinking of switching from a hospital into a home-birth setting.

Some had invested in a doula, and since most hospitals are limiting visitors to a single support person, the mother has to choose between her partner and her doula. So they’re opting out altogether, Ross says.

Others are scared of everything from a hospital supply shortage to overcrowding or catching the coronavirus at the hospital.

“Their fears do surround the fact that they are in a hospital regardless if it is only labor delivery, as there still may be or have been someone with the virus, due to the larger volume of people coming in and out of the hospital compared with home,” Ross says.

A webinar next week for doulas by Karen Laing, founder of Birthways and WisdomWay Institute, hit its capacity of 500 participants within a day of its announcement.

“It felt a little concerning that while hospital staff were getting regular briefings, doulas could be relying on information floating around the internet,” Laing says. “It’s been good to see that there is interest.”

We are hoping that emergency legislation can be put in place to significantly increase the number of families that can be supported with safe, trained home births.

Home births have been a rare phenomenon in the United States, making up just less than 2% of the deliveries, according to a 2019 review of national statistics in Birth. Many of those who had been choosing to home birth were doing so because they wanted to “embrace” the birthing experience. Today, they’re staying home for different reasons, changing the dynamic of the home-birth population.

But with the number of home births suddenly expected to increase, there’s a shortage of legally recognized home-birth certified midwives. (In the UK, over half of all births are attended by midwives, per NHS data.)

Every state has its own laws regarding home births, prompting some groups to start petitions asking the government to immediately provide what it takes to allow more home births.

In Illinois, for example, nearly 1,000 people have signed a new petition asking the state to provide instant licensure to certified professional midwives, as there are only 11 legally recognized home birth practices there and a sudden abundance of women looking to deliver at home.

“We are hoping that emergency legislation can be put in place to significantly increase the number of families that can be supported with safe, trained home births with student nurse midwives and certified professional midwives,” says Claire Zawa, care manager at Birthways, which offers pregnancy, birth, and postpartum services in the Chicago area. “We know that what is most dangerous for laboring people is to have an unassisted home birth.”

That’s why doctors are urging women to reconsider their sudden decision to birth at home in light of the coronavirus outbreak.

Immediate access to medications, blood, an anesthesiologist, and an operating room are prudent considerations for a safe birthing experience.

Mary Jane Minkin, M.D., clinical professor of obstetrics and gynecology at Yale University and founder of Madame Ovary, says that hospitals have plans in place to protect the mothers and babies, and the risk of a home birth is not comparable to the risk of a hospital birth right now.

“If God forbid you have a problem in the hospital, you can stick your head outside the room and say, ‘Help,’ and you can get five people in there to give you a hand,” Minkin says.

Kecia Gaither, M.D., director of perinatal services at NYC Health & Hospitals/Lincoln, agrees, adding that while the decision as to how a woman delivers her child is her choice, there are many things that can go wrong during a delivery. These include hemorrhage, fetal distress, shoulder dystocia, and more.

“I personally feel that immediate access to medications, blood, an anesthesiologist, and an operating room are prudent considerations for a safe birthing experience,” Gaither says.

While most hospitals aren’t able to test each mother who arrives for the coronavirus due to the shortage of tests, they do have isolation procedures in place if anyone is sick, Minkin says.

The American College of Obstetricians and Gynecologists has detailed guidelines for these scenarios, including temporarily isolating mothers with confirmed cases, and separating those mothers from their babies until safe.

“You don’t have to worry about the labor floor being infected,” Minkin says.

With the coronavirus spiking fear in plenty of pregnant women (and everyone else, for that matter), it’s difficult to reassure someone that they won’t get sick, especially inside a place harboring COVID-19 patients.

So, in a way, home births are being viewed by some as the safe option during this bizarre time.

“We never have a crystal ball about how things will go,” Laing says, “so in some ways, we’re a little more prepared to prepare for the unknowns, the unexpected, alongside our clients.”

If you think you’re showing symptoms of coronavirus, which include fever, shortness of breath, and cough, call your doctor before going to get tested. If you’re anxious about the virus’s spread in your community, visit the CDC for up-to-date information and resources, or seek out mental health support. You can find all of Romper’s parents + coronavirus coverage here, and Bustle’s constantly updated, general “what to know about coronavirus” here.