A lot of people, myself included, have been joking that there’s going to be a boom in babies born in nine months, conceived while parents are locked away in quarantine. And yes, there will be. But the question is, where should they be born?
Right now, I have pregnant friends utterly terrified of giving birth in a hospital during a pandemic. As they should be. No healthy person should be walking into a hospital right now outside of medical and support staff. So what’s the alternative?
An easy answer is more home births. But often, the easy answer is not necessarily the correct one. And it doesn’t solve the problem, not by a long shot.
The Cut ran a balanced piece on the choices women face during this crisis and explained the problem with everyone deciding to give birth at home:
The Cut missed another terrifying possibility: What if your home birth midwife gets coronavirus herself?
I had a home birth nine months ago with a practice of three midwives. The policy of the practice is to have two midwives at every birth: one to attend to the mother, one to the baby. During my birth, we hit a snag. One of the three midwives was out of the country when I went into labor, and another woman was laboring at the same time. My midwives were sent scrambling, and each had to find a backup midwife to come to assist in the births they were attending.
But what if one or more midwives come down with coronavirus, and what if they’re already operating at their practice’s capacity before they lose a colleague for weeks to recovery and quarantine? As it stands, independent home birth practices may not be any safer than a hospital.
Medical authorities have told us that all “elective” procedures have been indefinitely postponed. But birth is not elective. Women have to give birth now, and they will have to keep giving birth. The birth community, together, along with mothers, needs to develop a plan to help them do it safely.
While it’s true that one-third of home births are transferred to the hospital, the vast majority of those transfers are first-time mothers. For mothers with previous uncomplicated vaginal deliveries, that number drops dramatically.
The following are some suggestions on what birth professionals could consider to keep women and their babies safe:
To maximize the number of women they can serve, home birth midwives need to reevaluate who they take as patients. For the time being, to avoid the possibility of a hospital transfer, home birth midwives need to stop accepting first-time mothers. By doing so, they also increase their capabilities to have successful home births with as many patients as possible, easing the burden on hospitals.
For first-time mothers and those with more complicated births, we need to find other solutions. A hospital ship is destined for New York harbor, and hospital wards are being set up in school gymnasiums. We’re already finding ourselves getting creative. That creativity needs to expand to births as well.
We need to build more robust and capable birthing centers where there are none and build out what we currently have. Interventions (unnecessary inductions, for example) and cesarean sections need to be curtailed drastically. Mothers want and need to reduce the chances of extended hospital stays and complications. If mothers do need to birth in hospitals, they should be spending as little time as possible inside.
This pandemic is challenging our entire healthcare system to be more nimble, and that agility must extend to the realm of childbirth. Women and babies deserve the very best care the American healthcare system can provide, coronavirus or not.
Bethany Mandel (@bethanyshondark) is a stay-at-home and homeschooling mother of four and a freelance writer. She is an editor at Ricochet.com, a columnist at the Forward, and a contributor to the Washington Examiner’s Beltway Confidential blog.
