COVID-19 and Childbirth
By Erin Kaspar-Frett, Earth Mother Midwife; photo by Renee Barth Photography
These are interesting times in which we are living, loving, gathering (or not) and making and having babies!!! How is this affecting birthing? Our general area hospitals are having to change policies to meet emerging information and respond to infected medical staff. Even though our medical personnel are doing their best to prevent infection in their own lives, it can’t always be helped. The balance between care and safety can be tricky at the best of times.
The risk with this virus isn’t that it is deadly to most people like Ebola at a 75% death rate. The risk is that it is so contagious and can cause long term complications. For this virus 85% of people will get through it with mild to moderate symptoms, but it will take a person out of work or support contact for 10-14 days. But for the other 15% of humans, it is much worse and longer in duration.
Pregnant folks and babies are now considered vulnerable population. In pregnancy, a person is already more at risk for blood clots due to several factors. Add in the increased chance of blood clots from COVID-19, and the risk increases. As a midwife caring for this population, I am keenly aware that there are many layers to the situation: comfort, safety, personal choice, social responsibility and changing information as we learn more. It’s confusing at best.
There are more inquiries for out-of-hospital birth than I have ever experienced in 24 years of attending birth. In a practice only taking 2 – 3 due dates per month, we are receiving up to 14 calls in 5 days. Not everyone is a good candidate for out-of-hospital birth and some aren’t really sure that’s what they want. But they’ve heard about it and simply want more information. The reasons vary: safety, to fear of exposure to more humans, to worry about the chance of contracting COVID-19, to being tested, and to policies that limit support of doulas. For some, they’ve always wanted an out-of-hospital birth but just didn’t have the final motivation until now.
There are only a handful of licensed midwives attending births in this area, and we each have slightly different ways of handling the care of people giving birth during this pandemic. But we all share the same goal: safe birth for parents and babies while being as comfortable as possible and honoring of personal choice. The balance between how to support family autonomy in birth and safety of the family, birth team AND the rest of any practice is one that is constantly under review, or should be. I am painfully aware that if our team gets sick with anything, we have to wait days for a COVID test result to come in, and if it is COVID, then wait 10 days from the first symptom, as long as things are improving (current CDC and WHO recommendations). During that time someone could need an appointment or have a baby. But even more so, if I were to get sick from client contact, and wasn’t wearing a mask with another client contact, I could be spreading it. We are working to come together with this birthing community to do the best we can to prevent any unknown spreading.
The one thing we can all agree on is that this time period is causing all kinds of fear: being controlled by someone else, getting sick, losing a job, losing a loved one(s), others’ choices, having to birth in a different location than planned, having a sick baby, and others. My hope for this timeframe is that we find MORE tolerance and acceptance of others and the willingness to listen and meet in the middle, while being safe and including each other. In my practice I try to do this by asking clients to do partial virtual visits when possible, stay home if sick, wear masks in the office space and in exchange, I will carry the extra responsibility of wearing medical-grade masks at their birth, so they don’t need to do so while birthing.