At the Puget Sound Birth Center, where Seattle families flock for help with home births or a room in their candle-lit, hospital-gown-free birth center, Micki Persons usually presides over 30 to 35 births per month. In the last two weeks alone, she’s already added six more.
In neighboring Olympia, midwife Rachel Cook had five clients switch from a hospital birth to a home birth in the last two weeks. Kat Barron, a former home-birth midwife, announced two days ago that she was coming out of retirement. Five people have already reached out for her assistance.
“This is what we’re all seeing. We really need midwives stepping up,” Barron said. “Because would you want to go to a hospital right now? It’s pretty terrifying.”
As concern about the new coronavirus spreads, a growing number of women are considering birthing outside the hospital, according to midwives, doulas, and birth-center workers across the country who spoke to The Daily Beast. A fear of contamination—as well as hospital overcrowding, supply shortages, and increasingly tough restrictions on visitors—is leading more and more women to consider having their birth at home.
While popular in many other countries, home birth is very rare in the U.S., making up just 1.6 percent of all deliveries. Laboring in a free-standing birth center, rather than a hospital, makes up another half a percent. Often, the choice is due to personal beliefs about the medical system—beliefs often lumped under the same “woo-woo” umbrella as anti-vaxxers and Goop enthusiasts.
But providers say the current panic is changing the face of those seeking a home birth. Cook’s clients are usually mothers who had an earlier bad experience in a hospital, or women whose parents also birthed at home. But in a single day this week, the midwife said she received three calls from women considering home birth—all of whom were first-time mothers, and none of whom had previously considered an out-of-hospital delivery.
One such mom, who asked not to be named, said she loved her OB-GYN and had never considered having a home birth. But in recent weeks, she noticed herself focusing more on her fears about the coronavirus and less on her fetus and birth plan. This week, she called a midwife in Seattle about pursuing a home birth.
“I feel like by considering a home birth I’m taking the unknown of what the coronavirus can do to our society out, and it gives me the comfort of having some control,” she said.
“Not only that, I just feel like the resources are getting pretty limited and a lot of people need help,” she added. “If I have a healthy, low-risk pregnancy, why not give space for someone who doesn’t?”
A number of providers said they were also seeing moms switch to home birth much later in their pregnancies. Alicia Fishbein, a doula in Santa Clara County, California, where there are at least 66 confirmed cases of COVID-19, said she recently had a client opt for a home birth in the final week of her pregnancy. Persons said Puget Sound Birth Center has started putting together emergency home-birth kits for those who decide last-minute to have their baby at home.
Many of these providers see home birth as a safer, healthier model for low-risk pregnancies, and are embracing the trend. (“It’s kind of like the whole, ‘wash your hands’ thing,” Cook joked. “We don’t need a global pandemic to get people to wash their hands, but if it’s going to help...”) But others were concerned about the effect of so many women rushing into an out-of-hospital birth.
Lynn Hughes, a midwife at Rainy City Midwifery in Seattle, said she usually prefers to see patients early in their pregnancies, for at least an hour at a time. What makes a home birth safe, she said, is the trusting relationship mothers develop with their midwives.
“We need someone who’s going to say, ‘We trust you, I know you have my best interest and my baby’s best interest at heart,’” she said. “And that’s hard to develop in a couple of weeks.”
And of course, there are many women who can’t give birth outside of a hospital: those who have already had a C-section; those whose baby is in the breech position; or those who have an underlying medical issue. Even low-risk mothers will occasionally have to transfer to the hospital during labor, Persons said.
Tara Coffin, a pregnant woman in Seattle, admitted she was anxious about her recent decision to switch from a hospital to a birth center. Her baby is due in May, and she was planning to give birth at Northwest Hospital with the help of its midwives. But her husband has asthma, putting him at high risk if he contracts the disease. She worried that neither he nor her 6-year-old daughter would be allowed at her bedside.
“I’m a pretty anxious, data-driven person, and a birth center wasn’t my first choice,” she said. “But with all things considered, I was worried about being more likely to contract [coronavirus] in the hospital and not being able to have people visit.”
In New York, where the first diagnosed case of coronavirus came weeks later than in Seattle, midwives are just starting to see signs that their practice could be disrupted. Ashley Brichter, the founder of birth-coaching company Birth Smarter, said five clients asked her for midwife recommendations in the last week. Karla Pippa of NYC Birth Village Doulas said one of her clients had fled to a cabin in upstate New York to wait out the pandemic.
More often, however, birth workers said they were hearing concerns about the lack of access to hospitals. A number of major hospitals in New York City have canceled their childbirth classes in hopes of decreasing the foot traffic on campus—causing anxious parents to fret and putting a strain on independent educators. Lisa Greaves Taylor, a childbirth educator with Birth Matters NYC, said her phone had been ringing off the hook with families scrambling to get into their childbirth-education classes.
Hospitals around the country have also started limiting the number of people allowed in labor and delivery rooms, and occasionally banning children from the area altogether. The change worries doulas, who fear they will not be allowed in the room with their clients. (Hughes said she was recently barred from checking up on a patient who was admitted to the hospital for a C-section.) It also poses problems for lower-income families without access to childcare, and those who want more family support in the room.
Coffin said these restrictions were one of the main reasons she switched to a birth center, recalling a recent hospital checkup where she was not allowed to bring any friends or family.
“I feel grateful that I’m low-risk enough that a birth center is actually an option,” she said. “But I can’t imagine how stressful this is for parents who are working under a hospital setting and don't have an option to transfer out.“
“This is a situation where I think people could end up birthing alone,” she said.
A number of birth workers said they, too, were canceling meet-ups and taking the bulk of their work online. The women of Seattle Midwives have stopped seeing clients in person before 34 weeks, instead hosting one-on-one educational sessions online. A number of doulas said they were preparing for a future where they will have to livestream into births.
Brichter’s company, Birth Smarter, is allowing clients to livestream into some of their classes and expediting an online-only course that was originally slated to debut in September. But she added that she was worried about how an online-only model could affect both new and expectant mothers.
“The isolation is very hard for a pregnant person, to have to be at home all day without talking to or seeing other people,” she said, adding that many of her clients were now choosing to work from home. “Having a community is important to help prevent depression and anxiety, so I think the isolation is going to be hard.”
Persons, however, had a more optimistic outlook. She predicted the push to work remotely would give new parents more time to spend with their babies, and even show employers how easy it is to have new parents work from home. “I think it’s going to teach us how well we could connect through technology,” she said, “so that people don’t have to leave their home and they can room in with their babies.”
“I think it’s really going to allow us to see, ‘Wow, we can do better,’” she said.