COVID-19 has rapidly changed our lives and left pregnant women grappling with an uncertain future. What started with canceled hospital tours and birth classes has evolved into a childbirth landscape unseen in generations due to coronavirus and the influx of COVID-19 patients.
Moms Biggest Concerns About Hospital Birth Right Now
Moms are facing a host of new issues surrounding birth that were previously unthought of, but with COVID-19, more changes surrounding delivery and postpartum care appear almost daily, like:
- Limited or NO support people allowed at birth: In the hardest hit areas, rules surrounding who may be present during your birth are evolving daily. Recently, hospitals barred both doulas and partners to prevent infection, though this rule has been rescinded to allow partners.
- Separating mom and baby: Some hospitals are separating mom and baby if one is suspected of having the virus. This seriously impacts your bonding and breastfeeding at your most critical time together.
- Mom or baby catching COVID-19: We all want what’s best for mom and baby, which previously meant preventing sick visitors. With COVID-19, the virus doesn’t always present with symptoms, leaving mom to worry about themselves or baby catching the virus in a hospital setting, whether through contact with contaminated surfaces or carriers who are asymptomatic.
- Distracted or depleted hospital staff: Hospitals in some areas are struggling to keep up with a rush of infected patients, leading to stresses previously unseen. While staff wants what’s best for you and baby, staff may be limited, affecting care.
- Supply shortages: Hospitals are facing unprecedented shortages due to the increase in patients. With the hardest hit areas scrambling to come up with beds and other supplies, protective coverings and masks that were once essential may not be available, which may be jarring to moms.
- The unknown: COVID-19 is a novel coronavirus, meaning it’s new and unstudied. Scientists and doctors are learning more about the virus each day, but with such little data surrounding pregnant moms, moms are rightfully on edge.
During these unprecedented times, it’s natural to rethink your birth plans and consider other options that may work for you and baby, such as a home birth or birthing center.
Let’s do a rundown of what it takes to make these changes and if adjusting birth plans is best for you and baby.
But Can You Switch?
The decision to switch isn’t easy. There are several factors to consider, such as risks, your comfort level, and the timing. These vary on a person-to-person basis, and your situation may be impacted further by how COVID-19 is affecting your region.
As Maura Winkler, CNM states, “Home birth is not for everyone. For one, women need to be healthy and completely low risk to plan a home birth. You also need to have the right mentality.”
Who Should Make this Switch?
Before making any changes, you need to be honest with yourself about your commitment to a low-intervention birth. Ask yourself these key questions to determine what you want in your birth, including:
- Where do you feel safe and supported? Moms who previously committed to a hospital setting may have done so because they like the security it provides. Other moms may feel safer and more relaxed in their own home.
- Are you committed to a low-intervention birth? Some moms may be passionate about a home birth, while others might be on the fence or even nervous. While flutters of nerves are normal, (hello, you’re about to give birth!) actual anxiety surrounding it may mean a hospital setting is best for you.
What If I’m High Risk?
If you have a high-risk pregnancy, an alternative setting to a hospital may not be best for you and baby. High-risk conditions include:
This is especially true in an area seriously impacted by the virus, as the medical and emergency systems are already stressed. You don’t want to put yourself in a situation where help may not arrive in a timely manner.
Will My Insurance Cover It?
Insurance and home birth don’t always go hand-in-hand.
In some states, such as New York, home birth is required to be covered by insurance according to Maura Winkler, CNM. But in other places, many insurance companies do not cover birthing centers or home births.
You might be able to get an exception, however, especially with the spread of COVID-19. One mama, Michele, took this fight into her own hands and called her insurance company. Per her insurance provider, if her OBGYN deemed a home birth as medically necessary due to the outbreak and prescribed a licensed midwife, her insurance company would cover her.
To learn more about your options, start by researching the home birth laws in your state and calling your insurance company to discuss home birth benefits. Some companies cover home births but not birthing centers, so ask about each. Bringing up the current outbreak can aid in your request, particularly if you’re living in a hard-hit area. Coverage may be full or partial, depending on the insurance company. Remember: it never hurts to ask.
How to Switch From a Hospital to a Birth Center or Home Birth
Making the switch isn’t as difficult as you’d think. The key steps include:
- Act quickly: If you’re further along in pregnancy, time is of the essence, especially with more moms making the switch to the virus. Midwives and birth centers are filling up fast, so if you’re onboard with a hospital alternative, start the process ASAP.
- Speak with your current practitioner: Sometimes OBGYN have midwives they can refer you to. You can also ask your OBGYN to write the prescription noted above regarding a home birth because of medical necessity (COVID-19).
- Discuss how you’re feeling with other members of your support team: Speak with your partner and (if applicable) doula about your plans. Not all partners will be keen on the idea at first, but share your concerns openly and create a line of communication surrounding your decision. Some partners may be concerned at it being uncommon, but feel free to point out that over 35,000 home births occur annually in the US according to the ACOG.
- Locate a midwife or birthing center: If your current healthcare provider does not have a midwife referral, don’t feel overwhelmed. Per Maura Winkler, CNM, “You can start by just exploring what the home birth options are in your area. Depending on the state, there are different kinds of midwives licensed. One is not necessarily better than the other. Most offer some kind of consultation to learn more about home birth.”
- Research: When calling perspective care providers, ask questions. Here’s a list of sample midwife interview questions. Since meetings and tours are likely cancelled due to the virus, most providers are offering phone support and online fact sheets. Some birthing centers may have virtual tours.
- Book your midwife or birth center: If you think you’ve found the one, act fast as we mentioned above. Don’t be afraid to add your name to a wait list too while searching, as you never know when a spot will open up.
Birth Centers vs Home Birth Options
In your search, you’ll come across both birthing centers and home birth midwives. Each has their own list of pros and cons, but the decision should be based on what you’re most comfortable with.
The key difference is that in a birth center, you give birth in someone else’s home or a home-like facility, while a regular home birth means delivering in your own home. Both will also likely have a list of requirements you must meet to deliver with them, including being low risk.
Birth centers are freestanding facilities where mothers can give birth. They’re a great alternative to hospitals, allowing moms to give birth in a homelike setting. With birthing centers, moms should consider:
- Not home: The biggest drawback is that a birthing center isn’t your home. It’s still a foreign place, but that may not be a bad thing. Some women get more comfort from birthing in a place designed for the act rather than at home.
- Vary from conventional home settings to luxury birthing suites: It’s important to research to find one that best suits your desired environment.
- Vary in staffing: Some may offer on-site midwives, while others may only have nursing and support staff on hand, requiring you to find a licensed midwife to deliver your baby.
- Offer a wide assortment of medical supplies: Compared to a midwife’s supply kit, a birthing center may have more items on-hand. Ask what medical necessities they have on-site, such as oxygen, stitches, or oxytocin (in case of postpartum hemorrhage.)
- May supply differing types of pain management: Compared to a home birth, you may have more options to choose from, like nitrous oxide, acupressure, and hydrotherapy.
- More fetal monitoring options: A birthing center may have more fetal monitoring devices at their disposal than a midwife traveling to your home.
- Offer many birth tools: A birthing center likely has more birthing tools than you have at home or that your midwife can fit in the car. This may include birthing stools, bars, jetted tubs, and more.
- Hard to find: Freestanding birth centers are rare compared to midwives, so finding one in your area might be difficult.
- Book up fast: With birthing suites and beds to account for, birthing centers book up quickly.
There’s no place like home for some moms. With a home birth, your midwife comes to you, and you deliver your baby together in the privacy of your own home. With home births, you should consider:
- Offers the comfort of your own home: Some mamas may feel more secure delivering at home. There are no strange sights, smells, or faces to contend with, and you may feel more relaxed. At the same time, other moms may feel nervous about delivering at home or slightly less controlled. These moms may prefer the somewhat official setting of a birthing center.
- Limited pain mitigation: Compared to birthing centers, your midwife may not have as many options as a birthing center due to mobility of such items. This may rule out hydrotherapy in jetted tubs and the like.
- Less options of birthing tools: Similar to pain relievers, your midwife might not be able to transport a wide assortment of these to your home. A birthing center likely has bars, tubs, stools, and more, while a midwife may only be able to bring a ball and maybe a blow-up pool.
- Medical care in your home: Midwives carry the medical necessities to keep you safe during labor and delivery, such as monitors, stitches, and emergency tools like oxytocin. This allows you to receive grade-A care in your own home.
- Flexibility: Unlike birthing centers, midwives may have more flexibility with scheduling. Without physical space to worry about, they may have more slots available.
- Intimacy: In a home setting, the birthing atmosphere feels much more personal than in an out-of-home environment.
In your research, ask how each birthing center or home birth midwife is handling the COVID-19 outbreak. Specifically inquire about supplies, disinfecting, and staff. Some centers are discontinuing the use of nitrous oxide, for instance, so make sure you discuss your birth plans to cover all your bases.
Most are screening patients for the virus before admittance, and there is generally a support person restriction to either your partner only or a partner and doula.
How to Find a Midwife and a Doula
Besides asking your OBGYN for references, you can search online for providers in your area using resources like the American College of Nurse-Midwives. Using this tool in particular, you can browse home-based midwives and birth centers. If you prefer a more word-of-mouth approach, search online for natural birth groups in your area where women can recommend local care providers.
To find a doula, you can browse DONA International, an online network of professional doulas around the world. Networking with natural-based mamas in your area online is another great way to find a highly recommended doula.
How to Transfer Your Medical Records
When changing to a home birth or a birth center, you will need to transfer your medical records to the attending midwife. Most offices can do this electronically, so you won’t have to travel to your OBGYN.
Empowering yourself with knowledge is the best way to ensure a stress-free birth. This time in your life should be joyous, and knowing what to expect along the way eases anxiety. In addition to speaking with your care provider, taking a natural birth course online can provide insight on the home birth process, including how to safely deliver at home and how to naturally relieve labor pains. The Mama Natural Birth Course covers all this and has sections dedicated to your partner, too.
Learn how to have an amazing birth with the Mama Natural Birth Course 500
Home Birth? Get Your House Ready!
If you’re set on a home birth, it’s time to harness that nestling energy and prepare your house. Pick the area of your home where you’d like to labor and focus your energy on making it as comforting as possible.
Speak with your midwife before purchasing items, as they may provide supplies such as absorbent pads, a head light, and a birthing pool. The National Childbirth Trust has a nifty checklist of items you may want to grab, including towels, blankets, and items to aid in relaxation like candles. Don’t forget to pack a hospital bag just in case a hospital transfer is needed.
Make Peace With Your Decision
Change is scary, so it’s understandable if you’re feeling a little uneasy. Paired with the uncertainty we’re all facing with COVID-19, anxiety is to be expected. Know that whatever you choose, you’re doing what’s best for you and your baby.
A great way to fend off negative thoughts is with pregnancy affirmations, or positive statements about your pregnancy that reaffirm that everything will be okay. An example would be “my baby will be healthy,” or “my body knows when it’s ready to go into labor.” You can also combat stress and worry naturally with meditation and/or aromatherapy.
Turning to your support network is essential as you make a change. Lean on your partner as needed and discuss your birth plan often while sharing information you learn during your birthing course. Two empowered parents is better than one, after all. With this open dialogue, everyone is on the same page, and by talking about the changes, the new birth plan will feel like it’s always been yours all along.
Final Thoughts About Switching To Home Birth Due to Coronavirus
The COVID-19 outbreak may make it hard to remain positive, but you can take control of your birth plan. Switching plans can be done while socially distancing from the comfort of home, and with countless knowledge at your fingertips and the right team behind you, you can have the birth you dreamed of all along.