Giving Birth During a Pandemic

COVID-19 happened and now you’re left with more questions about where to have your baby than ever before.. You didn’t envision needing to consider even more safety and risk factors surrounding your birth, and now maybe you do not feel safe in your original intended place of birth. As a nurse and doula I have witnessed birth in all three of your optional locations and will share my insight with you.

Above all know this mommas: where you choose to give birth is where you will find your power. Where you choose to give birth is entirely up to you with the help of your medical provider and unbiased research on your own. Where you feel most safe giving birth will ultimately be the best choice for you. Growing up on a farm watching animals give birth was one of my favorite childhood activities. Now, I often relate the nature of laboring human moms very similar to the nature and needs of the animals in nature. It didn’t matter to our animals whether she delivered in the big pen, the small pen, or free range in the barn yard, it mattered most that she felt safe and could labor down in her own natural rhythm and way. The vet (my dad) never put these mommas on a clock and we never questioned their body’s ability to give birth unless she presented with contradictory evidence. When something did go awry, we were sure glad for the interventions that allowed the mom to deliver without complications, these were few and far in-between. Just like we do not need to teach our bodies how to heal from ailments, we do not need to hover over a laboring woman ensuring her progress is textbook.

Where a woman chooses to give birth should be without judgement, just like passing judgement upon a family who chooses to wait to find out the sex of the baby.

Where she chooses to give birth, when this decision is made in her power, will ultimately influence the outcome of her birth. We cannot separate the experience from the outcome both medically and emotionally. If you place a momma in her own home to give birth when she is scared to death of the idea and has no support suggesting to her otherwise, her best outcome will not be at home! On the contrary, if you place a low risk momma in a hospital to give birth and she does not progress on the “Friedman Curve” that says she should “dilate 1 cm per hour” then she will likely be poked and prodded with interventions that may or may not result in favorable outcomes. Working in the NICU I found myself always so interested with reading the baby’s extensive labor and birth report. There were many baby’s in our NICU whose lives were saved by medical interventions when their momma’s birth did not go as planned. However, I was SHOCKED as I read some of the reports of baby’s who had been medically induced out of the womb before he or she was clearly ready and then their baby lie in the radiant warmer requiring intensive care therapy. Most babies come when most babies are ready. The hard part is you can never go back in time and see what would have happened had you chose the other route. What you can do though, is educate yourself with all sides of the equation and not just listen to what your Obstetrician or Certified Professional Midwife is telling you. I feel for you mommas, with the added pressure stacked upon your shoulders to make already difficult decisions during this time. However, I am excited for you mommas as you are leading women into a new change and new era for birth, informed and EMPOWERED birth, where all women and partners are looking at birth with new possibilities and taking new responsibility for their education and outcomes.

Ultimately, you have three choice when it comes to your place of birth: hospital, birth center, or home. Who will be at your birth is also determined by your place of birth. There are pros and cons to each location for labor, I will briefly discuss all of these variables below, but please, do more research, don’t just stop here. Talk with friends or family who have experienced multiple of these variables. Read evidence based research that will give you many of the statistics to make your best informed choice.

Hospital birth: Perhaps my sentiments for choice of birth place rang through a little biased throughout this dialogue but please do not get me wrong, I LOVE attending hospital births! We need hospitals to give birth in. Over time we have changed as humans. We sit at desks or on sofas watching TV instead of bending and squatting in fields which compromises our pelvic outlet structure and body tone. We eat, breathe, and come into contact with foods and chemicals that create inflammation and hormonal imbalance in the body. Our modernized world is an amazing but at times consequential place. Thankfully, we have medicine to save lives from adverse outcomes like a cord prolapse or a uterus that has gave it’s all and now just needs help (pitocin) and the mom needs a rest (epidural). Thank goodness for operating rooms to perform a caesarean on a mom who medically would risk her life by giving birth vaginally. Thank goodness for hospitals that ALWAYS have nurses, midwives, obstetricians and hospitalists there to assist any woman at any time rolling into the ER. Hospitals are necessary, should they be our norm?

Birth center delivery: If you would like a more holistic, approach to your pregnancy then midwifery care at a birth center is a great fit for you! The same equipment a midwife has at a home birth is standard in the birth center as well as the hospital; except you lack an operating room and certain medications, like an epidural. However, the approach to labor is more trusted, less on a time clock than in the hospital. There have been many birth center births I have thought “thank goodness this momma is not at a hospital, she would have been cranked up on the pitocin and most likely negated the natural birth outcome she desires.” I have also in the same space thought “my goodness if this momma could get an epidural that may save her from complete exhaustion, maybe a transfer is in her best interest.” It is not a perfect world, but your mindset and preparation leading into the labor makes all the difference. If you have already made up in your mind you are going to deliver this way in this location, you will most likely set that intention into motion. Birth is full of variability, birth is unpredictable. However, more times than not a momma’s mind is in complete control of the outcome she will have. One last mention about why families choose birth centers are simply for the reason they would like a home birth feel just not in their own. It is kind of like giving birth then leaving your hotel room, some love it, some would rather be elsewhere. The biggest challenge with birth centers in the availability of a well renowned birth center in your area.

Home birth: 85% of pregnant women are considered low risk. Home birth is appropriate for all low risk women. The United States is the odd and not the norm when it comes to home birth not being a reputable standard. When I worked in the NICU we would hear the nurses all the time say “here comes another home birth train wreck” when in reality that adverse outcome would have likely happened anywhere. Furthermore, if the hospital room gives the mom the heebie jeebies and she is going to be crawling out of her skin the entire labor, anxious about any hospital acquired infection, then she will in fact not be in the most optimal place to give birth with an elevated blood pressure and high cortisol pumping through her veins. Home birth is not naive, selfish, or criminal. Home birth is also not for everyone (example: women with high blood pressure or diabetes).

Birth is not black and white, a one size fits all model. We simply cannot separate the experience from the outcome. Let us allow birth to become as simple as a choice as where you prefer to shop for groceries. You do not judge your neighbor for unloading his Sam’s Club grocery haul as you carry in yours from Costco. You simply respect and trust you made your best decision based upon your own education and experience. Both options will yield beautiful fruit, both options could result in positive or negative outcomes.

Ladies it is an unprecedented time for birth as well as health care. This global pandemic has highlighted weaknesses in our health care system as well as raised awareness to taking chronic health conditions way more seriously. This pandemic has also raised awareness to other means of giving birth to new beginnings in our lives. Birth is where a woman can go to find her power. I am so pleased to see this season in our world begin to expose women to choices and opportunities she never dreamed possible for herself.

The last thing I will leave you with is the importance of having the right team at your birth. No matter where you are laboring hiring a doula to be at your side will be PIVOTAL in your birth outcomes. Think of it this way, if you were preparing to run a marathon wouldn’t you rather have someone there to run with you every step of the way and coach you through the upcoming hills and obstacles? That is what a doula can do for you. Your midwife or doctor is focused on the mechanical operations of the birth (as well as coaching you) like making sure there are no road closures up ahead or they can safely receive baby as he/she crosses the finish line. Hiring a doula for your hospital, home, or birth center experience is in your best bet. {With the current situation most hospitals are not allowing doulas, some are not allowing a support person, please take this into consideration when choosing your prenatal care. Women should not give birth alone or without the support she requests!}

If you need assistance with hiring a doula for your birth, or need financial options, please reach out to KC Women’s Ministry for more information. We have doulas who can happily assist you in making sure you have the support you need at your birth.

This is your time ladies, I support you in any informed decision you choose. <3