Are More Expecting Mothers Choosing Home Births Due to the Covid-19 Pandemic?
A Talk with Certified Professional Midwife, Kim Rodriguez, About the Future of Birthing
Though it certainly felt like the world shut down during the Covid-19 pandemic, there was one thing that didn’t stop and in fact did not even come close to slowing down–and that was the birth of newborns.
According to UNICEF, “an estimated 116 million babies will be born under the shadow of the COVID-19 pandemic.”
That’s a lot of new life.
Of course, with all of the changes in health policies and safety protocol, there have been rising concerns on all sides of the aisle, from the skilled birth attendants (doctors, midwives, doulas) to parents themselves.
Now along with the everyday stresses that come with pregnancy and birthing, pregnant women and their partners have to consider other potential pandemic-centered realities. Concerns such as lockdowns and curfews, supply and equipment shortages, lack of available medical professionals to aid them, and what might happen if there is another rise in cases causing the health center or hospital they have chosen for their birthing experience to be overwhelmed with COVID-19 response efforts. [info from same UNICEF link, can link again if you want but not a direct quote]
Because of all of this, many moms-to-be are searching for alternatives–and many of these women are turning to at-home births with the aid of a midwife. There has also been a steady rise in pregnant women choosing to get the added help of a doula to guide them through the entire prenatal, birthing, and postpartum experiences.
We recently chatted via email with Kim Rodriguez, Certified Professional Midwife, at Way of Life Midwifery https://www.wayoflifemidwifery.com/ about life as a midwife and what she has seen in the ever-changing landscape of birthing and at home births in pandemic times. Kim has worked with The Happy Mama Place’s founder and doula, Jessica Ann, throughout the years here in northeastern Pennsylvania helping bring new life, wonder, and joy into the world.
An Interview with Midwife Kim Rodriguez on trends in birthing at-home
The Difference Between a Midwife and a Doctor
To start, could you please explain what the role of a midwife is and how a midwife is different from an obstetric care doctor?
Certified Nurse Midwives (CNMs) are medical professionals whose training included first getting a Bachelor’s degree in Nursing, and then a Master’s degree in Midwifery or Maternity Nursing. CNMs have some advantages: they can prescribe medication, attain hospital privileges, and file for insurance reimbursement.
There are also disadvantages: in most states, a CNM’s license agreement requires that she work within a written practice agreement with a supervising physician. Her working relationship with this physician is part of what legitimizes her practice. This physician defines the scope of her practice – what she can and cannot do as a midwife – and she practices under the “umbrella” of the doctor’s insurance policy (as well as her own). Therefore, her supervising doctor determines a lot about her services, including whether she can provide out-of-hospital birth services or not. Most CNM’s in Pennsylvania work in the hospital.
Traditional Midwives and CPM’s:
The term “Direct-entry midwife” (DEM) is the generic name for any midwife who entered the profession directly, without a nursing background. Such midwives are also known as Traditional Midwives. They get their training in two possible ways: First, they may attend a 2-3 year Direct-Entry Midwifery School. Women who attend these schools graduate with training and experience and are able to test to become certified as a Certified Professional Midwife (CPM).
Traditional Midwives gain their skills by the apprenticeship method – learning in a hands-on way from another, more experienced midwife. An apprenticeship can last from 2–8 years, depending on the busyness of the practice, and the apprentice graduates into full midwife status when both she and her preceptor feel she is ready. If an apprentice chooses to become a CPM, a lengthy process of documenting a requisite amount of experience and skills followed by a hands-on skills exam and an 8-hour written exam are required. Completion of this process grants the Traditional Midwife the credential of Certified Professional Midwife (CPM).
Midwifery care is unlike medical obstetric care in many significant ways. These differences are not just in the superficial aspects. It is not that midwifery is more “touchy feely” – although it can be that – or that it provides more quality time to the client – although it certainly does that. The differences stem from a fundamental variance in the underlying belief systems that give birth to the two styles of practice.
The midwife sees pregnancy and childbirth as normal states for the healthy mother. Out of respect for the birth process and a woman’s innate ability to bear a child, the midwife believes unnecessary interference is an unwise interruption of the body’s functions.
Like a lifeguard, she carefully watches and guides, assisting the woman to give birth, respecting the choices and values of the family.
She is a skilled practitioner, giving care and advice to the mother during normal pregnancy, labor and birth, and caring for the mother and newborn following delivery. A midwife is trained to detect any abnormality in mother or child and refers to medical aid if necessary. In the absence of medical aid, a midwife is ready and willing to use emergency measures to the limit of her education and experience.
How Does a Doula Differ From a Midwife?
Could you explain some of the ways a doula works to compliment a midwife and how a doula is different from a midwife?
In the out-of-hospital birth setting, doulas can be very useful. Although it is unlikely that a client birthing in the out-of-hospital setting would need a doula to help her avoid unnecessary intervention or to advocate for her, a doula can be helpful in providing physical and emotional support to the laboring woman and her family during the birth.
While at a normal labor, the midwife and her assistant will be able to provide all of the assistance the woman might need, we can all benefit from the presence of a doula’s energy, experiences, and support.
When the mother is laboring well and doesn’t need extra support, she can also act as an extra set of hands…..taking pictures, running errands, preparing food, cleaning up, or doing whatever else might be needed. Read “Why Hire a Doula? 5 Benefits for Expecting Moms” to learn more.
The saying “two heads are better than one”….is a good motto. Sometimes three heads are even better!
A midwife, doula, and assistant can prove to work in a very synergic way to accomplish an optimal outcome for Mother and Baby.
I strongly encourage every first-time mother to consider having a doula with her for her birth, as first time labors tend to be more lengthy and mothers tend to need more support.
The Rise in Home Births Due to Covid-19 Pandemic
Have you noticed a rise in the desire to give birth at home since the pandemic started?
YES! Not only are women wanting to avoid giving birth in the hospital due to risk of being infected, many women are concerned about the restrictions placed upon them.
The possibility of only having one support person during labor, the risk of strict hospital mandates that vary from hospital to hospital, concern over having to wear a mask while in labor, fear of their baby being taken away for a quarantine period if mother tests positive for Covid, fear that if their partner steps out, they are not allowed to return. These and more, are all factors that women have stated as reasons for not wanting to birth in the hospital at this time.
Keeping mother and baby safe are at a heightened level, but at the expense of sacrificing the overall birth experience. Home birth eliminates many of those factors because the family is in their own environment with minimal risk of infecting or being infected by others. This gives the family the best chance of having the experience they are hoping for.
At-Home, Birthing Facility or Hospital Births?
If a mom-to-be desired to give birth at home or at a birthing facility instead of a hospital, what would be the steps or protocol they should follow?
Educate! Learn as much as you can about home or birth center birth. How is it different, what can or can’t be done in those settings as opposed to traditional hospital birth, will insurance cover care, what are your responsibilities, etc…?.
I would suggest speaking with more than one midwife.
One of the best things about hiring a midwife or doula (instead of a “group”) is that YOU CHOOSE who is best for you!
It’s imperative that you feel comfortable with your choice and that you respect the competence of the provider you choose to be with you on your journey.
Lastly, have open communication. Talk through everything that comes up or that concerns you. Working through issues ahead of time, will help insure a less stressful labor.
Advice on Navigating Pregnancy During the COVID-19 Pandemic
Do you have any helpful tips or suggestions for moms-to-be on how to navigate pregnancy particularly during pandemic times?
Diet, exercise, mental, and emotional health are all key areas of focus during any pregnancy. During this time, however, those can become pushed to the side due to inconvenience or disruptions to our everyday life. Now, more than ever, we must be diligent to keep emotional support, friendship, and meeting the individual needs of each woman for a healthy pregnancy first and foremost. Although maybe not as convenient, thankfully, exercise, phone calls, instant messaging, socializing safely, and access to help are all possible. I would encourage all pregnant women to familiarize themselves with the recommendations for pregnant women during the pandemic. No decision that affects your pregnancy should be taken lightly.
Doing What’s Best For You and Your Baby
Is there anything else you’d like to touch on or talk about that we haven’t asked?
No matter what birth venue you choose, do not just blindly take your midwife’s/doctor’s/doula’s advice on decisions that you are faced with. Ask questions, research, and weigh your options. Ultimately, you have the responsibility and the right to make the choices that are best for you and your baby!
Helping Hands to Navigate You Through Pregnancy, Birth, & Postpartum
If you’re a mom-to-be and have questions on how to have an empowering birthing experience with the help of a midwife by your side, please visit The Way of Midwifery website https://www.wayoflifemidwifery.com/about-me or Facebook Page https://www.facebook.com/MyHomeBirth to find out more.
If you’re an expecting mother who is looking for additional support from a doula, curious about the benefits of placenta encapsulation, or want to ease pain, tension, and stress with a prenatal massage, check out The Happy Mama Place for all the ways we can help make your pregnancy a holistic and joyful experience. https://www.thehappymamaplace.com/prenatal-support/