Fearing Hospital Births, More Expectant Mothers Seek Out Midwives

May 6, 2020

Midwife Debbie Wong of Nine Moons Midwifery at a recent home birth.
Credit Courtesy of Sara Zia

Some people who would otherwise be fine with having a hospital procedure done are now avoiding the hospital out of fear of the novel coronavirus.  That includes some expectant mothers, more of whom are turning to out-of-hospital births. WMRA’s Jessie Knadler talks to local midwives about the surge of baby business, and the challenges they face.

As of the first weekend in May, there were nearly 500 confirmed cases of COVID-19 in Harrisonburg, according to the Virginia Department of Health. The city is among the regions of the state with the highest ratio of positive cases compared to population.

This has led to an uptick in phone calls to midwife Misty Ward, owner and clinical director of The Brookhaven Birth Center outside Harrisonburg. Over a single weekend, she says she received six calls from pregnant women seeking consultation, compared to about two consultations per month in normal times.

MISTY WARD:  They are afraid to walk into a hospital where the exposure is so much greater than being in the safety of their own home or in a facility that has no sick people in it.  

A decent percentage of callers are late transfers. Meaning, women in the third trimester who maybe were planning on a hospital birth. But given the city’s recent spike of COVID cases, are now having second thoughts. Late transfers aren’t ideal.

WARD:  But we’re making exceptions because of COVID.

Late transfers leave little time to develop the relationship that is foundational to the midwifery model of care. It’s why midwife and licensed physician Sarita Bennett of Winding River Birth Center in Charlottesville says she screens late transfers so carefully. She looks not only for potential complications, but she also wants to make sure the client isn’t coming to her based on fear of the hospital.

SARITA BENNETT:  It’s such a completely different model of care that you have to understand what it is you’re choosing. If they’re more wanting out of the hospital than they are choosing an out of hospital birth then that can be a higher risk situation with more likelihood that they’ll wind up in the hospital regardless.  

Like other healthcare providers right now, midwives have put pandemic-specific protocols in place: More virtual visits, limiting the number of people in the birthing center, taking clients’ temperatures before they come inside. Constant disinfection. Misty Ward again:

WARD: We’re having a really hard time getting basic cleaning supplies like, you know, I guess everybody is having this issue but … bleach and masks. We actually got 300 masks dropped off right before you called.

Ward says she’s only doing home births right now on a case-by-case basis, preferring the more controlled environment of the birthing center.

WARD:  There are more responsibilities when you have a home birth.

Sarita Bennett again.

BENNETT:  Anybody that’s going to have a home birth with us follows the isolation and decontamination protocols…we’re safe going to them, they’re safe having us there … it’s a bit of a community effort for everyone to follow those.

It’s one of the reasons why the American Academy of Pediatrics does not recommend home births. They and the American College of Obstetricians and Gynecologists recommend birth centers and, of course, hospitals as the safest bet.

The preference by the medical establishment for hospital births does not surprise midwife Debbie Wong of Nine Moons Midwifery in Charlottesville.

DEBBIE WONG:  They’ve never recommended it.

Wong welcomes the influx of interest.

WONG:  I almost feel like, well, you know, we should just welcome this. This is what we have been advocating for years.

Misty Ward wonders if this sudden interest will continue after the pandemic is over.

WARD:   It’s been very interesting for me to see so many woman having an interest in out of hospital birth now they have this external motivator of a virus but I’m wondering if after all this is over if home birth will become more mainstream if women are going to realize, oh, wow this safe option has always been there.

BENNETT:  I get most of my clients by word of mouth from other people I’ve served. So the more people who have home births, the more people will be influenced to consider doing it as well.

One big change midwives want to see: More streamlined credentialing. Right now, some states recognize some credentials, others don’t. It causes confusion and chaos as states such as New York, which has been hammered by the pandemic, try to bring in midwives from out of state to help with births. In her role as the president of the Midwives Alliance of North America, Sarita Bennett sees the problem.

BENNETT:  What people don’t understand is that this consumer demand is difficult to meet in a climate where there are trade restrictions against midwifery. It’s very much controlled by the people who say it’s not safe when it is.

Time will tell if the pandemic is what ends up mainstreaming midwifery.