Across the country, COVID-19 has pregnant families reassessing their birth plans and questioning whether home birth is a safer option.
As COVID-19 continues to silently and aggressively spread from person to person, home births have become a compelling option to many pregnant people who’d previously planned to give birth in a hospital.
As reported in news outlets such as The New York Times and Chicago Tribune, midwives across the country are experiencing a surge of interest in home births. Pregnant women are reconsidering their birth plans, especially as local COVID-19 cases rise and hospitals enact new policies surrounding birth and newborn care.
In some cases, hospitals are limiting support for birthing people, mandating inductions of labor or C-sections, or separating babies from mothers who are suspected to have COVID-19.
Some of these changes can lead to an increase of negative outcomes, notes a 2017 analysis showing that limiting birth support can increase the chance of medical interventions.
Likewise, separating moms and babies at birth can have a negative impact. Skin-to-skin care and breastfeeding have major health benefits, for the short- and long-term health of babies.
These benefits are particularly relevant during the pandemic, as both improve a baby’s immune function. The
As a result of policies like these, families are weighing their options. Cassandra Shuck, a doula in Charlotte, North Carolina, says she’s seen a surge of interest in at-home births within her community. Each day, new pregnant women reach out inquiring about how they can secure an at-home birth professional during the pandemic.
“Physiologically speaking, with all that’s going on, the mama-to-be may feel more comfortable in an environment where she has more control,” Shuck said.
Given the increasing interest in home births, the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recently released statements claiming that hospitals and certified birthing centers are the safest place to have a baby.
The AAP also published safety guidelines for those planning to give birth at home, along with who is considered to be a good candidate for home birth.
Here’s what to know about home births if you’re considering it.
Most health experts agree that people who want to give birth at home should have a low risk pregnancy.
According to Dr. Jessica Illuzzi, the section chief of laborists and midwifery at Yale Medicine, nearly 80 to 90 percent of low risk births can occur without complications.
“Most women who are full term, have a single baby who is head down without other significant medical or obstetric problems may be a candidate for home birth,” Illuzzi said.
The other 10 to 20 percent of cases, however, may have an obstetric complication and need to be transferred to the hospital for further medical assistance, she noted.
The AAP also recommends that pregnant women giving birth at home should be at least 37 weeks pregnant (less than 37 weeks’ gestation is considered premature), and that each woman has a healthcare team of at least two people — one of whom must be responsible for the health of the newborn.
Additionally, women who are considered to have a higher risk pregnancy — such as those with diabetes, preeclampsia, a previous Cesarean section, or carrying multiple fetuses — should consider giving birth in a healthcare setting, as they may develop life-threatening complications.
“For women that are in this high risk category, I do highly suggest considering a hospital or a birth center,” Shuck said.
If you’re contemplating a home birth, Illuzi says it’s crucial to understand all the capabilities, limitations, risks, and benefits of giving birth at home.
Talk to your birth specialists and understand what medications and equipment they’ll have available, along with their background and skills.
If you decide to move forward with a home birth, health experts recommend having a plan in place in case you need to be transported to the hospital.
The vast majority of low risk pregnancies will have positive outcomes at home, according to a
That said, some women may experience unanticipated complications — such as postpartum hemorrhage or a sudden drop in the baby’s heart rate or oxygen levels — that could require transport to a hospital.
According to a 2014 study published by The Midwives Alliance of North America that examined the results of almost 17,000 home births, approximately 11 percent of laboring mothers were transferred to the hospital. Most of these cases were transferred not because of emergencies, but because labor was not progressing.
Home births are even safer for those who have previously given birth. According to ACOG, about 4 to 9 percent of pregnant women who’ve previously given birth will need to move to hospital. This number is a decrease from the 23 to 37 percent of first-time moms who need intrapartum transfer to a hospital.
Still, in coronavirus “hotspot” areas, emergency services may be delayed. Also, the AAP suggests that giving birth close to a hospital is key in the event a complication occurs; having to travel more than 15 to 20 minutes to a medical facility has been associated with adverse outcomes for baby, including death.
One of the main reasons pregnant women are considering home births is due to the fear of contracting COVID-19 in a hospital.
Illuzzi stressed that hospitals, like those affiliated with Yale Medicine, in New Haven, Connecticut, are working diligently to “create safe settings for women to give birth.” Hospitals have increased safety precautions for pregnant women and newborns to limit any chances of exposure.
“Many hospitals have created areas strictly for COVID-positive mothers and staff assigned to work with these mothers do not care for other patients,” says Illuzzi.
Additionally, most staff members wear N95 masks, eye shields, gowns, and gloves if and when they expect a patient to have the coronavirus, Illuzzi said, adding that surfaces are cleaned and disinfected routinely to prevent infection.
If you’re interested in giving birth at home, talk to your doctor or midwife and share your thoughts and concerns with them.
They’ll be able to evaluate both the maternal and fetal health of your pregnancy, and identify any risks you should be aware of.
Shuck advises against unassisted home births. If you choose to give birth at home, make sure you have a certified birthing team by your side with the proper tools and equipment.
Do your research, weigh your benefits and risks, and prepare.
“This is a very personal choice and one that they should be talking about with their partner and birthing team,” Shuck said.
Julia Ries is an LA-based writer who covers health and wellness for HuffPost, PBS, Girlboss, and the Philadelphia Inquirer, among others. You can see her work at her website www.juliaries.com.