Laura Adkins was six months pregnant with her third child when she decided to have a home birth.
It’s an option that many pregnant women are contacting midwives about in light of the COVID-19 pandemic.
For some, it’s the fear of possibly being exposed to the new coronavirus in a hospital. For others, it’s the fear of being separated from their newborn if either mother or child is ill.
And for some, such as Adkins, it’s because if she labored and gave birth in a hospital, she would have to do it without the doulas who have gotten her through the births of her two older children.
“I didn’t make the decision because I was scared of COVID-19. I made the decision because every labor and delivery I’ve had has been about experience, because of the doula team,” said Adkins, 34, of Hilliard. “I heard (hospitals) were only allowing one support person. … Knowing I couldn’t have my doula support, that literally flipped everything for me.”
Adkins, ahead of her July 15 due date, talked to her doula about the possibility of a home birth and was told it would be a good option for her because her second child, daughter Sienna, now 18 months old, was born without Adkins receiving an epidural. After talking to her husband and praying, she decided to go ahead with it and booked Eliza Kay, a local midwife.
A doula supports the mother emotionally, mentally and physically during the birthing process but does not handle the medical part of delivery. A midwife has medical training and delivers the baby.
Kay said she has been inundated with website inquiries and calls from women who wanted to switch from a hospital birth late in their pregnancies.
“I’m not super surprised,” Kay said about the increased inquiries about home births. From mid-March to the end of April, she had 48 email inquiries, a jump from the usual five to 10 a month.
She has been cautioning some women about the decision to have a home birth — without painkillers — versus a hospital birth.
“I have had conversations with people that they shouldn’t be planning an out-of-hospital birth out of fear of hospitals,” Kay said. “It needs to be a decision that resonates with them.”
To qualify for a home birth, people must have a low-risk pregnancy, she said.
“We don’t have an operating room down the hallway,” Kay said. “For most people, birth is safe, but people need to understand they are taking on additional risk.”
While he understands why women might inquire about home births in light of the pandemic, OB-GYN Dr. Jason Melillo says the situation in Ohio hospitals is much different from what people might fear based on what they see in other cities and countries.
“We are not anywhere near the number of patients they are seeing in New York City,” said Melillo, OhioHealth’s medical director of women’s health and an OB-GYN at Avina Women’s Care, a private practice with several central Ohio locations.
In a week in late April, OhioHealth had 65 confirmed coronavirus cases in all 12 of its hospitals, he said. All those patients are isolated in designated wards of the hospital, and no staff member handles both maternity and COVID-19 patients.
“Hospitals are probably safer now even than they were before the outbreak,” Melillo said, citing decreased foot traffic, the screening of every person who enters, and masks being worn by everyone in the hospital. And hospitals have plenty of rooms available, he said.
“My advice to pregnant women is to have an honest and frank discussion with their obstetrician if they’re considering having a home birth. They are a bit unpredictable, a bit away from help,” he said of such births. “I think the fears people are having that are steering them to a home birth are fears that are unfounded.”
For Adkins, the presence of her doula was so important that she began to consider home birth. She thinks it will be right for her because she’s had a natural birth before, and, in the past, the worst part of labor and delivery for her was leaving home to go to the hospital.
Aly Romot, a local birth doula, had one of her clients switch to home birth this month. The birth went well, Romot said, and she got to be with her client rather than linked virtually — the way she now works with clients who have hospital births.
Because Romot can’t be alongside many of her clients due to hospitals’ COVID-19 restrictions, she has doubled the number of prenatal appointments — now also conducted virtually — she has with clients and their partners.
Now, Romot trains each client’s support person to be a “mini-doula” in the labor and delivery room, she said. Part of that is anticipating the woman’s needs during labor and delivery, and also helping her move into more comfortable positions to facilitate more natural and easy birthing, Romot said.
To handle all the requests Kay has received, she has taken to answering with an apology.
“I’m sending the response: ‘I’m sorry, I can’t do it; all other midwives in Columbus are booked,’” she said.
Midwives can take on only so many births a month because they don’t know when the baby will arrive, and they must be present for all births.
Kay’s first responsibility is to the clients she has worked with throughout their pregnancy, and she has to make sure that she can be there for them before taking new clients.