January 2021

Giving Birth During a Pandemic

by Ashley Carone

The silver lining of the pandemic is the added layer of insulation that it gives new parents.

I gave birth at home during the pandemic. Here is why there has never been a more appropriate time to birth at home.

Because my first child was born during the 2013 Ebola scare, I was somewhat mentally prepared when this year, at six months pregnant, I heard the first reports of coronavirus. I never imagined it would escalate to its current state which has created a world far different than the one my older daughter was born into. And yet, because I chose home birth, my pregnancy, birth and postpartum experiences have been largely unaffected due to the choice I made to birth at home.

The pandemic has brought our family a gift. In shedding light on the many disparities that are present in our society- widening the gaps in areas of healthcare, poverty, education, able-ism, sexism, the list goes on, this great unveiling has also shown us what is ultimately important at the root of it all—family, human connection, relationships, nature and our health. If you find yourself pregnant or wanting to start a family in the midst of this, don’t let the most foundational human experience of our lives be marred by the virus. It still can be a beautiful and connected experience if you choose healthcare that supports it.

I want to paint a picture for you of how it can be to birth at home, versus the “that’s just how it is” in the western medical model of birth. Currently, prenatal appointments happen only when there is something clinical that needs to occur, like an exam or a lab test. These appointments are 15 minutes and you go alone. One of the most special moments in pregnancy is hearing your baby’s heartbeat for the first time. Do you want that to be over FaceTime or be holding your partner’s hand? Once you are in labor, you go into the hospital for triage alone and masked, subjected to temperature checks, exposure questionnaires and nasal swab tests, while having contractions. Only when you are deemed in active labor and admitted, is your partner allowed to be with you, and only your partner is allowed— no doulas, no family members. Depending on hospital policies, you are forced to labor while wearing a mask— heavy breathing and all. Your baby’s first visual of your face is masked, and all the hospital staff is masked and suited up, face shields, gowns, the works. It is a sterile environment and you are whisked in and out in as little time as possible to avoid excessive exposure. Once you are home, you are alone for six weeks straight before you are seen by someone who can support you in your postpartum period, unless you have money to pay for a postpartum doula to come to your house. When you take your baby to the pediatrician, it is another quick, sterile, masked experience, if you even go in person, many practitioners are doing everything on Telehealth that they can. I have heard that the infamous six-week checkup is often even done over Telehealth. A recent study on pre-pandemic vs pandemic postpartum depression showed rates were up to 40 percent from their previous 15 percent— I wonder why.

You could choose this reality, OR, you could choose something that is as old as humanity itself, birth at home, attended by skilled and licensed professional midwives. All your appointments are in person, either in their office or in your home, depending on which midwife you hire. Your partner as well as your kids or other family members are welcome at your appointments. You can listen to your baby’s heartbeat for the first time surrounded by people you love. When you go to your appointments there is no cold, sterile environment and front office to first pass through, no receptionist asking you questions about exposure and taking your temperature. You just go to the office, wear a mask of course, and have an entire hour to check-in with your midwife and chat about anything that is coming up for you during your pregnancy— stress, your relationships, supplements and herbs to take, your baby’s movement, dreams you’ve had, discomforts you’ve been experiencing, your visions for the birth- anything that comes to mind.

When it comes time to birth, you are home in the comfort and safety of the nest you have carefully built for yourself over the past months in preparation for your baby’s arrival. Your midwives come to you quietly and sit patiently at your side, present but not interfering or prodding. You and baby are taken care of and if anything starts to veer outside of what is medically safe, the hospital is always an option, but due to the preventative high-quality care that midwifery requires, it is rare, and if a transfer to the hospital is called for, it is usually done far in advance of anything becoming an emergency. Once your baby is born into your (or your partner’s) own hands, they are on your chest, never separated. Their first vision is your face beaming down at them in its entirety. The first words they hear are only your partner’s and yours. The birth is your own. After the birth you are cared for at home for several hours until you are stable and tucked into bed, fed and given instructions on how to care for your body and baby. 24 hours later your midwives return to check on you and baby, then three days later, a week later, three weeks later, and of course, the six-week appointment. All of these visits occur at home with the latter occurring in the office once you are back up on your feet. Your postpartum time is supported, and your midwives are licensed to provide medical care to both you and your newborn through six weeks.
I write this in great detail because many people are shocked to hear they don’t have to go anywhere after their baby is born, that the midwives come to them rather than the other way around. Isn’t that the way it should be? Your body just went through a marathon and it is time to rest! The silver lining of the pandemic is the added layer of insulation that it gives new parents. There is nowhere to go, nothing to do, no FOMO (Fear of Missing Out), and being at home is what is best for baby at this pivotal and delicate time of life.

I want you and your baby to have the best start to life possible, and I know that if more people knew about midwifery care, and if it were more accessible financially, it would be the more common choice. A midwife in Santa Cruz charges between $5000-$6000 for her entire package which includes all your prenatal care (about 15 hour long prenatal visits), your entire birth and postpartum care at home and often includes a tub for water birth as well as the service of being able to get your blood draws and other labs done in the privacy and convenience of her office. This expense may appear quite high if you look at it as one big chunk of money out of your pocket. I don’t know a single midwife in this town who would turn down a pregnant client with an earnest desire for home birth – and I know them all. Where there is a will, there is a way, I have known people to trade services for home birth fees, to take out lines of credit, to be gifted money from family, to receive miraculous checks in the mail that they were owed and forgot about, to create long term payment plans of a few hundred dollars a month, the list goes on. The average couple will spend $30k on their wedding, but when it comes to the birth for some reason the expense is not seen as valued.

There are also options for the same kind of close, supportive and personalized care for pregnant people who desire or require a hospital birth. Midwives can provide “co-care”, which means you get the high-quality preventive and personalized care face to face in the office for your pregnancy alongside your care from your obstetrician, have your birth in the hospital, and then the midwives come to your home to follow up and continue with your postpartum care. All pregnant people deserve this type of care, no matter where they end up birthing. Most midwives in the area offer this option!

I’m writing this to implore you to consider new choices for your pregnancy and birth- especially during the pandemic. There has never been a more appropriate time to choose home birth! There has never been a more pivotal time in human history to make the more human choice- to choose human connection, to invest in preventative healthcare, and to welcome these new babies in a way that is the most gentle and loving way possible.

Ashley Carone is a mother of 4 and senior apprentice midwife living in Aptos. 

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