COVID-19 is upending many aspects of life, including the beginning of it.
Hospital birthing centers in the region have changed policies, sometimes quickly, limiting how many people can attend a birth. The goal is to protect the mother, baby and health care workers. This is driving up demand for home births.
Emma Donnelly is pregnant with her first child. She is due is early May and said her baby is really active.
“Suddenly, there's some stretching and the legs just start poking out," she described. "Like sticking right out of me!"
Donnelly said this is the baby’s way of saying, "I’m strong."
She planned to have her baby at Baystate Franklin Medical Center, because she said friends have had great experiences giving birth there.
"They were supported and taken really good care of and listened to and respected," she said.
Donnelly herself was born at home. At age 10 she watched her brother come into the world in her mother’s bed. But she felt a hospital birth was best for her.
"Somehow I had always thought that I would feel safe and more relaxed in a hospital just because I am a little more nervous, like things can go wrong," Donnelly said.
But in the last few weeks, the birthing landscape has changed rapidly because of the risk of the spread of the coronavirus. Amy Walker, director of midwifery at Cooley Dickinson Hospital, said previously there were few restrictions on who could attend a birth.
"Sometimes we [would] have a whole room of joyful family members and friends that are there to greet the baby," Walker said.
But now Cooley Dickinson, Berkshire Medical and Baystate Health allow only one support person to be at the birth. It can be a spouse, mother, doula, but only one — and only if they’re healthy.
For a period of time, Baystate Health required the support person to leave two hours after the baby was delivered.
"The concern was that the number of hours that someone was in the room and potentially exposing health care workers to the virus," said Heather Sankey, chair of Baystate’s Department of Obstetrics and Gynecology.
Sankey said in late March, the hospital shifted back. It now allows the support person to stay until the mother and baby are discharged, but they cannot leave the room and come back.
"Because they may become exposed during that time. And another reason is it can be very difficult to track. So we bring them food. We feed, obviously the patient, and also the significant other. And I think this has made a big difference," said Sankey.
Around the same time that Baystate’s policies were shifting, some New York hospitals stopped allowing any visitors, including the spouse or partner. (The state later overruled the hospitals.)
Emma Donnelly, who wants her partner at the birth, was concerned that might happen in western Massachusetts.
"It was the thought that perhaps my partner wasn't going to be able to attend the birth. And I just — I think that's the worst thing to do. I'm sorry, but it's terrible," she said.
So she's leaving the hospital for a home birth. Her partner and mother can be with her, but it wasn’t an easy decision, in part because of the cost. Donnelly said a hospital birth would have been covered by her insurance, but not a home birth — which typically is about $4,000. Then her sister jumped in.
"My sister did a fundraiser and that was, like, incredible," Donnelly said. "We raised $2700 on Facebook."
Donnelly is not the only one switching to home birth.
"All of us are at capacity," said Jharna Harvey-Ahmai of River Valley Midwives.
Harvey-Ahmai has been delivering babies at home for 28 years, and said home-birth midwives are stretched to their max.
Normally she would schedule three or four births a month.
"So we had three in April; we now have six in April. We had two in May; we now have six in May," she said. "And we were getting more calls."
The Massachusetts Midwives Alliance estimates there will be a 10 to 15% increase in home births this year compared to last. But Harvey-Ahmei said even if someone says they’re afraid to go to the hospital, she’s being careful.
"Making sure we were screening for low risk," she said. "Not everyone is meant to give birth at home."
Health care providers are also seeing pregnant women compare the policies of different hospitals, and consider switching, said Baystate's Sankey.
“Everybody was seeing a lot of women trying to shift around, reconsider their options, and that's really not the best thing for anybody," she said.
But most women are sticking with their plans to deliver in their hospitals — like Naila Moreira, who teaches science writing at Smith College. She's having her baby at Cooley Dickinson.
"I’m a first-time mom," Moreira said. "It feels very scary and new to me. And my partner is going to be a first-time dad. It's all very scary and new to him as well."
Moreira said he will be there with her, and that means she can’t have her doula, but she trusts the midwives at Cooley. At the same time, she’s aware her due date in early May could coincide with a jump in the number of coronavirus patients at the hospital.
"I'm concerned that the medical staff at the hospital could be pretty distracted caring for cases of coronavirus," she said. "And that they could really be in a real emergency state of mind, at a time that I'd really like to have calm, collected people around me."
Hospitals are trying to address that. Cooley Dickinson midwives, who typically work 24-hour shifts, now work half that. Amy Walker, director of midwifery, said the change is for two reasons.
"One, be able to preserve immune function for us," Walker explained. "And then also it's much easier to be present and supportive at 3 a.m. if you're only working 12 hours, rather than if you're working 24 hours and you’be been up for that whole time."
At Berkshire Medical Center, Lauren Slater, an OB-GYN, said she wears personal protective gear during a delivery. Even so, she can’t social distance — and do her job.
"It's a very physical thing," Slater said. "There's no way to put physical, distant distance between you and the patient when you're doing a vaginal delivery."
Even when she’s covered with a mask, face shield, gown and gloves, Slater said delivering an infant is still magical.
"The look on the mother's face when you hand her the baby, will bring tears to your eyes," she said. "And right now, we continue to do that without regard to the other things that are happening around us."
Slater said to further protect a mother and baby, Berkshire Health is discharging them quicker —sometimes in half the time — as long as they’re stable and comfortable going home.
