Beginnings Matter: A COVID-19 Response

Be still. Find your breath. Inhale. Breathe deep into your womb space. Exhale. Let go of fear and uncertainty. Inhale. Exhale. Inhale again. And repeat. Know that you are safe, your baby is safe, you are alive, and you are not alone. 

These times are different. There are many changes, but yet again, we are feeling universal homeostasis return in many ways. We are returning to ancient traditions + herbal medicine. We are connecting more than ever despite social distancing. We are helping each other. We are spreading love. We are in this together and we will make it out of this together. 


As a birth keeper, there are many unsettling words being tossed around about our current reality of this viral pandemic, or COVID-19. I’m a researcher. I like the facts. Statistics excite me. I like to know EVERYTHING about the THING. I encourage you to do the same.  As an apprentice in a busy midwifery practice, we have been extremely busy and working diligently to facilitate many changes in how we practice in response to this pandemic. We are planning for an influx of hospital transfers. We are writing protocols, and have the utmost respect for the vast nature of this virus and how it’s affecting our work. Our highest priority is safety. So as a researcher, I’ve been trying to get my nose in as much research and conversation pertaining to pregnancy and childbirth as I can. There is a common (unfortunate) theme that I am noticing, and that is “we just don’t know…”. It is accurate to say that there is not enough research on COVID-19, pregnancy and birth, but as Aviva Romm says, “what we do know is reassuring.” There are many amazing resources that I’ve found that are proving really helpful to not just birth workers like myself, but birthing parents. There is a lot of information, and it’s seemingly overwhelming to say the least. I’d like to share what I can with you, so without giving you all of the numbers here are a few resources that I’ve gathered together for you:


For providers 

https://nacpm.org/coronavirus-midwives-on-the-front-line/

Training and up-to-date information for home-birth midwives.


For birthers + providers: Evidence Based Birth COVID-19 Resources

https://evidencebasedbirth.com/covid19/?fbclid=IwAR3sBqkoNHadlB9KEOrBbc8FR7h8L4Cjy34x3l5LM83yLMIg7fq-wrUGKaI

  • On the EBB homepage, there is a link to a COVID-19 Community Relaxation Session – take time to process and breathe in community with others! 
  • Sign up for updates on the latest research surrounding this.
  • Links to public health organizations that further expand on research and recommendations. 
  • EBB states that, to date, there is NO evidence of parent-to-baby transmission of this virus.

https://avivaromm.com/category/covid-19/

Some things I pulled from Romms resource:

Women, including pregnant women, experience less severe reaction than men 

Pregnancy does increase susceptibility of respiratory viruses, but if contracted, COVID-19 seem to be generally mild to moderate 

  • Babies born to a mother with confirmed COVID-19 are generally healthy 
  • Prevention is essential, especially for pregnant persons with chronic illness or pregnancy complications 
  • Be very diligent about hand washing and avoiding exposure as much as possible 
  • It is still unknown whether the virus increases adverse outcomes such as preterm birth, but fever in the first trimester may be associated with adverse outcomes therefore a maternal fever of 102.2 F or above using a fever reduced to bring the fever down is recommended to reduce effects on the fetus. Tylenol is recommended. Discuss with provider before use. 
  • Babies born to moms positive at birth did not test positive at birth for COVID-19. Right now, it does not seem that this virus is transmitted to babies in utero. However, babies can and have been infected with this virus. How is still the question. 
  • In a China study, of nine babies that tested positive after birth, none of them had severe complications. 
  • Expanded screening for pregnant persons is still needed 
  • There are many precautions your providers are likely taking to reduce the risk of exposure to their clients and to themselves. Some are doing telemedicine visits, some are consolidating visits, some are limiting the number of people they see in person or spreading out visits from 4 weeks to 6 weeks for clients in their first and second trimesters. Ask your provider what steps they are taking during this time. 

(Closing thoughts, inspired by the resources here)

 

There are many suggestions that birthing at home over the hospital will reduce the risk of infection or exposure to both the birthing person and their baby. There is a lot of truth behind this, no question, but I am biased in this regard. Research supports that home birth is shown to be generally safer than hospital birth for low risk pregnant persons. IF you are choosing to switch from a hospital birth to a home birth, please consider all of your WHYs. Sit with it. Meditate on it. Do not react out of hysteria and panic. I advise against making the switch out of pure fear. Homebirth is a major commitment, physically, mentally, emotionally, financially and socially. If you are considering a homebirth, please reach out to me or another birthworker to discuss all of what that means. 

 

If you are unsure but considering a home birth here are a few suggestions: 

 

  • Obtain a copy of your hospital records, including all labs, ultrasounds and additional testing. 
  • Order a birth kit. You can find a basic home birth supply list here. If you have a midwife in place, reach out and ask them if they have a kit they want you to purchase.
  • Make + have on hand a birth plan. Consult with a doula. Our Flourish doula, Jessica, is ready and willing to help you with this. You need to know all of your options, especially if you were planning on an epidural. 
  • Be ready to cover the cost of a potential home birth. Some midwives are offering a late transfer rate, and home births generally cost between $3,000-$5,000. (based off of Southwest Missouri)

 

If you need more help in deciding what setting to birth in, I am willing to help walk you and your support person through the shared decision making process. Together we can weigh the pros and cons, benefits and risks, and allow further opportunity to explore more of the research. 

 

I am available for complimentary consults – no cost to you – to help navigate this time of uncertainty and heaviness. Small disclaimer: I do serve in a busy homebirth practice, and have limited availability as far as how many “outside” births I attend a month, so reach out as soon as possible! I am available for virtual and in person support. 

 

 

To reduce the risk of COVID-19, I do believe the hospitals are doing all that they can (and working tirelessly) to put safety protocols in place for birthers. Our goal as midwives is to keep mamas and babies safe, and I believe this to be true for hospital obstetrical providers, as well. Do keep in mind, however, that if you are birthing in a hospital setting, you may be forced to make decisions that you are not ready to make. You may also be limited to the amount of support persons you have present in the hospital (at least local to me this is true). If there are limitations to in-person labor support, consider a virtual doula. There is NO law that says you cannot do this!

 

It is also recommended that if you are considered low-risk to labor at home as long as possible before going to the hospital. If you are faced with these possibilities – making decisions, limited support, or doing the majority of your laboring at home – Flourish is here to support you. As a primary midwifery apprentice and Monitrice, I would love to provide you reassurance and support in any way that you may need. If you are planning to labor at home before going in to have your baby, I can support you in-person or virtually. 

 

As midwives, we tend to keep working when we are sick, and Doulas do the same. To mitigate exposure, It is appropriate to ask your chosen support person if they have been exposed, are exhibiting any symptoms, or are sick before they see you. If you have a doula, or another support person, it is wise to have a back-up plan in case they are exposed or get sick. The Flourish team is here to back you up. 

 

These times can be very unsettling for pregnant persons, but one thing is certain: beginnings matter. Firsts matter. You matter. Your baby matters. Your partner matters. And your birth matters. Your story matters. Find peace in knowing that you do not have to go at this alone. There are wonderful resources in place ready to provide reassuring and positive support to you and your family. Nobody should feel alone, unheard, unseen, or fear that their story is somehow automatically tainted because of this pandemic. Don’t buy into that.

 

You are loved. 

 

Be well,

Cassi

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