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With COVID-19 hitting hospitals hard, home births are on the rise

Jasmine Garsd Nov 20, 2020
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Home births were the norm at the turn of the previous century, and so were midwives, said historian and nurse midwife Michelle Drew. Courtesy Michelle Drew
COVID-19

With COVID-19 hitting hospitals hard, home births are on the rise

Jasmine Garsd Nov 20, 2020
Heard on:
Home births were the norm at the turn of the previous century, and so were midwives, said historian and nurse midwife Michelle Drew. Courtesy Michelle Drew
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Back in March, when New York City issued its lockdown order, Kimm Sun got a voicemail from a pregnant woman she’d never met who was due any day. “You could tell the woman was having a panic attack in the middle of the call,” she said. “Just, the desperation was everywhere.”

Sun, a midwife, said the expectant mom was too scared to go to the hospital. Sun specializes in home births. She said that as hospitals overflowed with COVID patients, she started getting close to 40 calls a day on some days. That’s around how many patients she sees a year. “Suddenly it just hit us, like a tsunami. We didn’t know what to do. The home-birth community became completely swamped,” Sun said.

At-home births have been getting more popular for a while but are still only about 1% of deliveries. Sun thinks the COVID spike will level off, but with only a little more than 12,000 certified nurse midwives in the U.S. right now, many say they’re overwhelmed. 

Historian and certified nurse midwife Michelle Drew said home births were the norm in the late 19th and early 20th centuries. And so were midwives. “Ninety percent were Black women, and 10% were ethnic immigrants,” Drew said. “Physicians still really weren’t attending births because it was not considered important.”

Midwives at their graduation from the Midwife Institute at Florida A&M College. It was the only hospital in Tallahassee that served Black patients during segregation. (Photo courtesy of State Archives of Florida)

By the 1900s, the American public hospital system was taking root, and the narrative changed. “They essentially demonized the midwives,” Drew said. “‘Why would you possibly want some dirty, old Black woman who is probably not literate, when you could have a physician?'” 

Giving birth is certainly safer now than it was 100 years ago, but the U.S. now lags behind other wealthy nations when it comes to pregnancy care. And maternal mortality rates have been rising. 

Nurse midwife Kiki Jordan said the pandemic hit as more people were talking about Black maternal mortality rates. (Courtesy Kiki Jordan)

Studies show hospital births are safer overall, but there’s evidence women with low-risk pregnancies can deliver safely at home. One of the reasons mothers choose at-home births is that they don’t feel they will be heard or taken care of in a hospital setting. 

It’s particularly a concern for Black women, who have two to three times the maternal mortality rate of white women. Kiki Jordan, a certified nurse midwife, said she’s received a lot more calls from Black expectant mothers. “COVID hit right around the same time that lots of people were starting to talk, and there was a lot of awareness gained about outcomes for Black women and Black babies in the hospitals,” Jordan said. “The combination of those two things — definitely we’ve seen people actually taking the leap and choosing out-of-hospital birth. It’s been like nothing I’ve ever seen before.” 

This was on Brittany Dandy’s mind when she found out she was pregnant in March. “I was pregnant for the first time, there’s a worldwide pandemic, New York City health care is completely falling apart and every headline I read is specifically about Black women, maternal health and COVID,” she said. “I knew that I needed to advocate for myself, more than other women.”

Black women’s maternal health risk and COVID’s impact on New York hospitals influenced Brittany Dandy’s decision to give birth at home. (Courtesy Brittany Dandy)

She also had to consider price. Even with insurance, labor and delivery cost an average of $4,500 out of pocket. And not all insurance plans cover at-home births, which cost anywhere between $4,000 and $8,000.

In the end, Dandy’s plan did cover a home birth, so she got in touch with Sun, the midwife in Brooklyn who was starting to get that tsunami of calls from all over the city. Sun was having to turn away women who were nearing labor. But she said she is aware of the disparities affecting pregnant women of color. “If you are a Black woman, we are going to prioritize you first because we know that it’s going to be harder for you to get help,” Sun said.

On Nov. 8, a cool autumn night, Dandy went into labor in her living room with Sun, her husband and a giant sign bearing the family mantra: “To be Black, and love fully, is both a beautiful act of freedom, and resistance.”

The pandemic was raging on, presidential politics remained heated. But Dandy said none of that was on her mind when, in the quiet of her home, she gave birth to a girl, Aspen James.

COVID-19 Economy FAQs

So what’s up with “Zoom fatigue”?

It’s a real thing. The science backs it up — there’s new research from Stanford University. So why is it that the technology can be so draining? Jeremy Bailenson with Stanford’s Virtual Human Interaction Lab puts it this way: “It’s like being in an elevator where everyone in the elevator stopped and looked right at us for the entire elevator ride at close-up.” Bailenson said turning off self-view and shrinking down the video window can make interactions feel more natural and less emotionally taxing.

How are Americans spending their money these days?

Economists are predicting that pent-up demand for certain goods and services is going to burst out all over as more people get vaccinated. A lot of people had to drastically change their spending in the pandemic because they lost jobs or had their hours cut. But at the same time, most consumers “are still feeling secure or optimistic about their finances,” according to Candace Corlett, president of WSL Strategic Retail, which regularly surveys shoppers. A lot of people enjoy browsing in stores, especially after months of forced online shopping. And another area expecting a post-pandemic boost: travel.

What happened to all of the hazard pay essential workers were getting at the beginning of the pandemic?

Almost a year ago, when the pandemic began, essential workers were hailed as heroes. Back then, many companies gave hazard pay, an extra $2 or so per hour, for coming in to work. That quietly went away for most of them last summer. Without federal action, it’s mostly been up to local governments to create programs and mandates. They’ve helped compensate front-line workers, but they haven’t been perfect. “The solutions are small. They’re piecemeal,” said Molly Kinder at the Brookings Institution’s Metropolitan Policy Program. “You’re seeing these innovative pop-ups because we have failed overall to do something systematically.”

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