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Health

The Coronavirus Changed Hospital Birth, So More Kansas City Women Are Opting To Stay Home

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Photo illustration -- Carlos Moreno
For women approaching childbirth in a pandemic, uncertainty about hospital policies has led more to consider home birth as an option.

People are still having babies, even in a pandemic. But where they feel safest giving birth has changed.

Having a baby is the ultimate leap of faith, an act of hope for the future in defiance of every logical argument in the other direction. Which is just one of the many reasons why giving birth in a pandemic is so disorienting. Particularly in a hospital, where unusual and hard-to-understand safety protocols serve as constant reminders that all is not right in the world.

Visitors aren’t allowed and masks are required, that much is understood. But just weeks from their due dates, as COVID numbers rise and experts warn that Kansas City is poised to become a hot spot, expecting mothers don’t know whether their partners will be allowed to be with them in delivery rooms. They worry about being separated from their newborns if they exhibit coronavirus symptoms or test positive. Doctors are preparing patients for anything and everything.

That appears to be freaking people out.

According to Google Trends, searches for "home birth" and "midwife" in Kansas and Missouri have spiked in the last couple of weeks, based on incomplete data. Kansas City doula Ashley Walburn, founder of Home Holistic, has seen multiple clients switch, very recently, from a hospital birth to home birth in the final stretch of their pregnancies. "That never happens," she says.

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This is a graph from Google Trends showing searches for 'home birth' in Kansas over the last year, as of September 10, 2020.
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This graph from Google Trends shows searches for 'home birth' in Missouri over the last year, as of September 10, 2020.

One of those clients is Jennifer Prudden, who became pregnant with her third child before the pandemic. "Everything went on lockdown right as I was starting my second trimester, just as I was finally ready to get out of the house a little bit," she says.

Prudden spent most of her pregnancy at home, maintaining contact with just a few relatives. Most of her friends and family never saw her pregnant.

She assumed at first that the pandemic would be under control in time for her August due date."Then everything kept getting extended," she recalls. "And I was hearing stories about dads not being allowed in hospitals. I don't think that was necessarily happening here, but things are changing every day. You can't plan for anything. You don't know what to expect. As we were getting closer, I was getting more and more anxious."

Prudden decided to bring a doula on board to support her through this strange new birthing reality. The hospital where she'd planned to deliver was still allowing doulas at the time. But four days after Prudden put that plan in place, the policy changed. Prudden's doctor tried to console her by letting her know the policy could change back again. But the uncertainty got to be too much.

"I just kept thinking, 'I don't want to do this. I'd rather just stay pregnant. I don't want to go to the hospital.'"

That's when she started researching home birth. She called a couple of midwives and talked through her health history and previous birth experiences. She was told she was a perfect candidate for home birth. Her only fear was that her husband would think she was crazy. She was already 36 weeks pregnant.

"I finally just kind of approached him and was like, 'so by the way, I don't want to go to the hospital to have the baby,'" she remembers with a laugh. "And he just kinda looks at me, like, 'What?'"

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Because Jennifer Prudden experienced most of her third pregnancy in a pandemic, important people in her life never saw her this way in person.

Prudden's story is part of a larger pattern that began in New York City, where the crisis first hit, according to Nina Martin, who covers maternal health for ProPublica.

"COVID kind of descended and emergency planners were focused on very sick patients in the ICU," Martin explains. "Nobody thought about all the pregnant women having babies in hospitals ... they just didn't have plans for that at all."

The last-minute realization that labor and delivery needed to go into emergency mode translated into a confusing, piecemeal approach, Martin says. "Places put draconian-sounding rules into place very quickly, rules that made no sense to anyone except the doctors implementing them. The suddenness and lack of planning understandably freaked out a lot of people."

That, Martin says, is what's causing spikes in Google searches for home birth. "We've seen waves of that across the country."

Martin points out that while the coronavirus pandemic triggered this particular crisis, a lack of planning for maternal care in public health emergencies is "a historic, systemic problem." Experts have been pushing for the inclusion of maternal care in planning for floods, hurricanes, fires, and other disasters, she says. "But they've never gotten traction."

As a result, even advocates for midwifery and home birth are concerned about families making choices quickly, under duress.

"Rushed decision making is a poor way of educating oneself," says Ginger Breedlove, the Kansas-based founder of a national advocacy group called Grow Midwives. "Home birth is safe, but if you're going to do it, there's a lot you better know."

Breedlove — who herself gave birth in a variety of settings, from home birth to hospital birth — says a particular place is not what makes birth safe. What’s best for women and babies, she says, is a seamless approach to care, with everyone working together. In the United States, options and providers are disconnected from one another. That fragmentation is what moms approaching due dates are up against now, as they take in the reality of hospital birth in a pandemic.

Jennifer Prudden found it hard to tell her OB she wouldn’t be delivering with her in a hospital after sharing the journey up to that point. But sitting with her healthy baby boy in her rocking chair at home, Prudden says she made the right move. The outside world has become less friendly, she says. “This is my safe place. I think that made it easier to give birth here, because I didn't have to go out and deal with any of the weirdness.”

She found extra sheets for the bed and an inflatable pool for laboring, but in the end, there wasn’t time for any of that. After having laboring through the night on the sofa, she woke up her husband and called in the midwife just in time. According to the time stamps on the photos, the midwife was washing her hands at 7:02 a.m. and the baby was out at 7:05.

About the only uncertainty now is what Baby Elijah, weighing in at 8 pounds 9 ounces, will someday say about being born at the height of the coronavirus pandemic in Kansas City.

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