Changing Your Birth Plans During Uncertain Times

Wow, things are a little nuts right now. The landscape of everything surrounding coronavirus is changing daily, with new adjustments to our daily activities becoming necessary as a community to prevent the spread of the virus.

One major development that is affecting birthing families here in the Denver area, as well as in places all around the country, is that many hospitals have begun to place restrictions on how many people a laboring person can bring with them for birth support. This development has sent the birth community into a tailspin, with women and families looking at out of hospital options in the last weeks of pregnancy.

Imagine heading into one of the most vulnerable times in your life, without the support you thought you would have? Women are being told that they have to choose between their partners and their mothers in the birth room, and that they can’t have their doula or their birth photographer. Luckily, there are movements all over to advocate for doulas to be considered essential personnel, and it’s working in some places. All the same, things have changed for birthing people, and we don’t know how long it will last.

Our practice, and those of many other midwives, has begun to receive calls from women looking to switch to home birth. We, and the midwives we know that have the capacity, are ready and willing to help in any way we can, of course. But we wanted to jot down a few thoughts to share with you, in case you are in the category of people looking for a home birth in the last weeks of pregnancy.

First, we are happy to help you! Even at the last minute. But there is a lot of ground to cover for you – ground that we’ve had months to cover with our clients who had intended to have a home birth from the beginning. Somehow, in the middle of all of this craziness, we are going to have to squeeze in some time to get to know each other. In these times, this might include some Skype conversations to get us started, with face to face clinical time as soon and as often as possible. Unfortunately, the nature of pregnancy care makes it so that not all of the visits can be via Telehealth (something we never did at all until this last week!). But, we are learning to communicate differently, and helping people learn how to be aware of changes to their bodies and their baby’s well-being, during those times when face to face is hard (when there is an illness in your family, for example.)

We also want you to know that home birth isn’t for everyone. Let us stress: we actually believe that almost everyone CAN do it, barring unusual circumstances or medical concerns, but it’s just not the right choice for everyone. If you have only just now thought of having a home birth, make sure to do lots of reading and learning about having not only an unmedicated birth (there are some really awesome online childbirth classes out there, like this one), but taking on the extra responsibility of birthing out of hospital, in your home. It’s a shift in perspective. We, of course, think home birth is where it’s at, but not everyone does.

Next, not everyone is a good candidate for a home birth. You need to be “low risk” – which means that you and the baby are healthy for an out of hospital birth. Things that might exclude you from home birth include diabetes, high blood pressure, twins, placenta concerns, etc. Before you transfer into our care, we will need you to have a copy of your prenatal records in hand so that we can review them and make sure that you meet home birth criteria (most people do).

It’s also important to know that you are hiring us for midwifery care, which does not guarantee a home birth – it doesn’t eliminate the possibility of a transfer into the hospital if there are complications during your pregnancy, birth or postpartum period. You should also take the time to carefully review the financial aspect of switching to midwifery care. Booking a midwife at the end of pregnancy typically involves non-refundable fees and out of network insurance billing. (Our contracts clearly outline all of this for our practice.)

Lastly (even though there is so much more to talk about, we’ll leave it here for now) we want you to know how much we feel for you right now. Pregnancy is already a challenging time, with lots of decisions to make and various things to worry about and consider, so we know how hard this must be for you. While we might not be able to be as high-touch and high-hug as we usually are at this time, we have ears to listen – we are here for you.