Are you rethinking plans to deliver your baby at the hospital?

As an expectant mom, you may be rethinking your original birth plan in light of the current COVID-19 pandemic. If so, you’re not alone.

Pregnant women across the U.S. are increasingly weighing the pros and cons of giving birth at a hospital. And this isn’t a completely new trend; home births have been on the rise in recent years. But midwifes are fielding an increased number of inquiries especially now, and taking on new patients—some of whom are changing their birth plan in the final weeks of pregnancy.

So, since we’re hearing from and about more and more women brainstorming alternative delivery options, we’ve gathered some information and thoughts we hope might be useful to you.

The American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Academy of Family Physicians, and Society for Maternal-Fetal Medicine issued a joint statement on March 30 with guidance that, “Hospitals and birth centers that are both licensed and accredited remain safe places to give birth in the United States.” They also note that, “Effective communication is essential in this time of increased stress and uncertainty and we encourage pregnant patients to stay with the health care professionals who have been providing their care and talk with their physician or midwife about their concerns regarding labor support and safe birth care.” The group continues to stand by these recommendations.

And yet, women who are making the change to a home-birth plan are doing so for a variety of reasons: some are worried about exposing themselves and their newborn baby to the hospital environment; others worry that their partner or other support person might not be able to be with them during delivery.

As expectant mom Careen Goebig told The Philadelphia Inquirer, “Switching to a home birth — that’s scary. God forbid something goes wrong, and you are not in a hospital. …[But] at least in my house, I know who cleaned it, and I know who was there before I gave birth."

Dr. Elizabeth Langen, an OB-GYN and clinical associate professor at the University of Michigan told Good Morning America, "My concern is that if people are choosing to have a home birth who have a higher risk of complications than people who generally have home births, then we might see harm come to people because they’re choosing a riskier location of delivery.”

Of course, the choice of birth plan is an extremely personal decision that has both health and emotional considerations. But if you’re currently rethinking your original plan, and weighing the possibility of a home birth, here are some things to think about, and questions to ask: 

Talk with your doctor

Before making any drastic changes to your delivery plan and location, by all means talk to your doctor. He or she is your best source of information about the status of the hospital where you’d planned to have your baby. Your doctor is also best positioned to advise on what alternatives may or may not be safe for you depending on the medical health of both you and your developing baby.

Certain women are not good candidates for an at-home birth, particularly those who have had a previous C-section; those whose baby is in the breech position; or those with underlying medical concerns. As Sindhu Srinivas, director of obstetrical services at the Hospital of the University of Pennsylvania, wrote in an op-ed for The Philadelphia Inquirer, “It would be much more dangerous for a patient that is not a suitable candidate for an out-of-hospital birth to proceed with that option if it is not appropriate.”

Find out exactly what your hospital/Labor & Delivery ward is doing to keep things as safe as possible—and what protocols you’ll be asked to follow

If your hospital is like most, there are many new procedures in place—and these may be changing frequently (especially if you live in an area where the healthcare system has been overwhelmed with COVID-19 cases). Ask any and all questions you want answers to, for example: Is the hospital testing every expectant mother and all staff? What, if any, new protocols apply to pre- and post-natal appointments?

If you’re interested in possibly pursuing a home birth, do your research

As noted by The New York Times, only three-quarters of U.S. states allow licenses for midwives to practice out-of-hospital deliveries. So, if you’re having an exploratory call with a midwife, ask about applicable certifications. Also ask what the midwife is doing to limit the spread of infection, as they are in and out of peoples’ homes—and possibly being exposed to COVID-19.

Find out the costs of a home birth

Before you decide to shift to a home-birth plan, find out all of the expenses related to it—and what your insurance will and won’t cover.

Recognize that you still might need to go to the hospital even if you plan for a home birth

There are plenty of stories of women having wonderful home-birth experiences. But just like every baby and every mother is unique, so too is every delivery. If planning for a home birth ends up being what seems like the best decision for your particular situation, prepare a contingency plan just in case. Have a friend or family member on stand-by, available to transport you to a hospital, if it becomes necessary.

Revising your birth plan—whether due to necessity or preference—might be one of the hardest things you’ve ever had to do. We have nothing but awe and respect for all the mothers-to-be out there, and we wish you a healthy, safe, and happy delivery wherever it will take place.

Read the full statement from The American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Academy of Family Physicians, and Society for Maternal-Fetal Medicine here.

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