The COVID-19 pandemic has caused a lot of uncertainty, including for families who are expecting a new addition.
The topic of having an in-home birth may have crossed the minds of couples more often as concerns about having a hospital birth rose, as some facilities limited visitors or even banned partners from being present.
After not feeling comfortable with hospital birth after her first child, Melanie Pilgram, a St. Joseph mother of six, had in-home births with the rest of her children knowing that if going to a hospital was necessary it would be safe. But she didn’t feel that was the case this time. Her latest son, William, was born on Oct. 18.
“I felt like I had to fight harder, because of COVID, that I especially didn’t want to be in the hospital without my husband,” Pilgram said.
Pilgrim has children with special medical needs, and not having the ability to do an in-home birth would have meant her husband would have to stay with their older children and she would have to give birth alone.
In-home births allow a woman to have her full support team in the comfort of her own home.
“One of the beautiful things this year has been that we can come in the house and shut the door and that whole world stays out there,” said Cheryl Gates, a certified professional midwife of 13 years who has previous experience as an emergency medical technician.
In addition to concerns about the actual birth experience, Gates said she has noticed additional stress and health issues in expecting mothers.
“The moms are having more high blood pressure than we’re used to, their glucose levels are high because they’re stressed. And so then we’re dealing with more gestational diabetes and second-trimester losses,” Gates said.
Discussions of what to do when a baby doesn’t make it also have been on the rise, Gates said.
“‘What is it like when you go home?’ ‘How do you find a funeral home?’ ‘Do you want to have your baby cremated?’ These are not conversations I’m used to having more than every couple of years,” Gates said, noting she’s had this talk four times since the beginning of December.
Gates said it is difficult to know the exact impact the COVID-19 pandemic has had on pregnant women.
“Even if they have COVID, early in their pregnancy, it can start micro clots in the placenta that affect the baby,” she said. “So maybe they don’t have active COVID but they had COVID and now they’re living out the effects of it. And so it’s very difficult to narrow down what is from COVID and what is just kind of co-morbid with COVID.”
Pilgram said some women may be reluctant to talk with their health professionals about their concerns related to the pandemic.
“They may not say how stressed they are because it’s too scary with COVID to be in the hospital. And even for me, it felt very scary with issues, and I worked really hard with diet and lots of things to make sure that it was still safe for us to be here,” Pilgram said. “If I was ever at risk of not telling my midwife how bad things were, it would be from COVID.”
At the same time, Pilgram points out it wouldn’t be fair to a midwife or other health professional to not be completely honest about any concerns.
“Her job is risk assessment. Her job is to keep you safe and healthy, but it’s not fair to be in the hospital with COVID and have a baby without your family, without your spouse, without any support to help you when it’s already a very vulnerable time. None of it is fair,” Pilgram said.
Having a midwife allows for a stronger bond to be built, Gates said, noting the number of visits before and after a baby is born.
“We have all the teaching guidelines, we go over them with them so that it’s a different relationship,” Gates said, speaking with Pilgram. “Like, we’ve started from the very beginning knowing everything, and by the time we’ve had two babies together, I know all your answers.”