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Pregnancies don't stop during a pandemic. Here’s what to consider

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Commentary

Donna Hooyen is a licensed midwife practicing in San Diego County. This was originally published in The San Diego Union-Tribune

In the midst of the coronavirus pandemic, with massive restrictions on social gatherings, more people working from home and limited shopping for necessities, one thing that cannot be rescheduled is birth. Pregnant people are still giving birth, and there is an urgent need to keep them and their babies safe.

Is it safe for babies to be born in the hospital right now? To answer that, it is important to know that birth is not inherently an abnormal medical condition. It is not a state of illness for a majority of people. It is a normal biological function of the human body. Many people are able to give birth without medical intervention when desired.

There are definitely times when medical support is necessary. In instances such as those, it is safer for a baby to be born in the hospital. There are times when an out of hospital birth is not advised or safe, regardless of the current health concerns. Weighing the risks and benefits of necessary medical procedures versus exposure to coronavirus to both the pregnant person and the baby will be part of the decision to give birth in the hospital.

In the current state of our country, more birthing people are looking for alternatives to hospital birth. For many of them, an out of hospital birth can be a viable and safe option. Midwives make this determination on a case by case basis, taking into account the person’s medical history and current pregnancy health status.

As a midwife, I am still needed to attend families having their babies right now. Birth doesn’t stop, and many pregnant people need skilled birth attendants with them outside of the hospital.

I am able to provide clinical care to the clients wanting to reduce possible exposure to a virus that is spreading rapidly, without a cure or vaccine at this time. I can still work. I can still use my skills to assess a pregnant person during the prenatal, intrapartum and postpartum periods.

If at any point it is determined that additional medical support is required, we can transfer to the hospital for appropriate care. In the event of a transfer, by starting care outside of the hospital, it is possible to reduce exposure to everyone. However, hospitals are no longer allowing anyone but the pregnant person’s partner to enter the hospital with them.

In providing these services to families that need them, I also am concerned about taking care of myself, my family and the families served. Reducing the transmission of coronavirus, flattening the curve, is the focus right now.

To help with this objective, I am working diligently to minimize my own exposure in non-essential settings, practicing social distancing and even limiting seeing some of my own family members.

I am sanitizing my equipment between clients, using one-time use supplies when available, and making sure to wash my hands and use gloves for contact procedures.

I am minimizing in-person contact by offering virtual appointments when appropriate and limiting the number of people that attend appointments to reduce exposure.

I believe emphatically that, for low-risk individuals, giving birth outside of the hospital is a viable option. When people go into the hospital, they are exposed to other patients and numerous staff who have been exposed to patients who may or may not be contagious.

Giving birth at home, or at a birth center, exposes the person to far fewer possibly contagious people. There will be fewer people at their birth at home. Typically, it would be their midwife, an assistant and a doula or second assistant.

In the hospital, it’s possible that a pregnant person could come into contact with more people than that in just one shift. And each person they come into contact with will have been in contact with all of their other patients.

By giving birth outside of the hospital, the risk is greatly reduced because there are less individuals involved overall. When attended by a medical practitioner trained and experienced in an out of hospital birth setting, for a healthy pregnant person, this is a safe option.

By providing this option, we can reduce the load on hospitals so health care workers can concentrate on more severe cases and deploy resources where they are more urgently needed while we practice social distancing to help reduce the number of coronavirus cases.

Commentary

Donna Hooyen is a licensed midwife practicing in San Diego County. This was originally published in The San Diego Union-Tribune

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