Midwives inundated with home birth requests amid COVID-19 pandemic
Many pregnant women close to their due date are being turned away
Some midwifery practices are being inundated with moms-to-be pushing for a home birth instead of a hospital delivery due to fears surrounding the COVID-19 pandemic.
In Windsor, Ont., most of those pregnant women who reach out are being turned away by local midwives because they can't accommodate people in the near-term. These women are primarily coming from obstetricians who previously planned a hospital birth.
"They're not wanting their babies in the hospital because they're worried about infection, exposure," said Andrea Cassidy, a registered midwife with the Midwifery Collective of Essex County.
"The women who are calling us now are women who are due very, very soon," said Cassidy, who's saddened she cannot help everyone. "We are usually booked months in advance."
In some cases, women with due dates just days away are calling in a panic wanting a home birth, said Cassidy.
"We don't usually get women this late in their pregnancy asking us," she said.
It's challenging to accommodate the "influx" because midwives can only have a caseload of 8 deliveries per month for themselves, and as a backup for other midwives.
The Association of Ontario Midwives said it's been overwhelming to adapt to virtual appointments with pregnant women and wearing personal protective equipment in ways they weren't before, both in hospital and at women's homes.
"One of the major, most noticeable changes is just having to talk about addressing people's anxieties and worries about the virus and the changes in their care," said Elizabeth Brandeis, president of the Association of Ontario Midwives.
Help on the way
To help, Cassidy's midwifery group has hired a new graduate, who was able to be accelerated given the current health crisis. In Ontario, those grads come from Toronto, Hamilton and Sudbury. She's also in talks with retired midwives, asking them if they're able to return to work.
"We're excited, we have space coming for the women calling us," said Cassidy.
As the head midwife at Windsor Regional Hospital, Cassidy said the OBs are supporting, understanding and respecting the womens' decision to have a home birth due to COVID-19 fears.
Despite some fears among pregnant women, Dr. Greg Hasen, head of WRH's obstetrics department, said the hospital is "quite safe" to deliver a baby amid the COVID-19 pandemic. He points to screening at entrances, and turning people away who have symptoms, even partners of the woman who may be in labour.
Hospital still 'quite safe' for pregnant women
They're treating every patient in the maternity ward as if they could have COVID-19 by wearing gowns, gloves, masks and face shields from triage to delivery. So far, there have been no positive COVID-19 patients in the OB unit, Hasen said, but they're ready if that were to happen.
There's room on the floor to separate patients with no symptoms or who don't have the coronavirus, from those who may carry the virus and place them on the "dirty end," Hasen refers to as another area on the floor. But he said they haven't had to use that area.
Hasen said home births aren't necessarily safer.
"I think no one knows about the risk of exposure to COVID in your home, assuming people are doing self-isolating and self-distancing that hopefully is reducing the risk, but again nobody knows about the asymptomatic carriers that may be coming into your home," said Hasen.
Despite the increased interest in home births, Hasen said he hasn't noticed fewer women delivering in hospital.
Last month, Nova Scotia suspended home births to curb the spread of COVID-19 and to protect midwives and birth attendants.
The Canadian Association of Midwives disagrees, as it pushes to maintain home births as a "safe place to give birth for many clients." The association also said this could be a way to reduce pressure in hospitals that may be overwhelmed and overburdened.
On a normal day, outside of the COVID-19 pandemic, Cassidy said home births are equally as safe as having a baby in hospital. But, she said infection and intervention rates are lower under the mother's own roof.
"Because babies when they're in utero get exposed to any of the bacteria that's in your household," said Cassidy, adding there's exposure to new bacteria inside of a hospital.
Traditionally, about 20 per cent of births with midwives are at home. And the trained midwives bring all of the same instruments and medications as a Level 1 hospital, things such as oxygen and medications for a hemorrhage.