At six months pregnant, Erika McBee had a plan for her baby’s birth. She was going to use the midwifery services at George Washington University Hospital, which seemed to offer the best of both worlds: a natural childbirth in a clinical environment. “That was the ideal for me,” says McBee, a 32-year-old nurse who lives in Bethesda with her husband.
But last week, as the novel coronavirus continued to spread rapidly across D.C. and the rest of the U.S., causing its first death in the District, she started to consider a backup plan. She began looking into delivering her baby at home, motivated by the desire to keep a hospital bed free for patients with COVID-19—and to keep herself and her expected child from getting sick.
At the hospital where she works, McBee saw the pandemic’s strain on the healthcare system firsthand, as patients were put in isolation and the hospital ran short on tests. (Out of privacy concerns, she requested the facility not be identified.) She talked to her boss about taking some time off after a patient whose IV she was administering coughed on her.
“Being a new mother, I don’t want to have COVID-19,” McBee tells DCist, adding that she fears “being on a ventilator when I’m supposed to be taking care of a newborn infant.”
She got in touch with Metro Area Midwives and Allied Services, or M.A.M.A.S., a Takoma Park, Md.-based practice she’d heard about from her doula and a recent article in the Washington Post. McBee had her first appointment with a M.A.M.A.S. midwife on Wednesday, via video chat, and says she’s comforted by the precautions the practice is taking. For one thing, many appointments are taking place online. Additionally, M.A.M.A.S. is sanitizing its clinic between in-person appointments and requesting that women leave their purses, phones, and partners outside the clinic to minimize exposure risks.
While much is still unknown about the risks coronavirus poses for pregnant women and newborns, the pandemic has already upended many families’ birthing plans. In New York City this week, the NewYork-Presbyterian and Mt. Sinai Health System hospital networks announced they were barring visitors—including spouses, partners, and other loved ones—from labor and delivery rooms, meaning women would have to give birth without them. Other hospitals around the country have enforced or are weighing similar restrictions, leading many women to search for alternatives.
Rachel Cipryk, a cofounder of D.C.-based Rock Creek Midwifery, says her practice has doubled its clientele this month and received a sharp uptick in calls because of coronavirus. Prospective clients have expressed concerns about potential delivery-room restrictions at local hospitals or said they’re reluctant to go to a hospital at all for fear of COVID-19 contamination, according to Cipryk.
She says she’s adding hours for new clients, having previously seen four or five clients a week. Some of the newcomers are as much as 36 weeks along in their pregnancies, and Ciprky says she has to work quickly to prepare them for natural births at home.
“If somebody had been with a traditional obstetricians practice or even a midwife practice in hospital, they may not have prepared for an unmedicated birth,” she explains. “They may not have prepared for all of the logistics of having a home birth.”
The pandemic has also impacted the way Cipryk does her job day-to-day. She’s scaled back on home visits, meeting with clients virtually as much as possible. This has meant that some of her clients are now procuring their own equipment—such as blood-pressure cuffs, measuring tapes, and stethoscopes—so they can check their vital signs and their baby’s heartbeat themselves.
When Cipryk does visit clients’ homes, she says she treads carefully. She reports feeling atypically nervous at an in-person prenatal appointment the other day. “I found that I was fumbling over my words and not as on top of a normal prenatal as I usually would be, because I was thinking so much about the thing that I had just touched in their house,” she says. “It’s kind of amazing how much headspace it takes up.”
Coronavirus concerns seem to be on the minds of expecting families across the region. Virginia midwife Hilary Biesecker says her practice Loudoun Homebirth and Healthcare has also seen a dramatic surge in inquiries recently. Biesecker points out that home births are safest for women with low-risk pregnancies. “We’re very confident in the level of care that we are providing in the home environment,” she says. “But there are also women that, frankly, should be birthing in the hospital that are looking to avoid it, and that concerns me as well.”
For Erika McBee, the nurse and Bethesda resident, preparing to deliver at home isn’t the only change in her life. While she’s on administrative leave, she’s also devoting energy to fight for insurance coverage for home births, which some insurance plans might not cover. Midwifery services can cost thousands of dollars, and McBee considers herself lucky for having much of the equipment needed to monitor her pregnancy.
She’s launched an online petition asking Maryland Governor Larry Hogan to provide financial assistance for women who opt to deliver at home, and has been in touch with the Maryland Insurance Administration. The petition has already received more than 600 signatures.
“I just thought, for myself this is a strain, but I can actually handle this financially,” adds McBee. “But I’m thinking about all the women who maybe don’t have good savings.”
