A growing number of expectant moms are considering home births as the coronavirus pandemic continues to spread and to overwhelm hospitals. This is true even in Mississippi, a state with few midwives and among the lowest percentage of home births each year.
“I’ve seen a considerable uptick in the number of women who are now interested in home births,” said Kristina Harper, a midwife in Olive Branch who serves women in Arkansas, Tennessee, and Mississippi.
“We are fielding an extra five-to-ten emails each day, an extra five-to-ten phone calls each day from women who want to deliver at home,” Harper added. “In the last two weeks, I’ve gone from one or two patients to four or five.”
Dr. Delta Stark, a prenatal chiropractor in Madison county and the Board President of Better Birth Mississippi, said this is true statewide.
“We specifically have been receiving an influx of questions and requests to join our consumer discussion page from pregnant women who even into their late third trimester are looking for out-of-hospital birthing options due to fear and concerns with COVID-19,” Stark said.
That’s one of the reasons for the newfound interest in midwives, who delivered virtually every baby in the mother’s house at the turn of the 20th century.
Part of the issue is new constraints on hospitals that have become swamped because of coronavirus. Though policies tend to change daily, some hospitals have begun to restrict all visitors, even the father of the baby. And then there is the fear that new moms will contract COVID-19 while at the same hospital as so many patients who have the virus.
“Some are looking specifically for midwives and home birth options,” Stark added. “But some are more concerned with the fear of not having support persons allowed into their birth setting (including family members, doulas, partners, etc.). These are very uncertain times to be birthing due to ever-changing hospital rules and regulations.”
Harper has been a midwife since 2004. She is a Certified Professional Midwife (CPM), which is a private national certification for midwives to establish knowledge, skills, and abilities. It includes training, education, supervised experience, and the successful competition of a skills assessment and written exam. Most CPM’s like Harper practice in homes or birth centers.
The Certified Professional Midwife credential, issued by the North American Registry of Midwives, is accredited by the National Commission for Certifying Agencies, the accrediting body of the Institute for Credentialing Excellence.
For those who don’t plan on working in the hospital setting, this is the gold-standard certification.
“Midwives, who receive extensive education and training, are qualified to attend to low risk women who desire a home birth,” Harper says on her website. “Midwives have proven over and over again, that they can and do safely attend to women who are low risk for complications during pregnancy and childbirth. Midwives aren’t there for when everything is going perfectly smoothly. Midwives are there because they are knowledgeable in normal, monitor for normal and are with the laboring mother for the majority of their labors.”
As Harper says, a home birth isn’t for everyone, only low-risk pregnancies.
Harper is licensed in Tennessee and collaborates with a physician in the Volunteer State.
She doesn’t in Mississippi because the state doesn’t license midwives. While a lack of license would generally be a positive, it also contributes to Mississippi having among the fewest home births in the country and no true birthing centers. Part of that is because the low number of midwives in the state. According to Stark, they generally have 10 practicing midwives at a time.
“In Tennessee it is easier to find physicians to work with and to get doctors to call in prescriptions,” Harper said.
But not in Mississippi.
“In my personal experience caring for pregnant moms in central Mississippi for the last three years as a prenatal chiropractor, very few OBs or hospitals are willing to collaborate care with midwives serving clients choosing home births in the area,” Stark said. “There are a few exceptions, but generally speaking there is a lot of push back for families seeking support and backup birth plans in a hospital setting. Again, I feel like this could strongly discourage some moms that may have a positive relationship with their OBs from seeing home births as even an option. The way this system currently works, it is not providing supportive care that honors a mom’s wishes to give birth the way she desires, and I truly think this negatively impacts your home birth rates as a whole.”
In this case, a license based on a private certification such as the CPM would likely lead to an increase in the number of clients using the service. This would make it easier for midwives to consult with physicians, to carry medications, and even for patients to have insurance cover the birth. This, in turn, would benefit insurance companies as the cost of a home birth is generally half to one-third the cost of a birth in a hospital.
But higher number of home births is something that could benefit the state even after the virus passes. In a rural state where many hospitals don’t deliver babies and there is a shortage of OB-GYNs, midwives could serve and expand their role.
“With continued limited access to care in rural areas of Mississippi, families are losing access to quality providers locally,” Stark said. “Due to current travel restrictions they are also being pushed towards an increased amount of birth interventions such as scheduled inductions and C-sections versus allowing labor to begin naturally, and thus increasing unnecessary risk for both moms and babies. By utilizing certified midwifery care to fill in the gaps in these rural areas for low risk births, along with collaboration from other birth professionals for high risk births, we can aim to provide safer, quality care for all Mississippi families.”
For Harper, she is going to continue her work caring for mothers and their babies. As she has always done.
“It’s a calling.”