Extreme Hospital COVID Policies Are Leading More
Pregnant Women To Choose A Home Birth
by Kerry McDonald, 9/26/21, Foundation For Economic Education

When I decided to have my third baby at home, I did so
because I felt that a home birth with an experienced midwife
would be the safest place for labor & delivery. My first two
were born in a large, Boston teaching hospital, & medical
interventions there caused complications for me. My last two
were born at home, on their own time, with no interventions
& no complications. You can read more about my home birth
experience [here].

More women are now discovering the safety & joy of a planned,
midwife-assisted home birth. The coronavirus has caused
expecting parents to question the safety of a hospital birth,
while restrictive hospital policies, such as mask-wearing &
visitor limitations, make labor & delivery in a hospital
less appealing.

Acc. to Joyce Kimball, a Certified Professional Midwife in

Massachusetts, more women are considering a home birth now
than they were pre-pandemic.

“My practice has seen an uptick in the interest in home
birth & community birth since the spring of 2020,” says
Kimball, who runs one of the busiest home birth practices in
the state. “Prior to 2020, I would receive 1-2 calls per
week from folks interested in non-hospital birth. Now I
receive about 4-5 calls per week."

"Every month I have a full panel of clients & refer away
several people a month,” she adds. This trend is occurring
in midwifery practices across the country.

Many of the reasons why these pregnant mothers are contem-
plating a home birth now are the same as they were before
COVID hit. They want a more personalized, less institutional-
ized birth experience. They want more control over the labor
& delivery process. They want to be surrounded by a
supportive birthing team, including family members,
friends, & perhaps their other children, in addition to
their midwives. They don’t want to be separated from their
baby at any time. They may pay more in hospital co-pays &
deductibles for maternity care than they would for a home
birth. They recognize that for most healthy women, birth
is a life event—not a medical one.

Acc. to Kimball, COVID has increased the desirability of
home birthing. She says that pregnant women may now feel
more uneasy during their prenatal care, with the heightened
focus on COVID protocols when consulting with their health-
care provider. They may not want to get tested for COVID
in the hospital, & have to wear a mask during labor &
delivery. They may not like the idea of keeping that mask
on during their postpartum hospital stay, creating an
artificial barrier to bonding with their baby. They may not
want their newborn exposed to hospital germs, including COVID.

Prior to the pandemic, interest in out-of-hospital births
was growing in the US. It is estimated that about 62,000
of the roughly 4 million US births in 2017 occurred at home
or in a freestanding birth center, & the number of US out-
of-hospital births increased by almost 80% between 2004-2017.

This rise in home births may be at least a partial reaction
to the country’s dismal hospital birth record. Despite
significant spending, the US has some of the highest rates
of maternal mortality & morbidity of any industrialized
country, esp. among women of color. A 2018 USA Today
investigative report concluded that “the U.S. is the most
dangerous place to give birth in the developed world.”

A planned home birth with an experienced midwife, on the
other hand, can be both safe & rewarding. Acc. to a 2021
study published in Frontiers of Sociology about the rise
in home births since the start of COVID, laboring women
“have been continually achieving safe outcomes in private
homes & freestanding birth centers with the assistance of
midwives in the US & abroad…COVID-19 has disrupted the
perspective of actual safety because staying at home offers
better protection from the pandemic for childbearers than
sharing a hospital with disease-stricken patients.”

New hospital COVID policies may also inadvertently drive
more women toward home birthing in the months ahead. For
instance, FEE’s Jon Miltimore wrote recently about a
hospital in upstate New York that announced a “pause” in
its labor & delivery services this month due to so many of
its nurses & other healthcare workers quitting over
COVID-19 vaccine mandates. Some of those expecting mothers
may choose to consider a home birth instead, particularly
in light of recent efforts to expand home birth access in
the state. Former NY Gov. Cuomo signed an executive order
in 2020 to allow Certified Professional Midwives to practice
midwifery in the state to help alleviate the burden on
hospitals due to the pandemic, but that order expired in
June. Advocates have since tapped the state legislature to
support the role of home birth midwives in the state.

Until the recent COVID-related executive order, Certified
Professional Midwives were forbidden to attend births in
New York, & some longtime home birth midwives have been
arrested there for delivering babies. One of the highest
profile arrests was that of Elizabeth Catlin, a midwife who
has been attending home births in New York for decades,
particularly in the state’s rural Mennonite community.
In 2018, she was arrested & charged with 95 felony accounts
for being an unlicensed midwife. Catlin is a Certified
Professional Midwife, a credential recognized in 30 states
but not in New York until the 2020 COVID-related executive
order. Last week, Catlin agreed to a plea deal that dropped
94 of the charges against her & left her pleading guilty to
one charge of practicing midwifery without a license. She
will be sentenced in December.

COVID has disrupted many previously entrenched sectors,
from education to healthcare. Frustrated by COVID policies
in schools or fearful of virus spread, more families have
shifted away from institutionalized learning & toward
schooling alternatives, such as homeschooling. Similarly,
more expecting parents frustrated by hospital COVID policies
or fearful of the virus are turning away from an institution-
alized birth toward home birthing & other out-of-hospital
birth options.

Restrictive institutional policies in both education &
healthcare are accelerating the growth & popularity of
more decentralized choices in these sectors. Continued
loosening of occupational licensing requirements, such as
those impacting New York’s midwives, along with ongoing
deregulation in healthcare & education, will expand choice
& opportunity for parents—from where they give birth to
how their children learn.

Kerry McDonald is a Senior Education Fellow at FEE & author
of Unschooled: Raising Curious, Well-Educated Children
Outside the Conventional Classroom (Chicago Review Press,
2019). She is also an adjunct scholar at The Cato Institute
& regular Forbes contributor. Kerry has a B.A. in economics
from Bowdoin College and an M.Ed. in education policy from
Harvard. She lives in Cambridge MA with her husband & 4 kids.

https://fee.org/articles/covid-policies-lead-more-women-to-choose-a-home-birth/

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