With the coronavirus pandemic in full swing, it is only natural to want to avoid stepping foot inside a hospital. However, what about when it comes time to deliver your baby? Would it be better to skip the hospital and deliver at home?

Home births only make up about 0.9 percent of all births in the United States. Women often say they have opted for an out-of-hospital birth so they can be in their own environment, feel that the experience is less medicalized, and believe that birth is a process that does not require hospital intervention when it is low-risk.

However, the data in the United States shows that home births are associated with some increased risks. Babies born at home have a three-fold increased risk of having seizures and neurologic problems, and twice the risk of having an Apgar score of 0 at 5 minutes (this indicates no signs of life). While the absolute numbers are small, it is a personal choice if that number is high enough to make a home birth feel uncomfortable for a woman.

On the flip side, we know that women who have home births have fewer C-sections (makes sense!), episiotomies, and forceps or vacuum deliveries.

So what about when coronavirus comes into the equation?

We’ve seen news stories where women who were previously planning a hospital birth have been contacting birth centers and home birth midwives to see if they can change their plans.

The American College of Obstetricians and Gynecologists, along with Dr. Deborah Birx, the Coronavirus Response Coordinator on the White House Coronavirus Task Force, have released statements to reassure women that the hospital is a safe place to give birth.

One of the most important points to note is that not every birth that starts as a home birth ends that way: up to 37 percent of women need to be transported to a hospital during their labor at home.

It is critical to keep in mind the emergency medical services are stretched very thin. Delays in waiting for 911 responses and ambulance arrivals can be the difference between life and death. Add this to hospitals that are working at their capacity, and an additional unplanned emergent situation can be difficult to manage.

In short, women who are pregnant during this time should absolutely voice their concerns with their doctors and midwives. Each hospital is going to extreme measures to protect their patients, and this is nowhere more evident than on Labor and Delivery where newborns and new moms are our VIPs. Ask your team how they are handling the pandemic and what precautions are being taken.

Knowing what to expect—and that now more than ever your labor team will work its hardest to make you feel like you are their sole focus—can help your baby’s birth be as safe and stress-free as possible.

Takeaways

  • The American College of Obstetricians and Gynecologists supports hospital birth at this time.
  • Up to 37 percent of women who labor at home need to be transported to a hospital, and with limited resources this can be a challenge and life-threatening.
  • Discuss your concerns with your doctor or midwife.

References

  1. American College of Obstetricians and Gynecologists. Committee Opinion 697: Planned Home Birth. April 2017.
  2. Grunebaum, A. et al. Apgar score of 0 at 5 minutes and neonatal seizures or serious neurologic dysfunction in relation to birth setting. Am J Obstet Gynecol 2013;209:323.e1-6.
  3. The American College of Obstetricians and Gynecologists. ACOG statement on birth settings. 20 April 2020.

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