Midwives’ Work During COVID-19

Hospital restrictions, pandemic fears led women to home births

When the COVID-19 pandemic was already in full swing in most states, 37-weeks-pregnant Jordan Shannon packed up her two toddlers in her Nissan Coupe and drove from New Orleans to Taos.

The devastating spread of the pandemic had shut down the birthing center where Shannon had planned to have her baby, so she headed for the southwest.

"There's really unfavorable birth outcomes in most of the southern states that were immediately nearby [and] there's really high C-section rates," Shannon tells SFR. "It was basically a combination of favorable non-traditional birth practices and also low virus rates."

Shannon purportedly is one of many expectant mothers who have chosen to avoid hospitals during the pandemic. New Mexico midwives anecdotally report an increase in mothers altering their birth plans to have babies at home or at birthing centers to avoid the current dangers and inconveniences of hospitals. State health officials do not have reports yet for 2020 about the number of home births versus hospital deliveries, so it's too soon to identify a trend.

Midwives say they have also struggled to get proper personal protection equipment (PPE), such as masks, gloves and hand sanitizer, along with other supplies such as formula for infants.

Dorothy Kaeck, a licensed midwife in Taos and owner of Corazon Midwifery, tells SFR she initially had trouble procuring vitamin shots for infants as well as PPE for herself.

"It was a tight squeeze for a little bit there and now I feel like I mostly have what I need," Kaeck says. "It was hard for probably about three weeks to get my hands on any sort of non-sterile gloves or rubbing alcohol or hand sanitizer and masks."

Like many healthcare workers, she has changed some of the ways she interacts with the mothers under her care.

"Some clients are requesting Zoom or telehealth visits and other people are less worried…and then what also has changed is that if I need to transfer to the hospital, I can't go with my client," Kaeck says. "That's a big change because usually I would go and start to be in the doula role and be their advocate in the hospital and now it's like, 'OK, see you later.'"

Kaeck is versed in the studies about maternal and infant mortality. Nonwhite mothers in particular face higher C-section and maternal and infant mortality rates in comparison to white women. But she is not too worried about disparities in coverage in Taos and other places around New Mexico.

"I think that the town's hospital is really set up to not have that disparity so much," Kaeck says. "When 50% of the clientele at the Taos hospital is Hispanic, that's almost the majority of the mommas going in so it's harder to have that kind of bias in care here."

Elena Stauss, owner of Santa Fe Midwifery, says the majority of her clients are white but she has had an increasing number of Latina and immigrant clients.

Stauss had planned to go on vacation to visit family members this spring but canceled her flights when the pandemic hit. Instead, she went back to work and quickly found clients. Although Strauss has also struggled to find proper PPE, she continues to meet with her clients in person and maintains strict stay-at-home requirements for herself and her assistants so that contact tracing is easy if someone gets sick.

Stauss also increased the time between appointments at her office so there is time to sanitize everything. She is currently working with 12 pregnant women and has helped with the birth of seven babies since stay-at-home orders started.

One of the babies was Jordan Shannon's son. Stauss drove from Santa Fe to Taos to be with Shannon during the birth. When she can't be with the woman during labor, Stauss makes sure to be available as soon as the hospital stay is over.

"I have a mama that she's going to have a C-section in a couple of weeks and they already told her that I cannot go and she was so sad," Stauss says. "And I said… 'As soon as you are out of the hospital, I'm gonna go see you in your home.'"

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