Giving birth is fraught with challenges even in the best of times. Add a health crisis and the complexities increase. In the wake of the Coronavirus, it’s not the easiest time in history to become a mum; however, life definitely goes on.
If you’re thinking of starting a family, or you recently discovered you’re pregnant, you likely have all sorts of questions about giving birth in the midst of a health crisis. The following is a summary of the most important things we’ve learned about giving birth in Australia in the midst of the COVID-19 situation:
Planning Far in Advance Gives You Multiple Birth Options
Under ordinary circumstances, a majority of Australian women make the choice to give birth to their babies in public hospitals funded by public Medicare. However, if you plan far in advance, you do have some other viable options aside from birth in a public hospital setting.
In some circumstances, private health insurance could give you access to a greater variety of options. This depends on variables such as the health fund you choose, the specifics of the plan you choose and your own individual situation. In particular, your age and the state of your health going into the pregnancy are both factors that are likely to influence the range of choices for where you’ll be able to give birth.
Your additional options might include giving birth in a private hospital; giving birth in a birthing center; and giving birth at home with a midwife. Birthing centers are only workable options in cases where the pregnancy has no discernible risk factors. After the onset of the COVID-19 crisis, there has been a massive surge in interest in, and demand for, home births in Australia.
Home Birth Might Be a Viable Option for You
Considering the ongoing public health crisis, significant numbers of mums-to-be have been questioning whether it’s safe to give birth at a hospital. There are also other concerns stemming from that one. In particular, hospitals have been limiting the numbers of people who are allowed to be present at the birth or allowed to visit mum and baby afterwards.
Your Support Options May Be Restricted if You Give Birth in a Hospital Setting
In some cases, the health authorities at hospitals have been limiting the numbers of support people present at a birth and afterwards. Some women have been limited to having only one support person present; and some clinics have not been allowing any support people at all.
These restrictions pose a problem for women who want to have their mums, partners, family members, friends and / or doulas present to support them when they give birth. This is one reason Australian women are increasingly becoming interested in home births; a mum who chooses home birth can have all the support people she wants.
How Safe Is Home Birth?
Safety is a concern for any mum-to-be – but if your pregnancy is considered a low-risk one, research indicates that your home is actually at the top of the list for the safest places you could give birth to your baby.
According to a recent study, there are no significant differences in adverse infant outcomes between home births and hospital births. Furthermore, babies born at home are 30 percent less likely to require admission to a neonatal intensive care unit (NICU) than their hospital-born counterparts.
At a planned home birth, women have a greatly reduced chance of coming into contact with pathogens including, but not limited to, the COVID-19 virus. While COVID-19 is the threat foremost in most peoples’ minds right now, it isn’t the most compelling concern when it comes to safety considerations; COVID-19 is not the only communicable disease that a pregnant woman or her baby could potentially pick up at a hospital.
There have been demonstrable and documented instances of newborns being colonised by pathogenic bacteria including Methicillin-resistant Staphylococcus aureus (MRSA) and Bacillus cereus after being born in hospital settings. When a woman gives birth at a hospital, it is possible that her baby could potentially be colonised by whatever bacteria happens to be present at that particular hospital; and the research that is available indicates that longer hospital stays have been correlated with greater instances of colonisation by pathogenic bacteria. In contrast, a baby born at home will only be exposed to the bacteria present in the home, avoiding exposure to all the pathogenic bacteria that are typically present in a hospital setting.
Finding Funding for a Home Birth
Publicly funded home births have extremely limited availability in Australia. As of March 2020, there were only 14 publicly funded home birth programmes available in the entire country. If you want to give birth at home, a possible first step would be checking out the availability of one of these programmes near you.
A publicly funded home birth isn’t your only option if you plan ahead. Some health funds do partially cover expenses for home birth. If you’re interested in the possibility of giving birth at home, or in any of your options other than public hospital birth, you can use the service available from AskJames.com.au to research health insurance policies and find a health fund that will help cover your expenses. Do be aware that it will be essential for you to make your plans far in advance. There is typically a one-year waiting period for health funds to cover any maternity expenses.
A perhaps even more compelling concern is the availability of a home birth midwife who could assist you with the birth. With the unprecedented surge in demand for home births right now, it can be challenging to find a midwife who will have the time to attend your birth. The further ahead you can book your midwife’s services, the likelier you are to enjoy the birth experience you want.
We’re in Largely Uncharted Territory
Many public health experts believe that COVID-19 is a new disease. As such, there are relatively few studies available to guide us on how COVID-19 affects pregnant women and newborns. Healthcare practitioners are drawing on their experiences from previous influenza outbreaks and from the 2003 SARS crisis of 2003 when they advise their patients.
What little information we do have regarding the disease and maternity is largely positive. COVID-19 does not appear to cause otherwise healthy pregnant women to become more severely sick than their non-pregnant counterparts. And so far, healthcare practitioners haven’t observed any additional risk of miscarriage associated with COVID-19. There also hasn’t been any observable correlation between the COVID-19 virus and abnormalities in unborn babies. Most women who have been studied thus far during the COVID-19 outbreak have delivered healthy babies.
In one small study, women who tested positive for COVID-19 also showed signs of placenta damage, but it is unclear whether or not that damage was caused by the virus; similar placenta damage has been observed in healthy women who do not test positive for COVID-19. In any case, the placenta damage did not adversely affect the birth outcomes for that group of women in any observable way.
Changes in Maternity Care as a Result of COVID-19
There have been some changes in routine maternity care as a result of COVID-19. Doctors and midwives are now typically recommending fewer in-person visits and, where available, more telehealth consultations. In-person antenatal visits are now frequently limited to less than 15 minutes in duration. Many antenatal classes have either been cancelled or moved online.
In the early months of the crisis, non-emergency, elective caesarean sections were postponed along with all other elective surgeries. Since then, elective surgeries in Australia have mostly resumed; but, with the massive backlog of surgeries, and the reduced capacity at which many hospitals are operating, you may find it challenging to schedule a non-emergency C-section.
These are some of the most compelling considerations to be aware of if you intend to give birth in the aftermath of the Coronavirus crisis. It’s a challenging time to introduce a new life into the world; but, if you’ve decided the time is right for you to become a mama, take courage and know that there have been many positive outcomes for other pregnancies, despite the crisis.