Many businesses across New Hampshire are closed right now because of the coronavirus pandemic.
But some are busier than ever.
Birthing centers are in that last group. The small, midwife-led facilities are getting inundated with calls from expectant parents. The new patients say they’re concerned that the hospital will no longer be a safe place to deliver their baby so they’re looking to change their birth plan.
But all this new attention is putting a strain on midwives as they try to maintain a more personalized birth experience.
Caly Duquette has always been interested in birth centers, but her husband TJ wasn’t that into the idea of her giving birth outside of a hospital.
She delivered their first daughter, Olive, at the Elliot Hospital and it went off fine. So when she got pregnant with their second, the Hampstead couple figured they’d just go back to the hospital.
And then came coronavirus.
“I just kept thinking, ‘You're going into a hospital, people go into the same entrance. People are breathing everywhere, touching everything.’ ” Duquette recalled. “I just felt like I would be bringing my newborn to a place that could potentially get her sick or me sick or my husband sick.”
Getting sick with COVID-19 or being separated from a partner or newborn are increasingly common fears among women who are pregnant during this pandemic. And those fears have now translated into an unprecedented demand for alternatives to hospital delivery.
New Hampshire has four free-standing birth centers, and all say they’ve been inundated lately with calls from expectant families. The centers are a smaller, state-licensed, independent facilities run by midwives. They’re meant to feel more like a home than a hospital.
Normally, midwives at birth centers work with patients throughout the entirety of their pregnancy and postpartum. Adrian Feldhusen, owner of The Birth Cottage, said she usually has a birth load of about 8 to 10 babies a month.
That was before the coronavirus. Now, women are calling Feldhusen every day. She was on her way to deliver her sixth baby in eight days when contacted by NHPR.
“It's feeling a little overwhelming,” she said. “But, you know, we just keep going on. We keep carrying on. There's not much you can do. Babies are going to continue to come. You can cancel knee surgery. You can cancel dental surgery. You can cancel going in for your physical. You can't cancel your baby.”
For women like Duquette, birthing centers feel like a refuge from the coronavirus. She found The Birth Cottage online, and when she called them up she was already 39 weeks pregnant. But she was so afraid, she told the midwives, could they take her anyway?
She was in luck. They had just opened a new location in Salem so they had room for her.
“I think because of all the stress from everything that's been going on, my body was like, no, no, you're not ready to have this baby yet. It was kind of like holding on to her. And then once I called the birth center and I got everything in place, I feel like my body was like, ‘OK, you're ready. You're not anxious anymore. She's ready to come.’ ”
One week after she placed that first call, Duquette started having contractions. She and her husband rushed over to the Birth Cottage - a place they’d never been before - and she delivered their second daughter, Reagan.
As it turns out, Reagan was the first baby to be born at the new Salem Birth Cottage, which for Feldhusen feels like a sign of the times: Delivering the baby of a woman she has never met, who came into her care because of fears of the coronavirus.
But this influx has put the midwifery community in a bind. On the one hand, it’s a good thing: They’re now introducing their practice to people who often had never heard of birth centers before.
Mary Lawlor, owner of Monadnock Birth Center in Swanzey and Executive Director of the National Association of Certified Professional Midwives, said she’s noticed this trend both locally and nationally. Lawlor said Monadnock Birth Center now has about double their typical birth load.
But, at the same time, birth centers are not built to work like this. And it’s been a struggle to keep up with the demand.
Feldhusen is trying to take on as many families as possible. That means rethinking her staffing, living in fear of running out of sanitizer and applying for waivers from the state to admit women so close to their due date.
Other midwives, including Kate Hartwell, owner of the Concord Birth Center, say they’re worried that taking on too many new patients, so late in their pregnancy, could jeopardize the quality of the birth experience.
“There is so much that we put into preparing somebody to have a natural birth, like there's nine months of education, birth classes and really developing a relationship of trust so that when my first timer is in the middle of it and she looks at me and says, “This is normal?” she's gonna believe me when I say, ‘Yes,’ ” Hartwell said.
So Hartwell has had to turn some families down. Sometimes it’s because of space: There are only two midwives delivering babies right now at her already busy facility. Other times she can just tell that the woman on the other end of the phone isn’t prepared for a birth outside a hospital, no matter how scared she is. Plus Hartwell has to make sure she can still remain committed to caring for her original clients, not to mention her own family.
There’s of course always the worry that she or her midwives will get COVID-19, which could wipe out their already small staff. This is partially why each birth center has decided to change their policies on home births, another popular request from families expecting babies during the pandemic.
Both Lawlor and Feldhusen said they are no longer doing home births. Lawlor has moved her original home birth patients into the birth center, and Feldhusen has had to cancel all home visits.
“Every time I go into somebody's house, I'm exposed to all the people in their home,” Feldhusen said. “I'm exposed to all their extra children, all the people they've come in contact with over the course of time. And very few people actually keep their house as clean and sanitized as we would.
Hartwell said she is still honoring the home births she committed to for the clients who contacted her at the beginning of her pregnancy, but she isn’t taking on anymore. She’s also had to have candid conversations for her home birth patients, making sure they are practicing the “strictest social distancing they possibly can” and making them aware of the potential risks of allowing even midwives into their homes.