Pregnancy During A Pandemic: Q&A with Midwife Hayley Oakes

Hayley Oakes, LM CPM – a midwife and a new mother –  answers all of our big questions around the realities, anxieties and empowered silver-linings of pregnancy and birthing during a pandemic. 
Pregnancy During A Pandemic: Q&A with Midwife Hayley Oakes

I have been getting texts from friends asking, ‘Is now a great time to bring another baby into the world, or is it the most terrible time?’ Because it feels like both. 

In one sense, you’re at home, you’re working from home, you’re going to be so present. In the other sense, if your pregnancy or birth turns high-risk and you do need more surveillance, it’s an anxiety-producing time to go into a hospital to be monitored more frequently, while trying to limit exposure. 

At this point, we don’t know how susceptible babies are to the virus. We haven’t seen any newborns with it. But it’s a trying time for new moms to experience less community and support during and after their pregnancies. 

I just spoke to a fellow midwife I used to work with, who delivered a mom who was positive with Covid-19. The midwife was in a full spacesuit and, as of now, the baby and mom are separated for two weeks to prevent exposure, which is the most devastating idea. 

If you remain healthy, however, the potential for exposure in medical facilities is the only thing that changes the risk to the baby. We really don’t know very much about the effect of coronavirus and pregnancies, but it’s likely that, similar to the flu, if you contract the virus during your pregnancy, you pass antibodies to the baby and the baby is protected. Your own anxiety and comfort levels play a much larger role in risk.

 

When everything started happening with coronavirus and social distancing, women began flooding the inboxes and voicemails of midwives in major cities like New York and LA. Panicked calls of wanting to switch gears last minute. The thing is, while home birth is really nice and the midwife can come to you, there’s a lot of work on the part of the pregnant person to stay healthy and low-risk in order to make home birth a safe option. 

There’s often this notion that goes along with pregnancy that you can eat or do whatever you want, because you deserve it. But if you are to remain low-risk, you need to work hard at eating well, exercising and being in tune with your body. 

It’s more serious than saying, "Oh, I'll just have a midwife and I'll just pop the baby out here." It requires a certain level of preparation and you have to be a healthy candidate, both physically and emotionally. 

Wanting to have a home birth, simply because you are afraid of hospitals right now, is not a reason to have a home birth – because you are much more likely to become afraid in the moment of labor, with no preparation of what's actually going to take place, and end up transferring to the very place you were trying to avoid. 

Around 25% of first time moms who are planning a home birth will go to the hospital for a non-urgent reason. It’s usually one which requires pain medication. The transfer is hard on these mothers, mentally and emotionally. They’re upset they ended up there after all the preparation with their midwife, they don’t trust their care provider, and all of that trickles down to how the mother bonds with her baby, how she breastfeeds, how they physically and emotionally recover.

Home birth is not meant for everyone. Hospitals are great and there's a reason for them. Even if you check all the boxes for home birth, even if you are healthy and low-risk, you have to ask yourself, ‘Do I actually want this? Is it to avoid [fear of the current situation] or am I trying to achieve autonomy and all the things that come with home birth?’ 

Typically, I see a client in a pregnancy about thirteen or fourteen times. I go to their house, their kids are involved, and their partners are involved. We touch the belly a lot. It's an intimate, high-touch, hands-on experience. Now, I only see a client four times during the pregnancy. The rest of those visits are done via telehealth. The same is true for postpartum: four or five in-person visits have been reduced to one.

My clients are encouraged to monitor their own blood pressures at home with an automatic cuff monitor and the baby's heartbeat with a handheld ultrasound called a Doppler. The idea, at this point, is that if mom and baby are thriving, there's no need to introduce potential exposure or risk. We see them less, which goes to show, amazingly, that the majority of healthy pregnant women don't actually need a lot.

When we do have in-person visits, I've set up a ‘mini outdoor clinic’ in my backyard, where the back gate is open and they don't have to touch anything. They come and sit down on chairs that can be wiped down before and after; they lay on a massage table that again can be wiped down before and after. There's no partners and no kids. 

That's been the biggest heartbreak of the experience: they’re doing this alone. They're even isolated from their midwife. They are missing these communal experiences that are usually a big part of pregnancy and birth. There’s a weird disconnect from how we’ve always done things.  

It's becoming very clear that there is almost a greater risk of not having the support, than the risk of potentially exposing someone to the Coronavirus. It's becoming really clear how unnatural it is to not have community and to not have physical, hands-on emotional support. 

Postpartum has been the hardest part for my clients. Isolation is hard enough, but becoming a new mom places you in this new vortex of baby. You’re so wrapped up in poops and pees, breastfeeding and recovering. Now, however, you don't have anyone coming in the house to do a load of laundry, prepare you a meal, or hang with your older kids. It’s becoming apparent that this is not natural, and not sustainable either.  

Like all trying situations, we are beginning to understand something that we took for granted – how imperative community and support really is.  

It’s important to remember that you are in this together with your baby: physically,  emotionally, everything. You are connected. Sometimes, we can get really wrapped up in the anxiety of all that’s happening, we can get in our heads and forget about the baby; how this affects someone else. 

It’s important to remember that you share all the same hormones – stress hormones included – that are pumping through your veins. Talking to your baby, which may sound woo woo, helps. What usually happens is you end up giving yourself a pep talk – which naturally lowers your blood pressure, your breathing rate and your pulse.Baby gets that recovery of stress hormones, too. They are flooded with oxytocin. 

While this is a time of a lot of loss and a lot of change, it’s important to remember to find the small wins and the small gains. Those are the things that, when it comes down to it, will determine how sufficient and strong and resilient a pregnant person is.

A lot of my clients are coming out the other side of this saying, ‘I really did this.’ The positive spin on this time is that there is a real sense of empowerment that comes with not looking to external sources all the time. This situation is really asking women to dig deep inside and to listen to their intuition, listen to their instinct; to not rely so much on others and outside things.  

Be so gracious with yourself. Everything is changing all the time right now. Live in that space of beauty and change, and allow yourself to be humbled by the ‘I don't know.’ Motherhood requires a lot, and that’s compounded by everything happening right now. There’s power in allowing ourselves to soften around the ‘I don’t know.’ 

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Hayley Oakes has been attending births since 2010 as a doula, midwife assistant, apprentice and licensed midwife, witnessing and supporting birth in all settings: home, birth center and hospital. She has also worked as a childbirth educator and guest speaker for a number of educational institutions. 

In  February 2019, Hayley became a mother herself. She resides in Highland Park, CA with her husband and daughter.  As a midwife, educator and new mother, she is committed to support women in having a safe and satisfying pregnancy, birth and postpartum experience to help grow healthy, happy babies. Support Hayley: @heybales. 

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