Midwifery Today, Issue 135, Autumn 2020.
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At the start of the pandemic, I was part of an upscale, holistic gynecology practice on the Upper East Side of New York City. We cared for women who were seeking alternatives to the conventional model of medical care and who wanted a more integrated, personalized approach to childbirth. I felt satisfied and fulfilled in my provision of individualized, holistic healthcare.
Then came Covid-19, and laboring women’s partners were banned from entering the labor and delivery unit. During the five days when the policy was in effect—before being reversed by New York’s governor—some pregnant women faced disruptions to their carefully laid birth plans, which caused them to feel disempowered and fearful of giving birth.
That is when I met Lea, who was eight months pregnant and planning to labor unmedicated at her upcoming birth. Lea knew that being surrounded by people who supported her wishes was key to birthing without any medical intervention and decided that homebirth was her most suitable option at this time.
Lea approached me to become her homebirth midwife but I didn’t consider myself ready to become one. I had attended a number of homebirths, but the bulk of my experience as a midwife was centered in the hospital, where backup is readily available. Transitioning to become a homebirth midwife meant relying on my own clinical skills to an extent not previously required. Although low-risk pregnant women have better outcomes with planned, attended homebirth as compared to hospital birth, I still did not feel ready to be the primary provider in a low-resource birth setting.
But there was something about Lea’s conviction about homebirth and trust of her healthy body’s inherent ability to be successful at it that drew me in. I really wanted to be her midwife. I know the energy, power, and vulnerability of un-medicated labor and birth. I feel deeply connected to the challenge and subsequent euphoria of natural childbirth in a woman’s own, natural setting. I view birth as a sacred life event and believe it is a critical time in the life of a mother and baby. From my work with women, I have learned that birth has the potential to impact the way a woman feels about herself as a woman, how she bonds with her baby, and how she integrates her new maternal role into her identity. I feel protective of childbirth as a fundamentally feminine experience that serves as an expression of feminine power and competence and would not want any woman’s birth experience to be marred by institutional barriers.
A reservation about being Lea’s midwife was my fear of managing a maternal or neonatal emergency. I talked to my own midwife, who is my mentor and professional role model. She helped me identify an experienced midwife who agreed to be with me at Lea’s birth. I felt confident and ready to play the role of primary midwife with a competent, experienced backup midwife present.
Soon after, two other women engaged me as their homebirth midwife, and before I knew it, my homebirth practice was launched! The opportunity to attend out-of-hospital, physiologic birth presented itself to me and I embraced it. I learned from this experience to follow your instincts, heed your inner voice, and build in the support that you need. I am happy with my decision to take the leap to practicing midwifery in a way that makes the best sense to me. I had never anticipated becoming a homebirth midwife at this stage in my career, but the Covid-19 pandemic has changed our best laid plans.