Home births: How did COVID-19 change how women give birth? | Opinion


Zoë Petersen, Deseret News

In June of this year, Nicole Pytlinski Pimentel from Fort Mill, South Carolina, gave birth to her first child at home. She told me of the decision, “If you had told me five years ago, even a year ago, that I would have done this, I would have said absolutely not, this is crazy.” 

Pimentel is part of a growing trend of American women choosing to give birth at home in the years post-COVID-19. Earlier this month, the Centers for Disease Control and Prevention released data showing that home births are at their highest level in 30 years. The Associated Press reported, “The report’s findings show the nationwide number of pregnant people giving birth at home rose from 1.26% in 2020 to 1.41% in 2021 — an increase of 12% and the highest level since at least 1990. That followed a 22% increase from 2019 to 2020.”

Of course, the vast majority of women still give birth in hospitals, but the reasons for the increase in home births are worth our attention.

What’s behind the rise? My own home birth midwife, Katie Shannon, a certified nurse-midwife and owner of Chesapeake Midwifery, told me, “Especially in the height of the pandemic, the hospital didn’t feel like a safe place to be and many women found themselves looking for home births.” 

The increase is particularly stark among Black women, with the AP reporting, “The rise in U.S. home births from 2020 to 2021 was sharpest among Black women, with an increase of 21%. That followed a 36% increase from 2019 to 2020, according to the report.”

Tanya Wills, a home birth midwife in New York City, explained that with the backdrop of George Floyd and COVID-19, “We started getting calls that said, ‘I’m Black and I want to have a home birth because I don’t want to die in the hospital.’ It’s not a difficult math equation for a lot of folks.” 

Black women aren’t just home birthing in significantly increasing numbers, but home schooling, too. According to the U.S. Census, in Black or African American households the rates went from 3% in the spring of 2020 to 16% by the fall. The rise in both homeschooling and home birthing are born of the same growing distrust of systems that are failing their community in particular. 

Among the middle and upper middle class clients that Abby Vidikan, a midwife in Los Angeles, sees, that same distrust is driving her booming practice’s growth. She told me, “I’ve seen a steady uptick (in business) since COVID started; this year is by far my busiest year in practice, and next year, the way that it’s shaping up, will probably top this year.”

What is bringing these women to seek home birth in record numbers? Vidikan explained: “A lot of clients are coming to me because of a general distrust in the medical system; I think a lot of that had to do with COVID policy, which at this point people are seeing as bad policy or over-reaching policy that has made them question the entire health care system.” 

That distrust certainly played a part for Evie Solheim, a new mother in Virginia who recently had her first birth at home. She told me about the messaging from her former providers about the COVID-19 vaccine: “Most of the nurses and doctors I saw weren’t too pushy but still said insane things like ‘the vaccine will make giving birth easier.’” She quipped, “I’d like to see the study on that.” 

Even though it feels like much of the pandemic is behind us, that isn’t the case for those in the medical system. For Katherine, a mom in Minneapolis, the push to seek a home birth came in May 2021, halfway through her pregnancy.

She told me, “I asked at an appointment what the hospital policies were and was told that I would be asked to wear a mask ‘as long as I could’ while in labor and my husband would have to wear one the entire time we were there. They also were apparently going to enforce masking while I was holding my newborn. The grounds of the hospital were off limits and we would essentially have been confined to our room.” 

Over a year and a half later, many of these hospital policies are still in place. Recently, I spent a night on a labor-and-delivery floor after I was involved in a car accident, and I was confined to my room, expected to always wear a mask when having procedures outside my room, and visitors were required to wear one while they were with me.

From New York City to Los Angeles, midwives Wills and Vidikan are seeing professional women — lawyers, teachers and even medical professionals — seeking their care. “This isn’t a cultural uptick in crunchy granola magical Instagram births,” Wills said.

While Vidikan is the midwife on call for LA-based actresses, models and influencers, she sees their growing interest in home birth to be borne of the same motivation bringing the lawyers and business owners to her: the desire to opt-out of a system they don’t trust, which boasts impersonal and potentially unpredictable care, with the potential for suddenly shifting hospital policies related to masks, birth assistants and visitors depending on COVID-19 rates.

For many, COVID-19 was a red-pill moment, accompanied by a great deal of disillusionment about once illustrious institutions we trusted, like those in health care. We’ve seen the result of that rising distrust in other health care decisions, as in the case of vaccination.

Some of these trends may be be dangerous, as when parents refuse all vaccines for their children, even those that have been proven safe and effective. But in the case of home births, we’re seeing women who are able to simply and safely opt-out of the traditional model of maternal care for a more personalized and intimate relationship with their health care provider. 

Full disclosure: I’m one of them and plan to have another home birth any day now. After my experience spending a night in the hospital after my car accident, I’m glad to be delivering at home, especially in a COVID-19 world. This will be my second “COVID baby,” and I feel lucky knowing that my care will be with a home birth midwife. 

Bethany Mandel is a contributing writer for Deseret News. She is a home-schooling mother of five and a widely published writer on politics, culture and Judaism. She is an editor for the children’s book series “Heroes of Liberty.”

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