How expecting families and birth centers are operating around a pandemic.

Story by Katie Linton

Copious amounts of maternity literature and baby name books cover counters and coffee tables in an expecting parent’s home. Continuously growing piles of diapers, clothing and toys stack up in closets and nurseries as awaiting parents try their best to prepare for one of the biggest changes in their lives.

Birth plans have been made, baby shower invites have been sent out and medical appointments have been scheduled. Creating a birth plan is the closest many can come to having any semblance of control over how the actual birth is going to play out.

Just a few months ago, expecting parents were debating between a home birth, a hospital birth or a birth at a birthing center. They were choosing whether the mother would want an epidural to relieve the pain during labor or to give birth naturally. They were considering a water birth, or the presence of a doula, a woman who gives guidance and support to a mother during childbirth. They were asking who should be in the room when the baby is born. Just the parents, or grandparents too… siblings?

Now, birth plans are just one of the countless things that have been thrown into the unknown amid the coronavirus crisis.

In January 2020, Snohomish County, Washington, was altered by the first case of coronavirus in the U.S. Soon there would be nearly 2 million cases of coronavirus. Due to its contagiousness, various stay-at-home and social distancing orders were placed on cities, and then on states throughout the country in hopes of slowing the spread.

Coronavirus has forced expecting parents to not only change the answers they had to the original set of questions that comes with expecting a newborn, but it has also presented a whole new set of questions.

The one that’s on the forefront of everyone’s mind: What’s the safest way to navigate the contagiousness of this crisis that will ensure the health of the parents and their newborn?

As expecting parents try to answer these questions for themselves, local birthing centers do their part in providing for the increasing number of people who have decided to turn away from their previously planned hospital birth.

Bellingham Birth Center has been on the corner of Cornwall Avenue and Alabama Street since it was established by Christine Gibbs and Catriona Munro in 2004. Chances are locals have driven by it countless times and may have noticed the ever-increasing number on the “babies born here” sign in the front window.

So far, many birthing centers are still able to provide an experience close to the original birth plan. Expecting mothers can still have close family members in the room. The fear of infection isn’t as apparent because birthing centers don’t deal with countless ill people coming in and out every day as a hospital does.

Munro estimated that Bellingham Birth Center has seen its business go up about a third in the last couple months.

Luckily, the increase of people using birth centers has not been too much to handle for places like Bellingham Birth Center. They have three rooms to choose from and given the variation of people’s due dates, it’s rare that there is any overlap, even with the increase in business. Not to mention, there are a couple other birth centers in town.

Bellingham Birth Center is taking everyone’s temperature before they come into the building and are taking extra steps to make sure objects with a high touch rate are frequently sanitized, Munro said. Ann Tive, owner of Birthroot Birth Center, said they are doing the same.

Tive has been a licensed midwife since 1990. She runs Birthroot Birth Center, an inviting pastel yellow house on Broadway Street in Bellingham. Tive said they are being extra cautious in making sure everything is sanitized and they also wear masks for in-person interactions. They are also doing as many visits as possible via Telehealth for both prenatal and postpartum appointments.

Only the most essential visits and check-ups are done in-person. Essential visits require a necessary hands-on assessment, things like blood draws or other sample collections. Most places are doing in-person visits from around 33 weeks to birth, with due dates at 40 weeks. That way, for the final couple months, the fetal growth, heart rate and mother’s vitals can be assessed in person, but some of the other visits can be done remotely, Munro said.

For Kinzie Sutton, a new mother from Ferndale, Washington, her prenatal care began changing in April when most of her appointments became phone calls.

“I only went in for face-to-face visits every other appointment, and at my face-to-face visits, I wasn’t allowed to bring my husband,” Sutton said. “And my labor and delivery class was over Zoom instead of in-person.”

It was a learning curve, Sutton said.

“We were already learning all this new and very foreign information and had to pay super close attention because it was on screen instead of in-person,” Sutton said.

Munro said although the hospital policies at St. Joseph’s Medical Center keep changing, people have either not been allowed to have anyone or not been allowed to have more than one additional person in the room during labor. This was the experience for Sutton. She gave birth to her son Jedson at St. Joseph Medical Center in Bellingham on May 8, 2020. Just her husband was in the room with her, as she was only allowed one additional person.

“It was a rather apocalyptic feeling,” Sutton said. “My mom brought me to the hospital and helped me check in to the childbirth center and then had to leave as I waited for my husband to arrive and be admitted with me.”

Aside from feeling alone in the hospital, there is the added concern of what the hospital will do with the baby after they’re born, Munro said. This is a concern specific to the coronavirus crisis, having to do with the possibility of the mother receiving a positive coronavirus test result.

Although the research is still limited, it’s possible that the virus can spread from a mother to an unborn baby via vertical transmission. In the few cases of newborns who have tested positive, it is unknown whether they contracted the virus before or after birth. Because the research is new and ongoing, if a mother were to test positive for coronavirus, it is recommended that their baby not be kept in the same room following birth because of the possibility that the virus has not yet been transmitted. This is a concern that has been expressed by several expecting parents as they transfer their care from the hospital to midwives at a birth center.

The possibility of having to give birth alone at the hospital can be a scary thought for expecting mothers. “I get both sides, because we’ve also chosen to limit the number of people that are allowed [in the birth center] at the birth because it’s the same thing,” Munro said. “The more people that are there, exponentially the more chance of someone getting sick.”

Bellingham Birth Center allows more people in the room during birth than a hospital. It’s a big reason people are choosing to forgo hospital births, Munro said.

Another possibility is having a home birth. Most midwives that work through Bellingham Birth Center offer home birth assistance, and given the circumstances, women in labor may feel there is less of a risk of contracting coronavirus by being at home.

However, from the perspective of a midwife, someone’s home is a very unknown environment. Munro said that midwives are actually suggesting using a birthing center instead of doing a home birth.

“If you think about it from the midwife’s perspective, going into a home where you can’t control what’s been sanitized or who’s visited or how things are cleaned, that puts the midwives at risk, and then that puts her clients at risk, and the other midwives who would come to assist,” Munro said.

For some expecting mothers like Sutton, giving birth at a hospital remained the plan. Despite some additional fear of giving birth at a hospital right now, it still remains a reliable comfort for others.

“I have always wanted to have a hospital birth because I have honestly been terrified of childbirth my entire life,” Sutton said. “So there was never really a question of whether I would be at the hospital or not. I was very happy with my decision to deliver at the hospital. It helped ease my nerves a little bit.”

When it came time for her to go to the hospital Sutton said she had to wear a mask whenever she was outside of her own room. Any time hospital staff were around her, they would also wear masks. They washed and sanitized their hands, what Sutton estimated to be twice as much as they normally would.

“Nobody was allowed to come visit once he was born. We were fortunate enough to get moved to a room that had a window so our parents and my brother came to the window and stood outside and were able to see our baby boy through the window,” Sutton said.

It might be easy to think of birth as one big moment, but there is a lot leading up to it and a whole lot afterward — doctor’s appointments, ultrasounds, childbirth classes, forming a birth plan, postpartum check-ups, “baby and me” classes, buying supplies and overall adjustment to life with a newborn.

“Childbirth is the most foreign but yet natural experience I have ever had,” Sutton said. “It was amazing seeing how my body knew exactly what to do even though I felt like I had no idea what I was doing.”

The days following a birth can be isolating no matter what, but now maybe more so now than ever.

Support systems people once had are either limited or unavailable and new mothers, like Sutton, said the best way she can describe postpartum is: “a real rollercoaster.” For Sutton, an unanticipated component of postpartum has been the influx of hormones, and of course, there’s the much-anticipated excitement of having a newborn that she wants friends and family to meet. Both have made postpartum that much more challenging, she said.

“We have social-distanced from pretty much everyone,” Sutton said. “We will have people come over sometimes and sit outside with us, but they stay 6-feet away and aren’t allowed to touch or hold our son. My love language is physical touch so it has been very challenging for me to not be able to hug my loved ones.”

The coronavirus pandemic is an uncontrollable addition to any birth plan and no amount of deep reading through all those coffee table birthing books can point expecting parents in the right direction. However, as people adjust to this unprecedented situation, resources like birthing centers and hospitals are working that much harder. Because the importance of a safe birth, and a healthy mother and baby remain constant.