COVID-19 or not, families have the right to choose home birth!
The NSDA believes that birthing families have the right to birth at home with the care of a registered midwife, despite COVID-19. Nova Scotia is the only jurisdiction to maintain a ban on home births during this pandemic. The NSDA wants to show support for families who are currently having to navigate a major change in their birth preferences and urges decision-makers to reverse their decision to ban home births. Though we understand the necessity to protect our wonderful and dedicated midwives, taking away families’ rights preemptively is short sighted. The anxiety and emotional anguish this is causing families may lead to long-term health consequences. Some families are now forced to make decisions they would not otherwise have even considered, such birthing unassisted (giving birth without the presence of a skilled primary care provider).
A Nova Scotia parent has started a petition in order to have the ban on home births currently in place in Nova Scotia due COVID-19 reversed, as it has been done in other jurisdictions. For those interested in helping with this cause, please click the button below. You will be sent to an external link.
For families and doulas interested in a letter campaign, please scroll to the bottom of this page! There is also a Call to Action.
Background
The IWK Health Centre and Nova Scotia Health Authority issued a joint statement Monday March 30 to announce a suspension of midwifery-led home births in the province. The decision was made without the consultation of midwives.
On April 4th, 2020, in a letter addressed to a number of high level health stakeholders, Ashley Ward and Todd McDonald pleaded their case to have the decision to ban home births revoked. They argued:
The Canadian Association of Midwives (CAM) and National Aboriginal Council of Midwives (NACM) released a joint statement on April 3rd that recommends that all governments:
- Maintain home births as it continues to be a safe place for midwives and mothers
- Use midwives and home births at full or expanded scope to alleviate pressures on an overburdened hospital system
- Use home births and continuity of care with midwives to reduce the number of interactions among healthcare professionals that risk spreading COVID-19
Dr Anthony Armson, President of the Canadian Society of Obstetricians and Gynaecologists (SOGC) says of the NS decision, that SOGC has not taken a stand against home births for asymptomatic women and “it is still their (the mother’s) choice to have a home birth, provided they can receive care from two experienced midwives who are willing to provide that.” (todaysparent.com Mar 31, 2020).
While the province may be concerned about the extra burden of ambulances transferring some mothers to hospital if the birth at home encounters complications, the Ontario and BC Midwives states that only “5% of transfers to hospital” require an ambulance. Given that NS only has an estimated 6-12 home births per month (CBC March 30, CJ Blennerhassett, President of the Association of Midwives), the expected outcome is thus .3 to .6 incremental ambulance transfers per month (or about 1 every two months).
Nathalie Pambrum, President of the Canadian Association of Midwives, says to policy makers “it is important to consider the important role that midwives can play in reducing the number of patients entering and overburdening these facilities (hospitals).” Further, “Choice of birthplace, especially in the context of the pandemic, must be decided by the midwives and childbearing families following best available evidence” and adds that there is no evidence to support that home birth is unsafe for the midwives or the client when they are using personal protective equipment. (todaysparent.com March 31, 2020). This statement seems to be supported by CJ Blennerhassett in a CBC article that states “she wasn’t aware of any evidence to suggest that home births put patients or midwives at greater risk,” (CBC “Nova Scotia Suspends Home Births, March 30, 2020).
Preventing the mother from having a birth at home significantly increases the exposure of the mother and baby to Covid-19. At a home birth, the mother is exposed only to the two midwives. When forced to birth at the hospital, the mother is exposed to the same two midwives, plus nurses, administrative staff, cleaning and food service staff, doctors and more. The risks of cross contamination to the midwives and the mother increase exponentially. Granted, the exposure to the midwives may increase if the environment at the home birth is left unchecked (i.e. multiple family members, kids etc), however, this can easily be managed by implementing policies that families must abide by. In fact, these exact measures were put in place by Quebec this month when they reversed their original decision to limit home births.
The International Coalition of Midwives released a statement that recommends, among other things:
- Healthy women experiencing a normal pregnancy and with support from qualified midwives, with appropriate emergency equipment, may be safer birthing at home than in a hospital where there may be many patients (even non-maternity patients) with Covid-19.
- Continuity of care models of midwifery care will reduce the number of caregivers in contact with the woman and her birth partner and decrease the chances of Covid-19 spread in hospitals; continuity of midwifery care should be encouraged and provided.
The outlawing of any product or service almost always leads to a “black market.” Already, we have seen firsthand couples choosing to give birth outside of the health system… they are opting to stay home and hope for the best without licensed medical professionals. These risks must be considered when creating health policy. This is something our family must now consider as well.
Finally, there is likely no group of citizens abiding by self-isolation rules more so than expectant mothers. Our family has self isolated for 4 weeks and will do so for another 6 weeks until our delivery date. Now, we are being forced to take ourselves, our unborn child, and our midwives into a hospital setting where we will be exposed to a significantly higher risk of contamination as well as unnecessary, unwanted, and unhealthy interventions. For this risk, all mothers at least deserve an explanation.
Letter Writing Campaign
A letter writing campaign can be a useful strategy to call upon decision-makers to consider changes in policies and practices. A letter campaign must be organized an well executed.
The NSDA encourages families who are affected by the home birth ban currently in place due to COVID-19 to put their thoughts on paper.
Consider the following:
What is the problem? (ie The current ban on home birth)
How is this policy affecting you and your family? Why is this significant to you? (make it personal)
What is the solution? (ie Having registered midwives provide care in the chosen place of birth of Nova Scotia families)
What may happen to you/how would you feel if the decision is not reversed?
Where to send your letter? Options include:
Your MLA (here).
Your care provider.
Your Health Authority’s Board of Directors.
Your birthing hospital’s CEO.
Your birthing hospital’s Birth Unit.
Your local news outlet.
