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Choosing a care provider and support person during Covid

Are you a pregnant mama-to-be (or partner to one) who wants to learn more about what the heck is going on in the birth realm during COVID? This blog will explain the local Tucson hospital policies and different options for choosing a caregiver.

Hospital policies vary hospital-to-hospital but for the most part all the local hospitals are only allowing one visiter OR support person. Keep in mind when advocating for yourself, the CDC has recommended that if the visitor is an essential member to your care, there should be an exception.

Here are some local hospital updated policies as of 10/13/2020:

Tucson Medical Center has offered PPE training for local doulas and opened the doors to having them back in the hospital in addition to the single support person (typically the partner, if applicable). The doula must be on their list of PPE-trained doulas in order to attend a birth in the hospital. TMC is also allowing one other partner/visitor in after 24 hours of labor to trade off with the initial support person. They are encouraged to stay the whole time to prevent coming in and out of the hospital.

Northwest Hospital is allowing one “permanent” visitor, partner OR support person and one visiter from 8am- 8pm. This policy is for partners, doulas and other visitors. The “permanent” visitor will get a wristband and may leave / re-enter but is asked to limit that as much as possible.

Banner UMC is allowing one partner/visitor and a trained support person (doula, birth coach etc..) who must be certified. Beyond that, one visitor is allowed each day for 3 hours total. Doulas must leave soon after the baby is born.

St. Joseph's Hospital allows one partner/visitor and a trained support person (doula, birth coach etc..). The partner/visitor cannot change. As of 10/13/20, visitors and doulas can leave and re-enter the hospital but it is strongly recommended to avoid that unless necessary. No one is allowed into OB Triage except the birthing woman, so she will go in alone and then reunite with her birth team when she gets to her room. Doulas must leave soon after the baby is born.

The polices have been changing pretty constantly and we understand that everyone is working hard to try to ensure the safety of birthing mothers and newborns. We also understand what a special and sacred time this is for mothers and families and we are so happy to see that trained support people are being seen as essential parts of the birth team!

We will do our best to continue updating these policies as much as we need to. If you already have an OB or midwife and you are not happy with the policies of the hospital they work at, call them and see if they can practice anywhere else - it never hurts to ask. You may also consider a homebirth if you are low risk and have great mental strength (and a strong desire and sense of trust in yourself).

Home births can be an amazing, safe, and powerful experience. It's ideal to have been planning and expecting a homebirth as your first option and not a last resort. Regardless, perhaps you didn't know how great of an option they can be. Home births can be done with a licensed caregiver, typically a midwife. They can also be performed unassisted for the prepared, intuitional, and trained mama.

Midwifery style care has been compared to a home cooked meal that you know where it came from and who cooked it. They offer a one-on-one care experience where they get to know you and your personal preferences and how they can best support you in your birth. They are there for you day or night to personally answer calls and texts. Home births are great because you get to be in the comfort of your own home, surrounded by who you choose, in control of yourself and your environment while being taken care of by a professional. Midwives may also accompany you at a hospital in the case of transfer - that is something you will have to discuss with the midwife. If you are interested in interviewing midwives to hire, check out our Resources page.

“ In a recent study from Midwifery & Women’s Health (JMWH) which examines nearly 17,000 courses of midwife-led care.... They found a cesarean rate of 5.2%, a remarkably low rate when compared to the U.S. national average of 31% for full-term hospital pregnancies... Women who planned a home birth had fewer episiotomies, pitocin for labor augmentation, and epidurals… Most importantly, their babies were born healthy and safe. Ninety-seven percent of babies were carried to full-term, they weighed an average of eight pounds at birth, and nearly 98% were being breastfed at the six-week postpartum visit with their midwife. Only 1% of babies required transfer to the hospital after birth, most for non-urgent conditions. Babies born to low-risk mothers had no higher risk of death in labor or the first few weeks of life than those in comparable studies of similarly low-risk pregnancies.”

If you were planning a hospital birth and looking forward to that epidural, then a homebirth may not be for you. You may, however, consider a local Birth Center as a good middle ground. There are a few here in Tucson:

Baby Moon Inn This is a freestanding, out-of-hospital birth sanctuary tended by midwives. This setting allows women to experience a comfortable, like-home setting focusing on natural birth. They offer prenatal care, a massage and facial, chiropractic care, support groups, 24/7 midwife access, childbirth ed, basic photography, postpartum care, home visits, lactation support and more. Find their contact info here.

El Rio Midwives, partnered with TMC

El Rios Certified Nurse-Midwives provide “high quality care for women”. They lead the maternity care team at El Rio which may also include nurses, obstetricians, maternal fetal medicine specialists, nutritionists, lactation consultants, and more so they are ready to be there for any family with unique needs. They only attend births at TMC hospital either in the labor and delivery rooms or their new Midwifery Center. The Midwifery Center was created to offer an intimate and supportive environment for natural childbirth

There are many studies on birth centers and their safety, one being the National Birth Center Study ll, Which included more than 15,000 people planning to give birth at a birth center, found:

  • No maternal deaths

  • A 4.4% cesarean rate

  • A low neonatal mortality rate of 1.3/1000 births

  • 98.8% of women would recommend birth center care and/or return

**No Hospital, Birth Center, or Home Birth Is Risk-Free** Better access to care, quality of care, and care system integration can improve safety for women and infants during birth.

It’s clear by recent hospital policy updates that there is still very much a need for doulas on the birth team, whether that's in the hospital, home, or birth center. Doulas can help you stay updated and informed on these changing policies.

Our doulas at Taking Back Birthing have completed the PPE training at TMC and are working hard to stay informed about the changing community standards of care. We can be your eyes and ears and help empower you to advocate for yourself and make informed decisions.

We are not care providers and do not do anything clinical which allows us to pour all of our support into your emotional, physical, and familial support! We focus on getting to know you personally and how we can truly be valued members to you and your birth team/plan. We will help you prepare for your labor, birth, and your postpartum. We believe that preparation, support, and knowledge are all key for having a satisfying birth journey.

In studies from Evidence Based Birth there was a “39% decrease in cesarean rate” when women were supported by a Doula, a “15% increase in the likelihood of a spontaneous vaginal birth”, a “10% decrease in the use of any medications for pain relief”, “Shorter labors by 41 minutes on average”, 31% decrease in the risk of being dissatisfied with the birth experience

As with everything, there are personal pros and cons to consider and making the best choice for you and your family is a key to a safe and satisfying birth journey. We believe women have the right to informed choice of the setting in which they give birth, and to exercise that choice, they must have access to options. For the resources we talked about and more, visit our Resources page and inform yourself to make the best choice for you and your family. Our trained doulas are always here to talk to and provide unbiased information!

We hope this was helpful and information for you! Stay tuned next week for our blog “What to Expect Giving Birth During Covid”!

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