Home Deliveries … of Babies

Photo Credit: In The Light Photography/Shutterstock

Kate Wilcox’s plan was to give birth to her fourth son at Doylestown Hospital in Pennsylvania sometime in early May. She had already delivered three sons, ages 6, 5, and 3, the same way — in a hospital, unmedicated, with a midwife.

Wilcox, 33, was set on a natural birth before her first child was born. It was the way both her mother and mother-in-law had given birth, which meant she had family support. Also, in her view medical intervention often begets more medical intervention, which was something she hoped to avoid. The idea was always to be in a hospital, though, just in case there was an emergency.

It wasn’t until April 11, exactly one month before her May 11 due date, that Wilcox began to reconsider her plan. COVID-19 was becoming increasingly more serious and the restrictions in maternity wards — along with the threat of catching the disease in the hospital — worried her. Suddenly, home birth seemed like the best alternative.

“We explored home-birth options, especially to keep me and the baby safe from contracting anything,” said Wilcox. “I also really wanted an unmedicated birth and was scared that these hospital restrictions would make it hard.”

Wilcox reached out to Ray Rachlin, a Philadelphia-based certified professional midwife and founder of Refuge Midwifery, and Rachlin had an opening. Wilcox, who is Maronite Catholic, believes her religious beliefs gave her the confidence to trust Rachlin to deliver her baby. “My faith allows me to trust in things you can’t see,” she said.

By the end of March, Rachlin, 32, was getting close to 20 calls a day from women who were due in April and May and looking to transfer from hospital to home birth. This was quite an increase from the 20 calls a month she was getting before the pandemic.

The problem, Rachlin said, was that she was fielding requests from women who wouldn’t have chosen home birth under different circumstances. For some women, the decision was wholly fear-based, which isn't a good reason, she said.

“Some of it was driven by fear,” she said. “I have turned people down in part because home birth is for low-risk births and it’s a different model of care."

Now, a few months into the pandemic, even though daily requests have slowed, home birth as an option has increased overall, Rachlin said — so much so that she’s booked solid for the rest of the year.

An Increase in Home Births

Rachlin, who has been a midwife for four years, says there is a part of her work that is related to her Jewish faith. It’s not just that she enjoys seeing some of her clients at Kol Tzedek Synagogue in West Philadelphia, where she is an active member. It’s also that midwifery connects her to something bigger than herself, a lineage of people who have been helping women give birth throughout Jewish and global history.

According to the National Institutes of Health, home births across the country increased by 77% from 2004 to 2017. In Pennsylvania alone, there were 2,611 home births in 2017. Of course, it’s still too early to tell how this number will change as a result of the pandemic, but Rachlin is hopeful that COVID-19 will only continue to make people more aware that it can be a safe choice.

“The pandemic has brought to light how home birth can be the safest option,” said Rachlin. “The risk-benefit has changed because people want more bodily autonomy in birth, in addition to being scared of infection.”

Chana Luba Ertel, a Pittsburgh-based certified professional midwife, agrees that the profession will be changed in some way because of the pandemic. “There is small, steady progress,” said Ertel. “Once people acknowledge the possibility of it, then we can start educating them about the realities of the safety of out-of-hospital births.”

Some of it was driven by fear. I have turned people down in part because home birth is for low-risk births and it’s a different model of care.

Similar to Rachlin, Ertel has found that her work in midwifery is connected to her Jewish faith, which is something she hopes will continue to be highlighted through this pandemic experience. Ertel used to teach a course on Jewish doula training in Brooklyn for Hasidic women where, for example, she emphasized how crucial Jewish midwives were in the story of Exodus. She hopes that, as midwifery continues to be thought of as a safe option, women will reclaim this history.

“We have a really strong heritage that has somehow gotten wiped away and pushed aside through the male-dominated Western world of birth,” she said. “Women have been helping women have babies since the beginning of time.”

While Ertel, 44, says that midwife requests have declined after the initial surge during the height of the pandemic, interest in the option has increased overall. From a client perspective, Wilcox agrees that home midwifery will become more popular as long as restrictions in hospitals persist. And she, for one, is happy about her decision.

Wilcox’s son Alexander was born on May 10. The birth itself was easy, she said, and she felt safe being at home, especially because she learned how well equipped home-birth midwives are to handle emergencies.


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