Keep Pregnant People Safe During COVID-19 in New York

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In the midst of a pandemic, healthy, low-risk pregnant people are being asked to admit themselves into hospitals whose ERs and ICUs are being overwhelmed by people very sick with COVID-19. Pregnant people – who require PPE upon admission – are being admitted into the same systems where the hospital staff themselves do not have enough PPE and every spare inch is being converted to care for more COVID-positive patients.

Pregnant people in this moment, are asked to go into the hospital, the epicenter of our struggle against this disease, while everyone else is asked to shelter in place. Obviously, this does not make sense.

Worse, pregnant people are induced early (which creates a significant respiratory risk to neonates); potentially expected to deliver devoid of their family members and doulas owing to new pandemic-driven policies at hospitals allowing the presence of only one birth companion; and – at significant risk – sent home early with nonexistent postpartum care.

We know that birth outside the hospital is safe — in fact, for those who are low-risk, it is safer than birth at the hospital. We know that the hospital system is going to be overwhelmed. We know that labor wards are soon going to become ICUs and that OBs will have to focus on their high-risk and COVID-positive patients. We know that we are going to be short-staffed as a great many healthcare workers test positive for COVID-19. We know that midwives are trained to attend births in a variety of settings safely. We know that the Javits Center has been converted into a massive hospital, and that the City now intends to convert rooms in 20 hotels into an additional 10,000 hospital beds. 

Why can’t we convert a handful of spaces much smaller than the Javits Center into safe auxiliary maternity units so we can get through this crisis without causing unnecessary trauma and harm to birthing people and their babies? 

In an unprecedented pandemic, we need our hospitals to work at full capacity. We should keep more healthy people out of the hospital — including pregnant people, partners and midwives. In the process, we will save our resources (limited PPE, hospital beds and staff) for those who need them most.

It wasn't always this way, in 2001, NYC had four free-standing birth centers and multiple within-hospital birth centers or midwifery-led care floors. Now, New York State has just three out of the 345 birth centers in the United States, with just two in New York City, both located in Brooklyn. Long-term, we should be fighting for more birth centers and better options for pregnant people in New York, but in the near-term, both of NYC's birth centers are now at capacity, and thousands of pregnant people are afraid, uncertain, and feeling without options.

To get through this pandemic, we need to protect the health of ALL pregnant people in New York and create Auxiliary Maternity Units NOW!

Recommendations:

  1. Create Auxiliary Maternity Units according to the guidelines set by the American Association of Birth Centers (AABC) and Commission for the Accreditation of Birth Centers (CABC) to expand capacity, reduce potential exposure and limit depletion of necessary critical care resources. (National organizations signing on to the letter of recommendations include Ariadne Labs, Association of Maternal & Child Health Programs (AMCHP), Pacific Business Group on Health, Lamaze International, National Association of Nurse Practitioners in Women’s Health, National Association of Certified Professional Midwives, Ancient Song Doula Services, Centering Healthcare Institute, DONA International, Every Mother Counts, Foundation for the Advancement of Midwifery, ImprovingBirth, Jewish Healthcare Foundation, March for Moms, National Doula Network, Our Bodies Ourselves, and Women’s Health Activist Movement Global)
  2. Expand the capacity of existing freestanding birth centers for low-risk women.
  3. Integrate doulas and other community-based perinatal health workers to provide education and support during pregnancy, labor, delivery, and the postpartum periods.
  4. Implement a community-based postpartum and newborn management plan that provides early discharge with safe follow-up care.
  5. Midwife-led Birth Centers, legalized in 2016 and regulated in November of 2019, simply lack a process for licensure in New York State. As a result, there are no new birth centers in the state, save the 3 that existed prior to the new regulations. Allow any licensed midwife to open a Birth Center immediately by following an application process for a temporary license, pending accreditation within a 6-month time frame. See Minnesota's application and law for reference. 

Resources:

Supporters

  • The American Association of Birth Centers
  • The Commission for the Accreditation of Birth Centers