Written by: Maggie Runyon, MSN, RNC-OB, CYT-200
I have sat down to write something to encompass the feelings I have about COVID-19 and how it is impacting birth care at least 5 different times now. Each time, I stop, because it is so hard to put into words the way I feel about everything that has happened in the last few weeks. We are in such a hard season…something unlike anything most of us have ever experienced in our lives. There is no “right” way to handle this crisis. Each of us is navigating this situation as best we can, and dealing with the reality that we are not operating in our ideal world right now. We are operating in a world in a pandemic, and the situation continues to evolve so rapidly that it feels impossible to keep up. That can become such an overwhelming feeling, and I’m sure all of us have found ourselves in a place where we can only see the negative impacts. I get it; I’ve been there a few times myself, and that’s natural and normal, and there is nothing wrong with being upset with what is happening. But I would hope that we could all try to take a deep breath and extend a little more grace to each other through this season.
Your BIRTH Partners was born from a desire to find a way to bring more people together within the birth world to talk about the issues that matter to us, and problem solve together to improve birth. So often, we find ourselves typecast in our role in the birth world: we perform a certain function or job, so that means we feel a certain way, and that’s that. It is easy to find ourselves in an environment where there is an obvious majority opinion and we are meant to just fall in line with the rhetoric, and that may make us function smoothly as a internal team and community, but it also makes it challenging to understand other perspectives and provide nuanced care.
I have been blessed throughout my career to be surrounded by a diverse array of birth professionals, who have each shaped and molded my view of birth and what it means to provide care during birth. I have supported birth as a nurse in small community hospitals, busy high-risk medical centers, and at home. And despite what you may hear, I have found overwhelmingly that the birth professionals in all these different environments desire to provide safe and empathetic care that results in happy, healthy families. Of course, there are many different care philosophies, just as there are many different values held by birthing people. And of course, there are those who do not practice safely or with empathy across all of our different professions. But as Bonnie Oscarson says “We must stop concentrating on our differences and focus on what we have in common. Then we can realize our full potential and achieve the greatest good in the world.”
COVID-19 has only magnified the issues that are already present in our struggling perinatal healthcare system in the U.S. We know our poorly integrated health system limits choice for birthing people and makes it difficult to facilitate care between community and hospital providers. We know that hospital staff often feel overworked, burned out, and struggle with how to support patient autonomy in our current malpractice climate. We know that our maternal mortality and morbidity rates are much higher than they should be, and that people of color are disproportionately impacted. We know that people who pursue and provide homebirth are often maligned over safety concerns and that 1 in 3 women feel traumatized by their birth.
All of these issues within birth care are intense and important and valid. And in many situations, they have become even more valid & pressing through the upheaval caused by COVID-19. When people speak out about these issues, many of us feel defensive of our role in birth and the way we practice birth care, and that makes it hard to have conversations. But the reality is that none of these people are wrong. Their lived experience and their concerns are real, even if they do not match up with our own. I have had to sit with this several times through the last month as I have read articles and social media posts that criticize various birth professionals and question their dedication and purpose within birth. My heart breaks for the many pregnant people and new families who feel anxious and out of control and are having so many of their plans and support systems altered by a vicious virus. And through all of this, we have created a situation where so many people feel they have to pick a side…they are siding with physicians, and hospitals, and public health policies OR they are siding with doulas, and midwives, and the rights of birthing people.
I believe this is a false dichotomy, and it will only result in more divisiveness and animosity and prevent true progress forward for an integrated perinatal healthcare system.
I believe we all need to continue to advocate for the causes dear to us.
I believe we need to speak up so that our voices are heard across the spectrum of options.
I believe we need to actively work to band together and reach out to our colleagues in different disciplines to find solutions that work.
I believe we can stay rooted in our convictions while remaining open to the way we can accomplish change.
We can speak up without necessarily criticizing individuals. We can elevate each other’s voices to promote change on larger scales. We can do this with mutual respect and empathy.
I love the communities I have seen coming together through this challenge. The way homebirth midwives are banding together to ensure more coverage availability for clients in their care. The way hospitals are moving prenatal centering care, and postpartum support & breastfeeding groups online. The way nurses and doulas and childbirth educators and lactation consultants and more are stepping up to change the kinds of services they’ve offered in the past and how they connect with birthing families. The way midwives, physicians, doulas, and nurses continue to leave the relative safety of their homes and risk spreading infection to themselves or those they love to care for those who need them.
How might we expand our efforts, even in this intensely challenging time, to foster connection and deepen our appreciation of the role each of us plays within birth?
How might we balance public health safety concerns with empathy for individual people and the needs of them and their families?
How might we use this time to actually create long lasting changes in the way we provide care so that we come out of this stronger rather than falling back?
Brené Brown writes “we don’t have to do it all alone; we were never meant to” and “no one belongs here more than you.”
YOU belong here in this community; no matter what your role is as a birth professional, no matter where you practice, no matter how you gave birth. I want to hear about your concerns and doubts and issues and challenges so we can use our collected resources to find solutions. I want to hear about your wins and the lessons you’ve learned so we can all celebrate and grow together.
Our whole podcast panel will be getting together later this week to discuss our experiences providing care during the COVID-19 crisis. We welcome your questions for any and all of us as you face these issues in your practice. We would love to highlight your stories.
We are in this together.