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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Vermont's Midwives Increasingly Called On During Coronavirus Pandemic

A person wearing a stethoscope.
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Many hospitals around the region are now strictly limiting visitors to prevent the spread of the coronavirus. At UVM Medical Center, for example, just one individual can accompany a person in labor and delivery.

This has meant a significant uptick in calls to certified midwives who facilitate home births according to Katie Bramhall, a midwife based in the Upper Valley and the President of the Vermont Midwives Association.

VPR's Henry Epp spoke with Katie Bramhall, whose practice is Gentle Landing Midwifery in Barre, Vermont and Lebanon, New Hampshire. The interview is below and has been edited and condensed for clarity.

Henry Epp: How have these hospital policies have impacted your practice so far?

Katie Bramhall: Birthing families are finding the community of midwives now and really expressing concern over that lack of support that they feel they are presented with, and asking a lot of questions about homebirth and about out-of-hospital birthing situations. A lot of the phone calls we're receiving are by families who had not really considered having an out-of-hospital birth. And so there's, you know, a lot of education that goes along with that.

So how are you advising the folks that are calling you right now and looking for alternative options to what they may have planned? Of course, the birthing process is something that many plan pretty extensively. And for so many, it's being upended right now. What are you telling those that are calling you and asking for advice?

Well, we're first doing is just really acknowledging that this is — feels impossible, is heartbreaking. You know, just really acknowledging the difficult situation that it presents for all of us. And then there are certain people who actually are pretty good candidates for having a birth outside of the hospital, even as a late transfer to care.

Usually late transfers to care, it's not a good idea at all to really consider that. But in a time of COVID-19, as long as somebody has had a healthy pregnancy — and that's that's a very objective assessment, not subjective at all: Is full term, has no underlying health issues and the baby's been checking out fine — it's definitely, you know, something that we can consider. We also have to take into consideration the people who we've already got in our practice and make sure that they get what they need in this difficult time. So it's a really big balancing act right now.

And so, of course, you are still performing and assisting with homebirths right now. Is that right?

Yes. I had two last week, actually. It's a very different process. Everybody's required to wear a mask. I probably went through 50 pairs of gloves just to make sure that I was protected and as was the family I was with. I actually chose to not do any hands on labor assistance for the first time ever in almost 500 births out-of-hospital. But then just instead just had to dig deeper and just sat down at the bottom of the bed in a chair and just used my voice as comfort the best that I could.

You know, the recommendation is just to limit exposure. And what that means is that, you know, it's just not a great idea given that COVID as a droplet-based illness. And so being really close to a woman who is unmasked and breathing really hard, you know the exposure potential for a midwife is pretty high, and it's just a messy, bodily-fluid kind of experience. Social distancing happens at a birth right now, too.

Well, just finally, Katie, I'm curious how you're planning to — or thinking about the months ahead, imagining that this might be the reality for for a while. What is that going to mean for your practice and for the practice of other midwives in this region?

Yeah, so I just hired another midwife in my practice yesterday. And the Vermont Midwives Association,  we're due for our second meeting this week to try and pool resources, both equipment and supplies and manpower — or womanpower, actually, — and womanpower so that we all, you know, can get the break we need, as well as keep the support going for our families. It's just like everybody else in health care, just a different version of it. We're managing our personal resources and our material resources and our spiritual resources, just like all of us.

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