+
popular

Here's to another unsung hero of the coronavirus pandemic—the midwife

Here's to another unsung hero of the coronavirus pandemic—the midwife
Photo by Alex Hockett on Unsplash

Imagine being pregnant in the middle of a pandemic, when a hospital full of potentially contagious patients is the last place you want to set foot. Where and how are you going to bring your baby into the world?

Thousands of parents-to-be facing this question have scrambled to make a plan that keep them and their baby safe during the coronavirus outbreak. And many have turned to the experts in safe birthing in non-hospital settings—midwives.

Depending on where you live, midwife-assisted birth in a non-hospital setting may be seen as totally normal, or it may be viewed with suspicions about safety. In the U.S., midwife-attended births had seen an uptick even before the pandemic, but the vast majority of births still take place in hospitals. In other countries, home births attended by midwives is the norm for low-risk births.


With the new coronavirus likely not leaving anytime soon, folks in the U.S. might want to hop on the "this is normal" train. With restrictions on visitors and birth support people, as well as the risk of infection, more and more parents are opting for an out-of-hospital birth experience.

Despite being the first state hit hard by the virus, Washington state has had a "tremendous leg up" on this front, says Jen Segadelli, Co-President of the Midwives' Association of Washington State and Clinical Education Supervisor of the Department of Midwifery at Bastyr University. Decades of relationship-building between the midwives and OBs in Washington has created a strong culture of collaboration, she says, making childbirth care in a pandemic far easier than in states where midwives and OBs operate mostly in separate spheres.

However, even in a state where doctors and midwives work well together, the unique circumstances of a pandemic create an entirely new set of challenges and considerations. Coincidentally—and thankfully—a playbook for handling childbirth during a pandemic had already been partially written in Washington before the virus even hit.

Seattle-area midwife Tara Lawal, who runs Rainier Valley Community Clinic, had written her Masters thesis on developing a midwife-led community-based model of care, which includes midwife-physician collaboration—a vital piece of the pandemic birth equation. And Emily Jones, a current Bastyr University midwifery student, is nearly finished writing her Masters thesis on the role of midwives in disaster preparedness. The central question of her paper: "What happens when hospitals run out of beds?" Talk about good timing.

Segadelli, Lawal, Jones, and other community birth providers in Washington have created a COVID-19 Response Coalition to address the needs of birthing families during the pandemic using the knowledge laid out in those midwives' research. "The goal is to not get ourselves to a place where we are suddenly New York and like 'Aw crap. We might have to divert two thousand births out of the hospital in two weeks, and where are we going to put them?'" says Segadelli.

For midwives, the specifics of "where" aren't as important as simply having a plan. "We can catch a baby anywhere," says Segadelli. "We would just prefer that there be four walls and running water and heat."

Washington has dozens of licensed freestanding birth centers, which offers a degree of out-of-hospital infrastructure in addition to home birth options. But not all states have those facilities. New York, for example, has just two freestanding birth centers, both in Brooklyn. So creative solutions have to be found when hospitals get overrun and birth centers aren't available.

Segadelli says one option is setting up ad-hoc birth centers in hotels or Airbnbs in addition to home births. However, varying state laws and regulations make those options trickier in some states than others. For example, some states don't allow midwives to carry certain life-saving medications, and some don't even allow midwives to legally practice at all.

Segadelli says differing state laws means a hyperlocal approach must be taken:

"This is the downside to the federalist legal system, right? We essentially have 50 different legal systems in this country. Our legality of practices are different state by state, and our scope of practice is different state by state. There are some states where you can't carry anti-hemorrhagic medication. You can't carry Pitocin to stop a postpartum hemorrhage. So the way that those midwives might be forced to manage this is going to look different than it's going to look like for midwives in Washington, who enjoy a pretty liberal scope of practice and a pretty extensive drug legend for emergency management."


Segadellisays midwives has seen a 25% to 100% increase in demand across the state since the pandemic began. Some requests are from patients who are near their due date, which poses an extra challenge for midwives who are used to working closely with patients throughout their pregnancy. Late-term transfers don't allow much time for relationship-building, and patients may not be prepared for the reality of an out-of-hospital birth without the option of an epidural. But in a crisis, people do what they have to do.

And problem-solving in real time is exactly what midwives do. "I think that's what midwives do well," says Segadelli. "We innovate. We problem-solve. We always have." Midwives also have valuable birth care expertise that traditional OBs don't. Doctors have begun approaching midwives in Washington asking how to get patients out of the hospital after birth quickly, which is standard practice for most midwives. Segadelli says that kind of knowledge sharing will serve birthing patients well, not only during this pandemic, but in any potential disaster situation.

"We are hopeful that we have somewhat managed to avert crisis in this state with early action with social distancing and preventative measures," says Segadelli. "But we are also hopeful that this has started a bigger conversation about when this happens again—I won't even say 'if,' we're way too connected as a global society for it not to happen again—or an earthquake or some other kind of crisis or disaster—when we're faced with it, that we've started to lay some groundwork here with our colleagues and as a healthcare system that recognizes we're going to have to have a plan. Because if we don't have a plan, the people who fall through the cracks are the birthing people and the babies."

While OBs are experts in surgical birth and high-risk birth situations, midwives are the experts in normal, low-risk birth. Both kinds of expertise are needed in a crisis, so the more birth care providers work in conjunction with one another, the better the outcome for all birthing families.

@penslucero/TikTok

Pency Lucero taking in the Northern Lights

Seeing the northern lights is a common bucket list adventure for many people. After all, it ticks a lot of boxes—being a dazzling light show, rich historical experience and scientific phenomenon all rolled into one. Plus there’s the uncertainty of it all, never quite knowing if you’ll witness a vivid streak of otherworldly colors dance across the sky…or simply see an oddly colored cloud. It’s nature’s slot machine, if you will.

Traveler and content creator Pency Lucero was willing to take that gamble. After thorough research, she stumbled upon an Airbnb in Rörbäck, Sweden with an actual picture of the northern lights shining above the cabin in the listing. With that kind of photo evidence, she felt good about her odds.

However, as soon as she landed, snow began falling so hard that the entire sky was “barely visible,” she told Upworthy. Martin, the Airbnb host, was nonetheless determined to do everything he could to ensure his guests got to see the spectacle, even offering to wake Lucero up in the middle of the night if he saw anything.

Then one night, the knock came.

Keep ReadingShow less

A father tries on a shirt that his 9-year-old son sewed for him.

There's always something very touching about receiving a gift from your child, especially when you know it's something that they really put their heart into creating. A video posted to TikTok by Aaron Gouveia shows that sometimes a child can give a gift that’s so surprising it’s almost too much to handle.

Gouveia, 43, is a Massachusetts father of three who posts videos as “Daddy Files” on TikTok about the joys and challenges of family life. On March 26, he posted a video featuring his son Sam, 9, that was so heartwarming it has received over 12.4 million views.

Keep ReadingShow less

Delivering packages AND safety.

Amazon delivery drivers don’t have the easiest job in the world. Sitting through traffic, working in extreme temperatures, hauling boxes … not exactly a fun time. So when a driver goes out of their way to be extra considerate—people notice.

One delivery driver has gone viral for the way she delivered a little bit of safety education, along with some lighthearted advice. The TikTok video of the encounter, which now has more than 4 million views, was shared by Jessica Huseman, who had only recently moved into her new house.

Keep ReadingShow less
Pop Culture

Robin Williams used the perfect gag to stop Oprah from outing Nathan Lane during live interview

“I’m not prepared to discuss that I’m gay on national television. I’m not ready.”

Robin Williams distracts Oprah from outing Nathan Lane.

Robin Williams was a gem of a person. The comedian knew how to keep people laughing, but as the years go on after his untimely death, we hear more stories about what a good friend he was. Recently, Williams' kind nature was the topic of conversation between Willie Geist and "Murders in the Building" star Nathan Lane on "Sunday Today".

Lane sat down for an interview to discuss his new play, and during the conversation, he reminisced about his first big role in the 1996 movie, "The Birdcage." In the movie, he played a gay man that was married to Williams' character and the pair were trying to marry off their straight son to a nice woman who had conservative parents. For Lane, the movie mirrored part of his personal life as he was actually a gay man and not just playing a part for the screen.

But this was the 90s, when being gay wasn't as openly discussed or accepted as it is today, so it's understandable why Lane wasn't prepared for a public announcement.

Keep ReadingShow less
@danyo_le/TikTok

This proposal is EVERYTHING.

Some proposals have everything. This one has “Everything, Everywhere, All At Once.”

Daniel Le recently proposed to his girlfriend, Annie, by renting out a movie theater for a screening of the 2022 hit A24 movie “Everything, Everywhere All At Once.” Unbeknownst to Annie, this version of the film would be cleverly edited to have Le playing key characters, all leading up to asking for her hand in marriage.

Le contacted multiple independent theaters before finding one that would accommodate his elaborate plan. Then, using a bit of editing wizardry—along with some help from his friends, who arrived at the theater before showtime to hide in the dark so Annie wouldn’t see them—he delivered the surprise of a lifetime.
Keep ReadingShow less
Public Domain

Albert Einstein and Charlie Chaplin at the premiere of "City Lights" in 1931

Albert Einstein and Charlie Chaplin are two of the most famous figures of the 20th century for completely different reasons, and an exchange early in their friendship sums up those differences perfectly—and hilariously.

According to the Nobel Prize committee, Einstein had only been keenly interested in meeting one person in Hollywood: Charlie Chaplin. He got the chance while visiting the U.S. when the scientist and silent film star were introduced during a tour of Universal Studios. The two hit it off, and in 1931, Einstein attended the premiere of Chaplin's 1931 film, "City Lights."

Reportedly, the men exchanged an expression of mutual admiration that demonstrated the actor's quick wit.

Keep ReadingShow less