Midwives, expectant families struggle to find a healthy balance during pandemic

A midwifery practice near North Bay is seeing a dramatic rise in demand for its clinic as a place to give birth. Registered midwife Aimee Carbonneau says the uptick likely comes as expectant parents are uneasy about going to the hospital during the COVID-19 pandemic.

"Almost everybody has changed their plan of birth place. So whereas we normally have about 50-50 people planning a hospital birth and people planning either a clinic or home birth... right now, other than, you know, the clients who have health conditions that will require them to have a hospital birth … everyone else is actually planning a clinic birth."

But there is only one birthing bed at K'Tigaaning Midwives' clinic in Nipissing First Nation, near North Bay — and expectant families need to have a Plan B in mind, Carbonneau added.

"Would you want to stay home or would you want a birth in the hospital? I think now, because there's so many people planning a clinic birth, the chances of simultaneous births happening are higher than they've ever been," she said.

"So we're really emphasizing that and [for] the people who put the clinic as their first choice, more and more of them are choosing home as their second choice."

Underlying anxiety

Carbonneau said the birth process can be "beautiful and sacred anywhere you are," whether it's in hospital, or outside hospital.

But she noted the current situation concerns her ... because "people are afraid of the hospital right now."

"More of our clients have this ... underlying anxiety. And my concern with that is, what happens in the postpartum [period]? We can offer you this beautiful clinic birth and then you go home and your grandma can't come over and help you, and your aunties can't come over and help you. And so you're just by yourself, maybe with a partner, maybe with other children, scrambling to try and keep it all together. Being really isolated," she said.

"And if you're already anxious prenatally, then what's your postpartum going to look like? Because things like depression and anxiety — if they're present before the birth — they're usually worse after. They don't usually get better after a baby's here."

Carbonneau said getting that support in place is key, even if it can't be in person.

"For most of our clients ... it's been several weeks [and] most of them haven't been going out. I think most of them are in a pretty good place. I try and encourage them to still go outside and get some fresh air," she said.

"You know, we are so lucky in northern Ontario. We have an abundance of trails and you can be walking for miles without seeing other humans."

Just like anyone else trying to cope with the COVID-19 pandemic, expectant families need to "eat healthy, drink lots of water, get some good sleep," Carbonneau said.

And if there are people who can "drop off casseroles" during the postpartum period, that can go a long way in terms of helping.

Midwives struggling with lack of PPE 

The pandemic has "put a wrench" in just about everything midwives do.

"You can't social distance and catch a baby," Carbonneau said.

"We do have some [personal protective equipment] supplies for now, which we're using when somebody comes into clinic. We've got face shields on order, but we don't actually have them in the clinic yet. So I'm hoping they will come soon."

Birth can get messy, and Carbonneau noted that COVID-19 is "a droplet contagious thing." So midwives are worrying about more than just sneezing and coughing.

"You have to think, when somebody is pushing really hard or just working hard in labour, you can imagine there's times where you get fluid on you."

She said they are scrambling to keep their supplies of PPE up.

"That's actually been the most stressful part of this ... just watching our supply go down and not really knowing where more is coming from," Carbonneau said.

"All of us midwives have been reaching out to our various connections and we have somebody on the rez who's going to sew us some more surgical gowns ... and there's midwives in Toronto who are gonna send us a box of face shields. But [there's been] no word from the government on when we can expect for supplies to reach us. It is frustrating to be a front line health care worker, to be in very, very close contact with families and to feel like you're not protected and they're not protected adequately ... or they won't be in a very short amount of time if something doesn't change."