At home or the hospital? Giving birth during a pandemic

Nancy Pedroza was expecting her first child, and the due date was just weeks away.

Then the pandemic hit.

Suddenly, she couldn’t bring anyone with her to her prenatal visits. She started learning more about the coronavirus and how some hospitals around the country were banning loved ones from being in the delivery room.

And she was terrified.

"It was scary to feel like I might have to do it alone," she told photojournalist Callaghan O’Hare, who documented her childbirth for Reuters. "It's nothing like having someone there that you care about and cares about you that's willing to hold your hand and tell you this is going to be OK."

Pedroza’s hospital in Fort Worth, Texas, told her that only one person could be with her in the delivery room, forcing a choice between her partner, Ryan Morgan, and her doula, Nichollette Jones.

The hospital also warned her that the policy was subject to change and that all visitors might eventually be prohibited.

So like many other expectant mothers right now, Pedroza started considering a home birth. But time was running out.

Midwives don’t often take late transfers, O’Hare said, because it takes time to build the trust and relationship for a home birth.

Another complication was payment: Pedroza’s Medicaid plan doesn’t cover home births.

The expectant mother contemplated an unassisted birth.

“She was considering that because she felt that that was safer than the hospital,” O’Hare said. “When she actually met (midwife) Susan Taylor, who agreed to reduce her rate and offer them a payment plan, that made it feasible for her to actually do a home birth.”

Pedroza was one day past her due date when Taylor reached out to her and offered her the reduced rate. Taylor even opened her home to Pedroza so that she could give birth to the baby there.

The stage was set. But more days passed and the baby still wasn’t coming. A week after her due date, Pedroza hadn’t shown signs of labor.

The window for a home birth was beginning to shut.

“At 42 weeks, you have to be transferred to a hospital unless you have an (obstetrician) sign off on it, and they didn't think that they would have an OB sign off because the baby’s fluid levels were low,” O’Hare said. “So Nancy started getting very stressed out.”

To help move things along, Pedroza and her team tried several methods.

She had a membrane sweep of her cervix, and she used a breast pump. She visited a chiropractor. She went for walks and drank raspberry leaf tea.

“They said, ‘Look like if you don't have a baby by tonight, we have to transfer your care to the hospital,’ ” O’Hare remembered.

It worked. The baby was on its way.

O’Hare remembers the labor progressing nicely at first.

After about 12 hours of contractions, it was time for a tired Pedroza to start pushing.

But when she started to push, the baby’s heart rate suddenly dropped to unsafe levels. The midwives had to call an ambulance.

Despite all of her work to coordinate a home birth, Pedroza would have to deliver her baby in a hospital after all.

The baby’s heart rate started going back to normal once Pedroza stopped pushing, O’Hare said. Emergency workers arrived quickly, wearing protective face masks, and Taylor explained the situation to them as they loaded Pedroza onto a stretcher.

“It was really scary. It was almost surreal,” O’Hare said. “And I just felt so sad for (Pedroza) because she had done everything to avoid the hospital and was still ending up going there.”

Taylor was able to ride in the ambulance with Pedroza, keeping an eye on the baby’s heartbeat as they raced to the hospital around 1 a.m.

When they arrived at the hospital, Taylor was able to brief the obstetrician on duty. But then she had to leave.

Only one person was allowed to be with Pedroza in the delivery room. And that would be Morgan, her partner.

Everyone had to wear masks the entire time — even Pedroza.

“Hearing the baby’s heartbeat on the monitor, it brought me so much comfort that I didn’t care I was at the hospital at that point," she told O’Hare.

At 5:55 a.m. on April 8, Pedroza gave birth to Kai Rohan Morgan, a healthy baby boy weighing 8 pounds, 5 ounces.

Anytime someone entered the room to see the baby, they wore masks and gloves. Pedroza and Morgan would have to put on their masks, too.

Pedroza told her that if she could do it all over again, she would still choose to do a home birth.

“She was happy with the care she received at the hospital for the most part. She just thought it was eerie to have to wear masks and to constantly see everyone else in masks and know why they're wearing that,” O’Hare said. “She said even when she had to sign something, she thought about having the pen pass between the nurse and her hands — just an extra level of paranoia that's not normally there.”