Like many expectant mothers, Gina Conley is nervous. But there is a lot more to worry about these days, with a virulent outbreak overwhelming hospitals and convincing pregnant women to opt for the relative safety of a home birth.
“I won’t have to go to a hospital where there are potentially a lot of sick people and staff that have been exposed to the coronavirus,” says the 32-year-old from North Carolina.
The pandemic has torn through one country after another, laying waste to economies, roiling public institutions and notching around 400,000 infections in the United States — more than 12,000 of them fatal.
© SAUL LOEB
Ashley Esposito, 35, is considering giving birth at home to minimize her risk of contracting the new coronavirus
As hospital wards become battlefields in the war against this looming threat, choosing where to give birth is a quandary many expectant mothers did not expect to have to face.
Fear of infection, staff and drug shortages, and increasingly strict rules on visitors are leading more and more women to consider shunning hospitals.
But soon-to-be moms must weigh fears for their newborns and worries over their own health with the prohibitive cost of having a baby at home.
Conley, who is seven months pregnant, said she will pay more than $4,000 to cover the services associated with a home birth, the largest of which is typically the midwife.
“It’s definitely not cheap but having the birth experience that we want, with a lot less anxiety — we felt like it was worth it,” the fitness coach told AFP.
Home births are considered “out of network” under many plans in the byzantine US health insurance ecosphere, and couples are rarely lucky enough to be fully covered.
– ‘Not an option’ –
Ashley Esposito, a 35-year-old data specialist from the East Coast port city of Baltimore, expects to fork out up to $8,000 up front.
“Paying all that chunk of money, especially given the financial situation, you know — there are people from my husband’s job who were laid off,” Esposito told AFP.
“Nothing is, like, 100 percent guaranteed.”
Related Slideshow: Coronavirus (COVID-19) outbreak around the world (Provided by Photo Services)
Medical workers walk by a police robot at the Wuhan Tianhe International Airport in China, after travel restrictions to leave the city were lifted, on April 8.
A girl puts her completed drawing of an Easter egg on the window of her home in Auckland, New Zealand, on April 8. New Zealanders are being encouraged to draw and display Easter eggs on their windows to create an Easter egg hunt that children can participate in during the COVID-19 lockdown.
A member of the palace guard wears a face mask along with his traditional Korean dress, at the Deoksugung palace in Seoul, South Korea, on April 8.
A woman wearing a face mask waits to cross a road as she walks her dog on an empty street in Tokyo, Japan, on April 8, on the first day of the state of emergency.
Employees of Harborview Medical Center pose for photos while accepting pizzas donated by basketball player and Seattle native Isaiah Thomas in Seattle, Washington, U.S., on April 7.
A resident of a nursing home waves at an elderly woman as the MAV Symphony Orchestra plays classical music recordings on the loudspeakers of a car going around the city to cheer up people under lockdown in Budapest, Hungary, on April 7.
Australian Prime Minister Scott Morrison delivers a ministerial statement on COVID-19 in the House of Representatives in Canberra, Australia, on April 8.
Travelers line up with their belongings outside the Hankou Railway Station after travel restrictions to leave Wuhan, China, were lifted, on April 8.
A city employee, wearing protective gear, poses for a photograph as he disinfects an area of Paseo de la Reforma avenue in Mexico City, Mexico, on April 6.
Men dressed up as superheroes Spider-Man and Captain America stand with a banner reading “Stay at Home” in Rio de Janeiro, Brazil, on April 6.
Workers wearing protective suits spray disinfectant at a subway station in Warsaw, Poland, on April 6.
A healthcare worker wearing protective gear is seen during a test for the coronavirus (COVID-19) outside a stadium in Bogor, Indonesia, on April 7.
An artist paints a mural on a wall in Pontefract, England, on April 6.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, departs after the daily coronavirus task force briefing at the White House in Washington, D.C., U.S., on April 6.
A resident picks up a box with food given to them by the army, at the Santa Rosita neighborhood on the outskirts of Guatemala City, Gautemala, on April 6, during a stay-at-home curfew designed to slow the spread of COVID-19.
Food is distributed from a truck as part of a government program in Port-au-Prince, Haiti, on April 6.
Municipal workers wearing protective suits spray disinfectant in Grozny, Russia, on April 6.
German tourists queue up to enter Christchurch International Airport in New Zealand, on April 6. Air New Zealand is operating a number of special charter flights on behalf of the German government to repatriate German travelers stranded in New Zealand due the COVID-19 pandemic.
Staff members of a hospital carry candles and oil lamps to show solidarity with people who are affected by the coronavirus disease, and with doctors, nurses and other healthcare workers from all over the world during a 21-day nationwide lockdown, in Kolkata, India, on April 5.
A volunteer woman wearing a face mask and gloves to curb the spread of the coronavirus sews face masks in a mosque in Tehran, Iran, on April 5.
Pope Francis celebrates Palm Sunday mass behind closed doors, during a lockdown aimed at curbing the spread of COVID-19, in St. Peter’s Basilica, Vatican City, on April 5.
A devotee stands next to palm fronds and religious icons placed on a table outside her home, as part of Palm Sunday celebrations in Quezon City, Philippines, on April 5.
A person wearing a personal protective equipment (PPE) suit exits the Elmhurst Hospital center, as the outbreak of coronavirus disease continues, in New York City, New York, U.S., on April 5.
A man wearing a mask looks on in Bnei Brak, Israel, on April 5. The ultra-Orthodox Jewish town was declared a “restricted zone” due to its high rate of infections on April 3.
A motorist rides through a disinfection tunnel during a government-imposed nationwide lockdown as a preventive measure against COVID-19, in Chennai, India, on April 5.
Residents receive free reusable masks distributed by the government at a community center, as stricter measures are announced to combat the outbreak of the COVID-19 in Singapore, on April 5.
People line up at a safe social distance outside the grocery store amid the COVID-19 outbreak in Medford, Massachusetts, U.S., on April 4.
People wearing face masks, amid concerns of the COVID-19 disease, commute on a train in Hong Kong on April 4.
Migrant workers and homeless people rest inside a sports complex turned into a shelter, during a 21-day nationwide lockdown to slow the spread of the COVID-19, in New Delhi, India, on April 4.
A woman wearing a protective mask is seen checking her cell phone in Woolwich district of London, England, on April 4, as the spread of the COVID-19 continues.
A view of beds at a shopping mall, one of Iran’s largest, which has been turned into a center to receive patients suffering from the coronavirus disease, in Tehran, Iran, on April 4.
Members of Local Defence Unit (LDU) offload relief food during a distribution exercise to civilians affected by the lockdown, implemented to prevent the potential spread of COVID-19, in Kampala, Uganda, on April 4.
A man walks in the middle of empty Westminster Bridge, as the spread of COVID-19 continues, in London, England, on April 3.
Medical staff wait for a patient, infected with coronavirus disease (COVID-19), to be embarked onboard a medicalized TGV high-speed train at the station in Strasbourg, France, on April 3.
U.S. President Donald Trump speaks about the new coronavirus in the James Brady Press Briefing Room of the White House, in Washington, D.C., U.S., on April 3.
People wearing face masks stand to pay tribute as China holds national mourning for those who died of COVID-19, on the Tomb Sweeping Day, in Beijing on April 4.
A resident wearing a protective face mask waits for coronavirus testing at a makeshift rapid testing center in Hanoi, Vietnam, on April 3.
A couple, wearing masks to prevent the spread of the new coronavirus, is seen waiting at Independence square in Quito, Ecuador, on April 3.
Police officers try to stop a rickshaw driver defying the nation-wide lockdown to curb the spread of the coronavirus, in Hyderabad, Pakistan, on March, 3.
City workers fumigate a street to help contain the spread of coronavirus in La Paz, Bolivia, on April 2.
NHS workers applaud on the streets outside Royal Liverpool University Hospital during the Clap for Our Carers Campaign in England, on April 2.
A volunteer from the Blue Sky Rescue team disinfects the Qintai Grand Theatre in Wuhan, China, on April 2.
A New England Patriots Boeing 767-300 jet with a shipment of over one million N95 masks from China arrives at Logan International Airport in Boston, Massachusetts, U.S., on April 2.
A volunteer sanitizes a bus passenger before he enters his municipality in Panchimalco, El Salvador, on April 2.
A currency trader checks the temperature of his colleague at the foreign exchange dealing room of the KEB Hana Bank headquarters in Seoul, South Korea, on April 3.
Women maintain social distance as they wait to receive relief supplies provided by local police authority in Dhaka, Bangladesh, on April 2.
People wearing face masks wait for a supermarket to open in Wuhan, China, on April 2.
Hotel room lights spell out “Vegas Strong” at the Wynn hotel-casino along the Las Vegas Strip in Nevada, U.S., on April 1.
Workers wearing protective suits pray before a disinfection operation in Kuala Lumpur, Malaysia, on April 1.
Women stand in a queue to receive relief supplies provided by the local community in Dhaka, Bangladesh, on April 1.
An aerial view of a notice dug into the sand reading #StayHome on Tamarama Beach in Sydney, Australia, on April 2.
Los Angeles Mayor Eric Garcetti wearing a protective face mask during his daily news conference in Los Angeles, California, U.S., on April 1.
A municipality worker disinfects a street in Bizerte, Tunisia, on April 1.
Residents pay for groceries by standing on chairs to peer over barriers set up to ringfence a wet market in Wuhan on April 1.
A baker presents sweets in the shape of the “coronavirus” (R) and antibodies with a face mask and eyes, in Erfurt, Germany, on March 31.
Police officers walk across an empty Red Square in Moscow, Russia, on March 31, 2020.
Crew members are seen as the Queen Mary 2 cruise ship enters the harbor where South African crew members are to alight after having tested negative for COVID-19, in Durban, South Africa, on March 31.
A young man cuts another man’s hair on top of a closed hairdresser, in Oxford, England, on March 31.
People follow social distancing as they line up to enter a supermarket, amid the coronavirus (COVID-19) outbreak, in La Paz, Bolivia, on March 30.
The One World Trade Center is illuminated in red, white and blue in recognition of the ongoing nationwide effort to combat coronavirus in New York City, as it is seen from Exchange Place, New Jersey, U.S., on March 30.
A woman stands alone on a bus stop during a workday following the implementation of stricter social-distancing and self-isolation rules to limit the spread of the coronavirus in Sydney, Australia, on March 31.
A security man walks along an empty Foch Street before a nighttime curfew imposed by the government to help stem the spread of the coronavirus in Beirut, Lebanon, on March 30.
People wearing face masks practise social distancing as they wait outside a Postal Savings Bank of China branch in Wuhan, China, on March 31.
A man reaches to a basket, that was hung up so people can donate or take for free food, as Italy struggles to contain the spread of coronavirus, in Naples, on March 30.
A medical personnel reacts in the COVID-19 unit of the Erasme Hospital in Brussels, Belgium, on March 30.
A bird flies past a drone spraying disinfectant during a demonstration during the Movement Control Order, limiting the activities of people in Malaysia as a preventive measure against the spread of the coronavirus, in Kuala Lumpur on March 31.
Homeless people get settled in a temporary parking lot shelter at Cashman Center, with spaces marked for social distancing, in Las Vegas, Nevada, U.S., on March 30.
Buddhist monks wearing face shields and masks to protect themselves from the coronavirus disease collect alms in Bangkok, Thailand, on March 31.
A healthcare worker sits on a bench near Central Park in the Manhattan borough of New York City, New York, U.S., on March 30.
Nurses work to prepare the intensive care unit in the new COVID-19 hospital in Verduno, Italy, on March 29, on the eve of its official opening.
An emergency triage tent is seen at Harborview Medical Center as efforts continue to help slow the spread of COVID-19 in Seattle, Washington, U.S., on March 29.
People applaud from their houses in support of the medical staff that are working on the COVID-19 virus outbreak in Barcelona, Spain, on March 29.
Environmental activists wearing masks symbolizing the coronavirus attend a prevention campaign as people take measures to protect themselves against the spread of COVID-19 in Seoul, South Korea, on March 30.
Volunteers in protective suits spray disinfectant on storefronts to help curb the spread of the coronavirus in Kabul, Afghanistan, on March 29.
A police officer maintains distance as he detains a man defying the lockdown imposed by the government amid concerns about the spread of coronavirus disease in Kathmandu, Nepal, on March 29.
A man walks past on a nearly empty Tokyo street amid snowfall during the first weekend after Tokyo Governor Yuriko Koike urged Tokyo residents to stay indoors in a bid to keep the COVID-19 from spreading, on March 29.
Migrant workers crowd up outside a bus station as they wait to board buses to return to their villages during a 21-day nationwide lockdown to limit the spreading of COVID-19, in Ghaziabad, India, on March 28.
Seattle Mayor Jenny Durkan speaks during a press conference at the CenturyLink Field Event Center, where a field a hospital for non-COVID-19 cases will be built, as efforts continue to help slow the spread of coronavirus disease, in Seattle, Washington, U.S., on March 28.
Medical and physician assistant students in personal protective equipment listen during a meeting before screening for possible coronavirus cases at a makeshift camp for the homeless in Las Vegas, Nevada, U.S., on March 28.
Indonesia’s Red Cross personnel wearing protective suits spray disinfectant on the road to prevent the spread of COVID-19 in Jakarta, Indonesia, on March 28.
China’s ambassador in Venezuela Li Baorong (L) and Venezuela’s Vice President Delcy Rodríguez are seen after the arrival of humanitarian aid from China at Simón Bolívar International Airport during the national quarantine, in Caracas, Venezuela, on March 28.
A violinist plays on her balcony to support health workers in Mulhouse, France, on March 28, 2020.
U.S. Defense Secretary Mark Esper (R) and U.S. President Donald Trump watch as the hospital ship USNS Comfort departs Naval Base Norfolk in Norfolk, Virginia, U.S., on March 28. The Comfort sails to New York City, New York, U.S., to aid in the coronavirus outbreak.
The message “Merci” (French for “thank you”) is displayed in tribute of those on the frontline to fight the coronavirus disease, on the facade of the Eiffel Tower in Paris, France, on March 27.
U.S. President Donald Trump (C) signs the $2.2 trillion H.R. 748 Coronavirus Aid, Relief and Economic Security (CARES) Act in the Oval Office of the White House in Washington, D.C., U.S., on March 27.
A man plays his accordion to lift his parents’ spirits after they started practicing social isolation in their house to prevent themselves from catching the coronavirus disease, in Concepción, Chile on March 26.
The London Eye is lit up as part of a nationwide salute to the doctors, nurses and staff of the National Health Service (NHS) in London, England, on March 26.
The MV Artania cruise ship with passengers tested positive for the coronavirus is seen berthed at the Fremantle Harbor near Perth, Australia, on March 27.
Members of the Arizona National Guard pack and sort food items at a food bank in Mesa, Arizona, U.S., on March 26.
A person in protective clothing walks through a temporary 2,000-bed hospital for coronavirus patients set up by the Iranian army at the international exhibition center in Tehran, Iran, on March 26.
A staff member of a coffee shop disinfects a customer coming into the cafe amid concerns over the spread of coronavirus (COVID-19) in Yangon, Myanmar on March 26.
A young girl attends a ballet class from home while practising social distancing during the outbreak of coronavirus (COVID-19) in Brooklyn, New York City, New York, U.S. on March 25.
A staff member sprays disinfectant at a cinema as it prepares to reopen to the public after closing due to coronavirus (COVID-19), in Shenyang, Chin on March 25.
A barber, reflected in a mirror wearing a protective face mask as a precaution against the spread of the new coronavirus (COVID-19), styles a customer’s hair in Havana, Cuba on March 25.
A policeman checks motorists at a roadblock during the first day of a 21 day government-imposed nationwide lockdown as a preventive measure against coronavirus (COVID-19) in New Delhi, India on March 25.
An aerial view of empty Octavio Frias de Oliveira bridge, a cable-stayed bridge, on the first day of a lockdown imposed by state government because of the coronavirus (COVID-19) outbreak in Sao Paulo, Brazil on March 24.
A soldier inspects beds for treatment of possible COVID-19 infected patients inside the Belgrade Fair, Serbia, on March 24.
People practice social distancing as they sit on chairs spread apart in a waiting area for takeaway food orders at a shopping malls amid coronavirus (COVID-19) scare in Bangkok, Thailand on March 24.
American Airlines passenger planes crowd a runway where they are parked due to flight reductions to slow the spread of coronavirus (COVID-19), at Tulsa International Airport in Tulsa, Oklahoma, U.S. on March 23.
Chinese tourists wear protective masks as they visit the almost empty, but recently re-opened, Badaling Great Wall in Beijing, China on March 24.
People wearing facemasks queue outside a shop at Pugoda on the outskirts of Sri Lanka’s capital city Colombo on March 24, as the authorities briefly lifted a curfew to allow residents to stock up on essentials amid concerns over the spread of coronavirus (COVID-19).
Football Federation Australia (FFA) Chief Executive Officer James Johnson speaks to the media during a press conference in Sydney, Australia, on March 24. Johnson said that the rest of the A-League soccer season has been suspended due to the coronavirus pandemic.
A man plays guitar and sings to his neighbors from his balcony two days after California’s Governor Gavin Newsom implemented a state wide “stay at home order” in Oakland, California, U.S., on March 21.
Australian senators practice social distancing as they attend a scaled-down session in the Senate chamber at Parliament House in Canberra, Australia, on March 23.
DJ and event producer Nash Petrovic live streams a set from his roof in Brooklyn, New York, U.S., on March 21.
Journalists practice social distancing outside a meeting to wrap up work on coronavirus economic aid legislation in Washington, D.C., U.S., on March 21.
A customer wearing a face mask stands next to partially empty shelves of instant noodles at a supermarket, following COVID-19 outbreak, in Taipei, Taiwan, on March 21.
The statue of Christ the Redeemer is lit up in the colors of the countries that are affected by the coronavirus outbreak, in Rio de Janeiro, Brazil, on March 18.
A worker wearing a protective suit disinfects a customer’s hands at the entrance of a public market in Caracas, Venezuela, on March 18.
Canada’s Prime Minister Justin Trudeau speaks with G7 leaders during a teleconference while under self-isolation, due to his wife Sophie Grégoire Trudeau testing positive for COVID-19, in his home at Rideau Cottage in Ottawa, Canada, on March 16.
Expatriates returning from Egypt, Syria and Lebanon arrive to be re-tested at a health ministry containment and screening zone for COVID-19, in Kuwait City, Kuwait, on March 16.
A worker in a protective suit sprays disinfectants near Al-Abbas shrine as a precaution against the outbreak of coronavirus, in the holy city of Karbala, Iraq, on March 15.
A student demonstrates how to wash hands during an awareness campaign about COVID-19 at a school in Chennai, India, on March 14.
Firefighters disinfect a street in western Tehran, Iran, on March 13.
The Eiffel Tower is seen next to a board that reads: “In the context of the COVID-19 the Eiffel Tower closes today from 9pm for an indefinite period of time” in Paris, France, on March 13.
Peru’s Alianza Lima and Argentina’s Racing Club play the Copa Libertadores match at the Presidente Perón Stadium in Buenos Aires, Argentina, on March 12. The match was played in an empty, closed-door stadium as part of the government’s measures to contain transmission of coronavirus.
People coming from Venezuela with protective face masks as a precautionary measure to avoid contracting the virus, show their documents on the border at Simon Bolivar International Bridge, in Cucuta, Colombia, on March 12.
Cleaning crew have their masks wiped down after they come out of Life Care Center of Kirkland in Washington, U.S., on March 11.
Employees from a disinfection service company sanitize a subway car depot amid coronavirus outbreak in Seoul, South Korea, on March 11.
Chinese President Xi Jinping learns about the hospital’s operations, treatment of patients, protection for medical workers and scientific research at the Huoshenshan Hospital in Wuhan, China, on March 10.
Esposito has added her name to a list of 1,300 people who have signed a petition urging health insurers in the state of Maryland to provide better coverage of home births.
Like many soon-to-be moms, she worries about new anti-infection rules adopted by some hospitals that limit the number of people who can be in the delivery room.
“This is our first healthy baby so my husband not being there is not an option for me,” said Esposito, who used in vitro fertilization after two miscarriages.
In New York, hospitals had barred husbands or partners from delivery rooms until Governor Andrew Cuomo stepped in last month and signed a decree stating no women had to give birth alone. Jordan Perez, 30, will soon reach full term in Homer, Alaska, where she decided to have her baby at home.
“I’ve always wanted to have a home birth but before the virus happened, my midwife team didn’t offer home birth,” said Perez, who sells cosmetic products.
“I think about a week ago, they said, ‘OK, let’s go for it. With the virus that’s happening, we can make it happen,'” she added.
With health services bracing for worse to come in a crisis of historic proportions, the American College of Obstetricians and Gynecologists says hospitals remain safe places to give birth.
Nevertheless, midwives are struggling to cope with the sudden boom in demand for their expertise in home births.
Of roughly 12,000 certified nurse midwives and midwives in America, an estimated 3,000 practice outside hospitals.
– Zoom appointments –
“We usually have between four and six (births) per month… and now we are maxed out at eight per month, and we actually have 10 in July,” said certified nurse midwife Mairi Breen Rothman.
Her practice — M.A.M.A.S., just outside Washington — has hired a third midwife, its schedule is booked solid through August, and it has had to turn away potential clients.
Midwives are being forced to change the way they work in order to prevent the spread of the virus — cutting down on house calls, seeing patients via online tools like Zoom and wearing face masks.
Rothman makes patients wait in their car rather than in the waiting room, and asks them to leave behind their personal possessions before going in for the examination.
“The clients come to the house and they text us from their car. When the person before them is gone, we tell them that they can come in. They come to the door via the separate entrance,” she said.
After the check-up, when the patient leaves, staff wipe down every surface that might have been touched, as well as door knobs, light switches, clinical equipment and so on.
“We clean the bathroom. And then we call the next person to come in,” Rothman says with a nervous laugh.
Esposito, who plans to give birth while watching part of the “Lord of the Rings” saga, said she will take no risks once her child is born into a world that has changed almost overnight.
“I’m just going to stay in my bubble for the most part,” she said.
“I don’t think we’re going to have much interaction with people other than, like, Skype.”