In Hyderabad, India, The Sanctum Birth Center is located on the first floor (second floor if you’re in the US) of commercial complex above with a Samsung showroom and a Cafe Coffee Day (the equivalent of a Starbucks). This center, all of maybe 10,000 square feet contains 6–8 labor rooms each with a tub, a single operating room, staff offices, a reception, a multipurpose room for yoga, gatherings and birth prep classes) and a pharmacy. Dr. Vijaya who is a Doctor of Physical Therapy and a non-nurse midwife has created an exceptional sanctuary where everyone can give birth, regardless of their level of risk. I’ve often thought to myself, why doesn’t that exist here in NYC?
In the midst of a pandemic, we are asking healthy, low-risk pregnant people to admit themselves, with (or possibly without) a loved one, into the same hospital systems (whose ERs and ICUs are being overwhelmed by people very sick with COVID-19) and have them take routine Covid tests when those with symptoms cannot. Pregnant people are being admitted into the same systems where the hospital staff do not have enough PPE, and every spare inch is being converted to care for more positive Covid patients.
We have decided that the safest thing for pregnant women to do in this moment is to go into the hospital, the epicenter of our struggle against this disease, while everyone else is asked to shelter in place. Worse — they are induced early (with a significant respiratory risk to neonates), potentially devoid of their partner, family members, their doula, and at significant risks sent home early with nonexistent postpartum care.
We know that birth outside the hospital is safe — in fact, for those who are low risk, it is safer than birth at the hospital. We know that the hospital system is going to be overwhelmed. We know that labor wards are soon going to become ICUs and that OBs will have to focus on their high risk and Covid patients. We know that we are going to be short-staffed as a great many healthcare workers test positive for Covid. We know that midwives are trained to attend births in a variety of settings safely. We know that the Javits Center is being converted into a massive hospital. Why can’t we do what fraction of what Dr. Vijaya has done in converting a handful of spaces much smaller than the Javits Center into safe alternative birthing sites so we can get through this crisis without causing unnecessary trauma and harm to birthing people and their babies.
In an unprecedented pandemic, we need our hospitals to work at full capacity. We should keep more healthy people out of the hospital — pregnant people, partners and midwives. And save our resources (limited PPE, hospital beds and staff) for those need it.
We need alternative birthing sites NOW.