Issue 5: Birth and caregiving under quarantine
We talk with a midwife and a caregiver to a partner with dementia.
Name: Phyllis Branch
Hometown: Marianna, Florida
Current Residence: Savannah, Georgia
Living Situation: Lives with husband of 61 years, Karl, in a little house with a half-acre pond, surrounded by woods, and five cats
Age: 80
Occupation: Retired; previously was a registered nurse
Phyllis is Erin’s aunt. She’s also a full-time caregiver to her husband, Karl, who is living with advanced-stage dementia.
Tell us what it was like for you when Georgia announced its quarantine.
I think when Governor Kemp said several weeks into the pandemic that he didn’t know you could catch it if you were asymptomatic I was mostly embarrassed. I thought, “Yeah, that validates every single thing people think about southerners.”
Has home quarantine changed your life much?
No. Karl had begun sundowning -- a condition that people with dementia also call “late-day confusion”, so we had stopped going out much in the evenings because it was difficult. Last week he asked me if I knew Phyllis Skinner, which is my maiden name. A few nights ago, he asked if I knew why our parents had named me Hannah, which is the name of his dead sister.
My little routine used to consist of drinking my morning coffee, reading devotional materials, feeding the cats, tidying up, that sort of thing. They had become almost like rites to me. Now, the only places I can go are the grocery store and the Post Office. I had not realized how important my little routine was to me.
Can you talk about that feeling of never being alone, especially as a self-described card-carrying introvert, when you’re the sole caregiver for someone with dementia?
I think it’s a wonderful example of not knowing how valuable something is until you lose it.
[Karl interrupts to tell Phyl he can see deer out the backyard.]
Ok, I’m back. Sorry.
Prior to the quarantine, I used to go to Mass, and I took a yoga class, and that was just pretty wonderful. Now we try to do church online, but because our computer is on its very last leg it’s been hard to do any Zoom.
You told me recently that you feel hopeful. But let’s be honest, you’re a rabid political Democrat. Can you square the two for me?
It’s a gritty kind of hope.
Do I have a choice? The opposite is despair. I won’t give into the despair.
And I guess I have days where I’m literally clutching by my fingernails, but I won’t give into the despair.
In light of Trump and COVID, what is your hope for the world my daughters will inherit?
I know their mom. They will grow up to be very capable women. And they will have learned somewhere along the way about community. We’re all going to have to learn that. The old bit about ‘pulling ourselves up by our bootstraps’ is bullshit. We’re going to have to learn to live in community. And to me, that’s what the masks are.
I have a friend whose dad was on the rationing board during World War II. After the war was over there really was no reason to ration sugar, but that was the board’s way of keeping the war in front of people at all times and making sure they knew that we were always in this together. And the masks are right there in front of us. It’s reminding us that we’re caring for somebody else and it reminds us of the other things we need to do.
So maybe your daughters will grow up in a world where they’ve learned that we’re in this together and that community is important.
Has there been anything that has brought you regular, daily joy?
After Hurricane Katrina people talked about IBBs. IBBs are “Itty Bitty Boats.” It was the itty bitty boats that finally rescued New Orleans and Louisiana. No big deal, just people coming in with flat bottom boats, canoes, rowboats, whatever. I try to find an itty bitty boat every day. And those itty bitty boats are bringing me through. Sometimes it’s a book; I’ve read some wonderful books. It’s the walk to feed the feral cats, or the walk down to the marsh.
What do you want to take with you to the other side of this?
How important every day of life is. This sounds so trite, but how important the little things are. We need to tell the people we love every day that we love them.
Anything you would leave behind?
No, it really hasn’t been that hard on me.
Sometimes when I’m having my ‘I feel sorry for Phyllis’ pity parties I think about how I can’t have home health aids, and how I need a haircut and a massage. But there are people out there who are honest-to-God suffering. How dare I give into this! So I would leave behind those days when I have my pity parties. There’s no reason for me to have them! Nobody wants to come anyways.
Name: Katie Shannon
Hometown: Maui, Hawaii
Current Residence: Beltsville, Maryland
Living Situation: Wife and two kids (7-yr old daughter, 3-yr old son), single-family home
Age: 41
Occupation: Midwife, Chesapeake Midwifery
Katie has been a midwife for more than 12 years and has attended more than 500 births, including the birth of Erin’s third daughter. Since the quarantine went into effect, Katie has witnessed a surge in interest in her services and home birth. Since mid-March, she has delivered six babies and has eight clients due in June. For more information on why some women are choosing a home birth since the pandemic hit, go here, here and here.
Help us understand what about the practice of midwifery changed for you during the early days of the pandemic.
On Friday, March 13, I was working at Mary’s Center and everything was coming out that schools were going to be closed and we were going to be home, and I was just thinking about how I was going to handle work and the kids. It took pregnant women a couple of days to let the news sink in about how the birth they had envisioned for themselves was going to be different before they started making calls to figure out what other services were out there. One of the first calls I received was from a friend whose daughter was pregnant and considering alternatives to a hospital delivery and I was like “Oh, that's interesting. I wonder if a lot of people are going to have this thought,” not realizing that it was going to be a lot of people thinking the same thing.
Tell us about some of those early phone calls.
The more typical calls were from people that were freaking out. They were really scared about being in a hospital that was full of infection. People were asking if we could be on-call for them in case they decided not to go to the hospital, which is not a service that we offer. They were asking if they could have a home birth with an epidural, which is something we don’t do. Women called who had had two or three c-section births who were now looking for an alternative to the hospital setting. It was just heartbreaking to talk to these folks who weren’t good candidates for home birth because I could hear the fear in their voices.
How has the home birth experience changed because of COVID?
In the end it hasn’t been as drastic as people had thought.
We don’t ask our clients to wear masks during the birth because we acknowledge how hard it would be to be in labor while wearing a mask. During the birth, we wear N-95 masks and try not to get into the client’s face and we are also having a little bit less physical contact with our clients. Certainly I can’t be a midwife without touch, so that’s been a hard thing to pull back from. Of course we always wear gloves for things that need gloves, but now we’re wearing them for things like putting a hand on somebody’s back.
The safety of tubs for use in water births were an issue for a little while because they’re often shared equipment, but Barbara Harper, a registered nurse and midwife, put out a great presentation about preparing a water birth during the pandemic that gave us a little bit more perspective.
The other big change was who you can have at the birth.
Before, our feeling has historically been that you can invite your whole high school graduating class if you want, because it’s your birth, your home, and your decision. But now we recommend that the minimum number of support people be present in the room for labor and birth.
This means for some of our clients doulas are one of those essential people to be in the room for their labor and birth.
We love doulas, and they have a huge role in labor and birth, especially for first babies, first out-of-hospital births, and for people whose partners are a bit less involved than they would like them to be. I think it’s tragic that doulas are not being allowed to come into the hospital these days. It’s a real disservice to women because doulas provide invaluable emotional support.
Has this quarantine offered midwives a chance to demystify homebirth?
Definitely. This is a silver lining to a really terrible situation, but it’s putting some positive light on homebirth midwifery and the value of out-of-hospital birth in general. Hospitals are absolutely necessary for people that need intervention, but if you don’t need intervention and it’s low risk, it’s really very safe to be at home.
What are you doing to care for yourself?
[Katie smiles on the screen and takes a sip of something.] Well, if you notice I just took a nice sip of wine! I have never spent this much time with my kids since they were born, and I’ve really enjoyed that! They’re really great people! We’ve had more dinners at home than we’ve had in years.
Both my partner and I have lost weight since we’ve been home since we aren’t going out to restaurants.
I’ve started a garden, which has been so much more enjoyable than I ever imagined. Every morning I go and check my vegetable babies! I’m finding new outlets and things I have time for now because the only things I’m doing are work and spending time with my family.
What do you want to take to the other side with you?
I would love to bring the newfound excitement about home birth. I watched how you grew, Erin, through your pregnancy and your birth, and how empowered you were by the process and the experience. It changed you, and it made you realize how amazing and strong you are, and if every woman could have that experience we would live in a very different world.
I would love to take forward not being so busy and really focusing on what’s important. The other night before bed, my 7 year old told me that when things go back to “normal,” we need to make weekends 3 days instead of 2 so that we can spend more time with our family. I couldn’t agree with her more!