Fearing Coronavirus, Many Rural Black Women Avoid Hospitals to Give Birth at Home

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Pregnant women in Tennessee, Arkansas and Mississippi have been calling nonstop to CHOICES Midwifery Practice in Memphis, but the center is booked. 

The callers are terrified that they or their babies will contract the novel coronavirus if they deliver in hospitals. Some women live in rural areas far from hospitals and obstetrics units. The center’s clients are primarily black and other women of color. 

“They’ve told us they’re going to risk it all and have an unassisted home birth,” said Nikia Grayson, a certified nurse midwife and director of perinatal services. “That’s very scary, and that’s what people are researching and seeing as a viable option.”

Many pregnant women are seeking out midwives to deliver their babies in homes or birthing centers rather than in hospitals, where they fear being exposed to the virus. But midwives and other maternal health experts say desperate women also are delivering without any medical assistance. 

“It can go left real fast,” Grayson said. 

Midwives across the country say they are stretched to accommodate additional deliveries because of the pandemic, while taking precautions to protect themselves and their clients. Midwives from Mississippi and Tennessee who deliver in homes are traveling to the rural areas around Memphis to help, Grayson said. But it’s dangerous to cross state lines without knowing where to go in an emergency.

The stakes are especially high for rural black women soon to give birth in Southern states. They have less access to health care providers and travel longer distances to care, while systemic racism and health care inequities put their lives at risk. 

The coronavirus pandemic exposes a fragile health care system that already marginalized and traumatized pregnant black women, said Dr. Joia Crear-Perry, president of the National Birth Equity Collaborative. 

“The intersectionality of being a black woman and that the rural South chose not to provide insurance coverage is a deadly combination for many,” Crear-Perry said. 

In Mississippi, the state Department of Health should address the concerns of pregnant women and families and discourage unassisted home births, said Wengora Thompson, who manages the Jackson Safer Childbirth Experience, a project funded by Merck and the Kellogg Foundation.