Our 2020-2021 Practice Stats! | Tampa Bay Home Birth Midwifery

Wow.
What. A. Year. It has been around these parts! Covid has changed so many lives and our practice has definitely seen the ups and downs of childbearing during a pandemic! We have seen unprecedented increases in complications which we can only ascertain was due in part to such increased levels of stress for the families we care for. Job losses, changes in childcare situations, lack of access to care related to Covid precautions, general worldwide pandemic doom and gloom. It hasn’t always been kittens and rainbows for our families just trying to enjoy the path to parenthood.

If there has been one silver lining in all of this for us as midwives it is that midwifery care is steadfast. It is historically the glue that binds together centuries of innate knowledge, grounding presence when the storms whip around us, and a reminder that there is hope that sometimes comes in tiny packages. We are grateful to our families who trusted us to walk the paths with them- no matter their outcomes. From triumphant VBAC home births, very necessary surgical births, and even lots of 1st and 2nd trimester losses. No day is ever the same over here but we are committed to showing up in all of the ways.

We also provide easy access prenatal/postpartum care only to folks who’d like to plan a hospital birth. This is an options clients may choose if they want pain medication during labor, need to plan a cesarean, or maybe have circumstances that would prevent them from being great candidates for homebirth! Some of these clients we also provide midwife-as-labor-support for to provide continuity or we connect them with a wonderful local doula. We have wonderful collaborative relationships locally with hospital based providers who attend the deliveries for these clients. It is truly the epitome of how teamwork makes the dream work for better maternity care outcomes- especially in communities of BIPOC folks!

For June 30, 2020-June 30, 2021 we accepted 121 clients into care. Some of which had early miscarriages, needed to switch providers due to insurance or relocating, etc…
66 clients who started care with us planning home births and 55 were planned hospital deliveries
Of those planned home birth clients:
+12% transferred to higher level care in the antepartum period (before labor began.) Reasons for a transfer during this period included pregnancy induced hypertension, pre-eclampsia, and uncontrolled gestational diabetes that needed medication management.
+13% transferred to the hospital during labor. These transfers included non reassuring fetal heart tones, desire for pain medication, prolonged rupture of membranes, and failure to progress during 1st (active labor)or 2nd stage (pushing.) Nearly all of our in labor transfers were first time mothers or clients planning vaginal births after cesareans (VBAC.)
+3% transferred to the hospital immediately postpartum . This accounted for one person transported for hemorrhage that required transfusion and follow up monitoring, and one person who transported with their baby who was in respiratory distress. Both clients were stable and did not require ICU admission.
+3% transferred to the hospital for newborn concerns. This accounted for two babies transferred for a low initial APGAR scores that required resuscitative measures, both were kept for observation but discharged home without complications.

For both our planned home and planned hospital clients:
+We had a 67% VBAC success rate! (We care for many special circumstance VBAC families who cannot access care elsewhere- VBAC after multiple cesareans, special scars, etc…)
+11% cesarean rate, with only a 4% PRIMARY cesarean rate.
+96% of clients were still exclusively breastfeeding at 6 weeks postpartum

No fetal, maternal, or newborn deaths.

Making midwifery care accessible to all is our top priority. While we love homebirth and believe it is truly the best option for otherwise normal, low risk, healthy pregnant folks who desire that option we know not everyone is there yet (or ever.) It is never the ‘homebirth club’ but it is definitely the ‘midwifery care club!’