KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show from WAMU 88.5. I'm broadcasting from my home in northwest Washington where it is currently raining outside. Welcome. Later in the broadcast how distance learning is unfolding across the Washington region. We'll talk with area schools, superintendents and one innovative teacher, who is conducting physical education online.

KOJO NNAMDIBut first pregnancy can be taxing mentally, emotionally and physically, but being pregnant right now in the midst of a Coronavirus outbreak means coping with a long list of added fears and uncertainties. Are hospitals safe? Is it better to opt for home birth? What happens if a person who is pregnant contracts COVID-19? What about the baby? And what does it mean to start a family during a global pandemic? We're interested in hearing from you. Give us a call 800-433-8850. Are you pregnant? What questions do you have about giving birth during a pandemic? Do you have a friend of a loved one who is pregnant? How are you planning to support them once the baby is born?

KOJO NNAMDIJoining me now is Mairi Breen Rothman, Co-founder of the Metro Area Midwives and Allied Services, MAMAS. She is one of the first eight doctors of midwifery in the United States. Mairi, thank you very much for joining us.

MAIRI BREEN ROTHMANYou're welcome. I'm so happy to be here and to hear you again even though I can't see you this time.

NNAMDIThank you very much for joining us. Tell us about MAMAS. What services do you offer?

ROTHMANWell, normally we offer the full scope of women's healthcare including maternity care and GYN care, primary care, breastfeeding assistance, at home intrauterine insemination, but right now because of COVID-19 we're paired down to just maternity services at this point, only essential services. And we serve D.C. and the close end suburbs of Maryland doing birth in women's homes.

NNAMDITell us how has your work changed this last month or so?

ROTHMANIn the last month we have taken on I think 20 additional clients as women are, you know, reviewing their birth decisions and their choice of where to give birth and are feeling like maybe they don't want to go to a hospital to have their baby. So we're taking on --

NNAMDIGo ahead.

ROTHMANWe've taken on a lot of new clients and unfortunately we've had to say no to a great number of women, because we have only a certain capacity that we can fill.

NNAMDIYes, because many pregnant people are opting for home birth due to fears of overcrowded hospitals and contracting COVID-19. What safety precautions are you taking with your practice?

ROTHMANWe are taking a number of precautions. Actually I would say the way that we do our practice has changed quite a bit in every way since the occurrence of this virus. And I will say too that women that -- I would say I hear three things from women who are transferring to us. One is they're afraid that they'll be more exposed to the virus. Another is they're worried that there won't be room for them as things ramp up. And another is that as we are trying to protect people from exposure to the virus more and more hospitals are limiting who can come with you. And trying to contemplate the idea of -- oh, my goodness. Sorry. There's thunder here.

NNAMDIYes, indeed. In my neighborhood too, as you can probably hear.

ROTHMANYeah. Trying to contemplate the idea of giving birth this incredibly --

NNAMDIOh, as a matter of fact it would appear that the inclement weather has affected my communication with Mairi Breen Rothman. Here is Saied in Virginia. Saied, you are on the air. Go ahead, please.

SAIEDHello, Kojo. How are you doing today?

NNAMDIDoing well. Considering.

SAIEDGreat. So we just had a newborn in March 26. So before the baby was born, of course, we were freaking out. And we were very worried about how we going to take her to the hospital how all this is going to go on. But thanks God she did on March 26. That's when the baby did. She went to the hospital. The next day she came back home. But we haven't even taken the baby to vaccination to pediatrics, because my wife is very worried about how, you know, take her to the doctor and with the nurses sort of stuff like that at the pediatrics with other kids with what's going on in the Coronavirus and stuff.

NNAMDII don't know if Mairi Breen Rothman can give you any advice about that. Mairi Breen Rothman is back with us. Our called was just saying that the baby was fine. They've taken the baby home, but now they're concerned about taking the baby to get vaccinations and the like. What would you advise?

ROTHMANWell, my first advice would be to talk to the pediatrician about what provisions they've made for the virus, because I know that all of us in healthcare practice have made a lot of adjustments. And there are a lot of pediatric providers, who are now having separate clinics for babies and children who are just having well check-ups. And some of those are being postponed for a little while, and just dealing with the essential more urgent visits. But the best thing to do is to talk to your pediatrician or your pediatric provider and just ask them what the best thing to do would be.

NNAMDISaied, thank you for your call. Good luck for you and your family. Mairi, how much does a home birth generally cost?

ROTHMANYou know, that's really hard to say because there are certified professional midwives who are -- have a scope of practice that just encompasses home birth. And then there are certified nurse midwives who work in a variety of settings including in the home. And each practice has its own way of managing their finances. So it's hard to really make a generalization, but I would say in this area it's maybe between $4,000 and $7,000 something that's really ballpark.

NNAMDIYou have said that this outbreak really magnifies disparities that already exist in our health system. I'm wondering if you can expand on that.

ROTHMANSure. For instance, in our practice we find that there are people -- we are not in-network providers for any insurance as most home birth midwives are not. A few are in-network for some plans and not for others. But what we find is that people who are on Medicaid, for instance, their birth might be covered if the midwife is in-network. But very few midwives who do home births are in-network for Medicaid. And so it doesn't cover home birth at all. And for people that don't have insurance, of course, the cost is quite prohibitive. So I know that all of us are -- in the home birth community are trying the best that we can to accommodate anybody that wants to shift over to this setting. But for some people it's just out of reach. And that's just another example of the unfairness of the system.

NNAMDIWhat do you recommend to people who've made a birth plan that includes a trip to the hospital? Should they stick to it?

ROTHMANI think that you have to consider a lot of things when you're deciding where to have a baby and who to have attend you. You need to look at your own health issues. If there are any particular reasons for a person to be in the hospital then those reasons would still exist, but the truth is that for the vast majority of women, childbirth is not a medical procedure. It's just a natural normal life event and if you can find a well-trained qualified person to attend you at your home and limit your exposure and give you still some control over, who is present and those kinds of things then that is an option that some people are, obviously, very attracted to, which is why there's an upsurge in people seeking that kind of care.

ROTHMANAnd I will say that, you know, in our practice, for instance, we are observing so many procedures to keep things sanitized between clients that we might see in our office to when we go to somebody's home for a home visit. We have them have instructions for how they can prepare the space that we're going to be in by disinfecting everything and then when we come in we're wearing a mask. They're wearing a mask. We're using gloves and everything. And then they have instructions to sanitize after we leave and to wash their hands again and same thing if they come to our office.

ROTHMANWhen we have a person come to our office they let us know from their car by texting that they've arrived. And we make sure that everything has been disinfected, our instruments, our doorknobs, light switches, bathroom, everything. And then we let them know it's okay to come in. And then after they leave we prepare for the next person. And then, of course, in the birth setting once they're in active labor and getting ready to have their baby, then we're doing the full PPE. So we're wearing coveralls with a hood, masks, and goggles.

NNAMDIWe got a tweet from Rachel who says, "I'm 29 weeks pregnant due in mid-June. We are nervous about going to hospital to give birth for sure, mostly worried about if family can help us after birth when we expect to be on our own to limit contact with the baby."

ROTHMANRight. That is a concern. And, you know, when possible if it's possible to have -- if your family members that you want to have come and help you are self-isolating for a couple of weeks before your birth and then they come to you having not been exposed to anybody for a couple of weeks and being completely asymptomatic and feeling totally well, that is a possibility. And, of course, people do sometimes have the virus with no symptoms so it's no guarantee. But you just need to think about what's best for you family and the best way that you can mitigate the risk for yourself and for others.

NNAMDIHere is Brad in Salisbury, Maryland. Brad, you're on the air. Go ahead, please.

BRADHi. Yes, my wife is eight and a half months pregnant and we should be expecting sometime soon within the next 12 days. I work in a retail establishment and a grocery store and deal with hands on with customers on a daily basis. Hand to hand contact with cash, goods, so on and so forth. I mean, I currently put in for my family leave, but, you know, we still have that stress on our mind, well, what about when we get to the hospital?

NNAMDIOkay. We only have about a minute left. What's your question, Brad?

BRADBeing her eight and a half months pregnant and I have asked OBGYN what's the next step should we do?

NNAMDIOkay.

BRADAm I going to be limited in the space in the room or I don't even have a clue. They've been able to provide me with much information.

NNAMDIMairi, what advise can you give Brad in about the 30 seconds we have?

ROTHMANSure. I think the best thing that we can do is protect ourselves and others the best that we can with whatever masks and gloves and washing hands that we can. And in the hospital just know that they are doing their best to do the same thing. And hopefully everything will go fine and you will come home with your nice little baby and everything will be well.

NNAMDIJosh tweets, "My wife and I planned a home birth with MAMAS. They are amazing. My message to husbands and partners is to be supportive and trust in your partners feelings about comfort and safety." Mairi Breen Rothman, thank you so much for joining us. She is the Co-founder of MAMAS. We're going to take a short break. When we come back, how distance learning is unfolding across the Washington region. I'm Kojo Nnamdi.