Abstract
In this article, I seek to understand how the COVID-19 pandemic has impacted childbirth in Puerto Rico, an island that was already in recovery following the occurrence of two devastating hurricanes in the fall of 2017 and a major earthquake in the winter of 2020. Thus, I argue that it is important to discuss not only how individual disasters impact birth, but also how their compounding effects do so. In order to address these research questions, I conducted remote interviews with Puerto Rican birth workers and researchers. During times of crisis, this pandemic included, home and midwife-attended births have become increasingly more popular. However, Puerto Rican midwives and doulas currently have less institutional support than ever. In a time of quarantine when home births are rising, we need to consider whether society is designed to facilitate these models of care. In Puerto Rico, pre-pandemic, there was a less than 1% home birth rate and there still is a lack of legal recognition and protections for homebirth midwives. As this article demonstrates, an acknowledgment of the near-invisible labors of these birth workers is needed, in addition to supplies, support, and protections for them—and not just in times of “crisis.”
Highlights
DISASTERS AND DELIVERIESFrom Ebola to Zika, a primary concern in recent epidemics has been how infectious disease impacts pregnant women and infants
In order to understand how COVID impacted birth in Puerto Rico, and how this differed from or was similar to previous disasters, I conducted remote interviews with 11 Puerto Rican women working in the fields of reproductive health and justice, 1See Davis-Floyd (2021) for descriptions of “low-tech, skilled touch” midwifery disaster care following the 2004 Aceh tsunami, the 2013 Hurricane Haiyan in the Philippines, and the Great Japanese Earthquake of 3/11/11. 2It is worth noting that in recent years the home birth rate has risen to closer to 2% in the United States as a whole. 3See Ivry et al (2019) for a discussion of childbirth experiences during an earthquake
My midwife interlocutors informed me that home births have become more popular and by extension, their services have been in high demand
Summary
DISASTERS AND DELIVERIESFrom Ebola to Zika, a primary concern in recent epidemics has been how infectious disease impacts pregnant women and infants. When Hurricanes Irma and Maria hit Puerto Rico in 2017, many laboring women were unable to get in touch with their primary providers or to get to the hospital (Stein, 2017) During this time, midwives were on the frontlines, leading disaster response and relief both in maternity and community care (Dieppa, 2018), as midwives in other countries have frequently done. Less than 2.5 years after Hurricanes Irma and Maria, when extreme earthquakes rocked the southern region of the island, these independent midwives were once again first responders Though they are adamant that no births occurred in the “tent cities” (due to safety concerns), they did provide prenatal and postnatal care for the women of the community—many of whom were still having difficulty recovering from the earthquakes, both emotionally and physically. We must acknowledge the complications in this shift, for both midwives and their clients, as I will later discuss
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