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Maggie Shannon

Midwife Patrice Bobier supports a client who chose the privacy and safety of her home to give birth. In November 2021 the U.S. Centers for Disease Control and Prevention published a large national study definitively showing that being infected with COVID-19 during pregnancy raised the risk of stillbirth, and that risk increased with the appearance of the more virulent Delta variant. The CDC expects to have data on the Omicron variant soon. “The good news is that [placental damage] is probably a very uncommon occurrence,” Schwartz says. “Most women who have COVID-19 while pregnant will do well, and most of their babies will, too.”

Midwife Chemin Perez checks on a patient's progress during her labor at the New Life Midwifery Birth Center in Arcadia, California. Recent studies of pregnant women who contracted the virus before the vaccine was available reveal they were at 40 percent higher risk of complications and were at greater risk of landing in intensive care, ending up on a ventilator, or dying when compared with uninfected pregnant women. Most of those who experienced severe problems had been hit hard by the virus.

To keep her staff and clients safe, midwife Chemin Perez (seen here in the middle) moved most of her birthing center into tents in the parking lot of New Life Midwifery in Arcadia, California, where pregnant women could have their regular prenatal checkups without fear of getting infected with the virus. “COVID is much more dangerous in a pregnant woman due to a suppressed immune system and lower lung capacity,” says Paula Brady, a reproductive endocrinologist at Columbia University. That at least partly explains why a notable number of pregnant women who fall ill with the virus land in the hospital.

Rather than risk a COVID-19 infection, many pregnant people have been choosing to deliver their babies in birthing centres or at home with a midwife, like the woman seen here. Early in the pandemic, hospitals overwhelmed with COVID-19 patients became hot zones for the coronavirus. By the summer and autumn of 2020, obstetricians began seeing a spike in preterm births. “And then we started to see maternal deaths,” recalls David A. Schwartz, an Atlanta-based placental pathologist and epidemiologist. It was some of the earliest evidence that if a woman was infected SARS-CoV-2 in pregnancy, she was at risk for an adverse outcome.