NORTH MYRTLE BEACH, S.C. (WBTW) – During the births of her first two children, Ashley Muir received the hormone Pitocin, had epidurals and underwent episiotomies — cuts done to make the vaginal opening bigger — at the hospital. 

For her third baby, she wanted something different. So, she opted for a home birth.

“You are in total control,” said Muir, who gave birth to her son on April 9. “You are in control of your situation at home, you’re in control of your baby. Ultimately, they always take the baby from you at the hospital, and you don’t know what they’re doing. You don’t know what they’re injecting them with.”

Last summer, Muir’s family didn’t know if hospitals would still be struggling with COVID-19 or keep strict visitor guidelines. She’d previously considered a home birth and decided to pursue it for her third baby.

“It was unbelievable,” she said. “You know, just being in the comfort of your own home, and just being able to have your child naturally, and not have any doctors or medicines intervene with just a woman giving birth to her child.”

Fear of the virus and tight visitor restrictions at hospitals during the pandemic have been attributed to a boost in women seeking home births over the last two years, a trend that midwives said has continued to grow. 

The nation saw a 19% increase in home births from 2019 to 2020, according to data from the U.S. Centers for Disease Control and Prevention. 

There were 577 home births in South Carolina in 2020, according to the data. During that time, as overall births decreased, the state saw its home birth rate jump to more than 1%. 

In 2010, home births made up about .47% of all births in the state, according to the South Carolina Department of Health and Environmental Control. In 2019, that was .69%.

Even with the boost, home births still make up only a small percentage of births. In South Carolina, the number of babies born at birthing centers has also stayed low. However, with few midwives, and only a handful of birth centers in the state, those numbers are essentially capped. 

There are 27 midwives who attend home births in South Carolina. 

“That’s not many at all,” said Audrey Trepiccione, a certified professional midwife and owner of Oceanside Midwives.

Trepiccione, who attends home births and is based out of North Myrtle Beach, moved to the area a year ago. Since then, she’s seen the number of midwives who attend home births in the Grand Strand increase from one to three.

Most midwives – who are licensed by the state to carry equipment and medications – are clustered in the Charleston, Columbia and Greenville areas. That’s reflected in state statistics, which show that Charleston County had the most out-of-hospital births attended by a midwife in 2019, at 215. It’s followed by Greenville County, at 196. Horry County had eight.

There were no out-of-hospital births in 19 of the state’s 46 counties in 2019, according to the most recent information from the Department of Health and Environmental Control. The agency has not published birth data from 2020 and 2021. 

Trepiccione said one reason midwife numbers are low is that South Carolina doesn’t have a midwifery school. However, more people are entering the profession, and more midwives have at least one student.

She points to a history of pressure from southern hospital lobbies to add restrictions on midwives.

“The regulations are a big factor,” Trepiccione said. “The southern states have been very slow to embrace this as an alternative, and they call it an ‘alternative’ even though it is very comprehensive, modern care. It is just Level One emergency care at your house, instead of going to the hospital.”

She has seen a boost in interest since the pandemic, which hasn’t waned. Not everybody who reaches out to her is qualified for a home birth – which requires a mother to be considered generally healthy, to not have had a previous cesarean birth and to not be expecting multiples. But she also isn’t able to meet her full need.

“There are many more women who want it than I can take care of,” Trepiccione said. 

Expectant parents find her on social media or hear about her through word of mouth. More patients, she said, can also be attributed to more people migrating to the area. Young families look up midwives, she said, which is accelerating the shift toward more home births.

In the past year, she’s had patients from California, Hawaii, New Jersey, New York and Oregon. 

She said expectant parents who come to her can have trauma from hospital interventions, want to stay away from high cesarean section rates at hospitals and don’t want medical interventions pushed on them. 

That’s what drove Muir to Trepiccione. Muir, who had watched videos about water births conducted at home, wanted that unmedicated experience. 

“They make it seem like it is something that is natural, that it is something you’re supposed to do, and, in reality, it’s not,” Muir said. 

Ashley Muir’s son was born on April 9, 2022, at home. (Courtesy: Ashley Muir)

Without medical interventions, she wasn’t tired after her youngest’s birth. At the hospital, she said she was exhausted and wanted to sleep for two to three days afterward.

Her 10-year-old son was also able to be there for the at-home birth.

“He was front and center,” she said. “That was one of my favorite parts of that delivery — was that he got to experience his brother being born.”