Doula Support During a Public Health Crisis

In response to the COVID-19 pandemic, hospital administrators are having to make tough decisions in an attempt to halt the spread of the coronavirus. One of these decisions has been to limit the number of people entering their doors—including doulas.

These decisions are not made lightly and don't reflect a lack of understanding of patient rights or an ignorance of the documented benefits of doula care. And they certainly don't reflect a disregard for patient concerns or birth experiences! 

These drastic measures are merely a reflection of the drastic times facing our nation!

While this may be understandably distressing to a client who spent weeks or months finding and hiring a professional birth doula, this is a time when the “emotional support” component of doula work can really shine! 

Doulas are adept at helping their clients deal with the unexpected, and now is no different! Doulas around the world are calmly helping their clients adjust to changes in how they envisioned their birth. And doulas have quickly adapted their services so they can still provide support—virtually! 

In contrast, some doulas have responded quite differently to this move to protect the health and safety of patients, healthcare workers, and the community. They have declared--unequivocally--that these changes WILL cause more interventions, more birth trauma, and more perinatal mood disorders such as depression and PTSD. End of discussion.

Instead of instilling confidence and decreasing fear in expectant parents, they are inadvertently instilling fear and decreasing confidence! 

To these doulas I would like to say:

Please stop!

Stop projecting trauma and negativity onto birthing families!

This is a stressful and vulnerable enough time even when there’s NOT a pandemic going on. Regardless of your stand on the ethics of doulas offering in-person support during this time, I think we can all agree that now is not the time to contribute to the fear and stress of a person about to give birth!

If your client is convinced they'll have a horrible birth unless you are present, then you might want to consider these questions: 

• Have you built up their self-confidence or is all their confidence in you? 

• Have you helped them develop a trusting relationship with a provider or have you fostered a distrust of all providers so they're scared to death of giving birth without you?

• Have you helped them find their voice or have you promised to speak for them?  

• Have you given them unbiased information about interventions and all their options or have you only given them select information that fits your birth philosophy?  

• Have you helped them find their power so they have the strength to face the unknowns of labor and birth or have you made them feel like they can't possibly face it without you?

Part of our job as doulas is to help clients navigate changes to their birth plan. Whether the change is due to a prenatal diagnosis, a labor complication, or a pandemic, our job is to remain calm and unbiased, not to get up in arms.

It's not about us or what we think of the change in plans. It's about helping them have a positive experience even with the changes. Even if those changes include the absence of their doula or--worse yet--their partner!

I am not saying birth trauma is not real. But if the time some doulas spent rallying, demanding our "rights”, stirring up fear, and projecting trauma onto clients was instead spent on helping clients find their strength, own their power, use their voice, and walk into this experience with confidence, there’d be no worry about them being traumatized by even a major shift in their birth plan--like a pandemic!

So, dear doulas, can we please focus on what we do best…providing unbiased, non-judgmental support to our clients? Virtual services may not be ideal, but in this less-than-ideal season, it can go a long way in helping our clients feel empowered and reach their goals!