Updated 6/13/20 – As of today the DPH has provided new guidance which requires all Massachusetts hospitals to allow “1 visitor” in addition to the birth partner. We are again providing in-person birth doula support. All Massachusetts hospitals have been directed to implement this policy by the state.

The memo is publicly available on the DPH’s COVID website below, if you scroll down to “Health Care Organizations — Hospitals — DPH Hospital Visitation Restriction Order”

COVID-19 Public Health Guidance and Directives

—————————-

COVID-19 has thrown a curveball into the way things work for labor and delivery in the hospital and is making birth education and support complicated. We want you to know the reality of how hospitals’ Labor & Delivery floors are handling the coronavirus, what our plan is to continue support despite possible restrictions and your options around all these changes. We are all hoping this virus moves through Massachusetts quickly and we can continue on as normal, but in the meantime, here’s what is happening. (See more COVID-19 resources here under COVID-19 and Virtual Resources)

Hospital Policies on Support during Labor and Birth – I could write about the current policies of all the Massachusetts hospitals we attend but the reality is that they are changing EVERY day. People should know these policies are fluid and ever-changing while COVID-19 moves through. We do understand hospitals are trying to handle things in the best way they can in uncharted territories but we still urge our clients to advocate for themselves and the support they need on an individual basis.

Our doula community and the families we support have done a wonderful job at helping hospitals understand we are a not visitors, and rather important members of the birth team. We thoroughly appreciated the statement AWHONN posted on their FB page as well as the letter DONA drafted for families to send. That said, for the safety of all involved, the less bodies present in one place the better, so restrictions at this point and as things grow are understandable and necessary.

What is our Plan for Support? We have made a plan of action to make labor and birth as beautiful and as smooth as possible for your family. It is understandably not what we first envisioned and we have had to acclimate given the current circumstances. The good news is we now feel fully comfortable and confident in our ability to support families even though we are not physically present.

For each of our clients we talk about their virtual labor plan. This includes preference of communication at each stage as well as helping families envision and understand how we work with them virtually. Using Video (usually Zoom),  we are able to watch and hear through video, speak with you and your partner privately through earbuds, or openly by video to communicate with your nurse and your OB or Midwife. In prenatal sessions we talk about how this is done seamlessly without distracting from the management of labor or the environment. While we may not be able to provide back pressure or feed you water we are still able to share witness and be in the moment to offer assistance when needed. We’ll be able to see your body language – when you’re in a good groove or when it’s looking like you need a change,  an affirmation, or a suggestion on a new position or new focal point. Through video we are still present – sharing with you that we know and trust birth and that this is what normal labor looks like (this is especially helpful for partners who may feel adrift and need that confirmation and calming presence). With earbuds we can listen to your breathing and sounds and hear if the sensations are running away with you, we can guide you with our own audible breath and sounds – just as if we were in the room with you. We can still help baby to move and labor to progress by  sharing position ideas and provide suggestions to your nurse or partner to make arrangements within the room (e.g., birth ball here, pillows there, massage there, move bed to this position). With video we are even able to share our desktop to show pictures of positions we are referring to. Finally, we can easily provide support if your care provider presents you with choices during your labor and you need information in order to make your decision.

Things you’ll need to maximize on virtual support:
1. The most helpful tool will be wireless ear pods or headphones. Ones you and your partner can share would be best, which is why wireless may work better. These will have to connect to a phone or, better yet, a laptop.
2. An established video chat available.
  • You will need a phone or laptop with a long extension cord. (you will likely be moving the laptop around the room if you have no ear pods)
  • Zoom will likely be the best option for computer video and audio. If you have an apple laptop then FaceTime will also be an option for a laptop or iPhone.
3. You and your partner should practice set up now. You’ll have to be able to set it up whether you are at an induction or in active labor. FaceTime and Zoom are both quite easy to jump into. It will be the audio aspect you’ll want to nail down in a way that won’t restrict movement for either of you.

What are Your Options –  If you find yourself at a hospital where support is completely denied, know your options.

  • It is illegal for any hospital to deny you support if you showed up at their emergency services.
  • You have the option to switch to a home birth if you are low-risk. Check out our resources for help in finding a home birth midwife. We’ll note also that it may be difficult to find someone who has room, so make some phone calls now to get information if you’re thinking of home birth as a choice for you.

Many, if not all, hospital childbirth education classes have been canceled. The great news is that educators, doulas, CLC and IBCLCS, and prenatal yoga teachers are all picking up the slack by providing virtual support and classes. Take a look at our resources under COVID-19 and Virtual Support

3 Comments

  1. Rebecca Urban on 03/15/2020 at 6:44 pm

    Bethany, thank you for posting this! We need to stay ahead of this and our clients deserve accurate information on their options! Peace, Rebecca

    • Rebecca Urban on 03/15/2020 at 6:45 pm

      Also, Urban Arrivals will be offering complimentary 15 minute phone sessions to anyone who wants information on their options.

      • admin on 03/15/2020 at 9:43 pm

        That is wonderful! Thanks for commenting Rebecca. We so appreciate you!! <3

Leave a Comment