Update 12/5/20 – The numbers in Massachusetts are going up and some Massachusetts hospitals have began to restrict doulas once again. For now, however, there are also some hospitals making exceptions for doulas. Some have taken the step to recategorize doulas as caretakers as opposed to visitors, effectively excluding them in any visitor restrictions. We applaud this, and encourage those who feel having a doula in person at their birth vital to consider switching to those hospitals.
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 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 these policies are fluid and ever-changing while COVID-19 makes waves. 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 sometimes 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 always physically present. We also still provide in home support for those who want to maximize their time at home before heading to the hospital.
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.
- 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.
Most in-person hospital childbirth education classes have been canceled, but are providing online options. Many birth educators, doulas, CLC and IBCLCS, and prenatal yoga teachers are also offering virtual support and classes. Take a look at our resources under COVID-19 and Virtual Support