Author’s Note: For context, this was published during the COVID-19 (coronovirus) pandemic of 2020. In March 2020, the medical system introduced a new level of unpredictability. This unpredictability is nothing new in the world of childbirth. If one thing is certain in childbirth: everything is uncertain. Doulas learn to expect the unexpected. However, COVID-19 has created a more common scenario for more women in childbirth: limited birth support in a hospital setting. This post addresses in general terms how doulas can support mothers and families with limited birth support options due to hospital requirements.
At various times, doulas may not be allowed to provide direct, in-person care for a birthing mother. When a doula is available, she can still provide remote or virtual support. This remote support can still increase the likelihood of a successful birthing experience. This can also be seen as background support. This suggests that the doula’s work is as much in preliminary preparations as in the actual birth.
Circumstances that would necessitate the need for remote labor support include the following:
- Hospital protocols that limit the number of birth support persons to be present. (for example, a c-section)
- Physical distance between the birth mother and the doula. (long travel time between doula and client, client delivers quickly)
- Emergent situations that tax hospital systems causing restrictions in support persons. (for example, hospital overload which leads to rash policy changes)
A common variable in all of these scenarios is this: the doula (professional support person) is unable to be physically present at the time of birth. In planning for all birth support scenarios, consider remote support as a contingency, whether anticipated or not.
Preparations for Remote Birth Support
Much of a doula’s work can and should be done before the time of birth. When possible, in-person visits with healthcare providers can help build connections and establish expectations. When an in-person visit is not possible, remote forms of contact can work. These include phone calls, emails, or even video chats. These remote contacts can allow you to introduce yourself to those that who will be working directly with the birth mother.
Another preparation tool is prenatal visits with the birth family. When possible, do these visits in-person. Distance or other circumstances (such as a stay-at-home order) could require alternative forms of communication. Video chats can help bridge the remote gap and allow the doula to see and hear the concerns of the birthing family in real time. These prenatal visits are also a vital time for hashing out plans, teaching support techniques, and offering one-on-one suggestions. The objective is to help the birth mother and her chosen support person (where limited numbers of support individuals are allowed) to prepare. This is especially true for a first-time birth.
However, at least one or two remote prenatal visits may also be ideal. These remote visits allow both parties to establish reliable forms of communication before the actual birth. These virtual visits will help to troubleshoot connection problems. This also prepares the birth family for the experience of remote support.
Remote Support at the Time of Birth
Providing remote support at the time of birth is not ideal, but may be the only viable option. Here are some suggestions on how to prepare for such a scenario.
- Contact Methods. Establish a preferred and multiple secondary forms of contact between the doula and the birth family. Perhaps the preferred form of contact will be a video chat between the doula and the birth support person. Secondary forms of contact may include the birth mother’s phone (instead of the support person), an actual phone number for all parties involved, and preferences of voice or text support. These secondary forms of contact should be established in the event that the preferred contact method fails. For example, an unreliable Internet signal may necessitate the use of phone calls.
- Affirmation and Reassurance. A strong, clear, and calm voice will help extend confidence to the birth family. Birth as a first-time experience for expectant parents can be extremely unpredictable. A reassuring voice in the process of birth can greatly improve the overall experience.
- Access to Doula Tools. Provide access to a doula bag or other tools, such as a birthing ball or rebozo cloth. Make arrangements for how and where these tools will be dropped off and returned. Take time to offer adequate instruction on how to use tools provided.
- Avoid Distractions. Make sure that your involvement in the birth process is not a distraction to what is happening on the other end of the line. If you have small children in your space, that may involve removing yourself form the same space or muting your microphone on your end. If your physical location is visually bright or distracting, consider voice-only/audio support over video support.
Remote Doulas Matter
Remote doula support, though not ideal, can still provide significant benefits to the birthing mother and family. Any birth support will improve confidence and successful outcomes for all involved.
Do you have experience with providing remote doula support? What other tips and suggestions would you add to the list?