You can add doulas to the long list of professions turned upside down by coronavirus. The birth coaches act as guides during pregnancy by offering prenatal care and childbirth workshops and assisting during deliveries, when they usually provide hands-on physical support in the hospital room.
At least, that was the case before the onset of Covid-19. Now, a majority of hospitals in the DC area are only allowing one visitor to accompany someone giving birth. Most patients opt to give that slot to a partner or family member, putting doulas in a tricky position, says Sarah Paksima, 41, of Poolesville, who runs the group DC Birth Doulas.
So, like everything else these days, the doulas are going virtual. “Our interpretation of social distancing and shelter-in-place has been if something can be done virtually, we’re going to do it virtually to keep everyone safe,” she says.
That means that the 18 doulas who work with Paksima’s group are now providing childbirth education classes, prenatal advice, and labor assistance via Zoom or FaceTime. Yes, that basically means they’re live-streaming births.
Via the screen, the doula can suggest different positions for the birthing parent or walk them through a breathing technique. And, a bonus—the partner can also channel their inner Secret Service agent, if they want: “We really like to have the [non-birthing] parent have an earbud in the ear [so we can] whisper suggestions,” says Paksima.
Obviously, this means that much of the physical work that a doula would normally undertake now has to be carried out in-person by the other parent. “They’re carrying a much heavier burden,” says Paksima. To help, DC Birth Doulas has created a virtual toolkit that outlines the positions and processes they’d normally provide in-person during a birth. “This has been a learning process for us,” says Paksima. “It’s been a lot. We’ve all been working 12-hour days because we’re coming up with this whole new product line and service.”
Alexandria resident Ashley Spellman, 35, of the DMV doula group Delivered LLC, says her group is making a similar switch. “We had to sort of pivot very quickly,” she says, of learning the news that hospitals would restrict visitors. “We haven’t done an in-person birth since this happened. It’s all been virtual.”
Spellman says her group has assisted four virtual births so far, and a third of its roughly 60 clients have inquired about alternatives to hospital births, such as delivering at home or at a birth center, so they can have their doulas present in addition to their partners. A fifth have already made that switch, she says.
And, in another sign of the times, Delivered LLC recently launched a virtual birth assistance package, where everything from prenatal consultations to birthing workshops to labor assistance will be done via a screen. “Some clients are hiring us for the virtual package with the option to upgrade in the future or vice versa, based on what’s happening,” says Spellman.
Of course, having to change a birth plan on top of worrying about a pandemic is difficult for parents, says Paksima. “Their biggest worry is that they or their baby will be impacted and get very sick,” she says. “Their second biggest worry is that they’ll be alone; their partner won’t be able to be with them and they’ll just be by themselves in a hospital room.”
It’s also difficult for the doulas—while a majority of the hospitals aren’t allowing visitors in the delivery rooms, some doulas are still providing labor assistance to parents at home until it’s time for them to check in. But about half of the doulas at DC Birth Doulas don’t feel safe doing that, says Paksima, even with added precautions such as wearing masks and making multiple clothing changes.
“It’s a challenge for my doulas who all really, really want to do their job,” says Paksima. “They feel a lot of internal pain that they can’t be there supporting their clients in person.”