Side view of woman preparing for birth with partner in face mask in the background

To Doula or Not to Doula…

Birth During a Pandemic

Pregnancy during a pandemic can feel so uncertain. Birthing people throughout the country have been challenged not only physically, but in creating a birth plan that reflects their ideal birth. For a time, in parts of the country, choosing hospital birth was choosing whether or not to birth solo. In March and April in New York City, partners weren’t even allowed in the hospital to support birth, let alone doulas. 

With time, hospital policies turned around again and partners were supporting, but many facilities were allowing one person accompanying the birthing patient only. Still no doulas. No moms, sisters, best friends….it was a decision for many whether or not to continue with the plan for hospital birth. 

Many birthing people began researching home birth or birth center birth. Thus eliminating the “one person only” rule being imposed by so many hospitals. Choosing a birth center allowed more flexibility, and doulas were still allowed. Choosing home birth, partners could have whomever they’d been spending their time with—including extended family—at their births. Those adding to their families could have their children cared for simultaneously while birthing at home. 

In Boulder County, families still have some choices. Most area hospitals—Longmont United, UH Longs Peak, BCH Foothills, and Avista—are still allowing a birth partner plus doula. This has enabled families to continue to hold their ideal hospital birth without much change. Birth in these facilities has been relatively “normal”…with some exceptions. Some facilities are requiring partners and birthing people wear masks until they’re safely in their birthing suites. Some are requiring COVID-19 testing during labor. Many are asking for people once admitted, to stay with their birth team—no coming and going. 

The Kaiser Facilities (Good Samaritan, St. Joes, Sky Ridge) are still following the “one person” policy. Families who birth there will have their partner accompanying them or a doula but not both. 

For newly pregnant couples, this is not new information. They have become pregnant during the pandemic and can do some research into birthplaces that resonate with their ideal birth. For some, a home birth is becoming more appealing, with options for other family members to attend the birth as well as fewer trips to offices for prenatal visits and care. For others, working in a facility with midwives and fewer restrictions (a birth center) feels best. Many are pleased with birth in hospitals where doulas are still allowed and can support them. 

Couples who became pregnant before the pandemic are making last minute choices regarding their births and for many, this means changing providers. As a doula, I have encouraged many to rethink what feels safest, and gives them the best opportunities to birth in the way they hoped. It is not an easy decision, but also helps keep birthing people feeling powerful in their choices after making them with evidenced based information and education. 

Recently, our collective, Sage Birth & Wellness Collective, has been asked to write a paragraph or two regarding safe practice during COVID-19. This is my statement: 

As a doula, I support and attend birthing people and their partners. I do this during a pandemic. As a women’s health physical therapist (PT), I treat my patients in a space that is kept clean and sanitized. My practice as a PT and a doula is my only exposure risk at this time. I feel this keeps me and my family safe. I feel this helps keep the community safe. I wear a mask every time I’m out, and take radical precautions when I return home from the hospital or office. I think this is necessary. I wear a mask at all prenatal and postpartum visits, and when appropriate, I do these virtually. I teach my childbirth education class virtually. While this is not ideal, it is the right thing to do in these times, and families desire and receive content. This is imperative. I have been tested for COVID-19 and the antibodies, both tests were negative. I attribute that to safe practice. Please reach out if you have questions about my practices. I am constantly humbled by my work with my families and birthing people. Your health and wellness is as important to me as mine and my family’s.
~ With Humility, Amy

Many other doulas, wellness professionals and physicians are making similar statements to their patients and clients. We are healers. We have a responsibility to our families as well as the families we choose to work with. The pandemic has changed birth in many ways, but not in the fundamentals of providing support to birthing people and their families. This has been a small way of providing people with choices, assisting with birth plans, and providing care and support both pre and post-natally. When birthing people are able to make their own choices, feel powerful in their decision making, and are supported with intention from the birthing community, they come through birth with their newborn—regardless of the way it happens— feeling strong. Empowered. Having no regrets. This is what it means to support as a doula. Empowering birthing people before, during and after the births of their baby. 

With so much love, support and hope, combined with knowledge and keeping up to date with current safe practice, I will continue to work as a birth and postpartum doula, and women’s health physical therapist. 

PT, CD(DONA), Physical Therapist at Sage Birth and Wellness Collective