Among all the chaos and uncertainty COVID-19 has brought us, one thing hasn’t changed: People are still having babies. But the landscape of giving birth sure has changed. And one of the big changes, in the hopes of flattening the curve, are new hospital visitation policies that, in some cases, cut doulas out of the equation. (For a period of time, some hospitals weren’t even allowing partners in, so people were birthing alone!)
As a society, we don’t learn about birth until we are already in it. And, we know there’s a lot of confusion about what we as doulas (pronounced do-la) actually do, so perhaps it wasn’t entirely surprising that so many can’t understand what is at stake when we limit support for those in labor.
As we share in our new book Why Did No One Tell Me This: The Doula’s Honest Guide for Expectant Parents, a birth doula is a nonclinical coach that provides emotional, advocacy, and educational support during pregnancy, birth, and the immediate postpartum period.
Because we stay with clients for so much of their labor (if you are birthing in a hospital, oftentimes you don’t see your clinical provider until it is time to push) and we are not bound to institutional policies, we have a unique vantage point on this process. Basically, we have access to the stuff no one else sees!
*Doula support looks different for every body, but some examples of what a doula can do include:
- Help you navigate conversations with your care provider about your pregnancy.
- Help you cope during early labor before you are with your clinical provider.
- Help you decide when to go to your birthing place during labor
- Help you avoid unnecessary interventions.
- Help you find ways to encourage the baby to descend through the birth canal while you have an epidural.
- Provide hands-on support, like massage, during labor.
- Assist with lactation once the baby is here.
- Allow for your partner to take a break.
- Help you process your birth experience and adjust to parenthood in the postpartum period.
Research shows that having a doula provides real benefits and affects outcomes, including: more positive view on birth experience, less risk of needing pitocin or a c-section, birthing babies with a higher APGAR score (1).
Labor and delivery is like approaching a jungle with no paths and no map. We don’t know when it is going to start, what it is going to feel like, how long it will last, what our babies will be like…
And birth itself can take time (sometimes, days). Our bodies do things that we have no control over. There’s blood, vomit, pain, poop, sweat, funny noises. Those giving birth outside of their homes enter an unfamiliar environment, half-naked, and hungry (most hospitals do not allow eating). Even with the best medical team in the world you will find yourself alone for most of your labor as the medical team bounces between with several patients at once and pay closer attention to numbers on screens outside of the room. Even after baby arrives, you may need need to spend days in the hospital postpartum, depending upon what happens during your birth.
So maybe now you can start to see why support, whether it comes from a doula, partner, or friend, is essential. This is all compounded by the fact that, throughout the entire process, we must emotionally confront some of our greatest fears as humans: giving up control, change, loss, and the unknown.
Do these themes sound familiar?
During COVID-19, the whole world is being confronted with these fears. And while the virus is novel, our societal reaction to fear is not. We need to look no further than the history of obstetrics in America—which shows a clear repeating pattern of forsaking the experience of our pregnant people in order to feel a sense of control. An action that can result in physical and emotional trauma.
We know that these are uncharted and terrifying times, and we are so grateful for the health care workers putting themselves at risk to show up and serve. But we must not lose sight that birth is an experience, not solely an outcome. And that the experience matters. How we treat our pregnant people in labor and the postpartum period affects outcomes and can have a major impact on pregnant people’s physical, mental and emotional health, their ability to care for their babies and even their babies’ well-being.
We must remember that safety is more than mere survival.
Our hope with Why Did No One Tell Me This? is to put the knowledge and power of a doula directly into pregnant people’s hands; to help you find your tools for a more easeful journey through the perinatal jungle.
To our dear pregnant people, we know that these are especially trying times for you. We want to remind you that your experience still matters. Bring pieces of your home with you to your birthplace to make it cozier. And, remember you still have rights as a pregnant person. Call on the staff as often as you need. Ask for five minutes alone to think things over when interventions are suggested. Ask all your questions. You know more about your unique body and circumstances than anybody else.
And, we hope that you can shift your perspective and start to see the perinatal period as an opportunity. Because all that baby growing can lead to some incredible personal growing along the way. What we learn from the perinatal period are our tools for life. After all, we never really know the path. We can only focus on how we move through. We must contract in order to expand. And getting through can freakin’ hurt.
You’ve got this.
*For those who can’t have a doula physically with them, virtual support is being offered quite successfully! So, having a doula is still possible!
- Bohren A, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. “Continuous support for women during childbirth.” Cochrane Database Syst Rev. 2017 Jul 6;7:CD003766. doi:10.1002/14651858. CD003766.pub6.