Keeping the Connection: Doulas During the Pandemic
When imagining their birthing experience, many expectant parents envision their partner, family members, and/or friends around them, providing words of encouragement and comfort during an often stressful time.
However, an additional support person that might be present in the birthing room is lesser known - the doula. Trained and certified professionals, doulas provide continuous support during labor and birth, as well as during pregnancy and postpartum.
The value of doula work has been backed up by the scientific community. Studies have proven that having continuous support makes a difference: labors are shorter, there is less of a chance for a caesarean, and it is less likely for an infant to be born with a low five-minute Apgar score (the Apgar test is completed five minutes after birth and determines how the newborn is faring outside the parent’s womb, with a high score signaling best health). Additionally, with a doula present, birthing persons were less likely to report dissatisfaction.
The Child Abuse Council is the proud home to a doula program that provides free services to both Illinois and Iowa. The program is headed by Debra Bozik, who supervises four Rock Island County doulas in addition to one full-time and one part-time doula in Scott County. From July of 2020 to date, the team has assisted with 35 births.
Unfortunately, as with many things, the Covid-19 pandemic has altered the normal flow of the birthing experience. Visitation abilities in hospitals limit the ability to meet in-person, as area hospitals have restricted birth persons to only one support person during provider appointments and during labor and birth. Additionally, the virus makes someone outside the immediate personal network attending home births potentially risky.
In short, CAC doulas have had to turn to alternative methods to continue to support expectant parents. Since March of 2020, the doulas have provided assistance and support virtually though video calls, phone calls, and text messages to keep the expectant mother in touch with their doula. If needed, iPads are loaned out to ensure connection is possible.
Debra, who in addition to her supervision duties is a certified doula, admits the initial shift away from in-person labor was disappointing to the doulas, whose job often includes physical comfort and pressure work during labor. Yet, the doulas have worked hard to continue to provide the best level of support possible, despite the technological barrier.
Part of what makes CAC doula services special is the ability to begin meeting with soon-to-be-parents weeks before birth. CAC doulas are community doulas, rather than private doulas. Debra explains that community doulas provide a special type of support that is often missed with private doulas due to the ability to forge a stronger connection after weeks of meetings and discussions. Private doulas often only meet with the birthing person one to two times pre-birth, assist with the birth, and perhaps follow up a week later. Alternatively, the initial connection between the CAC community doula and the expectant parent is formed in the 28th week of pregnancy. The pair then continue to meet every week for one hour until eight weeks postpartum.
During the meetings, doulas lead conversations about prenatal education and check up on how the client is doing. A main component of education is a focus on attachment and bonding. Debra notes that some parents are surprised to learn that even when the baby is in utero, there are still activities and things they can do to bond with the baby.
Prenatal meetings also include connecting parents with resources, as well as helping expectant parents create a customized birth wish plan. Using a program called Motherboard, they are educated about different birthing methods and other important information which they are able to use to make informed decisions. They are then able to take the plan to their providers to ensure coordination in that their wishes are carried out to the greatest extent possible.
During labor, doulas can undertake many different duties, all with the ultimate purpose of helping the client have the best experience possible. In non-Covid times, they can massage and apply counter pressure, or run warm water over them as they take a bath. They also check in with the other support people in the room, engaging them and suggesting ways they can help--something they can do virtually as well. From afar and in the room, doulas can also provide encouragement and emotional and mental support.
In the hour after birth, a time that Debra calls “one of the most important times in all of our life”, doulas help protect space for the parents and baby. Allowing alone time for the parents to bond with their newborn during this time is so critical, and doulas help ensure this time is not interrupted by excited family or friends.
After birth, doulas continue to meet with the family. The unique opportunity of the community doulas to connect long-term also gives parents additional support concerning postpartum depression. Clients are screened for a baseline in depression during pregnancy, and then screened again four weeks after birth. These screens can help give indication of who might need a check-in or perhaps a referral, ultimately helping both parent and infant.
Ultimately, whether interactions are in-person or virtual, the CAC doulas work hard to ensure the best outcomes for their client and baby. Upon reflecting on her own doula experiences, Debra remarks that “making that connection and helping parents execute their wishes” during birth is a powerful and rewarding experience.