In Bloom Doula Services

The pandemic has turned life upside down for everyone. I don’t think I am an exception to changes and sacrifice during this time becuase I know we all are worried about loved ones, our own health, making ends meet, and trying to stay sane during a lack of normalcy.

As a doula, I often think about what is happening in hospitals for birthing women right now and I feel completely heart broken for them. No hospital visitors bringing in flowers and balloons, no delivery of the meal you have been dying to eat for the past 12 hours, the grandmas/sisters/best friends who will be missing the births of their grandchildren and nieces or nephews. The worry of being pregnant during a time where your health, but also the health of your baby is put at risk. And the high possibility of not being able to have your support person present, which for me has always been my doula. I believe in the power of doulas, which is why I became one. I know they are more than a luxury; they are essential and many women are sacrificing so much when going without the doula they have been leaning on through pregnancy. All of these changes hurt my heart for people welcoming new babies right now.

Then I remember I am also one of those people. Since this is my third baby and my baby is due in August I have kind of excluded myself from pregnant women in my mind. Now half way through my pregnancy, and early in my career as a birth worker specifically, so I am dealing with changes on both sides. As a pregnant woman this pregnancy has already been a little different for me. It is only one month following a miscarriage. It is the first time I have had a lot of friends and family pregnant at the same time, and it is the first pregnancy I have experienced as a doula. Then throw that into the middle of a pandemic and it has been a weird ride. Before I even got pregnant I knew I wanted to have my next birth experience at a birth center, which is now a blessing during this pandemic because it hasn’t forced me to make any changes to my plans for birth. I still have my brith team attending, I still get to have the birth I want. I still feel safe in my birth center. But I know not all women who are pregnant right now can say the same.

I was unable to go to my client’s birth last month due to hospital restrictions on how many support people are allowed in the room. I have counseled several women on their options as they consider alternatives to the hospital during this time. I am constantly reminding women of their rights because a pandemic is not an excuse to abuse women during labor, and some hospitals are pushing a very thin line.

Mandatory inductions, required pitocin and epidurals, limits or banning of support people, requirements to wear masks, time limits on labor, enforced separation of mom and baby who test positive, or refuse tests. These are all very real situations for some women and it is not evidence based, it is not best practice, and most of all it is not ethically or morally ok. It is a violation of rights, and I feel for the women trying to navigate these murky waters.

First of all, we all know as doulas that the more interventions performed on pregnant and laboring women, the more we can expect side effects or even problems and complications that need to be addressed. A spontaneous, unmedicated labor is usually going to follow a natural trajectory of events. The more we interfere with the that, the more we can expect the need to address more issues.

For example, a forced, medically unnecessary induction will be putting a woman into labor whose body and baby may not be ready yet. This may lead to a very long, very slow progression. Baby may even respond negatively, which may lead care providers to restrict mom to her hospital bed. She may be in a lot of pain due to limited movement, a long labor, and contractions caused by pitocin that she requests an epidural. The epidural may work against the pitocin, or block mom’s ability to feel any sensation to where pushing is very difficult. Exhaustion, “failure to progress”, distress of baby are all reasons mom may be encouraged to now have a cesarean, which will extend her hospital stay, lead to a harder recovery, possibly lead to issues with breastfeeding, and this all could have been avoided had we not rushed an induction that wasn’t needed.

I feel confident that my care providers will not bully me into a situation like this. Midwifery care is more hands off, evidence based, and holistic. I know my midwife will not panic if I go past my due date. I know I won’t be scared into medical intervention because I may have a “big” baby. I know I won’t be pressured to have a medication or pain management method that I don’t want or need. I know if I were planning a hospital birth, and would be possibly giving birth without any member of my birth team there (but especially my doula and husband) I would have gotten out of there from the second I knew these changes were happening. Unfortunately that is a privilege not all women have.

The scary truth is that women’s rights in labor and delivery have been infringed upon for decades, now hospitals are using fear as an excuse to limit these rights further. Some women are taking this time to reevaluate what they want and transferring care to birth centers, and home births. Unfortunately, not every woman has that option. Birth centers are still under strict regulations when it comes to what conditions they can accept. In many places women who are striving for a VBAC, have a breech baby, or multiples have only hospital options. Some states have even made home birth illegal. So simply packing up and saying “I am out of here,” is a privilege of low-risk women who happen to be in the right state/city with the financial means available.

I am not saying the fear is unfounded, but these changes will have very real, lasting effects on birthing women for the rest of their lives. Women who will be dealing with traumatic birth experiences because they were robbed of the birth they had planned. A birth that was patient, supported, and empowered.

We need to remember now more than ever that pregnant women are not sick women by default. We need to remember that this will be one of the most monumental days of their lives, and they will never get a do over. We need to remember that doulas are essential birth team members and play an even more important roll as hospital staff becomes more and more overwhelmed, stressed, and limited. Doulas provide care for laboring and postpartum women that hospital staff can’t recreate. Our care is long term: we have months of relationship building going on prior to delivery. Our care is continuous. For hours, even days doulas will be present with laboring women. We won’t leave their side, or tend to others. We won’t leave when a shift changes. We will go home with these women and see them through to postpartum. These things matter when it comes to the prenatal and postpartum health of women; that mattered before the pandemic, and it still matters right now.