A note from the doulas about COVID-19
We understand that right now the world is looking a little strange and people in our communities are acting very differently than they were just a week ago. Like many other companies, our team has enacted some changes to our practice and we recently sent a letter to our clients to let them know. We thought some of you might find this information helpful, so we’ve decided to share an excerpt.
If you are not one our clients and find this info helpful, please drop us a note to say thanks at firstname.lastname@example.org. If you would like to learn more about how we can support you during your pregnancy and birth, please take a look at the rest of our website to learn more about our services and then hop on over to schedule a virtual consult with us.
Wednesday, May 6, 2020
Whew. Can you believe this has become our new normal?
Here’s one gift of quarantine: We’re finding it much easier to talk about the postpartum adjustment because of this shared experience. How everything started so suddenly and we all had the rug pulled out from underneath us and the whole world changed. We had some idea that things may change, but we didn’t expect so much to happen so quickly. There was surrender. Surrender to what couldn’t be changed. And some of us learned, more quickly than others, that there needed to be grace as we adapted to the new normal. And now, as with postpartum, after 6-7 weeks or so, things are slowly inching towards what normal used to be.
Where does this leave us with doula care? Well, last week there was further validation that doulas are essential workers. In the state of New York, Governor Cuomo signed an executive order declaring doulas essential and allowing them to attend birthing people. Yesterday, a hospital in Salinas, CA – just an hour south of most Bay Area hospitals – acknowledged that doulas are essential and announced that doulas will be allowed back into their labor and delivery unit. And we are starting to hear cases of doulas being allowed into the hospital here in the Bay Area, but those are still extremely rare. What we are seeing commonly is that doulas are providing clients at hospitals virtual support, via phone, text, and video conferencing.
Our team continues to provide in-person support to our clients, meeting them in their homes. Thus far, in our practice, we have found that most of our clients utilize our support via phone and text once labor begins, and then as always we are available for in-person support once they are ready. While we are in people’s homes, we are wearing masks, and either wearing gloves or following best practices for frequent and thorough hand washing. We have always employed best practices to avoid cross-contamination between clients even before the pandemic and as such whenever possible we are using single use items for our clients, and employing our existing cleaning and sanitization protocols for any items that are not single use.
For our clients birthing in hospitals, once they decide to go to the hospital, our support transitions to virtual support. Right now that support typically looks like phone and text support. We remain available to clients for video conferencing, however that has not yet been utilized by any of our clients during labor (now postpartum is a different story!) Why? We’re not sure, but what we do know, is that for our clients in labor, we don’t want technology to be a distraction for anyone during the birthing process. We are working with our clients to establish clear expectations for our communication and so far as we know, this has been working well for our clients thus far.
I mentioned postpartum and we are thrilled that people are really utilizing our services right now. Many people don’t realize the value we offer in the postpartum period as breastfeeding supporters, guides on baby behavior and newborn care, and coaches for the often challenging adjustment to life with a newborn baby.
The biggest change we have to announce is the launch of our virtual only services. Our virtual birth package is identical to our in-person birth package – the only difference is the price and the in-person support. For some of our families facing uncertain hospital visiting policies, this new option feels very comfortable. And for families birthing outside of the Bay Area, this option is obviously fantastic for lining up prenatal, birth, and postpartum support and education. As before, we are also available for individual virtual appointments with clients to help with prenatal preparation and postpartum support.
We are wishing all of you lots of love, grace, and ease during this phase of our stay-at-home orders. We’re here for you. Virtually of course LOL. Stay home, stay safe, stay healthy.
Czarina, Stephanie, and Abby
Monday, March 16, 2020
Well, that escalated quickly.
We are sending you all an additional update based on questions we received at this weekend’s prenatal workshop and based on updates we’ve received about hospital visitation policies. I started to write this yesterday and what I wrote was already out of date. So this could change again soon.
Prenatal and Postpartum Consultations
During the order for sheltering in place, we will be moving exclusively to utilizing Zoom for conducting our prenatal and postpartum consultations. If your prenatal or postpartum is already scheduled, we will reach out to you shortly with a link to meet via zoom.
Many of our clients and prospective clients have begun asking about options for birthing outside of the hospital. We have suggestions for you! Please head over to our Out-of-Hospital Birth Resource Page. What we really want you to know is that if you’re thinking of switching to an out-hospital birth, act fast. Home birth midwives are receiving a massive influx of inquiries and I suspect they are going to be fully booked through the summer within the next few days or weeks.
Hospital Visitation Policies and Shelter in Place
We’re just going to be super honest here. Hospital visitation policies are a moving target. Every time I start to write this paragraph something changes and I have to start over. There have been reports that some hospitals are restricting all visitors. That means even partners are not being allowed into the birth room. Phew. Breathe in. Breathe out. (We’re talking to ourselves here too.)
What does this mean for all of us? Honestly, right now we don’t know. Some doulas have shared that hospitals are limiting all visitors, some have allowed a partner, and some have allowed the doula to join. The best suggestion we have is that once labor hits, our clients call ahead to the charge nurse to find out the current policy and to request that your doula be able to join as an essential member of your care plan. We will likewise also call ahead to the charge nurse and security to ask if we will be able to join you when you arrive at the hospital. As always, we will be more than happy to join you at home and as we shared in our previous update, we suggest laboring at home for as long as possible.
Depending on how strongly you feel about advocating for yourself during an already stressful and vulnerable time, you can ask why the hospital is not following the AWHONN recommendations regarding doula support. We are not visitors, we are an essential part of your care plan for labor and birth.
With all of that being said, at this point we cannot guarantee that we will be able to join you once you arrive at the hospital. We could never imagine we would be in a position to utter those words. In the event that we are unable to join you in the hospital. Here’s what we plan to do instead:
First, some background. Over the past three years, we have had a handful of clients who utilized our support during their birth, but never actually called us in to join them. This was because they felt fully supported during their labors via phone and text support. We were able to be available when they had questions, requests for suggestions for coping, and we were able to join them virtually when care providers presented them with information or they needed to talk through a medical decision.
Following those experiences, we had long been planning to launch virtual doula support and there literally couldn’t be a more appropriate time to do so. In the event that we are restricted from joining you in hospital, we will be available to you virtually. You will still have us in your pocket, via phone and text, and we will also be available via zoom if you need a face to face or visual demonstration of a position or maneuver we are suggesting. Is this perfect? No. Is it what we want for you? Also no. Is it what you want from us? Probably not. But, it does seem to be the best plan B we can offer at this time (and we are certainly open to suggestions and feedback!) We know that our support with education and advocacy is only one part of the support you were hoping to receive. We know that our physical presence is important, and that is why we will continue to advocate for our presence at your side, before and during your labor. And if we can’t join you, we know that we will still serve a valuable role as you navigate the maternity care system, especially with these new rules and restrictions.
Most importantly, these restrictive visitation policies may have the greatest impact on your most important birth support person: your partner. If hospitals are not allowing any visitors at all, it will be important to prepare now. What will it look like for you to be in the hospital without any support people or loved ones? How strongly will you want to advocate for them to join you when you are in a stressed and vulnerable place? What might you need to make this a positive experience despite the challenges presented? This is a good time to have these conversations. If you want to talk more about that, we are here for you.
We also know that many of you have had your childbirth classes cancelled or put on hold. (What does that even mean?!) We would never leave you hanging. This week we will begin offering virtual childbirth classes, also via the zoom platform. Again we know that this is not ideal, but it is an option for parents looking to prepare for birth. We will be offering a series of ten classes, two each week, for the next five weeks. You can sign up for one or for all. Our classes will be offered live, so there will still be opportunities to check in, to learn and share with one another, and to ask your questions in real time. We know that there are a lot of pre-recorded classes out there, but we also know that adults retain more when they learn together. We hope to facilitate a healthy learning environment for our clients and we hope to instill a sense of wonder and anticipation for a positive birth experience.
I’m sure plenty will be changing within moments after I hit send. And I’ll be back in touch with more updates as we have them for you. Stay home. Stay safe. Stay healthy.
Sending you our doula love,
Czarina and Stephanie
Friday, March 13, 2020
You’re receiving this email today because of concerns we’ve received about the public health crisis caused by COVID-19. First, take a breath. There really is no need to panic right now. One of the biggest fears new parents are worried about right now is that of their baby’s safety, and happily it seems that this virus is largely not affecting children beyond mild illness. As of this writing there have been absolutely no deaths worldwide in children 0-9 years old and most people are recovering easily with mild symptoms.
– Our clients now have the option to have their prenatal and/or postpartum online via the zoom platform if they are engaging in social distancing which has been recommended by local public health agencies
– Hospital policies for visitors are changing day by day (and sometimes multiple times per day.) It will be important for you to advocate for us to join you if your hospital limits visitors.
– Out-of-hospital birth might be an option you’d like to explore if you are concerned about exposure in hospitals. Let us know if you’d like to chat more about those options.
– For the next six weeks, we will be piloting a new online pregnancy support group via zoom on Wednesdays at 4:30 PM
– Online childbirth classes are coming very soon!
And here’s the long version 😉
Here are a few evidence-based articles that may be helpful.
This last link has information about ACOG’s recommendations for pregnant people with COVID-19. There are a couple of particularly noteworthy items: that pregnant people are considered an at-risk population, and, that facilities should consider separating mothers and babies if infection is present. Again, as you read through, don’t panic. If you should find yourself in a situation where these recommendations would affect you, we will remind you that you have options and rights as a person and a patient.
How are local hospitals and labor and delivery units responding to COVID-19?
Recently other doulas in our community have shared changing protocols upon entering local hospitals, and we have also seen more stringent screening processes. We have heard reports that some Bay Area hospitals are limiting visitors and the policies are changing day by day. So far, we have had no issues joining our clients during their births.
Should your birthing location limit visitors, it will be especially important to communicate with hospital staff and security to advocate for our presence during your birth. Unfortunately our voices will not carry as much weight as yours as the birthing person. We suggest that you call the charge nurse ahead of arrival to ensure that the doula will be permitted into the room as part of the care team.
That being said, we do not anticipate having a problem joining clients in the future and we understand that this policy may have the greatest impact on families who wish to have our support and the presence of friends or family members as well. We are happy to help navigate the best times for us to step out to make space for visits from friends and family during your birth.
We always recommend clients labor at home as long as possible, and it makes sense that this approach would also help to limit exposure by limiting time at the hospital. As always we are happy to join you at home during labor.
Additionally, you may have your own concerns about entering hospitals during this time and if that is the case, we are happy to discuss your concerns and/or provide information about options for out of hospital births.
What is Silicon Valley Doulas doing to respond to COVID-19?
Following recommendations from the Santa Clara County Public Health Department, we are enacting temporary changes in our practice to increase social distancing. Starting this week we will begin offering clients the option to have their prenatal and/or postpartum consultation via the Zoom video platform. We will still offer in-home prenatal and postpartum consultations to our clients whose members of the household are and have been healthy and have not recently been exposed to others who are ill. If you opt for an online prenatal consultation, we will ship or drop off your TENS unit to your home.
We have found the Zoom platform to be an effective tool for meeting potential clients and for providing both prenatal and postpartum education and support and we are confident that this platform will provide clients the same opportunity to connect and prepare for birth as an in-home visit. (We will however miss seeing all of you and your amazing homes and nurseries!)
We will also be putting together online birth classes starting as soon as next week. We understand that many hospitals have cancelled all group education events, including childbirth preparation. Look for more information about online classes in your email in the near future.
One of the many reasons we founded our team was to ensure that our clients still had a familiar face at their birth despite the unexpected: emergencies, illness, etc. Our team has been prepared for this all along. We would never attend your birth if we had any sort of active illness, coronavirus or otherwise. And that being said, in the unlikely event we should find that our entire team is ill, we would immediately reach out to other Doulas in our community to ensure our clients had continuous support during their birth.
What can YOU do to respond to COVID-19?
Some people have been told to staythefuckhome.com and while we understand why these recommendations are being made, they come with their own risks – and one of the risks we see is that isolation and panic are stressful, and stress isn’t good for you, your baby, or your immune system. Here are some non-Netflix things you could try to help you survive social distancing and quarantine:
*New!* Online Pregnancy Support Groups from Silicon Valley Doulas! Wednesdays at 4:30 PM
This is a pilot program we will be offering from March 18 – April 22 specifically to support our clients that find themselves suddenly spending way more time at home than before. Please feel free to share the invitation with other pregnant folks who you think would find it helpful.
And with all of that: wash your hands, don’t touch your face, eat lots of garlic and ginger, stay home as much as possible, and don’t make yourself crazy, either by panicking over this pandemic, or from boredom from self-quarantining.
With Lots of Love from your Doulas,
Czarina and Stephanie