Is a Birth Doula a Visitor? It Depends on Who You Ask.
Before COVID times, there wasn’t much point in differentiating a birth doula from any other visitor. At least in Portland, OR, birthing patients were pretty much able to have as many visitors as they wanted. But along with COVID came “Visitor Restrictions” and it was here that many birthing people began to be separated from a very important support person on their team, their doula.
People who have chosen to have a doula on their team are looking for someone with a very different skill set than that of their partner. The partner is irreplaceable, as the loved one of the birthing person. Often they are also the other parent to the baby being born and it would be a travesty for them to miss this important moment. But the partner may not be at all well equipped to navigate the birth process, especially if they have no experience with birth. The role of a doula and that of a partner are quite different. How can one choose?
But if a birth doula was seen as an essential part of the birth care team, the birthing person wouldn’t need to choose.
It all hinges on whether a doula is seen as a “visitor” or a helper (a non-clinical caregiver).
If you ask me, a birth doula is NOT a visitor any more than a guide dog is a pet dog. Certainly, in both situations there is a dog. And I suppose that a guide dog could also be considered a pet. But there is SO much more to what they do. There is a reason why guide dogs can go where pet dogs are not allowed.
I view birth doulas similarly. Yes, a birth doula is visiting their client, but what’s happening in a doula/client relationship is therapeutic and it has a statistically significant, clinically significant effect on birth outcomes. Our presence, information, advocacy, physical touch, etc, actually results in fewer cesareans (among other benefits). At times, we are the only ones deeply listening to our clients and able to amplify their concerns in a way that gets them the medical attention they need.
The hospital would never say, “Oh, we don’t need a doctor here, because we already have a nurse.” They wouldn’t never deny someone an epidural on the basis of it requiring another staff person to “visit” the room (the anesthesia provider). None of these essential people would be considered visitors, because they are all providing a service. The only difference with a birth doula is that the doula has been hired directly by the client, not contracted with the hospital.
Hospitals in Portland, OR have largely lumped birth doulas into the “visitor” category, but in September of 2021 something changed. About a month after Legacy Hospitals once again restricted visitors to 1, leaving their birthing people suddenly having to choose between having their partner or their doula at their birth. They rolled out a policy that categorized birth doulas as part of the Birth Care Team. They required pre-verification of status as a Professional Doula (even if that doula is a student, or still in training) and required proof of COVID-19 vaccination. Once verified, the doula can pick up a Legacy Badge that allows for them to provide services to birthing families without being counted against the visitor limit.
As of today, most of the Portland Metro Hospitals allow for 2 support people in Labor & Delivery units. This means that a birthing person can choose to have any 2 support people, one of which could be a doula. I applaud this effort to give birthing people options! In the future, however, I hope to see more hospitals taking birth doulas out of the visitor category and putting us where we belong, as specialized, essential, non-clinical caregivers.
