Being there without being there: Virtual doula support during COVID-19

Being there without being there: Virtual doula support during COVID-19

This pandemic isn’t something I was prepared for. Yes, I knew it could happen in theory, but were any of us truly prepared? 

I worried about what it would do to my work as a doula, what it would do to my clients’ ability to have doula support during their births.

But I care about life and death. I care about the vulnerable people in my life. I care about my clients and their families and the vulnerable people in their lives. I have no wish to endanger anyone unnecessarily. 

Prenatal visits became Zoom calls. Postpartum visits became Zoom calls and phone calls. And birth support itself became virtual. This was strange, especially because one way that I often describe my work if I have to encapsulate it in “elevator speech” format is “I go with people when they have their babies to help guide them through their birth.” 

So what happens when I can’t go with people as they are having their babies?

Am I useless? Or is my job description just a little flawed?

The truth is that my birth doula support begins way before the birth and continues well after the birth is over. It’s in the articles and information that I curate for my clients. It’s the way I answer their questions without judgment. It’s the positions and techniques I teach them for comfort in labor. It’s the validation I give them for how they are feeling right now. It’s the guidance I give to their partner about how to be there for them in the most meaningful way possible. 

By the time they are at the end of their pregnancy some of my clients are excited about birth, when they used to be scared, some are just more confident because they know more. Some have unexpected challenges at the end of their pregnancy and need me to help them to know their options so they can pick the path that feels the best to them. 

During labor, I may not be physically present, but I am still available for my clients every step of the way

I’ve been a virtual birth doula for a couple of my clients now and do I love it? Not exactly. It feels strange to me not be able to provide that calming touch, grab that water bottle, or lock eyes during an intense moment, but there is still SO much I have been able to do while I am “at the birth”. Things like:

  • Listening to what discomforts they are feeling and suggesting a different position
  • Suggesting a massage, counter-pressure or acupressure technique for the partner to do
  • Letting a client cry and process some difficult moments from the birth
  • Talking over labor progress and thinking about possible options – everything from positions and non-invasive techniques to try, to medical interventions that may be available and pros and cons of all the options 
  • Helping decide if and when to get an epidural
  • Helping to process the change to a cesarean birth and helping it to feel like a joyous and triumphant birth

Logistically, here are the things I have done to prepare for providing doula support when I can’t actually be present in the room. 

  1. Extra virtual prenatal visits to help partners feel like they have the chops to provide the physical support needed. This means trying out Spinning Babies techniques, Rebozo techniques, finding acupressure points, and trying out massage techniques with me watching so you can get comfortable doing them.
  2. Technology – A laptop, phone, or tablet with Zoom, Facetime, Google Hangouts or any other video calling software. If using a phone, it can be helpful to have a flexible tripod like this one so you’re not spending time and effort trying to prop it up (if needed I can buy this for clients and then sanitize it for the next person). Another awesome technology tool could be bluetooth earbuds, so that partners can wear one earbud to get Cyrano-like direction from me without disrupting the person who is laboring and birthing. Clearly, those can be expensive, but if you wanted an excuse, this would be it!
  3. Tools – I provide clients with a rebozo, which can be really helpful for squeezing hips when that’s too much for one person to do all the time and SO many other comfort measures. These Aculief wearable acupressure thingys can be good for pain relief without needing to have your partner wear out their hands providing it. I have some that I can lend to clients for use during labor and sanitize for future use.  Also Sea Bands for acupressure to treat nausea can be used as intended or on the feet for an acupressure point that decreases anxiety (Kidney 1). These are fairly cheap to buy. (These ones cost slightly more, but are adjustable in pressure and length). A battery-operated fan (something like this) can be awesome too when you get to that part of labor where you’re working so hard that you’re HOT!
  4. Old-fashioned team building – If my client is in the hospital with me on virtual doula support, I send them with a bio about me to give to their nurse(s) as an introduction to me and the support I will be giving during birth. If the situation allows, I love to “meet” the nurse to say hello and build that team feeling so we can collaborate to support you. 

Following the birth, I’ve been able to continue to provide the postpartum follow-up similar to how I would do it in person. I was able to help a breastfeeding latch feel more comfortable over a Zoom call while my clients were still in the hospital. I help strategize about how to get more sleep and how much feeding and crying is normal and I can give referrals to specialists if needed. 

Birth doula work is in many ways what it always was: It’s supporting my clients, the complex humans they are, as fully as I can given the situation we are in.