These are unprecedented times. Have you heard? Of course you have. And you have probably
said that same thing yourself. We are throwing this phrase about so much with the COVID-19
pandemic that it is becoming alarmingly normal to be living in unprecedented times. Everyone
has been impacted by the adjustments that have been made to preserve health and safety. And
right about now, if it hasn’t already, it’s become a struggle. I’ve got to be honest, when I first
learned of the restrictions at our local hospitals, I was angry. I was upset that the women who
had chosen to have doulas at their birth would be forced to decide between having their
partner present or their doula. But when I took some time to reflect on the severity of the
situation, my heart was settled knowing that the restrictions were made for the health and
safety of everyone, including me. So I changed my thinking and jumped on board with my doula
sisters in being creative and inventive during the pandemic.

At the heart of the matter, my work as a doula is the same as it always has been. We have our
prenatal visit and our postpartum visit, only now it occurs virtually using Facetime or Zoom. It’s
important more than ever that we connect and discuss fears and worries about the upcoming
birth. It’s coming together as a team, and an opportunity for me to reassure and encourage
during what is such an uncertain and to some, scary time to have a baby. I am present for my
clients, offering reassurance and nonjudgmental support. And then postpartum, when stay in
place mandates have limited or eliminated the option of postpartum help from family and
friends, it’s critical that I check-in with my clients to see how they are doing and to answer any
questions or give any encouragement I can. It’s easy to feel isolated after giving birth in
ordinary times. In a pandemic, it’s pretty much a guarantee.

While the current situation has made it so I am not physically present in their birth space, I’m
still a presence at their birth. Let me elaborate. Some clients have chosen to have steady
support by way of video, using Facetime or Zoom. We are in touch in early labor same as
always, by phone or text. Then when their labor intensifies to the point that they would
summon me to join them, we setup the video connection and I am there. The words are the
same, the questions are those I would ask in person, and the recommendations are as the
situation warrants (cold cloth, position changes, comfort measures). Sometimes I am quiet,
assessing, watching and listening, ready to help when the need arises. But we know that
women are made to birth and as such staying silent is as important or more so, than speaking.
Some clients have preferred steady connection the whole way through with text and phone
calls and so I have honored that preference too.

I have been so very pleased with the reception I have received as a virtual doula in our area
hospitals as well. The nurses are working so hard to take care of their patients with the added
stress that comes with working in the medical field during a pandemic. And they have
graciously welcomed me to the birth space virtually. They have helped to incorporate me by
moving the laptop when the partner has forgotten, so I have a better view of my client. I have had conversations with the nurse, midwife, or doctor when there is reason to talk about options and to encourage the birthing woman as a team. We are all still connected, still have the same goal, and still have a job to do.

While the current situation has its challenges, I am grateful to still have the opportunity to
serve my clients. There is more need for doula support more than ever, with such a feeling of
uncertainty day by day, and the fear about bringing new life into a world that feels so unsafe.
As doulas we can still do what we do best—support our clients, offer reassurance and
encouragement, and to be a lifeline when they feel disconnected from the world. Hopefully, we
can return to being a physical presence sooner rather than later. But for now, this will work. We
have a job to do. And our clients are counting on us.

It was a privilege to co-chair the 2017 BirthWorks Conference in Virginia Beach, Virginia with Cathy Daub, founder and president of BirthWorks International. Thank you to everyone who helped behind the scenes, the speakers who inspired us and got us thinking, and the attendees who came together so willing and open to explore and learn. It was an incredible assembly, and arguably the best birth conference EVER to come to the Hampton Roads area. The conversations, inspiration, and waves of change are already being felt at local hospitals and beyond. Take a moment to watch this video that shows a glimpse of the incredible time we spent together.

I am looking forward to our next BirthWorks Conference, time and location yet to be determined. Below is a short testimonial from the 2017 conference, including words from Ina May Gaskin, and some local midwives you might recognize including, Blair Conger, CNM, and Terri Hewitt, CPM. Hear what they had to say about their experience and consider joining us for the next one! You do not have to be a BirthWorks member to attend. Our conferences are open to everyone.

It is important to know what a doula does….and what tasks they do not perform….before you hire someone to be your doula!

A birth doula…

• believes in the birth process and works to impart that same confidence to her clients

• recognizes birth as a key life experience that the mother will remember all her life and strives to preserve that memory in a positive way

• understands the physiology of birth and the emotional needs of a woman in labor

• assists the woman and her partner in preparing for and carrying out their plans for the birth

• stays by the side of the laboring woman throughout the entire labor

• provides emotional support, physical comfort measures, and reminds the couple of their options throughout labor

• preserves and complements the partner’s role in the birth, encouraging them to support
  the laboring woman as they are most comfortable and supporting them as they do so

• offers an objective viewpoint and assistance to the woman in getting the information she needs to make informed decisions about her care

• advocates for the woman by facilitating communication between the her and her partner, and her clinical care providers

• strives to facilitate labor progress by maintaining a calm labor environment with lighting
  and music and minimal distractions

A doula does not…

• perform clinical tasks, such as vaginal exams or fetal heart rate monitoring. However, I WILL provide physical and emotional support to you and your partner.

• make decisions for you. However, I WILL help you get the information you need to make an informed decision about your care. I will also remind you of your wishes as outlined in your birth plan.

• speak to the medical staff on your behalf. However, I WILL listen to your concerns and review options with you that you and your partner can discuss with the clinical staff.

• replace the father during labor. However, I WILL support and encourage the father and enhance his support style rather than replace it.

Here are some photos of me supporting families during and immediately postpartum: (photos by Kimberlin Gray Birth Photography)

Caitlin and Jordan welcomed their first child, a boy, on April 4! Oliver Eric came barreling into the world in a very surprising fashion! Caitlin went to her routine prenatal appointment just a couple of days past her due date. She had an ultrasound that revealed low fetal movement, and an NST that was not excellent. So they agreed with her provider that induction was the safest option for baby’s well-being. Caitlin went straight to L&D to begin the induction process, but not until her sweet nurse handed her a sandwich and snacks, because, you know, inductions are usually LONG. And Caitlin was dilated 1 cm with her first baby. This was going to be a long and involved process. Right?

Wrong!

This is where Oliver decided to throw everyone for a loop. It’s a perfect example of where making assumptions gets us…nothing. They began the induction with pitocin around 7:00 pm. Caitlin knew to rest and not get drawn into her contractions too soon. But her uterus responded very well with the pitocin and before long she was thrown into full-blown active labor. She was feeling overwhelmed and panicked as her body moved at warp speed. After just 2 hours of pitocin, at 9:00 pm she was dilated to 4 cm. Caitlin was in great discomfort and her baby was having decelerations that were concerning. She preferred not to have her water broken to speed things up, so after laboring for awhile, she opted for an epidural to help with the pain and aid in relaxation. Caitlin’s contractions were extremely intense, making it hard for her to relax and breathe deeply. Plus her blood pressure was very high and the epidural would help with that too. And after all, it could still be hours, right? But that’s where everyone was wrong! Shortly after the epidural was placed, Caitlin was dilated 9.5 cm! (No wonder she was in great discomfort!) There wasn’t even time for a nap. Oliver was born at 12:41 am on April 4 after just 3 pushing contractions! And lo and behold, he had a true knot in his cord, which might have accounted for the decels during labor. He is a lucky boy indeed.

Oliver’s parents were overwhelmed and in love all at the same time. From start to finish, Caitlin had her son in her arms less than 6 hours after they hung the pitocin. That’s an unbelievable timeline and just goes to show that you just never know. I am so proud of this couple for rolling with the punches and making the decisions that felt the best for them and for their baby. A few months have passed since, but they continue to learn and grow together as they parents their sweet Oliver. Congratulations on becoming parents and thank you for allowing me to accompany you on your journey and to share that amazing journey here.