Long before she got pregnant or became a mom, Safiya Barclay knew she wanted the support of a doula, a nonmedical professional who coaches parents through pregnancy, labor and the postpartum period.
“Being an African American woman, I was always frightened of the thought of not getting the proper attention and care at the hospital,” recalled Barclay, 36, of West Palm Beach, Florida.
Barclay got her wish: she relied heavily on the support of a local doula named Averjill Rookwood when she delivered a preemie daughter in the summer of 2020. That support had an unexpected plot twist, though.
Because Barclay gave birth at the height of the coronavirus pandemic, and because Barclay herself tested positive for COVID-19 while at the hospital, she couldn’t have any visitors with her in her hospital room — not even her husband or her doula. So, rather than rubbing the mom-to-be’s back and helping her do breathing exercises in person, Rookwood coached Barclay through her challenging birth experience over Zoom.
“I never imagined working with a doula remotely,” said Barclay, who still remembers how scared and lonely she initially felt in the COVID wing of the hospital. “However, Averjill made the experience extremely comforting, which made me have less anxiety. ... I just kept hearing her voice.”
During the coronavirus pandemic, many prenatal and postpartum doulas have been shifting away from in-person support and providing remote help for expectant moms and dads via Zoom, FaceTime and other videoconferencing platforms. The approach is definitely different, but it’s proving to be pivotal in the lives of many new parents.
A shift in approach
Talitha Phillips,a certified doula in Los Angeles, said her work as a labor doula slowed down significantly during the pandemic because many hospitals are not allowing extra support people to be present in delivery rooms. In contrast, her postpartum doula work has increased dramatically.
“I have not had a single week without postpartum work, usually for two to three clients at once, since March 2020,” Phillips said. “This is because so many new parents were left without support from their families or other friends because of COVID. ...
“Nothing replaces in-person relationships and advocacy, especially for low-income, at-risk and minority women,” Phillips added. “However, if it's between no doula or remote, it’s definitely worth it to have extra support virtually.”
Many OB-GYNs agree.
“Labor is a strenuous act for any patient, and receiving the adequate comfort during this act is crucial,” said Dr. Zaher Merhi, an OB-GYN based in New York City and Westport, Connecticut. “The introduction of virtual doulas has been a great tool for assisting patients during labor. The support that the doula provides to the patients ends up reflecting on her in the way she progresses through labor, making our job as OB-GYNs easier.”
Dr. Peace Nwegbo-Banks, an OB-GYN based in Pearland, Texas, said she eagerly welcomes doulas as part of the health care team.
“Data actually shows that doulas help decrease the risk of C-section because of their ability to manage the mother's anxiety during labor,” Nwegbo-Banks said.
Still, things can get a little complicated sometimes when a doula can’t be present in person.
“If the internet connection is lost, it can take the patient away from focusing,” said Dr. Vonne Jones of Total Women’s Care in Houston, Texas.“Overall, (though), if the patient would like to have a doula, it’s important that we all work as a team to allow for the best outcome for the patient.”
Easier access to doula care
In New York City, a place that became an epicenter for the fast-spreading coronavirus in 2020, doulas have been adapting to their patients’ needs for more than a year now.
“At the start of the pandemic, my expectant moms called me understandably stressed out, so I started supporting them virtually because I had no choice,” New York doula Liza Maltz told TODAY Parents. “I’ve helped parents advocate for themselves ... and remotely, I’ve had a nearly 100 percent vaginal birth rate.”
On one memorable delivery day, Maltz said she made arrangements to “set up a phone on a table near mom’s head using a stretchy tripod to hold the camera so I could see what was going on. The father held (another) phone right in front of mom’s face while in labor. I was like, ‘You’ve got this!’ and we were fully connected to each other and did deep breathing together.”
Maltz said the prospect of remote doula support comes as a relief for some mothers. “Some new moms feel overwhelmed in a tiny, crowded hospital room,” Maltz said, noting that the last thing they need is another person in there — even if it is a doula.
Many doulas say the advent of telemedicine and videoconferencing is making it easier for expectant moms to receive doula care — especially lower-income and minority moms who really need the support.
“The inequity in Black maternal and infant morbidity and mortality rates is what solidified my dive into doula work,” said Rookwood, the doula who helped Barclay deliver her preemie daughter in Florida over Zoom. “That fact that I could be three to seven times more likely to die after childbirth in the United States and in most developed countries worldwide in the 21st century was enough to knock the wind out of me.”
Rookwood works with RACE for Equity and other organizations to promote equity and access to care for women of all income levels. She often directs clients to the National Doula Network, which allows families insured by Medicaid to have access to comprehensive doula care and also helps the doulas providing the care to be paid a living wage.
“Doula care is not just for the privileged,” Rookwood said. “It’s for the pregnant.”
Convenient and effective
Could Zoom and FaceTime doula care extend far beyond the pandemic? Many doulas think so. Phillips, the doula from Los Angeles, said she believes most expectant mothers prefer an in-person doula, but they also like the convenience of being able to do interviews and check-ins remotely.
“I used to often meet in person three to four times before someone went into labor,” Phillips said. “Now we’re able to move at least one to two of those to a virtual format.”
Maltz said remote doula work also allows her to help parents-to-be in other parts of the country, not just in her immediate local area.
“I’ll do some in person again, but do love the model of virtual,” Maltz said. “With text or video, I am THERE.”
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