The current outbreak of the Covid-19 virus has radically changed our childbirth system, making it impossible for doulas to be physically present during most hospital births. However, doula support is just as valuable as ever. In fact, one might argue that doulas are needed now more than ever. In a time when expectant parents are anxious, navigating policy changes in their hospitals, as well as in their state and local governments, managing potential changes to income and daily living, and filtering through the onslaught of incoming news and recommendations, the guidance of a seasoned doula provides irreplaceable calm in the storm. When so much is out of our control, it is imperative that expectant parents have access to birth professionals who can answer questions, provide training, teach coping techniques, and be a voice of confidence and comfort in the birth room. While nothing replaces the physical presence of a doula, virtual support is the next best thing!
It is so important for me to emphasize that you are not alone and do not have to navigate this time by yourself. I’m happy to say that I already offer distance support and can vouch for the benefits of virtual doula support. At this time, I’ve created a special Virtual Doula Support package at a reduced rate of $300. (My traditional birth doula packages range from $500-$700.) The Virtual Doula package offers more comprehensive support than my Distance Doula package, including more extensive prenatal support and is perfect for expectant parents delivering under the current Covid-19 restriction. The package includes the following:
Up to three virtual prenatal support meetings during which I will help you navigate the current birth environment, create a birth plan, advise you and your partner on comfort measures and positions, provide extra training to your support partner, and more.
Email and text support, including unlimited on-call access beginning at 38 weeks of pregnancy.
Pdf files of labor resources and a concise labor guide for quick reference.
Virtual support for the entirety of your labor, method to be determined by the client and doula after contract signing.
Virtual postpartum meeting at 7-10 days after delivery as well as text/email support for up to four weeks after delivery.
Access to resource list of virtual and Telehealth postpartum support.
If you are experiencing financial difficulty due to Covid-19 but would still like doula support for your birth, please don’t hesitate to reach out. My deepest desire is for all families to have the best birth experience possible and am happy to make payment arrangements as needed. I’m here for you always, but especially in this current climate of change and unpredictability.
You may not have the birth experience you always thought you’d have, but together we can ensure that your birth is beautiful, enriching, and empowering. Though so much has changed, you still have options and the ability to take the lead. If you’re looking for a partner to accompany your family on this wild ride, I am happy to be your huckleberry. I know you can do this and I’m here for you every step of the way!
Love and light,
Mary Susan Delagrange CD(DONA)
Let choice whisper in your ear and love murmur in your heart. Be ready. Here comes life.
It’s World Doula Week and what a world we’re in! Many doulas are finding it difficult or even impossible to support their clients in hospitals, as visitor restrictions are incredibly high due to COVID-19, and understandably so. I find myself on both sides of the issue, 100% dedicated to staying home, flattening the curve, and not contributing to the problem, but also 100% convinced of the necessity of doula support for laboring families, especially now when so many of them are fearful and anxious. It’s a real conundrum, one I haven’t made peace with yet, if I’m honest.
However, I’m practicing what I’ve been preaching to my clients: Control what we can control and let the rest go. I am not the person in charge of hospital policies and have no control over whether I’ll be allowed in with clients. However, I can control my response to the situation and do my part.
The truth remains that doulas fill the gap. In normal, non pandemic birth situations, doulas are imperative because we’re able to stay with our clients for their entire labors. Unlike midwives, doctors, and nurses who have many other tasks and patients they’re working with, your doula sticks with you and doesn’t leave your side…unless she has to go to the bathroom. We’re not that good. 😉
It has struck me that the gap has widened now and we doulas have to adapt and be creative in order to fill it. But we’re still here. We’re still eager to serve, willing to do what it takes to help our clients achieve the most beautiful, peaceful, empowering births they can possibly have.
So, what does that look like, boots on the ground?
It looks like a ton of phone, text, and virtual support. It looks like more time spent sending resources via email, meetings being held on online platforms, and lots and lots of phone calls and listening. It looks like time spent reviewing resources and best practices, taking time to stay on top of developing reccomendations and hospital policies. It looks like constant reminders that we are never alone. It looks like reevaluating goals, sacrificing plans, and collectively coming to terms with what that will require of us.
But here’s what I know: there’s nothing stronger than a birthing woman. No force is equal to that of an empowered woman working with her body to bring a new soul into the world. There is nothing quite as striking as the intensity of a loving partner, steadily supporting a fierce, warrior mama.
We’re all being asked to dig in and be a little bit stronger than we thought we could be. And while that’s a little bit scary, it’s not impossible. The strength to move forward, to push through, to do the hardest things imaginable…this is the innate strength of birth. That’s what birth is! At its core, birth is this epic journey that pushes us beyond our mental limits to achieve the unimaginable. It lies within all of us to do the hard things. We’re all in labor, to some extent. Everyone in the world is waiting, sacrificing, expectant. Our lives are not our own anymore and just like a pregnant mother ready to deliver her child, we need to harness our strength, trust the process, and surround ourselves with people who will support us when we don’t think we can go on.
I’ve always said doulas are the cheerleader/coach in your pocket ready and waiting to guide and encourage you on your way to birth. It’s never been more true than it is now. Doula care may not be what we want it to be right now. Believe me, we desperately wish we could be by your side. But doulas are adaptable. We are creative, we are problem solvers, and we’re quick on our feet. Most importantly, we’re here for you. Physical distance doesn’t negate what a doula can do. The physical presence of a doula in your birth room is irreplaceable, it’s true, but the role of doula is not limited to physicality. We support birthing women as whole people, respecting the intricate tapestry of mental, emotional, and physical factors that are at play in birth. We provide resources, help ask questions, assist in navigating the medical world, and most importantly we speak truth, encouragement, and empowerment. We are the voice saying, “You can do it. You were made for this. I believe in you.”
Doulas are still necessary. When you need us, we’re here just like we’ve always been.
Dana has been featured before in the Bright Birth Story Collection. You can read all about her first birth experience here. Dana and her husband, who live in Texas, reached out to me during their second pregnancy for some Distance Doula support and I was so excited to support them from Cleveland. Distance Doula services sound odd at first, but having a doula in your pocket has proven to be such an asset to many of my clients. I hope you enjoy Dana’s story of sweet Margo’s entrance into the world!
After several long months of a very physically difficult pregnancy, I was more than ready to give birth. I’d had Braxton Hicks contractions since about 20 weeks, and they had intensified to prodromal or “false” labor on three occasions in the three weeks leading up to my due date. The last time was in the wee hours of Saturday, November 2, when I called a friend to come stay with Frankie because my contractions—while not extremely intense— had gone on for hours and came every 5-8 minutes. When I checked into triage and said as much to the nurse walking me back, she replied, “Oh, well if they’re not super painful you don’t need to come in.” Thanks, lady. When they checked my progress, I was 1.5cm dilated—the same as I’d been since my 36-week appointment. The feeling of defeat, exhaustion, and embarrassment washed over me and I spent the rest of the time before being discharged ugly-crying. I so badly wanted to be in labor. I very much was not.
Through all this, I was so glad to have a doula. I never had false labor with my first; I had contractions that started and never stopped, slowly intensifying over 40-some hours until I gave birth. This pregnancy had been so different, and I felt betrayed and let down by my body again and again. Mary Susan kept reminding me: Every contraction was preparing my body for labor. It might not be dilating my cervix, but it is all preparation to bring my baby into the world. Her support to trust and work with a body that I felt had failed me over and over throughout my pregnancy—when I felt weak; when I felt scared—was invaluable.
With her encouragement, I had my membranes stripped at my 40-week appointment on the morning of November 5th. Mary Susan described it as the least-invasive form of induction, reassuring me that it would not work if my body wasn’t ready. An hour before my appointment, I began to lose what I was pretty sure was my mucous plug—so I thought it might be. The NP who took my appointment that day said she had probably a 90% success rate of inducing labor with membrane strips, so we were hopeful, but we scheduled an induction for the following Monday, November 11 (my husband’s birthday, by his request) just in case. Later that afternoon, I started feeling pretty crampy, but I wasn’t willing to believe it was labor quite yet.
My first big contractions started around 12:45am (my babies really like to get things going in the middle of the night) and were coming every 5 minutes when I was up and moving around—but they’d slow to every 8-10… sometimes 12 or even 15 minutes if I was sitting or lying down. All the advice from my birthing class saying to sit down, have a glass of water, and see if contractions continue kept echoing in my brain. I still wasn’t willing to believe my baby was coming. But a little after 5am, without having been able to sleep at all, I woke my husband. We went through our morning, taking breaks for contractions… I went ahead and asked my on-call friend to pick up Frankie from preschool. Contractions were painful, but still: Close together while up and moving; pretty spaced out while resting. Terrified of returning to the hospital only to be sent home again, I wasn’t willing to go. Finally around 10:30am I decided to try to take a nap. If I wasn’t in labor, I might as well get some rest.
I woke around 11:40 and immediately began to cry in frustration. If I were in labor, surely I wouldn’t have been able to sleep! I got up and went into the living room where my husband was.
“I slept a little.”
“I’m in so much pain when I’m standing, but it slows to nothing when I’m sitting.”
“Well, sit down.”
“No!” I shouted at him (poor guy), “I don’t WANT the pain to go away. I WANT to be in labor!”
“Will you take a walk with me?”
We went outside; it was a beautiful day. We got halfway down our block and I had stopped every three minutes to hold on to Michael and breathe through a contraction. I could not move or talk through them. “Let’s turn around,” he said.
“We can keep walking without getting so far away from the car.” By the time we made it back to our driveway, my contractions were two minutes apart. “Okay, let’s go to the hospital,” Michael said, a little panicky.
On the 17- minute drive, I was grateful my contractions had such an odd pattern—I only had one in the car. But the walk up to triage was a different story. When I finally made it to triage waiting, two women were ahead of me. The nurse came in to get one of them, and as soon as she saw my face, she said “I’ll be right back for you.” I breathed through two contractions on the short walk from the waiting room to the triage room.
Michael met me in the triage room, where I was answering the questionnaire. When they finally checked my dilation: “Whoo, you’re at six and a half… seven!” I’ve never loved pain more. It was about 2:45pm when I was admitted.
My wonderful labor and delivery nurse, Rhonda, came in shortly later to bring me to the delivery room. She’d been told I wanted to labor naturally, when my actual plan was to eventually get an epidural, but to exhaust other methods of pain relief before doing so. I was so far along already, though, that Rhonda said I needed to ask for the epidural right away if I wanted one, or it may be too late. I had planned on an epidural and by that point needed relief, and the thought of pushing through my exhaustion was scary. So I didn’t have a chance to try nitrous oxide as I’d hoped, but when my contractions continued to intensify, I was grateful relief was coming. The epidural was in place by about 3:30, and I was administered the first dose of penicillin (I was Group B strep positive) shortly thereafter.
My main desire in laboring so long without an epidural was to prevent labor from slowing, which happened with my first. My contractions did not slow, and as with my first, I was grateful to be able to feel each one (though they weren’t painful) and to move my legs. But at the next check, I was still at seven centimeters. I was able to rest for a little bit, updating friends and family. When the OB came in to check on me, she felt the catheter bulb was in a funny place, kind of buoying my uterus. She pushed it out of the way. The nurse with her advised me that if I felt pressure, like an urge to have a bowel movement that wouldn’t go away, to call. I was so glad she’d said that, because not long after I felt that urge—Rhonda couldn’t believe it; I’d JUST been at a seven, but when she checked: “Yep, no cervix.”
The urge to push was nearly unbearable, but they wanted me to wait because it had only been three hours since my first dose of penicillin, and you’re supposed to have four hours before you deliver. The OB was also extremely busy that night—my nurse had paged her, but with each contraction I felt I’d burst if I didn’t push this baby out. I’d never felt that sensation with my first, but it was just as that nurse had described: Like I was trying to hold back a giant poo (sorry)– not exactly painful, but extremely uncomfortable. Finally Rhonda called the room the OB was in and told her to come to me right away. And when that didn’t work, she went into the hallway to flag someone down to go get her and bring her to me bodily.
When the OB FINALLY showed up a little after 7pm and got set up, I got in position and was given the all clear to push. After the first push, Michael confirmed what we’d known all along: “She has lots of dark hair!” The OB said she’d been face up, but she could feel her turning as she came down the canal—as babies should. An affirmation my doula sent earlier came back to me: “Your baby knows how to be born.” With those words in mind, I pushed again. Margo turned as she moved down—what a good girl. One more push and a primal yell, and I was looking at my baby girl, and immediately crying. Margaret Jean was born at 7:15pm; I got to hold her for the first hour after she was born, and I felt euphoric.
All my false labors had prepared me to have the labor I’d wanted—one where I could get my baby and my body most of the way there. The pain was scary, but I also relished it because I had waited for it so long. After a pregnancy where my body felt alien to me, making it difficult to function and hard to feel connected to my baby, I now recognize what a gift my labor and delivery were. I’m so grateful for the immediate connection I felt with Margo as soon as she was born, and (though I still wouldn’t wish false labor on anyone) for the time I had to lean into the process of giving birth.
Congratulations, again to Dana, Michael, and big sister Frankie! You are such a strong, special family and so, so loved!