Kanwal Haq, a New York-based doula, was on a flight returning from vacation last September when she received a text from a client that said, “It’s match day here.”
The baby was born a week early.
“I’m in triage right now because I’m only 3 centimeters dilated,” her client Alyssa Cotes Clark wrote, “But these contractions really hurt!”
“Let’s get our baby boy Ezra here!!!” Haq replied, adding a series of suggestions for what Courtes-Clark could ask the nurse to do to help ease her discomfort.
It was the first birth that Haq, 34, had assisted in. While she never envisioned assisting on a plane, the plan was always to support Courtes-Clark remotely, as she lives in Indiana.
Haq was able to support the birth from afar, communicating with her client, as well as Courtes-Clark’s husband and mother via text, offering advice on labour positioning, pain relief methods and how to progress through the birth.
“Kanwal was getting the support she needed from those closest to me, but I was also giving them the tools and supplies they needed to provide that support,” Ms Coates-Clark said.
almost 6 percent 70% of pregnant women in the U.S. seek out doulas, who provide specialized pregnancy and birth care and non-medical services. Research shows that in-person care is more effective than doulas. Doula Support During childbirth It can improve the mother’s situation especially Women of ColorThese include reducing anxiety during labour, shortening the length of labour and reducing the chances of premature birth.
Just as many therapy appointments and primary care doctor visits have gone virtual during the pandemic, so has doula care. Since then, virtual sessions have become a standard part of many doulas’ care packages. While there’s little data, experts say mothers feel more comfortable when doulas provide care and advice over the phone before, during, and after birth, even if they can’t be physically in the room with their clients. Reduce risk It reduces the risk of unwanted medical interventions during birth and increases the chances of satisfaction and support during pregnancy and after birth.
With maternal health complications and mortality rates remaining high in the U.S., a growing number of medical professionals and lawmakers are embracing virtual doula care as part of the solution. In April, Democratic senators introduced a federal bill that would expand the Medicaid program to cover access to doula care. Telemedicine Platformand already, 6 or more State health departments are beginning to incorporate virtual doula care into their programs.
While the bulk of a doula’s work involves providing physical and emotional support during birth, they also offer a variety of services before and after birth. “Doulas bring a lot of their services to virtual care, including breastfeeding support, birth planning, emotional support, and advice on navigating the health care system,” says Lori Asher-Pines, a health policy researcher at the RAND Corporation, a think tank, who co-wrote a 2010 op-ed on virtual doula care. Published in a medical journal In January.
By one estimate, more than six million women live in areas with limited or no access to obstetric care, and doulas are primarily High Income Women of color are hesitant to hire doulas because many insurance plans don’t cover this service. Hiring a doula in person before, during, and after birth can cost thousands of dollars out of pocket. Virtual support is a fraction of that amount, and doulas often charge hundreds of dollars per session, including support during labor.
Asher Pines also said going virtual will allow them to reach more people across the country.
For Florida resident Janae Hall, having a virtual doula during her high-risk pregnancy may have saved her life. She was pregnant with her second child in 2020, at the height of the pandemic, and diagnosed with preeclampsia, a potentially fatal form of high blood pressure. One day, three months before her due date, while driving, her left arm went numb. She pulled over and called doula Bridget Gelger, who is also based in Florida. GROW Doula.
“She said, ‘Call your doctor right now,'” Hall recalled. “I called my doctor and she said I needed to go to the emergency room right away. Because I was still in premature labor, I didn’t think much of it and just went to the hospital.”
Hall’s high blood pressure required her to remain in the hospital for about a month. Because only one visitor was allowed, a doula provided virtual care. Hall called the doula after each checkup to monitor whether her blood pressure would decrease and to better understand her prognosis. The doula also offered breathing exercises to reduce stress and logistical advice for her partner, like what to bring to the hospital.
At 34 weeks pregnant, Hall’s blood pressure hadn’t dropped, so they had to induce labor. Over FaceTime, Gelger showed his partner how to ease Hall’s pain and calm her nerves, including giving her back massages.
In the end, Gelger also watched the baby’s birth via FaceTime.
“A lot of people think, ‘Oh, I can just Google it,’ but unlike a Google search, this is where someone actually walks you through it, which is super convenient,” Hall says.
Anecdotal evidence from doula networks across the country has shown that mothers who receive virtual support have better health outcomes than mothers who do not receive care and are often comparable to mothers who receive in-person care. a Maven-funded researcha telehealth platform that offers fertility, pregnancy and postpartum care, found that among approximately 8,900 patients on its platform, women who had at least two virtual doula visits were less likely to have a C-section birth than women who did not have a virtual doula visit.
Collaboration Mount Sinai HospitalNew York City’s public health care system and two doula networks are working to provide support to immigrants, low-income people, and Homeless and prison women In Queens, New York, we frequently stay in touch using FaceTime and WhatsApp, which allows us to reach, for example, women in domestic violence shelters with strict visitation restrictions, or people living in their cars.
Pregnant women in these demographics are often wary of or shut out of the formal health-care system, but those who participated in hybrid doula programs saw more doctors, especially for postpartum visits, compared with new mothers who didn’t use the programs, said Dr. Sheila Maru, assistant professor of global health and obstetrics, gynecology and reproductive sciences at the Icahn School of Medicine at Mount Sinai and director of the doula program.
Angeline Love, a doula from Michigan, Maya doula network that works with Medicaid in six states to provide in-person and virtual care, said she helped one of her clients in September via an iPad her family set up in the delivery room.
“They Zoomed in with me when they induced her labor. They Zoomed in with me when they got to the hospital. Her mom just held up an iPad.”
Love returned to the Zoom call when her client went into labor, teaching her breathing techniques. “It was also important to be in the room and listen to the healthcare provider so that the client would fully understand and be able to make an informed decision no matter what was going to happen,” she said.
Love said there are drawbacks to virtual doula care compared to in-person support, the main one being that it prevents patients from building a rapport with their doula. Love’s preference is “to meet in person and build a great connection and rapport and trust,” she said. She added that it’s easier for a doula to pick up on subtle signs of physical and emotional concerns in person than over a video call, like if a headache seems serious enough to require medical attention or if the baby shows signs of distress after birth.
But these challenges are surmountable, she said, especially in situations where virtual doula care is a patient’s only option.
“For some people, hiring a doula of their choice may not be financially possible,” she says, “so we need to do everything we can to break down barriers.”
