What are Virtual Doula Services Anyway?

Limitations on Visitors, Concerns about Increased Risk of Exposure, and Parents in Rural Areas in Increasing Interest in Teledoula Offerings

Labor of Love Photography (Traditionally, doula work means serving clients in person. Virtual doula work is actually very similar, done from a distance.)

During the pandemic, many doulas and their clients decided the safer way to get professional support during their labor and birth was to hire a virtual doula. Some hospitals in our area do have restrictions on the number of support people a birthing parent can bring into their birth room due to concerns around risk of disease transmission increasing with each potential person as a possible asymptomatic carrier, and many expectant families and doulas have their own reason for wishing to reduce possible transmission as well. As such, the field of virtual birth support has truly blossomed.

The word doula comes from a Greek word meaning "servant" or in some translations, even "slave," or "female handmaid" and it's use to connect with the work of labor support and postpartum support seems to have started in the late 1960's with the surge of consumer pressure to change birth culture in the US and other industrialized nations. Birth doulas are folks who are trained and/or certified in offering Educational, Emotional and Physical support before, during and immediately following the birthing time. At this point, we have birth doulas, postpartum doulas, bedrest doulas, bereavement doulas for families experiencing perinatal loss, end of life or death doulas for those with terminal illnesses, doulas who attend their clients before and after abortions and D&C proccedures, sibling doulas who stay with a sibling during a hospital or birth center or even homebirth, geriatric doulas who serve folks through health issues in aging and I'm sure there are a few more I don't even know about.

There are many training and certification programs in the US for doulas, including StillBirthDay, CAPPA, Madriella, Bebo Mia, toLABOR, Earth's Natural Touch and others. Some training organizations emphasise ONLY the three areas of support I listed above (Educational, Emotional and Physical). Some also include pieces such as Advocacy (or Self-advocacy training), Partner Engagement (for those who are partnered) and other aspects of care. Doulas a nonclinical, meaning they do not do any medical procedures, don't monitor vital signs, do not do anything with testing or medical equipment. I think a good analogy is that doulas are to birthing families as classroom paraprofessionals are to students in school. We're the ones who know the individuals we work with really, really well (typically) and we know all the nonpharmacological, hands-on and many of us also know the holistic/whole person approaches to keep the birthing family connected to the process and asking questions of their care providers when questions arise.

So, what does it mean when it comes to Virtual Doula Services? Each doula will handle this in their own, unique way. For me, as I am not only a certified doula, but also a certified childbirth educator and hypnodoula, I spend a LOT of time prenatally teaching the hands-on skills to the birthing parent and their partner (if partnered) as well as the self-comforting techniques and mindset tools that come with my training in GentleBirth, Hypnosis for Childbirth, the Evidence Based Birth® Childbirth Class and my years of continuing education in childbirth education and doula work. I give my clients several hours of instructional materials through online, curated materials and synchronous video conferencing where we hone skills and practice exercises. We work together to develop a birth preferences list and a Plan B and sometimes even Plan C list. We spend a lot of time on self-advocacy skills, informed consent, using the rebozo, and how to get evidence-based care. It's a great program and folks finish it feeling excited for their births. On the big day, I typically get a phone call with a "we think this might be it" message, and I prepare myself for a day (or more often, night) of work. Depending on what the individual family needs, I may be contacted every few hours or I may be on the phone or video confrencing app for several hours at a time. I will give my clients reminders about what we talked about in class, positions to try, when to rest, remember to hydrate and use the rest room frequently, and so forth. I am also called whenever there is a topic the family feels they need to discuss with me or to gain additional information or insight as they work towards shared decision-making with their care provider. When the big moment comes, different hospitals have different policies in place, so I may hear baby born via audio, might get to see baby born via video or may be given a phone call or text after baby has arrived. Parents are still in contact with me for the first week after the birth, to debrief, get more information or support on various aspects of postpartum life, nursing/lactation tips, reminders about getting adequate rest, postparutm mood questions and so forth. The work I do virtually is actually not that different at all from what I do in person. And, having had so much front-loaded preparation, they tend to feel a strong sense of accomplishment because they felt so prepared.

Again, not every doula does things this way. However, if you're having a baby and you have been thinking about a doula and due to hospital restrictions or other concerns you'd rather have a doula virtually than none at all (wise call, by the way, as doulas are an evidence-based practice!!), go for it! As you would hiring a primary care provider, or choosing a nursery school or a caterer for a big event (when we used to have those in person), you'll want to interview a few doulas as experience, training and fit are all important aspects of hiring the doula who is the best available for your specific needs.

If you are curious about this and want to find out more, feel free to reach out. Meanwhile, I wish you and your family a safe and healthy spring.