Giving birth was anxiety-provoking enough for most women prior to 2020, but adding on a global pandemic is like tossing a brick out to women who are already treading water, barely able to keep their noses above the changing tides and crashing waves.
While I’ve bobbed up and down with women throughout their pregnancy journeys for the last 15 years, I’ve actually only attended three births. And they were my own! So I thought I needed to bring in the “big dogs” to help me formulate a blog post with practical information we could throw out to pregnant women like a life preserver.
Together, these 4 doulas have attended over 1500 births, hundreds in the last 2 years alone. They’ve seen the good, the bad, and the ugly. They’ve peeked behind the curtain, seen women at their most vulnerable, witnessed providers at the pinnacle of their performance, and are ready to arm you with everything you need to know in order to plan for a positive birth experience in a pandemic.
But first, there are two things we must define. What is a “positive” birth experience, and what the heck is a doula?
Some people feel a positive birth is one in which the mother and baby remained healthy and well throughout the delivery. Some define a positive birth as an intervention-free vaginal birth. And still, others think a positive birth is one where the mother happily checked off all the items on her birth plan.
After working with thousands of pregnant and postpartum women as a Women’s Health Physical Therapist and Pilates Specialist, here’s the definition I’ve come up with:
A positive birth experience is one in which the laboring mom felt supported by her birth team and felt like an empowered part of the decision-making process that led to the birth of her baby.
In this way, a positive birth experience is not tied to an outcome but rather tied to your feelings about how your birth unfolded. Read more about how to have a more positive birth experience here.
One of the best things you can do (in my humble opinion) to plan for a positive birth experience in a pandemic is to hire a doula. Mayo Clinic defines a doula as “a professional labor assistant who provides physical and emotional support to you and your partner during pregnancy, childbirth, and the postpartum period.” If you’re feeling stressed or anxious during your pregnancy or even in the time leading up to birth, a doula is a birth expert who is there to support the whole family, help you prepare, alleviate fears, answer questions, and remind you of ALL your options. In a world where health recommendations are changing all the time, and in a hospital where the staff is switching shifts throughout the day, a doula can be that one consistent and constant support person that acts as an anchor to ground you.
Now let’s introduce our doulas.
Some of their words of wisdom are things that apply to birth in general while others are specific to the current state of affairs we are experiencing. Many sentiments shared are echoed in similar ways while they each were able to weave their own unique tips into the tapestry of this canvas we call birth.
It’s like a dance.
And that’s what a good doula has mastered….when to lead, when to follow. But great doulas have learned to march to the beat of their clients’ own drum while managing to step on as few toes as possible!
Let’s face the facts: Knowledge is POWER so Robin’s number one tip is to Get Educated.
“Even if this is not your first birth experience, take a really amazing childbirth prep class. Even a refresher class is great. This will help build confidence and trust in the labor/birth process regardless of how everything unfolds. The class can be beneficial for both the mom and the partner as they prepare for the birth of the baby. Having tools to use that are familiar to them from the class and being able to implement those tools in labor/birth will bring a sense of confidence when things can be so unfamiliar.”
Tara and Nicki agree and add that it’s imperative to also choose a provider you trust.
“We can’t overemphasize the importance of choosing a medical provider who makes you feel respected and heard. We’re big fans of the midwifery model of care, especially during these times when anxiety levels are high. Your pregnancy and birth will be better experiences if your doctor or midwife treats you as a whole person and as an active participant in your health care decisions.”
Leah encourages pregnant women and their partners to “feel empowered to ask questions early about providers’ birth preferences like how many weeks past your due date they will ‘let’ a birthing person go before wanting to induce, can you eat meals during labor, can you labor in the shower, etc. So many families don’t ask these questions at all or wait until late in their pregnancy when it feels like a massive shift to entertain changing providers.”
If you’re planning to give birth in a hospital setting, you should probably take things one step further and check out some statistics. Robin suggests inquiring about “their C-section rate and their VBAC (Vaginal Birth After Cesarean) rate. These statistics can give good insights to how your birth may unfold at the hospital.”
When I talk to women in the final week of their pregnancies, I like to spend some time talking about the fears they may have as they approach their estimated date of delivery. Oftentimes, naming your fear out loud helps it lose its power. I hear different versions of the same 6 main fears (read more about Delivery Day Fears here), but the one that has really hit the jackpot in the last 2 years is “Fear of the Unknown.”
Birth, by nature, is about surrendering. Nicki and Tara say their number one tip for giving birth anytime (pandemic or not) is to be flexible. “Birth is unpredictable and mysterious. We do recommend preparing a birth preferences list as an exercise to understand your options and to have a vision for how you want to feel and be treated during your birth. But hold onto the details loosely. It’s just nature’s way of preparing you for letting go of control as you become a parent.”
While no one has a crystal ball to predict the answer to the question, “How exactly will my birth unfold?” there are other questions moms have these days that usually do have answers. Some common questions are:
The problem is local hospital policies can literally change overnight so Robin suggests contacting the labor and delivery unit of your hospital when you are about 37 weeks pregnant to see what their answers are to these questions. She also recommends having a “back-up” birth partner in case your partner gets sick. Nicki and Tara add that you can also “check out BirthGuide Chicago, a central website that provides updates on the latest hospital guidelines and restrictions. Not all hospitals have the same rules, and some people change their birth location in order to have the support they need.
It’s vital that you know what’s most important to you in your birth and that you speak up and ask for it.” And I thought Leah had an interesting suggestion when it comes to predicting whether your doula will be allowed to join you when the time comes. She says, “Research the track record of your current hospital to see if doulas were ever pulled early in the pandemic. The hospital systems that always allowed doulas to support clients may feel like a safer choice moving forward during these uncertain times.”
There are currently a lot of different opinions about masks and vaccines and the virus itself. Regardless of your specific beliefs, I think we can all agree that staying healthy in the days leading up to your delivery has never been more important.
Tara and Nicki acknowledge that “it’s valid to be extra careful and cautious with exposure, especially during the last month of your pregnancy. However, if you do get sick, there is no shame in that. Give yourself some grace, and treat yourself with extra care. Hydrate, rest, take baths, order in your favorite food, do some prenatal Yoga or Pilates.
But if all is well with you and baby, it might be better to wait for labor to start spontaneously and get to the hospital in active labor. Your home environment is the best place to feel safe and to let the beginning stages of labor unfold without added stress or intervention.” Doulas can help you decide the difference between early and active labor and most comprehensive childbirth preparation classes cover this as well.
It's important to acknowledge that expecting a baby already presents an opportunity for lots of unknowns, but it can be downright overwhelming when combined with social isolation and so many other uncertainties. Rather than obsessing over worst-case scenarios on the internet or wallowing in a pit of despair at the unfairness of it all, Nicki and Tara suggest that “A positive mind set is key to having a fulfilling experience.”
Some tools they have found to make this easier include apps for guided affirmations and meditation such as Gentle Birth and Expectful. Positive birth story podcasts are helpful too. They recommend The Birth Hour or Fear Free Childbirth. Robin recommends “creating a ‘Den of Zen’ at the hospital or birth location by bringing familiar things from home such as LED candles, music, a couple of your own pillows, a soft throw blanket, aromatherapy, affirmation cards, positive visuals, and your own labor gown. Things that are familiar to you can maximize your comfort and settle your anxieties.”
Giving birth in a pandemic can truly feel like a sink or swim situation. But arming yourself with knowledge, building a birth dream team, being curious and asking questions, and maintaining a positive mental attitude can all act like a life raft. And hiring a doula is like a motorized watercraft to get you to the other side! In these times of uncertainty, it’s important to remember that you are strong and capable of doing difficult things.
You are also not alone and are buoyed up by thousands of birthing mothers from around the world that are standing with you in solidarity right at this very moment in time.