Birth and postpartum doula Cassie Calderone returned to work from her own maternity leave in late March, just a week after the city’s shelter-in-place order went into effect. Her first birth was an induction, scheduled in advance, and the baby was born healthy and to happy parents at West Suburban Medical Center in Oak Park, just outside the city limits, on March 27. But because of precautions due to COVID-19, this birth looked different than any other in Calderone’s four years of practice. Calderone, who has a preschooler with asthma and a three-month-old, self-quarantined for two weeks before and after the birth for her clients’ and her family’s safety. And, she said, after her client’s 24-hour labor, she learned that the hospital had just implemented a new policy preventing visitors who left the labor and delivery unit from returning.
West Suburban, a popular birthing hospital, is just one of a handful of area hospitals that continue to allow parents to labor with a partner and a doula after both have been screened for exposure to COVID-19 (at West Suburban, this means ensuring visitors don’t have a cough, fever, or shortness of breath, though other hospitals may also ask about recent travel and contact with people who have tested positive for COVID-19); others include the Advocate system hospitals and Rush. In nearby Berwyn, the PCC Family Birth Center allows each birthing parent three visitors: a partner, another family member, and a doula. AMITA Health Saint Joseph does allow a doula in addition to a visitor, unlike other AMITA city hospitals. (The hospital confirmed this to Birthguide Chicago, which maintains a daily updated list of birthing hospital visitor policies.) But the lion’s share of hospitals, including UChicago, Prentice, and Mount Sinai, have adopted a strict one-visitor policy for labor and delivery units, counting doulas as “visitors” rather than an essential part of the birthing team. However, there’s still some inconsistency in how hospitals interpret their interim policies.
While the American College of Obstetricians and Gynecologists recognizes the significant benefits of doula-assisted births, it has not issued a statement on the topic of restrictive visitor policies during COVID-19: it recommended that patients ask their providers about specific policies for doulas. The Association of Women’s Health, Obstetric and Neonatal Nurses, on the other hand, came out with a strong statement of opposition: “AWHONN opposes hospital policies that restrict the presence of a doula in the inpatient setting during an infectious disease break.”
Ashé, who works predominantly with Black pregnant people and their families, said that these converging crises have raised the stress level for parents of color who are preparing to give birth during the pandemic. “A lot of [my clients] are feeling a greater sense of anxiety about the safety of them and their babies,” Ashé said. “That anxiety is compounded on top of the concerns and valid fears around racism . . . within the medical system.”
Last month, in response to Michigan birth workers lobbying for their work to be recognized as “essential,” Michigan governor Gretchen Whitmer released a statement saying that all birthing people should be able to be accompanied by a doula and a partner. In addition to helping support parents of color through an increasingly stressful hospital experience, Tanyavutti said the support of doulas can help free up already stressed hospital resources. “Our doulas help mitigate medical intervention,” she said. “You’d think they’d want to lessen the need for medical intervention.”
While CVD is also providing prenatal care virtually, the organization is working on a case-by-case basis with its doulas and clients to help them make an informed decision about whether in-person birth support and postpartum care is safe. In-person postpartum care is especially important for some families, Tanyavutti said. It can be extremely difficult to make breastfeeding work, especially if it’s not something that’s “normal” to a parent’s community or family, without early lactation support. “What we want to try to prevent is a generation of vulnerable birthing people and infants having less access to breastmilk and chestfeeding.”
