Whether choosing and/or circumstances require virtual doula services, I am equally honored and excited to be on your birthing journey team. This includes:
Private Prenatal Appointments (3 to 5): Any/all prenatal appointments occurring while a PSC Order is in effect will occur remotely via Zoom (1 appt. may be available in person, if mutually agreed)
On Call 24/7, including holidays, starting at 37 weeks of your pregnancy through the birth of your baby (up to 42 weeks), as usual.
BONUS PRENATAL APPT.: If PSC restrictions are expected to be in effect during this On Call period, I'm also offering (and recommending) at least one additional prenatal video appointment to discuss how care may be changing at clients' birthing location; review birthing support techniques (including, but not limited to Spinning Babies® approaches for comfort, ease, and birthing progress); support clients through any fears, anxieties, concerns regarding these circumstances; and resource the Birth Partner in preparation for being the only in-person support person (including how to utilize and optimize my Birth Doula support through phone or video during the rest of the birthing).
Birthing Support
Early Birthing: intermittent phone or Zoom support, as usual
Active Birthing support: You and I may be asymptomatic carriers of a life threatening infection/disease.
When you do not want to risk exposure: If you agree that to protect you and other expecting families from the risk of asymptomatic exposure to life threatening infection/disease, I should only be providing families remote support throughout birthing, please let me know, and I will gladly offer you intermittent and/or continuous (as desired/appropriate) remote support throughout your entire birthing, via phone or video.
When you are ok risking exposure: If you agree to accept the risk of exposing yourself to me as a possible asymptomatic carrier of life threatening infection/disease and would like me to offer you in-person support during active birthing at home and, if allowed, at your birthing location, depending on current governmental orders and my personal risk assessment for myself, my family, my community, etc., I may be willing to assume the risk of exposing myself to expecting families who may be asymptomatic carriers of any life threatening infection/disease. If I am prohibited from providing in person support during your birthing or do not feel that I can do so safely (for my own safety and/or that of my family, my community, etc.), you understand and accept that I will you offer you intermittent and/or continuous (as desired/appropriate) remote support throughout your entire birthing, via phone or video.
Transfer to Hospital: If you have accepted the risk that I may be an asymptomatic carrier of a life threatening infection/disease and asked me to join you in person during active birthing, unless increasing public safety threat warrants otherwise, and if mutually agreed, I can still plan to accompany you to the hospital to support that journey, especially if your partner may not pass the hospital's safety screening process. The most likely modified scenarios upon arrival at hospital during ordered hospital restrictions:
1 Support Person allowed, Partner passes screening: I will return home and remain available by phone or video continuously or intermittently (whichever is appropriate/desired) through 1 to 2 hours after the birth. (Note: With a video connection, I can provide you a deeper level of support on demand or on observance*, including witnessing and addressing things that you and/or your Partner may not realize are happening &/or can be supported.) I can keep an as active connection as possible/desired to support you through:
offering tips/suggestions &/or reminders for the
Birth Giver's activities/movements (such as Spinning Babies® techniques for space/balance/baby's descent), resting positions, breath support, body scan / softening guidance, nourishment/hydration, and/other things you might try to support birthing progress and sensation management;
Partner including how s/he can participate in helping the Birth Giver with the aforementioned items, as well as offering the Partner encouragement, reassurance, perspective re: ways s/he is supporting the Birth Giver, and/or suggestions/reminders for the Partner's self-care/well-being;
providing emotional support, reassurance, fellowship to both of you;
helping you navigate any changes or interventions that your medical provider may propose, including but not limited to offering you follow-up questions, more info./context than they may not have mentioned, and if desired, possible physiologic alternatives or considerations which might be important to you;
observing (while connected through video) and taking notes of your birthing process to help you reflect on your birthing at a later date.
*NOTE: As far as acting on my observations during a video connection, I can model certain support (such as when and how we can supporting the Birth Giver with cleansing breaths, leading body scans, how to tone/vocalize with the Birth Giver, etc.) and/or send support suggestions via text to the Partner to minimize any unnecessary auditory/brain stimulation to the Girth Giver, as much as possible/desired, especially if not time-sensitive.
1 Support Person allowed, Partner does NOT pass screen (or is otherwise ill/unable to participate):
Ideally you would have another close friend or family member with whom you feel safe who could join you, in lieu of your original partner. I would then offer support to you, your remote partner, and your accompanying support person, as described above.
I would love to join you in the absence of your primary Partner, but that might not be feasible or responsible (from the safety standpoint of my other expecting clients, my newly postpartum clients, and my family). Depending on the status of my other clients, assessment of personal and public safety risk, and Orders from governmental authorities, I may be able to join the Birth Giver at the hospital to provide in-person support and facilitate Partner's video connection. While the restrictions are in place, I would likely not be permitted to call in a backup Doula to come and replace me at any point, so I would need to defer my joining you in the hospital until you are in active birthing. (For example, if you were to have a 3-day induction, practically speaking, I would need not be able to stay with you for 3 consecutive days, especially since there is no need for in-person or continuous Doula support before birthing starts and picks up.)
0 Support Person allowed: I offer remote support to Birth Giver and Partner (including coping with the challenge of not being physically present with the Birth Giver). (See above for support I can provide you remotely.)
Transfer to SF Birth Center: The SF Birth Center ("SFBC") will likely continue to allow 2 non-SFBC birth team members to accompany you so, assuming we both agree to take the risk that we may be exposing each other as asymptomatic carriers of a life threatening infection/disease, I would accompany you and stay with you at the birth center until 1 to 2 hours after the birth. Otherwise, see above for support I can provide you remotely.
Backup Doula: I will still offer a backup doula to provide any support that is permitted & desired if I am not available to support you during your birthing. If I am unable to find an available Birth Doula who is willing to risk exposing themselves to you as possible asymptomatic carrier of a life threatening infection/disease, one will offer you remote support if I cannot.
Postpartum Appointment(s):
1st appointment is about checking in, processing the birth and experiences to date, making the adjustment to being home and recovering with a newborn, offering resources/referrals, etc. It is usually scheduled within a few days of giving birth and/or returning home from a hospital birth. All of this can be done remotely, so that would be the recommendation due to concerns about us possibly exposing each other and extended communities to COVID-19. If, however, clients have a strong desire to have me do this appt. in person, that may be an option, providing everyone is healthy, asymptomatic, accepting the risk that we may all be asymptomatic carriers of COVID-19, observing safety guidelines, etc. If clients gave birth at a hospital and want me to do this 1st appointment in person, it would require postponing this appointment until 14 days after sheltering at home and observing other standard safety guidelines. (I have had a client test positive for COVID-19 around a week or so after giving birth at a hospital, after testing negative upon arrival.)
2nd appointment focuses on supporting the Birth Giver's physical healing and/or emotional well-being.
instruction and support with self-care / well-being practices (EFT, TRE®, Self-Breema®, Yoga, self-massage, etc.) (which can be provided remotely through video appointment); and/or
emotional support & resourcing (which can also be provided remotely through video appointment);
If the Birth Giver would like me to do this appointment in-person in order to receive traditional physiologic postpartum care or Breema Bodywork*, we can either:
schedule this appointment as usual, provided we are all healthy, asymptomatic, accepting the risk that we may all be asymptomatic carriers of COVID-19, observing all standard safety guidelines, including everyone masking during the appointment, etc. and waiting at least 14 days after sheltering at home after a hospital birth; or
postpone the appointment until after the public safety threat has passed.
*Note: Breema Bodywork, massage, and other hands-on bodywork regulated by the California Massage Therapy Council (“CAMTC”) has not been permitted in California throughout the COVID-19 SIP, up until May 28, 2020, at which time they stated that they would leave it up to the Local Government. As of May 28, 2020, the timeline and plan found through the SF.gov website states that massage is expected to open up as part of Mid August / Phase 3. If you are interested in Breema Bodywork, please let me know and we can defer the appointment until regulating authorities have deemed it safe and legal to provide this service.
Any Subsequent Appointment for Birth Giver &/or Partner re: recovery and well-being can also be handled as indicated under 2nd Postpartum appointment section, above.