Preparing for Birth during COVID-19

The current COVID-19 pandemic is causing many expectant families to have to switch gears in preparing for birth. Our clients are no exception and we have been in constant contact to help provide the latest information on what to expect when they go into labor within the next few weeks.

Owner Aida Algarin was recently interviewed by the ABC11 Local News to provide a doula agency’s perspective on delivery room visitor restrictions impacting expectant family’s birth support plans. Watch full interview here: “Delivery room restrictions force expecting mothers to choose between spouse or doula”

Although visitor restrictions and CDC recommendations to separate symptomatic mothers from newborns are currently in effect or on the horizon, many expectant families are unsure what to do to prepare and the resources available to them. That’s where we step in to fill the gap and share some helpful tips.

Plan for extra support now.

With hospitals cancelling childbirth education classes, many families are feeling unprepared as to what to expect in labor and childbirth. In response to the higher demand, we are now offering online childbirth education classes. The following private classes are available: 1-hour birth planning session3-hour childbirth education class3-hour childbirth education for surrogacy birth class, and 3-hour newborn care class. Since our classes are private via the Zoom app, we present the content in context to your specific situation and take the time to answer questions that you may normally not feel comfortable or able to discuss in detail in a group setting. In our childbirth education class, we also guide you and your birth partner through learning about labor positions and comfort measures so that you can be prepared with techniques for managing through your contractions.

Consider adding virtual support to your birth plan. Currently, all area hospitals allow only one visitor and, in most cases, that includes your doula. If you told us a couple months ago that our clients would have to face making a decision to choose between their loved one or their doula to be by their side during labor, we wouldn’t have believed you. Expectant parents due within the next couple of months may need to plan for the scenario that no visitors may be allowed at all at some point. Now is the time to nail down the logistics for video calling apps (like FaceTime, Skype, WhatsApp) and what it would look like in real-time with support partners and doulas.

If you are considering hiring a doula, then it’s not too late! We are currently accepting new clients right up to your due date to provide prenatal planning sessions, virtual labor support, and postpartum follow up sessions. We support clients at birthing locations within 1.5 hours of Fayetteville and that includes home births. Contact us to learn more on how we can help guide you through these extraordinary times and provide you with the information and emotional support you need. 

Be prepared as hospital policies are changing in efforts to contain exposure. 

Many medical providers are moving prenatal care to telehealth services where it makes sense. This is not the case for all high-risk pregnancies where essential monitoring is required. Some providers are mailing patient kits with fetal dopplers for self-monitoring at home. Expect some prenatal appointments to be deferred to a later date and perhaps cancelled altogether as providers are trying to reduce your chance of exposure.  Be prepared to be flexible as provider’s are working through the logistical coordination challenges. Unless you require emergency assistance, most hospitals are asking that you call Labor & Delivery for phone triage before showing up in person.

When you do arrive to Labor & Delivery, all pregnant persons will likely be treated as if assumed positive upon admission to hospital. The aim is to increase the protection of the patients and the medical care team. Screening measures such as fever checks and intake questions take place at triage. No visitors or support partners are currently allowed to accompany patients during the triage process. Once the patient is admitted and moved to a birth room, then the support partner / doula can join them (per hospital visitor policy).

As of April 2nd, Cape Fear Valley Medical Center visitor policy requires the designated one visitor must remain with the patient at all times. This includes through the postpartum recovery until discharge. If the visitor leaves the premises, they will not be allowed re-entry.

Adjust your birth plans if your preferred options are no longer available. 

WakeMed hospitals and Womack Army Medical Center have recently removed nitrous oxide as a pain management option. Many expectant families who are hoping to have a less medicated birth list nitrous oxide as a preference in their birth plan. If that option is not available, you may need to consider learning additional coping techniques for labor. This is where a comfort measures class may help.

If you have hydrotherapy with tubs listed as a preference, you may need to confirm that option is still available. Some of the hospitals in the Triangle area are restricting the use of tubs during labor at this time. Central Carolina Hospital in Sanford is still allowing patients to labor in tubs for now, but not while delivering baby. Many homebirth midwives that cover our area are also not providing water tubs due to shortages in supplies at this time.

If you are planning to breastfeed, note that some hospital lactation support resources may be limited. If you anticipate potential lactation issues, have a plan in place with a private lactation support professional such as an International Board Certified Lactation Consultant (IBCLC). Sarah Lester, IBCLC from LATCH Breastfeeding and Postpartum Wellness Center currently provides virtual consultations and limited in person appointments. Order your pump as soon as possible to ensure you have it on hand should you need it.

Should the pregnant person test positive for Coronavirus at any point during their hospital stay, hospitals are preparing to follow the CDC recommendation to separate newborns from mothers for 12 days. The CDC suggests parents should be involved in this decision and medical providers should discuss the risks and benefits of such separation. If you plan to breastfeed, pumping breastmilk should be allowed in this scenario. Consider bringing your breast pump and leaving it in your car in the chance where you may need to pump and hospital pumps are not readily available.

Resources are available to help you prepare emotionally and mentally – both now and during your postpartum transition. 

Under normal circumstances, pregnancy and childbirth can bring a myriad of emotions. As doulas, we help our clients face these emotions and guide them through finding their inner strength. The current situation has presented challenges to where expectant families may have to think beyond birth and prepare for what may lie ahead.

Maternal mental health resources are available to you during pregnancy and throughout your postpartum period. Postpartum Support International has online resources and a hotline for pregnant and postpartum parents. They also have a virtual support group dedicated to fathers. Cinthya Bowmaker-Kareem also provides maternal mental health services at LATCH Breastfeeding and Postpartum Wellness Center. Several mental health counselors are now providing telehealth services over the phone and online. If you need to speak to someone, please do.

Facebook groups may also provide a way to connect virtually with other expectant parents. One local group that is popular with many of our military-affiliated clients is Pregnant Ladies & Mothers of Fort Bragg.  If you are seeking to connect with a local breastfeeding support group, the largest ones for the Fayetteville/Fort Bragg area are Breastfeeding Social of Fayetteville and the local La Leche League chapter.

We are accepting new clients for virtual postpartum support at this time and in-person support when social distancing advisory is lifted. You can contact us to learn more on how our team of postpartum doulas can help with your transition to parenthood and prepare before baby’s arrival.

Avoid making fear-based decisions. 

While we all face a lot of uncertainty in this pandemic and are constantly inundated with images in the media, it is not wise to make major decisions around your birth based on fear alone.

Many families find themselves suddenly exploring the option to switch to homebirths as an alternative. In the state of NC, licensed Certified Nurse Midwives (CNMs) are properly trained and legally allowed to medically assist homebirths. Some disqualifying medical factors, such as prior cesareans and being pregnant with multiples, would remove this as an option. Out-of-pocket costs with most insurances range from $2500-$3500 and there are only a handful of local midwives who serve our regional area.

If fear is driving you to consider birthing unassisted at home (also known as “freebirthing”), we ask that you consider the risks outweighing the possible benefits during a pandemic. Under normal circumstances, our doulas do not attend unassisted homebirths where a licensed midwife is not present. During a time where shortages in medical supplies are rampant and first responders will increasingly be exposed to COVID-19 positive patients, this is not the time to risk birthing at home without medical assistance, proper monitoring, and potentially being transported to a hospital that may not have your medical history on file. Although we understand why one would consider this option, we advise that the safest scenario in most cases at this time is to stay the course with your current birthing location.

We are here for you. 

If you are interested in a free one hour consult to learn more about birth planning, online childbirth education classes, and virtual labor support, please contact us today.

We hope to provide your family with the latest information on our local birth options, evidence-based guidance, and comforting support as you prepare for welcoming your baby and through your postpartum journey.

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About Central Carolina Doulas

There’s a good chance that you found Central Carolina Doulas because you’re seeking an exceptional birth and parenting experience. We invite you to see how our team of doulas can help you confidently prepare to welcome and care for your new baby.