A Doula's Message About Giving Birth During COVID-19

Dear Parents Giving Birth During COVID,

Let’s just say it out loud — this sucks. Let’s acknowledge that truth. Yell it, if you like, cry if you need, but get it out. It just really stinks.

This is not what you expected. It was not your dream. It is scary. It is overwhelming. There are a lot of unknowns as you turn the corner toward your labor, birth and the first weeks and months as a parent in the midst of a worldwide health crisis.

Now take a breath. Take another. And listen to this truth:

You are an expert at giving birth during COVID

Inside you is a mother or father who knows exactly what to do. The parent in you intuitively knows how to give birth during COVID — or any challenge — safely and how to not only to cope but thrive in the joys and challenges of new parenting. The parent in you knows what questions to ask, what lines to draw, when to let go of things over which you do not have control and when to powerfully take action on those that you do.

Parents of newborns have always faced challenges. For as long as there have been parents. The solutions, systems of support and the internal compass you both carry, have not succumbed to COVID-19. Nor will they.

Another truth is this: The virus will make us all more creative — you in how you care for your baby, me and all those in professions caring for pregnant people and newborns in how we care for you.

Perhaps there has never been a more poignant reminder of yet another critical truth: Healthy parenting is grounded in flexibility and openness to change. This moment, right now, is a teachable moment (you’ll learn all about these as a parent of a toddler, then later, as a parent of a teenager.) If you hold too tightly to any one idea of how your child will be, respond, or act as she grows under your nurturing, you will likely be disappointed. The same is true now, as you await and move through the birth of that child.

Things rarely go as planned in parenting, and that’s OK

In this, I think author Kahlil Gibran put it best when he wrote about children:

… though they are with you yet they belong not to you.

You may give them your love but not your thoughts,

For they have their own thoughts.

Birth is a lot like this. It rarely goes exactly as we plan.

As your doula, my job is to tell you what I know, the facts, the evidence, so that you can make informed choices during your transition to parenthood. It is also to share my experience in hopes that it will uplift and empower you. What I want most is t assure you that you can give birth during COVID-19, if not exactly as you planned, not far from it.

What I know to be true

So, here, not quite at the midpoint of the COVID-19 transmission arc in our region, is what I know. Far more importantly, here is what I know about you as a mother and a father.

Yes, hospital policies around how many non-medical people are allowed in the labor room are fast-changing. It is literally a day-to-day watch. But you are not helpless.

If your ideal plan includes more than you (laboring person and partner) in the labor room, make contingency plans. That way you won’t feel like a victim, or worse, alone, if the rules change. So, think of all the possibilities for how and where your baby might arrive and consider all the what-ifs. What will you do, what will you need, write them all down. Have plans A, B and C.

Flexibility is your ally if you are giving birth amid COVID

Yes, concern about the spread of the virus, especially among older people, may mean your first postpartum support plan may have to be thrown out the window. Remember plans change all the time. You’ve had big plans change in your life, and yet here you are, having a baby.

You may feel deeply sad and disappointed if your baby’s grandparents, family or your friends cannot be present the way you hoped. Feel it, but don’t dwell on it. There are ways they can be present. Make a new plan with the many ways you can get the support you need without someone walking into your home. Get creative. Ask people what they can do, rather than getting fixated on what they can’t.

Reach out to professionals — they are there for you

Remember that almost all the professionals you thought you might need are still available to you. Many postpartum doulas, lactation consultants, sleep experts, doctors and others in the business of newborn support will still help you, some in person, some on the phone, some via a virtual app. COVID-19 hasn’t taken them away, it’s changed their approach.

You are worried about your health and the health of your baby, I know. You’ve asked me what will happen if you or your baby get the virus. I want you to read what the Centers for Disease Control (CDC) has said about that. Because, really, it’s heartening. Thus far, although a lot is unknown, the vast, and I mean vast, majority of pregnant and postpartum parents and their babies do fine even if they catch this bug. The odds are heavily in your and your baby’s favor.

Breastfeeding is important especially after giving birth during COVID

You can breastfeed your baby — even if you have the virus. In fact, breastfeeding your baby will give the baby important antibodies against this phantom and others. Give yourself some relief. Read the CDC fact sheet here.

You’ve heard rumors that your baby will be taken away from you if hospital providers find you have COVID-19. I’m here to tell you they cannot and will not take your baby without your permission. They may emphatically recommend, as the CDC guidelines suggest, you keep 6 feet away from your newborn if you are sick, but you get to make that choice. It may help you to know that the World Health Organization (WHO) guidelines differ from the CDC. They urge parents and babies to stay together. Read the WHO positions here.

Your children are resilient and will be OK

You are wondering what all this means down the metaphysical road, for childhood and parenting and the meaning of life. Will your baby get to swing in park swings? Will your baby’s only early memories be of your eyes over a mask? Will you be able to build a parenting community around you free from paranoia and fear?

You don’t need to worry about these things. The rules of childhood and parenting are constantly evolving. That’s why there are so many parenting books out there. A new normal will arise. You’ll get comfortable with it. And here’s a secret: Your baby won’t know the difference.

Your baby won’t know anything beyond where they are. Except this: She will know, without any doubt, that you are the best mom or dad she has ever had. And you will be there for her.

Let’s get honest about doulas. Or about myself, as your doula. We doulas are a tremendous asset to families moving through pregnancy, birth and new parenting. Research has clearly shown that our presence reduces the changes of unnecessary intervention in labor and to better outcomes for mothers and babies.

But if I, in my eagerness for you to be confident in my support, inadvertently failed to instill in you the one and only thing I truly believe about birth, I must apologize.

Here it is:

You do not need a doula

You don’t really need me. You’ve got this. I’ll say it again: YOU HAVE EVERYTHING YOU NEED INSIDE YOU TO SAFELY BRING YOUR BABY INTO THE WORLD.

So, when you tell me, “I don’t know how if can do this without you,” I will tell you this:

If you were out in the woods all by yourself when your baby decided to make his appearance, you would know exactly what to do. You’d move in ways that help bring him down through your pelvis, you’d use your primal voice to keep your muscles relaxed, you’d move into just the right position for your baby to emerge, and then after both you and your baby had a moment to breath into your separation, you’d pick up your baby and he would latch onto your breast and feed.

I have to believe this or I couldn’t do what I do.

Most likely you won’t give birth in the woods. And myriad things could happen, both good and bad, during your labor. But the point here is, even in an emergency, you and your body know exactly what to do whether it goes smoothly or veers another direction. Let go. Follow your intuition. Listen with your parent’s heart.

But also trust your providers

I repeat: Trust your providers. Even though I know doulas are a critical part of labor care, I also know, no matter what, the right people will be in the room with you when your labor and birth day arrives.

In my 20-some years serving laboring families in homes, birth centers and hospitals, it is the rare nurse or midwife or doctor who does not want to physically and emotionally support a woman in labor. If we doulas or your mom or your sister or brother or daughter cannot be in the room, I trust that these caregivers will serve you as well as I know we would. Ask your provider to do that. Sometimes they don’t know how. Tell her what you need — a hand, reassurance, an epidural if you like.

They understand this isn’t what you were expecting. They weren’t expecting it either. Crisis brings out the human spirit.

Remember the people in the hospital are facing huge personal risk to care for you. Why? Because they care that much about you.

They are there for you.

Your doula is there for you too

If I am your doula, I will be there too. In fact, as fast as those hospital policies change, to protect you, I am recreating how I can serve you. I will be there for you in person as you labor at home. Yes, I will be wearing a mask and gloves. You probably should too. And then when it’s time to go to the hospital, I will go with you virtually. It’s not what we planned, but we will make it work for you. If it doesn’t work — our Zoom room has static or it just doesn’t help — I will hold space for your birth and be ready to offer whatever support I can however I can. And all the while I will know that providers are doing their best for you and your baby in the midst of a great many unknowns. I will silently thank them for their presence.

Here’s another thing I know. Another fact I hope you carry with you. It is easy to miss this fact in the sea of COVID-19 information.

Even in a crisis such as this, most birth is a normal, healthy human process.

Yes, there are those that stray outside normal and need close attention. There are emergencies. There are even the rare losses.

Most birth is still normal, even during COVID

But most birth is a normal, healthy human process.

Hold on to that. Don’t let the newly imposed visitor restrictions, the hospital providers you see suited up like spacemen in protective gear, the community midwives, or even me, your doula, wearing gloves and masks steer you from that truth. Don’t let any of this break your hope, no, let me plant the seed, your firm belief that your birth will be normal.

All the rest is precaution. It is necessary. But underneath it all, this beautiful normal primal process hasn’t changed for most of you.

It’s you and your baby working together to finally meet face-to-face. The fact that you are giving birth during COVID doesn’t change that one iota.

Cheryl Murfin, CD, is a longtime writer, a certified doula and mother of two grownup humans, including a King County Public Health nurse. She owns Nesting Instincts Seattle.