OPEN LETTER TO ALL CALIFORNIA HOSPITALS

We wanted to address your visiting policy as we were hoping to discuss the recent updates. The California Department of Health mandate that goes into effect on August 11 states that hospitals, nursing facilities or care facilities must either: “(1) verify visitors are fully vaccinated, or (2) for unvaccinated or incompletely vaccinated visitors, verify documentation of a negative SARS-CoV-2 test.” It does not say anything about restricting the amount of visitors, although your updated visitation policy does.
We primarily wanted to discuss that policy regarding the Labor and Delivery department. Your visiting policy specifically grants exceptions to visitation restrictions for religious visitation and designated support persons for patients with disabilities. As doulas, we are trained to support the birthing person through labor—we are trained professionals who provide emotional, physical, and informational care to birthing people during and after childbirth. We are not visitors, but rather support people who have gone through extensive training to assist in the labor and delivery process. We would argue that doulas, for those who hire them, are an absolutely necessary part of the birthing experience. One thing that both your updated policy and the state mandate infers is that the well-being of your patients is your priority. If that is the case, then certainly the presence of a requested doula (who is of course either vaccinated or recently tested—or both if necessary), would ensure the well-being of said patient.
Additionally, we know there is a current shortage of nurses, and we are concerned that might impact the continuity of care of our clients. Doulas, by nature of the job, offer your nursing staff support and relief simply with their presence. An updated Cochrane Review shows the benefits of birthing people having continuous support during labor. Trials of more than 15,000 people showed that this continuous support resulted in more vaginal births and less of a likelihood of pain medication, traumatic birth experiences, vacuum or forceps-assisted, Cesareans, etc. Their labors were also shorter by about 40 minutes and their newborns were less likely to have low Apgar scores. There is no evidence that having a doula or support person negatively impacts the birthing experience. It benefits everyone involved in the process when we are allowed to take part.
This letter isn’t meant to be a form of complaint, but rather a way to hopefully open up a bigger conversation about how we can support our birthing people. Your hospital has been at the forefront of progress regarding women’s health—your L&D department is spoken of highly in our community as being a place open to advocacy. The people who have hired us have done so because they feel it is a necessary part of their birthing journey to ensure that they are protected and informed. It will deeply affect their experience in a negative way if we are not permitted to support them. We are willing to work with you to adhere to new guidelines if requested, but we continue to believe that restricting doulas completely will hurt your patients and the reputation you have made for yourself.
Please let us know how we can proceed. We would love to have further conversations if you are willing and develop some guidelines to guarantee the safety of patients and hospital staff. We respect the health and safety of our communities and would never compromise that—we are merely searching for a way for our parents to be best supported through their medical journey.