Protecting the Rights of Birthing People to Give Birth in a Safe and Supported Environment

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As Doulas, we have been following the policies in place for pregnant people during the COVID-19 outbreak. Having served as doulas in Los Angeles, since 2008 and 2009, respectively, we are committed to protecting the rights of birthing people, particularly in regards to:

Giving birth with a support person of their choice

The ability to give birth in an environment that feels safe

To give birth with reasonable confidence that they will not be subject to unnecessary exposure to COVID-19

As of March 29, 2020, most hospitals are not allowing professional birth support into L&D and are on the brink of preventing partners from attending the birth of their child. We can appreciate the necessity of keeping potential exposure as minimal as possible. 

However, childbirth can be daunting for many families and even more so during this time of global pandemic. Birthing people need the emotional support of a chosen partner, and requiring pregnant people to give birth alone will increase the risk to them and their babies substantially. Birth partners and spouses play a key role in communicating with hospital staff. The presence of a support person prevents abuse that sometimes takes place, unnecessary interventions, manipulation and coercion, and has been demonstrated to improve outcomes. They play a necessary role in advocating for their partner and making sure their needs are attended to. This is especially important as we anticipate a shortage of healthcare workers. Having a partner there could make the difference between life and death for both mom and baby and helps with even simple matters. In childbirth, emergencies warrant an immediate, life-saving response. Allowing a support person helps to ensure that birthing people receive the medical attention they need and will help to prevent an increase in maternal and fetal mortality due to preventable circumstances. Having a support person will relieve additional stress placed on the nursing staff, especially as COVID-19 related staff shortages increase, and will go a long way in preventing trauma and subsequent postpartum mood disorders for the birthing person. The WHO recommends that birthing people, even those confirmed or suspected of having COVID-19 have access to a safe and positive childbirth experience, including “Having a companion of choice present during delivery.” Governor Andrew Cuomo recently announced a directive to allow birthing people to have a support person of their choice in all New York hospitals. Please consider following his lead and making a statewide policy requiring hospitals to allow a support person of their choice during labor, birth and postpartum. 

Additionally, we would like for you to consider alternative methods of responding to healthy pregnant people that are low risk. These families are in a higher risk category and going into the hospital that is treating COVID-19 patients places them and their new babies at a much higher risk for contracting COVID-19. 

Please consider:

Midwives are highly trained medical professionals, and should have an increasing role in the care and support of low-risk pregnancies and births as they do currently in most developed nations. Licensed Midwives and Certified Professional Midwives are seeing an increase of patients for out of hospital births, including home and free standing birth centers, as the fear of birthing in a hospital increases. Please require insurance providers, including MediCal, to cover home birth, free standing birth centers, and a wider spectrum of providers than their current selection of “in-network” providers during this time. Releasing insurance restrictions will make midwifery care more accessible to healthy, low-risk patients, relieve pressure on hospitals, and allow families to birth in the environment they deem safest. 

Additionally, out-of-hospital midwives are low on protective gear and medical supplies as many suppliers have had an increase in demand. Midwives need personal protective equipment allocated immediately.

There is a need for alternative birthing locations for those who are low risk. During this time as hospitals will be full with COVID-19 patients it makes so much sense to find other, safer birthing alternatives for these families.This will both increase hospital beds and prevent transmission of the disease. The Netherlands are converting hotels into birth centers and providing midwifery care. While many birthing people still want epidurals and other traditional medical care options, most of this could be provided in a hotel environment. Alternatively, please designate the hospital ship, Mercy, and other specific local hospitals for maternity care and/or other non-COVID-19 or non-communicable conditions.

Sincerely,

Dana Nassau 
Birth Doula, CD(DONA) HCHI

Katharine Deeb
Birth Doula, CD(CHB)