The Doula community of South Florida is dedicated to providing all birthing people with guidance and support during all phases of pregnancy no matter their choice of healthcare provider or location.

The purpose of this petition is to allow South Florida Doulas into hospitals local to South Florida (Miami-Dade, Broward, and Palm Beach Counties), for the mental and physical health of the pregnant and birthing persons during the COVID-19 pandemic. 

Doulas are not medical workers, however, they are absolutely essential workers and should be recognized as so.

It is understandable that visitors should be limited at this time and all safety precautions must be taken when it comes to visitors. Unfortunately, what hospitals fail to realize is that Doulas are NOT visitors. Doulas are recognized by the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) and the American College of Obstetrics and Gynecology (ACOG) to be an “essential personnel and part of the maternal care team.”

Having Doula support during labor and birth has been evidentially shown to:

• Decrease the likelihood of unplanned Caesarian
• Decrease use of analgesia 
• Decrease the likelihood of instrumental vaginal birth 
• Increase the likelihood of healthy birth weight
• Increase overall satisfaction of birth experience perceived by the family in care
• Improve five-minute APGAR scores 
• Shorten the duration of labor 

Professional Doula services are paid for by the birthing person or covered by their insurance if covered to guide and support them during antepartum, intrapartum, postpartum. This also includes pregnancy and infant loss support. The birthing person, their partner, and family all develop a close relationship with a Doula over the course of the pregnancy. The Doula provides education, emotional support, and resources that are extremely valuable to the birthing person. Together as a birth team, they are able to form a personalized birth plan specifically for the birthing person. 

Deviation from having a Doula in the hospital room removes any sense of control, confidence, and comfort for the birthing person and their partner. This can result in a traumatic birthing experience and can lead to dissatisfaction postpartum. This can include struggling to breastfeed and/or inability to bond right away, which can later turn into a myriad of other issues like Postpartum Depression or Postpartum Anxiety. 

We hope that you take into account the important role Doulas play. Having a Doula as part of the support team can make a world of difference, especially when we are working in partnership with the medical staff. Our community of doulas takes great pride in the professional relationships that we have formed with South Florida doctors, nurses, and hospital staff over the years.

Other large metropolitan areas such as New York City and Chicago have allowed doulas back in as essential hospital personnel to support laboring people during this pandemic. We ask that you do the same.

We are committed to following the CDC guidelines and working within the protocols and regulations of the hospitals to support a healthy birth experience for our birthing parents and their families.

As professional Doulas, we are committed to following all the recommended hospital regulations:

1. Following proper hand washing/sanitizing protocols personally and professionally
2. Staying away from clients and birth location if we ourselves are sick, or exposed to illness and instead of using back-up doula support 
3. Wearing hospital-provided masks, gloves, protective equipment when required and/or available
4. Limiting movement to the patient’s room as much as possible
5. Limiting personal items to bring in only what is needed for personal nourishment and hygiene
6. Encouraging all South Florida Doulas to enroll in specific training for COVID-19
7. Bringing identification of our professional doula training/certification, registering with hospital staff as a visitor/support person, or supplying other requested documentation.

Attached are statements issued by AWHON, DONA and ACOG below for your convenience. We are in this together! 

Thank you,

Nicky Dawkins, Full Spectrum Doula and Doula Community of South Florida

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REFERENCES:

AWHONN’s Position on Doulas with Patients During COVID-19

AWHONN recognizes that doula services contribute to the woman’s preparation for and support during childbirth and opposes hospital policies that restrict the presence of a doula during a woman’s active labor.

“Doulas are not visitors and should not be blocked from caring for patients in the antepartum, intrapartum and postpartum period.  Most doulas have been contracted by patients weeks to months ahead of time and have established provider relationships.  They are recognized by AWHONN and ACOG as essential personnel and part of the maternity care team,” said AWHONN member Nancy Travis, MS, BSN, RN, BC, CPN, CBC, Florida Section Chair.

AWHONN supports doulas as partners in care and acknowledges their ability to provide physical, emotional, and partner support to women.  AWHONN opposes hospital policies that restrict the presence of a doula in the inpatient setting during an infectious disease outbreak.  Read more about AWHONN’s position on continuous labor support for every woman here.

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DONA Statement:

Regarding doulas attending births in the hospital setting

Recently, we have heard reports of hospital restrictions which could inhibit a family from working with their doula during labor and birth.  As supported by both The American College of Obstetricians and Gynecologist (ACOG) and The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), doulas are an important part of the care team and provide informational and emotional support as well as comfort measures for patients during birth.  Numerous clinical trials show that when doulas are present for families, healthier outcomes are possible. According to the Cochrane database,  “Continuous support during labour may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labour, and decreased caesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score and negative feelings about childbirth experiences.”(2017, Bohren et al. ” Continuous support for women during childbirth.” 2017.  At this time, it is our position that doulas should continue to be permitted into the birth room as an essential component of the patient’s well-being and care, and it’s our hope that any hospital visitor restrictions will exclude doulas.

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Fetal Medicine (SMFM) joint statement: Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery says this about the effect of labor support:

“Increasing women’s access to nonmedical interventions during labor, such as continuous labor and delivery support, also has been shown to reduce cesarean birth rates.”

“Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”

“…the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery.”

“Given that there are no associated measurable harms, this resource is probably underutilized.”

Read more here: https://www.acog.org/~/media/Obstetric%20Care%20Consensus%20Series/oc001.pdf?dmc=1&ts=20140220T0709497934

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Infomation via Evidence Based Birth:

https://evidencebasedbirth.com/the-evidence-for-doulas/​

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/