Allow Doula Access in Texas Hospitals During COVID-19

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This is a petition to Gov. Abbott and to every hospital administration who is continuing to restrict doula access into their hospitals. 

The presence of a doula has been shown to shorten labor by 25%, reduce C-section rate by up to 50%, lower use of Pitocin by 40%, and reduce pain medication use by 30%. Breastfeeding, overall self-confidence, and a positive, satisfactory labor experience is also more common when a doula is present (Cochrane, 2011). 

Every health organization supports the presence and importance of a doula in the midst of pandemic. The CDC, ACOG, and AWHONN have all expressed this. 

So the question is, what are our hospitals waiting for? What is Governor Abbott waiting for? 

Hospitals not allowing doulas into their buildings reveals that they are truly not interested in prioritizing the health and well-being of their patients. 

We are asking all hospital administrations who are currently restricting doula access to change this policy and allow birth doulas in immediately. And in case there are still those who refuse or hesitate or drag their feet, we are asking Governor Abbott to mandate that hospitals allow doulas in. 

Doulas are not visitors, but integral health team members hired by the patient to improve delivery outcomes with methods backed by research. 

Please sign the petition to show your support and call for urgent action. If you would like to read the letter we are presenting to hospitals directly in Central Texas, a copy of it is below. 

Thank you, 

Sage Central Texas

Founding Members: Eryn Shaffer (Birth Doula, CHB), Stephanie Spitzer-Hanks (EBB Instructor, CD/PCD DONA, ICCE, CLC), Carley E. McCaw (CD, DONA), Ashley Cochran (CPM, LM), Malayia Curliss (Birth + Postpartum Doula, DTI)







September 14, 2020

To Whom it May Concern:

As a professional cohort of doulas, midwives, and community supporters providing much needed labor support in both the hospital and out of hospital settings, we are very concerned that hospitals are still restricting their patients from having professional labor support in the hospital. 

According to the CDC, current guidelines for COVID-19 include this specific instruction: “If restriction of all visitors is implemented, facilities can consider exceptions based on end-of-life situations or when a visitor is essential for the patient's emotional well-being and care.”

As doulas, our clients hire us specifically to provide emotional, physical and informational support during labor. As members of the health care team, we also help shorten labor and lessen the need for intervention, lightening the load of labor & delivery nurses and doctors, helping them focus on where they are most needed. ACOG states “Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor.” And Texas could use all the help we can get with improved outcomes. Our maternal mortality rate is worse than the national average, which is the worst maternal mortality rate in the developed world.  

In March, as COVID-19 was soaring, The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) formally reiterated their stance on Doula Care during the current pandemic:

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. 

In closing, we hope you will reconsider your policy on banning professional labor support. We have been providing labor support to your patients during flu season, SARS, H1N1, etc., and we value the safety and health of our clients, your patients, and your staff. 

As a group, we are committed to:

-Vigilant hand washing/sanitizing

-Staying home when sick

-Using back up as needed

-Wearing protective clothing, gloves, masks, etc as needed

-Respecting the safety protocols of the hospital

-Practicing social distancing from hospital employees/patients

-Practicing social distancing and appropriate quarantining measures in our personal lives

Our clients use doulas for very specific and personal reasons, and we hope you continue to support parents’ ability to negotiate care with true autonomy and shared decision making, including the freedom to access professional labor support.

Doulas are not visitors. They are essential support people and members of the healthcare team. They improve birth outcomes, increase satisfaction of patients, and help carry the load on L&D floors. The CDC, ACOG and AWHONN all approve of and encourage their presence in the midst of COVID-19. Blocking them from entry sends the message that you do not truly want the best outcomes for patients, and we hope that is not the case.

We look forward to seeing how you respond to this request and better the lives of your L&D patients and families. 

Thank you.

Signed by:

Sage Inclusive Network

Eryn Shaffer, Birth Doula (Carriage House Birth)

Stephanie Spitzer-Hanks, Evidence Based Birth® Instructor, CD/PCD(DONA), ICCE, CLC

Carley E. McCaw, CD(DONA)

Ashley Cochran, CPM, LM: The continuity of care that doulas provide benefits every aspect of birth, from the providers supporting it to the people giving birth; it is essential to us all to have less birth trauma in the community. 

Malayia Curliss, Birth + Postpartum Doula (DTI)