Topic

Birth Support

28 petitions

Update posted 2 weeks ago

Petition to Andrew M. Cuomo, Howard A. Zucker, Mayor Bill de Blasio

Hospitals Must Comply With DOH Guidelines and Allow Continuous Partner Support

Hospitals across New York are still interpreting and implementing Executive Order 202.13 and the subsequent Department of Health guidelines in ways inconsistent with the purpose of the order.  Patients are being forced to labor alone for hours in triage units, patients positive for COVID-19 are being denied partner support, patients are being denied support in PACU (post anesthesia care unit) after cesarean births, and patients are being denied support in Postpartum Units.  This is unacceptable and cannot go on.   ---------------------------------------- Some hospitals are allowing partners to continue their support in the Postpartum Unit (or Mother Baby Unit, in some hospitals). Other hospitals are forcing partners to leave within hours after birth, before the patient and new baby are transferred to the other unit. Some hospitals are also banning support people in the PACU (also called recovery), resulting in no postpartum support at all in the event of a Cesarean delivery. We know support for postpartum patients is just as essential as for patients in labor. The postpartum period is not only physically and emotionally taxing, nearly 40% of maternal deaths happen because of postpartum complications, namely,  hemorrhage, pulmonary embolism, and infection. Being alone in a room with a newborn to exclusively care for increases the risk of these complications going unnoticed. Further, new parents that receive continuous postpartum support have improved breastfeeding outcomes and lower incidence of postpartum mood disorders--the long term impacts of that are felt long after the stay in the hospital. Newly postpartum mothers, especially those who have undergone a Cesarean delivery, should not be left to care for their babies alone.  Last week, a patient who delivered her baby without partner support, via emergency Cesarean section at Columbia Medical Center, a New York Presbyterian Hospital, was left to care for her baby alone and fainted while holding her. It took a nurse 45 minutes to respond to her repeated calls. Fainting episodes like this are not uncommon--women in postpartum units are instructed not to stand up without assistance because it is so common--and are exceedingly dangerous for patients and their babies if they are alone. It increases both the risk to the patient (injury from falling) and baby (injury from being dropped or being suffocated by an unconscious parent).  In the past weeks, New York City has witnessed the problematic effects of conflicting policies from hospital to hospital regarding Labor & Delivery and Postpartum units. Expectant parents have fled the city to seek care elsewhere; have made late-term hospital and practice changes; are having increased extracurricular or unassisted out-of-hospitals births; and have flooded public hospitals and the few private hospitals who have allowed access to partners. These conflicting policies create an increased strain on hospitals that are interpreting the Executive Order to mean that partners may stay for the duration of the postpartum hospitalization. In fact, New York Presbyterian and Mount Sinai affiliated hospitals have both seen a remarkable decrease in L&D patient admissions over the past two weeks, whereas NYU and Lenox Hill have seen increased admissions from patients who have never received prenatal care from them or affiliated private practices. We have also seen an increase in patients who are discharging themselves against medical advice, earlier than recommended, so they can be with their partners.  Inconsistent policies regarding labor and postpartum support for patients has caused mass confusion and chaos among pregnant people and their families over the past several weeks.  These policies increase risks to mothers and their babies while not actively limiting exposure to COVID for healthcare workers, other parents, or infants. I encourage you to clarify the Executive Order to specifically state: “The directive of Executive Order 202.12 requiring a support person for a patient giving birth is modified insofar as to cover labor, delivery as well as the PACU and the entire postpartum hospital stay.” This would ensure the safety of postpartum patients and their babies and would minimize the risk that patients make rash, and at times, unsafe decisions about their care.

Jessica Pournaras
23,542 supporters
This petition won 2 months ago

Petition to Andrew M. Cuomo, Mayor Bill de Blasio, Phil Murphy

Safeguard the Right of All Laboring People to Have Support During COVID-19 Crisis

On March 21, the NYS Department of Health issued clear guidelines on treating patients in labor during the COVID-19 crisis.  These guidelines determined a support person, whether a spouse, partner or other chosen person, is essential to care for the patient during labor, delivery and in the postpartum period.  The World Health Organization (WHO) agrees.  We agree. As of March 26, all New York Presbyterian and Mount Sinai affiliated hospitals, and Staten Island University Hospital in the New York City area will act against WHO, CDC and DOH guidance and ban all support people--including spouses--from Labor & Delivery and Postpartum units.  This means people in labor will give birth alone and parent alone.  Parents will miss the birth of their child. Fundamentally, risks for the people laboring alone will increase substantially. Not only can partners and spouses provide physical and emotional comfort during labor and postpartum, they are also essential in alerting staff when something has gone wrong and the laboring patient cannot notify nurses themselves, like in the event of an eclamptic seizure or a fainting episode.  Timing is critical in these cases and monitors can be unreliable. We cannot expect nursing staff, already spread thin, to spend the limitless hours needed with each patient to ensure their health and their baby's health, to provide physical assistance and emotional support.  We know the hospital system is overwhelmed in this crisis.  However, the burden will only be increased by banning support people from Labor & Delivery. We must ensure no one gives birth alone. We must ensure the maternal mortality rate does not increase during this time.  

Jessica Pournaras
613,644 supporters
Update posted 3 weeks ago

Petition to Pete Ricketts, Nebraska State Senate

Doula Support in Nebraska Hospitals during COVID-19 Outbreaks

Dear Governor Ricketts, We are experiencing an unprecedented public health and national emergency. However, in the midst of a pandemic, mothers are still giving birth and are now facing additional stress and anxiety caused by the uncertainty of this virus, a change in their birthing plan, healthcare, and even their healthcare provider. Due to COVID-19, all hospitals across Nebraska have enacted a variety of policies that limit the birthing mother to one birthing partner and prohibit professional birth doula support from entering the birth space. But, in an effort to save lives, these policies are putting the birthing woman and baby at a higher risk.  Studies have shown that continuous birth support from a doula has a dramatic effect on mom/baby outcomes. [From Evidence Based Birth] * 39% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)* *15% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)* *10% decrease in the use of any medications for pain relief *Shorter labors by 41 minutes on average *38% decrease in the baby’s risk of a low five-minute Apgar score *31% decrease in the risk of being dissatisfied with the birth experience COVID-19 is taxing our hospital systems, and yet many hospitals are prohibiting the very people who could help carry the burden. In study after study, it is evident that doulas reduce the rate of unnecessary interventions and cesarean births (which requires three to four times as many health professionals as vaginal births do). Vaginal births also shorten the length of hospital stays, which means that more hospital beds will be open and families will be able to isolate at home much sooner.  In the midst of this crisis, obstetric organizations agree that doula support is essential.  AWHONN (the Association of Women’s Health, Obstetric, and Neonatal Nurses) released the following statement on Wednesday, March 11th: 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. The CDC States "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." [https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html?fbclid=IwAR0ZIHF8h6UUYoBvhs66cPcd6UxDs82GeBuD041kI4J_XoEdA_LmRkdBuJE The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-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.” We are asking that Governor Ricketts follows suit of New York’s Governor Cuomo’s executive order that clarifies “doulas are considered an essential part of the support care team and should be allowed to accompany a pregnant individual during labor and delivery as an additional support person, as medically necessary.” https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/042920_CMTF_Recommendations.pdf We are asking that you please confirm the use of doulas as an essential personnel team member in hospital births and follow New York and Michigan in protecting our role in the birth space. 

Nebraska Labor & Birth Professional Doulas
3,351 supporters
Update posted 4 weeks ago

Petition to Gavin Newsom, Eric Garcetti, Holly J. Mitchell, Kamala D. Harris, Dianne Feinstein, Ben Allen, Karen Bass

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

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 DeebBirth Doula, CD(CHB)

Dana Nassau
34,997 supporters