From around the world, report the impact of new COVID-19 restrictions on their ability to provide continuous emotional, physical, and informational support to pregnant people and their families. In a qualitative survey conducted in March and April 2020, we heard from over 500 doulas in 24 countries. Doulas practicing across the world revealed rapid changes to hospital policies. Even accounting for different public health responses across countries, the doulas in our study pointed to one common theme - their absence at births and the subsequent need to support birthing people virtually. In a follow-up survey and in interviews we conducted in July, we reconnected with doulas from our initial study to track their access to institutional birthing spaces. As countries experienced the effects of “flattening the curve,” we found that doulas were still not considered “essential” workers and the majority could not attend births. Our research shows that doulas have ambiguous feelings about the efficacy of virtual support, that they raise concerns about the long-term impact of COVID on their profession and that they are concerned about mistreatment and obstetric violence as birthing people enter hospitals alone.
The rise of COVID-19 cases at hospitals translates to shifting policies about who can be present at births. Our research looks at data from nearly 400 qualitative surveys on how doulas—women who provide continuous emotional, physical, and informational support to pregnant and laboring people—navigate new restrictions redefining who belongs and is considered an “essential” birth worker in hospitals in the United States. The spectrum of new hospital guidelines spans from allowing only certified doulas, oftentimes with their own personal protective equipment (PPE) and on pre-approved hospital lists, to forcing pregnant people to choose only one support person, and in extreme cases, to banning any labor support—doula or partner. We examine what doulas reported about the changing hospital policies and shifting landscapes of belonging, thinking through what these contestations mean for birth.
Birth doulas provide non-medical intimate support to pregnant people and their families. This support starts at the very foundation of life – breath. Doulas remind, encourage and accompany people through labour by breathing with them. However, the global COVID-19 pandemic has interrupted doulas’ intimate work, and they are forced to navigate new restrictions surrounding birth practices. Based on data collected from a qualitative survey of over five-hundred doulas as well as subsequent follow-up interviews with select doulas, we find intimacy at births disrupted and reshaped. We suggest that an analysis of doulas provides a unique way to think through the complexities surrounding reproduction precisely due to doulas’ ability to navigate intimate labour between and across boundaries.
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