Category: COVID-19

practicing comfort measures

What does a virtual prenatal appointment look like?

Published on by joannbishopdoula

In the days of COVID-19, doula support has morphed into a new way of providing services to clients. Since March with the Safer at Home orders, I’ve been conducting all prenatal visits via Zoom. We’re fortunate to live in an era when we have access to excellent technology to allow us to meet “face-to-face” yet be safe.

virtual prenatal visit
virtual prenatal visit

Here is what my living room looks like after a visit. Prior to the visit, I’ve delivered a packet to the client with all the handouts that we are going to review. All the information is also available in my online Resource Library for those who prefer to see it that way. The client is in their living room and I’m in mine and together we review the packet of childbirth education materials, practice comfort measures and laboring positions and answer questions. Some clients are actually preferring the virtual support as they don’t have to get childcare, and, it gives the supporting partner or husband a greater hands on role.

As a bonus, my Birth Plans now include much of the Postpartum Preparation that I offered as a separate contract prior to the pandemic. That makes the Birth Plans a great value and more comprehensive. Since many parents are not having the previously expected support of family and friends coming into the home once baby arrives, intentionally and carefully creating a postpartum plan is even more essential now. We review preparedness for baby’ care and mom’s recovery, discuss plans for sleeping, feeding, diapering, and household needs.

“The way hospitals, OB’s, and nurses are set up there is very little coaching or support during the labor and even delivery until your wife/parter is ready to push. Then the whole team comes rushing in ready to catch the baby. Having a doula (especially Jo Ann) to support us through the whole process (even virtually) helped ensure a more positive outcome not only in physical health for mom and baby but in mental and emotional health as well. This is something every woman should strive for and be able to achieve. Being that JoAnn now has virtual options (thanks to the pandemic) no matter where you are located, she is able to support you, so give her a call and see if she is the right fit for you. “

Testimonial from virtual support father 2020

If you are wondering if virtual birth doula support is for you, please give a call and we can see if it (and I) are the right fit to support you during this very important time of your life (414) 301-7729. Because doulas are part of the non-medical support team of your pregnancy, we are not issued PPE as are medical staff in the hospital and minimizing the number of people in a delivery room is strongly recommended to keep everyone safe, virtual doula support is an excellent option for those who still want the expertise of an experienced, certified doula but not the added risk and contagian of in-person contact.

Maternal and newborn separation in the time of COVID-19

Published on by joannbishopdoulaLeave a comment

Birthing families are facing additional stresses during the time of COVID-19. The health concerns of how the virus could affect them or the baby, the loneliness of physical distancing, working from home with older children, and much more complicate each day. Many parents are without the expected anticipated support postpartum of their friends and families upon returning home from the hospital.

A major worry of some is if they would be separated from their newborn immediately after birth should parents have confirmed or suspected COVID-19 or mother has a fever or cough. Fever in labor can occur due to something called chorioamnionitis, which is inflammation of the membranes. Fever can also be a common side effect of an epidural or meconium. There is conflicting research and advice on this topic of maternal newborn separtion. As a birth doula, it is one of the topics my clients are most concerned about. And to make it even more confusing is that the information continues to change.

The newest recommendation from the American Academy of Pediatrics and the CDC currently recommend separation. The AAP states “While difficult temporary separation of mother and newborn will minimize the risk of postnatal infant infection from maternal respiratory secretions.” The exact wording in their report is, “The likely benefits of temporary maternal and new born separation at birth for decreasing the risk of newborn infection should be discussed with the mother optimally prior to delivery.” Disappointingly, what is not mentioned is the harms of mother newborn separation. Know that parents are free to accept or decline this recommendation after an informed consent discussion. They do state that an alternative to separation includes keeping the newborn at least 6′ from the mother at all times with a physical barrier and to not breastfeed. This is in keeping with the CDC’s recommendations also.

However, in contrast all around the world, including the World Health Organization, the United Kingdom’s Royal College of Obstetricians and Gynecologists, UNICEF, and guidelines from Canada and Italy state the contrary. Their recommendation is to keep mother and newborn together unless the mother is too sick to care for baby.

You as parents have the final word. Evidence Based Birth has created a sample Informed Consent Form for Refusal to Separate Birthing Parent and Infant. You can link to the form on my Resource Library. Please reach out to your doula to discuss this topic prior to birthing.

Keeping balance in the time of COVID-19

Published on by joannbishopdoulaLeave a comment

We are three weeks into the Physical Distancing in Milwaukee required to flatten the curve from COVID-19. This is hard. We are social beings and being isolated goes against our nature. At first, I was excited about having some (unknown amount) of time in front of me to stay home, clean a few closets, read some of the stack of books on my nightstand, and slow life down a bit. But then, it hit me, the realization that this Physical Distancing wasn’t going to be just a week or two but some much longer unknown amount of time where we are not going to be going about the life we knew.

My coping methods to find and keep balance during uncertain times includes list making. Trying to feel in control of something in an out of control time. Lists of what to clean, which new parks to hike, what business systems and paperwork to revise, which clients to follow up with. But my higher self knows that is not the best use of this time, going inward and finding meaning and mourning for our world is where I need to be.

Today, I walked a different route out to the lighthouse on Lake Michigan. My husband took this picture of me and my pup and I think it is a good representation for how I’m feeling – a bit off kilter. The funny thing is, this lighthouse is actually very tall and straight. It is just the angle of the photo that makes it look like it’s leaning. And so it is with the world. The earth still spins and the sun still rises, just with a world-wide pandemic novel virus spreading through it; a bit off kilter too.

Be gentle with yourselves. Take the time you need to mourn and grieve the many losses we are experiencing. Hold in prayer those who are keeping our society running and caring for the most vulnerable. And those who have lost their loved ones or employment completely.

Pregnant families are among the most stressed at this time. Their birth plans are being impacted in countless ways including not knowing if their partner or husband will be allowed in the hospital with them, adjusting to virtual support from their doula, not having their family visit after returning home with a newborn. I can help with this. I have been and am supporting births virtually and working extra hard to prepare families to manage during the 4th trimester. Help is available, please don’t feel like you have to go this alone. We’re in this together and we’ll help each other find balance once again.

Virtual Doula Support

Doula support in the time of social distancing

Published on by joannbishopdoulaLeave a comment

Babies continue to be born despite the happenings in the world around us including a worldwide pandemic. The social distancing requirements to flatten the curve of the COVID-19 impacts our ability to be physically close to one another. This however, does not mean that we cannot be virtually close and continue to be connected and share conversation, information and support. With creativity and flexibility, you can still have the invaluable support of a professional certified doula near you.

As a birth doula, I know now, more than ever, it is critical to have the continuous support of a qualified and experienced birth doula beside you. Anxiety levels are heightened right now because of the uncertainty around us. The added concerns over the new regulations and fear from the unknown from the COVID-19 create higher stress levels in the mother. Most hospitals have limited the number of people who can be present in labor and delivery to one which is most often the husband or partner of the laboring woman. But as your doula, I can still be present to you via the excellent technology available to us today. I will work harder than ever to keep you empowered and feeling safe throughout the process of labor and birth.

We develop a plan together of how we will communicate when you are laboring at home and at the hospital; this may be FaceTime or Google Hangout. Having a long extension cord and charging cord for your device will give you flexibility in where you place your phone or iPad. A stand or means to prop your phone or iPad is also helpful. I can still be near you, see you and give suggestions on position changes and comfort measures. We can discuss any options presented to you during labor and make sure you are using informed consent and have the information you need. I can still coach the partner in ways to comfort and support you. Postpartum, I will encourage you to do skin-to-skin with your newborn and give advice on baby latching and nursing. The information you desired and wanted will still be there for you. You are not alone in this. Your doula can help you and support you despite not being physically in the room. We’ll get through this together.