Your BIRTH Partners

Being a Doula during a Pandemic #014

May 26, 2020 Your BIRTH Partners Season 1 Episode 14
Your BIRTH Partners
Being a Doula during a Pandemic #014
Show Notes Transcript

This week we are honoring the end of Internation Doula Month.  We have a panel of doulas on to discuss their experiences of providing care through a pandemic.  We're talking about work:life balance, virtual doula services and other ways to pivot during this time, and grow from here into a truly collaborative care environment.

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Maggie, RNC-OB :

Welcome to Your BIRTH Partners. We're here to break down barriers and cultivate community as we discuss issues that impact pregnancy, birth and postpartum. We welcome you no matter what your background is and are so excited to learn together. Today we are honoring the end of International Doula Month, which runs through May. We have a panel of doulas on to share a little bit more about their experiences of providing doula care through a pandemic. I am joined by Chante Perryman, Cat LaPlante, and Rachel Carbonneau, who will share a little bit more about what they've learned about work life balance, how they're pivoting to improve the kind of care that they are able to give clients during this time, and also what they hope to see from a more collaborative care future. On to the show! So I am so excited to have a wonderful panel of doulas on today to share a little bit more about their experiences, being a doula during a pandemic, something that we have not been able to experience before. So we want to talk about some of the challenges that have come along with that, kind of how they're growing within that space, what kind of support they can offer to other doulas during this time, and then also what they see as our future as we continue to work towards more collaborative care, and how we want to kind of move on through and past this whole experience with COVID-19. So I'll start by just letting them quickly go around and introduce themselves a little bit and just share a little bit of their story with you. Rachel, go for it.

Rachel, Doula :

Thank you so much, Maggie, thank you for having us. I'm really excited to be here and be part of this conversation. I am a doula based out of the DC metropolitan area. I have been a doula for 10 years, I run an agency, a team of 12 birth and postpartum doulas, and we are all pivoting right now and sort of re envisioning the support that we provide and how we can better align with other care providers during this pandemic and onwards.

Maggie, RNC-OB :

Awesome. Chante, tell us about yourself.

Chante, Doula :

Hi, Rachel. Hi, Cat. Hi, Maggie. I'm Chante Perryman. I am a doula, childbirth educator, evidence based birth instructor and spinning babies parent class educator here in Lexington, Kentucky. I have been a doula for seven years now, childbirth educator going on five years, I've been supporting families in my area for a little while now. Just rolling with everything that's going on with the pandemic. I know we're gonna be talking about virtual services, but I've been doing virtual services before the pandemic hit so I was kind of already prepared and ready and just like I'm still just flowing with the things so I'm good. Thanks for having me.

Maggie, RNC-OB :

Thank you for being here! And, Cat.

Cat, Doula :

Hey everybody, I'm Cat LaPlante. I am a childbirth educator, a doula, and evidence based birth instructor. I have been doing this work for I'm in my ninth year and it's been incredible. Like Chante, I was providing doula support virtually, and education virtually before the pandemic, but there was always a way to access people physically if I needed to. And now I don't have that unless they were in other states, which wasn't a whole big part of what I did. So this has definitely been an eye opening experience. It was easy to roll into, but I'm hoping that at one point we can get out of it. And it's gonna be fun talking about the experiences that we've had so far, virtually the challenges, but also what what truly it can do and still be able to provide the support that a doula can provide during this time.

Maggie, RNC-OB :

Hey, all right. So let's just dive right in. So you know, if we, if any of you want to kind of cover first, like just the experience, I think as you know, as birth workers, we are, you know, used to kind of being tied into that feeling of what's happening in ourselves and then the outside world and how we're kind of navigating that, and especially with the on call lifestyle, there's always been a very thin Fail between work and life and how everything rolls out. But I think just so much more technology now. And that being the only way to connect in that continuous on feeling that comes with that. How are you all balancing out time that is rejuvenating for you and let you take care of your needs and your families, while also balancing out the needs of clients and the birth world in general.

Chante, Doula :

I think it's a little bit easier for me now. And I say that just because like I said, I've already been doing this so it's not something new that I'm having to focus on. Like I was already offering the service. So for me, it's actually made my life a little bit easier. I only take one client a month. So in that, I don't have multiple people to keep up with in a month. So I'm still able to like offer classes, still able to do like the family work life balance, and still be able to provide like that one on one attention to the client who's due that month. That's a little bit easier for me.

Cat, Doula :

So I think it's been easier but also a little bit more hectic. So I try to schedule things out. I really like it. Although we know we can't schedule birth, but I tried to schedule out my day so that I am doing things that are with my family at certain times and then work at certain times because I also work from home. So the pandemic has made it so I have all of my children here and I have four of them, two of them school aged and two of them that are younger. So I am now primary teacher, caregiver, Chef, errand runner for my family while my husband still works out of the home. Plus working from home and now with doula support, being from home as well. It's gotten a little bit crazy. So one positive is that I have been able to actually take on primary clients again, whereas before, I stopped taking on primary clients about a year and a half ago and I was pregnant with my last child since the pandemic. I've actually been able to take on primary clients, which has been fantastic. But then realizing that that also comes with not just birth support, but prenatal visits as part of visits, other things to schedule in my day. And knowing that anyone can put a meeting on my calendar now at the drop of a hat also makes it a little more difficult to keep my schedule in line. Because you just have to go to a computer and log on now, you know, you don't have to go to a meeting anymore. So it's been it's been a work in progress for me and some of the other doulas that that I mentor because they're like, wow, I know I have more time at home. And I know I don't have to leave my house and do all that prep work. But now it's like, I'm just so busy all the time. So I think it is still important that work life balance to be able to schedule, I need to put my phone down, walk away from the computer, not look at it at all after this time and I've been doing that for I think pretty well for the past month. It's been great. Sometimes I get phone calls from clients or from, from colleagues after certain time at night that I'm happy to take but because I know I can very easily say, "Hey, you know, like, this is something we can talk about tomorrow. Let's schedule another time for that." It's been fun to do that, challenges, but still, there's light at the end of the tunnel every day, every day when I can walk away from my computer and my phone. Yeah.

Rachel, Doula :

It's been a little bit of a different circumstance for our family. We had a really rough year personally, not having to do with my career, prior to this pandemic, and we were starting to come out of it and regain our footing right about the time the pandemic hit. And we, my husband and I, had a talk about how we were going to communicate this to the children. We have kids ranging from six to 18. We've got four kids, and they're each sort of interpreting the world in this space in different ways, but we instead of calling it the pandemic or talking about the virus, which we figured out was frightening our kids, we started calling it the pause. And we started talking about how we've just sort of put a lot of life on pause right now. And in a way, it's been really great for the kids. I think there were a lot of social anxieties, particularly coming out of this last year for our family and what we've had to go through and process and this has been, in a lot of ways a great opportunity to sort of reassess what are our priorities with our day, what are our priorities in our home lifestyle. And so that's, you know, I think, in a lot of ways been a incredible silver lining. For us personally, it has made things a little more challenging in terms of connection with community in terms of, you know, working with working with clients, but also, you know, connecting with our friends and our family and these sort of things. And one of the things that I've noticed has been that where I used to get a series of text messages or a phone call from a client. Now I'm getting a request for a zoom meeting. And I'm finding that zoom meetings are sort of consuming our lives and that I'm spending, I now have 16 hour work days, which I never had before. And a lot of it is just our long zoom calls, that probably, in a lot of cases could be an email. So we're having to sort of reassess, you know, what our personal boundaries, what our professional boundaries, how are we connecting in meaningful ways that give us that sense of community building and that sense of personal connection and personal outreach, using all the technological tools that are available to us, but doing a little bit better job of picking and choosing which form of technology is right, for different interactions,

Maggie, RNC-OB :

the zoom, the video fatigue, all of that is definitely, obviously as we continue on, but this pause is definitely starting to, you know, wear on on all of us. Something that I was really fighting for, was not having as intense doula "visitor" restrictions, and so I would love to talk a little bit about that. I know you know, when, when all this hit, there's this whole idea that like we have to obviously try to limit as much as we can, the spread of the virus, flatten the curve, all of that. And you know, and part of that hospitals started doing all these visitor restrictions. And then slowly that morphed and quickly in some areas that morphed from like visitors to doulas being considered a visitor, and not being allowed, you know, to come with families into hospitals. As a nurse looking into the doula world that has been crushing for me to see kind of how that impacts our ways that we work together and really get to collaborate. And I think, you know, it hurts, it hurts our families to have less access to support and it's hard to have just that much more kind of isolation, thrust onto them during you know, pregnancy and birth. And so I would love for you all to just speak to that a little bit. We're all around the country...so what's happening in your community? Have you been pivoting or doing virtual? How are you making that work well for those in your care?

Cat, Doula :

so I think it's really exposed the the system to a lot of people, and I'm grateful for that because it's easy to kind of slip things under the rug and policies this way and that way and talk a lot about what could be happening. But if you don't see it people like that, well, it's not really there. Now that we're seeing "essential personnel" not be able to support clients, doulas not be able to support their clients in-person. It's all of a sudden expose the fact that we weren't that and considered that in many systems. And also it's really put, I believe my personal thoughts are that it's really put a huge barrier for doulas in general. Now that we're fighting to (and by fighting, I'm not saying like, you know, like with swords, running into places and knocking things down), that we're really fighting policy and regulation and trying to be seen as an equal part of the team. I don't know any doulas that have had a career where they have never been disrespected by hospital staff. I've definitely been at births where I've been part of the team. And it's been an awesome environment for the client. It's been an awesome working environment. And I've been respected by everybody in the room in my position as the as the support as the doula and then I walk into another room in the same hospital and it's a whole nother story. So it's not even hospital to hospital, it's person to person and if there is any, any wiggle room for people that don't believe that doulas were essential to the people giving birth, now they've found a card like they're holding it, they're like, "Well, you know, you couldn't come in during the pandemic. And weren't considered essential there. So I mean, right now, like you're just not.. you're basically just a service that can be provided and doesn't need to happen." And then I'm sitting over here, well, I mean, I havev my Master's in education, I've been doing this for a long time, I've had four births of my own where I've definitely needed support. And I have have had multiple women that I've supported in labor, and they know that they need me and I know that they need me. And it's a different support that you can give them, we can work together, but it also needs to be a respectful work environment for everybody to provide safety for the mother. So I think it's, it's exposed us. It's exposed our system and shown the inequalities that we have and the biases that a lot of people have about support and how it's supposed to look and given a lot of fuel to the fire for people that are not supportive of doulas before. So I think we're going to have a lot of work to do that we already had to do but now it's a lot more so I hate the doom and gloom of it all, but it's really I think a sad environment right now for supportive birth.

Rachel, Doula :

I agree with Cat on that scope into the fractured nature and nature of the healthcare system in this country, and this, I don't think we'd come as new news to anybody that's involved with health care. But the siloed nature of it has long been a problem for families, particularly for birthing families, has led to a lot of the disparities that we're seeing in outcomes. You know, one of the examples that I use when I'm talking to my clients is, you know, to explain to them, when they go in for an epidural, for example, they're going to be administered IV fluid as part of the administration of the epidural. Right, so the to go hand in hand. But there's the charting that shows how much IV fluid is administered as part of the epidural doesn't go to the baby's charts. So when the pediatrician is looking at the baby's weight loss, there's no Nexus that shows any relationship between elevated weight at birth from excessive IV fluid administered during the mother's labor, right? Those become two completely separate charts. And so we get pediatricians, we get lactation consultants that are very, very concerned about baby's weight loss. But there isn't anybody taking a retrospective look to the mother's labor and how much IV fluid might have been administered during that birthing process. And that siloed nature then creates a disparity where we've now got a baby that's losing close to 10% of its weight. And we're, you know, getting very concerned about weight loss and these sort of things. Maybe we're pushing formula, maybe we're looking at other interventions. And in a lot of cases, the the doula is the one person who's been on both sides of that equation and can sort of piece together the different parts of this puzzle to say, "Okay, well, here's how your prenatal experience was, here's what your labor experience was. And then here's what we're seeing in the postpartum period for birthing person and baby," and help to open channels of communication and help to foster that collaborative care among different providers. Right, the midwife or the obstetrician, the nursing staff, the lactation consultants, the pediatrician, and help the client ask targeted questions and get information so that they can make the best choices for their family as they're getting started. And now we've taken yet another piece of the puzzle out right, we've taken away that bridging support that's helping the families navigate the system and navigate this very siloed system where there isn't always as much communication among providers as we might prefer. In addition, we now are seeing under a pandemic that we're making a lot of fear based knee jerk reaction type decisions at a high administrative level, where there's a serious disconnect from what the actual sort of end user experiences of the birthing person in the family and, and then the baby after the birth. And these policies are going into place to protect the the hospital personnel to protect liability considerations to protect, well, you know, we've talked about availability of PPE, so there's a financial consideration, there's a resource consideration. There's a lot of considerations going into it. But the voice that isn't at the table is the voice of the people giving birth themselves. And alongside of that, the doula who helps to advocate for that voice as well. And without that voice in the conversation, we're losing a significant piece of communication about what the end user experience is and what the needs are. And here in the DC area, you know, as Cat was saying, different hospitals and sometimes different providers are responding differently or interpreting these policies differently. We have a hospital locally where the doula partner, mother, whoever, whoever this individual is, be one support person, but is allowed under current hospital policy isn't allowed in triage. So the laboring person is going into the hospital and having to make immediate decisions with no support, which is in violation of their patient rights, this state bill of rights for patients. But nevertheless, this is the hospital policy and the patients themselves don't have the tools to navigate it and certainly not in labor. You know, additionally, we're seeing at the same hospital support, people are not allowed into the OR. So in the event that a cesarean becomes necessary, that birthing person is again on their own, in what's often a very emotional, in addition to a very physical experience, these policies, I think, are being made for the protection of hospital staff and resources and financial considerations and all these things. But if we're making these decisions out of fear and out of immediate response to a crisis, without looking at the long term implications, without looking at the broader implications for the families that are experiencing these without looking at outcomes for the birth itself, but also for the postpartum period for these families, we're missing a significant piece of the puzzle. We did an informal study within our own clientele, since the pandemic started, we've seen a 100% increase in cesareans. Now, it's not the end of the world for someone to have a cesarean and and it's certainly life saving in many cases. But that stark an increase in so short a time. I think it's telling that these policies aren't protecting the individuals that ultimately are served by these institutions.

Maggie, RNC-OB :

For me in my area, when the pandemic started, I followed the pattern of the doulas out of Michigan. And I actually wrote a letter to my governor asking that doulas would still be considered part of the birthing team. Now, of course, my governor is busy so I did not receive a response but at least I like took that as an opportunity to try and reach out to him. But what I have realized is that a lot of the hospitals in my area, except for one, they are still considering doulas as part of that essential team member on the birthing team. So there are three pretty large hospitals here and two of them have that doulas are still permitted to be in the birthing room. Now there are some guidelines with that. But still they can still be there. So like after a baby's born doulas have to immediately they can't say postpartum at all, is like literally like 20 minutes and they're out. They do have to wear a mask. They do have to be screened before they can enter in. Me personally, I'm not attending any births in the hospital just as a personal choice. So I am letting clients and potential clients know that and I'm just offering just virtual doula support and they're still satisfied with having you there virtually instead of in person. Everything you all just touched on, I think there's there's definitely, you know, Chante there's huge discrepancies in terms of what we're seeing across the country. And I think it was, you know, been unfortunate is the how frequently policies change especially, you know, the first you know, month or so it seemed like literally every day something, you know, new is happening and things have seemed to, in some ways even out a little bit. But there is still just a lot of changes that have occurred. And there's not always great transparency about what's going on and who's making those decisions. I don't believe hospital administrators, obviously, they're not evil people. I don't think it's a malicious intent. But I do think that they are seeing one slice of the pie, and they don't have the context to understand how it is impacting everything else. And so certainly, I mean, you know, there's people who've been doing great in the letter writing campaigns and petitions to bring attention to, you know, all these different issues. And I think it's, you know, it's unfortunate, obviously, just because of the severe nature of what we've all been going through that it has been hard to get traction, necessarily on a lot of those issues because like you said, governors, they're very busy. They're dealing with a bajillion people coming at them who need you know, answers to their issue right then. And so it's been a little bit challenging to get, you know, responses necessarily on those kind of big levels. What I would love to see is that we were able to individually within our own communities, make better collaborative care decisions. I would love to see that doulas who have been you know, they're active in their community, they've been at these hospitals, the people who work at hospitals know them, right. Like I know, as a nurse, I know doulas who frequently come to our units, like we have relationships, you know, how can we all collectively come together to find situations that make sense for our area? Because again, there's going to be discrepancies and those are going to continue, you know, that we know that it's not, you know, there's not it's not necessarily reasonable if things are gonna be the same all the way across the board. But how can we come up with the things that mutually make us comfortable, you know, during this that everyone has one that everyone's voices at the table, you know, Your BIRTH Partners, our whole reason for starting was because we really want to see us breaking down the silos because all of these barriers to communication they don't benefit any of us. We all function best when we are working as a team, our clients or patients have better outcomes when they are fully supported by a diverse array of training and experience and they get the benefit of all that support. And so I feel like by removing doulas in so many places from like the hospital birth experience, you're taking away this huge chunk, that is something that we cannot replace or replicate, with the resources that we have, you know, in the hospital. You know, as a nurse, I can't always be there one on one with my patients because of the different clinical tasks I have to take care of and the patient load that day. Some hospitals have made it seem as if like, "Oh, well, that's okay. Because we can still like do a lot of things that doulas do here. And yes, I personally am comfortable helping, you know, people with comfort measures. I have done a lot of extra reading and education and trainings and have my own personal birth experiences that help to inform my ability to give care like that. However, that is not standard training for labor and delivery nurses. And so many of us are not ready and able to kind of step into that. I feel like it puts everyone at a disadvantage. It obviously primarily puts the client at a disadvantage because they're not getting the same access to care that they wanted that they need. And that we know is associated with better outcomes like research proven. Again, and again, we know we all support doulas, all of the major organizations from ACOG, and ACNM, and AWHONN. They all have stuff on their website talking about how great doulas are, because we know that and so I think it's that catch between the fact that we know this and like you said, right, we've been saying tools are essential, and they do all these great things. And so then, like, how do we get from where we've said that and we have the banners, and we're all supportive, and we're all pro doula and then how do we get from that to, like, actually living out that experience in care and putting kind of our actions where our words are? And so I you know, I just would welcome any, you know, kind of particular tips what you guys see do this better and move forward and I don't think it's, you know, it's one of the I think it's sometimes it's unfair because it's not as if like, "Oh, well, doulas, if you want to be like involved in birth, then you should just like, yeah, get involved, like, fix it." So I don't want it to come across that way. Because I think obviously, for everyone to be involved, we all have to be picking up, you know, doing the work to make it happen. We've certainly talked about the benefits, like virtual support that that's a bridge, you know, at this point that if and until hospitals are able to change policies, and have all of you know, the resources that they need to feel comfortable, and doulas are also comfortable entering the hospitals, because it's certainly, you know, give and take relationship there. You know, we can bridge with virtual doula support, and that does a lot, and that's great, but what can we do kind of as we continue to, you know, move past that and move forward?

Rachel, Doula :

Yeah, and I think there's a lot of options. I think that we actually are at a very interesting, pivotal moment in history where we have I mean, if we embrace this as this pause this opportunity to reconsider, reevaluate what our journey has been to this point, maybe where we are at this point now, looking at I mean, you know, we're we're starting to see some of the brokenness of the system in new and different ways. This gives us an opportunity to reevaluate and come forward in a more intentional way. Right? pick what it is that's meaningful to us. What are the preferred outcomes? What would we want the maternity healthcare landscape to look like? And then work towards that in a collaborative fashion. And as you've said, like a lot of these major organizations are in support of doulas. It's, it's not that the way forward has to be central to doulas but the doulas offer a voice that can help to build that collaborative care model, that it's not only the obstetrical teams making one set of decisions, and then the midwifery teams making another set of decisions and then the nursing team is making another set of decisions. There can be a collaborative conversation, and doulas just because of the nature of the work that we do can help to facilitate that conversation. We actually had a lovely conversation here in the area, and it hasn't gained as much traction as I had hoped. But I'm remaining optimistic about it, about using outpatient surgical centers for births because instead of bringing birthing people into a hospital and many of them have to walk through the ER to get up to the labor and labor and delivery units. Would it be safer to have them give birth in an outpatient surgical center where we could set up a maternal health care team? You know what I'm thinking, for example, my son had his adenoids removed earlier this year, and was in and out in two hours after general anesthesia. Right. So there there are anesthesia teams that can work in outpatient centers, there are surgical teams that can work in outpatient centers, we offer this for non obstetrical cases, right surgeries that are not maternal health focused. Is that something that we could build? And could we then promote services for lower risk families for whom home birth may not be an option? Right? Are there ways that we can promote safe home birth to hospital transfers, right so that people have the option to birth at home, but also can come into a hospital in a safe way without shame, without stigma, if the transfer is needed, right, all of these are conversations that that do this can help to facilitate because that's the space in which we've resided. Prior to the pandemic, we're familiar with this landscape we're used to providing that sort of communication and and open channels of options and exploration before a pandemic, and now during a pandemic. And I think the virtual support is one of those ways that we've shown that we as a collective community are eager and willing to pivot and participate in something new and different. My concern with promoting virtual support too heavily is that I don't want it to become the ultimate solution, where it is only a stopgap until we as a whole maternal health care community can come up with something that's better and protects the needs of everybody involved. So I think it's been, you know, one way that we've shown our willingness to to change and to grow and to try something new and different. But this is it's a bandaid it's not ultimately a solution or a long term response. There there are cases in which I think virtual doula support is wonderful. I think all of us on this call have provided virtual doula support prior to the pandemic, and certainly are happy to continue doing that during a pandemic, but there are families for whom that's simply not enough. And their voice needs to be honored as well.

Cat, Doula :

I think Rachel put it in a great way and it goes back to how this pandemic has exposed the system. And by exposing the system and now we have this like open wound that we can repair, which is really something if we're looking at it in a way" Okay, where are we going forward from this?" Now, we know that when...clearly if people are hiring doula still to provide virtual support, that is right there a sign that says people want doulas, right? They see the benefit. They know what the evidence says. They need other people there in the room to help that team atmosphere really shine for the person that is giving birth. So in that way now by exposing the system that we have lived in and all been a part of, for years and years and years and years, we can now repair it. And I think one of the best ways to do so is to start having conversations with each other. So I know that this is not a new concept, right? Like nothing, I tell Chante all the time, nothing is original at this point. Like we're not, we're not having to remake anything. What we are doing though, is we can now join committees, right? So we can say this new committee is going to figure out how policies are going to start being shaped and formed, given the fact that we have been living through and will likely continue in some sort of manner through this pandemic, right. So now we can have these policies and these committees that are talking inter professionally, we'll have you know, the OBs, and the midwives, and the RNs, and the doulas and everyone together maybe even a few parents from the community, about what is important to them so that we can start shaping the future of what this is going to look like. I think it's really important that all hospital staff when it comes to labor and delivery have some sort of idea what physiological labor looks like, and how it differs from a lot of the ways that routine care is provided. So going to and really making mandatory because the only way that you're going to get busy people that are stressed out of their own lives and work life balance is to make things mandatory. So make it mandatory, you know, a one hour session a lunch and learn type thing where they can learn virtually from a doula what she does with her clients, so that they can provide that sort of care that that our friends like you provide Maggie right so that have already reached out and done these professional developments that really highlight the different types of care that doulas provide versus what an RN can provide knowing the different barriers that an RN has an a doula has, right? So there's all these different, like smaller barriers within this large barrier here. So I think we take this exposure that we have had and that we've seen through the pandemic. And we can then repair layer by layer as we go to promote better policy as we start reliving in a time that things are changing. And if we go layer by layer, change layer by layer little by little so that the overall end result has less scar tissue and less scarring, then we would normally have if we were to just slap a bandaid on it and see how the body healed. So we do have a great opportunity right now. So my plea to like everyone listening, whoever this is, if you are a champion in your hospital and your hospital system, when it comes to breaking down these silos when it comes to really promoting in your professional development that you reach out to the people in your area. That are doing so or that you make yourself accessible so that they can reach out to you and start the committee. Right start this, start the conversation, start the discussion so that everyone has a voice. And that we come out of this in a much better light than even how we came into it.

Maggie, RNC-OB :

It is frustrating sometimes how hard it is to kind of get together and have spaces where we all are able to talk and have those respectful dialogues where it's not about sides, you know, it's not about us versus them. You know, one of the things I have picked up on in, you know, various communities that I've been in through this pandemic is that there is this just, there's this divide that it's like the hospital and the OB against, you know, the birthing family and the doulas and whoever else is out there in the community. And that just, you know, it just magnifies that feeling of separation and that feeling that we have to fight you know, against each other to preserve what it is that we find is most important. There are so many different really valuable perspectives. And we are not always all going to agree on everything. But I think the hope would be that as we move forward, we are inclusive of each other, you know, as a hospital staff like I think when we are coming up with taskforce when we are coming up with committees to address issues, we don't think necessarily about involving the people who are out there community. So we're not necessarily asking for, you know, birthing families or doulas to be on these committees with us just because that's not how the structure has typically been so it doesn't even come up, you know, come up with us. It's not really antagonistic, it's a lapse in you know, how we think about it. So Your BIRTH Partners, our mission is to improve perinatal healthcare by increasing collaboration and growing community amongst multidisciplinary teams of birth professionals, like that is what we want to do. We want to see ways that we come together. You know, you go to a restaurant, you are getting service from so many different people who are involved in your care. You have whoever you called me to maybe make a reservation, you have the hostess who helped seat you, the server who's going around and getting orders and bring you things you have, maybe you have a bartender making drinks, you have all of the people back in the kitchen, there's a bunch of them back there, sure there's the main chef, but there's people prepping, they're the people washing your dishes, there is the pastry chef, you have so many different of these layers of people who are all coming together to provide you with this one *great* experience. And following that analogy, you know, when you go out to eat, and you have a great experience, it's because all of those things went together, right? Like you're really well taken care of. You had great food, the drinks were good, the place was clean, everything meshed together into your own mind. So it's not about like just one individual part of that that stood out absolutely, that you have just an outstanding server or the food was just out of this world. But most of it, it's just the way that that all comes together. I want to see that happen in birth. It's not about one birth bro. People should try to make an impact on each other's lives, but it shouldn't be about remembering that like yes, it was the one nurse who made the difference, it was this amazing doula, I couldn't have been without her, it was my OB who saved my baby's life. Like, it shouldn't necessarily be about one individual provider, it should be about the feeling of "I had an amazing birth because I was surrounded by support that covered all of these different levels. I didn't have to fight because they were all on the same team. They were all working together to help me have this experience." I feel like we all do well, everything improves when we work together. And I feel like obviously, I say this probably like on every single podcast, and anytime I write anything for Your BIRTH Partners, but I just really would love for us to break down those barriers, get out of our silos, and just come at each other with arms and minds wide open to hear the other people's perspectives. Because I constantly learn new things from people when I actually just close my mouth and just listen to what people are saying because I have my one view from my lived experience, from my training, from what I've seen, but I'll have a really passionate conversation with a doula and then they'll say something I'll realize like "Oh, I was wrong. Okay, well, you know, learn something new...." And I'll go and talk to a doctor about something. And I realized, "Oh, I actually really wasn't thinking about that, you know, I'm not considering all the same things that they are." You know, I would like us to think of ways that each of us can reach out now to people in our community. So if you're out there listening right now, and you don't have a diverse community of birth professionals, let's start making some relationships. And we talked about earlier, everyone's pretty available right now, right? There's not quite as much claiming for people's time. So maybe now is the time a phone call, a zoom call with an OB physician and midwife in your community and just started talking about like, "Hey, I would really like to be more involved. I'd love to, you know, reach out, can we talk about ways to make this work." You know, if you are a hospital-based professional out there, you know, where are some of the doulas in your community or the lactation consultants, the body workers, the pelvic floor PTs, any of the other people who work out in the community to make this whole experience work. Can you reach out to them and find like, just get their contact information? Can you have referrals to give out to people when you see someone who has an issue, and you you aren't really trained to help solve it, you know? So how can we kind of start to build more of those bridges so that once we're all sorted, able to like come together in person, again, we can have really rich, meaningful, complete discussions that cover all of these issues instead of just continuing to kind of tuck into what's comfortable for us, because it is growth is hard. It hurts sometimes. And you know, healing doesn't come easily. But I, I just echo everything you all just said about how like, we can really take this. And you know, rise like the Phoenix, we can come out of this better, you know, than how we went into it. And really take stock in what has happened and how we can be more, more inclusive and really just make birth better. We want birth to go well, we want people to have great experiences, we love caring for people during birth, no matter what your role is, you know, as a birth professional. And now that I finished my soliloquy... thank you all so much for joining me on this panel. I really appreciate hearing about your experiences and you're dealing with this and you know, I hope all of our listeners will kind of tune in and let us know, you know what's happening in your community. How are you adapting? What are the things that you're doing that are just going great and are really helpful? And you know, the positives that come out of this? And what are the places that still need growth, where we still can kind of help brainstorm and come up with different ways to, you know, approach the issue. So I thank you all so much for joining us.

Cat, Doula :

Thanks, Maggie. Thanks, everybody.

Rachel, Doula :

Thank you so much.

Chante, Doula :

Thanks!

Margaret Runyon :

Thanks for tuning in. We love to talk birth, and we'd love to talk about it with you. Please join the conversation by finding us on Facebook, Instagram or Twitter. We're Your BIRTH Partners on all platforms. We welcome you to check out our show notes where we'll share more information about doulas and the role that they played during the pandemic. And we want to draw your particular attention to the virtual doula fund that we have set up in response to restrictions during COVID-19. Please go to yourbirthpartners.org/virtual doula. To learn more about how we're providing funds to help low income families gain access to virtual doula services during their pregnancy, birth and postpartum We appreciate your monetary donations, spreading the word, and all that you do as part of our community. Till next time! Transcribed by https://otter.ai