In a virtual format, almost everything a doula offers can still be provided:

• helping to find a comfortable position

• providing reminders about rest, nourishment, and hydration

• providing guidance, relaxation, and coping skills

• helping to answer questions

• helping to formulate questions for care providers

• guiding a partner through hands-on body work that cannot be provided from afar

Virtual Support During Pregnancy

Prior to the birth, you may want to make voice recording files and share them. Examples are guided relaxation, meditation and affirmations. While you certainly can direct them to apps and other sources for that, it may be helpful to start coaching them in an auditory way, creating that connection that you will be providing in advance of the birth.

Before labor:

• After choosing a format to use like Zoom or FaceTime, it's a good idea to walk your client through a session of doing it in advance of the actual Labor Day.

• If you are using Zoom, you might consider accumulating a collection of videos of positions and comfort measures that you would like partners to learn to do in advance.

• You may have to make some of these short videos yourself in advance. You may not want to wake your daughter at 2 a.m. so you can demonstrate the double hip squeeze!

• You can collect from online sources. During the course of labor these videos can be dropped into the chat box on Zoom.

• If your client plans to give birth at a hospital, remind them to find out if the hospital’s policies will allow you to provide continuous virtual support.

• When providing virtual labor support at a hospital, it is a good idea to check in advance on what the hospital’s Wi-Fi connection will be. Hopefully their own Wi-Fi will be good enough. Oftentimes, depending on the hospital's guest Wi-Fi, service is not effective.

• Be sure that you set realistic expectations with your clients in advance of them heading to the hospital. There is always potential for Wi-Fi to be ineffective in large buildings.

• Some institutions may not have good access with particular carriers.

Birth Bag:

Be sure to share ideas for your client’s birth bag. Items that you may carry in your doula bag may not be on their list of things to pack. Review items that you think they should take with them that you would normally bring yourself. For example, I usually have a fan for myself and the partner to use to cool the laboring person during the resting time between pushing contractions. The partner may not have something like that in their bag. While any piece of paper in the room could potentially be used as a fan, it is easier for you to say, "Now would be a good time to go get that fan you have in your birth bag.”

When Labor Begins

Depending on regulations in your area, you may be able to join your client in person during early labor. Begin what you can of rituals, rhythm, and relaxation at home, so that your client can continue following your guidance with these at the hospital.

Different doulas handle early labor support in varying ways. Many text in early labor. In the case of virtual support, consider establishing virtual contact early in labor, rather than by text. Allowing them to see and hear you early on in labor will help establish trust. They will begin to see that you are able to provide practical and appropriate suggestions. They will hear the calm in your voice or see the calm in your face. This can be helpful in avoiding heading to the birth location too early. Because of this early labor support, they will be more likely to actually continue to access your services when active labor begins.

Devices for Virtual Support

There are a variety of devices that birthing people can bring with them. Laptops, tablets, and smartphones are obvious options. Ideally, you want this to be a hands-free experience for them. The birthing person and their partner may want to bring a long cord for charging purposes, as well as an emergency battery pack. 

Laptop or Tablet

Pros of a laptop or tablet:

• can sit on a table or bed-stand

• your face will appear bigger to them

Cons of a laptop or tablet:

• must have a large enough surface to rest on; this is often the tray table in a hospital room

• support staff often move tables to do their work, resulting in you needing to have someone put you back in place

Smartphone

Pros of a smartphone:

• can be propped on a tripod in a variety of places in the room

• can be connected to a wireless/Bluetooth speaker

• can be attached on top of an IV pole, or even taped in place with a pop socket (with permission of hospital staff)

• can rest on top of the "pump box" of an IV pole (with permission of hospital staff)

• IV poles tend not to be moved as much as tables in a hospital room

Cons of a smartphone:

• may require the purchase of a tripod

• your face will be small

Protocols for having the virtual device in the labor room:

• As new staff members join the labor team, ask the birthing person’s partner to introduce you.

• Be sure that they put their device into "do not disturb mode". This will allow for an uninterrupted experience.

• Be prepared to have your device on mute, so they are not hearing background noises in your space.

• Be ready to "un-mute" it when you are providing verbal support.

• Remember that if the device you are shown on gets moved and you end up looking at the ceiling or something, they can still see you normally.

• Be aware of your resting face! Keep it calm and pleasant.

• As you speak, remember to look into the camera, not off to the side.

• Consider having lighting for your face.

• If the birthing family has two phones, you can always use the unused phone as a place to text the partner quietly.

• Remind partners not to plug into outlets with red outlet plates or unplug any devices in a hospital outlet.

• Be aware that at some hospitals, your device may have to be turned off during pushing times.

Used with permission and adapted from Connie Sultana, CD/BDT(DONA), ICCE, LCCE
Santa Rosa, CA
www.conniesultana.com