What does your village look like in the age of social distancing and new hospital protocols?
NY-based childbirth educator and birth doula Hilary Baxendale says, “Babies keep coming! Moms need current, real time information and support now more than ever.”
Lucky for us, technology has stepped in to close the 6 foot gap. From telemedicine visits to Facetime chats, to Zoom appointments, maternal care providers have pivoted to provide virtual offerings for hopeful, expecting, and new moms. Hilary adds, “I love how the virtual space enables me to maintain some connection with my clients. They fill my cup up as much as I try to fill theirs up.”
So what can you expect from virtual care? We look at four of the most popular virtual offerings for expecting and new moms, the surprise benefits of going virtual, and why it may be here to stay.
A birth doula is like having a personal cheerleader leading up to and during labor. Typically, they offer in-person support during the birth attending in the hospital or at-home, but virtual support has proven to be a surprisingly great substitute.
Research shows that the mental and emotional support a doula provides to families is what makes them so intrinsic to good maternal health outcomes. And thanks to technology, they can continue to do all of that digitally through a series of Facetime or Zoom meetings, texts, and phone calls.
From discussing your birth preferences, to empowering you to ask the right questions at your prenatal appointments, to planning for the unexpected, your birth doula helps you sort through the noise of Google and all the baby books.
Touch, massage, and counterpressure are usually part of their toolkit for helping a laboring woman cope, but social distancing and new hospital limits on support persons make these tools inaccessible. Instead, through virtual support, they coach your partner on how best to support you before, during, and after labor. Birth doula and childbirth educator, Joyce Havinga adds, “Doulas are the extra set of eyes and ears during a birth that take in the whole experience. We can assess what’s happening from a bird’s eye view and anticipate the birthing mother’s (or partner’s) needs. While it’s harder to feel the atmosphere in the room through a screen, I find families feel tremendous relief knowing they have backup support when things get hectic, which inevitably, they do.”
Finally, doulas hold space for you, even virtually. They are there to listen to your anxieties as they bubble up, dispel your fears, and help ease you across the threshold into motherhood whether that’s through text, a phone call, or video chat. And once you have that sweet babe in your arms, they’ll be there to listen to your birth story, to work with you to process anything that didn’t go according to your preferences, and to celebrate your new entry into motherhood.
A childbirth educator is a certified teacher who teaches you and your partner about pregnancy, labor, birth, and parenthood. Hilary explains that “Childbirth education classes are not just the place to get real-time answers to pregnancy and birth questions, but the place to make a connection with an instructor that can become a valuable resource for you. This doesn’t change in the virtual space.” You still get all of the information and relevant handouts are sent via email. Compared to books or pre-recorded childbirth education classes, you get the value of the most up-to-date information regarding hospital protocols and guidelines, which is especially useful in times like a pandemic where things change daily.
While the random chit-chats between couples and the hands-on portions of the class are not possible in the digital space, there are unique benefits, regardless of whether there’s social distancing protocols in place. Hilary shares, “It’s a perfect option for those who desire a more personal approach than more generic hospital-based programs.” Virtual classes are also a wonderful way for those who want training in specific birth or laboring techniques but do not have access to classes locally. As a Spinning Babies® Certified Parent Educator, Joyce says, “I have the opportunity to reach even more people with a virtual class, and at their convenience.”
A pelvic floor specialist is often a physical therapist uniquely trained to address issues surrounding your pelvic floor, such as building strength and connection during conception and pregnancy and restrengthening and correcting muscles after. The need for pregnancy support, postpartum pelvic floor rehab, and treatment of incontinence and pelvic pain persist even in a pandemic, so virtual appointments can be a tremendous help for those in search of relief.
Women’s pelvic floor physical therapist Marina Castellanos, PT, acknowledges, “You lack the therapeutic touch and hands-on experience with a therapist, but the value of pelvic floor therapy is so much more than that. We use online appointments to perform objective assessments for posture, walking pattern, balance, mobility, and function to determine areas of need and a treatment plan.” Many of the strengthening and rehab exercises are performed at home anyway, so already being in your home environment can lower the barrier to practicing them regularly.
A lactation consultant or counselor helps new moms navigate breastfeeding or determine an alternative feeding plan best for mom and baby.
Board-certified lactation consultant Carrie Dean is a big fan of virtual lactation support. “It’s wonderful how much can be addressed virtually. My protocol is to start with a virtual consultation. Then, if something is happening that needs more hands on attention, we consider an in-person visitation.”
One of the biggest roles a lactation consultant or counselor plays is that of confidence-booster. Nursing is so personal with each baby—there are so many variables!—and the frustrations, anxiety, and stress that come with nursing obstacles can be emotionally crushing to a new mother. A virtual lactation consultant or counselor can encourage mom to tap into her natural instincts and give a few tips and tricks along the way.
Carrie argues that the need of and demand for virtual lactation appointments has sky-rocketed. “With new mothers leaving the hospital sooner (i.e. before their milk comes in), and babies waiting longer to be checked on by a pediatrician all scream for the urgent need for lactation care. It’s essential to give families the tools and resources to help mom develop the best feeding plan for her and baby, especially as baby’s nutrition is so critical in those early days.”
A few pieces ares more challenging to troubleshoot virtually, such as an oral tongue tie exam and accurate weight gain assessment (they often have special scales that measure milk transferred to the mL), but there are workarounds such as being coached through an oral assessment by the lactation specialist and renting a scale.
Future of Virtual Maternal Care
While these offerings initially seemed temporary, they may be here to stay. According to Hilary, there’s a comfort that comes with virtual classes. “You can learn on your couch in your pajamas, snack when you’re hungry, and my pregnant moms can take bathroom breaks with ease.”
Not only is virtual support more convenient, but they can also be more affordable. Without the need to travel, providers typically charge less for their virtual services. For doula support, the savings can be several hundred dollars.
Virtual appointments allow for increased accessibility to care for those who may have difficulty traveling either because of the need to secure childcare, because getting out of the house seems overwhelming for a new mom, or because of the lengthy distance between their underserved area and their provider. As Marina says, “Virtual options have allowed me to treat new moms who live hundreds of miles away in upstate NY who found me through social media.”
There are also benefits to maternal care providers, who welcome the added flexibility of providing care from anywhere and not having to worry about making stressful commutes, especially during rush hour. For doulas, this is especially true. Due to the unpredictability of birth and the need to be “on-call” for weeks at a time, many doulas have refrained from taking on more clients. The new virtual option allows for more flexibility and thus may increase the access to doula care for all.
Of course, virtual care is not immune to technological glitches and snafus. Carrie warns, “There are connection glitches, dropped phones, mystery sound problems. It’s a new face of care, and a work in progress. I encourage everyone to be flexible and go with the flow.”
Virtual offerings will continue to evolve and accommodate more maternal care needs. But no matter how much technology advances, some things, according to Carrie, are irreplaceable. “I miss the hugs! I miss the baby snuggles! And I miss being the actual, physical shoulder for mom to cry on.”
Carrie Dean, IBCLC, is an International Board-Certified Lactation Consultant from Larchmont, NY. Find her here on MyNestwell or on her website.
Joyce Havinga-Droop is a Certified Birth Doula, Spinning Babies® Certified Parent Educator, a Certified GentleBirth Instructor and Certified Lactation Counselor from Larchmont, NY. Find her here on MyNestwell or on her website.