Could Virtual Doulas Help The Maternal Health Crisis?

We are going in the wrong direction—that is, regarding maternal mortality rates, because the numbers of 2023 showed a terrible trend. Maternal deaths in the US have more than doubled over the past twenty years, with certain states and races affected more than others. It’s not the kind of chart we want to top, but we are the leaders in maternal deaths during and after childbirth in developed countries. So, health care professionals and advocates are looking for both causes, and answers, to save future mothers and babies.

A recent study from Maven Clinic showed that virtual doulas have promise in this fight. They found that they lowered the cesarean section rate by 20%, and neonatal ICU visits by 28%, as well as a 31% reduction in unnecessary ER visits.

Melissa Dennis, MD, an OB-GYN with Partum Health, says that working with a doula should not be limited to the privileged. “As health care deserts become more common, virtual doula care makes working with a birth doula more accessible to a larger population,” she said. The goal of working with a doula is for patients to feel more educated about what’s to come, and therefore empowered to communicate questions and concerns to their care team, she added. “Doulas also provide ways to safely help patients achieve their own birth goals.”

But there are some barriers to ensuring that all doulas are properly trained and follow similar protocols across companies and geographical locations. “Because virtual doula care is new, there is not yet a standard practice that all doulas follow,” added Dr. Dennis.

Here’s what to expect from a virtual doula: “During pregnancy, a virtual doula can have prenatal sessions with a family over the phone, Zoom or FaceTime, where the family can talk their birthing goals and concerns, and can provide education,” she said. “Birth preferences can be checked and handouts can be shared electronically. The support that a virtual doula provides in labor may consist of texting, phone calls, video chats, video recordings, and referring to previously shared educational materials.

The idea that these doulas being just a text away could reduce actual maternal and newborn outcomes has limited research, but the “benefits look promising,” added Dr. Dennis. So far, he says research has shown the following benefits:

  • Decreased C-section delivery rate
  • NICU admissions for the baby decreased
  • Increased vaginal birth rates after cesarean delivery (VBAC).
  • Improved APGAR scores for the baby
  • Improved birth experience

Maven’s study showed that for those who met with a virtual doula more than once, the rate of C-section reduction was greater—at least 60% reduced odds, Maven reports. “If this result can be replicated, it would be an incredible step forward for patients who have historically had the poorest obstetric outcomes,” he added. In fact, 80% of maternal deaths are preventable with proper care, the Centers for Disease Control and Prevention report.

“I was not surprised to find that working with a virtual birth doula has a positive impact. Much of working with a birth doula is centered around education, support, empowerment, and advocacy. Individuals who work with a birth doula, both in person and or nearly so, enter their birthing location with a skill set and comfort level that exceeds those who do not work with a birth doula,” concluded Dr. Dennis.

Ready to consider a virtual doula?

Here’s how to find one that’s best for you, according to Dr. Dennis:

  • “When looking for a virtual birth doula, it’s important to keep a few things in mind: How well do I communicate with this individual, do they understand my wishes, and does their offering provide the support I need?”
  • “If giving birth with a partner, these questions will be a “we” instead of an “I” because a doula interacts with partners quite a bit, especially when the birth partner is in labor and the support partner needs guidance on how best to help.”
  • “Since there is no standard for virtual doula care, it is important to clarify how many prenatal visits will occur, what they will consist of, what type of education will be provided for the next referral, and what, if if any, support will be provided. during labor.”

There are many platforms that offer virtual doula services, such as MajorCarebut you can also ask your local doulas, midwives, OBGYNs, and other moms who they recommend.

Dr. expects Dennis that women who will give birth in the future will not see it as a luxury, but the common experience.

“I believe that having access to a doula, whether in person or virtually, should be the standard of care for birthing individuals. Virtual doula care is very exciting because it offers access to people who would otherwise have to go without. I see this as an important tool to help improve birth outcomes and equity.”

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