In our new series What It’s Like, we speak with people from a wide range of backgrounds about how their lives have changed as a result of the COVID-19 pandemic. For our latest installment, I spoke with Chanel Porchia-Albert, a doula and birth educator in Brooklyn and founder of Ancient Song Doula Services, about how the pandemic is affecting her organization’s work and clients.
Porchia-Albert founded Ancient Song Doula Services in 2008, and the New York City-based organization currently offers full-spectrum doula services, educational classes, doula training programs, and also puts on an annual conference, she explains. (Full-spectrum doula services involve care before, during, and after the birth, including in situations involving loss, such as miscarriage or stillbirth.) Porchia-Albert is also deeply involved in advocacy work around racial disparities in maternal mortality rates. Last year, Ancient Song’s doulas attended roughly 470 births, Porchia-Albert says.
As the COVID-19 pandemic continues, guidelines for how providers address pregnancy and birth are changing. The Centers for Disease Control and Prevention (CDC) has recommendations for how providers should treat pregnant people confirmed or suspected to have the virus, but practices vary between hospitals for otherwise healthy folks. People report that having a baby in a pandemic can be an isolating, confusing, terrifying experience—especially as many hospitals have taken the protective measures of banning visitors and restricting the number of birthing partners permitted during labor. Here’s how Porchia-Albert and other Ancient Song doulas are trying to make the birthing experience as safe and joyful as possible in this surreal new reality. (Her answers have been edited and condensed for clarity.)
SELF: When did you first start seeing the pandemic affect your clients and community?
C.P.-A.: The first thing we started to hear was that some hospitals had implemented a one-person policy, where only one person was allowed in to attend a birth, and some hospitals were not allowing anyone in at all. [Editor’s note: After some New York hospitals instituted this policy, Governor Andrew Cuomo issued an executive order mandating that all public and private New York hospitals had to let people giving birth bring one support partner into the labor and delivery room.]
We immediately switched over to be able to provide virtual doula services, offered to all of our clients. Virtual services also address the fact that we want to ensure the safety and wellbeing of the doulas when hospitals have personal protective equipment (PPE) shortages.
What do virtual doula services look like?
People have apprehension because our primary focus is offering connection. They think you can’t have that with virtual services, but you can. That doula is still on call. They are there 24 hours a day.
Because some of our clients may not have access to smartphones, we work via phone, text message, Zoom, FaceTime, as well as WhatsApp. We offer guidance and reassurance on what to expect and how to prepare. A lot of it is connecting clients to health resources and having conversations about the policies that are happening currently that could affect folks who are birthing, then adapting to those protocols.
We don’t abandon clients. We offer reassurance. We want to ease fears and provide information, and keep updating that information because it keeps changing.
Can you tell me a bit more about how the pandemic is affecting black parents, and other parents of color, who were already concerned about high maternal mortality rates in the lead-up to birth?
We work with anyone, but our demographic is primarily women of color, low-income individuals, Medicaid recipients, those who are undocumented, and those who may have child protective services cases.
We’ve been trying to address the fears and anxiety. Black maternal mortality is a real thing people were dealing with before, as well as the structural realities of how black people are treated within the health system. How does that become compounded when you have a health care crisis? To prepare folks for what to expect when they go into these settings, we’ve set up different tools where we offer webinars and information around what it means to center your human rights during this time. We provide resources so they can make informed decisions about their care without adding to their anxieties.
People are afraid. They are going to go into these institutions and worry that they or their child is going to come into harm’s way. We can lessen those fears by creating those platforms.
Have you had clients go into labor during the pandemic? How has that process gone with the virtual doula services?
About 15 clients so far have given birth during this period. One was at a birthing center, which was still allowing in a doula, and the rest were at hospitals where doulas couldn’t attend. It looks different every time. Sometimes the labor is really smooth and there are no problems—you’re still able to provide evidence-based information and answer questions. But in the event that there’s a connection issue, or maybe the support person that they have with them feels overwhelmed, they still have these tools from earlier preparation.
We also work with family members and/or partners, telling them, “I’m going to try to impart on you the best way to support your partner, your loved one, so they can get what they need during that time.” We’re trying to give them a crash course.
Have you seen any difference in the number of people interested in home birth?
There’s been an influx of people inquiring about home births, more than usual. People are not wanting to go to the hospital or try to find ways to get into a birthing center. But we’ve had to explain to them that there aren’t enough home birth midwives in all of New York City to have the bandwidth to be able to support everybody.
Then we talk about, what does it mean for you to labor at home for as long as possible to reduce your risk of exposure and being in the hospital for too long? Can we understand what the protocols are in terms of discharge time? Can we reduce the time spent in the hospital? We are really trying to support people where they are and make sure we are available to provide as many resources as possible.
Has there been any change in the number of prospective clients making inquiries to you for the first time?
I would say it’s gone up because we are now getting people messaging us on Instagram, which is not a normal occurrence. We’ve been posting a lot of general information for everyone, even if you’re not our client, to be able to access: a baseline of what to expect and how to prepare for birth, prenatal, or postpartum services.
What’s happening with your doula training program? I also saw on Instagram that you’re offering training services for nurses. Can we talk a little bit about that?
We’re still offering doula training. I have a couple coming up. They are all virtual now, which is interesting, trying to get the tone and vibration.
I also created a full-spectrum doula training program specifically for nurses because nurses started to reach out to me and ask, “Is there any way you can help us and let us know how to support these patients when they don’t have their support person?” In the first session, I was able to teach around 30 nurses from NYC and out of state.
The training for nurses is a crash course, not a full comprehensive training, which is usually several weeks long. We’re trying to get the information out to them as quickly as possible. Topics include centering emotional and physical support, understanding a human rights framework, and centering people’s bodily autonomy. Understanding how certain communities, particularly communities of color, particularly black women, already were stressed and concerned about the maternal mortality rate, now on top of that are concerned about a pandemic and possibly being sick or their newborn being sick. So, what does that mean, to really support someone in a way that amplifies their human rights during birth?
We talk about managing stress and triggers. Then there’s understanding how racial bias shows up, and things like how people on public insurance versus private insurance are treated differently.
We also discuss understanding and supporting unintended birth outcomes like a stillbirth, a miscarriage, or a traumatic birth event. And understanding that how a client identifies something as traumatic is not the same thing as how a provider would look at it—a healthy mother and healthy baby does not necessarily mean everything’s all right. All of this is pulled from a position of trauma-informed care. We want clients to feel like, “These people have my best interests at heart.”
Also, nurses and other providers are experiencing trauma, too, and we want to talk about that. What does it mean to provide care during this time in a way that centers you? How can you show up and be your best self when you see so many different things happening at one time? That weighs on a person, on your body, on your emotional and physical state.
How are you preparing clients to go into a hospital for birth at this time? What advice would you offer to anyone right now who is anxious about pregnancy and birthing?
We’re preparing clients for what their prenatal appointments may look like and prompting them to ask questions about how social distancing practices may affect their prenatal care.
We are also being really transparent about what the current situation looks like in hospitals. Policies vary from hospital to hospital, and it’s constantly changing. It’s really important to call your provider, call the hospital, or go to the website to see if anything has changed in the past 24 hours before getting there to give birth.
Understand that when you do get there, it’s not going to be a normal scenario. What you may encounter may be very scary and nerve-racking. You may have to submit to temperature checks, they’ll ask you a series of questions, and you might have to wear masks the whole time. It’s just a different feeling. We want people to prepare emotionally for what they and their support people will experience when they get there. Understanding the protocols can help you feel reassured.
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