Official Statement: Doula Care During COVID-19 in Georgia

Dear Hospital Administrators and Providers,

Since 1974, Healthy Mothers, Healthy Babies Coalition of Georgia (HMHBGA) has been the strongest statewide voice for improved access to healthcare and health outcomes for Georgia’s mothers and babies. Our mission is to improve maternal and infant health through advocacy, education, and resource access. We understand that these are difficult times for our healthcare system with the onset of the COVID-19 pandemic, and want to ensure that pregnant and postpartum women experience the best possible care and outcomes during this time.

This crucial care includes the presence of their prenatal, birth, or postpartum doula. Doulas are trained professionals that offer a unique form of perinatal service by providing emotional and other support throughout labor to delivering mothers and their families. Research has shown that doulas have positive impact on a number of maternal and infant health indicators, including:

  • Lower rates of cesarean sections
  • Higher breastfeeding initiation
  • Lower rates of preterm birth and low birthweight delivery
  • Higher patient satisfaction of overall birth experience

The American College of Obstetricians and Gynecologists (ACOG) states that the continuous one-on-one support doulas provide is associated with improved labor outcomes[1]. In the midst of the pandemic, the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) recommend that doulas not be considered as visitors but as partners in the provision of care[2]. DONA International maintains the position that doulas should be allowed in the delivery room as crucial care team members[3].

While we understand hospitals’ need to adapt to meet the demands that COVID-19 brings, we also know that Georgia's maternal and infant health outcomes are alarmingly poor. Georgia ranks fourth highest in low birthweight delivery, fifth in prematurity, sixth in infant mortality, and worst in maternal mortality[4]. Stress and anxiety are significantly associated with these negative outcomes and are likely to increase during this difficult time of uncertainty and isolation.

To address these concerns, HMHBGA recommends that doulas are included as essential persons of a delivering woman’s care team.  As such, doulas should be excluded from the hospital visitor limitation policies. As long as symptoms are not present, it is important that doulas are allowed in the delivery room to support patients in addition to their allowed visitors. Doulas are a necessary resource especially during this time of stress and confusion that both families and providers are experiencing. Doulas can stay with families throughout the laboring process to keep them calm as many providers are being overwhelmed with increasing demand. 

For your patients who are interested in utilizing in-person or virtual doula support, please note that they may call our 1-800-300-9003 Georgia Family Healthline, Monday – Friday, 9AM – 5PM to receive doula referrals.

If we can provide any additional information to assist you in this difficult time regarding maternal and infant health care during COVID-19, please contact us at: thecoalition@hmhbga.org.

Sincerely,

Elise Blasingame, Executive Director


[1] https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/02/approaches-to-limit-intervention-during-labor-and-birth

[2] https://awhonn.org/novel-coronavirus-covid-19/

[3] https://www.dona.org/covid-19-and-doulas/

[4] https://hmhbga.org/wp-content/uploads/2019-HMHBGA-State-of-the-State-Report-FINAL.pdf

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