COVID-19 Official Response to Hospital Systems Restriction of Doula Care

Official Press Release: November 16, 2020

Dear Twin Cities Hospital System Representatives,

First, we want to thank you for your efforts to continue to allow doulas a presence in your hospital system. While we understand the complexity and severity of our rising COVID-19 numbers in the State of Minnesota we believe that doulas are an essential part of the birth team and that families should be entitled to a doula of their choosing. Recently several hospital systems announced their doula restrictions saying that laboring people are only allowed one visitor or labor support person. This is in direct conflict with their rights. Furthermore, we have been made aware of a hospital system (Allina) that has decided to make the ‘doula restriction’ further restrict people’s access to a doula of their choosing by requiring that doulas register with the hospital AND be certified.

It would be historically appropriate for a medical system to enforce certification for medical personnel who are present in their hospital, however doulas, by definition, are NOT medical providers of any kind and are not employed by or managed by the hospital. We are paraprofessionals and are regulated not by certification but by the families who wish to hire us as their support. There is common misinformation and misunderstanding around what a Professional Doula is and how they are trained and certified. We believe that Professional Doula is the most appropriate description fordoulas who should be welcomed by hospitals to support laboring families.

We define Professional Doulas as labor support people who have attended doula training and work as birth support astheir profession. This may mean they have a website, a business name, are part of a doula organization and/or get paid to attend births. A hospital restricting their patient’s access to professional birth support to ONLY certified doulas are enacting a policy that is inequitable, harmful, and illegal. The path to doula certification and maintaining certification is full of financial and logistical barriers that restricts BIPOC doulas and marginalized individuals from obtaining and holding
certification.

The certifying agencies that Allina is using as their list of ‘allowed’ organizations is dated and not exhaustive while also limited to only organizations that offer in person training historically, which at this time is not viable. This list is only used by the Minnesota Dept of Health for reimbursement to doulas who provide services to Medicaid patients and is a fraction of the total number of active working doulas in the Twin Cities. The list of certifying organizations also excludes the majority of BIPOC run and owned doula training organizations. Research shows that the support of a culturally congruent doula has significant impact on improving outcomes in maternal and infant mortality and morbidity especially for Black birthing people. Often doulas from marginalized groups are trained by organizations that are not in the provided “acceptable doula certification list.” Thus, this policy would negatively impact the very Black and Brown bodies research shows are at risk for racial disparities and much poorer outcomes in pregnancy and birth.

Although we are unsure how regulating certifying vs professional doulas is solving the issue of COVID-19 exposure, it is the stance of the Twin Cities Professional Doulas that if hospitals are trying to regulate birth support that they can simply state that all patients in labor and delivery can have one personal labor support plus a Professional Doula. If they are interested in vetting whether someone is a Professional Doula, they can ask to see proof of training. This would also have the added benefit of reducing extra work for hospital staff and remain racially and socio-economically equitable.

Finally, at a time where we are experiencing a historically large amount of unemployed people it is especially harmful to further restrict people’s ability to make an income in their profession. The majority of a Professional Doula’s clients are hospital birthing people, therefore when Allina and other hospitals restrict families’ access to Professional Doulas, they are also restricting people’s ability to make a livable income for themselves and their families.

We are open and available to be part of the policy wording and problem solving. Our goal is and always will be in promoting optimal outcomes for laboring people and their babies, which is undeniable with the support of a Professional Doula.

Sincerely,
Twin Cities Professional Doula Community

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Current Doula Status of Twin Cities Hospitals during Covid-19