Today, the Doula Association of Alberta (DAA) met collaboratively with stakeholders from Alberta Health Services and the Alberta government to discuss site access for doulas at acute care sites across the province.
DAA shared impacts and inconsistencies of the current access policy, and how this is affecting birthing families both mentally and physically. Through evidence-based advocacy, the Association asserted that a more specific policy for doula access will positively impact Alberta families and healthcare practitioners: it will improve physiological birth outcomes, reduce birth dissatisfaction, reduce the incidence of both Caesarean sections and related hospital stays, and maximize patient care while reducing stress on other perinatal caregivers such as birth partners, nurses, midwives, and obstetricians. Real patient stories and outcomes were shared with the group to bring context to the statistical information.
While acknowledging the transmission risks of COVID-19, DAA also presented potential strategies to allow critical birth doula support while mitigating risks to hospital patients and acute care staff including conducting individualized patient needs assessments, requesting doula proof of training, and implementing additional Personal Protective Equipment (PPE) requirements.
Specific discussions of note as raised by AHS stakeholders:
* Why is virtual birth support insufficient?
[ The group was reminded that wifi and cellular connectivity in acute care sites, and most especially in rural locations, is not adequate for accessing continuous virtual birth support. Privacy issues were also raised as well as discomfort of clinical staff in having continuous video being used during birth. In addition, it was noted that virtual support negates any benefits to the birth partner in terms of sharing the caregiving load. ]
* What about the implications of social distancing?
[ Stakeholders were reminded that the positive statistical benefits of birthing with a doula are contingent upon hands-on physical support, and that in many cases, patients are already receiving direct physical support from their doula before arriving to the hospital. In the same way as other perinatal care providers - doctors, nurses, and midwives - are required to be in direct contact with a patient to perform their clinical duties, it is recommended that the same protocols would apply to doulas to achieve maximum benefit to the patient. ]
* What variability has been recorded between different sites and Zones?
[ A list of sites will be provided to the stakeholders group for review. Differing site and zone protocols were shared, calling attention to the fact that the current policy allows for a wide interpretation and enforcement by site administrators. ]
The discussion was well-received by all stakeholders, with recognition that DAA brought excellent, credible data to the conversation in the areas of patient impact and credible risk/benefit analysis.
The stakeholder group will reconvene before the end of May 2021 to further explore the current pandemic status, future policy revisions, and options to improve patient experience through in-person professional doula support at acute care sites in Alberta.