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The organization representing the province’s doulas says Nova Scotia Health’s decision to only allow one support person for those giving birth is unfair to families.

“The interesting thing is that the IWK is actually still allowing two support persons for birthing individuals, and most of the cases in the province are in the HRM area. But birth units in the rest of the province are limited to one support person,” Nova Scotia Doula Association (NSDA) chairperson Renée Curry said in an interview Thursday.

“What we are hoping is that the Nova Scotia Health Authority reconsiders their restrictions and allows at least two support people for birthing families in the rest of the province, as in, they follow suit with the IWK.”

In a May 4 statement, the NSDA urges Nova Scotia Health (NSH) to consider doulas “not as visitors, but as important members of the birth team,” noting that prior to the pandemic, doulas were considered an integral part of the care team for birthing families.

Curry described doulas as trained professionals who provide a range of support for families during birth, pregnancy, and postpartum. They provide their services as volunteers or are hired privately by families.

Nova Scotia Doula Association chairperson Renée Curry. Photo: Submitted

“Doulas are trained. We’re not just coming off the street to support families in labour. We do build relationships with these families,” she said.

“For us to be considered just just another support person is..I’m going to leave it there. It’s a little discouraging.”

Families have been reaching out and sharing their concerns with the NSDA. Curry said many are already experiencing significant pandemic stress, and the idea of not having their doula present during birth is distressing.

Curry said studies emerging from the first wave of the pandemic suggest depriving families of their support people has a negative impact on not only their birth experience, but their postpartum experience.

“The way that families feel in labour does translate into how they feel in early parenthood. We see higher rates of postpartum mental health issues and anxiety. Parents feel less confident,” Curry said.

“What can we do to prevent that, especially in the context of a pandemic where we know that you’re going to be deprived of more support after birth?”

Curry said doula support is all the more important because groups offering support are cancelled or only being offered virtually, and lockdown restrictions prevent support networks like close family and friends from visiting families at home after birth.

“So if we can give them the best start by providing support during labour and birth, then perhaps that’s a step in the right direction,” she said.

Besides supporting the person giving birth, Curry said doulas are there for the partner or other support person. She said the restriction — and the decision to recognize doulas as visitors and not members of the health care team — has left many pregnant people and their partners feeling anxious.

“Pandemic anxiety is running high for everyone, and not having somebody that they’ve built a relationship with there to have support in labour, when that is kind of kiboshed by policy, it can be very, very difficult for families,” Curry said.

“And so some of them are, well, for lack of a better term, really freaking out right now.”

Curry said doulas enter hospital settings respecting all COVID-19 protocols and are ready and willing to do whatever additional measures might be required.

“From the doulas that I’ve spoken to in the last few days about this, they’re ready to jump through hoops to be able to support their clients,” Curry said.

“Frankly, this is unfair for families and so this is why we’re being a little loud.”

The Halifax Examiner asked NSH about the reasoning behind limiting labouring people to one support person in birthing units. We also asked why doula support wasn’t considered an exception.

In an emailed statement, NSH said having loved ones present during hospitalization is important for patient care, experience, safety, and outcomes, and they know such restrictions are difficult for patients and families.

“Visitor restrictions are in place to protect patients, visitors, and health care workers by preventing the introduction and spread of COVID-19 at Nova Scotia Health facilities,” NSH spokesperson Carla Adams wrote.

“We have been taking a careful approach to restrictions, recognizing the importance of family presence, but having to balance that with what is required to continue delivering care that protects our patients and workforce.”

Adams said NSH is currently seeing a surge in the number of inpatients with COVID-19 and that requires a different response.

We need to take steps to minimize the chances of unknowingly introducing COVID-19 into our facilities as case numbers increase throughout the province. In addition to patient safety, reducing the number of people entering our facilities also reduces the risk of staff exposures, which could have an impact on service delivery.

While we have done our best to align them, visitor restrictions vary between Nova Scotia Health facilities and the IWK due to differences in space (i.e. availability of private rooms) and the volume of patients and visitors entering our facilities.

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Yvette d'Entremont

Yvette d’Entremont is a bilingual (English/French) journalist and editor, covering the COVID-19 pandemic and health issues. Twitter @ydentremont

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