Excitement. Joy. Fear. Anticipation.
People feel a range of emotions while preparing for the birth of a baby. While no two pregnant women are the same, there is one thing all share during this time: the need for support during pregnancy, birth, and the postpartum period while adjusting to a “new normal” with a baby at home.
As COVID-19 spreads through communities across the US and around the globe, health care providers have made reducing the risk of coronavirus exposure to pregnant women and their families a high priority. Consequently, many providers have made the difficult decision to limit the number of support persons who can be present during birth. This has compelled many doulas and community-based organizations to test ways to adapt what they have traditionally done in person to a new virtual world.
Communities participating in IHI’s Better Maternal Outcomes: Redesigning Systems with Black Women project are among those wrestling with these challenges. The aim of this Merck for Mothers-funded project is to reduce inequities in birth outcomes (maternal mortality and severe maternal morbidity) for Black women by ensuring equity, dignity, and safety.
Redesigning Systems participants have asked important questions about how best to adapt the physical and emotional support they typically offer pregnant women when they cannot meet face to face: What are the best ways to offer lactation support virtually? What will it look like to virtually support women during birth (e.g., via cell phone video calls)?
To ensure women have access to support in this time of physical distancing, community-based organizations are exploring ways to meet their needs using a variety of free video conferencing platforms:
- Center for Black Women’s Wellness/Atlanta Healthy Start Initiative (Atlanta, Georgia) — The Atlanta Healthy Start Initiative supports women before, during, and after pregnancy by addressing their health and social service needs, strengthening family resilience, and engaging community partners to enhance systems of care. Their Sista Circle meetings — started before the coronavirus outbreak — seek to engage, inform, and empower the women who join. The most recent gathering was held via video conference. Forty-one women joined, an increase in attendance from previous in-person meetings.
- Birthmark Doula Collective (New Orleans, Louisiana) — Birthmark Doula Collective has begun offering two new virtual support groups: one for pregnant and postpartum people to ask questions during the perinatal year, and another focused on mindfulness during the postpartum period. Birthmark launched these new groups in response to the many questions asked by pregnant people in their community who are unable to meet face to face with their doulas.
- DC Primary Care Association (Washington, DC) — The DC Primary Care Association is testing what they call “Virtual Mommy Meetups.” These meetings provide an opportunity for women to connect with one another, learn about and share resources, and support one another. Two women well-versed in doula care facilitate these meetups, sharing their experience and guidance. Women participating in the Virtual Mommy Meetups report that they enjoy the opportunity to connect with other moms with young babies and appreciate both receiving and giving peer support.
- Black Mother’s Breastfeeding Association (BMBFA) (Detroit, Michigan) — The Black Mother’s Breastfeeding Association provides virtual spaces for women to ask questions and receive breastfeeding support. Their goal is to uphold the mission of the BMBFA: To reduce racial inequities in breastfeeding support for African Americans families.
IHI will continue learning alongside these communities as they explore the growing field of telehealth during the COVID-19 pandemic. If your organization has identified successful strategies to provide virtual maternal health support, please email email@example.com to share your learning.
Shannon Welch, MPH, is an IHI Project Director.
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Recommendations for Designing High-Quality Telehealth
You Can’t Have Quality Without Equity
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