Is a Virtual Doula Even Worth It?

In February 2020, when I was 32 weeks pregnant, I suddenly became obsessed with the idea of hiring a doula for the upcoming birth of my first child. My husband and I had previously discussed it, but had never really wanted to spend extra money on the already-expensive endeavor of having a child. But then, as I was nearing the finish line, I realized that I didn’t want to do this without a doula. Little did I know that the COVID-19 pandemic would hit a month later and I would be forced to change all of my plans. Again.

Hiring a doula can be a wonderful choice for many families. But in 2020 and into 2021, with many hospitals limiting how many people can be in the delivery room (from just one support partner like I ultimately had, to two if you’re lucky, to none during the height of the pandemic in certain highly affected areas), doulas and their clients are now turning to the only option they have: Virtual support. But is a virtual doula really able to provide the same level of support? And is, well, the cost of a virtual doula even worth it when they can’t physically be in the room with you? I talked to my own doula — who supported me and my husband virtually for the March 30th birth of our son — and doulas across the country to get their take on what their jobs look like today.

The sudden pivot to virtual doula support

“A doula is a trained professional who provides continuous physical, emotional, and informational support to a person before, during, and shortly after childbirth to protect their memory of childbirth through helping them achieve the healthiest, most satisfying experience possible,” Amy L. Kucharski, CD(DONA), HCHD, a doula based in southwest Florida (and my doula) tells SheKnows. When the pandemic hit, she was not familiar with the business model of virtual labor support, but says that it “authentically made perfect sense” to her. “It never crossed my mind that I would stop supporting you — my immediate thought was to move into virtual support,” she says. “I was just not sure what that would look like, as I had not yet professionally and virtually supported someone through labor. “

For many women, and doulas alike, virtual support was a huge pivot into how they imagined the labor and birth process going. However, all of the doulas I spoke with talked about the flexibility needed in their jobs and how, at the end of the day, they are there to support the laboring person and their partner — and none of that had to change due to the pandemic. But some new decisions did have to be made.

“When the pandemic hit, I had three clients due within the first month,” Talitha Phillips, LD, PPD, and CEO of Claris Health in Los Angeles, tells SheKnows. “It was a really tough few weeks, especially for them, as they had to reimagine their upcoming births.” While one of the clients chose to have a home birth, the other two continued with their hospital deliveries. After helping the women labor at home, she escorted the families to the hospital — but then had to say goodbye once they walked through the doors. “Those were really tough situations. It was very emotional for all to say goodbye. Thankfully, both were very far along when they arrived and were able to stay in touch with me via phone or FaceTime for additional guidance and encouragement.”

However, Phillips admits that, during the height of the pandemic, many people were simply not seeking her services. “I provided some online support for birth classes and labor support and continued to be present for at-home early labor support or home births,” she says. “However, many families were forced to simply plan for a birth without on-site doula help.”

What virtual doula support looks like

For the doulas that were already offering virtual doula support, the pivot to a virtual-only model necessitated figuring out extra measures. “Once I knew hospitals weren’t permitting doulas in, I had to really educate partners on how to do comfort measures and advocacy techniques,” Chanté Perryman, a professionally certified birth and postpartum doula, certified childbirth educator, and Evidence Based Birth Instructor based in Lexington, Kentucky, explains to SheKnows. “The one adjustment I made was offering weekly check-ins with couples starting at 35/36 weeks pregnant to make sure they understood how to do the hands-on comfort measures without me physically being present. I actually had more clients reach out for support because I already knew how to offer doula services virtually. It wasn’t a new thing for me.”

Carrie Murphy, a full-spectrum doula based in New Orleans, tells SheKnows that one of the big advantages of virtual doula support is that she can now “doula anyone, anywhere!” After moving cross-country in 2019, she didn’t have a big doula practice in her new city yet so she started offering online doula services a year ago. The pandemic has allowed her to continue this work even as hospitals in her area are beginning to allow a second birth partner.

“I offer a range of virtual services,” she says. “From full packages that are similar to what I’d offer for in-person support, to one-off sessions where people can book me to talk about specific topics, like birth planning or coping with changes in pregnancy — kind of a doula AMA, if you will. All of my services are sliding scale. I offer add-on support for labor, too, which can include being available over phone and text for questions or actually being on FaceTime or Zoom during the birth.”

This kind of support can, in some ways, actually include more pre-labor conversations with your doula since they are virtually available to answer questions almost anytime. Since Perryman has offered virtual doula services for a few years now, she explains: “The offerings I have is that couples can contact me at any time once I am hired. I create a personal Zoom link just for them and they know I am only a phone call, text, or Zoom away. Virtual support, in my opinion, is a little easier because clients can reach me at any time and I don’t have to travel to be with them. We cover so much in our prenatal and weekly check-ins that the support person is already educated on how to do many of the techniques I would do if I was there in person. They may not know when to do them, but when I say ‘do some double hip squeezes,’ they automatically know how and I am not having to teach it during labor.“

My own virtual doula experience

My own virtual doula experience involved many supportive text conversations with my doula in the last weeks leading up to my labor and birth (during the first few weeks of the pandemic). My doula helped me to make peace with the fact that I was likely going to change my birth plan last-minute — from laboring without pain medication to likely opting for an epidural because I just didn’t think I could handle both the stress of labor and a pandemic at the same time. (I did, ultimately, get that epidural.)

She also was on-call when my labor started, and I distinctly remember her guiding me on how to count my contractions to see if they were close enough to go to the hospital. She told me to slow down and, for the next hour, focus on nothing else. My husband was in charge of packing up the car, making sure the house was ready… while I sat on my birthing ball and breathed through every painful wave that hit me, whisper-screaming a few choice curse words along the way. Without her guidance, I wouldn’t have thought to stop focusing on everything else and just focus on my body because, as it turns out, I was indeed ready to go to the hospital. Then, throughout labor, she continued to text with my husband, Adam, offering him advice and guidance on how to support me — including a couple of instances where he directed a nurse to help me turn to my other side after my epidural was in place.

“It was helpful to be able to talk to someone who has been through this,” he says. “I thought for sure I was going to pass out,” he laughs, “and I told her that. She said I would probably be fine, but to get a chair just in case.”

“My very first time giving virtual doula support during labor (for you) was a really peaceful experience on my end,” says Kucharski, “though I had some real ‘mother-hen ’moments where I was just concerned. However, meaningful support is not always hands-on or face-to-face support. I had to remind myself of this while you were in labor during long pauses of no communication. Physical distance doesn’t negate what a doula can do, and it was in the feedback from Adam that I realized that with the right birth partner plan, proper labor rehearsal, and positive reinforcement, virtual labor support can be effective.” I have to add: Having her guide us on labor rehearsal and provide positive reinforcement was a very fulfilling experience during the birth of my son.

The advantages

A lot of things have changed due to the pandemic, and having on-hand support from a doula during labor and delivery is definitely one of them — but that doesn’t mean that the support you can get has to be a lesser experience. In some ways, it can actually provide you with greater support, says Perryman. “Clients have a doula in their pocket, literally. The support person really gets to shine as the helper!”

During the early months of the pandemic, Perryman put together a video for other doulas on How to Offer Virtual Doula Support with the basics of using technology, educating clients in advance, and understanding how to still be a great support while not being physically present.

“I shared with them that even as doulas, our greatest asset is our hands, hearts, eyes, ears and comforting words,” she says. “All of these things we can still do virtually except the partner has to be the hands. With offering virtual support, they have to over-teach almost because our clients aren’t specialists in birth like we are. We can know the sound of an active labor moan better than anyone else. Parents are staying home longer during labor due to the pandemic. Doulas have to be just as connected to the clients and birth even if it is virtual.”

The disadvantages

Phillips, who has mostly switched back to in-person doula services, says that doing virtual support has allowed her to help women in other parts of the country by teaching a virtual birth class or being available during their labor and delivery. However, she does acknowledge that there are many disadvantages as well.

“During labor, I’m often massaging a woman’s back, helping her move into different labor positions, applying oils, making snacks, helping her hydrate, paying attention to contractions, and a good time to go to the hospital, and creating an environment that is soothing to her needs,” she says. “Those simple yet important acts are very tough to recreate virtually. There is important chemistry and trust that is built in-person so she feels fully secure and comfortable.”

The other doulas also agree that there are disadvantages to this type of support. “In a way, people have a much more wide variety of choices for doulas, which is great,” says Murphy, who is launching a birth-related online course in November. “But, we are humans — I think real, in-person connection and touch remains and will continue to be important in doula work. Laboring people don’t stop needing hip squeezes, massage, and a doula’s in-person ability to read the room’s energy because there’s now a virus around. I think there is a ton lost in virtual support during labor — eye contact, energy, body language, and more. And even the ability to meet someone in person before labor, enter their home, notice a piece of art or something, get into a conversation about something you have in common, feel more bonded — there’s so many interpersonal things that can happen in-person to deepen a relationship, including trust and respect, you know?”

Is a virtual doula for you?

If you are not one of the lucky women who lives in an area where the local hospitals have started to allow a secondary support person inside, or that option shuts down again as we enter a third peak of the pandemic in the U.S., then virtual doula support may be your only option. But that doesn’t necessarily mean that it’s a bad option.

“There will always be an element of virtual support,” says Kucharski. “I regularly receive questions via text messages, from current and past clients, around the clock. Virtually, doulas can be ‘on demand’ — with you — always.” However, she does admit that touch is powerful and it’s difficult to replicate that “special kind of support” through a laptop of cellphone. “But whether we are supporting in person or virtually, we will be supporting with an effort to reduce fear.” Reducing the fear and anxiety of labor and delivery — at least for my family — turned out to be essential.

Perryman, who has seen an increase in interest for doula services, especially for first time couples, says that not a lot has changed since “the birthing person wants to know the what and how’s of labor and the support person wants to know the ‘when do I do and how do I do’s’ of labor.”

For Phillips, she has actually seen an increase in postpartum doula services and a decrease in labor services. “I’ve had nonstop postpartum clients since the pandemic,” she says. “Since many family members were unable to travel, they wanted to make sure someone was available to help the new mom and family.”

Out of the doulas I talked to, Perryman was the only one who seemed optimistic about postpartum virtual doula support — which she says involves being in contact and her “asking them how they are adjusting, how breastfeeding or bottle feeding is going, how much are they eating, drinking and resting. With postpartum virtual support, it is more checking on their well being and emotional state.”

At the end of the day, the decision to hire a doula virtually is an extremely personally one, just as it would be pre-pandemic. “I think that having some support — such as virtual — is better than none,” says Murphy. “People are creative and resilient, and both doulas and the families we serve will adapt to make the best of this situation. Some people may really enjoy having a doula’s guidance before and after birth, and may want to keep the actual labor and birth private.” Phillips agrees, adding that “it’s especially important to have someone on your labor team that is neutral, experienced in labor and delivery, and that can provide the necessary attention to your needs.”

If you decide to hire a virtual doula, Perryman recommends finding someone local who is “familiar with the birth environment and hospitals in the community.” Although being virtual gives you the advantage of hiring anyone across the country, a local doula “can still give you insider information about providers, the best nurses to request, when to start heading over to the hospital, etc.” For me, this turned out to be especially true since my southwest Florida doula (Kucharski) was able to connect me to a virtual support group for local moms and has provided other insights into the parenting and child-rearing support communities nearby.

At the end of the day, a virtual doula can provide invaluable support for parents who need a little (or a lot) of help. When I was struggling with feelings of overwhelm and burnout shortly after my son turned 5 months old, texting with my doula really helped me to understand and process my feelings.

“I think personalized, dedicated support during the intense transitions of pregnancy, birth, and postpartum are always going to be valuable and needed, no matter how the support is delivered,” says Murphy. “During COVID, pregnant people and new parents are feeling even more isolated — unable to attend in-person classes or new parent groups, which can be so lovely to feel in community with others — so any way that people can feel seen, heard, and supported right now is great. So I highly encourage new parents to find what support you can, whether it’s a doula who checks in over text or a Zoom breastfeeding group. It’s completely fine and healthy to grieve for the experience you were hoping for. It’s also ok to let in the possibilities inherent in the one COVID is giving you — flexibility, resilience, and more.”

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