This is a guest post, written by Jada Shapiro, founder of boober.

While virtual doulas have operated for many years, the appearance of the novel coronavirus has transformed this once largely in-person role into a remote and critical one.

I am the founder of boober, a platform that connects expectant parents and new families to maternal care providers, like birth doulas, lactation consultants, postpartum doulas, and mental health therapists. Until March 2020, we were known for matching clients with expert care providers for in-person visits. I have always maintained that there is a time and place for virtual care, but there are certain aspects of support that can only happen in the same place. The time and place for virtual care has come. The pandemic has plunged us into unparalleled times and we all had to adapt. For us, that means providing the best support possible under current circumstances, matching parents to virtual care providers, so that we can meet people where they are right now: isolated, in need of support, and unequivocally at risk from in-person care. Our experience has shown that virtual doulas can be a tremendous help to new families during and after birth.

As hospitals work hard to reduce the possibility of transmission, extra people, including doulas in some cases, are currently not allowed in several hospitals around the US to support laboring people. Even when they are permitted to join, the risk of contagion (bringing the virus to the hospital unknowingly or bringing it home) has led many providers to choose not to attend in-person labors for the safety of their families, healthcare workers and the doulas. Now online remote doulas can be anywhere supporting pregnant people during the COVID-19 crisis.

What do doulas do?

Doulas provide physical, emotional, and informational support to you (and your partner, if applicable). Doulas can vastly improve your birth experience and reduce the rates of interventions in labor. According to the American College of Obstetricians and Gynecologists, one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. Doulas have always been about in-person care, but these extreme times call for significant changes in how we work and support people.

How do virtual doulas provide support to laboring people during a pandemic?

Virtual doulas provide independent, supportive care through video platforms, phone conversations and text. While particular services and styles can vary between doulas, a good doula will make sure that their clients have evidence-based information, practical pain-relief tools, and emotional and informational support. There is significant evidence that doula care improves birth outcomes. With doulas—and now partners—often being excluded from many delivery rooms, virtual support may be the primary option for many laboring people.

What services do virtual doulas typically provide and how do they do it?

Prenatal planning

The prenatal meetings are easily done virtually. During these planning sessions, doulas will educate their clients, help inform them about their choices, and empower them to ask questions of their care providers as they prepare for birth. This process also allows clients the opportunity to express any fears and concerns about the birth experience. This session is a great opportunity to learn what to bring in your birth bag, especially if your partner won’t be able to join you during labor and will help you feel more confident about approaching your labor.

Emotional support

Your virtual doula is there for you 24/7. They’ll take your phone calls, text with you, or be on continual or occasional video chat as you wish, to “sit with you”, support you and be there through the challenges and the joys of birth.

Is it time to leave for the hospital?

One of the more challenging aspects of hospital birth is figuring out when is the right time to go to the hospital during labor. With care providers recommending that people minimize their time in the hospital at this time, doulas can help you figure out how far along you are in labor through non-clinical cues like the strength, length, and duration of contractions, how the birthing parent is acting and what they report they are feeling.

Pain-management techniques

Your virtual doula can work with you during labor by telling or showing you pain-management tools and techniques throughout labor. They can talk you through guided breathwork and imagery, acupressure points to reduce pain and birthing positions to try.

Answers and reassurance

Your doula is on stand-by to answer any questions you may have about what is happening during labor. They’ve seen labor before and they are trained to know what is normal. They can also be your trusted cheerleader, reflecting realistically what is happening and how you are progressing with their knowledge of the stages of labor.

Evidence-based Information

your doctor offer to break your bag of waters and you want to consider the risks and benefits in order to make an informed decision? Doulas can talk it through the process, or can send you information to help you make the right decision for you.

What types of devices do virtual doulas use to provide support?

Doulas can be available to you online in a variety of ways throughout your labor, including laptop video, smartphone, or simply via text or email. It really depends on your needs and your preferences, as well as what your place of birth is open to. Several OBGYNs and hospitals have said they will help and welcome virtual birth support, so talk to your care provider now. This product or something like it can help you clip your phone right on to the hospital bed so your doula can be close at hand.

Virtual doulas can make a true difference for laboring parents, guiding them through the labor with information, emotional support and giving them some sense of control. Help does not stop at birth, though. When nobody is coming over to help with their newborn, virtual postpartum doulas provide postpartum support teaching new parents how to care for their infants, answering questions about newborns, supporting parents through early lactation, and providing an educated ear to listen and hear what the experience of becoming a new parent is like. While we all hope for the return of safe conditions for families, in-person care providers, and our community at large, in the meantime, we are glad to be able to support improving health outcomes of new families remotely.

Jada Shapiro is the founder of boober and a longtime birth and postpartum doula, childbirth educator, certified lactation counselor, birth photographer, and mother. An expert in maternal health, she frequently moderates and appears on panels at top parenting conventions and provides birth and breastfeeding consultation to TV shows, A-list actors, and major films. She is a media expert on childbirth, lactation, and parenting, regularly sought out by the New York Times, The Today Show, Time Out New York, NBC, CBS, E!, TLC and other outlets. She is also the founder of Birth Day Presence, which, since 2002, has helped 20,000+ New York families bring their babies into the community with childbirth education classes and doula services.