End Birthing Without A Companion

End Birthing Without A Companion


Nearly 400 births occur in Ontario each day – there is an urgent need to ensure that people have the support they need for a safe and healthy labour during the COVID-19 crisis.1


Province-wide, Ontarians are giving birth without the support of someone they know and trust because professional doulas are no longer authorized to provide in-person services.2 Ontario’s List of Essential Workplaces must be amended to allow doulas to provide physical and emotional birth support to clients who lack viable alternatives during the COVID-19 crisis. 

THE PROBLEM: A growing number of Ontarians are at risk of birthing alone. 

Since April 5, 2020, the Government of Ontario has prevented birthing people from choosing a professional doula to provide continuous in-person labour support. This policy is particularly alarming for vulnerable Ontarians who do not have access to another viable birth support person, especially given unprecedented demands on nurses, midwives, physicians, obstetricians and other healthcare workers. 

Doulas are the only safe and feasible labour support option for many birthing people. This situation is likely to become more common as the COVID-19 outbreak spreads, thereby increasing the number of family and friends who become ineligible to join their loved ones at their chosen place of birth. 

Pregnant Ontarians who are particularly vulnerable include: 

  • Single parents by choice; 
  • Those whose partners are not a safe option for support (e.g. risk of family violence); 
  • Those whose partners are unable to provide in-person support due to: 

○ Parenting responsibilities for older siblings (amidst daycare closures and social distancing) 

○ Illness, possible exposure to COVID-19, or physical disability; 

○ Out-of-town employment (including armed forces/foreign service) or immigration status; 

○ Religious or cultural systems not in line with direct primary birth support; and/or 

  • Those who are Indigenous or persons of colour; members of the 2SLGBTQ+ community; and/or are economically disadvantaged, who may face unique risks in pregnancy and childbirth outside of COVID-19. 

Doulas can provide vitally important birth support without compromising COVID-19 infection control measures. 

Infection control measures and efforts to manage limited supplies of personal protection equipment are required to reduce the spread of COVID-19 and protect frontline health care professionals. 

Recognizing the vital importance of birth support, hospital, birth centre and home birth policies across Ontario continue to allow birthing people to be accompanied by one support person during labour. This is an explicit exception to rigorous visitor restrictions to minimize risk of exposure to COVID-19. 

April 10, 2020 Association of Ontario Doulas www.ontariodoulas.org 


All birthing people have the right to choose their own labour support person: 

  • Amidst the COVID-19 pandemic, the World Health Organization is urging jurisdictions to protect the rights of birthing people to have high quality care before and after childbirth, including having a companion of their choice present during delivery.
  • WHO guidelines explicitly apply to all pregnant people, including those with confirmed or suspected COVID-19 infections. 

Birth support improves health outcomes and reduces demand for health and social services. 

Pregnant Ontarians should have the right to choose the birth support person that best responds to their needs, including the option of a professional doula. 

Access to labour support improves birth outcomes and reduces trauma: 

  • Research shows that continuous labour support leads to superior health outcomes for both birthing people and newborns.
  • Recent stressful life events are risk factors for postpartum depression and anxiety.5 Feelings of fear, isolation and trauma during childbirth are significant stressors in ideal circumstances and are likely exacerbated by social isolation and broader uncertainties resulting from COVID-19
  • A higher incidence of postpartum mood disorders would have an alarming ripple effect on immediate and long-term demand for mental health and social services during a period of unprecedented strain on our health care system. 
THE SOLUTION IS SIMPLE: Professional doulas must be authorized to work in Ontario during the COVID-19 crisis. 

We urgently call upon the Government of Ontario to amend the List of Essential Workplaces. Ensure that pregnant Ontarians – particularly those who are most vulnerable – have the right to choose their own support person during labour, including in-person care by a professional doula. 

For more information, including media inquiries, please contact: externalrelations@ontariodoulas.org 


1. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310042901&pickMembers%5B0%5D=1.7&pickMembers%5B1%5D=4.1

2. Doulas provide non-clinical support and care to individuals (and their partners, if applicable) during childbirth and the prenatal and postpartum periods. Apart from current restrictions due to COVID-19, Ontario doulas are regularly present at hospital, birth centre and home births, and viewed by healthcare staff as valuable members of birth support teams.

3. https://www.who.int/news-room/q-a-detail/q-a-on-covid-19-pregnancy-childbirth-and-breastfeeding

4. https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth

5. https://womensmentalhealth.org/posts/postpartum-depression-who-is-at-risk

April 10, 2020 Association of Ontario Doulas www.ontariodoulas.org

Download a copy of this document HERE > COVID-19 and Access to Birth Support in Ontario (FINAL)