London doulas worry tighter hospital visitor rules could shut them out of patient care

A recent policy change at London Health Sciences Centre (LHSC) to curb the rapid spread of measles has some doulas worried about the emotional and physical impact it could have on her clients.

Facing a surge in measles cases among mostly unvaccinated London-area residents, the hospital announced tightened visitor rules Friday for Children's Hospital, where measles exposures have been reported in recent weeks, and Women's Care Program, where its birthing centre is located.

For now, those coming to LHSC to give birth can have only one care partner at appointments and during labour and delivery, meaning patients can't have both a doula and spouse with them. The person must also provide proof of measles immunity or wear an N95 mask.

Brianna Bond said she relies on her doula for emotional and physical support. The London, Ont., mother of three is set to give birth to her fourth child at Victoria Hospital this week, and has a Monday due date. 

Of her children, two were born with the help of doulas during the COVID-19 pandemic — one in May 2020, the other in October 2021. Tightened visitor restrictions at the start of the pandemic meant her doula couldn't be there in 2020, an experience that was isolating and full of uncertainty.

Her doula was present the following year, "which was amazing," Bond said. "Everything is so different with each child, you can't possibly know everything, but these doulas do," she told CBC News on Monday.

"They're able to debrief with you afterwards. Trauma and PTSD after you've had a baby, until you've been through it, you really don't realize that's a thing."

According to data from Statistics Canada, nearly one in four mothers experiences postpartum depression or an anxiety disorder in the months after birth. 

"They're not there to drink a coffee and watch you have a baby ... I think that the hospital needs to be reminded of that."

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After CBC News contacted LHSC about the new policy, a spokesperson later clarified that patients who feel they require more than one person can speak to their care team about a potential exemption.

The co-owner of Bond's doula agency, Sarah Hutchison, said she was disappointed by LHSC's revised visitor policy and had lingering questions about the exemption carve-out.

"I have two clients who could go into labour today, they're already overdue. Are they supposed to get an exemption from their midwife? Is that a piece of paper we show once we're in the hospital room?" said Hutchison of Dynamic Doulas of London.

"In general, this feels like an overreaction. I don't feel like the numbers support this kind of response."

Measles cases have spiked in recent months across southwestern Ontario, with Grand Erie Public Health and Southwestern Public Health reporting several hundred in the last several months, most involving unvaccinated minors.

On Monday, the Middlesex-London Health Unit reported a lab-confirmed case involving a man in his 30s — the first in its jurisdiction since March 2024.

When clients hire doulas, they want advocacy, education, and emotional and physical support, Hutchison said. 

A doula supports clients before, during and shortly after giving birth. They're not health-care professionals who deliver babies, and don't have access to medical records or equipment. Although certified with different organizations, doulas aren't overseen by a regulating body.

"We understand exercising due caution, but this is a big deal for clients who have hired us for one of the most vulnerable times in their life," she said. 

She says studies have found doulas can reduce a patient's chances of needing a C-section or instrumental delivery, like vacuum or forceps deliveries, and mitigate the physical and psychological impacts of birth trauma.

Since 2010, Canada has seen the highest rates of maternal trauma during forceps and vacuum deliveries compared to other high-income nations, a 2023 McMaster University analysis found. 

"If women can come out of birth having had a more positive experience, this affects how they can go home and look after their infant. We're far from just a visitor coming in with them," Hutchison said.