SOGC, CFPC, NACM, CAPWHN and CAM Joint Statement on Support Persons in Labour
Ottawa, Ontario – April 24, 2020
Due to the COVID-19 pandemic, hospitals around the world have been forced to rethink their policies at all levels of care in order to protect staff and patients alike. This new reality has forced some hospitals to make difficult decisions when it comes to how they care for their pregnant patients in labour.
A support person for labour and childbirth is an integral part of birth experience. More than just a supportive presence, they are an essential participant in the birth. The support person is not a visitor; their presence and their role is of greatest importance to the person in labour, but is also valued by the perinatal care team.
During the pandemic, most birth facilities and hospitals have limited the number of accompanying persons. Some regions or hospitals have made the difficult decision not to allow any support persons during labour and delivery because of the inability to maintain safety for the patients, the staff, and the accompanying persons.
We now know that anywhere from 30% to 50 % of people who test positive for COVID-19 have no symptoms, making screening at the time of labour difficult to impossible. The only solution is to have sufficient personal protective equipment (PPE) and ensure that all accompanying persons screen negative for symptoms or fever, and can be in droplet PPE, with additional provisions to ensure that they do not pose a risk to others. In many places, there are shortages of PPE or insufficient staff to ensure that accompanying persons are not sick, do not become sick, and do not pose an infectious risk to other patients, partners or care providers on the birth unit.
In the face of a lack of necessary PPE and appropriate staffing levels to ensure safety, health facilities’ decision to prohibit support persons may be the only choice, but the consequences are of great concern to those giving birth, their partners and their care providers. Such a decision should not be taken lightly.
In the absence of support people during childbirth, including caesarean delivery, we encourage innovative practices to provide support throughout labour and birth. An example of this is anesthesiologists helping to enable skin-to-skin contact after c-sections. Special consideration must be given to the needs of individuals and communities that are disproportionately impacted by stigma, violence, and other traumas. The inclusion of support people for those birthing individuals must be prioritized.
As health care professionals who provide care during birth, we deeply regret the circumstances that have led to prohibiting support persons or partners from childbirth. We urge provincial ministries of health to ensure the protocols, staffing and equipping of the birthing rooms are sufficient to safely accommodate a partner or other support person for each individual through labour and childbirth.
April 24, 2020