Fiona Wright, right, birth and postpartum doula at CommUnity Doulas, visits Jordyn Ledgister, a doula and founder of CommUnity Doulas, at her Toronto home on Jan. 6.Chloe Ellingson/The Globe and Mail
When Jordyn Ledgister, who runs an online community for Black doulas, first came across a 2016 McGill University research paper, it confirmed her – and many other Black women’s – concerns about the risks to Black maternal and neonatal health. The study showed that Black mothers in Canada experienced a preterm birth rate of 8.9 per cent, compared to 5.9 per cent among white mothers.
“People often like to say there are no disparities in Canada,” she said. “But that study was one of the few that spoke to Black maternal health. As doulas in the Black community, we already knew these disparities existed, we just didn’t have the data to prove it.”
In 2023, Ms. Ledgister turned that data into action.
While the online community, the Ontario Black Doula Society, focuses on social and professional support for doulas in a largely unregulated field, CommUnity Doulas delivers hands-on services.The Globe and Mail
Through a partnership with MakeWay, a national charity that builds community-based solutions, she started CommUnity Doulas, which provides up to 12 months of nutritional and doula support to Black families in Toronto.
Last year, she received $80,000 from the Foundation for Black Communities, which allowed the project to expand its reach to more than 20 families.
“The disparity between Black and white mothers, particularly with preterm births, was the motivating factor for getting the work on the ground,” she said.
According to the World Health Organization, preterm babies – those born alive before 37 weeks of pregnancy – accounted for 13.4 million births in 2020, or more than one in ten. Prematurity remains the leading cause of death among children under five worldwide.
Black mothers in Canada experience higher rates of preterm birth than their white counterparts.Chloe Ellingson/The Globe and Mail
The Public Health Agency of Canada defines a doula as a trained professional offering continuous physical, emotional, and informational support before, during, and after childbirth but not medical care or diagnosis.
While the online community, the Ontario Black Doula Society, focuses on social and professional support for doulas in a largely unregulated field, CommUnity Doulas delivers hands-on services. Its mission is to improve Black maternal health experiences and outcomes in Canada through culturally grounded, community-based care.
Jay Kaufman, an epidemiologist at McGill University, co-authored the 2016 study. He said he had believed that Canada’s universal health care would level the playing field. But it doesn’t. Black mothers in Canada experience higher rates of preterm birth than their white counterparts – although the disparity is smaller than in the U.S., he said.
“It’s not quite as equitable as we imagined,” Dr. Kaufman said. “We thought we would observe an absence of disparities, so we were surprised to find some.”
He pointed to several possible explanations: uneven access to prenatal services, nutrition, stress, and environmental conditions such as pollution or noise.
Social factors such as working long hours, obesity, smoking, or limited doctor availability might also play a role.
CommUnity Doulas provides up to 12 months of nutritional and doula support to Black families in Toronto.Chloe Ellingson/The Globe and Mail
Though every Canadian has access to a publicly funded health care system, the reality is more complicated. An estimated 5.9 million Canadians don’t have a primary-care physician or nurse practitioner, according to a recent survey as part of OurCare, a project aiming to quantify the extent of primary-care shortage in Canada.
For Toronto resident Erin Parchment, those disparities became deeply personal when she became pregnant in 2023.
Without family nearby, Ms. Parchment sought the guidance she felt was missing. “I’d heard so many horror stories,” she said. “Women wanting natural births but ending up with C-sections, preterm deliveries, babies in distress, heart rates dropping. I wanted someone who could help me navigate pregnancy, labour, and postpartum care.”
Her biggest fear, she said, was not being heard in the delivery room.
She reached out to the CommUnity Doula Project.
An estimated 5.9 million Canadians don’t have a primary-care physician or nurse practitioner, according to a recent survey.Chloe Ellingson/The Globe and Mail
“I wanted to understand my options rather than being told what to do,” she recalled. “Having a doula gave me that voice.”
In the delivery room, the doula helped her breathe through the pain, rubbed her back, and prayed with her.
“They made the birth I dreamed of possible through their care and support.”
Dr. Kaufman said that researchers continue to study birth disparities across demographics, including Indigenous and other racialized communities.
“We still don’t fully understand what drives preterm birth differences,” he said. “The known risk factors explain only a small portion of it. Many hypotheses, from infections to psychological stress, are still being explored.”