Birth doula care was uniquely impacted by hospital visitor restriction policies enacted in response to the COVID-19 pandemic. Doulas were classified as "non-essential" personnel and thus generally excluded from providing in-hospital childbirth support. Research demonstrates that birth doulas, who attend approximately 6% of births, have significant positive impacts on various maternal and infant health outcomes, including psychological well-being. The present study drew upon social action theory to highlight the role that doulas played in supporting their clients’ self-change processes (e.g., problem-solving, outcome expectancies, self-efficacy, goal structures, cognitive schemas), which in turn influenced the extent to which pandemic-related disruptions to socio-environmental contexts threatened perinatal health outcomes. This research employed a methodologically rigorous, contextually bound, qualitative case study design to examine the impacts of visitor restriction policies and other contextual factors on doula services in the San Francisco Bay Area. This highlighted ways in which doulas adapted their services to continue delivering care and supported their clients in adapting to giving birth during the unusual circumstances of the 2020 Coronavirus disease outbreak. In-depth, semi-structured telephone interviews were conducted with 15 birth doulas, paired with a brief online survey. Findings contribute to our broad knowledge of the impacts of COVID-19 on maternal and child health care delivery and garner a more nuanced understanding of psychosocial interventions that may underlie the demonstrated positive effects of doula care on health outcomes. Theoretical and practical implications are discussed.