Author: Content Editor

  • Canada Day: Centering Indigenous Sovereignty in Birthwork

    Canada Day: Centering Indigenous Sovereignty in Birthwork

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    Canada Day: Centering Indigenous Sovereignty in Birthwork

    Canada Day is often celebrated with fireworks and barbecues, but for many, it’s also a day of grief. A reminder of land theft, cultural erasure, and the deep wounds of colonization. This Canada Day, let’s take the time to reflect on the foundations of our work: whose traditions we draw from, whose knowledge we uplift, and whose sovereignty we respect or overlook. 

    The truth is, much of what birth workers do today – holding space, honouring ceremony, and recognizing the sacredness of birth – are practices rooted in Indigenous knowledge systems. Systems that have existed on these lands since time immemorial and continue to thrive in communities that protect and reclaim them from policies of forced removal, assimilation, and systemic erasure.

    When we offer continuous labour support, affirm the role of extended kin, or talk about birth as a spiritual experience, we are participating in something that has always existed here. It is not new. It is not neutral. And it did not come from textbooks.

    This Canada Day, we invite birthworkers to do more than reflect. We invite you to act.

    Ask yourself:

    • How has colonialism shaped the way I learned to support birth?
    • Have I named and honoured the Indigenous roots of the practices I use?
    • Am I unintentionally upholding systems that exclude Indigenous knowledge?
    • Do I know the difference between cultural appreciation and appropriation?

    Take concrete action(s):

     

    Canada Day doesn’t have to mean ignoring the past. We can’t rewrite history, but we can decide how we show up in the present.

    Indigenous birth practices are not lost. They’re here. They’re vibrant. And they’re leading.

    The question is — are we listening?[/vc_column_text][vc_column_text css=”.vc_custom_1750883699682{margin-bottom: 0px !important;}”]Aunjrya Fleming

    About the Author: Aunjrya Fleming

    Aunjrya is the EDI lead for Doula School. She is a Registered Nurse and International Board Certified Lactation Consultant (IBCLC) with a deep commitment to reproductive justice. She brings years of experience working with racialized, refugee, and 2SLGBTQIA+ families as a maternal health navigator, educator, and advocate. Aunjrya is passionate about building equity-informed spaces that center safety, dignity, and agency for all birthing people.[/vc_column_text][/vc_column][/vc_row]

  • Doula Support for Queer and Refugee Families

    Doula Support for Queer and Refugee Families

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    Not the U.S. — But Not Off the Hook: Showing Up for Queer and Refugee Families in Canada

    Doula Support for Queer and Refugee Families: As we watch what’s unfolding in the United States — Anti-Queer policies gaining momentum, Pride events under threat, and migrant families facing raids and deportation — it can be tempting for Canadians to breathe a sigh of relief.

    But let’s not get comfortable.

    The truth is, Queer and Refugee communities here in Canada are still navigating systems that weren’t built for them. And while our headlines may be quieter, the harm can still run deep — especially when it’s met with silence.

    This Pride Month, we want to gently but clearly remind birthworkers across Canada: our work is political, too.

    Being a Doula in Canada Means Facing Our Realities

    Queer and trans families here still struggle to access gender-affirming care. Many refugee families — including queer refugees — face unsafe shelter conditions, long wait times for services, and a lack of culturally or linguistically appropriate care.

    Hate might not be in the policy — but it’s still in the room.

    Your clients may not be facing deportation, but they might still be facing systemic discrimination, generational trauma, or invisible stressors tied to what’s happening globally. The collective weight of fear, anger, and grief doesn’t stop at the border.

    So how do we show up here, now?

    1. Don’t Compare — Commit

    Instead of using the U.S. as a measuring stick, use it as a mirror. What does our silence mirror? What would we do differently if our systems were next? The truth is, many of the same skills, resources, and sensitivities being called for elsewhere are just as needed here — even if our government isn’t making headlines.

    2. Make Your Care Explicitly Safe

    Don’t assume people feel safe with you — show them. Ask about safety and identity like it’s as normal as asking about birth plans. Make space for chosen family. Update your forms. Know your own biases. Be proactive, not performative.

    3. Recognize Intersectional Risks

    A birthing person who identifies as a queer refugee can face layered vulnerabilities — racism, homophobia, housing insecurity, the arduous task of navigating a complex and novel healthcare system. Know who your local mutual aid groups are. Understand how refugee sheltering systems work. Connect with organizations supporting queer newcomers and undocumented folks. The more context you hold, the more safety you can create.

    4. Offer Local and Cross-Border Solidarity

    This moment isn’t just about who’s on your client list. It’s about standing with queer and undocumented communities everywhere. That might mean checking in on doulas, friends, or clients across the border. It might mean amplifying fundraisers or calling your MP. Oppression is global — and so is our responsibility.

    A Canadian Flag Doesn’t Equal Safety — But Your Practice Can

    This Pride, let’s hold two truths: we are not the U.S., and we are not absolved. Queer and refugee families in Canada still need more than signs promising a positive space. They need doulas who show up, speak up, and do the ongoing work of creating safety from intake to postpartum and beyond.

    Let’s commit to being those doulas.[/vc_column_text][vc_column_text css=”.vc_custom_1750689390681{margin-bottom: 0px !important;}”]Aunjrya Fleming

    About the Author: Aunjrya Fleming

    Aunjrya is the EDI lead for Doula School. She is a Registered Nurse and International Board Certified Lactation Consultant (IBCLC) with a deep commitment to reproductive justice. She brings years of experience working with racialized, refugee, and 2SLGBTQIA+ families as a maternal health navigator, educator, and advocate. Aunjrya is passionate about building equity-informed spaces that center safety, dignity, and agency for all birthing people.[/vc_column_text][/vc_column][/vc_row]

  • International Fertility Awareness Week: April 20-26 2025

    International Fertility Awareness Week: April 20-26 2025

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    International Fertility Awareness Week: April 20-26 2025

     

    Each year, during the last full week of April international conversations are focused on fertility during International Fertility Awareness Week. Both National Infertility Awareness Week (NIAW) and Canadian Fertility Awareness Week (CFAW) are held during the same week and voices are amplified to change the conversation around infertility. The purpose of these movements are to reduce stigma, educate the public about reproductive health and the challenges that many face in building a family, and empower those who experience fertility challenges. See NIAW initiatives here.

    This year, Fertility Matters Canada has some great events and initiatives during CFAW, and they’d love help in spreading the word. CFAW is a “nationwide movement dedicated to breaking the silence, raising awareness, and advocating for better fertility care across Canada. Each year, we come together to share real stories, amplify patient voices, and drive change for the 1 in 6 Canadians struggling with fertility. CFAW is about community, education, and action” (Fertility Matters Canada). 

    Here’s how you can get involved and support Fertility Matters Canada and their upcoming campaigns:

     

    Write a letter to your local electoral candidate-

    Fertility Matters Canada Launched a grassroots Federal Election Campaign for the upcoming federal election, aimed at urging candidates to expand fertility support and modernize the Assisted Human Reproduction Act of 2004. FMC’s goal is to reach 1,000 letters.

    How people can help:

    • Submit a letter to your local electoral candidates by visiting the following links:
    • Share the message: After submitting the letter, you’ll receive an email with details to forward to friends and family. You also encourage people to share the pinned posts on Instagram (@Fertility_Canada) and tag local candidates to keep pushing for enhanced fertility care.
    • More Information: Here is more information in ENGLISH and in FRENCH if you would like to create your own posts to promote the advocacy campaign.

     

    Share your Fertility Story

    Share your untold fertility story with Fertility Matters Canada so they can shine a light on the realities too often kept in the dark. Your story has the power to shift the conversation across Canada—bringing truth, empathy, and change to those facing fertility struggles. Whether you’re in the midst of your journey, reflecting on what you’ve overcome, or supporting a loved one, your voice matters. By sharing your story, you help break the silence, challenge stigma, and advocate for a more inclusive, compassionate conversation around fertility in Canada.

     

    Attend Light the Night

    Fertility Matters Canada hosts Light the Night annually at different monuments all over the country. “Focusing on bringing awareness to fertility in Canada, this event features landmarks from across Canada lighting green as a symbolic gesture to support those struggling with fertility or facing challenges in family building. Light the Night serves as a way to raise awareness about fertility, foster empathy, and create a sense of community among those affected” (FMC). Share and attend the Light the Night monuments near you, on Thursday, April 24th at dusk.

     

    Share CFAW Posts: 

    Share posts on social media including those about Light the Night, the Fertility Unfiltered Social: Brunch & Breakthroughs event, and more.

    Download the CFAW Social Media Toolkit to spread awareness

    Use the hashtags #CFAW2025 #FertilityUnfiltered and tag us in your posts

     

    Engage with content

    They’ll be sharing daily videos throughout CFAW, including Fertility Unfiltered episodes, Fertility Award winner highlights, and daily fertility stats. They’d appreciate shares to help amplify these messages. 

    Join FMC for daily Fertility Unfiltered patient video series, statistics by Canadian professionals, and celebrate daily with the announcement of the 2025 Fertility Award Winners! 

     

    Attend Fertility Unfiltered Social: Brunch & Breakthroughs, the powerful two-part closing event to Canadian Fertility Awareness Week (CFAW). 

    FMC wants to get real about fertility and family-building and this event is about real and raw conversations about fertility, family building, loss, resilience, and hope. 

    The event will include: 

    • A panel of bold voices sharing their unfiltered experiences
    • Delicious brunch, great company, and a safe space to connect and reflect with like-minded community
    • Thoughtfully curated goodie bags, because who doesn’t like some swag?
    • An inspiring call-to-action to push for fertility equity in Canada

    Whether you’ve lived it, are living it, or are supporting someone who is—this event is for YOU.


    -When: Saturday, April 26 | 10AM–2PM

    -Where: The Atrium at Ricarda’s, Toronto
    -Limited Spots 

    Sign Up!

    __________________________________________________________________

    Other upcoming Fertility Dates: 

    • World IVF Day – July 25
    • European Fertility Week (EFW): held annually in November
    • World Fertility Day – celebrated on November 2

    __________________________________________________________________

    Want to get involved in fertility conversations, fertility support, and fertility advocacy after Fertility Awareness Week is over? 

    Let’s Keep Talking about Fertility 

    At Doula School, we are passionate about talking about fertility all year long in our Fertility Doula program because we know just how important these conversations are. According to the WHO, 1 in 6 people globally face fertility challenges. Our very own Fertility Doula Program Coordinator Jessica Palmquist is also 1 in 6 and went through a unique journey to parenthood utilizing In Vitro Fertilization (IVF) to grow her family. Her fertility struggles are what inspired her to become a doula and work with Doula School as a passionate instructor. 

    Our Fertility Doula program otherwise known as our Fertility Support Practitioner is a cutting edge one of a kind program designed to equip graduates with providing clients with compassionate support and evidence-based practices in fertility, preconception, and assisted reproductive technologies.

    Let’s keep the conversations going and join us today!

    Fertility Doula – Canada 

    Fertility Doula – International[/vc_column_text][/vc_column][/vc_row]

  • The Art of Reassurance: Addressing Birth-Related Fears for Mental Health Stability

    The Art of Reassurance: Addressing Birth-Related Fears for Mental Health Stability

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    The Art of Reassurance: Addressing Birth-Related Fears for Mental Health Stability

    There’s no question about it — parenting is one of the most exciting milestones you can hit as an adult. However, that doesn’t mean becoming a parent is stress-free — especially as a person giving birth. Pregnancy can be a difficult time filled with mixed emotions, and these ramp up as the due date approaches. Having birth-related fears is perfectly normal, of course — especially with the abundance of information all of us have about childbirth today. Knowing every little thing that can go wrong is bound to generate stress. Luckily, addressing birth-related fears is easier with the right doula — and you’ll be by their side to help. With proper planning and support from you and their loved ones, clients will easily find light in the darkness and get the right mindset for the moment they go into labor. 

    So, let’s examine some of the ways you can reassure your clients to achieve mental stability before labor. 

    Support Is Essential

    To get your clients ready for childbirth, help them realize that they can’t prepare perfectly. Even with the most thoughtful approach and a caring doula, they can’t plan for every eventual situation that might arise. With that in mind, it is essential to learn to let go of at least some of the control they want to have over the birth of their little bundle of joy. 

    However, this also means learning to lean on you as their doula, their partner, and other loved ones. Together, you will provide the practical support they need as they get ready for the big day. Knowing they’ve got the right people beside them will make the whole experience less stressful. 

    For instance, you and the client’s partner can write a birth plan for the moment the baby arrives. In the process, you can explain anything they’re uncertain about and discuss your advice for each decision they need to make. 

    Still, addressing birth-related fears requires more than practical support. Now, more than ever, your client needs a partner who cares about their emotional well-being during pregnancy. However, the birth-related fears don’t end when the baby is born. Therefore, it is necessary to focus on postpartum mental health, as the emotional changes after birth can be just as challenging as the physical ones. A well-planned postpartum care plan is as important as a pre-natal one.  

    Address All Stressors

    Expecting a baby is bound to be stressful for your client. After all, they’re bringing new life into this world — feeling completely relaxed about the fact would actually be strange. However, that doesn’t mean they should completely let their stressors take over and cause anxiety each day. And that’s something you should make clear as a doula. 

    Without addressing birth-related fears and lowering stress, your client actually runs the risk of negatively impacting their baby’s development. That’s why stress management is absolutely necessary while pregnant. 

    How do you help the client achieve this? Well, this depends on their specific stressors. There are some things common for all pregnancies, but some sources of discomfort will depend on the client’s particular experience. Guide them through this process and help them recognize their sources of stress.

    For instance — are they getting enough sleep? With a chronic lack of sleep, the client’s daily stress can build to a point where it affects the baby. Also, you probably know that eating healthily is crucial for the baby — but it’s also important for the client’s daily mood. 

    Eating fast food and lots of sugar will result in constant energy crashes and mood swings. And it will make dealing with birth-related fears more difficult. Your clients should eat as healthily as possible instead. 

    Identify Specific Triggers

    Sure, a lack of sleep and malnutrition will make anyone’s emotional and mental stability more difficult to balance. However, all of us have some specific stress triggers as well. To help your client maintain mental health in the months and weeks leading up to childbirth, you need to identify their particular stressors. 

    Encourage them to discuss this with their partner/family and see if there’s anything they can do to make daily life less anxious. Getting enough birth and postpartum support from partners/familial support is essential, even with the best doula in the world. 

    Also, it helps them think of things that they find relaxing and see if there are any hobbies they can take up to alleviate stress. Some folks find pottery and baking relaxing — for others, it’s simply spending time outside or watching a movie. 

    Ultimately, your clients may need medical help as well to manage stress. Encourage the client to speak to their doctor to see if there’s anything they could help with — or provide useful advice. 

    Get Enough Exercise

    Most pregnant people have posture problems during pregnancy. This is no surprise, considering the sudden increase in weight they carry around every single day. And this becomes an increasing problem as they near their term. Slowly, this becomes a psychological problem as well — pregnant people need to deal with the fact that they’re not as mobile as usual. 

    Exercise can help with this — and it can also help them when it comes to addressing birth-related fears. During labor, your client will be using muscles you may not have worked out before — and you should make them aware of this. To ensure labor is as smooth as possible, guide them to strengthen these muscles and potentially reduce pain and aching after the baby arrives.

    Of course, safety is essential here — both for your client and the baby. Consult a medical professional before recommending any workout plans for your pregnant client, and ask them to get advice from their doctors, too. In most cases, light yoga can help. You can find plenty of specific plans for pregnancy online. 

    Pregnancy-specific squats may also help by working out pelvic muscles, and you can find other exercises to help with lower back pain. As the client’s pregnancy progresses, their lower back will become increasingly stiff — so this is important as well. 

    Wrapping Up

    Addressing birth-related fears is a vital part of preparing for labor. It’s perfectly normal to feel anxious or afraid — a client knows they’ll have to prepare their body for some degree of pain. However, even without drugs (about which they should always consult their doctor), there are ways to prepare them for the process. And this is a big part of your job as a doula.

    At the end of the day, the best way to prepare is to arm them with knowledge. The more they know about every detail of childbirth, the more they’ll be able to avoid mistakes and unnecessary unpleasantness. Plus, they’ll be ready to deal with any potential issues that might arise. 

    Naturally, healthy living during pregnancy will go a long way toward alleviating stress. When your client knows they’ve done everything in their power to achieve a healthy pregnancy — they and you have a lot less to fear. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1760583857451{margin-bottom: 0px !important;}”]

    Andrea PaulAbout the Author: Andrea Paul, Doula Trainer and Mentor

    Andrea Paul (she/her) is a devoted caregiver and mother of two who brings warmth, compassion, and enthusiasm to supporting doulas and families. With over a decade of experience as a birth worker, postpartum doula, lactation educator, and infant sleep coach, she’s passionate about helping families feel confident and cared for. As a doula trainer and mentor, Andrea finds joy in empowering new doulas to thrive and make a lasting impact in their communities.[/vc_column_text][/vc_column][/vc_row]

  • When Black Lives Are Under Attack: What Birth Workers Can Do to Stand Up and Fight Back

    When Black Lives Are Under Attack: What Birth Workers Can Do to Stand Up and Fight Back

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1739977217866{margin-bottom: 0px !important;}”]Birth Workers Anti-Racism: Supporting Black Lives: Black History Month, or Black Futures Month as I prefer, hits differently this year. It’s a scary time for Black people in North America. A president that most Black American voters did not choose has taken control of the White House. Trump’s second term is a manifestation of a sociopolitical climate wherein some will openly say that all Black people in professional jobs are unqualified DEI hires who should be relegated to “Black jobs.” These people are gleefully expecting some “Black jobs” to open up as all the migrant fruit pickers get deported. 

    At the same time, the president won’t stop talking about annexing Canada. The party leading in the polls for our federal election this year embraces similar ideologies as the MAGA movement, creating fear and anxiety for Black Canadians who don’t want to see the same sociopolitical climate ushered in here.

    Since 2019, significant progress has been made in the US to secure public funding for doula care, with programs often targeting Black and other racialized groups. This is in response to numerous studies demonstrating that there is a Black maternal health crisis in the US. Black women are 3 times more likely to die in childbirth than white women. We are also more likely to die from postpartum complications, more likely to have preterm labour, and a variety of other adverse outcomes. Similarly, Black neonates are more likely to die, experience birth injury, and have low birth weight. Researchers have agreed that social determinants of health such as medical racism, and racial trauma and stress are to blame

    Research also demonstrates that birth and postpartum doula care is an effective and cost-effective intervention that improves outcomes for Black birthers and babies. Black Congresswomen Alma Adams and Lauren Underwood, who co-founded the Black Maternal Health Caucus in 2019, have been significant contributors to systemic progress. This bipartisan caucus works to address the disparities in maternal health outcomes for Black women in the United States through legislation and advocacy. 

    Now these gains are at risk. The first month of the Trump administration sets a very different tone regarding what we can expect in terms of support for public health and health equity. In the first week, he withdrew the United States from the World Health Organization (WHO), the body responsible for coordinating international responses to global public health crises such as the pandemic. He also signed an executive order directing federally run insurance programs to exclude coverage for gender-affirming care for trans people (ie Medicaid, Tricare, etc) and public funding for abortions

    This administration is also making decisive moves against teaching Black history. For example, content regarding the Tuskeegee airmen has been removed from Air Force training. Seeing which way the wind is blowing, Google rushed to comply with this new direction by canceling its DEI programs and removing Black History Month, Indigenous People’s Month, and Pride Month from its calendar. Other companies have made similar moves. In a climate like this, support for Black maternal and neonatal health initiatives is in jeopardy, while the Black perinatal health crisis persists. 

    Given the power of the United States, and Trump’s threats against the sovereignty and independence of various nations, including Canada, Gaza, Mexico, Panama, and Denmark, global anxiety is high. Many people in the US and around the world don’t like the direction in which things are headed and recognize that resistance is needed. As doulas and birth workers, we are already engaged in a path of resistance to medicalized and systemic violence against gendered, racialized, queer, disabled, and equity-deserving bodies. 

    The intention of the “shock and awe” executive orders of last month is to demoralize the average person and make us feel like there’s nothing we can do. This is far from true. Fascist regimes are always met with sustained resistance, and they always crumble sooner or later. Our mission is to ensure that this happens sooner rather than later and mitigate the suffering caused in the meantime. Here are some practical strategies and tips on surviving and thriving in the resistance movement in the coming years.

     

    Self-Care

    All of these dramatic and alarming changes happening overnight and the uncertainty about what will happen next takes a toll on our mental health and well-being. That’s the point. Mentally ill people just trying to survive each day cannot resist effectively. Taking care of ourselves is one of the most important steps we can take to weather the coming storms. Brainstorm activities that make you feel better and try to do at least one thing on that list each day. Monitor yourself for symptoms of clinical mental illness and seek treatment as soon as you think you might be unwell. Support Black scholars and writers by checking out Tricia Hersey’s Nap Ministry movement and her books Rest as Resistance: A Manifesto, and We Will Rest. The Nap Ministry advocates for liberating ourselves from the expectation to be constantly working, and building communities of collective rest and healing through art and grassroots organizing. 

     

    Understand Intersectionality

    It’s telling that the Trump regime is attacking Black, Indigenous, and racialized communities, women’s rights, LGBTQ+ communities, people with disabilities, and low-income people. It’s consistent with the theory of intersectionality first advanced by Black feminist legal scholar Kimberlé Crenshaw. Oppression is not siloed. Racism, sexism, homophobia, transphobia, classism, ableism, and other discriminatory mindsets work together as a well-oiled machine. Marginalized groups and allies must also work together. You are probably familiar with the post-WWII poem, “First They Came” by Rev. Martin Niemöller. Do not wait for them to come for you personally. There is a very good chance they will come for you eventually. Stand in solidarity with people who are under attack right now. Inform yourself about how marginalized groups have already been negatively impacted by Trump’s executive orders and speak up. If you are Doula School alum and want to learn more about the Black perinatal health crisis in Canada and discuss its similarities to the treatment of Black birthers in other jurisdictions, check out the watch party to screen “The Standard of Care” on Mar 11, 2025

     

    Globalize Your Social Network

    Globally, those who are against the current direction far outnumber those who support it. We need to find each other and grow an international solidarity movement. One important lesson of these troubling times is that no country is an Island. Many people worldwide are impacted by the actions of a government that is not theirs. Find out what like-minded people in other countries are doing and figure out how you can work together. For Doula School alumni, our private Facebook group is a great place to start. As our program grows, the group is increasingly international. It’s a good way to talk to other birth workers about how it’s going where they live, their hopes and fears for the future, and what we have in common. The goal of a regime like this is to lock us in an “us vs them” mentality that fuels hate and fear and makes us easier to manipulate. Finding common ground and building solidarity with diverse communities is an essential act of resistance.

     

    Consumer Harm-Reduction

    Pay attention to how you vote with your money. As we all know by now, the opening volley of the US regime’s efforts to control the world is to initiate a trade war with numerous countries, including Canada, Mexico, and China. Check the labels on the products you buy and support your local economy whenever possible. The stronger each nation’s economy is, the less power the trade war and tariff threats hold. The people in power are highly motivated by money. This is the language they understand. If you live in the US, do some research and support companies that are defiantly maintaining their EDI initiatives and divest from brands that are complicit in these regressive policies.

     

    Votes Matter

    Are there elections coming up soon where you live? Pay attention to elections at each level of government, inform yourself about the different policy platforms and how they will affect you and your community, and VOTE on election day. Over a third of eligible US voters didn’t show up on November 6, 2024. We’ll never know what would have happened if they had. A key takeaway from the current chaos is that election outcomes have a significant impact on the daily lives of average people. We must exercise our democratic rights along with these other crucial actions. For those in Ontario, Canada, this means being ready to vote for a Premier on Feb 27, 2025. Ensure that you are registered, or have the documentation you need to register on election day handy. To register on election day, you need proof of address to confirm you are voting in the right riding (e.g. a utility bill) and a provincially recognized ID (e.g. a Canadian passport).

     

    Join Grassroots Movements

    Make an effort to learn about organized resistance that is already happening in your community and join their efforts. Share information with your friends and social networks about reputable organizations doing good work. Follow resistance organizations on social media and support their actions wherever possible. This can include going to demonstrations, calling and writing your elected representatives, volunteering, signing official petitions, and more. Don’t underestimate the power of grassroots movements. Regular people working together have been instrumental in bringing down every corrupt and oppressive regime throughout history. The people united will never be defeated. 

     

    About the Author – Keira Grant  

    Keira GrantKeira Grant (she/her) Inclusion and Engagement Lead Racialized Communities

    Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.[/vc_column_text][/vc_column][/vc_row]

  • Let’s Talk: Doulas as Peer Supporters

    Let’s Talk: Doulas as Peer Supporters

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    Let’s Talk: Doulas as Peer Supporters

    Author: Keira Grant, Equity, Diversity and Inclusion – Lead

    I just got out of the first session of a free, 30-hour Peer Support Core Competencies training offered by Support House. The virtual training is offered twice a week for 2 hours, over the course of 7 weeks. 

    If you’re wondering what the catch is to a free, 30-hour training – I’ve been trying to get a spot in this course for about a year. A maximum of 30 participants are accepted in each cohort. Every time I got the email notification saying that registration was open, I would race to sign up, only to discover that the course was already full.

    Nevertheless, I persisted. I recognized that this training is an important aspect of my professional development. In my birth and postpartum doula practice, peer support is already a significant aspect of what I do. Often this support to realize mental well-being during pregnancy and postpartum is the most life-changing dimension of my support journey with a family. The information on communication and debriefing in my dual stream course laid an important foundation, but about a year ago, I found myself wanting to strengthen this aspect of my practice.

    I’m proud to say that I have many hours of therapy under my belt, and I think more people should be proud to say this. In my case, therapy, along with mindfulness, and finding the right medication have been the trifecta that keeps my mental illnesses in remission. I often find myself drawing from my own therapy experiences and insights to support clients with their challenges ranging from settlement and refugee trauma, to relationship challenges, isolation, and overwhelm. This is the basis of the peer supporter role.

    Peer support training provides a framework for facilitating mental health and wellness discussions whereby the facilitator draws from their lived experience to support their peer in realizing self-determination and empowerment. In a way, it is kind of like being a mental health doula. Whereas mental healthcare professionals treat mental illness, peer supporters empower people to have a holistic and positive relationship with their mental health and wellness.   

    Peer support’s evolution also mirrors the rise of modern doula practice. Doulas emerged as a response to obstetric violence and birth trauma, and peer supporters emerged in response to psychiatric violence and human rights violations. The social changes of the 1970s that sparked a movement to reform birth also sparked a movement to reform psychiatric care, and services led by psychiatric survivor-consumers began to proliferate. Now, peer supporters are integrated into care teams in many mental health care programs.

    The perinatal journey is full of many joys, but mental health challenges are often a part of the experience. The expectation that pregnancy and new parenthood are unilaterally joyful experiences can make perinatal mental health challenges more confusing for our clients and make it harder for them to reach out for help. Being a doula and a peer supporter is a match made in heaven. We are already operating in a person-centered model emphasizing autonomy, empowerment, and the uniqueness of each journey. Peer support is rooted in the same philosophy. As doulas, we are often the first person clients open up to when they are struggling to maintain mental well-being, or need to process a traumatic birth. I am grateful to expand my skills in providing this powerful form of care.

    While many professional roles for peer supporters are jobs in mental health clinics and organizations, a growing number of peer supporters work in private practice in consultation with a regulated mental health care professional (e.g. an MSW-RSW). I look forward to being able to offer peer support sessions as an additional service of my birth and postpartum doula practice. 

    January 28 is Bell Let’s Talk Day.  While the day has been justly criticized for using mental illness to market a brand, it does succeed at taking mental illness out of the shadows and giving it the spotlight it needs. “Let’s talk” is also a perfect phrase to capture the collaborative and equality-based model that is so integral to the philosophy of doula care and peer support. 

    Are you exploring ways to build your capacity to talk to your clients about mental health? If you don’t have time for a 30-hour course, I encourage you to seek out other opportunities. Self-directed learning modules offered by Support House are a great place to start your quest. Talking, listening, and helping clients realize true well-being is one of the most transformative services we can offer. 

    Nurturing Black Futures: Black History Month Reflections[/vc_column_text][/vc_column][/vc_row]

  • Response to the Consensus Statement on the Management of Intersex Disorders

    Response to the Consensus Statement on the Management of Intersex Disorders

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1731959260366{margin-bottom: 0px !important;}”]This year, in the course of my prenatal and birth support work, I had the occasion to read The Consensus Statement on the Management of Intersex Disorders published in 2006. Now eighteen years old, the Consensus statement is still used by medical teams to guide ethical decision-making regarding the medical care of intersex newborns, infants, and young children. 

    Given this, doulas should be familiar with this Statement and ready to provide informational support to parents that is free from stigma and based on current evidence, including the stories of intersex adults. There are numerous concerns with this statement from a health equity and intersectional social determinants of health perspective. Many issues arise from how dated the document is. There are four problem areas with this statement: 1) Guidance on Terminology, 2) Guidance on gender assignment, and 3) Lived experience of intersex people not valued as evidence 4) The Kenneth Zucker controversy. 

    Guidance on Terminology

    The term “Intersex” is used in the article title, however, in the article body it lists “intersex” as potentially pejorative alongside several outdated and offensive terms. It then goes on to advise providers that “Disorders of Sexual Development” is the preferred term. This differs from the position of advocacy groups by and for intersex people, who counsel their audience that “intersex” is the term they prefer. 

    Intersex conditions are numerous and diverse. Framing all of them as disorders discounts the reality that many intersex people are able to have sexual relationships and children without ever needing medical intervention. The universal use of the term “disorder” insinuates that all intersex people have something “wrong” with them that needs to be corrected. This is simply untrue. Some intersex conditions can cause issues with the ability to eliminate urine, in which case this must be treated as soon after birth as possible. Other conditions may impact fertility, and sexual functioning, or increase the likelihood of having cancer later in life. None of these issues need to be treated during the newborn phase and parents should be encouraged to focus on bonding with their baby. The blanket use of the term “disorder” and the fear it is apt to inspire in parents does not support the measured and stigma-free approach to decision-making that is best here. 

    Guidance on Gender Assignment

    Unsurprisingly given the statement’s age, concepts like non-binary identity and gender-open parenting are not entertained. The Statement positions it as a given that parents will be deeply disturbed if they are not able to assign a gender to their baby at birth. It promotes making a gender assignment as quickly as possible after birth as the way to alleviate parental anxiety. Much of the pressure to diagnose and treat early that it advocates is rooted in the belief that parents need guidance on how to assign gender. The statement then offers guidance on what gender should be assigned to people with certain conditions.

    The idea that each individual is the most qualified person to identify their gender is never considered. According to the statement assigning gender is strictly the purview of the parents, in this case, guided by medical experts. 

    Earlier this year, I wrote about the concept of “gender-open parenting” and how and why it is enacted. This approach to parenting is guided by the belief that each individual has the right to assert and express their gender as free from external pressure as possible. Gender-open parenting is a wonderful option for parents of an intersex child to consider. Gender formation and expression happen in early childhood. Anecdotally, most children who have been raised gender open have self-identified their gender by the time grade one is over. At this age, most medical complications will not have arisen, and most medical interventions are still on the table. From the standpoint of promoting bodily autonomy and informed consent, parents should be encouraged to defer decisions about gender assignment and non-urgent medical intervention until the child can be a part of those conversations.

    The Lived Experiences of Intersex People

    More recent research on intersex people has found that many intersex adults have extensive medical trauma from repeated examinations and in some cases multiple surgeries during childhood. Moreover, many intersex adults attest that the surgeries they endured were cosmetically motivated, medically unnecessary, and in some cases harmful to their sexual functioning and/or fertility. Still, other intersex people whose parents forewent medical interventions state that they are happy, functional adults. 

    This qualitative evidence from intersex adults needs to be viewed as legitimate evidence regarding how intersex people should be cared for in childhood. I’m not sure how much qualitative evidence from intersex adults existed in 2006, but if there was any, it wasn’t included in the statement. 

    The statement does use statistical evidence drawn from intersex adults, using the gender identity held by the majority of individuals with specific conditions to justify assigning that gender to all infants with that condition. The Statement notes that gender may need to be reassigned if the initial assignment proves wrong. Again, the experts are to make this reassignment. The concept of the individual deciding their gender for themselves is not mentioned. 

    Throughout the document, the intersex child is discussed as a passive bystander to their health care decision-making. This is not aligned with contemporary approaches and attitudes regarding the importance of client-centred and directed care, informed consent, and bodily autonomy that should be enacted in every part of the healthcare system.

    Kenneth Zucker Controversy

    The Statement is a consensus among international experts on the diagnosis and management of intersex conditions. The Canadian expert who contributed to the statement is Dr. Kenneth Zucker. His name will ring a bell for many members of the Toronto 2SLGBTQ community, especially trans people, parents of trans kids, and their allies. For many years, Dr. Zucker was the director of the Gender Identity Clinic at the Centre for Addiction and Mental Health (CAMH). Many trans youth and their parents have accused Dr. Zucker of harming them by gaslighting them about their gender identity and trying to convince kids who were certain that they were trans that they were wrong and that in his expert opinion, they were cisgender and should focus on being comfortable with the gender they were assigned. Following significant and sustained outcry from the 2SLGBTQ community alleging conversion therapy, Dr. Zucker was relieved of his duties at CAMH, and the Clinic was closed. He defended his practices, appealed this decision, and was eventually offered an apology and a settlement by CAMH.

    The consensus statement manifests many of the concerns that were raised about Dr. Zucker’s ideology. They included:

    • The individual is not considered a valid authority on their own lived experiences and identity. 
    • Conforming to the gender you are assigned is the ideal outcome. 
    • Non-binary, genderqueer, agender, and genderfluid identities are not legitimized or even considered. 
    • Everyone must eventually conform to the box of “male” or “female”. 
    • Gender is something that is assigned to you, not something that you define for yourself. 
    • Having a child that can’t be easily slotted into one of those boxes is “disturbing” for parents.

    On this platform, I have talked about how these beliefs are harmful to trans people. They’re harmful to intersex people too, especially in infancy. The pressure to rush to gender assignment, potentially reinforcing the assignment with surgical procedures, is driven by these beliefs. Intersex people are being physically and psychologically harmed as a result. 

    ~

    For many parents, their child being diagnosed with an intersex condition will be the first time they have given any thought to the existence of intersex people. This is through no fault of their own. The gender binary is the dominant perception of reality. The lives of intersex people are shrouded in stigma and silence. As such, parents are highly vulnerable to accepting what they are told by medical experts at face value. The Consensus Statement is an excellent example of how medical guidance is not always objective. Our interpretation of “facts” is always mediated by our preexisting beliefs. 

    Doulas have a vital role to play in helping parents understand where medical recommendations are coming from and unpacking the beliefs on which seemingly evidence-based recommendations rest. The B.R.A.I.N (Benefits, Risks, Alternatives, Information/Intuition, (do something) Now/Never/Not Now) model of decision-making is an excellent approach to apply. We can also reduce stigma by sharing stories of positive outcomes for intersex individuals. Role models and other resources can be found at Intersex Canada or InterAct: Advocates for Intersex Youth.

    My social media post from October 28, 2022, offers guidance on specific questions parents should ask if their child is diagnosed with an intersex condition. A huge part of the magic of this work is the power to improve lives by being at the ready with unbiased, affirming, open-minded information and compassionate support. If we lead with compassion and inclusiveness, we can alleviate the medical harms currently happening to intersex babies and children. 

     

    Keira GrantKeira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities

    Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.[/vc_column_text][/vc_column][/vc_row]