Doula School Canada

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Light in the Darkness: Interview with Layla Micheals, an Infant Loss Parent

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Light in the Darkness: Interview with Layla Micheals, an Infant Loss Parent

At Doula School, one of our leading continuing education courses is our Infant and Pregnancy Loss Support certification program, which is such an important skill in our birth worker toolkit. Our gradates go on to support families who have experienced infant and pregnancy loss. It’s important to destigmatize speaking about infant and pregnancy loss because 25% of people experience loss at some point in their fertility journeys. We never want anyone suffering in silence.

Jessica Palmquist, our very own senior instructor and program coordinator for the infant and pregnancy loss programs experienced a unique journey to parenthood made possible through In Vitro Fertilization (IVF), which ultimately ignited her burning passion for fertility awareness and birthwork. Through her IVF journey after losing multiple embryos, she understands the importance of talking about loss and fertility struggles. With October being Pregnancy and Infant Loss Awareness month, Jessica Palmquist interviewed her best friend Layla Michaels, founder of Big Hearts Little Stars and she shares about the loss of her son Ryker and how she found light during her darkest time.

Jessica and Layla’s friendship began in the early 2000’s when they worked together at a Lululemon pop up store in Moncton, New Brunswick. Nearly decades later, after both women went through Assisted Reproductive Technologies they joyfully were pregnant together, both expecting baby boys who would one day grow up together and be best of friends. Jessica delivered in October 2019 and Layla’s estimated due date was Easter 2020. Layla’s water broke unexpectedly at 25 weeks gestation and she was hospitalized. Layla was in constant contact updating Jessica daily. Two weeks later, Layla delivered her son Ryker who lived a life too short and he died in her loving arms. When Jessica received the news of Ryker’s passing she held her newborn son Hudson tighter than she ever had and sobbed uncontrollably. Her heart had broken that day along with her best friend’s. Layla and her partner Adam had big plans for their son and had already built a life for him. Jessica and Layla had dreams of what their boys’ future would look like. This is another side of loss that often goes unspoken – the loss of the future and the loss of a family’s hopes and dreams. Loss is more than the loss of a life, it is the loss of a life and so much more. Jessica regularly asks about Ryker and Layla gingerly shares pictures from Ryker’s short stay in the hospital and the mementos in their home. Whenever Jessica and her family have the opportunity they honour Ryker on his birthday, holidays, and whenever she writes a letter to the family he is included. Jessica has been Layla’s biggest cheerleader as she has been trying to conceive after her loss. After four long years, Layla is pregnant and Jessica is excited to meet Ryker’s baby sister.

Get to know Layla, as she shares her loss story:

Would you like to share your story of infant loss?

We became pregnant with our son, Ryker, after two years of infertility and seeking out the help of a fertility doctor. The pregnancy was perfect, I wasn’t sick, and had that pregnancy glow and blissful ignorance thinking nothing would go wrong. Until it did.

At 25 weeks my water suddenly broke and I was hospitalized. Then at 27 weeks our son Ryker was born via emergency C-section. He was 2lbs 7oz and a fighter! It was touch and go in those first few days, but then he turned a corner and we thought everything would be ok. Then overnight, he developed a brain bleed that wasn’t something that could be treated or survived. We spent the remainder of that day with him, surrounded by our families, as we said goodbye so soon after we had just said hello. It was heartbreaking. But also during that time we created beautiful memories with him and said everything we needed to say. He died in my arms after about an hour and half from being taken off life support.

What was your experience with our healthcare system?

There is a big gap in experience across the country when your baby dies. But one universal area that I found is that there is not much direction or support for what to expect when you leave the hospital without your child. Your milk still comes in, you are still in active postpartum recovery, but it all feels very foreign and different when the baby you grew is no longer with you. The only check-up is the standard 6 week check-up, which felt years away. You are trying to heal and trying to process immense grief at the same time and it is truly too much to handle.

What did you find the most helpful in your journey?

I found the pro-activeness of friends and family to be what was needed. You often hear people say “if you need anything, let me know” or “call me” but when you are in the depths of grief, there is an inability to understand what you need, or have the courage or mental capacity to ask for the help. People would show up at our door with food, or to check on us, or the messages that came in reading “you don’t have to respond, but we are thinking of you and how you’re doing”. Those messages made me feel open to talking and I would respond every time. Asking me about Ryker and using his name helped as well. My advice to people: “do not ignore what has happened, it may be uncomfortable for you, but it is far worse for the family who has lost their child and are surrounded by people who do not acknowledge the space they are living in”.

You’ve been supporting the pregnancy and infant loss community for many years now. What was your motivation to start Big Hearts Little Stars, an organization that supports families who have experienced the loss of a child?

My motivation for Big Hearts Little Stars was to fill the gap that exists when parents experienced the loss of a pregnancy or child. It initially began with donating books on Ryker’s first birthday, 10 books of stories written by Mothers to Mothers, and 10 of Fathers to Fathers.

It organically grew from there into what we now refer to as our Comfort Boxes. We supply both our local hospitals with large and small comfort boxes that include items to assist families through the grief process after their child dies. Items include a teddy bear, baby blanket, memorial candle, books for parents and young siblings, a booklet of resources (local and other) and some other meaningful items.

We also offer a private support group on Facebook so that grieving parents have a safe space to speak and ask questions with others who have been on a similar path.

What services does Big Hearts Little Stars offer?

Directly we only have our support group, but we do have connections to a lot of community resources and access to contacts across the province. We will do whatever we can to assist families who reach out.

I have also gone to coffee with a few people, as sometimes it is helpful to have an in-person heart to heart when dealing with such an emotional and difficult time.

How did you find light in your dark time?

When you lose a child, there is no hope for their future. You can’t hope they’ll get better or magically return home. The reality is, they are no longer here and nothing changes that. The hope or light I found was in sharing our story and the story of Ryker’s life. In sharing our story, I have been told that it allowed other people to find the courage and strength to speak about a loss they had suffered and had never talked about. In being open and honest about the experience it has allowed other people to feel less alone in theirs. That is the hope that I hold onto, the hope that if we are able to help one person feel less alone in their loss, that we can all carry the memories of our children who walk ahead.

What advice can you offer parents who have experienced infant and pregnancy loss?

Take your time, and give your grief the time it needs. This can mean many things. There is no rush to feel better, and no linear way that you will move through your grief. There is no moving on, but you will learn to put one foot in front of the other, and as you do you will always bring their memory with you. The grief will stay with you forever, but it will not always feel as raw as it does in the beginning. You will grow around it, and it will grow around you. I would encourage you to share your thoughts and feelings if it feels right to you, but if not, that is also ok as well. No two people navigate this the same way (including you and your partner).

Are there any resources or recommendations that you would share with parents who have experienced an infant or pregnancy loss?

There are a number or very good organizations within Canada, the US, and abroad that offer support. Here are just a few:

Pregnancy and Infant Loss Support Centre (Calgary) www.pilsc.org

PAIL Network Sunnybrook (Toronto) www.pailnetwork.sunnybrook.ca

Return to Zero (RTZ) Hope – US based www.rtzhope.org

Saying Goodbye – UK Based www.sayinggoodbye.org

There are also many groups that are geared towards specific issues that may have effected the loss of a pregnancy or child. Stillbirth, Preterm Premature Rupture of Membranes, Termination for Medical Reasons, and each of these (and more) have their own support sites as well.

What about the parents who want to try again after the death of their baby. What challenges might they face when trying again? Do you have any suggestions that might support them on their journey?

I don’t think there is ever a right time to try again, if that is something that you wish to do. I strongly believe in therapy as it will help you navigate the decision and also the emotions that will come up during the trying process, whether that includes fertility treatments or you are able to conceive naturally. Once pregnant again, there will be obvious and not so obvious things that may trigger you along the way, based on your history with a previous loss.

There is a really good app and website for Pregnancy after loss (pregnancyafterlosssupport.org) that I have personally found helpful while navigating this pregnancy. In addition, there is a great book called Pregnancy After Loss by Zoe Clarke Cotes that has day by day reading and journaling which helps families navigate their pregnancy after loss.

Is there anything else you’d like to share?

Take care of yourself during this difficult time. Set boundaries where needed, and know that your feelings are valid and you are not alone. When you are ready there is a whole community out there that will help you navigate the days, months and years ahead, and honour you and your baby.

About the Author

Layla Michaels (she/her), is a passionate advocate for fertility and infant loss awareness. She is the founder of Big Hearts Little Stars, a nonprofit based in Moncton NB, serving families who have experienced the death of a child through pregnancy to infant loss. Her nonprofit was founded in 2021 after the death of her first son, Ryker in the NICU in 2020. The mission of Big Hearts Little Stars is to bridge the gap felt by parents in caring for their grief after loss, and knowing they are not alone. Families are provided a comfort box from their local hospital with items and resources to assist them in navigating their grief, as well as an online support group. Layla has also volunteered with Fertility Matters on their East Coast Miracles committee, who worked to raise awareness, conversation and political pressure surrounding fertility benefits and access in the Atlantic Provinces. Her personal fertility journey has taken her through multiple procedures in Canada, overseas, and then finally having to seek treatment out of province. It is Layla’s hope that access to fertility care becomes more accessible for all persons wishing to grow their families, alongside compassionate care for families experiencing loss as well.

Connect with Layla:

IG @laylabun IG @bigheartslittlestars Tictok @mamagotguts

Interviewer- Jessica Palmquist (she/her), Doula School’s fertility & loss support program coordinator and senior instructor works with a diverse population and believes education, reproductive health, and wellness services should be accessible and customizable. In addition to Jessica’s training as a certified Fertility, Birth, & Postpartum Doula & Infant and Pregnancy Loss Support Specialist, she is a certified yoga teacher and has worked in the public and post secondary section sector for nearly 20 years. Her own unique journey to parenthood made possible through IVF paired with a passion for teaching, learning, and helping others led Jessica to birth work.

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October 21, 2024
National Day for Truth & Reconciliation: Action is Our Collective Responsibility

[vc_row][vc_column][vc_column_text title=”National Day for Truth & Reconciliation: Action is Our Collective Responsibility” css=”.vc_custom_1727115223782{margin-bottom: 0px !important;}”]In 2015, the Truth and Reconciliation Commission of Canada announced that its investigation into the inter-generational trauma caused by the “Indian Residential School” system that the Federal Government of Canada operated in partnership with Christian Institutions between about 1880 and 1996 was complete. The commission published a final report that made 94 Calls to Action. Many Indigenous experts believe that completing these Calls to Action is an imperative aspect of rectifying the harm that settler colonialism has done to Indigenous people.

It’s been nine years since the commission published its report. The concept of Truth and Reconciliation is that repairing the damage can only be achieved with honesty. The truth is that the federal government has not done much to change outcomes for Indigenous peoples since the report’s publication.

On the 8th anniversary of the final report’s publication, the federal government issued a statement claiming that 85% of the calls to action were either complete or well underway. Indigenous Watchdog paints an entirely different picture. According to their analysis, only 66% of the Calls are completed or in progress. Twenty percent of the calls are stalled, and 20% have not yet started.

At the time of this writing, Indigenous communities across Canada are mourning and speaking out about injustice. Over 2 weeks this month, 6 Indigenous people were killed by police, with the RCMP responsible for 4 of the deaths. This overt violence at the hands of the police is a stark barometer for the level of violence Indigenous people are subject to in other institutions, including health care.

When it comes to the federal government’s action on the 7 health care calls, it is slim to non-existent. None of these urgently needed calls have been completed. This lack of action shows in the numbers. A 2023 study found that 18.6% more non-Indigenous women had a regular healthcare provider during pregnancy than Indigenous women. This was connected to statistically lower access to primary and specialized care. This applied to rural and urban settings, and disparities remained when socioeconomic status was controlled for. Similarly, the infant mortality rate is twice as high for Indigenous babies as for non-Indigenous babies. The studies’ authors conclude that racism and the resulting deep mistrust of the system are to blame.

Given the ongoing violence that Indigenous people face at the hands of institutions, mistrust is entirely justified. If our government were serious about establishing trust, it would be honest about its accomplishments on the Calls to Action and get the work done.

The Call to Action that has the most direct impact on how we should practice as doulas is number 22, which calls upon us to recognize the value of Indigenous healing practices and incorporate them in healthcare delivery. When engaging with Indigenous clients seeking perinatal support empowering and facilitating their reclamation and implementation of Indigenous teachings if desired is essential. For non-Indigenous birth workers, this looks like making referrals to an appropriate Indigenous doula where possible and doing the work of managing our colonial unlearning proactively and independently when not. We should also listen deeply and with humility to the teachings the client would like to impart.

As a training Institution, we are committed to enacting the 24th call: ensuring that all students who will be working alongside the healthcare system take Indigenous culture and awareness training. The goal of our Truth & Reconciliation module is to ensure that all program graduates are prepared to fulfill the 22nd call in their practice. We recognize that the module is a work in progress and we are paying close attention to feedback from our Indigenous students on how the module can be made more relevant and impactful. As our program grows to include students from more and more countries, we are exploring ways to connect the oppression of Indigenous people on Turtle Island to experiences of colonization, displacement, and resistance around the world.

We know our work is far from complete and that our spheres of influence are small. However, each small organization’s actions to fulfill the Calls to Action is an example and a challenge to our Federal government and other powers to step up and honour their commitments. We trust our actions will ripple out, and we look forward to continuing this essential work in our community.

Keira 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.

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September 30, 2024
Bisexual Clients Are Headed Your Way

[vc_row][vc_column][vc_column_text css=”.vc_custom_1727116431360{margin-bottom: 0px !important;}”]A Gallup poll conducted in 2021 found that 1 in 6 Gen Zers identify as LGBT+. Half of them identify as bisexual, with women being more likely to have this identity than men. For those of us working with pregnant clients, we can expect that Gen Z will account for an increasing share of our clientele.

Sometimes our students tell us that they don’t believe the LGBTQ content in our Equity, Diversity, and Inclusion model isn’t relevant for them because they don’t expect to serve LGBTQ people in their practice. That expectation is becoming profoundly unrealistic. Many people are Queer or Trans, but you have to create a welcoming environment for those clients to open up to you.

This is especially true for Bisexual people. While Bisexual people are the largest group within the LGBTQ population, we are also the most invisible. That’s why our awareness day is called Bisexual Visibility Day (September 21). Data shows that bisexual people are more likely than other sexual minorities to stay in the closet, and less likely to engage with the Queer community. This leads to higher rates of mental illness, suicide and other bad outcomes among the bisexual population. Even for bisexual people who are out, bi identity gets erased if we settle down in long-term, monogamous relationships. Many people find themselves being lumped into the categories of “gay” or “straight” depending on their relationship status.

This impact becomes more profound when bisexual people choose to parent. Cultural beliefs about the nuclear family intersect with assumptions about relationships, making many bisexual parents feel even less free to express their authentic selves.

We can improve outcomes for bisexual people and families by dismantling some of these inaccurate beliefs. I have been at LGBTQ family drop-ins where opposite-sex couples in attendance get side-eyed and are less likely to be engaged in conversation because of the assumption that they are straight people taking up queer space. We need to challenge ourselves to step outside of those limiting beliefs.

Conversely, many bisexual people don’t feel at home in straight parenting spaces either. We find ourselves thrown into uncomfortable conversations where straight, monogamous relationships are a “norm” that may not apply to our lives and histories. Once, in a group of otherwise straight parents, I was asked to tell the story of how my wife and I met. Since we met through mutual acquaintances connected to an ex-boyfriend she was dating at the time (years before we started dating), her dating history came up. At that point, one of the parents responded incredulously, “Wait a second, did you turn her?”.

Of course, my wife and I laughed about it later and I’ve thought of all sorts of hilarious responses to the suggestion that I “turned” my wife bisexual like you turn a person into a vampire. But at the time I felt pretty put on the spot and there was no clever quip at the tip of my tongue. I know the parent who asked was sincerely curious and meant no harm. However, I’ve been out as bi for over a quarter of a century. It’s obviously not a phase, and continuously finding myself in conversations where bisexuality isn’t considered a possibility or worse, gets dismissed, is exhausting.

As parents and birth workers, we need to open our awareness to the presence of bisexual people in our communities. We need to abandon the idea that we can assume a person’s sexual identity based on their appearance, mannerisms, or relationship status. Embracing conversations with curiosity, and being free from assumptions and judgment is a great first step.

Some very persistent myths about bisexuality need to be identified as untrue. Bisexuals are not confused, it is not a phase. We are not “switching sides” as we navigate different relationships. Bisexuality does not impact our ability to participate in any relationship modality truthfully. There are monogamous, ethically non-monogamous, and polyamorous bisexual people. Being in a long-term, monogamous relationship does not change a person’s bisexuality. It’s about the breadth of our capacity to love and be loved.

People of all relationship statuses and sexual identities should be supported to parent. As doulas, creating a space where clients feel welcome to bring all aspects of themselves to the birth room and new parenthood is a powerful offering that supports families in realizing the brightest possible future.

Keira 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]

September 23, 2024
Conquering Imposter Syndrome: A Guide for Doulas
[vc_row][vc_column][vc_column_text title=”Conquering Imposter Syndrome: A Guide for Doulas” css=”.vc_custom_1725986800661{margin-bottom: 0px !important;}”]Doulas play an essential role in guiding and supporting individuals through one of life’s most transformative experiences—childbirth. Their work is deeply impactful, yet many doulas grapple with imposter syndrome, feeling like they don’t truly belong in their role or doubting their abilities.

If you’re a doula experiencing these feelings, you’re not alone.

Here’s a guide to help you overcome imposter syndrome and embrace the incredible work you do.

Understanding Imposter Syndrome

Imposter syndrome is the internal experience of believing that you’re not as competent or capable as others perceive you to be. It’s common among many professionals, including doulas. You might feel like you’re faking your expertise, that you don’t deserve your success, or that you’re going to be “found out” at any moment.
1. Acknowledge Your Feelings
The first step to overcoming imposter syndrome is to acknowledge that it exists. Recognize that feeling like an imposter doesn’t mean you are one. It’s a common struggle and doesn’t diminish the value of your work. By admitting these feelings, you can start addressing them more constructively.
1. Reflect on Your Achievements
Take time to reflect on your journey and accomplishments. Consider the training you’ve undergone, the clients you’ve successfully supported, and the positive feedback you’ve received. Keeping a journal of your achievements and client successes can help remind you of your competence and the impact you’ve made.
1. Seek Feedback and Support
One of the best ways to combat imposter syndrome is to seek feedback from colleagues and clients. Constructive feedback can reinforce your strengths and identify areas for growth. Additionally, surrounding yourself with a supportive network of fellow doulas can provide reassurance and validation. Engage in peer support groups or mentorship programs to share experiences and gain confidence.
1. Continuously Educate Yourself
Staying updated with the latest research and best practices in childbirth and doula support can bolster your confidence. Continuous learning helps you feel more secure in your role and ensures that you are providing the best possible care. Attend workshops, read relevant books, and participate in professional development opportunities.
1. Set Realistic Expectations
No one is perfect, and it’s essential to set realistic expectations for yourself. Understand that you will have successes and challenges. Embrace a growth mindset, where you view challenges as opportunities to learn and grow rather than as failures.
1. Practice Self-Compassion
Be kind to yourself. Self-compassion involves treating yourself with the same kindness and understanding that you would offer a friend. When you make a mistake or face a challenging situation, acknowledge it with compassion rather than self-criticism. Remember, you are doing important work, and it’s okay to have moments of doubt.
1. Celebrate Your Successes
Don’t forget to celebrate your successes, both big and small. Recognizing and celebrating your achievements helps reinforce your sense of competence and accomplishment. Whether it’s a successful birth, positive client feedback, or a new skill you’ve mastered, take time to acknowledge your hard work and progress.
1. Visualize Your Impact
Visualize the positive impact you have on the lives of your clients. Think about the relief, joy, and empowerment you bring to families during a pivotal moment in their lives. Keeping this impact in mind can help you see the value in your work and remind you why you chose this path in the first place.

Imposter syndrome is a challenge that many doulas face, but it doesn’t define your capabilities or worth. By acknowledging your feelings, reflecting on your achievements, seeking feedback, continuing education, setting realistic expectations, practicing self-compassion, celebrating your successes, and visualizing your impact, you can overcome these doubts and embrace your role with confidence.

Remember, your presence and support are invaluable, and you are more than capable of providing the compassionate care your clients need.

Shandelle Ferguson (she/her)

Doula Canada Instructor, Labour Doula and Postpartum Doula

Certified Labour and Postpartum Doula (Doula Canada)

Shandelle Ferguson is originally from Newfoundland but now calls Nova Scotia her home. With a passion for changing birth culture in Atlantic Canada, you can find her chatting with other doulas, reaching out to birth professionals and helping new parents in their journey into parenthood. Shandelle is a certified Labor and Birth and Postpartum Doula with Blossom and Birth Doula Services.

A mother to three, you can find her drinking coffee, or wine, and spending time with her family.[/vc_column_text][/vc_column][/vc_row]
September 10, 2024
Breastmilk Isn’t Free: The hidden cost of human milk

[vc_row][vc_column][vc_column_text title=”Breastmilk Isn’t Free: The hidden cost of human milk” css=”.vc_custom_1724336247678{margin-bottom: 0px !important;}”]August is Breastfeeding Awareness Month, or as I like to call it, Human Milk Month. In the birth world, most of us can rattle off the numerous benefits of bodyfeeding in our sleep. The probiotics, the antibodies, the bioengineered brain growing magic – the list goes on and on. In addition to the numerous health benefits, there are many practical incentives to feed human milk. Formula is exorbitantly expensive for lower-quality food. It’s easier to put a hungry baby directly to the breast in the middle of the night than it is to coordinate a sterile bottle mixed with sterile water while bleary-eyed. But we are way off base when we tell new and expectant parents that human milk is “free food”.

Singing the praises of lactation is tone-deaf to the fact that a need to return to work or school is the leading reason why new moms and birthers give up on nursing before 6 months. It takes a lot of privilege to produce on demand, unlimited food for another person for 6 months. Exclusively breastfeeding a newborn is a full-time job that doesn’t pay. It’s accessible to people who have the means to keep a roof over their heads and food for themselves in the fridge while absent from the workforce.

In Canada, we are fortunate to have the option to take maternity leave for up to 18 months. But there are several catches. Legally, your employer is required to reserve your job for up to 18 months. They are not required to compensate you during that time. If you are eligible for employment insurance (EI), the government will pay you 60% of your usual pay, up to a maximum. For most people who were working full time, this amounts to a significant loss of income. About 20% of employers in Canada will top up these EI payments to varying amounts and timeframes. The EI program makes payments for 12 months, therefore if you want to stay home for 18 months, the final 6 months are “self-funded” – i.e. you have zero income.

As for the many people who are not eligible for EI, unless they were in a position to set aside 18 months worth of savings or have spouses or other family members who are in a position to support them while they’re on leave, they will find surviving for even 6 months with no income quite difficult.

Unsurprisingly, racialized, Indigenous, low-income, and single birthers are more likely to need to return to work less than 6 months after they have their babies. During Indigenous Milk Medicine Week and Black Breastfeeding Week, we reflect on why breastfeeding rates continue to be lower for Black and Indigenous women than their white counterparts. This is a huge part of why. Until we address economic disparities, talking up the benefits of breastfeeding will not change outcomes.

We need to start framing the birthing person being home for at least 6 months as a human right for the baby and the birther. In the US, employers are only required to hold jobs for 6 weeks. This needs to be framed as a human rights violation, for mother and baby. So-called “breastfeeding friendly” workplaces do not cut it. Usually, this just means that there is somewhere other than a bathroom for lactating parents to express milk. This completely overlooks the logistical challenges of pumping and storing enough to keep a young baby fed during the workday and the emotional and psychological benefits of direct feeding.

We can look to examples in Europe, especially Nordic countries, for human rights models of lactation and new parenthood. In Sweden, new parents are entitled to be free from work and receive benefits for up to 18 months after their child is born. This entitlement can be shared by a couple or used by a single person. Unsurprisingly, Sweden and other Nordic countries have higher breastfeeding rates at 6 months than other high-income countries.

When my wife and I were born, mothers were entitled to 6 months’ leave. When I had my son 12 years ago, we were entitled to 12 months. Now people are entitled to 18 months. These are steps in the right direction that make sustained lactation and adequate bonding and recovery more feasible for many people. But there is still room for improvement, especially more support for working and working poor families. We need to see subsidizing the cost of human milk as an investment in a healthier future for children and families.

Keira 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][vc_row][vc_column][/vc_column][/vc_row]

August 2, 2024
Gender-open parenting starts on day one

[vc_row][vc_column][vc_column_text css=”.vc_custom_1722343166871{margin-bottom: 0px !important;}”]It’s non-binary awareness week which lends a great opportunity to open a dialogue about gender-open parenting. It’s a practice-based approach to acknowledging that a person’s gender identity can be fluid and does not always align with the sex assigned based on a visual assessment of external genitalia at birth. Parents taking a gender-open approach take actions like choosing a gender-neutral name, building a wardrobe that includes “boys”, “girls” and neutral clothes, using they/them pronouns by default until the child chooses gender-specific ones, and offering the full range of toys and activities to choose from regardless of customary gender associations. This leaves the child free to explore and express their gender in their own time and way, including embracing non-binary, gender-fluid, and agender identities.

It sounds simple, but it’s not. The gender segregation of humans starts at birth or before. When my son was born he was swaddled in a reversible hospital blanket that could have pink facing out for babies with innies, and blue facing out for babies with outies. Often, if the baby’s sex is known or suspected before birth people will begin using gendered pronouns and language.

It also sounds relatively uncontroversial. After all, gender-specific clothing for infants wasn’t really a thing until part way through the 20th century. All little boys wore dresses until they were about school-aged. Haircuts were also not gender specific and names have flipped-flopped between and across genders based on region and fashion. Yet, less than 15 years ago when a Toronto family announced that they were raising their child gender-open, and to that end not disclosing the child’s biological sex to anyone outside of immediate family and healthcare providers, it created a community uproar that made headlines.

People who had nothing to do with this family were outraged, with some going so far as to call not sharing the nature of their child’s external genitalia with society at large “child abuse”. The move was ingenious in that it required people interacting with the child to use they/them pronouns or the child’s first name, which was exactly the source of outrage.

Most parents who raise their child gender open find this plan goes down the tubes if anyone learns the child’s sex assignment. Once this information becomes known they find themselves dealing with such a flood of gendered language, behaviour, and expectations that stopping it is like putting the proverbial finger in the dam. Some studies show that adults caring for newborn girls are more likely to refer to them as “pretty”, and “sweet” and newborn boys as “strong” and “smart”. The continuous conditioning to conform to gendered expectations continues from there.

Sadly, with confidentiality comes censure, especially since this is often kept from extended family members as well. A common valid concern is that the child will feel pressured to keep the secret as they grow older causing shame about their body and other psychological harm. In reality, gender identity typically asserts itself in early childhood, unlike sexual orientation which asserts itself at the onset of puberty. By the time they are old enough to speak well and be in social situations where they are changing around other kids, they will likely have chosen suitable pronouns and other gender markers that work for them. The child is never expected to keep a secret, rather it is the adults caring for them who are expected to maintain their privacy.

So, if you’re a birth worker supporting a family choosing to raise their child gender open or considering it, what can you do to affirm their choices?

Queer Culture

Often families making this choice are culturally queer, meaning that regardless of their own sexual and gender identity they are heavily immersed in and accepted by the queer and trans community. Affirming their right to parent gender-open is part of affirming their right to live open queer/trans lives, and raise their kids in the community.

A growing number of people who are not culturally queer are starting to move toward gender-open parenting. In certain ways, those parents face additional challenges, in that they are not as likely to be connected to a community, including healthcare and childcare providers, who are familiar with and supportive of this choice. In this instance, an affirming, queer/trans-competent doula has the power to make a huge difference in their ability to implement this choice by respecting and normalizing their preferences, connecting them with community support, and helping them brainstorm practical ways to avoid gendering their child.

Self Reflection

In some ways, people in Baby’s sphere who don’t know what’s inside their diaper have it easier. If you were there when they were born, or if postpartum support includes diaper changes, you don’t have the advantage of sincerely not knowing their sex assignment.

Don’t take that running stream of babble you’re maintaining with your young charge for granted. Be open to noticing the gendered implications of the way you’re engaging. In addition to language, there’s evidence that caregivers play with and speak with baby girls more gently than boys. Do you notice these behaviours in yourself? Can you consciously move the needle toward more gender-neutral interactions?

Also, remember that while the baby’s sex assignment might not be confidential information for every family, it may be highly so for this family. Have a clear conversation with the parents about their preferences and try not to let that information slip.

It’s Tough Out There

The intro to this article made it sound like you just had to do a handful of things, and voila – you’re parenting gender open. In reality, most parents who are quite gender aware, including trans and non-binary parents find it far more challenging than they thought it was going to be. Not knowing a person’s gender makes most people uneasy. It’s one of the most ingrained ways of sorting humans into categories. With uneasiness comes resistance. Moreover, much of how gender expectations are conditioned is subtle and can’t be avoided by using a certain pronoun or making sure all the clothes are yellow, green, and natural tones.

Parents need significant emotional support from people who understand why this choice is important to them. Just holding space for how challenging it is and encouraging them to preserve their values is an invaluable way that a birth worker can have a positive impact.

Keira 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]

July 7, 2024
Disability as a source of strength

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Often, when we think about disability, the focus is on what an individual is unable to do. However, given that 22% of Canadians live with some form of disability it’s clear that people with disabilities are capable of quite a lot.

Disability Pride Month has been observed in July in the US since the Americans with Disabilities Act was passed in 1990. It is now observed around the world, including in Canada. It creates an opportunity to highlight the strengths and contributions of disabled people and dismantle limiting beliefs about the nature of disability.

The term disability is designed to acknowledge that a person’s ability is limited by social and structural barriers that disenfranchise them and limit their participation.

In order to survive, many disabled people have to be ingenious in navigating a world that isn’t designed for them and which frequently doesn’t account for their existence. A strength-focused disability lens emphasizes the things the disabled person can do, using this as a starting point to reduce and remove barriers. It takes the view that what we construct as disability is simply natural variation among individuals and something to be celebrated rather than stigmatized. It’s a person-centered approach that prioritizes the disabled person’s right to self-determination and trusts that they are the expert on their strengths and limitations.

A strength-focused lens is a constructive framework for birthworkers supporting disabled birthers and new parents. These clients are up against many limiting beliefs regarding their ability to give birth and care for their newborns. For example, many prenatal healthcare providers believe that wheelchair users cannot push to deliver a baby and therefore must have early scheduled c-sections. This is not always true and there’s no evidence-based reason for that belief. A couple of years ago, we hosted a panel discussion of disabled parents, two of whom were wheelchair users who had birthed vaginally. One of them birthed precipitously. They both had to resist limiting beliefs on the part of care providers to realize the empowering births they deserved.

Several of the parents on that panel described intense surveillance in the hospital after their babies were born. The feeling that they were being watched and that people around them were waiting for them to fail rather than offering support was widespread.

Encouraging people to take pride in their bodies and their ability to birth their babies is at the heart of our calling as doulas. Disabled people have so many reasons to feel proud of what their bodies have achieved. We can remind our clients that they have already come up with countless life hacks to get things done. These are all skills that they can transfer to the new situation of childbirth and infant care. We can let them know that we know that they’re a lot stronger than most people think they are. And where they are not strong, that’s okay, we’ve got their back if help is needed and wanted. We can be that person they remember as someone who didn’t make assumptions about what they could do, but asked questions instead.

With such a high proportion of the population being disabled our birth work practices will inevitably include disabled people in the form of clients, colleagues, and ourselves. We see every one of you who provides long hours of birth support despite your chronic pain, or mental illness that requires regular sleep to stay in remission. We see all of you who tap into an extra reserve of energy to soothe a colicky baby or extend compassion to a new mother with postpartum depression. Your effort and your sacrifice matters. You deserve to take pride in the strengths of your body and mind that you share with your community each day.

Keira 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]

July 1, 2024
2024 Medicaid & CHIP Beneficiaries at a Glance: Maternal Health

[vc_row][vc_column][vc_column_text title=”2024 Medicaid & CHIP Beneficiaries at a Glance: Maternal Health” css=”.vc_custom_1718910346497{margin-bottom: 0px !important;}”]In the United States, publicly-funded healthcare is provided through Medicaid and CHIP (Children’s Health Insurance Program). These are joint programs of state and federal governments that provide health insurance to low-income people, children, people with disabilities, and pregnant people. These eligibility parameters mean that there are individuals who are eligible for coverage during their pregnancies and the postpartum period who are not eligible at other times. Medicaid finances 41% of births in the United States. Federal law requires states to provide coverage up to 60 days postpartum. A bill in 2021 gave states the option of participating in an extended coverage program offering coverage up to one year postpartum.

In May 2024, Centres for Medicaid and Medicare Services (CMS) released an infographic summarizing beneficiaries’ maternal health data. CMS collects demographic data on age, race and ethnicity, and geography. They collect outcome data on maternal mortality and severe maternal morbidity (SMM), underlying causes of maternal mortality, dental care access, postpartum contraceptive utilization, spacing between pregnancies, chronic conditions, timeliness of prenatal and postpartum care, smoking, behavioral health and substance use, neonatal abstinence syndrome, postpartum depression (PPD), preterm birth, and low-risk cesarean delivery. Additionally, they collect health system data on healthcare service provider distribution, state quality improvement activities, and state participation in an opt-in extended postpartum coverage program.

Key Take Aways

The data highlight key areas of disparity for Medicaid beneficiaries and provide an important road map for healthcare policymakers and system designers regarding where care could be enhanced. For example, the data show that Black birthers experience mortality 2.6 times more often than their white counterparts. This finding corroborates other research and supports advocacy efforts for publicly funded doula care as an intervention to reduce Black maternal mortality rates. Another useful observation is that birthers under the age of 19 experience higher than average rates of PPD (22% compared to an average of 17%). This suggests that in addition to universal PPD screening, additional attention should be paid to this group during the postpartum period.

This 9-page resource provides invaluable information to support US birthworker advocacy on expanded access to birth and postpartum doula care, freedom of provider choice and birth location, and mental healthcare. For birthworkers in Canada and other jurisdictions, it is an illuminating example of what can be learned from comprehensive demographic and outcome data collection practices.

Keira 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]

June 24, 2024
Emancipation is a collective State of Mind: Birthworkers need to talk about slavery

[vc_row][vc_column][vc_column_text css=”.vc_custom_1717529438169{margin-bottom: 0px !important;}”]As a child, I loved the “Heritage Minutes” on CBC. These memorable 60-second spots about Canadian history stand out more in my mind today than most of what I learned in Canadian history classes. One of the most notable stories was the Heritage Minute about the Underground Railroad which chronicled the moment when an escaped, enslaved African American family realizes they have successfully made it to freedom in Canada. “We’s free! We’s in Canada” exclaimed the family as they embraced each other tearfully.

Like many Canadians, I was unaware of Juneteenth until a few years ago when President Biden proclaimed it a national holiday. June 19th is a significant date in US history because it is when the last group of enslaved people were emancipated approaching the end of the Civil War. As a nation with a strong tendency to congratulate itself for being the nation that American slaves escaped to, it can be difficult to see what this emancipatory celebration has to do with Canadian history or society.

In fact, slavery was a normalized way of life in the colonized territories that eventually became known as Canada for over 2 centuries. In the early days of the colonial process, Indigenous peoples were enslaved, along with Black people brought to the Americas by the trans-Atlantic slave trade. It ended in Canada in 1807 when slavery was abolished throughout the British Empire. In contrast, Juneteenth commemorates June 19, 1865, fifty-eight years later.

So why is it important to talk about slavery today, and why is it relevant to birthworkers? To enslave people, you must first dehumanize them. The transatlantic slave trade codified beliefs about Black people that can’t be eradicated as easily as laws. These beliefs are alive and well, and responsible for much of the suffering experienced by Black people globally today. For example, on May 25, we commemorated the 4th anniversary of the brutal murder of George Floyd at the hands of a police officer. This is despite the many years the Black Lives Matter movement has raised awareness of similar incidents.

This is relevant to birth workers because this dehumanization is enacted in the health care system as well. We shared an article about “The Mothers of Gynecology” in February. The dehumanization that these enslaved women experienced as they were experimented on without anesthesia is the direct ancestor of the horror stories described by prominent Black figures such as Beyonce, Serena Williams, and Tatyana Ali. Their stories represent the stories of countless others who don’t have the same kind of platform, including many Canadian Black women and birthers.

As health researchers and policy-makers in the US struggle to combat the Black maternal and neonatal mortality crisis, growing evidence emerges that culturally competent doulas have a significant positive impact on Black maternal health outcomes. This evidence has led to an ever-increasing number of US jurisdictions providing public funding for doula care to ensure that this support makes it to families that need it most.

These strides forward are connected to a broader trend in US culture of acknowledging its racist past and that racism is still a part of the fabric of its nationhood.

Frankly, my observation as a Black woman who has lived in Canada for over 40 years is that as a nation, we are still stuck in denialist whitewashing. For example, while I had long since debunked the mythology of the underground railroad heritage minute, I had no idea that Indigenous people had been enslaved in Canada until I started researching this article.

We know that reconciliation cannot exist without truth. The path to collecting the same level of data that has made publicly funded doula care possible in the US begins with acknowledging that racism is as baked into our history and as prevalent in today’s social fabric as it is in the US.

Canadians observing Juneteenth can use today to learn about the history of Black and Indigenous enslavement in Canada and reflect on how it impacts the modern day. I highly recommend looking at the work of Black Canadian scholar and historian Dr. Afua Cooper. In particular, her book “The Hanging of Angelique: The Untold Story of Canadian Slavery and the Burning of Old Montreal” is a great read. It chronicles the tragic tale of an enslaved Black woman in Lower Canada (now Quebec) who was scapegoated and tortured into confessing to the great fire of 1734 in Montreal. Cooper’s prodigious research captures the nightmare of Canadian slavery and the early colonial period. Drawn largely from copious trial records, Angelique’s words are considered the earliest known first-person account of slavery in the New World.

Keira 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]

June 19, 2024
Pride is Being There for Each Other

[vc_row][vc_column][vc_column_text title=”Pride is Being There for Each Other” css=”.vc_custom_1717529719709{margin-bottom: 0px !important;}”]Nowadays, the word “Pride” is almost immediately associated with “Parade” in many people’s minds. But in the LGBT2SQ+ community we know that at its inception “Pride” went with “Protest”.

Most people think of the Stonewall Riots as the start of the gay liberation movement in North America. Here in Toronto, we had a similar watershed moment that acted as a catalyst for the emergence of the June Pride Festival. On February 5, 1981, Metropolitan Toronto Police initiated Operation Soap. Four Toronto bathhouses were raided and over 300 men were arrested. This was the largest mass arrest in Canadian history at the time. The arrests caused careers and families to be destroyed. The event sparked nation-wide protests and was an important turning point for Queer and Trans liberation in Canada.

These protests and rallies denouncing Operation Soap evolved into the Toronto Pride Festival, one of the largest pride festivals in the world.

In the four and a half decades since Operation Soap, there have been many reasons for our community to celebrate. We’ve made important strides forward like marriage equality and easier access to family-building. And by celebrating our identities, we resist the pressure to hide, assimilate, and deny our truth.

However, Pride still needs to be a protest. Backlash is here and it’s a real threat. Unfortunately, children seem to be the primary targets of this backlash. There is a movement aiming to make it hard for kids with queer parents to talk openly about their families and be affirmed at school while making it difficult for kids with cis, straight parents to learn that queers exist and humanize them. This movement also aims to force educators to disclose confidential information about the gender identity of their students, which would inevitably expose some of these children to abuse. A federal ban on conversion therapy in 2022 has simply driven the practice more underground, and no charges have been laid under the new legislation. Kids can’t show up to listen to drag queens read stories without having to walk past a phalanx of angry anti-trans protestors.

We can drown out this hateful backlash with a flood of compassion. It starts by declaring proudly and unequivocally that you affirm queer and trans people in your birth work practice. Then, you bring the skills to the table.

Here’s a guide to resources that can support you in growing a queer and trans-competent birthwork practice.

The Queer Doula Toolkit

This free download developed by Wellness Within and Nova Scotia Public Interest Research Group (NPIRG) is a must-have resource for birth workers supporting queer and trans clients. It is choc full of educational resources and fillable exercises. Some of these are on topics that are relevant to the 2SLGBTQ communities, like pronouns, queer families, and queer terminology. Others go over the usual perinatal health topic in a queer-trans-inclusive way. The toolkit is illustrated with vividly realized characters encompassing humans of all shapes, sizes, colours, gender presentations, abilities, and family structures.

The fillable exercises include a queer-affirming and trauma-informed birth plan. The birth plan is supported by trauma-informed reflections that ask the client to reflect on their triggers and potential coping strategies. The strategies can be documented in the plan, including how their doula can help.

Books & TV

Why Did No One Tell Me This? The doulas’ honest guide for expectant parents.

This book is a great resource for parents and birth workers. It’s not specifically queer, but it is written from an intersectional standpoint and uses inclusive language and imagery throughout. It’s a great option for parents looking to supplement their prenatal class or work with a doula and affirms a wide range of birthing people.

What Makes a Baby?

If the older sibling of a gayby (child of same-sex parents) wants to know where their new sibling came from, this is the book for them. Appropriate for early-years children, it answers the question “Where do babies come from?” in a way that is scientific and inclusive of the various ways in which queer and trans people family-build.

Flamingo Rampant

This independent children’s press has a beautiful and ever-growing selection of children’s books that celebrate the diversity of families and identities. Operating from an intersectional social justice lens, this publisher prioritizes stories about gender and sexually diverse children, youth, adults and families doing things that are bold, cool, adventurous and fun without making identity the focus of the story. Each book radiates a message of joy, acceptance, community, and love.

Keira 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]

June 4, 2024