Category: Anti-racism work

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Anti-Oppression Anti-racism work Equity Health Care intersectionality lactation LGBTQ2S+ surrogacy understanding bias

Reflections on Trans Inclusion in Birth & Lactation Support

Response re Inclusive Language

Miriam Main, one of the directors of La Leche League Great Britain (LLLGB) recently resigned because she objects to the organizational directive to be inclusive of all people who lactate, regardless of sex or gender identity. Her open resignation letter explaining her decision echoes much of the feedback we’ve heard in recent years from birthworkers who disagree with our use of language such as “chestfeeding”, “birthing person” and other terms aimed at ensuring that all people who birth babies and feed infants from their mammary glands feel included and supported with the resources required to meet their feeding goals. 

Her objections to trans inclusivity include:

  • Women cannot be physically and emotionally open with “men” present
  • Men will make LLL meetings unsafe
  • It might be dangerous for men to feed babies
  • Men feeding babies separates them from their mothers, causing damage to the mother-baby dyad.

November 20 is Trans Day of Remembrance. The day was founded in 1999 in protest of the murders of two Black trans women, Rita Hester and Chanelle Pickett. There is heightened tension regarding this day this year because of the US election outcome. Trans people in the US and elsewhere are deeply afraid that emboldened transphobes will be incited to violence. Further restrictions on trans people’s ability to access affirming care is likely coming. The inability to access gender-affirming care increases suicidality among trans people. While Main claims that she is not anti-trans rights, unfortunately, rhetoric like Main’s fans the flames of fearful and hateful myths putting trans lives in danger.

The Confusion About Main’s Objections

Main is against the presence of “men” at LLL meetings. Confusingly, she includes transmen and non-binary people in a list of types of “women” she has effectively supported at LLL meetings in the past as a leader. When she uses the term “men” she could be referring to trans men who gave birth to their babies or trans women using the lactation induction protocol to assist with feeding their babies. Through this confusing use of language, Main appears to be asserting that trans men are “women” and that trans women are “men”.

Main’s view is rooted in an idea called “gender essentialism”. This is the belief that there are two genders, that gender and sex are the same, and that the characteristics of the genders are an innate, hardwired aspect of our biology. While many people subscribe to this normative view, there is a growing body of evidence that it is scientifically inaccurate. Since the dawn of recorded history, in cultures around the world, there have been people who don’t fall into the binary sex and gender categories of “man/male” or “woman/female”. Many cultures have acknowledged more than two genders. Now science is catching up with these age-old lived experiences. 

Main’s statement recirculates several myths that we as birth workers need to dismantle:

Women Cannot be Physically & Emotionally Open with “Men” Present

Main argues that it would be impossible to maintain the open, honest environment of LLL meetings if men were present. How could women feel comfortable talking about things like chapped and mangled nipples, or nurse in front of others if men are present? Main doesn’t realize it, but she answers her own question. She notes that breastfeeding is “the great leveler”. She observes that LLL group participants put aside differences regarding race, religion, income, politics, and sexual orientation. They are united in their shared goal of feeding their babies from their bodies. Whether participants are cis women, trans men, or trans women they are all dealing with chapped nipples, sleepless nights, and internal and external pressure to use bottles. Imagine the world we’d be living in if we developed our ability to focus on what we share rather than what divides us.

Men Will Make LLL Meetings Unsafe

She also fears that women may not feel comfortable coming forward about domestic violence if men are present, noting that 1 in 4 women have experienced intimate partner violence. A Canadian study of trans people conducted in 2019 found that 3 in 5 trans women had experienced intimate partner violence. Contrary to some of the rhetoric surrounding the recent US election, trans women are not usually the perpetrators of violence. They are in the population that is at increased risk of experiencing gender-based violence. Cultivating the erroneous belief that trans people are a source of violence is a significant inciter of violence against trans people. This needs to stop immediately.

Damage to the Mother-Baby Dyad

The letter raises safety concerns that are fear rather than fact-based. She posits harm to mothers and babies caused by ripping babies from their mothers’ arms so that men can feed them. Like much of what is fueling the current trans panic, this is a total red herring. Babies are not being ripped from their mother’s arms so that men can feed them. In the case of trans men, they are usually the gestational parents of their babies. Non-gestational parents with breast tissue can induce lactation. This includes cis women, trans men, and trans women becoming parents through adoption, surrogacy, or their partner carrying the baby. The protocol to induce lactation is rigorous, involving high doses of hormones and domperidone for several months before the birth. In cases where nursing is shared between a gestational and non-gestational parent, this is with the consent of both parents. For anyone who has fed a baby with their body, it should be easy to see why sharing the load of this labour might be desirable. 

Regardless of the exact nature of the situation, it’s safe to assume that anyone showing up to feed a baby at a La Leche League meeting is a parent to that baby. That’s really all that should matter.

It Might be Dangerous for “Men” to Feed Babies

She asserts that it might not be safe for babies to be fed by a “man”. She cites no evidence of any safety concerns. This is because there is none. Aside from universal precautions regarding substance use or infectious disease, If milk comes from your nipples, you can feed it to a baby. Where supply is inadequate to meet the baby’s nutritional needs, this can be addressed as it would be for anyone. We all know how frustrating and overwhelming supply issues can be. Parents experiencing this challenge need more compassion and support, not less.

There’s no reason to believe that trans lactators are at increased risk of under-supply or babies that are failing to thrive. In response to Main’s open letter, IBCLC Ashley Pickett has shared some helpful research. She notes that “When people take hormones, they can still breastfeed. It hasn’t been shown to be dangerous. Many AFABs [assigned female at birth] are entering menopause, and breastfeeding while on HRT [hormone replacement therapy]. Some trans women have taken estradiol and domperidone and their breastfed babies thrive.”

The potential for trans women to lactate and nurse is a new phenomenon, and as such, bound to raise concerns. Ashley Pickett, IBCLC addresses this with the best available evidence also. She cites two articles showing no cause for concern at this time:

https://pubmed.ncbi.nlm.nih.gov/37138506/

https://pubmed.ncbi.nlm.nih.gov/7462406/

Drawing from the articles she cites, she also provides evidence to allay fears that hormones are crossing over into the milk supply and causing harm to babies:

“Spironolactone is poorly excreted into breastmilk and there are no reported adverse effects on infants.

Cyproteone Acetate (used for [male to female] transitions as well as more commonly for acne and hirsutism, alopecia, etc) in people [assigned female at birth] transfers at 0.2% of the parental dose. However, in trans HRT uses high doses. Switching to an injectable Estradiol Valerate may be enough to elevate estrogen and not require an anti-androgen, and safely breastfeed. Breast development would remain, but she may grow some unwanted hair.

GnRH treatment has been used in postpartum contraception for decades, and in this time, has been shown to be as low as undetectable in milk and up to 1-2 micrograms per feed at max. The amount ingested had no biological activity in the infant (would be destroyed in the gut before entering the system). When taken throughout pregnancies, as it has been for many many experiencing fertility care since the 1990s, there has been “no specific hazard observed” among newborns exposure.”

 ~

The REAL issue

Evidence has nothing to do with Miriam Main’s underlying fear. It is the same as that of our members complaining about our use of gender-inclusive language. She is afraid that she and her fellow cis women are being erased from spaces that should feel like home. While this fear is an understandable conditioned reaction to change, it is unfounded. Cis women continue to comprise the majority of people who birth and lactate. Our use of inclusive language is an action to begin opening the door for trans and non-binary people who birth and lactate to receive affirmation and support. For cis women reading this, take a moment to imagine what it would feel like to walk into an LLL meeting knowing that there will probably not be anyone else in the room who is like you, but you need help feeding your baby all the same. Would you be brave enough to walk into that room? Would you be grateful for any gesture that made it a little easier?

Letting trans folks in doesn’t erase us as cis women. It is not usually presented this way, but trans inclusion and acceptance create more freedom for cis women. As we dismantle rigid, binary gender constructs and break down boundaries regarding what a “woman” can or should be, we are all freer to express ourselves authentically. I was raised in a family of women who couldn’t leave the house without “putting their faces on”. Now, I wear makeup when I feel like it. I speak truth to power without hesitation because I’m not limited by the belief that being a “woman” requires passivity. Every day I engage in numerous actions that I take for granted that would have been unthinkable for a Black woman a century ago. I owe a huge debt of gratitude to racialized trans ancestors, like Marsha P. Johnson and Sylvia Rivera, who started the Stonewall Riots, and with them, the queer liberation movement in North America.

If we let go of the fear of erasure, we can invite in the potential for trans people to enrich birth and lactation spaces. We may discover that the experiences of trans people add an important perspective on issues affecting all of us who experience gender oppression and gender-based violence. Community support and mutual aid are not finite resources. We don’t have to worry that by making space for trans people, cis women will be squeezed out. There is room in the circle for everyone.

 

About the Author

Keira Grant

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.

Categories
Anti-Oppression Anti-racism work collaboration community decolonization national indigenous peoples day Trauma

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 CommunitiesKeira Grant

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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Anti-racism work Canada Health Care Maternal Mental Health Uncategorised

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.

Medicaid Insurance card with thumb holding it

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.

Black pregnant person with long braids and mustard coloured dress

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]

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Anti-Oppression Anti-racism work Canada decolonization

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]

Categories
Anti-Oppression Anti-racism work Canada collaboration community decolonization Equity indigenous doula intersectionality national indigenous peoples day

Land Back, Bodies Back

Indigenous standing on the dock of a lake and greenary

[vc_row][vc_column][vc_column_text title=”Land Back, Bodies Back” css=”.vc_custom_1717529147132{margin-bottom: 0px !important;}”]Many settlers (i.e. all non-Indigenous residents on Indigenous land) are resistant to the Land Back Movement. Misinterpreting “Land Back” as a call for all settlers to “go back where they came from”, they often get scared, then angry.

I am a Black settler on Turtle Island and I support the Land Back Movement. I certainly have no intention of “going back where I came from”. Aside from the fact that this would split up my interracial family, my ancestors hail from a Caribbean island wherein there are more of us in the diaspora than there are living on the island. If all of us who are now settlers elsewhere suddenly “returned” this would lead to social chaos and economic collapse.

Land Back isn’t symbolic either. It is about restoring the stewardship of this land and its resources back to Indigenous people, ensuring they have self-determination. It’s about changing the narrative such that Indigenous ways of knowing and doing become the status quo.

I am ride or die for a Turtle Island stewarded by Indigenous leaders. Climate change is heating up quite literally, with “wildfire season” starting earlier with bigger outbreaks each year. There is growing talk of returning to Indigenous “controlled burning” practices to mitigate the devastation. Indigenous communities were forced to abandon the practice because their colonizers thought controlled burns were “barbaric”. It’s one of countless examples of traditional resource stewardship practices that were abolished to the detriment of all.

The Canadian state has a long history of interpreting its treaties with Indigenous nations in bad faith. Settler-colonists spuriously interpreted the land as meaning nothing more than the ground we are standing on. Where treaties have designated the land to specific nations, the state and its agents have still felt entitled to help themselves to the resources on that land, including plants, water, minerals, and animals.

Indigenous nations have a more holistic understanding of the land. Everything the land produces is part of the land and the Indigenous elders representing their people signed the treaties with that pragmatic worldview. Seen in this way, our bodies and families are also part of the land. As such, reproductive and perinatal health and services are significant arenas for the Land Back movement.

Indigenous midwives and doulas are at the forefront of actions to decolonize and reclaim birth. Here are a few examples of their initiatives that are bringing Indigenous birth back to the land:

 

  • Konwati’shatstenhsherawi’s means “Women are Giving Each Other Power” in the Mohawk language (Kanien’kéha). This collective trains Indigenous birth helpers to support birthing people using ancestral worldviews and practices. Since the grassroots program’s inception in 2017 demand has been high and the 4-person training team is busy teaching new cohorts all the time.

 

  • Call Auntie is an Indigenous-led sexual and reproductive healthcare clinic operating weekly at Toronto Birth Centre, and as a pop-up at other locations around the city. They offer a holistic suite of services rooted in traditional Indigenous knowledge, including mental health, primary care, and social support programs. Their service model emphasizes problem-solving, removing barriers, and community-led care.

 

  • Pauktuutit Inuit Women of Canada is making important strides forward in expanding access to traditional midwifery in remote northern communities. Their position is that this access is a health and cultural right for Inuit people. They recently published a report finding that governments do not provide adequate financial support to culturally safe sexual and reproductive health care. They advocate for an end to forced birth evacuation and a return to traditional birthing practices on the land.

 

  • Mālama Nā Pua o Haumea is a collective of Hawaiian traditional midwives who are working to reduce maternal mortality rates which are higher in Hawaii than in the continental US. Recently, legislation governing midwifery care has changed and they are now required to become certified nurse midwives (CNM) or certified professional midwives (CPM). Pale keiki (traditional Indigenous Hawaiian birth attendants) experience multiple institutional barriers to completing this certification, including cost and relocating to an urban centre. In contrast to these 4-year certification programs, pale keiki train with a mentor versed in intergenerational knowledge for over a decade. Some pale keiki are continuing to provide culturally safe care in Pidgin, despite these legislative changes. (US)

 

  • Kehewin Cree Nation has launched a program to train traditional midwives and has received federal funding to open a birth center on its territory. The nation aims to see more Cree babies born on their land and to honour sacred traditions such as placental ceremonies. Trainees in the program learn the knowledge of their midwife ancestors alongside Western medical knowledge. Four women are in the inaugural cohort and the program will take up to 4 years to complete. Kehewin Cree Nation anticipates these 4 trainees will be the first of many.

 

 

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]

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About Us Anti-Oppression Anti-racism work birth Canada

EDI Year in Review 2023

[vc_row][vc_column][vc_column_text css=”.vc_custom_1709738042033{margin-bottom: 0px !important;}”]A river may be so still that you can see your reflection, but its current is always in motion. This year has been a time of great change for Doula Canada as we have welcomed renewal in the form of new leadership. We have taken advantage of this transition to reflect on revitalizing our commitment to equity, diversity, and inclusion at DC and in the birth sphere. Our goal is to ensure that Doula Canada alumni have the necessary tools and frameworks to meet the diverse spectrum of birthing people, families, and communities with compassion, affirmation, and allyship. In the coming year, we will continue to apply the lessons learned from all of your insights to realize policy, curricula, and continuing education that sets doulas, reproductive health educators, and birthworkers up for long-term success in an ever-changing world. 

Here are some of the highlights of our actions in 2023 and our plans to advance our journey towards achieving social justice in our learning community and perinatal social systems in 2024.

 

Content & Communications

One of our goals is to ensure that DC alumni have access to a wealth of information that offers insight into the experiences of equity-seeking birthers and families, and tools to empower effective support. This year, we accomplished this by creating and publishing original articles, position statements, downloadable resources, and live-streamed discussions.  

Articles and Position Statements 

Our blog provides ongoing equity, diversity, and inclusion content that situates reproductive justice in the context of social issues, and that supports our learners to cultivate a deeper understanding of the social determinants of reproductive health. In 2023, our blog offered articles on trans inclusion, domestic and gender-based violence, truth and reconciliation, poverty, black maternal health, and many other essential perinatal health equity topics. 

We also endeavoured to be responsive to the impact of current events on community well-being by providing a statement on the Israel-Hamas conflict that offered comfort to our members and practical strategies for preserving emotional stability and community connectedness.

Downloadable Resources 

In 2023, we created three downloadable resources to provide practical guidance for birth workers. The first was our Advocacy Toolkit. The toolkit continues the work done in 2022 to develop an advocacy framework for Doula Canada. The Toolkit works through examples of the ingenious strategies that birthworkers use to promote client self-advocacy and advocate on behalf of clients in a manner that affirms their autonomy and right to informed consent.

Additionally, we created two resources to support human milk feeding. One is an infographic on human milk sharing that provides information on the risks and benefits of milk sharing, as well as safety guidelines that support families to make informed choices about their feeding options. The second is a curated Lactation Recipe Box with meal and snack ideas that are packed with ingredients that gently encourage milk production. 

Live Streams

We continued our tradition of hosting great conversations with experts and thought leaders from within Doula Canada and the broader birth world. Our guests offer insight into how they’ve applied their training and lived experience to facilitate clients’ access to equitable care. In 2023, topics included empowering teen birthers, debunking fatphobic reproductive health myths, barriers to fertility care, what we need to know about birthers who use testosterone, and the experiences of black families with more than “2.5 kids”. Content ideas were generated from discussions with our members at live events and online and from suggestions made using our anonymous feedback form. Our audience can access this content at any time from our Facebook page or our YouTube Channel.

In 2024, live streaming content will shift to a virtual, guest speaker Q&A series, opening with Support Men’s Lactation Like a Boss on February 29. 

Programming 

Doulas for Reconcili-ACTION

Committing to our Truth and Reconciliation Action Plan, we launched the Doulas for Reconcili-ACTION program. The Doulas for Reconcili-ACTION program aims to include non-Indigenous doulas in important conversations about the impacts of settler-colonialism, and build cultural humility skills in an applied workshop format. Our first workshop was held for National Day for Truth and Reconciliation, and focused on the historical traumas imposed on Indigenous communities, and the role of doulas in mitigating risk factors for Indigenous families.

In 2024, the Doulas for Reconcili-ACTION program will be running on a monthly basis. 

Webinars

Recognizing a need for community healing and dialogues in the aftermath of the disturbing events culminating in the arrest of Kaitlyn Braun in March of 2023, we hosted a session aimed at providing a safe container for community members to unpack the feelings arising from this distressing incident. The session was facilitated by Elizabeth Evans, RSW, and Psychotherapist and generated a presentation for community members on collective healing after traumatic events.

In order to provide practical support to our members regarding the implementation of ethical practice as defined by the law, we also hosted a webinar on understanding the legalities of your doula biz facilitated by Ane Posno, LLB, an expert in health and contract law at Lenczner Slaght. The first webinar of its kind at DTC, the live session provided vital information on documentation, confidentiality, and reporting obligations for doulas. 

Organizational Development 

Census

For the first time in its over 20-year history, DTC undertook a demographic census of its student and alumni population to learn more about how we can ensure that our content is responsive to our existing population and target our recruitment efforts to attract equity-seeking communities that may be underrepresented at DTC or in the birth work field. 

154 members completed the survey and the findings were illuminating. DTC’s population is highly diverse, with DTC members being more likely to be equity-seeking than the general population across several categories including Queer people, and some racial groups (e.g. Black, Indigenous). Other equity-seeking populations, such as disabled people have representation that is similar to the Canadian population.

One challenge with analyzing this data is that 6.5% of our sample are international but Canadian data has been used for comparison. Other limitations of this data set include categories not always being exactly aligned with the categories used by Statistics Canada, and questions that should be further segmented to create clarity, most notably education. 

On the whole, it appears that organizational efforts to ensure that equity-seeking members feel included and represented have been effective at attracting diverse students to our programs. In 2024 we should conduct an evaluation of the EDI climate to learn more about the quality of the learning experience for equity-seeking students, focusing on learning more about the experiences of underrepresented groups. In the case of underrepresented groups, DTC could also consider key informant interviews with individuals external to DTC to learn more about their needs in a birth worker training program and successful recruitment and retention strategies for their community.

Roll out of advocacy framework 

In addition to sharing the toolkit mentioned above, we are in the process of ensuring that the lessons learned from the advocacy initiative are incorporated into the anti-oppression module in our courses. The revised curriculum was piloted during the live session on anti-oppression for the fall 2023 cohort of the holistic doula program. The new content includes introducing learners to the 3 soft-advocacy techniques used by doulas as codified by S.S. Yam, namely 1) creating deliberative space, 2) culture and knowledge brokering, and 3) Spatial maneuvering. Live session attendees have the opportunity to discuss examples of how doulas use these advocacy techniques to benefit clients.

TRAP module

In 2023 we launched our truth and reconciliation module, which focuses on educating students about colonial violence toward Indigenous communities. This module was inspired by various universities that have mandated Indigenous Credit Requirements (ICR) to show respect to Indigenous communities, and foster reconciliation between settler and Indigenous groups. In 2024, applications will be open to students and alumni wanting to participate in a review of the Truth and Reconciliation Action Plan, including the module. This committee will also focus on creating a template for a wider five year TRAP outline.

 

What’s Next

In 2024, we will continue to grow equity, diversity, and inclusion within DTC by undertaking a review of our policies and curricula, developing original video content and offering a mix of new and remounted webinars that build reproductive justice facilitation capacity within our birth work community. 

 

We’re grateful to our alumni community for always inspiring us to continue this important work. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”534490″][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1709738266702{margin-bottom: 0px !important;}”]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]

Categories
Anti-Oppression Anti-racism work community

The Mothers of Gynecology

[vc_row][vc_column][vc_column_text css=”.vc_custom_1707747263915{margin-bottom: 0px !important;}”]Anarcha, Betsy, and Lucy’s gynecological advancements have undoubtedly saved and improved countless lives. Yet they are not celebrated in most textbooks on gynecology or its history. Lucy, Betsy, and Anarcha were not medical researchers. Their ingenuity was a matter of survival. They were among the enslaved Black women that physician Marion Simms tortured and butchered by experimenting on them without anesthesia in the name of medical research.

Marion Simms is regarded as the “Father of Gynecology”. Not only is he remembered in the textbooks, but there is also a statue in his honour in his hometown of Alabama, in front of the clinic where he tortured Black women. He invented the speculum and the position of lying on one’s back with feet in the stirrups, that most birthers are expected to adopt in medicalized deliveries is named after him.

Simms believed that as a result of being less human than white women, Black women did not feel pain. He had no ethical qualms about conducting his “experiments” without anesthesia, despite the need to restrain the screaming women. When his medical assistants did and quit, he trained Lucy, Betsy, and Anarcha to perform this role. The three women perfected many of the procedures he was developing to save each other’s lives. Simms took the credit of course.

In 2022, a sculpture by Afrian-American artist and activist Michelle Browder finally began giving these women the recognition they are due while raising awareness of the suffering that was inflicted on them without their consent or free will. “Mothers of Gynecology” tells the stories of these heroes visually. 

All three women had suffered painful pelvic floor injuries during childbirth that affected their bowel and bladder control, making them unfit for hard labour on plantations. Now useless to their owners, they were leased to Dr. Simms in the hopes of him finding a cure that would restore them to productivity. His first experimental surgeries were failures. Undaunted, he continued his experiments, training the women to function as his assistants after his white assistants quit. They each became skilled medical providers in their own right. Simms experimented on a total of 12 enslaved women, but only Anarcha, Betsey, and Lucy’s names are preserved in his reports. To make his research more palatable, his reports state that the experiments were conducted on white women with assistance from white nurses. 

Browder’s arresting sculpture manages to convey the details of this horrific story in a way that transcends words and restores power and dignity to these exploited women. The sculptures are intricately fashioned from found metal. The three women are towering in this commanding piece, with Anarcha standing at 15 feet, Betsy standing at 12 feet, and Lucy at 9 feet. While the viewer’s emotional reaction to the piece is immediate and visceral, the symbolism possesses such a wealth of detail that you’d need to stand in front of it for at least an hour to pick up on everything. This Smithsonian article describes the symbolism like this:

“The statues incorporate meaningful—and painful—symbolism. Anarcha’s abdomen is empty, except for a single red rose where her uterus would be. Her womb sits nearby, full of cut glass, needles, medical instruments, scissors, and sharp objects intended to help viewers feel the women’s pain and suffering.

Medical scissors are attached to one woman. Another wears a tiara created out of a speculum—a device Sims invented for vaginal exams. The names of Black women [civil rights heroes] are welded to the statues.”

The figures have no arms or lower legs to represent the women’s lack of bodily autonomy.

Michelle Browder uses art as one aspect of her reproductive justice work. In 2022, she bought the land on which Simms conducted his experiments and is working on opening a clinic and museum for Black women’s health on the site. 

Simms’ racist belief that Black women had a higher pain tolerance than white women is still prevalent among healthcare providers. In perinatal health, this means Black birthers’ pain goes under or unmanaged, and pain that should sound the alarm regarding complications goes ignored. Black birthers know this and the main reason we seek birth doula support is to ensure we have an observer and advocate making sure our pain is being taken seriously and treated appropriately. 

Learning more about the mothers of gynecology is one activity that you can do to observe Black Future Month. You can find out more here:

 

Artist Works to Correct Narrative of Gynecology’s Beginnings

https://www.anarchalucybetsey.org/ 

 

 

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”534490″][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1707747309073{margin-bottom: 0px !important;}”]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]

Categories
Anti-Oppression Anti-racism work birth community

Respecting All Life: Reflections on International Holocaust Remembrance Day and National Day of Remembrance and Action Against Islamophobia

[vc_row][vc_column][vc_column_text css=”.vc_custom_1706563078413{margin-bottom: 0px !important;}”]That horrible day in 2017 when for no reason other than hate a 6 Muslim Canadians were killed at a Mosque in Quebec is still haunting. In a society that claims to love peace, equality, and freedom, the level of hate that spawned this horrific attack should never have been able to arise. What’s almost as haunting is that in the intervening 7 years, we’ve learned very little about the thinly veiled hate that is clearly pervasive in this country because we haven’t learned how to have an ongoing, brave discussion about it.

This year, Holocaust Remembrance Day (Jan. 25) and National Day of Action Against Islamophobia fall as a very deadly conflict in Israel-Palestine has raged on for over 100 days. While Jewish and Muslim Canadians are no more complicit in the conflict than any other Canadians, they have been forced to endure an unprecedented increase in hate-motivated attacks against them. I wish I was more surprised.

We’re too polite to talk about hate until people are getting killed, and by then it’s too late. We hold the guilty party accountable when the van attack and similar crimes happen, but we don’t hear the call to examine the society that created the van attack.

As birthworkers, we see and snuggle many brand-new babies. Every single one is special and they all deserve to grow up and live the lives they create for themselves based on the values that were cultivated in childhood. The presence of hate in the world makes this right impossible to realize for all children, so hate must be eradicated.

To our Israeli, Jewish, Muslim, and Palestinian alumni and audience, we know this has been an unbearably distressing last few months within your communities here in Canada and internationally. As birthworkers in your communities, you have had to process your own feelings while supporting birthers in your community who are under incredible strain. We know that extreme stress can contribute to complicated pregnancies and challenging outcomes. We see the vital work you are doing in your communities at this time and we are continuing to extend our compassion and support.

As doulas, we will continue to shine a light on hate in the healthcare system, institutions, communities, and ourselves. Only when hate is diligently brought out into the open and swept away can we have communities where all life is truly respected and it is safe for all children to grow. 

If you are looking for guidance on how you can support your community and access support for yourself at this difficult time, please visit our blog post “Our Hearts Are With You” from November 10, 2023. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”534490″][vc_column_text css=”.vc_custom_1706554746991{margin-bottom: 0px !important;}”]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]

Categories
Anti-Oppression Anti-racism work balance birth Business collaboration community connection Equity fear gratitude Health Care pregnancy rebranding shame starting fresh Trauma Volunteering vulnerabiliity

Using Doula Care as Community Aid: The Giving Equation

[vc_row][vc_column][vc_column_text css=”.vc_custom_1684151324317{margin-bottom: 0px !important;}”]As I’ve been going through our Truth and Reconciliation Action Plan, I’ve been continuously thinking about doula care and community aid, and how we can continue to decolonize our practices. As doula care becomes more “trendy” in current society, as it continues to dominate mostly higher-class spaces, how do we reflect on the roots of doula care, and stay true to community work? Of course, as doulas we do not feed ourselves and pay the bills off of warm and fuzzy feelings, but I think it is realistic to say most of us enter the field with a certain amount of passion and drive to create change in our communities. Whether that be being inspired by our own birth experience, or noticing how much of a difference our own doula made, most of us come to doula care for a deep reason.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1684151342874{margin-bottom: 0px !important;}”]However you identify, birth work has the ability to bring folks together. The birth and the postpartum periods are intimate and vulnerable. Individuals from marginalized communities may wish to hire someone with the same identity or lived experience as them. As someone from a certain background you may possess a set of skills, knowledge or spiritual/cultural teachings that someone from an outside identity may not. For example, a Muslim family may choose to hire a Muslim doula who may better understand their traditional customs and practices surrounding birth. An Indigenous family may choose an Indigenous doula who understands and celebrates their practices and understands the risk of violence within the medical system.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1684151427232{margin-bottom: 0px !important;}”]

Below are some tips on using your practice and voice as a doula to help your community:

  1. Marry your interests

An easy equation for finding what population you want to serve is this: identifier + lived experience + passions and skills.

Between your lived experiences and passions/interests and skill, lays your intended community. For example, as an Indigenous mental health practitioner who grew up low-income, I chose to narrow my focus on low-income families and trauma survivors. Think about the spaces you frequent, the groups you are a part of, your professional training and hobbies.

 

Identifier: Indigenous, Queer

Lived experience: Poverty

Skill: Social work background

Passion: Trauma

           _______________________________

Target communities:

Indigenous families

Queer Families

Low Income Families

Trauma Survivors

 

2. What can you afford to give?

Whether that is your time, or money, or expertise. Some doulas choose to dedicate acouple of births per year pro-bono or sliding scale. Perhaps, you decide to attend protests and events as a community member that are relevant to your population. You may have resources you don’t mind sharing.or books to loan out. Be creative!

 

3. Advocacy

What issues are impacting your community? How can you use your voice in a way that helps others? Perhaps you can assist in social movements regarding reproductive health.How do you use your social media. What current issues are really important to you?

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These are just a few of the ways that you can take your profession, and use it for social change. What other ways can you make waves?

 

Here are some exploratory journal prompts for you:

  • Why did I choose to become a doula?

  • What social issues am I passionate about?

  • What can I afford to give?

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1684154527320{margin-bottom: 0px !important;}”]-Kayt Ward, EDI Co-lead, BSW[/vc_column_text][/vc_column][/vc_row]

Categories
About Us Anti-Oppression Anti-racism work birth Business collaboration community connection decolonization Equity indigenous doula intersectionality Labour Doula LGBTQ2S+ Postpartum Doula research Trauma understanding bias

Doula Canada Presents: Anti-O Bingo

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Aaniin Doulas!

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This month we are introducing a new EDI initiative, and we want our students and alumni to play! Introducing…. Anti-O Bingo!
You’ve given your input, and we’re listening. Through our Truth and Reconciliation Action Plan, and our EDI surveys, we have identified anti-oppression and cultural training as one of the many areas Doula Canada doulas are interested in pursuing.

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How to play:
1. Click HERE to download your free Anti-O Bingo Card
2. Attend an event from each category
3. At each event, ask your facilitator for your custom .jpeg stamp. Paste it into a doc! (Remember to save it!). If you are attending a livestream (Just Birth, Fireside Chat, etc), please submit a paragraph on what you learned to kayt@doulatraining.ca
4. When you have all 8 stamps, please submit your doc to kayt@doulatraining.ca for your Anti-Oppression in Doula Care 101 Certificate and a ballot to win an $100 Etsy Gift Card.

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You have until December 31, 2023. Good Luck!

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Chi Miigwetch! Nia:wen!
Kayt Ward and Keira Grant, EDI Leads

[/vc_column_text][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”494571″ img_size=”full”][/vc_column][/vc_row][vc_row][vc_column][mk_button corner_style=”rounded” size=”large” url=”https://stefanie-techops.wisdmlabs.net/wp-content/uploads/2023/04/edi-bingo.pdf” align=”center”]Get Your Anti-O Bingo Card here![/mk_button][/vc_column][/vc_row]