Category: Equity

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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
community Equity intersectionality

Response to the Consensus Statement on the Management of Intersex Disorders

intersex families

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

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

Guidance on Terminology

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used in the article title, however, in the article body it lists “intersex” as potentially pejorative alongside several outdated and offensive terms.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

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

Guidance on Gender Assignment

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

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

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

The Lived Experiences of Intersex People

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

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

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

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

Kenneth Zucker Controversy

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

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

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

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

~

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

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

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

 

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

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

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]

Categories
Anti-Oppression birth Canada community Equity fear intersectionality LGBTQ2S+ pride reducing stigma sexual health shame

The Importance of Being Seen: Trans Day of Visibility & Pink Shirt Day

[vc_row][vc_column][vc_column_text title=”The Importance of Being Seen: Trans Day of Visibility & Pink Shirt Day” css=”.vc_custom_1714091548194{margin-bottom: 0px !important;}”]

 

When I was a kid, we were taught that not seeing differences, or being “colour-blind” was the right way to be “tolerant” and “accepting” of diversity. We hear echoes of this sentiment when we hear “They can do whatever they want behind closed doors, but why do they have to flaunt it in our faces?”

March 31 was Trans Day of Visibility and April 10 was International Day of Pink. Both observances attest to the importance of being seen as an integral dimension of human rights and inclusion. People who can only be their authentic selves behind closed doors can’t hold their same-sex partner’s hand during the anatomy ultrasound, or tell their care team that they want to be called “Papa” after they give birth. People who are forced to hide their identity behind closed doors are at risk of getting beaten up in bathrooms and dying by suicide behind closed doors. Trans people need to be seen so that kids like Nex Bennedict can go to school safely. Behind closed doors is exactly where abuse and violence hide.

Having safety to be seen means being able to fully participate in society. It boils down to countless everyday things that people take for granted when their identities are not contested. Being able to use public washrooms without risking confrontation or violence. Accessing information on reproductive health that normalizes your body and healthcare experiences. Not being asked to explain where your partner is at prenatal appointments when they are in the exam room with you. Being able to find pregnancy attire that aligns with your usual style.

Trans and queer people need to call for visibility and wear pink to get noticed so that we can lead normal lives.

As birth workers, here are some things we can do to help queer and trans folks feel seen in the reproductive and perinatal wellness sphere:

  • State explicitly in your promotional materials that you welcome and affirm queer and trans people
  • Use gender-neutral language in your promotional materials and handouts
  • Have open conversations with clients about their preferred pronouns and terms for their parenting roles and body parts.
  • Become familiar with resources in your community that support queer and trans families so you can make great referrals.
  • Educate yourself on health inequities faced by queer and trans birthers
  • Challenge queer and transphobia in yourself and others

You can find out more about Trans VisibilityVisibilty Day here

You can find out more about International Day of Pink here

 

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
birth community Equity Trauma

National Day of Remembrance & Action on Violence Against Women

[vc_row][vc_column][vc_column_text css=”.vc_custom_1701888370897{margin-bottom: 0px !important;}”]National Day of Remembrance and Action on Violence Against Women (December 6) hits a bit different for me this year. On December 6, 1989, 14 young women were murdered at Polytechnique Montreal. The women were pursuing degrees in engineering. Their murderer felt that by entering into a male profession these women were usurping a place in society that rightfully belonged to him. He ordered their male peers from the room at gunpoint to make sure we knew this was about hating women.

Earlier this year, doulas were targeted for gender-based violence because of their career choices. In this instance for choosing a feminized profession, the intimate and sexualized nature of which could be exploited by a fraudulent predator. As a result of the persistent efforts of the fraudster’s victims, she was arrested in March of this year and the situation did not escalate to worse violence. Still, I’m left with many questions about the climate of fear, suspicion, and infighting that existed within the doula community for months while police and other organizations that are supposed to protect the public did nothing to stop this person’s malicious, harmful behaviour. This despite so many incidents where woman-hating behaviour has escalated to femicide.

In Sault Ste. Marie in October, a known perpetrator of intimate partner violence murdered 5 people, including 3 children, adding momentum to a national call for gender-based violence to be declared an epidemic. We at Doula Canada wholeheartedly support this call, and add our voices to it. As birth workers, we know that pregnancy and postpartum are vulnerable times. Existing IPV often worsens, and in many instances, this is when it starts.  

Our own safety also matters in doing this work. We are often behind closed doors, in people’s homes, providing intimate care one-on-one. It’s not constructive to approach care work from a place of fear. Statistically, our clients are more likely to be victims of violence rather than perpetrators. However, one of the most disturbing things I learned from events earlier this year is that there is a casual normalization of sexual harassment in this field. Several people posted about having their time wasted by solicitation from fetishists posing as birth clients, as though this was simply par for the course. Privately, I’ve heard stories of doulas being sexually harassed by a client’s partner in the client’s home, and not knowing of any options for recourse. Earlier this year, when birth workers were being targeted, many birth workers focused on the perpetrator’s well-being rather than the well-being of a growing number of victims.

The reason for this attitude is the same as the reason why some jurisdictions (such as the province of Ontario) have refused to declare GBV an epidemic. And it’s the same reason why opportunities to stop the perpetrator in the Sue before he killed were missed. GBV occurs in the context of normalized systemic misogyny. Even in a profession aimed at reducing reproductive violence for our clients, we’ve forgotten to expect more for ourselves.

Alongside growing our conversation about GBV in relationships, we need to shine a light on occupational GBV. In other fields where home visits are carried out by a largely feminized workforce (e.g. nurses, social workers), trainees are given guidance on spotting red flags, mitigating risk, and acting to effect accountability. We’re going to start doing that here at Doula Canada. On Jan. 23 we will open this much-needed conversation by hosting a webinar on GBV in birthwork and how we can take charge of our community’s safety. We owe this to ourselves and each other. 

Webinar Details Here: https://stefanie-techops.wisdmlabs.net/training/webinar-gender-based-violence-in-support-work/

It is fitting that Women’s Remembrance Day falls within UN Women’s 16 Days of Activism Against Gender-Based Violence campaign. For ideas for actions you can take against GBV check on this resource on Canadian Women Foundation’s #ActTogether Campaign. https://canadianwomen.org/acttogether-campaign/

*If you are unfamiliar with the events of earlier this year that I reference in this article, you can learn more about that here: https://www.cosmopolitan.com/lifestyle/a44866427/kaitlyn-braun-doula-pregnancy-accused-fraud-harassment/

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1701888381111{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 birth Canada community Equity Trauma

International Day for the Eradication of Poverty

[vc_row][vc_column][vc_column_text css=”.vc_custom_1698093869318{margin-bottom: 0px !important;}”]The rising cost of food and collective grocery store anxiety rest on a bed of other precarious conditions. The price of everything has gone up. We are still seeing empty shelves in stores “post” pandemic as we head to the mall in shorts on a 33-degree October day. There are numerous causes for feeling uncertainty.

When society gets taken for a ride, children come right along with us. As someone who works with babies and families, on International Day for the Eradication of Poverty I’m reflecting on the fact that 50% of the world’s children are affected by poverty. 

Most of these children are not where I am sitting, in a high-cost-of-living, high-standard-of-living urban centre in Canada. However, people where I am are still afraid of not having enough, and it’s making many people afraid to start a family.

These fears are justified. Raising children is expensive, and we are facing a food crisis, a housing crisis, a climate crisis, and a healthcare crisis. People and families live in a lot of isolation which makes feeling secure challenging. Poverty has a significantly adverse impact on outcomes during pregnancy and childbirth, and on how all aspects of your life go from there.

Support from a doula reduces the risk of many of the adverse outcomes that poverty increases the risk of. Sadly, individuals who can benefit the most from improved outcomes are those who are least able to pay the cost of hiring a doula. 

Doulas and birth workers are a compassionate bunch. No one in this profession is here to get rich, and we want to provide our services to people who can benefit from them the most. However, we also have ourselves and our families to care for, and doing this work well takes time. Far too many kind-hearted people who have trained long and hard and love this work leave after a few years, turning to less rewarding work that pays the bills. When this happens, the doula’s skills go to waste and their community loses out on the transformative care they could have received.

Advocates within the doula sphere are exploring options to improve community access to doula support while making a long-term career in this field more sustainable. At Doula Canada, we are doing our part by developing a briefing note that will elucidate opportunities and challenges in the current perinatal care landscape, the potential for doulas and childbirth educators to leverage these opportunities and solve these challenges, and models whereby doula care could be cost-effectively funded by a mix of social partners including different levels of government, insurance companies, and foundations. This initiative is directed by the Advocacy Working Group, comprised of Doula Canada members and staff. The Advocacy Working Group is part of our commitment to manifest a culture of equity, diversity, and inclusion (EDI) action within our school. Stay tuned for more on the Doula Access Initiative in the coming months.

To connect with the Advocacy Working Group at Doula Canada, email Keira Grant, EDI Co-Lead at keira@doulatraining.ca.

 

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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Categories
Anti-Oppression community Equity

World Food Day

[vc_row][vc_column][vc_column_text css=”.vc_custom_1697463575735{margin-bottom: 0px !important;}”]World Food Day hits a little differently this year. The skyrocketing cost of food has driven the federal government to summon the CEOs of Canada’s largest food retailers to a meeting in Ottawa on Thanksgiving Monday.

Access to food is not just about the rising price of groceries in contrast to incomes that haven’t changed much. This year’s theme for World Food Day is Water is Life. Water is Food. Leave No One Behind. It calls us to reflect on access to food on a deeper level. The Food and Agriculture Organization of the United States notes that 71% of the planet is water, however only 2.5% of that water is fresh, drinkable water.

Canadians are blessed to live in a freshwater-rich country, however, 28 Indigenous Reservations across the country are still living with long-term boil water advisories. These communities have been systemically left behind, demonstrating that social policies and political will are central dimensions of ending hunger.

The statement “Water is Food” has an additional layer of meaning for birth workers. Water is the main ingredient in human milk, the ideal first food for all of us. When lactating parents don’t have access to clean drinking water babies are also left behind. When we view food and water as commodities we create a precarious circumstance for society’s most vulnerable members. 

As victims of the Nestle infant formula scandal learned in the most horrific way possible, diluting formula with contaminated water can mean death for babies. In addition to the health risks associated with formula feeding, the cost of infant formula has risen along with all other goods. This follows on the heels of a formula shortage that saw the price for one canister exceeding $70 in the Territories in 2022 according to one of our members. 

When we encourage and champion new parents to normalize, initiate, and sustain lactation and direct breast/chestfeeding we are engaging in a vital action to ensure food security in our communities. When we connect lactation support to action to achieve clean drinking water, and sustainable food networks for all, we are recognizing the intrinsic interconnectedness of social systems and family well-being.

You can learn more about the struggle to secure clean drinking water for all First Nations in Canada at First Nations Drinking Water Settlement. To learn more about how you can support Indigenous land and water defenders in Canada visit Indigenous Climate Action.

 

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 birth Equity

Women’s History Month

4 females in colourful clothing sitting together smiling for a photo

[vc_row][vc_column][vc_column_text css=”.vc_custom_1696691842834{margin-bottom: 0px !important;}”]For much of human history and in a myriad of cultures, the ability to create life was revered and seen as a source of power. When Rachel from friends, overdue with Emma famously says “No uterus, no opinion” – she’s describing an attitude that used to be a given. Things started to change in the mid-19th century as the then-exclusively male profession of medicine and the burgeoning specialty of gynecology gained legitimacy and brought reproductive health under its control.

When you control the uterus, you quite literally control the social order. You assume control of the means of producing the next generation, who gets to have a “legitimate” family, and who does not. 

For as long as patriarchy has sought to control women and people with uteri by controlling reproduction, we have resisted and fought relentlessly to bring reproduction back under our control and keep it there. 

October is Women’s History Month and this year’s theme is “Through Her Lens: Celebrating the Diversity of Women”. 

The diverse, heroic people who have fought for reproductive justice, access to choice, and humanized birth are countless, spanning time, place, age, race, gender, sexuality, ability, class, religion, and the full array of human experiences. By sharing a few of their stories, we begin to tell the story of our ongoing struggle for reproductive freedom through their lens. 

The work of these pioneers and modern-day heroes is part of the fabric of all we do as doulas, childbirth educators, and birth keepers to ensure that pregnancy, birth, mothering, and parenthood are empowered, affirming choices and experiences.

The featured figures in women’s history offer a lens through which can explore the movements that have shaped the context of birth work in the 21st century.

Dr. Elizabeth Bagshaw & Nurse Dorothea Palmer

Elizabeth Bagshaw started her medical studies at the University of Toronto in 1901 at the age of 19 and began practicing medicine in Hamilton, Ontario in 1905. The medical profession was overwhelmingly dominated by men at the time. The limited number of women in the profession were excluded from specialties such as surgery and steered toward obstetrics or pediatrics. As a result, maternal health quickly became the primary focus of Dr. Bagshaw’s practice. In 1932 she was asked to become the medical director of Canada first birth control clinic, which was illegal at the time. Despite the legal risks, Dr. Bagshaw accepted the role because she “understood that neglecting health care that only women need contributes to their subordination.” Bradshaw’s practice at the clinic consisted largely of fitting women for diaphragms and conducting follow-ups. The clinic served 400 women in its first year of operation.

At the time that she assumed the role, the Great Depression was ravaging society. Men were out of work, children were hungry, and maternal mortality was high. Women were dying from botched abortions. Family planning options were urgently needed. Despite these conditions, sharing birth control information was illegal and considered immoral by many. Bagshaw and her collaborators were called “devils” and “heretics”. 

The controversy came to a head in 1936 with the trial of Ottawa-based reproductive health nurse Dorothea Palmer. Palmer was charged with advertising birth control during home visits to discuss family planning. Palmer’s defence successfully argued that she had acted in the public good and she was acquitted. This defense was successful again on appeal, making things easier for Bagshaw’s clinic and other early family planning pioneers, although the law making advertising birth control illegal was not reppealed until 1969..

June Callwood 

June Callwood was a Canadian activist, journalist and writer who co-founded the Canadian Abortion Rights Action League in 1973, along with Kay Macpherson, Lorna Grant, Eleanor Wright Pelrine, Esther Greenglass, and Henry Morgentaler. Over the course of the 1970s and 1980s the organization played a pivotal role in the journey to full decriminalization of inducing an abortion in 1988.  After this milestone, CARAL continued its work to ensure equitable and safe access to medical termination of pregnancy.

June Callwood was also known for her journalism in support of social justice and women’s rights. Over the course of her journalistic career she wrote for the Globe & Mail, Chatelaine, McLeans, and other major Canadian publications.

As an activist, she was involved in co-founding over 50 social service organizations, including Casey House a hospice for people with AIDS and Jessies: The June Callwood Centre for Young Women, which provides a range of social services to young women and trans people experiencing pregnancy.

Dr. Galba Araujo

The Humanizing Childbirth movement began in Fortaleza, Brazil in 1975 when Obstetrician Galba Araujo pioneered a program to train traditional midwives and partner them with hospitals. His project gained international recognition, and acted as a catalyst for the World Health Organization to host a conference on technology and childbirth in Brazil in 1985. 

In 2000, the first annual conference on humanizing childbirth was held in Fortaleza Brazil, revitalizing interest in the Humanized Birth movement for the 21st century. This movement aims to de-medicalize birth and create a process wherein relationships and communication are centred and where personal and spiritual transformation are possible. 

While Dr. Araujo’s contribution was undoubtedly central to this movement garnering international recognition in mainstream medicine, the principles of this movement are drawn from woman-led traditional Indigenous midwifery in Brazil and other part of the Americas. 

Reverend Alma Faith Crawford

Reverend Alma Faith Crawford is one of 12 Black women who coined the term “reproductive justice” in 1994 and founded an anti-racist feminist movement aimed at equipping women of all races, classes, and sexual and gender identities with the option to choose to have family, whether through accessing adequate support to childrear, or by accessing options to prevent or terminate pregnancy. The organizing framework they developed for Women of African Descent for Reproductive Justice recognizes that the rage of choices available to a person are impacted by a person’s social experience, with people experiencing injustice and marginalization having diminished access to choice. Maintaining each individuals human right to reproductive justice involves dismantling all forms of social injustice at the deepest level of the system. In addition to equitable abortion access, reproductive justice advocates call for access to social services that would make is possible for more people to raise families with well-being.

Reverend Crawford also organizes with interfaith pro-choice advocacy organization Religious Coalition for Reproductive Choice. She continues her intersectional social justice work as a senior coach for Pastors Without Borders. As clergy in the United Church, she and her partner Karen Hutt create welcoming and loving spaces for members of the Black, LGBTQ+ community. 

Nurse Courtney Penell

Courtney Penell is an Indigenous labour and delivery nurse in Nova Scotia who performed the first smudge ceremony in a Halifax hospital in June 2023. Her ability to perform the ceremony in the hospital came at the end of 10 years of advocacy, that included collaboration with the hospital and the fire department to resolve safety concerns. The long-fought-for policy was implemented just days before her nephew’s birth, allowing her sister to become the first person to receive the ceremony in the hospital. Smudging is an important Indigenous ceremonial and medicinal practice that involves burning sacred herbs such as sage, cedar, sweetgrass, and tobacco. The specifics of the ceremony vary from Nation to Nation. Penell performed the ceremony according to her family’s Mi’kmaw traditions. 

Courtney Penell’s advocacy is part of a Canada-wide Indigenous movement to decolonize birth by reclaiming traditional practices and ceremonies, bringing birth back onto ancestral lands, introducing traditional first foods, and other liberatory actions. 

 

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”2/3″][vc_column_text css=”.vc_custom_1696691935455{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_column width=”1/3″][vc_single_image image=”520907″][/vc_column][/vc_row]

Categories
community connection Equity LGBTQ2S+

Bisexual Visibility Day

[vc_row][vc_column][vc_column_text css=”.vc_custom_1695560834217{margin-bottom: 0px !important;}”]According to national data, bisexuals make up the lion’s share of the LGB population. Yet, we are also the most invisible. This is because sexual orientation is usually interpreted based on relationship status and household composition, rather than on how an individual experiences their sexuality.

My wife and I have been together for 16 years, and co-parenting together for 11 years. We are both bisexual. Rarely is our family interpreted accurately by the outside world. I am Black, she is white, our kid is mixed race and presents as Black. We are also both femmes. As a result of these factors, we have been in countless interactions where my wife has been interpreted, and treated as “my friend who helps me out with my kid”. She has actually been a part of every moment of his life since he was an ultrasound image.

If she takes him to medical appointments she is asked to substantiate who she is in relation to him, or now that he is older, he has been asked to confirm her identity. This doesn’t happen when I take him to medical appointments. It is a good practice to confirm the relationship between adults and children at medical appointments. However, this seems to be happening based on race, sexual orientation, and gender-based assumptions about families, rather than as a universal safety precaution.

We’ve come a long way in terms of normalizing same-sex households, but as recently as this past school year, our kid came home with a form that had spots for “mother” and “father”. It is so easy to create a form that has two spaces for “parent/guardian”. Outdated forms such as this one exclude a lot of families that aren’t “same-sex households”. 

In general, we’re not very surprised by these microaggressions as we navigate a heterosexist world. What often lands more painfully are the microaggressions from within the LGBTQ community in relation to our bisexuality.

Recently, we were at a comedy night that was heavily attended by queer and trans people. Despite the largely queer crowd, one of the comedians made a biphobic joke. We groaned and gave each other knowing eye-rolls. This reaction sparked a conversation with a lesbian couple that was seated at the same table. We got to chatting with them and when we revealed that we have been together for the better part of 2 decades and are raising a child together, they made a remark that we have heard in lesbian spaces before: “Oh, well it’s like you’re lesbians then”. 

Like many microaggressions, the intention was clearly complimentary, but that’s definitely not how it landed. We are proud bisexual women. Our relationship with each other doesn’t change that. In these conversations, we find ourselves resisting the temptation to disclose being polyamorous and our relationships with men as a counterargument. No one should have to justify being Bi. That is just what some people are. We all understand that a person who’s been celibate for an extended amount of time isn’t necessarily asexual. It’s the same thing really. My sexual orientation is the one I was born with. Relationships are choices I make over time.

Not all same-sex couples are gay and lesbian. Not all different-sex couples are straight. Many of us raise children using a variety of family and community structures. Being told we are not real or that our identity is a phase hurts. 

A great way to make the world less painful for bisexuals and their families is to normalize and represent different family structures. Right now, there is a culture war over when it’s okay to start talking to kids about LGBTQ+ people. 

Who among us can remember receiving an explanation about marriage and families? We take for granted that there is no need to explain these concepts. We learn about these and other institutions by observing the world around us. LGBTQ+ people are part of the world. Representing queer and trans folk in a child’s world from day one is how we present an accurate portrait of reality.

There is content that affirms family diversity for all ages. Independent children’s publisher Flamingo Rampant offers an excellent selection of children’s books that show race, sexual, bodily, ability, and gender diversity with people and families doing all sorts of fun and magical things. Super Power Baby Shower by Toby Hill-Meyer and Fay Onyx tells the story of a queer, polyamorous family of superheroes preparing to have a baby! 

 Keira Grant (she/her) brings a wealth of experience to her EDI Co-Lead 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. As a mom and partner, she uses her lived experience to provide support and reflection for her clients and her work. Keira is the owner of Awakened Changes Perinatal Doula Services.

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Categories
Anti-Oppression Canada Equity indigenous doula understanding bias

National Day for Truth and Reconciliation

[vc_row][vc_column][vc_column_text css=”.vc_custom_1694354019009{margin-bottom: 0px !important;}”]September 30th marks National Day for Truth and Reconciliation in Canada, also known as Orange Shirt Day. The day is a national day of remembrance and reflection on the historic and current violence and oppression toward Indigenous Peoples. As a vocational school, we encourage our non-Indigenous students to participate in workshops, lectures, sharing circles, vigils, and more on September 30th.

The “every child matters” slogan dawned on orange shirts resonates deeply with us as doulas and care workers. As doulas we work intimately with families, infants, and children. The tragedies of the residential school systems and 60’s scoop, as well as the current oppression and violence toward Indigenous families in the forms of child apprehension, incarceration, birth alerts, and more are horrific and unacceptable, and impacts the families and communities we belong to and work with.

As doulas and allies, it is crucial to educate ourselves about the actions, policies, and systems that disproportionately impact Indigenous families, especially those that directly impact the work we do in terms of advocacy, intergenerational care, and reproductive justice. It is our duty to critically reflect on our identities, experiences, and our relationship to wider systems.

We understand that National Day for Truth and Reconciliation can bring up difficult emotions and be potentially triggering for our Indigenous students. We will be hosting a Indigenous-only peer support sweetgrass circle on October 1 from 1-3 EST on Zoom to debrief together. Contact kayt@doulatraining.ca to register. You can also check in 0n our progress here at Doula Canada by reviewing our NTRD Progress Report, which includes our goals between now and 2028.

Don’t know where to get started? Here are some ideas:

  • Follow Indigenous creators on Tiktok, Instagram, and other platforms
  • Take the University of Alberta’s free Indigenous Canada Course
  • https://www.ualberta.ca/admissions-programs/online-courses/indigenous-canada/index.html
  • Search up Kairos Blanket Exercises near you
  • Read up on the 94 Calls to Action by the Truth and Reconciliation Commission of Canada
  • Register for Doula Canada’s Doulas for Reconcili-ACTION Orange Shirt Day workshop
  • “Who Am I: Locating Oneself in Settler-Colonialism, A Conversation on Oppression Privilege, and Allyship” on September 30th from 1-3 PM EST on Zoom. $30, with all proceeds going to Aunties on the Road
  • Apply for our Truth and Reconciliation Action Plan Committee to contribute to our TRAP Five Year Plan
  • Assist in knowledge mobilization. Tag @doulacanada with the hashtag #doulasforreconciliaction on social media to share what you learned on September 30th that you think would benefit your fellow allies.

We understand that not everyone will have the same time, resources, finances, etc. to participate in some of the activities for the day. If you’re reflecting internally, please consider the following prompts (designed for non-Indigenous students).

  • What preconceived biases have been instilled in me about Indigenous Peoples? Where did I learn them from?
  • Whose land do I reside on? What is the story of the land here? (If applicable) How have I benefited from white/settler privilege?
  • Does the word “settler” make me uncomfortable? Why or why not?

Wishing you all a meaningful and educational National Day for Truth and Reconciliation.

Miigwetch,

Kayt Ward, EDI Co-Lead, BSW[/vc_column_text][/vc_column][/vc_row]