Category: Health Care

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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-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]

Categories
Canada community Health Care

Learning from US Healthcare on Doula Access

[vc_row][vc_column][vc_column_text css=”.vc_custom_1706711380769{margin-bottom: 0px !important;}”]I vividly remember “The Greatest Canadian”, a 13-part  competitive series produced by CBC in 2004. Each week, a biographical documentary on individuals who have made a great contribution to Canada aired, including Terry Fox, David Suzuki, and Tommy Douglas. Viewers got to vote on who the greatest Canadian of all time was. Tommy Douglas, recognized as the father of publicly funded health care in Canada, emerged victorious. 

Douglas’ win says a lot about the value we attach to our healthcare system and the national pride we take in making sure that every Canadian has access to the care they need. We often look to our American neighbours with pity when we hear about $700+ a month insurance plans ($2000+ for a family plan) or families going into debt or going bankrupt to pay for life-saving treatment. But if the Canadian healthcare system is so superior to that of the US, why is publicly-funded doula access expanding by leaps and bounds in the US, while progress on the same front has been stagnant in Canada?

Over the last few years, an increasing number of jurisdictions in the US have made doula care payable via Medicaid. Medicaid is public health insurance for people who are unable to access private coverage. 11 States that have introduced Medicaid-funded doula care programs include New York, California, and Michigan. California cites familiar research as the rationale for its decision: “doula care was associated with positive delivery outcomes including a reduction in cesarean sections, epidural use, length of labor, low-birthweight and premature deliveries. Additionally, the emotional support provided by doulas lowered stress and anxiety during the labor period”. 

One reason why advocates for publicly funded doula care have gained more traction in the US is that the US collects race-based healthcare data, along with information on many other social determinants of health. This data has demonstrated significant disparities in perinatal outcomes based on race, income, and other factors. The Black maternal and neonatal mortality crisis has emerged as a system disaster that requires urgent solutions. Combined with a growing body of health research demonstrating that doulas are an effective intervention that improves outcomes for Black birthers and babies, this has made a strong case for access to doula care for Black and other at-risk communities.

In Canada, we have the same research to show that doulas solve a problem, but we don’t have the same amount of data to show that there’s a problem to solve. That being said, while our race-based data collection needs to improve, we do collect data on other topics. In 2023 OBGYN researchers at McMaster University published findings on operative deliveries and 3rd and 4th-degree tears in Canada. They found that “among high-income countries, Canada has the highest rate of maternal trauma after births in which tools like forceps and vacuums are used”. Sadly, their research only compares operative deliveries (forceps/vacuum) to surgical deliveries (cesarean sections). They do not take into account the ample evidence that California and other US jurisdictions considered showing that support from a birth doula reduces the likelihood of any of these interventions. 

Not only do we need to collect data that demonstrates the impact of the social determinants of health, we need to put the research we do have into action. This action needs to encompass the role that all care providers play in improving conditions and outcomes for birthing people. This includes ensuring that all birthers can access the reduction in medical interventions and related increases in good birth outcomes and satisfaction that skilled doula support can achieve. [/vc_column_text][vc_single_image image=”534490″][vc_column_text css=”.vc_custom_1706711516822{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
Health Care Labour Doula pregnancy Trauma

Empowering NICU Parents as a Doula: Strategies for Support

[vc_row][vc_column][vc_column_text css=”.vc_custom_1696077782676{margin-bottom: 0px !important;}”]September is NICU (Neonatal Intensive Care Unit)  Awareness Month. ​This special month is dedicated to acknowledging the challenges families face and providing them with the support and resources they need.

As a doula you will encounter times where families are navigating a baby in the NICU for various reasons. This is an overwhelming and difficult time for all of those involved. It is a traumatic separation of parents and baby. A time where navigating expectations of what parenting was supposed to be and what it is, is up against the fear of will my baby be ok. 

Often times as doulas we feel scared and unprepared in supporting families as they navigate their way through this journey. Here are a few ways you can show up for families in the NICU. 

Listen

Just as you might support someone going through any kind of trauma by listening as they speak, simply lending an open, non-judgmental ear can be of huge help to NICU parents. Focusing on listening ensures that you honor the experience they’re having, instead of clouding it with your insights, birth story, or advice.

Consider starting with, “Do you feel like talking?” before asking any questions about their status or that of the baby. They may really want to share with you how much weight the baby gained that day or how they’re doing on certain good days, or they may really want to vent on some terrible days. But they also may not want to talk.  Asking if they’re open to talking before diving into a conversation is a way to respect their boundaries.

Support them in establishing communication with their baby’s care team: 

NICU parents often feel insecure about how to provide care for their baby who is in such a fragile condition.  It is important for them to know they are just as needed in the NICU as the medical team. 

  • Remind them they are their baby’s best advocate
  • Help them formulate the questions they want to ask
  • Remind them they can provide care to their newborn, changing diapers, taking temperatures, etc. The nurses will support them. 
  • Encourage them to keep a daily journal of their babies progress. keeping track of  baby’s individual body systems, like breathing, digestion, heart, brain, eyes, and any special conditions the baby has.  Keep track of milestones and ask the nurse what the baby’s current goals are.  Sometimes the goals will change daily, and sometimes they will stay the same for weeks.

Offer Practical Support 

As a doula this is our wheelhouse. Just as we would in the home, offering clear and concise suggestions about the type of support you can offer will help overwhelmed parents get what they need. 

  • Work with their support system to arrange food delivery for in hospital support and those at home. Gift cards for restaurants in and around the hospital, premade easy to heat up meals and snacks or even e-transfers will be greatly appreciated. 
  • Offer to do a load of laundry and bring it to the hospital ( or arrange for a family member to do so) 
  • Offer to be a communication liaison between the family and their extended family and friends, or help them find their person
  • Remember that the birther is also dealing with recovery, help them with practical recovery strategies like pain management, pumping, etc. 

Remember that the fear does not end when baby comes home 

 There is a lot of excitement when baby comes home however this doesn’t mean that the fear and concerns have ended. Often parents have not fully processed the trauma of being in the NICU and coming home creates a space for all of that to surface. 

Find the parents counselling and peer support resources. Expect some hypervigilance when it comes to caring for baby. Patience and listening will continue to be important. 

What strategies and tools do you use to support families in the NICU? 

 

Sondra Marcon (she/her). Education and Administration Coordinator
Sondra’s background in family therapy and mental health work drives her to create environment for her clients and students that is both supportive and challenging of bias and assumptions. Teaching and development of curriculum drives her to continue to grow. Sondra’s drive to become a doula came when she saw the impact of early childhood experiences and parenting has on the wellness of both the infant and their parents.[/vc_column_text][/vc_column][/vc_row]

Categories
fertility Health Care research

A Practical Guide to Navigating PCOS

[vc_row][vc_column][vc_column_text css=”.vc_custom_1694731059747{margin-bottom: 0px !important;}”]Polycystic Ovarian Syndrome (PCOS)

With Polycystic Ovarian Syndrome (PCOS) Awareness Month upon us, we felt it imperative to discuss the medical condition considered to be one of the leading causes of infertility and a condition most commonly undiagnosed. PCOS is not a lifestyle illness – it is a diagnosed medical condition that can be debilitating. A person does not get PCOS because of their lifestyle. PCOS is a common chronic hormonal condition that causes hormone imbalances, irregular cycles, cysts in the ovaries, lack of ovulation, among other long-term health problems that affect physical and emotional wellbeing. According to the World Health Organization, PCOS affects an estimated 13-18% of individuals with uteruses who are of reproductive age. This is an alarming number. What’s even more unsettling is that there is no cure for PCOS and up to 70% of affected people will go undiagnosed worldwide. Due to a lack of awareness, education, and taboo around fertility conversations many people do not discuss their reproductive health and menstrual cycles with their families and friends. If you speak to someone of reproductive age you are likely to find out that they probably know someone affected by PCOS, they may have been diagnosed with PCOS, or they might think that they have PCOS but be undiagnosed.

Individuals who are not diagnosed and go untreated may be at higher risk for developing conditions that increase the risk of cardiovascular disease, including high blood pressure, obesity, gestational diabetes, and high cholesterol. The condition also puts people at risk of developing increased thickness of the uterine lining, uterine cancer, having a preterm delivery and preeclampsia, and a greater chance of having a miscarriage. Research indicates that early testing, diagnosis, and intervention of PCOS improves fertility preservation and prevents complications such as obesity, insulin resistance, diabetes, infertility, and cardiovascular issues later in life, especially in at-risk cases.

I might have PCOS

If you suspect that you may have PCOS meet with a medical doctor who specializes in hormonal disorders to discuss your concerns. They will check for symptoms, discuss your medical history, and discuss the regularity of menstrual cycle. Some of the common tests for PCOS might include a physical exam – such as blood pressure and a pelvic exam etc…, blood tests, and a pelvic ultrasound.

I’ve been Diagnosed with PCOS

It’s important to talk about this misunderstood condition and its challenges because it presents differently for everyone in ‘real life’ and is considered a lifelong condition.

If you or someone you know have received an early diagnosis of PCOS, this information may be helpful in navigating where to start and getting the support you need:

  • Get a second opinion
  • Determine and understand your condition and presenting symptoms
  • Connect with a medical doctor who specializes in Gynecology and/or PCOS itself
  • Find a supportive medical team who validate your concerns and align with your long-term goals
  • Connect with a Fertility Doula who can support you throughout your journey
  • Find out if the diagnosis was prompted because of Hyperandrogenism, Anovulation/Oligoovulation, or Polycystic Ovaries on an ultrasound so that an appropriate customized treatment and support plan can be created
  • Get familiar with the concept of insulin resistance because there are a number of factors that contribute to high insulin in PCOS, and insulin resistance has been found to be one of the central factors of the condition
  • Determine the major component of insulin resistance in your condition
  • Get familiar with the long-term health considerations in PCOS
  • Learn about other holistic health modalities such as a Naturopathic Doctor for example who can support your condition
  • Explore which treatments will improve your individual symptoms
  • Adjust your lifestyle to reduce the PCOS symptoms

What else can I  do?

Alongside the goals of PCOS Awareness Month we can:

  • increase awareness and education
  • lobby for improved diagnosis and treatment of the disorder
  • disseminate information on diagnosis and treatment
  • hold agencies responsible for the improved quality of life and outcomes of those affected
  • promote the need for research to advance understanding of PCOS: improved diagnosis, treatment and care options, and for a cure for PCOS
  • acknowledge the struggles of those affected
  • make PCOS a public health priority

To lean more, visit:

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Categories
birth community Health Care pregnancy

Fetal Alcohol Spectrum Disorder Day

[vc_row][vc_column][vc_column_text css=”.vc_custom_1693401592473{margin-bottom: 0px !important;}”]Fetal Alcohol Spectrum Disorders (FASDs) are as prevalent as Autism Spectrum Disorders, but they are less talked about and wildly misunderstood. If you work with babies, you are likely to encounter one with FASD, but it often goes unrecognized and untreated. We’re going to do some myth-busting and share some facts that all birth workers should know and be prepared to share with clients.

  • Alcohol is a known teratogen (birth defect-causing agent). There is no known amount of prenatal alcohol exposure (PAE) or time during pregnancy when alcohol can be consumed without risk to the fetus.
  • 45% of pregnancies are accidental. Often, prenatal alcohol exposure occurs before pregnancy is detected. Early detection of pregnancy reduces the likelihood of PAE.
  • Not all PAE causes FASD to develop. The development of FASD is influenced by the amount of alcohol exposure and a mix of genetic and epigenetic factors. FASD affects people from all walks of life, races, and ethnicities
  • Social determinants of health influence the development of and treatment of FASD. For example, people who have had limited access to education, are less likely to be aware that consuming alcohol can harm their babies. People experiencing poverty and racism are less likely to disclose their alcohol consumption and seek timely treatment for themselves and their children due to fear of incarceration and having their children removed. 
  • While FASD is diagnosed based on the presence of specific facial characteristics, FASD can manifest in a variety of ways, with a range of symptom severity. Treatment needs to be tailored to the individual.
  • Newborns with FASD are often have heightened sensitivity to light and other environmental stimuli. They benefit from being cared for in a dark, quiet environment, and may need more soothing than other babies.
  • Many children with FASD struggle more with emotional regulation than other children. They can benefit from an established routine and early and active guidance on emotional regulation strategies such as breathing exercises. 
  • People with FASD often have specific strengths. For example, many people with FASD are highly self-aware, hopeful, collaborative, loving, and kind. Treatment that focuses on strengths rather than deficits is more effective.
  • Many people with FASD lead happy, fulfilling, and rewarding lives. This outcome is more likely with early, strengths-focused treatment. 

In recognition that we need to talk about FASD, the Canadian Government declared September FASD awareness month in 2020. The theme for 2023 is Uniting our Strengths: Finding Solutions Together.

As birthworkers, we can be part of the solution by informing ourselves of and celebrating the strengths of people with FASD. We can also hold non-judgmental, compassionate space for our clients to talk about drinking. Stigma is the leading reason why people don’t ask for help. 

You can also honour the achievements of people with FASD by wearing red shoes this month! “Red Shoes Rock” is a grassroots movement that started in 2013 with FASD educator and advocate RJ Formanek wore shoes on an international stage. 

In his own words: “Red shoes were critical to my narrative, they were the key to it all. They were all about being different… They spoke of speed, of freedom of thought and being different, and red running shoes with the power suit sent a message out there to the world.”

For more information on supporting families navigating FASD, check out our posts from 2021 and 2022.

 

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 expereince 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
Health Care sex sexual health

World Sexual Health Day

[vc_row][vc_column][vc_column_text css=”.vc_custom_1693400263770{margin-bottom: 0px !important;}”]Sexual health across the lifespan is much more complicated than what we learned in high-school sex ed, assuming our parents didn’t opt us out. The sex ed I received was exclusively focused on preventing pregnancy and disease. While these topics are vital, this narrow focus left me and many others ill-equipped to understand and navigate consent and fairness in intimate relationships, ensuring my own pleasure, trying to conceive, medicalized childbirth, and the changes of perimenopause. The education system left my generation to fend for itself regarding these everyday human needs.

This is a huge part of why I’m so passionate about the work that doulas, perinatal educators, and birthworkers do to promote population and individual sexual health. I love being able to sit with clients for an hour or two and talk about all of the things we don’t usually talk about. This includes talks about the strain that timed intercourse can put on couples trying to conceive. Or the impact that a complicated pregnancy has on a couple’s sex life. It can look like strategizing on options to space out pregnancies post-c-section. It’s as holistic and infinite as people’s lives are.

This year’s theme for World Sexual Health Day is consent. While the obvious implication is about consent to sexual activity, there’s an important connection to make with informed consent in medical decision-making. Women, female-assigned, and gender non-conforming people are at risk of sexual violence for the same reason that we are at risk of obstetric violence. In the context of a patriarchal, misogynistic society, our bodies are devalued and objectified. Society sends us the message that our bodies are not truly our own constantly. We are usually depicted as objects of sexual desire as baby-making vessels. This dehumanization of our bodies plays out on the street, in relationships, and in health care.

By supporting birthers to think critically about bodily autonomy in medical decision-making, and to honour their bodies by requiring informed consent, we support birthers to think critically about why they are at risk of losing bodily autonomy in all aspects of their lives, and we teach them to expect and demand more.

There is no sexual health without reproductive justice. The reproductive justice framework advanced by African-American women envisions a world where everyone can make reproductive choices, including the right to have and not have children, as facilitated by unfettered access to reproductive health care and social services. Informed consent is the foundation on which choice rests.

It’s also Labour Day, making this a great opportunity to express gratitude for all the hard and life-changing work that you are doing to promote health, choice, well-being, and change in your communities. We will continue to advocate for improved access to doula support and income security for birth and reproductive justice professionals. A labour of love is still labour. Clients deserve access based on need and we deserve to be able to make a living doing this community-building work.

 

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 expereince to provide support and reflection for her clients and her work. Keira is the owner of Awakened Changes Perinatal Doula Services.[/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
Anti-racism work birth Canada community connection decolonization Equity Health Care intersectionality pregnancy Trauma understanding bias

Why Black Futures Begin with Birth

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Why Black Futures Begin with Birth

Written by Keira Grant  – DTC EDI Lead for Racialized Communities

February is widely known as Black History Month. This term has rubbed me the wrong way since I was a kid, but it took me a while to put my finger on why. The reference to “history” is full of loaded assumptions that are highly convenient to colorblind multiculturalism. It suggests that racism toward Black people is something that happened a long time ago, maybe in a faraway place. Then slavery ended and then there was Black excellence.

Of course, there have always been excellent Black people, but that’s not really how the story goes. The beliefs that made slavery possible for centuries are part of the fabric of society. Even when we are excellent by eurocentric, capitalistic standards, it could still go the way it went for Tyre Nichols.

The violence that brutally ended the life of Tyre and so many others like him flows through all social institutions, not just policing. In countries such as the United States and the United Kingdom where race-based health data is collected, these data show that Black birthers are anywhere from 3 to 4 times more likely to die in childbirth than their white counterparts. Our babies are also at a significantly increased risk of death. This holds true, independent of education and socioeconomic status. The birth stories of celebrities like Beyoncé Knowles, Serena Williams, and Tatiana Ali, (whose story we’ll be discussing at March’s Equity Watch Party), bring these statistics to life.

At this time, many players in the Canadian healthcare system are calling for the collection of disaggregated race-based data. In the US, the collection of these data, and the resultant evidence of disparities has led to increased funding for programs that improve Black maternal health, including a proliferation of programs for accessing a Black doula. It has also supported requirements that health professionals receive training in implicit bias.

It’s been widely reported in the news that Tyre Nichols called out for his mom during the brutal attack that ended his life. Every Black person who dies as a result of structural violence is someone’s baby. When systemic disrespect and harm toward Black birthers and babies is normalized, rationalized, and justified it is the start of a pattern that impacts Black people across the lifespan. Emerging research is actually demonstrating that racial stress accelerates the aging process of Black women.

Creating a circle of love and support around Black birthers and their babies that is honest about what we are up against, and that celebrates our lives and well-being can have a profound impact on how someone’s life starts. It can affect how their life continues by showing them and their families that it is possible to create spaces where Black people are affirmed and nourished.

We talk about equity, diversity, and inclusion in this work all the time. During February, we have additional opportunities for our members to learn and engage in dialog about anti-Black racism and racial health equity in perinatal care. We are using the language Black Futures Month, “a visionary, forward-looking spin on celebrations of Blackness in February”.

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Categories
birth Business Canada collaboration community Equity fertility Health Care Labour Doula LGBTQ2S+ Menopause pregnancy research sex

2023 Social Media Event Calendar

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