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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

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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]

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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]

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Anti-racism work birth Business Canada Childbirth Educator collaboration community connection Equity fear intersectionality Postpartum Doula pregnancy reducing stigma research shame Trauma understanding bias vulnerabiliity

Recognizing Asian Heritage Month and Jewish Heritage Month

[vc_row][vc_column][vc_column_text css=”.vc_custom_1653215730289{margin-bottom: 0px !important;}”]May is Asian Heritage Month and Jewish Heritage Month. It’s a great opportunity to reflect on what we mean by “heritage” regarding the history of these two communities in “multicultural” Canada, and what this means for creating cultural safety in birth work.

I’ve lived in the GTA my whole life. Here, a “heritage festival” typically amounts to a street party with food, live music and dance, and other culture-specific entertainment. I am actually a great lover of a good street fair. The food and performances are usually lit. I have also learned a lot about Jewish and Asian history and culture at events like the Ashkenaz Music Festival and Taste of Asia. I also understand that many communities are not fortunate enough to have this level of exposure to culture and diversity. But these cultural displays are not only far from telling the whole story of the “heritage” of Asian and Jewish people in Canada, but they also contribute to “false peace” – the illusion that multiculturalism is working out, that we are all getting along, and that we are all equal.

In truth, there is anti-Asian racism and anti-Semitism at the core of Canada’s heritage. Those of us who remember “Heritage Minutes” from the 1980s and 90s may know about the lethal exploitation of Chinese migrant workers that occurred in the 19th century to support the construction of the trans-Canada railroad. There are many other examples, including the head tax, and internment camps during WWII

Anti-Semitism is equally a part of the fabric of Canada’s history. Wide-spread belief in a Jewish conspiracy to achieve global economic domination that originated in Europe and spread to North America made Jewish Canadians an easy scapegoat during the great depression. Additionally, to limit the economic advancement of Jewish immigrants in the early 20th century, Canadian universities implemented quotas that restricted the number of Jewish applicants who could be admitted to the school.

It’s easy to hear these stories and think “this has nothing to do with me”, “this is ancient history”, “I didn’t do these things”, and “let’s focus on the positive and how far we’ve come”. While these sentiments are understandable, the reality is that the present arises from the past. These uglier parts of our heritage are directly related to more recent attacks on synagogues and the hate crimes experienced by Asian Canadians during the pandemic. 

Moreover, this heritage underpins the modern assumptions that manifest more subtly as microaggressions that affect the day-to-day navigation of society and impact the long-term mental and physical health of equity-seeking people. Some of these stereotypes may seem harmless or even positive. But in reality, they fuel the construction of whiteness as the social norm, put people in boxes, and create false impressions regarding people’s realities.

As birth workers, we can create cultural safety regarding the beautiful and the traumatic aspects of each client’s heritage. We can create space for them to share whether they have any cultural or religious traditions that they would like to honour. And we can also be mindful of things like how common stereotypes about Asian women may influence provider perceptions of client autonomy. Or how the intergenerational trauma of Holocaust survivors may impact pain management. There are a number of ways that our identities can impact our pregnancy and parenting journey. Shining a light on the good, the bad, and the ugly of our heritage sets us up to ask the right questions and facilitate the needed conversations with all of our clients.[/vc_column_text][/vc_column][/vc_row]

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birth Canada Equity fertility pregnancy shame vulnerabiliity

Fat.

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Fat.

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1644624846918{margin-bottom: 0px !important;}”]Read the word.  Read it once, twice, and then again.

How does reading the word make you feel?  How about saying it aloud? 

Most of us have learned to treat fat as a bad word and, beyond that, a bad thing to be.  We hear this from our friends and our peers, our families, our communities, the media we consume, and the healthcare systems we turn to when we’re unwell.  Fat is the punch line of countless jokes, the subject of over 40% of New Year’s resolutions[i], and the fuel of a weight loss industry worth $332.8 million in Canada alone[ii].

Fat people are scrutinized everywhere—in clothing stores that stop at size 14, on airplanes with too small seats, in conversations with relatives that always begin and end with comments on our size.  More than anywhere else, you can find this scrutiny in healthcare.  “Obesity” is listed as a risk factor for almost everything.  Any fat person who has been to a doctor’s office can tell you this. Depressed? Lose weight. Ear infection? Lose weight. Infertility? Lose weight.

When somebody is pregnant, trying to get pregnant, or even just a person between 20-40 with a uterus, their body is monitored in a whole new way.  They might be told that their weight will stop them from getting pregnant, that it will cause them to miscarry, that gestational diabetes will be inevitable, that they will need to be induced early, that their baby will be big, and on, and on, and on.

While any of these things might happen to a fat person, they won’t happen because the person is fat. Intentional weight loss is not a magical cure.  In fact, dieting could even lead to further issues with conception or pregnancy, where a nutrient-rich diet is important and weight gain is linked to the healthy development of the placenta, fetus, and pregnant person.

Over the past several years, there has been a shift in popular culture towards body positivity. Championed by celebrities and social media influencers, body positivity tells us to embrace and love our bodies (and other people’s bodies) as they are.  If this seems like a stretch goal, then we can be body neutral, accepting our body (and other people’s bodies) as they are, as the tools we use to engage with and experience the world.  These approaches can feel revolutionary when we’re used to hating our bodies and can absolutely improve our relationships with ourselves, but they aren’t enough.

Sofie Hagan, author of Happy Fat, explains, “I am not a body positivity campaigner, I am a fat liberationist. I do not care if you love your body or not, I care about abolishing the systemic discrimination and abuse that fat people endure on a daily basis.  Body positivity is fine, but it doesn’t at all fix the problem.” (Twitter, October 25, 2021).

The problems that Hagan is talking about are systemic fatphobia and sizeism. 

Fatphobia tells us that fat bodies are undesirable, unhealthy, and repulsive.  It includes fat jokes in the schoolyard and your grandmother telling you how much weight you’ve gained, but also means that fat people are less likely to be hired, less likely to be seen as attractive, less likely to be taken seriously by their medical providers.  It doesn’t just make people feel bad, it can be a matter of life or death: when Ellen Maud Bennett died of terminal cancer in 2018, her obituary named fatphobia as the cause, explaining, “Over the past few years of feeling unwell she sought out medical intervention and no one offered any support or suggestions beyond weight loss.”[iii]

Sizeism privileges smaller bodies over larger ones.  Not just through beauty ideals but through the systems and structures that we interact with every day.  This can include everything from insurance policies that have a body mass index (BMI) cutoff to hospital gowns and beds that don’t fit larger bodies.

To confront fatphobia and sizeism we don’t just need increased confidence in our own bodies, we need a different approach to size and weight.

The health at every size (HAES) movement is pushing medical providers to recognize that people can be healthy at every size, that fat shouldn’t be treated as an illness, that weight loss shouldn’t be treated as a cure, and that there needs to be (literal and metaphorical) room for fat people in our healthcare system.  It’s an important movement, but still prioritizes health. Fat people can be healthy or unhealthy, thin people can be too. All of us, regardless of size, will experience variations in our health throughout our lives.  We don’t owe anybody good health, and we don’t need to be healthy to deserve respect.

We need fat positivity: a mental and systemic shift that includes and embraces fat bodies, regardless of health. [/vc_column_text][vc_separator color=”white”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1644624383626{margin-bottom: 0px !important;}”]So, as a doula, how can you provide fat positive support?[/vc_column_text][vc_column_text css=”.vc_custom_1644624485528{margin-bottom: 0px !important;}”]1. Don’t ask about or comment on your client’s weight.[/vc_column_text][vc_column_text css=”.vc_custom_1645143545782{margin-bottom: 0px !important;}”]2. If your client asks about how being fat will impact them during conception, pregnancy, or birth, share evidence-based information and resources that are size inclusive.[/vc_column_text][vc_column_text css=”.vc_custom_1644624540161{margin-bottom: 0px !important;}”]3.Support your client through their healthcare experiences.  If your client is worried about weight checks, let them know that they have a right to refuse or to ask why they are being weighed.  If they are worried about whether a hospital or birth centre will accommodate them (from weight limits on hospital beds to BMI limits on epidurals), contact the birth location to find out.[/vc_column_text][vc_column_text css=”.vc_custom_1644624580474{margin-bottom: 0px !important;}”]4. Provide emotional support, recognizing the trauma that many fat people have experienced in healthcare.  Your client might feel anxious, avoidant, or upset when having to interact with healthcare providers or entering doctors’ offices or hospitals.  Validate these feelings.[/vc_column_text][vc_column_text css=”.vc_custom_1644624610152{margin-bottom: 0px !important;}”]5. Recognize that everything from common birth support positions to equipment like birth balls or birthing pools haven’t been made with fat people in mind.  Consider in advance how to adapt your support to include fat bodies.  If your client is comfortable, this can include practicing support positions to see how they feel for you and your client, as well as any other support people involved.[/vc_column_text][vc_column_text css=”.vc_custom_1644624639055{margin-bottom: 0px !important;}”]6. Examine your own biases.  We grow up in a fatphobic and sizeist world, and internalize these beliefs from a very young age. Ask yourself what you think and feel about fat bodies, then ask yourself why.  This is hard, ongoing, and crucial work.[/vc_column_text][vc_separator color=”white”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1645287465765{margin-bottom: 0px !important;}”]Fat people deserve to have our pregnancies and births treated with respect and care. We deserve health systems that see us as whole people and not as problems. We deserve to have our strength and capacity recognized.  We deserve partners, healthcare providers, and doulas who support, affirm, and hold us as we are.

Interested in learning more?  Sign up for Doula Canada’s webinar on Addressing Sizeism and Fatphobia in Birth Work, happening on February 27th from 12:30pm-1:30pm EST.[/vc_column_text][vc_separator color=”white”][vc_btn title=”Click here to register for our FAT: ADDRESSING SIZEISM AND FATPHOBIA IN BIRTHWORK webinar” color=”mulled-wine” align=”center” link=”url:https%3A%2F%2Fstefanie-techops.wisdmlabs.net%2Ftraining%2Ffat-addressing-sizeism-and-fatphobia-in-birthwork%2F|||”][vc_separator color=”white”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1645287477111{margin-bottom: 0px !important;}”][i] https://today.yougov.com/topics/lifestyle/articles-reports/2020/01/03/canada-new-year-resolutions

[ii] https://www.ibisworld.com/canada/market-research-reports/weight-loss-services-industry

[iii] https://www.legacy.com/ca/obituaries/timescolonist/name/ellen-bennett-obituary[/vc_column_text][/vc_column][/vc_row]

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birth fear gratitude Labour Doula shame Trauma vulnerabiliity

Working Through Shame – an important doula lesson

[vc_row][vc_column][vc_single_image image=”73471″ img_size=”full” alignment=”center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1551307504674{margin-bottom: 0px !important;}”]Guest Blogger Jillian Hand from Hand to Heart Doula Services in St.John’s NL shares with us the importance of working through shame in doula work. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1551308858438{margin-bottom: 0px !important;}”]When I first read Daring Greatly by Brene Brown it rocked my world. What a HUGE game changer. So, imagine my excitement when it was added to the Doula Canada required reading list. If you haven’t already had the pleasure of reading Brene Brown’s work, here’s a quick bio – Brene Brown is a researcher with a Masters and PhD in Social Work. She lives in Houston and teaches as a research professor at the University of Houston Graduate College in Social Work. She has spent over a decade studying vulnerability, courage, worthiness, and shame.

Pretty heavy topics, right? How do these pertain to doula work, you ask? Well, think about it. What is more vulnerable than being in the position of giving birth? How often do we hear our clients express sentiments like “I feel like a failure”; “I’m just not strong enough”; “I felt invisible and worthless” – these are all statements involving shame.

So, let’s dig a bit deeper into shame. Brown defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging” (pg 69). She goes on to explain that shame is the fear of disconnection – “it’s the fear that something we’ve done or failed to do, an ideal that we’ve not lived up to, or a goal that we’ve not accomplished makes us unworthy of connection” (pg 68). We all experience shame. It is a universal emotion and unless you lack the capacity for empathy (sociopath anyone?), you have experienced it. Brown also distinguishes between guilt and shame. The difference is best understood with the following example – Guilt = I did something bad; shame = I AM bad. See the difference?

Let’s use an example we can relate to. As a doula, I’m sure we have all experienced moments of shame. If you haven’t yet, you will. Trust me. You wouldn’t be human if you didn’t. My first bout of shame as a doula was with my third client. We had discussed her wishes prior to the birth and I knew she wanted to avoid an episiotomy if at all possible. I supported her to the best of my abilities throughout her labor and when it came time to push. Then, this happened – As she was lying supine, pushing with all her might, I watched the OB pull out a pair of scissors. In my head, I knew I should say something because it was obvious at this point that he didn’t plan to. But I froze – maybe out of fear of confrontation or perhaps I was just too intimidated at that point to question the decisions of a doctor. I’m still not sure why I didn’t speak up for her. But I didn’t; and he cut her without a word.

I had so much guilt for such a long time. I did something bad. I didn’t speak up for her. I didn’t protect her in the way I was meant to. I didn’t give her the chance to say no. I watched him violate her informed consent and did nothing. The guilt was overwhelming… But the shame.. well, the shame was excruciating.  Because you see, I didn’t only think I DID something bad, I also thought I WAS bad. What a horrible doula I was! I felt unfit and unworthy of supporting women during this precious, vulnerable time. Not only did I harbor guilt about my lack of action, but I internalized it and made it about who I was as a person, as a doula. Now THAT is shame.

I didn’t talk about that experience for a long time. I never admitted that I saw those scissors. I found it hard to look my client in the eye while she explained after the fact how painful her recovery was. I avoided the second postpartum visit because I couldn’t face the shame I was experiencing… and of course, that just reinforced my shame, deepening it until I felt like I was drowning.  That’s what shame does – it spirals and makes us pull away, disconnect, avoid. The more it silences us, the larger it looms. I almost gave up being a doula after that.

I didn’t quit though. I came to learn that I was actually a very good doula. I just wasn’t perfect. I learned to cut myself some slack when it comes to mistakes. I found empathy in my heart for that newbie doula who still hadn’t found her voice to speak up against obstetric violence, and who lacked the confidence to take a stand. She did the best she could in that moment. I truly believe that now.

As doulas, we will experience shame. We will also witness the shame of others – our clients, their partners, family members, our doula colleagues. Unfortunately, Brown’s research confirms that there really is no way of avoiding shame. Shame resistance is impossible. “As long as we care about connection, the fear of disconnection will always be a powerful force in our lives, and the pain caused by shame will always be real” (pg 74). What Brown did discover however is that we have the ability to build shame resilience. “Shame resilience is a strategy for protecting connection – out connection with ourselves and out connections with the people we care about” (pg 76). It’s about moving from shame to empathy, which is the real antidote for shame. It’s the “(pg 74).[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column border_color=”#441f93″ blend_mode=”soft-light” css=”.vc_custom_1551308244095{background-color: #300032 !important;}”][mk_blockquote font_family=”none”]It’s the “ability to practice authenticity when we experience shame, to move through the experience without sacrificing out values, and to come out on the other side of the shame experience with more courage, compassion, and connection than we had going into it” (pg 74).[/mk_blockquote][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1551308385042{margin-bottom: 0px !important;}”]So, how do we build our shame resilience? Brown identifies four elements, and the steps don’t always have to happen in order. They are:

Recognizing Shame and Understanding Its Triggers.

I love the description “Shame is biology and biography”. To build shame resistance, we must first be able to detect shame in our bodies. That’s the biology. Do we flush? Feel nauseous? Get headaches? What is our physical reaction? I know mine inside and out. First, I feel queasy and I get clammy. Then, my mind starts to race, and my breath quickens and a headache starts, right behind my eyes. I flush and can feel the grip of anxiety.

The biography piece refers to our ability to figure out what messages and expectations triggered it. What’s the story we are telling ourselves? Let’s take my shame story for example. The expectations I set for myself were that, as a doula, it was my sole responsibility to protect my client against unwanted interventions in any situation.

 Practicing Critical Awareness.

This is where reality checking comes into play. How realistic or attainable are the messages and expectations driving your shame? Was it realistic for me to set the expectation that I alone was responsible for the actions of my client’s healthcare team? Was it attainable for me to assume that I had the power to stop unwanted intervention? I know now that I am only one person.

Reaching out.

Are you sharing your story? Empathy requires connection and if we aren’t reaching out, we aren’t connecting. WHO we choose to share our story with is vital. Are we choosing someone who has earned the right to witness our vulnerability? Are they going to hold space for us in a non-judgmental way? If not, we might want to choose someone else because those that judge us and do not have the ability to provide us with compassion and empathy will only feed our shame.

When I first shared my story, it was with another doula who I trusted wholeheartedly. She listened and validated me, and was able to tell me about her own experience with shame. I didn’t feel alone anymore, and it made me realize that we all have moments of humanness where we make mistakes.

Speaking Shame.

Finally, are you identifying shame as SHAME? Are you saying the word, out loud? It’s important that we talk about shame and ask for what we need when we feel shame. By naming it, it loses its power.

Now, when I feel shame coming on, I look it in the face. I say to myself “This is shame”. I know exactly what I need to do to work through it. I call that same friend you gets me and I say “I need help, I’m in a shame spiral”. She knows exactly what that means. We talk it out. I usually cry. I tell her I need to hear that I’m still a good doula. I need her to believe that I did the best I could. She always believes me. Always.

Working through shame takes work, and self-compassion, and most of all, empathy. Remember, you need to go I.N.T.O it.

Identify it.

Name it.

Talk about it.

Own it.

I promise you, you will make it to the other side.

Brown, brene. (2012). Daring Greatly: How the Courage to be Vulnerable Transforms the Way we Live, Love, and Parent. New York: Avery Publishing.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1551307936785{margin-bottom: 0px !important;}”]

Jillian is a certified birth and postpartum doula through both Doula Training Canada and DONA International . She is one of the original founders of the Doula Collective of Newfoundland and Labrador.She is also a Certified Birthing From Within® mentor and doula and  a Birthing From Within® Birth Story Listener. This training, along with a master’s degree in social work, has provided her with the necessary skills to facilitate the processing of difficult birth experiences in a way that leads to growth and wholeness. Finally, She is a birth doula trainer through Doula Training Canada, as well as the mother of two beautiful and creative children. 

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