Category: understanding bias

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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.

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Anti-Oppression community LGBTQ2S+ Trauma understanding bias

Trans Day of Remembrance

[vc_row][vc_column][vc_column_text css=”.vc_custom_1700318432768{margin-bottom: 0px !important;}”]Trans people’s existence is not an ideology. Transness is a natural and inevitable aspect of the wondrous biological and social diversity of human beings. As humans engage in a debate about whether or not some humans get to use bathrooms, attend school safely, and read stories to children, much of the panic regarding “gender ideology” is fueled by myths and misinformation that appear to have taken off like the wildfires that plagued us this Spring and Summer. 

Like wildfire, these myths are dangerous because they kill. Trans youth are at 7.9 times the risk of attempting suicide and 4 times more likely to be the victims of violent crime than their cis counterparts. Those who lose their lives to violence continue to be overwhelmingly trans, Black women. That’s why November 20 is Trans Day of Remembrance.

Here are some of the most toxic myths fanning the flames of fear and hate, followed by the facts that can douse those flames.

Myth 1: People come in two kinds, male and female. 

Fact: There is ample scientific evidence that human biology is far more complex than inny equals girl, outie equals boy. 

MRI-based studies show that the putamen (the region of the brain that controls cognitive functioning and other tasks) in trans people differs from structural norms that are consistent with their assigned gender and more closely resembles their felt gender. (Flint et. al. 2020; Clemens et. al. 2021)

Epigenetics is the emerging science regarding how different genes in our biological makeup get switched on and manifest. This epigenetic study found that since all human embryos start with the potential to be male or female, hormonal variation during sex differentiation can cause genetic changes that cause a person’s gender to be different from their sex.   

I’m a science junkie and I could go on with articles about hormone receptor mutations and genetic perspectives. But I think you get the idea that the biology of transness is a lot more complicated than the primer we got in grade school.

Myth 2: People who think their gender is different from their biological sex are mentally ill.

Fact: Well, technically being trans is a mental illness. The 5th edition of the Diagnostics and Statistics Manual (DSM-V), a compendium that provides diagnostic criteria for all mental illnesses, refers to transness as “gender dysphoria”. There is consensus among the mental health professionals that write the DSM that the appropriate treatment is supporting the person to live as their felt gender. Receiving a diagnosis and treatment for gender dysphoria is an involved process. It takes years to be approved for interventions like surgery. People under the age of 16 cannot receive permanent interventions like surgery. As the emerging biological science suggests, the classification of “gender dsyphoria” as a mental illness is controversial in trans communities. For now, people have to meet the diagnostic criteria in the DSM-V to receiving gender-affirming healthcare.

Myth 3: Trans people are emerging because of the new “gender ideology”.

Fact: While some of the terminology being used is relatively new, people whose gender experience differs from biological “norms” have always existed. Research shows that over 150 Indigenous nations on Turtle Island recognized a third gender before colonization. Indigenous communities were by no means unique. For example, hijras in South Asia have been recognized as a gender group dating back to the 1200s. Similarly, in pre-colonial Uganda, there was the mudoko dako.

Myth 4: Talking about trans people in schools “sexualizes children” and “grooms them” into becoming trans.

Fact: As the facts above demonstrate, trans people have always been here. People are born trans as a result of complex biological factors. The kind of experience they have is determined by society’s attitude toward them. In the pre-colonial societies I mentioned above, trans people were honored and respected members of their communities leading secure and productive lives. Talking about trans people will not make more of them magically appear. Explaining sexual and gender diversity to kids is no more inherently sexual than explaining heterosexual marriage. Failing to talk about LGBTQ+ people won’t make them go away. However, silence will make people more unsafe.

It’s fitting that November 20 is also National Child Day. The goal of the day is to open dialogue about the vulnerability of children and what we can do collectively to keep them safe and honour their rights. Telling kids the truth is how we can keep them safe. Treating all people with dignity and respect is how we create environments where kids feel safe to be themselves. Arming kids with the language to talk about their bodies and experiences is how we keep them safe from actual groomers. Building up their confidence and self-respect is how we keep trans kids alive and well.

 

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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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]

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Anti-Oppression community connection Equity intersectionality LGBTQ2S+ Newsletters pride understanding bias vulnerabiliity

Unlearning the Nuclear Family

[vc_row][vc_column][vc_column_text css=”.vc_custom_1685714926487{margin-bottom: 0px !important;}”]When I was a kid in the 80s, the family sitcom dominated television. From the Huxtables to the Keatons, to the Seavers, it was always Mom, Dad, and 2.5 kids. By then, the nuclear family had become the norm, so usually, both Mom and Dad worked outside the home. 

I always knew I wanted to be a mom someday. Even though my family didn’t look like the ones I saw on TV (I was raised by an Aunt and a Grandma), somehow it never occurred to me that the family I made someday would look different from the ones I saw on TV. I always pictured Daddy, babies, and me.

As I got older and came out as bisexual, my visions of future family life expanded to include the possibility of parenting with a “Daddy” or another “Mommy”, but I was still locked into a really nuclear understanding of what “families” looked like. 

Now my life has taught me a lot better. I do parent my only child with my wife, but welcoming Baby into our family made so much more than three. Our chosen family comprised of friends and partners from our queer and polyamorous communities has always been a huge part of our parenting journey.

We know many beautiful families configured in ways that transcend a couple with kids. We know quartets of a lesbian couple and a gay couple who have chosen to co-parent. We know gay and lesbian besties who have chosen to co-parent with their respective biological and chosen families behind them. We know lesbian couples with a known sperm donor who is deeply involved in their child’s life. There are triads or “thrupples” (a partnership involving 3 adults) who choose to raise families. This could look like a mom having a baby with each of her two male partners, or two women each having a baby with their male partner or any other number of ways of creating a family.

The reality is that Queer and Trans Culture isn’t just about having a life partner who was assigned the same sex as you at birth. Our cultural norms are forged from a history where the most conventional, nuclear way that we could have a family was still socially unacceptable. Many of us and our queer elders were rejected by our biological families for being honest about who we are. As a result, our community has been resourceful and resilient in carving out new ways of defining “family” and building family units that allow us to be whole. We create our own villages that know who we are, where we’ve been, and where we’re going to support us while we child rear and do this thing called life.

5 was a vital turning point for queer and trans families. It made the relationship to the child the focus of parental rights, rather than biology. The law also makes it possible for more than two people to be the legal parents of a child. This legal change was extremely important, but it’s only a fraction of the needed social change.

We must unlearn the idea that “parent+parent+kid(s)=family”. There are infinite equations that can add up to a family. As professional support people, we can embrace the expectation that clients seeking our help could come in ones, twos, or more, reflecting any mix of gender identities. 

We can also expect that folks living outside the parental binary are seeking our support specifically because they can expect that other parts of the health and social service systems don’t expect them, and might be hostile toward anything or anyone that challenges their expectations. We can create an unconditional blanket of compassion and support around all the beautiful shapes and sizes that families come in. That blanket is also a shield against fear and hate that preserves the sacredness of the parenting journey for all people.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][mk_padding_divider][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1686178152124{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]

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

Doula Canada Presents: Anti-O Bingo

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Aaniin Doulas!

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

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

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You have until December 31, 2023. Good Luck!

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

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

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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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Anti-racism work birth Health Care intersectionality Labour Doula LGBTQ2S+ Postpartum Doula Trauma Uncategorised understanding bias vulnerabiliity

Advocacy at Doula Canada

[vc_row][vc_column][vc_column_text css=”.vc_custom_1669384798061{margin-bottom: 0px !important;}”]Doulas support birthers, babies, and family members during an intimate and emotionally charged experience that often involves many medical twists and turns along the way. For many doula clients, pregnancy and childbirth are among the most complicated experiences with our healthcare system they will have ever had to navigate. We know that birthers need to feel in control of what happens to their bodies and to be making informed choices about their care to create a positive experience and avoid trauma. 

Doulas can change a person’s healthcare experience for the better by supporting their bodily autonomy and informed decision-making. Additionally, we are well placed to notice systemic issues that impact our clients again and again, and to use our knowledge to encourage and support changes.

Learning to engage in this type of advocacy within the scope of the doula’s role, so that our efforts are helpful, is an important aspect of our learning and professional development. To support our students and alumni, Doula Canada has developed an advocacy framework that defines advocacy in the context of doula practice and describes approaches to individual advocacy that are aligned with respect for client autonomy. 

Our framework identifies three categories of advocacy that doulas engage in: systemic advocacy, self-advocacy promotion, and individual advocacy. 

Systemic advocacy is any effort to change, remove, or add a policy or process that affects the lives of birthers, families, babies, or doulas. Examples include lobbying your elected federal representative to change the birth evacuation policy or amplifying social media campaigns that raise awareness regarding perinatal mental illness.

While we don’t usually think of it as such, our work with clients to support them to know the evidence regarding their perinatal circumstances, and ask the right questions of their healthcare providers is a form of advocacy. We encourage them to use their voice and make their conversations more effective because they are armed with information.

Sometimes, especially in the birth room, it might be necessary to advocate for the client in more direct ways. It is important that this individual advocacy does not manifest as speaking for or over the client, or in a manner that could worsen their care or medical situation.

A 2020 paper by S.S. Yam based on interviews with doulas identified three types of tactics that doulas use to advocate for their clients during labour and delivery. She calls these “soft-advocacy” techniques because they differ from what we usually think of as advocacy. Staff and instructors at Doula Canada agreed they used these strategies and had lots of guidance to offer on exactly how to use them. Their guidance was used to develop the advocacy framework. 

The three tactics identified by Yam are 1) creating deliberative space, 2) cultural and knowledge brokering, and 3) physical touch and spatial maneuvers. 

Creating deliberative space refers to strategies that give the client more time to ask questions and make decisions. One example of how doulas do this is by noticing that care that deviates from their preferences is about to happen and bringing it to the client’s attention, prompting them to ask about the intervention that is about to happen.

Cultural and knowledge brokering refer to the tactics doulas use to make sure the client understands medical jargon or cultural norms. This could involve paying close attention to the information provided by the medical team, observing how well this is understood by the client, and repeating the information in language that the client uses and understands.

Physical touch and spatial maneuvering refers to the ways we use our bodies and physical contact with the client to advocate for their needs. Examples include using our bodies to conceal the client from view, modeling consent by asking permission each time we touch the client, and using our presence to back up the client during interactions. 

The complete framework is linked below. It offers more detail on the three types of advocacy and the soft-advocacy strategies. It illustrates these concepts using case studies based on staff and instructor experiences. 

In 2023, Doula Canada will continue its work to support advocacy among its members by developing an advocacy toolkit from the framework and launching an advocacy working group for students and alumni. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][mk_button corner_style=”rounded” size=”large” url=”https://stefanie-techops.wisdmlabs.net/wp-content/uploads/2022/11/advocacy-framework-paper.pdf” align=”center”]Click here to view the full Advocacy Framework document[/mk_button][/vc_column][/vc_row]

Categories
Anti-racism work Canada collaboration community connection decolonization Equity indigenous doula MMIWG Uncategorised understanding bias

Doula Canada’s TRC Action Plan Draft

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Aaniin! Boozhoo!

As most of you know, the 30th of September each year is National Day of Truth and Reconciliation or Orange Shirt Day. The day is used every year to commemorate survivors of residential schools, as well as push for change in the form of allyship and reconciliation between settlers and Indigenous Peoples. But- reconciliation doesn’t begin and end on September 30th. It is something that is a continuous process, every day, for people inhabiting Turtle Island.

This month, Doula Canada is releasing our Truth and Reconciliation Action Plan Draft for students and alumni to check out! Based on the Truth and Reconciliation Commission of Canada’s 94 Calls to Action, our reconciliation plan for 2023 reflects the goals outlined in the recommendations by the commission. You can see the action plan here below.

What does this mean? It means that these four recommendations are what we are working toward in 2023. As we continue our journeys as a vocational school, we will continue to evaluate how we can incorporate more of these goals into our curriculum, programming, and overall community at Doula Canada.

It doesn’t end here. We want to hear from you! An anonymous feedback form for both Indigenous and Non-Indigenous members is available using This Link. (https://docs.google.com/forms/d/e/1FAIpQLSczDwoD1ZmkYI501_8Xv8JaeOkhkEEsQq_rM4K_AywfuUu8Jg/viewform?usp=sf_link)

There will also be a two-hour Indigenous-specific focus group in November led by Inclusion and Engagement Lead for Indigenous Peoples, Kayt Ward. Honorariums will be provided to participants. Please stay tuned for dates and times or email Kayt at kayt@doulatraining.ca if you’re interested in participating.

 

September 30th- How are you reflecting? Staff at Doula Canada will be participating in various learning experiences throughout the day, and we recommend students do the same. Don’t know where to start? Follow our social media to register for events we will be promoting by external organizations, come to one of the following events, or try a journal prompt.

  • Indigenous members pop up Bannock and Tea circle. Topic: Peer Support and Grief. September 30th, from 6-7 pm EST on Zoom.
  • “We Were Children” Film Night and Settler Learning Circle. September 30th from 7-8 pm EST on Zoom.

Journal Prompts:

What can we do as educators and birth workers to decolonize and deconstruct power systems in Canada? How can we dismantle oppression, and create a safe and equitable space for all?

What is my relationship with the land I reside on. Whose land am I standing on?

How can I participate in decolonization and the Landback movement?

How does settler-colonialism impact my life?

Chi Miigwetch,
Kayt Ward, Inclusion and Engagement Lead for Indigenous Peoples[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”461820″ img_size=”full” alignment=”center”][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”461821″ img_size=”full” alignment=”center”][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”461822″ img_size=”full” alignment=”center”][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”461823″ img_size=”full” alignment=”center”][/vc_column][/vc_row]

Categories
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]

Categories
birth community Equity Postpartum Doula understanding bias Webinar

Supporting Disabled Parents

[vc_row][vc_column][vc_column_text css=”.vc_custom_1650627316399{margin-bottom: 0px !important;}”]Welcoming a new person into your home and the world is always an emotional and life-changing experience with so much joy, but also many challenges and adjustments. Imagine navigating all of the usual challenges, when additionally you can’t hear your baby’s cries, see if they are too hot or too cold, or don’t have the mobility to do diaper changes or easily lift your baby.

This is a reality for many new parents, and it’s a reality we don’t see reflected in popular culture or in services and support for new parents. Disabled people are rarely depicted in parenting roles, despite the fact that 1 in 8 birthing people identifies as having a disability. One of the features of ableism is that disabled people are infantilized and not seen as sexual beings. As a result of these stereotypical and inaccurate beliefs, disabled people are assumed to not be parents. 

Additionally, until well into the 20th century, disabled people existed in a climate of eugenics, where many disabled people were unnecessarily advised not to reproduce and in some instances, sterilized against their will.

Even today, many disabled people report that they are discouraged from childbearing, and given inaccurate or misleading information about the impact of their disability on their fertility or ability to child bear. 

There is a growing body of research that shows that perinatal care providers are woefully uninformed or misinformed about the needs of disabled pregnant people. Just finding a clinic with an accessible exam room and other disability accommodations can be challenging and severely limit provider choice. Physicians and midwives are not trained on the needs of disabled patients and they themselves report that they feel insecure providing care to disabled patients. 

For parents who need assistance with newborn care, funded options are limited. In Ontario, there is a program called the Nurturing Assistance program. This program provides access to a support worker who can provide neonatal care under the parent’s direction, while the parent is present and involved in care. Support like this empowers parents to bond with their newborn while receiving assistance on their terms with the tasks that their disability limits them from performing. 

While Nurturing Assistance is an excellent resource, there are many challenges with the current program. Firstly, only individuals who meet the criteria for the self-directed funding program are eligible for nurturing assistance. This means people who do not need a support person for their own activities of daily living, but who do need assistance with newborn care are not eligible for funding. As a result, only a small proportion of disabled parents in Ontario can receive support from this program. 

Further, the support is usually provided by Personal Support Workers, often through agencies where the disabled parent is already receiving support. Personal Support Workers do not receive training on neonatal care and are often unwilling to accept such assignments or struggle to provide adequate support.

Disabled parents who do not qualify for the Nurturing Assistance program must pay for a support person out of pocket if this accommodation is needed. 

Whether the support person is paid out of pocket or through public funding for the rare families who qualify, support from a postpartum doula is an excellent way for disabled parents to receive nurturing assistance. More disabled parents need to be aware that trained support from postpartum doulas is available, and that funding from the Nurturing Assistance program can be used to hire doulas. Doulas need to be competent and comfortable providing support to disabled parents. They are key members of the parenting community who can truly benefit from the skills we bring to the table.

 

 

 

On Thursday, April 28 at 5 PM EST, we are hosting a webinar on supporting disabled parents. The 90-minute webinar will provide doulas with insight into how ableism manifests in perinatal care and parenting spaces, and the challenges and support needs of parents with physical disabilities during the postpartum period. Doulas should walk away feeling competent and confident about welcoming disabled parents into their practice.

The session will feature presentations from Rebecca Wood, Coordinator of Parenting with a Disability Network, a program of Centre for Independent Living Toronto. Rebecca will provide an overview of resources available to disabled parents and more information on the Nurturing Assistance program.

Gillian Cullen, a full-spectrum doula with Birthmark will provide practical guidance on postpartum care based on her experience supporting physically disabled clients through the nurturing assistance program.

Most importantly, two disabled parents, Gabriela Carafa and Terri-Lynn Langdon will speak from their lived experiences regarding the challenges they faced, the accommodations they needed to parent, and the supports that did and did not work well.

This webinar, presented with closed captioning and Q&A available in the chat, is a vital opportunity for doulas to build capacity in the provision of anti-ableist, disability-affirming support.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][mk_button corner_style=”full_rounded” size=”large” url=”https://stefanie-techops.wisdmlabs.net/training/birthworkers-as-nurturing-assistants-support-for-disabled-parents/” target=”_blank” align=”center”]Register HERE for the Birthworkers as Nurturing Assistants Webinar[/mk_button][/vc_column][/vc_row]