Category: understanding bias

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Anti-racism work birth Business Childbirth Educator Equity Health Care Labour Doula LGBTQ2S+ research understanding bias Virtual Webinar

Why Is Evidence-Based Research a Vital Skill for Birthworkers?

[vc_row][vc_column][vc_column_text css=”.vc_custom_1645285741139{margin-bottom: 0px !important;}”]

Why Is Evidence-Based Research a Vital Skill for Birthworkers?

[/vc_column_text][vc_separator color=”white”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1645285895328{margin-bottom: 0px !important;}”]The term “evidence-based” gets used a lot more than it gets explained. “Evidence-Based medicine” is a movement within health care practice that started about 30 years ago. It is a shift in approach to relying on the best available research data to support clinical decision making regarding testing, diagnosis and treatment. It differs from the previous practice in medicine and other health professions where teaching was largely apprenticeship-based, and physicians relied on their personal clinical experience to determine patient care plans (Masic et. al., 2008).[/vc_column_text][vc_column_text css=”.vc_custom_1645285507272{margin-bottom: 0px !important;}”]Relying upon scientific evidence to make decisions has the potential to improve patient outcomes because decisions are made based on clinical data that clearly show what happened most of the time when certain choices were made or methods used. It all sounds logical and straightforward, but evidence-based care is actually more challenging to implement than it sounds and it is not without controversy. In reality, evidence-based care happens very inconsistently (Lehane et. al., 2019).[/vc_column_text][vc_column_text css=”.vc_custom_1645286010844{margin-bottom: 0px !important;}”]This is where doulas have the potential to help. There is no organized system whereby new research makes it into the hands of healthcare professionals. There can be quite a lag between new, credible research being published and health care professionals updating their practice to align with it (Lehane et. al. 2019, Soliday and Smith, 2017). It takes physicians an average of 17 years to change their practice in accordance with new research. [/vc_column_text][vc_column_text css=”.vc_custom_1645285541602{margin-bottom: 0px !important;}”]Additionally, while unintentional, an evidence-based approach can be in contradiction with a patient-centred, individualized approach to care. The standard 15 minute medical appointment does not make it feasible to conduct research for each individual. This means that even providers who are staying apprised of new research developments may provide “one-size fits all” care due to resource constraints.[/vc_column_text][vc_column_text css=”.vc_custom_1645285557316{margin-bottom: 0px !important;}”]Institutional policies and legislations are often even slower to change with new evidence. For example, while evidence has been available for quite some time that routine antibiotic eye ointment for newborns is unnecessary, this is still a hospital requirement in many jurisdictions. If providers feel pressured by institutional policy, these interventions are often framed as requirements. From the provider’s perspective that is true, however the patient always has the right to refuse treatment. Often, legislation and institutional policies only change when concerned patients and healthcare providers call for change (Soliday and Smith, 2017).[/vc_column_text][vc_column_text css=”.vc_custom_1645285573376{margin-bottom: 0px !important;}”]Doulas who are skilled at evidence-based research can support clients to gather and interpret credible scientific information that is specific to their unique needs and circumstances. Clients equipped with this information are well-positioned to self-advocate by speaking a language the provider understands (Soliday and Smith, 2017). I know from lived experience as a Queer, Black woman that being an informed and educated healthcare consumer makes for much more empowering healthcare experiences.[/vc_column_text][vc_separator color=”white”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1645286312153{margin-bottom: 0px !important;}”]On February 24 at 6 PM EST, I am hosting a webinar on conducting evidence-based research in birthwork. The webinar will focus on preparing a strong literature review for perinatal informational support. A literature review refers to the process of compiling and synthesizing all of the current and relevant scientific information that is available on a topic. Analysis involves assessing the quality of each source and summarizing the complete body of literature. [/vc_column_text][vc_column_text css=”.vc_custom_1645285639985{margin-bottom: 0px !important;}”]During this session, we will discuss what exactly is “evidence”. We’ll go over the different types of health research evidence that exists, as well as how to determine which sources are credible, and how different sources can vary in quality. Participants will also learn about the different types of bias that can crop up in how we search for and analyze information, as well as how to spot and reduce bias in their own research.[/vc_column_text][vc_column_text css=”.vc_custom_1645285655944{margin-bottom: 0px !important;}”]Using real scenarios provided by DTC members and webinar attendees, we’ll walk through how to turn a client concern into an unbiased research question and find a solid answer that supports your client to make informed decisions and have confident discussions with their healthcare team. [/vc_column_text][vc_column_text css=”.vc_custom_1645285674079{margin-bottom: 0px !important;}”]My approach to research draws from a mix of my graduate education in health services research, professional experiences in policy and healthcare research and my lived experiences as a Queer, racialized healthcare user. I am very excited to share knowledge and grow with those who can attend![/vc_column_text][vc_btn title=”Register here for our RESEARCH SKILLS FOR BIRTH WORKERS Webinar” color=”mulled-wine” align=”center” link=”url:https%3A%2F%2Fstefanie-techops.wisdmlabs.net%2Ftraining%2Fresearch-skills-for-birth-workers-webinar%2F|||”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1645285701619{margin-bottom: 0px !important;}”]Citations

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., O’Connor, M., Corrigan, M., Burke, F., Hayes, M., Lynch, H., Sahm, L., Heffernan, E., O’Keeffe, E., Blake, C., Horgan, F., & Hegarty, J. (2019). Evidence-based practice education for healthcare professions: An expert view. BMJ Evidence-Based Medicine, 24(3), 103–108. https://doi.org/10.1136/bmjebm-2018-111019

Masic, I., Miokovic, M., & Muhamedagic, B. (2008). Evidence Based Medicine – New Approaches and Challenges. Acta Informatica Medica, 16(4), 219–225. https://doi.org/10.5455/aim.2008.16.219-225

Soliday, E., & Smith, S. R. (2017). Teaching University Students About Evidence-Based Perinatal Care: Effects on Learning and Future Care Preferences. The Journal of Perinatal Education, 26(3), 144–153. https://doi.org/10.1891/1058-1243.26.3.144[/vc_column_text][/vc_column][/vc_row]

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Anti-racism work Canada community connection decolonization Equity indigenous doula intersectionality MMIWG national indigenous peoples day Trauma understanding bias

National Day for Truth and Reconciliation

[vc_row][vc_column][vc_column_text css=”.vc_custom_1632997516706{margin-bottom: 0px !important;}”]September 30th is now National Day for Truth and Reconciliation. So what does this mean? How does it relate to doula care and birth work?

The National Day for Truth and Reconciliation comes after decades of emotional labour and advocacy from Indigenous communities, as well as a year of grieving Indigenous children and investigating the tragedies of the residential school system. Not only did Indigenous families experience the horrors of this system, but many others as well, such as the epidemic of Missing and Murdered Indigenous Women and Girls (MMIWG), the 60’s scoop, and current extraction of environmental resources.

This is not history. This is happening now. Something needs to change.

Why are we asking members to reflect today? Besides being citizens on Indigenous lands, birth and postpartum workers interact directly with Indigenous families, and play an integral role in mitigating systemic oppression and intergenerational trauma.

For example:

  • Providing culturally sensitive care and awareness when working with Indigenous families
  • Providing trauma-informed care for those impacted by violence and adult child survivors of the child protection system
  • Creating space for cultural birthing practices
  • Advocating against racialized medical violence

Getting comfortable with truth and reconciliation requires a lot of discomfort. This is okay. It is only when we face our shortcomings head on that we can progress toward change. We welcome you to reflect on some questions today.

Reflection Questions for Doulas:

  • How have I benefited from capitalism, colonialism, and extraction of resources?
  • How have I upheld colonial norms that can potentially cause harm?
  • What did I learn growing up about the history of Canada and Indigenous Peoples?

When we can acknowledge we are a product of wider system indoctrinations like white supremacy, colonialism, etc. we can separate our character from the issues at hand. Good people can do harm. Good people are capable of racism, classism, and perpetuating colonial norms. Shame restricts us from moving forward.

In an effort to show this to you, here is mine. As an Indigenous person, I am still capable of perpetrating colonial harm.

  1. I benefited from colonial post-secondary institutions and obtaining a western education
  2. I have upheld colonial norms in the social work field as a mandated reporter
  3. I learned in elementary school that Canada obtained the land fairly and through agreement with Indigenous Peoples. Since then, I have done a degree in Indigenous Studies and learned about the tragedies of colonialism.

Don’t know where to start? Dr. Lynne Davis of Trent University and her class “Transforming Settler Relations” have compiled a database of Canadian initiatives that support allyship, education, and decolonization. Find an initiative here: https://transformingrelations.wordpress.com/

You can take action today by signing up for our trauma series this fall. The workshop “Intergenerational Trauma: The Doula Connection” on October 28 from 7-8:30pm EST will focus primarily on working with Indigenous families impacted by trauma and systemic oppression. All proceeds will go to The Indigenous Foundation.

To any Indigenous and non-Indigenous doulas who have questions, need support, or would like to chat about truth and reconciliation, please contact Kayt at kayt@doulatraining.ca

Miigwetch,
Kayt Ward (She/Her)
Indigenous Inclusion and Engagement Lead, BSW[/vc_column_text][/vc_column][/vc_row]

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Anti-racism work Business Equity intersectionality LGBTQ2S+ Members understanding bias

Applying an Equity, Diversity, and Inclusion Lens to our Curricula

[vc_row][vc_column][vc_column_text css=”.vc_custom_1626172064269{margin-bottom: 0px !important;}”]In Fall 2020, Doula Canada circulated a survey that was looking to hear specifically from members self-identified as belonging to equity-seeking groups such as, but not limited to, Indigenous, Black, racialized, immigrants or newcomers, LGBTQ2S+, and/or disabled peoples. We really wanted to hear directly from members about their experiences, learn from them, and listen for ways that they felt that we could do better. Something that came up repeatedly was the gaps in our curriculum materials that resulted in members feeling excluded – things like gendered language, white dominant images, only heteronormative references, limited or inappropriate cultural references, and more. We were feeling this too and it was powerful to hear it echoed back at us!

We certainly see that, historically, the primary narrative in education and training in the perinatal field (especially in Canada) centers and reflects persons and experiences characterized in the following ways: white (including white/light skin tones and hair that tends towards long, blonde/brown and straight/wavy), in a heterosexual and racially homogenous couple, able-bodied, thin, 30-something, with pregnancy intentional and resulting from sexual intercourse between a cisgender woman and man. This narrative has been applied to both doula clients and doulas themselves. It is seen in images, language, resources and references, and focus of discussions. This narrative leaves so many valued people and groups OUT.

In late 2020, we took deeper action to change this narrative in our own house by initiating the development of a robust Curriculum Checklist that is built around an intentional integration of an equity, diversity, and inclusion (EDI) lens in curriculum materials (oral and written). Yes, a checklist sounds like it could be ugh when it comes to EDI work  – like a token action that gets people off the hook from doing any deeper, transformational work. We thought about that! Our Curriculum Checklist is for internal and external course developers and instructors who work with Doula Canada. It pushes them to reflect on how people who differ from the primary narrative are excluded and ignored, or, are mentioned and described in ways that present them as out of the ordinary. The Checklist means that dominant biases get reduced or removed from our curriculum through an intentional and guided change in language, images, references, and resources. The Checklist is also part of our Equity, Diversity and Inclusion (EDI) Action Plan (that we will officially launch soon). 

We have just started to test out the Checklist in practice. We will watch the results and take action as required. We see it as a living document that will be continuously refined and improved. Right now, it largely focuses on sexual orientation, gender identity, race, and culture as areas where the dominant narrative is exclusionary. We have started adding more on intentional inclusion of Indigenous Peoples and disabled people.

Wondering what it looks like? Here are a few snippets![/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”377355″ img_size=”full”][/vc_column][/vc_row]

Categories
birth Childbirth Educator Equity fertility intersectionality Labour Doula Postpartum Doula understanding bias

Using Inclusive Language in Birth Work

[vc_row][vc_column][vc_column_text css=”.vc_custom_1617899935998{margin-bottom: 0px !important;}”]Let’s start with this: not all birthing people are women.

The birth world is full of ideas about who can get pregnant, give birth, and parent.  This is reflected in the images we see on social media (hello, white dresses and flower crowns), the materials available to us (the classic La Leche League text, “The Womanly Art of Breastfeeding”), and the language that automatically gets applied to pregnant people (“Hi mamas!”)

If you’re somebody whose understanding or experience of parenthood fits into these ideas, you might not have even noticed that they exist. If you’re somebody whose understanding or experience of parenthood exists outside of these ideas, you’re probably painfully aware that they are there.

If your own personal connection to pregnancy and birth is rooted in being a woman, that’s okay. If your passion for birthwork, your reason for becoming a doula, and your personal brand are all rooted in working with women, that’s okay too.  What isn’t okay is forcing these ideas on to people who don’t fit into them.

As doulas, our work is meant to be client-centered.  This means listening to our clients’ needs and doing what we can to meet them. As well as being about which resources you share and which comfort measures you offer, being client-centered is about how you recognize your clients and the language that you use. If you are working with a client whose experience of pregnancy, birth, and parenthood don’t align with your understanding of these things, then it is your job to shift your framework to include them.

Some suggestions:

  1. When introducing yourself to a client, share your pronouns as well as your name: “Hi, my name is Anna and I use she/her pronouns.” This creates space for your clients to share their pronouns too.
  2. Think about the language and images you use in your own materials and brand.  Who does it include?  Who does it exclude?
  3. Share the terms that you use, but acknowledge that clients’ may use different ones.  “I generally use the term breastfeeding, but let me know if you would prefer chestfeeding, nursing, or something else.”
  4. Recognize that we are always learning and growing and sometimes that means we will make mistakes.  If you are challenged on something that you’ve said or done, say thank you and move on: “Thank you– parent, not mom.  I’ll try to not make that mistake again.”
  5. When possible, challenge other service providers’ language and assumptions too.
  6. Find opportunities to celebrate a range of identities, experiences, and families.  You can do this through your conversations with colleagues and clients, your social media, and events like Pride.

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][mk_image src=”https://stefanie-techops.wisdmlabs.net/wp-content/uploads/2021/04/instead-of.png” image_size=”full”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1617915869980{margin-bottom: 0px !important;}”]Building an inclusive doula practice means being intentional about the way you understand and reflect who can get pregnant, give birth, and be a parent. Unlearning and expanding these ideas can be challenging, but also rewarding.  Doing this work means that you’ll be ready to work with all clients, not just all mothers.

What are you doing to make your work inclusive?  Let us know in the comments![/vc_column_text][/vc_column][/vc_row]

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Anti-racism work decolonization Equity intersectionality Members understanding bias

Update: Equity, Diversity, & Inclusion Work at Doula Canada (2020-2021)

[vc_row][vc_column][vc_column_text css=”.vc_custom_1614781526791{margin-bottom: 0px !important;}”]Thank you for visiting!

In this message, we are outlining the equity, diversity, and inclusion work that Doula Canada, with the guidance of its two Inclusion and Engagement Leads, began in 2020 and will continue to develop, update, and amend as a part of our learning and engagement on these topics and their relation to birth work.  This message will also outline our response to recent feedback, and the actionable steps that we are currently working on.  This process will take time, and we are committed to the important conversations and changes in the days, weeks, and months to come.  

The following work was done prior to the current events that Doula Canada is experiencing and were in no way a reaction to these recent conversations:

 – The hiring of two Inclusion and Engagement Leads for Doula Canada
[Applications were accepted between November 2019 and June 2020]
 [Interviews:  April-June 2020, Positions began: June 2020]

  • Creation and distribution of Equity & Inclusion Climate survey for all Doula Canada members who self-identified as members of equity-seeking groups, including but not limited to, members who identify as Indigenous, Black, racialized, a person of colour, LGBTQ2S+, disabled, and/or living in poverty. The survey was sent to full Doula Canada membership.
    [Survey sent: September 4th, 2020] 
  • Analysis of survey answers (Oct/Nov 2020) and meeting with full Doula Canada staff to review and discuss next steps for support and learning
    [Survey reviewed with staff:  November 24th, 2020] 
  • Drafting Doula Canada Equity & Inclusion Action Plan.  The overall goal of this plan is to embed equity, diversity, and inclusion, over the next few years, in all aspects of our work, from our organizational policies and practices to our daily work as staff and instructors.It emphasizes action, accountability, and meaningful engagement.
    [Draft started: November 11, 2020
    [Estimated completion: July 1 2021 ]
    For further information or discussion please contact monika@doulatraining.ca and anna@doulatraining.ca 
  • The initial draft of EDI Curriculum Checklist.  This checklist is an internal document that has been developed to support integrating an equity, diversity, and inclusion lens into curricula that is delivered on behalf of or in collaboration with Doula Canada. It will be utilized in all course audits and in the development of new materials.
    [ start date: November 11th, 2020]
    [Status: Sent for review/feedback from DTC team, including instructors, February 2021] 
  • An initial audit of labour doula, postpartum doula, menopause doula, fertility doula, triple stream, and dual stream curriculum for inclusive language, representative images, removal of incorrect or derogatory terms, and updating of statistics. 
    [Start date:  August 9th, 2020
    [End date: December 2020; now in the second audit with external advisors with July 1, 2021 expected completion date] 
  • Contacts made to set up training for instructors and staff in topics of anti-racism and anti-oppression training.  We are in communication with external facilitators to host training for all staff and instructors.
    [Communication date:  June 5th 2020, follow up in September 2020 and January 2021] 
  • Creation and addition of an introductory module about Anti-racism, Anti-Oppression, and Knowing Your Privilege in birth work.  This module was added to all primary Doula Canada programs by the end of December 2020.
    [Start date: September 21, 2020]
    [End date: December 2, 2020]

 

The following actions were taking between February 16th, 2021 and March 1st, 2021 in response to community and member feedback:

  • Communication via email to individual persons who felt harmed by the actions or  decisions of DTC staff or administration
    [Communication date:  February 16, 2021-February 19th, 2021] 
  • Hiring of consultants who work in equity, anti-racism, and anti-oppression capacities to discuss communication and how to move forward for the betterment of all persons
    [February 19th, 2021] 
  • A pause of all DTC social media accounts, to reflect and plan better engagement
    [February 19, 2021] 
  • Removal of instructional materials about rebozo teachings and other culturally specific practices from our learning materials.
    [February 22, 2021] 
  • Town Hall for persons who have access to DTC learning materials
    [February 24, 2021] 
  • Reallocation of anti-oppression, anti-racism, and privilege module to an earlier place in the online module system, based on feedback from the town hall.
    [February 25, 2021] 
  • Meetings with potential moderator/s for social media, who have anti-racism and anti-oppression experience.
    [February 19, 2021, ongoing until person is hired for role] 
  • Preparation of communication for stakeholders, members, and staff
    [Ongoing]

The following are deliverables that Doula Canada will continue working towards and will continue to reassess throughout 2021.  These plans may take time and will be done with respect and acknowledgment of our members voices and needs:

  • Hiring of instructors who are BIPOC, 2SLGBTQ, or members of other equity-seeking groups whose materials and instruction practices do not represent the white, heterocissexist history of modern birth work. 
  • Learning for our staff and administrators with qualified and compensated trainers on topics related to anti-racism, anti-oppression, and privilege. 
  • Review and implementation of the curriculum checklist 
  • Next steps in the development of the Equity and Inclusion Action Plan draft, including staff review and member engagement (via a small advisory committee and general membership survey), followed by implementation 
  • A restructuring of staff and management to ensure communication with our members is open, ongoing and thorough. 
  • The formation of a DTC customer counsel (member council) 
  • Regular feedback forms and town halls to hear concerns and feedback from registered members. 
  • Reassessment of our equity-seeking scholarship application  
  • Active recruitment of external course instructors who can offer instruction and/or materials on topics related to birth work and social justice, equity, anti-oppression, privilege, implicit bias and other topics of importance to members (as shared through ongoing feedback, communication, and engagement)

We thank you for your feedback and encourage you to continue reaching out via email or phone.  Persons who have chosen to take learning with DTC can also provide feedback via the anonymous Feedback Form under the 2021 MEMBER RESOURCES tab in their personal login.  Your feedback assists our staff in updating learning materials, creating new systems for engagement, and knowing what DTC needs to do to support its members.

Questions about the Equity, Diversity, and Inclusion work or recent events can be sent to info@doulatraining.ca.  Your message will be forwarded to the appropriate staff member. 

All communication is electronically kept on file with DTC (from 2016 onwards).

[/vc_column_text][/vc_column][/vc_row]

Categories
birth collaboration community Health Care intersectionality reducing stigma sex Sex & birth sexual health Uncategorised understanding bias

Intersectionality: Why Looking Beyond Identity is Key in Sex and Birth Support

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If you’ve perused my course on Sex & Birth, you’ll notice that an entire module/week is devoted to intersectionality and voices from the margins right at the start of the course, so that these ideas remain with us throughout the rest of the weeks. Why is this important, you ask?

First, I want to introduce you to a very important person: Jasbina Justice, the editor of the Sex & Birth Manual.

I could not have done this work without the guidance and brilliance of Jasbina Justice. Jasbina Justice is an Intersex Femme queer person who is mixed. They are South Asian and Caribbean. They are a settler living on colonized land known as Tkaronto, Turtle Island, land of the Haudenosaunee, Anishinaabe, Mississaugas of the New Credit, Huron-Wendat and other Indigenous peoples. They live with an invisible disability and have Complex PTSD. They have been running workshops, doing consultations, and generally working in equity and social justice for the last five years. They are a poet, writer, multimedia artist, performance artist, community educator, facilitator, former sex worker, and yoga teacher.

As a white settler, I knew I was going to need some help! It was working with Jasbina that helped me understand these 4 important reasons for the inclusion of intersectionality in this course:

#1 Intersectionality is the understanding that the totality of our person cannot be understood by merely looking at each of our identities in isolation. Rather, it is at the intersection, or where these identities meet, where unique and compounded oppression’s can be found.

The term intersectionality was coined by Kimberlé Crenshaw in the late 80’s when she was trying to find a way to explain black women who experienced obstacles not just because they were women and not just because they were black, but because they were both black and women. Here is a great video of Crenshaw breaking down the definition. This is important in sexuality education because…

#2 Most sex education in Canada is taught from a white, colonial, cisgendered, able-bodied, heterosexual, middle-upper class, educated, incomplete perspective.

Though about 72.5% of Canadians identify as white, this number continues to drop and dramatically changes depending on the area. In Tkaronto, specifically, more than 50% of folks belong to a visible minority (you can see the stats Canada breakdown here). In Saskatchewan, the indigenous population is predicted to increase threefold by 2045.

In 2012, 11% of Canadians had some kind of physical or mental disability that limited their day-to-day life. Sex and disabilities is often disregarded at all levels of education (elementary, highschool, undergraduate), unless someone is specifically seeking to learn about this topic.

Although the percentage of trans or intersex folks who birth is relatively small, it is all the more reason to make sure we are not lost in trainings because we are often lost in the literature and research.

When you belong to a minority group, it is easy to feel isolated and not have information that is relevant to you. This exclusion from information is dangerous to all aspects of our health, including sexual health.

Continue reading “Intersectionality: Why Looking Beyond Identity is Key in Sex and Birth Support”