Tag: advocacy

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Anti-Oppression Anti-racism work Equity Health Care intersectionality lactation LGBTQ2S+ surrogacy understanding bias

Reflections on Trans Inclusion in Birth & Lactation Support

Response re Inclusive Language

Miriam Main, one of the directors of La Leche League Great Britain (LLLGB) recently resigned because she objects to the organizational directive to be inclusive of all people who lactate, regardless of sex or gender identity. Her open resignation letter explaining her decision echoes much of the feedback we’ve heard in recent years from birthworkers who disagree with our use of language such as “chestfeeding”, “birthing person” and other terms aimed at ensuring that all people who birth babies and feed infants from their mammary glands feel included and supported with the resources required to meet their feeding goals. 

Her objections to trans inclusivity include:

  • Women cannot be physically and emotionally open with “men” present
  • Men will make LLL meetings unsafe
  • It might be dangerous for men to feed babies
  • Men feeding babies separates them from their mothers, causing damage to the mother-baby dyad.

November 20 is Trans Day of Remembrance. The day was founded in 1999 in protest of the murders of two Black trans women, Rita Hester and Chanelle Pickett. There is heightened tension regarding this day this year because of the US election outcome. Trans people in the US and elsewhere are deeply afraid that emboldened transphobes will be incited to violence. Further restrictions on trans people’s ability to access affirming care is likely coming. The inability to access gender-affirming care increases suicidality among trans people. While Main claims that she is not anti-trans rights, unfortunately, rhetoric like Main’s fans the flames of fearful and hateful myths putting trans lives in danger.

The Confusion About Main’s Objections

Main is against the presence of “men” at LLL meetings. Confusingly, she includes transmen and non-binary people in a list of types of “women” she has effectively supported at LLL meetings in the past as a leader. When she uses the term “men” she could be referring to trans men who gave birth to their babies or trans women using the lactation induction protocol to assist with feeding their babies. Through this confusing use of language, Main appears to be asserting that trans men are “women” and that trans women are “men”.

Main’s view is rooted in an idea called “gender essentialism”. This is the belief that there are two genders, that gender and sex are the same, and that the characteristics of the genders are an innate, hardwired aspect of our biology. While many people subscribe to this normative view, there is a growing body of evidence that it is scientifically inaccurate. Since the dawn of recorded history, in cultures around the world, there have been people who don’t fall into the binary sex and gender categories of “man/male” or “woman/female”. Many cultures have acknowledged more than two genders. Now science is catching up with these age-old lived experiences. 

Main’s statement recirculates several myths that we as birth workers need to dismantle:

Women Cannot be Physically & Emotionally Open with “Men” Present

Main argues that it would be impossible to maintain the open, honest environment of LLL meetings if men were present. How could women feel comfortable talking about things like chapped and mangled nipples, or nurse in front of others if men are present? Main doesn’t realize it, but she answers her own question. She notes that breastfeeding is “the great leveler”. She observes that LLL group participants put aside differences regarding race, religion, income, politics, and sexual orientation. They are united in their shared goal of feeding their babies from their bodies. Whether participants are cis women, trans men, or trans women they are all dealing with chapped nipples, sleepless nights, and internal and external pressure to use bottles. Imagine the world we’d be living in if we developed our ability to focus on what we share rather than what divides us.

Men Will Make LLL Meetings Unsafe

She also fears that women may not feel comfortable coming forward about domestic violence if men are present, noting that 1 in 4 women have experienced intimate partner violence. A Canadian study of trans people conducted in 2019 found that 3 in 5 trans women had experienced intimate partner violence. Contrary to some of the rhetoric surrounding the recent US election, trans women are not usually the perpetrators of violence. They are in the population that is at increased risk of experiencing gender-based violence. Cultivating the erroneous belief that trans people are a source of violence is a significant inciter of violence against trans people. This needs to stop immediately.

Damage to the Mother-Baby Dyad

The letter raises safety concerns that are fear rather than fact-based. She posits harm to mothers and babies caused by ripping babies from their mothers’ arms so that men can feed them. Like much of what is fueling the current trans panic, this is a total red herring. Babies are not being ripped from their mother’s arms so that men can feed them. In the case of trans men, they are usually the gestational parents of their babies. Non-gestational parents with breast tissue can induce lactation. This includes cis women, trans men, and trans women becoming parents through adoption, surrogacy, or their partner carrying the baby. The protocol to induce lactation is rigorous, involving high doses of hormones and domperidone for several months before the birth. In cases where nursing is shared between a gestational and non-gestational parent, this is with the consent of both parents. For anyone who has fed a baby with their body, it should be easy to see why sharing the load of this labour might be desirable. 

Regardless of the exact nature of the situation, it’s safe to assume that anyone showing up to feed a baby at a La Leche League meeting is a parent to that baby. That’s really all that should matter.

It Might be Dangerous for “Men” to Feed Babies

She asserts that it might not be safe for babies to be fed by a “man”. She cites no evidence of any safety concerns. This is because there is none. Aside from universal precautions regarding substance use or infectious disease, If milk comes from your nipples, you can feed it to a baby. Where supply is inadequate to meet the baby’s nutritional needs, this can be addressed as it would be for anyone. We all know how frustrating and overwhelming supply issues can be. Parents experiencing this challenge need more compassion and support, not less.

There’s no reason to believe that trans lactators are at increased risk of under-supply or babies that are failing to thrive. In response to Main’s open letter, IBCLC Ashley Pickett has shared some helpful research. She notes that “When people take hormones, they can still breastfeed. It hasn’t been shown to be dangerous. Many AFABs [assigned female at birth] are entering menopause, and breastfeeding while on HRT [hormone replacement therapy]. Some trans women have taken estradiol and domperidone and their breastfed babies thrive.”

The potential for trans women to lactate and nurse is a new phenomenon, and as such, bound to raise concerns. Ashley Pickett, IBCLC addresses this with the best available evidence also. She cites two articles showing no cause for concern at this time:

https://pubmed.ncbi.nlm.nih.gov/37138506/

https://pubmed.ncbi.nlm.nih.gov/7462406/

Drawing from the articles she cites, she also provides evidence to allay fears that hormones are crossing over into the milk supply and causing harm to babies:

“Spironolactone is poorly excreted into breastmilk and there are no reported adverse effects on infants.

Cyproteone Acetate (used for [male to female] transitions as well as more commonly for acne and hirsutism, alopecia, etc) in people [assigned female at birth] transfers at 0.2% of the parental dose. However, in trans HRT uses high doses. Switching to an injectable Estradiol Valerate may be enough to elevate estrogen and not require an anti-androgen, and safely breastfeed. Breast development would remain, but she may grow some unwanted hair.

GnRH treatment has been used in postpartum contraception for decades, and in this time, has been shown to be as low as undetectable in milk and up to 1-2 micrograms per feed at max. The amount ingested had no biological activity in the infant (would be destroyed in the gut before entering the system). When taken throughout pregnancies, as it has been for many many experiencing fertility care since the 1990s, there has been “no specific hazard observed” among newborns exposure.”

 ~

The REAL issue

Evidence has nothing to do with Miriam Main’s underlying fear. It is the same as that of our members complaining about our use of gender-inclusive language. She is afraid that she and her fellow cis women are being erased from spaces that should feel like home. While this fear is an understandable conditioned reaction to change, it is unfounded. Cis women continue to comprise the majority of people who birth and lactate. Our use of inclusive language is an action to begin opening the door for trans and non-binary people who birth and lactate to receive affirmation and support. For cis women reading this, take a moment to imagine what it would feel like to walk into an LLL meeting knowing that there will probably not be anyone else in the room who is like you, but you need help feeding your baby all the same. Would you be brave enough to walk into that room? Would you be grateful for any gesture that made it a little easier?

Letting trans folks in doesn’t erase us as cis women. It is not usually presented this way, but trans inclusion and acceptance create more freedom for cis women. As we dismantle rigid, binary gender constructs and break down boundaries regarding what a “woman” can or should be, we are all freer to express ourselves authentically. I was raised in a family of women who couldn’t leave the house without “putting their faces on”. Now, I wear makeup when I feel like it. I speak truth to power without hesitation because I’m not limited by the belief that being a “woman” requires passivity. Every day I engage in numerous actions that I take for granted that would have been unthinkable for a Black woman a century ago. I owe a huge debt of gratitude to racialized trans ancestors, like Marsha P. Johnson and Sylvia Rivera, who started the Stonewall Riots, and with them, the queer liberation movement in North America.

If we let go of the fear of erasure, we can invite in the potential for trans people to enrich birth and lactation spaces. We may discover that the experiences of trans people add an important perspective on issues affecting all of us who experience gender oppression and gender-based violence. Community support and mutual aid are not finite resources. We don’t have to worry that by making space for trans people, cis women will be squeezed out. There is room in the circle for everyone.

 

About the Author

Keira Grant

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

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

Categories
Anti-Oppression birth Equity

Women’s History Month

4 females in colourful clothing sitting together smiling for a photo

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

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

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

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

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

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

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

Dr. Elizabeth Bagshaw & Nurse Dorothea Palmer

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

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

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

June Callwood 

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

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

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

Dr. Galba Araujo

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

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

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

Reverend Alma Faith Crawford

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

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

Nurse Courtney Penell

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

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

 

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”2/3″][vc_column_text css=”.vc_custom_1696691935455{margin-bottom: 0px !important;}”]Keira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities

Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_single_image image=”520907″][/vc_column][/vc_row]

Categories
community connection Equity LGBTQ2S+

Bisexual Visibility Day

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

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

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

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

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

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

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

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

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

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

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

 Keira Grant (she/her) brings a wealth of experience to her EDI Co-Lead role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community-building initiatives. As a mom and partner, she uses her lived experience to provide support and reflection for her clients and her work. Keira is the owner of Awakened Changes Perinatal Doula Services.

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Categories
fertility Health Care research

A Practical Guide to Navigating PCOS

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

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

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

I might have PCOS

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

I’ve been Diagnosed with PCOS

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

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

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

What else can I  do?

Alongside the goals of PCOS Awareness Month we can:

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

To lean more, visit:

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Categories
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]

Categories
Anti-racism work Equity

How do we DOula Advocacy?

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What is Advocacy?

“Advocacy” can describe any efforts or actions to change a policy, system, or institution that is in some way harmful to individuals or communities. It can also describe efforts to affect outcomes that are aligned with the needs or interests of particular individuals, groups, or society.

Current examples of advocacy include the efforts of Indigenous communities to expose the atrocities at residential schools and seek truth and reconciliation from the Canadian government.

In the context of perinatal healthcare, advocacy is usually focused on updating practices and policies that are not evidence-based, changing the scope, compensation, or other labour conditions of a health profession or occupation, or health equity and patient rights issues.

In the context of doula practice, advocacy can operate on three levels: self-advocacy, systemic advocacy, and individual advocacy (Gray & Jackson, 2002, Centre for Excellence in Disabilities).

Advocacy is not without controversy. The line between advocacy and activism is unclear and for many, this has a negative association with confrontation, aggression, and violence (Gray & Jackson, 2002).

For doulas, this controversy has some unique dimensions. One such dimension is that the field is growing, changing, and still seeking legitimization and security within the healthcare system. Another is that the philosophy of doula practice is largely focused on patient empowerment, making the role of systemic and individual advocacy unclear and subjective among doulas.

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 refers 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 refer 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, modelling consent by asking permission each time we touch the client and using our presence to back up the client during interactions.

All of this is to say that doulas are indispensable in helping pregnant persons navigate the daunting, confusing, and sometimes violating process of giving birth. They are especially valuable for birthers who are already predisposed to face disadvantages in our medical system due to racism and sexism.  Although doulas are poised to mend critical disparities in maternal health, they alone cannot fix inequities in the health system. Standing up for the rights of pregnant persons must go beyond the delivery room and extend into other spheres of advocacy related to disproportionate access to housing, lack of nutritious food, deficient public transportation systems, and inadequate sexual education.  Advocacy needs to happen with all levels of policy makers, hospital administration and the general public.

Doula Canada has taken our Advocacy Framework and turned it into an accessible tool for birth workers to practice the skills of advocacy for themselves and their clients. It’s downloadable below.

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][mk_padding_divider][/vc_column][/vc_row][vc_row][vc_column][vc_btn title=”Find the Advocacy Toolkit here ” color=”turquoise” link=”url:https%3A%2F%2Fstefanie-techops.wisdmlabs.net%2Fwp-content%2Fuploads%2F2023%2F03%2Fdtc-advocacy-toolkit-2023-1.pdf|target:_blank”][/vc_column][/vc_row]

Evidence-Based Research for Birthworkers | APRIL 25 @ 6:30 PM

This 90-minute webinar will show you how to compile evidence-based research and summarize it for your client’s specific needs. We will cover turning client issues and concerns into research questions, creating good keyword searches, and strategies for making research accessible to non-medical people.
This is a vital topic for birthworkers because comprehensive, evidence-based information is a huge part of how we support our clients to have a positive, empowered experience.
Become an expert in helping your clients separate the wheat from the chaff in a vast field of information.  Using case studies, and Q&A, birthworkers will leave with concrete tools to help clients fill gaps in their knowledge, distinguish credible scientific literature from misinformation, and present academic research in a way that anyone can understand.
Categories
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]

Webinar: Supporting Young Parents, an event with Lorena Murialdo of Planned Parenthood Toronto

This 60 minute webinar will host Lorena Murialdo, from Planned Parenthood Toronto, who will lead a discussion about supporting young parents in today’s birth and parenting climate.

What will this webinar cover?

We took it to our DTC crowd to ask them what they would like to learn most about!
When we asked our members about what they would like to see covered, some of the answers included:

-What support young parents need in the early postpartum period
-What it feels like to become a parent when you (may or may not) still be being “parented”
-Resources best suited to youth in terms of things like continuing education, housing, age appropriate support, and community services,
-Mental health for young parents and how unplanned parenthood impacts labour, birth, and postpartum times

-Fostering healthy relationships with doulas and others in the absence of parental support

Lorena will address many of these and speak to what she feels is pertinent to her work and important for modern birth workers to be aware of.

This 60 minutes is sure to be packed full of thought-provoking suggestions and points for growing competencies when supporting young parents!

When:  Tuesday October 18th @ 1pm EST via Zoom
*recorded for playback (registrants only)/ closed-captioning available at all DTC events*

Cost:  $20 per participant

For more information about Planned Parenthood Toronto please visit:  https://ppt.on.ca/

__________________________________________________________________________

Lorena Murialdo is a Community Health Promoter with over 25 years of experience
working with diverse youth and young parent communities. Lorena specializes in
mental health, sexual health, life skills, personal development and parenting. Lorena is
also owner of b_mindful and over the past decade has focused her work on advancing
mindfulness based stress reduction and intervention programs as well as social and
emotional learning opportunities in educational, health care settings and a range of non-
profit and for profit work place environments and organizations. Lorena has a genuine
interest in community health and health promotion initiatives that enable youth and
young parents to gain greater control over the decisions and actions that affect their
overall health and wellbeing.

Menopause Doula I ONLINE I April 3 course ACCESS date

Applicants recognize that this course material will not become available April 3rd, 2022.

This is an online course with 10 modules of content, 4 live meetings, 6 core assignments, module quizzes, a final exam, and a minimum of 20 practicum hours. Students have 24 months to complete all course requirements for completion.

Live meetings are scheduled for 7:30pm EST on:
April 21
April 28
May 5
May 12
*June 2 – optional business discussion and Q & A session

Students are asked to attend 50%.  All meetings are recorded for playback