Doula School Canada

Tag: doula

  • Response to the Consensus Statement on the Management of Intersex Disorders

    Response to the Consensus Statement on the Management of Intersex Disorders

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1731959260366{margin-bottom: 0px !important;}”]This year, in the course of my prenatal and birth support work, I had the occasion to read The Consensus Statement on the Management of Intersex Disorders published in 2006. Now eighteen years old, the Consensus statement is still used by medical teams to guide ethical decision-making regarding the medical care of intersex newborns, infants, and young children. 

    Given this, doulas should be familiar with this Statement and ready to provide informational support to parents that is free from stigma and based on current evidence, including the stories of intersex adults. There are numerous concerns with this statement from a health equity and intersectional social determinants of health perspective. Many issues arise from how dated the document is. There are four problem areas with this statement: 1) Guidance on Terminology, 2) Guidance on gender assignment, and 3) Lived experience of intersex people not valued as evidence 4) The Kenneth Zucker controversy. 

    Guidance on Terminology

    The term “Intersex” is used in the article title, however, in the article body it lists “intersex” as potentially pejorative alongside several outdated and offensive terms. It then goes on to advise providers that “Disorders of Sexual Development” is the preferred term. This differs from the position of advocacy groups by and for intersex people, who counsel their audience that “intersex” is the term they prefer. 

    Intersex conditions are numerous and diverse. Framing all of them as disorders discounts the reality that many intersex people are able to have sexual relationships and children without ever needing medical intervention. The universal use of the term “disorder” insinuates that all intersex people have something “wrong” with them that needs to be corrected. This is simply untrue. Some intersex conditions can cause issues with the ability to eliminate urine, in which case this must be treated as soon after birth as possible. Other conditions may impact fertility, and sexual functioning, or increase the likelihood of having cancer later in life. None of these issues need to be treated during the newborn phase and parents should be encouraged to focus on bonding with their baby. The blanket use of the term “disorder” and the fear it is apt to inspire in parents does not support the measured and stigma-free approach to decision-making that is best here. 

    Guidance on Gender Assignment

    Unsurprisingly given the statement’s age, concepts like non-binary identity and gender-open parenting are not entertained. The Statement positions it as a given that parents will be deeply disturbed if they are not able to assign a gender to their baby at birth. It promotes making a gender assignment as quickly as possible after birth as the way to alleviate parental anxiety. Much of the pressure to diagnose and treat early that it advocates is rooted in the belief that parents need guidance on how to assign gender. The statement then offers guidance on what gender should be assigned to people with certain conditions.

    The idea that each individual is the most qualified person to identify their gender is never considered. According to the statement assigning gender is strictly the purview of the parents, in this case, guided by medical experts. 

    Earlier this year, I wrote about the concept of “gender-open parenting” and how and why it is enacted. This approach to parenting is guided by the belief that each individual has the right to assert and express their gender as free from external pressure as possible. Gender-open parenting is a wonderful option for parents of an intersex child to consider. Gender formation and expression happen in early childhood. Anecdotally, most children who have been raised gender open have self-identified their gender by the time grade one is over. At this age, most medical complications will not have arisen, and most medical interventions are still on the table. From the standpoint of promoting bodily autonomy and informed consent, parents should be encouraged to defer decisions about gender assignment and non-urgent medical intervention until the child can be a part of those conversations.

    The Lived Experiences of Intersex People

    More recent research on intersex people has found that many intersex adults have extensive medical trauma from repeated examinations and in some cases multiple surgeries during childhood. Moreover, many intersex adults attest that the surgeries they endured were cosmetically motivated, medically unnecessary, and in some cases harmful to their sexual functioning and/or fertility. Still, other intersex people whose parents forewent medical interventions state that they are happy, functional adults. 

    This qualitative evidence from intersex adults needs to be viewed as legitimate evidence regarding how intersex people should be cared for in childhood. I’m not sure how much qualitative evidence from intersex adults existed in 2006, but if there was any, it wasn’t included in the statement. 

    The statement does use statistical evidence drawn from intersex adults, using the gender identity held by the majority of individuals with specific conditions to justify assigning that gender to all infants with that condition. The Statement notes that gender may need to be reassigned if the initial assignment proves wrong. Again, the experts are to make this reassignment. The concept of the individual deciding their gender for themselves is not mentioned. 

    Throughout the document, the intersex child is discussed as a passive bystander to their health care decision-making. This is not aligned with contemporary approaches and attitudes regarding the importance of client-centred and directed care, informed consent, and bodily autonomy that should be enacted in every part of the healthcare system.

    Kenneth Zucker Controversy

    The Statement is a consensus among international experts on the diagnosis and management of intersex conditions. The Canadian expert who contributed to the statement is Dr. Kenneth Zucker. His name will ring a bell for many members of the Toronto 2SLGBTQ community, especially trans people, parents of trans kids, and their allies. For many years, Dr. Zucker was the director of the Gender Identity Clinic at the Centre for Addiction and Mental Health (CAMH). Many trans youth and their parents have accused Dr. Zucker of harming them by gaslighting them about their gender identity and trying to convince kids who were certain that they were trans that they were wrong and that in his expert opinion, they were cisgender and should focus on being comfortable with the gender they were assigned. Following significant and sustained outcry from the 2SLGBTQ community alleging conversion therapy, Dr. Zucker was relieved of his duties at CAMH, and the Clinic was closed. He defended his practices, appealed this decision, and was eventually offered an apology and a settlement by CAMH.

    The consensus statement manifests many of the concerns that were raised about Dr. Zucker’s ideology. They included:

    • The individual is not considered a valid authority on their own lived experiences and identity. 
    • Conforming to the gender you are assigned is the ideal outcome. 
    • Non-binary, genderqueer, agender, and genderfluid identities are not legitimized or even considered. 
    • Everyone must eventually conform to the box of “male” or “female”. 
    • Gender is something that is assigned to you, not something that you define for yourself. 
    • Having a child that can’t be easily slotted into one of those boxes is “disturbing” for parents.

    On this platform, I have talked about how these beliefs are harmful to trans people. They’re harmful to intersex people too, especially in infancy. The pressure to rush to gender assignment, potentially reinforcing the assignment with surgical procedures, is driven by these beliefs. Intersex people are being physically and psychologically harmed as a result. 

    ~

    For many parents, their child being diagnosed with an intersex condition will be the first time they have given any thought to the existence of intersex people. This is through no fault of their own. The gender binary is the dominant perception of reality. The lives of intersex people are shrouded in stigma and silence. As such, parents are highly vulnerable to accepting what they are told by medical experts at face value. The Consensus Statement is an excellent example of how medical guidance is not always objective. Our interpretation of “facts” is always mediated by our preexisting beliefs. 

    Doulas have a vital role to play in helping parents understand where medical recommendations are coming from and unpacking the beliefs on which seemingly evidence-based recommendations rest. The B.R.A.I.N (Benefits, Risks, Alternatives, Information/Intuition, (do something) Now/Never/Not Now) model of decision-making is an excellent approach to apply. We can also reduce stigma by sharing stories of positive outcomes for intersex individuals. Role models and other resources can be found at Intersex Canada or InterAct: Advocates for Intersex Youth.

    My social media post from October 28, 2022, offers guidance on specific questions parents should ask if their child is diagnosed with an intersex condition. A huge part of the magic of this work is the power to improve lives by being at the ready with unbiased, affirming, open-minded information and compassionate support. If we lead with compassion and inclusiveness, we can alleviate the medical harms currently happening to intersex babies and children. 

     

    Keira GrantKeira 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]

  • Embracing Mothering, Releasing Motherhood: Women’s History Month

    Embracing Mothering, Releasing Motherhood: Women’s History Month

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1711640523303{margin-bottom: 0px !important;}”]I loved one-sided “conversations” with my son when he was an infant and it’s one of my favorite things about postpartum visits now. I refer to all my clients by their first names, however, when I’m providing postpartum support to clients I know identify with terms like “woman”, “mother”, and “mom”, I often find myself talking to Baby about how wonderful their mama is and what a great job she’s doing, especially when they get to the stage where their eyes follow her around the room lovingly. 

    This often sparks a conversation with the client, especially if no one else is there. That’s part of my goal. In a patriarchal world, “mother” is a loaded construct. Adjusting to the idea that you are now someone’s “mama” is one of the most emotionally and psychologically intense aspects of the postpartum experience for first and only-timers because of everything that is expected of motherhood. 

    Canadian feminist scholar Dr. Andrea O’Reilly has devoted her academic career to understanding what it means to be a mother. A mother of three herself, she understands “motherhood” as something separate from “mothering”. Motherhood is a patriarchal institution that sets rigid, specific, and unattainable expectations on the care work of raising children as a means of exerting control over women’s bodies and lives. To meet patriarchal expectations of motherhood women must be selfless, long-suffering, patient and kind, and compliant with expectations of good, wholesome women. Patriarchy’s archetypal mother does not sexualize herself, but she also doesn’t “let herself go”. She keeps an immaculate home and serves balanced, from scratch meals. She has well-groomed, well-behaved children. She always knows exactly what to say and do to comfort her family and keep peace and order in the home. By the 1980s, contributing to the household income was added to the list of expectations. As an avid fan of The Cosby Show, it did not strike me as unusual that high-powered lawyer and mom of 5 Clare Huxtable would make fresh squeezed OJ and pancakes from scratch for her brood on Saturday mornings, served in the comfort of their stunning, self-cleaning Park Avenue home.

    As a working mom of one in 2024, it strikes me as absurdly implausible, and that’s intentional. The point is not for anyone to be as perfect as an 80s sitcom mom. The point is for all of us to feel like we’re failing by comparison.

    Conversely, O’Reilly defines “mothering” as autonomous, empowered, and priceless social labour that we construct and define according to our deep knowledge of family, community, and personal needs. As a verb rather than a noun, “mothering” is action-oriented and the role is created by those who enact it. Mothering does not require the relinquishment of self but affirms each mother’s right to undertake the role in a manner that is faithful to her authentic self. 

    When supporting new mothers I hold space for their joy and discomfort with being called “mama”. I normalize using alternative monikers if that’s preferable. My wife was not comfortable with “mother” as a label, so we went with a variation of her nickname instead. I encourage them to insist on making space for the things that made them “them” before they had their beloved baby. We unpack unrealistic and sexist expectations of moms as they arise. I affirm the need to putting yourself first sometimes, for the overall good of the family. We lay the groundwork for them to define the role according to what works for them and their family. Liberating new mothers from the constraints of motherhood and facilitating their intuitive enactment of mothering is one of my favourite aspects of being a doula. 

     

    We hope our woman-identified audience is having an affirming Women’s History Month this March. For those of you who mother, we affirm your right to do this living giving, nurturing work on your terms. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”534490″][vc_column_text css=”.vc_custom_1711640593876{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]

  • EDI Year in Review 2023

    EDI Year in Review 2023

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1709738042033{margin-bottom: 0px !important;}”]A river may be so still that you can see your reflection, but its current is always in motion. This year has been a time of great change for Doula Canada as we have welcomed renewal in the form of new leadership. We have taken advantage of this transition to reflect on revitalizing our commitment to equity, diversity, and inclusion at DC and in the birth sphere. Our goal is to ensure that Doula Canada alumni have the necessary tools and frameworks to meet the diverse spectrum of birthing people, families, and communities with compassion, affirmation, and allyship. In the coming year, we will continue to apply the lessons learned from all of your insights to realize policy, curricula, and continuing education that sets doulas, reproductive health educators, and birthworkers up for long-term success in an ever-changing world. 

    Here are some of the highlights of our actions in 2023 and our plans to advance our journey towards achieving social justice in our learning community and perinatal social systems in 2024.

     

    Content & Communications

    One of our goals is to ensure that DC alumni have access to a wealth of information that offers insight into the experiences of equity-seeking birthers and families, and tools to empower effective support. This year, we accomplished this by creating and publishing original articles, position statements, downloadable resources, and live-streamed discussions.  

    Articles and Position Statements 

    Our blog provides ongoing equity, diversity, and inclusion content that situates reproductive justice in the context of social issues, and that supports our learners to cultivate a deeper understanding of the social determinants of reproductive health. In 2023, our blog offered articles on trans inclusion, domestic and gender-based violence, truth and reconciliation, poverty, black maternal health, and many other essential perinatal health equity topics. 

    We also endeavoured to be responsive to the impact of current events on community well-being by providing a statement on the Israel-Hamas conflict that offered comfort to our members and practical strategies for preserving emotional stability and community connectedness.

    Downloadable Resources 

    In 2023, we created three downloadable resources to provide practical guidance for birth workers. The first was our Advocacy Toolkit. The toolkit continues the work done in 2022 to develop an advocacy framework for Doula Canada. The Toolkit works through examples of the ingenious strategies that birthworkers use to promote client self-advocacy and advocate on behalf of clients in a manner that affirms their autonomy and right to informed consent.

    Additionally, we created two resources to support human milk feeding. One is an infographic on human milk sharing that provides information on the risks and benefits of milk sharing, as well as safety guidelines that support families to make informed choices about their feeding options. The second is a curated Lactation Recipe Box with meal and snack ideas that are packed with ingredients that gently encourage milk production. 

    Live Streams

    We continued our tradition of hosting great conversations with experts and thought leaders from within Doula Canada and the broader birth world. Our guests offer insight into how they’ve applied their training and lived experience to facilitate clients’ access to equitable care. In 2023, topics included empowering teen birthers, debunking fatphobic reproductive health myths, barriers to fertility care, what we need to know about birthers who use testosterone, and the experiences of black families with more than “2.5 kids”. Content ideas were generated from discussions with our members at live events and online and from suggestions made using our anonymous feedback form. Our audience can access this content at any time from our Facebook page or our YouTube Channel.

    In 2024, live streaming content will shift to a virtual, guest speaker Q&A series, opening with Support Men’s Lactation Like a Boss on February 29. 

    Programming 

    Doulas for Reconcili-ACTION

    Committing to our Truth and Reconciliation Action Plan, we launched the Doulas for Reconcili-ACTION program. The Doulas for Reconcili-ACTION program aims to include non-Indigenous doulas in important conversations about the impacts of settler-colonialism, and build cultural humility skills in an applied workshop format. Our first workshop was held for National Day for Truth and Reconciliation, and focused on the historical traumas imposed on Indigenous communities, and the role of doulas in mitigating risk factors for Indigenous families.

    In 2024, the Doulas for Reconcili-ACTION program will be running on a monthly basis. 

    Webinars

    Recognizing a need for community healing and dialogues in the aftermath of the disturbing events culminating in the arrest of Kaitlyn Braun in March of 2023, we hosted a session aimed at providing a safe container for community members to unpack the feelings arising from this distressing incident. The session was facilitated by Elizabeth Evans, RSW, and Psychotherapist and generated a presentation for community members on collective healing after traumatic events.

    In order to provide practical support to our members regarding the implementation of ethical practice as defined by the law, we also hosted a webinar on understanding the legalities of your doula biz facilitated by Ane Posno, LLB, an expert in health and contract law at Lenczner Slaght. The first webinar of its kind at DTC, the live session provided vital information on documentation, confidentiality, and reporting obligations for doulas. 

    Organizational Development 

    Census

    For the first time in its over 20-year history, DTC undertook a demographic census of its student and alumni population to learn more about how we can ensure that our content is responsive to our existing population and target our recruitment efforts to attract equity-seeking communities that may be underrepresented at DTC or in the birth work field. 

    154 members completed the survey and the findings were illuminating. DTC’s population is highly diverse, with DTC members being more likely to be equity-seeking than the general population across several categories including Queer people, and some racial groups (e.g. Black, Indigenous). Other equity-seeking populations, such as disabled people have representation that is similar to the Canadian population.

    One challenge with analyzing this data is that 6.5% of our sample are international but Canadian data has been used for comparison. Other limitations of this data set include categories not always being exactly aligned with the categories used by Statistics Canada, and questions that should be further segmented to create clarity, most notably education. 

    On the whole, it appears that organizational efforts to ensure that equity-seeking members feel included and represented have been effective at attracting diverse students to our programs. In 2024 we should conduct an evaluation of the EDI climate to learn more about the quality of the learning experience for equity-seeking students, focusing on learning more about the experiences of underrepresented groups. In the case of underrepresented groups, DTC could also consider key informant interviews with individuals external to DTC to learn more about their needs in a birth worker training program and successful recruitment and retention strategies for their community.

    Roll out of advocacy framework 

    In addition to sharing the toolkit mentioned above, we are in the process of ensuring that the lessons learned from the advocacy initiative are incorporated into the anti-oppression module in our courses. The revised curriculum was piloted during the live session on anti-oppression for the fall 2023 cohort of the holistic doula program. The new content includes introducing learners to the 3 soft-advocacy techniques used by doulas as codified by S.S. Yam, namely 1) creating deliberative space, 2) culture and knowledge brokering, and 3) Spatial maneuvering. Live session attendees have the opportunity to discuss examples of how doulas use these advocacy techniques to benefit clients.

    TRAP module

    In 2023 we launched our truth and reconciliation module, which focuses on educating students about colonial violence toward Indigenous communities. This module was inspired by various universities that have mandated Indigenous Credit Requirements (ICR) to show respect to Indigenous communities, and foster reconciliation between settler and Indigenous groups. In 2024, applications will be open to students and alumni wanting to participate in a review of the Truth and Reconciliation Action Plan, including the module. This committee will also focus on creating a template for a wider five year TRAP outline.

     

    What’s Next

    In 2024, we will continue to grow equity, diversity, and inclusion within DTC by undertaking a review of our policies and curricula, developing original video content and offering a mix of new and remounted webinars that build reproductive justice facilitation capacity within our birth work community. 

     

    We’re grateful to our alumni community for always inspiring us to continue this important work. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”534490″][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1709738266702{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]

  • The Mothers of Gynecology

    The Mothers of Gynecology

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1707747263915{margin-bottom: 0px !important;}”]Anarcha, Betsy, and Lucy’s gynecological advancements have undoubtedly saved and improved countless lives. Yet they are not celebrated in most textbooks on gynecology or its history. Lucy, Betsy, and Anarcha were not medical researchers. Their ingenuity was a matter of survival. They were among the enslaved Black women that physician Marion Simms tortured and butchered by experimenting on them without anesthesia in the name of medical research.

    Marion Simms is regarded as the “Father of Gynecology”. Not only is he remembered in the textbooks, but there is also a statue in his honour in his hometown of Alabama, in front of the clinic where he tortured Black women. He invented the speculum and the position of lying on one’s back with feet in the stirrups, that most birthers are expected to adopt in medicalized deliveries is named after him.

    Simms believed that as a result of being less human than white women, Black women did not feel pain. He had no ethical qualms about conducting his “experiments” without anesthesia, despite the need to restrain the screaming women. When his medical assistants did and quit, he trained Lucy, Betsy, and Anarcha to perform this role. The three women perfected many of the procedures he was developing to save each other’s lives. Simms took the credit of course.

    In 2022, a sculpture by Afrian-American artist and activist Michelle Browder finally began giving these women the recognition they are due while raising awareness of the suffering that was inflicted on them without their consent or free will. “Mothers of Gynecology” tells the stories of these heroes visually. 

    All three women had suffered painful pelvic floor injuries during childbirth that affected their bowel and bladder control, making them unfit for hard labour on plantations. Now useless to their owners, they were leased to Dr. Simms in the hopes of him finding a cure that would restore them to productivity. His first experimental surgeries were failures. Undaunted, he continued his experiments, training the women to function as his assistants after his white assistants quit. They each became skilled medical providers in their own right. Simms experimented on a total of 12 enslaved women, but only Anarcha, Betsey, and Lucy’s names are preserved in his reports. To make his research more palatable, his reports state that the experiments were conducted on white women with assistance from white nurses. 

    Browder’s arresting sculpture manages to convey the details of this horrific story in a way that transcends words and restores power and dignity to these exploited women. The sculptures are intricately fashioned from found metal. The three women are towering in this commanding piece, with Anarcha standing at 15 feet, Betsy standing at 12 feet, and Lucy at 9 feet. While the viewer’s emotional reaction to the piece is immediate and visceral, the symbolism possesses such a wealth of detail that you’d need to stand in front of it for at least an hour to pick up on everything. This Smithsonian article describes the symbolism like this:

    “The statues incorporate meaningful—and painful—symbolism. Anarcha’s abdomen is empty, except for a single red rose where her uterus would be. Her womb sits nearby, full of cut glass, needles, medical instruments, scissors, and sharp objects intended to help viewers feel the women’s pain and suffering.

    Medical scissors are attached to one woman. Another wears a tiara created out of a speculum—a device Sims invented for vaginal exams. The names of Black women [civil rights heroes] are welded to the statues.”

    The figures have no arms or lower legs to represent the women’s lack of bodily autonomy.

    Michelle Browder uses art as one aspect of her reproductive justice work. In 2022, she bought the land on which Simms conducted his experiments and is working on opening a clinic and museum for Black women’s health on the site. 

    Simms’ racist belief that Black women had a higher pain tolerance than white women is still prevalent among healthcare providers. In perinatal health, this means Black birthers’ pain goes under or unmanaged, and pain that should sound the alarm regarding complications goes ignored. Black birthers know this and the main reason we seek birth doula support is to ensure we have an observer and advocate making sure our pain is being taken seriously and treated appropriately. 

    Learning more about the mothers of gynecology is one activity that you can do to observe Black Future Month. You can find out more here:

     

    Artist Works to Correct Narrative of Gynecology’s Beginnings

    https://www.anarchalucybetsey.org/ 

     

     

    [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”534490″][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1707747309073{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]

  • 10 Ways to Improve Your Emails to Doula Clients

    10 Ways to Improve Your Emails to Doula Clients

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    Doula School alumni will often ask “what’s the best way to get new clients?” and our answer is almost always the same – email. It’s the most effective way to connect with people and become a regular part of their lives. On a social media platforms like Instagram or Tik Tok, you’re competing with hundreds if not thousands of accounts – all vying for someone’s limited attention. Conversely, once you get into an email inbox, you go right to the top each time .

    There are several ways to build your email list. It can include past clients, freebies (like guides or offers), advertising on Google or Facebook, opt-in forms on your website, and so much more. Today we aren’t talking about BUILDING your list, we’re looking at how to get the most out of the list you do have. Whether you have 20 people or 2000, having an email list that is working for you can make all the difference in your doula career. Below are 10 ways to optimize your emails and improve your sales.

    Use an Email Platform

    There are SO many different platforms out there for managing your email list. Some of our favourites are Kit, Mail Chimp, and Constant Contact. Even if you have a small list, it’s important to be using a professional email platform. This allows you to set up automations, send emails in bulk, manage unsubscribes, and so much more. The good news is that most of these services offer a free version you can start with. Perfect for doulas starting out with a small marketing budget.

    Add Personalization

    Most email providers will offer the ability to “personalize” messages. So when you get someone’s email address, you can make sure to get their first name as well. That way when sending out an email it will start with “Hi Marie” instead of more robotic or impersonal openings. Research has shown that adding personalization can help improve results from emails and make readers feel more connected.

    Ask for Reviews

    As birth workers we sometimes feel uncomfortable asking for support or feedback from clients. But we’re here to tell you it’s ok! Clients will be excited to share their testimonials, especially if they had a great experience working with you. Reviews on your website, social channels, google, and in emails can make a huge difference to sales. Future clients are always looking for “social proof” that you’re a trustworthy person and a doula they want to work with.

    Use Images of Yourself

    You know when you’re on a website or Instagram page, you can always tell when someone is using a lot of stock images. There is nothing wrong with using images you bought online now and then, but you’ll find that your emails and social content does better when it feels personal and real. Don’t be afraid to use photos of yourself in action. Maybe have a friend take some nice pictures of you at the park, or snap a couple of you working with a client (with their consent of course). Over time you can create a catalogue of images to use in a bunch of places.

    Improve Your Subject Lines

    The average email is only going to have an open rate of 30 or 40%. That means most people on your list may never even read the content! That’s why the subject line is so important. It’s your one chance to make an impression and get the reader interested. The best lines tend to be short and punchy, creating a sense of urgency for the reader. For example, something like “5 Baby Proofing TIPs from a Doula.” Most email platforms will let you test multiple subject lines per message, so you can start to understand what works best for your followers.

    Only use ONE Call-to-Action

    Have you ever gotten one of those BUSY emails with like 7 different places to click? They can be overwhelming and hard to understand. The key to a good email is keeping it simple. Don’t be afraid of white space and making it easy for a reader to follow. You do this by having only ONE call to action. If the email is about your overnight doula services, then make sure that’s the only thing you’re asking people to click on.

    Don’t always SELL

    Having someone’s email address is a big deal. They’re letting you send them information that goes directly to the top of their inbox. That’s a privilege. And it’s a privilege you can lose quickly if you abuse it. Every email you send can’t be a sale or a product or a doula service. Make sure you’re adding VALUE to your readers. This could be through tips and tricks, personal anecdotes, birth stories, interesting videos, or anything. By providing value, your readers will be more open to receiving the odd sale or product offering.

    Have a Plan

    We talk to some birth workers who feel overwhelmed by creating content and email newsletters. I don’t know when to send it? How many should I do a month? What kind of content? It can be a lot to manage, especially when your focus is working with clients. One way to simplify this is to have a plan. If you’re going to send a newsletter every 3 weeks, then set that schedule and stick to it. It will also help your readers start to expect your content on a regular basis.

    Consistency

    Designing things is fun. It’s especially fun if you have a bit of design know-how in photoshop, or adobe, or just got your new CANVA account. You might feel the urge to constantly be creating NEW and innovative designs to use in emails (and on social media, the website…etc). However, new designs can be confusing for readers and clients. They want to know what to expect. And seeing a consistent color, font type, and design will allow them to start recognizing your doula or birth brand. Where possible, try to pick a standard look and feel that you can maintain.

    Automate Where Possible

    You might be reading all this and thinking “I barely have time to reply to clients, when am I going to write additional emails?” That’s ok, it’s a lot! The good news is that you can automate a lot of things through email platforms. For example, maybe when someone provides their email address, they are automatically sent 2-3 emails that explain your doula services, what they cost, your availability, and more! It will take a bit of time in the early going to set up automatic email funnels, but these can save you a TON of time in the long run.

    Make sure to check back with the blog next month, as we’ll be sharing more doula marketing and sales tips.

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

  • Respecting All Life: Reflections on International Holocaust Remembrance Day and National Day of Remembrance and Action Against Islamophobia

    Respecting All Life: Reflections on International Holocaust Remembrance Day and National Day of Remembrance and Action Against Islamophobia

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1706563078413{margin-bottom: 0px !important;}”]That horrible day in 2017 when for no reason other than hate a 6 Muslim Canadians were killed at a Mosque in Quebec is still haunting. In a society that claims to love peace, equality, and freedom, the level of hate that spawned this horrific attack should never have been able to arise. What’s almost as haunting is that in the intervening 7 years, we’ve learned very little about the thinly veiled hate that is clearly pervasive in this country because we haven’t learned how to have an ongoing, brave discussion about it.

    This year, Holocaust Remembrance Day (Jan. 25) and National Day of Action Against Islamophobia fall as a very deadly conflict in Israel-Palestine has raged on for over 100 days. While Jewish and Muslim Canadians are no more complicit in the conflict than any other Canadians, they have been forced to endure an unprecedented increase in hate-motivated attacks against them. I wish I was more surprised.

    We’re too polite to talk about hate until people are getting killed, and by then it’s too late. We hold the guilty party accountable when the van attack and similar crimes happen, but we don’t hear the call to examine the society that created the van attack.

    As birthworkers, we see and snuggle many brand-new babies. Every single one is special and they all deserve to grow up and live the lives they create for themselves based on the values that were cultivated in childhood. The presence of hate in the world makes this right impossible to realize for all children, so hate must be eradicated.

    To our Israeli, Jewish, Muslim, and Palestinian alumni and audience, we know this has been an unbearably distressing last few months within your communities here in Canada and internationally. As birthworkers in your communities, you have had to process your own feelings while supporting birthers in your community who are under incredible strain. We know that extreme stress can contribute to complicated pregnancies and challenging outcomes. We see the vital work you are doing in your communities at this time and we are continuing to extend our compassion and support.

    As doulas, we will continue to shine a light on hate in the healthcare system, institutions, communities, and ourselves. Only when hate is diligently brought out into the open and swept away can we have communities where all life is truly respected and it is safe for all children to grow. 

    If you are looking for guidance on how you can support your community and access support for yourself at this difficult time, please visit our blog post “Our Hearts Are With You” from November 10, 2023. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”534490″][vc_column_text css=”.vc_custom_1706554746991{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]

  • Facilitating Accountability

    Facilitating Accountability

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1706107261056{margin-bottom: 0px !important;}”]As birth workers, we often see things or hear things from our clients that should not have happened. It could be an ultrasound tech sharing an interpretation that is later contradicted by their primary care provider, causing the patient confusion and anxiety. It could be membrane sweeps, AROMs, or episiotomies performed without the client’s consent. Or nurses disclosing information to family members while the client is unconscious, leaving the patient to receive a broken telephone story from their family later. 

     

    These incidents range from irritations to serious breaches of practice standards, and things are more likely to “just go wrong” for systemically marginalized people. Clients are usually at a loss as to how to seek accountability or believe they can do nothing to address the harm they’ve experienced. 

     

    Some may be aware of complaints processes that exist, but concerns about outcomes on either end of the spectrum – nothing will happen, or the worker will get fired – are often a deterrent. And of course, our clients who have just had babies or experienced a loss may simply not have the time and energy to engage with a complaints process.

     

    In truth, there are far more opportunities to address what happened than most people think. Speaking up can lead to many positive outcomes, including a faster return to well-being for the client, and learning and improved practice on the part of the care provider. The processes focus on restorative justice, learning, and growth, rather than punishing the provider.  There is an understanding that the vast majority of workers in the healthcare system care about people and want to help. The options outlined below are suitable depending on the context and seriousness of what happened.

     

    Speaking with the Care provider directly

    For my clients who decide to speak up about their experience, this is usually the option they go with. This is especially true of midwifery clients who have an ongoing relationship with their care provider. 

     

    We can support clients in this process by clarifying the concerns and rehearsing the conversation to make sure key points are captured and that the client feels empowered to self-advocate. 

     

    I’ve seen improved treatment relationships and greater client well-being arise from these conversations. Especially in the case of complex births, creating a safe environment to debrief the experience with the provider is essential. Debriefing a traumatic birth with the care provider is a protective factor against birth trauma.

     

    Engaging the Care Team

    If multiple people are involved in a client’s care, sometimes a care provider with whom the client has a positive relationship can be a liaison between them and a provider with whom the client is having challenges. For example, in the case of the oversharing ultrasound tech mentioned above, it might be appropriate for the midwife or OB’s clinic to reach out to the ultrasound clinic to let them know about the impact this had on a client. This leverages the clinics’ mutually supportive relationship that should incorporate giving and receiving constructive feedback. 

     

    Patient Relations and other “in-house” processes

    Talking with the provider directly isn’t always the right option. This is especially likely to be true in a dynamic where the client felt intimidated or belittled by the provider, such as a discriminatory incident. Our debriefs with clients can explore their level of comfort with the various options.

     

    Depending on the setting in which the care took place, there is usually an internal process for raising concerns. For example, most hospitals have a patient relations department that can work with you to resolve issues. There is often a mechanism for the hospital to anonymize information raised with the provider. Staff within patient relations will investigate the complaint and decide on the best way to address it. This could include seeking an apology from the care provider, supporting them to learn from what happened, or more serious action depending on the nature of the complaint.

     

    Regulatory Body

    Suppose a client has a serious concern about someone involved in their care who is a member of a regulated health profession. In that case, they have the option of filing a complaint with the care provider’s regulatory body. In Ontario, these regulatory bodies are called “Colleges”. They may be called “Boards” or “Associations” in other places.  If you’re unsure of the system where you live, I recommend searching for “regulated health profession [your province/state]” and finding out more about health professional regulation where you live, especially for the professions providing perinatal healthcare, such as nursing, midwifery, medicine, pharmacy, and diagnostic imaging.  

     

    Professional regulatory bodies fulfill a range of functions including setting educational requirements, registering members, setting professional standards, and investigating complaints and reports. 

     

    Anyone can go to the College with a complaint about one of their members. When health professionals work in settings where they have oversight, such as a hospital or clinic, management is legally required to report certain types of information to the regulator. It’s one of the reasons why it’s always best to take the complaint somewhere internal first. 

     

    A range of things can happen, such as a letter with recommendations, reflection exercises and activities to support professional development, and a meeting with an expert in an area where more learning is needed. In some instances, the regulator may take no action. In some situations, the College can pursue an internal prosecution of the member. Again, a range of outcomes is possible, including having their license to practice their profession removed. This outcome is very infrequent.

     

    Complaints Commissioner, Ombudsman, etc.

    Provinces in Canada have arms-length government bodies that ensure the quality of public services such as healthcare. In Ontario, complaints regarding healthcare can be taken to the patient ombudsman. In Quebec, complaints can be made with the Complaints Commissioner. This 2022 case study explored the advocacy potential of many individuals accessing this complaints process. In 2019, “Obstetric violence” became a focus of media attention in Quebec due to a series of articles published in La Presse about experiences during childbirth, including inappropriate comments, procedures performed without consent, and being separated from babies. In the weeks following these publications, the Complaints Commissioner received an influx of complaints that spoke to a systemic pattern. The Commissioner is well placed to liaise with government policymakers and she produced a report with recommendations aimed at improving perinatal care. This led to several outcomes, including workshops for service providers on communication, information sharing, and consent.

     

    “It’s me, hi! I’m the problem. It’s me”

    Transparency with our clients about accountability includes making sure they know what their options are if they have concerns about us! Keeping the lines of communication open so they feel comfortable coming to us with concerns is ideal. If a client has a concern about a certified doula or perinatal educator that can’t be worked out, the client can go to their certification organization. In Ontario, If clients have concerns about how their personal information was used or shared, they can file a complaint with the privacy commissioner.

     

    Seeking accountability has the potential to be healing and empowering for clients, while providing a learning opportunity for the client. When working with diverse humans at a sensitive time, hearing critical feedback compassionately and receptively is integral to our ability to grow in our practice. It may not always feel great in the moment, but if we reflect honestly on constructive feedback, it can be a wonderful catalyst for deepening our practice.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”534490″][vc_column_text css=”.vc_custom_1706107304539{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]

  • Insurance Announcement

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1707147428773{margin-bottom: 0px !important;}”]We are thrilled to announce a huge win in our movement for better access to doula care in Canada. Effective immediately, Sun Life has approved that Doula Training Canada certified doulas are on the list of approved providers whose clients can use their benefits for coverage IF they have that coverage in their plan!

    This will make it easier for thousands of people to afford the cost of this life-changing support. Doula Canada is so proud to be considered a leading certification organization for doulas in Canada and find itself listed alongside the two other largest organizations internationally (DONA and CAPPA). As we continue our strategic growth initiatives, we will continue to expand the work we do to advocate for families’ access to doula care in Canada and around the world. 

    How to Help Your Clients Get Reimbursement

    For your clients to be able to submit receipts for reimbursement from Sun Life, invoices must contain the following information:

    • Your Full Legal Name and company name
    • Address
    • Services provided
    • Service dates

    Price (if you collect tax, your tax number is legally required to be on all your receipts/invoices)

    The certification/graduation number that was included in your graduation letter from DTC.

    Please also keep in mind that not everyone that has SunLife coverage will be able to use their benefits for doula reimbursement. Insurance and benefit plans are complex and vary from person to pereson. Clients should confirm their coverage to be sure of what might be covered.

    If you would like us to send you an updated certification document with your certification number please email us at info@stefanie-techops.wisdmlabs.net and we’ll be happy to email you a new certificate.

    While this is undoubtedly a huge win for DTC doulas and our clients, we don’t intend to rest on our laurels. We will use what we have learned from our success with Sun Life to continue to advocate for more insurance companies to cover doula care! A reminder that each person’s plan is different and not all customers will qualify. They should check with Sunlife for their specific coverage. 

    If you have any questions please feel free to email us anytime at info@stefanie-techops.wisdmlabs.net

    Doula Training Canada

    www.DoulaTraining.ca[/vc_column_text][/vc_column][/vc_row]

  • National Day of Remembrance & Action on Violence Against Women

    National Day of Remembrance & Action on Violence Against Women

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1701888370897{margin-bottom: 0px !important;}”]National Day of Remembrance and Action on Violence Against Women (December 6) hits a bit different for me this year. On December 6, 1989, 14 young women were murdered at Polytechnique Montreal. The women were pursuing degrees in engineering. Their murderer felt that by entering into a male profession these women were usurping a place in society that rightfully belonged to him. He ordered their male peers from the room at gunpoint to make sure we knew this was about hating women.

    Earlier this year, doulas were targeted for gender-based violence because of their career choices. In this instance for choosing a feminized profession, the intimate and sexualized nature of which could be exploited by a fraudulent predator. As a result of the persistent efforts of the fraudster’s victims, she was arrested in March of this year and the situation did not escalate to worse violence. Still, I’m left with many questions about the climate of fear, suspicion, and infighting that existed within the doula community for months while police and other organizations that are supposed to protect the public did nothing to stop this person’s malicious, harmful behaviour. This despite so many incidents where woman-hating behaviour has escalated to femicide.

    In Sault Ste. Marie in October, a known perpetrator of intimate partner violence murdered 5 people, including 3 children, adding momentum to a national call for gender-based violence to be declared an epidemic. We at Doula Canada wholeheartedly support this call, and add our voices to it. As birth workers, we know that pregnancy and postpartum are vulnerable times. Existing IPV often worsens, and in many instances, this is when it starts.  

    Our own safety also matters in doing this work. We are often behind closed doors, in people’s homes, providing intimate care one-on-one. It’s not constructive to approach care work from a place of fear. Statistically, our clients are more likely to be victims of violence rather than perpetrators. However, one of the most disturbing things I learned from events earlier this year is that there is a casual normalization of sexual harassment in this field. Several people posted about having their time wasted by solicitation from fetishists posing as birth clients, as though this was simply par for the course. Privately, I’ve heard stories of doulas being sexually harassed by a client’s partner in the client’s home, and not knowing of any options for recourse. Earlier this year, when birth workers were being targeted, many birth workers focused on the perpetrator’s well-being rather than the well-being of a growing number of victims.

    The reason for this attitude is the same as the reason why some jurisdictions (such as the province of Ontario) have refused to declare GBV an epidemic. And it’s the same reason why opportunities to stop the perpetrator in the Sue before he killed were missed. GBV occurs in the context of normalized systemic misogyny. Even in a profession aimed at reducing reproductive violence for our clients, we’ve forgotten to expect more for ourselves.

    Alongside growing our conversation about GBV in relationships, we need to shine a light on occupational GBV. In other fields where home visits are carried out by a largely feminized workforce (e.g. nurses, social workers), trainees are given guidance on spotting red flags, mitigating risk, and acting to effect accountability. We’re going to start doing that here at Doula Canada. On Jan. 23 we will open this much-needed conversation by hosting a webinar on GBV in birthwork and how we can take charge of our community’s safety. We owe this to ourselves and each other. 

    Webinar Details Here: https://stefanie-techops.wisdmlabs.net/training/webinar-gender-based-violence-in-support-work/

    It is fitting that Women’s Remembrance Day falls within UN Women’s 16 Days of Activism Against Gender-Based Violence campaign. For ideas for actions you can take against GBV check on this resource on Canadian Women Foundation’s #ActTogether Campaign. https://canadianwomen.org/acttogether-campaign/

    *If you are unfamiliar with the events of earlier this year that I reference in this article, you can learn more about that here: https://www.cosmopolitan.com/lifestyle/a44866427/kaitlyn-braun-doula-pregnancy-accused-fraud-harassment/

    [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1701888381111{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]

  • 16 Days of Activism Against Gender-Based Violence

    16 Days of Activism Against Gender-Based Violence

    [vc_row][vc_column][vc_column_text css=”.vc_custom_1701109787897{margin-bottom: 0px !important;}”]For our observance of UN Women’s 16 Days of Activism Against Gender-Based Violence, we reflect on how doulas are involved in ending obstetric violence at the individual and systemic level. Reflecting on this year’s theme, we call on governments and insurance providers to Unite and Invest to Prevent Violence Against Women and Girls by funding better access to doula care.

    Where we need to go

    As doulas, companions, and birth keepers, we know in our bones that our presence alleviates the challenges of birth and new parenthood and supports people to have joyful, transformative experiences during this major life event. 

    A growing body of research supports our intuitive knowledge. Doula care is an effective perinatal intervention that reduces the need for medical interventions, including c-sections, decreases low birth weight and preterm births, and improves satisfaction with childbirth and postpartum well-being, among many other benefits. These benefits have the biggest impact on families adversely affected by the social determinants of health, including low-income, and racialized people (Cidro et al., 2023; Greiner et al., 2019; Kozhimannil et al., 2016; Marshall et al., 2022; Ramey-Collier et al., 2023; Robles, 2019; Thomas et al., 2023; Wodtke et al., 2022; Young, 2022).

    Yet, despite this, only 6% of birthing families receive support from a doula. Doulas are usually paid by families out of pocket, and care is not usually available to the populations for whom having a doula might have the greatest impact.

    Some exciting changes are happening in the United States. Starting from around 2020, several studies found that racialized birthers and newborns experienced much poorer outcomes than their white counterparts, including an increased likelihood of death. This disparity was most significant for black people. These studies opened a floodgate of conversation about a Black maternal health crisis in the US. State healthcare systems are under significant political pressure to find solutions. Doula care is seen as a critical intervention that improves outcomes for racialized birthers and babies, and many Medicaid-funded doula programs are emerging (Rochester, Delaware, Michigan).

    Sadly, Canada is lagging in finding innovative ways to make doula care accessible. One reason for this is that it is harder for researchers and advocates to demonstrate similar racial disparities because Canada does not collect race-based data. There is ample anecdotal evidence that Black and Indigenous people experience the same medical racism that has been identified in the US, but individual accounts can’t provide the level of “proof” that makes a strong case for funding.

    That being said, a recent study by obstetrician researchers at McMaster University learned that birthers in Canada experience a high rate of operative vaginal deliveries (forceps or vacuum) and has higher rates of 3rd and 4th-degree tears than any other high-income country (CTV, 2023). Continuous support from a doula during childbirth reduces the need for interventions like operative deliveries.

    Call to Action for International Day for the Elimination of Violence Against Women (November 25)

    Whether you are a birthworker, a birther, or a concerned citizen, you can add your voice to the call for better access to doula care by doing two things:

    1. Write or call your Member of Provincial Parliament (MPP) and let them know you want coordinated public funding for doula care in your province’s healthcare plan. 
    2. If you have extended health coverage, call your insurance carrier and let them know you would like doula care to be an insured healthcare expense. More insurance companies covering doula care would make this support accessible to many more families.

    Birthworker Affirmations for 16 Days

    We use affirmations to buoy our clients, but what about using them to protect ourselves from burnout as we extend compassion to clients and act for systemic change? As part of our observance of 16 Days of Action Against Gender-Based Violence, we offer these 16 affirmations to support you on your birth work journey.

    1. My work humanizing birth humanizes communities. The merits of this work are limitless.
    2. My practice of self-compassion is integral to my ability to extend compassion to my clients.
    3. Changing one life changes everyone’s life. By supporting each person I honour our interconnectedness.
    4. My actions can make a difference.
    5. I will manifest the village I need to support me to continue manifesting change for birthers and families.
    6. By facilitating a non-judgemental space, I play an invaluable role in creating a safe space.
    7. By creating a sacred space for birth, I bring great joy to families, which increases my own joy.
    8. When I remember to take a deep breath, my client is reminded to breathe deeply.
    9. With collaboration and determination, we can realize humanized, empowering birth for all families. 
    10. My acts of service provide a blanket and a shield to families at their most vulnerable.
    11. My compassionate presence and loving words are a powerful antidote to suffering that can exist within birth, making space for more joy.
    12. By inspiring birthers and families to believe that physiological birth is possible, I play a tangible role in making physiological birth attainable.
    13. I will preserve my energy for the real struggle. 
    14. It is a blessing to walk alongside families during this intimate and transformative time, for which I am deeply grateful.
    15. With deeply rooted compassion, I can be a willow or an oak in service to my clients’ needs.
    16. With the birthwork community’s diligence, one day all births will be humanized births. I am honoured to be a part of this movement.

     

    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.

     

    We invite you to practice with the ones that resonate with you. Please share any of your own affirmations that would support the birthwork community.[/vc_column_text][/vc_column][/vc_row]