Reproductive Justice and Doulas

by Anna Balagtas

While the term “reproductive justice” may conjure images ripped from today’s headlines, the framework of this practice at the core of a doula’s work builds a foundation for a person’s reproductive journey upon four pillars of advocacy, protection, affirmation, and validation.
Hold on a second. What is a doula?

A doula, also referred to as birthworker or birthkeeper, is a reproductive careworker who supports folks mentally, emotionally, physically, and resourcefully through a person’s reproductive journey. Birthworkers are also advocates for their clients and ensure they are receiving the care they deserve and are hoping for throughout their reproductive lives (fertility, birth, afterbirth, and through life transitions). The most common types of doulas are birth and postpartum doulas, though the work of birthworkers are not only limited to those two reproductive experiences. Later, we’ll talk about the different types of birth workers that support folks through the full spectrum reproductive experience. At Brood Care Inc., we currently offer birth and postpartum doula services for clients in Vancouver’s Lower Mainland and Victoria, BC.

What do I need to know to become a doula?

To practice as a birthworker, there is undoubtedly tons of advice to guide you through becoming one. Though much advice is available, the core work of being a doula all falls under the pillars of Reproductive Justice.

Reproductive Justice (RJ) is a blend of Reproductive Rights and Social Justice. This term was coined in 1994 by the SisterSong collective who were a group of Black, Indigenous, and women of the Global Majority. RJ was invented as a response to American reproductive politics. The framework in RJ was put in place to protect, affirm, and validate the rights of any person going through transitions within their reproductive care. Currently, there are four pillars within Reproductive Justice.

The Reproductive Justice Pillars include:
  1. The right to bodily autonomy
  2. The right to have children
  3. The right not to have children
  4. The right to parent in a safe and supported environment
What does Reproductive Justice have to do with being a doula?

Like we mentioned earlier, the most common types of doulas you may come across are birth and postpartum doulas – both of which are support systems who fall under the pillar of “the right to have children” within the RJ framework. Having said this, there are many other types of doulas that perhaps you’ve never come across who support under other pillars of the framework.

Birthwork is more than just supporting folks through the right to have children. In celebration of the vast and beautiful full spectrum care doulas support, we’ve listed a few examples of doulas who practice under the different pillars of RJ.

 

 

THE RIGHT TO BODILY AUTONOMY

Sex Work Affirming Doulas

Sex work affirming birthworkers are folks who understand that sex work is sacred and valid work. Many times, sex work affirming doulas are folks who are or have been sex workers themselves and understand the complexity of feelings that former or current sex workers may go through when moving through reproductive experiences. Much of this work is guided through the important lens of trauma informed care.

Gender Doulas

Gender birthworkers are folks who support people who are exploring, curious, or questioning their gender. Usually, gender doulas are people who are gender diverse, non-binary, or gender non-conforming (though this isn’t always the case) and understand the complexities of what it means to explore and move through the different facets of gender. Gender doulas help folks in transitioning into what feels most comfortable for them, supporting folks navigating feelings of gender dysphoria, as well as affirming their journey along the way.

Body Transition Doulas

Body transition birthworkers support folks who are seeking body transitions that best affirm their identity and gender. This could look like supporting someone who is engaging in HRT (Hormone Replacement Therapy), teaching classes or facilitating lessons on body transitions, or caring for a client in the aftercare of a gender affirming surgery.

Disability Justice Doulas

Disability justice birthworkers are advocates, aides, and accessibility workers who support folks who have disabilities. This could look like being an aid for a person who needs support in their day-to-day activities, providing accessibility transport for someone who needs to travel long or short distances, transcribing and interpreting text or video materials for folks with hearing, eyesight, or learning disabilities, or advocating for accessibility needs for folks within any given space.

Death Doulas

Death workers are folks who support people in death or in preparation for death. This could look like getting paperwork in order such as wills or power of attorney, preparing folks emotionally and or mentally for death, assisting folks in MAID (Medical Aid in Dying), supporting the family while they move through the process of grief, or in holding death cafés.

Harm Reduction Doulas

Harm reduction birthworkers are folks who support their community with a harm reductionist lens. This could look like creating harm reduction kits and passing them around the community, gathering supplies, food, and basic personal items to give to unhoused folks, advocating and sharing resources to folks moving through reproductive experiences who are also engaged in using drugs, or educating other folks in what it means to be a harm reductionist and why harm reduction saves lives.

 

THE RIGHT TO HAVE CHILDREN

Fertility Doulas

Fertility birthworkers are folks who assist people who are looking for fertility support. This could look like road mapping a fertility plan so folks may conceive, educating folks on body literacy and body cycles to further understand fertility, teaching workshops or providing 1:1 support on the different forms of conceiving (IUI, IVF, etc.) or navigating infertility and the grief that comes with no longer having this reproductive option. Fertility doulas may also be greatly knowledgeable in contraception and contraceptive methods for folks who are seeking contraception resources – in this case, fertility doulas would also fall under the support system of “the right not to have children” in the RJ framework.

NICU Doulas

NICU birthworkers are folks who support families engaged in the NICU (Neonatal Intensive Care Unit). This may look like providing overnight support for the family, preparing meals, caring for older children while other folks in the family are in the NICU, providing information and resources, or supporting the people affected by the NICU in processing feelings and emotions. NICU birthworkers are similar to postpartum doulas, however their work is more revolved around a hospital setting.

Adoption Doulas

Adoption birthworkers support folks who are currently in the process or are starting the process of adoption. This may look like prepping intended parents for the home visits and interviews, supporting folks in the paperwork, emotional support in the waiting process, providing information and resources, or supporting folks in the transition of being newly adoptive parents.

Black and Indigenous Doulas

Black and Indigenous Doulas are Black and Indigenous birthworkers who exclusively support their own kin throughout their reproductive care. Because of systemic racism, Black and Indigenous children are overrepresented in the foster care system meaning that many Black and Indigenous families are separated from their children. As well, there is the Black Maternal Mortality crisis in which systemic racism plays a huge role in the deaths of Black birthers not receiving the care they deserve in childbirth and therefore die. There is also the case of eugenics in the mix as there are cases of forced and non-consensual sterilization among Indigenous birthing bodies. Black and Indigenous birthworkers play the important role of advocating, affirming, and facilitating the equity that Black and Indigenous birthers deserve when seeking support in their reproductive care.

Fat Positive Doulas

Fat positive birthworkers support fat folks in receiving the care they deserve regardless of their weight. Much of the medical system relies on an outdated and harmful fatphobic view of what it means to be healthy. Fat positive birthworkers can support folks who are seeking respectful and affirming healthcare by debunking myths, providing information and resources, and affirming that all bodies are fantastic bodies.

Pregnancy Loss Doulas

Pregnancy loss birthworkers support folks who are going through and will undergo through a pregnancy loss. This could look like helping in processing emotions and grief, caring for the carrying person in the immediate stages of loss or during, providing meals, or caring for older children in the grief period. Pregnancy loss doulas are similar to postpartum doulas though instead of supporting through a new birth, it’s supporting through a new loss.

 

THE RIGHT NOT TO HAVE CHILDREN

Abortion Doulas

Abortion birthworkers support folks before, during, and immediately following an abortion. This could look like being a sounding board and non-judgemental ear to someone who is exploring abortion options, providing resources on abortion care and methods, being an aid in after abortion care, transporting folks to abortion clinics, or staying by their client’s side during the abortion process itself.

Hysterectomy Doulas

Similar to body transition doulas, hysterectomy birthworkers can provide support emotionally and physically to folks who are exploring or engaging in the process of hysterectomy (the removal of reproductive organs). This could look like gathering and sharing information and resources regarding hysterectomy, support during the surgery, or supporting in the aftercare following the hysterectomy.

 

THE RIGHT TO PARENT IN A SAFE AND SUPPORTED ENVIRONMENT

Prison Doulas

Prison birthworkers are folks who support incarcerated birthing people in prenatal care or accompanying them during the birthing process. There are few prison doulas within Canada and even fewer means of learning how to become one, but following the work of Wellness Within, there is now a curriculum for aspiring prison birthworkers to learn how to support incarcerated birthing people.

Doulas supporting Undocumented Folks and Migrant Workers

Birthworkers who support undocumented folks and newly migrant people may aid them by helping undocumented folks access safer health care or navigate systems without status. As well, these birthworkers may support migrant workers in advocating for health benefits, assisting in mutual aid, providing food and lobbying for workers’ rights.

Food Justice Doulas

Food Justice birthworkers are folks who understand that food justice is related to reproductive justice because food is nourishment and food keeps us alive. Food justice doulas help support folks who are affected by food deserts and makes sure communities are accessing nourishment they deserve by bringing produce to communities, transporting families in reaching grocery stores, or advocating for adequate food establishments be built in a community where they may be a food desert.

Environmental Justice Doulas

Environmental justice birthworkers understand that Canada has an environmental racism crisis that affects mostly Black and Indigenous communities. Their work is rooted mainly in advocating for policy changes so that the environment that Black and Indigenous birthers live in are sustainable and safe so they may gestate and parent their children and thrive in their communities without needing to worry whether the water they are drinking is safe, if the food they are consuming isn’t poisonous, or whether their health is at stake simply because of the area that they live in.

Learning about full spectrum doula support is amazing! What now?  

We end this list here for now, but know that the full spectrum of reproductive care support reaches more than what we have named here. Also, an important reminder that birthwork isn’t all physical work  that’s ableist thinking. Shoutout to our virtual doulas, policy makers, system disruptors, educators, facilitators — they are just as much of a birthworker as folks who are supporting people physically and on ground.

In support of your learning of what it means to be a full spectrum birthworker, here are some of our favourite resources below to get you started in your deep dive of Reproductive Justice!

Books
Podcasts
 Videos
 Folks on Social Media

I’d like to leave you folks with another gentle reminder: learning to become a birthworker doesn’t have an end stop – this work is ongoing. There is no finish line to carework and that expansiveness is exactly what makes carework so vast and beautiful.

Words By Anna Balagtas

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We work and live on the unceded and occupied territories of the Sḵwx̱wú7mesh Úxwumixw (Squamish), səl̓ilw̓ətaʔɬ (Tsleil-Waututh) and xʷməθkʷəy̓əm (Musqueam) Nations. Since time immemorial, the original peoples of these lands have cared for their families and communities. We are committed to honouring their teachings, legacy and their sovereignty.

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