Doula toolkit to make birthing process more inclusive

A toolkit centring queer birth experiences is providing safe and affirming perinatal support for 2SLGBTQ+ people in Nova Scotia and across the world.

The Queer Doula Toolkit was created by Wellness Within, the Nova Scotia Public Interest Research Group (NSPIRG), in collaboration with Nicole Marcoux and Jordan Roberts, who are both doulas with the Volunteer Doula Program in Halifax. The team received funding from the Tegan and Sara foundation.

Clark Macintosh, queer doula co-ordinator with Wellness Within, first felt the need for a toolkit 16 years ago when they were supporting a queer person through giving birth.

“I was quite aware just of the way that the system was really built to be very ciscentric, heterosexual,” said Macintosh, who is also the finance and resource centre co-ordinator with NSPIRG.

The idea remained on the backburner as Macintosh was immersed in advocating for more pressing issues, such as providing MSI coverage for gender affirming surgeries.

As the years passed, more queer folks around Macintosh were starting families and facing barriers in the health-care system. A friend's Facebook post looking for a queer doula brought Macintosh's attention back to the lack of resources supporting the 2SLGBTQ+ community through the birthing process.

After a conversation with Marth Paynter in the comments, creating the toolkit became a natural next step, said Macintosh.

“There really aren't very many resources. … Some of the most basic and apparent barriers to care are just even being considered as part of the maternity care world” said Paynter, practising nurse in reproductive health and chair of Wellness Within.

“So, changing our language, changing our default position, to break away from the hetero-normativity that is so pervasive in this type of care, so that families, patients feel listened to, part of it, validated.”

Paynter added that there's more to maternity care than having a healthy baby. The birthing person's experience is just as important.

“(It) can frankly be traumatizing if you are not treated with respect and conscientiousness, towards who you just really are,” said Paynter.

The toolkit has sections addressing correct language, queer family dynamics, and strategies to cope with anxiety. The team received input from birthing queer folks, and those who supported them at birth, and medical professionals including nurses and an anesthesiologist.

They also heard from people who wanted to have children but were concerned about how they would be treated in hospitals or through traditional doula programs because they identified as queer.

Due to the pandemic, all the consultations had to be done through an online survey instead of in-person focus groups, said Macintosh.

Still, the feedback from the survey shaped the toolkit into a resource for the community. Some of the topics they received a lot of feedback on and were later included in the toolkit were advocating within the medical system and chest feeding, Macintosh said.

Since launching the toolkit last June, the response has gone beyond anyone's expectations, they said.

People in Sweden, Australia, the U.K., and the U.S., specifically Texas, have downloaded the toolkit and used it in their communities. DONA International, the world's leading doula certifying organization, is also using it as a resource, according to Macintosh. It's also being distributed to the IWK Health Centre staff, said Paynter.

The toolkit will continue to grow as more people provide their feedback. Macintosh hopes to create more culturally relevant resources and to include more information about incorporating traditional birthing methods into hospital care.

Wellness Within and NSPIRG are also planning a doula training workshop in September where Macintosh expects more topics to add to the toolkit will arise. The workshop is a closed-space training for Black, Indigenous and People of Colour who identify as part of the 2SLGBTQIA+ community. The training will be held virtually over three days and will be facilitated by our DONAcertified trainer Wanda Cox with funding from the Tegan and Sara foundation.

The toolkit can be downloaded at https://wellnesswithinns.org/queer-doulas