Putting them on a strong spiritual path: Indigenous doulas responding to the needs of Indigenous mothers and communities

Abstract

Objective In the past few years, increasing numbers of Indigenous doula collectives have been forming across Canada. Indigenous doulas provide continuous, culturally appropriate support to Indigenous women during pregnancy, birth, and the post-partum period. This support is critical to counter systemic medical racism and socioeconomic barriers that Indigenous families disproportionately face. This paper analyzes interviews with members of five Indigenous doula collectives to demonstrate their shared challenges, strategies, and missions. Methods Qualitative interviews were conducted with members of five Indigenous doula collectives across Canada in 2020. Interviews were transcribed and returned to participants for their approval. Approved transcripts were then coded by all members of the research team to ascertain the dominant themes emerging across the interviews. Results Two prominent themes emerged in the interviews. The first theme is “Indigenous doulas responding to community needs.” Participants indicated that responding to community needs involves harm reduction and trauma-informed care, supporting cultural aspects of birthing and family, and helping clients navigate socioeconomic barriers. The second theme is “Indigenous doulas building connections with mothers.” Participants’ comments on providing care to mothers emphasize the importance of advocacy in healthcare systems, boosting their clients’ confidence and skills, and being the “right” doula for their clients. These two inter-related themes stem from Indigenous doulas’ efforts to counter dynamics in healthcare and social services that can be harmful to Indigenous families, while also integrating cultural teachings and practices. Conclusion This paper illustrates that Indigenous doula care responds to a wide range of issues that affect Indigenous women’s experiences of pregnancy, birth, and the post-partum period. Through building strong, trusting, and non-judgemental connections with mothers and responding to community needs, Indigenous doulas play a critical role in countering medical racism in hospital settings and advancing the resurgence of Indigenous birthing sovereignty.

Grounded in Community: Development of a Birth Justice‐Focused Volunteer Birth Companion Program

“…A related goal of the program is to increase the racial, cultural, experiential, and socioeconomic diversity of the volunteer birth companions. There is compelling evidence that perinatal outcomes improve when the racial and ethnic makeup of birth workers reflects the population that they serve 16,26,27 . However, there are barriers to this goal.…”

“…There is compelling evidence that perinatal outcomes improve when the racial and ethnic makeup of birth workers reflects the population that they serve. 16,26,27 However, there are barriers to this goal. Many birth workers with diverse backgrounds may not be in a position to volunteer their time.…”

“…15 The evidence shows that culturally sensitive and traumainformed continuous labor support has significant positive effects on birth outcomes 1 and counters the negative effects of systemic racism. 16 Unfortunately, continuous labor support by a companion of choice is not universally supported as recommended by the WHO. 5 In the dominant fee-for-service model, in which clients pay out of pocket for private doula services, those with limited resources are often unable to benefit from trained birth companions.…”

The need for sustainable funding for Indigenous doula services in Canada

“…As with other community-based doula groups who serve underrepresented populations, the interviewed doulas view their motivations as honouring the culturally specific needs of their communities, ‘holding space’ for their clients by countering racism in medical settings, and ‘being good relatives’, callings that are rooted in relationality and reciprocity. 21 , 23 , 60 …”

“…20 Specifically, Indigenous doulas play a critical role in countering medical racism in hospital and clinical settings and advancing the resurgence of Indigenous birthing sovereignty. 21 , 22 Indigenous doulas are rooted in cultural teachings and spiritual connections, and therefore, play an essential role in the re-establishment of self-determined Indigenous birthing practices. 23 – 25…”