Sovereign Womanhood and the Misappropriation of Reproduction

We DO have so much power in us. So then how do we end up filing into our hospitals with our birth plans and coming out cut or broken, with a baby in our arms?

All over the world, and especially all over North America, women are finding new ways to birth in their own sovereign power. This can be terrifying. It can be fulfilling. It can be both.

I am speaking to old women who are attending birthing mothers as Traditional Birth Companions. I speak with younger women, mothers of young children themselves, who are devoting their time to attending the births of the women in their communities. I am speaking with women who have said "No!" to the maternity care system we have installed in our countries, and who are giving birth alone or with their families. I see sisters helping sisters. I see communities that are thriving, attending each other in birth, as in life.

Here in Canada, we have very strict regulations about what constitutes someone's right to provide care to a woman during her childbearing year. If you perform any of these restricted practices, without an officially regulated midwifery license, and without being employed by and liable to the health services establishment, then you are practising midwifery without a license.

Billie Harrigan is a Traditional Birth Companion in Ontario. She does not perform restricted practices, and she does not call herself a midwife. She says that Vaginal exams are rude, but also that they constitute a very clear message that our reproductive life and our bodies are not our property: they are the property of the state, and only people mandated by the state can invade them. Number 7 of the Ontario Midwifery Act states that vaginal exams are a restricted practice. In other words, you cannot put "an instrument, hand or finger beyond the labia majora or anal verge during pregnancy, labour and the post-partum period."

Ok, don't get me wrong here. I don't actually WANT to do vaginal exams. I also think they're rude. Not only that, my doula students have heard me say for years that the only reason for so many endless vaginal exams is that medical professionals are not taught about how sexual birth is. The sexuality and the mind-blowingness and the all-out intensity of birth is sublimated into rituals such as vaginal exams (actually, it is absolutely amazing to feel a baby's head in someone's vagina. Just saying. But I keep my hands to myself.)

But my point is, that women have been regulated for far too long. Our bodies have been misappropriated by a maternity system that pretends it is doing things to us for our own good, and it is not. Why do you think many a woman going into the hospital wants (or discovers she needs) a doula by her side? Because the doula can try to prevent some of the grosser abuses from taking place. But not all. And certainly not enough. Not enough to make the difference to so many, many women who feel that they have been violated (and they have!) when all they wanted to do was to give birth to their child.

So, what is happening? Just when the pandemic started making our lives more restricted and difficult, women started wanting to birth away from Covid-infested hospitals. We all, as our lives changed, started to take deep breaths and realize that we don't actually want to go back to the old "normal". I am getting weekly calls and emails from women who want to learn about new ways of birthing. I'm connecting with women around the globe who are moving forward to change the face of birth; to change the world, starting with birth.

Want to come on board? Come along!

“Come, come, whoever you are. 

Wanderer, worshiper, lover of leaving. 

It doesn't matter. 

Ours is not a caravan of despair. 

Come, even if you have broken your vows a thousand times. 

Come, yet again, come, come.” 

Rumi

And, if you are one of us who has indeed experienced trauma, abuse, and despair during your birthing, even more reason for you to move away from that reality, bring your scars and hold your head up high and cry out: "Enough!"

What is to be done?

You can listen to the Baby Magic Podcast for inspiration.

You can join my Traditional Birth Attendant seminar.

You can reach out to me or to any of the fine women on our podcast for community, information, wisdom.

You can reach deep into your womanhood and remember that you are strong! You are magical! I love you!

For those of you who have a legal interest:

Here are the restricted practices in Quebec:
"Any act the purpose of which is to provide the professional care and services required by a woman during normal pregnancy, labour and delivery and to provide a woman and her child with the professional care and services required during the first six weeks of a normal postnatal period constitutes the practice of midwifery. The professional care and services concerned consist in
(1) monitoring and assessing a woman and her child during pregnancy, labour, delivery and the first six weeks of the postnatal period, and include the provision of preventive care and the detection of any abnormal conditions in the woman or child ;
(2) conducting spontaneous deliveries ;
(3) performing an amniotomy, performing and repairing an episiotomy and repairing a first or second degree perineal tear or laceration.


In addition, in an emergency, while awaiting the required medical intervention or in the absence of medical intervention, applying suction, conducting a breech delivery, performing manual placental extraction followed by digital exploration of the uterus or performing resuscitation procedures on the woman or newborn also constitutes the practice of midwifery."
(http://legisquebec.gouv.qc.ca/en/ShowDoc/cs/S-0.1
In Ontario, they are much less vague:


"1. Communicating a diagnosis identifying, as the cause of a woman’s or newborn’s symptoms, a disease or disorder that may be identified from the results of a laboratory or other test or investigation that a member is authorized to order or perform on a woman or a newborn during normal pregnancy, labour and delivery and for up to six weeks post-partum.

2. Managing labour and conducting spontaneous normal vaginal deliveries.

3. Inserting urinary catheters into women.

4. Performing episiotomies and amniotomies and repairing episiotomies and lacerations, not involving the anus, anal sphincter, rectum, urethra and periurethral area.

5. Administering, by injection or inhalation, a substance designated in the regulations.

6. Prescribing drugs designated in the regulations.

7. Putting an instrument, hand or finger beyond the labia majora or anal verge during pregnancy, labour and the post-partum period.

8. Administering suppository drugs designated in the regulations beyond the anal verge during pregnancy, labour and the post-partum period.

9. Taking blood samples from newborns by skin pricking or from persons from veins or by skin pricking.

10. Intubation beyond the larynx of a newborn.

11. Administering a substance by injection or inhalation as provided for in subsection 4.1 (2). 2009, c. 26, s. 16 (1). (https://www.ontario.ca/laws/statute/91m31)"

Competitive Spirit

The first official running race I participated in was this one: a half marathon (21 kilometers), when I had just turned 59. I loved everything about it! The camaraderie; the cups of water; the corny posters; the feeling that I couldn't do it and then I did!

I still love running races. I've done a bunch of them since then. The first in-person one I did since the beginning of Covid was last October. My smile lasted about two kilometers, when I lost myself in the joy of hearing all those other runners' feet pitter-pattering in front, beside and behind me. Then my self caught up with me and I spent the next two hours or so agonizing about my life and all the things that were going wrong and have gone wrong in the past.

Am I an impostor? Was the main question I kept asking myself. The jury is still out on that one. Because here's the thing: as soon as I say I'm anything, especially these days as the social media is ready to pick up and amplify any little piece of horse shit that escapes my mouth, as soon as I say I'm a midwife or a caring person or whatever, a witch and the like, then .... then I am that. And I necessarily have to be the BEST at whatever it is I've said I am.

And if I'm not the best, then I'm an impostor.

We live in an age of experts.

Experts, apparently, study stuff. They know about stuff and they can tell other people how to do things. But there are so many, many experts out there it's hard to know who to believe. So a regular person just finds the expert they agree with and build a game plan from there. But that leads to some difficulties: first of all, you can't just pick any expert. Some people do actually know more than others about any given subject. As a lay-trained midwife, I know that I don't have as much technical knowledge as an OBGYN... so I shouldn't represent myself in opposition to them. But I do, or rather, we do ... we seem to be living in an age when we are all projecting images of ourselves that are larger than life, and better than the puny reality.

The second difficulty with finding an expert to guide you on your way is the problem of responsibility. If you're following an expert's advice and things go sideways, who are you going to blame? Yourself? I don't think so. If you've already decided that you need an expert to help you do whatever it is that you want to do, then you've already given them some degree of responsibility. 

So, if we do away with experts? Well, no one is going to do brain surgery on themselves I hope. But maybe we could tweak the idea a little bit. Maybe we could add some humility to the picture. Perhaps we could reduce our need for experts, trust ourselves a little more, and remember that living life isn't actually like running a race. No one really wins: it isn't really about the survival of the fittest.

Finding Center

I lost my centre over the past few months and I'm not sure how. I've been feeling like a small boat in the middle of a big sea. The desires and defeats and dreams of others became my reality. I stepped up to a plate I don't really like.

Yesterday,  no it's last week now, I ran a half marathon, that's 13 miles. My phone had broken so I didn't have music to listen to, so I only had my own thoughts and the sounds of my feet, my breath, and other runners talking or the Canada Geese honking in the background. I thought about how I have gotten to where I am, and how my beliefs and convictions have changed and matured over time, but how they got mixed up and sidelined over the past year or so.

Women's reproductive health has always been very important to me. I've worked in the field of maternity care for over twenty years, mostly as a doula but also as a midwife. I am not registered to practice as a midwife here in Canada, so I've restricted my practice to other places and different ways of practicing. 

As the complications and controversies grew and thrived as we lived through a pandemic, I started to hear from women who did not want to go to the hospital to have their babies, and neither did they want to have their births attended by registered midwives. In their opinion, the restrictions put in place for birthing women and their families were oppressive and inhuman. So these women wanted to give birth on their own.

Most of the women who contacted me felt strongly that they did not want to wear a mask during labour; they did not want their partner or doula to be restricted; they do not believe that the Covid vaccine is necessary or valuable. The vaccine passport in Quebec is now required for a doula to accompany a woman to a hospital or birthing centre, and this is also part of the reasons why this group of women are seeking answers elsewhere.

My life has been devoted to a few things: my own family - my husband, my five sons, and their new families; my attempts to live a good life; and my desire to facilitate change for women, their children, and the world as a whole. For me, that desire became focused on working to find ways to make decent, safe, respectful, woman-centred health care available for every woman. 

So when women started calling me and wanting my assistance, advice, and companionship, I agreed that I would provide prenatal support - virtually - and I would accompany them along their decision-making paths to childbirth. You know what? That's insane, and reckless, and lacks consciousness, and that's why I believe that I somehow, somewhere, lost my center. The paradigm doesn't work. Because prenatal care is about touch, and attention, and the five senses, the sixth senses, and all the senses in between. Common sense, for one. 

If a woman wants to give birth on her own, for whatever reason, I actually support her in that choice. I don't like to tell people what to do, generally. But I also like to hold people accountable for their actions. And that means that if you're giving birth on your own, then you don't involve me. Why not? Let me explain: I've had many calls from women who want to give birth "outside of the system". And they want me to be a "fly on the wall." Why would they want that fly there? "In case anything goes wrong". Well, the fact is that, in fact, things DO go wrong during childbirth. And if you're giving birth on your own, you should recognize that and figure out what you're going to do in that situation. 

But it's not right to rely on the knowledge and experience of a fly, and it's not right for a doula to offer to be that fly. Because then when things do go wrong (which, yes, is very, very rare), then what's a fly supposed to do in an emergency? 

I'm taking time away from some things for the next little while, and I don't even know which things. I will be making some time for myself: time to think, to ponder, to meditate, to run, to declutter, to find peace, to find my center again.

Birth Uprising Manifesto

I have been thinking a lot about my basic values, and I've come to the understanding that these five simple words spell out my goals, in terms of my life work with families through the childbearing year, and specifically with women through their reproductive life journeys.

Safe and Sacred Birth Choices.

Let’s start at the end and work backwards to the beginning!

1. Choices

2. Birth

3. Sacred

4. and

5. Safe

1. Choice

Choices are so important! And in our reproductive lives these days, we do have many, many options and choices. But sometimes we’re presented with choices that we feel have been already made for us, or we don’t understand what choices we have. This is where the idea of informed choice comes in.

Informed choice and informed consent are often used together in a medical setting, but they’re not the same at all. Informed consent means that you’re agreeing to something that someone has explained to you. I said yes to something that you kind of explained was an absolutely necessary thing I had to do.

Consent means I said yes. The informed part can be really vague.

Informed choice can mean that too, but real informed choice means that all of the options are explained to you so that you fully understand them - and their consequences. And then you can make a choice.

A real choice. And that choice, just like in what we like to call consensual sex, might be “no”. "No", I don't want to have a child right now. No, I don't want to be induced. No, I don't want you to do that.

I want choices to be informed, respected, and real for women during their reproductive lives.

2. Birth

Well, birth is where we all come from so it’s pretty important. But birth choices, for a woman, can also mean making the choice not to give birth. Ever. Or not to give birth right away. Our choices around birth start with whether to have a baby or not and move through the whole process after that choice has been made, and beyond.

If you decide to have a baby, then the complex choices start: where will I give birth? Who do I want with me during this childbearing year? How do I want to be treated while I am pregnant and birthing? Why am I being offered this medical choice, or another one? When will my baby arrive? Can I decide when I’m going to give birth? Why does my labour not start? Why does this hurt? What should I do?

There is so much education and respect that is not available for women during their childbearing year.

I want every woman cared for with respect, humility, love, and compassion.

3. Sacred

The word sacred can mean different things to different people. Lots of you might feel some resistance or annoyance with the word. That’s okay. Except that this word might be a key to understanding the childbearing year, women’s reproductive life, and even life in general in a different way. In a way that recognizes and affirms that we are not ultimately in control, that there is something bigger and more wild growing and living through us. Even if it’s chemical reactions, or hormones, or nature (whatever that is) or Spirit, Creator, Universe or God…. if we start to imagine that we aren’t the captain of this boat, ESPECIALLY if we are attending a woman during her childbearing year, then that humility will lead us to a place where we can actually provide better care. If we understand that the body isn’t just the body, and it is made up of physical things and also things that we can’t really name, like emotions, intuitions and thoughts. And that the body and those more unnameable things work together to make not only that human being you are accompanying, but also yourself; So that we come as humans to assist, to attend, to accompany other humans, but never as a higher power or an authority.

Sacred care in birth leads to better physical outcomes, happier babies, happier mothers and a better world.

4. and

"and" can open up so much possibility … I just included it because it’s one of the five words …and why shouldn’t a simple conjunction mean as much as another fancier word? And for me, this is the truth of working with women throughout their reproductive life; again, it’s a question of humility. Who am I, fancy person with years of study, to think of myself as fancier than a simple person who has asked for my assistance? If I decide that she can no longer teach me anything, then I’ve closed the door to real healing. That little word “and” can teach us a lot: it’s a little insignificant word but it binds the two parts of the sentence together. Like love.

Every birthing mother deserves to birth in love.

5. Safe

I’m not going to talk right now about the dangers of childbirth. Just ask Dr Google and you can scare yourself silly. I won’t tell you all the scary statistics or tell you the horror stories. But what I will tell you is that our maternity system, the global maternity system that we have in place right now, is hurting women and babies. The affluent women are surviving technology-led birthing practices that take no account of the whole human beings in front of them. The less affluent women, and the black and coloured women in the US, are being treated worse than animals and are being denied decent care, either because of poverty, racism or both.

I want a maternity care culture where the safety: physical, mental, emotional and spiritual, safety of the woman who is birthing the child (or children) is the absolutely most important thing in the world at those moments, for the people attending her.

I am working hard towards this goal.

This week, I’m crying for the mothers I’ve served. The details aren’t necessary for now but I’ve spoken to six women this week; one with a tragedy; one with rage against her doctors; one with a potentially fatal diagnostic error; one with a natural birth that was interfered with; one is expecting to birth alone; one setting her boundaries hard and high.

Women shouldn’t have to fight for their right to have good, respectful care during their childbearing year.

My demands are:

Birth attendants (doctors, midwives, nurses, doulas), do you know that there is a whole movement of women who don’t want to be cared for by you, because they don’t want to be treated badly? They are not children, they are humans with whole lives, and they want to be able to make choices that may be different from yours. These women also deserve SAFE care. Here are some suggestions:

Take some lessons in self-care. This is not an option. You can’t care for others, especially for those who are bringing a new life into this world, if you do not care for yourself.

Cultivate your ability to love others. Love is not an option. You must love the woman you are supporting.

Leave your ego at the door of the birthing room. No, you are not in control. No, you are not the captain, and, no, the buck doesn’t stop with you. You are an assistant, a vessel, maybe even a highly trained one. But your job isn’t to provide judgement.

Be honest. If you don’t want to take extra time before you reach in with an intervention, take the time to explain why and ask yourself honestly if you know what the consequences would be if you waited. If you’ve never waited, and there are no studies to show what happens when you wait, then it’s all superstition and you don’t really know. If you say, “I’m not comfortable with not waiting, but there are no studies to back me up” then a dialogue can begin. If you say, “We have to do blah blah or your baby will die.” then there’s no dialogue, just fear and power and ego.

Be curious. Maybe some of the methods and theories suggested by others are actually valid. Have a look; open your eyes; don’t do a knee-jerk “NO!”. This goes for all of you – I’m not targeting doctors here. I know enough alternative practitioners who are quick to judge as well.

Be attentive. Medical practitioners have forgotten how to be attentive with their senses, and not with their machines: Sight, smell, touch, listening are the four senses we use (and we leave taste for dinner!). And intuition, and the important sense of humour! I don’t know of any kind of healer, where they’re a specialist with sixty years experience or a beginning midwife, who does not value the kinds of messages their intuition will give them, if they’re open.

Listen to the woman who is birthing. Who is she? What does she want? What does she know?

And here's some advice for all you women out there, trying to navigate the realities of your reproductive lives:

Be curious. Ask around and find the path that suits YOU, not your friend, your mother, sister, or even your partner.

Learn and keep on learning. Knowledge is power!

Reach out! There is a whole world out there, and there are people who might be able to give you the answers you are looking for.

Don’t be shamed! Whatever you choose for your journey is your very own choice, based on who you are, who you were and who you will be. Whether to bear a child, where, with whom, and how are all personal choices that don’t belong to anyone except you and your partner. If you feel shamed by a friend, a group or a professional, stay away!

Listen to your body.

Demand choices! Demand your rights! Don’t be bullied, even when you are labouring. If something doesn’t feel right, stand up and say no! If you can’t do that on your own, then hire a doula. If you can't afford a doula, find a free one! I guarantee you I will find you a free doula if you want one…

Know that we love you! Find a community, we are around.

For more information about Birth Uprising, leave a comment or reach out, you can find me!

Love, power, peace and love again.

Midwifery and Bullshit

 

These are not midwifery tools, but they could be. 

I have started offering prenatal support and consultation to women who are looking to give birth in an autonomous way. Several of these women are being followed, or have been followed, by registered midwives here in Canada. I've also spoken to a few practising midwives in this country, and I believe our midwifery establishment is in crisis.

We were an unusual country. Midwifery was illegal in all of our provinces and territories until the 1990's, when provinces started to recognize that it would be useful to register and educate midwives in the medical model. During the twenty years from the 1970's until midwifery was legitimized and regulated, midwives worked illegally to assist mothers at home, and there were a few midwives who were charged with practising medicine without a license. 

During the 1990's, midwifery became regulated and legitimized in several provinces. Midwifery education programs were developed and offered in universities across the country. These programs were very hard to get accepted into, and required a formal academic background over life experience. Most of the original lay midwives who had been practising illegally before legislation were "grandmothered" in to the Colleges of Midwives, but the applicants who were accepted into the programs were generally younger and obviously less experienced. 

Midwives were and are in great demand. The supply is very limited, partly because of the restrictions that competitive educational options and limited employment options mean for anyone who is drawn to the practice. Provincial governments in Canada have succeeded in effectively reducing the number of potential practising midwives, either with restrictive educational possibilities, or by limiting the ways that midwives can practice.

Because of the lack of registered midwives, and because the available midwives were practising in the medical model, several women over the years in various provinces in Canada chose to give birth either unassisted or with Traditional Birth Companions. As well, midwives trained in the US or elsewhere started offering their services as midwives and attended women at home. This was risky, because with the creation of a College of Midwives, anyone offering restricted practices under the provincial midwifery acts could be (and were!) prosecuted by the provincial College of Midwives. So far, this has happened in B.C., Saskatchewan, and Quebec. 

The pandemic of 2020 changed the face of birth. Women who were hiring doulas to accompany them to their hospital births found that the hospital authorities had full power to limit the number of people present, and doulas were left at home in front of their phones, providing encouragement, support and continuity of care from afar (Hats off, shout out, Kudos to all you doulas out there!!!). Home birth was restricted or banned in some areas, and midwives were given even more rules and regulations they had to practice under. 

Hospitals were seen, rightly so, as places for sick people (hmmmm, isn't that what they always were?). A few women, certainly a larger number than in 2019, decided that they would give birth on their own. Others decided that they would continue with midwifery care and fill in the gaps with the council and support of other practitioners.

Here is a little account of what is wrong with midwifery today, gleaned from conversations I have had with women seeking answers, and why I believe it has gone wrong:

• Newborn mothers and babies do not need immediate testing. They need skin-to-skin togetherness, if the immediate indications of their health is good.
• Newborns do not have to latch on the breast like a champion within the first half hour of life. Again, they need skin-to-skin togetherness. Mother will need to eat and drink. Attendants should stick around with gentle attention.
• If you say that you will offer a woman attendance at her home, and you visit her home and bring equipment and preparations ... she is not going to hear your quid pro quos and fine fine print at the bottom of your conversations. She will be deeply disappointed when you tell her that (for whatever reason, that has to do with YOUR infrastructure and organization of lack thereof) she cannot after all birth in the comfort of her own home.
• Women over 40 are not inherently dangerous. They can carry a baby to term and do not need extra testing or worrying conversations about how risky their pregnancy is. That's why she chose you, a midwife, so they wouldn't have to be bullied.
• Midwives have to learn to keep their faces pleasant. So many women have let me know that they got really scared when they saw a young midwife look at their lady parts with horror/fear on their face. A vulva or a newborn's head can look wildly psychedelic, but usually is no reason for alarm.
• The word "should" doesn't belong in your vocabulary if you are attending a birthing woman. 

Women now, a small percentage but nevertheless a percentage, are choosing to give birth at home autonomously instead of seeking the attendance of a midwife or a physician. This fact makes me sad. Why? Because I believe that every woman deserves a safe and sacred place in which to birth her child. Some women want to birth in the hospital. That birth should be as respected and loved as a birth that takes place at home surrounded by a circle of women. Some women want to birth at home, and these women deserve respectful, kind, reliable, and legal midwifery care. 

There is work to be done!!!

Mothers, Babies, Chaos

Fifteen years ago, I created a ground breaking, unique, stellar doula course with my colleague Lesley Everest. We wrote and taught a ten-month long program that fully prepared doulas to do their important work, with confidence, respect and knowledge.

Part of that course required the students to do some volunteer work with mothers and babies. Two of our students spent a summer accompanying 14 marginalized women through their late pregnancies, labour and birth, and immediate postpartum period. I was away for the summer, as I always am, and I got back to their stories of difficulties and birth, and new families… and so a seed was planted.

That was the summer of 2004. Over the next couple of years, our students continued to volunteer to accompany marginalized families through the childbearing year, and we became recognized by nurses, social workers, dieticians, physicians, midwives, and families as an important resource for those who had, in some cases, literally nothing.

In 2006 Montreal Birth Companions was “officially” born: it was registered as a charity and we were able to apply for funding (even though we never actually received any!). For the next ten years, until 2016, I matched needy mothers with willing doulas. Over the course of its history, MBC served almost 1000 families. Some of them needed a doula to attend the birth of their child. Some needed resources that we couldn’t provide, so we referred them elsewhere. Some needed prenatal education, postpartum assistance, or caring for older children.

I know that now there is a movement amongst the doula community that says loud and clear that for the work to be “valued” it should not be given away for free (that is, for no money). My answer to that is twofold: the first echoes Chance the Rapper “I sing for freedom, not for free”. The second asks who exactly would accompany these mothers if we didn’t? These were people who did not have an extra dollar to their name. They had no money, little clothing, sparse food and crowded shelter.

We served refugees, refugee claimants, women with no status, domestic workers who had been illegally sent away from their employees homes, young women, women from every different country, religion, background, color … the only things they had in common were that they were pregnant and they were poor. We served mothers who had fled war and destruction; mothers who had fled rape and forced prostitution; mothers who were hiding from their violent partners. We served families who just needed help navigating the foreign medical system. We served women who didn’t know how to call emergency services (no, birth is not an emergency, but a haemorrhage is … and do you know how to dial emergency services in Benin?).

And now you may ask, why? Why did we bother? Surely these families were fortunate enough to be able to attend a modern hospital with dedicated professionals to assist them? Yes, absolutely. The women we served were very fortunate to be able to birth in a safe environment. But for women in an already precarious situation, it is so important for them to give birth with as few interventions as possible. For two reasons: first, the less interventions a mother has, the easier it is to recover after childbirth. If life is already challenging, why not give the new mother the best start possible? Secondly, many of the families we were serving, especially after about 2010, did not have access to our provincial health care coverage. This meant that they would have to pay per treatment. The very cheapest hospital birth cost a new family from five to seven thousand dollars. This would be a birth where they only spent 24 hours in the hospital, and the attending physician didn’t charge too much. The most any of our clients owed when she left the hospital was $39,000. We tried our very best to prevent a new family from having to pay for unnecessary treatments. Once we explained to the medical staff what the situation was, we were usually met with understanding and patience.

In 2016, I experienced the consequences of creating an organization with no structure. My joke was always that MBC (Montreal Birth Companions) stood for Mothers, Babies and Chaos. Basically, my mandate was to provide free doula services for mothers in need. That’s what we did, successfully, for many years. But Star Hawk, in one of her books, describes the frailty and danger of an organization that does not have a clear structure: what can happen is that the members of the organization can start to feel threatened, if not by the leader, then by the lack of structure itself.

Two of my doulas were attending the birth of a refugee woman. Only one doula was allowed in the room at one time (the hospital had a rule that only two support people were allowed, and the preacher from the woman’s church decided to attend the birth). The doulas had not previously met the woman; this was an urgent request from the midwives who were following her, and they had not told me that this person would be there.

Over the course of the labour, the preacher harassed the two doulas with sexually intimidating comments, and finally in the morning he physically assaulted one of them. When the doulas told me, I told the midwives and the clinic, and I was met with a strangely layered response: the man had also harassed a nurse at the clinic, and we should be tolerant because he is from another culture where it is common to act like that. 

This bizarre attitude threw me completely, and left me and “my” doulas with no resources except one person outside the organization who tried to facilitate. I felt guilty; the doulas felt angry and shamed, and none of us knew what to do. Why? Simply, because I had not built an organization that contained within it the structures to be able to deal with unforeseen events. Even if you’re an anarchist, even if you don’t believe in Boards, Presidents, and Secretaries, you have to create some kind of structure that can deal with attack.

So what did I do? I stepped down as director and a collective took over the work and the organization. I was so shaken by what had happened I had to leave the work to others. I withdrew, ran my café, and did a lot of running. In December 2016 I was sitting on the bus and I read a tweet by a Syrian journalist about what was happening in Aleppo. I learned that many families had made the dangerous crossing from Turkey to Greece, where they were being housed in camps.

By January 2017 I had packed my bags and headed to Greece to provide midwifery care to the young families in the camps and elsewhere in Greece. It was one of the coldest winters on record. People were housed in UN tents inside abandoned factories. Some of the more vulnerable were moved to apartments and hotels that were vacant and made available. I met with one family from Syria who were being housed in a small room with water literally dripping down the walls, intermittent electricity, and a shared bathroom. She was almost at term, and her baby was breech, and when I suggested some exercise she said it was too painful because of some bomb shrapnel she still had in her hip.

While the larger NGOs argued over bureaucratic details, such as which organization could visit which hotel, I quietly gathered needed resources (clothes, diapers, soap…) from the over-filled basement of the NGO I was working with, and drove to visit pregnant women all over the north of Greece who were in need. I worked with some amazing, brave people and I will never forget that experience.

But then I got back to Montreal and I was met with a deep weariness. I felt that the tiny drop in the huge ocean of need was never going to be enough. I stopped practising as a doula, knowing that there were younger, better, more enthusiastic doulas out there (many of them trained by myself or my colleague). My extensive knowledge of undisturbed, woman-centered childbirth made it difficult for me to witness many of the hospital births I was called to, and my discomfort spread to others around me. I no longer attended home births, as the definition of “practising midwifery without a license” was at the same time clarified and obfuscated by two different legal battles in Canada.

So, where am I? Well, of course, life goes on, so I have a large family to attend to, a successful café to run with middle son, all sorts of projects in the air … and yet … I was made to serve, and I’m looking for another project, so if anyone needs a CPM without papers (let them expire), doula teacher, or a Jill-of-all-trades to work for freedom, I’m in!

Trickle Down?

Let's face it ... good stuff doesn't trickle down. You have to work really hard to get the good things in life to the people who deserve them: shelter, medical care, food, clean clothes, and all of those things that many of us take for granted.

In the last ten days, I have had over ten requests from women who desperately need maternity care. I can only provide them with free doula care, from the volunteers who donate their time to Montreal Birth Companions. Some of these volunteers are students, some are experienced doulas.  But doulas don't provide medical care, and most of these women have not had prenatal care, so they are at risk for worse outcomes than the generally healthy population of our fair city.

I was called at 2:30 in the morning last week by a doula, frantic with worry. She had been called by one of our clients who was bleeding heavily. I told the doula to call 911 immediately. She did so and mother and baby survived.

Several times over the past week I have been juggling available doulas to accompany one of the MBC mothers who was laboring and needed companionship. Doulas are people too, some are on vacation, some are pregnant, most have other jobs.

I assisted at a birth where the midwives were unable to provide the mother with effective care postpartum. I was at another birth with a baby who became ill after birth. I got another call from a doula whose client was bleeding after giving birth, and the midwives had not made it to the house on time.

I have had several requests over the past few weeks from mothers who cannot find a midwife, who don't want to birth in the hospital, who are looking for an unregistered midwife. Unregistered, underground, or illegal midwives work without any medical backup and if they need to transfer their clients to the hospital, have no standing with the medical staff and are treated either as doulas or as "friends". Unregistered midwives often make calls that are not as effective as they could be - they work on a basis of mutual respect which sometimes can mean taking risks that may be dangerous and unprofessional.

I am seeing the writing on the wall, and it is telling me that we are not taking care of our mothers and babies. I can't always be there to answer the phone when a mother is in need, or a doula, (and rightly so) cannot provide medical care when there is no doctor.

Something must be done! Se non ora, quando?

Women who want to be Doulas

Mamas, please let your babies grow up to be doulas.....

We started Level Two again two weeks ago - time is already flying - there's so much to teach and learn at every level! Two of the Level Two students are accompanying a birthing woman today, so they won't make it to class tonight.

I am so pleased to have met my new students. The group of women this year is very diverse, in age, background, experience... and yet we are all drawn by the desire to accompany women through the journey of childbirth.

I believe that all midwifery students should have to accompany at least fifty women through the birthing process (but even better one hundred or more), and that most of these should be in the hospital environment. Why is this?

Doulas learn to sit on their hands and let the birthing process unfold.
Doulas learn to keep their mouths zipped while they maintain a safe space for the woman.
Doulas learn respect.
They learn that the birthing process is unexpected. That it proceeds better when it is undisturbed, but that nature is pretty flexible with its rules.
They learn what NOT to do.
They learn humility, kindness, diplomacy, and they learn when to speak out and when not to.

We may all have our different ways of practice, just like we were all born slightly differently, just like we will birth differently. But we all practice companionship, which is the most important aspect of our care.

Learn to be a doula here.

Ethical Birth Work

I was an intern at a maternity clinic a quite few years ago and I had some interesting experiences there. One young woman came to get some experience as a midwife, so that she could decide if she wanted to make the jump from being a doula, or if she was going to move to physiotherapy instead. On her first afternoon, the clinic was very busy, and she was led to a room where found she was the only midwife (not even!). She became depressed over the six weeks I knew her, and she left miserable and feeling violated.

I was very interested in what was happening. I have had a dream all my life of returning to Uganda where I spent my first three years, and working alongside the TBAs there to provide maternity care. I am fascinated by how organizations work, and I love to see how particularly women's organizations unfold, and how we keep (or not) bullying and aggression out of the ring.
I have travelled to many places. I have so many memories of different places and different people. I remember being led up a rocky path in the mountains of Morocco when I was seventeen, by two young women. We found a stream and drank, and spoke with our eyes and hands. We laughed. I gave them my earrings.

In Africa, a few years later, a young woman ran to me carrying her baby. I knew he was dying. She thought I may be able to help because of the color of my skin. I couldn't.

I travelled on my own, avoiding danger or fleeing when necessary. I used my polite manner and my eyes and hands to communicate friendliness, and I was never hurt too badly.

Years and many experiences and chapters later, I decided to finally get my certification as a professional midwife. My visit to the maternity clinic was one step along the road. One night, at around three in the morning, I was in a birthing room at the clinic. I was not supposed to be "primary", but the woman who was on for that night was exhausted from a hard birth, so the head midwife told me to assist. The birth was difficult, and the head midwife told me to enter the woman and manipulate the baby's head so that he could be born. I had my hands in the woman, when the boss midwife entered the room, tapped me on the shoulder, indicated that I should leave, and she had another intern take my place.

She was having a power struggle with the head midwife. Her ego was too big to fit through her pelvis, that's for sure!

But what about the woman giving birth? How did she feel when my hands left her, there was a tense emotional moment, and a new person's hands went in? Did she feel violated?

I have no interest in manipulating baby's heads, actually, I believe they get born better if they're left alone. But I also believe that the epicentre of the birthing room HAS to be the mother who is birthing her baby. A birthing room is no place for politics to unfold. Aggression and rudeness do not belong there. Love belongs. Peace belongs. Honor and respect belong.

There is a wider discussion going on right now in the midwifery world, about how this plays out in the bigger world picture of midwifery today. Student midwives from North America are traveling to poorer countries to earn their qualifying numbers so that they can become certified as professional midwives. Is this right or wrong? How can we accept a student midwife's desire to do good, and screen out the "number whores" (these are the students who travel to other countries simply to get their qualifying numbers, giving little thought to the women they are working with or for).

There are many small clinics all over the world where courageous, passionate, dedicated and professional midwives work every hour of every day to improve maternity care for the women they serve. Let's not throw the baby out with the bath water! For many of these clinics, paying volunteers from rich countries are one of the few ways they manage to stay solvent. But we do not need students to travel to other places so that they can experience a woman dying...birth is not reality television.

I believe the answer is within. If you go into every birthing room with love in your heart, respecting the other people in that room and honoring the birthing mother, then you will find yourself unable to use a birthing mother as a number, a statistic, or an educational tool. Women who give birth are worthy of the greatest respect. Let our politics play out elsewhere, away from the new baby, away from the birthing mother, away from the birth room.