By: Ashley Hayward

Indigenous doulas are trained professionals who provide physical, emotional, and informational support to birthing individuals before, during, and after childbirth (Doenmez, et al., 2022). They  are crucial advocates for reproductive justice, dedicated to supporting the health and well-being of Indigenous families. Their work moves beyond traditional birthing support, challenging and resisting colonial systems that have long marginalized, discriminated and oppressed Indigenous people and communities. An example of a colonial system is Health Canada’s evacuation policy, which forces Indigenous birthing people living in remote areas to travel to urban centers to give birth. This experience is known to be isolating and traumatizing for the birthing person, as they often travel alone and unsupported, leading to a range of stressors that result in poor health outcomes. 

Traditionally, birthing people gave birth in their home communities with the support of Elders and community members, making the arrival of a new baby a celebrated community event. However, colonial systems such as the evacuation policy disconnect birthing people from their cultural and communal support systems, undermining the integral role of Indigenous families and communities in birthing.   

While there may not currently be Indigenous doulas specifically specialized in arthritis, their wide scope of care and training, and cultural knowledge ideally position them to care for conditions that disproportionately affect Indigenous peoples. Given the high prevalence of arthritis among First Nations (18-19% of the total population), Inuit (13%), and Metis (21%), Indigenous doulas could be well-suited to provide care for clients with this condition. Thus, by providing culturally safe care, these doulas can address immediate health needs, improve health outcomes, and contribute significantly to the broader push for justice and equity.

Reproductive justice, a term coined by 12 Black women in 1994, extends beyond the pro-choice (the right to choose whether or not to have an abortion) framework to encompass bodily autonomy – the right to have or not have children, and parent in safe and supportive environments (Ross & Solinger, 2017). For Indigenous communities, this concept is deeply connected to their historical and ongoing experiences of colonialism, which have systematically undermined health and autonomy.

In Canada, 53.8% of children in foster care are Indigenous, but account for only 7.7% of the child population (Government of Canada, 2023). This overrepresentation in child and family service is the direct result of colonialism and racism. These differences are worsened by systems that often fail to provide culturally competent care. Indigenous doulas help bridge these gaps by offering support grounded in cultural traditions and practices, ensuring that Indigenous birthing individuals receive care that honours and respects their needs.

Indigenous doulas are trained paraprofessionals – professionals who have specialized training but are not regulated or licensed as medical practitioners – who provide physical, emotional, and informational support to birthing individuals before, during, and after childbirth (Doenmez, et al., 2022). What sets them apart is their unique ability to integrate cultural knowledge and practices into their care while advocating for health justice and equity. This includes the use of traditional medicines such as sweetgrass and cedar, ceremonies like smudging, and birthing practices that honour Indigenous knowledge while operating within the confines of colonial systems including healthcare or child welfare.

Their work is crucial in creating an empowering and respectful birthing environment. By incorporating traditional practices, Indigenous doulas help reconnect families with their cultural roots, a vital step given the historical context of forced assimilation and cultural erasure. This cultural reconnection benefits not only the birthing individual but also the broader community, re-centering the birth as a celebration for the community.

Indigenous doulas advocate for practices that respect Indigenous sovereignty and self-determination in healthcare and social services. They push for the inclusion of traditional birthing practices within mainstream healthcare settings and defend the rights of Indigenous women and birthing individuals to make decisions about their reproductive health free from coercion and discrimination.

Indigenous doulas often educate healthcare providers about the unique needs and cultural contexts of Indigenous patients, promoting a more inclusive and respectful approach to care. This work is vital in addressing the systemic racism and injustices that lead to health disparities and marginalization, ensuring that Indigenous voices are heard and respected within the healthcare system and helping to build stronger, healthier, Indigenous communities. Their work is a powerful testament to the resilience and strength of Indigenous peoples and an essential part of the broader struggle for justice and equity.

References

Doenmez, C., Cidro, J., Sinclair, S., Hayward, A., Wodtke, L., & Nychuk, A. (2022). Heart work: Indigenous doulas responding to challenges of western systems and revitalizing Indigenous birthing care in Canada. BMC Pregnancy Childbirth 22, 41, 1-14.

Government of Canada. (2023, February 15). Reducing the number of Indigenous children in care. Retrieved from Indigenous Services Canada; First Nations Child and Family Services: https://www.sac-isc.gc.ca/eng/1541187352297/1541187392851

Ross, L. J., & Solinger, R. (2017). Reproductive Justice: An Introduction (1st ed.). Berkeley: University of California Press.

Varcoe, C. B. (2013). Help Bring Back the celebration of life: A community based participatory study of rural Aboriginal women’s maternity experiences and outcomes. BMC Pregnancy and Childbirth, 1-10.

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