Indigenous birth knowledge fills massive gaps in healthcare, but needs support

Co-founder of Indigenous doula collective says Indigenous birth workers need to be “supported and not exploited.”

Danette Jubinville believes that healthcare systems have a lot to learn from Indigenous knowledge systems. That’s one of the reasons why, in 2015, Jubinville co-founded the ekw’í7tl doula collective, a doula training program by and for Indigenous people.

The ekw’í7tl collective, which means “family” in Sḵwx̱wú7mesh Sníchim (the Squamish language), provides “full-circle mental, emotional, physical, and spiritual support” for Indigenous families during pregnancy, labour, birth, and postpartum care.

Jubinville, who is Cree and Saulteaux from the Pasqua First Nation, spoke with IndigiNews about how their Indigenous-led doula training differs from mainstream trainings, why the revitalization of Indigenous birth practices and care is an essential part of Canada’s reconciliation process — and why they’ve decided to put future trainings on hold. 

The following conversation has been edited for length and clarity. 

Danette, why is it important to have Indigenous-led training for Indigenous doulas?

We originally had identified a number of goals and priorities as a part of our vision for coming together as a collective, and Indigenous-led doula training was at the top of that list. At that time, and still now, there was no Indigenous-led doula training education program that you could attend in person in B.C.

We [the doulas of the ekw’í7tl doula collective] had all done training in more mainstream, non-Indigenous programs, like DONA (Doulas of North America), which I think is the most well known doula training. We felt like there were a lot of missing pieces within that training in terms of making it relevant for our communities. We also felt like our own Indigenous knowledge systems have so much to offer and should be what is leading and guiding our own work as Indigenous birth workers.

How was the doula curriculum co-developed?

An allied midwife, who we know through the Strathcona Midwifery Collective, moved to Port Hardy, and was serving the Indigenous community there through a position with the First Nations Health Authority (FNHA). She identified the need and desire for an Indigenous doula training, and so she reached out to ask if that was something we wanted to bring up there. We made a proposal for the Indigenous doula training workshop and we piloted that training and curriculum in Port Hardy in November of last year. We were also able to deliver it once again in Vancouver, which was a partnership with the B.C. Association of Aboriginal Friendship Centres, with participants who attended from around the province.

ekw'í7tl doula collective offers doula training on the North Island
From left to right, ekw’í7tl doula collective members Cheyenne La Vallee, Miranda Kelly, Olivia Louie, and Danette Jubinville. Photo by Simon Paul Photography

How many doulas have taken the training?

It’s around 40, with 20 participants in each training group. 

And how does the training differ from other doula trainings that are offered?

Our training really centers on Indigenous Peoples’ experiences, knowledge and desires. We really tried to bring Indigenous methodologies and ways of knowing into the curriculum. We also acknowledge that Indigenous Peoples are incredibly diverse, so we tried to make a lot of space for cross-cultural knowledge sharing. One of the ways that we did that was by centering storytelling within our curriculum.

We also made sure that there was an Elder or Elders present every day at the training and that they had the space that they needed to share. We brought in stories from past clients that they had offered to us to share. We invited participants to go home to their families and think about their own cultural knowledge and how they can bring that into their birth work practice. There’s a lot of appropriation that happens, so we just made sure to create this respect and reverence for the knowledge that Indigenous people around the world have brought into birth work.

We had all of the pieces around the physiology of birth that any other doula training would cover, but we really focused on supplementing that through the lens of Indigenous Peoples knowledge and perspectives. Part of that was bringing in an Indigenous reproductive justice framework for understanding how colonialism has impacted Indigenous experiences in reproductive health. The shame around that is not ours to carry, like the history and ongoing practice of coerced sterilization, abusive abortions, the medicalization of birth, the evacuation policy, and of course, the fragmentation and dispossession of Indigenous parenting and family structures through things like residential schools and the child welfare system. We made sure that those things were named throughout the curriculum.

Danette Jubinville offers a doula training with Marissa Charlie for the Squamish Nation
Jubinville and Marissa Charlie delivering a prenatal workshop for the Squamish Nation

In developing this training, did you experience any barriers?

We have found that it’s really difficult to sustain the work because Indigenous doulas are not a part of the public health system and are a private form of health care. By and large, our people and populations can’t always afford to pay out of pocket, so the grant program has been really important in giving Indigenous people access to this kind of care. 

We are filling these major gaps in the healthcare system that are well known, but [the doulas] are not being paid or valued for that contribution. I want to name these problems because since delivering the training in Port Hardy and in Vancouver, we’ve been asked to continue to deliver the training, and we have taken the stance that our training needs to be on hold until there is a more sustainable and less exploitative ways for Indigenous birth workers to enter the workforce once they’re trained. 

I think [this training] is a hugely important piece of reconciliation. I think the revitalization of Indigenous birth practices and care has been named so many times, even in the Missing and Murdered Indigenous Women and Girls inquiry as a need from our community. This is the stance that we’ve taken, and we’ve made our community partners and other stakeholders in the province aware of these problems. And so, we’re waiting for the issues we’ve raised to be addressed meaningfully.

What is your vision for the future?

It’s become extremely clear that Indigenous people and communities are absolutely the knowledge holders and experts in what they need and want, and are the experts in their own healthcare. There’s no reason why our health systems, services and programs should not be led by the self-determined needs of Indigenous communities themselves. What is needed is simply the resources to be able to do that and to build infrastructure around the visions that they have, and it absolutely needs to be community driven and grounded in each community’s vision for what that should look like.

Systems really just need to start listening to Indigenous people and providing the resources necessary to make their visions happen. We all have people in our own communities who are capable and gifted in this work. I think the vision in so many communities is to have Indigenous babies born into the hands of Indigenous people, caregivers, and family members. 

It is our hope that the collective can help support the building of an Indigenous birth centre in Vancouver as a culturally safe place of maternal reproductive health care for Indigenous families who live and travel to Vancouver. 

Jubinville will take part in an online conversation about Barriers and Breakthroughs in Indigenous Reproductive Health, facilitated by IndigiNews, on Wednesday, Dec 9. More details here


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