Holding a sacred space for everyone – building an inclusive doula practice
A guide for doulas on building an inclusive doula practice through cultural humility, self-reflection, and respectful, woman-centred care in the birth space. Cultural humility focused around birth is something I as a support person needs to dive into, which means learning and even unlearning things.
Both personally and as a support person, I will meet people from all different backgrounds, religions and sexualities, so need to have an open mind and willingness to dive into cultural humility and learn. Cultural humility is not something we learn in a short time, it is a lifelong commitment of openness self-reflection and self-critique.
In doing this the goal is to shift power imbalances in maternal care for women so that we create an inclusive doula practice.
As a birth support worker, I am willing to learn about the different cultures, nationalities, values, beliefs, traditions and more that come with cultural diversity as I go through life, but not to ever be naive in thinking that I know it all, because I don’t and wont.
Like in life we are continuously learning, things are always evolving and you can never always know everything!
This is important to me, so that I can create a sacred space for women and potential clients of all cultures and sexualities where they feel safe with me and feel that they are treated with understanding and respect.
So we all as individuals and birth coaches need to focus on listening to clients with that understanding and respect to build a strong trust-based relationship.
Some key points for inclusive care:
- Don’t confuse cultural competence with cultural humility. They are very different. Cultural competence aims to gain a certain amount of or ‘enough’ knowledge and skills to work with different cultures. Then there is cultural humility, in which we support people need to strive for. It is the lifelong commitment too, understanding self-reflection and keeping an open mind to diversity and knowing that we can never know it all. Opening our heart and mind to being inclusive of everyone. This will not only shape you as a doula but as an individual.
- It is important for us to understand a client’s culture and beliefs so that we can avoid unintentional discrimination and potentially make a client feel inequal or disrespected, which can lead to damaging the relationship between you and the client/ potential client.
- Cultural humility is also important to help achieve reproductive justice as it gives us a guideline to address these power imbalances, acknowledge intersecting oppressions and hold a respect for the experiences our clients or clients’ families and ancestors have lived through.
- When it comes to cultural humility, we need to acknowledge that we are the support person, our client is the teacher, just like we acknowledge the difference in we are the support person, and the midwife is the medical practitioner. We as doulas need to do what we do best and listen, listen to the client’s unique story, beliefs, preferences and experiences.
- Having awareness of cultural humility and everything that we can learn with it will result in us holding a sacred, supported, and safe space. Not just for the client but the client’s family too. It is a goal of mine in my doula career to be inclusive of clients of all ethnicities, cultures, indigenous communities and sexualities.
Tips for us Doulas:
- When building a relationship with a sexually diverse client, always ask preferred pronouns and use gender neutral language.
- Allow your clients to define their birth goals, listen actively, and ask questions when not aware of something that may be diverse or unknown to you. Questions open conversations and that’s where it all begins, along with a respectful mindset.
- Engage with diverse groups or communities and support them, this is how you continue to learn and put yourself out there to be respected and seen as a culturally diverse doula.
- Be self-aware and dive into anything that may come up for you that could hinder you being open to the diversity.
- Journal your culturally diverse interactions to identify areas of personal growth.
How to advocate when your clients’ cultural preferences are being disrespected:
When to advocate?
- Advocacy should be at the first sign of disrespect. The quicker you advocate, the quicker you can centre your clients voice, autonomy, safety and mental wellbeing.
- Work accordingly and efficiently with your client and her family to create a “birthing on country” (if indigenous) or a culturally safe environment (based on specific culture) that respects the clients traditions. This could be with family presence, food, specific items wanting to be brought into hospital (regarding they are of no hazard) and modesty.
- Connect with and seek out cultural liaison officers or Aboriginal Health Officers if needed for formal communication and to help advocate for the client’s cultural needs. (Though this shouldn’t be needed in our world today.)
- If you feel you are doing everything and cultural needs are still being dismissed, document the conversation and ask for it to be documented in the clinical record, to hold them accountable for the decision.
- Use your birth plan as a tool, make sure the birth plan covers cultural practices and is discussed with the medical team from as early as your first appointment.
- Please don’t hesitate to escalate if necessary, your escalation could be the last warning to someone who has disrespected a culture before.
- If an immediate provider is disrespectful, involve higher-level management, such as the unit in charge nurse, midwifery manager, or patient advocate services.
By equipping ourselves and diving into cultural humility with an open heart and mind, this will improve birth outcomes and help you build stronger trust and respect-based relationships. Hopefully, in turn, making you feel good about yourself and your services and vice versa for the client.
Cultural humility isn’t separate to being a good doula, it IS being a good inclusive doula.
We all have the same goal, to support women in achieving an emotionally, physically, mentally and/or spiritual birth.
To all the women out there no matter your race, religion, beliefs or sexuality, you are strong, you are capable, and you are deserving of a positive birth experience, however that may look for you!
Helpful Resources:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11581955/
https://www.birthblissdoulacourses.co.uk/post/what-it-means-to-have-cultural-competency-as-a-doula
The well-known book ‘Reclaiming Childbirth as a Rite of Passage’ I feel is a great read as Dr Rachel Reed talks about many different practices from various cultures. A very diverse book when it comes to speaking about birth through different time periods. This book can be and is loved and appreciated by many due to the diversity in it.
https://www.rachelreed.website/rcrp
My name is Jessie Dana Wilkins, and I am a doula who has completed training at the Doula Training Academy and service the southern suburbs of Adelaide. I would love to connect with you, and talk about your preferences, wants and needs when it comes to achieving your dream birth.
I look forward to hearing from you.
Business Name:
Held Sacredly
Business Email:
[email protected]
Phone:
0414 926 296
Business Profile:
https://doulatrainingacademy.com.au/doulas/jessie-wilkins/
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