Indigenous doulas improve cultural safety and access to reproductive care

women holding a crying baby

​Indigenous doulas play a crucial role in providing culturally appropriate support to Indigenous women, Two-Spirit, trans and gender diverse people during the perinatal period and beyond. Serving as strategic leads on doula care at Vancouver Coastal Health (VCH), Danette Jubinville and Olivia Louie are two such doulas who are bringing this role back.

Indigenous communities across Turtle Island have always had people who acted as helpers during pregnancy, birth, and postpartum. These roles were fluid historically, but we now refer to them as Indigenous midwives and doulas. Indigenous doulas build connections with birthing people and provide wrap-around care, including companionship, information and connection to resources to empower birthing people and help bring warmth and ease to maternal and reproductive health experiences.

It's a calling

Being an Indigenous doula is not just work for Danette and Olivia, it is a calling. It's also their ancestral heritage. Danette comes from the Pasqua First Nation, while Olivia has roots in the Tla'amin and Key First Nations. “My great-great grandmother, Isabel Bear, was the last traditional midwife in our family. I feel that she called me into this work, because the ancestors want to see Indigenous babies being born in safe and loving ways in our own lands once again," says Danette.

Similarly, Olivia feels that her grandmothers, ancestors and future Elders call her to this work. Her great grandmother Rebecca B​​rass was the last traditional midwife in her family and her great-great granny Mahnta was an Indian doctor. For Olivia, this work brings memories of their teachings, stories and spirits.

“As Indigenous doulas, we know the importance of providing care that is grounded in our traditions and practices that speak to the unique experiences of Indigenous women and birthing people," says Danette. Olivia adds, "Our work is deeply rooted in our cultural traditions and teachings. We are guided by our ancestors and the cultural traditions and teachings they have passed down to us, and we carry that knowledge with us as we support our clients."

Breaking down barriers to better health outcomes

Committed to reproductive justice, Indigenous doulas are improving access to care and support for clients most vulnerable to social, racial and systemic inequities. The biomedical model of maternal health care, evacuation policies and Indigenous infant apprehension can make hospitals traumatic spaces for many Indigenous birthing people and their families.  To remove barriers, Indigenous doulas have established relationships with culturally safe care providers in their communities and are able to facilitate these connections with their clients. As Olivia puts it, "We know that Indigenous people face numerous barriers in accessing quality care, and we are committed to working alongside our clients to overcome these barriers and improve health outcomes."

Providing full-spectrum care

Full-spectrum doulas offer care and non-judgmental support to individuals who are trying to conceive, experiencing pregnancy loss, seeking abortion care, or going through fertility treatments, in addition to pregnancy, birth and postpartum support. According to Danette, "Being a full-spectrum doula means being there for people at all stages of their reproductive lives. It's about understanding that each person's journey is unique. It's about understanding the whole person – their physical, emotional, and spiritual needs –  and that they deserve to have someone who can support them, no matter what they are going through."

Indigenous doulas are trained in models of care and interventions which significantly improve Indigenous Peoples' experiences of maternal and reproductive health care. They pair Indigenous knowledge with western medical knowledge to create culturally relevant and affirming experiences.

Next steps for Indigenous doulas

Danette and Olivia are piloting a first-of-its-kind Indigenous doula program within a regional health authority in the hopes of growing access to doula care in the Vancouver coastal region. This effort builds on the tremendous work Indigenous doulas and midwives have been doing locally and nationally to make their models of care accessible such as the work of ekw'í7tl doula collective, in which they are both members. Their program also seeks to create sustainability for doulas in their profession and raise awareness about Indigenous doulas to support and develop similar Indigenous-led programs. ​