Recently, the Association of Ontario Doulas (AOD) released their Statement of Position on Non-Aboriginal Traditional Birth Attendant/Companion (TBC) (January 15, 2024) that you can read by following this link.
Since it is a position that is directed at my work in creating and defining the role of a traditional birth companion, it warrants a response.
Content note: This Statement of Position uses sex-based language. The word ‘women’ is used in its historical and traditional context to mean that half of our species that arrives with the biological potential to ovulate, menstruate, conceive, gestate, birth, and lactate. By continuing to read this post you agree to be entirely responsible for your own reactions and your emotional, psychological, and intellectual well-being and hold us free from liability for use of this word.
Billie: of the family Harrigan, elder and companion, Statement of Position re: the Association of Ontario Doulas’ Statement of Position on Non-Aboriginal Traditional Birth Attendant/Companion (TBC)
Whereas the Association of Ontario Doulas (AOD) has released their statement of position regarding non-aboriginal traditional birth attendants/companions that directly misrepresents this emerging sovereign alternative that is spearheaded by me and my efforts, I, Billie: of the family Harrigan offer my commentary and position on their position.
It arrives unsurprisingly, and reads as submissive pandering to existing patriarchal power structures that are both collapsing and increasingly detrimental to the wellbeing of the women who use these services and their babies. It’s filled with innuendo and suggestion that is perhaps meant to intimidate their members into ongoing conformity and obedience.
Since I am the one who has created the unique role of a traditional birth companion in Canada and beyond and I am the one who gave it that name, I am the one who defines it. Not the AOD. Their misrepresentation of my work is stunning. However, it may fit with my hypothesis that the doula profession is limited in its maturation by their alarmingly high and early burnout. Wisdom and insight require time and perseverance.
Prior to the push to move women into hospitals after WW2, it was the tradition in Canada for most women to simply call the neighbour who had some birth skills and experience. This neighbourly support did not include the medical surveillance and interventions associated with modern midwifery. Traditional birth attending or companioning did not have the tools nor the religious-like zeal to engage in today’s fear-based management of a common physiological experience.
Whilst a TBA has “historically referred to indigenous midwives, lay midwives, and community midwives”, a TBC is an invention of mine based on my own 40 years of experience as a companion (as I define it) and my work as an academic specialising in maternity care. Further, traditional midwifery, as that which was practiced prior to the fairly recent medicalisation of childbirth, in no way resembled what passes for midwifery today. The AOD is conflating practices from different eras by using ‘historical’ to define this role and inserting modern medical regulation & practices to suggest they are operating in tandem.
The historical role of the TBA has been largely eliminated by that great coloniser, the WHO and its unholy alliance with pharma and their money in favour of the western medical model as created by Rockefeller and Carnegie. Actual traditional practices have been replaced with modern interventions based on our current cultural belief in the supposed perils of women’s physiology. To suggest a TBC engages in these modern medical practices, as opposed to historical (traditional), non-medical, and un-controlled offerings is to incite division through misrepresentation.
Their statement included the medical industry’s response to women’s choices to leave these services. It’s expected that any industry with a monopoly that is losing control will come out with some statement about how their former customers are being foolish or dangerous. It’s just another example of their suffocating paternalism. The AOD would benefit from reflecting carefully on why they too participated in this paternalism.
It was a curious statement that licensed medical practitioners “are the only ones authorized to ‘practice spontaneous childbirth’” as women all over the earth are releasing their babies in a practice of spontaneous childbirth without any authorisation whatsoever.
It should be noted and carefully understood that the “risk that child welfare organisations may investigate” comes ONLY from another human who calls this agency for an investigation. This human is overwhelmingly a licensed medical practitioner who takes exception that the customer, who arrives to access their services, did not use their services prior to needing their services. It’s a well-documented terror tactic in the realm of obstetric violence that is designed to send a message that families will be punished for non-compliance. It comes from deeply rooted medical narcissism, cult-like behaviour and belief in their offerings, and a complete absence of trauma-informed training or skills. It behoves the AOD to take a firm stand against this heinous practice and advocate for families rather than including it as a threat to families who may not acquiesce to medical control over their family decisions. This omission alone disqualifies the AOD from having a voice for medical autonomy in Ontario.
The AOD’s insinuation or assumption that a TBC “manages labour or conducts the delivery of a baby” in contravention to the Controlled Act is an example of organisational ignorance, as no one has actually contacted me to find out what we do. Further, it’s inflammatory and fuels a political agenda that isn’t about women’s health outcomes but rather the AOD’s hopes for a regulated role within Ontario’s massive medical infrastructure.
Their inclusion of “there have been a number of serious incidents, including a death, in which the birther has chosen a non-Indigenous Traditional Birth Attendant/Companion” takes a page from the technocratic medicalised birth services industry’s playbook that excessively threatens their clients with a dead baby or a dead mother to gain acquiescence in lieu of informed consent or refusal. It was an abhorrent attempt to implicate non-regulated companions as being directly responsible for an adverse outcome. Given the extreme circumstances of the last few years, there have been an exorbitant number of serious incidents and deaths. And yet, there was no mention of the rate of adverse outcomes or deaths in the presence of regulated practitioners. The AOD can no longer claim any moral high ground when it comes to denouncing this tactic to bypass consent. They have learned how easy it is to play the ‘dead baby/mother’ card.
It's important to address their vague threat that “Legal entities may confuse individuals operating in this capacity as people working as unlicensed healthcare providers” along with mention of fines and detention. This confusion could be easily eliminated by careful statements that speak the truth. There is no confusion when the role of a TBC, as I have created it, is represented truthfully and accurately.
Their statement declares that “some” Indigenous communities reserve the use of the word “traditional”. Whilst this may be so for some communities, there is no consensus within the English language that limits its use to aboriginal peoples. Instead, it has a broad understanding to mean things that are not new, typical or normal for someone or something, or doing something for a long time for a particular group. The AOD has misappropriated the historical TBA and the current TBC into their political ideology that is an affront to both.
Modern technocratic medical maternity services are the result and technological iteration of Rockefeller medicine that gained a monopoly through the fraudulent Flexner report and oil money. Safer and saner alternatives exist and could be accessed by more families. However, existing power structures enjoy a monopoly and will not yield to women’s sovereignty and their alternatives. The AOD has come out firmly on the side of existing power structures in spite of their devastatingly high adverse outcomes, trauma, and postpartum suicide as a leading cause of maternal mortality. Their allegiance is with historical patriarchy, medical paternalism, and the ongoing bondage of women in childbirth to a medical model that will not change despite any delusion that they will work together with doulas to improve maternal care outcomes.
In fact, if there’s any lingering confusion about the actual position of the AOD, consider that they put out a call for snitches. The witch hunts never did end.
Despite statements like this from organisations who appear to want to appease oppressive systems for potential recognition or ‘credibility’, the real work to improve maternal outcomes is being done by ordinary women who opt for safer solutions so that more babies arrive safely and gently from healthy, empowered, and non-traumatised mothers. They are becoming more useful humans. The AOD misrepresents my work for political gain, but the women carry on. As we always have.