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  • Writer's picturemisha

Inclusive Birthwork: 4 Considerations

I hadn't planned on writing this blog post quite yet, but in the last few days, seven (7!) people have sent me emails or Facebook messages asking me for advice on how to make their practice (more) inclusive of queer and gender-diverse clients/patients. This isn't the first rush of emails/messages from folks asking me for my advice on this matter either, but it really struck me in a weird way this time.

I think for a lot of people in birthwork in my city (and all over thanks to the Internet), I am the most "out" and proud care provider that they know or that they have fairly easy access to. It's kind of flattering on one hand, but it feels kind of weird and overwhelming. Thankfully, I feel like most people who have approached me seem very sincere in their desire to *appear* inclusive and welcoming of birth clients who are not all cishet white women. It's still a lot of emotional labour to have to repeat what for the most part seems like basic information to me, so I decided to stick it into a blog post.

I think it's easier to start by talking a bit about what an inclusive practice doesn't look like. One of the phrases many people like to toss around when advertising or talking about their practices is "queer-friendly", "trans-friendly", or more commonly "LGBTQ-friendly". An overwhelming amount of people think that "LGBTQ-friendly" is synonymous with being inclusive. When in reality, being "friendly" means that you don't really have to make an effort to do anything other than not refuse clients/patients who are not cishet. That's it. It basically means that this person, provider, or clinic doesn't discriminate based on aspects of a person's identity that is not heteronormative. "Friendly" is not safe(r), inclusive, or affirming. This is the bare minimum that a birthworker can put forth.

The next step up is typically language. A birthworker will read an article, such as this one (which is alright and does link to some good resources) and then go home and scour their website and remove as much gendered language that stands out at them and replace it with gender neutral language that the article suggested. They might even add "inclusive practice" to their next run of business cards or byline on their Facebook business page. So, now we have a "friendly" birthworker who advertises as "inclusive", but they still haven't learned much about LGBTQ+ culture or really grasped what it means to be inclusive.

I have to ask myself, why wasn't this a concern for them when they started their business in the first place? Asking for help to appear more inclusive after the fact seems more like a marketing move than a genuine desire to be inclusive. - W. G. P.

While that quote is a little damning, I can't say that I don't agree with it, but I do know several birthworkers who over time came to know more about LGBTQ+ issues, health disparities, and developed a sincere desire to offer LGBTQ+ folks care and to generally be inclusive of them and their needs in their practices. And I appreciate their efforts. People change, people grow, and people decide to have that reflected in their practices. It is also okay for birthworkers to decide that they are not going to be inclusive, that while they might remain "friendly", they do not plan to try and attract or appear attractive to LGBTQ+ people and families, which is most LGBTQ+ people's preference if a provider isn't willing to go all the way in trying to be inclusive.

What can a (cishet) birthworker do if they want to actively transform their practice to be an inclusive one or to build their practice from the ground up to be inclusive from the start?

1) Cultural Sensitivity Training: if you are not a member of the LGBTQ+ community or you have a limited exposure to the whole community (let's say you are a lesbian, but you are not versed in much regarding trans and nonbinary folks), getting yourself training from people who are members of the community, especially other birthworkers in the community is paramount to anything else. And compensate these folks: while some might seem to be okay constantly educating cishet birthworkers on how to provide care to queer folks, it is draining, emotional labour to repeat yourself over and over and over. Even if you sign up for a free training or your friend who is a queer birthworker freely answers your questions about queer perinatal health and care, throw them some dollars or other compensation and gifts of appreciation that you know they will like/benefit from. An abundant list of cultural competency resources can be found here; while most links are geared towards midwifery and obstetrics providers, most are useful for all birthworkers. If you practice a speciality that you are having a difficult time finding resources for, hit me up, because I can probably send you some. Also, if any physical therapists are looking for resources, let me know, because I have several for when I had to educated my home visiting physical therapist.

2) Digital Presence - Website, Social Media, and Other Media: if I visit your website will I see pictures of white, cishet appearing couples or will I see a variety of humans and families? Do your social media posts only mention "pregnant women" and only feature glowing white femmes? Does your Facebook page and your website explicitly state that you provide care to or serve LGBTQ+ clients and families? Does it state that you have undergone cultural training in order to provide inclusive care? Do you post articles and websites that feature LGBTQ+ people and families and that highlight their health disparities in general or in regards to pregnancy and birth? These are the kinds of things prospective LGBTQ+ clients look for when we visit your corner of the Internet.

3) Analogue Presence - Educational Materials, Handouts, Contracts/Intake Forms, Business Cards, and Other Non-Digital Communications: are your printed materials inclusive of LGBTQ+ clients? Do you use gender neutral language, a mix of gendered and gender neutral language, or only gendered language? When I fill out your intake forms, is there a space for me to write in my gender and pronouns or do I have to pick M/F (maybe "other") or is there no option at all, because you assume all of your clients are women? If you teach classes of some kind, are they geared towards (hetero) couples or do you acknowledge single parents and alternative family structures (polyamorous families, co-parents, lesbian & queer couples) or pregnant people being supported by their friend(s) or relative(s) instead of a partner/spouse? Does your business card have your pronouns included or indicate that you are inclusive in some way (rainbow/trans flag, "all clients/families welcome", "LGBTQ+ Care Provider", "inclusive doula practice", etc.)?

4) Motivation Check: what is your motivation for becoming inclusive or appearing to be inclusive? Is it because you have noticed a lack of resources for LGBTQ+ people and families in your area? Is it because you have become aware of the health disparities of LGBTQ+ people and you want to do your part to minimise them? Do you view LGBTQ+ people and families as an "untapped market" and a potential pool of additional clients/patients? Do you want to appear inclusive to seem like a more "woke" practice for the demographic that you already cater to? Have you also considered that there will be potential clients/patients who will decide not to use your services, because you advertise that you provide care for LGBTQ+ people and families and that some other care providers might not refer clients/patients to you or invite you to community events? Ask yourself why you want to advertise that you are inclusive and why you want to provide inclusive care, especially if you are not a LGBTQ+ birthworker or other health care provider.

And those are my main suggestions. We can get into specifics about how to format and word documents for specific birthwork and so on in a more tailored one-on-one meeting, but this should point folks in the right directions and get everyone to think about why and how to be inclusive. If you do nothing else, go get yourself some cultural competency training!

If you have questions or want more guidance, please email me:

The easiest way to compensate me for this post is:$midwitchery


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