On Reproductive Justice

At Beltane Birth Doula Services, we believe that the ability to create, birth, and raise new human life is one of the most powerful things we are capable of doing in this life. Though children are born every day, and we often take for granted childbirth and parenting as normal parts of life, becoming a parent truly is a lifechanging experience and one that is deeply important. Imagine it: you are a portal that brings a human life – an entire universe of possibility – into our world, seemingly from nowhere. It’s an everyday miracle. A million different things had to happen exactly so for your baby to be conceived and brought into the world. But of course, it’s a lot of responsibility as well. You are your baby’s first home, their first impression of the world and their safe place. Birth is power and responsibility. Because we believe in the power of life-bringers, we also firmly believe that people with uteruses should always be in charge of their reproductive potential. One of the key principles that guides our work is reproductive justice. We recognize that there are many societal and personal factors that can attribute to people’s ability to access the care and support required for them to truly be in the driver’s seat of their own reproductive lives. Powerful systems that are designed to support people of particular racial, ethnic, abilities, sexual identities, and socioeconomic backgrounds facilitate access for some people and make it more difficult for others. We believe that all persons regardless of race, gender identity, ability, or income deserve equitable access to supports that empower them. Here’s a quick overview of some of the work we see that has yet to be done in supporting reproductive justice for all.

Fertility

Here at Beltane Birth Doula Services, we consider both contraception (preventing pregnancy) and preconception (planning for a pregnancy) as part of fertility care. We know that, too often, ideas about who should and should not become a parent shape how people access supports in these areas. Access to acceptable contraception – including access to abortion care – is often limited to people based on income, location (people in rural areas may have more difficult access), and the perceptions of prescribing providers. Increasingly, we have also seen how patriarchal ideas about life-bringers can result in the widespread elimination of contraceptive support options for people who may become pregnant. We believe that access to knowledgeable providers who can provide thorough education about the available choices and can help facilitate those choices is something that should be available to everyone. No one should be forced into parenthood. On the other end of the spectrum, we know that access to preconception support for people who do wish to become parents is often significantly lacking. Though infertility is recognized as a medical issue for opposite-sex couples, medical support for fertility problems is funded sporadically or not at all in many provinces throughout Canada. Even where incentives such as tax rebates exist, the costs of pursuing fertility treatment are financially prohibitive for many families and often require extensive travel, time off work, and other accommodations that are not accessible to all. We believe that adequate preconception support starts with better education for all people, better training for health care providers to diagnose and address reproductive health issues long before people seek to conceive, and equitable access to reproductive technologies when they become necessary. We also fully support the use of reproductive technologies for same-sex partners wishing to conceive children and believe our health care system should be set up to equitably support these families.

Pregnancy and Birth

In recent years, we’ve become increasingly aware of the way that pregnant people are treated differently based on who they are. BlPOC parents often experience higher rates of maternal morbidity and mortality because of inequitable treatment by health care providers, whose personal biases may contribute to different clinical decision making in favour of their non-racialized patients. We also recognize that clinical research and medical training are also biased in favour of non-racialized people, meaning that our knowledge and training around supporting pregnant people is likely missing awareness of important differences between people that can impact treatment and outcomes. Though people may be subject to oppressive forces based on their racial, ethnic, sexual identity, or ability, people across social identities may be subject to obstetric violence or mistreatment by the health care providers. We believe that pregnant and birthing people deserve to be treated with reverence and respect. We believe that the right to bodily autonomy should serve as an essential guide in supporting people during their pregnancy and birthing time and that considerable work has yet to be done in ensuring that all care providers have the tools, training, and attitude necessary to put bodily autonomy first. This does not mean that we do not recognize and value the difficult jobs that health care providers do in this setting; rather, we always aim to facilitate a spirit of collaboration, partnership, and mutual respsect between care providers and birthing families to achieve the best possible outcomes.

Postpartum

Whether through a happy and successful birth or through loss, we know that birthing people often feel abandoned in the period immediately following birth. We believe that one of the greatest challenges to true reproductive justice is in some of the societal issues that are significantly underrecognized. The importance of postpartum physical and mental health is often neglected. As such, an increasingly large number of birthing people experience physical and mental challenges in the postpartum period without adequate support. Depending on the communities of support that people naturally have around them, people may or may not have the support they need to navigate this significant transition in their lives. We would like to see more societal awareness and support for the postpartum period, as well as more thorough follow-up from health care providers, especially in the areas of postpartum mental health, pelvic floor recovery, and future fertility planning. Indeed, we believe that it is important to recognize that life is often dramatically changed for birthing people following their births and that the societal pressure to ‘bounce back’ or return to ‘normal’ as quickly as possible is more reflective on oppressive expectations that are placed on birthing people, rather than on a realistic assessment of what a good quality and robust life for new parents looks like. What is needed here is nothing short of culture change that recognizes the essential and important role of caregiving in our society.

As with all things, our understanding of reproductive justice is ever evolving. The more time we spend in this space supporting families, the greater our awareness of the obstacles to true, equitable care for all people. However, so too does our awareness increase of opportunities and avenues to improve the landscape in which people create life. While we must recognize the issues people face in order to address them in the moment, we continue to focus on imagining how we might move forward into the future from a place of love, respect, and possibility.