Podcasthon Special Episode: Breaking Barriers in Birth Work with BeboMia

🎙️ Special Podcasthon Episode: Breaking Barriers in Birth Work with the BeboMia Doula Scholarship

This Birth Journeys Podcast® episode is part of Podcasthon, a global movement uniting podcasters to spotlight impactful causes. We’re shining a light on the BeboMia Doula Scholarship Program, which provides essential training to those who wouldn’t otherwise have access, transforming birth experiences worldwide.

Birth educator and doula trainer Bianca Sprague shares how birth experiences shape parenthood, yet modern healthcare often prioritizes efficiency over personalized care. Doulas bridge this gap, advocating for birthing people, supporting partners, and ensuring all families receive respectful, individualized care—regardless of background.

Through BeboMia’s Scholarship Program, Bianca has helped train thousands of birth workers, awarding over $350,000 in tuition assistance across 50+ countries. These scholarships combat disparities in maternal health by expanding access to culturally competent care—ensuring that support is available where it’s needed most.

"My goal is to empower women and queer folks, and I chose to do it through doula training." — Bianca Sprague

🎧 Listen now to learn how BeboMia is transforming birth work!
 

Visit BeboMia

Learn more about the BeboMia Doula Scholarship

Donate to the BeboMia Doula Scholarship Program

Grab your Birthworker SWAG - proceeds go to the doula scholarship program

Transcript

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Speaker 1 1:57

Thank you . Thank you so much for having me back and that was so lovely . I can't get enough of when people read or talk about me . I used to get so shy about it and like , uh , and as I've done my own healing work , I just it makes my heart feel so full , I just let it wash over me . So thank you for those kind words . Yeah , that folks have two years

Comprehensive Doula Training

Speaker 1 2:25

, I mean they never leave the community and we could do continuing education forever , um , so it's .

Speaker 1 2:31

It's very comprehensive , as it should . Really important . It's not only fighting the medical system of which is deeply flawed like we teach how to change the system which is not while somebody's giving birth . There's lots of ways around that to change the system which is not while somebody's giving birth . There's lots of ways around that to change the system . But there's also that runs alongside of that . It's really important that we teach our doulas to not be attached to outcomes , because people can be fighting their system as well as being like I will get you that home birth , I will get you that unmedicated birth . I will avoid an operative birth , if somebody actually might prefer an operative birth , and so there's many ways that a not great trained birth worker can actually do harm , and one of the big ones is chaos in the birthing space , when you're using that to go to war rather than you have to prepare your clients . And then there's lots of other ways that we challenge the systems .

Speaker 1 3:58

Yeah , yeah , truly , yeah , yes , yeah , yeah , yes , yeah , yeah , yeah , yeah , thank you . Yeah , we know the limitations of time that nurses have . There's so much charting and we know that the workload is just it's unreasonable , the workload that's put on a nurse , and I know that there's lots of nurses that would really love to be doing the different type of patient care , because that's usually why you went into a helping and healing field is because you wanted to do that , but unfortunately , due to bureaucracy and the business of medicine , you're standing in front of a computer , checking , clicking

Nurse Workload and Patient Care

Speaker 1 5:33

. You don't get to really develop that relationship with your patients , which I know it can be really sad for nurses and midwives too Once it regulated . Midwives are in that same boat now too , and I know that there's probably a really big loss feeling and it can be a challenge for a nurse to have what they wish it was and what the reality is , because I know lots of nurses are like , no , we do lots of fill in the blank and I was like , no , you want to be doing lots of that , but you're actually not .

Speaker 1 6:02

Like if I had a timer and was like , go , how much hands on time did you have touching my client ? It's very low and I do not hold that against nurses . They're also down , getting the shortest end of the stick , as far as if we go to the top of government and policymakers and then the president of the hospital system , the board , and it works its way down and nurses , you're just right down there with doulas and the patients , yeah , it's raining down on you . So we keep that in mind because that is also what's happening for nurses , like getting kicked all day long . And I love nurses and you guys are between a rock and a hard place and it does mean that nurses do shitty things , but it's explainable because fatigue and not enough time and you're also being guided by the doctors right , guiding in the wrong direction .

Speaker 1 6:54

Every doctor . If a nurse has heard a doctor say everybody gets pit , then you start parroting everybody gets pit . And so the first time somebody's . I don't think I want it . They're like everybody gets it . So put your arm out because I have stuff to do and I'm like this is the nurse's fault . That's the culture that you're working within . Yeah , I've been bullied , yeah .

Speaker 2 7:31

Yeah .

Speaker 1 7:41

Yeah , yeah , yeah , yeah , for sure , yeah , yeah , we are rest upon them . Yeah , for sure , yeah . And as a doula , we really want to be bridging their core team . That birthing person is brought in so that might be their partner , if they have one , their sister , their mother , whoever they've said . These people are safe and intimate to me .

Speaker 1 9:09

I get the pleasure of supporting nurses and like how do we do our jobs and allow them to stay in the bubble that they want to be in , and truly , when I think of my role it's , or any doulas we were like taking care of lots of different facets simultaneously , and a lot of times people think we're just there for the person giving birth , and it's not . It's so much better that way , because the person giving birth might not want you to touch them and might want you to be like nowhere near them , and so sometimes you're like what happens if somebody doesn't want to be massaged ? You're like lots , lots still happen , and this is helpful too if anybody has a partner that's who's pregnant and listening to this , your partner might be like , oh , I don't want to be replaced or I don't know why they'd be there . Partners need so much care . They don't know what's happening , and even if they have a medical background

The Role of Doulas as Bridges

Speaker 1 9:59

and they know all about this , their job is to be present to their loved one as well as to have time to sleep and eat and update people , if that's part of their plan , because after the baby's born , the partners and support people are up so that birthing person , can you know , once the adrenaline down a little bit , can crash , and that they have a rested , watered , fed care team ready to take over .

Speaker 1 10:25

And the role of a doula is just . It's such a robust and amazing one to be in that space . Yeah , truly A heartbeat that there's heartbeats . Yeah , more blood .

Speaker 2 11:11

Yeah , yeah , I'm glad .

Speaker 1 11:26

Yeah , yep , yeah , yeah . And and we now know this , we know so much more that the adage used to be like healthy mom , healthy baby , all over hospital walls and how we define that is just what you're saying is alive and mostly alive . Like the bar of alive is not even that great . Yeah , like it's rough . And we now know how somebody feels about their birth is actually the most important thing outside of obviously keeping their heart beating . But like the sending people home with birth trauma , feeling disempowered , feeling like they just lost their voice and expecting them to step into parenthood and when I say step into parenthood , I don't just mean changing the diapers and doing the work of it , but like stepping in , feeling like they have the skills and tools and ability to protect and advocate for their child for the rest of their life . And when they have just lost their voice or been even the language using failed to progress . Like any of these kinds of words , we had to break your water for you . You're not doing it on your own , so we need to help you that stuff more we can ever . Even people here who are like no , I'm not that woo , I wouldn't be impacted by that . I promise you , you are impacted .

Speaker 1 12:43

Yeah , it just these messages go in and already we feel like we're not enough . Not to mention we're going home with unnecessary interventions that have side effects that are terrible , that our pelvic floors have been obliterated unnecessarily

Birth Trauma and Postpartum Support

Speaker 1 12:57

, stitches , unnecessarily incorrect lactation support , if any at all , these things . So then we're like , okay , here you go , and so we've got this depletion . Physically and emotionally it's rock bottom . And then we don't know how to actually support new parents out in the world . People show up with stuffed toys for the first couple of days and then that's the end of that . So it's so useless . And then you feel like you have to entertain , so you have to put pants on because everybody's coming over and your friends from high school are on your sofa and you feel like you need to be chatting . All of these things . That's just the reality and we think that's normal , that's been normalized and it would be fine .

Speaker 1 13:36

Everybody , if you're like , why are we picking at this ? It's working ? It's clearly not , because postpartum mood disorders have never been higher . Death by suicide is one of the leading causes of new moms in the first 12 months . So it is not working for us . We just think it's normal to be like depleted and sad and hate your partner . We're like it's just being a new mom yeah , but it's beautiful . And then we feel like we're like , oh , we hate this . But we can't say we hate this because people think we're saying we hate being a mom , ie our children , and so I'm so passionate about this , clearly , but like do is by protecting our client's voice , whatever it looks like . And this is a home birth , this is an induction birth , this is your plan is to have an epidural the minute you walk through that door birth . This is an elected C-section , this is an emergency . It does not matter where and how you're giving birth . Your voice has to be protected , your body has to be protected .

Speaker 1 14:39

Kelly , you're talking about nurses and one of the elements that's missing in all of this is the fact nurses are human and you , right away , are running up against a bias as soon as you meet a nurse , and we can't help it because it's all people . But unfortunately we're so susceptible to language and how we feel in birth because it's so vulnerable and our frontal lobe is flicking in and out , hopefully just staying out , but unfortunately our birth environment doesn't allow it just to like shut off , but it's like flick , flicking in and out . So you're like kind of in your body , thinking rationally , and you're kind of in this other place that you've never experienced . And so now we're like potentially have a healthcare provider that has a judgment about your fat body or thinks you're too young to have a baby , or you've had too many babies , or you don't speak English well enough , or that you're a part of a poly family , or they don't like your pronouns , whatever these things are . Again , because nurses are human and so we've got this whole element . That's happening , that will happen 100% of the time , because all people have a judgment of other people , but how it is expressed is kind of up in the air , and so the role of a doula is to actually mitigate the risks for all of those things . And you don't know what those things are for you because you don't know the those things are for you , because you don't know the nurse you're going to have . So the nurse might also be a racialized person , in which case you might not experience racism , or they might be queer , so they might be open to that , but they still might be fatphobic or they still might have ageism , or they don't like the choices that you're making and if they were doing it they would think you know you're careless or they suspect that you probably look like you've done drugs . But it might just be because you have green hair and not great dental care . Trained doula a goodly trained doula a well-trained doula also learns how to buffer for those things . So our clients might not even know that this stuff's happening because the doula has literally put themselves between these potential isms or biases or judgments .

Speaker 1 16:49

I know that there's nurses who I loved working with and then I've had clients come in that something about them rubbed them the wrong way . They were like I have a judgment here . And then they've been really rough with my client and so I've been able to be like hey , do you want me to do that ? Or make eye contact , because I have built a rapport with the staff to be like you're not treating my client the same way that you would . You've treated all my this-aged married clients this way and you're now treating my 15-year-old client very differently . So I get to do that before my 15-year-old client might know that they're getting punishment treatment , which nurses of teens do . They're like we're going to make this as uncomfortable as possible so that you know you've made a grave mistake here in having a baby as a child , and so I get to protect that space , hopefully , hopefully , my clients have missed it .

Speaker 1 17:38

Or like guiding

Scholarship Programs at Bebo Mia

Speaker 1 17:39

the nurse out to be like , hey , listen , I feel like you might be a bit off today , because I've had just such wonderful experiences with you and I'm just like I really need their birth to be as wonderful as it is . So if you're not really feeling up to it , do you think we could swap nurses ? Or do you need to go eat something ? And that's how I can have that . And my clients don't know that's even happened . I come in and I'm like great , your IV is going . Are you happy in this position ? Do you want some ice chips ? What do we want to do next ? And they're just like this is great , I'm continuing on and I'm going to have my baby , and so those are things that most partners or friends or sisters wouldn't know how to do it . They'd just be like oh my God , that nurse is such a bitch , or like , and then we kind of circle in and A , the behavior doesn't stop , and B , now like there's tension .

Speaker 1 18:28

No , it's impossible for most people , yeah , yeah . Well , because biases do go both ways . I want to hold that . The clients might be like I don't really want a racialized person being my nurse , somebody with an accent , somebody whose perfume smells too bad , whatever the thing is . Biases are going all directions .

Speaker 1 19:06

Yeah , yeah , and I just I love that I get to really moderate and support in that way and and just have my clients just not know about it , because I know I've also had lots of nurses roll their eyes because they're doing something quote weird , and I'm just like I just make sure that my clients don't feel a judgment of this thing . There's things that even I'm like , wow , that's kind of weird , but like it's not my birth , we're going to go with it . And sometimes it feels weird to even hold that space and sometimes I'm like get thrown into whatever the song or the symbol or I don't know . I just I'm thinking of some husbands that were a bit cringy in my mind , but I'm like they're in their zone and it's beautiful and magical to them . So yeah , I wouldn't do this at my birth , but it's not my birth . My job is to just support their birth . I love how you set your tone . I have to work on how I say it being like there's weekend trainings available and you did the weekend , which is what I think in my head to say it . I have I say it being like there's weekend trainings available and you did the weekend , which is what I think in my head to say it . I have to say it . You , yeah .

Speaker 1 21:17

So our scholarship oh man , I'm so proud of this program and it kind of got away from me . It started just like one student I don't know in 2014 , maybe 20 , 2012 , somewhere around there that we offered our first scholarship and now it's bonkers . We've given over $350,000 in tuition away to predominantly equity-seeking groups with students in over 50 countries , and so when they come in , our scholarship committee reviews all the applications and the committee is made up of also recipients as well as health care professionals around the world and once they're in , we actually have our scholarship . Students go through just like a standard . They're not separated in any way and they get the full program . So with that , they get their live lectures , which everybody does . They get their access to office hours , their practicum sessions , breakout sessions , free therapy , because we believe that when we're doing this kind of care work , we see things that have big T and little t traumas and we want to have healed helpers and healers out there . They get the entire program as well as lifelong continuing education and with that we also have what we call the scholarship light up series and these also go on forever , that all of the scholarship recipients throughout time . We go once a month and we have this .

Speaker 1 22:38

I don't know why . I've never been to church but I like picture it like this gospel session , like they're just , like there's these really good , feel good , reach out to community , keep our hands on the pulse . We really want to see scholarship recipients finish and we know that some of the precarity that comes with folks who have no and low income , there's a lot of additional stresses that need to be acknowledged and need to be held and need to be like not to say that if somebody can come up with a tuition , you don't also have these stresses . But we really nurture our scholarship community so that it's not just like here's your entrance and then Godspeed and let's see how you go with everybody in the standard stream . So we do those light up sessions , as I say , monthly , and in that we do community support and then we always have I'm not using sermon , I don't know why I've fallen into church language . There's an element yeah , like it feels too flat because they are . They're really touching and I know yeah , sure , I know I don't know what's happening to me , but I do Something about the light up feels different than anything else we do .

Speaker 1 23:51

But , yeah , then we have a thing after and like the last one we did was about asking for help . What are the barriers to asking for help ? And I and part of it is I actually do that one , probably every six months or so like a touch base on asking for help , because it's really brave to ask for help and we hold every person that's reached out and said you know what ? I really want to do this ? This is a difference I want to make in my community and I want you guys to get me there and that's so brave . And so sometimes people are like they've done it and then they've retreated back again and I want people to keep asking for help . All should be asking for help all the time , regardless of income . This is something that we struggle with . It's part of this neoliberal nonsense of go into your house , you live alone , you figure it out on your own , you just live with your baby alone and if you're a good parent , you'll do it all . I feel like this scholarship committee has already done such a massive , vulnerable thing that it's like a really fun conversation to keep that going , because I already think they're ahead of the group on that skillset .

Speaker 1 24:57

One of the things we also are really proud of is maybe three years ago we pivoted to offer partial scholarships as well , because we did have folks write to us saying I'm not no income , I'm low income , but I have saved half my tuition and I can't . I'm like I keep trying and for two years I've been trying to do the program because I just happens and then I don't get that last little bit . So people can ask for a 30% scholarship , a 50% scholarship or 70% scholarship and with that we've been able to offer have maybe 50 additional students a year go through . Yeah , I don't know why it took us so long to think of that . I was like , and then it hit me . I was like people can just ask for a little bit of help Because it was so hard , because everybody would just be sent in the full tuition , and so then we'd be like we have 15 scholarships . But there was people that are like I don't actually need $2,000 . I need $500 . I have the rest ready , and so that was really exciting .

Speaker 1 25:54

And we've made even a bigger impact and with our application process . We've been tweaking the application every semester since we started the program because it's kind of like an ever changing . We never want it to feel like poverty porn , which is , and we never want people to have to prove that they're in need . It's to us we're like use your integrity and if you're coming in low integrity and we never want people to have to prove that they're in need , it's to us we're like use your integrity . And if you're coming in low integrity , which we have , people after that we've seen they've opened their Facebook up or they've shared things and I was like , oh , that sucks that you've gone on three vacations because there's people that you know your integrity is out and we just let them exist . With that they've done a low integrity thing . So we've been really intentional with the types of questions we asked and why we're asking it , so that being under-resourced sucks .

Speaker 1 26:42

I was single parented for many years with never enough . It felt so terrible Anything that would like quote , offer help that I was like you need to make me to feel like so shitty to maybe get some crumbs , and so we've . We take feedback every semester to be like how did you feel filling this out ? Because we want people to feel empowered and excited from the moment they start filling out that application and not feel like we don't want you to dig through and tell us all the terrible things . We want to like yeah , like it's not a race to the bottom . We , yeah , and some and some places there's room to share that .

Speaker 1 27:17

But we really want people to see how resilient they are and see the gifts that their life experiences can provide their community , because we know lived experience is way more impactful than traditional education streams . And so somebody's writing saying they've been incarcerated since they were 18 from crimes of poverty . Now they're out and they want to do these things and they want to support the incarcerated community . I'm like let's fan this . Let's not talk about the fact that you fell into the terrible industrial prison complex . Let's talk about that . You have a lived experience and you know what's happening to other pregnant people who find themselves in these situations , which most of the time is the system's failing individuals and it's not the fault of the individual . Now they're treated completely differently by society and deserve care and support and celebration and love , and we want them to talk about what they can do with this experience and send a ripple of amazing out into the world , rather than having like crumple in that now they're reintegrating into society and not cherished .

Speaker 1 28:21

And it is a work in progress because , much as many of our students or folks that apply are from Canada and the US and Australia and England , we do have people that are applying from many countries where some of the questions are not relevant . They're just like wait , what are you talking about ? For example , equity-seeking groups . We have , say , people applying from the MENA region , so it's the Middle East , north Africa , and they're not an equity-seeking group in North Africa . As a racialized person , they're part of dominant culture , and so we have to navigate through because we're like , okay , they say they're not an equity-seeking group , but we can see that they're a Black person , but they're not experiencing racism in their country , and so it's so nuanced and complicated , which is why we have representation from different countries who are reviewing these applications , and there's other things that I don't know . It's not necessarily culturally relevant some of the questions , so we do have to find , like , really creative ways to draw out that information , knowing our program is global and folks get to answer . We've gone on a whole journey here , so here's your question .

Speaker 1 29:27

But they get . They get so much support because one of the things we're really proud of is the no hidden fees part of our certification . Like you come in , you're certified and it's up to us to do your continuing education . It's up to us to recertify you . It's up to us to keep you relevant and current with your skills , and so our scholarship recipients have the exact , the full program that every person does . There's nothing different about what happens as they come through and with that , because it's great that we teach people how to be doulas , but we need to teach people how to connect with clients or be picked up by a hospital system or an insurance company . However , you want to get paid

Breaking Down Birth Options

Speaker 1 30:10

Throughout the whole program . Their business training that runs alongside it it's all included as well , and they go through their business cohort with their peers . They're going through and getting that training and it's really fun .

Speaker 1 30:24

I love I get to teach all the business stuff and it's my favorite because we talk about all the things you can do with this training , which is not just hands-on care . You're an expert known reproductive health and justice , from fertility all the way to that postpartum period , and so we spend a couple hours literally talking about all the businesses you could start with this information , because I know lots of people are really drawn to it . But they're like oh , I have three kids under six and so we're like you will soon be able to be on call because your kids are going to be in school in a couple of years and , in the interim , here's all these really amazing in-person products and digital businesses that you can start , so that you are setting that groundwork with your business and your brand and so that , when you are ready , if you are , maybe your business , that you , your digital business , is great and you just continue on that . But if you're like , no , I really want to do hands-on traditional doula care , that we have that priming done , so that you're not just like after your first kid goes to kindergarten , that you're like , okay , well , I guess now I'm going to start my doula business . There's lots of stuff that you can be doing . So we teach all of those skills which allow people to actually make this profitable and lucrative and to support as many families as possible , so they know how to find you .

Speaker 1 31:44

Yeah , so we have the Ember Blueprint is what it's called , and so that's on the site as well . We have a what are they called ? I wanted to say Kickstarter , but it's not . It's like one of those apps that you can continue to donate and we just keep it open all the time , and so folks can , and all of that goes right into the scholarship fund . The fund , at this point , is just my donated money because I feel passionate about it , so I cover all of the tuitions for for all of our scholarships . So I cover all of the tuitions for all of our scholarships . But we also have a swag shop and 100% of the proceeds of our swag shop . So if anybody buys a sweatshirt or water bottle , mug , anything like that , all the profits also go into the scholarship fund . Yes , of course , of course , oh , of course , of course , oh , my God .

Speaker 1 32:57

To talk about briefly how doula work actually is transformative for the doula , I think we introduced group therapy , like free therapy , to the program because we noticed how the information is for people who say , learn about informed consent , or learn that they never had to take their pants off in labor , or that they learn that they experienced medical racism , because they just always felt like something had happened but they didn't know . Oh , I didn't know , we shouldn't cry it out , and that everybody just told me to , or like I was misinformed or I was lied to or whatever those things are . As we go through the program , my goal is to have doulas the student doulas , doulas in training have this like transformation for themselves . So like my goal is actually to empower women and queer folks and I chose to do it through the vehicle of doula training . But I want people at the end of the training to have a better understanding , socially and politically , of the environment that they live within . And so we have people come into the program that are like haven't heard a lot of the language that we use , they don't really know about inclusive language outside of , like the obnoxious performative things that they might hear out in the world , but by the end of it have had some shift to understand their own personal biases , to have an understanding of like a reconnection with humanity which I know seems like way out there , but we've done it so intentionally that at the end you're just like I feel like I have more love for myself and for people out there and to also have an assessment of the environment that they are existing within , because when a lot of women and queer folks most women and queer folks have some kind of precarity or lack of safety in their environment , it might be within their family of origin , it might be within their primary relationship or their partnership . It's for sure out in the world we're not safe , which is why we carry our keys between our knuckles when we get in our cars . We're not safe and to have a better understanding of safety first for us and then we're able to provide that really amazing care and honestly , becoming a doula , it made me a better parent . It made me a better human . I've allowed it to be this vehicle for my own healing and I'm not alone in this . We have lots of students . I would say the majority of students leave being like I'm just , I know I've transformed and then going out and advocating for other people . It's such powerful care work . So I think that I want people to know you can make it whatever you want out of it , but we teach you that it's a place that can actually fill your cup and empower you to make potentially changes in your own life , whatever that looks like , but be able to help and heal yourself and then go out and do this there's also it can be quite profitable . So I want to talk pragmatically , because it's all great that you're like cool , my heart will be lighter . But it is a business and so you know there's a few ways that you can get paid as a doula , which is an important element of it .

Speaker 1 35:56

I believe birth work should be compensated . I also believe every person deserves a birth worker . There's a gap that I think systems and society needs to fill , because I know that we can get pulled into this . Well , if everybody needs a birth worker , how can you be charging for this ? I also deserve to make a living wage . So we talk very candidly about that , that there is a gap between these two truths and like , how do we bridge that gap ? And so we support in some of that bridging . But the reality is there are folks that will pay you for doula care .

Speaker 1 36:30

So the average doula in the US makes about 50,000 . That's for birth doula work , about 50,000 . That's what the latest studies say . There's a pretty big variance depending on if you live rurally or in a city . I would say the average doula a full-time doula in the city makes six figures because charging between $2,000 and $4,000 a client is pretty standard in most urban settings . I charged about $4,000 a client when I lived in Toronto . I just moved rurally and I had to cut that exactly in half because I live in a tiny town with a tiny rural hospital and that would be staggering to spend that . And so if you're working part-time , obviously you're going to make less if you're living in a small community . So I actually counter that with digital products , which now puts me on a global platform as my private , like my personal business , as a doula .

Speaker 1 37:24

That is one way . Is people like writing a check or handing you cash and being like come to my , come , provide care . There is also a way that you can be connected with insurance companies . So you can either do contracting or credentialing with an insurance company , and one is the insurance company like pays you through your clients benefits or they have TRICARE or Medicaid . You can also set up I always forget which one's which , because obviously , as a Canadian , we have a different medical system . Hold on , I have notes that I keep . I literally have the tape to my desk because I have to reference it so many times a day . You can also , so that's credentialing is they pay and then contracting . Sorry if I've mixed this up . It doesn't matter , because you can do one or the other , and then contracting is where you're actually . Just you are contracted by the insurance provider and they just open the floodgates and send you clients . Now you don't make as much per client that way , However , your roster is always full . You don't need a website , you don't need business cards , you don't need to come up with a logo . It just goes through your insurance number , your provider number , and so that's a really cool stream .

Speaker 1 38:34

That did not exist , and so that's been a lot of progress made for those in the US . There's also hospital programs , there's nonprofits , there's lots of other ways you can get picked up , or through an agency or collective . So if you're like , oh , I don't think I'm a very good entrepreneur , there's lots of things now that you can do to have this be your full-time career or as many clients as you can take , but that feels like some kind of exciting progress . I can't speak to the insanity that's happening with your administration currently and how these programs are going to run . So , godspeed , speed feed , yeah , it's like . Yeah , yeah , that's true , and the bottom line , which I hate that . It's an entry point , but we have had change with it . We know doulas save money .

Speaker 1 39:33

Now , unfortunately , the healthcare system is pulled between being in bed with pharmaceuticals and they also want to save money and that is a conflict , because having a doula is less epidurals , having a doula is less interventions , and so they're like but it means less of this . Yeah , that's true . That's true , that's true , and the science is . The evidence is there that having a well-trained doula in the space decreases epidurals , decreases operative birth , decreases unnecessary interventions , increases

Making Doula Work Profitable

Speaker 1 40:07

negative outcomes . Labors are shorter . That means those people are out of those beds and the next person can get in . So if we speak the language of the system , which is bottom line language , we have the evidence and so they are noticing , which is why we've had this rapid .

Speaker 1 40:23

Suddenly nobody knew what a doula was to now them being like yeah , the hospital , we'll pay for it , come on in doulas . And it is because we make such a big difference at the bottom line . They're grappling with the fact that doctors have a lot of pull and pharmaceuticals have a lot of pull and for some reason they're against doulas , even though , come on , get a grip , get a grip . But we do challenge practice-based care , but practice-based care needs to be challenged Again . We would not touch it if outcomes were great , but we've had the highest rate of mortality and morbidity of birthing people and babies in any period of modern history . So , like too many people are not surviving birth to be like you know what it ain't broke , don't fix it . Yeah , no , yeah , yeah , yeah , it's yeah when you need medicine .

Speaker 1 41:47

So I serve a lot of nurses and doctors as my clients and it's my favorite because I I like that . I have to like kind of tiptoe , like I have to get creative . It keeps me on my toes . I can't get into my spiels in the same way because I can't be like doctors are going to , because they're doctors . And so recently I was talking to one of my clients who is a family doctor with obstetric specialty and we're talking about what's her birth location . So I was like what's your birth location ? And she's like I have a midwife so I could go have a home birth . And I was like yep , and she's like , but I know that my community wouldn't understand my choice because we have the messaging that home birth is a dangerous place to give birth . And I just listened and even though all the research shows giving birth at home is the safest place physically . No , not everybody wants to give birth there , but it is physically safest place to give birth , and she's .

Speaker 1 42:42

I have the studies in front of me and as doctors we still say if you prioritize safety for you and your baby , you would not give birth at home because that's semi-careless , you have everything you need here . And so it's a really interesting conversation to have , because I was like so what are we going to do for you so that you can not be a doctor and be spouting things that are incorrect ? How are we going to cut through and go to the truth of evidence-based care ? Just to give birth is at home . So where do you want to give birth ? Let's like , leave safety out of it because we know it's at home . What does your heart want ? Right ? But anytime I work with nurses and doctors , I have to do so much of that because I'm like what do you think of this ? And they're like we should book our induction at 40 plus three , and I was like there's no evidence for this . What do you want to do Having those kinds of conversations ? Because it's really hard to just go with what's always been done , even though what's always been done violates most of the governing body's recommendations , from the World Health Organization , from ACOG and the SOGC , depending on what country you live in . And so it's an interesting space to navigate through .

Speaker 1 43:51

And going back to having more time , as in your training , just think you have to have more time to learn these things , to learn these nuances . And I did a how did we say it ? A weekend training . That's all that was available almost 20 years ago when I did it , and I was a med school dropout , so I felt really confident with anatomy . I'd been , I'd done all my hours in the hospital . It was a venue that I feel comfortable in , and I still , when I went to my first birth , I still stood in the parking lot flipping through my notes from my weekend training , being like what do I ? Okay , what happened ? Like I don't know , like I was terrified and this is somebody who's like very overqualified . And I still was like what do I do if any of these things happen ? And so we want our students to be like not only have we learned this or something adjacent to it , I also have a team that I can contact at any time , because our peer group stays open forever for our students , and I went in . We didn't have smartphones when I had my first birth , but there are organizations that have that Like . We want you to go in and be like okay .

Speaker 1 45:01

So my client , the doctor , saying this we've tried this . My client is at six centimeters . They say they're only going to give them one more hour . What do I do ? I can't remember . I'm feeling like so tired and immediately we're like try this position . Have you done acupuncture ? Here's the evidence . Someone will always drop in . Here's the research and what you can say do the healthcare provider to buy another hour after that if there is no change ? All of these things nipple stimulation , turn out the lights , go for a walk , change the music . Is your client hydrated , fast and furious ? There's all this stuff which is so helpful when you might be in a time that even at some I've put stuff in the group that I'm like I don't know why , but I , my brain , I can't even think of what to do right

Transformative Power of Doula Work

Speaker 1 45:41

now for this thing and to be like oh right , I haven't tried that , let's do that , and so that's something that is just like . It's so powerful because we have to have a community to support care providers too , and so that they have a place to dump out and then they can just keep providing care out of the circle . And so we have again a longer training . So you just you get way more . You also have that forever community to catch you and support you and help you navigate through the ever-changing landscape .

Speaker 1 46:12

We learn more and we know more every year . Yeah , I could brag about me all day long . Yeah , seriously , yeah , and there's so much brilliance when we do things collaboratively and that's something that I've learned as the head of a movement and even though I do work so hard to do everything non-hierarchical , I do sit in the seat of the founder and head of a movement and I've learned the more that I like shut up and sit down , like how powerful it is , and so I love like with my students , even now as a head facilitator , I say things and I like I take so much every class , like I learn mountains , like I have a book that I just writing down to be like I've never heard this . Oh my God , this is so cool . I also have students from different countries , so we get amazing practices .

Speaker 1 47:10

And like foods I've never heard of , and like what they use them for and traditional practices . Like it's amazing just to hear the approach , a global approach to birth and raising of children , people sharing not only their lived experiences . But there's programs , there's education that we just have never heard of in North America and that's standardized or even just accessible in other countries . And so I was like what do you learn all about this ? I didn't even know this existed , let alone a whole program about it . Like , tell us about it . Like that's incredible . And I know that we can change the face of birth to not look like what we might have been forcing to , which is like traditional I'm putting in air quotes which is dominant culture and like a familiar thing , but like we have the opportunity to right now tackle it with a really interesting , multidisciplinary , different lived experiences , because the folks accessing healthcare in any specific country are coming from different backgrounds . We have so much global movement of citizens and bodies .

Speaker 1 48:15

I don't know how the homogeneity of your nursing staff , but Toronto the nurses come from incredible backgrounds , many of them being doctors and midwives from other countries who can't practice .

Speaker 1 48:26

So now they're in nursing and I've seen really cool stuff done because somebody was a doctor't practice so now they're in nursing and I've seen really cool stuff done , because somebody was a doctor in Iran and now they can be a nurse in Canada but they had to still go through all of nursing school but like , but they do incredible things to like prevent third degree tears , for example . That I've never seen and I was like that was amazing . Anyway , I could talk about this forever too , but I just think we have a really unique position with what the internet's done , what's immigration and emigration has done , that we can be tackling births with such a like unique perspective . And I think doulas are the only opportunity I see that could bring something different to the table to shake things up , because everybody else is , they're stuck in the role that they have to play and they're bound by so much bureaucracy and policy and accountability to insurance that I think that doulas can be a vehicle for change rather than just a stopgap for the high rate of killing babies and mothers .

Speaker 2 49:30

Yeah , yeah , and I think you know it's just such a great opportunity to belabor the point , work together as a team but utilize our resources right , Because even if there's somebody in the space that's a relatively new doula that took one of those weekend programs , I try to , I will incorporate the doula in the process and I will also talk to them like they know what I'm talking about and give them the opportunity to even if this is a new thing for them help me move this patient so that you can like kind of learn maybe this position or whatever , and sometimes they'll pull me out and be like thank you so much . I'm like you're the person though , You're the support , you are the calm in the room , right , I'm not going to take that from you regardless . And so to be able to always like work together and lift people up and in support of birth givers , I think is super important , because if we're not working together then it's to the detriment of the birth giver .

Speaker 1 50:18

Yeah , for sure it just it harms the family . They're stuck in the middle of this shenanigans and they're already at risk giving birth in a hospital , statistically and and birth itself as a biological function has risk associated . And then we've got this weird egoic pull happening simultaneously and everybody deciding what would be the best and safest . And I had to , unfortunately , learn the hard way because I had this bias when I first started as a baby doula and I had to learn the hard way that even what I thought would be best and safest was not best and safest for my client . Ie , I had this bias when I first started as a baby doula and I had to learn the hard way that even what I thought would be best and safest was not best and safest for my client .

Speaker 1 50:53

I had two clients that I really what I would have said supported but they would have said coerced into having a home birth and at the end they were like giving birth at home was the worst thing I could have imagined . I wanted to be at the hospital and it wasn't just me . Also , their partner was rallying and the midwife was like I don't want to take 100% , but I do . I have to take responsibility . That I kept . I wasn't hearing them being like I want to go to the hospital . I was thinking like we're close and we're , by the time we get there , like we could just have the baby right now at home . And the follow up they were like that was terrible . I , they were like that was terrible . I said I wanted to go to the hospital . Two of those . I didn't get it the first time and it took two for me to be like oh I , actually I don't know what's right for somebody .

Speaker 2 51:38

That's a big lesson , because everybody's looking at evidence and trying to use evidence to . I guarantee you , being in the hospital , I've had similar experiences . We all do . And then we all back up and realize , oh okay , maybe that wasn't like , maybe I could have done that differently , or maybe I didn't have the tools to do it differently . But I'm going to go seek the tools to do that differently and to empower myself because , yeah , I think it is important .

Speaker 2 51:57

And something I do want to mention is that home birth for a how do I say this ? Physiologically straightforward ? I don't want to use normal Normal is a word that triggers people but physiologically Low risk . Yes , low risk . There we go . Baby's going to come out the way that we anticipated . There's no other complications . Yes , home is definitely a great option for those that want to consider it , especially if you have collaborative care with other outside resources . It gets hairy if you don't have that , which in the US , depending on where you are , that gets complicated . But the times when , like I'd said , the hospital is helpful is if , a that doesn't feel comfortable for you . B you have other complications , which I feel like what's happening in the medicalization of childbirth , in that we are able to help people that are higher and higher risk give birth ? Is we are applying those survival skills or learn tactics to low risk scenarios yeah , and that's where the risk is coming in .

Speaker 2 53:04

That's where . So that's why , when we say home birth , there's evidence that home birth statistically is safer . Right , there's a whole lot that may go into that truth , because we're just looking at statistics .

Speaker 2 53:17

Right , it's nuanced , but that's what's happening . The hospital is learning how to care for sicker and sicker people and bring babies into the world under those circumstances , and it doesn't necessarily apply to low risk circumstances , and so that's where patient centered care is so important , and if you're in the hospital , that's why it needs to be protected , and if you're at home , then that's a whole skill set I don't have .

Speaker 1 53:41

I want to qualify also that the benefit , some of the things with home birth is low risk of infections , because you're not in the hospital , which is the grossest , dirtiest place on the planet , correct , filled with all the germs .

Speaker 2 53:51

No matter how we clean it yeah . But also it's the mecca , the mecca of yuck bro , the mecca of yuck .

Speaker 1 53:58

So you don't have that and you come with health care providers that get more Like midwives , get more time , they get to know you , they customize your chart , those kind of things . And if you live in an area with a birth center , that's like the sweet spot and this is what Kelly and I were trying to say that unfortunately , for most people it's either home or hospital .

Speaker 2 54:16

There's not much of a connection between the two Having to transfer starts to get hairy .

Speaker 1 54:21

Yeah , it's a big gap between there and so there's a few birth centers around North America not as many as there should be . But if we look at the model like the UK , which has its own bullshit , so I don't like the UK is nailing it . But I just actually had a pot on my podcast as somebody from the UK that I'm really tired of people in North America holding up the UK model like it's so great , it's just as terrible and here's why . But they do have . The majority of birth is handled in birth centers by midwives If you are part of the 1% that actually needs obstetric care and most birth is really boring .

Speaker 1 54:55

And then folks who know that they're extremely high risk , so they live with chronic disease or really serious visible and invisible disabilities and they know having a baby is going to be a very high risk thing because they have heart issues or chronic kidney failure , there's things or they have cancer and they're pregnant . There's specialists that handle that , but again , that's an even smaller percentage . Most people , birth is boring and I love boring births , which we actually one of my students did a poll because I say boring births when I teach all the time and one of my students did a poll to ask what did first time birthers think about the term boring birth , and they didn't get it . But when they asked small tips , so people who've had two or more babies , that wasn't for you , kelly , that was for your listeners .

Speaker 1 55:37

When they asked small tips they were like oh , yes , my goal is a boring birth . Yeah , and it's so interesting without that lived experience of birth , that first time birthers were like wait , I don't understand a boring birth . Then they were like almost offended by the term . So I was like don't put that in your marketing , because for primates , which are people who are going to have their first babies , but like people who have been through the system , get it that . They're like oh , it does not need to be , this big hub doesn't need to be dramatic .

Speaker 2 56:05

Yeah , it says it doesn't not need to be this big hubbub .

Speaker 1 56:07

It doesn't need to be dramatic , yeah , it doesn't not need to be dramatic . Let's keep it boring , because the act of birth is and has lots of feelings .

Speaker 2 56:13

Yes , let's not take away from that .

Speaker 1 56:16

Yeah , like it , just it stands on its own two feet . Anyway , it's . I just think that there's so much that needs to be shifted and it feels some days impossible when I stand back and I look at the beast that I've been throwing stones at for 20 years that I'm like , did I even make a difference to the world ?

Speaker 1 56:36

And I have to work really hard to be like if we didn't have anything pushing back on the system , every one

Small Pockets of Change

Speaker 1 56:42

of my clients would have the higher risk of feeling disenfranchised , harm unnecessarily , interventions might not have survived . And to know that I personally have supported hundreds of families and to have , to the best of my ability because I can't promise anybody any birth outcomes I know that they were safer and more empowered than if I wasn't there . And to know that I've trained thousands of practitioners all over the world who were doing our little pockets of pushing back against these systems that are not serving us . To know that those little tiny pockets have been parents that stepped into parenting empowered and in doing so they raised their children being empowered . And when I can see that and look at what's happened over these two decades I've been doing it , I can feel that there's been a difference . Because if I just imagine myself fighting the system and now the administration that even though I was a Canadian .

Speaker 1 57:39

I just spent so much time working in American spaces that I'm like , oh my God , the machine . It's like Fern Gully , like the whole rainforest is just like and so but I know that you helping your neighbor and your friend , like you know , as a new doula , you usually start first with the community of folks and you being able to do that . It is these like little kind of like beacons that that protect the space and magic happens . And I think that this is actually how we can change the world . If we go back to protecting birth and parents , I believe it would be a profound entry point .

Speaker 2 58:16

I agree . Yeah , that's 100% agree that we're doing that . It's root cause we're attacking the root cause . Yeah Well , Bianca , it's always so great talking to you . Is there anything that we didn't touch on that you wanted to bring up ?

Speaker 1 58:31

No , I think that's great , and I just the scholarships . We open them a couple times a year , so check back to the website . If you're between sessions right now , do keep checking back , because then they'll just be open and you can get your applications in . But they do close for two three month periods .

Speaker 1 58:47

So , yeah , we would love to have you and we have our standalone birth doula training as well that folks can check out , which is wildly affordable if you have that before you step into our full spectrum . So there's lots of options for entry points into this work If you're feeling like really excited and you want to get going right now and the semester might be partway done or hasn't opened yet , awesome .

Speaker 2 59:12

Thank you so much . I really appreciate this and I love chatting with you and commiserating sometimes .

Speaker 1 59:21

I love our chats . I love your podcast .

Speaker 2 59:23

I think you're doing really , really great work .

Speaker 1 59:25

I've also just thought over the last , however long I've known you year and a bit , I think that you've done . I just can like feel the difference of your passion and your commitment to A unlearning the culture that you were raised within .

Speaker 2 59:39

I'm still in , yeah .

Speaker 1 59:42

And just I can feel your passion for pushing back and I just I love when we have people like you .

Speaker 2 59:49

I love you and I love what you're doing . Yeah , I definitely went from this is why we do this in the hospital to let's think about this a little bit .

Speaker 1 59:57

Yeah , I've watched it and I can feel it and I can hear it and how you speak and the types of questions you ask your guests and I think it's really amazing and I just want to hold space that all we can do is learn and do better . Yeah , and you don't know what you don't know , and I can feel how you like really trusted the people that you've brought into your community to guide you and to teach you and then to bring all your wealth of knowledge to be like what magic can come from this ? Yeah , I got to do something .

Speaker 1 1:00:28

I feel like I'm just really proud of what you're doing . Well , thank you , and I think it's really cool and I think you should look at your own stuff to be like I can't believe how far I've come . Yeah , it's really fun to go back rather than cringing .

Speaker 1 1:00:42

I know there's blogs . I've written stuff . I used to say that I'm like oh my god I'd be cancelled . I'd be like dragged in the street . I've already been . I used to say that I'm like , oh my God I'd be canceled . I'd be like dragged in the street . I've already been canceled , so I'm uncancelable . Now I'm like bring it whatever , but I'm like I know more and I do better and I didn't know when I was 26 . And you're putting yourself out there .

Speaker 2 1:00:59

That's the part We've all just been like I're going to go this way , or maybe I'm not fighting everybody . Maybe we can find a way to all move forward .

Speaker 1 1:01:15

Yeah , you hear people , you hear people differently and stuff , so I want to hold the name . We should celebrate learning rather than cringe at where somebody was before . Yeah , and I can viscerally see how passionate and committed you are to changing the environment and so many people say they want to come into healthcare to change it from within Few people actually . Once you're in it , it's now the water you swim in and you actually can't see the mess and you are truly changing it from within and I'm really grateful for that .

Speaker 2 1:01:48

And the thing is I think I didn't have a voice for what I was wanting to do , so I started with what I knew , and then I've interviewed so many doulas that I've learned as I've gone . I'm like , oh , that's a way I can do that , or that's a way I can say that , or they've pointed me towards evidence that I can bring you know , and surprisingly , a lawyer , yeah , who is on the same page . I was like , wow , ok , there's a lot of support out there .

Speaker 1 1:02:15

So we see you , gina . Yeah , gina , we love you . We love you . Gina , lawyer , gina , childbirth attorney Exactly I am . I think it's really great and I love having you in our community , I love being in the same in the community that we're both part of . I think you're doing great , great Thank you .

Speaker 2 1:02:37

You too ,