Why should the charitable sector invest in the idea that better births and postpartum periods lead to healthier parents, babies, and communities – and what might that investment look like?
When we talk about upstream solutions, how far up are we willing to go? How might Canadian communities improve with more deeply rooted, community-based, intentional care networks designed with pregnant people and parents in mind? And why should the charitable and non-profit sector care to help?
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When Leah Morris was pregnant with her first child, her partner was deployed to Afghanistan. This meant she was on her own during most of her pregnancy. “My birth was not so great,” she says. “It could have been extremely traumatic for me. I don’t remember it as a negative experience, though, just an experience. That’s because of my doula. She flipped that switch and made a huge difference on how I remember that day.”
The birth of my first child could have been extremely traumatic for me. I don’t remember it as a negative experience, though, just an experience. That’s because of my doula.
Leah Morris
Morris’s experience with her volunteer doula had an encouraging and empowering effect, changing the course of her life’s work. When she was offered an opportunity to train at no monetary cost with the volunteer doula program at the Mik’maw Child Development Centre, she took it. “I realized that is what I wanted to do with my life. I wanted other women to have that experience. It really makes such a difference.”
Morris vowed to take one paid and one volunteer client monthly, to do her part to support those who couldn’t afford doula services. She acknowledges her privilege in being in a position to offer this free care, but she says that women shouldn’t have to depend on the good will of others to access it.
Doulas are birth workers who provide one-on-one support. Their support is non-clinical, offering social, somatic, systems-navigation, and self-advocacy support to parents before, during, and after birth. They’re proven to improve maternal health experiences, especially for families on the margins.
“In the end I left [doula work] due to exhaustion. There’s a lot of baggage that comes with clients most in need of free doula care,” Morris says. “Ultimately, we’re not social workers or mental health professionals. And then we’re sending them to resources that are over capacity. We end up taking on a lot of burdens ourselves. It’s not fair to us or our families.”
When pregnant people and parents lack community infrastructure, basic support needs go unmet and parents suffer. Seemingly simple things that come with a healthy community – social networks, help with keeping the body nourished and the mind regulated, advocacy while moving through systems – can become complex challenges for one or two people to bear.
Globally and historically, community-led care structures – particularly during pregnancy, birth, and postpartum – are considered normal.
What might it look like if the charitable and for-impact sector stepped in as support for a community arm, nurturing programs and systems that could serve as a village network for parents getting into the swing of their new roles raising babies?
Globally and historically, community-led care structures – particularly during pregnancy, birth, and postpartum – are considered normal. The phrase “It takes a village to raise our children” is rooted in the idea that a village exists. In the current Canadian context, however, it is more like many islands than a village. Community networks have become challenging to maintain and even inaccessible. Deep isolation and loneliness, a result of Canada’s more individualist culture, persists. With the cost of living constantly on the rise, more people have less time, fewer resources, and limited capacity to help others on a consistent basis. When the village is either far away, at work, or unavailable, it’s hard to support one another.
The perinatal period, and the relationships that emerge from these initial years, is foundational and critical in child development and outcomes. Despite this, little or no culturally responsive long-term programming exists to support this influential stage in people’s parenting journeys.
The impact opportunity in perinatal mental health is inarguable . . . for any philanthropist or foundation who cares about equity or children, or mental, women’s, or community health.
Vani Jain, Daymark Foundation
Philanthropy can help to birth a new kind of care, leading to improved maternal and mental health. This has the power to improve community health and wellness. If the sector invested in the idea that better births and postpartum periods water two gardens at once – healthier parents who are able to re-enter the working world nourished and ready to progress, and healthy babies who are set up to become productive and healthier members of society – then we can begin to bear sweeter fruit as a nation in matters of maternal and general health.
“The impact opportunity in perinatal mental health is inarguable,” says Vani Jain, executive director at Daymark Foundation, a family foundation seeking to advance women’s mental health. “It’s such an opportunity space for any philanthropist or foundation who cares about equity or children, or mental, women’s, or community health. It’s an issue that touches on so many areas.”
Daymark board member Michael McCain calls perinatal mental health the “apex predator in the mental health world” because of the implications and impact of poor outcomes. The mental health and well-being of the mother directly affects that of the children for which she’s responsible, and anyone else in the home. “Mental health issues are not always best met with a mental health intervention,” Jain says.
Investment in programs and people that facilitate a more village-oriented model of perinatal care and support, alongside the Western model of medicine, could lead to transitions that help improve the overall health and outcomes of our communities.
The expectations of independence, and the isolation and loneliness that follows, are often the result of a culture of capitalism that sends the message that you can, should, and must do it on your own. Jain recalls her own internalized pressures to be a perfect new mom and how challenging it was. She also expresses the value of a neighbour coming to spend time with her in a moment of “overwhelm”; this is The Village.
While charities continue to tackle tangible needs like food support, poverty alleviation, affordable housing, and the like, a deeper, more intangible need continues to go unaddressed and under-resourced: meaningful, supportive connections and relationships during parenting, pre- and post-natal.
The philanthropist, both at the individual and institutional level, may be shocked to see how far their investment could go when they support people to create and maintain meaningful relationships, starting from the roots – and in this case, the womb. Funding for people and programs that help others encourage, engage, and support pregnant and new parents would help distribute the load of that initially overwhelming and intense perinatal period. This would birth a force of people mandated to cultivate meaningful, rooted relationships with parents built on trust, not just the baby’s progress. They could essentially collaborate in building The Village. Hunger, poverty, and general injustice are all so much harder alone. Social support is one simple tool and small step to help parents navigate those challenges with more confidence.
That tradition of being in community with others during this period has been lost in our current society. We’re separated, categorized, and told to do this all on our own.
Gillian Cullen, Birth Mark
“That tradition of being in community with others during this period has been lost in our current society. We’re separated, categorized, and told to do this all on our own,” says Gillian Cullen, the founder and CEO of Birth Mark.
Birth Mark is one of very few charities in Ontario that provide no-cost full-spectrum doula and perinatal support. To date, the organization has supported more than 1,100 births in the Greater Toronto and Hamilton area. “A lot of the people we work with have never been truly supported during their time in Canada. I’ve heard things like ‘I’ve been here for 10 years, and I never had anyone that really cared about or believed in me until I walked into Birth Mark,’” Cullen says. “These are the basics and people aren’t getting them.”
Unfortunately, after six years of programming, June 2024 marks Birth Mark’s last month operating as a free doula service until further notice: finances to fairly compensate doulas has dried up.
The work of doulas has had impact at the individual and institutional level, disrupting the status quo that says alone is okay and that the medical model is always best. Doulas’ popularity in the United States and the United Kingdom has risen as both countries collect data illustrating their impact, especially in communities of colour, particularly Black and Indigenous populations. Canada does not collect race-based data, which leads to a lack of understanding around health disparities or the viable solutions to overcome them.
Doulas are just one step, a vehicle toward a solution. Ultimately, the true need is deeper, the more meaningful support they can facilitate and provide.
Leaders like Cullen and Jain are hopeful and believe the tide is turning in philanthropy as more women become philanthropists. Either by their own wealth or inheritance, they’re joining the ranks in the charitable sector and are addressing the needs that matter to parents, people, and families.
One such philanthropist is MacKenzie Scott, who gave a transformative trust-based gift to MakeWay Foundation, a Canadian charity and foundation that prioritizes supporting community-led solutions for problems that affect nature and communities. The money will “enable projects to achieve greater stability and resilience,” says Lizzie Howells, director of the shared platform at MakeWay.
Two funded projects on the platform providing this village for pregnant families are the Northern Birthwork Collective, serving the Yellowknife area in the Northwest Territories, and the CommUnity Doulas Project, serving the Greater Toronto Area in Ontario. “We specifically wanted to support equity-deserving community impact, particularly for BIPOC individuals and communities,” Howells says. “It was really important to us that grants had low barriers to access and were unrestricted. We know that what groups need is flexible funding.”
Investment in a more village-oriented model of perinatal care and support alongside the Western medical model could improve communities’ overall health.
The Northern Birthwork Collective provides cost-supported programming and services for all stages of the reproductive journey, including conception, pregnancy, birth, postpartum, miscarriage, loss, abortion, and parenting. CommUnity Doulas is a pilot project that provides 12 months of continuous doula support for Black families in the Greater Toronto and Hamilton Area, with the purpose of building a network of support to navigate the challenges of parenting and pregnancy, particularly while Black in Ontario. Initiatives like these are The Village Canadian pregnant families need.
Investment in a more village-oriented model of perinatal care and support alongside the Western medical model could improve communities’ overall health.
At the individual, institutional, and political level, resources can be directed to cultivating solutions that begin to fill the gaps in current models of pregnancy and postpartum care, taking us from:
- Facilitating sick care to facilitating preventive care
Resources are poured into managing symptoms associated with poor parental health. Healthcare systems are overburdened, forcing nurses and physicians to prioritize the most urgent. Philanthropists can fund community-led programs and people who support pregnant families with the basic nutrition, fitness, and maintenance and support, both educationally and emotionally, during the perinatal period. This can decrease the burden on medical systems and nurture a more holistic and supportive culture of community care.
- Centring physician comfort to centring patient comfort
Providing direct funding to community-led, body-literacy, and pregnancy education programming that can help parents and allied health professionals better advocate for parents’ needs and wishes during the birth and postpartum experience leads to more informed and empowered patients. This leads to patients and parents feeling more confident articulating their needs and concerns, allowing physicians to more effectively communicate to meet those needs and concerns.
- Acknowledging racial disparities to accommodating racial equity
Medical systems are aware that the problem of health disparities exists. Moving toward equity, however, can look like implementing community-informed policy, practices, and programming that equips clinicians to meet patients known to have poorer outcomes, due to prejudice and discriminatory healthcare experiences, with extra tenderness and an appropriate level of curiosity and care.
- Normalizing neglect and isolation to prioritizing community care
Isolation and independence during the perinatal period is not the global norm; interdependence and collaboration during the perinatal period is. Funding community care can look like investing in long-term programs and people designed to serve and be present with pregnant parents and couples. This buys the time needed for trust and networks to grow.
The medical system is here to stay – and we’re grateful for it. What communities also need though, is time, support, and attentive care. At present, those are not services medical institutions are best positioned to provide.
As people in the business of helping people, the philanthropic and charitable sector has an opportunity to help both the current and the coming population by creating systems that better support the core of communities, our families. By linking arms with community, they can help create The Villages needed to raise our children.
