Why doulas are important in Native American communities


Downtown Eastside women find sisterhood talking about menstrual cycles

Indigenous women’s group revives teachings about ‘moon time’ to heal from past traumas

By Cherise Seucharan, Eva Uguen-Csenge, for CBC News Posted: Apr 21, 2016 8:00 AM ETLast Updated: Apr 21, 2016 4:55 PM ET

Vancouver’s Downtown Eastside can be a grim place for women, with high rates of trafficking and street violence. But every other Wednesday, a group of women are learning to honour their bodies –– by reviving Indigneous teachings about periods or “moon time”, women’s lodges and the medicine wheel.

“We’re in tune with our bodies and what’s going on,” says Nora Hanuse, founder of the Women’s Healing Circle, which meets at the Aboriginal Front Door Society, a culturally-based wellness centre in the heart of the DTES.

By reviving Indigneous ceremonies in an urban setting, Hanuse hopes she’s helping to undo some of the stigma women hold about their bodies — and creating a safe space to talk about the traumas many have faced as Indigneous women.

To this end, Hanuse incorporates into her weekly meetings what elders have taught her about the powerful role of women.

Smudging bowl

Hanuse uses her smudging bowl and feather to conduct cleansing ceremonies. (Cherise Seucharan)

Hanuse, originally from the Kwakwaka’wakw First Nation near Cape Mudge, says menstrual cycles are considered to be sacred and the time of the month when a woman is at her purest. In some Indigneous communities, women on their monthly cycle will gather in moon lodges where they are revered and served by other members of the community.

Among the groups’ participants are survivors of residential schooling, former foster children, and women who have suffered from substance abuse.

“A lot of them carry a lot of sadness and hurt and anger,” Hanuse says.

‘Because they’re lost’

Despite the high proportion of Indigneous people living on the Downtown Eastside, Indigneous women still have a hard time finding places to learn or practice traditional ceremonies. Hanuse says many need the women’s group “because they are lost.”

Nora Hanuse

Nora Hanuse welcomes the women into the Aboriginal Front Door Society on the Downtown Eastside. (Cherise Seucharan)

The Women’s Healing Circle is one of the only places in the city that provides a safe and welcoming space for all women, whatever their circumstances.

“I never judge them, no matter what their background is,” says Hanuse. “And that’s how I treat everybody on the Downtown Eastside. I love them as if they were my own children or they were my own family … If they come to me and say ‘I need a hug,’ I give them a hug because there’s not enough humanity down there.”

Living in the Downtown Eastside can require tough skin, something that often translates into hostility between women.

“Women, our claws come out and we get vicious. We become the aggressors because we self-doubt ourselves. We don’t have enough pride in who we are. I’m guilty of it too.”

Hanuse has come a long way herself. She survived childhood abuse only to fall into alcoholism and later an abusive marriage. She found her way back to teachings at the age of 23 after seeking counselling which encouraged her to reconnect with her culture.

Woman-centred teachings

Hanuse sought the knowledge of an elder to help lead the group in teachings, so she brought in Elder Lorelei Hawkins, who has lived and worked with women on the DTES for decades.

Hawkins began her journey to becoming a traditional healer when she returned to her Cherokee lands as a young woman. She brings her traditional knowledge of menstrual cycles or moon time to the women and teaches them about their connection to the earth.

Elder Lorelei Hawkins

Cherokee elder Lorelei Hawkins teaches the Women’s Healing Circle about the blood flow which connects them to the knowledge of their ancestors. (Cherise Seucharan)

“Women have a blood flow from moon time that connects to Mother Earth,” says Hawkins during one of the circles. “Because our blood flow goes to Mother Earth and because we carry life, all of the knowledge and the footprints that come before us, we carry that within us as women.”

Hawkins roots all her conversations about sex and positive body image in Indigneous culture and spirituality, with an underlying message that women have a special, powerful connection with the world.

“It was the women who are the keepers of the ancient knowledge … they’re the keepers of the culture because they actually teach it and show it and enact it,” says Hawkins

Hawkins uses the medicine wheel — a circle made of yellow, red, black and white quadrants with each quadrant representing one aspect of a person’s well-being — to explain how to keep all parts of the body in balance.

Hanuse encourages the women to apply these teachings to everyday experiences — and challenge feelings of shame about their bodies and sexuality. She feels women should enjoy their sexuality without judgment.

“If it feels good and it isn’t hurting anyone, you should do it and there’s no shame in it,” Hanuse says.

Funding it herself

Hanuse first came to the Aboriginal Front Door Society as a six-month practicum student through her master’s program at UBC. Three years later, she remains with the women’s group, funding the group’s meals and programs — even after the money ran out last year.

‘I do what they need, not what I need, not what some funder tells me they need.’ – Nora Hanuse, founder of Women’s Healing Circle

“I fund it myself and would keep funding it,” she says. “It’s my baby.”

Hanuse values the independence she has to respond to the individual needs of the women when they arise. She uses a variety of methods to help them cope with negative emotions, incorporating everything from smudging ceremonies to crafting and journaling.

“I do what they need, not what I need, not what some funder tells me they need. I do what the women need,” says Hanuse.

Reclaiming breastfeeding in Indian Country

IndianCountry_BMC_01_770x578 (1)

In many Native American cultures, breastfeeding is viewed as more than nourishing babies the way nature intended; it’s viewed as a way to nourish a baby’s mind, body and spirit.

“We believe that breast milk doesn’t just nurture babies, it conveys a mother’s life story, including her knowledge and culture,” explains Amanda Singer, president of the Navajo Nation Breastfeeding Coalition. “Breast milk makes babies strong and healthy, so that they’re ready to face the challenges of their tomorrows,” Singer adds, validating the importance of breastfeeding in Native American communities.

For many Native Americans, however, this belief and the tradition of breastfeeding has lapsed over generations of historical trauma. The U.S. government’s assimilation policies divided families and discouraged or disallowed cultural teachings. The boarding school era, when Native children were separated from their families in the late nineteenth and early twentieth centuries, was especially devastating.

Today, Native mothers and babies have one of the lowest exclusive breastfeeding rates at six months (as recommended by the American Academy of Pediatrics) of any race or ethnicity in the nation. At the same time, they face serious health challenges, including skyrocketing rates of obesity and diabetes, which lead to other health problems. 

For Native communities, breastfeeding is a public health issue. Because of the enduring health benefits breastfeeding provides, community leaders and medical professionals are making a concerted effort to reconnect Native women to the cultural tradition of breastfeeding.

First Lady Michelle Obama’s launch of Let’s Move! in Indian Country in 2011 and the call for every Indian Health Service (IHS) birthing hospital in the United States to become Baby-Friendly has spurred the transformation of hospitals in Native communities. As of December 2014, IHS announced all 13 of its birthing hospitals are designated Baby-Friendly, meaning they provide optimal maternity care and breastfeeding support. Now, more than 4,500 Native American babies each year will benefit.

To help make Baby-Friendly a reality in Indian Country, IHS hired Anne Merewood, associate professor of pediatrics and director of Boston Medical Center’s Breastfeeding Center, as a consultant. “We know that breastfeeding can significantly improve the health and well-being of Native American mothers and babies,” explains Merewood. “That’s why we’re partnering with IHS, tribal hospitals and Native communities to increase breastfeeding rates in Indian Country.”

Merewood and her team worked with hospital administrators, doctors and nurses to help them understand the Baby-Friendly Initiative and train them on the 10 Steps to Successful Breastfeeding, required for the designation. A key to her success was collaborating with Native doctors and nurses to serve as advocates and conduct trainings, ensuring cultural relevancy with the content. She also credits IHS for their leadership and commitment to realizing this vision.

“Indian Health Service’s achievement sets a new standard in breastfeeding support to which every birthing hospital in the U.S. ought to aspire,” says Merewood. “If IHS hospitals, which have limited resources and serve high-risk populations, can achieve Baby-Friendly designation, then any hospital can do this.”

Bringing breastfeeding back to Indian Country

“The Breastfeeding Center’s efforts have been instrumental in accelerating a cultural shift to make breastfeeding the norm again in Indian Country,” says Carla Thompson, vice president for program strategy at the Kellogg Foundation. “This shift is critical for the health of American Indian babies and their moms, and for our communities as a whole.”

With funding from the W.K. Kellogg Foundation, the Breastfeeding Center is helping create a network of breastfeeding support in tribal communities and with others who want to improve breastfeeding rates in Indian Country. They launched the Indian Country Breastfeeds website to share resources and connect the people and groups working to support breastfeeding in Indian Country.

In May 2014, the Breastfeeding Center hosted the first-of-its-kind Maternity Care and Infant Feeding in Indian Country conference, bringing together 150 health professionals, hospital administrators and community leaders from 20 tribes to learn about the past, present and future of breastfeeding in Indian Country. In addition to increasing understanding and support for the Bringing Baby-Friendly to Indian Country Initiative, the conference instilled a sense of camaraderie and connection between IHS hospitals who had gained – or were on the pathway to gaining – Baby-Friendly designation.

The Breastfeeding Center’s next focus is on helping tribal birthing hospitals achieve Baby-Friendly designation, which will benefit more than 5,500 Native American and Alaska Native babies and their moms each year.

Pregnant aboriginal women find ‘world of difference’ in Edmonton inner-city program

By Nikki Wiart, CBC News Posted: Jul 27, 2015 7:00 AM ET

It’s not often a job description includes monitoring fetal heart rates and taking blood samples in the back of a car or in the bathroom of a fast food joint.

Falon Quinn

Falon Quinn is eight months pregnant, and says HER Pregnancy is giving her the help she needs to keep her baby. (CBC)

But that’s exactly what employees of an inner city prenatal program in Edmonton do.

At-risk pregnant women on the street are “incredibly scared of the system,” says Marliss Taylor, a nurse who helped found HER Pregnancy — which stands for Healthy, Empowered and Resilient — in 2008.

HER is an aggressive outreach program for pregnant women living on the streets. It’s based out of Boyle Street Community Services’ Streetworks program in downtown Edmonton and it’s seeing a lot of success.

In an independent review of the agency, Children’s Services predicted that 95 to 100 per cent of HER’s clients would have lost their children to apprehension. Instead, 52 per cent of those women were actually successfully parenting — photographic proof of which lines the walls of the program’s pregnancy room.

Falon Quinn is eight months pregnant, and says HER Pregnancy is giving her the help she needs to keep her baby.

“I would probably still be homeless — pregnant and homeless — not knowing what to do,” Quinn said. “Probably doing drugs and alcohol if I didn’t have the supports I do today.”

That success hasn’t been lost on the provincial government either. As of early July, Alberta’s new NDP government promised the program an additional $200,000, on top of the $1.4 million over three years promised in 2014 by the Progressive Conservatives.

Alberta Health has also provided funding for two similar programs in Red Deer and Calgary.

Aboriginal focus, shared experience

Morgan Chalifoux, a pregnancy support worker with the program, is Métis; she’s been through the system, lived on the streets and was a teen mom.

HER pregancy

Morgan Chalifoux, (bottom left), a pregnancy support worker with the program, previously lived on the streets and was a teen mom. She says those shared experience helps her connect with clients. Kristen Rowan (top left), Trish Gladue (top right), and Nadine Santin work with pregnant at risk women in Edmonton. (Nikki Wiart)

“Honestly, if I wasn’t aboriginal, if I didn’t have the experience, if I didn’t use when I was on the street, if I didn’t understand what it was like to have my son threatened to be taken away from me … I wouldn’t be able to have the success that I have now with the clients,” Chalifoux said.

According to Erin Konsmo, from the Native Youth Sexual Health Network, these shared experiences “make a world of difference.”

“When you see somebody that looks like you, that can speak about communities that are similar to yours, experiences that are similar to yours, you’re going to have a much safer experience as a young mom.”

Ninety per cent of HER clients are aboriginal, including Quinn, who is from Saddle Lake First Nation. That’s a large reason why 50 per cent of Streetworks’ staff is also aboriginal.

“Indigenous-to-indigenous relationships are super important,” said Konsmo, who has a Métis and Nehiyaw background.

The program’s manager, Marliss Taylor, said the high number of indigenous clients is a reflection of bigger issues within the community.

“I think that a lot of mainstream folks still don’t appreciate the incredible effects of the residential school system,” she said.

“[HER] has a really critical viewpoint on some of the larger historical legacies that make people homeless,” Konsmo said

More flexibility than mainstream health care system

HER is a modest operation, with three pregnancy support workers, two registered nurses, and a social worker. It is made up of a small, dimly-lit room filled with secondhand furniture that they call their pregnancy room, as well as another room for nursing.

“It’s close to them. It’s a little gritty; doesn’t feel like a formal doctor’s office,” she said.

‘That fetal heartbeat is much more than just a diagnostic ‘how’s the baby doing?’ It represents hope.’ –  Marliss Taylor, nurse with HER Pregnancy

HER employees help clients make key decisions early on in the pregnancy and support whatever decision is made. HER will put clients in touch with a Children’s Services agent, so that when the baby is born, the agent knows who the mother is and what work they’ve done to keep their child. In many cases, it means they are less likely to immediately apprehend the child.

The program also approaches prenatal care from a harm-reduction standpoint rather than an abstinence-based one, which can include encouraging women who use drugs and alcohol to use less.

“We have women come in and say ‘I need to hear that baby’s heartbeat because I feel like using right now.’ And that’s a control for them,” Taylor said.

“That fetal heartbeat is much more than just a diagnostic ‘how’s the baby doing?’ It represents hope.”

HER pregnancy

Homeless and pregnant women can drop by Boyle Street’s pregnancy room for everything from advice to providing HER Pregnancy staff with a blood and urine samples. (Nikki Wiart)

HER keeps supporting mothers up to six months after delivery to ensure they’re on the right track to being a successful parent.

This dedication is what makes the program different from others offered through Alberta Health Services.

“You can just come and talk to them and they’re not like, ‘OK, you gotta go. I have another appointment,'” Quinn said.

“They make you feel comfortable and make you feel like they’re family.”

A feeling Taylor said can make a huge impact on a soon-to-be mom.


Aboriginal Maternal Health in British Columbia


The Pregnant Frog Woman
Artist Jamie Nole- Injanes Art LIfe

“Our grandmas tell us we’re the first environment, that our babies inside of our bodies see through the mother’s eyes and hear through the mother’s ears. Our bodies as women are the first environment of the baby coming, and the responsibility of that is such that we need to reawaken our women to the power that is inherent in that transformative process that birth should be.
(Katsi Cook as quoted in an interview with Wessman & Harvey, 2000)”