Birth & Beyond Conference • October 3 2014 • London, ON

Andy Inkster, MAHealth PromoterLGBTQ Parenting NetworkSherbourne Health CentreToronto

Alanna Kibbe, RMRegistered MidwifeSeventh Generation MidwivesToronto

333 Sherbourne Street, Toronto, Ontario M5A 2S5 • (416) 324-4100 ext. 5276 • ainkster@sherbourne.on.ca

1

Providing Care to Trans Clients: Considerations for Pregnancy, Birth, and Post-Partum Care and Support

Workshop Description

Drawing on their professional experiences, Alanna Kibbe, RM, who is a practicing midwife with Seventh Generation Midwives in Toronto, and Andy Inkster, who is a health promoter for the LGBTQ Parenting Network, will provide an overview of specific concerns of providing appropriate prenatal, birth, and postpartum care and support for trans parents.  Trans people experience birth both as pregnant people themselves, and through a co-parent’s pregnancies. 

Pregnancy and birth are very gendered experiences in our culture, which present an implicit challenge to trans people.  That challenge is also an opportunity for care providers to provide a high level of client-centred care, while examining the gendered component of their own practice. 

The intended audience for this workshop is midwives, doulas, nurses, and other birth professionals who have an interest in providing trans-competent support and care to their clients.

2

Agenda Learning about trans: What does trans

mean?

Trans inclusive language for the childbearing year

Complexities of Conception – planned or unplanned

Pregnancy – social & physical changes

Birth – choices, hopes, and plans

Postpartum & lactation – Creating a supportive environment

Transition to parenting

3

Who is trans?

What does trans mean?

What is gender identity?

Medical procedures?

27% of trans people in Ontario are parents

4

5

Image from “The Cost of Gender” filmwww.costofgender.com/

Inclusive language for the

Childbearing YearBreastfeeding

Pregnant Woman

Mother

Chest feeding, lactation

Pregnant Person

Parent

Other examples?

Complexities of Conception Planned

Fertility services Partners with sperm Known donors

Unplanned Trans people can still get

pregnant & can still impregnate

Parenting choices

Who is in a family?

7

Fertility Support

(in)Fertility support is generally cisnormative and heterocentric

Still Trying:LGBTQ fertility peer support group

Once a month at Sherbourne Health CentreToronto

8

Pregnancy - Social

Pregnancy is very gendered 1st trimester – Disclosure

Disclosing pregnancy may mean coming out as trans

2nd – 3rd trimesterClothing & social gendering

Being pregnant can mean being gendered in a very different way

Implications of social intrusion and expectations of pregnancy

9

Clinic space? Client records? Posters?

Health promotion materials?

Forms?

Language?

Information? Washrooms?

How is your care gendered?

Birth

Types of birth choices:

C-section Hospital Birth Centre Home

Birth Hopes vs. Plans

When plans change Keeping birth environments safe

11

Making Birth Environments Safe

Preparing staff Expectations of the birth worker vs needs of the

client Creating safe space anywhere!

Article:Adams, Elllise. If transmen can have babies, how will perinatal nursing adapt? American Journal of Maternal Child Nursing 2010 Jan-Feb;35(1):26-32.

12

Postpartum Supportive home, supportive environments Defining family Transition to parenthood Hormonal changes Paperwork, registration Restarting testosterone

13

Lactation

Supporting lactation Birth parent lactating Non birth parent and lactation Challenges and choices

Supporting NOT lactating Lactation and gendering Many ways of bonding with baby

14

15

Joint programs of Queer Parenting Programs at The 519 Church Street Community CentreLGBTQ Parenting Network at Sherbourne Health Centre.

Dykes Planning TykesThis course emphasizes donor insemination, adoption, and co-parenting for lesbian, bi, and queer-identified women.12 week & Weekend Intensive

Daddies & Papas 2BEmphasizes adoption, surrogacy, and co-parenting for gay, bi, and queer-identified men.12 week

Queer & Trans Family Planning(s)Depends on participant interest and need.Weekend

Family Planning Courses

16

Joint programs of :Queer Parenting Programs at The 519 Church Street Community CentreLGBTQ Parenting Network at Sherbourne Health Centre

A weekend course for people of diverse family structures and identities, including gender queer, trans, bisexual, poly, pan or omni-sexual, dyke, butch, femme, boi, lesbian, gay, queer, or other, and their partners.

Outside Toronto? Join us for the weekend!

Fall 2014 SessionFriday, November 28 - Sunday, November 30at Sherbourne Health Centre, Toronto

$125+ HST per person, sliding scale available

Register online: lgbtqpn.ca/planning

Queer & Trans Family Planning

Further Training

17

Rachel EpsteinCoordinator

LGBTQ Parenting NetworkSherbourne Health Centre333 Sherbourne StreetToronto, ONM5A 2S5

(416) 324-4100 ext. 5219repstein@sherbourne.on.ca

Andy InksterHealth Promoter

LGBTQ Parenting NetworkSherbourne Health Centre333 Sherbourne StreetToronto, ONM5A 2S5

www.LGBTQParentingNetwork.ca

18

(416) 324-4100 ext. 5276ainkster@sherbourne.on.ca

/LGBTQPN

@LGBTQPN

19

Alanna Kibbe Registered MidwifeSeventh Generation Midwives TorontoHead Midwife, Sunnybrook Health Sciences Centre

SEVENTH GENERATION MIDWIVES TORONTO | 525 DUNDAS ST E, SECOND FLOOR | TORONTO | ON | M5A 2B6 | PHONE 416-530-7468 | FAX 416-530-7478

(416) 530-7468akibbe@sgmt.ca

SEVENTH GENERATION MIDWIVES TORONTO525 DUNDAS ST E, SECOND FLOOR TORONTO ON M5A 2B6WWW.SGMT.CA

20

A weekend community-building course for people of diverse family structures and identities who are expecting a newborn, whether through birth, adoption or surrogacy. Come find out about the stages of birth, creating a birth plan, life after giving birth, understanding newborns, self-advocacy strategies, and much more. Partners, co-parents, surrogates and other support people are welcome.

Fall 2014 SessionFriday, October 17 – Sunday October 19, 2014at The 519, Toronto

$125+ HST per person, sliding scale available

Contact: cveldhoven@The519.org

The Queer-Positive Pre-Natal Class

Report: Transforming Family Trans Parents and their Struggles, Strategies, and Strengths

44 Page report describing the experiences of trans parents

Recommendations to social service, health, legal, and educational institutions.

21

Transforming FAMILYA ten minute documentary that jumps directly into an ongoing conversation among trans people about parenting. It is a beautiful snapshot of current issues, struggles and strengths of transexual, transgender and gender fluid parents (and parents to be) in North America today.www.LGBTQpn.ca/trans-parenting/The film was directed by Rémy Huberdeau in collaboration with the LGBTQ Parenting Network, and with support from: The Community One Foundation and The Centre for the Study of Gender, Social Inequities and Mental Health. 

22

Info SheetsLGBTQ Parenting Recognition

Birth Registration in Ontario

Second Parent Adoptionin Ontario

Declarations of Parentagein Ontario

23

Coming soon!

Other References

Bauer G, Boyce M, Coleman T, Kaay M, Scanlon K. Who are Trans People in Ontario? Trans PULSE e-Bulletin, 20 July, 2010. 1(1). Downloadable in English or French at http://www.transpulseproject.ca.

http://www.glaad.org/transgender/trans101

The 519 Church Street Community Centre Glossary Available from Rainbow Health Ontario: http://www.rainbowhealthontario.ca/glossary

24