BADT Teachers Answer: What is Preconception Doula Support?
We are so excited to offer a new, highly requested Continuing Education course this year– Fertility & Conception. While this is a topic we address in both our Full Spectrum Doula Training and our Childbirth Educator training, this course will go deeper and wider.
In short, preconception doula support, sometimes referred to as fertility doula support, is nonjudgmental, unbiased emotional and informational care for an individual or family who are considering or actively exploring pregnancy.
Some of BADT’s core teachers are chiming in to share about their experiences in the role of fertility doula. Keep reading to learn more about what this work can look like in action!
What is Preconception Doula Support?
When does “preconception” work begin? At what point do/should clients reach out to a doula for preconception support?
This truly depends on what a client is looking for from their preconception support. Are they looking for guidance to understand and navigate their options for conception? Are they working through big feelings around growing their family? Do they need support beginning/reopening conversations with a partner/co-parent/family member around conception? Preconception doula support can provide care and guidance for all of these questions, and more. A client who is seeking preconception support should reach out when they feel they could benefit from access to evidence-based, non-judgmental information to support their decision making, and/or when they feel that they could benefit from an additional emotional support person to process thoughts & feelings around their preconception journey. (Deirdre Bain)
Preconception support can begin at any point. Oftentimes people want support when they are contemplating a potential pregnancy, evaluating options for growing their family, and looking for general information. This work might be ongoing or it might be short-term. Clients reach out at all different times and for various needs. Some folks reach out during the contemplative state and others reach out when they are ready to take action. Some clients know how they would like to pursue growing their family and are looking for logistical support, emotional support, or additional education around their plan. (JB)
Share some of the conversations, topics, and reflections you invite your clients to consider during preconception support.
What information do you already have about paths to conception? Do you have strong feelings about one path to conception over another? How does your family structure impact your options for conception?
If they are looking primarily for education from their preconception doula care, what is their learning style? Do they prefer to:
Talk things through
Read
Watch videos
Listen to audiobooks/podcasts
Some combination of the above
Do you have a support network? If they have a partner or co-parent, how are you communicating about your wishes/hopes/fears for your conception journey? Do you have people who will listen & support you who are not your partner/co-parent?
Many parents are surprised by the amount of time & energy required to navigate a conception journey, how are you planning to care for yourself throughout your preconception journey? Are you able to take time to rest when you need to? Do you have access to mental health supports? Are you open to participating in peer groups for families trying to conceive (TTC)?
Have you considered the costs of various conception methods? Do you have health insurance, and if so, do you know what is covered and what is not? (Deirdre Bain)
Because I work primarily with queer and trans people, a lot of the conversation that we have is about the various reproductive technologies that are available to them, as well as genetic material and the ways that they might access genetic material. We ask reflective questions about a range of topics, including but not limited to: their intentions for the process; how they would like to feel throughout the process; if they would like it to be a more or less clinical process; their familiarity with some of the statistics around various reproductive technologies and their success rates.
We often talk about the nuance and considerations around choosing known donor material vs. anonymous genetic material. We also talk a lot about being treated as a person who is “infertile” in circumstances that don’t necessarily mean that they are clinically infertile. Another point of validation and support for folks’ emotional experiences is the lack of insurance coverage for their fertility needs. I also hold space for the ways clients want and need to be validated in their identities as parents by their care providers, systems, communities, and families. (JB)
How do you care for yourself as you support others on their reproductive journeys?
A lot of the care that I provide for myself as a careworker is the same whether I am supporting someone through preconception, pregnancy, loss, abortion, postpartum, or any other transition: general self and community care. As much as possible, I ensure that I am not operating at an emotional deficit and doing what I need to care for my body and myself as I care for others.
Around preconception work in particular, though, I notice that because I am a person who is not parenting, a lot of the reflective questions around the contemplation of parenthood can be particularly activating for me. Thus, I make a special point to ensure that I am not taking on any of my clients’ feelings as my own and that I have a really clear distinction and boundaries between my own thoughts, feelings, and needs, as a person who is not parenting, and the thoughts, feelings, and needs of my clients who are pursuing parenting. (JB)
Check out How to Practice Self and Community Care as a Birthworker on our blog, as well!
Share some of your favorite books, IG accounts, podcasts, or other resources that you refer clients to.
Resources from JB:
New Essential Guide to Lesbian Conception, Pregnancy, & Birth by Stephanie A. Brill (book)
MAIA Midwifery & Fertility Services (classes and support groups)
Beyond the Baster Classes with Refuge Midwifery (classes, not currently scheduled but stay tuned!)
Swelling with Pride: Queer Conception and Adoption Stories by Sara Graefe (book)
And Bay Makes More edited by Susan Goldberg and Chloë Brushwood Rose (book)
Pride and Joy Podcast, The Hardest, Most Rewarding Thing (podcast)
Trans Fertility Co. (robust online hub of resources)
Resources from Deirdre:
LGBT Resource Guide - Queer Conceptions (information, testimonials & resources regarding TTC in Ontario)
Laine Halpern-Zisman Queer Conceptions - Queer fertility doula in Ontario offering a range of services from cycle charting and emotional support, to information on insemination, advocacy, and resources.
Dr. Pratia Sharma - Fertility doctor, Mom, Founder of theConceptionDiaries, Medical Advisor, Lilia, OVRY, and Board Member at CFAS.
The Conception Diaries - A blog providing information regarding fertility & conception journeys (note: gendered language)
How would you explain the nature of the client-doula relationship during preconception work? How often do you typically meet with clients?
Most of my preconception clients choose to meet 1-2x/monthly. Sometimes they want to meet more often when they are actively trying to conceive– meaning with each ovulation they are making an attempt at getting pregnant. I do this work with folks on a month to month basis so they have the option of taking time off, either for logistical or emotional reasons. People will sometimes want or need to pause the work that we do together through the process of trying to get pregnant and will want to return to it when they have more capacity oir when things are more logistically lined up. (JB)
What does your work look like with clients who have conceived? What shifts/changes with this transition?
When clients are successful in conception, I continue to offer the option of month to month support, which can be a format that feels familiar, consistent, and grounding to them. I also offer an “early weeks of pregnancy” package that runs through the first 14 weeks of pregnancy, to see them into that transition and continue to provide support. We end up talking about a lot of the same things that we did preconception, and we return to these conversations now that there is the reality of a pregnancy to consider. (JB)
How might preconception support from a doula pair with support from a healthcare provider like a midwife or OB?
Preconception support from a doula pairs really well with clinical provider care during the conception period. Oftentimes, people are navigating institutions and practices that are businesses, especially in the case of folks who are accessing and purchasing genetic material. They are often interfacing with a business, and they are treated as such. The fertility technologies that they might utilize can also feel transactional to them. Of course, this isn’t true in all cases, and many preconception clinical providers are amazing and treat their patients with compassion and care.
In either case (and of course there are many models of care in and between all of this) having a doula to help you prepare for these appointments and these checkpoints. Together we come up with lists of questions and to reflect on how each appointment goes. This process can be helpful in validating your experience through the conception process.
Additionally, working with a doula can support you in feeling like you have time dedicated to this process. For a lot of my clients, they may find that they don’t have space in their day to day life to think or feel a lot about the journey of trying to conceive, so our monthly or bimonthly meetings are standing appointments to experience whatever they are thinking,feeling, and needing around the process. And if there is a partner or partners who are involved in the process with them, to be in conversation with their partner(s) about the process as well. I think this is something people really deserve the space for outside of the clinical model. (JB)
Join Us in Class!
If this work interests you, our blog and tools related to menstruation education complement and support preconception work. Additionally, as a preconception doula, you will also want to have a strong referral network.
Find out more about our Fertility and Conception CE here. Enrolment opens last week of February! Keep an eye on our social media or sign up for our mailing list to ensure you never miss a course update!