⚘ Why A Harm Reduction Approach to Birthwork?
Harm Reduction is a set of strategies and ideas designed to reduce the potential harm of drug use. It is also a human rights movement centering the dignity, autonomy and well-being of people who use drugs. So, what does it have to do with birthwork? My practice began with supporting survivors of violence with lived experience of addiction through their birthing and postpartum journeys. Thus, harm reduction informed how I approached supporting those individuals in a very straight forward way. I was able to sift through misinformation about the effects of substances on their pregnancies, remind them of their wholeness and worthiness, and advocate alongside them as they encountered stigma in care settings.
Through accompanying those parents, I began to understand how harm reduction as a framework provides a foundation for birthwork that better serves all people, whatever their relationship to substances. The essence of harm reduction practice is meeting people where they are at and trusting their sense of what is best for them at any given time. This framework:
Centers the individual’s unique circumstances, resources and needs;
Recognizes that risk is always present, and also relative;
Places directly-impacted people in the drivers’ seat;
Recognizes individual behaviors take place within a matrix of oppression & harm, and it is our duty to mitigate harm while we transform structures;
Focuses on accompaniment and rejects notions of saviourism.
This approach informs all my birth companion and education work. You may be wondering how this looks practically. For one, I do not assume the needs of folks I work with, nor do I assume there is a single source of information or set of guidelines that will best serve everyone. I will ask you outright what information *you* would find valuable, and work diligently to create judgment-free spaces where we can discuss your individual circumstances and needs. I will practice transparency about the sources of information, my own biases and perspectives, never spoonfeeding clients “evidence-based” information that may not be useful to them.
By way of concrete example, I provide an optional module on nutrition in pregnancy and postpartum for childbirth education learners that applies a fat liberation lens to guidance on eating. This offering is optional and not integrated into live class meetings because I do not want to assume that nutrition is the key focus for all pregnancies, that all nutrition options are equally available to everyone. Nor do I want to assume anyone’s relationships to eating and nutrition. If you want information, it will be made available to you, but I will not set goals around nutrition, weight, or movement in pregnancy for anyone. My role is to learn what is relevant to your situation and facilitate decision-making that feels right for you alone, always honoring autonomy and offering compassion.
