Your BIRTH Partners

Moving Beyond Burnout #017

September 21, 2020 Season 2 Episode 3
Your BIRTH Partners
Moving Beyond Burnout #017
Show Notes Transcript

We are sharing about the realities of working as a birth pro and the sacrifices and toll that can take on us.  How do we recognize burnout and carve out practices that go beyond self-care so that we can be sustained in this work?
Birth pros are at a high risk of burnout; we often lack the resources from our employers, our communities, and permission from ourselves to breathe, to pause, to take care of our needs.  Studies recognize 40-58% of birth pros across the spectrum of roles identify with burnout, and we know this shows up in the way we provide care and support others.  Continuing to live through a global pandemic has heightened both the demands on us, and lessened our outlets...where do we go from here? 

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Maggie, RNC-OB :

Welcome to Your BIRTH Partners. We are here to break down barriers and cultivate community as we discuss issues that impact pregnancy, birth and postpartum. We welcome you no matter what your background is, and are so excited to learn together. Today I am joined by our own Angela Mike, Certified Nurse Midwife, and Pansay Tayo, doula, we are going to be digging into burnout. And this is such a an issue throughout healthcare, it's magnified in the birth professional community, and this pandemic is just pushing it to new heights. And so we wanted to take an opportunity to dig a little bit deeper into what it has meant for us to, you know, operate as birth pros in different environments, places where we felt supported, places where we haven't, and what are some of the steps that we've taken to make it so that when we serve in our capacity, as professionals, when we get that opportunity to care for other people, that we're doing it well, that we're doing it from a place in ourselves where we are able to really pour into others. And we are able to provide boundaries and balance to our lives, and to model that for our clients. So that we can all move through birth in ways that feel genuine to us and honor all of our different roles. So I'm really excited to share this conversation with you all. On to the show! So Angela, I would love it, if you would just kind of start us off and share a little bit more about what kind of brought this topic up close to your heart and why you wanted to speak to it now.

Angela, CNM :

I think that, you know, we always talk about, you know, how can we improve health care for women? How can we improve health care for mothers and babies, I feel like it is often that we are expected as birth workers to do more, and give more of ourselves and not take a break, and be okay with being exhausted and be okay. And like we are supposed to accept that this is a part of the work. And we are shamed. And we are discouraged from taking time to ourselves and for ourselves. And if we want to leave or do something with our families, there is like this, almost there's this like social punishment for doing that. And this I don't know, I felt like we needed to take a different direction with one of our podcasts because we always talk about us giving to women, and serving women, but no one's serving us.

Pansay, Doula :

So true. So true.

Angela, CNM :

Yeah.

Margaret Runyon :

It kinda harkens back to like that very first episode we did on the podcast was talking about, you know, kind of some of these themes. And I think now, you know, several months later, having lived through/living through a pandemic, the stakes are that much higher, and everyone is being pulled in like that many different directions all the time.

Pansay, Doula :

This is a very intense and needed conversation. And I think it's so difficult for us to address and, or it runs so frequently within the birth community. Because it's a very, you know, well known challenge with women, period, right? Even in my own life and childhood, when you look back at our cultures and our upbringings, because I really think that's where a lot of these things start that you're not strong enough. If you take a break. Mm hmm. You know, that it's, you know, work, work, work, work, work. And that signifies how powerful we are. If we get sick, how fast can we heal, to get back to work to get back to tending to, you know, the children. I myself being raised by a male, I think I got an extra dose of that, you know, it wasn't any, you know, I could remember, come from out of a tonsillectomy surgery and maybe, you know, gave me a week and a half and it's like, okay, let's go get the bathroom clean. You know? So with with most women, a lot of women, I do know that to be the background, did we see self care growing up?/ You know, just being able to do it all signifies your strong woman, even more so with black women, "you're a strong black woman" taking that into our birth work, because I know I experienced it myself, we, we want, we want to help and we want to nurture, and we want to make, you know, bring change, and we want to, you know, help save and empower, you know, our women that we forget that the things that we need to teach will help guide them, that we need to show that we are, you know, operating within those boundaries, you know, ourselves. But you know, you're excited about the new career, about the knowledge and just being able to help and it's like, you know, I'll take all the phone call, all the emails out, you know, do a consultation for two hours. You know, you just want to do do do. Right, what point are you showing healthy boundaries, which big thing that we need to teach our pregnant moms right now expecting mothers about boundaries, and how how to take that time to heal, and show and teach people how you need to be treated and care for, you know, doing these precious and sacred, you know, moments, but we're not doing them, ourselves. So, I guess starting that, from the beginning of all of our trainings, wherever the birth work training is taking place, I believe it should begin there. That how can we care for our women? How can we care for, for our community, if we drained, right? Well, we're not working at our highest, you know, in our best potential, if we're tired, you know, if our brain is foggy, you know, if we're burnt out, right. So even now, you know, my change, come with my mentees, you know, and to teach them even though you're excited, it's a beautiful thing to want, you know, to help our mothers and to guide them. But you can't have you know, like a mom that's like, call, you know, no contract, and she's, you know, calling you every day and texting you every day and want you to drop, you know, drop everything to, you know, attend to them, it's a business, it is a business, right, and we have to set healthy boundaries for ourselves. And also, it's a good thing for our clients to see that we have to take time for ourselves. So we are operating and our focus and highest potential.

Angela, CNM :

I could not agree with that more as a women in general, it is a part of our nature to nurture. It is just a part of who we are. We want to care for those around us. We care for complete strangers, whether it is in a clinical setting or in our neighborhoods, we care for random children that come across this is just who we are. And so it is ingrained in us to be yes with servants. Yes. And then there are of us that go into this field of helping people of serving people. And absolutely do you get lost you the guilt of not being able to be all the things to the clients, to their families, to your co workers or colleagues. It is all encompassing sometimes. And then there's the guilt of not being present in your home, not being a present mother, not being a present partner to our spouses. And certainly there is no such thing as being present for yourself. Like at the end of the day, you can't there's nothing else to give of yourself. And, it's just, I find it intriguing that we are in this culture where the expectation is that we give, give give and we're expected to suck it up, you know, and not complain and we're expected to have more energy on top of the energy we don't already have because we completely burnt out our use and I will say as much as I love birth and pregnancy, it is exhausting. It is exhausting. Yeah, I've been, unfortunately, you know, a part of many births where I was faking it till I made it, I was so done mentally. But on the outside, I was being an actress, because I knew how important it was to be there for that family. And, gosh, and I knew, I think the part of it that, you know, continues to drain you with that, you know, at the end of this birth, and it'll be beautiful, and it will be worth it, because it is worth it every single time. But then you have to go home to your family who have not seen you and they expect you to function at 100% as well. Yeah, and be completely present. We're put in positions where there was no leeway to say, Hey, I'm human, I need someone to allow me to take care of myself, I don't even need someone to take care of me just I need time to take care of myself. Can that be granted to me?

Pansay, Doula :

Yes.

Angela, CNM :

And that is why? I mean, I thought about it for years and years and years, I always knew in my heart that I wanted to be a home birth midwife, or work in a birth center. But you know, after 15 years and in birth, I know I realized I cannot do that. I can't do that. I don't, I never get a break. And I'll be compassion fatigued, and that is when you start making mistakes. That is, as healthcare providers, that is when you miss things, or you get laid off, because you don't want to do something, you know, because you're tired.

Maggie, RNC-OB :

Yeah, it is. I mean, I think that we underestimate the just the level of burnout that happens across I mean, I think it's obviously it's throughout all health care professions, because then that giver piece of as people who pursue that, sure people all have their own motivations, but so many of us do go into it, because we have that that draw to, you know, care and provide. And that makes a lot of times that lines up with personalities, who aren't good at boundaries, who aren't good at serving our own needs. And I know when I was looking over at, you know, some stats for this, and you know, there were several studies done, you know, in the 2010s. And, you know, the rates of burnout across the board for midwives, OB-GYNs, nurses, you know, anyone touching birth, they all range between, like, 40 to like 58% of birth pros were feeling burnt out.

Pansay, Doula :

Yeah,

Angela, CNM :

I got a new job. Unfortunately, I did. I switched my job because I was burnt out. I was I was so burnt out, I just needed a break. I needed a break. Yeah.

Maggie, RNC-OB :

And you do, you deserve a break. And there's all the cliches around self care, you know, you can't pour forth from an empty cup and all that. But it's true there, you just literally we can't, we cannot just constantly give and give. And like I said, I think that's part of this whole bizarre world we're living in right now where we're going through a global pandemic, and we're just supposed to keep acting like maybe we're not, and we can still do everything I used to do otherwise, just, there's like an Nth level of insanity on top of everything. And so I feel like even like, it's just more so now. And then we're so concerned because things keep changing. And we're concerned about the health of those in our care. We're concerned about our family's health, and navigating all of this. And it's not easy, I think, you know, you were talking Ang like, in this new job, what are you feeling is like the difference maker, like what are things that we can search for as birth pros that like, people who can make decisions can kind of provide to, you know, those that they're working with to help?

Angela, CNM :

What my initial assessment is; we can't be greedy. I cannot let money be the driving force. Because it is greed, that makes it acceptable for us to work without the appropriate amount of resources or personnel to do our job effectively. When we take shortcuts in that arena, that's where I ran into issues. During my first week of orientation, the first day excuse me of orientation, for this new organization I work with the speaker had us all go around the space and introduce ourselves and what our job titles were. And I remember hearing I am not lying, not lying. I remember hearing about five or six different descriptions of jobs were assigned to one person "I was hired solely to do this." And that kept going on. And I was like in awe, because at my last position, I was like, well, I did all of those jobs, those were all my job titles, plus being a healthcare provider, plus being the supervisor to all of the nurses in our clinic and all of the nurse midwives in our clinic, plus being in charge of scheduling plus, plus, plus plus. And all I could think was how is this that's why I was so done. I, like wasn't sleeping, I was constantly stressed, I cried a lot. I felt like I could never keep up, I felt like, I would see my schedule. And I'm like "I don't want to see this type of patient today. I don't want to do this, oh, they put an induction in on my my call day," I just, I get phone calls that someone is being triaged for labor and I am feeling sick because I don't want to go in because I'm so tired. I just want to sleep in my bed and be home with my family. And I realized now very quickly after now seeing patients in this, this clinic for the last two weeks that it is because I was doing way too many jobs and still expected to function like I was doing one still expected to function like nothing else matter. Like my happiness and well-being didn't matter, my family didn't matter. All that matters was me doing the job that I had been tempted to do effectively. And now with this new position, I have my own team, I have my own nurse, and I have my own medical assistant. And they do everything for me. So that all I have to focus on is seeing my patients and doing patient careful. I can see 25 patients and see them without rushing and take care of their need. And complete all my documentation and go home, like at the end of the day, and not end up staying over. That never happened. At my last job ever. I would have charts that were well overdue that needed to be completed and signed off. But I just didn't have the energy. Because I was so bombard about all my additional duties and tasks. And now that I'm here I I enjoy it. I'm like so happy. Wow. I am so happy to see my patients. I even took two walk in patients yesterday. I'm like, absolutely bring her in because they make it easy for me to do my job and to do it effectively. And they spare no money at ensuring that we have what we need.

Pansay, Doula :

What brought on the shift into the into the new position? The new job? What was the was it that were you did you just start looking for another job? Or what particularly happened to make it, to make the shift?

Angela, CNM :

It wasn't one thing in general, it was several things over three plus years, three plus years of working in that particular job, but I worked it to other private practices before. And I just knew something has to change. Something needs to be better. It has to be different. I am not happy. And I know that my calling in life is to care for women, I know that this is where I'm supposed to be. But when I am feeling anxiety as I drive into work, and feeling sad when I'm looking at my schedule, and sad when I see all of the additional tasks and duties that I have to do or when I check my work email, and there it is filled with things that I need to do. I hate like I literally, I stopped caring. I was like I just don't care. I just don't care. I'm just not going to do this one thing. I can't; things were being turned in late or subpar because I just couldn't keep up. And I mean, I would be in with appointments with patients. And I would feel myself thinking, "Oh, God, problem focused. I can't deal with all these things." That's how I felt. That's certainly not how I treated the women are cared for. But that's how I felt like "oh, this is taking too long. Oh my god. Like I don't want to deal with this right now." You know, and I never used to feel that way, I never used to feel that way. You know, that when you have no time and you're exhausted and you are just beat down, you just don't care, you're not happy. So that is what caused the shift, I'd like something has to change. I was like, either, I am not meant to do this work for women, which I did not believe, or need to change my work environment, and I need to find something different. That's what I did.

Maggie, RNC-OB :

And I love that you had that self awareness to realize that and if you're not then depriving the world of you, and you as as a midwife, because that has been such an important role for you. It really reminds me of the Audre Lorde quote, where I think I've seen it a lot on social media lately, and it just rings really true that "I've come to believe that caring for myself is not self-indulgent, caring for myself is an act of survival." And, you know, especially as a black lesbian woman, obviously she, you know, shouted that message that like it is okay. To care for yourself. And it's not just, you know, I think so many of us we do we have that you feel selfish, or that you're, you know, taking something away from someone else. But it's necessary for you to then show up in any of the other roles that you have in your life. Yeah, what do you feel like, Pansay? How do you? How do you feel you're, you're finding balance? How are you helping, you know, your mentees as you're guiding them through this? Because it's not, not everyone can get a different job? You know, right, there's only so many opportunities, etc.

Pansay, Doula :

Yeah, Mm hmm. And look, you know, as we, as we're teaching and you know, guiding women into finding their voice and birth, right, finding your voice with your experience, you know, taking back birth, this is your experience. And here it is, we have to find our own voice that said, "Okay, this is too much. Well, this is enough, you know, no, I can't take this on." Yeah, but I definitely feel that one, one part of that, within the community, that I've experienced is to not charge your worth for the client, so that way, you're trying to get all of these clients to make rent, right? So you need all you know, tons and tons of clients to feed your family, tons and tons of clients. And with that, your time is shot. Right. Because as much as you you know, you'd love to work in you know, you love to help the financial component of it, you know, if there is, if I do not have another job, and my doula work is, you know, my sole financial source, then I need multiple clients to keep the rent paid to, you know, and even I, they, you know, you will get guilt, you don't guilt it from the community, or you're charging this amount for doula work. I mean, like, really, and it took me, you know, it took some talking to, from from elders, you know, in, within the community that you charge, you have to charge what you're worth, and you can't feel guilty about that the amount of time and effort that you are putting, you know, into these, these wemos, prenatal visits and going to the, you know, doctors with them, and, and all of that, and that that right, there was a shift for me, because it allowed me to then relax, okay, so I do not have to fill a month schedule, to try to, you know, keep things going. So I feel like more of that need to be talked about within, you know, community that, you know, yes, yes, to leave a slot or two, you know, within your schedule of the year to help, you know, sliding scale to help women that are in need. Right. But that, you know, just to work yourself in the ground should not be what we're doing month to month, you know, right to, you know, to fulfill our our passion.

Maggie, RNC-OB :

Mmm no.

Pansay, Doula :

Mm hmm.

Angela, CNM :

That's such a good point. Is this culture, what is this culture that we have created? That makes it okay to work ourselves into the ground? Like, what is it about it? Like, I mean, and really up until this pandemic, you call in sick for work, your colleagues, your leadership, your boss, they are pissed. They want an excuse. They want a doctor's note? They it's unreal, your kids are sick. Y'all, shamefully I have dragged my sick children to work with me. One of my kids I was so grateful that I was on call because I'm like "well he can just sleep in the call room with me." And my baby had the flu and strep, I had no idea. And the next day I was gonna go to work with him. And he was like beet red, his eyes are red. He's like, Mommy, "I can't get up, my whole body hurts." And I am like "what is this? Why is this acceptable to me to just keep going to work and keep pushing and putting my family's health at the back burner?" At the back burner. And so, unfortunately, because he physically could not move, and I looked at him, I'm like, Oh, my God, and then I felt the need to take pictures to send to my colleagues, and they would know, I wasn't faking it. I wasn't trying to get out of work. My kid is sick, you know? In my head, but I, I'm sorry, I'm gonna cry. I'm so mad that I have done that so many times, to my children, to my family. I've sent my kids to school with sprained ankles, and just wrapped their ankles up and gave them motion and Tylenol, and wrote notes to their teachers saying they're fine. Don't [worry] I need to go to work? I'm like, why is acceptable? Why is that acceptable?

Maggie, RNC-OB :

Assistant, we created it as like, there's no margins, right? You know, so like, one thing gets thrown off. And, and that's it. And it's obviously like, that's not real, it's a construct, we've, we've created that because of how we design systems, because there's not enough to go around because you know, especially when you're working with other people, like there's not enough staff. So if one person calls out, well, then like that was the whole thing. So now, it's gonna be a miserable day for everyone. And that's, that's the system, you know, that's not just, that's not you. And it's...

Angela, CNM :

Yeah.

Maggie, RNC-OB :

And it's heartbreaking. I think like, as we're sort of thinking of this, and like going forward, I get when I was looking at it, like Shafia Monroe is a consultant, she does a lot of trainings around birth and taking care of yourself. And she had this this article about, like, steps to self care. She had these four steps that like, self-care's a mindset and that the first was that like, believe that you deserve be cared for? Yes. Which it's still like, that's step one. And I'm sure there are a lot of people who would listen to be like, Oh, I'm not sure that is. I don't know if I really believe that. And then, you know, she goes on, like, believes that the world will continue safely as you rest. It will, it will.

Pansay, Doula :

Yes.

Maggie, RNC-OB :

And then the next one that you're like, Okay, sure. I believe we cared for him, then you're like, oh, but will it because there's so much. It will. But it does, it does continue to turn.

Angela, CNM :

Yeah.

Maggie, RNC-OB :

Certainly you need to take care of the people in your immediate circle your family, your you know, the people you care more sure, but they can be cared for by someone else. There are other people who can step in, and do that too. So that you can ever like have a moment when you know, she goes on just like and then believing that you are more important than your job.

Angela, CNM :

Yes. It's so funny. That that was what pushed me and I actually shared a quote on social media fan that same thing, because I'm like, if I died today, you know, a lot of people are gonna be sad, or be devastated. My job. My colleagues, yes, it'll be a sad thing. Oh, it sucks. Angela died. But guess what? The show goes on saying no one else can come and feel my spot. Yeah, it does not matter if I am there or not. And that is what gave me the push. I was like, "you know what, my life is important. And I deserve to be happy. And I am no longer going to put myself second, I'm no longer going to send my children to school with injuries, and drag them to work sick, because I'm concerned about how others are going to feel," so to speak, and not that I don't care about others, but that's not going to be the priority when other things are more important.

Pansay, Doula :

When you think about how we can make the shift to change this, right, you know, when I look at my daughter, and I look at my you know, my granddaughter, it's like, okay, they mimic us, right? They just do what we do. And I you know, I recall finding, you know, finding my daughter just you know running out the house, right? She's running out the house, like "did you brush your hair? Did you do this?" And you know, not taking time, right for herself just to groom herself or you know, you can take a bath slowly, you know?

Maggie, RNC-OB :

Yeah.

Pansay, Doula :

And when I started to see that I said, "oh, look what you're doing?

Angela, CNM :

Mm hmm. Rolling out of the house, yeah.

Pansay, Doula :

Yeah, I'm teaching her to not take time for yourself. That put everything before simplistic things as brushing your teeth, grooming yourself, taking a bath. I'm like, "Okay, this this, this is not good. This is no." So making that shift so that I know moving forward, this will not be their story. You know, and that was major in my household major that made me like, "Okay, if I have to do work for me, I have to do it for me, at least, you know, for them." So this does not continue. So that's been the greatest eye opener and reward for me, especially as female. You know, that's, that's something that we should love doing. You know, we are caring for ourselves. And we again, we better care for others, when we're cared for, when we're okay.

Angela, CNM :

Yeah>

Maggie, RNC-OB :

It does. It ripples...

Angela, CNM :

Right. So, gosh, I mean, you, you hit the nail on the head and say, rushing out the house, doing all these things. It just shows that we put other things first. And we should have, we should have, why don't you have time to slow down and just take a bath? Or just put your makeup on? If that makes you feel good? You know, like this? Yes.

Maggie, RNC-OB :

Yeah.

Pansay, Doula :

Yes. I'm so happy that you've made this change. Thank you for yourself. Yes. You deserve it. You deserve it. We all deserve it.

Angela, CNM :

Yes, we do. We all deserve it. Yes.

Pansay, Doula :

And you do and you deserve. You know, there's there are seasons in life. Right. So I think that's where, you know, you've tuned in that right now, in this season, like this was the shift you need to make. Wow. And that that's Yeah, that's good. That's good things, you know, ebb and flow. And we can't be expected to just be doing 150% forever, it's not sustainable at all. And we have to have grace when when we need to step back or, or transition, move to the side, find a different way, a different way, to care a different way to, to serve and love and you know, to live out our gifts. There are a lot of ways to do that in birth work. Mmm. Yes.

Maggie, RNC-OB :

Thanks for tuning in. We love to talk birth, and we'd love to talk about it with you. Please join the conversation by finding us on social media, we're Your BIRTH Partners on all platforms. We would really love to connect more on this topic. So we know burnout is prevalent and compassion fatigue, and that we all have hard days and moments that make us question if we're finding a balance and how can we keep doing this work that's really meaningful to us, while also caring for everything else that matters in our lives. So please share with us strategies that have worked for you, ways that you found community, that you found job roles that give you satisfaction and also let you find some peace. Till next time! Transcribed by https://otter.ai