The Future of Community Birth Care #080

As we wrap up season six of the podcast, we have shared so many incredible conversations over the last 11 episodes as we dove into what community means in birthcare.

There is so much breadth of thought and energy these folks bring through their ability to see what could be, despite the ways that our systems fail us now.

And so in this episode, I share these visions for the future of community birth care from the 11 guests that we had on this season. I invite you to take in, digest, ruminate on their answers as you come up with your own.

Hear more about creating our collective vision for the future of community birthcare including:
~accessible, IN ALL ways
~equitable, prioritizing the needs of queer, trans, & gender nonconforming people
~inter-disciplinary and birthing-person led
~expansive support that meets all needs
~grounded in radical optimism!

Connect more with this season's guests through their profiles found here!

Transcript

Maggie, RNC-OB  0:03  
Welcome to Your BIRTH Partners, the podcast identifying gaps, acknowledging biases, and co-creating a trauma informed standard of birth care with change agents across the spectrum of birth work. I'm your host, Maggie Runyon. I'm a birth nurse, educator and advocate who has been searching since 2010. The answers to how to provide better care during pregnancy, birth and postpartum. Through my own pregnancies and supporting births in home and hospitals around the country. I've seen firsthand many systemic flaws that exist in perinatal care. Through these conversations, I'm thrilled to share with you insights and inspiration as we work collectively to transform birth care.

Well, welcome, as we wrap up season six of the podcast, we have shared so many incredible conversations over the last 11 episodes as we dove into what community means in birth care. You know, community was the very first episode that we released for the podcast almost three years ago. And through this time, as I've had the pleasure of talking and diving into some of these really complex topics with over 60 people, I am just so grateful for just all of the breadth of thought and the new energy that folks bring the ability to see what could be, despite the ways that our system has failed us now. And so in this episode, I share these visions for the future of community birth care from the 11 guests that we had on this season. I invite you to take in, digest, ruminate on on their answers as you come up with your own. I hope as you listen to these answers, you are as inspired as I was to hear them and to share and dream, this collective vision together. Onto the show. 

To start us off, we have Anna Balagtas, radical birth worker, community organizer and founder of the pocket doula.

What does community birth care of the future look like?

Anna, Radical Birthworker  2:07  
Oh, loaded.

Maggie, RNC-OB  2:10  
Juicy, I know, right? 

Anna, Radical Birthworker  2:14  
Juicy...what that would look like, is human, I think, just based on the trajectory of where my work is going right now, what this really looks like is prioritizing, queer, trans, gender non conforming, non binary folks who are of the global majority, having their care prioritized, number one, and number two, where I'm pulled more towards to right now is having access for migrant folks and undocumented folks to have similar or the same access as folks with status, or folks who are privileged enough to have a piece of paper that says, You are valid in this country. It's like putting out little fires, you know, I can't say I want world peace, because it's like, where are you actually beginning? Yeah, if you just put the whole buffet in front of you, then you're gonna get full real quick. And so I think for now, because of where my work is going, those two things are where I want to prioritize, and where I see most of the work needs to be done in these spaces. And that's also because of me as who I am as a person, my positionality is, these are the areas I am the most informed in. And so I think I would be the best agent to be a part of these communities or to be a part of this change, because I have the lived experiences within them. And I think that is really valid and valuable when you're trying to spark create or be a comrade to change is if you have experiences in that you are such a valuable person in that community. So for right now, that's my answer.

Maggie, RNC-OB  4:01  
Next up, we hear from Dr. Cody Pyke, Attorney physician, bioethecist, and all around thought leader in perinatal care, what is the future of community birth care, community perinatal care, look like to you if you got to spin it?

Dr Cody Pyke, Attorney  4:16  
I really think and I'm not saying this to just promote the National Perinatal Association. But that what I saw there as a medical student back in 2016, when I saw it, that's what I thought I thought this is the future. And it's about creating an equitable space where we can all speak to each other. And also then take that message cohesively as a community to outside of our community to convince them that they should listen to us essentially, where parents of NICU babies have an equal voice as the most decorated neonatologist or high risk obstetrics specialists, where no one rolls their eyes at someone who is a vocational clinician, as opposed to a fully licensed clinician, yeah, I think once that mutual respect is cultivated, we can really do some amazing things. And I think the future of perinatal care is interdisciplinary, I think the future of perinatal care, by its definition is going to be team based, admittedly, with some of the capital P policy decisions happening and with the Dobbs decision, I think the future of perinatal care is going to be a battlefield in a lot of ways. And to that, I would say, for those of us that do this work, we have to take care of ourselves. And it's not selfish or weak, to take care of yourself. It's actually taking care of your patients to take care of yourself. It's taking care of the people you're advocating for, to take care of yourself. Because the last thing you want to do is burnout where you can't help anyone. And so I think it's going to be an uphill battle. I'm not a sunshine and roses kind of person. I've got lots of idealism, but I'm a pretty pragmatic person. But I do think that it's gonna get better. I still have states that birthing and babies their hotbed issue because students care about these things. Yeah. And I think the more our community as advocates to make the broader public and community, bigger community aware of the issues, it's going to galvanize change, because no one, no one wants to see negative outcomes, no one, regardless of their political background, or their religious ideology. We can all agree that if someone is trying to have a baby, there's a way that should be happening, where they are supported. And there's a positive outcome, we can all agree that people should be respected, we can all agree that people should be entitled to feeling in control of their own bodies. It's just a matter of translating, translating the different ways of talking through different belief systems through different professional or interdisciplinary systems and saying, I think we've just been talking past each other this whole time. And we actually agree, let's figure out a way that we can come up with a policy that makes a reality. Well, we've all want to help. Who,

Maggie, RNC-OB  7:31  
Allison Tate, of Allison Tate Birth Companion shares next about what this means to her. What is community birth care look like for you if you were crafting it for the future? 

Allison, Birth Companion  7:42  
Oh, goodness, what would it look like for me? Well, it's obviously got the birthing person, centrally, it looks like whatever they need it to look like is safe, says respectful. It is based in culture. It is birthing people being surrounded by those who wish to be without any, you know, any constraints around what that looks like. It's about returning to humanity. It's about being human beings, again, listening, feeling, being present, safety, all all the basic things. And obviously prevention of form and trauma, but just truly enabling people to live their reproductive experiences and the way that they wish to do so surrounded by those who show up and the way that they need. And just throw out everything that prevents us from doing that, you know, shedding the layers, and being human beings and then just birth to save humanity, right. There's no more human experiences and births and deaths and it's a privilege to walk in those spaces.

Maggie, RNC-OB  8:47  
Next up, we have Pansay Tayo, doula, mother to mothers and founder of the Sacred Pause Red Room, and Sacred Butterfly Births. What does community birth care look like for the future for your children, for your grandchildren, as they go into this?

Pansay, Doula  9:01  
I guess how it looks now they are, you know, they're very involved in you know, everything that I do a two little ones actually got to come to a birth about two weeks ago, scooped them out of the bed and run to the birth. But the way they see it right now is they see pregnant women doing yoga together, they see pregnant women meditating together, we come together, they eat, you know, they see circles where we might just you know, we don't want crafts, we were creating things while birth space. Basically women crying all the time, but they're not fearful. You know, of that because they know that this is the safe space where we get to decompress and release, you know, all of these things, but we're doing it in a setting of support, right of support. I really want, my vision for this year, because my vision is how can I help more women with finances do not have to be, you know, like, I like to have you as my doula to have all these things but I can't afford it. Looking at the shifts of births sets, I began this work this year where this year I feel that it has been kind of sealed for me that this is the way it's supposed to be done. This is how because it's not just birth stories lives have been changed, husbands lives have been changed, partners have been changed, the mother's lives have been changed, the grandmothers lives has been changed. So to keep this community in my prayer is that I'm able to show other tools and other birth workers how to do this. I do plan on talking to a few midwives this year to see if we can kinda if somebody will be open to doing centering care with what I already have going online. Because it seems it works. Yeah, it's working. So for my children and grandchildren to know that you have options to know that their support systems to know that there are safe spaces to know that you have choices to know that the spiritual the mental and the emotional is a part of your sacred transition into womanhood into pregnancy and also postpartum Where's community must the baby is out? Where's community wants the the new woman is unfolding, who's bringing her food was clean. The house was getting getting her water, who was assisting with breastfeeding holding the baby while she showers telling her it's okay. Those days where she's just crying and bawling. What have I done? How did I get here? Yeah. Life? Those days? Yes. But my prayer is that they know how to do it. That's That's my legacy. Yes. If nothing else, let these girls know how to turn in careful women, how I am. But as of right now, I'm excited to you know this with a thoughts of birth, what they think about it, and even at the ages, where they are, yes, yes.

Maggie, RNC-OB  12:12  
Now, Erin Heacock will share from her experience as a birth advocate and new postpartum nurse. What is your what is your vision that you, you know, imagine, for what like community birth care could be for the future for, you know, generations to come? 

Erin, RN  12:27  
I hope it's more accessible. I like when people can have an option of where they want to have their baby how they want to have their baby. So I hope that it becomes more accessible, like not just a hospital or births or, I mean, I just know about aren't like this area. So it just may be in this community that I talked about that. Yeah, this community, I feel like it would be really cool to have more options, birth centers and more midwives, midwives that support birth, how it's happening, and not only try and change it to Yeah, I feel like the only option in this community is hospital birth, or you homebirth. But I hope someday that bird can go back to being looked at it's like a normal, physiological process and not something that we need to necessarily always augment or change, or I hope they can just be more left alone. Yeah, it can happen, how it's gonna happen, because when we try and change it, those changes, lead to other things and like, just like cause and effect kind of thing.

Maggie, RNC-OB  13:51  
So you'll hear next year Emily Edwards, doula, nurse, advocate, and founder of the good birth co; what does community birth care look like? What is your vision? How would you cast thatfor what it could be?

Emily, RN & Birthworker  14:06  
 Phenomenal question. I think, really, it's that every person who is preparing to become pregnant to give birth or who has just had a child, that they have access to the right care at the right time by the right provider, and that their needs and their priority concerns are absolutely central to everything we do. And to make that possible. We need an entire community around that person, local geographical community, but also community that shares values and shares with their shares in that experience with them and the desire for the outcomes to to be supportive, because we can talk about good outcomes by I think community care, community birth care, especially you is going to ensure that no one falls through the cracks. That be the person who had an abortion. The person who had a stillbirth, the person who died had a surprise pregnancy and they didn't know they were pregnant, and they gave birth, whatever that extreme kind of piece of the story, or the one that doesn't quite fit into that perfect happy, healthy mom and baby and nuclear family that they feel supported and seen. That's ultimately what I would say community birth care. But

Maggie, RNC-OB  15:31  
Next, Dr. Kia Lannaman will share from her experience as an MFM and founder of Accessible Professionals. What do you think community birth care can look like? What is like the vision you would cast for how we how we move forward holding all of these different elements? What could it look like?

Dr Kia Lannaman  15:47  
That's a great question. And I think, you know, in politics, we have different parties, because we don't always agree. And that's not, that's not necessarily a bad thing. Sometimes it's okay to say, you know, actually see things differently. And I hear you, I respect you. But you're, I'm not going to join you in this thing that you want to build. I think that maybe we need to have another party. And I question and I know some others that are questioning whether we can really build one tower that serves all better in a system that's been going on for, you know, several, multiple decades, and may not, it's hard to change the course of a big ship. So I wonder if what is going to happen over time is there going to be different different options, different parties of community, the typical community that's going to survive, that doesn't have to change in order to, to continue doing what it's doing. And then a new wave of people that are saying, let's do this a little differently. Let's be okay to asking questions of ourselves that we hadn't asked before. Let's listen a little bit more. Let's collaborate more with the people that we're serving, let's really let them have autonomy, but be uncomfortable and let that grow us. And so that community may involve more collaboration between midwives, nurse practitioners, physician assistants, physicians, I was at something the other day, and it was so invigorating, it went to a home birth office, like a center for a breach training course, I was the only withdrawal for the medicine provider there was one of two OB-GYN is there, the person the only other OB-GYN was the person teaching the course. But it was where I was with all midwives, midwives assistants. And I walked away invigorated, and I just thought the courage these midwives have that do home births is a portable and like even just being around them from a weekend, it transferred some courage to me to say, You know what, these are growing opportunities, I think the more that you are around other people that you can learn from if you'll be come off your your elite pedestal and just say, I can learn from this person, they have an area of excellence that maybe I don't have, and just all that exposure can grow everyone I've learned so much from a nurse practitioner that I've worked closely with for years. And I'm like, wow, she's excellent, boom, boom, boom, boom, she has so much knowledge of boom-boom-boom-boom. And the more around her, I'm learning from her, and she's learning from me, and we can share knowledge, and it doesn't have to be competitive, and it really can just elevate the service that we provide. But I just thought to myself, Oh my gosh, some of us need to be around New Wave sometimes, you know, there's, you're locked up, like the things that, you know, but not everybody. There's so I mean, there's some learning that has to go into that to have, you know, that you're not competing that some people are not practicing, you know, which medicine and, and that we're all here to serve, and that, that you can learn from someone who had a different career path and draping paths than you and that their experiences are still valid. So So I think what I think is going to happen is that another party is going to come up with their that there are going to be different communities have offerings of birth care work, and there's going to be the the traditional, that will always be there and that may change a Rusev slightly here and there. And then there are going to be other silos of options that people are going to start to realize as as the world becomes more accessible to each other through the internet, they're going to realize the options that they have, whether virtual or in person, and in those that are interested in that are going to seek that out and they're going to find it

Maggie, RNC-OB  20:00  
Sharing next is Kayden Coleman, seahorse dad, trans advocate and educator. What could community birth care, community care during pregnancy and postpartum?

Kayden, Advocate  20:09  
Like, my vision is for it to be equitable. My vision is for there to be a requirements that in order to provide care for in any reproductive space that you are willing and open to and able to provide care for anyone, regardless of gender, gender identity, sexual preference, familial structure, race, ethnicity, religion, I hold firm to the fact that nobody should be in medical care at all, whether it be reproductive or not, that is not open to properly and in an equitable and moral manner care for these individuals in that space. It's 2022, we're about to be in 2023. There's no reason why there should be all of these medical disparities surrounding people from marginalized group not receiving the care that they're supposed to be. So my goal, it's not just for trans people, it's not just for queer people, what I see my vision, is everybody just receiving the care that they deserve. And that's equitable across the board above where we're at now, chair,

Maggie, RNC-OB  21:26  
Carlyn Masters next, with her background as a social worker, and community advocate. What does the future of community birth care look like for you? 

Carlyn, LCSW  21:32  
Community abolition and community? I think abolition is is what that looks like for me. Because truly until we have, until we have abolished these systems of oppression, we cannot stand in radical progressives, patient centered care. And being in community with one another is how we get to abolition. So, you know, it's a tough topic. It's like, my coworkers, and I joke about like, people will be like, Hey, how's it going? Or like, Hey, what's going on? Like, this is not a fun topic, like, this is not that I mean, snacks. This is a lot to sit through, but we can do it. And we do it together. I think that's what becoming an abolitionist is, right? It's acknowledging that we show up to this work, not by ourselves, we are part of a community, we are part of a greater vision, right? We can and should always come with positive regard, but radical optimism, transformative justice, and the well being of communities will never and has never lived in the state, the state is not going to fix this. Yeah. And those, that work will come from us. I cannot speak to hospital work anymore, because I don't do it. But when I was there, these hospital administrators don't give a shit about you, you are abused and completely taken advantage of in the birth work world, if you're in a hospital. It's on purpose. You know, we have to maintain this radical optimism that we can and we will do better. In a lot of ways, it's hard because at the end of the day, you leave your beat down. It feels overwhelming, but it's meant to feel that way on purpose. It's meant to, to create this feeling of helplessness. But I mean, the some midwives, the nurses that I worked with, like some of the greatest people and most passionate advocates, we can do this, but we do it together. We do it. As you know, members are of our profession. We do it as members of our community. Community will save us and we need to get back to this imagination we need to reimagine our future because it could be a really great one.

Maggie, RNC-OB  24:00  
Next up is Shalini Shah, sharing from her experience as an IBCLC prenatal educator, doula and founder of BIPOC in the Bay and the Shah, sisters, what is your dream, your vision for community birth care?

Shalini, IBCLC & birthworker  24:16  
Oh, I love that. I mean, I think really, at the end of the day, just my dream is just like, unabashedly expansive support, and understanding and so just, you know, the theme of what we've really been talking about today is just trusting that people know what they need and giving them the opportunity to receive that. Whether that means and you know, we talk about, for example, like cesarean care and we have these conversations around like there are too many cesareans in the United States. But that is a different conversation from supporting people who have cesareans Yep, someone saying to me, this is my choice, this is what I want. Who am I to tell them? No, like, I know better than you what what is there for your body. And by giving people this, just pure, true authentic support, and love and acceptance and trust, is starting at the baseline of that if the amount of just radical change and love people are starting their journey with of parenthood, how much we can kind of shift the conversation, because people won't. In an ideal world, we're not starting from a level of just being traumatized. We're starting from a level of like this, like just loving pragmatism, in a way, like, I accept you for who you are and who you are telling me. You're telling. You're sharing your experience. And I accept that. And I love it, because I love you carry it.

Maggie, RNC-OB  25:57  
And to wrap us up is Dr.Erin Sadler, psychologist at Children's National Hospital. If you got to spend your vision for what kind of the future of community birth care community perineal care could look like what would it be? 

Dr. Erin Sadler, PsyD  26:09  
My true vision, personally, wouldn't be what I think about comprehensive care, we know that everything kind of moves in a cycle and all the generations are really connected. And I would love for there to be a space in time where everybody has a care team that is well connected together, whether that is we have our perinatal specialists who are with birthing people all through pregnancy delivery, postpartum, and could ideally just stay with him for the duration of whatever happens next, and then as needed, and of our mental health specialists who are able to stay with young children through their childhood into adolescence. And my hope is way down the line somewhere. Well, if he had a space where everything has a reach shifted, where we've grabbed enough caregivers, that the generations that they're raising the parents, that could be children that they're raising, had had a generation of parents who've had all the support and care that they need. So that way, we can reduce all the ACES as much as we can. And then we have a generation of children who are raised in a space where their aces are so low, that they can really just just go off into the world, and then we reshift the cycle, then it's just a lot of positive experiences. And said, just simply based on the care that people were able to get both in early childhood, or into adulthood, as they're becoming caregivers and raising children. So there's that piece of it. But how that looks is weaving us into everything is weaving this type of support and care knowing that it's also level that it doesn't require psychologists to be everywhere, but there are multiple levels, we have our do loans, our really tiny anybody, any therapist, any person who is connecting with birthing people, or new caregivers, have the ability to, to know what's helpful and and be able to have their one touch because if everybody is able to connect, and have a role in adding one beautiful positive experience of the family, that that can certainly outweigh a lot of the adverse one.

Maggie, RNC-OB  28:21  
Well, a powerful episode, and I hope it has hit you all much the same way that it did for me, I hope you leave this feeling aware of all of the potential that there is to reimagine our systems of care to truly come together in community to show up for folks the way they need through pregnancy, postpartum parenting, and to really to know that just as these individuals shared their vision, each of you has a valid vision for the future of care. And we would love to hear from you about it. So feel free to find us on social media. We are your birth partners across all platforms. We would love for you to share a little tidbit or even give a little shout out about what your vision for community birth care looks like the future. We'd love to share with you