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NATAL, Episode 6: “Brittany’s Story”

Episode Summary

Unable to find an OBGYN that reciprocated the genuine excitement and warmth she felt about becoming a mother for the first time, Brittany pursues prenatal care with a midwife. In this episode, we explore alternative care models, the vital role of partners and loved ones, and hear from Demetra Seriki, a midwife in Colorado, who is determined to make sure all Black birthing parents can afford quality, affirming full spectrum care.

Episode Notes

In this episode we mention:

Follow NATAL on social media: @natalstories

Join our Facebook Community to connect with other parents, birth workers, and advocates.

NATAL is produced by You Had Me at Black and The Woodshaw. Listen to You Had Me at Black wherever you get your podcasts.


EPISODE TRANSCRIPT

Britanny Patterson: And so I wanted to express my concerns. From that point, moving forward to time of delivery, I need to know what your protocols are. What is the process? What can I expect from you to doctor’s appointments that I come into? How can I prepare for each doctor’s appointment? You know, some of the basics, what are some of the tests?

When do these tests happen? Versus show up to a doctor’s appointment, “Okay. We’re going to do this test.” No, I’d like to know what’s going to happen before and I’d like you to explain it to me so I can let you know if I want that or not. But that’s not really how hospitals usually work. They’re used to people coming in and you have whatever done.

[NATAL Jingle]

You’re listening to NATAL, a podcast about having a baby while Black

 Gabrielle Horton: Hey, y’all, welcome back to NATAL. I’m Gabrielle Horton. If you’ve been tuned into NATAL this season, you know that we’ve spent a lot of time talking about what care really looks like for Black birthing parents across the country. Like Britanny Patterson, the parent at the top of the episode, we’ve had a whole bunch of questions about what prenatal visits, doctor interactions, and even delivery can or should look like.

And so far we’ve seen how much that care varies depending on your location, insurance and even income. With 99% of babies born in hospitals, we’ve also gotten a pretty good look at what birth looks like for the majority of Black parents. We’ve heard from them about the abundance of hope they place in their labor and delivery teams; hope that their OB GYN and nurses will help them have a healthy pregnancy; hope that there’ll be treated with respect and care; hope that their questions will be met with answers, confidence, and honesty.

For some parents, hospital deliveries have gone really well for others, not so much with the stakes as high as they are for Black birthing parents, we can’t continue to accept this variation in care as normal.

So what if I told you that there are models of care that don’t send her, the OB GYN and hospital staff as the only decision makers during a family’s pregnancy? What if I told you that there are models of care that emphasize collaboration, wellness, community, and even self-advocacy. Models that welcome questions about the process tests and protocols.

In this episode, we’re going to hear Britanny’s experience with one of these alternative care models. And we’re also going to talk to a midwife in Colorado to better understand the critical role of Black birth workers. Their expertise and training have sustained our communities since we got to this country in 1619. But first, let’s start in California with Britanny’s story.

Britanny Patterson: My name is Britanny. I live in Santa Clarita and I’m a proud mama of baby boy, Roderick. And we call him Ro. And this is my needle story.

Gabrielle: In 2017 Britney and her partner, Rod found out they were pregnant.

Britanny: And I was really excited to become a mom, but at the same time, not rushing it, wanting to take my time with it. And so when I did find out that I was pregnant, it was a surprise. And it was unplanned. And so finding out that I was pregnant was definitely nerve wracking. At the same time, it was just a blessing and so I received it and just move forward and was excited. And my partner, I think he felt the same way. Definitely nervous and felt a little bit overwhelmed, especially being a man, going into fatherhood. Like his concerns are a little bit different than mine.

Gabrielle: Once Britanny reached the end of her first trimester, the couple was excited to share the good news with their family back in Ohio.

Britanny: You know, we had fun with it too. We just flew home, didn’t tell anyone, and surprised everybody. And it was a lot of fun. And we recorded most of those reactions, which is awesome. I was able to put it together into a video and I have like this nice compilation of all the surprise reactions. I love that I have that and I’ll be able to share that with Ro when he gets older.

I think that initially the first thing is, okay, I need to, I need to make a doctor’s appointment. And then of course we did have a conversation around finances, living situation and just, you know, just all those normal thoughts that come up.

Okay. How do we go from here? And while we have a baby coming in nine months, you know, what do we need to do? So a lot of, a lot of thoughts around finances,

Gabrielle: The couple was making their way through their pregnancy to do list. But when it came time for Britanny’s first prenatal appointment, things didn’t go so well.

Britanny: And, um, had a doctor’s appointment with OB GYN and she was not Black. Um, and she was just less than enthused. I’m not sure she was having a bad day, who knows. But we tried our best to connect with her. Like I’m a people person. So any person I’m talking to, I’m going to ask questions and get to know them a little bit.

And I try my best to do that. And she was not, she wasn’t for it. And so she just kind of was just doing the standard procedure. And I just felt like it was very mechanical. There was no feeling really involved in the whole process. And, you know, we were excited at that point. Especially me, so I didn’t really let any of that get in the way of how I felt, but just afterwards i was like, that was not okay.

That was not cool. It wasn’t a cool experience. And I even asked Rod about like how he felt, because the whole time she never made eye contact with him. And she also, she didn’t really, I wouldn’t say she suggested, she just said, just so you’re aware, you don’t necessarily have to come to all the appointments.

They become monotonous, you know, it’s the same old thing. And right there I just didn’t agree with that. It shouldn’t be the same. If it’s the same, then I feel like you, as the, the OBGYN is you’re doing something wrong. I have life growing inside of me. So every time I come, my stomach is growing, different feelings come up, you know, it shouldn’t be the same thing.

And so I felt like that was her way of politely saying that she would probably feel more comfortable if he wasn’t in the room. And I strongly disagree with that. From the beginning, I, you could see the gaps in how the father is really excluded or not treated the same as the mom. So it makes sense that they’ll kind of step back, take a seat back.

And when it comes time for birth, they may not know how to show up because they they’ve been put on mute throughout the whole experience. And I just, I wasn’t for that.

Gabrielle: Even though her body was going through all these changes. It was really important for both Britanny and Rod to feel seen, heard, and cared for during their prenatal visits.

After all, they both made this baby and they were both eager to meet their baby with every bit of information and resource available to them. They wanted to learn, grow, ask questions, and enjoy the pregnancy. They just wanted their OBGYN to feel the same.

Britanny: And, uh, so I just let the nurses know that I never wanted to have an appointment with her again.

And not to book me with her. And I requested that they booked me with the OBGYN who did my pap smear. Um, it was a similar situation. She was more jolly, I’ll say like more bright. But she had more of that hat of “I’m the doctor, and so this is how, you know, I’m running the show. This is how things are going to go. Therefore, I know what’s best. Allow me to lead this process.”

And it was as frustrating because she would interrupt. Like just in her mind, just thinking, “Oh yeah, I know what you’re going to say.” It’s like, well, no. And even if you do, let me get this out. So that right there, I felt like, well, if you continue to interrupt me, you’re not respecting what I have to say.

You don’t want to hear me. You’re not listening. In between those appointments I had done so much research, and my concern had grown for just how the hospital system works.

Gabrielle: By this point, Britanny had seen two OBGYNs, neither of them made her feel cared for. In addition to all the Google searches and reading, Britanny had recently watched a 2008 documentary produced by nineties talk show, host Rickie Lake.

Britanny: I rewatched the Business of Being Born. 

Gabrielle: The film focuses is on New York city and explores the history of obstetrics, midwifery care, and the economics of childbirth thing. And it gave Britanny a whole lot more to think about.

Britanny: So that just kind of brought up all these emotions. And so I wanted to express my concerns and ask about like, from that point, moving forward to time of delivery, I need to know what your protocols are. What is the process? What can I expect from each doctor’s appointment that I come into? How can I prepare for each doctor’s appointment? What are some of the tests? When does these tests happen versus show up to a doctor’s appointment, “Okay. We’re going to do this test.”

No, I’d like to know what’s going to happen before, and I like you to explain it to me so I can let you know if I want that or not. But that’s not really how hospitals usually work. They’re used to people coming in and you have whatever done.

Gabrielle: As much as Britanny cared about the data and every single step of the process.

She also cared about being cared for. This was her first baby, and Britanny was in California, thousands of miles away from her family. But more than anything, this mom to be just wanted to know that her hospital team saw her as a whole person, whose questions, concerns and feelings mattered.

Britanny: And so throughout my entire process, I felt like I never got that from any healthcare staff. I never got anyone to say, you know, “Britanny, how are you feeling? I see that you’ve been working really hard and I’m really impressed. I’m really proud of you that you’re taking an active role. I love that you’re leading in your pregnancy experience, I think is so beautiful. And I just want to check in with you, how are you feeling?”

Because I know it’s a lot, you’re growing a baby inside of you. Nobody ever did that. And I was able to get that support from my mother, um, who lives out of state. And I was able to get that support from Rod, my partner, and that was helpful. But it’s still, you know, with my mom being away, it’s like, you still kind of want that motherly love in a way.

And I saw it in some of the research that I was doing with watching videos and seeing how other midwives would care for their patients. And I felt it through a phone call that I had with a midwife, a local midwife, who owns a birth center out here in Santa Clarita. I got off the phone with her and I cried because that was like the feeling.

A connection that I was looking for that was missing. And it’s so simple. It’s just listening. And her, she goes, “Oh my gosh, congratulations! This is your first baby. Oh, wow. Like you are just in for a treat. It is, it’s going to be so amazing, like you’re in for the time of your life. And I’m so excited for you.”

And she gave me some tools and resources to then go and do my own research. And, you know, it was just great. And I’m like, why, why couldn’t I have had this at the hospital?

Gabrielle: Britanny’s question was so valid. Why was her experience with the OBGYNs so different than the short call with the midwife? Coming into NATAL, I had very little knowledge about this larger birth worker community. Let alone midwives. Certainly I had heard of them, but I didn’t really know what they did and why they mattered.

As you might recall from Episode Two, midwifery practice in the US is not just some new trendy buzzword. Up until the mid 20th century, when OBGYNs and hospitals became much haves for delivery, Black healthcare providers also known as granny midwives provided medical, emotional, and physical care. And more often than not, they were caring for poor and rural pregnant parents, Black and white, throughout the South.

These trusted healers were trained to serve their communities when slavery, Jim Crow, desegregation and sheer economics made it nearly impossible for families to receive adequate care. Today, midwives are required to complete a midwifery education program and meet rigorous qualifications to be legally registered to practice.

And for many Black midwives, this work is personal.

Demetra Seriki: My name is Demetra Seriki. Uh, but my clients call me Mimi.

Gabrielle: Demetra is a Black woman, wife, and mother of four. She’s also a certified professional midwife in her hometown of Colorado Springs. There, she runs A Mother’s Choice Midwifery, a private practice.

Demetra: So how I got here was, you know, being a teenage mom. And caring for my friends who were in the same school as me as a teenage mom. You know, some of us didn’t have family support. Some of us didn’t have partner support. And so that is where the seed was planted to do this work. I didn’t know what a midwife is. I didn’t know. What it would look like to be more than a support person, but I always knew my place was in that realm of supporting birthing people. I always knew that at a very young age,

Gabrielle: There are several types of midwives that vary by state, training, and licensure status. Midwives provide a full range of primary health care services for childbearing people.

They include family planning, and pregnancy, birth, and postpartum care. It’s almost like if your OBGYN was a trusted neighbor, who served all the expecting parents in the area, you know? In 2018 researchers confirmed what many birth workers already knew to be true, which is that integrating midwifery care into regional health systems is strongly associated with lower rates of C-sections, preterm births, and maternal and infant death.

But even with this long history and the research to back it up, midwives still remain on the margins of maternity care in the US. Some States don’t even acknowledge them as legitimate practitioners. And in others, they’re not even allowed to work in hospitals. And if we’ve learned anything about how our medical system treats Black birthing parents, especially now, during a global health pandemic, we know that this collaborative, parent-centered approach is as essential today than ever before.

Demetra: Like when you call an OBs office and you’re like, “I’m eight weeks pregnant!” you might be super excited. You might be nervous. You might be anxious, you might be unsure. Right. And it’s like, “Okay, when was your last period?”

You know? Um, “Okay, well, this is when we’re going to see you.” And when you pick up the phone and you call a midwife and you say to me, “Hey, you know, I’m looking for a midwife. I’m pregnant.” The first thing out of my mouth is congratulations. Congratulations. I don’t think that we do that enough, um, in a society, specifically in Black and Brown communities, just really acknowledging that you’re pregnant and this is a time of celebration.

It shouldn’t be a time of fear. It shouldn’t be a time of you being afraid of being judged, um, because there’s a lot of that. Um, it can come from your community and your family. When you were in the care of a midwife, you are seen as a human, you are met at a very humanistic, a level of care. You’re not an incubator. You are not a vehicle. You are a pregnant person. Your life is valued and your baby’s life is valued.

Gabrielle: So much of Demetra’s advocacy lies in her commitment to removing barriers to care for Black childbearing folks. She makes sure that young parents aren’t navigating pregnancy without a support system like she was nearly 20 years ago.

Demetra: A good amount of the work that I do is for folks who are seeking a home birth. However, the practice itself offers two types of service. So, um, home birth is one, uh, but the other is our prenatal open-access. And the prenatal open access was created solely based on the voices of the community. For folks who were looking for a perinatal care provider, who was of color, or specifically a Black person, um, but fearful to have their babies in the home and wanting to still have that hospital birth experience, but recognizing how important it is to have a provider who looks like them, who can meet them, where they are to have an environment in which they don’t need to code switch. And so that’s what the prenatal open access is.

Gabrielle: Now that was a kind of energy Britanny wanted to feel from her hospital providers. That one phone call, let her know that it was in fact possible for her to receive the type of support she deserved. If you’re like me, right about now, you’re probably thinking this sounds awesome, but what does it cost? So let’s talk numbers real quick.

According to the Center for American Progress, the average out of pocket cost for a hospital birth is $4,500 with insurance, but let’s say you don’t have insurance. You’re looking at a price tag of roughly $30,000, but what about midwifery care? What does that cost?

Demetra: Midwifery care in an out of hospital setting is quite pricey. That’s why it looks like it caters to the upper echelon of communities. So for here in Colorado, for example, what you’re going to find the most is $3,000 to $5,000 out of pocket.

Gabrielle: That fee includes prenatal care, midwifery and nurse care during labor and delivery, and oftentimes, home visits after birth. But for parents like Britanny, who simply want a midwife versus an ob to manage their prenatal care, that cost can be even lower. Because midwifery care isn’t always covered by health insurance, and prices vary by practitioner, some midwives offer  sliding scale, pay-per-visit, and payment plan options to ensure that families aren’t going broke just to have a baby.

Demetra: So it’s $40 per visit. So you come in and you see me, it’s $40 and then that goes down. Once you hit 36 weeks, because obviously I’m seeing you more frequently. Um, so that goes down, I believe it’s 25. Um, until you have your baby and then you go to the hospital, you come back to me and then the face to face visits are 20 bucks. So the goal with the prenatal open access was not to create a cost last barrier, it was to remove a cost barrier. Like I really had to think about how can I work outside of systems and structures, because the systems and structures that are in place are not working. And our outcomes aren’t better.

So that was really, really important, not to create another financial burden. No, I don’t require full payment all at once. A hundred percent of my families are on payment arrangements and because of the cost it’s doable.

The last thing I want to do is create a circumstance or a situation where a family cannot receive the care that they need. Because of finances to me, that’s just, it’s inhumane. It is, it’s not right, ethically it’s not right.

Gabrielle: Even though Britanny considered her health insurance coverage to be pretty good, these very systems and structures presented yet another obstacle. She was still getting the runaround about whether or not her midwifery care would be covered, and what her options for care would be.

Britanny: I had some, some of them saying, no, it won’t be covered.

The couple of people, I think it was maybe two or three, I think three, different representatives I talked to said, yeah, it can be covered, but it’s going to take a lot of digging, a lot of following up and yeah, so it just seemed like, okay, it’s going to be a challenge. And then there’s still the risk that it won’t be covered.

Gabrielle: Still, Britanny kept at it. All of the phone calls and long wait periods gave her a chance to sharpen her questions, figure out what she needed to ask, and who she really needed to talk to. Steps that Dimitria also encourages her families to do.

Britanny: So I had to learn to be more succinct with my questions and with my responses and learn to use their language, to ask the right questions. That helped.

And that was a part of how I found out about midwife care. And when I did talk to a kind lady and she goes, “Well, you know, you can see a midwife.” And that was early on after I told her a little about my experience and I was like, “Oh, I would definitely like to meet with the midwife,” and the lady I met with, she was very, she was nice, but I don’t know.

I don’t know if I was the first Black person or Black people that she’d ever seen because it was just always weird. But the main thing from that appointment, I would say is. I knew in my mind that I wanted to have a medicated birth, no interventions, you know, so long as everything’s going well. And I expressed that to her.

Gabrielle: That first midwife appointment was far from perfect.

But Britanny knew exactly what she was looking for. And well, this just wasn’t it. One thing that did make Britanny feel good was that the midwife made eye contact with rod and engaged with him as much as she did with Britanny. Those seemingly small details left the couple of feeling hopeful about their midwife search, even if this first appointment was a little awkward, they crossed their fingers that the next midwife they’d meet would be the one.

Britanny: So that was the difference. And I did mention that to her. I said, well, I want to say thank you for including Rod, including my partner, because we didn’t get that from the last two appointments that we had with OBGYNs.

And she did give a recommendation for another midwife because of the birth goal that I had, and the midwife that she was recommending previously owned her own practice. And she also had, she had water births at home with her kids. And so I’m like, okay, well she has, you know, an experience similar to what I’m looking for, more on the, unmedicated, less intervention side.

So yeah, I would like to meet with her. She was really nice. Still, it was just a disconnect. There was a gap. There was just the emotional attraction wasn’t there. But I felt comfortable moving forward based on her experiences with giving birth, me explaining my birth plan. She was attentive. She listened.

There was just the emotional connection wasn’t there. It’s hard to put into words other than just emotions, you know, you can be nice and then you can show love. And it wasn’t like that love. Like gas me up. Pumped me up. Can we get well excited? You know, can we get some oxytocin the room? That’s my mindset on it.

[Birth Stories in Color promotion]

Throughout this season, we’re highlighting different podcasts that explore various facets of the Black birthing experience. Birth stories and color is a podcast for people of color to share their birthing experiences. It just space that celebrate mourns with and support folks of color and their transformation through birth. The show emphasizes the role of storytelling as a way to equip parents. Listen to birth stories in color on Apple podcasts and Stitcher to join their community. Go to birth stories in color.com and follow them on Instagram and Facebook

Gabrielle: As Britanny’s pregnancy advance, she started to settle into a healthy rhythm with her new midwife. Britanny enjoyed having more time space to say what you wanted to say and ask freely. And Rod was right by her side throughout the entire process. According to Demetra, that individualized, relationship-based care is exactly what parents can expect with a midwife.

Demetra: You know, when you come in, my appointments are 30 minutes.

Initials are an hour, but those 30 minute appointments cover, you know, your standard vitals, to do your blood pressure, your pulse, your pulse ops, your temperature. That’s done pretty quick. You, we do a urine dip, we do weight, moms do the weight on their own. Um, and then we do your standard measuring of the belly of your belly, and listening to your baby. That can all be done in like five weeks. Once we hit 24, 26 weeks, I feel like we have a good idea understanding of who I am, who you are, what expectations are and boundaries and stuff like that. And we began to focus more on things that are coming up, such as screening, um, teaching people what it means to have autonomous care, right.

Like really explaining the right to autonomy. Yes. We talk about it when you come into care in your intake, but now we’re starting to offer you. And I say offer because it is not mandated. I’m offering you the choice of gestational diabetes screening. I’m offering you the choice of, um, GDS screening. I’m offering those to you. I’m not telling you.

It’s very interesting. Partners are usually pretty quiet. Trust me by the time they’re like 36 weeks, like, partners come in with all kinds of shades, like, “Oh,  no, she didn’t do what you told her. She ain’t been taking her vitamins.” Like they just spill all the tea. That just goes to show you how significant relationship based care is.

Like you’re really empowering families when you begin to really not just tell them what autonomy means, but you’re actually invoking it through shared medical decision making.

Gabrielle: This care model where parents get to be active decision makers and have a say in what happens to them and their bodies, and how, all of this at the very core of midwifery and Britanny was enjoying every bit of it.

With all of her research, Britanny became really interested in the idea of delivering at a local birth center, but her insurance company wouldn’t cover it. And the out-of-pocket costs, was just too much for her and Rod. The hospital was the only option.

Britanny: I needed to just kind of let that go. So I just had to grieve that a little bit, and the midwife at the birth center, she was encouraging and she said, “You know, it doesn’t like you can still have a very beautiful experience at the hospital.”

I’m thinking, yeah, you’re right, I can. I just was focusing around fears and the things that could go wrong. And I just had to then fix my mind on, yes, I can have a beautiful birth experience at a hospital. I’m just going to have to really work hard for it. And I’m gonna have to go in there prepared, you know, I have to be my own doctor first.

And so by me going in there and knowing the protocols and that then, you know, helps me to be able to ask the right questions and make a birth plan that, a quality birth plan, that they can honor and respect and it’s to them, it communicates okay, they came in, they came in here, prepared.

Gabrielle: Birth plans are the North star, y’all. That’s why we talk about them so much. A birth plan is a personal wishlist of how you want your delivery to go. From where you give birth, to how many people are in the room, to your preference for pain management. Even the little details are included. Like, do you want the lights damned while your favorite song plays in the background?

And do you want your boo, bae, partner, mama or friend to feed you ice chips while you wait for your baby’s arrival? It can be as specific or as broad as you want to make it, but it’s also fluid. Cause sometimes shit happens. But you determine when and how it changes. For real though, birth plans are a documented way to hold healthcare workers accountable.

They’re another resource Black birthing parents can use to exercise their autonomy. As we think about ways that parents can prepare and feel empowered through their perinatal journey, the birth plan is just one tool in this larger toolkit. Midwives prepare families for all of it.

Demetra: They’re required to do a birth plan because I need them to understand when they make that change of venue for whatever reason that everything that we have talked about throughout their pregnancy, it doesn’t go out the door just because you entered brick and mortar structures and systems. It doesn’t. You still have your birthrights intact. So, and, you know, I spend a lot of times talking to partners, like, look, y’all, can’t just fold it up.

Like text them, hold them, as soon as I’ll hit them, I’ll be like, do what they say, like nooo bruh. Nah, it don’t work that way. You know? Sorry, let’s be real. Like I’m giving you tools too, like, you know, this is what we do. This is what they want. This is what she wants. And really just working with them as a unit. And that is what those conversations look like until they give birth.

So there’s a lot of conversation. Um, you know, there’s a lot of, just a lot of effort and energy put into relationships and that’s, that’s what makes midwifery unique. You have to trust Black moms, you’ve got to trust mothers of color. You know clinical data, you know as a midwife books and education have taught you, but you don’t know her body. She knows her body. So we gotta listen.

Gabrielle: Knowing that Britanny wanted an unmedicated birth, her midwife suggested she look into doula services. After all, Britanny’s midwife was just for prenatal care and wouldn’t be by her side during delivery.

Like midwives, doulas are an integral part of the birthworker community. They’re trained professionals who provide physical, emotional and educational support to a parent throughout their perinatal journey. They’re kinda like a childbirth coach.

In some cases, they join for prenatal visits, advocate on behalf of the parent’s birth plan, and during delivery they might use relaxation techniques to ease labor pains.

 Britanny: So when she said, you know, you can still have a great birth at hospital. Uh, you can look into hiring a doula and they can advocate for you. They can assist you and support you. And I began to do research on doula doulas and we interviewed three different doulas.

All of them were very nice. None of them were look like me; none of them were Black, um, and as nice as they were, and even the experience that many of them had, there was still something in me, like none of them were like ding ding ding. Like you found it, this is gonna, this is it. This is it. This is the person. I never felt that, and I had to go with my intuition. I just go with, you know, energy and how I feel.

Demetra: But baby, your intuition will never lead you astray. Your intuition will tell you don’t mess with that one. And she, no, no. That’s not going to end well. Your intuition, you go into your intuition. When that little voice is like “Mmmmm exit to the left,” you need to pivot and exit to the left. It is okay. That’s number one, intuition. Number two, I do show up as my authentic self. So I, when people call me, I’m pretty sure at the beginning they like, “hmmm” and at the end they’re like, “Oh, she like Black auntie. Oh, we like her.”

I’m just honest. I’m like, you know, and I will use words like in full transparency, it’s important for you to understand this is my philosophy of care. So that way I can give them a tangible tool of, okay, listen, I strongly feel like this is not going to be a good fit for us. I feel like in your heart of hearts, this is where you want to be. So let’s get you some tools, a doula, let’s get you some, some safeguards in place so that you can enter that space with a sense of preparedness. Like that’s super, super important.

 Without that, it doesn’t matter if it’s out of, out of hospital birth or it’s in hospital, you’re gonna have a train wreck. So that’s super important. Last year the Black Women’s March, and I did a speech on birthrights, and one of my comments in there was “Baby girl, if it doesn’t feel right, it ain’t right.” Do your due diligence, do your homework. Ask people about that provider. Don’t just go because you feel like that’s the only option. When you say I’m just going to go, cause that’s the only midwife available or that’s the only OB available, you are literally rolling the dice on you and your baby’s life. Period, period. So lean into that intuition it’s there for a reason.

Gabrielle: With just two months left in her pregnancy, Britanny had to make peace with the fact that she wasn’t gonna have a doula present at the hospital. So in addition to her midwifery prenatal care, where she was learning all these new skills, Britanny started thinking about other ways she could mentally and emotionally prepare for what was about to come.

Britanny: So Ro was due August 23rd and I ended up having him August 19 so a few days before my due date. And for me, I wanted to work as close to my due date as possible, but I also wanted to leave time to just center myself. I was already going inward. Like the last month of work I’m just like, I don’t really need anyone to talk to me right now. Just let me be in my space.

I was watching birth–birth videos on YouTube, you know, like just immersing myself in it so I could prepare my mind. I needed to know what birth looked like. I felt I needed to know what it look like in order to do it. I mean, I know my body’s gonna do with it needs to do, but in order to, focus in and to prep my mind so I wasn’t like all over the place, is to know, to, to see it, to see what it looked like. Everyday I was inputting something to do with birth or pregnancy preparation. I also did some body work as well. That helped a lot with minimizing achiness. Um, but other than that, I mean, I felt great for the majority of my pregnancy. I felt good, felt beautiful and loved the way people would respond to me growing my baby.

Gabrielle:   As prepared as she was, Britanny was still a lil nervous.

Britanny: I have very few, I had a few times where I remember asking, well it was a couple, maybe it was two times I asked Rod, I said, “Do you really think I can do it?” And he goes, “Yeah, you can do it.” And he said, “Do you believe you can do it?” And I go, “Yeah, like with it–like, I don’t know why I just feel that I can do it.”

And so it was just a little, I think I was just getting a little nervous because like one way or another, this baby has to come out.

So the night before, uh, I went into labor, it was the night before I started having some leakage, and I wasn’t sure what was happening. I was nervous and I’m like, “Oh my gosh, my water might’ve broke.” But it wasn’t a lot. It was just a little bit.

So another thing too, we were intimate that night and I’m pretty sure that kind of helped to trigger something.

So then the next morning I woke up and I felt a little bit crampy and I still had a little bit of leakage. So I’m just thinking, okay, well, we’re getting closer to the time, but I never, I didn’t freak out. I just let him know, I let Rod know I was having some discharge.

Gabrielle: Britanny knew.  It was time. Her body was preparing to go into labor.

Britanny: 11:00, 1130 is when I was starting to feel contractions, but I still wasn’t sure. I mean, now it’s like, well duh yeah, those are contractions. But I don’t know if this is, especially if it keeps happening. And it’s like, obviously you’re having first baby and so I’m just not sure about it. So Rod recommended, I call the hospital or call one of the nurses on call and just let them know. So I did.

Britanny: on the way to the hospital. I had some contractions and I just, I would moan through the through it. I was just letting my body surrender into my body and letting whatever needed to happen and come out, letting it happen. And then I decided to call my mom and let her know and ask her if would say a prayer for us. So she said a prayer over the phone.

And we got to the hospital, it was 7:36 when they checked me and I was six centimeters dilated. This is what I did appreciate about the hospital: I didn’t have to, neither of us had to fill out a bunch of paperwork. I gave them my insurance card and they went to go get a room ready, prepped, so that they could check me and see how far along that I was. And that was it. It was very smooth. But again, we prepared. So we went on the hospital tour, we knew what the rooms looked like. We knew how many outlets we would have available to us. We knew that we could have a diffuser, you know, we knew we could have music. So we were just, we already knew what we, we already had a plan. We just needed a room.

Gabrielle: Once they settled into their room, their care team checked in about the couple’s birth plan.

Britanny: So we had, that was the only thing Rod brought in with us is the birth plan. we had multiple copies, we had like four or five copies. I had a sign that I was going to put on the door. I never felt the need to do that because of how I was treated. I felt good. So I didn’t end up putting that on the door, but we did make sure that, you know, they had a birth plan.

Britanny: Another nice thing is that I ended up getting a, a Black nurse. And this was my first encounter with a Black birth worker throughout my experience.

So I’m just like, “Hey, sis!” in my mind, like, “Hey, yes!” I’m really excited. And uh, so she’s like, “Yeah, I got her, I got her.” And um, even her voice, it was just well, I’m like, yes, this is great. This is awesome. So we went to the room, I was still just, you know, moving through my contractions. And, um, I didn’t put on there that I didn’t want any IV fluids or anything like that. I wanted to drink water. I had snacks and stuff for, you know, for me to keep my energy up.

Gabrielle:  A natural, unmedicated delivery was included in Brittney’s birth plan.

She wanted to feel free and in control as she welcomed her baby into the world. And an IV hep lock wasn’t part of that plan.

Britanny imagined the hep lock would tether her to one of those big metal iv poles with bags of fluid and tubing all over the place. But actually IV hep locks are a lot simpler. The small needle goes into the forearm or hand without any tubing or poles. It gives nurses immediate vein access, in case of an emergency.

Britanny: So I had a quick conversation with Rod and he’s like I mean, you know, they’re not giving you an IV, it’s just a hep lock, so if you feel comfortable, then I would just, I would say to do it and then just do it. So I decided to get the hep lock. Mind you, I’m still having contractions, you know, every so often– five to seven minutes apart. I’m on the medicine ball and I’m like leaning against the bed, just kind of swaying and rocking, moving. And, uh, the nurse she brings in the anesthesiologist and she goes, so, um, I brought in one of the best, like he’s really good at, you know, putting the IV in. And so I know you don’t, you said you don’t like needles, so we’ll just make it real smooth.

And then at that point he asked, the anesthesiologist asked me if I wanted to hear anything about an epidural. And I said, no, I don’t. And so he goes, “Okay, so we’ll just do the hep lock. We’ll, you know, be real quick and then get out of your hair.” Anyway, my eyes were closed, I’m rocking and he begins to, or he says, “Okay, so I’m going to, or when this contraction stops and I’m going to go ahead and, and do it.” I go, okay.

He’s like, “We’ll just do it in between contractions” And like to me sounds, sounds great, sounds awesome. So I let him know I have a contraction coming. I’m like moving my hand a little bit. He’s like “No no no we have to get this in”. So he continues to try and stick me and get a vain while I’m swaying on the ball and trying to not move but still trying to move through the contractions. Cuz it’s hard to just sit still when you have that much power moving through your body.

Gabrielle:  The anesthesiologist ended up administering the hep lock. And it’s not that Britanny wasn’t expecting it, it’s just that it happened so fast, and differently than what they agreed upon.

Britanny: I feel that he wanted to hurry up and get it done. I didn’t like that he, like in the beginning, he affirmed and said, like, we made verbal agreement that he would do it in between contractions. And then all of a sudden it changed because you decide to get impatient. And it’s like, and I don’t, and I didn’t even want the hep lock.

It seems minor. But to me, when I think about it, you totally disrespected my space. And I like that– those are little small things that we let people get away with. And then they become bigger things and that’s not okay. If someone says, stop, you need to stop. Like there was no emergency, there’s no reason for him to, you know, have to do that.

Gabrielle: These seemingly small, but not small at all violations of patient trust, during labor are things that Demetra not only hears about often but actively prepares her families to push back against during their hospital stay.

Demetra: And you’d be surprised at the questions that come up. Like most people understand what induction is and Pitocin is, and, and you know, what breaking of the waters are, but what they don’t understand are, are the violations that take place inadvertently to our bodies. Right? Um, like having a nurse come in and, you know, pulling the sheet back to do an exam and not giving you that modesty and privacy, just because you’re having a baby. That doesn’t mean that you need to be fully exposed for an exam. Like something so simple to me could be devastating to somebody whose birthing, you know what I mean? So just really walking them through the different things that they can potentially be exposed to and, and how to handle it.

Gabrielle: Aside from that anesthesiologist, Britanny’s labor was going as well as could be. Her contractions weren’t letting up. This baby was on the way.

Britanny: The labor itself, it was good too. It was– contractions was very intense. But I was never suffering or in agony. I had a few moments where I felt pain and that’s where I was freaking out, at moments with like pressure,  but once I would get back and focus on my breathing I was good to go. And I was saying that at the end like okay I’ve gotta get him out now because I was so tired. Like it’s time. And I was kind of talking to him in a way but not directly to him. I was more so talking to Rod, like it’s time for him to come out, he’s gotta come out now. And I’m pretty sure–i think–i believe he heard me and he knew, and I even knew that it was about to happen.

Gabrielle:  On august 19, 2019, after nine months of meticulous planning, research, and prenatal midwifery care, Britanny and Rod were finally saying hello to their healthy, baby boy Ro.

Britanny: Once he came out, I felt relieved. I felt the warmthness of him. Oh, it’s funny. So when he came out, she grabbed him and like, she lifted him up. And so he was facing me. I was looking at him and he peed. So that was really funny and super cute. I was just relieved. I think my first, I was like, oh my gosh, like, okay, he’s out, he’s here.

So at that point I’m just feeling him and I kind of pulled him up closer to me. We did delayed cord clamping. So they gave that time to let the cord stop pulsating. And at that time I was just, you know, talking to him, kissed him and I just rubbed him. I was more so just rubbing him and making sure, you know, he had good circulation and blood flow. Rob was able to cut the cord and he was just really warm and I was just comfortable right there. I was tired. So I just want, I just wanted to just keep him there and just lay for a little while.

And my recovery was great. I had no issues, not even much pain. And something that I didn’t mention about the nurse is that she didn’t provide a lot of physical like a lot– She didn’t provide touch and hands on. She was more of that spiritual voice in coaching. She was almost like that mother connection. That was very helpful with just focusing on your breathing and, you know, after the contraction, it’s easy to just kind of like stay tense to like, stay in this state of like, woo.

Like your body is just like, it’s, you have all this energy surging through you. And so I would need to be reminded to just like, just let your body fall, relax. And so that was super helpful because that makes a big difference, which is kind of like preserving the energy that you do have, and just like allowing your body to just drop.

I think our birth experience, it was what it should have been, because it was really just me and Rod and it’s been me and Rod. And so just that’s something I always have. Knowing that he stepped up, he showed up, he was there. I mean, he didn’t leave the room at all. I don’t even think he used the bathroom at the entire time. So the whole time he was there giving me water, giving me a little bit of snacks and giving me the counter pressure and just encouraging me as well around my breath.

I’m sharing my story because we need to hear more stories from Black mothers, from Black parents, from Black families. We know that the maternal mortality rate among Black women is extremely high. The highest. We know that the infant death rate among Black babies is extremely high. And so these are conversations that we need to have. And it’s like we need to have these stories. I love how my, my sister describes it as, um, we have to be willing to have courageous conversations. It’s not always easy and comfortable to share your story. Sometimes it can be triggering, you know, if you’re still dealing with things. So I respect and understand that some people, it may take time for them to do that. But I realized that my story is not just about me.

And it’s only one example. It’s an example of actually accomplishing your birth experience and still having to, um, unpack certain challenges and just the overall like battle with the healthcare. So having to like release that energy, let go of that. Um, so I know if I’m going in well prepared and informed of what’s going on and I’m still having challenges. I mean, can you imagine someone’s going in and they have no idea what to expect or what to look out for? Or what do you like, they may not even know, like I don’t even know the birth plan I want, what do I, they don’t know. We don’t know.

Gabrielle: And it’s true, for a lot of parents — knowing what to ask, who to ask, where to go for this, where to go for that, it can be a lot. Frankly, it’s hard to say what you don’t know, if you don’t know. So hearing from parents like Britanny, and midwives like Demetra, they remind us that not only are we not alone as we navigate our reproductive futures — we’re also deeply in community with one another, sharing the traditions and practices of our foremothers as we continue to demand justice in the delivery room, and outside of it.

Britanny: We can talk about, and we need to, because if we don’t share our stories, the same things are going to continue to happen. So my hope is that, um, women going into the hospital to have an unmedicated birth that they now are a little bit more equipped. They have more tools for their toolbox to go in, with a certain language or just knowing what to research. And they can go in and come out on the other end, you know, with a great experience.

Gabrielle: As we all engage in this process of reimagining a society where Black life does indeed matter, it’s just as important that we talk aloud about what we want the future of care to look like for Black birthing parents and birth workers.

 Demetra: I think the extension would be that more people in the community know that we exist. Like that is important, right? Because onesies and twosies they’re wins, tens and thousands changes a lifetime. It changes a generation. So what I would like to see in the future would be more of those open access models of care, where people can be able to affordably or be covered under insurance and feel safe in the hands of their midwife, but also be able to honor their desires of being in a hospital. I want to see tens of thousands of Black moms and dads and partners and people seeing that they have the right to choice and they have the right to be able to say, I want this, and I want this, and I can have both.

Gabrielle: This birth work, this expansive community of midwives, doulas, herbalists, acupuncturists, and so many others — it matters.

But not only does birth work matter, it’s urgent and absolutely essential on our path to Black liberation.

Britanny is now a part of this illustrious community. Since the birth of her son, Britanny’s completed training to become a lactation consultant and birth doula.

Britanny: I’m taking like a personal responsibility to stand up, and advocate, to share my story and learn, and really like do different trainings and stuff. It’s been a passion, but now it’s shifted to being part of my purpose. How we birth matters. And I’m not talking about just vaginally or via C-section, I’m talking about how we’re made to feel and do we feel safe? And does our baby feel safe? And also talking about people who didn’t feel safe in their births and the trauma that is carried with that. And it’s time for us to heal.

Gabrielle:  And she’s right. This is our time. This is our time to say no more to the models of care that fail to recognize our humanity, models that thrive on our death, rather than our breath.

This is our time to realize that everything we’ve been looking for already lies within us, within our homes, relationships, and communities

This is a time where we can stop to think about… what else? what could be? Or even, what should be?

This is our time to remind folks and ourselves that reproductive freedom is not just a progressive soundbite. We are actively and intentionally pursuing reproductive freedom by any means necessary.

Sometimes that means we may have to leave the hospital to do so. But we’ll get into that next episode.

This episode is dedicated to Sha’Asia Washington, a 26 year old Black woman who died giving birth to her daughter Chloe on July 3, 2020 at Woodhull Hospital in Brooklyn, New York.

Sha’asia was a partner, daughter, friend, and mother. She deserved more. She deserved life.

And we, along with countless others, are fighting for the lives of Black parents everywhere.

May Sha’Asia rest in power.

 

Gabrielle Horton is an executive producer of NATAL. She began her audio production career at NPR member station Michigan Radio and Crooked Media and now works as a producer for such podcasts as Hear to Slay and The Black List. Gabrielle is a graduate of Spelman College and the University of Michigan.

Co-published with You Had Me At Black.

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