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The US, known for medical progress, is facing higher maternal mortality rates than almost any western country, and too many women don’t get the birth experience they hoped for.
Enter my guest, the amazing Chanel Porchia Albert, founder of Ancient Song Doula Services, who is here to chat with us about breaking barriers and bringing doula care to everyone. Get ready to learn about doulas' impact on birth, bridging gaps in healthcare, and making sure all birthing people have the support they deserve.
In this episode Chanel opens up about how becoming a mother boosted her confidence as a birth activist, motivating her to empower others, shares some fun details about her meeting with the Vice President of the United States, and we talk all about:
- What inspired Chanel to become a doula
- The importance of emotional, physical, and info support through pregnancy, birth, and postpartum
- The wide range of support offered by full-spectrum doulas
- How doulas and midwives create a super support system for pregnant individuals, combining their strengths for a smoother birth journey
- Tips for finding affordable options for doula care and how to interview doulas to find the right fit for YOU
- Chanel's take on universal policies for maternal healthcare
- The importance of finding joy in birth
Thank you for joining me for this episode. Please SHARE with those you love, who'd love this conversation. Follow me on Instagram @dr.avivaromm and Chanel @chanel_porchia, and check out Chanel's work at ancientsongdoulaservices.com.
Aviva: The word doula comes from the ancient Greek word for servant or to serve. And anyone who knows a doula knows that this is what her life is dedicated to: Serving mamas in need during labor, and after baby is born. The term was first used in relationship to birth in the late 1960s when anthropologist Dana Raphael, a protege of Margaret Mead with whom she co-founded the Human Lactation Center in Westport, Connecticut in the seventies, and who also coined the term matrescence or becoming a mother, described the power of women supporting women in labor. Studies since that time, initially done by Kennel and Klaus in Guatemala, have supported the significance of doulas or any supporting woman, attending another woman in labor for reducing pain, length of labor, and the need for medical interventions.
Doulas have become more widely popular in the last decade, though for many years and often still, the ability to hire a doula privately has been cost-prohibitive for too many women, and often women most at risk of difficult birth outcomes and also at risk of bias in medical settings.
We need doulas now more than ever for as many birthing people as possible, especially when not birthing with a midwife, to reverse the terrible spiral we're in of a shocking fact: That maternal mortality is actually on the rise in the most medically resourced country in the world, the United States, one of only two countries experiencing this increase worldwide.
This is unacceptable by all accounts, and according to the Centers for Disease Control (CDC), more than 80% of pregnancy related deaths in the US are preventable, and Black and Brown women are at greatest risk regardless of socioeconomic status or education level. Nationwide, Black women are three times more likely to die from childbirth -elated complications than white women in the US. And in New York City, Black women are eight to 12 times more likely to die from pregnancy-related causes than white women.
Studies have shown that people who have a doula on their birth team are less likely to have a low birth weight baby, less likely to have C-sections and epidurals, and are less likely to have complications and are more likely to be satisfied with their birth experience. They're also more significantly likely to initiate breastfeeding. The American College of Obstetricians and Gynecologists, (ACOG) and the Society for Maternal Fetal Medicine reported that the continuous presence of a doula is one of the most effective tools to improve labor and delivery outcomes.
Yet despite their recognized benefits, as of 2015 only 6% of birthing mothers receive doula care. Cost can be a barrier – out-of-pocket costs for private births for doula care are often up to $1,500. Enter my guest today, who's on a mission to change all of this.
Chanel Porchia Albert is the Founder and Chief Executive Director of Ancient Song Doula Services, a reproductive healthcare organization focused on providing resources and full spectrum doula services to women of color and marginalized communities throughout New York City and northern New Jersey. Her work within infant and maternal health has led her across the globe to Uganda, where she has served as a maternal health strategist in rural war torn areas. Her work in birth and reproductive justice spans research and methods of care of marginalized people and people of color, bringing a human rights framework into birthing rooms, and institutional reform and accountability measures within healthcare to address implicit bias and racism.
She's involved in maternal health research and advocacy, which includes working on advisory boards with Ariadne Labs at Harvard School of Public Health, Columbia University Medical School, and various others. She also serves as a consultant on birth justice and provider engagement within the New York City Department of Health and Mental Hygiene, and on various independent projects with Ancient Song. Chanel and ancient song's work has been featured on CNN's Champions for Change, the cover of Working Mother magazine, the New York Times, Self Magazine, and most recently, Now This and Vogue magazine. She's also just had an audience with Vice President Kamala Harris during Black Maternal Health Week, where they talked about the critical role doulas play in saving lives and improving maternal health outcomes.
When she's not working on legislative policy or facilitating workshops, you can find her spending time with her six children. I've known Chanel for several years. We've jammed together about doulas on an Instagram live during COVID, and we finally met on a dance floor at an Every Mother Counts fundraising event in December of 2022, which felt like meeting an old friend. Her intelligence, warmth, passion and power are unmistakable.
Aviva: It's wonderful to have you here on the podcast. Thank you so much. And what I'd love to do today is dive into a lot of levels – personal, political, and granular – because my hope and goal for this episode, Chanel, is that I want every listener to know what a doula is, why a doula is so important for birth in our modern culture and context, and how to find a doula. So really practical. And I also hope that maternal health advocates are listening so that they're inspired to advocate for affordable doula access in hospitals and communities because it can still be expensive to find a doula. I've worked in hospital doing obstetrics in my weird intersection of being a midwife – physician, and sometimes we find a doula, but the doula doesn't speak anywhere near remotely the language of the person giving birth. So there's still obstacles. Let's jump right in. And if you would, can you share in your words what a doula is and what a doula doe
Chanel: I think essentially a doula is someone who provides nonclinical emotional and physical support, but also who is an advocate. And so when we're talking about centering the voices of those who historically their voices are not heard within the healthcare system, and when I say that I'm talking about Black, Brown, Indigenous people of color. Those who are disabled, individuals who are undocumented or incarcerated, who maybe have substance usage, or maybe you are homeless and you're pregnant. We don't oftentimes look at and see those people as either deserving and/or that's something for you. And I think a doula in those respects is someone that everyone needs. Whether you are a low-risk individual who has the necessary supports in place, or you may have a chronic health condition that is going on, you deserve to have the support that you need.
And so when we think about it, ancestrally people always had support. We lived in these communities where you had auntie, you had a cousin, you had somebody who was there who was supporting us through our reproductive health choices. Somebody's making food, somebody's doing something, somebody's bringing something. Someone is preparing that birthing person to be able to bring life into the world. We don't have that anymore because of the ways in which the world has really become isolated. I think that parenting is in silos, or maybe you don't have a parent, maybe your parents live a distance away.
Aviva: And then there was COVID, right, which put everyone in that situation.
Chanel: So now everybody's birthing in isolation. And so a doula's there to be able to provide support, education, information, and helping you to make an informed decision about your care. And in spaces where other complications or intersections of other things come up, we're also there to act as advocates to help you to advocate for yourself. So we're not speaking on your behalf, but we are providing information for you so that again, you can feel like you're really centering your bodily autonomy and being affirmed in whatever your reproductive health choices are and your parenting choices are.
Aviva: Absolutely. And also, you used a couple of terms that I want to draw out a little bit. One is you said even low-risk birthing people benefit. And I want to just emphasize that low-risk means that somebody is under 35, doesn't have obstetric complications during pregnancy. There's very clear parameters from what an obstetrician or family doctor means when they say low-risk, right?
But the reality is that once anyone walks into a hospital, low-risk or not, you're still going to be exposed to a whole set of interventions and expectations and rules that immediately increase your risk. When you talk about activism, to some extent, it's educating people ahead of time to know what their choices are and that they have a right to make choices. But then in real time, being a partner there to help them, remind them that they have autonomy in these choices.
Chanel: I think what has happened is that we've grown up in a culture that has told us that when you're selecting a provider, you go to wherever your insurance company tells you to go, or you go to whatever is in close proximity to you, accessing whatever your friend told you to go to, or maybe your parent went there and now you go there.
But we're not necessarily doing our due diligence when it comes to asking them questions. How do you even know that you like this person's energy that you're coming in contact with and that you have the right to interview them? Because as someone who is providing a service to you, you have the right to ask a series of questions. And if they don't answer those questions in a way that makes you feel like, okay, this is where I want to go, then you have other options. I think a lot of times people don't feel like they have options, and that can feel even greater, especially if you happen to be someone who happens to be on Medicaid, or you're considered to be low income.
Aviva: Or you live in a county where there's one hospital really far away, and that's all you can get to cause you don’t have a car.
Chanel: Exactly. Exactly. So that's like, oh, that's my only option. When we are talking about advocacy, we're letting folks know like, no, no, no. You have a options. You can ask questions. You can ask questions so you feel comfortable enough they've answered your questions, and if you feel like they haven't answered your questions and you want to move on to somebody else, you can do that too.
Aviva: Or you're being treated as a, I'm doing air quotes here, since folks will be listening, air quotes. You're being treated as a difficult person, right? Cause you're even bothering to ask questions.
Chanel: Exactly.
Aviva: You and I have talked about this before, but for listeners who haven't heard us chat, what is your personal journey to this work? What inspired you to become a doula?
Chanel: The way in which I was treated by a midwife and a doula, the care that I received from a midwife was unmatched. I had never experienced someone really listening and asking me what did I want? How do you feel about your care? Taking time to explain things to me. And that was important. Because I was coming into my motherhood as someone who, I lost my mother at the age of 14.
And so you know, I don't think people really think about the mothers who are mothering without their mothers and what that means and the impact that you can have on someone when you provide care to them. And she really took the opportunity to really center me, center me in that conversation, understanding that I was newly married, too, and so incorporating my husband into that process and what that meant for us as new parents, and defining what our parenting looked like then and there. It's very powerful when you tell someone, well, you're already a parent. You know what I mean?
I think we look at parenting as this thing that happens after the placenta has come out. Now you are officially a parent. It's like, no, no, no, no, no.
Aviva: Totally.
Do you remember some of the things specifically? Was it ways of being talked to, were there phrases or ways of being touched or heard that really got in your bones. Like my midwife and mentor, Sarahn Henderson, she taught me at the 24-hour home visit, third-day home visit, we always would ask mamas what they remembered about their birth, what was their birth story, what were the things that they wanted to bring up that didn't sit well with them, that did really resonate, so that they weren't internalizing trauma, but they also were remembering their joy and power. Any things that you learned that you're like, I'm going to always do this.
Chanel: So the first thing is asking me, well, what does support look like for you? Not dictating to me, this is what we're going to do. This is the plan of action. It was really like, “Well, what does this look like for you? What does it mean for you to be a parent?” And really thinking about that. “What's your vision for your birth?” And I was like, “Do I have a vision for my birth?” I knew I didn't want to birth in a hospital, but those are some of the things that I carry with me. As I teach others, I teach them the same thing. That really, I think, sets the tone for the relationship that you are going to have with your provider, especially because now what you're centering is that that individual that's sitting before you is an expert in their own care.
Aviva: Yes.
Chanel: And you're learning with that person. And that helps the growth and development of a relationship, which is important because this essentially is the person who is going to help to guide or usher in your child into this world. Children basically, they birth themselves when they're allowed to, and the midwife acts as that guide and you want that person who's going to be the first person to interact inside that moment to be centering a positive energy. Centering you and what it is that you see for yourself, how you see your body, how you navigate through the world, how you want to center your parenting.
And so I appreciate midwives for the fact that they come with this gentleness and openness that allows for the fluidity of those conversations to happen with ease that don't feel like they have to be forced, as opposed to, a lot of times I've met with OBs who they're looking at a chart and they're saying, “Oh, this is, and this you.” And it's like, okay, well, that's maybe my health history, but that's not all that I am. And not taking into consideration the other social implications of my relationship with my body and how I grew up and bumps and bruises, and how did someone feel about their genitalia, religious, cultural, all these dynamics that come up that people don't even think about.
Aviva: I always ask that question too, what does support look like to you? And I remember very specifically having a pregnant mama I was working with for her home birth, and she had experienced sexual trauma. And the perpetrator would always say, use words, breathe, relax. These would be the typical words that we might use as midwives or doulas. For her, those were very triggering trauma words. So to say, “What does support look like to you?” Are there words that resonate with you? Are there things that are not great for you to hear? And her sharing that with me was really transformative about don't make expectations about any way of supporting someone, because it may be very different for their experience.
Chanel: Yeah, and I think that's where essentially we're meeting people where they are, not where we expect them to be. And that's what I think makes a difference between someone having a wonderful reproductive health experience and feeling like, oh no, that wasn't it.
Aviva: I really want to go a little bit deeper into this difference between what we think of as an expert, and what you just said about the mama is the expert, the birthing person is the expert on their own body. We get a very specific image in our mind when we think of an expert, and studies have looked at this and said to adults and children and said, draw a picture of a doctor. And even though somebody might have a mother who's a physician who's in that study, they unanimously or almost unanimously draw a white man in a white coat. So we have this internalized idea of what an expert is when it comes to obstetrics. And yet in our culture, that's clearly not proving to be the safest person for birthing people.
So you started Ancient Song Doula Services in 2008, and that organization provides doula services to low income communities of color, offers affordable trainings for people in those communities to become a full spectrum doula. For listeners who aren't familiar with the term, what is a full spectrum doula to you?
Chanel: I think a full spectrum doula is basically someone who just supports someone through their reproductive life course. They have an understanding that ever since you have been birthed into this world by someone, there have been experiences that have impacted and shaped how you see your body, how you see yourself in relation to others, and also your reproductive health. What does that mean? Were you affirmed in those conversations as a child? Did you have an opportunity if you got your cycle, did you have a conversation with your parents about that? Were they supportive about it? Or did they just say, oh, hey, this is what you use and keep it moving. And it's understanding that all of those life experiences lead up to someone deciding to have a child or not to have a child.
So really a full spectrum doula is supporting someone through abortion access. If they are having abortion, they choose not to have a child. If they're having a child and what that looks like. If you're thinking about getting pregnant to know about the resources and how to get pregnant and how to support that pregnancy. The postpartum period, and preparing for postpartum, but also being there and thinking about the intricacies that come up that we oftentimes forget about. And then I came up with this term because I'm a mother of six children, and so I say postpartum is forever. I've said it, I'll continue to say it. I have t-shirts that say it. So, if you want to get a shirt, you can get one.
Aviva: I need one of those shirts
Chanel: I'll send you one. But yeah, I think postpartum is forever. And so understanding that growth and development. Full spectrum doulas are really working along that line of understanding those things and being able to offer support for individuals through the various different things that can happen. Miscarriage, stillbirth, all of the things, grief loss, multiples. They're there to be able to provide that support.
Aviva: Midwives, of course, we do much of the same. And I heard someone say in a video, I was a little dismayed, she was a doula who was being interviewed, and she said, “Oh, well, midwives do the clinical and doulas do the care.” And I was like, wait a minute. We've gotten this dichotomy set up between midwives and doulas here, which is not how it actually is.
Can you talk about what your thoughts are on, if someone's planning a home birth and they have a home birth midwife who is also obviously providing that kind of care and continuity and sensitivity, does she want to potentially have a doula also. If someone's having a midwife in the hospital or just having an OB? What are your thoughts on the doula-midwife intersection?
Chanel: So one, I think midwives are the comprehensive, all the things, but also midwives have other patients to attend to at the same time. And so while they are still able to carve out time to sit with you for maybe 30 minutes to an hour to really talk about what your planning stages are for your reproductive life course, they also understand that there's someone who can also help you with preparation at home. There's that person who can offer those comfort measures before I get there, and once I'm there, so I can set up and really focus on maybe some clinical tasks that need to take place.
So midwives, they can offer the same care as doulas, but really I think doulas offer a kind of buffer to the midwife in being able to assist them in being able to navigate a birthing situation so that it's not just all on them in terms of being able to support someone. Sometimes situations are overwhelming, and you need an additional person to be in the room with you.
I think folks need to know the distinction between a homebirth midwife and a midwife that is in a hospital-based institute.
Aviva: Totally. And in a hospital setting or even a birthing center, there are maybe multiple people in labor at one time.
So doulas are facing different challenges of being able to be provided reimbursement, which means in those settings where reimbursement is not available it's more challenging for the pregnant person to find a doula because you have to pay out of pocket. What are, in your opinion, the biggest challenges in finding a doula and how can people looking for a doula find doula care affordably and accessibly?
Chanel: I think in terms of finding a doula, there are many different avenues to be able to find one. You can find your local community based organization. You can go online, you can Google. There's a ton of platforms in particular, there's some that are recently popped up. If you're looking for a doula of color, you can go to the Black Doula Directory, which is newly formed by Sister Midwife Productions in conjunction with Baby Dove. If you're looking for affordability, there are some doulas who volunteer their time. There are some who do offer a sliding scale. Also, one of the things that I did and continue to do is barter. And I think oftentimes people look at that. What do you mean barter?
Aviva: I've had bookshelves, walls, and bread.
Chanel: Yeah, I mean, you'd be surprised. I've had folks make bookshelves and make a sign for Ancient Song or do some graphic designs. I think it's a way to honor someone's craft and understand that there is one hand to give and one hand to receive. And so looking at different ways in which to be able to support someone while also not feeling like… because oftentimes a person who's the receiver can feel sometimes less than because they're not able to put something forward to someone who's offering so much care. And this is a way to balance the scales where everyone feels honored and respected within the transaction.
Also, I have a partnership with Baby Dove. And through that work, they have formed the Black Birth Equity Fund which actually will give someone $1,500 to be able to pay for their doula. And so if someone's listening and you need a doula, you can go onto Baby Dove and look up Baby Dove Black Birth Equity Fund, you can apply; they only actually ask you very simple questions. They will literally give you $1,500 so that you can pay that towards the cost of your doula.
And wherever state you are or city that you're in, there's a lot of different maternal health initiatives. Ancient Song is a part of them. And so if you happen to be in New York City or New Jersey area you can go to our website and you can check out the different resources that we have available for you. So you can access either a low-cost doula or a free doula.
Aviva: Any non-negotiable questions that you feel like every person should ask when they're interviewing a doula? If there were three questions, what would those be?
Chanel: Well, first I would say feel out their energy, regardless of who they are. You could say, “”Oh my God, I saw you online and you're the best, and I keep hearing this and da, da, da, da.” But if you meet someone and you're like, this is not it, then I need you to listen to your intuition and don't do it.
Aviva: And that is so important because our actual physiology changes, and that's the physiology we need to be able to be relaxed and literally open and birth.
Chanel: Right. And if you are there with someone who you don't feel comfortable with, that's not going to happen. And so I would say, yeah, I guess basic questions, maybe how long have you been doing this? How do you handle difficult situations? And if there's something personal to you that is really important, make sure that you lift that up. If you're someone who has experienced past sexual violence, if you have had a DV (domestic violence) situation, whatever the case may be, make sure that you put that at the forefront of understanding. Okay. Do you have any knowledge base around this particular area? Especially if that's your top thing that you were really concerned about. And then everything else can fall into line.
Aviva: And Chanel, as things get more popular in this country, as they always do, and as doula awareness has grown, which is a brilliant thing, it also becomes an opportunity to create programs. There are a lot of doula training programs that have cropped up. Any red flags that people should be aware of, other than how they feel. Is there a minimum length? I know it's a hard question. Anything that comes up for you?
Chanel: Yeah, I mean, I would ask a person, what kind of education have you received? Is it centered in cultural humility or cultural congruency? What was the protocols that you had to go through there? Is there a standard of practice and code of ethics that you have to follow and abide by? Were you taught about a Know Your Rights framework? Does that person have the capacity to be able to center you in a conversation? A lot of that is based on the training that they have received. Is it grounded in a Know Your Rights framework? Is it grounded in a human rights framework? Is it grounded in a birth or a reproductive justice framework where you understand that people have certain inalienable rights that need to be uplifted while they are bringing a life into this world?
And then of course, how many hours did it take you to do this? There's a lot of different trainings. There's weekend trainings, there's things that are longer. You want to ask those questions. How long have you been doing this? Do you have to continue to re-certify? Things of that nature. But I also want to be mindful of the fact that a certification doesn't necessarily denote someone's experience. A doula is someone who traditionally comes from a real traditional ancestral background of really grounding people through their choices in your community, your town, in your village. And a certification doesn't necessarily mean that you have a doula who's going to be able to center you. Sometimes the best doula is a doula who has those things.
That's how you center a culture of care. And you change a culture of care by allowing individuals to really center their cultural identity and their experiences and whatever that looks like for them. And so, yes, going through a certification process is important, but also understanding that these are traditional practices and not wanting to take away from the folks who don't want to do that, who want to remain grounded in their ancestral and traditional practices, but still want to be able to provide community support. And they are grounded and rooted in that. They train, yes, but they train with apprentices right under someone else. And I don't think we've necessarily in this culture value apprenticeship as much as it used to be valued, but even midwifery.
Aviva: My training was apprentice training, and I was trained before there was any national certification. So I did ultimately become a CPM (Certified Professional Midwife) in the first group that went through, after the grandmothered-in group. But my mentors did not go through that training and still have not gone through that training and they are absolutely experts.
Chanel: Right. We go back to that conversation of expert and who's the expert, take those things with a grain of salt.
Aviva: I've been really thinking about this word “allow” lately. because it's a word that comes up in the hospital a lot. You're not allowed to eat. You're not allowed to get up, you're not allowed to do this. And so I was thinking about this recently about how really dialed-in care providers allow birth. They allow birth because they're not stepping in the way of birth. And so allowing birth is very different than allowing a woman to do this or not do this. That’s another thing I really look out for is when a provider says, you're allowed to do this or not allowed to do this. Red flag for me.
Chanel: It is more of a directive in a power kind of dynamic when someone does says that. And then I think that's where it starts with, what does support look like for you? What does care look like? I also train medical residents, and I've said that to them. And they are like, “Wow, I never thought to think about asking someone what does support look like for them?” And I’m like, well, yeah, if you want to get a basis for a relationship, shouldn't you ask? Yeah. Instead of assuming that because someone has been admitted, they've signed some documents that you're just allowing them to do something. No, there's something called continual informed consent. So how are you allowing them to really center their bodily autonomy to give continuous informed consent?
Aviva: And informed refusal, right? There’s a legitimate thing called informed refusal. And this is really important cause we live in a culture where, I mean, even getting consent for pelvic exams is not required in every state. Unconsented, pelvic exams are legal in some states, which just explodes my brain when I think about that. But if you have medical residents who aren't even being trained to ask if they may do a vaginal exam in labor and then taking no for an answer, how would we expect them to think to ask, what does support look like to you?
I guess that's a big question I have for you is if you could wave a magic wand and change anything in the US maternal healthcare, what would be your top priority?
Chanel: I think my priority would be first creating universal policy for maternal healthcare in general. I think a lot of the problems that happen within the maternal health infrastructure has to do with the fact that it's so segmented. You can have two hospitals that are directly across from each other and have two different policies on what it means to birth. I think with a universal policy, what does it mean to center pregnant women and birthing people in maternal health. It would allow for stability within the profession and stability for the person who's accessing those resources.
Aviva: So you're not saying universal healthcare policy or universal insurance, you're saying universal policies around how pregnant people are centered?
Chanel: Yes. But also we do need universal healthcare.
Aviva: We do.
Chanel: But even with universal insurance, that doesn't necessarily mean that it's equitable, right? Because now you're talking about equality. You can have universal healthcare insurance, but that still doesn't mean that there's going to be balances in who gets what. What I'm talking about is if we have a standardized universal policy in maternal health that says that within the context of United States, this is what maternal health looks like, this is what you have access to, this is what you're going to get, and everybody's going to get what they need because this is the standard, this is what the care can look like. That would, I think, lessen the confusion around what are my options?
I also would want to open a pathway for education in terms of perinatal workforce development for midwives – and so bringing in more midwifery care services as primary care providers for folks throughout their reproductive life course, and then physicians coming in when necessary, and working in conjuntion.
It's thrown around in the medical world about these collaborative care frameworks. We need to have this collaboration. But what does that really mean? It really means then to integrate the doula, the nurse, the midwife. Have these individuals who are working in conjunction with also the community and understanding that although you may have these standardized platforms, you also understand that you're taking into consideration the culture of the community.
Aviva: This universal core of access that then gets adapted for cultural sensitivity and cultural sensibility.
Chanel: And being culturally responsive to the needs of the community. Hnderstanding how that shifts. So if there is a pandemic, then what does it now mean then to shift care in order to center folks in an equitable way? And I use that word equity and not equality, because there could be a lot of stuff where we could think it's equal because you have this and you have that, but what does it really mean to uplift that? And that's understanding that it's going to look different in different places, and that's okay. But do the people who are accessing that care feel like someone is being responsive to them and that's reciprocal? And not just for the patient, but also for the provider. Because I think providers get left out of the conversation when we're talking about folks who are providing care. Nobody thinks about the internalized trauma of the provider.
Aviva: Yeah, something that I think is really underestimated because we know that the internalized trauma of the provider plays out in the healthcare of the individual at the receiving end, whether it's exhaustion, irritability, fatigue, mistreatment, forgetting to do something.
Chancel: Exactly. Exactly.
Aviva: And 50% of all OBs now are women, but it's still a very male-dominated field emotionally. And this is astonishing, but women physicians have a 150% higher suicide attempt rate than any other population in the US. Male physicians, 70% over the average population. And we know that people have better outcomes when they have a female physician. We also know that there's an incredible disparity in how many Black and women of color physicians there are. And we know that Black and Brown babies do better when there's a Black and female physician. So what are the barriers to entry to the system, but also what's making women providers so depressed and traumatized that they're either leaving the system or practicing with trauma.
Chanel: I think it's not just about having a female provider or having a person of color that looks like you. It's also making sure that that educational component is lifted up. What does it mean to understand that the whole of medical education needs to be completely revamped? It's not serving anybody, it like anybody across the board in an equitable way.
Aviva: So one of the questions I have for you, and this is really for the listeners who are sitting at home going, well, I want to be a birth activist, but I didn't go to the Kennedy School of Government and I didn't get a Bachelor's or Master's degree in political science, but you didn't either. And you're one of the leading birth activists out there and you're a mama. Any thoughts to share on how you owned your power? How you gathered your confidence to be an activist for people who are listening and really want to do more of that themselves?
Chanel: I grew up in a very interesting household. I grew up in a household that where my grandparents were city officials. I would sometimes come downstairs and see congressmen sitting in the living room. I helped with canvassing at the age of 12 or 13, passing out campaign flyers and having conversations. When I was in high school there was a program called Democracy Now, and it really was about learning how to give democratic speeches. I was heavily into politics and policy by the age of 12 or 13. I thought that I wanted to go into policy but I was like, nope, nope, nope. Never mind. Changed my mind. Went to college and was like, no, that's not what I want to do. I think one thing that I want to say to folks is that you can't deny who you are. And so I can't deny that I really, really enjoy the policy landscape. I really, really enjoy reading bills and being involved and having conversations with individuals.
Aviva: And you literally cut your teeth on it, it sounds like.
Chanel: Yeah.
Aviva: That's amazing.
Chanel: And one thing that my grandfather told me when I was a kid, and I know a lot of this has to do with just his growth and development in times of segregation and all other things was 1) you always look someone in the eye when you're speaking to them no matter what and 2) always remember that they put their pants on one leg at a time like you. Basically what he was saying is they're a human being just like you are.
Also, spiritually I believe that the Most High has given me certain words to be able to relate to folks in a way that they can understand that allows for me to be in two places at one time. That allows me to speak to community in a way that feels affirming to them, but also speak to folks who are “on The Hill” and be able to relate to them as well.
Aviva: I think it's so important to be a bridge like that. That's how I see myself with the midwife and the MD hat is being able, to some extent, to read the room and feel comfortable, but also relate to people where it's, again, meeting people where they're at.
Chanel: Yeah, where’s they’re at And it's understanding them. I remember people kept asking me, are you nervous about meeting the Vice President? Are you nervous? I was like, no, she's a person. She's a human being.
Aviva: I feel the same.
Chanel: What I'm more nervous about is really making sure that I'm able to uplift community and really center the voices of the people that I work with every day in a way that they feel affirmed. Those are the things that to me are more honorable than sitting in a space with someone. It's like when you are in that space, how are you using that to advance someone in their parenting? And so as a mother of six children, yes, I bring my children when I go to places because I want mothers to feel affirmed in, you don't have to ask permission to be a mom.
Like my son, my oldest, I've taken him to caucus meetings; they've seen that I. I've spoken on panels and sat with my three-month old in my lap and had to breastfeed while I'm talking about legislative policy or something. Because my motherhood is what defines the issue. You know what I mean? And I think that when we try to hide mothers or we to make them feel smaller, as if you have to choose whether you have a career in a certain thing or not. You can sit at a board table and I can still have a very rational conversation with you around what I need to do while still centering my child in an affirming way.
And I think that because we live in a society that's based on patriarchal views of what it means to advance in a career, we forget about the fact that once you birth a child into this world, you are powerful. I realized that day, I was like, there's nothing that I can't do. I have created a human being here people.
Aviva: For me, I just became such a fierce mama bear of protecting my own baby, my rights, and then extending that to other birthing.
Chanel: Yes. To me, it's like I'm not just my own children's mother. I grew up in a community where my teachers, they lived down the street, you know what I mean? And they were accountable to you as well. You had to be accountable to them. So it was a checks and balances. You weren't just allowed to go outside and just do anything because not only did you represent your family at all times, but you represented your community. And so I want my children and other people's children to feel the same way.
Aviva: You talked about centering joy, and I'd love to wrap our conversation with the importance of this. We've heard necessarily so, ad infinitum, and we need to keep hearing about the dire statistics, the trajectory that the United States is on with maternal health, maternal mortality, maternal morbidity, infant mortality, and particularly for communities who are at highest risk. We have to talk about this. But then that creates a terrible potential emotional labor and fear. And fear is not a friend of birth generally. So share with us how you're celebrating birth, celebrating joy in birth, and how mamas can do that for themselves. Pregnant and birthing people can do that for themselves.
Chanel: Yeah. I think about just thinking about baby pictures and prepping a room or talking about the joys of parenting. Oftentimes I think people like to lead with, oh, child, you got to worry about this and you got to worry about that.
Aviva: It's like, right, what is it about pregnancy? It's like, please come tell me your scariest, worst story about everything.
Chanel: I think what it is really and truly is the fact that we have a lot of parents, grandparents, and aunties and others who have experienced birth trauma
Aviva: Yeah.
Chanel: There are so many people who haven't had an opportunity to really express what has happened to them. And they weren't allowed to center themselves in a conversation. So now it's like, well, let me tell you the worst possible story. And it's not to scare you, but it's them really trying to warn you so that the same thing doesn't happen to you. And so we need to have more intergenerational circles around what does it mean to heal that trauma? I saw a post recently that said that when your mom is pregnant with you, you have the cells of your grandmother.
Aviva: It's deep. It's really deep. It's deep. Because like you said, you have the cells, but the actual epigenetic shifts that are happening in the grandmother are creating the hormonal environment, the neurochemical environment that is actually shifting. Yes, those next generations, three generations at once.
Chanel: And so when I saw that, I was like, wait a minute now. Right? Because it brings so many things into context. When we start to think about birth trauma and trauma responses and how things come up and why, when you hear stories, well, this happened to auntie. And so you want to make sure that doesn't happen to you. And those things are not necessarily because folks are just trying to be dull and doom and gloom. What it is is them trying to, they've adapted this adaptive behavior to really protect themselves. And they want to protect you too.
Aviva: Yeah. They're just processing it, I think.
Chanel: And that processing happens to be happening while you are still trying to process your own experience of what it means to become a parent.
Aviva: Well, and you're vulnerable, right? Because you're a sponge, taking every bit of it in. It's like you're scanning the landscape for anything that could be a cue to information or to self-protection.
Chanel: Yeah, so when we talk about centering joy, I ask folks, “What does joy mean to you in your parenting?” And some of it is just around the ability to just be and to have the necessary resources in place, or to know that their child is going to come into a world that is safe. That could be scary when you can't necessarily promise someone that. But you can show them ways in which to navigate certain systems, to avoid some of those pitfalls, to create joy and to center hope, and really create an intergenerational pathway for joy in the birthing experience through our grandparents and our parents and our lived experiences.
And so, yeah, I try to include everybody in it, and let's just talk about it. Because as much as parenting can be, well, these children do the most, since they start to get older, it's also really joyful. I just made a post on Instagram where I showed the different faces that a mom makes in a day.
Aviva: Oh my gosh, I got to look at that one. I haven't seen that one yet.
Chanel: To their children. Everybody's like, oh my goodness, this is, I feel seen. And I'm like, yeah. You know what I mean? Because we go through these different emotions throughout the course of a day or as we grow in our parenting.
Aviva: Oh, thank you so much for taking the time to be with me. I love to ask this question, and it is, if you could tell your younger self anything, how old would she be and what would you say?
Chanel: Ooh, if I could tell my younger self anything… She would be 10 years old and I would her all the things and the places that you thought you were supposed to be, you're going to be there. So don't worry about anything. Cause when I was a kid, I was just like, I'm supposed to do something. I want to be a lawyer. I'm going to do something in international business. People are going to know me. And I said that when I was a kid because I felt it. I felt like this urge inside of me that somebody was supposed to know something, But I would tell my 10-year old self, don't worry. People are going to know.
Aviva: You're going to be shaking hands with the VP in 2023.
Chanel: The more I think about the process of seeing the VP, it becomes surreal because the first thing I wanted to do was I wanted to call my grandmother. I wanted to call my Nana, and I wanted to be like “Nana, look like this happened”. And that's the part that all of the other stuff is whatever. But I just really wanted to share that with her. And I remember I went to my phone and I looked up her number, and I know it doesn't exist anymore. And I actually called it, and I knew that she would've just cried and she would've like, I can't believe it. And your mom would be so proud and all the things.
She worked for the city. She was the director of city welfare. And I just remember going to her office and seeing this Black woman who had her own office who was running a whole department of a whole city, I remember her treating every single last person who came in there like a human being, and they would say, “Good morning, Mrs. Brown.” “Hi Mrs. Brown.” People who were coming in for services who were basically down and out and in whatever personal experience that they were in. But she made sure that she knew their names, she made sure that she talked to them, she made sure that she treated them human beings. And I've gone into social services and seen the way in which people don't treat people like that. They feel like no one is seeing them. They're dehumanized. So to be in that position, my first instinct was to call her and be like, “yo, man, look at this”. To just tell her and show her – “I saw you, I saw you”.
Meeting the Vice President was great, but I think it means even more when you have your family to share with. And so the biggest thing from all of this is whatever you do, however you are lifting up your own health, the health of your community members, it's basically about being able to share those moments with your family at the end of the day. And that's where the joy comes in at. That's when you feel like, whew, I did that. Because those are the people that affirm you. Those are the people that see you. Those are the people that know you. Those are the people who are your lifeblood and you are their legacy while you are creating that for your children.
And so that's what I want my children to see. That's what I want my children to be able to do, to call me and share those moments. And I want other parents to be able to do that with their kids. And the only way that we can do that is if we really change the way in which we care for one another and how we see each other. It's just real simple. It's not anything difficult. People make things harder than they need to be. All you really got to do is just care. And want to see someone be their best self the same way you would want someone to see you be your best self, see that for other people, and then it becomes easier to see it for yourself.
Aviva: Thank you for sharing that vulnerability and such a personal moment and story with me. I really, really deeply appreciate it.
Chanel: Thank you for centering the voices of birthing people and of women and just creating a platform to center reproductive health.
Aviva: Thank you. That means everything to me, coming from you, I have incredible respect for you and the work you're doing and the legacy you're creating and the waves and shifts. So it's just a blessing and a gift to even be in the same circle doing the work together. And I really look forward to seeing you next. I shared in the introduction how we finally met in the flesh on a dance floor, which was really nice.
Chanel: Yes. It's a great way to have an introduction, an in-person introduction.
Aviva: Thank you for being everything you are and doing all that you do, and for just keeping it real. And we'll put all the links to all the things below. And I look forward to having a conversation with you in one year, two year, three years where things are so different than they are. And we're having some just massive celebration going, do you when? And can you believe how quick all this changed?
Chanel: Yes. That would be amazing.
Aviva: Talk to you soon. Thank you everyone for listening.
