MASS Design Group was founded on the understanding that architecture’s influence reaches beyond individual buildings. MASS (Model of Architecture Serving Society) believes that architecture has a critical role to play in supporting communities to confront history, shape new narratives, collectively heal and project new possibilities for the future. During a recent conversation between our director Nashira Baril and Amie Shao, Principal at MASS Design, they reflected on what this birth center project means - specifically personally and professionally for Amie as she approaches the work as an architect and parent. Also how the building partnership model is more than just sharing space with other like-minded organizations but creating an ecosystem that requires the reimagination and equitable redistribution of capital for a healthy family to a healthy planet.

A conversation with our beloved architect at MASSDesign

MASS Design Group was founded on the understanding that architecture’s influence reaches beyond individual buildings. MASS (Model of Architecture Serving Society) believes that architecture has a critical role to play in supporting communities to confront history, shape new narratives, collectively heal and project new possibilities for the future. During a recent conversation between our director Nashira Baril and Amie Shao, Principal at MASS Design, they reflected on what this birth center project means - specifically personally and professionally for Amie as she approaches the work as an architect and parent. Also how the building partnership model is more than just sharing space with other like-minded organizations but creating an ecosystem that requires the reimagination and equitable redistribution of capital for a healthy family to a healthy planet.

Nashira: Thanks for hanging out with me – you know I'm a huge fan of MASS Design and I still pinch myself that we are together in this process to design a birth center in Boston at the heart of a community movement and healing sanctuary.

Amie: I remember meeting you in 2019 and being just blown away by your vision. MASS has always been premised on how buildings can heal and contribute to equity. From healing the body by designing hospitals in Rwanda to acknowledging trauma and inspiring healing by designing the National Memorial for Peace and Justice in Montgomery, AL.

Nashira: That’s really what initially attracted me to MASS Design. I’ve been working in public health and racial justice a long time and this work always comes with the labor of explaining - explaining that current systems are not working well, explaining that it’s not about individual behavior, explaining that to truly get free we need to radically redesign. Before knowing about MASS, I could not have imagined finding architects who are so clear that space is not neutral, that design creates or inhibits equity. In fact, I am pretty sure those are your words – I’ve learned a lot from you. So, tell me what excites you about Neighborhood Birth Center.

Amie: I’ve spent years as an architect working in general healthcare design at MASS. But when I gave birth to twins, and had an extended stay in the hospital, I got really passionate about childbirth design in particular. I remember being there and thinking to myself, nowhere can spaces of beauty and healing have a more profound impact than during and immediately after childbirth. The mom in me wishes I’d known about birth centers as an option (doulas and everything else too!) And the architect side of me, I remember saying to my partner, also an architect, “if this were designed more like home, our experience would feel totally different.” I’m so glad people in Boston will have this in the future. I appreciate how Neighborhood Birth Center roots birth in the community, and then the way you are enveloped by the partners.

Nashira: Yes, shout out to our partners – Resist, Inc, The Movement Commons, Center for Economic Democracy, and City Life/Vida Urbana – and this organizational ecosystem we have built on solidarity and collectively creating a new economy and a new future.

Amie: This feels like a really aligned project because everything we do at MASS is focused on advancing equity and supporting organizations to make real the ways that space both grounds and uplifts their vision and their ability to support, or in this case, transform, the communities that they serve. MASS works with a lot of nonprofits, funders, philanthropies, but we haven’t yet seen an ecosystem coming together under one roof in this way. Especially, the ways you are approaching economic sovereignty and intentionally opting out of the commercial real estate market. It’s powerful and we are excited to help you make it real.

Nashira: I know you are committed to supporting our visioning process (I am so excited to dive into the homework you gave us to identify the look and feel we think captures our values.) But I have to ask, what’s one design element that you would not want us to miss?

Amie: Hmm, well, some birth centers that I've visited, especially if they are renting the space, are making the most of an inherited structure, like a dental clinic turned birth center. It takes a lot of effort and capital to rework those spaces and it’s remarkable how they feel after midwives have transformed them. I think we get the benefit of learning from what’s worked for them and their longings for birthing spaces. My biggest hope for you, for us, is that we get the opportunity to build out the heart of the space – that we don’t just reuse a long hallway with a waiting room, but that we dare to imagine a space with a courtyard, outdoor spaces, gathering areas, a cafe…I like to think about how you come out of your birth room, how you move throughout the space. In other words, it would be a missed opportunity if it were a bunch of nice birthing rooms but we didn’t get to design the heart of the space.

Nashira: Yes! I think about this a lot. I have to actively shift from a place of feeling scarcity, to believing in abundance. There’s this belief in nonprofit, healthcare, entrepreneurialism, that we should trim our budget, low ball costs, cut corners, and do more for less. With the costs of real estate and construction in Boston (not to mention that insurance reimbursement wont cover the actual costs of operating the birth center, we are faced with raising a ton of money. And it’s almost easier to go back to the plan and try to trim costs by reducing the number of birth suites, or cutting the garden, or the atrium from the design. But, what’s the impact of saying we need an extra six-or seven figures in order to build the birth center that Boston actually needs? I refuse to sacrifice creating a beautiful space that has the power to transform people for generations because we are afraid to say we need to raise another $1M, when for many people and corporations in this city, that’s a rounding error. There are enough resources for Boston to have an exquisite, luxurious, birthing center, the presence of which will benefit everyone, even if they never give birth there.

Amie: I’m really excited to see what’s to come. In June we’ll provide you with some visuals to help you all build a public-facing buzz about how the birth center could anchor a larger space for community healing, connection, and organizing. It’s really beautiful to think of us sort of midwifing another world – creating a physical space where both babies are born and people practice being together differently.

A screenshot of the team at MASS Design sharing an early conceptual model of how birth center care relates to the other gathering and organizing visions for the shared space.

Nashira Baril 4/5/22 Nashira Baril 4/5/22

Announcing Boston Women’s Fund’s 2022 Movement Building Grantees: A Q&A with this Year’s Recipients

See this Q&A with Director Nashira Baril and others on the Boston Women’s Fund Blog

Can you describe the need that motivated the founding of your organization? Is there a particular story that comes to mind as the catalyst?

I spent most of my career steeped in the very traumatic data of the maternal health crisis, and in particular the ways that crisis bears down on Black birthing people. In 2013, I had a powerfully transformative home birth experience with midwives and felt a tension between what I experienced and the stories I know of loss and trauma and sadness. Over lunch with Dr. JoAnna Rorie, my mentor and long-time Boston midwife, we talked about reviving the 30-year-old vision of a Roxbury birth center and bringing to scale the high touch care of midwives in a warm homelike setting, but covered by insurance and accessible to all. I quit my job shortly after that fateful lunch, and began pouring into this project — for the first six years as a volunteer, then came on as part-time staff last January after the intersecting crises of 2020 opened up a portal of possibility and accelerated our work.

What goals will the BWF Movement Building Grant award help you reach?

Most birth centers are for-profit entities, started by midwives, using their own personal savings or lines of credit. At Neighborhood Birth Center, we have committed to birthing a nonprofit model, allowing us to maintain a humanitarian mission and share power with community. In doing so, we are steadfast in our commitment to community engagement and weaving a web of believers around this vision.

In addition to real estate development, fundraising, and business planning, we see shifting the narrative and building community as a fundamental piece of our sustainable success. Therefore, we seek to build partnerships with funders committed to movement building. This grant from BWF will support our efforts to socialize the community to midwifery and birth center models of care by hosting and participating in events from birth story slams, to house party fundraisers, to church gatherings, to social media conversations, to tabling at events. Midwives will join board members in support of educational efforts and other opportunities to speak about birth center models and safety. Areas of focus are safety, dignity, and FAQs from a client perspective.

What’s one thing you’d love for others to know about your organization?

A freestanding birth center is a home-like setting providing midwifery-led, family-centered care to healthy pregnant people outside of the hospital. Birth center midwives provide continuous, supportive care, using interventions only when medically necessary. Birth centers are integrated into the healthcare system, referring patients to hospitals for consultation or transfer of care when needed. Freestanding birth centers are the perfect solution to meet the triple aim in health care: lower costs and better outcomes with high satisfaction rates. A shift of 10% of births from hospitals to birth centers would save $1.9 billion annually.

Neighborhood Birth Center is a community-grounded, Black-led, nonprofit birth center that is part of a national movement to #ReclaimMidwifery and create a future in which quality health care is accessible to all. We believe that birth is a sacred process, and when the pregnant person is centered, the experience has the power to transform and heal individuals, families, and communities. We are designing everything from physical space to policy to organizational culture with a commitment to healing the past and creating a new model of care.

When you think of your work over the last year, what are you most proud of?

I’m most proud that we have kept a sense of abundance at the center. It’s hard! But it feels so good! Often, in this nonprofit fundraising hustle, and in the broader context of deeply internalized experiences of late-stage capitalism, we are faced with scarcity. The belief that we should trim our budget, low ball costs, cut corners, and do more for less. One of the ways that showed up this year was in my sticker shock at the costs of construction in Boston and immediately, I and others, started to feel like we could trim costs by reducing the number of birth suites, or cutting the garden, apothecary, or atrium from the design. But that feeling was fleeting. We have a shared practice of naming “oh, there’s that feeling of scarcity again” and acknowledging it, then breathing into abundance.

What’s the impact of saying we need an extra six-figures in order to build the birth center that Boston needs, versus, not building it to the specs we know we deserve? From that place, there is no comparison. I refuse to sacrifice creating a beautiful space that has the power to transform people for generations because we are afraid to say we need to raise another $1M, when for many in this city, that’s a rounding error. So, I’m most proud that we are not making decisions from a place of scarcity and limitation, but from the belief in abundance and that there are enough resources for Boston to have an exquisite, luxurious, birthing center, the presence of which will benefit everyone, even if they never give birth there.

See the full blog post with other BWF grantees here: https://www.bostonwomensfund.org/post/announcing-boston-women-s-fund-s-2022-movement-building-grantees-a-q-a-with-this-year-s-recipients

Nashira Baril 4/5/22 Nashira Baril 4/5/22

Philanthropy Today: Inside 2 Capital Campaigns Upending Big-Donation Traditions By Drew Lindsay

The unique approach to capital campaigns of Birth Detroit and Neighborhood Birth Center:

“When talking to donors, she instead focuses on the broader goal that she shares with Welch: to establish midwifery as a key component of a maternal health care system they believe is failing everyone. To wealthy white donors, Baril says, “Let’s be clear: This isn’t working for you, either.”

“We want to invite everyone to see themselves in this vision,” she says. “We’ve heard from white folks with terminal degrees earning $200,000 a year who are largely unhappy with their experience and their care. That understanding has really informed our approach to fundraising.”

Welch and Baril are both new to fundraising, learning the conventions of campaigns even as they upend them. With Wright, they try to anticipate the questions that might arise from donors about naming opportunities, board seats, and other campaign standbys. “It feels good to stand on our values,” Baril says. “But it’s also exhausting. We have to practice being countercultural at every turn.”

Nashira Baril 8/7/20 Nashira Baril 8/7/20

March Like a Mother for Black Lives, June 27, 2020 (transcript)

Nashira Baril (with her daughter) speaking at March Like a Mother for Black Lives Rally, June 27, 2020Photo by Tess Sheflan — Nashira Baril (with her daughter) speaking at March Like a Mother for Black Lives Rally, June 27, 2020
Photo by Tess Sheflan

Watch the video of Nashira following our new board member Dr. Ndidi Amutah-Onukagha speaking about the Black maternal health crisis and making a call to action for academic institutions to shift power and resources to community here.

I have been feeling a lot of dissonance lately: dissonance is defined as the tension between disharmonious events.

A few days after George Floyd’s murder I was sitting at my parent’s house in Rhode Island, in our COVID pod, working on the deck, while within earshot, my two and a half year old was holding court at the compost, tending to the red wiggler worms, directing them to the avocado pit and away from a random clam shell. A few feet away on the other side, was my husband, inside working. In between each work call he had, he'd made calls to his friends, each one of them would start like this “hey Black man, how you living right?” And what followed was a painful conversation to bear witness to. He spent much of the time of two weeks we were there inside the house because of the increased police presence with the reopening of RI beaches.

I was – and I am still experiencing dissonance. As the mother of two Black babies, 7 and 2.5, I’m witnessing them love the freedom of this covid summer - as strange as that sounds. While we haven’t left our postage stamp of a backyard in Mattapan, there’s no camp, no school, no daycare and nowhere to be. And they are experiencing joy in the sprinkler and in the garden. While my heart and the world weeps and rages around us.

Black grief. Black joy. Dissonance.

In early April, Arundhati Roy, Indian author and political activist wrote a piece called “the pandemic is a portal.” In it she offered up that disasters and crises, like pandemics, are “pattern interrupters”. That this pandemic is offering us a chance to break out of the trance of dominant consciousness.

About the global longing for a return to normal, she wrote “Nothing could be worse than a return to normality. Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.”

The pandemic is a portal. The call to lean into this moment - thick with pandemic and police and vigilante violence - has resonated with me in recent months.

I am working to open a birth center poised to be the first freestanding birth center in Boston.

And on that first Saturday in March, when COVID hit my neighborhood and we started sheltering in place, I got the first of what would be two dozen similar inquiries: the voice on the other end of the line or through the text is super pregnant and asking “Is your birth center open?” And to every inquiry in the last three months, my answer has been no. Now, if I had a philanthropic commitment for every time I have been asked that, we’d be much closer to opening.

But it’s not only in COVID that I’ve received these calls.

We’ve long known that Boston’s robust healthcare landscape would be significantly improved by the integration of a freestanding birth center.

A volunteer project for 5yrs already, I jump for as many grant opportunities as I can. This week I was responding to an RFP, and I saw this question “What are we doing differently as a result of the community response to George Floyd’s murder?” I’ll pause here for us all to take that in. So, for $5,000 I painstakingly explained how we are doing nothing different except doing the labor we always do to center Blackness, while grieving.

I told them how the crisis of the current moment is familiar to us as people who live and organize under the constant threat of conditions created by white supremacy and heteropatriarchy. Boston’s first and only birth center is being built by Black mothers who face increased risk of death and infant mortality in pregnancy and childbirth, and we are working, parenting, and building a healthcare start up in the midst of a global pandemic, while we witness rampant and preventable racial inequity in COVID-19, police violence, and assaults by the media. I told them that what we are doing differently is that we are focusing on healing our hearts and staying radicalized while holding the rage and sadness in our homes and in our community. We stand committed to organizing to actively shift the distribution of power and resources to ensure people of color and other structurally marginalized communities have access to safe, out of hospital birth.

My Sister, Dr. Ndidi spoke no word of a lie. These equities are not natural. There’s nothing inherently higher risk about being pregnant while Black other than living in a society that is structured on a racial hierarchy with us at the bottom. But there’s another important piece to note which is that when we say “4x more likely” or “200% more often” it’s always relative to the white rate. And that is a big illusion that we should aim to close the gap and align Black birth outcomes with those of white folks. What we learned in surveying for the birth center was that white cis women with a graduate degree or higher and who earn $200,000 a year in the greater Boston area, they reported horrible experiences in their pregnancy and childbirth. They felt disrespect. One person reported that the nurses made fun of her vocalizations while she was in labor. Another said she felt like she was birthing in a machine.

Let us not be fooled, the maternal health system is not working well for anyone. We have to get clear about this. When we zoom out and look at measures of infant mortality or life expectancy across the 37 OECD or economically developed countries, the US has terrible outcomes. What’s more – if we looked at the data of white population of the US as if it were its own country, it would still fare in the bottom in infant mortality when compared to other countries, just a hair better than the US as a whole. What a distraction to try to “close the gap” and level Black outcomes to that of our white counterparts.

Let me pause and make a call to the white folks in community with us today – please receive the call to justice from a place of being clear about your own skin in the game. Do not fight racism because it’s bad for Black people. In the same way we do not want men to fight patriarchy because they feel bad for women. You’ll tire and give it up tomorrow if you are doing it from a place of service and not solidarity. Yes, across all systems, outcomes are better for white people, but your freedom is an illusion. Dissonance!

So, my two babies were born at home, into the loving hands of my mother and highly trained midwives. Hours after my son's birth we were on the back deck, enjoying an unusually warm October day enjoying food and drink. I was encircled by midwives who trusted me and my body and who were committed to bearing witness to my power, first and foremost.

And I hold this experience with dissonance as I know countless stories of trauma to also be true.

So along with my elder midwives, I feel called to be part of a community expanding birth options here in Boston because dissonance is exhausting. Reconciling disharmonious events is exhausting.

What does a new world look like when it comes to pregnancy and childbirth? Let’s imagine, or reimagine really, because all of our ancestors knew this wisdom before we pathologized physiologic birth.

Join me – close your eyes if you want, put a hand on your heart or your womb if you want, raise a fist if you want, feel the support of Mother Earth under your feet, take a deep breath and imagine with me the energy of our first birth center: a beautiful spa-like space, one that could rival any Newbury street spa with fine linens, plush robes, and fruit infused water and teas. It is lovingly staffed by midwives, providing full spectrum care during the throughout pregnancy, labor, birth, and the postpartum period. There’s wrap-around care from mental health providers, chiropractic, reiki, yoga, massage, an apothecary with sacred herbs. I see a welcoming, joyful place to relax and to connect, a space to be seen and to see each other. I feel an organization operationalizing equity in everything from who holds the contracts, to how the organization is governed, to who entrusts us with their care during the most powerful transformational time of pregnancy and birth.

There is a sense of belonging.

When I listen closely, I can hear children asking questions about bellies and boobies, answered lovingly by caring adults aware of their simultaneous transformation to big sibling and their expanding worldview. There is a calmness in the space that comes with people experiencing healthcare where our full selves – our bodies, our traumas, our identities, and our relationships – are honored and belong.

It is led by people of color, and because it is so, everything from policy, to space, to programming has been designed with an eye to justice and liberation and an eye to checking embedded white supremacy and heteropatriarchy.

When I close my eyes, I feel Neighborhood BirthCenter as a place where everyone gets free.

There have been powerful studies to demonstrate the safety, cost savings, outcomes, and intergenerational healing made possible by investing in community birth centers.

Yet, in a city as rich in health care resources and endowed wealth as Boston, Black, queer, trans, and disabled volunteers are rubbing two pennies together to open our first birth center. Dissonance.

The question is, what’s getting in the way?

I believe we have to reconcile the dissonance between our espoused beliefs in justice and equity and our relative inaction. The threat of returning to normality. The desire to return to normalcy.

Arundhati Roy also wrote once “Another world is not only possible, she is on her way. On a quiet day I can hear her breathing.”

When I listen to the new world breathing, I tune into a belief in abundance, and I know, and when I look at you, I know, that there is the wisdom and will to grow and leverage full spectrum capital for this birth enter and very birth center around the country that is being asked in this moment “Are you open? We need you.”

Nashira Baril 2/18/20 Nashira Baril 2/18/20

Birth Detroit & Neighborhood Birth Center

Teams from Birth Detroit and Neighborhood Birth Center plan to convene our teams in a retreat, co-creating space for healing, wellness, and emergence.

For the better part of the last 2 years, we have been connecting regularly with birth justice leaders in Detroit who are also working to launch the city's first birth center, Birth Detroit. Our partnership is centered on the shared understanding that to advance equity, we must reintegrate the heart into our work and transform the relationships, practices, policies, and systems that maintain inequities, beginning with our own practices and extending across institutions and in this case, across cities. We have an exciting goal for 2020 (for which we are actively grant writing!): Teams from Birth Detroit and Neighborhood Birth Center plan to convene our teams in a retreat, co-creating space for healing, wellness, and emergence. In addition to the technical and emotional support shared across the staff and volunteers charged with the sustainability of these nonprofit startups, we will also engage consultants and partner organizations such as other women of color led birth center start ups and national organizations committed to perinatal health and health equity.

Find out more about Birth Detroit in their newsletter.

Nashira Baril 7/19/19 Nashira Baril 7/19/19

Meet Nashira

How we come into this world, how we are ushered in, met, hopefully embraced upon our arrival, impacts the whole of our time on this Earth.

-Alice Walker

This spring, I shared part of my story and how I ended up working on the birth center at the Black Maternal Health Week event at Tufts University, and I was gently reminded by my advisors to share it here too, so those of you I haven’t met yet, know a bit about who’s behind the day-to-day work on Neighborhood Birth Center.

I’ll start by saying the original idea for a Boston birth center belongs to midwives, organizers, activists, and leaders who came together in the early 80s in response to the concentration of maternal and infant death in Boston’s Black neighborhoods. These leaders envisioned a community-designed, out-of-hospital option for midwifery care, and while they faced some pushback, their dream of a freestanding birth center in Boston never died. I feel blessed to have come into their path and to be in partnership with them as we rebirth this project.

Beginning with my ancestors

I am the great granddaughter of Octavia, the granddaughter of Simone and Annie, and the daughter of Claudette. My mother and great-grandmother are/were midwives. I was born to a straight white cis woman in Connecticut in 1979. Her whiteness certainly influenced and advantaged her pregnancy experiences and birth outcome. And still she had a terrible experience being othered at that hospital 40 years ago because she was single and poor, and because I was Black. Her birth plan was laughed at, her best friend (a woman) was not allowed in the room initially, and when she begged to keep me by her side postpartum, they brushed her off as tired and wheeled me away, eventually suggesting a psych consult when she couldn’t stop crying.

Seven years later, she gave birth at home to my sister and then two years after that to my brother. The experiences of their births transformed both of us – she became a doula and later a Certified Nurse Midwife, and I, by age 9, had a strong narrative and worldview about pregnancy and birth.

Falling for Boston

When I graduated from Umass Amherst, with a degree in Women’s Studies and Legal Studies, I knew I wasn’t going back to rural CT, but the country mouse in me wasn’t ready for NYC. So, I moved to Boston with a plan to be here for one year then move to California or abroad for grad school. I began working as a women’s health case manager at Brookside Community Health Center in Jamaica Plain on a federally-funded effort called REACH 2010 to address racial health inequities. This was part of the city’s ongoing efforts, like the Fetal Infant Mortality Review of the late 90s, to research and address social factors that contribute to better health outcomes for white residents and poorer health outcomes for Boston’s communities of color. In spite of frequent “threats” to relocate, I spent the next 12 years at the Boston Public Health Commission, during which time, earned a master’s degree from Boston University School of Public Health in maternal and child health and co-founded the Center for Health Equity and Social Justice. Accepting Boston as home, I bought a condo in Dorchester and married a few years later.

Home birth, please.

I always knew I wanted to birth my children at home, but my partner needed some convincing, so we explored important conversations about our experiences, beliefs, and worldviews. And when pregnant in 2012, we began navigating our way in (around? through?) the very white home birth culture in Boston. From my experience in public health, I was painfully clear that women of color have poorer birth outcomes even with “protective factors.” (Meaning, even though I was married (to a man), owned a home, had a graduate degree, and earned a good salary working for the city, none of this would necessarily protect me or baby from a bad outcome.) I also knew that when birth is revered as a sacred process and the pregnant person is centered, the experience has the power to transform and heal individuals, families, and communities.

In the spring of 2013, our daughter was born at home in Dorchester. My midwife did not arrive on time, so my mother caught her granddaughter! There is a bond between those two that can only be attributed to the sacredness of that moment. I think it’s important to talk about miscarriage too, since our society has a practice of isolating pregnant people before 12 weeks as a way of silencing stories of loss. We experienced two miscarriages before each live birth, including a molar pregnancy. In the fall of 2017, our son was born in our current home in Mattapan. At 6am, after only a few hours of labor, we woke our daughter, then 4.5 years old, and she held me while I birthed her brother in the water minutes later.

Just as my mother’s birth experiences shaped my worldview, and my daughter’s birth shaped that of my husband and I, our son’s birth shaped my daughter’s worldview. (Here is her version of the birth story!) I share my birth stories often and anywhere – I recently told a woman at the hair salon while under the dryers – because I want to be part of a shift in the dominant narrative about birth from being scary and painful to liberating and powerful. The more we lift up powerful stories of birth, the more we normalize the expectation that it can be so – and the more we understand the benefits of a freestanding independent birth center in our midst!

Full circle…

In 2014, I asked Dr. JoAnna Rorie, CNM, my friend and former advisor at BU to help me convene a conversation with Catherine Walker, Elmer Freeman, Gene Declerq, Bob Masters, and some of the other original holders of the vision and history of a Roxbury birth center. We agreed that it was time to relaunch this idea of a Boston birth center, armed with more data about safety and healthcare savings data and with the support of and lessons from a growing number of freestanding birth centers across the country.

Now, I don’t want the story of my mom’s hospital experience, my choice of home birth, and my work on the birth center to lead anyone to think I’m anti-hospital. I think it’s important to state that very clearly. What I believe is that people deserve choices about what kind of care to engage in during pregnancy, labor, birth, and the postpartum period. I am grateful that we live among world-renowned hospitals – grateful that my dear friend, who was induced recently at 37 weeks because of preeclampsia, is healthy and thriving with her baby. I’m grateful for the access to high tech and highly skilled care available to pregnant and birthing people in and around Boston who need intervention. I do think hospitals have a lot of work to do to improve outcomes, and also I know that’s not going to happen by simply creating community programs or diversifying hires, so I’m also grateful that some of my most trusted friends and colleagues are working hard from within those systems to advance equity.

Do you see what I see?

When I close my eyes, I can feel the energy of Neighborhood Birth Center – I see a welcoming, joyful place to relax and to connect, a space to be seen and to see each other. I see an organization operationalizing equity in everything from who we contract with, to how the organization is governed, to who entrusts us with their care during the most powerful transformational time of pregnancy and birth. When I listen closely, I can hear children asking questions about bellies and boobies, answered lovingly by caring adults aware of their simultaneous transformation to big sibling and their expanding worldview. I feel a calmness in the space that comes with people experiencing healthcare where our full selves (our bodies, our traumas, our identities, our relationships) are honored and belong.

There’s one thing I have become increasingly clear about as I’ve tinkered away at this over the last few years: a birth center cannot open on the strength of volunteers and good will alone. There’s a powerful circle of people who share this vision with me – a volunteer board of directors and senior advisors, followers on social media, and my husband who is definitely a doula to this project, understanding the never-ending to do list of non-profit start up. We are readying ourselves for the next phase which will require significant investments of time, money, trust, partnership, and many hearts and minds working collaboratively to co-create this most special space. In addition to the 5-10hours a week I try to carve out for the birth center, I work full time doing leadership development and capacity building for Human Impact Partners, a national nonprofit based in Oakland, CA, and I do freelance consulting with public health organizations working to advance racial equity. I’m proud to say that I’m still breastfeeding my 21month old, and that my 6 year old builds LEGO birth centers for snails and barbies alike. And when I get a break, I still retreat to the country – and can be found jumping in a northern New England lake or at the Rhode Island shore with my family.

Nashira Baril 7/19/19 Nashira Baril 7/19/19

Proud of Our Progress

We are proud of the work we’ve accomplished to date as a group of volunteers who work full time and are parents, practitioners, and activists!

Since 2015, the planning process has been deeply guided by the wisdom of a robust advisory board made up of community leaders who are parents, midwives and other birth workers, researchers, and other experts. Our progress lays a strong foundation for the center’s projected 2022 opening:

We have a comprehensive plan, including a detailed planning timeline and budget and 5 year operating projections.
Lead by Sanam, we completed a thorough needs assessment to gauge interest in a Boston birth center, to hear what informs people’s decisions about care when they are pregnant, and the things that matter most during pregnancy, labor, birth, and the postpartum period. We asked about when care feels discriminatory, and when it feels magical. This is deeply informing our design process. We have drafted an academic paper to share our findings with the public health field.
Nashira has been regularly participating in an intergenerational, multi-organizational collective co-designing multi-use space to house the birth center and others (artists, activists, educators, organizers, healers - including our own advisor Luana Morales, youth, elders) who are working to make our communities more whole.
We are now incorporated with the State of Massachusetts with federal tax-exempt status pending, and we have secured a fiscal sponsor so we can fundraise and write grants.
Speaking of grants, our small but mighty development team (Nechama, Meenakshi, and Nashira) continue to write for grants and fellowship opportunities to support Nashira’s time and to bring on other people to support the planning process.
We have built a nice partnership with MASS Design Group a non profit architecture firm whose mission is to research, build, and advocate for architecture that promotes justice and human dignity.
Between fall 2017 and spring 2018, we participated as a Community Innovation team in the prep and launch of MIT’s Make-the-Breast-Pump-Not-Suck Hack-a-Thon. Through this opportunity we expanded our network of healthcare innovators and social entrepreneurs and made special connections with women of color innovating around breastfeeding all over the country.

There are countless other things we are proud of accomplishing like the renaming (from Birth Sanctuary) and rebranding with a new logo, the design and launch of new website and social media, hiring our first ever summer intern, Ebere, and finalizing a 16 page color pitch book that reflects all of our planning and vision, to support our fundraising strategy.

That’s a lot for a group of volunteers who work full time and are parents, practitioners, and activists!

Photo by Elena Koycheva on Unsplash

Nashira Baril 4/11/19 Nashira Baril 4/11/19

When Upstream Public Health Efforts Fall Short

Over nearly 20 years working in public health I have noticed an increase in individual and organizational commitment to “health equity". But in spite of commonly shared definitions references to the social determinants of health, there is not a shared analysis about why inequities exist

Over nearly 20 years working in public health I have noticed an increase in individual and organizational commitment to “health equity". But as I explain in this piece “When Upstream Public Health Efforts Fall Short”, in spite of commonly shared definitions references to the social determinants of health, there is not a shared analysis about why inequities exist. And how we define the problem, shapes the meaning we make, the conclusions we draw, and the actions we take. (Spoiler alert: the problem is structural.)