Meet Nashira

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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 should 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 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 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 I know that’s not going to happen by simply creating community programs or diversifying hires, and I’m also grateful that some of my friends 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 close my eyes, I can hear children asking questions about bellies and boobies, answered lovingly by caring adults aware of their simultaneous transformation and 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.

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 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.)

Imagine...

Imagine receiving personalized prenatal care from a highly skilled provider team led by licensed midwives, who share a deep dedication to comprehensive parent-centered care. You will have time in your appointment to build relationships your providers, and receive the kind of care you want and that is best for you and baby.

Imagine building community with other pregnant and parenting families through childbirth education classes, in prenatal yoga, or in group meditation.

Whoever you want to be part of your care and birth experience is welcome at the birth center - your grandfather, your best friend, your Capoeira teacher, and/or your 3 year old. In addition to being by your side, they can also find comfort in the beautiful living room and kitchen while you labor.

Neighborhood Birth Center will engage a community of doulas offering continuous physical, emotional and informational support before, during and after childbirth. Access to healers offering yoga, meditation, reiki, massage, pelvic floor physical therapy, chiropractic, and acupuncture, and mental health practitioners offering psychotherapy, counseling, and support groups. All of these supports as well as lactation & nutrition support, childbirth classes, and new parent groups are important to pregnant people and new parents and should be easily accessible in one place.

When you arrive at the birth center in labor, you will receive the best and safest of care from highly skilled midwives and birth assistants whose training centers on the fact that pregnancy and birth are normal life processes. You will have access to one of the beautifully designed state of the art birthing suites featuring a luxurious and specially-designed tub, and large walk in shower for the comfort warm water provides in labor. You will also have the option of nitrous oxide, or laughing gas, to help manage pain through labor. (Supplies and safety equipment are easily accessible but not overwhelming in the space.) In addition to sitting or leaning on the birth ball or stool for comfort, you can use Swedish bars securely built into the wall or sling anchored to the ceiling to support you in a squat or leg raise to open your pelvis. All of this could help move baby down the birth canal and provide some pain relief. You may choose to wrap yourself in a plush robe and you will have the freedom to move around the space as your body needs.

You can get some fresh air on a small private balcony or just open the doors while you relax in bed. You can customize the space with your own music, or other accessories to make it feel like home.

"The birth center approaches pregnancy and birth as a normal family event until proven otherwise. [And] encourages family involvement and provides a safe environment for families to experience the social, emotional, and spiritual renewal inherent in birthing forth new life while attending to the possibility that a problem may arise that will require medical intervention or care in the acute care setting of the hospital. This is in opposition to the view that pregnancy is an illness and birth a medical/surgical event that needs to be cured." -American Association of Birth Centers

When baby is born, you will have time to relax and bond. The team will provide extensive breastfeeding teaching and help to get you off to a wonderful start. Once you are ready to go home you will have supports in place for you and your baby’s wellness, including a home visit in the first 2-3 days and warm, welcoming office visits at 2weeks and 6 weeks postpartum.

This is possible. This is coming. Allow yourself to imagine.