33- Jennie Joseph-Vaginal Birth- Endometriosis-Hysterectomy-Commonsense Childbirth-Luke

October 11, 2023Posted inCesarean Section, Endometriosis, Hospital Birth, Postpartum Depression/Anxiety
33- Jennie Joseph-Vaginal Birth- Endometriosis-Hysterectomy-Commonsense Childbirth-Luke

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In this episode, I had the amazing opportunity to interview Ms. Jennie Joseph about her journey into midwifery, in addition to her own personal experiences with endometriosis, giving birth as a midwife, and postpartum depression. We also discuss the impacts of the healthcare system in the U.S. on black birthing families. 

Disclaimer: This podcast is intended for educational purposes only with no intention of giving or replacing any medical advice. I, Kiona Nessenbaum, am not a licensed medical professional. All advice that is given on the podcast is from the personal experience of the storytellers. All medical or health-related questions should be directed to your licensed provider. 

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Transcription of Episode 33:

Kiona: 0:11

Hello, and welcome to Birth As We Know It. I am your podcast host, Kiona Nessenbaum. I have experienced birth as a doula, a student midwife, and as a mother of three amazing children with my husband and high school sweetheart by my side. After attending over 130 births, including my own, I’ve realized that each birth experience is truly unique. So make sure you subscribe and join me every week as we are guided through many different birth experiences through the lens of the storyteller. Please be aware that some of the stories can be triggering to hear, so feel free to pause, take a breath, and come back and listen whenever you’re ready. With that said, let’s prep ourselves to dive deep and get detailed about what really happens in the birth space. As a reminder, this podcast is intended for educational purposes only, and has no intention of giving or replacing any medical advice. All advice that is given on the podcast is from the personal experiences of the storytellers. All medical or health related questions should be directed to your licensed provider. Hello everybody and welcome back to the Birth As We Know It podcast. Today I am extremely honored and just ecstatic to have this amazing woman on the episode today. Some of you may know her, some of you may not. And if you don’t. You’ll get to know her. today I have Jenny Joseph, midwife and activist who is the president and founder of Common Sense Childbirth. So welcome Jenny. Thank you for being on.

Jennie: 1:49

Well, thank you, Kiona. I’m thrilled to be here today.

Kiona: 1:52

Yeah. let’s first start off for those that don’t know you,by telling us a little bit about yourself, what you do and who’s in your family.

Jennie: 2:01

Yes. So I’m a midwife and I have been a midwife a long time at this point, 42 years. what I do is always midwifery-centered one way or another, but I do a lot of things. Now, around that, not just, taking care of pregnant postpartum people and delivering babies, but I have sort of expanded that out into activism, into education, training, consulting, accreditation, and so on. So, lots of peripheral things have sprung up around the midwifery. But the core is that that’s who I am and I think that’s who I’m always going to be at this stage of my life. I don’t think it’s going to be anything different. My family consists of myself. I’m a widow, so it’s just me. And then my son, my only child, who’s now 37, and my grandchildren. I have a 13-year-old boy, grandson, and a Just four-year-old going on 40, granddaughter. And then I have a little doggie, my lovely Willow, who is five. That’s my family.

Kiona: 3:08

Beautiful, beautiful. That is amazing. I love that. your pup’s name is Willow actually.

Jennie: 3:14

Willow Joy. She’s got two names.

Kiona: 3:16

Oh, that’s so sweet. Oh, I love that. Oh, that’s beautiful. and I love that you described your, I believe you said granddaughter, who’s four, as four going on 40.

Jennie: 3:28

hmm. Miss Amaya. She’s quite the trip. But she’s my heart. I delivered her in my birth center in the water birth pool. It was one of the most amazing experiences of my entire life

Kiona: 3:42

Mmm.Jennie: 3:42

and career to be able to deliver my grandbaby. So, yeah.

Kiona: 3:47

Oh, that just touches my heart. I think that’s so beautiful. Because the dynamic is different, when you are supporting family. Oh, goodness. Mmm. Yeah, Goodness. Yeah. So, tell us a little bit about when you first started attending births. Cause you were not in the US you were in the UK.

Jennie: 4:07

Yes. So, my heritage is my parents are from the West Indies. My dad was born on the island of Dominica, a tiny island in the West Indies, and my mother was born in Barbados. So, they married and immigrated to the United Kingdom back in the, late 1950s. I was born in England. I’m the first born and I have three siblings. We were all born and we all were raised in mostly in England, but my dad was in the air force. So we traveled, we were in Germany and so on and just all around the UK. So, my, Midwifery education, I actually trained in London, and I trained in a hospital environment, and, I didn’t know, to know that there was any difference in midwifery anywhere else in the world. Because, my experience was, and any time I traveled or any time I researched, I knew that midwifery was normal for most every person who had healthy, straightforward pregnancies. And I also knew that obstetricians took care of complicated pregnancies and worked collaboratively with midwives. So I say all that to say that, my changeover to living in the United States kind of took me by surprise in that I didn’t do any research that part. I just showed up. And I was horribly surprised to find out that that midwifery wasn’t actually any longer anyway a normal and expected way to manage pregnant and parenting people. So I said all that to say that, I was born, raised, educated, and trained in the United Kingdom. And,like many, Second generation West Indian families, considered myself British, Black British. And, just didn’t think much about any of it other than till I landed in the States. And then that’s a whole other story, so.

Kiona: 6:01

Yeah, I love that you got trained in Britain and I love your background and the story from your family and how it grew together and, how you guys traveled. So I guess one question that I have based off of that is. When you transferred or came over to the US what was the biggest shock of realizing that you couldn’t practice midwifery? Like where did your mind go at that point?

Jennie: 6:27

Oh my goodness, my mind went everywhere. I mean, first of all, I felt really silly, because I just assumed, the rest of the world, we look at America and we’re like, oh, everything’s here, like the land of milk and honey, the streets are paved with gold. Why wouldn’t you be here? You’ve seen Hollywood, you understand the history, you understand all the story that is exported into the world about America, right? It’s the most affluent and most resourced country in the entire world. So, I felt kind of stupid, because I didn’t think to research. Why would you? I mean, I know Americans have babies, so like, what’s the big deal? I’ll get here and I’ll jump right into, doing what I’ve been doing for, at that point, 10 years and I will just duly catch babies. And I actually thought I was going to work in the hospital as well. So that’s another big thing that was totally not in my radar. I had been used to working in hospital environments. I also worked in community settings. I did home visits. I was the literal call the midwife of my era. we moved on from the 1950s and the 60s, like the TV show. And, they would ride bicycles in those days, but by the time that was me, I was working in an environment where we had blue little minis, the mini cars to drive rather than bikes. Everyone knew the midwife was coming because you’d see a blue mini and you’d be like, there’s the midwife. So it was similar, it wasn’t much different. It was more modernized. So in the, eighties. I was busy doing community midwifery where I would do home visits for postpartum moms and, newly delivered moms, did a few home births. And also I worked at the hospital at the same time. So, I get off the plane, I came to the States to marry my sweetheart. An American, beautiful, American guy that I just fell head over heels. Brought my son at the time, he was two and a half when we got here. And, duly got married, and just was like ready to live the full life. And that’s when it hit me, like a ton of bricks. I was beyond shocked and very quickly discouraged. Much of the ridicule and snickering, laughter was, What are you talking about? We don’t do that. That’s old. Oh, we’ve moved on. Are you kidding? Uh, and all the other types of responses, none of which were positive. And I actually became quite depressed because I was like, well, now what? I’m an unusual midwife in that in the era that I did my training. They were still in europe looking for midwives to come on from the nursing discipline. So I was one of the first batches of what we called now direct entry midwives meaning I wasn’t a nurse But I was hospital trained. So at the end of my training, I was equivalent to any nurse midwife. I was able to work in the hospital. I was able to move up in the hospital hierarchy. I was the youngest, charge nurse. I was at 22, I was a charge nurse. Which is actually kind of ridiculous because I was very silly and immature. But nonetheless! I could catch the babies. I knew how to do that stuff, right? So I got started really early, and I got promoted really early, but I didn’t have that knowledge that this wouldn’t be the same anywhere I was in the rest of the world. So there was the ridicule, there was the laughing, the finger pointing, and then also the shame. I’m just going to put that out there because I felt less than due to lack of having, for example, a registered nurse degree separately or having, the, college level credentials, because again, I was hospital trained. That’s changed since I’ve left the UK. But, in those days, you didn’t do a university training for midwifery or nursing. It was vocational and you were trained on the floor, which actually makes sense if you think about it. Because when you’re finished you know what you’re doing, as opposed to you read the book and you hope for the best and you did a clinical rotation for two whole weeks, So that was where it sort of landed. It landed pretty sadly, pretty miserably, because like I said, I got kind of depressed and down. And I actually started working for an OB doctor in Orlando. And I was duped because that doctor, first of all, didn’t explain that I needed to have some type of a license to work with him. He was Canadian, French Canadian. And also the doctor was very keen to make sure I didn’t go anywhere near the hospital or have the patients imagine that I could follow them. He was very clear. You’re going to stay in the office. You can check the patients do everything else but you are not to be out there, you know, other than inside of this environment. I didn’t really understand why

Kiona: 11:05

Hmm.

Jennie: 11:05

I went along with it. I was happy to work. I was happy to get back into being with pregnant folk and get my hands on bellies and such, but I was not able to practice as a midwife. And I didn’t even know, like I say, that I had to have a license as such. So, a year went by and, I began to notice a pattern with that doctor. A white Canadian, French Canadian doctor, who, every time the, very busy practice, packed every day, we had, maybe 60 patients a day. It was just madness

,Kiona: 11:38

Hmm. Mm-hmm.

Jennie: 11:39

Every patient of color that came in had to have two questions asked. How is your period? And, kind of really like trying to elicit like, Oh, it’s bad, it’s painful, it’s heavy, it’s clots or whatever. So the solution to that was you needed to go for surgery. Or, have you finished having your children? And so the surgical book would be run up and down the hallway all day because every time a person of color was in the room, could we get a surgery out of that person? And those surgeries were tubal ligations or hysterectomies. Yeah. And so I had also had endometriosis myself personally, and I share this part because it’s really an integral part of my journey in the United States. When I came in 1989, I was, 30 years old and I’ve had endometriosis most of my adult life. I’ve had quite a hard time with it. A couple of times I’ve had some hormonal treatments. I had done all the things that we could think to do. And I suffered quite badly with it. So, I explained to the doctor I was working with, I had this problem and he said, Oh, I can fix that for you. I’m, I’m going to do laser surgery. I’m like, Oh, cool. New, new technique. And, my husband was horrified. He said, you don’t have your doctor that you work for do anything on your body. And I’m like, I work for him. It’s fine. And so the long story short. Four laparoscopy surgeries through the course of the year that I worked for the doctor. Each time after each surgery, I was worse. And at the end of the year, I went to another OB physician, GYN, to get a second opinion. And that doctor said to me, Oh, you’re in trouble. Showed me that my ovary was pretty bad with the endometriosis and all the different, areas that he could see adhesions and scarring. And he said, I’m gonna, solve your problem. You need to have your uterus removed. And I was at that point in so much pain and so distraught I said yes. I woke up from that surgery without my uterus and both ovaries were gone. 30. 30 years old. And on top of which, he had already, and those were the days when we used the hormonal injections called Premarin. I don’t know if that’s, you’re probably too young to know about Premarin, but Premarin was a very high estrogen, synthetic estrogen, that many women were on, which they pulled from the market after many years of trials have shown it wasn’t safe. Anyway, I was on Premarin. My other doctor, the doctor I was still working for, fired me. Wanted me back in the office within two weeks. Wouldn’t give me the six weeks recovery. He was annoyed because he didn’t get the hysterectomy.

Kiona: 14:19

Wow……

Jennie: 14:20

Yeah, deep stuff. So I say all that not to make everybody miserable or, frustrated or annoyed, but to say that the genesis of so much of what I see happening here is based on these ways of being, these historical and institutional ways of perpetuating harm, perpetuating racism, classism, sexism, discrimination, maintaining the capitalism that is the health care system. And so, when we look at our maternal health outcomes and our maternal mortality and morbidity, and we throw our hands up and we say, we just don’t know, how is this so? This is how it’s so. And we do know. And until we can really come to terms with that, we’re not going to really make a whole lot of progress because we’re running around like chickens. We’re blaming the women. Oh, well, she was overweight or she didn’t get prenatal care in time, or she didn’t do what she was told, or she’s bad and wrong, or the wind is blowing to the Southeast. It doesn’t really matter. The reasoning behind all of this is must be something wrong with this person Or they haven’t done what they should have done. So therefore hold the system harmless.

Kiona: 15:36

Hmm, yeah, wow, Jenny. So first and foremost, thank you for sharing that part of your story. I think that it’s important, to thank you and that aspect because that is a vulnerable thing to share. And I thank you for that. as far as working for that doctor, and him expecting you to come back two weeks time. That’s just the tip of the iceberg for what… Many, many, many OBGYNs and physicians and the system, our healthcare system, expects of mothers or birthing people after they have their children, meaning they expect a quick return. They expect that, I don’t like this term, but they expect the immediate quote unquote bounce back after a humongous life changing thing. And also, how petty is he? To be so selfish and to see you as just another bill to charge. When you were coming in with so much expertise and him not valuing that expertise because of a paper license. And for him to say, well, you didn’t let me do it, so. You’re fired.

Jennie: 16:58

Yeah, well, and, you know, this is, that was the modus operandi. That was how he was treating all his patients of color. Because every last one of them, like I say, was off to surgery for some reason or another. Whether there was a real valid reason or whether they just said, yeah, I’m tired of having this period, So, this is something that historically, from a gynecological point of view, has been the curse of, black women from enslavement through. this is not new. black women were experimented on, the, the, the slaves, the, the most famous, of course, many, but many, the most famous are Betsy, Anarka, and Lucy, who were, they even have a portrait, they have paintings of the, experimentation, the, the physicians, the white physicians coming in, the masters, slaveholders selling, I guess, opportunities to come in and learn on these human beings, human chattel, the experimentation in terms of the repeated surgeries, to fix vaginal fistula, rectal fistula, which are really basically damage after having babies and, having a hole or opening between the rectum and the vagina, leaking feces, leaking urine, all of these things that can show up when birth is obstructed, when babies don’t come through well or quickly. And in those days, they weren’t always doing C sections. So this was a real big gynecological problem. And specifically the white physicians were looking to figure out how to support white women who were suffering. Who were ostracized, who were unable to function once they’d had this happen. And so J. Marion Sims was one of the lead physicians who discovered, by doing numerous surgeries without anesthesia, without any real, with impunity. That he could, not only repair fistula, but he could teach that, and this has not changed. So, one way or another, you’ll see, in modern times, the perpetuation of those ways of being, whether it’s medical students having opportunity to examine, and then there’s a lot of other things that are going on in the community. whether it’s the lack of support for folks while they’re under anesthesia without their consent. Whether it’s, The propensity to induce laborers to make the commodity fit into the nine to five. Whether it’s, well, I need X amount of revenue to come through this practice. So if I do enough surgeries, cesareans, et cetera, I’m going to make my amount that I’m looking for. These areas have to be unpacked. And recognized. And I strongly believe counted towards these. Supposed, intractable outcomes that we are suffering, that we just apparently don’t want to recognize the genesis, where they’re coming from, but yet here they are in plain sight. And they have always been here. It was Fannie Lou Hamer in the 60s during the civil rights era who said, I’m sick and tired of being sick and tired. That hasn’t changed. We’re still sick and tired of being sick and tired. And she had what they used to call the Mississippi appendectomy, which was having surgery for one thing, coming out of that surgery, minus uterus, ovaries, tubes, whatever, like parts. That was a sort of an ongoing thing, too. The sterilization without consent of Black women.

Kiona: 20:21

Mm. Yeah. Man, there’s a lot to unpack there because it dives so deep into history, but also, like you said, it is still here. It is still present. It is being covered up in ways that seem to be that quote unquote normal way of practice, normal policy, normal ways of studying getting education. So that is a lot to unpack and honestly, that’s the work that you’re doing as well as all of these other midwives and specifically, I would say midwives of color trying to break this cycle, trying to, help educate people from our communities and help empower people from our communities and remind people in our communities that agency of their voices matters and the decisions they make, the education they obtain can really change their outcome. And something simple with education, when it comes to educating our communities, it’s not, oh, let’s sit down in a classroom and read this book, or let’s sit down and watch this slide show. Education really comes through conversation and. Being able to communicate like, hey, have you experienced this? Have you done this? Or watch out for this, or hey, here are the statistics on this. We don’t have to be the statistic. We can do what we can and what we need to do in order to support you to carry your baby full term and not have a preterm baby, So it goes very deep.

Jennie: 21:52

It does, And it’s really hard. It’s hard to hear. It’s hard to absorb. It’s hard to process. And it speaks to much of the powerlessness, even with education. we have statistics that are clear. Affluent black women, educated black women, celebrities. Doesn’t really matter. That’s how deep the systemic harms are built in. Right? If you can be, the most famous athlete in the entire world, right? And have, I can only imagine, more money than, I don’t know how many people put together. Likely the, best insurance, you know, how that goes in America. You can have good insurance or you can have bad insurance, but probably the best. And likely the most sweet and willing and, professional doctor. And still almost die. And the only reason you didn’t die is because you managed, in this instance, your advocating for yourself worked.

Kiona: 22:57

Yeah. Mm hmm

Jennie: 22:57

We can be very, very clear that you can teach or support folk into advocating for themselves, and that still doesn’t make a difference.

Kiona: 23:08

Right

Jennie: 23:09

Because, it’s only by literally the skin of her teeth that Serena made it through. It was that close. And that was simply based on just not listening, not believing that a black woman would actually be worth listening to or believing, including a woman of that status.

Kiona: 23:35

Yeah.

Jennie: 23:36

Yeah.

Kiona: 23:37

and, that’s just one of the many examples out there in the world, of course, but,

Jennie: 23:42

Mm hmm.

Kiona: 23:43

that kind of goes hand in hand with the stigma that black people don’t feel the same pain, black people have thicker skin, and the fact that that was actually done in a study, that boggled my mind. Like, who in the world ran this study? I can’t, I’m going to have to look up the name of the study because I don’t have it at the top of my head, but there is a study that was shown that I came across as a student midwife that was saying that these providers were saying and giving some specific statistics saying that black people have thicker skin compared to white people, and they didn’t feel as much pain. And that also goes along the lines of, especially in birth, the quote, unquote, angry black woman. You know, having to literally raise her voice in order to be heard at all, and that’s a problem and it’s always been a problemJennie: 24:40

Yes.Kiona: 24:41

and it’s something that needs to continued to change and be worked on.

Jennie: 24:45

I will add on there, the fact that we’ve spent, the last 10 or 15 years saying cultural competency out loud as, the thing to address. These biases, these implicit biases, explicit biases, that we thought that was the answer and then we’ve changed a little bit and said, okay, we understand the difference in terminology, such as cultural congruence or cultural humility as a way rather than cultural competency, because for the minute it came out, it was like, oh, well, you need to know that Chinese people do blah, blah, blah, and Asian, um, you know, African people do blah, blah, blah. As if there were this like monolith in each cultural group and all you had to do was learn it and then you were competent. Right. And so that’s changed. Luckily, gratefully, I’m happy to see that, but I’m not sure that we’re doing really much better when we talk about implicit bias. It’s a little bit more, convoluted. And of course, it offers folk an opportunity to look at their own as opposed to, you know, like, you could choose to look or you could choose not to, or you could even look and see and then realize and then just go on. And I do think what we really need to be looking at is not so much the individual because we’re human beings, but rather the structural and the institutional that say it’s okay that you don’t have to listen to Serena if you don’t feel like it, like likely that nurse is probably still working.

Kiona: 26:10

right,

Jennie: 26:11

Because institutionally and structurally, that’s okay. So this is where we can do some work. So, when we look at their studies, for example,a study that was showing that when there’s a match, babies, mothers, families do better in their outcomes when their provider is a cultural match. You just have to realize that so many unconscious and subtle ways of being are actually life saving, because the opposite is true.

Kiona: 26:45

yeah.

Jennie: 26:46

At the end of the day, What I call materno toxicity, that’s the name I made up for all of this stuff. Materno toxicity shows up because of who you are, not where you are. Yes, of course, if you’re in a low income neighborhood or you’re in a stressed environment or a violent environment, yes, you obviously are in materno toxicity. It’s not healthful or wonderful for you or your baby or your pregnancy. So you’re a little bit into some toxicity environmentally. But I talk about materno toxicity from a perspective of it pops up because of who you are

Kiona: 27:20

Mm.

Jennie: 27:20

because of how you look and someone’s perception of you. That’s why materno toxicity can be lethal. Not because you didn’t eat right or you didn’t take your prenatal vitamins or your blood pressure just poof went up all of a sudden out of the blue. No, it’s because the person responding or people responding to you have a certain subconscious most of the time, but often conscious way of being, i. e. your black skin is thicker therefore, or you don’t feel pain. So this is trying to just sort of point out as we keep exploring and digging into ways to solve this miserable problem that we have, that we might want to look at it differently to how we have been, given that we’re not making a whole lot of progress.

Kiona: 28:07

Yeah. I like that term. Is it materno or maternal

Jennie: 28:11

Materno I just put the O in there to make it more fancy and I could put a hyphen. materno-toxic,

Kiona: 28:18

Yes.

Jennie: 28:19

But it’s a made up word, um, we talk about toxicity typically around the fetus, you know, like as usual, the mother’s just like extra in the way. there’s not a lot of application of that kind of thinking to the mother. It’s to the fetus. So we talk about teratogens, which are harms to the baby in uterus as a fetus. And then of course, Once the baby’s out, you know, the pediatrician is a whole big specialty of itself to then join in with, you know, the baby, the baby, the baby, the baby, right? Dr. Stube says, one of the obstetricians that works, in the fourth trimester world and does a lot of work in there, she coined the phrase, the candy wrapper. The mother’s like the candy wrapper. Once the baby’s out, just toss the wrapper away. And yet we wonder why we have all of these postpartum ills. Morbidity and mortality is worse in the postpartum than it is anywhere else. The highest numbers of folk are harmed and lost in the postpartum. And that’s because we don’t care, at the end of the day.

Kiona: 29:17

yeah. And that’s, yeah, that simply shows up when people come to visit postpartum. They’re like, oh, the baby, the baby, the baby. Let me see the baby. Oh, so cute. Rarely had I seen as a doula or student midwife when I would go to postpartum visits and family was around. Rarely would I see someone check in on the birthing parent. Rarely. And that was one of the things that I intentionally did as any person that could make any kind of impact anywhere, you know, just even checking in and saying, how are you feeling? I have a lot of people, you know, I feel like babies are booming right now. I don’t know why so many babies are being had around me. Um, like my sister’s had babies in the last year and my best friend just had a baby a couple of weeks ago and I’m constantly. Doing the check in with them. Like, how are you mentally doing? How are you feeling? How’s your body? Like, how’s, how’s your relationship with your partner? Um, you know, how is everything going? Because it’s a full family dynamic. it’s no longer just the two people, like partner, birthing person. It’s a dynamic that survives in my mind. I don’t know why, but I feel like a family is like a mini ecosystem within the larger ecosystem. So.

Jennie: 30:38

It absolutely is. And you’ve, you’ve hit the nail on the head there. Thank goodness you’re standing in the gap because there isn’t anyone coming. No one has really taken on that responsibility for postpartum folk in America. So, you know, when I was in England, like I said, I would do home visits, mostly for postpartum mothers, and that was legally mandated. So, The rule was that if you were delivered in a hospital environment, you might go home and whatever day you go home, the midwife picks up and does the home visits up to 10 days postpartum as a matter of course. So what I had to do was be call on everybody who the hospital said they had sent home. And in my day, we were also keeping mothers in the hospital, first time mothers, six days postpartum and then second time and subsequent mothers three days. So my role was to pick up and I’d have a list every morning. Okay, this many folk were discharged. You need to start go visiting in your area. And I would go and some of the mothers would be like three or four days postpartum. Some of them would be a week postpartum, but I would still do the visits up until ten days minimum. And at ten days we determined whether they still needed visits or not. Guess who the visits were for? The mothers! That was baked in, right? They also, mothers who delivered at home or in a what we called, the GP unit, which was like a, center setup, where you had an early discharge at six hours post delivery. We would also go to the house twice a day for, until they were three days postpartum. So I’d do a morning and an afternoon visit for them, and then a daily visit like everybody else. This was, this was 1980s. You know, this was what we were doing back then. I started training in 1979. It was normal, right? So I had my baby in England and I was first time mom having a baby. I was a midwife already. I’d been a midwife for five years when I had my son and um, I thought I knew everything because I was a midwife, and I was a charge nurse, and I was Miss Fancy Pants young flibbity jibbit lady, you know, and so, and I also looked very young, which didn’t help. So a lot of the mothers that I would attend in the, in the hospital would think, Get out here, where’s the midwife? Go get the midwife. You’re not the midwife. And I would be so affronted. Like, how dare you? Of course I’m the midwife. I might be in the disco every night, but I am still the midwife. So, anyway. I had my son, after having spent many years teaching, we used to call them parent craft, you know, childbirth ed classes. And, tending to mothers, both in the hospital and in the community setting. So I thought I knew everything. And I was so excited to be pregnant because I’d had endometriosis and I was told you’ll never have a pregnancy you cannot conceive because your endometriosis is so bad. So it was an oopsie surprise and I was still thrilled because I was like, ha ha, this is the miracle child on its way. So I really enjoyed my pregnancy. I had not a day of anything like it was just glorious. those days we didn’t have ultrasounds for sex of the baby. We had ultrasounds when you needed to have something right so I didn’t know what I was expecting but I already was clear because I dreamt about this child I saw her face and I was new I knew I was having this girl but I had a boy’s name picked out but I was like well I’ll have to wait to see the baby before I can get this girl’s name because we could not come up with any girl’s names, so I knew that the boy’s name was Luke, but I didn’t have a girl’s name. I didn’t like Lucy, so that didn’t work, so I was like, I’ll just wait, so duly go into labor, and my first contraction brought me to my knees, and I’m like, oh dear. We’re in trouble here because I’ve been telling people about puffing and blowing and just doing these fancy little things and they’ll manage their pain. And I was like, Oh, we got a long road. I can’t cope. And it’s not a good look. Um, I’m in the hospital having, because people have babies in the hospital and everywhere else without any real particular drama, right? Because it’s normal. And the hospital is run by midwives. Right. Maternity hospitals were run by midwives. So I was having my baby with people that I knew and colleagues, in my field. And so it wasn’t work in and I was yelling and it was like, I’m out of control and I’m hardly got started in this labor. And so. Every contraction I vomited, or was heaving at least, trying to vomit. It was the most miserable. I went from a Tuesday night, my motor broke at 6 p. m. on Tuesday, and I had my baby 8 a. m. on Thursday. And I was a holy mess. Like, it was just horrible, and I just yelled and screamed and railed and argued and was like, you know, the whole shoot me, take, you know, do something, um, the head spinning, the vomiting, you name it. it. went on and on and on, and then I had him. And I’ll never forget that part. You never do, right? As he came out of me, he was looking, because his head was backwards, of course. He was posterior. And, um, that was why half of the, you know, the drama. And as he was born, he was looking up, and I could see his face, I could see his eyes, and he looked me dead in the eye. And, you know, if you could have, like, illustrated that scene, it would have been, like, the lightning bolt between the eyes. Like, just a locked gaze, and it was, like, just… Some surreal thing that just transpired between us where he was looking like he was literally looking at me. I don’t expect he really was, but that was my memory of it. And, um, we just connected and I was also just taken aback because it was a boy and, you know, I didn’t know I was. I was. like, it’s a girl, I’ve seen this girl, I dreamt about this child, I saw the face, I know exactly what this baby looks like. And this baby didn’t look anything like the baby I dreamt about. And it was a boy, so that took me by surprise, I wasn’t expecting this boy. But I knew his name,

Kiona: 36:48

Mm-hmm.

Jennie: 36:48

I had known that name since I was six weeks pregnant. So he’d given me the name, but I just wasn’t going to accept that it was a boy. So anyway, Luke was born, and it was the most… Surreal. I think from the perspective of being a midwife and also being a mother all mixed in,

Kiona: 37:10

Mm-hmm.

Jennie: 37:11

I had seen that over and over, you know, I don’t know how many countless babies and families being formed in front of my eyes on a daily, sometimes two and three, running up and down the labor floor, right? And to do that, have that experience myself was, I really don’t have adjectives. I don’t have language to match. That feeling, um, but you know, um, I’ve got pictures, there’s proof, you know, I mean, I really look like death warmed over, um, I’m just like, you know, deer in the headlights, all of those kinds of images have been captured on film, my baby breastfed without a single solitary problem, if nothing else, I mean, that was like butter, just like. Just straight to the nipple and no trouble and never look back. I breastfed for, almost two years, but The thing about the labor for me was the not being prepared as a midwife blindsided no clue That anything like what I had just experienced was likely to be what I was going to experience. None whatsoever. And this was the miracle child as well, you know, so I thought I was prepared. I thought I was like, you know, I’ve got all the skills. I’ve got all the access. I’ve got all the support, Still…Mm mm. So, it was, surreal and it was beautiful. It’s still very strong of a memory in my mind. He’s 37. And… What happened to me after he was born, because I ended up parenting on my own, I got a horrendous, nasty postpartum depression. It’s six months postpartum. It didn’t happen in the beginning. I was back at work. I was going on about my way. My mom used to keep my child overnight, so I didn’t have him with strangers. I kept breastfeeding, like I said. It was just totally out of the blue. Just like the labor, and it, it went fast. It was a quick one. It was all at once, like, almost as if the six months had just sort of been on hold and then released. And, I was not coping at all well and got to a point really, um, I was suicidal, you know, I, I remember the day I, drove directly to the doctor’s office and, um, my family practice doctor, everybody has a GP family practice doctor. In the UK, luckily. Because universal health care, imagine, and so I went rushing into the waiting room and they were like, take a seat, take a seat. And I’m like, No, I’m not taking a seat. And the person was like, No, you have to wait, you don’t have an appointment. I’m not waiting. I need to see the doctor right now. And I started yelling. And they’re like, Oh, okay, come on, come on, let’s take you back. You can see the doctor right now. And the doctor was, Very, very helpful. Intervened, got me therapy, got me medication, et cetera. And here I am, but it was also the wake up call to postpartum is not funny. It can show, it can be, gradual or it can be that instant, just like that. Just like that. And so, those experiences helped change how I midwifed. I suddenly was not so keen to be flippity jibbit Jennie. Running around on the floor being cute and just living my life. And what those families, those mothers said to me all those years ago was absolutely true. In terms of technician, yeah, I might have been a midwife, but I wasn’t a midwife.

Kiona: 41:12

And that shifted real quick, huh?

Jennie: 41:15

Yes, it did.. And last thing, you know, because it enabled me to really be and do like I think all of us that are in this work do, which is your lived experience counts and your lived experience is what drives, what’s possible for change.

Kiona: 41:33

Yes. I agree with that 100%. Yes. Yes. Yes. Wow. So again, there’s a lot to unpack in that story. There’s some questions that I have that I’m trying to hold and not lose. The first question that I have, we’re going to go back a little bit is you had mentioned how they said that with you having endometriosis, it was going to be hard to conceive naturally or at all. Did you see any impact from endometriosis throughout your pregnancy? Like, were they talking to you throughout your pregnancy with any risks that could happen or, did anybody try to talk you out of having a vaginal birth with endometriosis?

Jennie: 42:11

No, we see. And I think this is the difference between the United States and the rest of the world. So, never was there mentioned, for example, with my endo, that, I would need a hysterectomy as an answer. Like, the life threatening cures were left for life threatening situations. I had never heard of anybody having a hysterectomy. Other than they were at death’s door or they had cancer. And the people that were having hysterectomies in my experience in London and Europe were elder folk who literally had cancer or, they had some uncontrollable bleed. The entire ten years that I worked at the hospital in London, there was one maternal death and I’ve never forgotten it. The whole hospital practically shut down, I’ll never forget. In the cafeteria there were hushed tones and hand wringing and Have you heard? Oh my god, this happened. We don’t know what happened. Like, nobody knew what to do. Because there was a mother who died during a C section. That had never happened before! I don’t know how long it was, because I left England in 1989. I don’t know how long it was before the next one occurred. But in my time in that hospital environment, there were people who had never heard of such a thing. The entire hospital was at, like, a gog and talking about it. And the, the unit didn’t know. The maternity unit was, like, all over the place. They just could not, nobody could make sense of that.

Kiona: 43:47

Right. The thing that I found interesting about you mentioning how the whole hospital was hush hush about that maternal death is that when it does happen here in the U. S., that does not happen. And I feel like the reason why I’m saying that is because The statistics show, well, I’m not going to, I’m actually not going to talk about statistics because I personally don’t know enough to say numbers and I don’t want to sound like I’m talking out my hoo ha.

Jennie: 44:18

Well, you don’t know about it. I mean, I think you should talk about statistics, Kiona, because we have a certain set of statistics that are, you know, matching what it is we want to have it match. Right. So the last 10 years, maybe 15, where maternal morbidity and mortality began to be mentioned and then counted has caused a lot of consternation because historically we’ve never bothered to count. So now it looks like something’s worse than it was or increasing. No, it just never got counted. And even now we aren’t counting. So why say that, for example, because if you die in the ICU,

Kiona: 44:58

Mm hmm.

Jennie: 44:59

You died in the ICU. You died from a heart attack or a stroke or an infection. You didn’t die because you just left labor ward and got to the ICU. Your death certificate is going to be hard put to find a little box that says, was this related to maternal? Because it’s, right, we are collecting how we want to to keep ourselves looking good. So our statistics are on top of that kind of way of being and thinking, right? If you go home from the hospital and die in the community, who’s counting? If you die from suicide, if you die from opioid overdose, if you die from… Cardiomyopathy at three months postpartum. Who’s counting? So the statistics are relevant. So when you hear three to four times as many black women are dying as white or others, that’s just the tip of the iceberg with what we’ve actually bothered to collect. Likewise, when we hear about maternal mortality reviews where doctors and stakeholders pour over records and try to figure out what happened. When they finish figuring it out, they say, yeah, you know She didn’t get care in a timely fashion and she died of a preeclamptic seizure. Which is it the timely fashion or the preeclampsia? At the end of the day She would have gotten care in a timely fashion if someone was listening. If somebody in the ER actually knew what preeclampsia was Because she’s not in the labor floor anymore. So place matters. Knowledge of what you’re doing and how you’re doing it matters a whole lot from the perspective of the providers, the agencies, the risk managers, et cetera. Right. So the statistics are really important, but we also have to remember that they’re not really accurate.

Kiona: 46:42

Right. Yeah.

Jennie: 46:42

We try harder each year to get them more accurate. And guess what we noticed? They keep rising. And the rest of them that never got counted still don’t get counted. And the families who lose their loved one don’t get a voice to say or do anything about that either.

Kiona: 46:59

Yeah.

Jennie: 47:01

How do you advocate for your family if your wife just died in triage on the way into having a baby? Where are you going from there? Who are you talking to?

Kiona: 47:11

Yeah. Because the finger’s getting pointed away.

Jennie: 47:14

Exactly. You’re in the triage. Oh, well, it was an emergency, uh

,Kiona: 47:20

Yeah.

Jennie: 47:22

right?

Kiona: 47:22

Yeah. All of that is 100 percent true, and the reason why earlier I said I didn’t want to talk about statistics is because I am not, fully aware of where those numbers are right now. I didn’t want to say a number and have it not be valid, you know?

Jennie: 47:34

Sure!

Kiona: 47:35

But I definitely do feel that statistics are 100 percent important, and… The, the navigation of getting the correct statistics and focusing on the correct things to count, when to count them, how to count them, and, labeling it as it should be labeled. And it’s hard. And the reason why it is hard is because there are so many moving parts. There are so many different socioeconomic contributions to the reasons as to why things end up the way they do statistically. Does that make sense?

Jennie: 48:14

Yes. And it also has become a handy, another reason to move the blame across. Oh, social determinants of health. That’s what it was. Right. And again, going back to what I was saying before, if we look at this structurally, there’s only one reason that there’s social determinants of health are so impactful in pregnancy and birth outcomes. And that is because we perpetuate them. We have them on purpose and we don’t want anything to change. Likewise, we can call out social determinants of health because then once again it puts the blame right back on somebody else. But let’s talk about maternity leave, paternity leave, ability to sustain your family. Because you had a new life. That is not a social determinant of health, but that is contributing to the morbidity and mortality that we are suffering. So, there’s all these subtle ways of hiding and obfuscating and ending up with, oh, the statistics are showing this, that, or the other thing. Even if they weren’t there, even if we weren’t counting, it’s obvious. Why? Because this has been centuries of the main approach to human bodies, human chattel, black bodies, that that is, unfortunately, the commodity that fuels America.

Kiona: 49:49

Yeah, that’s 100 percent true. I’m trying to find a way to respond to that because… There’s so much there, you know, in that, that 30 seconds that you just spoke, there’s so much there in, in that statement or the statements that you made. And it’s true. It’s something that we will continue to fight for. And you had mentioned before, that whatever change needs to happen or whatever change we are working for and fighting for, we are not gonna see in our lifetime.

Jennie: 50:20

Right. This is generational work, but this is where I’m also calling for a pause. You know, my podcast is called the Perinatal Pause. Because I’m looking at, is that what has to happen here? Do we have to stop for a minute? Stop running like chickens? So that we can think and understand how we got here? And why we’re still here. This is one of our dilemmas. We need to move this needle, we need to stop this human rights violation in plain sight and we want to act with velocity. And at the same time, as we rush headlong, We’re not really getting anywhere because it’s very hard to think this through from these other angles, these other aspects. When we make that switch to looking at this problem from the wider angled lens, we see the intersections of the problem. But we have an entire industry that runs on Don’t see those problems outside of yourself. Blame the person and stick with that game plan”. That’s the one that works. That’s the one that’s expedient. That’s why we have to keep spending this kind of money to maintain and do more research and extract and, keep looking outside. We’re not really clear that the institution or the system or the medical industrial complex or any of the things that we don’t really want to face is the culprit.

Kiona: 52:05

Right.

Jennie: 52:06

And that’s why it’s going to be generations before we make a whole lot of progress, sadly.

Kiona: 52:11

Yeah. And,, that makes me think of navigating a little bit back to the postpartum time where you were talking about how you ended up having postpartum depression six months after your son Luke was born. And the reason why I’m going back to that is because you had just mentioned how this is generational work and it’s the way that the systems are set up, that is contributing to the statistics, right? And so that makes me think of the statistics of postpartum like psychosis and postpartum depression and all of this and how we leave kind of like the candy wrapper that you were talking about from Dr. Stubbe is the candy wrapper analogy of we leave people that have just birthed a child behind and focus on that child. And I wanted to go back to your personal experience of you said that you, you advocated for yourself by going into your GP office and saying, I’m not waiting for an appointment. I’m not sitting down. I need to be seen now. The statistics that are not being counted are also some of those people.

Jennie: 53:23

Most of those people.

Kiona: 53:24

Yeah. And they’re going in and some don’t have the energy or capacity to advocate for themselves.

Jennie: 53:31

Even if they do, especially those that are already in some way marginalized. Right? And in this country, being marginalized, unfortunately, doesn’t matter whether you have affluence, education, or means of support. Marginalized folk, you can advocate for yourself all day long. I know I’m broken record here going back to Serena, but that, of all the examples over the years that I’ve done this work in this country, her story has been the most illustrative of everything I’ve talked about

Kiona: 54:01

Mm hmm.

Jennie: 54:02

because she was advocating for herself, obviously, because she’s still alive,

Kiona: 54:06

Right.

Jennie: 54:07

right? But she left alone. Let’s say she hadn’t or she didn’t do it well, she’d be dead. It’s that simple. It’s like, that’s where we come to terms with what we’re really up against. So we’ve got a system here where you can’t just bounce into the, the doctor’s office and demand to be seen. The first question is, well, have you got your insurance card? What’s your co payment? Have you met your deductible? Who are you? The doctors are over at the hospital delivering a baby. Sit down. And any number of, I could go on for a half an hour with what the front desk people have been trained and told to say, and whether they believe it or not, they will do it if they want to keep the job. So if we go back, way back to what I was saying earlier about the physician I worked with, there was an employee who was employed literally to run up and down that hallway all day every day with the surgery book. That was a job because that physician ran that practice for that express purpose.

Kiona: 55:07

Mm hmm.

Jennie: 55:08

Right. So we have to consider that physician’s offices, private physician’s offices are set up to be private businesses. Let’s just bring the capitalism back into play because it’s, entrepreneurial work. Right. And then community clinics, those offices are with groups of doctors and set up in a slightly different way because hopefully with more access for folk, but not really. Well, you’ve got to do the sliding scale application where have you got your driver’s license? Can you show us your electricity bill? When was the last time? Blah, blah, blah. Oh, you didn’t pay the last bill and you still have a balance, et cetera.

Kiona: 55:42

Mm hmm.

Jennie: 55:43

You’re still having your breakdown, you’re in the midst of a crisis. So in America, if you’re marginalized, what you do is not only expose yourself to that level of harm and discrimination, but then you also jeopardize yourself because, Oh, you know what? You need the Baker Act. You need someone to come and let’s call the police. You’re not, well, you’re yelling. Oh my gosh. Angry black woman. Let’s get safe from you. We need to protect ourselves and let’s take your kid while we’re at it. Why don’t we? Let’s call DCF as well. Let’s get those protective, child protective folk up in here. This poor child. This is the unfortunate, and I’m making this a stereotypical response. I don’t know that everybody would respond the same way, but when we want to do let’s play Monolith, we might as well just play it all the way so when I talk about my model of care, my JJ Way model, The number one tenet, the first thing that has to be addressed is access. And I don’t just mean you got in the door and someone said go sit down. I mean access to the quality and safety and equitable care that you’re seeking. Access. Unimpeded. No one turned away. We’ve been 25 years as a non profit. That’s basically the mission in a nutshell. Every person, every time. No one turned away.

Kiona: 57:07

And you get clients that come in all, all times of their pregnancies.

Jennie: 57:13

At the last minute. We’ve got so many folk, especially folk who move into the area. No one will touch them with a 10 foot pole. They are wandering the streets for weeks trying to find providers. Every ER says, go call so and so and see if you can get in. And you call so and so and they click the phone on you. Because what do you mean you’re 37 weeks pregnant and you don’t have a physician? Get out of here.

Kiona: 57:34

Mm hmm.

Jennie: 57:34

Systemic, right? The hospital has some sense of umbrage and frustration if you should present in labor without a physician. How dare you?

Kiona: 57:45

Yeah.

Jennie: 57:46

How untidy of you? How rude?

Kiona: 57:49

Right.

Jennie: 57:51

What, what are you thinking? you see? Yeah, you’re right. So it’s, these are the pieces that are lethal.

Kiona: 57:58

Mm hmm.

Jennie: 57:58

These are the pieces that are causing harm and these are not visible because we don’t want to see. When a hospital says, Oh, we’re a nonprofit and we take anybody, we don’t turn anyone away. They don’t actually mean that.

Kiona: 58:12

Yeah. And it’s horrible because it’s so true. There are so many holes and loops and jumps that people have to go through in order to be seen, you know, and of course there’s the understanding of an individual provider being overworked. But like what I mean by that is one person can’t do it all, which is why we have group practices for midwives as well. You know, like one person can’t do it all. And I say that because there are hospitals that turn people away because they feel like there’s too many, I can’t say this for all hospitals, but there are plenty of other ways that they can support that client or that patient to get what they need rather than pushing them away and being like, you’re not my problem.

Jennie: 58:54

Well, they like to, I think, you know, again, be affronted on your behalf that you are a nuisance, that you’re ugly and you have a reason to be treated this way. You create it for yourself and including you’re the wrong color. You’re the wrong ethnicity. You have a different language. You are othered in the carrying out of this so called care that is being offered to everybody else. But the othering maintains your likelihood of having a poor outcome. And that’s where the human rights piece shows up.

Kiona: 59:36

Yes.

Jennie: 59:37

So we have a real dilemma because we really are unable to see or address what, you know, it’s hard for folk to have to admit that that’s so. So, we, we go round in circles and we do such things as yes, but we understand social determinants of health. So we make sure to let our clients know about the food bank. We tell them about the hot 800 number so they can get support from XYZ social service agency. Right, that’s. The way we’re going to solve this problem. No, it’s not So we’ve got a deeper problem. And again, I think as we stop pause and think it through. We’ve got more work to do we can advocate for ourselves and each other But we also have to be careful that we don’t join in with agreeing that we should fix our own problem. Can’t fix a problem that’s as deep as an entrenched as this one.

Kiona: 1:00:33

Yeah.

Jennie: 1:00:33

You can’t fix the fact that a 30 year old person can go like the sheep to the slaughter and lose all the reproductive parts in one fell swoop. And no one has anything to say about that. No big deal. But you can’t change the fact that more folk in the postpartum are abandoned to complete just nothing to see here. No one is interested in you. Get away. Even if you have a six week visit.

Kiona: 1:01:02

Yeah, I was just gonna say even if you have a six week visit, it’s still hard to get in contact with someone when you do need help. What you do is you get this number and you end up calling the central hub or the operator. And then you are trailed along this phone tag system of trying to talk to someone who can help you get what you need. And the thing that makes it hard in the system here in the U. S. is Most of the time, your solution is, Oh, the doctor’s busy. Go ahead and go into urgent care. Or go into ER. And then that leads the client to needing to pay all of these super strenuous and expensive bills for something that could have been resolved if the doctor would have seen them.

Jennie: 1:01:43

I’m going to even say sometimes the doctor cannot or will not resolve a postpartum issue because what do they do at the six weeks is that’s indicative of where the mindset is. They do a pap smear. That’s it. If you score high, if they do an Edinburgh postpartum depression screen or some type of psychological behavioral health screen, they don’t have anything to do with the answer. They wash their hands, they did the screen, they check the box, they bill. That’s it. There isn’t a referral to anybody because no one’s in behavioral health in postpartum. So now that we have seen some states being interested in providing postpartum Medicaid, for example, for one full year, I’m glad to see it. And I’m asking myself and many others, I’m asking the question, well, who’s the provider? Who is going to deliver this postpartum Medicaid year for a year? Because the gap still remains. You get two days in a hospital, and there you are. Bye.

Kiona: 1:02:41

hmm.

Jennie: 1:02:42

That’s it. And if you get a six week appointment, good for you, and I don’t know what it does for you. And then, once again, bye. My personal postpartum depression didn’t show up until six months. But I had an access point

.Kiona: 1:02:56

And some people don’t.

Jennie: 1:02:57

Most people don’t. Most people don’t have anything. Even if you have a GYN at that point, well, you’re not pregnant anymore, so now you’ve got to bill your insurance to GYN, the nurse will set up for a GYN visit, the doctor will come in and try to do that said GYN visit, and if you’re crying, it’s like, oh, you need a psych, go ahead to look in your insurance and see who does behavioral health, have a nice day.

Kiona: 1:03:19

Mm hmm.

Jennie: 1:03:20

So there’s no access to the actual quality of care related to what’s wrong. There’s no equity in that care. And there’s no safety in that care. Hence, we have a perinatal problem. Perinatal is around birth. Before. During. And after. This is not about midwifery. This is not about the labor and delivery day. This is not about, the, positive pregnancy test. This is not about the two day, I’m leaving the hospital looking cute with the balloons and the flowers and the baby and the bassinet. This is not about any of these points along the way. This is a continuum of problems that, I’m going to say it again, are lethal.

Kiona: 1:04:08

Absolutely. And you made the perfect segue to bringing up perinatal because as you’re talking about this, I’ve listened to all of your episodes on your podcast and in your intro and even throughout your episodes, you’re talking about the meaning of perinatal, like what perinatal actually means and defining that because it is on all sides of pregnancy. It’s the before, the after, before conception, just the thought of prepping and, you know, doing all of the things and realizing that the perinatal moment in a person’s life is very long. It is not, Oh, pregnancy done. Oh, baby’s here now. Cool. Like I tried for a month. That means I’m officially pregnant and now a pregnant person, it’s, so much more. And it’s also the time you mentioned between pregnancies, you know, my kids are four years apart. So my perinatal moment between my kids is four years, but I have three kids. So I have a 10 year old, a five year old and a one year old. So. I’ve been in my perinatal moment for,

Jennie: 1:05:13

That whole time..

Kiona: 1:05:14

yeah, and I will continue to be, you

Jennie: 1:05:17

Yes.

Kiona: 1:05:19

Postpartum, the postpartum moment. Yeah, postpartum is forever.

Jennie: 1:05:23

I have a 37 year old. Postpartum is forever.

Kiona: 1:05:27

Yes. And there’s always that saying where people should bounce back. Like, oh, you should bounce back. Air quotes all over the place here. And people don’t even start to feel… anywhere close to where they used to prior to having children until like seven years after having your baby. And This is like they were saying that physically your body is not anywhere close to Not it’s never gonna be what it was because your body like your biology is literally changed. You know, it has literally been shifted So the the reason why I’m bringing this up at all is first Just adding to the point that postpartum is forever and you literally feel it physically, mentally, psychologically and it kind of goes to the point of When you’re a parent, and even if you’re a person that birthed a child and put them up for adoption or unfortunately had a stillbirth, you know, like, even though you don’t have a baby in your arms, you are still postpartum. Everything about you is postpartum. So, yeah, I’m just going on a rant here

Jennie: 1:06:34

No, it’s not a rant. It’s relevant and it adds to this picture that we’re trying to paint and we’re pausing long enough to be able to paint that picture because we can recognize, and I’m sure your listening audience agrees, that if we are just going to hone in on this sort of ideal bubble of joy, which is the American version of motherhood, Parenthood, right? As if that’s what we’re trying to get to, then we’re also doing a disservice. Historically, and, across the world culturally, motherhood and childbearing is deeply a part of the whole society’s, community’s way of being.

Kiona: 1:07:24

yeah,

Jennie: 1:07:25

It’s embraced, it’s supported, it’s enveloped.

Kiona: 1:07:29

that’s a great word for it.

Jennie: 1:07:31

Into the ways of being right. So if we have ourselves set on a pathway to let’s just try to get back to bounce back to Gerber baby, cutesy commercial TV, commercial version of parenting. We’re still not going to get there. It’s impossible.

Kiona: 1:07:53

Yeah.

Jennie: 1:07:54

We need to realize just like we do, with Sankofa, the, African, symbol of looking back to go forward. We need to look back and learn and understand how we got here and then figure out generationally, how do we change. From one generation to the other to undo what has been so deeply put in place. And you’re really smart to mention the impact on your body. If we think about epigenetics, if we think about generational transference, we’ve got a lot that we carry and it’ll take a lot to get to the other side.

Kiona: 1:08:38

Yes, absolutely. And I think one thing that people can do that’s like a physical thing that can like have us look back and kind of learn from our past is we need to, especially here in America, I don’t see it as much unless it’s from, I’ve actually seen it more with BIPOC families than white families, is multi generational housing, making that community of being and having that support and my, my home is lucky enough or not even lucky enough or fortunate enough necessarily, but like, uh, yeah, I’ll say fortunate enough. We have that in our home. I would not be able to survive the way that I do as a mother. I would not be the best version of myself as a mother if I was doing it alone. And I feel like so many people in America here. Do it alone. Even if they have a partner, that partner up and leave soon after, cause they need to pay the bills. So people are doing it alone. And so I think that is one way for us to look back at our past and the history of, or I, I don’t, I don’t even want to say the history, but just looking back at how, enveloped birth is around the world. As a natural communal part of life. I feel like here in America, that’s not the case. It’s like, cool. We had another person have a baby. Let’s clear this bed out, put them in postpartum and then we’ll, we’ll kick them out in a few days, you know? And I feel like I was fortunate enough to experience having that extra support postpartum to have some of that cultural, aspect from my mother in with having food brought to me in bed and me not having to go. Downstairs and, um, being able to have that privilege of even having, I have two cultural background. I have many actually cultural backgrounds in my family. We are very multicultural, very blended and I love it so much. There are two primary things that I experienced postpartum with all of my children. One was this Guatemalan beverage that encourages lactation. And it’s super good. There’s some chocolate in it, but then it’s also just a whole bunch of, like, wheat and oat and all of these other things that encourage lactation. When I say my breast were engourged, oh my gosh, I can’t tell you. Um, and I loved it. And then the other part is my mother in law is Nepali and she would always cook every meal that I ate with ghee with fresh organic Nepali ghee and it really changed and I feel like this is kind of going off topic, but I feel like that goes into how the nutrition that you receive postpartum really changes how you heal.

Jennie: 1:11:32

No, it’s not going off topic at all. It is literally, you know, you’re naming the components that constitute safety, quality, equity,

Kiona: 1:11:50

Yeah.

Jennie: 1:11:51

right? Those pieces in another world or in another space and time would be guaranteed because you’re human.

Kiona: 1:11:59

Right.

Jennie: 1:12:01

Not optional, not if only, not uh, we’ll see how we feel today, but guaranteed because you’re worthy. In place because of your humanity, not even a sort of a opposite thought than anything other than you must be centered because you are bringing life, period.Kiona: 1:12:26

Right.Jennie: 1:12:27

That’s it.

Kiona: 1:12:29

That um, actually brings me to question how your postpartum was soon after like your immediate postpartum because you said your mother was there. And how was that? Like, how did that support you in those postpartum times?

Jennie: 1:12:43

it was, the early days were fine because I was literally in, I moved back home and, I did night shift, I was able to pump, my mom would actually she had to, spoon feed my kid because he would never take a bottle. He never actually weaned from the breast to a cup, but she figured it out because she was my mom, right? she wasn’t the babysitter, right? And so I was very well supported. It was when I moved out and went on my merry single way with, you know, superwoman, schemer, like, I know everything. I’m good to go. And, Didn’t work out. At all.

Kiona: 1:13:17

and and so did you, after you did realize that you were in deep postpartum depression and around the time when you went to your GP, did you make a decision to change that?

Jennie: 1:13:30

Well, I couldn’t at the time. I didn’t go back home, but I started going to group therapy. That’s what they recommended for me. It wasn’t just individual therapy, it was group. And I’d never done that before, but group therapy worked for me too, interestingly. I mean, you know how these things do. I don’t know what was the specifics about it, but I did group therapy for about a year, and I guess that became my community. And, I was partnering with more of the, single moms and people who had similar, and we made it through, we pulled each other through and, I came off of my medication and I went on about my way, but, I think there was certainly the stressors that we take for granted in this day and age and at this pace that we run in America, you know, I mean, they give you, I don’t know if they still do, but I’ve been out of England for 30 some years, but as a single mom, you got a child care place, that you was free that they would say, bring the baby, you don’t have to have a job, you don’t have to pay any money, but would say, you need to go to the swimming pool and swim, go, go have a come for a coffee morning, all the moms, you know, and hang out. So there was like a social support. Network built in from the daycare center. They were asking, have you done this? Have you done that? You should go for a walk. You know, like all of these supportive for the parent, as well as for the child, free.

Kiona: 1:14:54

That’s amazing!

Jennie: 1:14:56

Because people actually considered that your child needed looking after, as well as you needed looking after to be able to look after your child.

Kiona: 1:15:05

Right.

Jennie: 1:15:06

Likewise, in England, every other corner had a women’s health clinic. You could get women’s health care, free.

Kiona: 1:15:15

Mm.

Jennie: 1:15:16

You could pop into the clinic and get your birth control or pop into the clinic and have, medical care because it was for women, right? So these kinds of supports that are normal in most other places. In the most resourced country in the entire world, with all kinds of, you know, research and, and reason to actually have understood this way earlier and could have done something about it. There’s a choice here to not act, but rather perpetuate what’s actually expedient for a system that is built and is functional as it’s built. To maintain the status quo.

Kiona: 1:16:03

Mm hmm. Yeah. I have said that multiple times. A lot of people say that our system is broken when the fact is it’s not broken, it’s working exactly how it was built to work. Which, yeah, it kind of leads me a little bit to the term burnout because we’re talking about single parents. We’re talking about things that were in the UK for free that are not accessible here for free. Um, that leads to burnout in all aspects of everything around. Parenting, birth, everything. And what I mean by that is that’s burnout for the provider. That’s burnout for the parent, it’s burnout for, just everybody. So I guess my question to you is how do you feel or potentially relate to the term burnout?

Jennie: 1:16:51

I resonate with that term and my work is based on that term. My work supports perinatal workers on purpose. I have an entire network, it’s called the National Perinatal Task Force. Where we, on a national level, are searching out each other, finding each other. Saying, I see you sis, you’re out there on the front line. And we want to work together. We have our tenets for the task force are collective care. So, oh, do your self care, knock yourself out. But by the way, let’s have some accountability to actually doing it. So collective care. Collective leadership. So that we can learn to thrive, learn to grow. We are entrepreneurial. We’re obviously invisible. People are not supporting us. People are not funding us. So we’re just getting on with it. And so we need that collective leadership, to help each other as we, do our work. And then we focus on workforce development, the perinatal workforce. Those are the folk who are on the front lines in the communities, and those are the folk that are making these changes. These changes are not coming from the institution first. Remember, the institution is still thinking about, Oh, we need to bring lavender oil into the labor and delivery, maybe that will do it. You know, they’re not going to change what they’re doing, they’re just going to mask. And add a peripheral lip service to what they’re doing. So the work is going to always occur in the community first. And the community is also providing the folk that are in the institution. They come from the community into the institution. So the burnout is factored into what we do in the task force. It is a support network. We are looking at changing this world. We’re looking at transforming to what we consider a more just and loving system. But we have to do that by supporting ourselves and each other first so that we can survive it because we are just as much in jeopardy as the families we serve. We lose our elders more readily. We have such burnout that it’s not just discomfort, but it’s actual ill health. It is high blood pressure. It is all of these things that, you know, have us really actually be, at risk. So that’s one of the areas. And then the other area where I really focus on burnout is the fact that we can’t build a midwifery workforce or a doula workforce without considering the level of burnout that it takes to get through that training and out the other end, the level of effort it takes to maintain a practice once you are out the other end, and then the level of continual aggravation. I’ll just use that word that shows up because of the lack of acceptance Or respect even for your professional work. That’s a continuum of burnout that will not change anytime soon, sadly. And then lastly, we’ve got the fact that to, to provide the no one turned away kind of clinical and emotional support that we do through our services. The folk who are on the ground doing that work, those providers. Go over and above every living single day. They can’t just do the routine, Oh, well, you get five minutes, get out of here. Next, they are giving of themselves. They are sharing their gifts and talents. They are empathizing. They are listening. They’re absorbing the vicarious trauma that comes with having to have their clients sit down in tears again and explain what happened this time. That is a level of burnout that is unmeasurable.

Kiona: 1:20:36

Yeah.

Jennie: 1:20:38

That’s, how we manage. We, we acknowledge what it is. We acknowledge the reality of it and we ask for help and support. Sometimes it falls on deaf ears and sometimes we get it, but we’re still here. We’re not going anywhere. But this is definitely baked into everything we do. So we have two areas of concern. Centering mother baby family. And centering the providers who take care of mother baby family in the community.

Kiona: 1:21:09

Yeah, I love that. And so you just mentioned your National Perinatal Task Force. What does that look like nationally? Like how, for example, you’re based in Florida. How does that look for someone that’s here local with me in Washington?

Jennie: 1:21:24

Yeah, we have safe perinatal safe spots around the country. We just passed the 200 mark. In Washington, we also have, beginning easy access clinics. And so I’m pretty sure you’re familiar. We are trying to spread the model this way to build out the national network so that there’s going to be power in that network. So that we can all survive, we can all thrive. So yes, if you go to the website, perinataltaskforce. com, you can see our map and you can see what’s near to you or who’s near to you. And even if there’s no one near to you, we thank you COVID, we are now pretty good at our long distance, our telehealth, our telesupport, our, you know, doesn’t really matter where you live at this point. Someone will be available to support you, to help guide you, network you in, help you navigate.

Kiona: 1:22:23

And so what does that look like for, someone who is in need of services?

Jennie: 1:22:27

We just, it’s like the Underground Railroad, you know, it’s like, okay, you’re here, I know so and so, let me see if I can connect with them, let’s see who they know. We are networking our way through this, and this is not a new project, program in that sense. Birthing Project USA, I don’t know if you’re familiar, that was… It’s one of the ways that earlier, you know, was begun by Catherine Hall Trujillo, who organized stops along the way in the Underground Railroad for New Life. Um, and that was with sister friends, mentors, big sister, little sister kind of thing. Similar ideas. We’ve done this historically for how long now? We just applied it to the perinatal. That’s it

.Kiona: 1:23:09

I really love that. I think that is very important because it provides both the people in your area and outside of your area, a way to access care.

Jennie: 1:23:17

Mm hmm.

Kiona: 1:23:18

It really does create that community that’s needed during the extremely important perinatal time.

Jennie: 1:23:25

Exactly.

Kiona: 1:23:25

But Ms. Jenny, I truly appreciate all of the time you’ve spent with me here today. I do just have a couple of closing questions before I let you go. The first question is what is one piece of advice that you would give to all pregnant people as they prepare for labor and birth?

Jennie: 1:23:41

I would say that do your very best to find a level of support. So starting where things are, you could in your family or close friends network who is willing to stand in the gap with you. They don’t have to be expert. They just have to be willing to stand with you. So I liken that to like, you know, if you If your kid falls out of the tree and breaks his arm and you’re flying down the street, going to the ER, you’re on the phone calling, Okay, my church, um, member, she’s in that hospital, I think she might be on, let me see if she’s in the ER today. Oh, my friend who’s married to a doctor, doc, what can, who do you know, like, we know how to network. We already know when it’s an emergency. Have the support team be built out from the mindset not to be doom and gloom, but rather to be ready. To stand with you to advocate alongside you if you can find a doula Or afford a doula get a doula to do that. Along with your family and friend members who are going to be standing with you. Have everyone around you who cares about you understand why you need their support. Have them understand what you have concerns about what you are worried about what you might even be fearful of. If you can find a provider that will listen. Great. Not only use that provider, but share. Keep spreading the word. I found one over here who sits down with you for more than five minutes. Okay, share. If you find a midwife or a, um, nurse practitioner or an obstetrician who is aware of the statistics, share. Help your other friend from work who’s also expecting. Help your neighbor. We need to keep building up our networks of support. So it’s kind of like Amway. Build your downline. Build your team. Keep sharing. Each one, teach one. Understand it’s great to have a whole bunch of stuff for the baby shower, but it’s a whole lot better and safer to have the professional and the non professional support teams ready to go. Not just for labor, like you said, but maybe to pop to the doctor’s office with you so you’re rolling deep, so they see, ooh, somebody cares about this one, I better pay attention. That’s my best advice. Sure up your teams now. Don’t wait till the last minute. Explain to them why. Ask them to do whatever is in their capacity to do. Grandma might only want to just be in the room so she can rub your feet. And as soon as the head’s coming, she wants to be out. Honor that. Let her be the foot rubber. You know, find the jobs that people want to do in order to be there for you in the way that you need them to be there.

Kiona: 1:26:30

I agree. 100%. And one thing that I think is important to mention here is that like, You want people in your birth space that will actually have a job because you know, you don’t want people that are just sitting there and distracting you and taking you out of your funk when you’re giving birth. But it’s so important to have your support people around you before, during after. And I love how you mentioned bringing in professionals and non-professionals, you know, there are people that just have life experience. And like you mentioned before, your experience helps navigate how you support people.. Whether you’re a professional or not. So I love that so much.

Jennie: 1:27:05

Yeah.

Kiona: 1:27:06

As for the next question, what advice would you give to people that want to become a provider or midwife?

Jennie: 1:27:11

This is a difficult one for me. And I do try really hard, not to dissuade, but to ask folk to, with caution, think it through. Think it through. If you’ve got a young family, stop. No. That’s the answer. Just no., if you’ve got teenagers, hmm, maybe stop again. Think it through. If you’ve got grown kids and they’re out of the house and you’ve got an opportunity maybe to look at a second career and you can manage that switch from what normal life looks like to this birth world, yes, that’s great timing. Those are the folk who are going to be able to sustain themselves. It’s very difficult otherwise to be able to do both, raising young families, teenage families, managing partners when you go into this work, because the number one question, the question that causes the most consternation, long term memories, trauma, and angst is when will you be home? And if you don’t have a good answer for that one, nevermind. Maybe this is not the time. Look for the nine to five. If you’re not actually in the labor side of this work, you can still do amazing powerful work and be very fulfilled and support communities and, but also maintain your own family. So not delivering or not attending births, not being part of that birth process, but rather preparing families and then picking them up on the postpartum side, which is where we know there’s a lot of need, has been really quite a revolution in terms of, oh, perinatal birth workers can also fill in these gaps. They don’t have to just choose midwifery or doula, but rather they’re able to choose childbirth education, community health worker, medical assistant, postpartum supporter, lactation and so on, and removing the birth actual experience, but able to continue in a career path. And this is also a pathway or pipeline to future when, children are older or whether more support is available to then go into nursing or to midwifery or even medicine. So, Um, we’re really excited about utilizing the clinical space, the outpatient clinical space to grow perinatal health work. And many of our safe spots, our perinatal safe spots, start out just doing support and grow into clinics in order to widen and grow the volume of people that they can serve.

Kiona: 1:29:49

Yeah. I think that’s great. And that is really great advice to kind of put in the forefront of people that are interested in this work to know that yes, this work is very amazing, but it is also very hard and it’s hard on not just you, but your family. The on call life is something that is Absolutely insane because everybody is so used to. Working on their own time, working on their own schedules. and when I was living the on call life, I didn’t realize how intense it was on my family when I was in it, because I was in it right

Jennie: 1:30:24

Yeah,

Kiona: 1:30:25

now that I’m out of the on call life, when I was on call briefly for my sister’s birth, my husband was like, Oh my God, okay, what do we do? Like, what, where did the kids go? What about, you know, like all of this stuff changes and the dynamic shifts of everything, and it adds a lot. That was unexpected for me in the beginning. I was like, Oh, I’m just on call. Like, that’s fine. But it’s also like, Oh yeah, I want to go out to get some ice cream with my kids. Oh wait, I’m on call. So I need to make sure that if I am going to go get ice cream with my kids, I need to make sure that I can come back and drop them off at home in time. Uh, there’s not enough traffic. I have everything I need to go to where I need to go. And Do I have food? You know, so all of that.

Jennie: 1:31:08

it’s a lot.

Kiona: 1:31:09

it is a lot. And I like how you really emphasize how having young children may not be the best time to do it. Like there are, I see plenty, plenty, plenty of midwives out there that do have young children or decide to have children after they’ve accomplished becoming a midwife and being licensed and they have young children at the same time they’re opening their practices. Um, So I guess I say that to say, can it be done? Absolutely. It can be done. Is it easy? No way in any shape or form. Is it easy? Um, and I personally have sadness behind it because I had my son, I was pregnant with my son when I applied to midwifery school and then I had him and I was doing birth work right away in the birth space, literally handing a sleeping infant over to my mother in law saying, got to go to a birth. And there was one time when I was, I did five births in a week as a student midwife, and that was insane to me. Never saw my children awake because whenever I would come back, they would be sleeping. The part that was sad for me is I realized after I had my daughter who has been attached to my hip from the moment she came out of the womb, because I’m not doing on call life, I’ve seen her accomplish milestones in her life that I missed from my son because I was in birth work. I was gone for many, many hours at a time. So. That is definitely something to think about and consider. So I have two final questions for you. What is one word you would use for your own personal pregnancy, labor, and birth experience? And then potentially another word for how you view your career as a provider in this space?

Jennie: 1:32:45

I have two words for the my personal experience and it was eye opening for the provider in this US space. USA, then it is, two words again, soul destroying.

Kiona: 1:33:04

Yeah, that’s a deep one. That is very, very deep. And very, very real. Very real. Oof. Okay, Ms. Jenny, I have one final question for you, and it is, One that I think will be pretty, pretty easy. What is one resource that we can share with our listeners on your behalf? And of course I will share all things, Common Sense Childbirth, that’s, they’re going to have all the links to all that loveliness.

Jennie: 1:33:36

Thank you. Maybe the perinatal pause podcast. My goal is, there are four million births in the United States every year, more or less, and so I set out with a plan to, if I can reach a million people who can understand what perinatal means, that may help us move this needle faster. And so, I would love that people are curious, what is she talking about perinatal, she must mean prenatal care. She must be talking about prenatal, and no, I’m not, I’m talking about perinatal. And we’ve talked today about why. So it would be maybe a way to reach more, I’m trying to build a movement to understanding, embracing, and enveloping pregnant folk in the perinatal and postpartum and so on. So, The Perinatal Pause. Maybe they’ll listen in and help, help them see how this movement needs to grow and be part of that movement to grow. We need to get back to safety, quality, and equity in the united states.

Kiona: 1:34:49

I love it. I think it is a beautiful resource. It’s, it’s really good. I’ve listened to every episode so far and I believe it was your first episode, there was a phrase that you said that really stuck with me, which was, The healing is in the conversation.

Jennie: 1:35:04

That’s right.

Kiona: 1:35:05

Yeah. Well, thank you, Ms. Jenny. I truly truly appreciate your time. Yeah, I, I am very honored and, very thankful that you took time out of your busy, busy schedule to meet with me today. So thank you.

Jennie: 1:35:18

Thank you for having me. Thank you and good luck with this. This is really great.

Kiona: 1:35:22

Thank you.

Jennie: 1:35:23

appreciate what you’re doing.

Kiona: 1:35:25

Yeah. I feel like it’s as close as I can be into getting into the birth space right now because

Jennie: 1:35:30

That’s right That’s right.

Kiona: 1:35:31

That on-call life.

Jennie: 1:35:32

Yes.

Kiona: 1:35:33

Yeah.

Jennie: 1:35:34

Yes.

Kiona: 1:35:43

Interviewing Ms. Jenny Joseph for this episode was an educational and eye opening experience. And I’m sure that was true for the listeners as. well. I am so honored that Ms. Jenny felt comfortable enough to share her own personal struggles with endometriosis and postpartum depression in addition to sharing all this amazing work that she’s doing alongside others in the birth community. Ms. Jenny. I think you indefinitely for sharing your story and experiences with me and for the wisdom that you’re passing along to the generations that follow. Sitting down with you reminded me of how much more I need to learn about the perinatal time and how I will continuously learn more throughout my lifetime. So, thank you so much. Next week I interview Kyle Kaz, owner and founder of matriarch birth photography. Kyle shares two very different birth experiences with us. One of which is a very traumatic, unplanned, Cesarean. That was followed by a healthy and healing VBAC at home. So tune in next week to hear the details on that. Bye for now.

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Last updated on September 18, 2024