“We’re overhauling our whole training,” says Lindsey Bliss, founder of Carriage House Birth – a multi-service doula agency in New York City.
Lindsey, a mother of seven, including two sets of twins, reached a tipping point with the recent explosion of the Black Lives Matter movement.
After years of witnessing disempowered births and a system that didn’t make space for the concerns of Black and brown birthing people, she decided the space needed a complete overhaul.
“We realised we weren’t doing enough,” the Queens birth worker says. “We’re really trying to refocus with an anti-racism lens.”
Aside from the race inequalities in birth (Black women in the UK, for example, are five times more likely to die in childbirth than white women), Lindsey is also advocating for a greater shift away from defensive medicine, campaigning instead for empowered birth experiences.
More options, more listening, less preventative intervention, and greater education are her hopes.
Here, Lindsey speaks of her own birth experiences, explains why she hugs the oak tree down her street, and shines a light on the birthing environment in New York City.
You became a doula 12 years ago. What motivated you to get into this line of work?
My first set of twins was treated as a high risk pregnancy. There were a lot of fear based protocols surrounding twin pregnancy. They were like “oh, this is high risk”. And I had zero complications, nothing that really deemed me high risk other than growing two babies. It really scared me the whole journey when I gave birth, the OB was like “we could just do a c-section right now.” And I’m like, “whoa, wait a minute”. And I had to really advocate for myself for a vaginal delivery. And I remember on the other side of it thinking, what if I spoke a different language? What if my skin was another colour? Like, I don’t know if I would have had the same outcome. And I also was doing rape crisis work at the time. So I was already doing advocacy work, but in a different area. And I saw some of the parallels with birth doula work and the rape crisis counsellor work. And I just kind of fused the two after my own… it wasn’t even a very traumatic birth experience, it was just a very disempowered experience. You know, I had to do a lot of advocating. My second set of twins I gave birth to at home.
Your roots are in New York. Can you share anything about what perhaps makes the experience for birthing people different in New York City to other places?
Unfortunately, we are a lot more conservative than most places. There’s a lot of defensive medicine. Everything’s very litigious. So there’s a lot of “we’re going to do this just in case this happens”. There’s not a lot of evidence based care. It’s more preventative care. The options are shit. As far as New York goes, we have one birthing center. There was an in-hospital one that got turned into private rooms because the medical industrial complex prioritises profit over people.
That being said, there are amazing care providers stuck within this system. Wonderful nurses. There’s wonderful midwives. There’s wonderful OB’s. There’s not a lot of wonderful ones, though. I have that list kind of tucked away and I share it with my clients, but it is not chock full of options here. You’re not told your options. I wish that being a birth worker was not something that was necessary to fill in the gaping hole in maternal health care here.
So do you think that’s why doulas have grown in popularity over recent years, to fill that gaping hole?
Yes. But also, what are doulas? A band-aid on a hemorrhage? I’m not saying that doulas aren’t wonderful, but I think that what needs to happen is that a new system needs to be built. The system’s actually not broken. It’s working just fine for the people it was intended to work for.
And who are those people that you think it was intended to work for?
Well, I’d say wealthy white folks. But even those people are experiencing traumatic births and experiencing obstetric violence or there’s no informed consent. These things are happening to white people, too. They’re just happening at less of a rate than for Black and brown people. You know, the disparities here in New York are astronomical. You’re 12 times more likely to die during childbirth if you’re Black as opposed to your white counterparts. Doulas are not the fix, but they can help folks navigate their choices within a system that, you know, a lot of people are afraid of.
It seems that there’s so many theories as to why the disparities are what they are.
It’s racism. Straight up racism. People are not believed. Minimising people’s concerns or not really listening when people say something because they don’t believe that they know what’s going on with their bodies. Also, there are theories that it was believed that Black people experience less pain. It’s rooted in slavery. Most of the gynaecological knowledge that we have is because of experiments on slaves. You know, so the whole foundation was built on using slaves for experimentation. It’s so ingrained in the system, it’s like the entire system is rooted in white supremacy. It’s rotten to the core.
So how do you suggest birth workers break out of that?
Follow Black leadership, follow the Black reproductive justice advocates that are doing the work. Ancient Song is an organisation in Brooklyn that’s doing the work. There’s another organisation trying to open up a birthing center in The Bronx. It’s called The Birthing Place. Midwifery care in my personal opinion is a great way to change the narrative of birth here in this country. If there were more midwives leading the care, I do think there would be a shift. A lot of the solutions that are being proposed are being proposed by the Black leaders doing the work, because you can’t speak for a community unless you are part of the community.
When you say more midwives leading the way, is that not the case generally?
Midwifery care is not the norm. OB care is, which means they’re always looking for a problem, even if a problem’s not there. There are tons of inductions that are happening. The epidural rate is sky high because there’s so many inductions. People don’t feel safe at home so then they go to an OB in a hospital. There’s not enough birthing centres for folks that are somewhere in the middle. Some of us have a choice and some of us don’t have the privilege of choice. Most people can’t afford a home birth. A hospital birth will be fully covered. A home birth, you’ll have to pay some money out of pocket. It’s fucking ridiculous.
What would you say was the most empowering birth you had?
My twin home birth, because I fought so hard for it. You know, I had an OB up until about 38 weeks pregnant. And then I hired a home birth midwife who delivered me at home and her assistant was also a midwife. That experience was by far the most empowering because I didn’t have anxiety. I was at home. It was my first home birth. I realised I experience pain when I’m stressed. I wasn’t stressed and I didn’t have a painful birth. It was intense because my twins were born at 40 weeks, one was eight pounds, one was seven pounds nine ounces. I was laughing in between contractions. There was none of this anxiety. There was none of this holding, I wasn’t trying to escape out of my head.
Were there any methods or techniques that you used to navigate that experience?
I think it was just coming into my own body, not feeling like it was a trauma to give birth. Birth can feel like a violation of your body. I’m a survivor of trauma of sexual assault and so for me, my first birth experience was very traumatic. And my twin birth, I had an epidural and it was just a different experience for me. This is the first time I was able to step into my body and be fully present, and aware that I was doing this, that it wasn’t something happening to me.
What are your thoughts on more New Age schools of thought around, say, hypnobirthing or self pleasure during birth?
I think hypnobirthing can be really wonderful, regardless of if the baby comes out the door or the window. I think meditation, hypnobirthing, any type of grounding work is one hundred percent impactful on your birth journey. And, you know, listen, you do hypnobirthing and you end up having a cesarean birth. I’ve had clients listening to hypnobirthing tracks while they’re in the OR having their baby. I think a meditation practice is really helpful. Certain things help move labour along, orgasms help move labour along, go for it. I only know one person that’s actually had an orgasm while delivering. And I do think that they can help with pain. Anything goes. We need to create room for people to explore their tools. And be comfortable with utilising whatever those tools are. I’m not against any of these modalities, just be realistic in how intense it might be.
What does an empowered, non-traumatic birth look like to you?
Somebody who is being informed throughout the whole process and is empowered in the decision making process. Somebody who is able to have their bodily autonomy intact. It’s people that understand that they have the power to make an experience good or bad based on the way they respond to it. And also, I’m going to go back to care provider. People spend a shitload of money on, say, a wedding, but they don’t put that same energy towards giving birth and they go to whatever doctor their friend went to or the gynecologist they’ve been seeing since they were 14. There’s this thing in America; we put doctors on this pedestal and just listen to what the doctor says. I think we need to do a lot more research on the place we’re giving birth and our care provider. If you want a free birth or if you want like a scheduled caesarean cool, make an informed decision. I’m very nonjudgmental in my opinions on what type of birth is the best birth, because there is none.
And finally, how do you stay grounded or present as a mother to so many children and living such a busy life as a birth worker?
Oh, I’m so human and I struggle with keeping it all together like most flawed humans do. I have a regular practice of exercising. I eat really well. I check in with myself. I have to have a mindfulness practice. I also have to connect with nature. I go on a walk and this is so silly, it’s almost kind of embarrassing. I do a walk, I do like two miles every day. Sometimes I jog, sometimes I walk. I go to this tree every day and I put my hands on this oak tree and I give it a little reiki. I receive a little reiki and I do self reiki sometimes when I’m by my tree friend and I give it my bullshit too, my stress and anxiety. And the tree has a big vulva, it looks like, at the bottom of the tree, it’s got a portal on it, it’s my birth tree.
You can follow Lindsey’s personal doula account, @doulabliss here and her doula agency, @carriagehousebirth here.