Where you give birth shapes how you give birth. The setting influences how decisions get made, which options are available, how much privacy or support you have and what happens if something changes. Every setting has pros and cons — understanding them can help you clarify what’s most important to you.

This piece in an excerpt from our print zine, Birthing While Black: A Hospital Guide, created in partnership with the BLACK Wellness and Prosperity Center in California, Tre Borden /Co and the James Irvine Foundation. The zine is NOW shipping!

The American College of Obstetricians and Gynecologists (ACOG) recognizes that “every woman has the right to make a medically informed decision about where to give birth.” While positive home birth data does exist, much of it comes from countries with better-integrated care systems than the US — a gap we’re still working to close.

In short: do your research (you’re going to hear this from us a lot). Consider any pre-existing conditions, as well as any experiences — from beautiful to traumatic — that may shape your feelings of safety. Get familiar with your needs, preferences and options. Ask questions. If your care feels misaligned, get a second (or third) opinion. You have the right to understand what birth settings are available to you — and which are safe based on your individual health. Home births and birth centers can be great options for low-risk pregnancies. But if you have a medical condition or higher-risk factors, the hospital may be the safest choice. Knowing what’s available — and what’s realistic — helps you make confident, informed decisions.

Get the Guide

The creation of this zine has been a labor of love — inspired first by my own hospital birth experience and those of my close circle, and then shaped over years of supporting mothers as a doula and birth assistant, informed by other birth workers doing this work every day.

Over time, I kept seeing the same patterns play out:

A mother enters the hospital system — by choice or by circumstance — and things begin to move quickly. She and her partner (and sometimes extended family) aren’t fully aligned. Her vision for her birth starts to slip. Language gets introduced that no one fully understands. Decisions get made. And suddenly, things are just… happening.

Before we know it, she enters into motherhood in a wave of confusion — and in too many cases, coercion, trauma or shame.

And I hate to say it, but that’s if she enters at all.

We continue to see high-profile stories about women being mistreated during labor, birth and postpartum — some of the most vulnerable moments of our lives.

Dr. Janell Green Smith. Temecia Jackson. Adriana Smith. Mercedes Wells. Karrie Jones. Cherise Doyley.

These are not just headlines. These are real people. Real families. Members of our communities.

I think about what their healing journeys must look like. About the ripple effects of this type of trauma. And it sickens me.

Because it doesn’t have to be this way.

I don’t believe one zine can fix an entire system.

But I do believe this: as we work toward systemic change — alternatives, access, policy — families still need tools they can use right now.

Because you can know your rights.
You can even understand what’s happening.
But being supported in exercising those rights — in real time, in that room — is what actually changes your experience.

Agency without support is fragile. This zine is designed to reinforce both.

Inside Birthing While Black: A Hospital Guide, you’ll find:

• How to plan for a birth experience that centers you, your family and your values

• A clear overview of how hospital labor unfolds, from triage through postpartum

• Explanations of common interventions and how to evaluate your options

• The difference between hospital policy and medical necessity

• Grounded language for communicating with providers, before during and after labor

• Guidance on building a birth team aligned with your values

• What to expect if plans change, including cesarean birth

This is not about controlling every outcome — that’s impossible, no matter where or how you birth. It’s about walking into that room informed, supported and with a sense of agency.

This shouldn’t fall solely on the shoulders of mothers, nor is it something that can be outsourced to midwives or doulas to “fix.”

We all have a role to play — partners, families, communities — in how birth is experienced and supported.

This requires a cultural shift around birth, not just a change in venue. This zine is the first of many offerings designed to support that shift. Thank you for being here and playing your part in improving outcomes for our families.

Get a copy of Birthing While Black: A Hospital Guide for yourself or someone you love.

Get the Guide

Much gratitude to our partners — the BLACK Wellness & Prosperity Center, Tre Borden /Co and the James Irvine Foundation — for helping bring this zine to life in print and into the hands of families across this country.

With the growing daily demands in our lives — and on our psyches — we’re being reminded how important it is to create space to fully, unapologetically rest.

We live in a culture that glorifies productivity and treats rest as something we can’t afford, or something we’ll “get to” eventually. Too often, we get to it when our body fails, and forces us to lie tf down. And we definitely can’t afford that.

To our beautiful birth workers, parents, those carrying life — to all humans, living in this chaotic time… this is your friendly reminder:

Rest is not optional.
We repeat: rest is not optional.
It’s not something to be earned.
It’s not something to do later.

It is a crucial foundation for healing, clarity and creative power. Without it, no practice, no vision, no relationship, no calling has the space to take root. Without it, we can’t effectively serve — our clients, our children, our partners… ourselves.

So here’s a loving invitation…

One day this week, consider making time to:

• Rest — in whatever way your body is asking for it.

  • Say “no” to a social outing or project that may sound nice but isn’t necessary. (“No” is a complete sentence.)

  • Take a cat nap instead of folding that pile of laundry. Bonus points for delegation (done > perfect)!

  • Take a moment during your workday to sit outside and get some fresh air (without your phone).

  • Go to bed early instead of binge-watching, working or scrolling.

  • Do one other thing that feels restorative for you.

• Before bed, listen to the sleep meditation above, an offering by

  . You’ll be glad you did. 🥰

Let yourself receive the gift of stillness. Notice how it feels. If you feel resistance, that, too, is useful information. Take note, offer yourself patience… and rest anyway.

Sending love. 🤍

If you like this, you may also enjoy our 30-Day Womb Wellness Ritual with :

This piece in an excerpt from our print zine, Birthing While Black: A Hospital Guide, created in partnership with the BLACK Wellness and Prosperity Center in California, Tre Borden /Co and the James Irvine Foundation. The zine is NOW shipping!

Get the Guide

Understanding your rights, your options and your body’s innate wisdom is one of the strongest ways to prepare for the life altering passage of birth. Education won’t guarantee a specific outcome, but it will help you move through the experience with more clarity, confidence and calm.

Physiological Birth vs. Medicalized Birth

A physiological birth is one that follows the body’s natural rhythms and hormonal cues, typically involving spontaneous labor, minimal technological interference, labor companionship and a focus on the parent’s instincts and comfort. It also includes things like skin-to-skin contact with baby and delayed cord clamping immediately postpartum.

When uninterrupted, your body releases a carefully choreographed cascade of hormones — like oxytocin, endorphins and prolactin — that help labor progress, ease pain and support bonding with your baby. But these hormones are sensitive. High stress levels and spikes in cortisol can interfere with this natural flow, stalling labor or increasing the need for intervention. That’s why emotional safety and a calm environment aren’t just “nice to have” — they’re essential to supporting physiological birth. Practices like dim lighting, quiet surroundings and skin-to-skin contact with baby (along with delayed cord clamping) can help preserve this delicate hormonal dance and ease the transition into postpartum.

A medicalized birth involves more clinical oversight and reliance on procedures, medication and technology — like inductions, epidurals or continuous monitoring — which may be helpful or necessary depending on the situation, but aren’t always tailored to individual needs.

There are also hybrid approaches, where physiological processes are supported within a medical framework. Many births fall somewhere along this spectrum.

Keep in mind, hospitals are designed for clinical care — which means their routines and protocols can sometimes make a physiological birth more difficult to achieve. If you’re aiming for an unmedicated or low-intervention birth, it’s important to find a provider and location aligned with that vision. Some hospitals offer midwifery-led care or birth center-style options within their system. And while hospital staff may rotate, a dedicated doula can offer support that centers your voice throughout the process.

Not every body or pregnancy will allow for a fully physiological birth — and that’s okay. You might feel a sense of disappointment or loss around that, and that’s valid too. You deserve care that honors both your reality and your emotional experience.

And if physiological birth is an option, but not aligned with your birth vision, your choice also deserves respect and support.

Birth is deeply personal. Even with the same parents, no two births look the same. The goal is to be well-informed — not rigid. Talk with your trusted provider about your hopes, and work together to explore what’s realistic for you.

Whatever path feels right for you, we encourage taking a birth education course that aligns with your values and vision. It will help you understand what’s happening in your body, explore your options; and ask meaningful, educated questions as you prepare for birth.

Cesarean vs. Vaginal Birth

In the U.S., more than 30% of births happen by cesarean section — a surgical procedure that delivers your baby through incisions in the abdomen and uterus. That’s twice the rate recommended by the World Health Organization, and rates are even higher for Black women. C-sections can be life-saving — but they’re also major surgery, with longer recovery times and higher risks in future pregnancies. Too often, they’re offered for reasons like scheduling convenience or liability concerns, not true medical need.

Cesarean birth is sometimes presented as the “easier” option or a way to bypass the pain of labor. While it may offer more predictability, it also involves major abdominal surgery — and recovery begins while you’re caring for a newborn. Too often, the full risks and long-term considerations aren’t clearly explained. We believe you should have the whole picture.

In a system that doesn’t always center our individual outcomes, it’s essential to understand our options. Vaginal birth is not always possible, but when it is, it can support faster recovery, hormonal regulation and early bonding. The most important thing is being informed — and choosing the path that supports your health, your baby and your healing.

And if you’ve had a previous cesarean, know this: a vaginal birth after cesarean (VBAC) may still be possible. While some providers say, “once a C-section, always a C-section,” that’s not always true. VBACs can be safe and even redemptive — and you deserve to know if it’s a medically safe option for you.

High-Risk Pregnancy

A pregnancy is typically labeled high-risk when certain conditions or circumstances increase the likelihood of complications for the parent or baby. This designation often means you’ll require more frequent monitoring, additional testing or the care of a specialist — and for many, a hospital birth becomes the recommended or required setting.

Common high-risk factors include:

• Chronic high blood pressure (hypertension or preeclampsia)

• Gestational diabetes (especially if uncontrolled)

• Type 1 or Type 2 diabetes

• History of preterm labor or preterm birth

• Placenta previa or placental abruption

• Multiple gestation (twins or more)

• Breech or transverse baby position (at term)

• Advanced maternal age (35+)

• Teen pregnancy (under 17)

• Prior cesarean section or uterine surgery

• History of stillbirth or pregnancy loss

• Autoimmune disorders (i.e., lupus)

• Kidney or liver disease

• Clotting disorders or history of thrombosis

• Obesity (depending on BMI and associated risks)

• Fetal growth restriction (IUGR)

• Rh incompatibility

• Substance use disorder

• Certain infections (e.g. HIV, active herpes, toxoplasmosis)

• Severe anemia or other blood disorders

That said, not all “high-risk” labels are created equal. Some conditions — like breech presentation or gestational diabetes — may still allow for an out-of-hospital birth depending on your provider’s training, your state’s laws, and how well the condition is managed. Some highly skilled midwives can safely attend breech or twin births, though this is increasingly rare and requires specialized experience.

In other cases, the risk level may be exaggerated due to outdated policies or provider preferences. For example, some hospitals classify VBACs (vaginal birth after cesarean) as high-risk by default, even though research supports VBAC as a safe option for many. Similarly, “advanced maternal age” is not a diagnosis — and while it may warrant additional monitoring, it does not automatically rule out the possibility of a healthy, low-intervention birth.

This is why informed decision-making matters. Ask questions. Understand the reasons behind any “high-risk” designation. Every body is different. Every provider is different. And every state has different laws that determine who can legally support what kind of birth.

You may find that your care options are limited — but you may also find that a trusted provider is willing to work with you to safely manage your care, rather than automatically funneling you into a surgical or highly medicalized path. Knowing the difference is key.

Pain Relief: Epidural Block

An epidural block (typically referred to as simply “an epidural”) is a regional anesthetic injected into the lower spine to block pain from the waist down. It’s the most common form of labor pain relief in the U.S., used in 70–80% of births. You’ll find more regional pain relief options below, in the Alternative Pain Relief section.

For many, an epidural offers significant relief — allowing rest during long labors, reducing the intensity of contractions, and helping some parents feel more present or grounded. But like any medical tool, it comes with trade-offs. Some side effects include:

• Drop in blood pressure

• Fever

• Inability to urinate (may require catheter)

• Shivering or itching

• Longer pushing phase

• Risk of spinal headache

• Rare but serious risks like nerve injury or infection

Timing matters — placed too early (before active labor), it can increase intervention risk. Some hospitals offer “walking” epidurals, but they’re rare. Know this: an epidural isn’t bad or good. It’s a tool. Learn how it works, understand your options and decide what’s right for you.

Alternative Pain Relief Options in the Hospital

Pain in labor is real — but so are your options. No matter how you give birth — vaginally or by cesarean, with or without medication — you will experience some form of pain or discomfort. Whether it’s the intensity of contractions, the soreness of recovery, or the sting of a healing incision, pain is part of the process — not a failure or something to fear.

Pain is also information. It lets you know something is shifting. In labor, it’s a signal that your body is doing the work of bringing life forth. While medication can help manage it, it may also numb some of that awareness — and that’s something to weigh as you consider your options.

If you’re hoping to avoid or delay an epidural, ask your provider what tools your hospital offers. These may include:

Movement & Positioning

• Walking, rocking, squatting or swaying

• Using a birthing ball or peanut ball

• Upright or hands-and-knees positions to reduce pain and support baby’s descent

Breathwork & Guided Relaxation

• Deep breathing, visualization and vocalization can anchor you through contractions

• Practice ahead of time — or ask your doula or nurse to guide you

Hydrotherapy

• Laboring in a shower or tub can ease tension and offer natural pain relief

• Some hospitals have tubs — ask and tour ahead of time

Heat & Cold Therapy

• Warm compresses on the lower back or pelvis

• Cold packs to reduce inflammation and soothe pressure points

Counterpressure & Massage

• Applied to the lower back or hips during contractions (often by a doula or partner)

TENS Unit

• A small device that delivers electrical pulses to block pain signals

• Some hospitals allow them, some provide them — bring your own if needed

In addition to epidurals, hospitals may offer other medication-based options for managing labor pain, including:

Nitrous Oxide (Laughing Gas)

• Inhaled through a mask to reduce anxiety and help manage pain perception. You control when to use it.

• Side effects may include dizziness or nausea, but these wear off quickly. Safe for most birthing parents and babies.

Systemic Analgesia (Opioids)

• Given by IV or injection to “take the edge off” without full numbness or unconsciousness.

• Can cause drowsiness, nausea or (in high doses) breathing issues; may affect baby’s alertness and early breastfeeding.

Local Anesthesia (Pudendal Block)

• Numbs the vaginal, vulvar and perineal area with an injection; often used just before delivery or for repair.

• Minimal effect on baby; rare risks include allergic reaction or nerve issues if overdosed.

Regional Pain Relief (Spinal Blocks & Epidural Blocks)

• A spinal block is a one-time injection into spinal fluid for fast, full pain relief — commonly used for C-sections; wears off in 1–2 hours.

• A CSE Block (Combined Spinal–Epidural) combines immediate relief from a spinal with long-lasting pain control via epidural; uses lower medication doses for similar effect.

• Both options have the same side effects and risks as an epidural block.

General Anesthesia

• Medications given through IV or injection to reduce pain perception. Induces unconsciousness for rapid pain relief — used mainly in emergencies, like urgent C-sections.

• Risks include aspiration, breathing issues and newborn drowsiness or low breathing rate after birth.

There’s no one “right” way to manage labor pain. Every person has different thresholds, histories and medical needs. What matters most is knowing, researching and discussing your options, listening to your body and feeling supported in whatever decisions you make along the way.

Pre-Existing Conditions & Prenatal Care

If you have a medical condition like hypertension, diabetes, fibroids or a previous cesarean, prenatal care becomes even more important. Learn how your condition(s) may affect labor and birth and what steps can reduce risk. This is a great topic to bring up when choosing your midwife or OB, so you can plan ahead and avoid unexpected decisions down the line. The right provider will help you understand your options — not scare you into submission.

One starting point to consider is the Preconception Medical Assessment (PreMa), a tool that can help you identify potential risks so you can shape a personalized care plan early on.

Common Hospital Interventions & Alternatives

In birth, an intervention is any action or procedure used to monitor, manage or alter the natural course of labor and delivery. Some interventions are necessary and lifesaving. Others may be routine, policy-driven, or offered out of habit — not because something is wrong.

Common interventions in hospital births include:

• Continuous electronic fetal monitoring (EFM)

• Labor induction (using medications like Pitocin or procedures like membrane stripping)

• Artificial rupture of membranes (breaking your water)

• Epidural anesthesia

• IV fluids and restrictions on food and drink

• Limited mobility during labor

• Vaginal exams to check cervical dilation

• Episiotomy

• Vacuum or forceps-assisted delivery

• Cesarean section (C-section)

• Immediate cord clamping

• Separation of baby and parent for routine procedures

Definitions for each of these can be found in the glossary. Some may be medically necessary — but others may be offered out of routine, policy or habit. Learn what each intervention is, when it’s truly indicated, and which interventions are optional. The more informed you are, the better prepared you’ll be to navigate decisions with confidence and clarity — even in the moment.

Your Legal Rights in a Hospital Birth

Generally speaking, you have the legal right to:

• Be fully informed about your care

• Refuse or consent to any procedure

• Ask questions — and receive answers you understand

• Have a support person with you

• Access your medical records

These rights don’t disappear when you walk into a hospital. But in the intensity of labor — or the speed of medical decision-making — they can be easily overlooked if you don’t know them ahead of time.

Informed consent is more than a signature on a clipboard. It’s a process — one that requires your provider to explain, in language you understand:

• What the proposed procedure is

• Why it’s being recommended

• What the risks and benefits are

• What alternatives exist (including doing nothing)

You then have the right to take that information, ask questions, weigh your options and make the decision that feels right for you.

You also have the right to informed refusal — meaning you can decline any procedure you do not consent to. That includes interventions like cervical checks, Pitocin, membrane sweeps or even cesareans — unless your life is in immediate danger and you are physically or mentally unable to consent (more on that below).

Exceptions to informed consent: In rare, truly emergent situations — such as if you are unconscious, lose decision-making capacity, or require a life-saving intervention immediately — a provider may act without explicit consent under the principle of implied consent to preserve life or prevent permanent harm. Even then, they are ethically expected to honor your documented wishes and known values wherever possible. This is where an aligned birth partner and doula becomes essential — someone who knows your plan, can advocate clearly in the moment, and help ensure your preferences are respected even when you can’t speak for yourself.

Bottom line: You are not obligated to comply with everything suggested. You can always ask, “Is this urgent or can we talk about it?” or “What happens if I wait or say no?” Staying curious and clear about your rights is not being difficult — it’s being informed.

Using the BRAINS Framework

When you’re faced with a decision in labor, the BRAINS acronym can help you slow down and explore your options:

• B — What are the Benefits?

• R — What are the Risks?

• A — Are there Alternatives?

• I — What does your Intuition say?

• N — What happens if we do Nothing right now?

• S — Ask for Space or Support if needed.

This tool can help you stay centered and collaborative, even in moments that feel rushed. You can use it yourself, or your birth partner or doula can help guide the conversation using these prompts.

How Hospital Policies Shape Care — and How to Navigate Them

Hospitals are governed by policies that aim to streamline care, manage liability and standardize procedures — but they don’t always leave room for individual preferences. Routine protocols (like limiting movement after epidurals, or restricting food intake during labor) may be framed as non-negotiable, even when there’s room for flexibility. Visiting hours, mandatory monitoring and documentation requirements can also influence how supported or restricted you feel.

Here’s the truth: policies aren’t always laws. You can ask questions, request exceptions and push back respectfully. This is where preparation pays off — knowing your rights, having your preferences documented and choosing providers and support people who will advocate for your care plan. When something doesn’t feel right, it’s okay to ask, “Is this a policy or a preference? Is there any flexibility?” Respectful self-advocacy is a skill — and you don’t have to do it alone.

This work is grounded in a simple question:

What would maternal care look like if it were designed around families instead of institutions?

This work didn’t begin as a concept. It emerged from patterns I kept encountering again and again:

• Families making high-stakes decisions with incomplete information.

• Essential information bound by private appointments and one-on-one support.

• Holistic approaches to pregnancy and birth largely absent from mainstream education.

• Birth workers translating complex systems in real time, without shared tools.

Borne exists to change how that knowledge moves — to document it, distribute it, and make it usable.

The beliefs below guide how this work is shaped — what we prioritize, what we challenge and what we refuse to normalize.

These aren’t slogans. They’re the lens through which we gather stories, conduct research and decide what gets built next.

What We Believe In

Family-Centered Care: Maternal care should begin with the needs of the mother, baby and family — not the institution.
Whole-Person Care: Support and decision-making must reflect a person’s values, culture and humanity, not just clinical metrics.
Informed Consent: Every person navigating reproductive care deserves full transparency, context and real choice — not pressure and partial information.
Physiological Birth: Birth is a natural process. Medical care should be available when needed or desired, but not positioned as the default.
Innate Wisdom: The body holds intelligence. Communities hold knowledge. We honor both.
Generational Healing: How we care for families during birth shapes what carries forward — physically, emotionally and culturally.
Redefining Safety: Unnecessary intervention is a risk — not a safeguard. Safety includes dignity, autonomy and long-term wellbeing.

These beliefs reflect what families and birth workers have long known — and what systems have consistently failed to support.

What We Refuse to Accept

Normalized Trauma: Just because it’s common doesn’t mean it’s okay.
Survival as Success: “Healthy baby, healthy mom,” is insufficient.
Profit Over People: Care should be led by values — not billing codes.
Uniformity & Elitism: There is no single “right” way — only what is appropriate, supported and informed.
Burnout as a Badge: Birth workers should not have to self-sacrifice to sustain their work.
Power Struggles: Hierarchy has no place in healing.

Refusal is not rejection for its own sake. It’s the first step toward designing something better.

Family-Centered Maternal Care Framework

These beliefs are a piece of the foundation of a practical framework we’re developing around family-centered maternal care — not as a buzzword, but as a working model. A framework informed by decades of research, centuries of ancestral wisdom, lived experience and present-day conditions and constraints.

Right now, this effort is being built through primary research, documentation and synthesis.

Who Informs This Framework

Providers

Birth workers and clinicians — OBs, CNMs, doulas and nurses — especially those navigating the gap between what families need and what existing systems permit.

Families

Parents and families willing to speak candidly about what shaped their experience — what supported them, what caused harm and what they wish they’d understood earlier.

Systems & Infrastructure

People working within hospitals, insurance, public health, policy and funding who understand how incentives drive outcomes — and where change is actually possible.

Advisors

I’m also convening a small circle of trusted voices to guide and pressure-test this work as it develops, spanning clinical, community-based and cross-sector perspectives.

The goal is integrity, not consensus.

If you’re aligned with these values and see yourself in this work — as a birth worker, seasoned parent, advocate or someone carrying hard-earned wisdom — I welcome hearing from you.

This is not about having the “right” answers. It’s about capturing what’s real so we can build upon what already exists, to create something more honest and useful for families navigating birth.

If you want to learn more, I invite you to share your interest or book a conversation HERE.

Many people assume interventions begin with IVs and monitors — but they often start much earlier, in subtle and routine ways. Knowing this helps you spot patterns, ask better questions and stay rooted in your preferences before decisions are made for you. This isn’t about saying no to everything — it’s about staying connected to your values and making choices that feel right for you, from pregnancy through postpartum.

This piece in an excerpt from our print zine, Birthing While Black: A Hospital Guide, created in partnership with the BLACK Wellness and Prosperity Center in California, Tre Borden /Co and the James Irvine Foundation. The zine is NOW shipping!

Get the Guide

Common Hospital Interventions & Alternatives

In birth, an intervention is any action or procedure used to monitor, manage or alter the natural course of labor and delivery. Some interventions are necessary and lifesaving. Others may be routine, policy-driven or offered out of habit — not because something is wrong.

Common interventions in hospital births include:

• Continuous electronic fetal monitoring (EFM)

• Labor induction (using medications like Pitocin or procedures like membrane stripping)

• Artificial rupture of membranes (breaking your water)

• Epidural anesthesia

• IV fluids and restrictions on food and drink

• Limited mobility during labor

• Vaginal exams to check cervical dilation

• Episiotomy

• Vacuum or forceps-assisted delivery

• Cesarean section (C-section)

• Immediate cord clamping

• Separation of baby and parent for routine procedures

Learn what each intervention is, when it’s truly indicated, and which interventions are optional. The more informed you are, the better prepared you’ll be to navigate decisions with confidence and clarity — even in the moment.

Interventions Don’t Start at the Hospital

A common misconception is that interventions begin only once you’re admitted to the hospital, but many begin during pregnancy. Some customary pre-hospital interventions may include:

• A provider recommends scheduling labor induction without a clear medical reason

• Frequent cervical checks in late pregnancy

• Stripping of membranes

• Recommendations for early inductions based on non-emergent reasons (i.e., convenience or provider preference)

• Prescriptions for growth scans or non-stress tests without clear clinical indication

• Pressure to schedule cesareans based on suspected large baby or prior birth timing

• Statements such as “I can’t let you birth vaginally after 40 weeks” that may introduce fear or pressure without individualized risk assessment

Speaking outside of a strictly clinical context, society’s orientation toward birth can also serve as a sort of “social intervention”: offhand comments from well-meaning friends or relatives, social content, or even casual questions and remarks from neighbors... These informal “interventions” can subtly influence your decisions and sow doubt, often without you realizing it. Recognizing these influences is just as important as understanding the clinical ones — and just as worthy of thoughtful reflection and investigation.

Before agreeing to any intervention, ask questions (can this be said enough?). You deserve to understand why it’s being suggested, what your alternatives are and how it may affect your birth.

We suggest following the BRAINS Protocol. When you’re faced with a decision in labor, the BRAINS acronym can help you slow down and explore your options:

• B — What are the Benefits?

• R — What are the Risks?

• A — Are there Alternatives?

• I — What does your Intuition say?

• N — What happens if we do Nothing right now?

• S — Ask for Space or Support if needed.

This tool can help you stay centered and collaborative, even in moments that feel rushed. You can use it yourself, or your birth partner or doula can help guide the conversation using these prompts.

ACOG suggests asking:

• Why are you recommending this?

• What are the risks of waiting?

• What’s the process like, and how long might it take?

• What happens if it doesn’t work? (Or consider: “What are my options if this procedure doesn’t work?)

• Can we try natural methods first? (Or consider: “I’d like to try natural methods first.”)

• Is my cervix ready? (Note: this only applies if you have agreed to cervical checks, which are considered an intervention).

• Can I go home and come back later? (Or consider: “In your medical opinion, is it safe to go home and come back later?”)

• What are my options if I decline?

Just keep in mind, these questions are worded from the perspective of the gynecologist. Know your rights, know your options, and stand by them. “Can we try” can become “I’d like to try.” Unless you find yourself in an emergency situation, you can always request space and time before you decide.

If your provider is unable or unwilling to walk you through this, it may be a red flag.

The “Intervention Cascade”

Keep in mind: an intervention doesn’t always go according to plan — one intervention often leads to another. For example, a medical induction may lead to stronger contractions, which increase pain, prompting an epidural. That can slow labor, leading to more interventions to speed it back up — and possibly, a C-section.

This doesn’t mean all interventions are bad — many are life-saving. But unnecessary or poorly explained interventions can disrupt your experience and increase your risk of complications. That’s why preparation matters.

2025 was a year of stretching.
A year of increasing faith.
A year of stripping away what was excessive so I could get to what actually matters.

It was the year I formally introduced Borne to my community.
The year I turned 40 (iykyk).
The year my husband and I marked eleven years in business and seven married.
And through those milestones, something settled in me — a clarity I’m carrying forward.

As I reflect, there are six things from last year I’m bringing with me into 2026. I share them with the hope that it may serve as a mirror — a form of encouragement (Lord knows we need all we can get). If you have a minute, I’d love to hear what 2025 taught you, too.

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1. Boundaries.

Boundaries. Boundaries. Boundaries.

2025 made it undeniable: my time is finite, and so is my energy. If I believe I’m here to fulfill a specific purpose, then I cannot afford to spend my energy on what doesn’t return it.

We’re taught to think this way about money — ROI, savings, investments. But this year, I applied that same discernment to my energy. To relationships. To work. To collaboration.

Reciprocity is not optional.

I looked up and realized a decade had passed, like that. Multiple businesses built. Three children born. A bonus child loved. A marriage grown. I have poured out so much — in life, in business, in literally creating and nurturing life.

Now is my time.

Boundaries protect us from the slow leak of energy — the drama that clouds our vision and distracts us from our actual mission. (And yes, sometimes that drama is self-inflicted. Growth will humble you! Okay, me. I mean me.)

2. Autonomy > Attention.

I’ve never needed attention. If anything, I’ve actively avoided it (some might say, to a fault 👀).

Still, we live in an attention economy that insists visibility is the price of success. It’s seductive and FOMO-inducing for the best of us. And sure, maybe there were moments over the past decade where chasing attention could’ve led to faster growth or more money. But I’m done second-guessing.

What crystallized this year is this: I value autonomy more.

I don’t want to have to feed a machine every day to earn a living. I want to build something lasting. Something tangible. Something that exists in people’s hands and lives beyond social platforms.

What once felt like a limitation now feels like my greatest strength — and I’m leaning into it fully.

3. Intuition + Architecture.

Intuition has never failed me. It led me to my husband. To my family. To many chosen sisters. To entrepreneurship. To birth work. To a more expansive version of myself.

But intuition alone isn’t enough anymore.

I’m entering my fifth decade on this planet, and I understand now: if I don’t call the play, someone else will.

In my next chapter, I’m being called to build with greater precision. To design something even more durable. Community-supported. Independent of political cycles, trends or fickle brand budgets.

Systems. Scaffolding. Engines that don’t break.

For Borne, this also means more tangible tools — guides, zines, curriculum, practical information families can actually use to navigate a maternal health system that is overwhelming, fragmented and, too often, harmful.

No one is coming to save us.

We have to build our own structures.
Rooted in our values.
Clearly mapped.
Aligned with the future we’re collectively willing into existence.

4. Flow > Force.

How many times have I tried to force what wasn’t for me?
How many no’s did I take as personal failures instead of redirections?

2025 taught me to release what doesn’t flow.

If it’s for me, it will find me.
If it’s not, I let it go — gladly.

Timing has always been everything in my life. There were projects I was eager to bring into the world years ago — ideas that felt urgent, necessary, obvious. But they weren’t ready. And more importantly, I wasn’t ready to carry them the way they deserved.

What felt like delay was actually preparation. Skills being sharpened. Language being refined. Capacity being built.

Now, when something isn’t moving, I don’t force it. I ask what’s still being built — in me, or around me.

5. Embodiment.

As Queen Badu once said, you don’t get what you ask for — you get what you are.

This year wasn’t about learning more (although I definitely did that too). It was about becoming.

Getting quiet. Pouring into my family. Pouring back into myself. Making time to rebuild my body after powering through three births in four years. Getting to know this new version of me. Treating yoga, pilates, tea rituals, morning walks as the sacred, nonnegotiable work they are.

I realized that my assignment isn’t to be the loudest or the longest-tenured. My assignment is translation: taking what’s complex, clinical and intimidating and making it accessible.

My work is about documenting the return of birth to the hands of those who have always held it: midwives, doulas, mothers, families — the village. It’s about shifting the culture around birth, one family at a time. And my work starts with me embodying that culture and modeling it for my family.

6. Ask for Help.

If I’m being honest, ya girl still doesn’t feel particularly comfortable asking for help.
But I’m learning to do it anyway.

2025 required me to lean on my community in ways that didn’t feel great for my ego. Ways that challenged the version of myself that prides herself on figuring things out, and making it work no matter what.

And every time I asked for help, guess what?
I didn’t die.
Nobody showed up at my house pointing a finger at my failure to do it myself.

What did happen was more subtle. I had to keep asking myself: whose rubric is this anyway? Why is my self-worth so tied to doing things alone? Why have I subscribed to this myth of individualism while committing my life to building community?

Those two things don’t actually go together.

As much as I’m called to serve the people I love, they’re called to serve me too. That isn’t weakness. It’s nature. It’s how we sustain the ecosystem.

Learning to receive without guilt is something I’m still practicing. But in 2025, it became conscious. Intentional. A discipline in its own right.

And that’s something I’m most definitely carrying with me into 2026.

Have you had a chance to reflect on 2025 yet (how are we halfway through Jan??)? What did you take away? What are your intentions for the coming year? I’d love to hear from you. 🤍

Leave a comment

No matter where you give birth — hospital, birth center or home — the people on your team will greatly impact your experience. Who you choose to surround yourself with can make all the difference in how seen, heard and supported you feel — before, during and after birth.

I’ve attended births in all three settings as a doula and birth assistant, and have personally given birth in a hospital and at home (twice). And outside of the simple (yet admittedly, not always easy) understanding that your birth belongs to YOU; having the right people in the room is arguably the most important set of choices you can make for your birth experience. There is no substitute for an aligned system of care, advocacy and support around you through this life-changing rite of passage.

Maybe a Black midwife or OB is nonnegotiable for you. Maybe you want all five of your sisters nearby as you labor at home. Or maybe you want your partner by your side as you deliver, and no one else. Maybe your vision isn’t clear yet (if that’s the case, read this). But if you can, aim to identify and communicate your needs as early as possible, so you can avoid last-minute stress, changes or unnecessary conflict close to your due date.

Here’s the truth: your team matters as much as your setting — and sometimes even more. A supportive, aligned team can help you avoid unnecessary interventions, reduce complications and reinforce your confidence to birth in your power.

Let’s take it step by step, and clarify who you want to join you in your sacred birth space.

Your Birth Partner: Who Should Be in the Room?

A birth partner can be a spouse, significant other, family member, friend or chosen support person. What matters most is not the title, but the trust. They should make you feel safe, grounded and respected. They don’t need to know everything about birth — but they should be emotionally present, supportive of your choices and ready to advocate for your needs when you can’t.

Your birth partner should:

• Be supportive of your birth vision.

• Be reliable, and willing to show up for you.

• Be able to stay calm under pressure (bonus points if they operate well with little sleep!)

• Be able to advocate when needed.

• Be someone who can stay grounded while you do the work of labor.

And let’s be real: your birth partner doesn’t have to be your life partner. If your partner isn’t aligned with your plan, doesn’t handle medical settings well, adds stress instead of support, of if they’re not in the picture, it’s okay to choose someone else. This is your birth — your initiation into motherhood — and your peace comes first. The wrong energy in your birth space can slow labor, and even contribute to less favorable health outcomes for yourself or baby. This forever mark the way your child was brought into this world. This is not the time to be diplomatic or to “feel bad” — get the support that you and baby need.

And remember: birth is not a spectator sport. Less is more.

Choosing Your OB or Midwife

Whether you’re working with a midwife or an OB-GYN, it’s important that you feel comfortable asking questions — and that your provider listens and responds with care. If possible, meet with multiple providers until you find the right fit. Trust and safety are core components of a positive birth experience.

Above all, I believe that mothers and families should have agency throughout their preconception, prenatal, birth and postpartum process; and should be supported in the choices that are right for them. That said, I am proudly Team Midwife for low risk pregnancies. And even if you’re categorized as “high risk” within the medical system, it’s worth consulting with an experienced midwife to confirm whether this “risks you out” of their practice. Often, health circumstances that are viewed as high risk by the medical system can be monitored under a midwife’s care, and you may still be able to give birth in a free standing birth center or even at home, if that’s a priority for you. As always, do your research according to your state laws and what’s available in your local community.

Because 98% of us give birth in hospitals, most often with an OB-GYN, I want to share what most of our families don’t hear:

• If you’re low-risk, midwives are statistically safer. Midwife-led care for low-risk pregnancies is linked to fewer interventions, fewer cesareans and healthier outcomes for both mother and baby — without sacrificing safety.

• OBs are trained to manage emergencies and surgery. This is lifesaving when complications arise — but in low-risk births, that training often leads to higher rates of intervention.

• Continuity matters. In a midwife-led model (at home or in a birth center), you’re far more likely to know the person who attends your birth. In hospitals, your provider may change with each shift.

When interviewing providers, ask about their philosophy of care and how it aligns with your values.

Some sample questions to get you started:

• What is your philosophy of pregnancy, birth and postpartum care — and your role in it?

• What made you want to become an OB-GYN or midwife?

• What care model(s) do you follow?

• Do you support unmedicated delivery?

• What has been your experience with [insert type of birth or preexisting condition]?

• What is your approach to complications?

• What is your approach if a mother goes past her estimated due date?

• What is your approach to interventions like induction or cesarean?

• Do you support my preference to [insert birth or postpartum preference]?

• Do you recommend a doula? Why or why not?

• Can you walk me through your process and systems? For example, when I have blood work done, how and when do we review results?

• What is your philosophy on weight gain, nutrition, prenatal supplements and exercise during pregnancy?

• What prenatal screenings and tests do you offer or require?

• When are you on-call?

• Do you offer, or can you recommend, breastfeeding support?

• How should I get in touch between appointments if I have questions or concerns?

• Do you work with backup providers, and can I meet them?

Questions specifically for midwives:

• What factors would “risk me out” of your practice? Are you able to help me create a plan to prevent these?

• If I went past my estimated due date, what protocol do you follow? How “late” can I be and still birth under your care?

• Do you work alone or as part of a team?

• How many clients do you take on at any given time?

• Are there any doulas that you’ve worked with and can recommend?

• What postpartum care do you provide, including newborn procedures?

Whether you choose an obstetrician or a midwife, remember that individual providers may follow a traditional model or incorporate elements from multiple approaches. No matter what, you should feel considered and well cared for.

You can explore state midwifery associations, local community birth worker networks and trusted referrals.

Sista Midwife Productions’ directory is a great resource for finding Black midwives (this is how I found my amazing midwife-turned-sister, Ashley Greene of Serenity Midwifery & Birth Center).

If you’re a Black woman planning to work with an OB, either because of your health needs or simply your preference, I highly recommend getting a copy of Dr. Tiffany Woodus’ guide,The Mocha Maternity Survival Guide: Choosing The Right OBGYN: Helping You Safely Navigate The Black Maternal Health Crisis.

But Wait…What’s the Difference Between a Midwife and a Doula?

There are common misconceptions about midwives and doulas, their roles and how they complement each other. Many people think the two are interchangeable (they’re not), and some assume midwives only attend home births (they don’t). Let’s take a moment to clear that up.

What is a Midwife?

Midwives are licensed healthcare providers who deliver babies and provide prenatal and postpartum care. They can practice in hospitals, birth centers or homes, depending on their training and license. In hospitals, you’ll most likely encounter:

• Certified Nurse-Midwives (CNMs): registered nurses (RNs) with advanced training in midwifery. They can practice in hospitals, birth centers and homes, and are licensed in all fifty states.

• Certified Midwives (CMs): non-nurse professionals who complete graduate-level midwifery education and pass the same board exam as CNMs. CMs are licensed in select states and often work in similar settings as CNMs.

There are other types of midwives you may find in out-of-hospital settings:

• Certified Professional Midwives (CPMs): midwives trained specifically in out-of-hospital birth, including homes and freestanding birth centers. They complete accredited midwifery education or a structured apprenticeship and must demonstrate extensive hands-on experience in community birth before certification through the North American Registry of Midwives (NARM). CPMs are the only U.S. midwives whose credential requires home birth experience. They are licensed or regulated in many, but not all, states.

• Licensed Midwives (LMs): midwives who hold a state-issued license to practice midwifery, most often in homes and birth centers. Training routes vary by state but typically include accredited midwifery education and supervised clinical practice, sometimes overlapping with CPM requirements. Some states license CPMs under the LM title, while others issue a distinct LM license. Scope of practice and regulation depend on state laws.

• Traditional/Community Midwives: midwives who train outside formal medical or academic pathways, often through apprenticeship, community mentorship or lineage-based traditions. Their care may be rooted in cultural, spiritual or ancestral practices — such as those of African American “Granny Midwives,” Indigenous birth workers or midwives serving immigrant communities. Traditional or community midwives may or may not hold a state license depending on local regulations, and primarily attend births in home or community settings.

Because licensing laws and training pathways vary by state, take time to research who is available in your area, what their credentials mean where you live, and how their philosophy aligns with your own. The right midwife is the one who supports not just your safety (that goes without saying), but your values, your autonomy and the kind of birth experience you want to create.

What is a Doula?

Doulas are trained birth professionals who provide continuous support throughout pregnancy, labor and postpartum. Their care is rooted in emotional, physical and informational support — helping you prepare, advocate for your needs and stay connected to your vision throughout the experience. Doulas aren’t medical providers, but their steady presence can make a powerful difference: they offer comfort measures, translate complex information and help families navigate options with confidence. They support the whole family — not as a replacement for a partner, and not to fix family dynamics, but to offer grounded, compassionate reinforcement during a life-changing transition.

Continuous support from a doula has been shown to significantly improve birth outcomes, including lower cesarean rates, reduced need for pain medication, shorter labors and more positive birth experiences.

Both midwives and doulas play vital, complementary roles — but they serve very different purposes. A midwife provides medical care. A doula provides unwavering, human-centered support. I hope you can find exactly what you need.

Do I Really Need a Doula?

Only you can decide what support feels right for your birth — but I strongly encourage considering a doula, no matter which birth setting you choose. The right doula offers steady, informed, nonjudgmental care throughout your journey. They help you stay connected to your voice, your body and your plan — especially when things move fast or feel overwhelming.

Both the American College of Obstetricians and Gynecologists (ACOG), and the American College of Nurse-Midwives (ACNM) acknowledge the role of doulas in supporting better birth outcomes. ACNM’s Position Statement on Birth Doulas is a valuable read, and ACOG’s website has some helpful information and articles in support of doulas.

• Continuous support saves lives. Research shows doulas lower the chance of cesarean, shorten labor and increase satisfaction.

• Hospitals move fast. Staff rotate, timelines are tight and interventions are common. A doula offers continuity and calm in that environment.

• Out-of-hospital, doulas still matter. Even in the most supportive midwife-led setting, the right doula can help you and your partner stay grounded, connected and nourished. Their presence allows your midwife to stay locked in to you and your babies’ health status and any needs that arise, while your doula can serve as translator, guide and moral support, as needed.

Both the American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse-Midwives (ACNM) recognize doulas as improving outcomes. This isn’t about luxury — it’s about care.

If cost is a concern, look into community programs, sliding scale options, or pro bono services. Start with:

• Local community-based collectives

• Mama Glow Doula Matching

• Sista Midwife Productions

• Black Doula Network (BWPC)

• Joy in Birthing

Choosing the Right Doula for Your Setting

Hospital Birth

Find a doula skilled at navigating medical systems, communicating with staff and protecting your voice when things move quickly. Some hospitals welcome doulas with open arms. Others may have restrictions, especially during busy periods or due to COVID-era policies. Talk with your provider and hospital ahead of time about your intention to bring a doula, and make sure your doula is comfortable advocating within that setting.

Unfortunately, doulas are often undervalued or dismissed in medical settings, despite being a vital part of the birth team. As a client, your advocacy for their presence and role can help shift the culture toward more collaborative, family-centered care.

Birth Center/Home Birth

For out-of-hospital (OOH) birth, you’ll want a doula who understands physiologic birth — the body’s natural rhythm when labor is undisturbed — and who knows how to work in partnership with midwives rather than in parallel with them.

OOH births tend to be quieter, more intimate and more mother-led (you can find a detailed post I wrote about OOH birth here). Your doula becomes part of the rhythm of the room:

• protecting your sense of safety

• helping you stay grounded in your body

• supporting you through position changes

• reading the energy and intensity of labor

• reinforcing your confidence as your midwife monitors you and baby

In this setting, a doula isn’t just a buffer between you and the system — they’re a companion, a mirror and a calming force in a space designed for slowness and trust.

Because many families choose OOH birth specifically to avoid unnecessary interventions, your doula should be deeply attuned to supporting labor without disrupting its natural flow: offering techniques like counterpressure, breathwork, movement, massage and emotional reassurance that help your body do what it’s designed to do.

A doula experienced in OOH birth will also understand:

• how to maintain a peaceful environment

• when to step back and when to step in

• how to collaborate fluidly with midwives

• how to support you (remotely or in person) through long early labor at home before active labor intensifies

This synergy — midwife + doula + partner + your own inner wisdom — is one of the reasons many families describe home and birth center births as deeply empowering, and even healing.

Across All Settings

Wherever you give birth, ask your doula:

• How do you advocate for clients when things shift?

• How do you support partners as well as birthing parents?

• What is your approach when unexpected changes arise?

• How do you help protect physiologic birth?

• How do you collaborate with medical staff or midwives?

The right doula will not only share your values — they’ll help you hold onto them when it matters most.

Insurance Considerations

Some insurance plans, Medicaid programs, or health savings accounts (HSAs) cover midwifery and doula services — but not all. In California, Medi-Cal now covers doula care under the California Momnibus Act (SB65), an important step toward making support more accessible. Check your benefits early, ask your midwife or doula if they offer sliding scale or payment plans, and see whether your hospital has community doula programs. It’s worth looking into — the support can be game-changing.

If you made it this far, thank you so much for reading and I pray this is a useful resource for you, your client or someone you love. This entire body of work is meant to be a living, growing community resource and knowledge base.

• If you’re a birth worker, OG parent, advocate or just an informed citizen — please comment below or email me with anything you’d add to this!

• Mothers/families — if you still have questions after reading this, please do the same. Comment or email me anytime.

Simply put, matrescence is the process of becoming a mother, a term coined by anthropologist Dana Raphael in the mid-1970s. Similar to adolescence, “matrescence describes a developmental transition that is hormonal, physical and emotional.”

Watch the full conversation above, and find a few key highlights and resources below.

About :

After an unplanned but powerful homebirth — and a coercive hospital stay — Kyndall became deeply invested in caregiver advocacy and maternal well-being.

She now serves in a strategic and operations role at Funders for Birth Justice & Equity, an organization where donors learn, organize and invest in birth and reproductive justice movements and infrastructure. She’s also a matrescence coach and consultant, building cultures of care for moms that center maternal health, leadership, joy and creativity.

Conversation Highlights:

Resources:

Less is Liberation (Book)

The Wheel of Matrescence

There’s something about cooler days that makes a warm cup feel especially restorative. Whether you’re planning, pregnant, postpartum or a birth worker supporting families, plants can offer gentle support through every season. These four blends are a simple, nourishing way to balance hormones, calm the nervous system and replenish minerals when your body needs it most.

Tea Blends by 🌿

🌸 Preconception Glow Tea

Womb prep + hormone balance

Ingredients:

1 tsp Red Raspberry Leaf – uterine tone

1 tsp Red Clover – fertility support + gentle detox

1 tsp Nettle – minerals and iron

½ tsp Moringa – whole-body nourishment

½ tsp Rose petals – floral softness

Cinnamon chips – cozy finish

Tastes like: earthy floral with a kiss of warmth 🌹

Optional: add honey or a splash of oat milk

🤰🏾 Pregnancy Calm Tea

Mineral support + mood balance

Ingredients:

1 tsp Red Raspberry Leaf – uterine tone

1 tsp Nettle – mineral boost

½ tsp Lemon balm – calm and ease

½ tsp Moringa – gentle energy

¼ tsp Spearmint – smooths the flavor + tummy tamer

Tastes like: minty green sunshine 🍃

Optional: add a slice of lemon or drizzle of honey

🌺 Postpartum Replenish Tea

Rebuild + restore

Ingredients:

1 tsp Moringa – increase milk + minerals

1 tsp Oatstraw – nervous system nourishment

½ tsp Chamomile – rest + gut healing

½ tsp Ginger – warmth + circulation

Cinnamon chips – cozy finish

Tastes like: warm chai with a floral hug ☕️🌼

Optional: coconut milk + honey = instant postpartum latte

⚡️ Birthworker Energy Blend

Uplift + sustain

Ingredients:

1 tsp Moringa – deep nourishment, iron, gentle energy

1 tsp Peppermint – crisp and refreshing

½ tsp Lemongrass – bright citrus lift

½ tsp Hibiscus – tangy, vitamin C–rich color pop

Tastes like: green tea meets pink lemonade 🌺

Optional: a drizzle of honey and a slice of orange

Somehow, in our modern world, birth outside the hospital has come to be seen as a “fringe” choice — for the wealthy, the white or the woo-woo. But for most of history, birth happened at home, within community. Hospitals weren’t always the norm; they became the standard only in the last century, shaped by policy, profit and perception (*cough* propaganda).

Today, in the U.S., birth is treated as a medical condition, and hospital birth is treated as the default. It’s where 98% of us give birth — and many of us never pause to even consider that other options exist. And often, providers — or even family — discourage exploring those other options.

For many, hospital birth feels like the only path because it’s the only one ever presented — not because it’s the only safe one.

So this isn’t about convincing or romanticizing. It’s simply a reminder of what’s available, and that — taking into account our medical status, of course — we have the right to birth where and how we feel safest.

And to be clear: out-of-hospital birth isn’t glamorous. It’s not (just) the dreamy videos you see on TikTok. It’s…birth. It’s messy. It’s intentional. It asks for presence, surrender, trust and partnership with your body, your baby and your team. It’s not about fear or rebellion. It’s not about you being “extra.” It’s about returning to something actually quite normal: to the quiet power that birth has always required.

So let this be a starting point, not a conclusion. If something inside you has been nudging you to explore options outside of hospital birth, this is your invitation to heed that voice. As always, I urge you to do your research, trust your intuition and choose what aligns with your needs and values.

What is Out-of-Hospital Birth?

Out-of-hospital (OOH) birth simply means birthing outside a hospital — often at home or in a freestanding birth center — with the support of trained midwives. These are planned, not emergency, births for healthy, low-risk pregnancies. (The medical and midwifery models often define ‘low-risk’ differently — something worth exploring as you do your research.) Midwives bring equipment, monitor safety throughout labor and have clear protocols for transfer if medical care becomes necessary — bridging the best of traditional and modern care.

It’s worth noting that some families choose to birth entirely without professional support — often called free birth. That’s a distinct path, one I respect but won’t speak to here. My focus is on the midwifery-led care model that centers relationship, safety and family autonomy.

Why OOH birth is core to Borne’s mission

At Borne, we believe that care should begin and end with the family — not the system. We believe in midwifery-led, family-centered maternity care where the parents’ and family’s voice is centered and decisions are made together. Not the hierarchy we’ve grown accustomed to, where insurance companies, hospital policies and profit margins often outrank people.

In a family-centered model, your care is continuous — the same midwife or small team walks with you through pregnancy, birth and postpartum. You’re not “a patient.” You’re the center of your story.

Let’s talk about safety (and myths)

When we look at the data — and the lived experiences of families — the picture becomes more nuanced than the myths suggest.

“The hospital is always safer.”
Many people assume hospital birth is automatically safer. But for healthy, low-risk mothers, research shows that planned out-of-hospital births attended by qualified midwives have similar safety outcomes — and far fewer unnecessary interventions.

“OOH birth is rare for a reason.”
Roughly 98% of U.S. births happen in hospitals, but that dominance doesn’t prove superiority, it reflects how our systems are built. Most families never hear about out-of-hospital birth as a viable option because insurance coverage, hospital partnerships and public policy overwhelmingly funnel care toward institutional settings. Even so, out-of-hospital births have steadily increased since 2020, now accounting for nearly 2% of all U.S. births — the highest rate in over 30 years.

“There’s no evidence for birth centers.”
U.S. birth-center studies show low cesarean rates and high breastfeeding initiation when care is midwifery-led and transfers are integrated.

Context matters.
The U.S. cesarean rate rose again in 2023 and our maternal mortality rate continues to climb, even as other high-income countries improve. According to the CDC, U.S. maternal deaths more than doubled between 1999 and 2019, and recent data show that rates remain highest among Black women. Despite the near-universal reliance on hospital birth — where 98% of U.S. births occur — our outcomes still lag behind our peers. We have to be honest about what that means: the crisis isn’t happening outside the system, it’s happening within it.

What changed after COVID

During and after the pandemic, families began asking deeper questions about safety, autonomy and support. Out-of-hospital birth rose nearly 20% from 2019 to 2020 — and it’s still climbing. That rise reflects more than fear of hospitals; it reflects a growing desire for personalized, respectful care that sees the family, not the chart.”

What we’re seeing is not a trend, but a remembering. A desire to be known, seen and supported through one of life’s most intimate transformations.

The benefits of home and birth-center birth

Where you give birth shapes how you give birth. The setting influences how decisions get made, which options are available, how much privacy or support you have and what happens if something changes. Every setting has pros and cons — understanding them can help you clarify what’s most important to you. Because the cons are so often emphasized, I’ll focus on the pros of OOH birth here.

Home Birth

• You’re surrounded by your own comforts — your scents, your sounds, your rhythm.

• You choose who’s in your space.

• Your midwife focuses on physiological birth, supporting your body’s natural process.

• You receive continuous care from preconception through postpartum.

• Shared decision-making is the foundation, not the exception.

• The care is personal, relational and centered on your family — not protocols.

• And for families paying out of pocket, home birth can often be more affordable.

Birth Center Birth

• A calm, home-like environment with medical readiness nearby.

• Midwifery-led care that honors your body’s wisdom.

• Continuity of care and individualized attention.

• Shared decision-making, genuine listening and support.

• Often lower cost than hospital birth, with strong data on safety and satisfaction.

Both options rely on trust — in your team, your body and the process — and both are designed to keep families at the center of care.

Challenges of hospital birth

Hospitals can absolutely save lives — and they do, every day. But they can also make it harder for families to experience birth as sacred, connected or even humane. Remember: hospitals are designed first and foremost to administer medication and perform life-saving surgeries. If you want or need access to pain relief, or if you’ve chosen a cesarean birth, a hospital is the obvious and safest place to be.

But if your goal is a physiological, unmedicated birth, you may find yourself working against the current. Hospital systems are structured for efficiency and risk management — not intimacy, continuity or autonomy. That doesn’t make them “bad,” but it does mean most are not built for the kind of birth experience many families envision.

Common challenges include:

• Gaps in communication or informed consent

• Rushed timelines driven by policy, not physiology

• Frequent staff changes, limited privacy and inconsistent care

• Higher rates of induction and surgical birth

• Rigid rules about who can be present or how you can move

• Implicit racial bias that still shapes care for too many families — sometimes resulting in disrespect or even criminalization

• And the sheer emotional cost of feeling unseen in such a vulnerable moment

Acknowledging these realities isn’t about walking in fear. It’s about being aware. When you understand the environment you’re entering, you can plan and advocate with clarity — knowing where to lean in, where to push back and when to ask for support.

The heart of it

In short: do your research (yes, I know I say this a lot).

Consider any pre-existing conditions, as well as any experiences — from beautiful to traumatic — that may shape your feelings of safety. Get familiar with your needs, preferences and options. Talk to a midwife and/or doula who is aligned with your values. Ask questions. If your care feels misaligned, get a second (or third) opinion. You have the right to understand what birth settings are available to you — and which are available to you based on your individual health.

Home births and birth centers can be great options for low-risk pregnancies (and even VBACs, twins, breech, advanced maternal age, and other labels that the medical system considers high-risk). But if you have a serious medical condition or higher-risk factors, the hospital may be the safest choice. Knowing what’s available — and what’s realistic — helps you make confident, informed decisions.

Out-of-hospital birth isn’t for everyone, and that’s okay. What matters is that families know it exists, that it’s safe for many, and that it’s an option grounded in evidence, care and history.

We deserve systems that trust families.
We deserve care that honors physiology and harmony.
And we deserve to remember that birth — no matter where it happens — belongs to us.

Recommended Reading & Further Learning

• Reclaiming Childbirth as a Rite of Passage – Rachel Reed, PhD, Midwife

• Safe in a Midwife’s Hands – Linda Janet Holmes

• The Doula Book – Klaus et al.

• Nurturing the Family – Jacqueline Kelleher

• Birth Without Fear – January Harshe

• WHO: Positive Childbirth Experience Framework

References & Resource List

U.S. Birth Statistics & Trends

Centers for Disease Control and Prevention (CDC).
Trends in Out-of-Hospital Births in the United States, 1990–2022.
National Vital Statistics Reports, Vol. 73, No. 2. (February 2024).

CDC National Center for Health Statistics.
Births: Final Data for 2023 (preliminary release, NVSS).

Maternal Mortality & Morbidity

CDC National Center for Health Statistics.
Maternal Mortality Rates in the United States, 2021.

NIH / JAMA.
Tikkanen, R. et al. “Trends in State-Level Maternal Mortality by Race and Ethnicity, 1999–2019.” JAMA, 2023.

Commonwealth Fund.
Tackling the U.S. Maternal Health Crisis. (2022).

Out-of-Hospital & Midwifery Outcomes

Cheyney, M. et al. “Outcomes of Planned Home Birth with Midwife: A Prospective Cohort Study.” Birth, 2014.

Stapleton, S.R., Osborn, C., Illuzzi, J. “Outcomes of Care in Birth Centers: The National Birth Center Study II.” Journal of Midwifery & Women’s Health, 2013.

Scarf, V. et al. “Planned Place of Birth and Maternal and Perinatal Outcomes in High-Income Countries.” Cochrane Database of Systematic Reviews, 2018.

International Confederation of Midwives (ICM).
Global Standards for Midwifery Education and Regulation. (2021).

International Childbirth Education Association (ICEA).
Family-Centered Maternity Care Position Paper. (2020).

Systems, Access & Insurance Barriers

Time Magazine.
“Home Births Became More Popular During the Pandemic. But Many Insurers Still Don’t Cover Them.” (2022).

Aetna Clinical Policy Bulletin 0329.
“Planned Home Birth.” (2023).

ValuePenguin.
“Does Health Insurance Cover Home Birth?” (2023).

BirthPlace Lab (University of British Columbia).
Giving Voice to Mothers – U.S. Survey Report. (2020).

Comparative & Global Context

World Health Organization (WHO).
WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience. (2018).

OECD Health Statistics.
Maternal Mortality and Cesarean Rates, 2023 Update.

A Doula Isn’t Your “Magic Fix

Birthing the Answers to Our Prayers

The History of Midwifery & Gynecology in the US

If you’ve been around here for a while, you’ve probably seen pop up in our community spaces — in videos, conversations and comment threads that make you pause and say, “Yesss, that part.”

Eve is a Dallas-based doula and student midwife, founder of EVE Birth Services, and a beloved voice in our village (also our founder’s real-life doula — twice!). Known for her honest, spirit-led approach to birth and community care, Eve’s work reminds us that this path isn’t just professional — it’s sacred and divinely-appointed. She’s currently in what she calls her “cocoon season”: studying, mothering and preparing for her next chapter in midwifery.

Eve has shared her wisdom in a few of our favorite pieces — Fibroids & Womb Health, Iron & Energy, and Beauty Rest: A Guide to Healing Sleep — and in live conversations like Postpartum Healing and VBAC Birth. Every time, she drops gems.

Recently, a community member ( 👋🏽) slid into her DMs with a few thoughtful questions about the path to becoming a doula, balancing evidence with intuition, and what it really looks like to live this calling day to day. The answers were too good not to share, so we turned the exchange into a Q&A. Enjoy!

LP’s Vibe: What path to become a doula did you take?

Auntie Eve: I trained through BEST, but my real education came from birth rooms, grandmamas’ wisdom and Spirit. You gotta start somewhere, but doula work isn’t a “follow these steps” kind of calling. It’s sacred. It’s a contract between you, the family and that baby’s soul. Spirit is trusting you to show up with clean hands, a steady heart and intuition tuned in.

Do you wish you’d chosen a different path — or see how the path could be made easier for someone just starting out?

If I could change anything, I’d make the process more community-based and less commercial. Everybody’s trying to “brand” this work now. I’d love to see more mentorship, more real-life training and fewer folks gatekeeping wisdom that was never meant to be sold. It should feel like apprenticeship, not an application. If you’re new, find a solid mentor and some hands-on experience — that’s where the real learning lives.

How do you balance science and spirituality — evidence-based research and ancestral knowing?

Science is the how. Spirit is the why. I keep up with research, but I also know birth ain’t a lab experiment. I trust herbs, prayer, ancestral knowing and the body’s wisdom. I blend both because our clients deserve care that honors the whole being: body, mind and spirit. Like Queen Afua says, this work is priestess work.

How do you manage the unpredictability of birth when you’re also a mom?

Unpredictable means I need a plan. Birth doesn’t wait for anyone, so I stay ready. I’ve written out my kids’ full drop-off and pick-up schedules: addresses, times, tutoring, swim lessons, basketball — all of it. I keep a list of the meals they like, bedtime routines and what to do if I’m not home.

I’m a single mom, so when I have to call someone for help, I set them up to succeed. My village doesn’t have to guess — it’s all written down. And I teach my kids what to do when Mama’s at a birth, how to move through the morning like clockwork.

Sometimes I leave while they’re asleep and come back before they wake up, and they walk out the door fed, greased up, uniforms on and backpacks ready. That’s what balance looks like for me: systems, surrender and a whole lot of faith.

What’s one way the doula community needs to evolve?

Whew. Where do I start? We need less competition and more collaboration. More transparency about money, ethics and emotional boundaries. More inclusion of Black, Brown and community doulas in “mainstream” spaces — without tokenizing us. We gotta return to the roots: birth work as service, not status. This isn’t influencer work. It’s altar work.

Looking back, what’s the first thing you wish you’d done differently?

Trusted my gut sooner. I spent too long trying to “look” like a professional doula instead of being who Spirit called me to be. Now I know: your intuition is your certification. The rest is practice, humility and faith.

What books do you recommend for doulas-in-training?

Auntie Eve:

• Spirit Babies — for understanding that babies choose us and that conception, pregnancy and birth are sacred contracts.

• Placenta: The Forgotten Chakra — because the placenta is more than an organ; it’s the first altar, the baby’s twin and the bridge between worlds.

• Sacred Woman by Queen Afua — the blueprint for reclaiming womb power and spiritual hygiene.

• A Modern Map to Ancient Midwifery — a reminder that this path has always existed; we’re just remembering what our grandmothers already knew.

• Reclaiming the Spirit: Midwives, Medicine, and Birth in the South by Linda Janet Holmes — where she travels through the South and Africa interviewing traditional midwives and healers.

• Listen to Me Good: The Life Story of an Alabama Midwife — the living testimony of what this work looked like before birth centers and hashtags.

You can take every certification in the world, but if you don’t understand birth as spiritual technology, you’ll miss the magic.

Next Up

Join us for the next Ask a Doula Anything: Daddy Edition (Part 2), Live on Tuesday, October 14th at 3pm CT/4pm ET.

will join our founder, and her husband Nkrumah to build on last week’s conversation about how partners can best support during pregnancy, birth and postpartum. See you there!

From time to time, we’ll spotlight a handful of community members — birth workers, healers and advocates — whose work cares for us, inspires us and often complements our own. Because this isn’t just about reading or learning, or being on a “list.” It’s about knowing each other, supporting each other and growing together.

Feel free to follow, subscribe and get in touch! We hope this serves as the start of many fruitful connections.

Ashley Greene, CNM

Serenity Midwifery & Birth Center
Waxahachie, TX

Her Work:
Midwife Ashley has been serving families in the DFW birth community since 2014. A former doula and Labor & Delivery RN turned Certified Nurse-Midwife, she now leads Serenity Midwifery & Birth Center — a freestanding birth center built on her own homestead in Ellis County. Serenity was created for families who want to birth in peace, surrounded by nature and care that feels like home.

More About Her:
A mother of four, Ashley has experienced birth in many forms — from medicated hospital births to two Cesareans and a redemptive water birth after both. She also supported Borne’s founder through her own redemptive births, and her care continues to ripple through our community.

Reach Out:
🌐 Website
💌 Email
📱 Instagram

Osibodu

Funders for Birth Justice and Equity (FBJE) & Kadence
New York, NY

Her Work:
Kyndall is the Co-Director of Strategy and Internal Operations at Funders for Birth Justice and Equity, the leading network helping donors learn, organize and invest in birth and reproductive justice movements. She’s also the founder of Kadence, a platform building cultures of care for mothers — centering maternal health, leadership, joy and creativity through coaching, consulting, content and community.

More About Her:
After an unplanned but powerful homebirth followed by a coercive hospital stay, Kyndall became deeply invested in caregiver advocacy and maternal well-being. She has led youth engagement at G4GC, designed participatory grantmaking at NoVo Foundation, and serves on the board of Vote Mama Foundation. Anchored by faith and womanism, she believes every person deserves the power, agency and resources to decide how, when and whether to grow their family.

Live Convo:
Kyndall joined us for The Exchange: A Birth Keeper Gathering on Tuesday, October 28th to explore Matrescence — the transformation of becoming a mother — and how we can better support that passage through care, culture and community.

Reach Out:
🌐 Website
📱 LinkedIn

Dr. PT, DPT

The Self-Care Physio
Oakland, CA

Her Work:
Dr. Anietie “Tia” Ukpe-Wallace is the force behind The Self-Care Physio, where she helps women reconnect with their bodies and rediscover what true care feels like. A California-based pelvic health physical therapist, Tia blends science, movement and deep compassion to support healing from the inside out. She’s also a founding provider at the East Bay Birth Collective in Oakland, CA.

More About Her:
Originally from Yonkers, NY, Tia’s path began with a love of dance and yoga before evolving into a calling to serve women’s health. Her work is informed by her own journey through fibroids, pelvic pain and cesarean birth — experiences that shaped her into the practitioner she is today: empathetic, wise and deeply committed to helping others heal.

Reach Out:
🌐 Website
💌 Email
📱 Instagram

“During birth we want the pelvic floor to soften and lengthen. Strength matters — but resilience is the goal.”

Why this conversation

After having three babies in five years, I learned the hard way that pelvic floor health is not optional. Too many of us hear “do your Kegels,” but we’re never taught what our pelvic floor actually does, how it moves with our breath, or how to protect it in pregnancy, birth and postpartum. We invited Dr. to share what every mother and family should know about their pelvic floor — and what to start practicing today.

Q&A

Who are you and how do you support families?

Tia: I’m a pelvic floor physical therapist in Oakland. I’ve worked in hospitals and now run a private practice inside a birth collective with midwives, lactation consultants, doulas and mental health therapists. Pelvic PT supports bladder, bowel and sexual function — and plays a big role in pregnancy, birth and recovery.

Are Kegels the answer?

Tia: Kegels aren’t the whole story. We want resilience — a pelvic floor that’s both strong and flexible. During birth those muscles must soften and lengthen so baby can pass. Many folks do Kegels incorrectly, and most aren’t assessed. I train strength and mobility through breath and functional movement, not isolated squeezes alone.

“Pelvic health ≠ Kegels. It’s coordinated strength, mobility, and breath.”

How does breathing affect the pelvic floor?

Tia: Picture your body like a cylinder. The respiratory diaphragm under your ribs is the top, your pelvic floor is the bottom.

• Inhale: diaphragm drops, belly expands, pelvic floor lengthens

• Exhale: diaphragm rises, pelvic floor lifts
  Deep, three-dimensional breathing keeps this system coordinated. Shallow, shoulder-heavy breathing creates tension that shows up in the pelvic floor.

When should someone start caring about their pelvic floor?

Tia: Before pregnancy if possible. Two simple starts:

1. Three-dimensional breath — expand front, sides and back of the ribcage.

2. Know your anatomy — look at and gently touch your vulva and perineum. Body literacy helps you notice changes early and advocate for care.

Best way to breathe in labor to protect the pelvic floor?

Tia: Diaphragmatic breathing. Try inhale 6, exhale 6. It lowers heart rate and helps tissues stay supple between contractions. For pushing, short bouts of Valsalva (big inhale, hold, bear down) can help — but not for two hours straight. Use diaphragmatic breath as your baseline, then Valsalva briefly when needed.

“Use 6-in, 6-out to come back to baseline. Push with intention — not for the entire stage.”

Is breathwork just physical, or something more?

Tia: Both. Deep breathing stimulates the vagus nerve, helping you regulate your nervous system. Some connect to the science, others to the energetic — throat, heart, root, sacral. Different languages, same truth: breath creates safety and coordination in the body.

What about access and education?

Tia: Access matters, and so does education. Not everyone can see a PT weekly. Many strategies are teachable in community spaces and doable at home. Birth workers can normalize pelvic floor care, offer simple breath and movement tools, and help families know when to seek assessment.

Quick practice: 3 minutes a day

• Sit or lie comfortably.

• One hand on ribs, one on low belly.

• Inhale 6 through the nose — feel front, sides, and back of ribs widen, pelvic floor soften.

• Exhale 6 — ribs narrow, pelvic floor gently lifts.

• 10–12 cycles. If you lose the rhythm, pause and reset.

Pro tip: Practice daily in pregnancy so it’s automatic in labor. If you’re postpartum, start here before adding load.

Signs to check in with a pelvic floor PT

• Leaking with cough, laugh, sneeze, running

• Pelvic heaviness or pressure

• Pain with intercourse

• Constipation or trouble fully emptying

• Unresolved back, hip, or SI pain

• Birth injury, tearing, or scar tenderness

About our guest

Dr. “Tia” Wallace, PT is a pelvic floor physical therapist based in Oakland. She practices in a collaborative birth collective serving pregnant and postpartum families.

Join the village

If this helped, share it with a friend. Borne is building a community where mothers and families can access education and tools rooted in holistic care and cultural nuance.

• Reply with questions for a follow-up Q&A with Dr. Tia

• Bay Area birth workers — want to connect with Tia’s collective? Reply “Oakland”

With love,
Lindsey

We went live to talk about fatherhood, advocacy and what it really means to show up for your partner through birth, postpartum and beyond. What followed was honest, a little silly, and full of gems I wish every expecting couple could hear.

If you missed it, catch the replay above, and below are some highlights from our conversation — Ask a Doula Anything: Daddy Edition.

And thank you , , and many others for tuning in live! Our next scheduled live will be on the topic of Matrescence with . Let us know what other topics you’d love to learn about in the comments below. ♥️

Recap

Birth as a Rite of Passage (2:00 – 3:00)

Nkrumah: “I’m very proud of the work that you’re doing with Borne… I really believe that if Black women and Black families are able to reclaim birth as a rite of passage and we’re able to do that outside of the conventional means, then it is an indication that we can do anything… when you think about building a future for our people, this is a vital part of that future — our ability to create life and to do it on our own terms.”

Lindsey: “…birth, pregnancy, postpartum… this is the foundation of our families, of our societies, and how we come into this world really does set the tone for what’s to come.”

Why All Doulas Aren’t Created Equal (9:00 – 10:35)

LF: “You were my doula in my first birth… and we hired a doula for our second and third… do you recommend hiring a doula outside of daddy or partner and why?”

NK: “Do I recommend? First of all, all doulas are not created equal. Don’t hire a bum… you’re better off fending for yourself. I believe that the role of the doula is a communal role… traditionally held by the sisters and the aunties in your community. But [now we have to hire everybody…] because we don’t have community in the same way anymore… and it is a very, very important piece. If you could imagine just the comfort of having a sister who has been through the process… it just makes a great deal of difference — particularly in a hospital setting — because when you’re dealing with an institution, you definitely need advocates to represent your interests.”

Birth Is Magic — Protect the Birth Space (11:40 – 14:45)

LF: “That’s actually a question I have — what does it look like to protect that [hospital] space during birth?”

NK: “First of all, I think one of the most important things that would empower women is to claim their power. When you’re about to have a child, this is your process, it’s your pregnancy, it’s your labor, it’s your birth experience…nobody is going to do it for you. It is something that must be done, that you have to do yourself. And thus, you should have everything the way that you want it.

Dad’s role [particularly in a hospital setting] is to advocate for the wishes and intentions of the mother while her mind is doing the work of bringing a baby to the earth. When you’re birthing in a hospital setting, [the staff is] going to try to guide the process in their interest, and dad’s role in that context is to say ‘no’ a lot, according to what mom has said that she wants. It’s very important to be clear about what your intentions are before you get in the midst of it, so that your advocates: your partner, your doula, whoever else is there with you, can hold the line.

So many things that are optional, are presented as though they’re required. And you have to have the presence of mind to say, ‘Nah.’ ‘Not right now.’”

LF: “What you’re speaking to, too, is education… [For a partner] to show up on game day and you didn’t do any of your due diligence, you don’t know what any of the procedures are, you don’t know what the process entails… you’re not going to feel like you can protect or you can speak up because you don’t know shit. So I think a big part of that is being engaged throughout the process, and dealing with your own fear and baggage.”

Home Birth: The Real Home Court Advantage (18:10 – 20:00)

LF: “What do you think about approaching a situation where the mother wants to birth out of hospital and father is like, hell no?”

NK: “Well, it goes back to the first thing I said, which is this is the mama’s birth. This is the mama’s pregnancy, so what she wants goes. Now, I would say if you have a misalignment like that, that is a sign of trouble. But at the end of the day, mama’s got to have it her way.

If there’s any debate about birth in hospital or birth at home, the answer is birth at home. I cannot advocate more strongly for that. We learn that they treat pregnancy like a sickness and they treat labor like a medical emergency when these are natural bodily functions. If there’s not illness or trauma, the best, flyest place you could be for this process is the place that you’re the most comfortable, which for most people is at home. And there’s like a hundred reasons why home is the preferred venue, but just to state it simply, it’s home court advantage. You will be the most comfortable there. And hey man, if something goes wrong, that’s what they got ambulances and cars for. Babies have been being born forever in a day, and most of the babies who have ever been born in the history of the world have not been born in hospitals.”

Know Your Rights — Hospital Policy Isn’t Law (20:00 – 24:45)

NK: “I heard a sister say that doctors are to Black women what police are to Black men. And the reason why I bring that up is because when you deal with the police, you have rights, but the police take advantage of your ignorance of the rules and your rights in that scenario. And the exact same thing happens in the hospital. That’s why I said before, they will present things that are options as if they are required, and they will insist on things that are optional as if they are required… as if they’re law.

I would say it’s irresponsible to birth in a hospital and not be up on policy and law where you live. You need to know what the policies of that hospital are. And you need to be prepared to articulate no in French, in Spanish… however many ways you need to be able to say no, you need to be able to stand on it.

An example is they love to hit you with the cervical checks: coming in, putting gloves on…and it’s like, wait a minute. I don’t think my wife wants to be fingered right now… she just wants to relax and do the work that she’s got to do to bring this baby.

So many things that are optional are presented like they are required. And because we got white coat syndrome, you just be like, ‘whatever you want,’ and it’s like, no. It’s irresponsible to deal with any institution and not know the laws and policies that govern your interaction with that institution.”

Don’t Follow the List — Seduce Your Partner (28:10 – 31:15)

LF: “Some providers will say you’re past your due date, here’s the list of things to do to induce labor… and it’s like, the point is not the checklist… the point is the intimacy, the space. They say the same conditions that made the baby are gonna get the baby out.”

NK: “When it’s time to get that baby out, you’re gonna have to seduce that woman… put the woman in a state of relaxation, safety, comfort and pleasure. The body is a pharmacy: one hormone creates a cascade and leads to the next… this opens up that, shifts and then boom, before you know it, we having a baby. It’s really the time to be trying to catch her again.

Why Everyone Is Sleeping on Postpartum (39:20 – 44:40)

LF: “What’s one thing you wish fathers knew more about or more fathers knew about postpartum?”

NK: “Man, I think everybody is sleeping on postpartum. Everyone’s conception and focus on having a baby is the labor part…and so once that is done and everybody’s healthy, it’s almost like all the support kind of just dissipates and it’s like, ‘okay, we did it.’ But, no.

LF: Now you are a family… or a new version of a family… and yeah, it begins.

NK: I would say that for a man, the postpartum period is a time for you to be a servant and a facilitator. You have to figure out how to make it so that this woman doesn’t have to do nothing but build a strong connection with this child. The baby has been in the womb — a part of the mother — and now is outside the mother and must develop that closeness, that anchor with mom.

And so as a father, you need to be taking as much obstruction out of the way as possible. If that is household obligations, do it. Pay for it to get done, call your sisters, call her sisters… Whatever. Get it done. Make sure mama gets some sleep. Because I think a great degree of the dysfunction that happens in postpartum… a lot of it is attributed to sleep deprivation.”

Legacy & Raising Children as Stewardship (47:00 – 49:25)

NK: “Men should not be having children if they don’t want children… these children need to be wanted and desired. I know we be desiring all kinds of stuff, but I desire to architect a family, and children are a very important part of that. And so, you know, my participation in this process and in this journey is not just about the interpersonal between me and you, it’s the service of a mission. Our family is a very powerful family…these children are investments and our service of them and my service of facilitating your process to bring them here is stewardship. And so it’s a values, and a perspective thing. It’s not about me ‘helping you out’ or me doing something nice for you… this is about taking responsibility for my family.”

Birth is not just a mother’s journey — it’s a family initiation. When fathers understand their power to protect, nurture and educate themselves, we all win.

If this conversation spoke to you, share it with a father, brother or friend who’s preparing to walk that road.

Families need more support than ever, and many of us are searching for ways to keep this work sustainable. Because opportunities and resources can feel scattered, we’ll keep pulling them together for you here. Explore what fits your practice or community, and share in the comments which opportunities (and where) would be most helpful to you!

United States

Baby Dove — Black Birth Equity Fund (U.S.)
Amount: Up to $1,300 toward doula services
Due: Entry Period 10 ends October 31, 2025

Provides grants directly to Black expectant mothers to cover doula care. Doulas can encourage clients to apply; funds are distributed via Players Philanthropy Fund. Limited number of awards each entry period.
Click to apply

California

Central California Alliance for Health — Doula Recruitment Program (CA: Mariposa, Merced, Monterey, San Benito, Santa Cruz)
Amount: Up to $65,000 + incentives
Due: Jan. 20, 2026

Covers first-year costs for doulas and organizations recruiting and credentialing for Medi-Cal. Once enrolled, reimbursement is available at up to 150% of the state fee-for-service rate.
Click to apply

Florida

Florida Blue Foundation — Maternal Health Grants (Florida)
Amount: $270,000 to $400,000 (over 3–4 years)
Due: October 6, 2025, 3pm ET

Supports nonprofit programs working to improve maternal health across the state. Appropriate for doula hubs, midwifery practices partnered with CBOs, and hospital-community collaborations.
Click to apply

Georgia

State of Hope — Georgia DFCS
Amount: $5,000–$10,000
Due: October 15, 2025, 11:30pm ET

Funds community projects focused on family strength and stability. Proposals can include maternal, postpartum and doula-centered supports.
Click to apply

Sister Song Birth Justice Care Fund (GA, NC, KY, FL)
Amount: Varies (client care reimbursements through the fund)
Due October 6, 2025 (prerequisites)

The Birth Justice Care Fund is building a roster of doulas, lactation consultants and maternal mental health therapists. To qualify, doulas must have attended at least 5 births by the deadline, lactation support pros must hold IBCLC/CLC/CBS certification, and therapists must be licensed in GA, NC, KY, or FL. Approved partners will be eligible to provide funded services through the program.
Click to apply

Maryland

Howard County RFP 06-2026 — Social Supports for Pregnant/Postpartum Individuals
Amount: Contract funding, amount varies
Opens: October 22, 2025

County funding for services that support pregnant and postpartum people considered high-risk. Open to community-based and provider organizations.
Click to apply

Missouri

The KC Doula Program — Family Scholarships (Kansas City, MO)
Amount: up to $6,000 per birth
Due: November 3, 2025

Scholarships covering prenatal, birth, and postpartum doula care for families in Kansas City. Families apply jointly with their chosen doula.
Click to apply

New York

New York State Medicaid — Doula Services Benefit (New York, statewide)
Amount: Fee-for-service and managed care reimbursement
Due: Ongoing enrollment

Open to doulas meeting training or experience criteria. Enrollment enables billing through managed care organizations for covered services, including up to eight perinatal visits and one labor and delivery encounter.
Click to enroll

Canada

McMaster Midwifery Research Centre — 2026 Midwifery Research Grant (Canada)
Amount: CA$25,000 - 30,000
Due: NOI Nov 15, 2025; Full app Jan 15, 2026

Supports midwifery-led research. Applicants submit a notice of intent, followed by a full application. Decisions announced April 1, 2026.
Click to apply

Doulas for Aboriginal Families Grant Program — BCAAFC (British Columbia)
Amount: up to CA$1,200 per pregnancy
Due: Ongoing

Provides funding for Indigenous families in BC to access doula care. Families apply with a doula; multiple service models are eligible.
Click to apply

In the Borne Manifesto, I spoke about moving beyond survival mode, into a reality where family-centered care is the default standard of care in birth. But some of you may be wondering, what even is family-centered care, and how is it different from “typical” care practices?

If you’re a birth worker, you’re likely intimately familiar with the midwifery and medical models of care — among others. I want to highlight a framework that doesn’t always get enough attention:

Family-Centered Care (FCC), Defined

Originally introduced in the context of pediatric care in the 1950s, family-centered care grew out of a movement to change the dehumanizing aspects of mid-20th-century hospital care.

At the time, parents were excluded from children’s care for fear of spreading infection. Children were often left alone in sterile, institutional settings. Research on the emotional trauma of separation — combined with advocacy from families and forward-thinking providers — began to change that. Over time, FCC gained wider adoption.

Key characteristics iinclude:

• Listening to families (respect & dignity)

• Facilitating choice (participation)

• Sharing accurate information (information sharing)

• Building confidence to participate in health care decision-making (collaboration)

While this all may sound pretty basic, Western medicine has long operated in a paternalistic, hierarchical model, based on “physician authority and passive patient acquiescence.” While this dynamic shifted significantly in the 1970s — following a series of scandals in medicine (unearthing of Nazi medical experiments during the Second World War and the Tuskegee Syphilis Study), as well as the civil rights and second-wave feminist movements — unfortunately the culture still reflects the seeds of hierarchy (and good ol’ fashioned patriarchy).

Far too often, today, patients’ and families’ voices are ignored, they’re excluded from the decision-making process, they experience coercion… or worse.

FCC in Maternal Health

To truly understand the importance of family-centered care in maternal health, we have to return to the history of midwifery in this country — a model that has always been family-centered, but was systematically erased with the rise of modern gynecology. This is a review for many of us, but it’s history that bears repeating, so that it’s never forgotten.

Midwifery in the U.S. has deep roots in Black and Indigenous communities, stretching back to the 17th century when enslaved African women — many already skilled in midwifery — were brought to the Americas. They carried knowledge of birth and healing that was passed down through generations.

The so-called “father of modern gynecology,” Dr. J. Marion Sims, built his reputation by leasing and experimenting on enslaved Black women in Alabama without anesthesia, beginning in 1844. As such, gynecology itself was founded on torture and chattel slavery. Given these origins, it begs the question: why do we continue to blindly trust OB-GYNs as the unquestioned authority over birth outcomes?

As late as 1900, nearly all women in the U.S. gave birth at home with midwives. That changed with the rise of privatized medicine and a targeted smear campaign that painted midwives as “unsanitary” or “superstitious.” Hospitals positioned themselves as the modern, respectable alternative — consolidating both power and profit. By 1940, only 44% of births were attended by midwives. By 1969, that number had dropped to just 1%, where it has hovered for decades.

The COVID-19 pandemic marked a turning point. Fear of hospital exposure and rising distrust of medical institutions led to a surge in home births across the U.S. — with Black women showing the sharpest increase. At the same time, birth workers — midwives, doulas, chiropractors, herbalists — have been stepping up to fill the gap, correcting miseducation and restoring a legacy of birthing in power.

Family-centered care in maternal health isn’t new. It’s ancestral. It’s rooted in midwifery. And it has always belonged to the people.

The Bridge

At Borne, we advocate for family-centered care not only because it reflects the midwifery model — which has always been rooted in listening, choice and collaboration — but because family-centered care applies even when a midwife isn’t in the room. Families deserve this level of respect whether they’re birthing at home or in a birth center with a midwife, or in a hospital with an OB-GYN.

The way we see it, FCC is the bridge. It humanizes hospital care, it reshapes OB-GYN practices, and it restores dignity — no matter the setting.

Roots of FCC in Maternity Care

One of the pioneers of family-centered maternity care was Celeste Phillips, RN, EdD. Beginning in the 1950s as well, she challenged practices that excluded fathers, separated babies, and medicated women without consent.

Her (then) radical philosophy: the childbearing experience belongs to the family, not the caregivers.

Phillips helped pioneer the single-room maternity care model, where families could labor, birth, recover and bond in one space. In her book Family-Centered Maternity Care (1994), she codified ten guiding principles that continue to shape practice today:

10 Principles of Family-Centered Maternity Care (Phillips, 1994)

1. Childbirth is wellness, not illness.

2. Care is personalized to each family’s needs.

3. Education prepares families for active participation.

4. Families make informed choices.

5. Partners and support people are included.

6. Family presence is encouraged during birth.

7. Continuity of space and caregivers is prioritized.

8. Mothers are primary caregivers for their infants.

9. Mother and baby are treated as a unit.

10. Parents remain involved in newborn care, even with high-risk babies.
    

The Vision

Imagine if every family in this country had access to this model. Imagine what it would mean not only for birth, but for postpartum, for parenting, for generations

Family-centered care isn’t just a model — it’s a shift in values. It says families belong at the center, not the margins. It says birth is not an isolated medical event, but a rite of passage that shapes generations.

At Borne, this is the vision we’re working toward: restoring trust, restoring dignity — restoring the village.

This week inThe Exchange, we explored what family-centered care — a foundational part of the Borne mission — really means in maternal health. One highlight I want to share here: the work of Celeste Phillips, RN, EdD — a pioneer of family-centered maternity care whose name I hadn’t heard until recently.

In the 1950s, she began challenging practices like excluding fathers, separating babies, and medicating women without consent. Her radical (for the time) philosophy was simple but profound: the childbearing experience belongs to the family, not the caregivers.

In 1994, she codified this vision into 10 principles of Family-Centered Maternity Care, including:

1. Childbirth is wellness, not illness.

2. Care is personalized to each family’s needs.

3. Education prepares families for active participation.

4. Families make informed choices.

5. Partners and support people are included.

6. Family presence is encouraged during birth.

7. Continuity of space and caregivers is prioritized.

8. Mothers are primary caregivers for their infants.

9. Mother and baby are treated as a unit.

10. Parents remain involved in newborn care, even with high-risk babies.

Imagine if this were the baseline for every family today.

You can watch the full conversation above and hear more about how these principles can reshape maternal care.

Until next time…

Around the world, cultures from Nigeria to China honor the postpartum period — the time immediately after birth — with 30–40 days of rest, nourishment and hands-on support for new mothers. In the U.S., dominant culture prioritizes productivity and promotes “snapping back,” overlooking a critical window for healing and bonding. It’s no wonder that approximately 1 in 7 mothers experience postpartum depression within a year of giving birth.

I know that, unfortunately, we all don’t have the luxury of time off or a big village — especially single parents or families who’ve just relocated. But for the sake of your own health and sanity, I encourage you to get creative: ask for help, plan ahead and build in rest however you can. Definitely don’t let pride stop you from getting what you need.

You just carried and birthed a whole human — you deserve care, too. Even if you feel “fine,” trust me: your body needs time to heal. Let this be a time of restoration, not performance.

After my two home births, my midwife’s guidance was one week in the bed, one week on the bed, one week around the bed. Many say five days each, and call it the 5-5-5 Postpartum Rule, but if you can take a week each, DO. IT.

The way I see it, postpartum is forever. You will be raising this human…forever. Take this first 40 days to pour back into yourself and set a strong foundation for the decades ahead. You’ll also be modeling self-care for that sweet baby of yours. 🥰

Support roles to line up before baby

Below is a (non-exhaustive) list of support roles you may consider coordinating before baby comes, to allow space for rest and healing. Talk this through with your partner, if applicable, so you enter postpartum with a plan aligned to your priorities, budget, time off and family structure.

Meal Support: someone to cook (or drop off) warm, nourishing meals — or organize a meal train. There are websites to help you remove the guesswork, and give out-of-town family and friends a simple way to care for you from afar. Preparing your own freezer meals before baby arrives is also a great option. And never underestimate the power of a well-stocked snack cart!

Childcare: a trusted person to care for any older children or help with school runs and activities, plus consider home life: meals, bedtime routines, etc. Please fight the urge to “do it all.” Invite your village to carry some of the load. Just be sure to make some time for extra snuggles.

Home Support: help with light housekeeping — laundry, dishes, tidying, trash, etc. This may look like hiring a housekeeper for a couple of weeks, or it may be asking a friend or family member to help out. Or simply your partner agreeing to a short list of things to take off your plate in those first few weeks. Planning for this ahead of time prevents you from lying in the bed silently cursing piles of laundry (or the %&?!”@/!!s who are not folding them).

Errands & Logistics: someone to run errands, pick up prescriptions or handle grocery runs (or consider using a delivery service). Again, plan with your partner or house mates ahead of time to see where some of your typical contributions can be redistributed.

Bodywork & Comfort: a designated friend, doula or healer to run herbal baths, help you set up a sitz bath, prep teas or offer gentle massage. This may feel “extra” at first, but that’s only because, sadly, our culture normalizes our pain and discomfort. If budget is an issue, call on a friend or consider adding a healing fund to your registry (prioritize this over the fancy gadget!)

Chiropractic Care or Acupuncture: both can help with pain relief, reduced inflammation, faster healing, stress reduction and so much more. This care can be game-changing through the pregnancy itself, and carried into postpartum. Pro tip: Look for a Webster-certified chiropractor, who’s trained on specific analysis and adjustment of the pelvis.

Emotional Support: a trusted listener or postpartum doula/therapist who checks in regularly. A safe emotional outlet can be a crucial lifeline during this period.

Postpartum Doula: if possible, we highly recommend hiring a professional to guide you in recovery, basic feeding and newborn care. Most will be able to support in a handful of the roles on this list.

Lactation Consultant: if you plan to breastfeed, their support can be game-changing — helping with latch, milk supply and any early challenges (read: less stress!).

The "No" Person: assign a friend or family member to be the gatekeeper. (You probably know the one). “No, we’re not taking visitors yet.” “No, we’re resting now.” “No” is a full sentence.
Pro tip: let family and friends know ahead of time that you’re limiting visits after baby arrives. When you’re ready, you’ll share photos or updates. If someone does visit, it should be to support your healing — whether that’s bringing food, folding laundry or holding the baby while you rest. No, you’re not being “difficult.”

These roles don’t have to be filled by separate people, of course, and they can be family members or people you hire. You know what’s best for your family. Just be intentional about planning — and clearly communicating — who will carry which pieces so you don’t have to.

If this list feels like a lot or you’re thinking, “I don’t have people,” you might be surprised. Ask anyway — and accept that it might not be perfect. Fill what gaps you can, and maybe just keep the laundry mound in a corner, out of your sight. It’s not about perfection, it’s about intention.

The point is: Prioritize rest and healing over everything.

And cherish that little newborn bubble. As the OGs say, “It goes fast.”

Quick planning checklist

• Choose your rest plan: 5-5-5 or 1-1-1 weeks

• Draft a visitor policy and pick your “No” person

• Set up a meal train or freezer-meal plan

• Assign chores: laundry, dishes, tidying, trash

• Line up childcare help and school runs

• Save contacts: postpartum doula, lactation consultant, therapist

• Gather comfort items: herbs, sitz bath, peri bottle, nipple balm, pads

• Book bodywork: masseuse, chiropractor, acupuncture

• Stock the snack cart and bedside water

• Post the plan on the fridge/in the group chat so your village can plug in

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