Episode 93: Midwifery Beyond Birth + Body Image With Aiyana Davison
Episode 93: Midwifery Beyond Birth + Body Image With Aiyana Davison
In this episode we sit down with.... Aiyana Davison.
Aiyana Davison (pronouns: she/her/hers) is a Certified Nurse Midwife and Women’s Health Nurse Practitioner-BC currently practicing in Southern California. A passionate professional, some of her most pressing priorities include: shedding light on and aiding to eradicate the inequalities that exist within healthcare, addressing the crisis that Black womxn (people) face in the U.S., the provision of quality care for all individuals and families, and the preservation of the legacy of Black midwives and birth work. With this in mind, Aiyana uses her business and social media platforms under the name The Vagina Chronicles to educate, engage, and create safe space for those interested in all things birth work, empowerment, and overall obstetric and gynecologic health. Aiyana has been featured on a wide variety of platforms including ESSENCE, Peanut, Elvie, Ovia Health, Mama Glow, and Black Mom’s Blog. Within her work, she encourages healing through sharing and vocalizing stories (as opposed to the long-standing historical traumatic secrecy) to aid with the advancement and success of vulnerable communities.
In this conversation we talk about:
Aiyana’s personal body image story- experiencing shame at a young age and her journey of unlearning
The role of a midwife and the differences of working with one
Hospitals and spaces not being designed for the black community.
How Vagina Chronicles is playing a role in destroying the secrecy of women's health
Steps to take to help create accessibility in women's health for BIPOC
Connect with me...
Twitter: @thevagchronicle
Website: thevaginachronicles.org
Resources we mention in this episode:
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TRANSCRIPTION
Episode 93: Midwifery Beyond Birth + Body Image With Aiyana Davison
Katelyn:
Okay. Aiyana Davison, welcome to the show. I'm so happy you're here.
Aiyana:
Thank you for having me. Glad to be here.
Katelyn:
Yeah, really I have no expectations for this conversation and a million questions to ask you and can't wait to get to know you. So let's just dive into your body image story. So the first question that we ask everybody is your first body awareness moment. So what did that look like for you- that one moment where you realized I'm in a body and apparently, this means something in the world that I'm living in? What did that look like for you? And also, how did that moment shape your relationship with yourself- with your body image and with food moving forward? What's your story?
Aiyana:
Yeah. So um, actually, I have like three tiny stories or pivotal points early on that come to mind. The first one is a story that's told to me by my mother. I think I was probably about three or four, and getting ready for bath time. And she was like, you know, getting ready to help me take clothes off. And she did it. And then I told her, like, no, wait, I can do it myself. So I proceeded to put all my clothes back on, and then took them off again, just to show that I could do this and get in the tub and take care of my own self. The second story is, let me try to remember here. So I was part of an after school program. And, you know, we would go swimming, it was through the YMCA, I'm definitely like a product of the YMCA growing up. And so when I would go to the after school program, we'd go swimming. And then of course, you know, we need to come out of our suits afterwards. So I must have been probably nine or 10. And I remember my mom coming to pick me up one time, and we were getting out of the swim classes late. So she came into the locker room. And I think all my little friends and myself, we were all getting dressed or changing in the same changing area, you know, these are people that I see on a daily basis. And so when we got to the car, when we got home, the conversation was like, you know, you need to kind of get dressed and change in a separate, changing area, because your body is private, like, no one else should really be looking at it. You also know, like, people shouldn't touch you inappropriately, that's the kind of conversation that we were having. And nothing at the time was happening in the changing room. But I think my mom just realized, like, there's so many of us together, which in my mind as a kid that was creating a safe place, right? Because you're with your friends who you know, and you trust them as a kid. And you're putting these clothes on and taking them off in front of people who are safe, as opposed to like being by yourself where someone could bust in. But you know, because that's my parent, I'm listening to them telling me you know, be private, be private. So that's shaped me a lot now. Because it's not until like the last several years that I feel free enough to like share parts of my body. So even when changing in front of friends, I'm also an only child. So that's a big thing too. So like changing in front of friends, if we're on a trip or vacation, it used to be a really big deal, like, whereas others are maybe more open in terms of changing in front of people. Privacy is always in my head. And I think that's where that stems from.The third and probably most pivotal time where I realized my body, I'm in a body and that this means something and going a step further to say like this means something to the rest of the world and how they view my body is kind of an unfortunate one. And this definitely shaped like my relationship, probably with food and judgment from others. I went to church regularly and one of the members of the Church of someone who was expected to be close family said to me.. well, probably should back backtrack a little bit- out of the people that I are the girls that I hung out with growing up on the church side, I was probably what would appear to be the more heavier set of them. However, looking back at photos, they were just really very, very skinny. And so when I look back now I'm like I looked average, I looked okay, like I didn't appear to be overweight, you know. And that was never something that I was aware about before until this conversation. So this parent, one of my friends' mothers said to me, Well, you know we're trying to figure out how x y&z should gain a little bit more weight. And which now in retrospect, now I hear what I was seeing, which was this skinny versus bigger difference. And so she said, we're trying to figure out how she can gain more weight. And I think that I'm paraphrasing, I think she said next, she was like, Well, what do you do? What are you eating that makes you so much bigger? And so at that time, I didn't want to answer the question. But in my growing up, you know, as someone who's an elder, you answer their question, someone who's older than you, someone who is like, who could take care of you, you answer their question, even if you're uncomfortable. I think that's a lot of how many children in many of our generation operated. And so I was very uncomfortable. And I felt like, well, that's all you see. And so from there, from that point on, I was probably middle school aged or if not, maybe elementary school age, I don't remember the exact age. But I remember feeling like I was always the biggest one of the group. And again, like looking back at these things, when I look at photos from back then, I realized that I'm really not any much bigger than my friends or, or the average child that age, if you will. It just was a comparative between the group. But I think that moment made me realize I'm in a body that causes attention. And not that I had a problem with attention. But it was negative attention. Like I wasn't, I was fat, and I wasn't eating healthy enough, or the things that I was doing to my body lent to me, looking this way. So that's one of the most pivotal times of those three things, and I think of it as independence, privacy, and then shame. And that's kind of like the basis of my relationship with my body. And I thought about doing a lot, and I'm still working on quite a bit to unlearn some of the things that were taught in those lessons.
Katelyn:
Wow. Those are three really impressionable pillars. And they're so different from one another too. It's interesting that you said independence, privacy and shame, because I was thinking in my mind as you're sharing all of this, the independence I had this, the word expression, like just full expression, like, this is me, I don't need you, Mom, this is my body, I'm okay, which it sounds more independent than expressed, maybe it's one of the same. But and then yeah, that need to cover up that privacy and also, just the fear within privacy that I really am hearing in your story to have just censoring yourself not necessarily from like this purity standpoint, but more like we need to be safe, like my body is it's at risk in some way from being violated. And I have my own experience with that I can really relate to- just that low grade anxiety that is kind of put on us by way of needing to feel safe all the time. It's kind of like the messages that we're taught when we're kids like don't go up to the car, you know, if somebody rolls down the window, or don't open the door if somebody knocks or rings the doorbell just like, all of these messages when your brain is forming at such an impressionable age that you have to try to remember that are really fear based. And then also that shame that you're experiencing in the third pillar of your story. It's so foundational. So how did that shape your middle school years, High School, young adulthood? What are some memories of your relationship with your body that really stand out? Or is there anything that kind of captures just that journey that led you to where you're at right now?
Aiyana:
Yeah, so for most of middle school and probably most of high school- I grew up on the East Coast, Massachusetts, so we're, we're fluctuating through seasons so the summer is hot, hot, like humid hot. So 80 degrees feels like 100 and you're sweating and then you know very cold winters which was fine. Well not fine but all bundled up and you got all these layers. The falls are cool. The spring is just perfect most of the time with a little bit of rain, so we really did go through the seasons just to paint a picture. But to say all that, from middle school to high school, I don't remember a time where I didn't wear a jacket, to school, whether it's hot, cold, I had this one jacket. So I'd put on my clothes, I'd have jeans and a T-shirt on, and I'd still have a jacket over and it would be 80 degrees outside. And that's where the shame was there, I probably couldn't have identified it then. But like, um, I think that more so the last story that I told about how someone else viewed my body is what shaped me the rest of the time, like I wanted to be covered up, I didn't want necessarily for my body. I wasn't into showing curves, anything like that. Meanwhile, at home, like our family, we were definitely on the more voluptuous side. And so like, my mom would comment on my, my bottom and my hips and my thighs, and not in a bad way. But internally, I think, you know, I thought it was a wrong thing. But it was like, Okay, someone else can see my body. But this is also a safer place. So it's okay here, but I know that I'm taking that piece of information. And that's got to be a body part that gets covered. Even in summers, I mentioned the YMCA, I was a camp counselor there for years. And so when we'd be out with the kids, I would wear these really, really long shorts, like I'd have shorts or like Capris on, I wasn't into the short shorts, my arms wouldn't be out. Again, that jacket, if it was too hot. I think by that time, in high school and into college as a camp counselor that I would usually, you know, remove the jacket, but it will be tied around my waist. So I had this crutch. And it really wasn't until probably mid to late 20s and early 30s that I really began to quote unquote, show off my body or show more parts than I was when I was previously. So it really did shape me. And then what's funny, or not maybe not funny, I don't come from this fabulous lifestyle. My mom was a single mom and raised me after the age of seven. She went from like a six figure salary to being out of work. And we were able to somehow still keep the house and she was still able to feed me. Between us, we used to have like a little game, where or I guess we made it into a game, where sometimes we look in the fridge and it will be like we compare it to our different churches ever since because there's different churches we go to. And so like when it's a fuller day, we would compare it to the larger church where churches are full, there's lots of people. So when the fridge was full, we'd be like it looks like this. And then when the fridge is empty, we'd compare it to like maybe a smaller church where there's less people there. Maybe a different night of the week where they're having church, and so not many people are there. And I say all that to say like, despite the mindset that whoever this woman was who talked to me about my size, or gave me this outlook on my, my body. I wasn't eating a whole lot like, and it wasn't like I was binge eating or you know, had the opportunity to eat a whole lot all the time I was given. And those are usually pretty good portions. We never went without food. But we did have like, you know, kind of a rough and challenging time in my childhood. But I don't remember it being sad or depressing. I just remember it being one where we do things like we would make up games to, kind of, I guess, soothe what could be traumatic.So my relationship with food, probably. It's something that again, I think is an ongoing process. I'm still working on that. But for me, I wasn't always eating often. And what she said didn't really affect me in terms of like, oh, I can eat this and that, but my body itself. That was just always I think in my head on a daily basis. Like people can see your body and there's a potential for them to say something. And so if I cover this up, then they can't really comment because they won't be able to see. And I think that was my safety net. Like I said a crutch for most of my middle school and high school years.
Katelyn:
Mm hmm. Yeah, I really get that triangle avoidance tactic that you're pursuing. If I'm covered up, then I can avoid any possibility of shame or judgment around my body. I think it's so interesting how our minds work in that way, and how we adapt these safety measures for ourselves that keep us feeling that way. And it really does sound like your jacket was your security blanket. Were you talking about this with anybody- about your feelings with your body? Like your group of friends growing up- were you having conversations? Were you talking to your mom about some of these feelings that you were experiencing? Or were you kind of just internalizing everything?
Aiyana:
I think for the most part, I was internalizing quite a bit. However, this story, my mom only, like recently, found out and her response was like, I wish you had told me. And then also, I wish you knew you had permission to speak up at that time, because if anyone is offending you, or you feel threatened, you should be able to speak up about that type of thing. And so I think she was really hurt. Because she didn't know that this is what had been said. And then I think she saw the cascade of how it truly impacted me and seeing my own self. And you know, I think it came up sooner. Not in a joking way. But I'm like, Well, you know, this person said this to me, when I was growing up. And like, that really made a huge impact. I think it actually came off of one of the photos again, from childhood, looking back, and I think I said out loud to her. Wow, like, I really wasn't what I thought I was in my head, which was this bigger person, and not that there's anything wrong with, you know, how we hold our weight. But I think that in my mind, I was there was no being there was no being great. And in what she was saying to me. I don't know if that makes sense. So it was like, whatever I was doing. wasn't quite enough, in a way. But again, I didn't have this conversation with my mom, I remember with my friends, we did kind of, you know, we talked about different things, and weight was one of them. And I don't think it was what we really dwelled on because, to be to be honest, the friendships I had as a kid- a lot of them were really, like, in my mind a little more mature, we were talking about things that although I guess this would be a mature point, but I think we're thinking about things that weren't our bodies were were mostly laughing it up and, you know, talking about how ready we were for college and, and, and different experiences and relating in terms of like our our upbringing. I think those were the conversations we were having, but I didn't really, I don't think I really expressed how I felt about that particular story. But it's something that I will never forget, I remember where it happened, how I felt, I remember being short, much shorter than the person who was talking to me. So I know I was younger. And I remember, like the feeling I felt at that time.
Katelyn:
Yotally, those moments are so pivotal. And they really do bring up all of these emotions when we reflect on them. Was that the only one for you? Was it the experience that you were trying to avoid? Or did you have any other instances in your adolescence and young adulthood where there were explicit comments made about your body that just kind of reinforced the desire to cover up even more?
Aiyana:
Hmm, um, like I said, you know, the, the family part of things, but I never at right now, I don't feel as if, or believe that I took it as a you know, as a, you know, a negative comment about my body. We again, from my mom's side of the family, we are definitely well endowed in the chest and in the bottom. And so I fit quite well into our group here. And I'm just trying to think of like anything else that would have really made an impact. I think I really did take that thought, though, that that first conversation or that the conversation with someone who wasn't a family member, and just kept going with that.
Katelyn:
Yeah, that's what it sounds like I was just curious. And I also really understand what you mean- those passive conversations, especially in our families, and just our friend groups, where we just have normalized body talk to like a really unhealthy degree in our culture, just using even those innocent conversations to reinforce the shame and to give fuel to the fire of wanting to cover up even more, even if it's not directed to us in a, in a derogatory way, or like a, you know, Ill intentioned way or something, anything like that. So, Aiyana you mentioned that you are still working on your relationship with food. What does that mean? When did you even begin to come into a place in your life where you realized you had a relationship with food? You had language for that, and that it was a relationship that you wanted to work on?
Aiyana:
Oh, um, that's a good question. I think things were very routine, again, growing up, and of course, when I went away to school, and so when I went away, it's like, you begin to make decisions for yourself. And there are consequences to them whether or not you believe that they're there. So, you know, making the decision to actually get up and go and get breakfast at, you know, at the cafeteria, where I went to school, or getting lunch or dinner. And of course, again, I think for most people in their 20s, it may not be as this is generally speaking, because for some it is more than others, but it may not be the four first thing in our minds, like healthy nutrition, or thinking about how, how you respond to things and this food involved. So I definitely have been at times what's called an emotional eater, depending on a conversation. And so I think that probably outside of undergrad, and maybe even around 2007-2008, is when I actually was intentional about making sure that I began to eat well. And what I was consuming, looking at taking a look into that. Recognizing that it plays a really big part in how I feel. But also, knowing that sometimes how I feel it, I want to eat something because of that. Like that, vice versa, kind of relationship there. And then definitely when I finished nursing school, weight was, you know, heavy on my mind. And I would say, you know, of course, stemming from childhood weight was on my mind as well. So it was like, Oh, I gotta lose this weight. And that became a different conversation.
Katelyn:
How so?
Aiyana:
I think because I was beginning to not like how certain parts of me looked or how I looked in certain clothes. And it could be that I could have changed the clothes. But I was like, No, I also want to feel better, too. And so that's when I kind of entered a little bit of the dieting world. And went on a weight loss program. They're not in business anymore. And was eating like these bars and stuff. And it just was like, Okay, this is not working for me. Yeah, because I wasn't seeing much change. And then there wasn't a lot of accountability either. And I needed that. And then I actually came across a friend who was working with a trainer. And this is when I began to see a pivotal shift in my body and the things that it could do. First time working with a trainer, she didn't even focus on nutrition at first, she just like just let's get in here, we're going to do these workouts are going to be hard, but you can do it. And like immediately her first thing was like you're so strong, like your body can really move a lot of weight. Like when it comes to lifting. She's like you're not gonna have any problems. And then when it came to cardio, it was like that was my least favorite thing to do. And so she's like, but you got to incorporate it. And so we do a little bit of both. And I saw this massive shift in not just how I look but how I felt and this feeling, the strength that she was talking about, you know, and then she was like, Okay, well now let's talk about the nutrition so I started to clean that up too. And again, felt good moving. Meanwhile, I was able to do my first 5k, I hated running, and did that with her help, and then kind of got back into this rut again, after I stopped training with her. So definitely, I am definitely a person who during high stress my body and the cortisol, I definitely retain a lot of fluid. And I noticed that and that impacts how I move, and why that's important. I know we're going all over the place, or at least I am. Why that's important is in the work that I do, especially as midwife, we have to be able to move and move well, I mean, you can, you can do a lot of things, but without being able to move, but it's important because if someone wants to get in a certain position for birth and labor, I need to be able to either squat, bend the knees, you know, be on the floor, and you're waiting, like there's a lot of waiting in those positions. And I know right now, it doesn't feel good in some of those positions. But to go back to your initial question about food and relationship and what it all means, I think, again, it probably wasn't until after undergrad that I really started paying attention to how I was eating, and what was going into my body. And at least acknowledging that when I felt a certain way that I would go to food as a comfort.
Katelyn:
Interesting. Yeah, it is really interesting. And also, I think it's, I can't wait to get into what you do now as a midwife. But how incredible having this really amazing story about your body that has brought you to this place where your body has a completely different meaning at this point in your life, how your relationship with your body, and you know how you treat her, because it really emphasizes the work that you do today. And I know that ties in really greatly to your passion and your purpose and your why in this world it sounds like so I really hear all of that. When did you get to a place in your life where you started feeling more comfortable in your skin where you kind of ditched the sweater that you were holding on to for the earlier years in your life?
Aiyana:
Mmm hmm. Am I even there yet? Um, I would say honestly. Probably like, again, late 20s, early 30s becoming more competent and realizing like, Hey, these are certain parts of my body that I actually love. And that I actually like, and it feels good here like this, this part of my skin feels good. I'm probably late 20s, early 30s. Recognizing that people are going to have their opinions about my body. And I can either choose to let that impact me. Or even make it matter. Like because honestly, it doesn't matter. Really, what, what, what we think of ourselves. But also we're very human and validated as part of humanity too. So I think, yeah, and the 20s, early 30s, I really was beginning to change mindsets, I still have quite a bit of struggle. But what I've been working on the last couple of years is like if it doesn't feel good, or doesn't feel like it's, it's going to serve me then I have to let it go. I can't walk into that. So other people, other people's perceptions of me, I have to let that go.
Katelyn:
Yes. Like creating that boundary, realizing that it's not your responsibility to control how other people feel about you. That's been huge for me too. And also, I just want to pause for a moment in your story and really emphasize where you are today. And the fact that this is the journey, you're still on, the journey we all are. And I think sometimes when we have conversations like this, about our body image, and about our relationship with food, there's this expectation that there has to be an ending to the conversation. And really, this is just the chapter that you're in with your life. I really appreciate you being so vulnerable with where you've come from and where you are today and how that ties into where you're going in the future. It's so important to emphasize this because so often we feel like we're not doing it right, or we're not doing enough or where, you know, that shame is creeping in around not having it all together or not figuring it out. And really, it's just giving yourself that space and the permission to take it a step at a time. Continue learning. Continue evolving this relationship with yourself, which is really beautiful.
Aiyana:
Yeah, there's definitely no final destination. And it's, it's like, I mean, at some point, you know, we're, we're not, we're not going to leave forever. But there's no final destination to this. But also, what I've learned too, is like weight loss, because that was so central in my life for a long time, that cannot be like my everyday ins and outs, it cannot be my all. Because I think for me, I was becoming so consumed by it, that nothing else mattered. And then that means that something somewhere else is going to suffer. And so, really, it is like appreciating the body as it is for me right now. And what it can do for me and being happy with that. And then also, I've been saying a lot lately, like I've been writing out like affirmations and things that I want to manifest and it's like, well, I, I have the body that will sustain me for the work that I need to do. And then I am treating it well, in order to continue to do the work. And so that's been really pivotal for me, within the last year, especially. And then to like thinking about, like, the body shaming part, or people's judgement, you know, that's a projection of something that's going on with inside of them, yes, a million exclamation point. It is, and then even even, even this conversation that seems so like foundational for how I would walk into my adulthood, and walk into walk through, you know, through my childhood with this person's thoughts on my body, you know, their anxieties over what they need to do for themselves, again, came out in through their mouth onto me, and was a projection of something that they were dealing with. But as a child, I know none of this, I, I hear what I hear, and you take that to be truth. And so now it is unlearning. And also reimagining what my life looks like so that I feel good, and not just not just in my body, but in my mind and my spirit and all those different aspects. Oh, it's continuous. It doesn't ever stop.
Katelyn:
Yeah, it's continuous. And I think it's so powerful. The intention that you've reset for yourself, and how you are committed to having this relationship with your body and letting go of the, you know, really deeply ingrained beliefs around changing, changing your body weight loss, and what that's tied to, you know, that shame, that security, that fear, that safety, all of these things that are so deeply, deeply ingrained in, it sounds like your story, but for so many of us, most of us, and letting that go. And like you're mentioning, reimagining what it means today, it's just, it's, it's really important, and it changes everything. Like, you know, there's not an end to this journey. But damn things get a lot more fun in life to render and we don't have to suffocate our mind with these, these shaming body thoughts all of the time. Right? Yeah, for sure. So tell us about the work that you do today. Let's go into the here and now and also your vision too. So you're a midwife and we've never had a conversation about as you corrected me for everyone listening? I said midwifery and Aiyana corrected me. And thank you for doing that. So how did you even get into this line of work? What got you inspired in the first place? And what's this part of your chapter of your story?
Aiyana:
Yeah, um, I love the work that I do. Um, and basically, growing up, the vision for me was being able to help other people that was like, what was super important to me. So it was like, Well, what, what area of or what kind of career could I have? That would help folks? Not necessarily realizing that midwifery truly, truly looks at a lot of the folks that do it, it really is like a calling. Like, it really does speak to you. I, you know, I'd firmly believe that but but basically, I had my mind set on becoming a doctor and specifically an OBGYN and went through quite a few steps to get there. And it just was not happening the way that I anticipated it would. But I was also talking about childhood. I was also very much interested in thrilled by things like science, like we learned about the heart, that was huge for me, and I was like, Oh my gosh, look how these valves are working, and the blood is flowing and like, what the heart does to get blood all over to the body. And I'm just fascinated by that. And then I clearly remember watching a video, and I can't recall if it was like our sex ed class or like we had gone to like the children's museum somewhere. And they ended up like, or some museum or some, some kind of showing where they had they had someone who was actually birthing her baby on video, and while everyone else was great grace that I was like, Look, there's a baby and like, this is the most amazing thing as kind of weird for not weird, but I think I'm kind of kind of an outlier. For the children who were around my age at that time. But um, but yeah, I thought it was going to be an OB GYN not to downplay it, but I'm thankful I'm not that's not where my passion lies. My passion lies within the world of birth, as it pertains to like the physiological, the holistic. And that's what midwifery is about. And so much more we also offer whole person care, and whole family care. But most folks know us to be out in the homes helping people have their babies at home or outside of the hospital as a portion of it actually practice in a hospital setting. So midwives do private practice in hospital settings to depending on state regulation, but we provide work we're healthcare providers, you know, you can come to see us for your annual pap you can or not annual but your scheduled pap routine pap, you can come to visit us for of course STD counseling and protection and treatment. You can come see us for irregular periods or bleeding management menopause. I can place an IUD I can place an excellent one if people want that.
Katelyn:
Yeah, wild. I didn't know any of this. I had no idea that a midwife offered all of these services. So, where do you go to get all these services? Are you located in a hospital? Or is it separate from the hospital industry? Are you a standalone clinic? What are the steps?
Aiyana:
So it really depends. My work is a really broad umbrella term for because there's a few different routes in which it can go. So I'm a certified nurse midwife at CNM. And basically, I have a registered nursing background. So I went to school to become an RN or nurse and worked as a nurse for a little while and then went back for Master's level education in women's health, nursing women's health. And that's what affords me the certification in midwifery because of that training. So if you think of like a nurse practitioner, I'm we're we're pretty much on that same level. They also call them advanced practice providers. Some people train for midwifery and have no nursing background, those are usually Certified Professional midwives or licensed midwives or licensed professional midwives. And they don't have to necessarily go through registered nursing training. They do need a little bit of background in science, but there's an apprenticeship that happens so they follow someone who is already practicing as a licensed midwife. And they get their training there. They still have to take boards and a certification in order to practice. You will not find them in the hospital. certified midwife that's a different type of midwife as well. They can practice in certain states in the hospital, but the CPMs LM they do not practice in the hospital. They're skilled at out of hospital birth, as well as the other things we talked about. So yeah, so our Our training covers quite a bit. And how do people go about finding them? Well, depending on the hospital, some hospitals employ wives and the hospital I work at does, and we're actually one of the largest employers of midwives nationally. I believe and That just means when you go in, you can or depending on your insurance, you can ask if, you know if there's a midwife that works in the hospital, you can also seek them out, because midwives who do practice out of the hospital can also some of them will take insurance, depending on what what state they're in and what their coverage is like. Some of them will take out cash, or just cash only pay. It just depends. But we do offer all these services for folks. And I think, I think I'm working hard to try to, like let people know like, hey, it's not not just even though these are great things. It's not just birth and babies, it really is like full, what they call Well, woman care. But I love to say, well, people care.
Katelyn:
So why would somebody hire a midwife over going with just a certified nurse practitioner? Let's just use me, for example- I'm not pregnant right now. But let's say that I was, and I was at a place in my life where I had to make this decision. What's the difference between working with a midwife versus just the traditional hospital or nursing route?
Aiyana:
Yeah. So it really depends on your goals and expectations and your desires for birth and pregnancy in your care. A lot of care as you might, many listeners might very well know, care in certain areas is very rushed. It's very demanding. It's very patient blaming, as opposed to patient shared decision making. And I believe midwifery truly offers a different perspective, a holistic and physiologic perspective into health care. For folks who are looking for someone who's going to take their time, explain things, be vigilant about what's happening. For example, most folks who choose an out of home, or out of hospital birth, or birth center birth, they're gonna spend an hour with their midwife at each visit. So, whereas you might spend 15 to 20 minutes with me, as a midwife, I know that sounds crazy, but you might spend 15-20 minutes with me in the hospital setting. And I tell my patients, especially the ones who look for me, I'm like, Hey, I might run a little bit late, but like, just know that all your questions are going to get answered as much as I can. If I could spend an hour with each patient in the hospital setting, I would, but just the numbers don't afford us that opportunity. But midwifery care outside of the hospital and even within the hospital, I think it just lends an extra touch of compassion. And I'm not saying that doctors can't be compassionate people working in the hospital can't be compassionate. But in a world where so we're so focused on rushing and getting to the next thing, and parenting and family and building or not family building, you know, family prevention, if you will, is is something that people need to take their time with, I think midwives offer a lot of the answer to that. So we take our time, we're thorough, we provide as one of the midwives like I look up to, she says, we provide exceptional care. And I truly believe that, for the most part we are, we're intentional about making sure you feel like you've made decisions that work best for you, with the given information that we have. Not everybody, I want to make it really clear, not everybody can have a home birth, like that. It just, it's just not. That's just not realistic. Honestly, there are some people who want it and they try it because they're able to, and may end up in the hospital and that's completely fine. There are some people who, who what we call risk out meaning they maybe have another condition that we cannot, you know, safely perform a home birth. And then there's others who just, you know, for pain management purposes really just want to go to the hospital, because you can't get an epidural at home. That's not that's not gonna happen. And that's completely fine. Like, I want folks to know that too. Like, I support the bottom line of midwifery care is just to support people at every angle, and whatever walk of life they're going through. And so that's really important for me to get across because midwifery doesn't mean like I just serve this one population x y&z It means I'm, I'm helping people at any point in any stage, however best I can for them, again, to make the best decision that works for them in their healthcare.
Katelyn:
And just to be clear, you can support your clients in the hospital too, right? It's not just homebirths- your clients can deliver in the hospital and you'll be a part of that delivery process and whatnot. Right?
Aiyana:
Right. Yeah. The other day, I think, and it's so funny to me, because I've been doing this for quite a little while but it's like a new thing for certain people, but Um, you know, I think it was like a family member who was in the room where this patient was being evaluated for birth. And they were like, so once you come in, like, when do we call the doctor and I was like, we're not calling the doctor, there's no need to.
Katelyn:
I'm glad that you're sharing this example, because I was just about to ask that. So there is no need for a doctor when you are with your patients or clients, because you're delivering the baby for them, right?
Aiyana:
In most cases, yes. Like, if this is a, I hate to use a term normal, but if there's no complications, there's nothing else happening. There's no need for what we call co management, where I'm also managing things with another physician there than I will be. It's just me, you know, and really, what that means is, it's you because like, if you want to, like if you want to grab your baby, as it's crowning and coming out, do it. Like, it's we're, you know, we're all about giving birth back to people, because I think it's been taken away like that power behind it. We don't realize how powerful our bodies are, and how powerful our minds are. And I think part of the job of a midwife is to, you know, remind folks that they have this power, that they have this dynamic ability to birth the baby and also, like, sustain life and create a family. We also have this ability to not create, like, like, that's also part of my job. Part of my job is if someone doesn't want a child, like we talked about that, like, that's part of it, too, but But yes, to answer your question, yes, I practice in hospital not for long, but I practice in hospital and, and people come to see me and yet that's it. It's me. Yeah. To call the doctor in for something specific. It's just me.
Katelyn:
It sounds like you're a therapist and a doctor, like an angel all in one. Do you typically work with the same- do you refer to the people that you support as clients or patients?
Aiyana:
I go back and forth between them, you'll hear me say clients, patients prefer family. Just whatever, I think best suits or or however best the person feels comfortable. But then also like, what feels right at the time too, you know.
Katelyn:
Well for purposes of this conversation I'm glad that we're distinguishing because I actually was genuinely curious how you actually make that distinction. But do you support yours, we'll call them patients in a multifaceted way? For example, do you tend to work with the same patients over birth control or some of the other services that you offer as well as birth delivery? Or do they kind of go in and out and compartmentalize the services that you offer? What's the typical trajectory for working with somebody?
Aiyana:
It's a little mix of both. Um, recently, I've had a resurgence of like, what I call repeat customers, and then people just looking because of social media, people just looking for me, and they're like, I found you. And so like, now I'm your patient. I'm like, Great, let's do it. But um, recently, I've had a lot of when I say repeat customers, so like, we've we've, we they've already had a pregnancy before. And so they're coming back pregnant again. And so like, here we are again. But once they've had their baby, and if their plan is to have more, I will also like, you know, do their pap smears or birth control management, they usually are trying to come back to me to see me. And I think that just speaks to the level of care provide not to like toot my own horn, but...
Katelyn:
No, totally well. So for everybody who is not familiar with you, Aiyana is kind of a celebrity midwife.
Aiyana:
Midwife, just regular.
Katelyn:
You're a celebrity midwife, and I'm dying to know how you even created this platform for yourself, because I want everybody to check out your website and your social media channels and all these things, because there is so much content that I am just craving diving into from the conversation. But what even prompted you to start this educational platform? And also just your passion for educating people on the social justice aspects of midwifery as well, too? How did you link the two together? I know as you and I talked about before, they really can't be unlinked. But what brought you to the work that you do today from this educational component?
Aiyana:
Yeah, so early in my midwifery career, I'd been a midwife for about for over five years now. And early in my career, I was finding like this, I felt this sense of like, I've lost my voice. Because it's such a huge change. I went from being an RN, where I could, you know, I could have a few patients and one night, and then the shift is over. And that's it to a huge, you know, this huge role change where I'm a provider, and I'm, I have to consistently watch over these groups of people who have trusted me with their care. So like, I'm looking at their labs and then following up with them, and then bringing them back in six months later, or a year or several months for follow up, or, like, I've got to call them back because of this result, or, you know, so it's the experience is really huge shift. And the initial place I started working was a very, very busy teaching hospital practice. So it was, on average, in a 12 hour shift, because we do some shift work. I could be at the birth of six to seven babies that was common, like that was very common. And that's, that's quite a bit like, whereas someone who maybe does home birth might have six or seven births in a month. I was having that like in a day. So I would come home and literally sit down and like probably the first time I'm eating is at the end of the day. Wow. Yeah, so talk about body image shifting, like in the first year, I probably gained about 50 pounds. Again, I mentioned cortisol, all that stuff, like stress. But coming back to it. So I, in the first few years, just felt like I wasn't myself. And that's somebody who is verbal about what's happening, wanting to share information, wanting to educate, wanting to make sure people understand. And I went to go see the California African American Museum, they did a screening of death by delivery, which talks about the maternal, the black maternal morbidity and mortality rates, which if people don't know, black women are three to four times more likely to die during pregnancy, childbirth, and shortly thereafter, three to four times more likely to die than white counterparts. In certain states, that number sometimes doubles or goes up quite a bit like in New York, it was about 12 times more. Georgia, I want to say they also had higher numbers. So it depends on where you are. But I went to go see the screening with a good friend of mine who actually is now a doula. And I can explain the difference about that in a minute. But um, she's a doula. And we went there, and it was like, they had made mention of something and I spoke up to say, like, you know, like be basically to say, like, we're here as midwives, we're in the hospital, we're in these spaces. It's just like people are not, they're not aware that we're around as midwives. And that was like the first time I really felt like I was walking in my truth as a midwife. And so out of that blossom, the vagina Chronicles, which was like I had been joking about it for a while, like, my life is the vagina Chronicles because there's, like, I can't go anywhere. If someone knows you're a midwife, we're in the birth work field, like you can't go anywhere without hearing either their birth story, or friend's birth story or birth story story that they attended, or something in lines or regards to pleasure and sex, and I have no qualms about it, like, I will get into it. Like wherever I am. no qualms about it. But um, but out of that, after that time, death by delivery, it was like, You know what people need to know, like, we're here, people might not only need to know that midwives are here, but there are black midwives who do serve their community. And we're in the business to, again, provide that exceptional care. Not that we're going to save anybody, but that, at least we can offer some of these safe spaces where our people can feel a little bit more protected than they do, you know, going into larger hospitals and institutionalized patient places that weren't designed for them. So it blossomed from there, I really had no intentions of getting to where it is now. But I've just been my most genuine self and like so. So people ask me all the time, like, well, what got you here is like I was being myself. So if I woke up in the morning, I thought I was sharing it in my stories. If, if I had a thought about something where I felt like you know, I'm seeing a lot of this, like I'm seeing a lot of people come in and not know about the anatomy of their own body. They're not knowing that the place where they actually pee and go to the bathroom, or is a different place from where a baby comes out of like they weren't aware of these things. And so it's like, somebody's gotta teach them and I'm just like, I went to school. Yeah, I paid a lot of money for it. But like, Guess what, I'm going to share what I know because this shouldn't be a secret. And I think also the that that's part of the base of the Vagina Chronicles, too, is like destroying the secrecy like, there's secrecy and miscarriage. There's secrecy and abortion, there's a secrecy and infertility. And people who want to have babies with reproductive assistance in other ways and freezing your eggs like there's so much secrecy surrounding it. We're kind of taught in many cultures, especially the black culture, like we're not supposed to talk about those things. Or you don't learn about something that maybe a parent or an aunt or friend or sister went through until you go through it. And, and so out of that, like really the Vagina Chronicles is born. It's like educating, providing facts as much as possible and like debunking some of the myths that are out there too. So that's kind of the birth story of the Vagina Chronicles. And it's blossomed into something I'm proud of, and something I hope continues to grow.
Katelyn:
It's so needed. It's so needed for so many reasons that you explained. But to your point, we're just expected to know all of this. And at the same time, there's all of this secrecy and shame and taboos that have been created around women's bodies. Actually, as you're sharing all of this, I had this distinct memory of a few years ago, being at a friend's house, I was with a friend who was going through her residency program. And she was in the birthing station at the time. And so it was me and a couple of other girlfriends just sitting down on a Friday night having wine and asking her all these questions about birth And, you know, at the time, we were 30 years old, and it was just like, how do we not know this? Like, this isn't okay, that we don't know this, you know, there's something deeply wrong with the fact that we are, you know, in childbearing years and we don't know what to expect. There's a huge disconnect. And so I'm so grateful that you are creating education for people to understand their bodies on a really intimate level, and break the stigma, and the shame around all of these things that you're acknowledging. It's so important. One thing really stood out to me that you mentioned, and I know you're incredibly passionate about speaking out in your amazing community about this, but you mentioned hospitals and spaces not being designed for the black community. So can you riff on that? Because I think there's so much there, and also, perhaps the cliffnotes version, we don't know. We will just have to have you back. But what are the things that we need to know about this topic?
Aiyana:
So yeah, it's hard to condense and I'm very talkative. I'll try my best. But I was speaking at a little conference recently. And basically, this, like, what came out of my mouth is like black women have carried modern medicine on their backs there, they are responsible for it. And it might seem a little pretentious, it might seem a little arrogant to say, but it's definitely the truth. If we go back to slavery, and what happened on plantations, excuse me. Black women were their bodies were used without their consent for the purposes of experimentation for certain procedures that we use now, especially in modern day obstetrics and gynecology, as well as anesthesiology. So the enslaved were used for research but also used for procedure work. So like, you know, back in the day, suturing wasn't a thing after birth, like, you know, you could walk around and develop this fistulas, which are kind of like little tunnels, so from like, vaginal tissue to rectal tissue, and that alone could cause an obvious like infection and then death, because at the time, they weren't treating the same way they would now. And so one of the doctors, Marion Sims, you might have heard his name before was performing procedures to try to fix these fistulas without using anesthetic, so if anyone has had a baby, and even if you haven't, just imagine, like, there's a reference point, someone mentioned, like it feels like a watermelon coming out of a tiny little hole. And so imagine, like you had, you're having this baby and, and the pain that's associated with that. But then like, I'm going to perform a procedure on you to try to close up whatever gaping tissue there might be, but I'm not going to use any anesthetic. And I'm also not going to ask your permission to do it. I'm just going to do it because you're my property. And then for which these practices were done. So that white woman would not be able to would wouldn't have these long term effects that all women essentially were facing. But then there was the development of anesthesiology, so that the white woman wouldn't feel the pain of what was happening when they're sutured and getting these procedures done. So when I say like black woman literally carried modern day medicine, through like that's what I mean, like our bodies were used for research we were used for experimentation in order to get to where we are now. And this is just hitting the tip of the iceberg. You know, many of us were on display for what our bodies looked like, we were told that we don't feel pain as much as you know, white women and that's just not true. What's true, is if you felt pain, and then you displayed that you would be beaten even more as an enslaved person. So it's like a, there's kind of like a catch 22 You're damned if you do damned if you don't, you know, if you're quiet, they think you're strong. And you can take anything if you make noise, you get in trouble for that. Excuse me, so, um, so when it comes to my you know, midwifery back at that time, what was happening? The roots of black midwifery in America. Black people weren't given the same luxury as white people to have the accessibility or availability of white physicians for them. They may have had the physicians come in, just to do a check to make sure that someone was able to work in a field or continue their work in enslavement. But we weren't even with the foundations of hospitals as institutions where people will go for their health care, we weren't allowed there. And so what happens is you have this community of people who need health care who need help having their children and midwives. The black midwives in the deep south were the ones who were attending these births and providing for people in various ways and even going further beyond just midwifery. Before, black people could even consider hospitals as a place where they could go, black middle midwives were essentially serving the communities, not just, again, like I said, for birth and having babies, but also like, if they couldn't, if someone couldn't get to a physician or a physician couldn't get to them, then the midwife was most likely going to step in with whatever herbal remedy or whatever she had in her knowledge bank, to try to help them out and provide them with a level of care that they wouldn't get elsewhere. With the advent of hospitals, and health care, as it is, or as it was back then, we see that different people would come in and talk to the midwives and they were like, well, yes, you're delivering all these babies and caring for all these people. But what you're doing isn't sanitary, and we're told that it was wrong. And so initially, I believe they started with training to train midwives, but then it became, we're going to take away your license, like you can't practice here anymore. And it really did a disservice to the community and just kind of broke apart. What we know as black men, black men were free back then but I always like to point out that black midwives are alive and well, and very much in tune with what's happening. I think I think even in some of the comments, the conversations we have now, you might find that midwives aren't brought to the table. So like even them, the maternal morbidity and mortality rates for black women and indigenous people in brown and brown people. You'll see that a lot of physicians get brought into the table, but midwives are often left out. doulas are even now becoming ever so present in the conversation. Like there's a lot of legislative work that's going into that as well. And doulas are, they are professionals that can help you through your birth experience. There's all different types of doulas. But doulas aren't trained for actually helping you birth your baby, they're not trained for like resuscitation. They're not trained for emergencies that happen, you know, whether in the hospital or outside of the home, they support people during that time frame. But, um, but a lot of these conversations live, leave out what midwifery has to offer, which is a whole other perspective. And if you talk to people who have had, you know, really good experiences with midwifery care, I think we would be doing better service to people and sharing this information, and what we do and how we service our communities. And also the rich history. That's there, too. So like I said, I could go on and on, but I will.
Katelyn:
I wish you could. I seriously wish we had like five more hours. So we'll definitely have to have you back. Do you typically work with doulas then?
Aiyana:
That's a tricky question. Um, so in the hospital, I'm not necessarily like, it's not like I'm assigned with a doula. But if a patient requests one, I can probably provide some resources for them depending on what they're looking for. And then also, some of them will find them on their own, which is great. So they will hire a doula themselves to help them through the pregnancy, birth and postpartum. And then I might work with them in terms of like for the actual birth that they're, you know, they're there and alongside them, a lot of homebirth midwives will work again, alongside doulas as well. Like they might have a specific doula that they refer their clients to, because they have a really good relationship, and they work really well with patients or what have you. So I would say the work of midwifery and the work of those who are doulas run parallel together, and we work hand in hand with each other to make sure that we get these great outcomes as much as possible. But it's not always and it's not a must, but it is sometimes, and it's lovely when we do.
Katelyn:
Okay, so, I have a really clear idea of what a midwife is. And I am so grateful. Before we wrap up, what is your hope for imparting all of your wisdom and your education within your community? And even our time together today? What's your vision for people to take forward? And also from even a social justice perspective as well, too- How can everybody listening to this really do their part, whether it's advocating for themselves or creating more equal spaces, or any type of political activism that we can be doing? What are some easy entry points into being able to normalize this conversation and creating accessibility for everybody?
Aiyana:
That is a fabulous question. I love it. There's no one right answer I feel and I think that's like the bottom line that I've come across is like, there are so many different avenues and aspects and ways in which people can help and bring light to this conversation. We need people in research, you know, historically, research is either conducted by non black and brown people, and then like performed on black and brown people. And then the information is not given back to us if we talk about things like the tusky study, and various things throughout the years, things that weren't of our consent. So we need people in areas of research, we need finances, we do need more black midwives and sustainability through that. We need more black and brown spaces and birth centers that are led by black people so that you know their community can be attended to at the level that we understand because there is something about seeing a provider that looks like you that does make a huge difference. Like you know, you can believe what you want but the studies are out there for that too. And then there's legislative work that is happening too. If you look up the mom NuBus act M om nibs that is a select series of legislative bills and acts to try to get Some changes happening for black and brown people, and just birth in general birth and postpartum in general nationally. And they've made quite a bit of headway in the last year and a half, maybe even two years, trying to make these adjustments. And what I want people to take away is like, a few things. One, like you have full permission to learn more, and understand your body, like it's yours, make it yours. You know, like, I know, there's a lot of cultural and familial and our own personal relationship with self, that kind of maybe is a barrier for us to learn more about ourselves. But I encourage you, you live this life, once, as far as we know, like, just in that lifetime, know who you are not just like, in an emotional sense, but in a physical sense to like, you know, it's okay to put a mirror between your legs to look and see what's there. It's yours, you know, and then asking the questions. No, it's important when you go in, not just to be told one thing, but also to understand what you're being told. So if there's a diagnosis that's presented, and you're not understanding what it is, and what the treatment realms are, and like maybe if there's other modalities that you can do for treatment that don't involve medication, and perhaps lets you, like, ask the question, and don't be afraid for a second opinion. I always say this to recognize I'm speaking from a privileged place, when I say like, you know, if you don't bond with a provider, find somebody else. Because a lot of people don't have the opportunity to go elsewhere. They're, you know, they have insurance, and it covers here. And they may not be able to go see, you know, a ton of different providers, but in your best way possible. Either trying to find somebody who you can align with, and if not bring an advocate with you. Like, it's gotten tricky with COVID, because not all places are allowing other providers in or other personnel in when you go on for your visit. But you know, you can pick up the phone, you can take notes, you can, you know, ask for a further explanation, so that you can explain to somebody else, you know, and maybe they can break it down for you in a different way. As it pertains to the social justice piece. And like I said, the two aren't separate, like health care and social justice aren't separate. And I think that's been the problem for so long, like, we separate these things, but it's really very much ingrained, and inherited and how things have developed over time. But, but really, truly listening to black people and believing what they say. And I have to check myself on this too. Because sometimes, you know, I'm in a toxic environment of healthcare where, again, what we say goes, and so I have to check myself and say, know what, what the patient is telling me is what they're feeling experiencing, that's what it is. And so I need to listen to that so that I can put the pieces of the puzzle together and we can come together and make a decision for their treatment or, you know, management of whatever's happening in the best way possible. But listening to black people, we're not listened to, like we're telling you we're doing we've been telling you we've been dying for years, we've been telling you these things are wrong for years, but in the age of where social media is, you know, up top, not at the top of things. And then also, you know, coming out of a pandemic where people are forced to sit down and then listen. Like I think we're now coming to light about things that have been ongoing for quite some time. You can believe what you want, but we're telling you what it is, you know, listening and then you know if you want to put your money in places there are several different routes you can go Black Mamas Matter Alliance, Sister song. There's several places where you can go a birth equity fund if you want to donate those are places, places to start for things that will really not only provide you information but a place to help if you're looking to help. So much.
Katelyn:
Thank you so much for just dropping all of this truth and also giving really clear steps forward. I appreciate you so much. Where Can everybody find you and get into your world and fall even more in love with you?
Aiyana:
Sure I am on Instagram @thevaginachronicles. I do have a website that was just revamped. So I'm very excited about that. And that's thevaginachronices.org. And I just actually released some T-shirts that talk about black birth and like black breastfeeding. So the proceeds from that are going to my transition from hospital to out of hospital birth so I am making that dive into more of the home birth and birth center world so if you want to throw some coins at me, you can there on our own shop and there's more products coming as well. And then I go on Twitter every once in a while the vagchronicle because it wouldn't let me put the whole thing in there. Not so much on Facebook but I am about these communities, we're actually getting ready to launch our next postpartum prep group, we did one this year, probably do about three or four next year. And this is just preparing for postpartum because so many people don't. And that's a whole other world. And we can talk about that another time. But that's like separate but also included, but it's a whole other world outside of having your baby is preparing for the rest of your life as a parent. And so we get into like the emotional role, change, the grief process. And it's been exceptional, the clients we had in there for this past group, we're amazing. And we just want to keep it going and repeat. So look out for that. That'll be January. Well, actually, the first group will probably be February of 2022. But we'll begin advertising at the end of this year.
Katelyn:
Thank you so much. We'll be sure to link all of this in the show notes so that it's really easy and accessible for everybody. But yes, you will absolutely have to come back on and talk about all things postpartum and also just the brilliant work that you are continuing to do. I appreciate you. And I can't wait to just continue getting to know you beyond this conversation. Thank you.