Wellness

Solving the Crisis in Maternal Health—and Finding Bliss in Birth

Solving the Crisis in Maternal Health—and Finding Bliss in Birth

Solving the Crisis in Maternal Health—and Finding Bliss in Birth

Latham Thomas headshot

Latham Thomas didn’t set out to be a doula. But when she had an out-of-body experience bringing her son into the world, it became clear to her that she was meant to work with people in moments of great transition. “I see it as serving as someone who holds your hand as you’re crossing the river,” Thomas says of her work. It’s about ushering in the spiritual power of whatever process she’s attending to. In addition to her clients on the precipice of motherhood, Thomas attends to people cultivating major ideas, like books or screenplays, and those who are transitioning out of life as they die.

Thomas also works to empower clients in pregnancy and birth. For her, that means explaining how the childbearing process can be one of pleasure and spiritual healing, not pain and fear. Ideally, Thomas says, “Childbirth unfolds as a meditation—as an altered state of consciousness.” She knows most people who give birth don’t experience it that way. That’s precisely why she teaches clients what they’re up against and how to advocate for themselves from prepregnancy through postpartum: She believes no person should be robbed of that birthright. In a system organized against women’s reproductive rights, especially for Black women and other women of color as well as trans and nonbinary people, it takes real work to ensure the positive and safe circumstances where an ecstatic birth experience is possible.

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A Q&A with Latham Thomas

Q
How are motherhood and reproductive health in crisis, especially for Black people?
A

I see it as a fight for not only the point of birth but also the forces at work on a person before they’re pregnant and when they’re pregnant. What are the factors that that exacerbate someone’s preexisting conditions and put them and their baby at risk of harm? From my lens, this is really about protecting Black life—not just looking at it when we get to the point of crisis, but really investigating how we remove the barriers that make motherhood safe and comfortable and equitable so that people can live fully actualized lives.

The birth journey is represented in media as an isolated experience. When I look at it, I see a continuum. I see that at every life stage, our bodies are legislated against, and there are threats to our success.

This happens at every stage. If you’re at the beginning of menses—the phase that you’re in when you first start bleeding—we have people who are suffering period poverty, who cannot get access to menstrual products. We impose taxes on menstrual products as if they aren’t essential health care purchases, which is ridiculous.

Then we have pregnancy itself. We get to the juncture where there may be abortion and loss. Again, our bodies are legislated against. People aren’t able to make choices aligned with whatever their needs are at that life stage.

Then the birth. We’re in a time when people can die in childbirth. We don’t have adequate protections in place. And on top of the immediate risks, a traumatic birth experience impacts whether someone has anxiety, depression, or post-traumatic stress postpartum.

When you’re breastfeeding: It only recently became legal in all fifty states to breastfeed in public. And even still, it’s not socially acceptable to be out and breastfeeding.

Then when folks are trying to figure out how to go back to work, one in four people goes back to work ten days after having a baby. Imagine being on your period: Usually days one through three, we don’t even want to leave the house. We’ll just rest, eat things that are comforting and warm, not work out, chill, and maybe cry. Most of us don’t particularly want to go to work during that time. Meanwhile, in this country, you’re asked to go to work ten days after having pushed a human out of your body. We don’t have a federal paid family leave policy.

I look at every juncture where we’re not supporting birthing people, and I’m seeing that everything from menstrual health to postpartum health is in crisis. This is not only a crisis that exists at the point of birth. As a culture, we haven’t figured out how to accept women in their bodies throughout their lives.


Q
How do you approach the maternal health crisis with clients?
A

The crisis is something that I definitely focus on when I’m educating clients. But the overall orientation of the work and experience is also about joy. I don’t want people to be reading the news and watching TV and going on Instagram and thinking, Oh my god, I could die in childbirth. I don’t want that to be the consciousness people are in. I want them to know how to protect themselves, how to advocate for themselves, and how to journey through the birth continuum whether they have support or not. I want them to know what it looks like to be supported. I don’t want death to be the mantra.

“I look at every juncture where we’re not supporting birthing people, and I’m seeing that everything from menstrual health to postpartum health is in crisis.”

Awareness of the maternal health crisis is wonderful because it gets people to have this visceral connection to what’s going on in the world, but it also can be debilitating or frightening. It can make you think, I don’t want to do this. Like, I don’t want to have a baby because what if something happens? We want to get people out of that this-could-happen-to-me consciousness. We have to restore hope and joy as our birthright and make sure that as we journey through this process, we have all that we need.


Q
How do you teach clients to advocate for the care and experience they deserve?
A

In terms of advocacy tools, we make sure that there’s a patient advocacy safety net in place. We get a sense of what a patient’s desires and needs and fears are. Some people are educated on their journeys, and others are just learning for the first time, so we get an idea of where they need to watch more movies or read more books or articles so that they can shape their own views of what’s going on throughout the birth process. We apply a lot of counseling techniques to conversations about what’s coming up for them and what they might be struggling with. We make sure to validate their feelings, because people’s clinical needs are not always met. We teach them how to navigate the medical process and how to speak to medical providers. We make sure they feel comfortable with their medical providers, and if they have concerns, we might switch out those providers and get the clients in a place where they’re comfortable. We evolved with people around us to support us through this really powerful time in our lives, so we also establish a birth village for support.

That said: I see the birth continuum as a journey in which there’s wisdom to be gained in the process and in which we should be joyful. We should feel the juiciness of our bodies—really embrace all of these changes we go through. If we’re not attuned to all that magic, we miss a lot of the beauty that’s unfolding. I seek to educate in a way that is not just about the clinical things that are occurring in pregnancy and birth but also about the deeply spiritual things that are blooming.


Q
How do you teach clients about pregnancy?
A

I merge the science with the spiritual so my clients can really understand what is underway. Birth is a meditation. It’s an altered state of consciousness. I talk about birth as a ceremony, similar to a ritual involving peyote or ayahuasca. It’s a journey, and the person comes out of it with something in their spirit they didn’t have when they started.

We’re programmed to go through a state of total bliss during birth. People don’t talk about that. But birth is a process driven by your emotional processing system, the limbic system. Other parts of the brain, mainly the amygdala and the neocortex, which control fear and worry as well as your rational mind, have to shut off so that you can enter this primal state. That primal state is an altered state of consciousness where it’s almost as if this portal opens up. It’s hypothesized that you undergo the effects of the same active neurochemicals, like DMT, that are found in ayahuasca. And so this process really is like a trip—like this ultimate high that overcomes you with a sense of joy and oneness and unification.

“We have overmedicalized the process of pregnancy and birth. Nobody tells you it can feel good.”

This is a ritual event. However: We have overmedicalized the process of pregnancy and birth. Nobody tells you that it can feel good. Nobody tells you that it’s part of your birthright to have access to that joy and otherworldliness and ancestral wisdom that kicks in when you’re in that heightened level of arousal. So many people never feel those sensations. They never get to a place where they can get out of their head and into their body.


Q
What happens in the body when the birth process does not feel safe?
A

Generally, we have designed spaces for people to give birth where they might not feel safe. When we think about people who are at risk during birth—we’re talking about Black people and Native American people, who are five times more likely than White people to die in childbirth or from childbirth-related causes—these are people whose needs are not being met in the system as a whole. As they’re going through the birthing continuum, they’re being undermined, they’re being neglected, they’re being told that the pain is not that bad, and they’re not getting the support that they need. Imagine all that’s happening to you: You’re not going to feel safe. Your body’s not going to be able to surrender to the process.

We understand how birth works, biologically. Yet we still don’t think about the fact that the process is governed by our emotions. Our bodies are old. We haven’t evolved to biologically understand that a doctor saying something a certain way to you isn’t the same as being chased by a lion. And so if I’m upset, angry, or scared, that’s going to create a different cocktail of hormones than in a birth where I feel safe and relaxed. It will involve more cortisol, adrenaline, and noradrenaline. That’s kryptonite to the ecstatic birth hormones (primarily oxytocin, the pleasure and bonding hormone, as well as prolactin). Instead, I have this flood of hormones telling my body that there’s a threat and I have to get to safety. All the blood is shunted away from my internal organs, including the uterus, and is shooting out to my limbs and to my brain to get me to a place of being able to flee.

“We haven’t evolved to biologically understand that a doctor saying something a certain way to you isn’t the same as being chased by a lion.”

These stress hormones govern your body until you feel safety again. That could be a long time. You may start getting in a zone where your body delays birth and you have to inject Pitocin to artificially strengthen contractions. But if we can make a birthing person feel as comfortable as possible, if you can get them to a place where they trust their body, where they can surrender, then we have a chance for a better birth outcome and also for increased satisfaction around the process. And that’s really what I’m seeking for people: for them to remember the experience as beautiful.


Q
What do people need in order to access the spiritual side of childbirth?
A

We are keeping people from the medicine of an ecstatic birth by overmedicalizing the process itself. For people who are in high-risk pregnancies, a medical perspective is appropriate. But for those who are low risk, we’re not giving them space to experience birth as a spiritual journey.

Because of the reliance on medicine and our collective wanting to control the body, we have created a model that undermines the needs of birthing people. What we need to feel for a full experience of birth is a similar set of things we need to feel in order to be intimate. You need safety. You need a sense of security. You need to feel that you’re not being observed. That might mean being in a room that’s quiet, that’s clean, that smells good, maybe with candles lit and music on.

“From my lens, this is really about protecting Black life—not just looking at it when we get to the point of crisis, but really investigating how we remove the barriers that make motherhood safe and comfortable and equitable so that people can live fully actualized lives.”

It is important to experience intimacy and sexual pleasure—including solo pleasure—as a self-care practice during pregnancy because it helps us train for the birth event. Oxytocin is the pleasure, love, and bonding hormone. If our bodies have more oxytocin flowing through the bloodstream during pregnancy, we’re more likely to have good levels of oxytocin when we’re birthing. That lends itself to a healthy birth as well as an ecstatic experience of the birth itself.


Q
How much of this has to do with the birth plan? Can people have ecstatic experiences with a C-section?
A

I’ve worked with people who have had all these ideas about what they wanted their birth to be, and it went to plan and was beautiful. I have worked with people who have had planned C-sections, where they knew in advance it was going to be that way, and they were able to have an experience that was beautiful. And then I’ve worked with so many people who have gone in with a plan and had the opposite happen, and still they’ve had beautiful experiences. This is why we don’t plan but instead set preferences around the experience. We prepare for all outcomes, and we make sure that people feel educated, safe, and seen. What I’ve noticed is that even when labor doesn’t go as planned, we can process what the labor was like, and that ecstatic healing is always available.


Latham Thomas is a doula focused primarily on pregnancy and childbirth. Thomas is the founder of Mama Glow, a platform for reproductive health education and doula training, and the author of Mama Glow: A Hip Guide to a Fabulous and Abundant Pregnancy and Own Your Glow: A Soulful Guide to Luminous Living and Crowning the Queen Within. She is a graduate of Columbia University and The Institute for Integrative Nutrition.


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