Doing better by black mothers and babies

Photo credit: LaToya Ruby Frazier for The New York Times


There’s been a ton of discussion in the birth world this month about Linda Villarosa’s excellent New York Times Magazine feature, and for good reason. It would be an understatement to say that this longform report is a compelling read. Framed by the heartbreaking personal story of one mother in New Orleans, Villarosa’s piece lays out the history of black maternal and infant mortality in the U.S. in fascinating, infuriating detail:

Black infants in America are now more than twice as likely to die as white infants — 11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies, according to the most recent government data — a racial disparity that is actually wider than in 1850, 15 years before the end of slavery, when most black women were considered chattel.

Yeah. I’ll give you a minute to read that again.

Methodically, Villarosa dismantles the myths and assumptions that have obstructed progress for black mothers and babies in the United States. She shows us how the research community continues to dig deeper to unravel the knot of causation:

Though it seemed radical 25 years ago, few in the field now dispute that the black-white disparity in the deaths of babies is related not to the genetics of race but to the lived experience of race in this country. In 2007, David and Collins published an even more thorough examination of race and infant mortality in The American Journal of Public Health, again dispelling the notion of some sort of gene that would predispose black women to preterm birth or low birth weight. To make sure the message of the research was crystal clear, David, a professor of pediatrics at the University of Illinois, Chicago, stated his hypothesis in media-friendly but blunt-force terms in interviews: “For black women,” he said, “something about growing up in America seems to be bad for your baby’s birth weight.”

With engaging prose, Villarosa surveys a broad range of past and current projects focused on making sense of the abysmal statistics. She shoots down the various shame/blame theories that have persisted over the years (no, the high rate of infant death for black women is not due to smoking, drinking, using drugs, being overweight, being too young, or being poor) and brings us up to speed on what the evidence says about the long term effects of systemic racism on black bodies:

The bone-deep accumulation of traumatizing life experiences and persistent insults that the [Black Women’s Health Study] pinpointed is not the sort of “lean in” stress relieved by meditation and “me time.” When a person is faced with a threat, the brain responds to the stress by releasing a flood of hormones, which allow the body to adapt and respond to the challenge. When stress is sustained, long-term exposure to stress hormones can lead to wear and tear on the cardiovascular, metabolic and immune systems, making the body vulnerable to illness and even early death.

If reading her story makes you weep with sorrow and rage, it’s supposed to. And yet, she also shows us glimmers of hope. Villarosa highlights the vital work of several groups working hands-on to create better birth outcomes for black families: SisterSong, the Birthmark Doula Collective, the By My Side Birth Support Program, and Sisters Keeper are among a nationwide network of organizations trying to bridge the gaps in healthcare.

Here in Portland, a city whose long-term sustainability centers on attracting and retaining non-white families from away, we have a few organizations working woman-to-woman to improve black maternal health; the Community Doula Birth Program supports births at low/no-cost and In Her Presence provides a variety of social support, to name two. But as Villarosa notes in her conclusion, very few doulas can earn a living solely from birth work, especially if they are trying to reach low-income populations, and doulas can’t change the game all on their own regardless. As a state and as a nation, we still have centuries of systemic oppression to overcome and repair.

There is a growing body of research demonstrating that maternal and infant health outcomes are better when mothers have good social support during pregnancy, birth, and postpartum recovery. For families with resources, that kind of help can be bought (and even then, Villarosa emphasizes, income and education are no protection against low birth weight for black babies.)

For the rest, for the majority, we need fundamental, structural change — in workplaces, healthcare, state law, insurance coverage, and social attitudes toward birth. We need medical professionals to listen to, and believe, black women. Prioritizing the health of black mothers and babies is prioritizing the health of our communities. Making space for women of color to connect with each other and with resources is a good start. Creating systems that pay birth workers a livable wage is even better. Improving the way doctors and nurses interact with women of color is better still. So how do we get there?

Now that we know better, let’s do better, Maine.

Baby sleep advice

Co-sleeping? Self-soothing? Crying it out? Baby sleep is mysterious and overwhelming in the early days…and then again around four months…and again any time they have a cold or a developmental leap. When you Google “why won’t my baby sleep” at 4 am, you are quickly buried by the avalanche of opinions out there on the best way to influence your baby’s sleep patterns.

But don’t despair: There is hope! There is help! There are educators out there who can explain it clearly to tired parents.

The Baby Sleep Geek offers virtual consultations for tired parents to get a little empathy, a lot of useful tips, and customized sleep plans.

Dr. Karp is the baby sleep guru and creator of The Happiest Baby on the Block. if you are willing to wade through a lot of sales pitches for the Snoo, his specially designed baby bed, his blog has helpful advice about soothing your baby to sleep.

Gwen Dewar, PhD’s writing style strikes a balance between academic and reassuring. Her Newborn Sleep Patterns: A Survival Guide for the Science-Minded Parent explains many of the reasons why we struggle to get enough rest for ourselves and our babies. This resource might be a bit too detailed if you are looking for quick solutions in the middle of the night, but if you are a person who likes to understand how things work, take a peek during the daylight hours.

For desperate parents in southern/midcoast Maine, BirthMe offers overnight infant care in your home that includes gentle guidance for your baby to develop healthy sleep patterns.

This stage doesn’t last forever, but when you’re seriously sleep deprived, everything feels like a permanent catastrophe. If you are having scary thoughts or panicky feelings, call the PSI warmline at 800-944-4773. You are not alone. You are not to blame. And with help, you will be well.

What does Ballast & Buoy mean?

No, I did not use the Hipster Business Name Generator to name my LLC. I was using an ampersand before it was cool. The moniker was birthed after months of planning and wondering about the future. I wanted a name that would really convey how my services would provide comfort and care for exhausted new parents, and the writer in me was holding out for a real spark.

During an evening of drinking deep intellectual conversation with some of my wordsmith-iest friends, we hit upon the idea of ballast, the stabilizing weight in a ship’s hull. I immediately loved the imagery of a family as an oceangoing vessel, and it felt right for our seaside city. Ballast on its own, though, wasn’t quite enough. My postpartum family care would do more than simply keep the ship from capsizing. It would help parents navigate the newborn months and move forward. We wracked our brains for the perfect complement, and parted ways with the thought still incomplete.

Luckily for me, one of those friends found inspiration driving home over the bridge to South Portland that night, and left me a voicemail saying, “I’ve got it! Ballast and BUOY!” She’d nailed it.

Ballast & Buoy helps parents stabilize and stay afloat.  As your postpartum navigator, I show you the ropes, rig the sails, and stock the hold with provisions while you explore uncharted territory. When the occasion calls for it, I might even swab the poop deck.

I’m not an old salt (…yet), but Casco Bay is my happy place, and I am learning to sail one teetering afternoon at a time. In the meantime, I’m here to help your family get your sea legs.

Big exciting news! Rosemont Wellness Center

I am SO PLEASED [and caffeinated, tbh] to share with you all that Ballast & Buoy now has a meeting space in meatspace. This spring I will be rolling out a number of parenting groups and classes in the beautiful new studio/classroom at Rosemont Wellness Center. What does this mean for you? Ballast & Buoy will be offering more postpartum support at more affordable rates to more families.

We will kick off with the Baby Lunch Date, a weekly gathering for parents with babes in arms. Drop in for a little tea and sympathy on Mondays between 11 am and 1 pm. I can’t wait to see you all!

Even if the infant days are well behind you, RWC’s grand opening celebration is Sunday, March 18th from 3-7 pm. Please stop by to say hello, see the space, and have a few snacks from Tin Pan Bakery. We will have art from the Rosemont Artists Guild on display and several family-friendly activities that are fun for all ages. It’s going to be a great party.




Free screening and discussion of Motherland

My friends at the Portland Public Library are wrapping up their summer documentary series with a free screening of Motherland. Ramona Diaz’s documentary, the winner of the 2017 Sundance World Cinema Documentary Special Jury Award for Commanding Vision, gives us an intimate look inside the world’s busiest maternity hospital.  In a hospital that is literally bursting with life, we are immersed in the chaotic world of the maternity ward and the resourcefulness of the people who live and work there.

I’ll be there to introduce the film and lead a short discussion afterward. We’ll laugh, we’ll cry, it will be better than Cats. Please join Ballast & Buoy at the library for this eye-opening and thought-provoking event.

Childbirth is often a communal process, with a team of nurses, doctors and loved ones simultaneously witnessing the miracle of life. In one Philippines hospital, “communal” is an understatement. Ramona S. Diaz’s latest film, Motherland, takes us into one of the busiest maternity wards on Earth.

Filled with warmth, humor and heartache, Motherland is a vérité portrait of childbirth–with all its joys and challenges depicted on screen. It is also a fascinating study of a country where conservative Catholic ideas about childbirth and contraception prevail, making the film an ideal starting point for conversations about reproductive healthcare policy.

(From the POV series on PBS)


Motherland: free screening and discussion

Rines Auditorium of the Portland Public Library

Thursday, September 28, 2017

6:30pm – 8:30pm

Downtown, metered street parking is free after 6pm. There is also a parking garage next to the library on Elm Street.

Support for postpartum depression and anxiety

Postpartum depression and anxiety are sneaky, lying, many-tentacled beasts. In my work providing postpartum family care to parents in greater Portland, I regularly come in contact with families who struggle to right the ship after the tempest of pregnancy and birth has passed. PMADs (perinatal mood and anxiety disorders)  can masquerade as unexplainable dread, disconnection, rage, and a desperate need to escape from the life you’ve created for yourself. It’s a bewildering, isolating experience for mothers and the people who love them.

Fortunately, postpartum depression and anxiety are treatable. With proper diagnosis, treatment, and assistance, these monsters mucking with our minds can be vanquished. That’s why Ballast & Buoy is a proud supporter of the Maternal Health Alliance of Maine, a 501 3(c) dedicated to helping families affected by postpartum mood disorders. This nonprofit startup is small but mighty, and they are working actively toward their goal of connecting the whole state with the best resources and remedies for postpartum mood disorders.

Over the past few months, MHAme has trained several Portland-area facilitators including myself to lead support groups for women in the postpartum trenches. Our format, the empathy circle, provides gentle companionship for mothers feeling overwhelmed by (or sad, anxious, or angry about) motherhood. It doesn’t matter if your baby is 4 weeks or 4 years old.You are not alone. You are not to blame. You are welcome here.

Please join us for any or all of our upcoming meeting dates:

  • Saturday, March 4th 10:00 am
  • Tuesday, March 21st 6:00 pm
  • Saturday, April 1st 10:00 am
  • Wednesday, April 19th 6:00 pm

All MHAme’s support groups meet in the Wishcamper Center on the USM Campus. The building (34 Bedford Street) is marked as Muskie School of Public Service and Osher Lifelong Learning Initiative. Parking is available behind the building and in the adjacent free parking garage that is attached to the Abromson Center.

MHAme will be launching a new website this spring with more information about their mission and methods. Until then, if you have questions about the support groups, call me at (207) 558-BABY.


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