Another season, another long-overdue post. I’m done with my classes and now in clinicals. I am regularly conducting pap & vaginal exams under the guidance of my awesome preceptor. I am regularly finding myself with my fingers inside the vagina of a person I just met. It’s as awkward as it sounds, but even more *extra* cuz I’m me.
- Providing reproductive healthcare to people with vaginas, as someone who primarily has sex with people who have vaginas.
Clinical vaginas are challenging to me because I have encountered many vaginas in my life in very non-clinical (aka sexual) circumstances. Like most queer people, I have a fair amount of guilt around my sexuality that I have worked around (and occasionally through), but apparently have more working through to do. I had to get over my own internalized homophobia & transphobia just to apply to midwifery school. And here it is, coming up again. The first few times I put my fingers inside a patient in a clinical setting, I couldn’t help but have memories of previous lovers resurface. Wracked with guilt about unconsciously sexualizing my patient, I found myself getting nervous and trying my best to not counter-transfer that guilt to my patients. It’s awkward.
2. Providing reproductive healthcare to people of color & immigrants, as a self-identified person of color and child & partner of immigrants.
When I introduce myself to patients of color, I see a momentary flash in their faces when I recognize them acknowledging me as a person of color. Sometimes my patients smile to me briefly. Sometimes I can see their whole body relax. I find myself identifying with patients because they live in the same area of the city as I do, or because they are from an area of Mexico I am from, or an area in Mexico or Latin America I have family in or have visited, or their story reminds me of a friend or family member. When I communicate with my patients in Spanish, I catch misunderstandings that have occurred with previous providers that are not native Spanish speakers, even if their (learned) Spanish is exemplary. When they talk about having experienced violence at the hands of police or ICE agents, I think about the times I have personally experienced police violence. When they talk about experiencing xenophobia, racism, or classism, my body and mind freeze as my own experiences swim to the surface.
In my experience providing services (as a nurse, case manager, educator, facilitator, and community organizer and advocate), it has always been difficult navigating my identities with my clients. Clients at times form a bond with me because of my race/ethnic (Latinx/mestizx/Indigenous) identity, only to distance themselves upon discovering my sexual orientation (queer) or gender identity (genderqueer). This has especially been the case when working with heterosexual, cisgender women of color.
3. Providing reproductive healthcare to mostly heterosexual, cisgender patients, as a gender non conforming person.
Because so much of the scope of midwifery care is used providing reproductive health care, I am seeing mostly heterosexual patients who are pregnant. Because there is such a need for Spanish-speaking providers in my area, and providers of color in general, I am mostly working with Latinx/mestizx patients, with a handful of Black and white patients. I decided to grow out my hair to a more feminine-presenting length the day after Trump won the election. Since I started seeing patients more regularly, I have chosen to wear more feminine-appearing clothing. I even started wearing makeup. Even though I identify as genderqueer, I have chosen to exercise my cisgender privilege by appearing as the gender I was assigned at birth. I do this intentionally because it is easier, and I am hoping it will make my patients feel more at ease. Many patients choose midwifery care because they are more likely to be seen by a female-identified provider. A part of me feels like my patients will feel “duped” if they get me as their provider and I have short hair and am wearing a bow tie. It has been my experience that cisgender, heterosexual females sometimes feel uneasy or uncomfortable with me when I am presenting as more masculine. I am not there for me. I am there for my patients. If presenting as more feminine will make my patients’ pap go more smoothly, I am more than willing to present as more feminine.
4. Providing reproductive healthcare to trauma survivors as a trauma survivor.
As a midwife, it is my responsibility to evaluate the vaginas and breasts of my patients. These are areas of the body, though super useful for pleasure and procreation, are also highly valued, exploited, and abused, and chock full of trauma and triggers. I am a survivor of childhood sexual assault, and have struggled with post traumatic stress disorder for more years than I have not. At the same time, I have ample work experience with trauma survivors, and am comfortable and familiar with trauma-informed care. I think what is different now is that while being a doula is incredibly physically demanding, actual physical care is a new area of healing for me. In the past, I supported trauma survivors in healing their emotional, mental, and spiritual selves. The physical components of care were beyond my scope. My personal and professional experiences with trauma make me feel like I am at both an advantage and a disadvantage. My experiences may make my patients feel more understood, or heard. I personally prefer seeing providers who are survivors themselves, if they feel comfortable disclosing that to me. On the other hand, being a survivor myself makes me vulnerable to getting triggered by my patients and their stories. In fact, I already have. There have been a few times I have not been able to locate a patient’s cervix after incorrectly placing a speculum. I literally froze up and almost had tears come to my eyes when I realized my failure and noticed the patients’ discomfort. My preceptors had to swoop in replace the speculum and even complete the exams. I could feel my heart racing and face turn red in fear and shame.
There’s no time for processing in health care.
My preceptors have been gracious and haven’t revisited my painfully awkward reactions. They’ve become more supportive and have talked me through what to do, encouraging me to do so with my patients, as well. It’s become a bit easier, but still feels like a challenge rather than an informative investigative process. It wasn’t until I saw the keynote speaker at the American Association of Birth Center’s Birth Institute in Anchorage, Alaska that I was willing to finally admit to myself that in spite of years of work and therapy, my abuse was affecting me.
5. Bears
Winning a scholarship from my school to attend this conference was such a spectacular opportunity. I was able to have a round-trip, direct flight to Anchorage paid for, as well as the conference registration and 5 of the 6 nights I stayed out there. A colleague who had lived in Anchorage advised me to rent a car so I could get out and explore, and I did. On my first full day I saw my first glacier, climbed a mountain, saw a rainbow, and came across 3 bears. By myself. I hiked to the top of Flattop Mountain trail with plenty of light left before sunset. The hike was challenging and my phone tracked it as having climbed 63 flights of stairs. At the top I was surrounded with breathtaking views of Anchorage, the bay, the sun sparkling off the ocean, the mountains, and a rainbow. The air was crisp and I basked in the silence. I decided to climb back down and began the attention-demanding trek back down hundreds of stairs. Having passed a platform near the top third of the almost 3-mile trail, I looked ahead and gasped the words “oh f*ck” as 3 bears, one large black bear and two smaller, younger brown bears crossed the trail, not 20 feet away from me. By some miracle, only one of the smaller brown bears noticed me, their head perking up and looking directly at me momentarily before deciding to continue following who I assumed was their mother. I was terrified and had no idea what to do. Instinctually, I decided not to draw attention to myself and silently backed up to behind the platform, where I crouched silently for a full 5 minutes. I waited until the bears were on another mountain, tiny specks on a giant mountain that I would take a few pictures of before texting my location to my wife and running the entire way back to my car in the parking lot. It took me 17 minutes.
Before finding the Flattop Mountain trail, I was at the Alaska Wildlife Conservation Center where, oddly enough, I saw bears, along with reindeer, caribou, wolves, ravens, and moose. For whatever reason, I felt compelled to burn sage when there was a bear lazily stretching in the sun, only a few feet away from me, an electrified fence between us. The bear reminded me of my dogs, and I apologized to the bear for having to be held behind an electrified fence to protect it from people. I apologized for all the damage people had done to its home–the forest, the rivers, the glaciers, and the oceans.
Later that week I was in the northwoods of Wisconsin, a guest of Anishinaabe birth workers in the Red Cliff Reservation and Tribal Health Center. Their people traditionally identified themselves by 7 different clans, each of which were represented by animals and virtues. The bear clan was known for their courage, advocating for family wishes and dreams, sharing teachings, and affirming the power of birth, strengths, and challenges. One of the tribal elders gave us tshirts of the health center, and on the back was a bear, a bear claw print over the heart.
There is so much wisdom to learn from bears, from rivers, from mountains, from trees, from elders, from my patients and preceptors and teachers and friends. From parents and babies and vaginas. Wednesday night, the Chicago Birth Workers of Color (ChiBiWoCo), an organization I helped start that started off meeting in my kitchen, won the Reproductive Justice Trailblazer award from the Chicago Abortion Fund. I know I belong here, and I know I will be amazing at it. I know I already have been. I continue to be humbled everyday, and hope to support people in making crucial reproductive decisions in a way that feels safe, empowering, and even healing.
Vida Doula Services 