"When You Support Clients in-Person, and by Changing the System" Transcript

Ajira: You’re listening to Doula Stories, a podcast where we use storytelling to encourage, inform, and love on doulas.

Keelia: Each episode we’ll hear a story about what happens in the birth room from the doula’s perspective. I’m Keelia, she/they…

Ajira: And I’m Ajira, she/they…

Keelia: And we’re so glad you could join us for today’s story.

Today we’re hearing from Ari Stoeffler, who’s a reproductive justice advocate based on unceded Pawtucket and Massachusett land, in what is now known as Boston, Massachusetts. Ari is also a dear, dear friend of mine. We met when we worked together at the Boston Abortion Support Collective, or BASC as it's usually referred to, and Ari actually ended up being my tattoo doula for my first tattoo. So Ari, I am just thrilled to have you on the show today.

Ajira: I'm very happy to meet you, Ari, and I did hear about the tattoo doula-ing so I hope that you will have some tips to offer folks who might be interested in wanting to offer that service.

Ari: Always.

Ajira: But tell us about yourself!

Ari: So I’m Ari. I use they/them pronouns. I consider myself from Paraguay, although I was raised in New Jersey. I’m a transracial adoptee so I identify as indigenous and mixed race and was raised in a primarily white area in New Jersey. I also consider myself to be someone who comes from queer ancestry, and I'm still figuring out exactly what that means but I consider myself to be a queer person who’s inherited years and generations of what that means.

I consider my people to be queer, trans folks of color, a mix of those two things is primarily what my community looks like, although my work looks quite different than that considering the fact that I do reproductive health. So while my community looks quite diverse, a lot of the work that I do is also in very white spaces and very, at this point in time, still very women-centered spaces.

I am currently in a combination of a couple of different jobs. My main job is working in an organization that does national abortion funding, and there I manage case managers who do regional abortion funding across the country. And so my primary job is supporting direct service people and doing financial counseling and abortion funding, as well as project management to look at kind of the equity structures that lead to how we make decisions and doing that. I also do consultant work with a research organization that focuses on reproductive health, and there I do work based on researching how we can do contraception and abortion care better for our trans and gender expansive communities. And that's a project I've been involved in for the last about four years and also certainly informs how I do my work from a gender equity lens and doing abortion care, and in general reproductive health. And I also volunteer for the Boston Abortion Support Collective which is actually where I met Keelia. And that is an organization that is near and dear to my heart. And I will say it is the place in which I feel I do the most what I would consider reproductive justice work, not just reproductive health work, in the sense that it is lead with intention by folks of color and it is intended to have racial equity and gender equity at the forefront of the work that we're doing as well as other equity work, although those are the two that we primarily talk about the most, I would say. And so in doing that work, I am with the people that I consider my people, that fuel kind of the rest of the work that I do and that work is focused on doing for the most part, in-person abortion support work, although I will say with COVID, as I can imagine most support people can empathize with, that has changed significantly and looks very different now. As a queer trans person of color I do healthcare navigation and justice work because I myself and my community are hard-pressed to find places where we can receive care that treats us with care, actual care.

Ajira: Woo! Ain't that the word.

Ari: Yeah, so I do this work in as many ways as I can to address that. So that’s a little of who I am.

Ajira: Thank you I mean Keelia’s probably like, they're just used to this awesomeness.

Keelia: Yep.

Ajira: But I’m like woah, blinded by the sun here.

Ari: Aw, thank you.

Ajira: So, so, so grateful for the work that you're doing and the way that you talk about it just feels so good. Like I'm feeling this resonance in my body.

Ari: Thank you.

Ajira: And I’m glad that you’re out there doing this work because it's so needed. I really appreciated you underlining how much this work is needed and from so many different angles and lenses.

Ari: Mm.

Ajira: I’ma sit with, I’ma just breathe into that for a minute, thank you.

Keelia: Mm, yes, Ari is the coolest. And they're going to get into some examples of what their work as a support person—using support person in place of the word doula—what their work as a support person looks like in three different stories that they’re gonna share with us today. And all of these support stories are examples of what full spectrum support can look like within the system itself. So for many of us, we come into the room to provide support as someone who doesn't work for the hospital or for the clinic or for a similar system, and Ari is going to share their perspective of what it's been like on the other side of things, instead of coming into the room from the outside to provide in-person support. Although, as we will hear more about, they do that as well so we're going to kind of cover several different angles to all of this.

So again, Ari, thank you so much for being here. And we have one more question for you before we get started with your stories, and that is: what are some of your recharge activities when you aren't supporting folks?

Ari: Oh that's easy. First answer is my dog. I have a 3 year old pitbull who I am not casually obsessed with. I just think she’s the best. She's my best friend, I love her a lot, and we spend all of our time together. And I would say honestly, this is a thing that I found through most of my life: having animals has been a really important part of my life. I grew up as an only child and having pets was just like a huge part of me feeling connected to something. And so having an animal that's there often, who just like is there to exist without knowing all of the complexities of what it means to live in this world, and just is there to be your company and to love you I think is such a helpful grounding thing for me.

The other part of it is video games. I play a lot of video games with my partner. I am a really big fan of intentional silliness. I spend a lot of my life being very serious in my work and I really, really, really feel like intentional silliness is very important to me. And so video games and silly movies and things like that are things that help my brain turn off.

Ajira: I agree with this. Intentional silliness. I love that.

Keelia: Yeah. I actually think that’s how we initially… That was when I first fell in friend love with you, is when we had a BASC game night and I saw you acting out... I think it was Moana? We were playing some kind of charades.

Ari: That sounds right, yeah.

Keelia: And you just went all in. And I was like, “That person is going to be my friend.”

Ari: People who have no chill about games are some of my favorite people of all time.

Keelia: Yeah, that would be me.

Ari: Mmhmm, that’s why you’re one of my favorite people of all time.

Ajira: Oh my goodness.

Keelia: Oh, well…

Ajira: Wait when you say no chill, do you mean people who are sticklers for the rules? Or do you mean people who’re just breakin’ everything?

Keelia: Oh you cannot say that that’s me.

Ari: I mean, so I mean people who are like, “We are gaming now.”

Keelia: Mmhmm.

Ajira: Okay.

Ari: Like with a capital “G.” I mean I have a very close friend of mine who, one of the first times we ever played games was like, “I just need you to know, I will do what it takes to win. If that means I’m gonna cheat, I will do that.” And I remember being like, “I respect that. Thank you for telling me. Now we can play the game the same way, and we can make it a Game.” And so like I really, I just appreciate people who are like, “This is how I'm going to play this game, and we are going to play a Game, and this is serious business,” in a way that is absolutely absurd.

Keelia: I think I know who that person is.

Ari: You do know exactly who that person is.

Ajira: They’re not talking about me, y’all, sorry.

Ari: Mm-mm. No I’m sure if this person listens to it, she will know exactly that I am talking about her, and I feel great about it.

Ajira: Awesome.

Keelia: I am so excited to hear the different stories you have for us. Is there anything you want us to know before you jump into the first one?

Ari: No, I mean I think I'm going to do my best to try to kind of create threads across them and talk about like why they're related to each other. But I think those threads are in my brain so if there's things that you feel like are being implied that I can pull out more explicitly you are welcome to ask.

Keelia: Sure.

Ari: But in my brain there’s a thread there.

Keelia: Yeah, no problem. All right, so where does your first story start?

Ari: So the first story that I want to pull actually started about a week into what I would consider my reproductive health career, which was… at the time, I would say I did not identify as a support person. I had done support work in a lot of ways when I was in college but I don't think that support person was a word that I would have used. That was about 7 years ago. At the time I had just started working at a reproductive health clinic and one of the requirements for my job which was working in the call center, I was taking calls and helping people book appointments was to shadow in the clinic, and part of that shadowing included shadowing an abortion.

I had never seen an abortion before in person, although I've been pro-abortion for many years and so for me I knew that this was going to be a moment where I was very excited to support someone and also knew that I'm not great in clinical settings.

And so I remember going in feeling very aware of how much I might feel uncomfortable in the situation just viscerally being around a clinical room. And so In the actual appointment itself the person that I was supporting it was a random patient, and I don't be random in any bad way I just mean it was a day that I was supporting and they said, “Here is a patient who said ‘yes’ to someone coming into the room.” There was really no prior conversation, I had never met the patient before. And so at the time the person that was supporting was someone who had been dealing with a lot of other medical care at the time. She had been, I want to stay, in the hospital for about a week before her abortion actually took place due to a lot of other medical care that was going on in her life. And by the time she came in for her abortion she was clearly at a point in time in which her body had been kind of dragged through a lot of health care, and it had a lot to show for that: she was very tired, she was very weak, she was dehydrated. And overwhelmed by being present in medical care for so long. And in a lot of ways, this one experience for her was a part of a much bigger medical care and medical experience, and one that I would say was not necessarily super kind to her as a Black woman.

And so I remember entering the room and meeting her, and just seeing that she was in a very emotional place immediately, you know? I think there are lots of ways in which we can perceive how emotional someone is, and I remember just entering that room and just feeling. Feeling the immense amount of anxiety for her. And almost all of her anxiety was centered around wanting to have sedation. So at the clinic that I was working at, we did offer sedation for abortions. It was an IV sedation so it did require us to be able to put an IV in someone's arm to do that. Because she had been in medical care for the entire week, her IV situation was incredibly challenging because she was a very small person who was very skinny and had also been dehydrated for a quite a while, and had been in medical care for a while to her arms were quite, they had lots of places where they had already used an IV on her that had both worked and not worked. And so the ability for us to put an IV into her to start the procedure to help her be comfortable was pretty challenging because she just genuinely did not have a lot of landscape to use for that.

I remember her sitting there just saying, you know, “I really, like I don't care what it takes. I just need this thing in.” And I remember sitting there and the doctors for better or worse trying to help her and support her and saying, you know, “If we can just get started it'll be done sooner,” and her saying, you know, like, “This is what I need. Even if it’s gonna take 20 minutes to do it, I need this.”

My role at the time in the grand scheme of things was a little bit unestablished. I would say, you know, I was there as a support person in the room but there was no specific like, “This is what you were here to do, is just to observe.” Actually I should reframe: I was not there as a support person, I was there as an observer. However, I identify as a support person in the grand scheme of my life and even if I didn't then my instinct was to go hold the hand of the patient, and so at that moment in time I switched into support person mode, and I went up to the patient and I spent most of the procedure just holding her hand through it and talking to her.

It was a… it was a really traumatic experience for her, and I don't wanna use the word traumatic to speak for her, but in the sense that I could tell it was very challenging for her. And so it was an experience which took about 10 to 15 minutes for them to get an IV, and they wound up having to do it in her hand because of everything I described earlier with the IV situation. And and just existing next to her, and holding her hand the entire time and being the one person who was there to just look her in the eye and be present and not be dealing with her arms or hands or any of the IV I think was something that was incredibly powerful for myself and for her.

And I will say it was incredibly impactful and something that I still think about to this day, and still holds the same amount of emotion in a lot of ways, and also was a moment, was the catalyst of me realizing that I wanted to continue to do support work and find different ways to do it over the years, and that's something I'll talk about as well. But it definitely was a moment of a spark of knowing that that's something that I will want to continue to do for a long time.

Ajira: I think one of the things that I really appreciated in your telling was the way that you talked about how the providers were trying to say to this person like, “Hey, we can just do the procedure and it's not going to take that long and it could be done,” and this person was so clear in advocating for themselves and what they needed, and saying like, you know, “I don't care. What I want is to have the sedation to help me feel comfortable with what you need to do.” So I think that sometimes it can be really easy as a provider or somebody who is doing this work, you know, even as birth workers I would say that sometimes folks get lost in the kind of colonized mindset thinking of like efficiency and thinking about like, “Oh if we just bear down we can just get through it and it'll be done and then we can clean up the aftermath,” kind of thing. And forgetting that, you know, the experience of whatever-it-is matters as much and more so, you know, even more importantly than all of that: what the person actually going through the experience wants trumps everything else. So even if you don't understand it, even if it doesn't make sense to you, even if it isn't what you would do, that is irrelevant. If this person wants this, that's what they should have.

Keelia: Mmhmm.

Ari: Right. And I will say she was absolutely right. As soon as she had the sedation she relaxed and like clearly kind of just went into the place that she wanted to be for the experience.

Ajira: And that makes a difference.

Ari: It does! She knew what she wanted.

Keelia: Mmhmm. Do you remember whether the wheels were already kind of turning in your mind seeing like, what if these care providers had the time that it would take with this appointment to give her the attention and care that she needed? Or what if there was somebody who was supposed to be here and providing the kind of support that you ended up providing? Like were those pieces of what care from the system could look like already on your mind?

Ari: I would say it was a spark.

Keelia: Mm.

Ari: I was so new, you know? It was my first week working in this clinic and everything was overwhelming and it was a period of time in which you’re in a new job and you're just have no idea who you are when you're doing at work. And so me realizing that a) I couldn't work in the clinic because I am definitely someone who has a vagal response to blood. I'm so here for people who push through that, and I'm just not one of those people, and I will forever support people in the clinic, and I just know I can't be in that room every time. And it was the realization for myself that because I can't be that person, that I want to support the providers in as many ways as I can to help support patients in as many non-clinical ways as possible which I can speak to you in a little bit, but also has to do with why I was actually part of the Boston Abortion Support Collective’s project in getting some support people into the organization over time.

Keelia: Mm. I guess before you jump into your second story, would it help to have like a quick zoom through time between that story and where the second one starts?

Ari: Sure! Yeah I guess that would be helpful because I will say that that spark didn't turn into me saying, “I want to become a support person full-time.” It did to turn into me saying, “I want to do support work.” And for me support work looks looks a lot different I would say, or at least I have imposter syndrome about what it looks like for me because I don't do as much in-person support work as a lot of people that I love. And so for me a lot of support work looks like systems work.

Keelia: Well and can I just add something right there?

Ari: Absolutely.

Keelia: That even folks who I know who do full-time support work like birthwork, for example—full-time support work in birth—often still have that same sense of imposter syndrome.

Ari: I know!

Keelia: like, “Well I've only ever supported births in a hospital setting,” or “I've only supported five births,” or, “I've only supported a hundred, and so-and-so over there has supported a thousand, and they've been mostly homebirths,” you know? That there's like… I just want to affirm as someone who is hearing these stories about the kind of support you provide, and as your friend who has received support from you on countless occasions: in case anyone is in doubt still, Ari is the best when it comes to support person. And I also hear you! And like your experience of imposter syndrome is pretty understandable.

Ajira: Yeah.

Ari: Yeah. I will also say it also has to do with the way that we talk about what a job means you know?

Ajira: Yes.

Ari: And what does it mean that my job is not to be a full-time support person, versus the work that I do?

Ajira: Yes.

Ari: And so I have compassion for myself for the nuance of what I just said, and I kind of did do that thing where I undervalued my support work, but also I am fully aware of the fact that that’s something that I'm actively working through.

Ajira: Can I add one more piece?

Ari: Sure!

Ajira: Because I also think that this is pointing to something that, you know—and I blame it on colonization because it's true—but I think that there's also this element of creating hierarchies of value about, you know, like supporting someone in person is more valuable than supporting them virtually. Or supporting someone you know without leaving a five-day birth is more meaningful than going to the hospital and staying there for a few hours and then leaving and coming back. And I want to call bullshit on all that. Because I think what it actually is is whatever support you offer to whoever in your life needs it in the way that they want it is valuable. And I don't think any one is more valuable than the other. And I will say that, you know, as much as we want to dismantle these systems because we can see the harm that they perpetuate on all levels to all people The fact is that we're not going to be doing it today or tomorrow And so having folks who are working actively on various aspects of it from you know being at a birthing person to supporting someone who's going in for an abortion virtually to working on the systems that are providing the services to folks all of those pieces matter and I for one am grateful that you're working on the part that you're holding because I know that I'm not going to be doing that, you know? So I'm glad, I’m grateful that you’re there to do that part. And it makes me feel really good to know that the people who are looking for that kind of support have an ally or an accomplice or—and I hate these words so much—they have someone on their team who is working for them from the other side, you know? So I'm glad you’re there.

Ari: Appreciate that.

Keelia: Yeah. I think that’s kind of the perfect lead-in to your next story, Ari, right?

Ari: Yeah. I mean I think in the grand scheme of things, I appreciate everything you're saying and if I heard someone else say what I just said, I would probably say all those things to me too. And also I think there's a lot of reality to how we internalize what it means to do support work, so I appreciate that compassion. I am someone who, in general, in how I do my work, has become more fixated over the last few years on what it means to build power in doing this work. I think that's why I have chosen to push myself to grow into more management roles, and more systems-oriented roles, and so that's part of what I try to do when I mess with our systems. I choose to change from the inside, and I absolutely understand and respect those who do it different ways, but that is my version of trying to do this work.

The second story I'm going to tell is a little bit later in my career, so it's probably about three or four years later. In the interim I was still working in the call center and then there was a change in which I became someone who did late term abortion navigation. So for about a year or two that was a primary part of my job, and I was working with patients who were starting in the clinic or maybe not even starting in the clinic, but most of them were starting the clinic who would come in thinking they were certain gestational age, and then would find out that they were much farther along than they thought that they were. And so my role was to help them navigate that.

In Massachusetts, our cut off is 20 weeks and 6 days [to get an abortion] and so often times that also meant that I was working with patients who were going across state lines. So the story I’m gonna tell is the patient who was going across state lines.

So I was working with a patient who had come into the clinic, and thought they were much earlier along. This is something that would happen often. As someone who was doing late term abortion access, I was very aware of the nuances of why someone would need late term abortion access and one of them, a pretty regular one that would happen was someone thought that they were early and found out that they were quite further along. This person was unsure of the last menstrual. Which is usually how we judge how far along someone was, and so thought they were quite earlier along and by that I mean just in the first trimester. And I don’t say “just” so say that that’s not far along for some folks, but in the grand scheme of things as someone doing late-term abortion access, she had not anticipated being very far along.

She came into the clinic with her parents and found out pretty quickly that she was much much further along. Because of where we were in the state and in the country, having an abortion in Massachusetts was not an option. And so for context, the real factors that were going into this was that the person's tension was between the level of care she needed to have an abortion, and the type of support that she was receiving outside of herself and her mother. And so what we were talking about was a patient who was quite far along, who, if we wanted wanted to support having an abortion, was going to have to move immediately. And by move immediately I mean cross several state lines and wind up in Colorado and spend tens of thousands of dollars to have a multiple-day abortion. And so, I'll be real, this is not the first nor the last time that I had worked with someone who far along, nor was

it the first or the last time that I had worked at that level of the logistics, but it stuck out in my head for many reasons. And one of them list the ways in which their context was so important to what they were doing. And so this was a situation where someone had a family member who was incredibly supportive so her mother was in the clinic with her and was absolutely wonderful—this person was a minor, for context—and so her mother was absolutely wonderful and so supportive and I just, I will smile every time I think of her.

And unfortunately they both shared that the rest of their family was incredibly not. And so everything that they had to do had to happen with complete privacy and confidentiality, including Insurance coverage, including traveling across state lines, including everything that was involved in the procedure.

Keelia: Yeah, when you say Insurance, you mean like insurance bills. If there was someone else paying the bill, they couldn't see this show up, like that's the level that they were at.

Ari: Yep. Right. And like credit card could not show that the hotel was in another state, like everything needed to be private because the risk level of someone finding out was that the two of them would not be able to function in their family structure anymore in the way that they needed to. And so I don’t know exactly what would have happened if they had been out but it doesn't matter because their intention was that it was not an option. Their family finding out was not an option, and so that was what we moved with. And so we had a lot of conversations around the logistics that it would take.

And at the end of the day, we were able to pull it off because we had resources across the country that were able to help raise tens of thousands of dollars and pay for all the lodging and pay for all the travel. And I will never forget the faces that were made of relief in response to knowing that it would work out, and also the panic of, “How are we actually going to do this now that this has all worked out?” An important part of the story is that they had literally never left the state before. So this is their first time leaving their home state, was to go do this. And it was the first time of many immediate family members who had ever left their home state, and it was also something they could never tell their family about, which was like, what I was reflecting on, was a very interesting dynamic for them. They were taking a huge leap of faith and in doing this thing.

You know I remember setting up all the logistics and the part that also stuck out was a conversation towards the end which was the moment where you realize what support work looks like, which was us having figured it all out and then talking and saying, “Great! So you’ll be set at the airport.” And then at the last minute her saying, “Well, I don’t have a ride to the airport.”

And realizing that after all of logistics, that if we couldn't get her to the airport all of it was moot. And so we set up a time, set my alarm at 5:30, woke up, called her and said, “Are you ready?” and she said, “Yes,” and I called a Lyft to her home and got her to the airport and watched her arrive and knew she was safe. And it was a moment of realizing just all of the things that go into what it means to do support work.

And she came home and we did the same thing. You know, on the last day she said, “I'm arriving at 4:30, can you call me a Lyft?” I said, “Yep, I'll set my alarm,” and it was a very early morning. I set my alarm, got her a Lyft and went right back to bed. And I just remember the powerful moment of connecting with her afterwards, and just the relief in just knowing that this was something that she would probably never be able to share with the rest of her family, and by she I mean both the mother and the patient.

And I will never forget that feeling and knowing but if it weren't for every single thing going right, that person would not have had her abortion. And by going right, that's a very subjective term, right? Like this person was coming from an unsupportive family. What does that mean for everything to go right? But in the grand scheme it meant everyone was able to pay for things, they were able to have nothing with her name on it, and we were able to make sure that everything went as smoothly as possible given the circumstances they were in. And it is why I do support work and it's also why I do abortion work, you know? I think we’re a very small network of resources and if you know who to talk to, we can pull off an immense amount of work off for someone if we need to. It's just about knowing the right people. So support networks, I think is really what I have focused on since then, through learning what it means to do this work in collaboration with other people.

Keelia: I just I so appreciate you sharing that story for highlighting what systemic support can look like, that it's not just the money, it's making sure names aren't visible, it's literally you setting your own personal alarm. Like I actually remember when I first joined the Boston Abortion Support Collective, you have been part of the cohort, I believe, that had done more research into what folks needed to access abortion in Boston. And here we had this group of support people, myself included, who were all ready to, in my imagination, do more of the hand-holding, talking through options, tissue-passing, you know, not that none of those things aren't incredibly valuable. But the feedback that we were collecting was people just need rides. Like that was the overwhelming ask. They don't need someone to hold their hands, like that would be nice, and the saltine crackers and the ginger ale and the, you know, puke bag, and whatever else. What they really just need is someone to get them from A to B and then back, and like sit in a parking lot and wait for them, and drive them back home.

Ari: Yeah, I've done more support work through logistical support then I have in-person even through the Boston Abortion Support Collective because of what people need.

Keelia: Mmhmm.

Ajira: I think this whole thing is just really highlighting for me, as well, how easy it is when you do support work or want to get into support work to become seduced by your ego's idea of what a hero you're going to be, right?

Keelia: Yes.

Ajira: Or what a good thing you’re doing. How much you're helping because you're gonna, I don’t know, I don't know, enlighten minds or whatever fantasy we each carry in our imaginations about what that looks like. And sometimes people just need you to be quiet, pull up in the car and then drop them off and not say anything else. And sometimes support looks like, you know, waking up, ordering a Lyft, and going back to sleep. And that's more than enough, if that's what people are asking for. I think that reminder to stop centering ourselves and our own desires and our own idea of what's right and good is so helpful, right? Because if we really want to show up for folks then we need to show up for them in the way that they are asking us to, not in the way that we think they need, right?

Keelia & Ari: Mmhmm.

Ajira: Reminds me of the story I heard about when I was younger about how—and who knows, I've not verified this so this could be false—but there was a story about Finland or some other country up there in the north where it's very snowy, where winter is always there, apparently, wanting to help the poor Africans and sending like snow machine things. I don't know what they're called, the big machines—you might know, Boston people—to clear the snow out of the road.

Keelia & Ari: Snowblowers?

Ajira: Yeah, so they sent a—I don't know if it was snowblowers or the ones that like push the snow out of the way?

Keelia: Oh goodness.

Ajira: But they sent a bunch of these machines to Tanzania which, if you don't know, is a tropical country and we only really have snow on Kilimanjaro, the tallest mountain in Africa.

Keelia: Clear the snow off of the very top of Kilimanjaro.

Ajira: Exactly, so we could keep Kilimanjaro clear snow if we needed to.

Keelia: Thank heavens.

Ajira: You know and it's kind of like, okay, so presumably that country felt really good about itself having helped some poor Africans. But it didn't actually help.

Ari: Right. Right.

Ajira: And I think that's a key piece. It’s like, okay, it's nice that you're baking everything you bring fresh, or it's nice that you, you know, knit everyone a baby blanket. But is that what they ask for, is that what they want from you?

Keelia: I mean, I would even argue that it goes beyond it just not being helpful. It like very actively hurts them. Now they have to find a way to deal with a bunch of snowblowers, you know? And they probably have to find a way to say thank you, and make these big eyes and take photos and come off as someone other than, you know, the ungrateful poor person, the ungrateful Black poor person.

Ajira: Sigh. We’re not allowed to do that.

Keelia: And the extra harm, I think probably the worst harm, is that that country or whoever designed that project, then all their attention is diverted to: “I did the good thing, and now I don't need to spend any more energy educating myself, finding out from the source what they could actually need.” Like it just, it’s a full stop, right? It’s like, throw some money at a problem and that’s it.

And that example can carry over everywhere. I feel like maybe in birth work I find myself thinking that we're not here to collect people's tears like they’re trophies.

Ajira & Ari: Mmhmm.

Keelia: You're not supposed to be going around and like the more people who cry onto your shoulder, the better support person you are, and the more stories you have so you feel good about yourself. I don’t think very many people think that way, but our role is so special, and we hear from so many people, “Thank you,” like, “I couldn't have done this without you,” which is its own thing, like yes, you could have, you did, like I know I helped but you did do the thing.

I just think it's so tempting to just feel like a savior. To feel like that is our job.

Ajira: Yeah.

Keelia: And it really isn't. What we do is enough. What Ari did waking up, calling a Lyft.

Ari: Mm. I will say, when I first started doing late term abortion access, I threw myself in with bad emotional boundaries. Because that's what happens when you are someone who cares a lot and you do work that has a lot of people who are in stress, and can feel like they're in crisis, and are in crisis sometimes. And I remember I was trained by someone who had been doing the work for about 12 years before. We have a lot of different politics in a lot of ways because of our identities but our core selves of wanting to support people is very aligned. And I remember within the first month her telling me, “You can't want an abortion more than they want for themselves.”

Keelia: Mm.

Ari: And I will never forget…

Ajira: Oh my goodness. *snaps* Please say that again for the people in the back.

Ari: You can’t want an abortion more than they want it for themselves. And it was literally life-changing, and it is still something that I think about everyday in the sense that my job isn't to want something for someone else. It’s if they want it, to make it easier for them. And so it shifted my mentality around abortion work at a time in which if it hadn't, I think I would have gone into it with a lot more saviorism than would have been appropriate.

And I think I feel very strongly that my saviorism mentality comes out around my systems work, and I try really hard to have it not come out of the individual level. And I think that's where it feels appropriate. Because, let's be real, I think all of us who do this work do have a little bit of like, “I’m trying to fix something here,” and so I don't think saviorism itself is inherently bad for not censoring ourselves all the time.

Keelia: Right.

Ari: I think if it's coming out on the systems level, I think it's way more appropriate than an individual level cuz I'm not trying to save any individual person, that's not my job. But I am trying to fix our systems and so I think that's where it feels more comfortable for me to have that mentality live.

Keelia: Yeah. I actually had a question for you about that, when you were on the phone with this mom and just double-checking, like, “I’m calling a Lyft for you. Are y'all, you know, you have to be outside with your suitcases at this time,” whatever those conversation looked like, by then because you’d been doing this for a while, what was it like for you to navigate the in-person emotional care work with the systemic kind that you are also doing?

Ari: The in-person’s always easy part for me, personally. Like I was there in the clinic when the patient found out how far along they were, and I was the person who was called to meet with them after. So I was there for about, within 15 minutes of that realization on their end. And I will say that's the part that feels like my… my space.

Keelia: Mm.

Ari: Being in a room with someone who's going through a lot, and just sitting there and being like, “Yeah. This is really hard. And also, you're not alone. There's a lot of things we can do to help.” I think that's the place that I feel happiest.

It's why, honestly, why, as I've gained management experience and become more project-oriented and doing more management of people who do direct service, that’s my loss, is that I lose that part of working with patients. It’s that I don’t work in person as much. And I think that that's what makes me saddest and also I’ve reconciled with the fact that at least I can do systems work. But the in-person work is the place that I am happiest.

I make no assumptions about how someone feels about abortion until they tell me how they feel about it. And there have been plenty of people I've worked with for whom it's just another logistical thing for them to check off, and there’ve been plenty of people who I’ve worked with where it consumes them for that moment in time. And I am comfortable in both settings because I've been around a lot of emotion around abortion because I've been working in the fields for about seven and a half years. And so I feel grounded enough to be present for most people regardless of where they are in those moments, and so that makes it much easier because I also know what I can offer. If I didn't know what I could offer I think I would also feel unbalanced.

The systems work is where I feel the largest part of tension. And it's not tension in a bad way, it's the catalyst of me saying, “This is where I need to be.” The part that I find to be less enjoyable, it's the part where I have to look at what does equity mean in the bigger picture, what does it mean to do this work, what does it mean for us to think about logistics of barriers for patients and how do we really address this when, in the grand scheme of things, I’m still working in a system that's run by rich, straight, cis women? That's the part where my fire comes out. Where when we’re working with the patients, that's the good stuff that fuels the fire. But the fire comes out when I do the systems work, because that's where I realized: if I can just fix that stuff, so many people's lives would be easier.

Keelia: Yeah. Also kind of the perfect segue into your third story.

Ajira: Yeah, I'm really excited to hear what the next one is and get into like a bigger question of like how do you do this work with the weight of this entire system that, in all these ways, is built to not create space for people's experiences, especially BIQTPOC folks who have uteruses! And their experiences.

Ari: Mmhmm.

Keelia: Right, like I was gonna say, like for people like you, Ari! Like you’re doing this…

Ari: Yeah. Yeah, I do this work for my people, too, yeah.

Ajira: Yeah. Yeah.

Keelia: Right. Like having to change the system for them working alongside folks who probably don't look like you or are not necessarily your people.

Ari: Yeah.

Ajira: Even like working in an organization which is supposedly against the system, and then how quickly disheartening it can be to discover, you know, all the concessions that have already been made and have already been synthesized into the organizational culture so that it seems… I always bring up cognitive dissonance, but I think it helps me understand so many things, and I think that with nonprofit culture or reproductive health organization there can be such a temptation to do like one general classification of like, “Oh you are doing good work Because this is needed and therefore we're not going to interrogate anything else about what you're doing or how you're doing it and any critique about the specifics of what you're doing is an attack on the like foundational piece of what you exist for, and therefore cannot be permitted. And how problematic that can be, and how difficult it can make it for people who are typically not viewed as the norm because—ding ding ding—we're still operating in the system, and we’re still centering, you know, let's be frank: white, cis, het men. Above everything else, no matter what the, you know, if there's a system you can bet your bottom dollar that's what it’s centered around. Even if it purports to, you know, exist for this, that or the other thing. And so bringing the reality of your own lived experience as well as like the desires that you have for creating space for our people, and then having to cope with how big it is, right? Because it's not fair to expect you, one solitary person, to dismantle this whole system by yourself. We can’t be like, “Oh Ari’s got it, it’s good. We got that part done.”

Ari: It doesn’t mean I’m not gonna try, at least, but I will definitely take as much help as I can get.

Ajira: Exactly! Like how can we all pull together so we're pulling it down brick by brick, you know? And how can we be more focused on continuing to… like if I pull down a brick every damn day of my life and I live to my own projection of 130 years in total? I'm going to put in a good like 90 years of brick pulling, you know? That's a good 90 bricks that you can be sure I'm going to pull down with me. And if each of us is doing that, we're going to go much further than if I just spend my whole life throwing myself against this wall, you know?

Ari: Absolutely.

Keelia: Mm.

Ari: So the gap between the last story and this story is probably about the same amount of time as the first story to the last, most recent one, which is to say I had changed roles again. And the third story I’m telling is when I was managing our department that had held both the call center role that I was in, and late-term abortion access work, and some other smatterings of work as well. And so I was kind of in a position where I was doing a lot of first-contact work for the organization, a lot of work to manage patient expectations, a lot of systems work that was non-clinical support for our clinic. And so a few years prior to this story, or I guess the thread of this story lasts a few years, but the beginning of this story was when the organization I was working with made the decision to offer gender affirming hormone therapy.

Gender affirming hormone therapy in this context was talking about someone who’s looking at taking testosterone or estrogen progesterone. And the reason someone would be taking that is around gender affirmation. So we use the term gender affirmation instead of “sex change” which is an older term, just to make sure that we’re being inclusive and empowering for the trans community, and so that’s the term that I’ll use. If you hear me use “GAT” that’s what I’m talking about.

Keelia: Cool.

Ari: This was also a time in which a lot more trans people were becoming prominent in the media. Laverne Cox had become a lot more prominent, Caitlyn Jenner had come out recently, like it was a time in which the trans community was getting, I would argue, both good and negative attention. Any attention that you give to the trans community can come with fear, especially from the trans community itself, just if you don’t want that attention from the cis community. And cis community just meaning people who are not trans. And so our organization made the decision to start offering gender affirming hormone therapy which would allow us to be actively inviting the trans community into our doors in a way that… The organization was not not already seeing trans folks but we were not offering something that was intentionally designed to bring the trans community into our services specifically to care for them. And I will say very explicitly, I am a member of the trans community and I have been on hormones for ten years which is a very big part of why this story is relevant and why I do the work that I do around the trans community as well.

And so, through that decision The organization wanted to move ahead and just start offering this service. At the time, I was one of two out trans folks at the organization who had been invited into a committee to do this work alongside a lot of other providers and folks who had titles that were making higher decisions than we were, but we were the two folks in the room who were the trans folks to speak for the trans community because, as most marginalized people have experienced, sometimes you’re the person who gets invited in the room just to represent your entire community.

It was an intense first meeting. I remember spending a lot of time talking about bathrooms, and then a lot of cis people being really upset that we spent a lot of time talking about bathrooms. And it was the moment in which I said, “We’re not ready for this.” And so I had a lot of serious conversations with folks. And I will say that I’m grateful that I was stubborn enough to be listened to eventually. We needed to do a training on gender affirming care before we did anything that was specific to the trans community.

Ajira: Mmhmm.

Ari: Meaning, everything that we offered already needed to be trans inclusive and gender inclusive before we could start offering a new service. Because if we were offering a new service without doing that internal work around what it means to talk to someone who’s trans, then we’re just inviting in a community that is going to be harmed. And I will say for myself as a trans person I was very aware of the fact that we are a very small community and we talk internally. And if one person goes to a clinic and has a bad experience, they’re gonna tell 10 people, and those 10 people are gonna tell 10 people and the trans community is not gonna see that as a safe space. Which is very valid, and I want to make sure that that is clear. Like it is very valid that trans people do that. They should do that. That is what it means to survive in healthcare.

We spent probably the next two years, or at least a year and a half, taking a step back, based on the feedback that myself and the other trans person in the room had given. We wound up then deciding to create an entire training on how to do gender stuff better, first. And so I was part of implementing that training internally. One of the reasons why I was part of doing that work was because I also, on the side, was doing research for a reproductive research organization that does research on reproductive health across the country, and I was working on a project that focused on trans and gender expansive care. And so I had a lot of lenses on how to do reproductive health in ways that were better suited to be trans-inclusive, both from my own personal experiences as a trans person but also because I was working with a large team of people who’d been focusing on this work for a little while. And so through the conversations we were able to have the educational spaces in which I was able, with—we affectionately referred to the person as our “cis-cilitator” instead of our facilitator. It was similar to, I’ve done a lot of racial justice training where like we have one person of color do the training and one white person do the training so that it’s not all on the person of color to do that emotional labor. This was similar for the gender trainings in which we had a trans and a cis person do it.

And so over the years we were able to kind of move the needle a little bit internally on how folks were talking about gender. I will be very real that I would’ve loved to have moved the needle more and also the reality is that we needed to start offering the service, and it was going to take a long time to get folks really to where they needed to be.

Keelia: I just, like, cannot imagine how much work that took on your end. How many conversations that took, how many uncomfortable conversations for you, because slowing down and doing research, and having to admit that you don't know everything already, to jump ahead and just do the ABC capitalist way of “productivity”... To slow down is so unsexy. To non-profits, and to individuals, you know?

Ari: Yes.

Keelia: Like that person with the snowblowers, if we’re bringing up that analogy again, like they were probably pumped to start searching online to see what the best snowblower… you know, like once people… In my experience, many people who are providing any kind of support, once they have what they think is the solution they want to jump right in. And for you to have to convince folks to take a step back and slow down to do the thing properly, I just, I applaud you forever.

Ari: Thank you. And I will be real, I think they both did it out of the goodness of their heart, because they were convinced that it was not going to work the way they did, and I'm going to be also very real that capitalism requires you to have more patients. And if you don't have more patients you’re not going to be able to offer the service.

Keelia: Mmhmm.

Ari: And so they realized that the risk was that if they did it wrong, they would lose their trans population.

Keelia: Patients vs patience.

Ari: And so there was both the goodness and a very real money element there.

Keelia: Yeah.

Ari: I think what I want to say to that is that the folks who got it, got it. And I really appreciated that they were on my side, and this included cis folks as well. But, you know, it was a lot of work.

And so we finally started being able to offer this service after a few years, which was really great. After doing focus groups, after doing a lot of work to get it to the point where we knew what we were doing, we finally ran the trainings and did the focus groups and started offering the service. Very quickly though when we started offering the service it became clear that are trans patients’ appointments for gender affirming hormone therapy were taking infinitely longer than our other appointments considered to be the same type of appointment in terms of complexity of medical care—so like an annual exam, for example. A type of appointment that has multiple pieces of it, but is not terribly complex from a medical perspective.

Keelia: Do you mind clarifying like the reason why an appointment being a specific amount of time from a systemic point of view why that's so important?

Ari: The more patients you see per hour, the more the clinic makes. So there is a very specific push for productivity in a clinic that can, in very real ways And very real ways bump up against quality patient care and ways that is not an individual fault of a provider butt is, again, a systems issue.

Keelia: Right, right.

Ari: And so it is not a provider saying, “I don't want to be present for a patient.” It is the entire tension of what it means to work in healthcare as a capitalist system.

Ajira: Can we pull those two threads apart someday, please?

Keelia: One day.

Ari: Some day, right?

Ajira: Can we not have healthcare be a business? Cuz damn.

Ari: It’s what it means to do healthcare.

Keelia: Yeah.

Ari: It's the same thing as birth being scheduled for c-sections.

Ajira: Absolutely. It's like if it's a business, it can’t also be people-centered, y’all.

Ari: Yeah!

Ajira: Because by virtue of it being a business, it’s gon’ be money-centered.

Ari: Exactly. And so what was coming out was that our patients who were coming in for GAT services were taking a lot longer than patients who were coming in for the same type of complex medical care. And there was a realization that we couldn't figure out quite why. And so I had a meeting with a bunch of our gender affirming hormone therapy providers, and by “meeting” I mean we sat at our lunch table and talked about it because that's just how it works sometimes to do this type of change, where you like have individual people you talk to and you’re like, “I know that this thing is happening. Talk to me about why.”

And so it became very clear after the couple providers I talked to that the pattern was that our gender affirming hormone therapy patients were talking about so much more than just medical care. We were talking about what it means to get their name changed, we were talking about what it means to have access to top surgery referrals, we were talking about what it means to have supportive family members, we were talking about what it means to have resources that could help them navigate a lot of this stuff. We were talking about the fact that it's true that a lot of our trans folks have housing insecurity in a disproportionate way.

And so it was very clear that a lot of the things that disproportionately impact trans communities were coming out in these conversations, and that those things were not clinical conversations. Those things were conversations around medical care and medical support, but they weren't needing to be happening from the provider perspective.

And so I was able to advocate and build the program, and over time, was able to hire someone who became a patient navigator who was able to do that work. And they were phenomenal and they were someone who, over time, we created a system where we worked with the providers directly to figure out what were the patterns that patients were identifying they needed support on, and created a screening tool, and that screening tool picked out the things that we knew Disproportionately impact of the trans Community both because of the research that was done in general for the trans community also because of anecdotal feedback from our patients. And through that screening tool, we were able to create a list of resources so that if a… The worst thing you can do is ask someone if they need support and if they say yes you're like, “Oh that's too bad, I don't have a resource for that.” And so we did a lot of work to create the resources themselves, to make sure that when we actually implemented the screening so that if someone said yes we had support for them. And so over time we were able to build this program so that this person was able to provide support across all of our health centers across the state so that any time of a patient came in and was looking for that service we did the screening first and depending on how that screening went, the provider was then able to say, “I'm glad you identified the type of support you need. We’re gonna talk about your medical care first, and then I will transition you into talking to this navigator.” And that was able to balance this patient's care needs around needing support outside of their clinical care with also balancing the system’s need around making sure that the providers were then able to move on to the next patient.

I will say it is probably one of the things that I can, with the least amount of complication, say I am truly proud of. I have a hard time saying that I'm proud of things, but that’s one that I can say was. I was proud of doing that work because I left that organization not too long ago, and in that process I left behind the person who I trained who is now running the program.

Ajira: Yay!

Ari: And is a trans person of color. I'm very proud of what they are doing. We are still connected in a lot of ways because we both share community and because I'm still in abortion world. I will never leave my old job in a lot of ways, and that’s something that I love is that I get to still collaborate with my old coworkers. But it is something I'm very proud to have left behind, and know that it is in good hands with someone who I truly believe shares the values that I did when I was starting that.

Keelia: Yes!

Ajira: That is so satisfying!

Keelia: Ugh. Yeah!

Ari: People were able to come in and get the care that they needed in a way that was more proactive. The intention of what we created was to make sure that we recognized the gap in care and addressed it in a way that both allowed the patient to be seen by the people that they needed to be seen by. but also did not negatively impact every other patient. And I think that's really where the system stuff gets hard. It’s like how do you do this sustainably so that every person who needs to be seen can be seen without taking away resources? And so that was the challenge was figuring out how to add a resource, and support patients, and also make sure that the clinic was being supported as well.

Keelia: Right.

Ajira: I think it also looks like acknowledging that these issues that patients were bringing up are related to their medical care experience. And I think that sometimes, I've certainly had the experience where I've tried to paint the picture of what the condition of dealing with, how it impacts, you know, the rest of my body, the rest of my life, the rest of my family, and, you know, the other people in my life, et cetera. Only to be kind of told like, you know, “No. It's your elbow that hurts. That's all I'm concerned with,” you know?

Ari: Mmhmm.

Ajira: I think that sometimes providers can be very, like—not through any fault of their own necessarily, but I definitely think the system encourages this—that kind of view of like, “I'm just looking at this hormone and nothing else,” as though it exists in isolation. And the truth is that people's experiences are much more intertwined, you know, much more holistic. And the fact of the matter is that it's not as simple as, you know, “Hey, I need this hormone.” There are ramifications in all directions. And having the space for a provider to be able to hear you on that and then also point you towards resources, reflect your lived experience—all of those things makes such a difference in the way that people can come away from that. And, I would argue, really actually support healing as well because it can be tempting when working in this, you know, in the medical industrial complex to just be like, “I gave a pill, I did the surgery, my part is done.” And it's like well, no, if we're not also saying like, “Hey, this is how it might impact other aspects of your life.” Like if we’re not also covering those things, and at least helping people find the support they need to cope with that part, then are we really helping?

Ari: Yeah. It's one of the reasons why I stay in healthcare, cuz I think there's so many other issues that I feel so strongly about and would be just as enthused if I were as far into them to be working, but I see healthcare as a crux issue in a lot of ways.

Ajira: Yeah.

Ari: You know, there's a lot of reality to the fact that if you're housing insecure, you’re not gonna be able to provide healthcare for yourself. There’s a lot of other things going on your life. There's a lot of barriers to being able to take care of yourself.

Ajira: Yeah. Oof.

Keelia: Thank you for what you’ve done.

Ari: Course! It’s, I mean, I’m grateful for the opportunity to talk about it.

Keelia: How does it feel looking back over the last few years that you've been telling us about? You know, how Ari started off and what you're up to now?

Ari: I both feel the same and Incredibly more radicalized. I think I would say I'm someone who's had core values that existed through most of my life that aligned with the work that I do now. It's why I do the work that I do now, and it's part of my survival as a queer trans person of color. And also I will say the ways in which I've had to learn about what it means to build power in doing this work has really humbled me and excited me and challenged me. You know I think I've had to learn what it means to to be mindful about which battles I pick and where I do it.

[Ari’s dog, Pepper, barks in the background]

Excuse me! The dog. And so I think I would say I’ve just learned about when to speak up, and who to speak up to.

[Pepper keeps barking]


Keelia: It’s really cute.

Ari: She’s very furiously protecting the house because clearly something’s up outside.

Ajira: Thank you, Pepper.

Keelia: Protecting you from terrifying squirrels.

Ari: I know. And she’s just got the loudest bark. And it’s, I will say, even as someone who loves her immensely and sleeps with my face next to her all the time, it still startles me.

Keelia: Take your time, no problem.

Ari: She’s… yeah. But yeah, it's really radicalized me to understand that I want to do systems work. I do want to change things from the inside. I think, in the grand scheme of things, I have an infinite amount of respect for the different ways in which all of us decide to radicalize the world for the folks who, I think, align with the values that I’m trying to do. And also think we all have to navigate the ways in which we do a balancing of our own self care and the impact that we want to have. Over the years I've just realized that the impact I want to have is more on a systems-level. And, again, I think that's why from the beginning I said I’ve had imposter syndrome about what it means to be a support person. Because I've decided that I’m moving away more from doing more direct service work and I've done more management of support systems and that, to me, is something that I'm still learning. To find my voice as a support person and continue to do sustainably.

But at the end of the day, my support people are always my community. BASC is my community. The people I've met there—Keelia, you know, you're my community for that reason. I think it's I do support work and I surround myself by the other support people and that is what makes my work sustainable in a lot of ways. Because it's hard work, and it's personal work, and I also don't think I could see myself doing anything else.

Keelia: Mm. And that group of people that… You bringing up BASC again. We weren't all working in settings like this, you know? This work is not just in systems that look like this. There is a whole host of people who are organizing and providing full-spectrum reproductive justice support outside of these systems as well. In creative, really beautiful, empowering ways. And I'm just so grateful for the pieces that you're holding. I just… ugh.

Ajira: That’s the whole podcast is just me and Keelia going, “Ugh. We love you so much.”

Keelia: Love you so much!

Ari: Aw. I’m so bad at compliments. But I appreciate it.

Ajira: If you were talking to, you know, Ari 8 years ago, before that first story that you shared with us, before that first observational experience which quickly turned into a support one, what do you think would have been helpful to know? And/or, what would you say to somebody listening to this podcast who's thinking like, “This is the work I want to get into,” either, you know, supporting folks who are looking for abortion support, or wanting to work within the system to, you know, work alongside you pulling these bricks down.

Ari: Yeah. I think I would say two things. One is to trust yourself. I think I've spent a lot of my life gaslighting myself around my values of what it means to do this work, because I've done it in opposition from a lot of people who, in theory, share my values, but also exclude me in the conversation, and by me I mean my entire community.

Entrusting that I'm not wrong and continue to advocate and, I will say, trusting myself that being the squeaky wheel in a moment when you’re vulnerable in an organization is always worth it, even as hard as it can be. And by always worth it, I don’t mean always worth it. I mean always worth it for me. I think everyone needs to balance for themselves what risk it means to be that person and the identities that you hold. And I will say, I was considered the feelings person for a really long time, and was kind of discounted as that squeaky wheel, or felt myself feel that way even if it wasn't true, and that feeling itself I think is important to name.

So I think trusting yourself and not giving up. And finding your people is a big one. You know, I also will be very real: a lot of the work that I did would never have happened without side conversations with people who… We would get drinks after work and talk about how we were going to, you know, start the next conversation with the people who have power in that room. And so I would say a lot of organizing is stuff that's done on the side. It's finding your people. It's learning how to stand up for each other. It's learning how to make sure that you're not alone in a room. It's making sure that if there's someone else in the room who needs to be that they're also there.

The other thing I would say is that I think it's called the curb sidewalk effect? It's the idea that like if you create something that is meant to make someone who has the largest barrier, to make their life easier, that everyone else's life gets easier as well. So the curb sidewalk idea is that like curbing a sidewalk and making it easier for a wheelchair to go down is something that benefits the folks who need it the most, which is folks who use wheelchairs, but it’s also beneficial to anyone who uses a stroller, or a scooter, or a bike, or a delivery van, or anyone else who needs mobility support. And it’s the idea that if you can reach the people who need it the most, you're also usually benefiting the people who need it less but could also still use it.

And so I would say when I approach systems work, I try really hard to center the folks who need the most support because the trickle up effect of everyone else who needs less support is also gonna be helpful vs the mentality of “If I can help the people who are easiest to help, everything else will sort itself out.”

Ajira: Absolutely.

Ari: Centering the folks who need it the most, the rest usually works out much easier.

Ajira: Mmhmm. I don’t know why people are so scared of this.

Ari: Yeah. Because it’s more work. But I think it’s the important work.

Keelia: Yeah. It's more work and they think, “If we turn that curb into a ramp, then I'm not allowed to use it.”

Ari: Right. That it’s just about someone else.

Keelia: Right. Like really twisted logic.

Ajira: “You are not allowed to use this curb anymore, in fact you can’t even come down the street, or to this neighborhood. You might have to leave the country.”

Ari: Right!

Keelia: I’m trying to blend all our analogies together. “You can’t push your snowblower down this sidewalk.”

Ajira: Yeah. Absolutely. Centering the most marginalized among us improves things for everyone. A rising tide lifts all ships. There’s no like point at which it’s like, “Oh no! I can’t walk on this curb anymore!”

Ari: Right! Everyone benefits from it.

Ajira: Yeah.

Keelia: Ari, do you have any words of wisdom that you wanted to share with folks?

Ajira: Yes!

Keelia: Aside from the ones you’ve already shared?

Ajira: Apart from giving us everything, can you squeeze a little more juice out this lemon?

Ari: No, I mean I think the best words of wisdom I can give are to try to make it as sustainable as possible. And to find your people. I think my challenge will always be for the rest of my life is how to do this work without doing it in a way that doesn't allow me to also take care of myself. And I think I will say, as a support person, my instinct is to put other people first. And that is part of why it's really important for me to surround myself with other support people because it reminds me that… They're there to remind me the same thing I’m there to remind them of which is that we all need to take care of each other. Intentional silliness is a big one, intentional friendship is a big one. Having support with other people who get it, you know? Support work looks so different in so many different ways. But there is a core part of that which is that I think people who do the work see each other doing it and are able to connect. And doing that in ways that I think really truly speak to a movement that I really hope all will pick up more over time.

Ajira: What do you recommend folks look into before they start doing this work? What are some resources you'd recommend they check out?

Ari: I think that's really hard. You know, I think one thing that I struggle with a lot is what does it mean to educate yourself about this work? Who do we center when we educate ourselves? I think the best thing that I can say is listen to the folks who are experiencing the most. Listen to the folks who have experienced things in their own lives and aren’t speaking to other people’s experience through the saviorism complex of doing social work. That’s a really big one, I think.

Pay people for their labor. If they are not asking to be paid, you should still pay them. I think listening and making space for people who do this work and have done this work for decades is really important. I think listening to communities of color and centering the ways in which These systems have existed outside of traditional health care for generations and have been excluded from that. That's where we need to put our attention, is we need to see how people have been scrappy outside of traditional healthcare systems and center that and listen to that.

I think what’s hard is that I am someone, I don't read a lot. I read for pleasure I don't really read a whole lot of academic or theory work, and I say that specifically because I have a lot of people in my life in academia who do that, and I'm so here for it, and I so hate it for myself. It’s just not how I choose to move through the world. I’d rather talk to someone all day long and, again, pay them for their labor for educating me. Gonna say that, importantly. But I'd much rather do that and I think it's why most of the learning that I've done has been through listening I think that's one of the best things that you can do. And I think staying humble and recognizing that there's always so much more to learn when doing this work is really important. And I will say that I am intentionally trying very hard to never stop learning. But I do think that doing it in non-traditional ways through conversations are how I choose to do it which makes it hard for me to recommend a resource other than to say find where these people are doing the work, and show up and listen first before you say anything.

Ajira: Listen first. There's a proverb in Swahili that says that you cannot learn anything when your mouth is full of your own words.

Ari: Mm, love that.

Keelia: I love that.

Ajira: If anything from today’s episode resonated with you, leave us a review on iTunes or your favorite podcast listening app, and follow us on Facebook or Instagram @doulastories.

Keelia: This episode was produced by me, Keelia Alder, and our music is by Rick Bassett. Special thanks to Ari Stoeffler for sharing their stories with us. If you want to see what full-spectrum resources Ari recommends to birthworkers or anyone needing full-spectrum support, check out the show notes for this episode. Thanks also to Cameron Sharpe, and to my divinely beautiful, dazzlingly clever, and angelically good co-host, Ajira Darch.

Ajira: Ari also asked to share this note: thank you, Keelia Alder, again, for being a part of my community that allows me to continue this work sustainably. And for being a really, really, really good friend.

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