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Join us in diving deep into Myla Flores’ incredible story of becoming a leader and visionary in the birth field! From Myla’s early experiences as a birth doula to her ongoing advocacy for safe, dignified birth options, Myla’s passion shines through as she discusses the challenges and triumphs of birth work.

Discover how The Womb Bus, a mobile wellness hub, brings essential education, resources, and outreach to blossoming families in under-resourced areas. Learn about Myla’s vision for The Birthing Place, a future birth center that will offer midwifery-led collaborative care, and about group efforts to expand access to safe, informed reproductive care for all. Tune in to hear firsthand accounts of the impact The Womb Bus has had on neighborhoods in NYC, providing vital services and support to those who need it most. From fibroid screenings to lactation support, Myla and her team are breaking down barriers and creating pathways to reproductive wellness and empowerment.

Resources
Learn more about The Birthing Place and The Womb Bus here!
Follow The Birthing Place on Instagram here.
Follow Maryam Reproductive Health + Wellness on Instagram here.
The Birthing Place is launching a capital campaign! Learn more and support their growth.

    For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker’s book, “Babies Are Not Pizzas: They’re Born, Not Delivered!” If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

     

    Transcript

    Dr. Rebecca Dekker – 00:00:00:

    Hi, everyone. On today’s podcast, we’re going to talk with Myla Flores, founder of The Birthing Place and Womb Bus, about her mission of improving perinatal care in New York City. 

    Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Dekker, and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details. 

    Hi, everyone. I’m so excited to welcome today’s guest to the Evidence Based Birth® Podcast. Myla Flores, pronouns she/her, is a certified doula, Lamaze certified childbirth educator, a Spinning Babies® certified parent educator, and certified lactation counselor. And now she is coming to talk to us about being founder of The Birthing Place, My Loving Doula, and Womb Bus, and we’re going to talk about their mission of improving perinatal care in New York City. Since Myla became a birth doula in 2006, now heartily experienced as a full-spectrum doula, midwifery birth assistant, childbirth educator, lactation counselor, and mentor to many, she has become a leader and visionary in the birth field, building a suite of community programs where people can access safe, informed reproductive care before, during, and after pregnancy. The Womb Bus, Myla’s innovation of a mobile wellness hub, brings essential education, education, resources, and outreach to blossoming families. This serves as a vehicle to increase awareness and provide services and preparation for The Birthing Place, a future birth center offering midwifery-led collaborative care. Myla, welcome to the Evidence Based Birth® Podcast.

    Myla Flores – 00:02:55:

    Thank you so much for having me. I’m happy to be here.

    Dr. Rebecca Dekker – 00:02:59:

    Myla, you know, ever since we heard about The Womb Bus here at Evidence Based Birth® and how innovative that was, we wanted to feature you and your story. And I was wondering if you could start by sharing more about yourself and how you became involved, not just in birth, but in advocating for families giving birth.

    Myla Flores – 00:03:19:

    Yeah, it’s a long story. I would say, interestingly enough, it goes back generations. You know how maternal grandmothers are the, where we originated? My maternal grandmother, who I shared her womb with many, she actually died to maternal health conditions post-pregnancy, immediately post-pregnancy. And it just came to me even within the past couple months that even though I have a very in this lifetime story of what brought me to birth work, I realized that that story is something that is foundationally a part of me and part of why my mother was a midwife. And now in 2024, I find that it’s important for me to continue a journey forward beyond being a doula and that wonderful work that I bow down to and all my peers who are doing similar work and being able to educate families. And realizing that with all of that comes still a need for options. And knowing that we have very limited options. And where I reside in New York City, it is actually pretty, pretty slim. And so we’ve managed to work within these limitations. We must expand and not work within an unfortunate and unfair limitation. So it’s important that we advocate. And as a community of birth workers, as a community of people who care about our loved ones, and we all know someone or love someone with a womb, we’ve all come from a womb. That idea of making sure that our future generations can have access to safe, dignified birth that really honors the sanctity of what birthing can be. So that is why I advocate and will continue to do such pretty much for a lifetime and hopefully make an impact on the generations to come.

    Dr. Rebecca Dekker – 00:05:34:

    And what you’re saying really makes me think about the timelessness of birth, you know, like stretching back to our ancestors, but also stretching forward into future generations. And then also you’re talking about where you live right now and the metropolitan area where you live is home to, you know, around 20 million people. But you’re saying there are very few options. So are most people, they have to walk a set path and they can’t deviate from that kind of prescribed path? Is that what the situation is like?

    Myla Flores – 00:06:10:

    Pretty much. Yeah. We named it in a sentence to elaborate a little further on like the option that I’m wanting to expand on for my community and the New York City and New York State area is access to birth centers. We have really two functioning, operating birth centers that have licensure and able to be reimbursed for facility fees, just two functioning birth centers in this entire state. And so one serves the city. It’s pretty deep in Brooklyn. We have 8 million people in the city. And then, like you said, 20 million in our state, and we have another one upstate that’s like, you know, and there’s so many rural areas of New York State. And so this is very much a limitation. And so, yeah, that prescribed path is basically a hospital journey. And that is a valuable journey for so many, and one that we have to continue to appreciate and respect and have a balance of understanding that this is an option that we also need, but not at the cost of not having other options. 

    So folks can birth out of hospital and go a route that, if that’s the path for them, birth with a midwife out of the hospital with CNMs here, certified nurse midwives. That works. It’s a path that sometimes is difficult to access due to lack of reimbursement, lack of options, and also lack of support. And then also you have your standard not being able to fall in the category of low risk. I want to use that word with caution or that phrase with caution because sometimes people hear the phrase high risk and you know from all the wonderful work you do with Evidence Based Birth® that sometimes things can be perceived as high risk. But when you dig a lot further into it and you’re getting direct information from your clinical care providers, you can learn more about what makes you actually eligible or in a category of folks who also can deserve a out-of-hospital birth option if that’s what you seek.

    Dr. Rebecca Dekker – 00:08:28:

    I think it reminds me of The Business of Being Born and how popular that film was, you know, around 12 years ago. And it showcased a midwife going around doing home births in the New York City area. And it kind of gave me, I guess, which I guess is a false impression, that it was easy to find, you know, you could have a home birth pretty easily in that area. But from what you’re saying, it’s pretty limited. There’s probably not that many midwives doing it. It can only be legally a nurse midwife, not a CPM. And then I know a lot of people may live in situations or conditions where a home birth is not a viable option for perhaps their setting with roommates or being too small of a place to set up for a birth and that sort of thing. So a birth center would be a good in-between for a lot of people. So tell us about, you know, what inspired you to found a birth center and what have the challenges been like, what is that process like?

    Myla Flores – 00:09:31:

    Yeah, thank you. The journey is definitely in progress. And what inspired me is the experiences of working in out-of-hospital birth. I started in 2006 as a home birth midwife’s assistant. So I was very aware of this being an option that I happened to have the privilege of witnessing. And in those settings, I remember feeling like, wow, this is beautiful for people to have this option. And then I… worked at birth centers as a doula in different states. In Seattle, where I’m from, I supported some birth there. I supported in some initial stages of bringing a birth center to Atiak, Uganda. And when I came back to New York after that, I was like, wow, New York really needs more of this option. And I found that it was huge legislative obstacles, not even obstacles, just straight up barriers for the reality of the existence of birth centers in New York State at that time. And that was like 2008 when I was really digging into that desire. And so we are innovative people. We can do the work, different work. In lanes that are appropriate for us. And for me, it was as a birth doula in community with other birth doulas of color and just wanting to make sure that there was greater access to that. 

    Now, when it comes to the continued desire to have a birth center, in 2015, when things were starting to shift and feel more real to see legislation getting more attention and more support. I knew that there could be something down the line. And then in 2020, when… COVID hit and many people were really craving and demanding and, you know, uplifting the option for out-of-hospital birth. And when, you know, it was deemed an important number one task is to create out-of-hospital birth options here in New York. You’re catching my eye rolls because like, I’m thinking about that comment at that time from our governor at that time, and then to think that here we are four years later and we haven’t grown from that point, from the words spoken to the actual existence of more birth centers, midwifery-led birth centers at that, it just hasn’t happened. But meanwhile, because, you know, New York State and just when it comes to these kind of bureaucratic journeys, there’s going to be feet being dragged, you know. And so at that time when The Birthing Place was founded, we had high hopes. Okay, maybe we’ll have a birth center in the next couple years. But as it stands, the legislation that we were able to pass at the end of 2021 for midwifery-led birth centers was actually kind of destroyed before it passed into legislation, which kind of negated a lot of what we wanted to be the results of that legislation. Meanwhile, all is not lost. There’s still more. And we can get to that in terms of the advocacy parts later. 

    But what we were able to do is say, you know what? We have education. If most people are birthing in the hospital, what can we do? So we have not only our childbirth education classes, but our deep dive. Topics on, you know, advocacy on, you know, inductions and you know, we’re obviously pulling from the current research and a lot of the content that Evidence Based Birth® offers to have some really current, juicy, good stuff to help people be informed and, you know, walk into inductions more empowered. But I’m getting a little detailed here, all to say that, you know, we dove into education and a lot of special, important topics that are really valuable, comfort coping strategies for labor, etc. So then we said, you know, well, we have a lot of support from our community. We were able to get a couple family foundations to say, hey, how can we help your birth center to exist? And so they gave us some support. And because we couldn’t put it right into a birth center, we said, how about we create the Womb Bus? 

    And the Womb Bus is our innovation to be able to reach our community more immediately with resources, the education I mentioned, but also access to perinatal providers and wellness offerings like acupuncture, chiropractic support and nutrition counseling and the range of what our community of providers really want to offer to the community of families who are seeking and deserving and not really having access to these kind of supports. And so we chose neighborhoods that happen to have the highest rates of infant mortality. We chose to center and focus on the Bronx, because the Bronx is an under-resourced area, as all of New York. And it kind of hurts me to say those things, because I know that everyone wants these options. But you know, this is where our community was mostly near and around. And so this is where our focus is. And so, now we’re moving from this, let’s just say education into wellness and eventually birth. This wellness piece, we had our mobile wellness hub, the Womb Bus and we are just on the verge of opening Maryam Reproductive Health and Wellness Clinic in the Norwood area of the Bronx with collaborative care with OB, two midwives, doula, and then also the range of perinatal providers, wellness providers, that are going to bring special services as well to this clinic. We are establishing our medical practice so that we can get that as well-oiled of a machine as possible to be able to understand how to integrate that into the future birth center. 

    So the goal, Rebecca, I’m just going to be bold and I’m going to say it, that the goal is that in this year, we’ll be able to fully acquire the property that we’ve been offered since 2019. Property offered to us, that we’ll be able to acquire that and build and because we’ll be able to show our impact of how we’re able to support families with this collaborative care practice that we’ll get significantly more support, not just from our community and foundations and individuals who are inspired, but hopefully our government. Some recent legislation was passed that there should be more funds going to perinatal care centers, which that’s what we are, you know? So I’d like to see, I would like to see them go beyond um, saying and, just go beyond the words and moving into the action and the actual financial support for these community-based solutions to be uplifted and able to really propel our work forward in the way that we envision.

    Dr. Rebecca Dekker – 00:17:08:

    Yeah, that is incredible. Thank you for sharing the challenges and what you’ve done. And I think it’s really inspiring to think, you know, even when you have these complete barriers placed in your way, like you can’t do this, then you’re like, well, what can we do? And you start building towards that dream of having a birth center. And the Womb Bus reminds me of there are some other people doing similar work, Michelle Browder has an RV that goes around rural Alabama offering the kind of care you’re discussing and education. And I think in Haiti, I’ve heard of like there’s a pink truck that Midwives for Haiti uses to deliver prenatal care and providers to rural areas. And I just love that idea of the mobility of it. And then if you go on your Instagram page and you look at, you know, you’ve been on the news, there’s videos, the Womb Bus, it’s like right in your face. Like you can’t miss it. So can you describe the Womb Bus for us so we can get like a picture in our head?

    Myla Flores – 00:18:14:

    It’s really a special vehicle that we like to think of it as like a place of comfort. It is pink, it has “Womb Bus” on the top, on both sides and the front. And it has a… some art on there, uterus art and art of a whole variation of people of color and non-binary folk, just like it’s beautiful. In the inside, there’s some mint color to kind of balance the pink and there’s a little fake grass on like under the sink area. Yeah, it’s pink with like little mint and then a little green. I’m describing colors right now and I don’t know if that’s what-

    Dr. Rebecca Dekker – 00:19:05:

    Yeah. No, is there space then for you to have an appointment with someone inside or what happens inside the bus?

    Myla Flores – 00:19:14:

    Well, in the first year when we launched it in 2022, we were like, okay, this is for the birth workers. We’re here. We have our, you know, whatever beverages and just like our comfort on the bus. And then we set up a tent. And because we were bringing it to the neighborhoods I mentioned, the parks in some of these neighborhoods, we would just like set up a tent and like have stuff outside, right?

    Dr. Rebecca Dekker – 00:19:40:

    Okay.

    Myla Flores – 00:19:41:

    And that’s how we did it for the whole first year. And occasionally there would be like a person coming for lactation support and we’d have them on the bus and, you know, do some lactation session with them. Yeah. And then year two, last summer, this past summer, we were able to do more direct care on the bus. And so because it’s not like… we’re providing the care as like the birthing place and Womb Bus. And we’re connecting with licensed professionals who have their own work that they do. We’re just the hub, right? So we just made sure that we were working with like licensed acupuncturists who were like acupuncturists, I mean, who were able to do what they did. And then maybe they’d have a couple people on the bus. We were able to do fibroid screenings. And so those were some of the things that we would bring that we would kind of create space. And it has a little curtain too, so that there’s just like the back area. But the original intention of having a Womb Bus would have been like a larger vehicle, which would have been, you know, those, you see them, they’re like little-

    Dr. Rebecca Dekker – 00:20:48:

    Where they do like mammography screenings and stuff like that?

    Myla Flores – 00:20:51:

    Yeah. Yeah. They have them for dentists. They have them for all kinds where you could like, there’s a different room, right? Where it’s not as big. So it’s, the largest type of van you could possibly have. And the tallest, that’s what we have, a sprinter, but it’s not as much space for that. So we consider it more like an outreach vehicle. I’ve pictured in my, not that we’re going to go this route, but I’ve pictured a world where, you know, we have three types of Womb Bus. One is, where it could be more like a clinic. And then one, which is the outreach vehicle, which is what exists. And then one that might be something to where we bring community members to where they need to be, or like, you know, have like a birth worker field trip to a farm upstate, or, you know, just being able to do birthy birth birth stuff together. I haven’t mentioned this, but we have like this really cool collective of doula collectives where, you know, the BIPOC-led collectives in the upper Manhattan and the Bronx area came together to create very cool program for our community of doulas and basically between like the mentorship, the one-on-one opportunities for apprenticeship and community building. Professional development workshops, we have that. And so sometimes we just like to get together and do stuff in person since that was built during a time that it was mostly just everything virtual.

    Dr. Rebecca Dekker – 00:22:26:

    Right. So kind of going from isolation to building in-person community. And I love the idea of a nice weather, having the tent set up outside. And I can imagine it probably makes more common practical sense to have a smaller vehicle like a van instead of a giant RV in the Bronx.

    Myla Flores – 00:22:46:

    Yeah, because parking is… is a mess sometimes. I mean, I can parallel park that thing. And then there’s, you know, two other awesome like drivers. Thankfully, you know, we’ve, it’s, it’s, it’s not big. You’re right. Totally.

    Dr. Rebecca Dekker – 00:23:01:

    Yeah. Yeah. It fits for what you’re doing. And I would love to hear if, are there any stories you can share with us of, of how the Womb Bus has made a difference, like going into the community and as opposed to having people have to come to you, I imagine there’s people who are getting care and services through the Womb Bus that wouldn’t otherwise be able to easily access that.

    Myla Flores – 00:23:24:

    Oh yeah, yeah, yeah, definitely. Lots and lots. One of the things that I’ll ask sometimes at the end of a… of a day together is what did you see? What did you hear? What did you feel? What did you learn from our street team, the folks who are present with us that day? And there’s a lot that comes up in that little, you know, few minute check-in at the end. One that’s coming to mind right now is a person who’s in the kind of health field. Not specifically birth, but she’s in the health field. She was in a community position. And yeah, she just needed some support with breastfeeding. You know? And came with her baby and was just like on the verge of frustration and was using a nipple shield and was like. We had… Maya from, um, Doulas en Español with us that day, who they’re really great with, um, supporting lactation. And so they were on the bus and, you know, just getting some nice in-person support. 

    And, you know, my street team was like saying what night and day afterwards when she came off the bus. Like, yes, with a huge smile on her face. Happy that she would never have, in this particular case, she had immediately weaned herself off of the… nipple shield completely because the latch was really great and not painful. And so it was just like a, you know, less than an hour of, of a full time together. And that includes before and after, not even just on the bus. And she, you know, we kept in touch with her and we knew that, you know, that the whole trajectory of her breastfeeding journey was completely different. And so between that and people who’ve just come by and said, you guys are here on which days? Cool. I’m going to come here on those days, you know, because I just need somebody to talk to and, you know, just to be around people. Good vibes. 

    And so they’ll come back. We love when repeats come back. That’s, it’s so sweet. Oh, and one more. This was at Watson Gleason Playground. There was a… these three gentlemen passing by. And just looking as they’re walking. And one of them stopped and was like, so what is this? And after hearing the short spiel, he was like, hold on one second. And he calls his girlfriend on the phone. He was like, hey, come downstairs and just walk towards the playground. No, just come. Trust me. Just come. And his girlfriend comes pregnant with her bonnet on and she’s like looking at the other pregnant mom sitting there. And then they start to vibe and talk to each other about their pregnancies. They’re both really ripe. You know, we were able to give them useful things. And, you know, thankfully, there’s organizations that might give us some in-kind donations because they’re like, oh, we know that this would be useful for your community. And then I’m like, yes, I agree. 

    So in this case, one of them, we were. Showing how to use a blood pressure cuff so that she could keep checking her blood pressure. The other one, we were able to give stuff relevant to them and useful. And then one of them had came, sorry, the other mom who was sitting there was someone who took our free childbirth education classes. And she was like, oh, and you’re going to be in my neighborhood on such and such day? Great. I’ll come meet you in person. And that person, her husband had to work far away. So she would have like three and four days at a time without a partner. So it was really nice to be like in community with other people in her neighborhood. So like beyond us, like when we’re gone, when you’re able to connect with other pregnant people in your neighborhood that you might’ve not been able to find, like that’s powerful. That’s beautiful.

    Dr. Rebecca Dekker – 00:27:19:

    Yeah, it really is. You mentioned repeat clients and it made me think of parents with little kids who are pregnant again and how difficult it is in the New York city area to just get around with, I know people do it, but I grew up hearing stories from my mom who lived there when she had a little, and then had another baby there. And she used to tell me, she still talks about the nightmare stories of trying to get places with a stroller and on the subway. Or if you do have the access to a car, losing your parking spot to go somewhere and just, you know, the difficulty with transport. With little kids. So being able to go to where people live and like you said, build that community and in a way that’s easy and, you know, for them, that’s incredible.

    Myla Flores – 00:28:10:

    Mm-hmm. Yeah. It’s very fulfilling. It’s very like at the end of an outreach day, you’re like, oh.

    Dr. Rebecca Dekker – 00:28:20:

    So tell me more then about, you know, what still needs to change in New York legislation-wise in order for you to have a birth center.

    Myla Flores – 00:28:34:

    Thankfully for us, we do have a unicorn in the mix. And that unicorn is Dr. Carla Williams. She is an OB/GYN who has had her own hospital experiences with her birth. She’s also had out-of-hospital birth experiences because… you know, after she decided for that to be her route of choice, she’s just an individual who truly values this accessibility point. Our legislation as it stands makes it significantly easier for someone who is in a doctor position, an MD position, to open a birth center. So that’s the couple that exist here. They’re medically directed by a doctor. And so even though we were able to pass the midwifery-led… legislation. It’s not being implemented in the ways that it can and should be. So I was recently elected president of the New York State Birth Center Association. And so for these next two years. And really starting now, we’re getting into strategy mode. Thankfully, like I mentioned, we can open a birth center with the model that we have. That’s not, that’s not where it stops, right? Because the whole goal is for every borough to have an option of a birth center, hopefully way more than one option of a birth center.

    Dr. Rebecca Dekker – 00:29:58:

    And there’s not enough unicorn OB/GYNs out there for that to be possible.

    Myla Flores – 00:30:03:

    Exactly. Exactly.

    Dr. Rebecca Dekker – 00:30:05:

    So Myla, keeping that dream and that vision in mind that you’re building towards with the Womb Bus and next the Maryam Clinic and then the full-fledged birthing place or birthing center, can you talk with our listeners who are not familiar with freestanding birth centers about what are some of the advantages of a freestanding birth center for people who are eligible to give birth there compared to a hospital births and how this might impact your community?

    Myla Flores – 00:30:35:

    Yeah. Yeah. I get into vision mode every time someone talks about this and I can picture it and I want it so bad for all of us because birth centers make a difference and it’s no surprise why it is an option for people in so many other states. Sometimes I like to mention that like states like, um, Florida, Texas, Pennsylvania, California. They have 30 to 60 birth centers in their state and we’re really lacking. And so when we have birth centers, we’ll be able to reap the benefits that you’re mentioning. And some of those include. Reducing the amount of preterm birth that there is, reducing… the amount of low birth weight babies. And so it reduces total cesareans also. And these are all proven by the Strong Start study done by the American Association of Birth Centers where… they got birth centers involved throughout the country to be able to show impact. And not only did they reduce all of the things I’ve mentioned, they also enhanced better birth outcomes overall. It was more cost savings to the clients as well as to the state and increasing client satisfaction. Okay. So, this is like, it’s a no brainer. We should have this.

    Dr. Rebecca Dekker – 00:32:10:

    If we care about the health of families and outcomes and experiences, birth centers are an incredible solution. And sometimes I’m like, why don’t we just… like they should just have one in every major area, should have at least one that people can access because it does not make sense to withhold that option from families.

    Myla Flores – 00:32:34:

    Absolutely. Yeah.

    Dr. Rebecca Dekker – 00:32:35:

    Except that I know from our experiences in Kentucky that the reason. If you go down to like, what is the root cause of why we don’t have birth centers? Because there’s zero in my state. And I watched a midwife go through, spend her retirement trying to fight this. The only reason we never got a birth center in Kentucky is because the hospitals close by oppose it. All the legislation, anything that’s proposed. And even if you think you’re going to get the legislation through at the last minute, they will do something to sabotage it. And often it comes down to whatever male physician is in charge at the largest hospitals in terms of the president, you know, or the medical director. And I’ve tried to get appointments with these people and the condescension and the belief that they know what’s best for families is what holds us back. And it really literally goes to, you know, racism and sexism. And that is the root cause of why it’s so difficult. I don’t know if you agree with me, Myla.

    Myla Flores – 00:33:51:

    Oh, totally. And it’s a money thing too with just-

    Dr. Rebecca Dekker – 00:33:56:

    Yeah, they don’t want the competition. That’s true.

    Myla Flores – 00:33:58:

    Exactly.

    Dr. Rebecca Dekker – 00:33:59:

    Yeah.

    Myla Flores – 00:33:59:

    The history of Kentucky and that case you brought up, it’s so disturbing. And I’m sorry for so many of the states that have to go through this nonsense. What I believe in New York- is what we have is an opportunity for our… community, because there are so many people here, they could really get riled up in a desire to want something, some option. Just like the little period of time where during COVID, no partners were allowed and it was just converting people. Oh my god, thousands and thousands. In an instant, everybody’s signing this petition. I think that the issue with birth centers is that not enough people know that it is our issue because they haven’t been exposed to it. The norm is such the norm that hospital birth is the route. And then either that or you have to go the so-called extreme of choosing a home birth, which is a wonderful option that I love when people have that route available to them. A lot of people here don’t even really know what a birth center is. Right.

    Dr. Rebecca Dekker – 00:35:13:

    Right. So you’re dealing with like a basic lack of education or understanding of what you’re trying to advocate for.

    Myla Flores – 00:35:21:

    Yeah, yeah. And I’d say here, you know, when we get our community on board with that, and also when we do things like partner in thoughtful ways with our hospitals, right? I’ve, you know, a couple years ago, now three years in. Even though they have their different, unique challenges and limitations, and I won’t go into it because it’s really touchy, but being able to offer doula-led childbirth education in some of these clinics and hospitals and do different workshops for collaborative team building for different residents or family medicine doctors. We’ve participated in that and really just building to let people know and remind them that we’re here to collaborate. We are not here to say that this is the route that everyone should go. I have a very even-handed approach when I’m talking about inductions and cesarean birth. I’m not dissing the fact that these are helpful and necessary and believe that we can and should be referring to each other when our birth center does exist. There will be people who will want this option, and you’ll want to know that there’s a place you can trust to refer them to. 

    When I think about it coming down to money also, in addition to that you know, racism and sexism and… you know, a lot of what you raised. I find that when I’m having these conversations with different legislators or comptrollers, I have to talk about the money because that’s the bottom line for them. And I find that it’s also so convincing. And if we were to name it on just the money alone, it should also be the very thing that’s available to us. Because if I even steer away from the fact that it’s a cost saving to the clients, the people who would access this care when it comes to the fact that more than… 50% of our population here in New York is on Medicaid, and what study, it was a Washington, D.C. Medicaid study where they estimated the cost savings per birth. It was… $1,163 per birth. And so that’s like, if you do some math, quick, easy math, it would be $11.6 million per 10,000 births if we had an option to this type of care. 

    This is like one of the equations that I’ll sometimes bring up is, what would this mean in New York? If in 2019, we had, you know, 110,000 births and 56% of those people birthed by Medicaid, and 85% of those people were considered low risk, we’d have a potential cost savings. Obviously, not all 85% people would choose out-of-hospital birth, but a potential cost savings of $61 million. You know, and this is just like, the thought of having an option for out-of-hospital birth beyond the cost savings when I just think of my sister, my neighbor, my niece. I want them to have this option. They may not choose this option, but it is unfair that we don’t really have it on the table of something to be truly considered here. But that will change. And I’m certain of that. And I feel very confident in the path that we’re taking and the strategies moving forward.

    Dr. Rebecca Dekker – 00:39:05:

    Yeah, we’re so lucky to have you doing this work, Myla, along with everybody else you work with. And for our listeners who want to follow or support or somehow get involved either in fighting for fair legislation or just finding out how they can help with your programs, what’s the best way to get involved?

    Myla Flores – 00:39:28:

    Sure. Yeah, we welcome that and want that. I think the page that we keep semi up to date is our Instagram page. Our handle is @birthingplacebx. And in the link tree there, there’s a few links that you can go in the direction of depending on your interest. There’s a give to Maryam link. Which would support our community programs. There’s one for Womb Bus. There is a volunteer link where you could give information on how you can support. If you want to join our street team, we have in the spring, we have orientations for that. And, you know, there’s just, because this is truly a community-led, driven and funded initiative every day, we’re like, hmm. We could use a fill in the blank, someone who’s good at writing or editing or has experience with…”fill in the blanks.” So you could really just reach out and say what your strength is, and we’ll organize ourselves to be able to utilize you and integrate you and weave you into our mission.

    Dr. Rebecca Dekker – 00:40:40:

    Well, thank you, Myla, so much for sharing your vision, part of your story with us and how people can help. And we really appreciate all the work you’re doing to support families and to bring perinatal care to the next level for the future generations.

    Myla Flores – 00:40:55:

    Thank you so much.

    Dr. Rebecca Dekker – 00:40:58:

    This podcast episode was brought to you by the Evidence Based Birth® Childbirth Class. This is Rebecca speaking. When I walked into the hospital to have my first baby, I had no idea what I was getting myself into. Since then, I’ve met countless parents who felt that they too were unprepared for the birth process and navigating the healthcare system. The next time I had a baby, I learned that in order to have the most empowering birth possible, I needed to learn the evidence on childbirth practices. We are now offering the Evidence Based Birth® Childbirth Class totally online. In your class, you will work with an instructor who will skillfully mentor you and your partner in evidence based care, comfort measures, and advocacy so that you can both embrace your birth and parenting experiences with courage and confidence. Get empowered with an interactive online childbirth class you and your partner will love. Visit evidencebasedbirth.com/childbirthclass to find your class now.

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