I transferred OB-GYN offices at 33 weeks with my second child, mostly because I had lost my trust in the doctors at my old practice, but also, at least a tiny bit, because the new one had a plant wall. The practice was somehow brighter, everything felt more careful and considerate, and, at my 6-week postpartum checkup, my OB just sat with me for 20 minutes, chatting about what life is like with a little baby, about how I felt, about how my body was recovering. Between the poles of a medically interventionist delivery and free birth in the jungle, it felt like there was a new space for a more positive birth experience. I was reminded of that feeling when I met with Erica Chidi Cohen, a doula, health educator, author, and co-founder of LOOM— a center offering classes, meet-ups, and community for women from the "reproductive empowerment" stage through 24 months postpartum in Los Angeles. Picture women relaxing on floor cushions with their babies, tired mothers lit by the sun as they nurse their child by billowing curtains in disposable underpants, and you have LOOM. The Instagram feed ("WEAVE got you") moves me to tears.
We know that we can do better for mothers in the U.S. America ranks the worst for maternal mortality of any other nation in the developed world, and somewhere between 15 and 20 percent of women worldwide experience postnatal mood disorders, per the World Health Organization. These are statistics I have tapped out many times, but the clinical trappings of this information don't quite get at the gulf in care. Speaking to other mothers about their birth experiences, there is a deep well of resentment, trauma, and sadness at work. Women don't feel nurtured.
Cohen wants to change that. She is wearing all-white when she visits the Bustle offices, bringing that 'grammable SoCal glow with her. Online, her look is "the me I wish I was," all linens and earth tones and jumpsuits — she exists in the same twilight as the Christy Dawn models (and in fact acted as postpartum doula for Christy Dawn). I am hunched, harried in black, as is the fashion in New York City. In contrast, everything about Cohen radiates calm. "Women in the U.S. are undereducated about what is going to happen to their bodies physiologically and emotionally," she tells me, "and a lot of that has to do with just our culture in the U.S., the baseline being Puritanicalism, so not a lot of exploration of the vagina, fluids, sex, there is just not a lot of interest there." I nod. I try never to say the word "fluid" in polite conversation.
Cohen has worked as a doula (clients include human angel Joanna Newsom) and health educator for 10 years, and her book, Nurture — A Modern Guide To Pregnancy, Birth, Early Motherhood, & Trusting Yourself And Your Body, is an incredible re-imaginging of what a birth manual can look like. It details the nuts and bolts of pregnancy, but also includes tips on how to manage or process your emotions at each stage. Inside, there are sweet recipes I would like to imagine I will make, and little worksheets and "mantras" dotted through the book, which is wrapped in a tactile cover that feels ~semi-homemade~. The book is thorough, and offers a mix of hard science and alternative ideas about health (homeopathy is an ~idea~). Reading it, the shortcomings of your typical pregnancy books really bloom ("this week, your baby is the size of a grapefuit"). To illustrate the difference, if you were about to jump out of a plane, might you like to know a little about how your mind will work, alongside the requisite specs on the parachute? Nurture tells you "this is happening," but also "here's how to cope with that change." After consuming my copy, I immediately shipped off one to a pregnant friend.
Under-education is just a perfect environment for creating anxiety, isolation, depression.
At LOOM, the classes follow seven "paths," which set up parents for each stage, whether "considering," "expecting," "parenting," or traversing "loss." As someone who attended a weekend birth class that focused largely on holding an ice cube while imagining contractions, the depth of information in each "path" is impressive. The infant feeding class, for example, covers what exclusive pumping looks like, since it can be a good option for people who bring sexual trauma to parenting.
Heather Makri started following LOOM on Instagram during her third pregnancy after friends mentioned it as a place "to go once that baby arrived," she tells Romper by email. When she suffered a miscarriage and stillbirth at 36 weeks pregnant, she reached out to a few places, including LOOM, to see if they offered loss yoga. "There was prenatal yoga and postnatal yoga, but how do I go to prenatal yoga and not scare all of these expectant moms? And I also was not ready to go to mommy-and-me yoga as I wasn't ready to see moms with babies, because that was supposed to be me."
Makri had previously miscarried at 6 weeks pregnant, and, in addition to the grief, was weighted with the feeling that she was unwelcome in the birth space. "Almost like a tainted person who is sick, I felt worried I’d be shunned because if I got too close, maybe someone else would have a late-term loss, too," she explains. "Strange feelings but they are what they are. Yet LOOM was able to help me let those go."
LOOM offered Makri a loss visit (there are also loss doulas), and she felt immense relief at having found a place to go. It was, she says, "the most positive, safe space to discuss such a (strangely) taboo topic." As the mother of a 3-year-old son, she couldn't afford to fall apart. LOOM's loss class went over the mental aspects of grief and taught the group physical techniques for healing. "I could not have asked for a better place to be able to share and heal and leave feeling positive," she says.
In addition to the classes, LOOM offers free meet-ups and drop-ins for women and families, and is building out an online presence so that women everywhere can access the information. Whitney Arrington 33, found LOOM on Instagram, and is currently in the "expecting" pathway. She attended her first private sessions with Cohen alongside her husband at 8 weeks pregnant when "the only person of authority to talk to about pregnancy" was her OB, as she explains to Romper. In Cohen, she says, "I felt like I had a really great therapy session and spoke to a really cool doula, who spoke to any fear" she had. Currently in her third trimester, Arrington says LOOM has connected her to other expectant couples around the same stage, and offered "a very body-mind-spirit approach to the transition into parenthood." On the phone, she says she feels excited and open and confident about birth.
"What we are realizing is that under-education is just a perfect environment for creating anxiety, isolation, depression, and so I think the move really is to get women and their partners about what is going to happen," Cohen says. That is her broader mission — to reach moms, dads, carers, like you and me, and to normalize the facets of trying, expecting, and postpartum that we simply have not talked about.
She hopes to dismantle the negative, shame-y culture around birth. "I don't think how a person chooses to give birth or how their birth unfolds is a reflection on who they are entirely. There tends to be this intense essentialism that shows up when someone gives birth or becomes a mom, that 'Well I am giving birth in a hospital, so that's who I am.'" And this mentality can spiral when someone experiences a traumatic birth, and feels control wrested from them. Enter the birth coach, the doula or advocate, and the birth knowledge she hopes to give women. "Having an awareness of what to anticipate definitely helps to de-escalate your feelings of 'Things aren't going well,' and mitigate the intrusive thoughts that show up when you're anxious," she explains.
And there are a lot of things that can go poorly.
The crisis of care for new mothers follows the contours of race and class, which in turn are compounded by motherhood. Women of color suffer much higher maternal mortality, as do their babies. Black women have a higher incidence of diabetes and hypertension, and are less likely to be insured, per NPR's report with ProPublica. But even wealthy Black women have worse health outcomes than white women; A study published in Pediatrics found that 30 percent of women surveyed could not afford diapers, and that it was a leading cause of mental illness in new moms. Meanwhile, the National Alliance on Mental Health notes that African-Americans are 20 percent more likely to suffer mental illness due to unmet needs and other barriers to well-care, but that talking about mental illness is often stigmatized in African-American communities. Everything is connected, and Cohen's ultimate hope is that the medical establishment will see what she is doing and adopt some of her philosophy.
Cohen admits that postpartum care is somewhat of a luxury, at least in its current form. "You don't have to be extraordinarily wealthy to access it," she says, "but it is either something you have to save for or plan against to afford it." The top insurance plans sometimes include doula services, and the savvy mother can use FSA funds to set up postpartum doula care, or find a doula who can do double duty as a lactation consultant, for example, while there are also non-profit programs for low-income families, and doulas often serve a mix of subsidized and private clients. But many women don't even know the option exists.
All the things that happen physiologically are considered 'normal.' Bleeding for eight weeks is normal. Taking a shit that is horrible is considered normal.
The image of the doula as a kind of "hippie accessory" is not lost on the team behind LOOM, who instead position the role as a birth support and advocate, there to support whatever birthing choices a mother makes and adapt their approach to her individual needs — to find out what works for her. Doctors, Cohen notes, "are trained to look for pathophysiology"; for when "something is wrong." That's why much of the postpartum experience that women find daunting and debilitating isn't really addressed by medical providers. "All the things that happen physiologically are considered 'normal,'" Cohen says. "Bleeding for eight weeks is normal. Taking a shit that is horrible is considered normal." The role of your doctor isn't really to deal with that stuff, or to manage your way through. And no shade to physicians: Cohen's father is a doctor. She grew up following him on rounds.
Cohen is, for a tired parent like myself, super-engaging. She's speaking the language I hoped to hear. I'm disengaged from religion, far from family, and I want a guru. When I mention my kids, she exclaims, "Two under two — are you here? That's a lot! How are you doing?!" Every mom knows the power of simply feeling "seen," as we say. Hearing "yes, this is hard!" can be a balm in itself.
Cohen understands the value of creating a space for women and families to explore all the aspects of motherhood, but the need for a physical gathering — for contact and community — is a key part of the philosophy. Reaching women is part one, but finding a way to bring women together, and provide a true space for their experiences is the ultimate. For Makri, six months on from her loss, "There are moments of sadness and they will always be there. But now I have some tools to help me acknowledge that sadness and then be able not let it overtake me." In considering with her husband the possibility of trying again, she says, "knowing that we could have someone support us either way is a comfort worth more than anything." Whatever stage or experience, LOOM promises to be a place women can go.
Before Cohen took her glow out into the streets of New York, I wanted to talk about an important aspect of this whole thing: the LOOM #aesthetic. I want to chat wicker baskets, pastel rugs, mauve floor seats, blond wood beams. "You're still a person," Cohen says of the women (and men!) who come to LOOM in the midst of the pre- and postnatal transitions. "We worked really hard on the aesthetic and design to make the space feel good."
I realize in that moment that wanting a care provider who asks you how you're doing in an emotional sense is no more out of the realm of possibility than having a place to get postpartum care with some choice macramé on the walls. We all deserve a movement class and a knowledgeable coach to help us find "flow" before and after baby. These are not elitist ideas or the bastion of the upwardly mobile urban hipster. Caring for mothers is the original thread.
Check out Romper's new video series, Bearing The Motherload, where disagreeing parents from different sides of an issue sit down with a mediator and talk about how to support (and not judge) each other’s parenting perspectives. New episodes air Mondays on Facebook.