In Conversation with Takiya Sakina Ballard of Sakina Health

To learn more about Takiya’s work, please visit her website and other platforms!

Takiya Sakina Ballard of Sakina Health is a Licensed Certified Nurse Midwife, International Board Certified Lactation Consultant, clinical educator, and mentor. To learn more about her story and extensive career as a midwife, please read our Q&A below!

 How did you get started as a midwife?

I became pregnant while enrolled in a nursing program in college, which was the best thing that could have ever happened to me. It was no coincidence that I happened to be taking my maternal-child nursing course at the time, and my class became my childbirth education. As I was growing life in my womb, I was learning about life. During that time, there were a couple of crucial things that happened. The first one was a career day where a midwife, an advanced practice nurse, came to talk to our class, describing her profession with such great joy. She articulated an autonomy by which she practiced. This intrigued me.

And the second, later in the semester, was my birth experience, going into labor during the week of finals. Upon my admission to the hospital, my clinical nursing instructor, the person who had been teaching me about labor and delivery and maternal childcare in the hospital setting, was on staff and took me as her assigned patient for the day. I had no idea that she worked at the hospital that I was planning to birth in. I assume she recognized me and took the responsibility of protecting me from unnecessary interventions. At the time, I was unaware of her intentional actions. She offered me the option of laboring in a Jacuzzi room in a whirlpool and I remained there until it was time to birth Now, this was 1997, so water birthing or laboring in water in the hospital setting wasn’t commonplace.

She came in and she listened intermittently to my baby, and checked in every now and again. She didn’t bother me. She didn’t tell me anything that I had to do or subject me to policy or procedure. She just let me do my thing in the water and innately cope with contractions as my body was directing me. When she heard my voice change and that birth might be immanent, she helped me out of the jacuzzi tub and walked me to my bed in the birth room. She called the doctor and two pushes later I had my son. Completely unmedicated, a 20 year old who knew nothing, who was just trying her best to make it through, was how I presented. She provided me unbiased and respectful care, and might I add, from a woman who did not look like me.

A few years later, I rehearsed the stories of the midwife who spoke to my class and how she spoke with such joy about her profession. I wanted that! Then I started thinking about my birth story, realizing that my nursing instructor had given me a gift. She anticipated my needs as a patient and met those needs and I didn’t have to voice anything. She met the need by just trusting me to birth my baby on my own terms. In my own journey as a clinical care provider I wanted to do that too! I had this incredible sense to pay it forward and give birthing people what was given to me as that gift. So I went back to school and started the midwifery program at New York University, in 2000, and in 2003 I became a Certified Nurse Midwife.

Why did you decide to do home births?

I began my career employed as a Certified Nurse Midwife in the hospital setting and quickly realized that while I had gain proficiency of skills and a well-grounded knowledge base,  women had no choice to govern their own bodies. I didn’t feel that my practice philosophy at the time was congruent to what I believed in my heart. It became increasingly difficult to practice with integrity because I was torn between the medicalized birth that I had learned and practiced and the natural birth that I knew was possible, like my own story. So I became a rule breaker, and the nurses and I are getting together devising ways we can be secretive about how we can allow women to birth in positions and in ways that upheld their wishes but went against the normal medicalized versions of birth in an industrialized setting. This wasn’t how I was supposed to “pay it forward”. I didn’t want to secretly protect the rights and decisions of birthing people. I wanted to do so adamantly and unapologetically!

So I turned to birth in birthing center settings, as the answer to my dilemma and was employed by a birthing center that offered, birth in the home, birth center, and hospital and that also was governed by the community and not a large hospital system with hidden agendas and motives. It was managed by the community for the community. I finally felt at home and learned truly how midwifery should be practiced! It was that employment experience that gave me new understanding and reshaped my philosophy of care. I realized that care provided in the home setting was truly uninhibited and offered the birthing person the purest sense of freedom and comfort and I’ve been practicing in the home setting ever since.

  What were the advantages of having a home birth?

It has been my experience that for many birthing people, the advantages of a planned home birth might include:

  • Being in a familiar, comfortable setting of which one has control.
  • There is little to no pressure to use unnecessary medications and interventions.
  • Birthing people are encouraged to be in charge of the birth process and exercising their voice to choose their own labor positions and elements to be included in the birthing process are upheld and respected.
  • The cost is reduced significantly although, there may be more out of pocket costs upfront, due to inadequate insurance benefit coverage for homebirth providers.
  • Preferences for cultural or religious practice and considerations are upheld without being subject to stringent policy and procedure.
  • Care is provided usually by no more than two clinical providers lending to the development of strong ties and a genuine trust between provider and patient. This allows for truly individualized care to be offered.
  • Recovery for both the birthing parent, newborn, and family are easier to provide as follow-up services are provided in home and most often include supplemental services like lactation and rigorous postpartum care which are often overlooked and inadequately provided in mainstream maternal-child care settings and services

Tell us about your decision to retire from active practice and why you have started to mentor new midwives. 

If you know anything about midwifery, then you know that midwifery is hard work. It’s a joyous, empowering, and wonderful work, but it is hard. It is hard mentally, it is hard physically, it is hard emotionally and you’re constantly giving, you’re constantly pouring out into people.

I don’t say this to complain, but I’m saying it to give the real truth to what midwifery requires. It’s sacrifice. If you’re doing midwifery right, you should feel exhausted. You should feel like someone pulled from you because you’re giving. However, once you give, you also need to tap in and be refilled and that’s the part that sometimes I found was hard to do.

As midwives pour out, we must then be filled back up and that means investing in self-care, family time, and really carving out respite time for yourself. I didn’t always do that nor did I have to resources to consistently do so. So my journey became harder, and my time became more invested in the work and subsequently I got weary. I always promised myself as I navigated through my career, that I would stay true to my “why” and the philosophy of how I decided to truly waking alongside people in a respectful and supportive way.

If I ever found myself feeling disheartened, by the constructs of the culture of healthcare, that negatively affect my practice or how I interacted with my patients and I began to feeling disconnected to my work that, I would walk away and serve in another way. So when practicing burdensome, and it was no longer light to carry, I promised myself that I would never become a midwife who was short patient, that took out her feelings on another person. Being in that position, when you don’t realize that you’re in that frame of mind, you can inadvertently injure and harm and I didn’t want to do that.

In my decision to retire, I reflected on my journey in midwifery. I realized that what I lacked my entire career was mentorship. I have journeyed alone and it had taken its toll. I knew then that in order for me to continue in that legacy of paying it forward as an individual, it was only going to do my heart justice to become what I needed all along and that was a mentor. As I announced my retirement, I also announced the establishment of my mentorship program. This was my phase two! And now, I mentor specifically black and indigenous people of color healthcare professionals at various positions in their career. I do this specially for this population of people because of the disadvantages they face due to the racism that exists in healthcare education and practice settings that affect their matriculation through programs and entry and retained position in the healthcare workforce.

 Any advice for those considering a home birth? 

Beginning your research or investigation into what it may look like and feel like to birth at home when you know you want to become pregnant. Having the opportunity to thoroughly and fully investigate all available options is critical to having an satisfactory experience. Begin forming your birth team to include all supportive partners and clinicians who will be vital to upholding your wishes and desires to how you want to birth. Other than the midwife, the traditional provider who practices in the home, doulas, childbirth educators, lactation specialists and postpartum nurses or care providers may be added to the team. Consistently educate yourself regarding optimal health and wellness practices throughout pregnancy and thereafter. Uphold those practices consistently in your day to day routine. Involve your partner and loved ones in your process and employ them to become your advocate. Clearly articulate your wishes to them and have your wishes documented as well. Be sure to also investigate your insurance benefit and financially prepare for the cost of homebirth, as insurance plans inadequately contribute to the overall cost.