We're your hosts, Kimberly Jones and Emily Lampert.
Today we spoke to Sasha Sumling, one of the few black-identified doulas practicing in Houston.
[Kim] Conversations around black maternal death and black maternal health, and the harms that black women experience during childbirth were just really robust, particularly after 2020 and the aftermath of the death of George Floyd. Then, at the beginning of this year 2022, I had the opportunity to see a film called Aftershock at Sundance, which is about the need and the necessity for having advocacy for black women and non-white women in the birthing experience, learning about how important that was made me really interested in speaking with someone who was an advocate.
[Emily] Something that I thought was particularly interesting is how central the body was to her work. I think non-traditional medical practices or non-mainstream medical practices are kind of obsessed with the body to take this clinical approach to the body. And it was so interesting to see somebody talk about an affective approach to the body instead and how central the body and touch and all of these different things are to this experience of care.
[Kim] Yes, quality was the big takeaway that I got from our conversation, and also the tactile experience that is necessary for women to feel safe, and how important that is for advocacy.
Thank you for having me. Yes, I'm Sasha Sumling. I'm a licensed Texas massage therapist exclusively working in pregnancy, labor, postpartum and infant massage for the past 12 years. I have extensive experience throughout the Houston community, working with physicians in a local area. I was born and raised in Austin. I moved to Houston in 2001, where I've raised three of my children with my husband of 20 years. In addition to massage therapy training, I'm also certified as a special delivery medical doula. I'm a drill-certified postpartum doula, lactation consultant, and mind and body wellness practitioner, specializing in holistic nutrition and hypnotherapy, also an evidence-based birth instructor.
I also hold professional memberships in the American Massage Therapy Association, DONA International, the National Black Doula Association, and Postpartum International. I'm also the founder of Massage Mama, which is a pregnancy massage and doula care service where I provide in-office and outcall services for all my clients. I believe the power of touch is deeply healing and my ultimate goal with my clients is to promote inner peace, healing, and to empower women and children to overcome challenging circumstances. My youngest daughter has a rare autoimmune condition so I know the struggles and joys of mothering amidst challenges.
Kimberly Jones 03:04
I want to begin by talking about what being a doula means for you. What is your typical day like?
Sasha Sumling 03:11
A typical day for me is dealing postpartum outcalls in the morning and in my office in the afternoons doing pregnancy and labor prep massages. I do not work on the weekends. That gives my body a chance to rest and restore, so I can be the best of myself for my clients. But I'm always on call 24/7 via text messages, emails, video chats because let's not forget our babies come whenever they want.
Emily Lampert 03:36
Thanks, Sasha. I wonder if you could tell us a little bit about how and why you decided to pursue this kind of work?
Sasha Sumling 03:44
Surely. So my background is business management but then I decided to stay at home after getting pregnant with my third child. I became a stay-at-home mom for about seven years. When she was going into kindergarten, I wanted to get back into work but I wanted to do something that I felt like was more meaningful of my time, not necessarily just doing like a nine to five. I went did some running and got a really bad shin splint injury that led me to have to go to physical therapy for quite some time, so I naturally got very into that environment. I started to feel empowered. I started to feel myself becoming my, you know, my better self, so I thought maybe I can do something like that. And my husband always told me that I was like a natural caregiver anyway, so I was trying to figure out how to become a physical therapist, but every time I googled PT, massage therapy popped up. And I was like, okay, well, what is massage therapy? I don't know about happy endings, you know? And how am I gonna tell my husband I want to be a masseuse, so during my research, I came across medical massage therapy and then talked to my husband about it and we agreed that I could, you know, study medical massage therapy, and then he and I both pinkies promised that I wouldn't work on men. So I kind of knew where I wanted to go. And my textbooks, there was just like a little paragraph or two about pregnancy massage, the contraindications and what it was, but that was about it.
So I wanted to figure out what that was all about. And then after having three kids on my own, going through the birthing experience, being pregnant, I feel like I can relate better to my clients. After finishing massage school, getting my board certification, and Texas licensure, I did another 500 hours in prenatal care. The way my practice runs, is I get the benefit of building my rapport really early with my clients with pregnancy massages, which naturally leads to labor prep, which leads to the physical care in their labor and birthing process as their birth doula and helping them postpartum as their postpartum doula. So I get the full circle of practice. And so that's pretty much how I started.
Emily Lampert 05:56
And I'm hoping that you can maybe explain a little bit for our listeners with basic differences between a doula and a midwife, which is maybe a little more familiar to people.
Sasha Sumling 06:07
The difference between a midwife and a doula is quite a lot. People seem to mix them up a little bit given to the woman from the initial booking to the postpartum period. They're the ones that do all the medical aspects and catching of the baby. Doulas, however, are coaches, mentors during the labor and birthing stages. They offer physical support such as massage, emotional support such as reassurance and encouragement, advocacy support such as teaching self-advocacy, and or being a voice for the birthing woman who could be unable to speak on her own, and informational support such as childbirth education. Doulas are not medical professionals. They do not perform medical tasks. They do not get medical advice or diagnosis. They do not judge you for making your own decisions. They do not replace your birth partner and they do not catch the baby.
Kimberly Jones 07:20
Thank you. I wonder too if you see the work you do as a doula as kind of an extension of mothering?
Sasha Sumling 07:29
Definitely, definitely, definitely. I just remember those words my husband told me, You're a natural caregiver and that's just who I am.
Kimberly Jones 07:38
The work that you do directly relates to our series title Medicine, Race, and Democracy. What are some of the ways that you see that the labor in both the sense that you are engaged in connecting to medicine, race, and democracy?
Sasha Sumling 07:53
I believe in mixing medical modalities, I do believe holistic medicine and Western medicine can work together. You can be a minimalist and technology-driven at the same time. It's all about balance. I think all races should have access to the same quality of care. No birthing person should be left behind. I also believe that people should have the right to choose the quality of care without judgment.
Emily Lampert 08:22
Thinking about democracy, I wonder what aspects of your work you find particularly pressing, especially in today's political climate? Do you find yourself kind of increasingly involved in advocacy and activism more so than when you first started your career 12 years ago? And are there ways that unaccredited people can support you in your support of birthing people?
Sasha Sumling 08:44
It's a very emotional question. And my heart it's like palpitating. A lot of it has to do with the lack of access to reachable resources and education to young adults, specifically having children. They don't understand anything about their bodies, and how they got pregnant in the first place, and what happens during childbirth. There's a gap there. Even now in 2022, they still just don't know. You'd be surprised at the questions that they asked about their bodies in childbirth. I had a very close family member who recently lost her baby during pregnancy, because to my knowledge she didn't have the high quality of care. I believe she was going to smaller free clinics, getting basic information, not getting proper screening, and overlooking an enlarged fibroid, which led to the miscarriage.
I believe my work now more so is about advocacy, teaching birthing persons how to self-advocate and how to speak up on their concerns, personal preferences, values, and goals. And if they're not being heard, or taken seriously, to move on to the next and to get a second opinion. Go ask for help. Don't be afraid to ask questions. Don't shy away. I didn't know better going through my pregnancies. I trusted my only resources that I believe I had at that time, which was my doctor, and my mom and him. The doctors know best what my great-grands were always telling me. The doctors know best just do what they say. At the end of the day, I think did the doctor really have my best interests in mind? I think we should be more confident, and people should stop making birthing people feel less than because they're having a baby, especially young adults. I feel like they just shame them in so many ways. Being belittled is one of the worst feelings ever.
Emily Lampert 10:40
Your work is so important and frankly your answer kind of blows me away because I never really realized how much birthing people are decentered within their own process of giving birth. You also seem very invested in inclusivity, maybe you could talk a little bit about the term birthing person rather than mother?
Sasha Sumling 10:58
Surely. We all tend to self-identify in different ways with certain pronouns: she, her, him, they, and so forth. People may feel less empowered or more empowered if they're called otherwise. So instead of just narrowing it down to a mom or mother, it is more accepted if you just call them birthing people or birthing persons.
Kimberly Jones 11:26
This really goes in line with what you've been emphasizing, which is what's important is not just that people are cared for, but the quality of the type of care that people are receiving. Also in your answer that I thought was just really beautiful and eloquently given where you spoke about your relatives and the kind of legacies that were damaging to the way that they experienced their pregnancy. I wonder if you could talk about how much of those responsibilities for the way that black women and marginalized women and people of color show up in the birthing process can we lay at the feet of the past?
Sasha Sumling 12:04
Surely, first and foremost, black women have always been depicted as being strong, tough, with high pain thresholds, that we can push through pain and discomfort, that we experience less pain than white people. When we vocally voice our concerns, black women come across angry, disrespectful, the angry black woman that no white person wants to deal with, automatically assuming we're uneducated because we're just loud, trying to voice our concerns. Being a black woman automatically comes with pregnancy complications. Here's where the racial disparities start to come into play: dying in childbirth, preterm births, low birth weights, stillborns, and C sections. We must start taking back control of our bodies. We have to start standing up for ourselves. We must have more black people making decisions for our health care to eliminate racial disparities by first hiring black practitioners, black support persons, and black support educators
Emily Lampert 13:16
Since we're talking about the past right now and that the legacies that come with slavery, I wonder how you see yourself as a black doula fitting into this long history and long lineage of black medical practitioners in the United States, but specifically in the South.
Sasha Sumling 13:30
Currently, I'm one of the very few black LMTs licensed massage therapists in my area of Houston, Texas who specializes in maternity care. Growing up, no black person I knew talked about getting massages. I mean even showing too much skin or talking about any body parts was taboo. I want to reach black women, educate them about the power of therapeutic touch, and how that could benefit them physically and emotionally in preparation for childbirth and postpartum. My goal is to train and educate others alike. I currently teach evidence-based childbirth classes exclusively for black and brown families.
Kimberly Jones 14:13
We were speaking before we started about the reason why I wanted to speak to you these legacies of black maternal death. So I really do see your work as radical care. And I think you spoke a lot about what makes care work so important for black women and brown women and just birthing people in general. What do you think is the most difficult reality that you have faced about the work that you do? I think you said that you're one of the few black women practitioners that are in your field. I can't imagine that's easy.
Sasha Sumling 14:46
No, it's not. With that being said, I'm not being supported by medical doctors. At times. I don't feel respected as a licensed professional certified in medical modalities. There are still doctors that have the old mindset that massage during pregnancy will induce labor. It's the lack of knowledge on their part, therefore they advise patients not to get pregnancy massages. Over a year ago, I had a client after getting one massage and purchasing a package of sessions to opt-out of continuing because her doctor told her no massages. She didn't want her to be induced. As a birth doula, I'm literally looked upon as the help, which technically I am, but I often get overlooked, not seen, not addressed by name by doctors and nurses. It's quite difficult. It's important that we understand that we're all on the same page and have a clear understanding that we have different roles to produce one positive outcome at the end of the day. Not one person can do all the roles and I'm not there to step on anyone else's role. The birthing person benefits at the end because we make one birthing team.
Emily Lampert 16:07
I'm really struck by how you're kind of confronting these legacies of racial violence. I'm thinking about your comments about access to knowledge about one's own body and how you providing access to that and providing these classes in advocating for birthing people and advocating that they have control over what's happening over their own body. Really just in awe. I know at the beginning, you mentioned that you take weekends off because you need that time to rest, especially when you're facing the challenge of historical and contemporary realities of black motherhood. I am curious, how do you take care of yourself in all of this without getting burnt out?
Sasha Sumling 16:46
Well, I have to tell you that I'm that mama. I got to be completely involved in my children's every day from making lunches into being at all the after-school activities and my children are currently now 25, 21, and 18. I stayed at home before I started my practice. My youngest was in kindergarten when I started. I was trying to be Superwoman, you know, I was trying to be wife, mom, licensed massage therapist, and doula. I soon started to see that I wasn't given 100% of myself at home and wasn't given 100% to my children, into my clients. As a black woman, I wear a lot of hats. I was having a hard time taking one hat off and putting the other hat on. I was doing five to six births a month, making sure I made every practice every game recital, every theater performance, hats all over the place. About five years of that and some personal health challenges with one of my children, I had to find a perfect balance. My office has always been about 10 minutes from my house. I was able to manage my clients and make it to the bus stop by 3 pm. I currently do all my massages during the day, teach childbirth classes at nights one day a week. I now take on two to three birth clients a month and I still don't work on the weekends. I still like to have the flexibility of being able to travel and to see them because my two youngest are in college now. I keep my Sundays exclusively for family as much as possible. And lastly, I like to keep my hair and nails done. I believe in color therapy because I work with my hands. You'll always see me with bright-colored nails that are very well manicured. I do get personal massages bi-weekly or weekly if my schedule allows, nothing less than 90 minutes. I get chiropractic adjustments once a month, and you'll often find me outdoors on my deck with a glass of red wine.
Kimberly Jones 18:47
The theme I think it's just quality, quality of the time you spend with yourself with your family, quality of the care for birthing people. And I am wondering if you can talk a little bit about what diminishes quality of care for birthing people and where does your advocacy fit into that space?
Sasha Sumling 19:07
We are currently dying in pregnancy, and childbirth, and postpartum. That's just a fact. We must become self-advocates more often now than before because of the medical system is failing us as black and brown people. The problem is there's not a lot of people of color who are making decisions, so we must have more black and brown people in the industry to make a difference.
Kimberly Jones 19:33
Sounds like part of the problem is that there's a lack of understanding about non-white bodies.
Sasha Sumling 19:38
Exactly. And then black people want to be able to relate to and feel more comfortable speaking to someone who looks just like them.
Kimberly Jones 19:46
What are your thoughts on the current state of the health and medicine industry?
Sasha Sumling 19:51
It's failing us as black people. It is what it is. It's failing us.
Emily Lampert 19:56
It's really clear that your work is intimately tied to human connection, compassion, and care for people and their bodies. I wonder if you feel these are elements that are properly emphasized in today's healthcare industry? I mean I could wager a guess and say the answer is no.
Sasha Sumling 20:15
My heart is pounding again, yes, by hearing you read that question. In the beginning, they had eliminated us from much, which was traumatizing for the birthing person and the doula. Speaking for myself, it was very hard not being there. I build a very intimate rapport with my clients very early, and I'm very, very hands-on as a massage therapist. So that's why it was really hard for me just not to be a part of it. Eventually, the healthcare industry got it. It's now in writing that doulas are part of the birthing team and not considered the second birthing person allowed in the hospital.
Emily Lampert 20:52
Wow, that's so interesting. Do you think that your position has kind of gone from protest to inclusion? Do you see yourself more as a part of or apart from mainstream birthing practices?
Sasha Sumling 21:05
Definitely. I believe doulas are essential workers, considering we're on call 24/7, offering continuous labor support. Doulas decrease the risk of caesareans, decrease the use of medication for pain relief, increase the likelihood of a spontaneous vaginal birth, shorten labor, and decrease the risk of being dissatisfied with their birthing experience. Doulas should be viewed as a valuable evidence-based member of the birth care team because of their continuous labor support, which is a basic need for any birthing person.
Kimberly Jones 21:47
Definitely. Health care is a right and it should be care. We talked a lot about being in Houston and being in the South, but you're part of a larger community of practitioners as well. Do they communicate a different experience based on where they are and where they practice?
Sasha Sumling 22:06
The North is much different than the South. Sister doulas all over here we get together and we vent. We cry over the phone. We pray together all that stuff because although it may have different aspects, it's still just the same all over.
Kimberly Jones 22:25
How was the North different? Is it easy for the birthing person?
Sasha Sumling 22:29
During early COVID, the North had it really bad, specifically in New York. They didn't even have the access to one support person. It was no doula, no husband, no nothing. And so we quickly had the switch from being completely hands-on to being virtual. How do you get that kind of continuous support virtually? So like I said, not only was it traumatizing to the birthing person, it was traumatizing to the doula. We have to rethink or revamp our practice of care or areas of care to help them so it was a struggle.
Kimberly Jones 23:06
This is just beautiful to hear you speak. Yes, Megan is emotional in the room. I really liked the language that you use when you're talking about the work that it's care, and not so much this is my business. This is my job. So do you think that the market and capitalism are inserted in the work that you do leads to this disposability of black people and blackness?
Sasha Sumling 23:31
If we're talking about racial capitalism, then perhaps. There is racial order or racial hierarchy with capitalism the whites are at the top, and the blacks are at the bottom. If you are black, and a birthing person, you don't have the best of luck because of racism, and the hospital model of care, the hospital lawyers, and administrators on the top of the totem pole, they make all the decisions and rules on the type of care, type of procedures, who does them, and who receives them. It's not the doctors and midwives like some assume. The birthing persons and the birth partners are at the bottom of the totem pole. They don't have control. They have to sign all these consents and etc. The people at the top the capitalists control the birth narrative in the hospitals. So yes, capitalism is a problem, especially if you're black. We cannot undo racism without undoing capitalism, because racism is the foundation of capitalism, the power hierarchy.
Kimberly Jones 24:38
Well, I absolutely agree with the influence of capitalism. And I do think that it does create the grounds in which racism can flourish. I'm thinking of being outside of that process. And in some ways, I think that the work that you do is kind of outside because as you talked about earlier, you are almost told that you shouldn't be doing this type of work because it's more focused on the person who is birthing rather than the systems that are trying to force the baby out almost.
Emily Lampert 25:13
In the face of all of this that we've been talking about, right, what motivates you to continue? Are there any aspects of your work that you particularly cherish and value?
Sasha Sumling 25:24
Well, I always, always pray and ask God to place me where he wants me to be. Every day. If I'm stepping outside, please place me where you want me to be because I'm always on call. So I'm just kind of here and there everywhere, building relationships, that are lifelong, long-lasting is the thing I cherish, getting spontaneous pictures in the mail and seeing birthday posts on social media. You really know you've made an impact when you have like repeat clients coming back for the third or second or third pregnancies. The most precious, however, is the very, very raw emotions that are shown the exact moment the baby is fully born. It's the immediate tears of joy, the excitement, the surprise. As a doula, I feel like a superhero at that moment. Then, it's finally the genuine gratitude you get from the birthing persons and the birth partner for all the hard work you put in both physically and emotionally. Because we are offering physical and emotional support, so it is physically and emotionally taxing on the doula's body so that gratitude is very, very rewarding for me.
Emily Lampert 26:38
Is there any other person that's a part of this birthing team, aside from perhaps the birthing person themselves, who is as involved as a doula is? I know you talked earlier about how you establish these relationships very early on. You go through postpartum care. But as you're talking about you interacting with these people for years and years, how long-lasting are those relationships and is that something that's key to this idea of care?
Sasha Sumling 27:05
It is definitely long-lasting, I start to see them as soon as the mama feels achy, 12 weeks, 20 weeks, whatever it is, and then it continues on to postpartum that's almost a year's time right? That's nine to 10 months. Then, we gotta count the fourth trimester. So that technically is a year you've been working with this one family for a whole year, and never stops, you know. I can be in my office, and then I'll get a picture or a birthday invitation or something like that. Then, you know, months and maybe a year go by and next thing you know, I just found out I'm pregnant, are you available? You know, it can be 18 months, two months later, and then here they come running back. That makes me extremely happy to know that I make an impact, and they value the work that I do and they come back and surprise me with little stuff in the mail.
Kimberly Jones 27:58
I do want to ask a question before I ask my final question. It is about connecting birthing people to disability. We talked before we entered the room about how I define disability. Sometimes the language of a birthing person is really connected to their body being disabled, and also part of a performance in which people are allowed to touch them. Can I touch your pregnant stomach? Can I feel all over you in those ways in a similar way that sometimes people do to people who are disabled? They ignore those boundaries that that person might have. Can you talk about that experience for birthing people and the harm that it does?
Sasha Sumling 28:37
Surely, that's established really early during the doula consultation where you talk about the individual's birth wishes, their preferences, values, and goals, and then you go deeper into their fears. What motivates them? What trauma they may have had? It can come about just as some of the simplest questions like what music do you like? Like they could say I don't like this kind of music because this music makes me feel this kind of way. Or as a massage therapist in my intake form, it asks have they ever had a massage before? Because that lets me know if they even value touch, or have they ever been touched before and what kind of touch therapy it should have to start out with? Or if they had a massage therapy, what were their experiences with it? Would they prefer massage during labor or not? Because even though I'm a massage therapist, and I do see them throughout their pregnancies, they may not want that kind of touch in labor. Just getting to know them in the beginning helps with the disabilities you're talking about. Also, not every doula is for the birthing person, so it's very important that you get those interviews across. There are some doulas who only work with queer black or brown people, women who've been sexually traumatized as surrogate moms. I've worked with several surrogate moms throughout my career that experiences I know where because you have a person carrying someone else's child and giving birth to that other person's child. There're so many emotions going on, that they have to separate themselves from to give the baby back. That's a totally different topic. So you have to have a certain heart or skill set to work with surrogate moms or women who are physically disabled or women who are overweight because not every doula is for every person. It initially starts in the doula consultation just asking questions. You'll soon find out you may not be the right doula for that person. And because doulas often have a sisterhood, we can refer out to maybe someone who's better suited for that birthing person to make sure they have what they want at the end.
Kimberly Jones 30:49
That sounds like your advocacy begins really, really early right by just making sure that you are the right person for the birthing person. Yes. My final question is the question that I've been asking everyone I've spoken to, which is what are you reading right now?
Sasha Sumling 31:06
I wish I was reading. Honestly, I admire those who can actually sit in bed and read a chapter or two. It's just not that's not me. I mean, if I try I am out. First two sentences, I am like dead to the world, but I sincerely enjoy audibles. I prefer biographies, autobiographies, more specifically with celebrities, at least that is my little de-stressor, finding out what's going on with them. Recently, Gabrielle Union had a new book that just came out, all of them.
Kimberly Jones 31:40
We're gonna need more wine for that, right? Yeah. Thank you so much. This has been like an inspiring conversation, really, for all of us in the room.
Sasha Sumling 31:52
Thank you for having me.
Hosted by Kimberly Jones and Emily Lampert
Assistant Produced by Jason Lee and Lauren Ginn
Produced by Lan A. Li
Music by Paolo Pavan