Birth, Grief & the Nonlinear Path to Parenthood with Atoosa Benji

Introduction and Candle Lighting

Britta Bushnell: Hello, folks, and welcome to Transformed by Birth, a podcast about the rite of passage of pregnancy, birth, and new parenthood. I'm your host, Britta Bushnell, author, mythologist, childbirth educator, and an all-around deep diver with a side of goofball. I'm so glad you're here. Today we're talking about the nonlinear nature of transformation. So grab your comfy beverage of choice — I've got a fresh mint tea in my cup this afternoon — or take us along for a walk as we connect with midwife and doula trainer Atoosa Benji. Before we begin, we start the way we always do by lighting a candle. If you want to join me, please do, or just take a breath as I light mine. Today's candle is in honor of the twists and turns on the path of change.

Whoops, that one didn't light. Let me try again. There we go.

Transformation is nonlinear. It's divinely inspired and divinely timed. We're transformed with every breath, with every experience. We can choose to let transformation flow, or we can grip tightly to the illusion of control and try to make it go according to our will. You might think that's me, but those are not my words — those words belong to today's guest, Atoosa Benji. Yeah, clearly there's a lot of alignment there. She shared that with me in her intake form.

After 25 years in this work, Atoosa is not just describing some sort of ethereal philosophy; she's sharing the vision of what she's witnessed over and over again, firsthand. She knows it from the inside — the trenches, as we say — or, I kind of like to use terminology that's less war-based and more guardian, so: she's been in the mud, she's been down in the garden doing the gardening. One of the images I had for this podcast, back when I first started it over a year ago, was the idea of giving listeners the opportunity to overhear conversations birth pros have with one another — fly-on-the-wall kind of stuff. Well, Atoosa and I shared a cab to the airport, headed home from a conference, and talked the whole way. So that kind of conversation is what I want you to be able to hear.

So, who is my guest? My guest today is Atoosa Benji, a licensed midwife, educator, speaker, birth doula trainer, and founder of Mama Tusa. Her work spans puberty and menstruation through pregnancy, birth, postpartum, and menopause — the whole arc, folks. She educates and supports families and birth professionals across every birth setting: home, birth center, hospital. I gotta ask her if she's had any births in the woods, folks — I don't know — always with an emphasis on informed and compassionate care. Atoosa is also an educator with When Survivors Give Birth, bringing awareness to the intersection of trauma, healing, and the childbearing experience. She's deeply committed to strengthening the birth community through bilingual Spanish education, doula training, and collaboration between doulas and OBs, and she hosts the Mama Tusa podcast, where she brings honest conversations about birth, bodies, parenting, and reproductive health into the open. Beyond the professional work, Atoosa is a wife, mother, and grandmother — we talked about these, it's kind of fun, we'll see what we get into in this conversation — roles she says have deeply shaped the wisdom, humor, compassion, and real-life perspective she brings to every other thing she does.

Welcome, Atoosa. I'm so grateful to have you here. Thank you for joining me.

Atoosa Benji: Thank you, Britta. I'm honored, deeply honored, to be your guest.

Britta Bushnell: Oh, it's wonderful to have you. So you did write that passage and shared it with me in the intake form for this podcast — that transformation is nonlinear, divinely inspired, and divinely timed. Can you unpack that a bit for our listeners? What does that mean to you?

Transformation as Nonlinear and Divinely Timed

Atoosa Benji: Yeah, it's probably got a lot of projection about where I am in my own journey right now, which has a little vibration of sort of impatience where — I want the forks in the road to clearly tell me. I want, like, a burning bush, and I want a voice from God coming down, coming into my dreams, and writing on the walls in flames. I just want very — oh, girl —

Britta Bushnell: I feel you. Like, can you just tell me that this is pointing me in a direction I want to go.

Atoosa Benji: And it's funny, because I do this like two-way prayer, where I write a letter to God, usually in the morning before the sun comes up, and then I have God, or universe, or spirit, whatever your definition is, write back to me. And so often I will write, "Show me, show me, show me, show me, show me," and God writes back, "I am, I am, I am," and I'm like, "But, but what do you mean, I will show you?" So I think it has a lot to do with many of the things we say with birth — there are things that are revealed, and there are things that are not revealed until they should be revealed. And there's no way to make anything go faster than it's supposed to go. Everything has a timing, everything has a rhythm, everything has a reason — and perhaps not pushing so hard, sort of, you know, in birth terms, just laboring down and letting the baby stretch the mama out, instead of doing that count-to-10-and-take-a-deep-breath-and-hold-your-breath-and-push-it-out. It's a little forced sometimes. Sometimes you need that, and sometimes it's a little bit forced.

So I think that passage really, in transparency, came from some of my reflection as I'm in this stage of my life, which is deeply transformational. I don't think we give enough — I mean, I was never listening to elders talk enough about grandmotherhood, and the transformation of going from mother to grandmother, or from mother to mother-in-law —

Britta Bushnell: Yeah.

Atoosa Benji: — or losing all the mothers — mother, grandmother, mother-in-law, grandmother-in-law — and then being the elder. Like, when did I become the elder?

Britta Bushnell: Oh boy, I feel that one too. I had an episode with DeeDee Moore of More Than Grand that was really powerful about that grandparenting thing — just FYI on that. But I want to hear from you the nonlinear piece. Talk to me about how you see the transformation as nonlinear, specifically around birth and becoming a parent, because so often we think of the transformation into parenthood as linear — you have a baby, or you adopt a baby, or you have a baby by surrogacy, and you become a parent. But I'm getting — and I think you and I agree on this, so I'm completely fishing for things that I think you and I align with on this — talk to me about that as nonlinear.

Grief as the Root of Nonlinear Understanding

Atoosa Benji: The first time I used the word "nonlinear" in relation to any journey was actually the journey of grief — you know, having lost my own mother very young, and being raised by my grandmother, and obviously now having lived life on the planet for half a century, it really became very evident to me that many times someone might lose someone, and the grief is so deep and so painful, and they feel like they're never going to be able to move on, and then they start to feel better, and they're like, "Okay, I'm getting a little distance from it, I'm starting to feel like myself again," and then — boom — you go back down. You get a memory, or you feel something, a big feeling related to that, and you're like, "Wait, I thought we had already moved beyond this." And no — somewhere in my cellular memory, it is very awake and transformational. So really, mourning and loss was the first place I truly felt the nonlinear-ship of the journey.

I think that in our Western way, we like linear. We like boxes, we like graphs, numbers, percentages, timelines, and we like things to be done in the time and order that we planned them, or we think that they should be. And one of the biggest lessons in things not being according to our time is birth, and when babies decide to come and how they decide to come. But the actual integration of parenthood, or motherhood, or someone who has had the transformation of a child leaving their body — and maybe isn't even raising that child — is nonlinear. It's not based on the experience of, "Now the child is one, I should feel like this. Now the child is two, I should feel like this." Because I can tell you that my oldest is now 33 years old, and there are sometimes lessons in parenting that I get, or glimpses of things that I thought should have been put in a beautiful turquoise package with a bow on the shelf, much like your beautiful book over there — and they're still a little leaky, they're not fully put away.

And raising children, and then becoming a grandmother, and then watching people have babies — all of these transformational things — they can't be linear. They cannot be linear because they're infinite. And how do you turn infinite into linear? Linear is a box, it's contained. And in my opinion, there's no such thing as time, and there's no such thing as a graph of when we should learn, or when we should feel, or when we should get certain lessons. But sometimes I look back and I'm like, "Wow, if only I'd known that as a young mother, what would I have done differently?" And then sometimes I think to myself, "Thank God I didn't know that as a young mother. Thank God, thank God my brain didn't even go there, because it couldn't and it wouldn't. It didn't have that power." It was like trying to make — you know, remember the first computers? I think you and I are — do you remember the Commodore 64? You are not going to make the Commodore 64 do what my iMac does now. It's not going to, because we didn't —

Britta Bushnell: — know what we needed to know to be able to do that then. Just as we do not know what we need to know now, we didn't know what we needed to know for this moment back when we were brand new moms. And that there can be a frustration of wanting to know more before our time. One of my mentors, Pam England, would always say that you grow the ears to hear that you can't actually — you know, so often we hear the statement, "Why didn't anybody tell me?" And you and I, as professionals in the field, can sometimes feel like, "Oh gosh, I really thought I did tell them that." And likely we did — but that doesn't mean, even if somebody has told somebody, or even if information has been shared, that they had the capacity, or shall we say the ears, to be able to hear it.

Capacity, Vessels, and the Ears to Hear

Atoosa Benji: For sure, and I love the word capacity. I just learned a new word in my mother tongue, which I'm still learning words in — Farsi. The word is jambe. I was like, "What's jambe?" My friend said something like, "She doesn't have the jambe," and I'm like, "What's jambe?" She goes, "Jambe means the size of your vessel." She doesn't have the capacity to hold whatever you're asking her to hold in that vessel. I can't have you hold a gallon of water in a four-ounce teacup. And our capacity grows — and when I was at a certain place, you couldn't put more than four ounces of water inside my cup, and it grew. And also the vessel changes, Britta, right? The vessel changes. There are times where you're like, "Bring it on, bring me the sea, I can take it all," and there are other times where you're like, "I just need a minute, because this cup is feeling really full and really heavy, and I'm not able to hold it."

And I think that's part of much of what we were talking about earlier before we started — it's honoring how big your ears are, and how big your jambe is, at all the different parts of our life. And the other funny part of this, which I'm sure you've experienced as an educator and a speaker and an author, is — have you ever had a scenario where someone hears you speak and then later says, "You said this, and when you said this, this is what it meant to me," and it was actually not what you meant at all? But that is the ears that person needed to have at that time, to hear whatever they needed for their transformation.

Britta Bushnell: Yeah, I mean, I've definitely had moments where someone will come back after I've given a speech and they'll say, "When you said—" and I'll think to myself, "I don't even think I said that." But we do hear things, and we do have capacity for things in the timing and space and dance that — I don't know, maybe that is divine timing. And that also doesn't necessarily mean that there aren't moments when the universe pours buckets and buckets of water on us, and all we have is a teacup. There are times when we feel like we can be drowning in it.

Atoosa Benji: Absolutely, especially in birth work.

The Weeds We Cannot Clear: Doula and Midwife as Guide, Not Rescuer

Britta Bushnell: Especially in birth work, and especially in times of transformation — which also takes me back to your work with the nonlinear, which really felt like it got inspired with grief work, or a personal experience with grief, and how powerful that is. I think when we're talking also about birth, because grief has a place in talking about birth, and in the experience of new parenthood, but it's not talked about very much. So can you talk a little bit about grief in pregnancy, birth, and new parenthood? And you also have experience with When Survivors Give Birth, and I'm curious how these different things intersect in your experience, in all the different ways you work with families.

Atoosa Benji: Yeah, how long is this podcast — four or five hours?

Britta Bushnell: Right, I know. Big question, Britta.

Atoosa Benji: Okay, we need a sequel. Let's see. I believe wholeheartedly that grief lives under the surface. If you have this beautiful river, then underneath is access to grief. Now, when in our journey are we willing to tap into it ourselves? When do we have the time, the willingness, the resources, even the privilege, to stop and be like, "Oof, that's big, I am feeling that to my core"? At times we're able to access it, and we go down and we get it, and at other times it comes up to greet us.

And one of the things about being in birth work now for 25 years — I always, when I was a young childbirth educator and a doula, I wanted to be — I guess what do they call them, you have helicopter parents, right? And then you have lawnmower parents. Have you heard of lawnmower parents? I love these.

Britta Bushnell: Yes, helicopter is always hovering, and lawnmower is clearing all of the obstacles out of the way, right, to make everything even, so walking is smoother.

Atoosa Benji: So smooth. I was a lawnmower doula, and in my early years as a midwife, I tried to be a lawnmower midwife, where I want to clear everything for you in the time that I've known you, and I want our experience together, and your birth into motherhood and parenting and whatever this journey is — I want to take every weed, every bump, every gravel, and straighten it out, so that by the time you get there, it's just smooth sailing. Now, there is a version of that which is proper education, anticipatory guidance, informed consent, informed choice — all of those things, right, that are inherently a part of our work, especially as a midwife. But the more I do this work — I don't remember if it was during our interview when you were on my podcast where we talked about it — I had this lovely woman having a baby in my practice, and her mother said to her, "Sweetheart, if I could do it for you, I would," and she was talking about labor. I do not have the ability to take out every weed, to know which bump is behind which mountain, which mountain or which river or lake you're going to face. There is — and there's honor to that — I'm not supposed to. I'm there to hold you and guide you to the best of my ability, but you're the one who has to travel —

Britta Bushnell: — the path.

Atoosa Benji: You have to travel the path. And in that path, you know, God forbid, there are things that happen that come out of left field — losses and miscarriages and things that happen where you're like, "Where the heck did this come from?" And then there are other times where the grief is so quiet — nothing actually happened, but it's that glimpse during a pregnancy where — actually, a mother was sitting today on my prenatal seat, and she said, "I just keep thinking about how my life is never going to be the same, how my time is never going to be my own, how I'm never going to be able to leave the house with just my wallet like I do, or just my phone."

Big Grief and Little Grief

Britta Bushnell: Yeah.

Atoosa Benji: And I think in our climate, also, our world right now is war-ravaged, and for those of us who have fled and are immigrants, or are still living in war — whether it's literal bombs, or it's the war in the life that you're living — I feel like there's a deep vibration of grief for many of us. The other day I was reading my granddaughter a book about a little girl who had to leave her country and her grandmother, and she had a bangle that she loved, and her grandmother said, "Honey, we have to take all our jewelry off, they're not going to let us take it." And she was like, "But it's my one bangle." And her grandmother said, "I'm sorry, we have to leave everything." So they got to where they were going, and they were eating pita bread sandwiches they had brought, and she bit into her pita bread sandwich, and her grandma had hid her bangle inside the piece of bread. And I was reading this to my grandkid, bawling — the grief of leaving — I've left two countries and started anew. The grief of that was so deep in the year 2026 that I may not have felt in 1997, which I felt very deeply in 1979 when I left my country, or 1986 when I left another country. So who's to say? But it was like a stab in my heart, the tears just wouldn't stop. My grandbaby was like, "Grandma, are you okay? Are you having big feelings?" I was like, "Yes, honey, having big feelings."

And those big feelings, and the big-G grief and the little-g grief — and that mom in your office, speaking about the grief of leaving the house with just her phone and her wallet, and the loss of that — those are all real. They're real forms of grief. And loss is intertwined with transformation — they are inseparable, because when we're in a process of great change, we are leaving behind parts of ourselves, parts of our lives. There are things — like, for me, I remember having a baby, I was kind of excited about the idea of not going out for late nights, like dance clubs and late-night dinners — those weren't really a big part of my life, I wasn't sad about that, I was kind of like, "Okay, great, we're good, we're good." So those kinds of leavings were fine. But the bodily autonomy of being able to rest when I wanted to rest — I grieved that, because I was not able to rest simply when my body wanted to rest as a new mom, and that's worthy of grief.

Anger as the Animated Form of Grief

Atoosa Benji: Absolutely, 100%, and a million forms. Sometimes it's just a glimmer of grief. Sometimes it's the kind of grief that makes you all jumbled up, and you can't really focus, and you're foggy. Sometimes it's the kind of grief that takes you to bed. There's no wrong way for the grief. And, oh — anger can also be sort of intertwined with grief. Anger is like the angry form of grief, you know what I mean?

Britta Bushnell: They can be intertwined and tangled up and hard to tell apart sometimes.

Atoosa Benji: So hard to tell apart. And for me, grief is quiet, anger is the animated form of grief. I had tremendous anger after I had my child. Tremendous anger. Why didn't anybody tell me? Why didn't anybody tell me that babies can cry for four months without stopping, and your boobs can shoot milk across the room, and your baby can choke on the amount of milk that's coming out? And why didn't you tell me that my friends would be in Mexico while I'm sitting on a rocking chair? And, for my culture, one of the things that made me so angry — we're Middle Eastern, and you get pregnant, the next question is, "When are you having a baby?" There's no, "Oh, we're going to wait seven years to have our baby." Especially in my day, 35 years ago when I had my kid, as soon as you get pregnant, the next week people are looking at your belly, "Is there a baby in there? Is there a baby in there?" So I have this inherent — I don't want to say pressure, but epigenetic pressure — to have a baby. And I was 19 years old, and I was like, "Yay, baby, it's gonna be my friend, we're gonna be in a stroller, we're gonna walk in the park, the baby's gonna be my buddy." The baby was not my buddy.

Britta Bushnell: No, no.

Atoosa Benji: The baby was not my buddy. And it's so sad to say, but there was not the elation and attachment and, "Yes, please sleep on top of me, I love co-sleeping" — like, no, I don't. Like, where did I end and where did you begin, and what's happening now? And that happened when my daughter was born, and I even feel it deeply again now that my daughter is older, with her daughter, because there are expectations, like, "Hey Mom, will you—" and it's like, "Do I have to say yes? Can I say no? Is it okay to say no? Can you just get off of me? Can everyone just leave me alone right now?" But you're a grandmother, and you always want to say yes. So it's all intertwined in such a wild manner that I never could have thought of, and I feel grief because I wish my grandma was here so I could talk to her about what it was like for her when she first became a grandma — which I never got to ask, because I didn't have the knowingness to ask, because I didn't think it would be this.

Britta Bushnell: You didn't know you needed to know — you didn't have the questions to ask. Just as we sometimes don't have the ears to hear, sometimes we don't have the questions to ask until after the point when the asking is no longer possible.

Atoosa Benji: Absolutely.

Britta Bushnell: Or at least the answering is no longer possible. It's such — and that dance is also part of the piece that can be frustrating, that can cause some of the grief and anger — the desire to have control and the ability to craft our lives in the way that we want to, and yet, especially around times of transformation, control is an illusion. And you and I basically are in the field of helping people, to some degree, find a way to open to that illusion —

Puberty, Loss of Control, and the Body's Timeline

Atoosa Benji: — from puberty to menopause, right —

Britta Bushnell: — and then into death. So yeah.

Atoosa Benji: And then into that. I teach puberty classes to people, and when I'm teaching girls, some of them just straight shut off, because they're like, "Hell no, my boobs are not going to do that, my vagina is going to do what? No, no, it's not." And they will literally shut off, or get angry, or zone out. Some of them are just angry — "Why are you even here? Why?" And, "Why did my friend get her period already and I didn't? How come her body looks like that and mine looks like this?" And the grief that can sometimes come — as we talk about in When Survivors Give Birth — the loss of childhood, where you begin to attract attention in a way you did not before you went through that transformation. Almost like a loss of people not looking at you, or not giving you a certain feel, and then it gets pinned on womanhood or puberty or changing, because of the grief that you had no control over this time in your body. You have as much control over when your breasts grow as where — as when you get your period, and when your baby's coming, and when your one year of not having a period is done — unless we're all playing with hormones and stuff, but that's a different discussion.

When Survivors Give Birth: Trauma-Informed Care as Universal Precaution

Britta Bushnell: Yeah, yeah. I would love to actually, since you brought it up again, hear you talk a little bit about When Survivors Give Birth — that organization, what it does, and how you help in that organization.

Atoosa Benji: It's actually an interesting thing. I took a birth doula training because I had an amazing doula, and I decided to become a birth doula.

Britta Bushnell: Such a common path into it. It's a very common path.

Atoosa Benji: It's also a path — when I train doulas, we have to own and hold our grief about our birth and our parenting and all of that before we enter the room, because — I actually have this meditation-slash-prayer I always teach my doulas, which is: "Universe, please allow me to leave my birth, my experience, my journey, my biases outside as I enter this hallowed ground with a whole new opening and perception and willingness about this person's experience." So we do a lot of that. But I read their literature, and it was all from Penny Simkin, and I decided to go to a DONA conference, and I saw Penny Simkin, and I was like, "Oh my god, that's Penny Simkin, she's so famous" — and she was so humble and so quiet and so lovely that I was like, does this woman know she's a world-renowned author, scholar, researcher, educator? Her humility really struck me. And at one of the events, I just asked if I could have coffee with her in between two sessions, and she said yes. So I had this beautiful friendship with Penny.

Many years later, I wanted to go back to midwifery school, so I wrote her this long letter, and I said, "Hi Penny, would it be okay if I come and see you? I see that you and a woman named Phyllis Klaus are teaching a workshop, and I'd love to come to Seattle to take the workshop, and also, while I'm there, can I come and see you?" And waited for a response. Waited for a response. Nothing. "What is going on?" So I ended up calling her — I told her what I needed, and she was like, "Of course, yes," she'd put a date on the calendar, "Come, we'll see each other, after the workshop we'll have lunch, whatever, great." In the meantime, the letter I had sent never arrived — came back, returned to sender. She never even got it.

Britta Bushnell: You sent this letter via snail mail —

Atoosa Benji: Snail mail, straight to a Seattle address, and I was like, "Why isn't this lady—" and I didn't just want to call Penny Simkin, like, who calls Penny Simkin? But she was so accessible, she would pick up her line, she was so awesome, rest her soul. So I said, "Yeah, I'm gonna take this training, it sounds really interesting." She's like, "Yeah, you should take the training." And I went to — and I took the training, and Phyllis Klaus blew me away. She has a presence and a knowingness — talk about the mud, her hands have been in some rose bushes and other things in the garden.

Britta Bushnell: I too have had some pretty phenomenal experiences with Phyllis Klaus and her — yes.

Atoosa Benji: She's something. And I resonated with a lot of the things the book talked about. There's things in my past that I can say I wish didn't happen, but if they didn't happen, then I wouldn't be who I am. So everything happened the way it was supposed to happen for my transformation.

I spent the day with Penny Simkin — she let me sit at her office desk the entire day, we talked, we walked, we had lunch, we took her dog in the car — I spent a date with Penny. And then it was time, and she said, "I want you to talk to a few midwives, go on my computer and email this particular midwife and see if she'll set up a meeting with you." I was like, "Okay," and I'm trying to get into my Gmail account, and she's like, "No, no, no, do it from my email — somehow people respond to me very quickly, I don't know why." I was like, "You don't know why, really?" So we just had this phenomenal day.

I started going through the process to do my certification, and the organization just sort of wasn't fully gelled — it was Penny and Phyllis. Phyllis had written this book, Phyllis as a social worker, Penny as a physical therapist turned doula and trainer, and the book was phenomenal, and the training between them almost seemed like two people who just wanted to get the word out. It wasn't fully organized. So everything I taught, when I became a midwife, when I was a doula, all those things came from this trauma-informed perspective through the book When Survivors Give Birth — and this was before little-t trauma and big-T trauma were even coined. Trauma-informed care wasn't really even talked about much — this was the early 2000s, way before the pandemic. So I was doing trauma-informed care innately in everything that I did.

A few years ago, Penny passed away, and I got an email from one of the trainers who had been teaching with Penny, saying, "We are restructuring the organization, would you like to be a part of it?" I was like, "Absolutely." So about eight of us have come to the table — there's going to be a book we write, there's going to be very formalized trainings all over the country, all over the world, and I'm so honored to be a part of it, in work that I've already been doing. But to bring Phyllis and Penny's work into the light again is very powerful. The book actually belongs to the Simkin estate, so there had to be permission and all sorts of things to make it work again — with Penny's blessing. Penny gave the blessing before she died, and now we're working with her daughters to revamp the book and revamp the trainings.

I plan to teach doctors and nurses and midwives and all providers, because I treat trauma the same way I treat OSHA precaution — I have to assume that every person whose blood I draw has HIV or Hep C, so I put on my gloves, I have universal precaution protocols. There must be universal precaution protocols around trauma. We must assume that everybody we are about to touch has something that needs to be treated with extreme tender loving care, and I would love for that to just become the standard.

I myself remember going to a phenomenal doctor — she was amazing — and on my intake form it said, "Do you have a history of childhood sexual abuse?" And I ticked it, I marked it. She said nothing about it. She said nothing about it, and she —

Britta Bushnell: — acknowledged it on a form, and then it just goes unaddressed.

Atoosa Benji: Unaddressed. And she was an amazing doctor who gave me an hour of her time and was phenomenal. And I was like, if this doctor is not acknowledging it, what's happening out there? So my pet peeve is: if someone shares that with you in an intake, you must address it. Because part of being seen — that could be the first time that person ever shares with anyone, because a piece of paper feels a little safer than just saying it out loud. And a lot of that came from Phyllis and Penny's book.

Britta Bushnell: Oh wow, well that sounds like such important — the fact that you're going to be part of stewarding that work into its next iteration, to be able to really impact people in such positive ways, and hopefully providers, so that when it — I hate to say it's kind of like the trickle down — it will really impact the people that they serve in a respectful way. So I think that's phenomenal too.

Atoosa Benji: And not in a cover-your-ass way.

Britta Bushnell: No.

Atoosa Benji: Like, "Let me take this training because I have to take one more training on trauma-informed care, check it off, cover my ass" — forgive my bad words on your podcast.

Britta Bushnell: Oh, bring them.

Atoosa Benji: But in a true integration of — when you are entering a woman's body with your fingers, a person's body, however they identify — where has that person been? What has that person's journey been, that you are now becoming a part of intimately? Are you respectful of how you're moving around the room? It's vital. It's as vital as putting on gloves when you're drawing blood.

Collaboration Across the Birth Team

Britta Bushnell: Yeah, yeah. I love that we're speaking about this like that. And I'm also hearing — because you move very fluidly between talking from the side of your experience as a doula, but then also as a medical professional in the form of midwife, and then also trainer, and engagement, and podcast — you have lots of different hats you wear. But one of the things I know you're passionate about is collaboration. I'd love to hear you talk a little bit about that — as somebody who's had a foot in one part and a foot in another, how do you dance between those, and what about collaboration matters to you, and what does it look like?

Atoosa Benji: Whew! It's another big one.

Britta Bushnell: I know I tend to lob in three or four questions.

Atoosa Benji: No, I'm the same way, I get it. I hate to use the word "village," but I'm going to use the word village. How can you be a provider just working on your own, out in the yonder, with pregnant people? Pregnancy, by definition, is not designed to be done in a silo. So how can being a provider for that person be done in a silo? Whether you're a doula, or a chiropractor, or a pelvic floor therapist, or whatever you're doing in this allied field — I realized very early on when I was a doula that — I'm a natural connector. "You should meet Britta, she's a lala" — those connectors —

Britta Bushnell: Just look at that. Some — I've heard that referred to as being a maven. As soon as I heard that term I'm like, "Oh, Denise is a maven" — I start thinking about people in my elder sphere who I think of as mavens. So I think maybe you're —

Atoosa Benji: — a little maven too. Thank you, I'd be honored. So I realized very early on that when I was referred by a physician or a midwife to someone who needs a doula, 99% of the time I would do the interview and get hired, and most of the time it was a really beautiful birthing experience. And I tracked this, and I was like, "There's something here." There's something really lovely about a doctor or a midwife entering the room and knowing your doula — it creates an immediate feeling of non-adversarial trust, alignment, and it makes the birth room feel better. Now, don't get angry at me, listeners, I'm not saying every doula has to be friends with the doctor and everyone has to be one happy family. What I'm saying is there is an element of respect and understanding that I can't do what you do, and you can't do what I do, but it's when we come together that we create a synergy and make it better for our clients.

Britta Bushnell: Absolutely.

Atoosa Benji: And especially when we have a dance of respect between those different types of practitioners, it makes it better for everybody.

Britta Bushnell: Yes.

Atoosa Benji: Everybody — and even with the nurse in the room, there's just a feeling of everyone respecting that everybody is vital, and everybody's role is unique and honored.

Britta Bushnell: Yes, sadly it doesn't happen all the time, and we know that.

Atoosa Benji: All the time, for a million different reasons, including systemic garbage and all the other biases that, as humans, we hold — which is another podcast. But I realized this, and so now in my network, when I refer a childbirth educator, or a pelvic floor therapist, or a tongue-tie specialist, when that referral comes from me, people are like, "Okay, I trust this person, and I trust that this person has really good people in their network." Fast forward, I become a midwife, and I realize I would love to have physicians I can collaborate with during the pregnancy, so that if the person spikes high blood pressure, or develops cholestasis, or any of the other things — I can pick up the phone and say, "Hey, this is what's going on, can you see this person?" And that person will pick up my phone on the first ring, and we have collaboration. I'm really grateful I have that with a handful of physicians in the city, and the same person can take my hospital transfer if we need to go from home to hospital in a non-emergent setting — of course we could go to the nearest hospital and get very good care from a hospitalist, hopefully, right, a hospitalist is a doctor who works shift work at the hospital in OB — but that person seeing a familiar face, a familiar voice when they're transferring, which is already such a time of extreme heightened adrenaline — they don't have to go into the hands of a stranger for their collaboration. I think that's just been powerful.

A couple weeks ago I got a text from clients I had referred to someone, and they were like, "Atoosa, what is up with your network? Everyone you tell us about is amazing." And yes, everyone I tell them about is amazing, but also, when it's coming from a trusted source, you already go in with the lens that it's going to be pretty amazing. So for me, that's collaboration.

Britta Bushnell: Yeah, and collaborative care has been shown in research to improve outcomes, as well as patient-client satisfaction, when there is that collaborative care. To be able to take a client from your care and hand them with respect and connection to an OB in a hospital, and know they're going to be well cared for, is really powerful.

Atoosa Benji: And our central nervous systems in this work get so tired — nurses, doctors, surgeons, midwives, doulas, our nervous systems are wrecked. So anything we can do to bring joy and warmth and respect into the birth room — imagine the energy that baby will feel when the baby comes in, and what that client feels when they're being cared for in this way, versus everyone being on their own island. Like, "I don't know, ask your nurse," or "I don't know, ask your doula," or, "Who? What is a doula? Who is a doula? Who are you? What am I?" It just creates this adversarial feeling that is one of my many pet peeves in this work. There's no space for adversary. None of our nervous systems can take it, so selfishly, we need to get rid of it.

The Doula-Midwife Hybrid: Doula Monitrice

Britta Bushnell: Yeah, no, collaborative care is so powerful. And you also offer a service I'd love you to talk about — it's kind of a space that, in some ways, fits in the zone between doula and midwife. Can you talk about that?

Atoosa Benji: It's the hybrid! And I'm so excited to talk about it, thank you for asking, because so many people really don't know this exists — and, you know, they have my frustration, "Why did nobody tell me that you could do this, this is awesome." The role is the role of a doula monitrice. So classically, when someone is a doula — let's say a certified doula, because certified doulas have a very clear scope of practice, which includes not being a medical provider.

Doulas do not do anything medical. They don't diagnose, they don't prognose, they don't take blood pressures or check cervixes or any of those things. The role of a doula is education, advocation, comfort — that's the role of a doula. The midwife's role is caring for the client and their baby for nine months, or whenever they come into care, being there to catch the baby, and taking care of mother and baby for six weeks afterward, if baby is with the mother. So in the state of California, I'm licensed by the medical board — some midwives are licensed by the nursing board, and each of us has a slightly different scope of practice depending on which part of the country you're practicing in.

So people will often hire me to be their doula — I'm doing education, advocation, and comfort measures. But because I have the license from the medical board as a midwife, I am also able to listen to fetal heart tones, take vitals, assess labor, know when something's not quite right, check the client's cervix for when they might want to transfer to where they're having their baby, and bring the lens of a midwife to the picture — the tips and tricks that midwives learn, and all the things we know about the body. My clients are really getting so much out of this model, and so few people know about it. So if you know a midwife in your community, ask them if they do doula monitrice services. Some do and some don't, but when we do, we often have physicians we collaborate with, so that your midwife has your doctor on speed dial — knowing that your midwife is not doing the delivery, but the doctor trusts that your midwife knows what's not normal, will call when things are happening, and you're working in this beautiful orchestra of care. And our outcomes are great — people are just raving about, "Wow, no one told me this was a possibility."

Britta Bushnell: I'm so glad you spoke about it. I have had clients who have used this type of service, especially — I find it's been really helpful for clients who, for a variety of reasons, know they want to work in a hospital, and they really deeply want the midwifery model of care, and this kind of gives them an opportunity to dance between those two types of care, and they've been very happy with it.

Atoosa Benji: Well, it's nothing that they're not doing in many other countries routinely, right? In most other countries — my brother just had a baby with his partner in Amsterdam, and they needed a transfer, so I asked him, "Well, how did that go for your midwife?" He was like, "What do you mean, the midwife was part of the hospital?" I was like, "What?" He's like, "Well, yeah, she transferred, she called the doctor, and then she just continued caring for us." And then she became the postpartum doula — the midwife became the postpartum doula for three weeks, Britta.

Britta Bushnell: That is continuity of care if I've ever heard it, my goodness.

Atoosa Benji: And that's where we know we have better outcomes — collaborative care.

Britta Bushnell: Right there.

Atoosa Benji: So this is just my Los Angeles —

Britta Bushnell: Yeah —

Atoosa Benji: — mavericking, MacGyvering this model that in many other countries exists innately and is covered by insurance.

Britta Bushnell: Yeah, and it is available — I do know there are other midwives who offer this kind of possibility in other areas as well. So if you're listening and you're not in the Los Angeles area, and you're curious about this, ask around. Ask doulas — doulas often know who's doing this kind of work.

Atoosa Benji: Yeah — and I'm a midwife, but I still have a lot of doula in me. But a doula may not have midwife in them, because they don't have that training yet, or if they ever want to. And there are midwives who don't come near hospitals with a ten-foot pole — they're like, "Absolutely not, I work in the out-of-hospital setting, I'm good, I don't do doula monitrice work." But the ones who can work very fluidly between the two — I think it's just a sweet spot for our clients who want it.

Closing: Where to Find Atoosa, and the Closing Question

Britta Bushnell: I love that. So, before we wrap up with my final question that I ask all of my guests, I want to hear a little bit — we've spoken about your doula work, your work with When Survivors Give Birth, we've talked about your midwifery, but we haven't talked about your podcast or any of the other things you're offering. Do you want to share a little bit about the other ways people can connect with you, Atoosa, in your work?

Atoosa Benji: Oh my goodness, that's so sweet. Let's see — so I have the podcast, the Mama Tusa podcast, we drop every other week, and amazing people like Britta will —

Britta Bushnell: I recently recorded my episode, I don't know when it will land in relation —

Atoosa Benji: — we're about six weeks out from the original recording, just because I'm a crazy Virgo and I like to have — I don't like to be behind — so we're a little bit ahead, which is nice, I'm so grateful. The podcast started off being all different birth experts, including birthing people and people who've had children, and very quickly, after about a year, became more birth stories. Being a midwife myself, I never knew that people would be so excited to hear other people's birth stories, because it's like what you're in, you don't realize other people don't always hear and see it. But when we did all the numbers and stuff, people loved the episodes with the birth stories, so that's what it has transformed into, and it's just beautiful, and I love it. I just love, love, love podcasting.

I also train doulas — I train doulas in English, and I train doulas in Spanish, and I love the work I do for Spanish-speaking doulas, because they go on to work bilingually with indigenous languages, other languages, not just Spanish-English, but also Spanish-Mixteco, and serve the communities they're in. I work with Naomi Drucker at her office — I am sort of like an auxiliary midwife in her practice, we have our own practices, but we help each other and other midwives in the community. The beautiful thing about the LA birth community is, if I'm stuck, I can always pick up a phone and a midwife will pick up my phone on the first ring. And if they can't, midwife code is, "Are you okay?" Always. And if you say no help, three midwives will call you, which is just such a beautiful thing. The grandbabies, watching my daughters grow up, teaching — I still have a soft spot for childbirth education, which is such a funny thing. But I just love it.

Britta Bushnell: Yeah, I hear you on that one.

Atoosa Benji: What — why is it so magical, Britta?

Britta Bushnell: I know, it is — well, because I think both you and I are inherently teachers at heart.

Atoosa Benji: Totally, yeah. And part of my — okay, God, "clinic or classroom, what do you want?" And God keeps saying both. I'm like, but how, how?

Britta Bushnell: Well, I don't know which hat you want to put on for my final question, but — it's what's one — I'm checking —

Atoosa Benji: — from excitement.

Britta Bushnell: Well, it's just: what's one thing that you feel passionately about that you want new or expectant parents to see, hear, feel, or know during this profound period of their lives? It's just — I know there's probably a thousand, but just pick one — it doesn't have to be the one, but which one comes to mind today?

Atoosa Benji: I would love for people at this time to not go to so many different sources for information. Pick a trusted book, a trusted person, and once you have done or spoken to that person and read the book or the page or whatever you've chosen, say thank you to the person, close the book, take a deep breath, and say, "I know the answer" — because you are the one that knows the answer. Nobody knows better than you what you need for you, or what you need for your baby. You can read, you can scroll, you can Google in the middle of the night, you can ChatGPT, you can Claude — so many things you can do, so many experts on so many topics. But you are the expert on your body, and you are the expert on your baby. And I think in a generation where we have so much information oozing out of every device, we sometimes lose our power. And I think especially for people who have trauma in their background, or have situations where things have happened and they haven't been believed, and they've lost confidence in themselves — I would love to be able to give you your voice and your power back by telling you: you know. And it's not in a book, I promise you, it's not in a book. Go to the book as a resource, go to the person as a trusted resource, but then come back to you.

Britta Bushnell: Thank you so much, Atoosa. Beautiful wisdom. And thank you, listeners, for sharing this time with us. If something shared today impacted, supported, or moved you, please share this episode with a friend. I produce this podcast myself, and your support makes it possible. To show a little love for the podcast and these conversations, please follow, rate, and review. If you'd like to continue the conversation, please join us on Instagram at Transformed by Birth. I look forward to being with you again on the next episode of Transformed by Birth. Now let's gather what we want to take away from this episode with an inhale, and on the exhale, I'll blow out the candle. Until next time, bye, friends.