Here at Major Care, it’s important to us to keep abreast (pun intended!) of the movers and shakers in the maternal and child health world—and support their important work. So, we’re kicking off a monthly blog series where we highlight an amazing perinatal practitioner and learn more about what they’re doing and how they do it.  This month, we’re excited to chat with Kayla Bitten, a student midwife, doula, and childbirth and breastfeeding educator.

Kayla provides trauma-informed birth, postpartum, and lactation support to Black families in her hometown of Birmingham, Alabama—all while building the first-ever postpartum clinic in the state and studying to become a certified professional midwife. Kayla also offers education and trainings for both parents and birthworkers.

We love her witty social media presence, penchant for truth-telling, and deep commitment to reproductive justice. To learn more about Kayla and her work, we invited her do a Q&A about her birthwork beginnings, opening the clinic, and the important of postpartum support for Black birthing people and families. 

Major Care: Tell us a little bit about yourself and how you came to birthwork.

Kayla Bitten:  So I started birth work while I was in California (where I lived for ten years). I first got interested in birth work because of a tragic event that happened with my aunt and pregnancy loss in a car accident. She ended up having a miscarriage and somehow I just jumped right into knowing what to do to support her and be there for her physically, but also emotionally and mentally. I found myself saying things like, “I know it hurts, but it’s okay. I’m here for you.” Rubbing her, making sure that we were able to have a safe space where we sat. It was just a whole thing. So I unpacked it a couple of days after and I was like “What I just did has to be a thing.” I think I was 18.

So, I learned about birthwork and doula work. I already had a really deep connection to wellness and healing because of the conditions and situations of women in my family. So, I trained with community doulas and midwives in California, then went on later on and got some certifications. Then found myself in Alabama, which is where I’m from, where I was born and raised

MC: When did you come back to Alabama?

KB:  I came back because my mom was sick with cancer, so I decided to help  and figure out how to continue to be a birthworker. And then once she went into remission, I was like “Okay, I can dedicate even more time to my birthwork because I’m going to be here.” I planted roots. I met my fiance.  It’s been six years now. 

MC:  Can you speak to why you feel called to support postpartum specifically? Especially for Black families in Alabama? 

KB: So first of all, it’s already a full situation when it comes to trying to give birth as a Black birthing person. I think that people have to remember that most people I serve (most people are people of color) they’re already going through emotional and mental turmoil during birth.  They’re then saying, “Okay, cool. We’re down. We got through it. We didn’t die.” And then the postpartum period is just almost completely forgotten. There is no continuing support or care and anything of that nature. Parents are only checked on once during six weeks. 

I thought that was crazy. We are checking on this little being that needs a lot [the baby], but leaving space for a lot of negative things to happen to parents. Postpartum has always been a huge thing for me—healing, nourishment. And it’s the healing, it’s the education, it’s the access. And of course, also trying to navigate lactation, which is already a very difficult situation when it comes to the relationship that Black people have with lactation, breastfeeding/chestfeeding.

Perinatal mental health is huge when it comes to communities of color. I think it’s really important to figure out, “Where are those gaps?”  There’s a lot that people are trying to navigate when they’re in their postpartum period. Going back to work—Black folks have the highest percentages of returning to work before anyone else. So they’re navigating that, but few people are talking to them about their mental health because it can be a taboo topic in general, but especially in communities of color. On top of that, I often hear stories about how postpartum parents are being put in jail, or they’re being put on a 48 hour psychiatric hold, because they’re telling folks, “I’m going through something and I just had a baby”…but with no actual support.

I have always been very called to look into the future for people as parents. Postpartum just doesn’t stop at the six week mark. What does sex look like for you now? What does birth control look like for you now? What type of conversations do we need to have? What are your new triggers? Those things are really important and something that a lot of providers don’t hone in on. So when I decided to open the clinic and also become a midwife, I decided that I was going to specialize in postpartum. And as a Black woman and a queer woman, I am trauma-informed in the care that I provide. 

MC:  Can you tell us a little bit about how you came to open up the clinic?

KB: I started opening the clinic last year during the pandemic. I first started The Postpartum Clinic virtually, because I was already running a lactation group for north Alabama families of color, specifically for lactation (200 plus women and families). I was realizing that lactation was something a lot of them were struggling with during this time. And so I was like, “Okay, then let’s do this thing!”

We’re about a year old now. We were doing mostly virtual— we crowdsourced funds to make sure that we were able to operate virtually and have the perinatal mental health specialist, have the platforms, all the things that we needed to get started. Now we’re transitioning to where it can actually be an actual physical clinic instead of a virtual clinic. It’s going to be in central Birmingham. It’s not too far away from the Alabama Milk Bank, actually. I’m hoping to be a drop-off location for them. 

MC:  What’s your overall vision for the postpartum clinic?

KB:  We have a mental health specialist, an educator, and then there’s me. We have lactation appointments (for those who are or want to chest or bodyfeed as well as those who want to pump) and we help you navigate that. We also have a series of different classes, including postpartum and infant care.  There are individual smaller postpartum appointments, too. The overall vision is that people can purchase The Postpartum Clinic’s membership, which is 12 month’s worth of appointments, educational classes, mental health screenings and more. So come in, get the membership, get an appointment, come to a class or group, and you can ensure you feel confident and supported for up to a year postpartum. 

We also have community programs where we do do a lot of outreach. So, we help those who are adolescent parents and more. 

MC:  Is there anything else you want to say about supporting lactation in Alabama and in the South?

KB:  I think that if people understand the barriers for people here in Alabama with lactation during the postpartum period, then we can do better. Within my region, Black women go to work sooner than anyone else. We are often working jobs that are lower paying. So that means it requires a lot of work to continue lactating. That’s access to pumping spaces, talking to managers about pumping and these types of things.

We are in a food desert. Hospitals are few and far between.  There are not enough IBCLCs in private practice or out of hospital. I don’t even know if I can even count on one hand the number of private practice IBCLCs here who are Black.

So creating access and diversity, as well as understanding lactation and inclusiveness. How it is that you educate people? How it is inefficient? Treat people how they want to be treated—not how you want to be treated. So you have to ask, “What do you need? What’s happening within this community? How do I meet people where they are?”

Thank you, Kayla! To learn more about Kayla’s work, visit ThePostpartumClinic.com. If you are able, we really hope you’ll donate at the GoFundMe for the clinic, which is a little over halfway to the goal at the time of this writing. Follow Kayla on Instagram at @thepostpartumclinic and @thesouthernmidwife.