Ray Rachlin, they/she, Refuge Midwifery
Katie: Alright! Well thank you so much for making the time to chat today. Just to get started, could you tell me a little bit about who you are and about the kind of work you do, about your practice?
Ray: Sure, my name is Ray Rachlin, my pronouns are they and she. I’m a professional midwife, licensed midwife and lactation counselor here in Philly, Pennsylvania. I serve kind of Philadelphia, southeast PA and then all of south Jersey. My practice is part home birth, so I’m a home birth midwife and I help people give birth in their living room or their bathroom or y’know, hallway, wherever. And I also help queer folks get pregnant. So, specifically doing home intra-uterine insemination or home IUI, and kind of trying to build community with queer people who are trying to concieve, get pregnant, have new babies. Both through teaching classes like “Beyond the Baster” which is my favorite, funnest class to take when how to get pregnant when you lack sperm, and also community events.
Katie: Awesome, that work is so important! What are you queering right now?
Ray: I think I’m constantly trying to queer birth work and the birth world. I think… yeah, pregnancy and birth and having new babies is like the most gendered experience in our society. I got into birth work from a social justice/reproductive justice perspective, and what I kind of continue to find and work around is that the way that the childbearing year is gendered really takes away people’s agency and humanity in the process and y’know, queer-centered care is individualized care that calls people by their names and treats them as respected individuals, and everybody deserves that. That’s what I’m kind of trying to work for and build within the birth community here in Philadelphia. Folks that are providing queer-centered care in all aspects of y’know, pre-conception, pregnancy, birth and postpartum.
Katie: Awesome. And what inspired you to do the work that you do?
Ray: I definitely got into it through activism and social justice work. Long before I got into birth, I was a labor organizer and then… life situations came up and I was like, “I want to learn how to support people!” so I became a doula. It was like this switch flipped: oh, this is what I’ve supposed to be doing with my life. And birth kind of had all the answers of all the ways I saw problems and systems of oppression coalescing and it was like, “Oh, this is where everything starts and where I want to work.” I felt like, as a doula I was a bandaid on a gaping wound and the first time I went to a home birth, it was life changing. Because I was there as a doula, I’d probably been a doula for like 1-2 years at that point. And what I saw was the midwife worked around the needs of the person in labor. That when you bend over to listen to the baby, instead of telling someone, “Oh, we lost the baby, you need to get back in the bed.” birth looks completely different. I saw agency, I saw empowerment in a way that.. And just a birth that was fundamentally different from anything I saw in the hospital, and it was like OH – that’s what I need to be doing. And If I’m doing this at home and hospitals have to compete with this kind of care, they’re gonna have to behave better. That started off this long trajectory of choosing to become a direct entry midwife, so I trained exclusively with out of hospital birth, so home birth and birth center. So I just wanted to create a different paradigm of how we get to provide care that restores choice and agency to families and ultimately creates competition for hospitals so they have to change their practices to be more family centered.
Katie: Yeah. I really appreciate the framing of that both for what it is in and of itself and the uniqueness of out of hospital birth experiences, and also how that is also like pushing change within the systeem.
Ray: Yeah. I think there’s lots of different ways that, y’know, midwives are change agents in every part of society in every society that exists. But midwifery in the US is particularly a mess and like, some folks choose to work within systems to try to create change and that was not the road for me. I was like, I wanna work out- I want to create an alternative that isn’t navigating the same systemic oppressions in the ways that I’m having to provide care. There are a lot of limitations to out of hospital birth in the united states, and like, working outside the system but for me the benefits are outweighing the downsides and we can create our own alternative that better meets our needs.
Katie: And you’ve touched on this in all of your answers, but just to be really explicit about it, how do you describe your support philosophy in the care that you provide?
Ray: I think for me, being a midwife is about showing up for this process. I don’t have a particular stake in what choices people make or how their birth goes but it’s about providing consistent support, providing full information so you can make decisions about your body and understand what’s going on, feel supported and like someone has your back through the whole process. I think that’s what helps people into empowered parenthood. Just having someone in your corner for all of it. A good friend of mine phrased this well, and I kind of like, this is what I always come back to: Midwifery is about the restoration of choice. Y’know, bringing choice and autonomy and agency and respect back to pregnancy and birth. It’s done through relationship with my clients, it’s done through informed choice, it’s done through slowing things down and so there’s time to make decisions. It’s creating a revolution in our life and society through birth.
Katie: And so, I asked you a little bit about your natal work, but I also need to ask you about your natal chart. What’s your sun, moon and rising?
Ray: I’m a Capricorn. I think it’s very obvious to anyone who meets me. I’ve also had folks tell me they’re glad— I’m right on the cusp – I was born at like 11:55am on the cusp day in January, and I’ve had many people tell me they’re glad I’m a Capricorn, not an Aquarius as a midwife and I’m like, okay sure. I always get my rising and my moon confused! One of them is Taurus, the other is Aquarius. When I first was trying to figure it out, my partner was like, “Well, definitely Taurus cause you’re very stubborn” and I was like, “Huh, yeah.. probably true.” But I think, yeah 100% Capricorn.
Katie: As a fellow Capricorn sun, I… I’m also glad to have you in the mix of Capricorn birth folks.
Ray: It’s like extremely organized, regimented, y’know, with this process that you cannot predict at all..
Katie: Yeah, yeah, like, mmm no idea what’s gonna happen, but let me tell you, I have 36 plans already made and we’re gonna just pick whichever one, we’re gonna just keep switching them around til something works!
Ray: That is exactly true, yes.
Katie: What is your favorite thing about being a queer support person, a queer midwife and/or about working with queer and trans families?
Ray: I think it’s just the way that I can provide culturally competent care. It’s these little things that y’know, you don’t necessarily know this til youre in it, but I remember once doing a postpartum for a family I’d helped catch the baby of that, we were just talking about going through butch phases when we were teenagers and… just having a provider that y’know, just kinda gets it. Understands you, your family, your pronouns. There’s just a lot of shared understanding so you don’t have to explain yourself in a way that leads to a more relaxed care experience. And ultimately, a better care experience, cause you’re seen.
Katie: Absolutely, and then that time that is not actually about you trying to educate your provider about who you are and instead, and is instead about like “what do you need?”
Katie: Wildly different experiences of care.
Ray: For sure.
Katie: Reladetly, if you could change one thing about the experience of trying to get pregnant, prengnacy and birth for queer and trans families, what would it be?
Ray: It’s a good question, I think I have a two part answer. The first is insurance reimbursement, because our families are not recognized in the insurance structure and not recognized in fertility treatments, not recognized in our care needs. Trans people have a really, really high out of hospital birth rate and out of hospital birth is not well reimbursed so the options that we try to seek out to meet our care needs and our unique family needs are not, are only available to people with money and typically white people with money. So I think there’s the systemic ways for families to be better recognized in the insurance system so we can access the fertility support we need: access sperm, access second parent adoption with a lot more ease. But then also just the real issue is lack of representation. Pregnant people are assumed to be moms, and their partners are assumed to be dads, and that’s represented in pictures, in books, in literature, in providers offices and it is so, so, so engrained. And It’s really hard to figure out our own family narratives when we’re not represented anywhere, and we’re constantly having to translate stuff to apply to us.
Katie: What is one piece of advice that you would give to a new or aspiring queer/trans birth worker?
Ray: I think linking up with other queer birth workers. I feel like I have been gay for a long time, and in that time I’ve not always been a queer/trans competent birth worker. Gender is so ingrained in pregnancy, birth and postpartum and I had to do a lot of unlearning and really the best way to continue to do that unlearning and learn how to best serve my community is through the people who are already leading this work. We’re probably the best able to meet our community needs, and also being queer is not a given for being a queer competent or trans competent birth worker, for sure. There’s a lot of extra work that needs to be done.
Katie: Absolutely. And so much of it is about the stuff that we’ve also internalized about ourselves that also it’s sooo, it becomes so personal.
Ray: Yeah, like gender and babies – I constantly find myself at growing edges where I have a client using they/them pronouns for the baby and I slip up on their pronouns like 5 or 6 times like what the hell? I have more work to do. There’s always more work to do. But it’s like having the community both to learn from and also to support me in continuing to do that work.
Katie: I think that those communities both of support and accountability are so important.
Katie: And what is something not natal related or reproductive related about you and your life that you want to share?
Ray: I think (laughs) my biggest, like, hobby or side-thing outside of midwifery is powerlifting.
Ray: It’s kind of, yeah, I’ve been like a gym bro for like many years. (laughs) Now that I can’t go to the gym, ummm, yeah, now like a home gym bro, I guess. But, yeah! Feels like a very different side of my life and personality, but is also a very big part of my identity.
Katie: Wow. That’s incredible. I mean, I feel like a similar type of intensity in like..
Ray: Yeah- I only do things that are intense. I don’t really, like, so I knit so maybe that’s not intense. But typically, it’s like…
Katie: Just something I can really go hard at!
Ray: Yeah, my best lift is bench, which I’m very proud of.
Katie: In. Credible. Finally, where can people find you in the internet land?
Ray: I think most people find me through instagram, so my practice is Refuge Midwifery, it’s that on Instagram and Facebook. It’s been a really amazing tool for connecting with birthworker community, queer perspective parents and just like trying to continue to build knowledge and power around our families and birth and birth justice. I do an “ask the midwife everything Friday” (some Fridays), and just ways to access midwifery care that doesn’t involve hiring me as your home birth midwife. Y’know, as a practice, I’m serving around an hour radius around Philadelphia for home birth and for doing home IUIs, and I do also sometimes have folks who are outside my service area who just want to do preconception care with me because I’m good at helping people get off gender-affirming hormones to create a pregnancy and just want someone to help navigate that that knows the same language. And definitely the pandemic has opened that up more, so I’m doing a lot more virtual care than I ever have before, so for that you can find me on my midwifery website which is refugemidwfiery.com
Katie: Awesome, thank you so much. It was so wonderful getting to chat with you.
Ray: Yeah! Thanks for asking me to do this, I’m excited for the resource that you’re making.