The Feministing Five: The Changing Woman Initiative

For this week’s Feministing Five, we met with the Changing Woman Initiative, a developing non-profit and Native-American-centered women’s health collective focused on developing a culturally focused women’s wellness center and birth place. We spoke to co-founder Nicolle Gonzales to learn more about this fantastic burgeoning organization.

Nicolle Gonzales (left) and Brittany Simplicio (right) of Changing Woman Initiative.

The Changing Women Initiative aims to renew cultural birth knowledge to empower and reclaim indigenous sovereignty of women’s medicine through women’s stories and life ways. Currently in its visioning and strategy-building phases, the Initiative plans to build its own birth center that will focus on Native cultural teachings on wellness. Its founders, Nicolle Gonzales and Brittany Simplicio, are both Native American certified nurse midwives who are leaders in integrating Navajo, or Diné, wisdom into their practice. To learn more about the Changing Woman Initiative and donate to this incredible organization, check it out here.

And now, without further ado, the Feministing Five with Nicolle Gonzales!

Suzanna Bobadilla: Thank you so much for speaking with us today. To get us started, could you introduce yourself? 

Nicolle Gonzales: I’m Nicolle Gonzales, and I’m a certified nurse midwife. I’m the founder of the Changing Woman Initiative. We started developing it about a year ago, but I have been thinking about it for the last two years.

SB: Could you tell us more about the initiative? 

The Changing Woman Initiative is right now a concept that we are trying to put on the ground with a development of a birth center for Native American women. The concept is to incorporate women’s stories around childbirth and teaching in our Diné culture and Native culture into women’s health care, specifically prenatal care. The initiative is a big umbrella to start that conversation with the community and to address birth, motherhood, and pregnancy. The goal of the strategy planning that we will have in a couple weeks is to have the community talk about that it is that they want in the birth center, what needs are not currently being met, and to come up with a community approach to address those needs. Definitely, pulling from our cultural strengths and knowledge about our own health is a central piece to it.

Right now, I work in Los Alamos at a private practice. I take care of Native American women from the Northern New Mexico tribes, like the Tewa Pueblo. Within my own practice, I definitely see a lot of barriers toward accessing prenatal care. I also see issues of health literacy within Native women, for example, understanding why health care is important. I see differences in their understanding of their bodies and their pregnancies. I take care of a large demographic of women in Los Alamos who are from are a rich, educated background. When they come to pre-natal visits, they know if they want a doula and they know their diet plans. When I talk to Native women, discussing what they expect from me as their midwife and their pregnancy, and I start to relate teachings about our bodies and our health through our culture’s belief system, there seems to be more of an understanding about their bodies and then the women feel that there is a connection to their ancestors. There is an understanding that what they are going through is a ceremonial process, it’s sacred, and it should be protected. I see how it benefits the women when we can bring these cultural teachings into the clinical setting and use them to take care of them.

Instead of bringing a very medical model of care into the birth center, we want to focus more on the cultural teachings and stories around birth and motherhood in order to share and empower women to realign themselves. Historically, because of Indian Health Service and field matrons who came to our tribes to teach us how to mother and parent, our own teachings have gone by the wayside. I feel like non-Native healthcare professionals don’t really understand that for us Native people, our wellness perspective comes from those teachings and ceremonies that we participate in. Our culture is pushed aside as not being as [important as] talking about the medical aspects of Type 1 diabetes or problems with pregnancies. Well, when you start talking about those teachings, then you start to see more of a positive outcome.

SB: If we could jump five years into the future and visit the Changing Woman Initiative’s birth center, what would it look like? 

NG: The birth center, as I see it, is a very green, wood building with a fireplace and a tipi outside. It has a very holistic community feel. When you walk in, you automatically see cedar burning. I want people who come to the birth center to be transformed into this ceremonial space. When you are in a ceremonial space, you respect it. It’s where prayer and counseling happen. When you are in that space, you automatically behave a certain way. That’s the feeling that I want when people go to the birth center. It is a sacred space when you think about where birth happens, in that first breath. The center should be a positive space of healing and wellness, not death and despair like a hospital setting.

I definitely see this wonderful wall of grandmothers. When you think about where we get our information from, it’s our grandmothers who pass that on to us. I know my grandmother’s photo will be up there along with Brittany’s. It’s a reminder of where this knowledge comes from, along with a respect for it.

I would love to see tubs so if women want to birth in tubs they can or if they want to in the tipi, they can in the tipi. It’s really important to have a fireplace at this birth center, and I’ve been thinking about how that would be. The fireplace is where our perspectives clash with modern medicine because of the dangers of oxygen and other fire hazards. When you talk historically about where birth used to happen, in the hogan or in someone’s home, the fireplace is an important place. In our Navajo, or Diné, culture that’s the center of our home and it’s what warms our baby’s head. There is a lot of cultural significant in the fireplace and I would love to see that in the center.

I would love to see a lot of support from communities like the tribes to come to our space to have meetings. It’s a natural and comfortable space. As far as services, birth and prenatal care happens there. We do have a fair amount of women who have diabetes so I would love to take care of them there and some days do diabetes education. We are still doing research for the cultural teachings and herbs that we would want to use, so I would like a specific space for that to happen.

Each birth room will be large and special. When I used to do births with the Santo Domingo Pueblo in Albuquerque, everyone came. Grandma, grandpa, aunts and uncles would come to wait for the baby. I want everyone to come and if they would like to drum and sing as the baby arrives, that’s welcome and available.

As far as the building goes, I would like it to be round and for it to face the east. There is so much significance in the east, especially as women would come and talk about their pregnancy and how they would want it to go. It’s very different from a clinic where there is a big table in the center and the light is bright. There is no ceremony in that, it’s just a pathologic process.

SB: It’s very exciting that you have launched a GoFundMe campaign where people can donate the initiative and spread the word. Could you tell us more about the campaign? 

NG: We are such a small group right now. It’s me, Brittany Simplicio, and our newly formed board. I have a grant writer now, and she’s amazing. I have my home office, we have an email address, and we are working on our website. The funds raised through GoFundMe are actually supporting all those efforts. We can’t do it all by ourselves.

We wrote a grant recently for a feasibility study that is going to look at an location of the birth center and it will collect information from the tribes on what their needs are. It’s really an important piece because as we look for more funding through grants, we need to show that this is a sustainable model that can be replicated in other tribal communities.

We will have visioning and strategic conversations with our community, where we will get their input on their health care needs and concepts such as wellness. Beyond that, there is also the business aspect like Medicare and reimbursements. Right now, I’m on a board for a birth center, and it does cost a lot of money to run one. I’m looking at the financial longevity so it can be successful. The reason why a lot of Native women are not accessing birth center services is because it can cost a lot of money. Recently, legislation passed a Birth Center licensure law, and we are trying to make it affordable for everyone. For example, when you go to the hospital to deliver there is a fee associated with the hospital delivery and the provider who delivered the baby. Birth centers who are not licensed through the Department of Health cannot accept reimbursements so people end up paying out of pocket. That can be anyway from $150 – $1000 to deliver at a birth center. That price range is not accessible for all Native women.

SB: Let’s pretend you are stranded on a desert island. You get to take with you one food, one drink, and one feminist. What do you choose? 

NG: My drink would be Indian tea. My food would be some kneel-down bread. My feminist would Jennifer Denetdale — she’s an indigenous feminist and Diné.

Images courtesy of Changing Woman Initiative