Meet the Midwife: An Interview with Selena Eisenberg
We want to introduce you to Selena Eisenberg (they/them) of Igi Osè Traditional Birth Services, a Pittsburgh-based midwifery practice.
Selena is a passionate advocate for informed choice and supporting folks in marginalized communities. They have also been working closely with St. Clair Hospital staff to create a more family-friendly environment, especially for families who want doula support for their birth.
Selena is an important member of our local birth community, and we hope you enjoy getting to know them better here!
Tell us a bit about your midwifery practice.
I love my work, and when someone asks me to support them, I am honored and overjoyed to be asked.
I believe that when people choose me and commit to the financial burden of accessing care, they deserve to know I will be the midwife who arrives. This means I keep my client list small. I know other midwives in the area who take on 6-10 births a month - that isn't something I can do and still keep the promise that when I get a call, I will be available. I am comfortable with 3-4 births per month at a maximum. My calendar fills up quickly so I encourage people to reach out early.
On the other end of the pregnancy journey, I sometimes have last-minute availability due to clients who may have transferred to a different level of care with another provider. I take on new clients up to 32 weeks pregnant. My heart goes out to people who have planned a birth with a provider only to find out that a breech presentation is forcing them to either accept a cesarean or find a provider willing to support vaginal breech birth. Those are the people that immediate openings (birth is expected in 6 weeks or less) are reserved for.
One day I hope to convince our local hospitals to train all providers to manage vaginal breech birth and I am hopeful. There are hospitals in eastern PA that have done this and I am working to make it a reality here. Until it is, I will ensure I keep space available to support those who would rather change providers. Choosing to have major abdominal surgery is never easy, and doing it to stay with a provider or hospital team where you feel safe and heard is valid. No matter what choice is made, support and kindness are what you deserve.
I serve all people, but I prioritize people historically marginalized in hospital spaces. These same people are often not financially privileged and have fewer options because of that. I believe care must be accessible, so I use a sliding scale system. If someone needs care and the sliding scale options I offer aren’t enough, I encourage them to reach out to discuss other options including barter, alternative payment methods, or funds donated to my practice by community members.
My business name, Igi Osè, is Yuruba for the Baobab tree (hear the pronunciation). I practice African Traditional Religion (ATR) and wanted to honor where that originated, as well as my own heritage.
How did you come to midwifery?
I am traditional midwife. The short version is I trained through self-study and apprenticeship.
The much longer version is that I have wanted to support people during pregnancy and birth since I was old enough to be asked, "What do you want to be when you grow up?" Getting here was not what I thought it would be though. Life took me from pre-med undergrad to parent, then nursing school to health advocate, then back to pre-med undergrad. And finally, to embracing traditional midwifery as my true path because of ancestral learning and a personal journey of self-discovery and unlearning of white supremacy and patriarchal views.
I say the journey started over 16 years ago (with classes, research, and countless hours of training that make up the western portion that most people focus on), but truly it started long before that. I can see the lessons when I look back at taking peers to Planned Parenthood or telling friends about the importance of responsible intimacy. The people I supported through their journey to parenthood before I knew that those things were part of this space.
What do you feel are your particular strengths as a midwife?
I think I have several specific strengths that work together to make me a better midwife.
The first is that I am very literal. So when research, mentors, and experience told me that unbiased information was key to positive experience, I made that a pillar of my practice and my interactions in birth spaces. I am human and like all of my colleagues I have bias - but what I do about it is what I think is unique. Rather than justify my bias with studies or arguments, I simply say I am biased and can't speak on this in a neutral manner, and here is why and the this is the opposing argument.
The next strength that I think helps me be a great midwife is that I enjoy learning purely to learn. I love having tools in my toolbox even if I never use them. I train and take classes and courses that I hope I never need. This helps my clients feel safe so they can relax and just experience their journey knowing I will only ever make suggestions or apply skills if I have to.
The last strength that is unique came from a time that I worked in theatre. I learned that the author of the play and the lead in the show were irreplaceable, but that everyone else is a supporting player who can either support the vision or exit stage left. Antenatal care is the same! The person who comes to me is the author and the lead; they tell me what the story is, and my only role is to help them achieve the vision.
What's the biggest misconception people have about what you do?
There are so many! Honestly it’s a little funny that the two most common are opposites, and just come from different groups of people.
The first is that if something goes wrong in labor that I don't have the ability or knowledge to keep people safe. The flip side of the coin is that I am a "medwife" who forces people to have exams and tests, that I don't trust birth, and that my care is the same as what you would find in a hospital.
Traditional midwifery care is about autonomy and safety. The Grand Midwives beautifully walked a line and were able to support their communities while avoiding maternal and infant loss. I do my best to honor them and behave as I think they would. I sit on my hands and trust birth until the situation and the birth tells me I need to step in and apply skills to maintain safety. Birth and wellness aren't black and white - each experience is different and the nuances have to be embraced.
What's the most challenging part of your job?
That depends on the day. Most recently I have been spending much of my time deep in the statistics of health equity and outcomes. I love working with, speaking to, and educating hospital-based providers about out-of-hospital care and doula support.
The challenging part is that the statistics aren't just numbers. They are my clients, they are my community, they are people who trust me to keep them safe or who trust that when they head to the hospital, they will receive equitable care.
The numbers and stories I spend so much time with hurt my heart, but they also give me the energy to keep having hard conversations in sometimes hostile spaces.
What's the best piece of advice you have for people exploring home birth?
Decide what things are most important to you, and ask for proof.
If you want a certified professional midwife (CPM), get proof that the provider you’re interested in passed their exam. If you want someone with breech training, find out who they trained with, go to that organization, and verify that the midwife completed their training. If you want someone who bases practice in religious faith, ask where their spiritual community is. If you want a traditional midwife, ask if someone in the community will claim them as trained.
You have to know what you are not willing to compromise on, and then make sure your chosen midwife checks those boxes. I wish I could say just ask, but I really encourage you to look for proof just to be safe.
There is not a single midwife who is perfect for every client. You may not be able to find a midwife who checks every single box you’re looking for, so prioritize the things that will help you achieve your vision and make sure your birth team is aligned.
Do you offer any other services besides home birth midwifery?
I am happy to provide well care, conversations about fertility, and correcting common myths about midwifery and home birth. I also train labor and postpartum doulas through the Childbirth and Postpartum Professional Association (CAPPA) and I teach a midwifery assistant course. I have also developed a training for hospital-based care teams to better understand the importance of community doula care, as well as how and why they should foster that relationship for their patients.
I accept some requests for guest speaking about birth, equity, and similar topics.
I occasionally take on doula clients if they have a situation that is complex and additional support is necessary. I also offer one-on-one support for things like birth plans, explaining medical terminology or testing, and even helping people sort through birth options such as providers, hospitals, doula recommendations, etc.
How do you see midwifery growing in the Pittsburgh area? What changes would you like to see to midwifery or the local birth culture in general?
Here in Pittsburgh, I am excited to see more conversations about doulas and birth support, the rights of birthing people, and a bit more about what responsible homebirth or unassisted birth looks like. I think fundamental to a positive outcome is having the information about all of the options. But that can only really exist if all of us in the birth community talk about the choices without attachment to being the provider someone chooses. I’m happy to be starting to see more of this.
On a state level I want to see reimbursement from insurance plans for doulas and homebirth. On local level I want to see more honesty. I want to see:
pregnant people able to talk to OBGYNs about their homebirth plans without fear of retaliation.
homebirth providers being more honest about what they call themselves and the training they have completed.
honest conversations between hospital providers and out-of-hospital providers.
Progress can't be expected when we aren't laying our cards on the table and developing relationships. Without progress we will continue to see an equity gap that is killing people.
I want to see a thriving community where people can enjoy pregnancy and birth knowing that the information they used to make choices was unbiased and whole, and that all choices are accessible regardless of financial privilege. The truth and the options don't matter if only the privileged can access all the options.
I have a free care fund and a free training fund open to donations. When someone needs financial support to hire me or to train to become a birth worker, they can have those funds as a gift or a loan based on their personal choice. I wish I could serve everyone for no cost but that isn't something possible in our society. I hope community members will donate to the free care and training funds so the financial burden of receiving care and education won't have to be carried by families and students alone.
To summarize, honesty and financial freedom are hands down the two greatest things I hope for in the Pittsburgh birth community.
What is your favorite part of your job?
I love seeing people go from cautious and hesitant to confident advocates. I love seeing people walk in all their strength and navigate their care without regret. It is absolutely amazing. My clients’ birth stories and photos when I am left out of the picture are my favorite because the people I supported finally believe what I say all along: "You can do this and you don't need me."
How can people contact you?
You can reach out through the contact form on my website: www.igiose.com. My email is selena@igiose.com and I’m on Facebook and Instagram too.
I look forward to hearing from you!
