EBB 364 – How to Prevent and Heal Birthworker Burnout with Doctoral Student Ihotu Ali and Grace Flannery, Certified Professional Midwife

Dr. Rebecca Dekker – 00:00:00:

Hi everyone on today’s podcast we’re here to talk about the intersection of burnout informed consent and systemic change in maternity care with Ihotu Ali and Grace Flannery Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Dekker, and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details. Everyone and welcome to today’s episode of the Evidence Based Birth® Podcast. Today, I’m so excited to talk with Ihotu Ali and Grace Flannery about preventing and healing burnout and how burnout is related to systemic problems in maternity care.

Ihotu Jennifer Ali is a birth worker and soon-to-be holistic health doctor who is passionate about reclaiming ancestral ways of healing our wombs, our families, and our sense of connectedness to each other. Ihotu Ali was raised among community healers on both Nigerian and Irish-American sites of her family, who instilled in her a vision that world peace came not from politics, but from people who had truly healed their wounds. Ihotu went on to work with the United Nations as maternal health researcher in Africa and the Caribbean, then as a doula and massage therapist in New York City, before returning home to Minnesota and going to medical school in response to the trauma she witnessed as a healer on the front lines after George Floyd’s murder in 2020. Ihotu founded the Oshun Center for Intercultural Healing, located inside a community clinic that offers affordable whole-person health care, mentors Black, Brown, and Indigenous healers, and offers training on reducing harm in health care and cross-cultural appreciation and exchange.

We are also joined by Grace Flannery. Grace is a licensed community midwife in Minnesota. Her practice, Trillium Midwifery Care, serves clients planning home births in the Twin Cities metro area. Grace is also a licensed emergency medical technician, EMT, and a board-certified phlebotomist. As a 2024 Teaching Fellow with the Sweetwater Alliance at the Oshun Center for Intercultural Healing, Grace works closely with Ihotu to guide group conversations with the Sweetwater Alliance community on equity, harm, and healing as they show up in healthcare and community spaces. For Grace, the art of midwifery is rooted in sincere relationships, weaving in a blend of age-old wisdom, current research evidence, and well-established community standards. As a community midwife, Grace is devoted to offering midwifery care that is inclusive, highly personalized, and responsive. She sees the strength of community midwifery in the model of care, which emphasizes autonomy, building trust, consistent presence, and thorough education. Ihotu and Grace, welcome to the Evidence Based Birth® Podcast.

Grace Flannery – 00:05:02:

Thank you.

Dr. Rebecca Dekker – 00:05:03:

It’s been a long time coming. We’ve wanted to have you two on the podcast to talk and share your wisdom with us. I was wondering if you could start off by just telling our listeners a little bit about how you two met and started working together and kind of what drew you to each other.

Ihotu Ali – 00:05:19:

Grace and I met as doulas, years ago, right?

Grace Flannery – 00:05:24:

Ten.

Ihotu Ali – 00:05:24:

Ten years ago.

Grace Flannery – 00:05:27:

Ten years ago.

Ihotu Ali – 00:05:27:

It feels unreal.

Grace Flannery – 00:05:29:

I know.

Ihotu Ali – 00:05:30:

I think we met in a diversity and equity inclusion type task force within our local doula group here. So is that right?

Grace Flannery – 00:05:41:

Truthfully, I actually don’t remember exactly where we met or when. But I do remember… Attending one of your self-abdominal massage workshops. And just being really interested in the work that you were doing at that time.

Ihotu Ali – 00:05:59:

Yeah. Yeah. And so it’s been 10 years working together as birth workers and see. How we both change time. I remember, Grace, when you became a midwife and you went back to midwifery school. And then some years ago, I went back for chiropractic and both super still in birth work. But from different lenses now. And the world has changed a lot. And soda has changed a lot over the years. I should say it feels like a homecoming because, you know, I used to… Such a big part of the you know the EBB family now after many years being away and coming back and having this conversation just feels like a big… For a circle moment.

Dr. Rebecca Dekker – 00:06:39:

It’s a full circle moment. And we’ll make sure to link in the show notes to Ihotu’s many episodes of EBB. This is not your first time. On the podcast and you’ve done some amazing teaching here in the past. I’m really excited that you’re here though to talk about burnout because I know this is something that you, Ihotu, have wrestled with for years and Grace, I’m sure, is a community-based midwife. It’s something you’ve also dealt with. And it’s a hot topic for birth workers that we talk to from all over the world. How do you keep going? In a career that sometimes feels like it’s designed to. You in a way because you put your heart and soul into it and There’s, you know, a lot of exposure to trauma. There’s also a lot of hope and empowerment and amazing moments, too. So I know it’s a blend. But we also want to make sure that birth workers can keep doing the work as long as they want to. So can you talk a little bit more about like the importance of this topic for both of you? And also in the context of like birth worker, healthcare in general, and bodily autonomy.

Grace Flannery – 00:07:53:

Yeah, Ihotu Ali and I got started working together more recently in the… Kind of the wake of George Floyd’s murder and the uprising in Minneapolis and a resurgence or rededication that a lot of people brought to racial equity work and an interest in community-based organizing. And so I joined then the Sweetwater Alliance, which is a Ihotu and the Oshun Center’s program. As a fellow, but I think we have to tell the story of the work we were doing within that group in order to contextualize how we arrived at the need to really discuss burnout as a root cause of a lot of challenges we’re seeing across healthcare. And I think it’s important to note too that you had originally invited us to come on to this podcast to talk about informed choice and consent in birth spaces and why we decided and ultimately suggested that we shift the topic a little bit. And so, Ihotu, I feel like you should talk about the Sweetwater Alliance.

Ihotu Ali – 00:09:02:

Yeah, well, I kind of have to go back a little further than that, actually, because I’m in a place in my life where I’m integrating. So I got to go back a little further and then I’ll catch up. So my first birth. Was a near miss. Right? Someone who was very close to not surviving childbirth. And when you talk about trauma in the field, that’s how I started. And, that was just a slice of the many different types of kind of traumatic things that I was. Into at the time I was working in war zones and just really interested in how do we bring peace into places of war or trauma. I have spent so many years trying to find a way through different professions and roles and schools to get to a place where. I’m not burnt out because I started as a community-based doula who was extremely burnt out. I became a massage therapist. It’s been through COVID very burnt out. Then I became a organizer. I was very burnt out. Working at EBB and then went to chiropractic school. And, uh, got probably the most burnt out I’ve ever been through these past years. And I think what I’m realizing is it’s not the role that you hold. It’s in here. It’s in here. You can go through so many different roles. The system has a piece of it that is…designed to extract. And until you find a way to hold your internal boundaries, no matter where you are, you will always be subject to that extraction. Right? And so it takes an extremely strong spirit in order to hold that line when you see the extraction coming and say, no, I refuse, or I will divert, or I will find a way to creatively navigate and jump differently through that space to hold my own center. So that’s kind of what we’ve been playing with, with the Sweetwater lines over these years, and particularly Grace and I going. Into a very deep dive over the past six months or so.

Grace Flannery – 00:11:16:

Or more like a year and a half.

Ihotu Ali – 00:11:18:

I mean, well, when we really like pulled everything away.

Grace Flannery – 00:11:21:

True. The last six months have been quite intensive. That’s true.

Ihotu Ali – 00:11:24:

Because that’s when we were initially going to do this podcast and we’re like, no, we’re not. We haven’t done a deep enough dive. She was like okay.

Dr. Rebecca Dekker – 00:11:32:

Well no, I, I remember thinking well, this is like we’re practicing it right now. Right. It wasn’t the right time, you two were, in the midst of it.

Grace Flannery – 00:11:41:

Yeah.

Dr. Rebecca Dekker – 00:11:41:

In the midst of the extraction as you might call it. And I think you know do you raise a really good point, about holding onto your center and to your own power and energy, because I think many birth workers are very empathetic people, and they want to give. And give and give. And what they don’t realize is that sometimes there are people and systems that all they do is take and they don’t replenish. And it just becomes a big imbalance. And so I think you’re right, Ihotu talked about the pattern of being burned out in whatever role and learning how to hold on to yourself and not letting people take from you is part of it.

Ihotu Ali – 00:12:23:

And making choices about where you want to give. Give fully to the areas that you’re prepared to give fully, but that means you got to hold a lot of other boundaries up, right? And when we want to, Grace and I are the kind of folks where we want to do everything. We want to be involved in all the organizations. We want to do all the good things. And that’s a recipe to burnout. And now you’re not present with anyone. With yourself, with your family, with your clients. And I do feel like as birth workers, I remember, you know, this is why we do interviews. You don’t just hire a doula based on the resume, right? You interview them. You want to feel their presence. You want to see how they answer your questions. You want to see how they hold the space for you. That’s different than a doctor, right? We’re okay with a doctor having lots of different qualifications. A surgeon must have done that particular procedure many times before for us to trust them. But a doula, you want to meet them. A midwife, you want to meet them.

Dr. Rebecca Dekker – 00:13:17:

You’re going to feel their energy.

Ihotu Ali – 00:13:19:

And when you’re burnt out, you have nothing. You cannot be present. You can’t activate in the moment when you’re needed. You can’t hold space, right? So much of being a birth worker is about getting all of those distractions aside. So you can hold this precious space for this person to do a very hard, important thing. And if you don’t have the practice of doing that with yourself, how can you guide someone else through it? And so our presence, I think, as birth workers is different than maybe doctors or other health care workers. Also important that they have presence, but they can kind of get away with it, perhaps.

Dr. Rebecca Dekker – 00:13:55:

Of not bringing maybe 100% of their presence.

Ihotu Ali – 00:14:00:

And the burnout is what we’ve noticed through our work is that when you’re in that space of burnout, you’re just trying to get through the day and you can’t stop and smell the rose when it’s in front of you.

Grace Flannery – 00:14:11:

Yeah, this thing about… Burnout and our It’s about our capacity, our resilience, our presence as. And in my case as a midwife or as the provider in the space, how I am internally really influences how things feel in the space in general. So much of our conversation is about mindfulness and honesty with ourselves about what it is that we can really do, what it is that we can really offer, who we actually are. And some of the honesty comes from, you know, really challenging the shoulds, if you will, and really challenging these ideas that we have about what we should say, how we should behave, what we should be capable of doing, how much we should be capable of taking on. I mean, you’ll notice there are certain themes in the conversation today, and a lot of them have to do with reckoning with this fact that we can’t necessarily do as much as we are told we should be able to do. And. We have to allow space for less, for slowing down. So that we can reclaim our… Ourselves so that we can then turn and bring that presence into the birth space. And this actually goes for hospital staff as much as it does for community practitioners like me who, you know, in the model of care I’m offering, there is just kind of by its very nature more space for relationship. The visits are longer. We can slow things down in a hospital or a large clinic-based environment where A provider is seeing 20 or even 30 patients a day in visits that are less than 10 minutes long when it comes to the actual face time between that provider and that patient. I think it becomes really impossible to… Manage this tension that exists between the humanity of the people in the room, the medical staff and the family or the patient, and the institutional pressures that are around that person. So I think we’ll talk a little bit about that too.

Ihotu Ali – 00:16:21:

And then you brought up the story of Sweetwater, right? So we went through all these hot topics, let’s call them, right? Informed consent. We were taking Rebecca from your, you were the one who introduced me to Tamil Cohn’s work. The characteristics of white supremacy and the antidotes, and we applied it to healthcare. So we’re looking at perfectionism. We’re looking at urgency, all these things that show up, right? Quantity over quality, right? Perfect, right? So many patients can’t spend time with all, can’t build real relationships with all of them. We broke, we had very in-depth conversations month by month. Over a year, a couple of years, with a collaborative of, I think we had up to at one point 40 different healthcare workers, therapists, yoga teachers, nurses, midwives, doctors. Chiropractic students, right? We’re all having these conversations. And it all… We notice a pattern. We could only get so far. And then we hit the burnout wall. Like everything boiled down to burnout. And we realized like we would get going on a really good top, like informed consent was so good or like, you know, agency and choice and allowing, we had good conversations about like asking consent of infants, you know, before doing pediatric exams. We would have these ideas, and then we couldn’t actionize on anything. The group itself and just the world for the past few years have been so taxed we’re taking on so much we want to be everywhere we want to do everything we want to fix everything today-

Dr. Rebecca Dekker – 00:18:03:

They constantly being bombarded with news that, you know, a thousand years ago, we wouldn’t have known much more beyond our village, you know?

Grace Flannery – 00:18:12:

Yes. This is literally something that we were planning on bringing up is like, yeah, Rebecca, she’s right with us.

Ihotu Ali – 00:18:20:

Yeah, she is. Yeah, we can’t do it all. And we got to be real. But we can choose what we’re going to do. That’s the thing. Choosing the thing, the right thing, not just getting swayed everywhere.

Dr. Rebecca Dekker – 00:18:33:

Right. And you, you know, in your discussions on burnout, you said each time the group would, you almost like reach the bottom of your well, or my therapist calls it like your bucket of resiliency is overflowing and so you can’t fit anything else into your bucket. Um, what are some of the symptoms? Because in my experience, I’ve witnessed a lot of birth workers and healthcare workers get quote unquote burned out and then start exhibiting physical symptoms that they don’t realize are the burnout, like perhaps headaches or digestive issues. Like what are some of the symptoms you all have seen?

Ihotu Ali – 00:19:09:

Everything in the chiropractic world. Headaches, back pain, anxiety. Some even some level like. Shut down. Freeze. Right. Vagal. Vasovagal. Nervous system. Polyvagal stuff. Sleep issues.

Grace Flannery – 00:19:32:

I actually want to challenge us even further, right? Because I think a lot of people don’t realize they’re burnt out, right? Our society has us convinced that a certain way of existing is the right way. I just want to ask people, how many days of the week… Do you get to the end of the day and feel like all you did that day was manage your to-do list or run after your schedule? How many days of the week do you get to the end of the day and realize you rushed the entire day? Or how many days of the week do you actually feel like you were able to embody the energy of a day off or a staycation or a lazy Sunday or however you want to refer to this? The way that we would manage our pacing, our internal rhythm, our energy on a slow day where we’re trying to strip away the nonsense and give ourselves a break. Probably should be a lot closer to the way that we operate every day, right?

Ihotu Ali – 00:20:31:

Like, no, no, you said like, how often are you a walking to do list? And I love that concept. And I’m also like, I’m damn proud when I’m a walking to-do list because I got through all my things. Like, that is a stress response. Like, when I’m proud of how productive I was. Now, there are seasons in your life when you have to be that. I get that. But, like, that pride in how productive I was. Like, that is exactly what we’re talking about. That you weren’t anything else but productive all day. You weren’t a human. You were just a robot.

Dr. Rebecca Dekker – 00:21:06:

I see people who become accustomed to that level of like giving, giving, giving, going, going, going. And they almost can’t slow down. And I’ll see them actually add things to their schedule. And I’ll be like, why did you say yes to that? Or why did you sign up three more kids for three activities each or something like that?

Grace Flannery – 00:21:26:

This is Ihotu’s. So many of our conversations are about reminding ourselves, no, we’re staying focused. And then Ihotu will be like, well, what if I create this program that does like, and I’ll be like, Ihotu-

Ihotu Ali – 00:21:40:

We’re doing it again.

Grace Flannery – 00:21:41:

Yeah, you’re doing it again. But it’s like an addiction.

Ihotu Ali – 00:21:44:

Honestly, it’s an addiction.

Grace Flannery – 00:21:46:

We have an addiction. Productivity. And I want to say, though, there is a way to be in a relationship with your to-do list. You know, you can have a personality where it’s satisfying to be productive. I’m one of these people. I really like discrete tasks that I can kind of conclude and that they feel wrapped up into a nice little bow and I can clear them off my plate. Like, I derive a lot of satisfaction from that. And I think it’s less about a black and white, like, we are never, we can’t appreciate productivity. Or we are only productive, and more about our relationship with ourselves in that, and how many questions we’re asking ourselves. In this moment right now, how do I feel? In this moment right now, what are my needs? In this moment right now, is it a good moment for me to handle this situation or this task? Or is it actually that I need to do something else? In this moment. Is my, what’s my personal rhythm? What’s my personal kind of way of operating throughout the day? Do I… Love to do emails from 7:30 to 8:30 a.m. in the morning. I, in fact, do. You could ask my business partner when I respond to the most portal messages from clients. When do I send the most faxes? When do I handle them? It’s like right in the morning. I don’t know why that, but that’s my personal preference. And it feels really good to do it at that time.

Dr. Rebecca Dekker – 00:23:11:

And you probably have high energy at that moment. And so it doesn’t feel as much like a burden.

Grace Flannery – 00:23:16:

Yeah. Whereas if I try to force myself to do that same hour of work from 3?30 p.m. to 4:30 p.m., it’s absolutely detrimental to my health and well-being. And are there times when I have to just push through? Yes. But I think the freedom comes when we can ask, when we can get to know ourselves this way and look for ways to structure our days where there’s more space for ourselves. And obviously we’re facing, you know, limitations of. The environments we work in or our schedules or kids or, you know, but there, there are ways for us to be in inquiry with ourselves on these things and to create these opportunities for space.

Ihotu Ali – 00:23:55:

So. And what you’re speaking to, I see, is the seasons. We’ve talked a lot about seasons. And if you’re season, if you’re, if you live in a completely. On way. You’re always on. You’re always checking those emails. You’re always able to go. You’re always able to motivate. What if a situation comes up with your spouse, with a family member, with a neighbor, with a patient or client where you need to be off? You need to listen. You need to calm down. Just give them space. You can’t do it because you are stuck on on. Or if you’re stuck on off, which we’ve seen a lot of this over the years too, where people have gotten so chronically burnt out, so deeply persistent in that burnout that they can never switch to on. They’re always off. Whatever says goes, I’m going with the flow.

Dr. Rebecca Dekker – 00:24:45:

They just disconnect.

Ihotu Ali – 00:24:50:

I have so much deep, deep respect for rest. It is so important. Rest is resistance. Rest is liberation. Also, rest comes in seasons. Sometimes you’ve got to get energized and fight for something that’s happening around you. And. The nap has to be later. But when you live in a space of seasons, there’s time for it all. There’s time for rest. There’s time for work. You can activate when you need to. You can. You can listen. You can hold space. You can witness and observe. You can protect when you need to. But if you’re stuck on or stuck off. That’s like a muscle memory that you’ve lost, right? And that’s when you get headaches because you can never turn the tension in your head off, right? Or you’re in depression because you can’t get up in the morning, right? So many physical and kind of psychosomatic things can come up, but so much in just the nervous system presence, right? Like I’ve always have a buzz, you know, or I just always feel like flat, right? That may not bring you to a doctor or a chiropractor anywhere, but… It may show up in how you hold your pregnancy. May show up with your kids, may show up with how you are with your patients. And that is when it matters. You know, it matters as a human as well, but it also matters in our healthcare systems.

Dr. Rebecca Dekker – 00:26:06:

It can matter with autoimmune conditions. It’s another example.

Ihotu Ali – 00:26:09:

Right. I mean, I’ve heard of autoimmune as described as, and this is very metaphysical out there, but. In an energetic sense, you’re not holding your internal boundaries. Or you have turned your internal boundaries against yourself, right? So there’s ways of understanding that like we have to, where the cell has its protective boundary. Right. And on every level of ourselves, we need to have our protective boundary where we know what’s us. And what’s something else, what’s a foreign invader, what’s safe. Not confuse them.

Dr. Rebecca Dekker – 00:26:42:

So how do we do that? How do we build stronger offers between us, unhealthy systems, unhealthy patterns, you know, reconnecting to us and getting into those seasons. Do you have any… Solutions you’ve been discussing amongst yourselves.

Ihotu Ali – 00:27:00:

We have done our deep dive and something is working.

Dr. Rebecca Dekker – 00:27:05:

What is that?

Grace Flannery – 00:27:06:

Well, as I started, it’s this internal shift. So it’s also support, right? Seasons. There are a few… S, S words.

Ihotu Ali – 00:27:20:

Just lay it out.

Grace Flannery – 00:27:21:

Oh, no, I’m getting no point. Ihotu loves a mnemonic. Ihotu li loves a little mnemonic that she can use to remember.

Ihotu Ali – 00:27:27:

Five years of memorizing science. I’m like, I don’t remember anything anymore unless I have like a little trick.

Grace Flannery – 00:27:34:

The four S’s. It’s the four S’s we will present to you today.

Ihotu Ali – 00:27:39:

So what are they again? Smallify? Okay, so… Seasons making things small, support. And also spirit, if you’re a spiritual person, this helps quite a bit as well, too. So the first thing, like Rebecca, you were saying is like, understanding we can’t do everything. We have to make some really strategic choices. And one of my teachers, I used to dance with the company. Dance company and My teacher would say, Ananya Chatterjee would say, smallify or like bigify. So I love that word, like smallify your life. And then Grace was like, that sounds like Marie Kondo. Do you want to share?

Grace Flannery – 00:28:25:

I just started saying Marie Kondo your schedule. These are the things, these are quite literally, this is not stuff we develop to spit out on this podcast. These are the things we say to each other. We have a really robust chat. We send each other voice memos almost every day. And we are always, these are the little quick one-liners we develop to remind each other of this work that we’re doing. Help regain that center all the time. And I can’t tell you how often we just throw them back and forth. And even in our work, I wanted to say we took February completely off. We barely talked to each other for a whole month because we were in hibernation mode. And this was an agreement we mutually made. And so some of it is really clear communication about as we’re doing this inquiry with ourselves and really realizing and reckoning with capacity and what we want to do with our energy is to… Share with the people around us where we’re at. Of build alliances and be in it together. And so both of us realized like winter is a time of slowing down. It’s a time of hibernation. We needed that. We needed to incubate in a certain way, each of us individually and our work. And so we just agreed, okay, we’ll do a once weekly check-in. Decided we were going to share a word of the week to kind of embody how the week felt to us so that if we didn’t have a lot of capacity, we could just… Share that one word. And then if we had more, we would share more. And then we would, we picked the work back up once we got to like mid, mid-March, late March. Actually, we ended up taking a little longer in our hibernation than we had planned. But that, that again was a mutually agreed upon shift.

Ihotu Ali – 00:30:08:

Because we have essentially become accountability partners for each other to explore this idea of burnout. And what it was is out of the Sweetwater Alliance, Grace took on this fellowship where we said, we want to dig to the bottom of this. And so what will it take? And the thing that we kind of hit on was this meditation that we created called One Main Thing, which kind of came out of me looking at to the two sides of my family. So I’m half Nigerian and half, you know, Minnesotan. Is my hourly gong, Thich Nhat Hanh. We’ll talk about that later. It’s another one of my practices. The gong goes off. So. I noticed that the two sides of my family were responding really differently to their lives and to kind of stress in their lives. Mom’s side of the family. We’re super involved in many, many things. And my dad’s side of the family… Kind of worked. Like they kind of just did. They had their family. They didn’t do anything else. Maybe church. They, you know, if they were career focused, they just did that. Right. There was not they weren’t as spread thin. And so I said, Grace, what if we try to like figure out what actually is the kind of one thing that we’re most committed to? Make that a true priority and try to pull out all of the other things. And that’s how we developed like, okay, how do we, it was easy to find the priority. And it was hard to figure out how do we get these other things to take less of us. And that’s how we were like, okay, well, if it could be seasonal, we can do more things in the summer. But then we’re going to slow everything else down in the winter. Or we’re going to need support because I have the addiction to doing more things and adding to my schedule. So Grace would continually, when I’d check in, be like, hey, I don’t do that. Grace would be like, you’re doing that thing. Yes, okay, how do I find a way to make that thing happen in the summer or next year. And the rub with all of this is… We want to do all our things. You have to find a way that you’re not doing them all at once. You cannot do everything all at once. You can have a long life, but you have to spread things out. And the S, the spiritual part, is that this is not new. As Grace is saying, spiritual teachers for millennia have been telling us. To focus, to be present, to give your attention fully. And then we have a world that continually every day tells us to be everything to everyone all at once. We just… Kind of have to make a choice about, what? Trajectory you want to have in your life. If you want more of that presence, it takes more focus. If you want to do many things, you’ve got to understand that it’s going to split. Your consciousness, your nervous system, right? Your time, and which do you truly want for your life?

Dr. Rebecca Dekker – 00:33:15:

A couple things that were popping into my head while you were talking. First of all, the schedule. Or smallifying your schedule? Is that one of the S’s? Or smallify your life? I remember I took a month off in January of 2019. Kind of like a sabbatical. Towards the end, I started getting really anxious about coming back to work at EBB because I was so afraid of my schedule. And I remember thinking, all of a sudden I had this light bulb moment. Like, I’m acting like this victim. Like, my schedule is in control of me. Like, I can control my schedule. And that was a really big, like, lightning bulb moment for me because then I realized I could. And I like your idea of looking for the One Main Thing because I’ve always looked at it in terms of, like, cutting things out of my life, which feels like coming from, like, kind of a negative perspective. If you’re talking about One Main Thing, it’s more about like, what am I prioritizing? And then the other thing with being present, is that one of the S’s or that’s spirituality?

Ihotu Ali – 00:34:20:

Throughout. I feel like that’s spirituality might be connected to that presence. Yeah.

Dr. Rebecca Dekker – 00:34:25:

Yeah, I was thinking too, when you were mentioning being physically present and embodied and how many people, like if you just go walk around the busy area, you know how many people are glued to their phones. Or if you’re in a waiting area, everybody’s just mindlessly scrolling these, you know, 15 second clips of videos and not really truly physically, mentally and emotionally and spiritually present in their environment and what impact that has on us as well. Seems like a coping strategy, but not a very healthy one.

Grace Flannery – 00:34:58:

It is, yeah. And this is a big part of the deeper work and why it takes time and why it has taken Ihotu and I, you know, a year and a half of being engaged in this arena. Because it’s… Quite literally a rewriting of… Some deep… Wiring, you know, and patterning that we have developed in response to the pressures and stressors of our environment, our society, the way that our workplaces are structured, the expectations of, you know, relationships and just… You know, the things that we’re all facing as adults.

Ihotu Ali – 00:35:37:

The spirituality helps you find that.

Grace Flannery – 00:35:40:

Yeah, the One Main Thing is a way of reconnecting with… What our essential purpose is. And, you know, each person we’re, we’re born as we are and kind of have like a fundamental purpose and some reason that we’re here. And not everybody has had the opportunity to connect with that. And that’s a really kind of deep, you know, way of expressing it. But, um, A lot of us, I think, because of the stressors and pressures that we’re facing every day, have lost connection to our sense of purpose or maybe haven’t, like I just said, haven’t found it at all and or have lost connection to it. And so for health care workers, you know, a lot of us have found our way to our purpose, which is this, you know, service of people and their health and well-being. Question that we have is, you really experiencing that sense of purpose in your daily work or has that been robbed of you? And are you kind of participating in that vicious cycle of disconnection from your purpose? And so the One Main Thing, meditation or reflection that we created, uh, and will share is all around helping to kind of unlock and reconnect in yourself and start to hear those messages about what is your purpose? What is it that you’re meant to be focused on? What is it that you’re meant to be most present with? For some people, they’ll realize that’s their family or their home life. For some people, they’ll realize that that’s their mission at work. For some people, it’s activism. For some people, it’s faith and participation in their faith community, right? But… Then once you realize what that One Main Thing is, you have an opportunity to. Assess the structure of your life as it is right now and ask yourself, honest questions. And I keep calling, I keep saying that honest questions because it’s really easy to bypass this process. And Just kind of make stuff up, you know? Uh, and you have to really clear the… Debris to get down to the truth within yourself and everyone’s truth is different and so our idea is that you could use this recording or some of the other resources that we will you know leave for people to Clear that debris. Find the way that works for you to connect deeply and seek those answers. And from there, you apply practical solutions to helping yourself restructure things to the extent you need to. To kind of reclaim the space for yourself, you know, that we’re also separated from or divorced from or fragmented from, right?

Ihotu Ali – 00:38:21:

I think that’s so beautifully said, Grace. And these things can change over time, right? Your One Main Thing may change. So when I first did the meditation. My One Main Thing came up as school. That was like… No! No, I didn’t. Want that to be. But the place that I was in, this was several months ago, I was still in a place where I had to put school first. And I was having a lot of trouble doing that because I wanted to be back in my community. But I realized I really want to finish so then I can serve my community. It allowed me to make hard, have hard conversations with myself. And my community members and my family where it’s like I’m gonna be there for y’all but right now is not that time and to be able to just like puzzle piece my life such that I can do what I have to do now so that now I can start to switch and I can fully be there for my community as I’m getting out of school. That was really critical for me to realize the unhappy truth. I had to keep focused on my number one priority. It kind of gave me an extra boost to get through to the end. And I knew I wasn’t letting things slip through my fingers just because I couldn’t do it all. Like this feeling, this anxiety of like, I can’t do it all. I want to be there for everyone. And I, you know, like I was realizing that’s. For me, that comes from like a tiny bit of like saviorism in yours. Like I feel like I can fix things. That. I’m not allowing myself to be a human having this experience go through life. And having joy and presence through that experience. So it was… I feel like it was really, it was really an interesting experience. And talking it through with Grace. Dear, what you chose as your One Main Thing, right? I don’t know if you want to share it all, but…

Grace Flannery – 00:40:26:

Yeah. Last year, my One Main Thing was, you know, in 2024, my One Main Thing was myself, my home life, my health, my marriage, my… I just really needed to, I was working on burnout. You know, I really needed to give myself the space to work on burnout. And that meant deferring or pushing off or delaying different commitments. I stepped away from some. You know, committee work that I was doing in the midwifery organization on the state level. And I was like, okay, well, I’m going to be really focused on my midwifery practice, my home birth practice, and myself, my own well-being. And it meant, you know, that I wasn’t actively maintaining as many of my friendships or family relationships in terms of how often I was initiating communication, how often I was seeing people. But I was just clear with people about that. And I think this is something I really want to talk about is that, we are not saying you choose one thing and you cut everything else out of your life. It’s like you said, Rebecca, like sometimes we have this idea that if we’re overwhelmed, we just need to clear the decks, like hit the deck, clear the decks, you know, like stop everything. Like I can’t handle it. And there’s this desire to do that. That’s almost never the right solution. Certainly there are going to be times for some people where clearing the decks is what they should do. But in most cases, abandonment. And avoidance are not the right solutions to things. And it’s more about, you know, this moderation or, you know, how we, how we kind of push and pull our various commitments and responsibilities. Yeah. Over time. So me saying to certain friends, like, you’re not going to hear from me as much. I know typically it’s my habits, like reach out a lot, but, um, I’m super inwardly focused right now. And, and so, um, whatever, right? And so that people kind of can set their expectations accordingly. And then there’s a lot less room for… Disappointment and rupture and harm in community and in relationships too, which is something we talk about a lot. And then this year, my commitment is work actually. So midwifery work, doing things like this podcast. I’ve been invited to teach a workshop next month. And so I’m doing a little bit more speaking and teaching than I have historically done. And it feels like a really important transition in my career to let myself lean into this kind of area that I feel excited about.

Ihotu Ali – 00:42:50:

And if we hadn’t gone through the total fear, like that mortal fear of stepping away from committee work and stepping away from… Honestly. We have stepped away from a little bit of, quote, community work, which that is our heart and souls. Like that is hard for us on a level. And I know it’s hard for the organizations that we’ve been a part of. And we’re not. Not endorsing, like we have seen the white flight, like people leaving social justice work over these years. This is about reprioritizing. This is about taking a moment to breathe. Look at the lay of the land. Where am I most effective for the long run? And find that place and then do that work wherever it is. But if I have run an organization with a lot of white allies for the last many years, how many people have just left without explaining to me why, without communicating? I thought it was a good thing. It wasn’t a good, like, these were all temporary, almost like hypocritical relationships. Like, they were not based on substantive real. Alignment. I would much rather have someone take a step back and say, I got to re-figure out what my priorities are and then not come back, but then maybe come back or someone else steps in and say. I have done the work. I know this is in line with my life purpose and I’m with you in it, not in a performative way, not in a surface way, in a we’re doing this life path together way.

Dr. Rebecca Dekker – 00:44:28:

It sounds like the One Main Thing, you might have your One Main Thing that, you know, is your guiding light throughout life. You also have the One Main Thing that you’re doing right now that has seasons as well. So you might be more inward facing sometimes and then more outward facing once you’ve replenished yourself. Does that sound kind of like a good summary of what you’re both saying? So what is the One Main Thing, meditation? Is that like something you’re going to walk us through now? Or is this a recording that we can like link to?

Ihotu Ali – 00:45:03:

We can definitely link to it. Yeah, absolutely. It’s really, I mean, and just to give a summary, it’s really an opportunity to get quiet with yourself. And ask your inner wisdom. What is that thing that lights you up. Right. Um, and then there’s that process of kind of how do you modulate? Right, and smallify. You don’t cut things up, but you’re maybe smallifying and modulating the other things around it so that you’re clear that your center purpose, right, is at the center and these other things. You know, your electrons orbiting, your leaves falling, right? They’re different than the center of the oak tree. And yeah, things can change. And I always feel like, again, living with the seasons is a huge thing in Minnesota because we have really intense seasons. But indigenous traditions all over the world and generations have come back to our connection with the land, wherever we are. You know, that connection.

Dr. Rebecca Dekker – 00:46:10:

Or the moon.

Ihotu Ali – 00:46:11:

Exactly.

Dr. Rebecca Dekker – 00:46:12:

Or the tide.

Ihotu Ali – 00:46:13:

Right. They all have their period of recharge and then outward energy and then recharge and then outward energy. So us taking our time to sit back and reflect allowed me to be way more present and bring so much more clarified kind of words to you today than I could have six months ago.

Dr. Rebecca Dekker – 00:46:38:

I totally get that. So it was seasons, small, spiritual, and what was the other?

Grace Flannery – 00:46:44:

Support.

Dr. Rebecca Dekker – 00:46:46:

Support. What does that mean?

Grace Flannery – 00:46:49:

It’s a combination of things, right? Like it’s the people in your lives who you’re… Sharing yourself with and for Ihotu and I, it’s our relationship has become really important to each of us. And, um, it’s also specific tools. Like there’s, there are tools, tech apps, you know, Ihotu has the, um, Plum Village App, the Thich Nhat Hanh Plum Village community. Um, Buddhist organization and the app. Lays a gong on her phone every hour, which just kind of like helps. Oh, what am I doing? I’m a person with a body, like reorient, you know-

Ihotu Ali – 00:47:24:

Because the addiction will always be there.

Grace Flannery – 00:47:29:

And so there’s the specific concrete tools and everybody is going to find different tools, right? And so I think our goal in presenting a resource list is to present an array of different types of tools so that people can play around with stuff and see what sticks and what doesn’t stick. An app doesn’t work for me. And so what has worked for me is just like my internal observer, just really working with my internal observer and observing patterns, observing my own behavior, observing what’s happening in a space and really sitting in reflection of that. But I am a person who has practiced Buddhism my whole life and has a really strong and long meditation practice and mindfulness practice. And so that’s part of why that particular action is what works for me. It’s like a muscle I’ve, you know, been working for. 30 years or whatever. So, but I wanted to say one other thing, which is just this idea that If we’re true with what we’re able to do and we really are able to maintain our health and well-being and the seasonalities and the, you know, ever-shifting nature of our work. I really believe that our fundamental contribution at the end of a career, at the end of a life will be greater, right? If we force ourselves to do everything, we consistently overschedule and override our capacity. We work beyond ourselves as a matter of routine. And we force through because we have this idea that we’ve been taught to believe that, you know, that’s the way that you can’t give up on the work. You know, you can’t give up on if I’m not there pushing in that area, you know, that I’m a failure or I’m not a good person or whatever the messaging is. Ultimately, you experience burnout and the consequence of burnout is that your contribution is reduced. So. If we can step back and take this grander view, if we’re able to heal ourselves and then operate from this place of honesty about our capacity, what we’re able to do and the work with the tides of that, what could we be? Able to contribute over the course of a 30-year career or our lifetime. And that… I just want to leave us and everyone with that kind of a question, right? Like, could we have the courage and the bravery to trust that? That idea and let go of these pretty ingrained patterns of you know, overriding ourselves towards exhaustion.

Ihotu Ali – 00:50:06:

I have struggled with a lot of feeling like I am not allowed to have time for myself. I am not allowed to. Take, take, uh, time to meditate, it took a long time for me to get to a place where I deserved time, because I grew up in a family where I really took care of everyone. And if I wasn’t there, then I felt like things would fall apart. And there are some deep patterns around. There’s, I give space for everyone. I will fight and hold space for you. But no one’s fighting for me and I’m not fighting for me. And, it has gotten really ingrained, I think, in activist communities in of color. I see it a bit in birth work too, where… I have not packed my schedule to the brim. Then I’m not really doing the work. And I… There’s a part of me that still feels that way. That I want to show up, I want to show. Maybe that’s the thing. It’s an external showing. Right? But in my heart. I want to be as passionately like in the work in my heart as I am like how it’s showing up externally. You know, when you post all the time online and people like, oh, you’ve got so many posts or whatever. But like all of it is not like quality, powerful. It takes a while to put together really good posts that’s really saying something. I just feel like. You got to really investigate that that thing inside of you. And allow yourself a moment to. Gosh, I remember the day when I like went and got my nails done and I was like, I’m totally selling out. I just, and I’m not taking it to extremes, right? Like I am not taking vacations to Europe every weekend. Like I know that I care about my community. I know that I’m- I know that I’m giving, but I don’t actually anymore want to give more than is also coming back to me. Like, I want to be in a mutual flow with the universe and with my community and to give everything away. I don’t think that is what our ancestors wanted. When they said, you know, that we stand on each other’s shoulders. I don’t think that’s the spirit of it, is to give everything away and be a martyr. Now. Are we still working through all this? Yes. I think… I believe that liberation is something. We live now and in the future. If you believe in… You know. So many indigenous philosophies, particularly Afro. African philosophy and Afrofuturism. That the past is the present is the future, that are all connected, we are all connected, then the abundance that comes from me inside of my heart. Does extend out to everyone else’s hearts. And when I live in a place of constant scarcity, when I feel bad that I want to do, I want to rest on a Saturday morning instead of doing more work. I think that is the powerful change that we need in the world. Right? Finding that ease in our bodies, giving ourselves permission. And if my, another app I love, if my Finch, Finch is a free app. I have said if you can, I actually share it now with my, with a few friends and my mom and my sister. We get up in the morning, we do our little, it’s a self-care app. It’s a little bird. And as the bird grow, as you do more self-care, like goals, as you check off your goals. The little bird grows. For those of us from like the 80s and 90s throwback to the Giga Pets and Tamagotchis, but with the self-care turn, like when, I’m on my little app, it tells me like, get up. Do not just check your email first. Get up, put, you know. Burn a candle. Put on nice music. Allow yourself to breathe. Step outside. Get some fresh air. Go get some exercise because I have not exercised in years. You know, like perimenopause is going to come on like, woof, intense. You know, once I do all those things, I’m plump. My energy is full and I can give all that now to my emails and to my clients and to my patients and to my students. Right. But if I was coming from that energy of like just scraping to the next thing. I don’t believe that is the energy I want to carry out into the world.

Dr. Rebecca Dekker – 00:55:08:

A lot of us probably use caffeine to kind of artificially create that energy, which I don’t mean to make anybody feel bad. I know it’s not going away.

Ihotu Ali – 00:55:17:

It’s okay.

Dr. Rebecca Dekker – 00:55:18:

Yeah. Sometimes I ask myself, why? Like, why do we need that? You know, why can’t we generate our own energy when we wake up? It’s just kind of an interesting philosophical question I have.

Ihotu Ali – 00:55:30:

Cortisol.

Dr. Rebecca Dekker – 00:55:30:

That I don’t know the answer to. Yeah, cortisol, you think?

Ihotu Ali – 00:55:33:

Well, if you have a chronic overproduction and overrelease of cortisol, it makes it very hard to get up in the morning. Cortisol Awakening Response is what we talk about in.

Dr. Rebecca Dekker – 00:55:44:

Okay. Interesting. Well, Ihotu and Grace, you’ve taken us a long way in this conversation together from starting about talking about feeling extracted from and burnt out and empty to ways that you were like. Embodying practices that keep you more full of energy so you can do your main purpose. Do you have any final words of wisdom to share with anybody who’s listening right now? Oh you know, is feeling particularly seen by this episode or maybe even cried at some point because they felt like, you know, they’re feeling it. They’re in it right now. What, any final words for them?

Grace Flannery – 00:56:28:

Yeah, I think it’s absolutely possible to… Be in a good place and it takes courage and it takes… Love and it takes patience. But I mean… We two people are a testament to what’s possible. And I really think it’s okay to slow down. And I mean, quite literally, like move more slowly. Like watch yourself breathe. Move your body more slowly. I’m not even talking about like do less things in your day, but I’m literally talking like. Move more slowly, which I feel the need to say more than one time, I think, because we have really forgotten even how to do that. And so throughout the day, if you notice that you’re getting really sped up or you’re kind of stuck in productivity mode or you’re rushing from thing to thing, is to just move your body more slowly for a little bit. Breathe. Watch yourself breathe. And I even want to just ask if we can multitask a little less, because what we’re learning in neuroscience is that multitasking really isn’t a thing. And that what we’re instead doing is just shifting our attention back and forth really fast from one thing to the other thing. And that’s very exhausting. And I think that’s something that’s contributing a lot to. Burnout. And so it’s really hard. But can you just do one thing at a time? If you’re driving, what if you just drive? Does that mean driving in silence? Yes, it actually does. If you’re cooking, can you just cook? If you’re walking, can you just walk? And we ended up talking a lot about Thich Nhat Hanh today as a teacher that both Ihotu and I are very connected with. And this is something that he teaches too, is just do one thing at a time and bring your presence to it. And a lot of healing comes from that. And so I, just felt like I really needed to say that as, a last thought.

Dr. Rebecca Dekker – 00:58:51:

Yeah. And if somebody’s listening, I think Grace’s advice is great. Like a tip for today, slow down, pause, maybe look up at the sky or down at the earth and just like notice everything that’s around you and also feel the feelings like if you’re feeling overwhelmed right now or tearful like let it out because I think bottling it up and pushing it down is also harmful so you got to kind of release the feelings that you’ve felt while listening to this today Ihotu, I know you’re feeling things. I can see it in your face.

Ihotu Ali – 00:59:23:

I know, there’s a lot. Well. By the nature, you know, that we are subject to the nature of the world and the circles we live in and the job we have, et cetera. And so by the nature of being. In chiropractic school these last many years. It is so hard for me to do one thing because I’ve taken on. And I remember this with growing up with my mom, who’s a single mom, three kids. One of the kids had special needs. It was like… I literally have too many things to hold. I know. I’m aware. I would love to put some of these things down, but I cannot, right? Or like, I’ve got to feed my kids. I’ve got to go to work. I’ve got to manage this life that I can’t just take a break from. And I just, I really hold space for people who are in that scenario where you feel stuck. And, um, oone thing that has worked for me in that space is allowing myself to be not judgmentally where I am. So I can’t do the dishes only doing the dishes, but I can play a meditation sometimes. Or I can listen to a lecture while doing dishes. Right. And so I have done some coupling. Not like my brain is trying to do different things. Like my hands are doing one thing, and finding the coupling that gives you a sense of like relaxation in yourself, either because you got something done that had to get done. Or, I really, lately, I really like doing meditations while I’m driving or… Um, doing dishes because that actually brings me into a more present place. If I’m quiet, my mind just runs. So knowing the difference of like what actually gets you there versus what you hope, you know, or finding what works for you truly. Other thing I would say too is no matter how restrictive the day-to-day conditions are that you live under. That smallify, there’s nothing wrong with smallifying. If you don’t have a lot of money. Live fully within what you do have. If you don’t have a lot of time, live fully within what you do have. Bigger and all these things. Is it’s like a trickster energy in American culture. I feel a twinge of that in myself. And, being able to be present and find contentment in your… Your day, however your day looks, find one moment of contentment in that day. I think that is the hardest and most important thing to find in life. That contentment where you can take a full breath. Where you step outside and you look at the stars. You have a moment of reverence. You give gratitude. People sense that in you. And I feel like the work is not only external, there is internal work, like we know in birth, right? Like those early hours of labor, right? It’s not that nothing’s happening. It’s just more internal. And so knowing when you’re at that place. Is key. And I think just, um, If you are curious about this work, listen to the meditation. Reach out to someone to be a buddy for you in your journey. Reach out to either of us if you have questions. I want to get linked up with communities that are in this practice in the Twin Cities, and believe. I’d love to end with this one quote. We’ve done a lot of work lately at Oshun Center with… Nnedi Okorafor, who is an African futurist writer. She wrote several books, including The Akata Witch, which we did a beautiful program with recently. Here in Minneapolis around. Futurism and in a place where there’s so much chaos and really just a lot of us feeling down about the world. She calls herself an irrational optimist and she reminds us that. Change happens in your mind. You cannot manifest anything that you didn’t see in your mind’s eye first. And so how can we be irrationally optimist in this world that feels rough? And believe. Believe that something can change. Even if you’re faking it till you make it, believe that something can change and start walking that path and reach out to help. Whether to our peers or to our ancestors, to our teachers. Find a book. Be open to anything coming across your path that is that light to continue following the thread.

Grace Flannery – 01:04:23:

And it’s okay to be you. That’s the other thing I think that is so important is it’s okay to be you. And I’ve started saying that to myself all the time. It’s okay to be you.

Dr. Rebecca Dekker – 01:04:40:

Thank you, Grace and Ihotu, that was beautiful. And I hope that this episode is enlightening and inspiring. Heartwarming and, you know, all the things for our listeners today. Can you share the best ways to follow your work? And we will also link in the show notes to the meditation as well as any other resources you’ve mentioned.

Ihotu Ali – 01:05:01:

So you could learn about the Oshun Center on our website, Oshun, O-S-H-U-N, center, C-E-N-T-E-R dot com. And I’m also at Oshun Center is on Instagram. As well as I’m on Instagram, Ihotu Ali.

Grace Flannery – 01:05:21:

I’m on Instagram @midwifegracef, although I will be honest and say I don’t post that much. And I think the Sweetwater Alliance is a great place to be for people who are interested in digging into this stuff. We’re transitioning our programming right now and going to be working on some online-based modules that you could access kind of asynchronously or on your own time. So moving away from live meetings and creating resources like these guided reflections. You know, things. So, check us out via the Oshun Center website in the coming months. We’re going to be doing this work, so we’ll be there.

Dr. Rebecca Dekker – 01:06:05:

Thank you so much, Grace, Ihotu.

Ihotu Ali – 01:06:08:

Same here, Rebecca. Good to see you.

Dr. Rebecca Dekker – 01:06:12:

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