Rue Khosa, founder and owner of The Perfect Push, a childbirth and lactation practice in Redmond, has earned so many degrees as a nurse practitioner that her name is trailed by an alphabet soup of accreditations: ARNP, FNP-BC, IBCLC. But to the many new parents who look to her and her medical clinic for essential and steadying delivery and postpartum support, Khosa is known more familiarly as “The Boob Boss.”
When I ask Khosa how she characterizes the work of The Perfect Push, she tells me that the mantra of the organization is “Supporting the Heart of Parenting,” and for her, that translates into a mission to provide parents with the evidence-based and empathic wraparound care they need to make informed decisions for their growing family and to thrive in the early days of new parenting and beyond. Khosa’s unique perspective on supporting new parents is informed by her own cultural experience of being born and raised in the Shona culture of her native Zimbabwe, where an older female family member typically moves into the home of an expectant family shortly before birth to help the mother prepare both emotionally and physically for delivery and motherhood. They call this tradition “kugarira.”
As a woman of color, an immigrant and an experienced provider of maternal-child health care, Khosa, who is a mother of two adored sons herself, is deeply concerned by the appalling maternal and infant mortality rates affecting our communities here in the United States and around the world. Motivated by the belief that access to adequate health care is a fundamental human right, Khosa founded The Perfect Push Foundation last year to work toward systems and solutions that will empower vulnerable birth communities, promote sustainable and culturally sensitive care, and eliminate health disparities. We caught up with Khosa to learn more about her journey and vision for The Perfect Push.
How did you get from point Z(imbabwe) to point A(merica)?
During my high school years, I watched “Beverly Hills 90210.” I would watch it, and the grass was greener, the blue was bluer — everything just looked so much brighter in the States. I remember saying, “That’s it. I want to go to school in the States. I want to be a lawyer.” So, I got myself together, applied to schools. I ended up at UCO, the University of Central Oklahoma. I remember getting off that plane and thinking, “Uh oh — this is not what I saw on TV! Where are the palm trees? Nothing is green. Somebody lied to me!” That was my journey to the States.
Zimbabwe was starting to go through a lot of political turmoil, and I remember my mom saying, “Yeah, things are not good here. You can go and you can become a lawyer, but there’s no guarantee that you’ll get a job or if you’ll even have a country to come back to.” I started thinking about what profession I could do so that, whatever happens, wherever I go in the world, I still have a job. I thought, well, there is nursing. I’ve always loved taking care of children. That was always something that came easily and naturally for me, so I started looking at the path of nursing school, and just never looked back.
How did you eventually make your way to Washington state?
The first time I came to Washington state was as a travelling labor and delivery nurse for the University of Washington. But, really, it was about a boy. I met my husband, and he brought me to Seattle one summer, and he lied, “It is always like this!” So, I took a contract at the UW so that I could spend more time with him and get to know him. The rest is history.
What is the founding story of The Perfect Push?
We had our first son, Tai, in 2013. He was delivered at Overlake, where I was working as a labor and delivery nurse. Nursing with your nurse sisters is like a sorority. Everybody knew exactly when I was due and the intricate details of my pregnancy and life. I remember thinking, “Everybody should have this [awesome experience].” When I went into labor, I felt like a VIP.
Because I had this bevy of amazing nurses taking care of me, my husband kind of stepped back, and four hours and 44 minutes later, after I had this experience, I asked him, “So, what did you think?” He responded, “I don’t know. I guess now I’m a dad.” I thought, “Oh wow. What happened? He wasn’t part of it.”
Our son was itty bitty. He was maybe 5 lbs. 11 oz. when we took him home. And I just had the biggest boobs! I worried, “I’m going to suffocate my son! One boob is bigger than his whole body. And why does it hurt so much? And how do I hold him? Why do I not know what I’m doing? This is my job. I’ve done this for eight-plus years, teaching other people how to do this, and I’m stuck.”
I thought, there’s got to be a way for us to give women a beautiful labor and delivery experience that includes the partner, and then support them when they get home with baby, because this is where they really need support. That’s when I started thinking about The Perfect Push. Literally the wheels started spinning around that time, right after my son was born.
What aspects of parenting culture in the United States need to change?
I come from a culture where when a mom has a baby, everybody rallies around the family. And there’s somebody watching the other kids. There’s somebody cooking. There’s somebody helping [the new mom] learn how to breastfeed, how to take care of her lady bits. Making sure that everything’s okay with dad, and that he’s learning how to take care of his wife and appreciate how she’s changing and who she is and supporting that.
We come here, and people have babies and there’s nobody. Everybody in labor and delivery makes sure that the baby comes out great, and then we kick you out after 24 hours. And we don’t see you again for six weeks. That’s so worrisome to me. Even though people say, “Well, I’m going to see my pediatrician,” and the pediatrician may ask mom a question or two about how she is doing, it’s all about the baby. It needs to be about the family as a whole.
That’s really what The Perfect Push is about: supporting the heart of parenting by making sure that the parents are okay; that the parents have all the information that they need. Because if we can wrap our stethoscope arms around them, give them all the medical knowledge that they need, we know baby’s going to be okay.
What do you see ahead for The Perfect Push?
Last year we launched our foundation, which is something that’s really close to my heart, because we want to be able to provide an area where we can actually help start training community doulas, especially in communities of color, especially in the native American communities and underserved communities. We are motivated to start growing that tribe to create more of what we call kugarira, the actual term for rallying around the mother to help her prepare both emotionally and physically for the new baby. I think if we are really going to start tackling the maternal and infant mortality rate issue in communities of color we need more providers of color to come in and just be a part of the community, understand the community and provide culturally appropriate and culturally sensitive care.
I really love what I do, but we do it for a privileged part of Seattle. I believe to whom much is given, much is required. And so that was part of the reason I started The Perfect Push Foundation — because we’ve got to be able to do something. We’ve got to be able to start to recognize that it’s not somebody else’s responsibility. And for me as a woman of color and a medical practitioner in the childbirth field, I can’t keep on saying, “Well, somebody else is going to take care of it.” Because if not me, then who? I think if more people were aware of what the infant and maternal mortality rates were in communities of color, they would be shocked and stirred into action.
