Podcasts about certified nurse midwife

In this enlightening conversation, Shelley Hines shares her journey as a healer and teacher, exploring her spiritual guidance and profound connection with Mary Magdalene. She discusses the misconceptions surrounding Magdalene's identity, her role as a divine feminine figure, and the significance of the Magdalena Asteroid in astrology. The dialogue emphasizes the importance of intuition, the healing power of understanding one's lineage, and the awakening of the soul group associated with Mary Magdalene. Shelley encourages listeners to embrace their inner messages and trust their spiritual journeys. Shelley Lynn Hines, RN, MSN, is a student of life with a special focus on the Feminine Divine, and all things mystical. She had a true call and knowing that she was to become a nurse since the age of five. Working as a Registered Nurse, healer, teacher, and Lifestyle Consultant/Coach she has been helping women over 30 years. As a Certified Nurse-Midwife she attended the births of over one thousand Earthbound souls directly into her awaiting hands. Her interest in the safe arrival of these unique beings fueled her fascination in our life between lives as she furthered her studies into hypnotherapies including past life regressions and medical hypnotherapy. This also led to a brief time working with hospice patients and supported her belief that our souls come and go through a similar if not the same doorway. Born with an astrological and veiled Piscean Moon, Shelley has been sensitive to and gravitated toward all things metaphysical and occult or hidden from the mundane since a very young age. Reading her horoscope as soon as she could read, led her to study with the Steven Forest Apprenticeship Program, receiving a Master's Level Certification in Evolutionary Astrology. Using the birth chart as a tool to aid in validating the soul's purpose, karma, and dharma, is one of her methods for healing. She also includes her certification as an Intentional Creativity (T) teacher assisting women and men to set the inner critic aside and allow the muse to have a voice, so important in these times of increasing uncertainty and censoring. She is the founder of “She Rises in Wellness Women's Retreats (C)” and her biggest passion is to gather likeminded women for comfort, guidance, and learning. After a mystical experience in 2016 she began studying in earnest all things Mary Magdalene and is authoring a soon to be published book about Magdalene's archetypes in the hopes of educating the public regarding this historical figure who represents the Feminine Divine. Find Shelley: www.shelleyhines.com Magdalene Society Private Facebook group Astrologyshines Facebook page Learn more about your ad choices. Visit megaphone.fm/adchoices

In this enlightening conversation, Shelley Hines shares her journey as a healer and teacher, exploring her spiritual guidance and profound connection with Mary Magdalene. She discusses the misconceptions surrounding Magdalene's identity, her role as a divine feminine figure, and the significance of the Magdalena Asteroid in astrology. The dialogue emphasizes the importance of intuition, the healing power of understanding one's lineage, and the awakening of the soul group associated with Mary Magdalene. Shelley encourages listeners to embrace their inner messages and trust their spiritual journeys. Shelley Lynn Hines, RN, MSN, is a student of life with a special focus on the Feminine Divine, and all things mystical. She had a true call and knowing that she was to become a nurse since the age of five. Working as a Registered Nurse, healer, teacher, and Lifestyle Consultant/Coach she has been helping women over 30 years. As a Certified Nurse-Midwife she attended the births of over one thousand Earthbound souls directly into her awaiting hands. Her interest in the safe arrival of these unique beings fueled her fascination in our life between lives as she furthered her studies into hypnotherapies including past life regressions and medical hypnotherapy. This also led to a brief time working with hospice patients and supported her belief that our souls come and go through a similar if not the same doorway. Born with an astrological and veiled Piscean Moon, Shelley has been sensitive to and gravitated toward all things metaphysical and occult or hidden from the mundane since a very young age. Reading her horoscope as soon as she could read, led her to study with the Steven Forest Apprenticeship Program, receiving a Master's Level Certification in Evolutionary Astrology. Using the birth chart as a tool to aid in validating the soul's purpose, karma, and dharma, is one of her methods for healing. She also includes her certification as an Intentional Creativity (T) teacher assisting women and men to set the inner critic aside and allow the muse to have a voice, so important in these times of increasing uncertainty and censoring. She is the founder of “She Rises in Wellness Women's Retreats (C)” and her biggest passion is to gather likeminded women for comfort, guidance, and learning. After a mystical experience in 2016 she began studying in earnest all things Mary Magdalene and is authoring a soon to be published book about Magdalene's archetypes in the hopes of educating the public regarding this historical figure who represents the Feminine Divine. Find Shelley: www.shelleyhines.com Magdalene Society Private Facebook group Astrologyshines Facebook page Learn more about your ad choices. Visit megaphone.fm/adchoices

  Jami Hain has been a Certified Nurse Midwife for 13 years and owner of Nativiti Family Birth Center since 2014. She has supported women in her role as doula and a Nativiti birth assistant since 2003 and has been … Continue reading →

What if you already have what it takes to breastfeed your baby—and just need the right support to unlock it?This question is at the heart of my conversation with Lisa Paladino, Certified Nurse Midwife, IBCLC, and a fierce advocate for women and babies. Lisa has decades of experience helping families navigate the powerful, joyous, and sometimes confusing, emotional, and occasionally challenging terrain of breastfeeding. Not just a brilliant clinician, but a graduate of both my Women's Integrative and Functional Medicine and Herbal Medicine for Women training programs… and now, a lifelong friend.Lisa is the passionate founder of Tongue Tie Experts. She's spent decades supporting parents through the intense, sacred, and often confusing path of breastfeeding—especially when things don't go as planned.Lisa's journey from hospital-based nurse and midwife to fierce advocate for women's rights and breastfeeding education is one you won't forget. And what we unpack in this conversation might change how you see everything from nipple pain to infant sleep—and even adult airway health.In this episode, we dive into:What exactly is an IBCLC—and why it mattersThe silent struggle of mastitis, milk supply issues, and painHow breastfeeding shapes your baby's airway—and possibly lifelong healthThe heartbreak of not making enough milk—and how to support yourselfSetting yourself up for breastfeeding success before the baby comesWhy so many moms stop breastfeeding before they want to—and how we can change thatAnd yes… we go there with nipple toughening myths, lactation cookies, pumping in broom closets, and airplane glares. Because we've all been there—or know someone who has.

In this insightful episode, HeHe welcomes Trisha Ludwig from the Down to Birth Show to explore the critical aspects of breastfeeding. They discuss the tremendous benefits for both mother and baby, including improved mental health for mom and reduced cancer risks. Trisha emphasizes the importance of prenatal education, the role of partners, and why breastfeeding is a learned skill. They also cover common breastfeeding problems, the significance of skin-to-skin contact, and how pain can indicate the need for latch adjustments. Essential tips for advocating breastfeeding in hospitals and advice on how to manage newborn feeding cues are also highlighted.   Guest Bio: Trisha Ludwig is a Certified Nurse-Midwife and International Board Certified Lactation Consultant with a Master's degree from Yale School of Nursing. After practicing as a homebirth midwife she started a holistic gynecology and women's health practice, which she ran for 10 years. She is passionate about supporting and optimizing women's transitions through the major shifts such as pregnancy, postpartum, peri-menopause, and menopause. She believes in treating health issues on the physical, emotional, and spiritual level.   She is a mother of three children, all of whom were born at home. It is her knowledge as a midwife and women's health practitioner, but most importantly as a mother herself, which gives her first-hand insight into the complex emotional shifts of the postpartum transition. As a woman who is equally passionate about her work as she is about mothering, she understands the process of “becoming mom.” SOCIAL MEDIA: Connect with HeHe on YouTube Connect with HeHe on IG    Connect with Trisha on IG    BIRTH EDUCATION: Check out our free class on how to avoid a c-section and reduce tearing in labor here!   Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone!   LINKS MENTIONED: Connect with Trisha

  Part 2 – Continued from last week… Jaelin Stickels is a Certified Nurse Midwife who is honored to work with families as they experience pregnancy, labor, birth, and the postpartum period. Jaelin followed her passion into midwifery and has … Continue reading →

  Jaelin Stickels is a Certified Nurse Midwife who is honored to work with families as they experience pregnancy, labor, birth, and the postpartum period. Jaelin followed her passion into midwifery and has been practicing with women and babies since … Continue reading →

Feeling drained, moody, or out of balance? It could be perimenopause. This episode dives into practical strategies for managing hormonal changes, optimizing energy, and navigating the perimenopausal transition with confidence. Double board-certified women's health nurse practitioner and certified nurse midwife Emily Sadri, NP, shares her expertise on identifying root causes, balancing hormones naturally, and building sustainable habits to support your health. You'll learn how to assess hormone levels, address thyroid dysfunction and blood sugar imbalances, and implement tools like continuous glucose monitors and targeted supplements. Emily also explores the role of stress management, diet tweaks, and hormone replacement therapy to keep you feeling your best. Whether you're proactively preparing for perimenopause or already experiencing symptoms, this episode will empower you with actionable tips, expert insights, and a clear roadmap to thrive through hormonal changes Topics Covered In This Episode: Hormonal balance and perimenopause Natural remedies for hormone health Managing blood sugar imbalances Stress management techniques for women Hormone replacement therapy insights Show Notes: Visit emilysadri.com to learn more Get $100 off The Hormone Club program with code DRMOMPOD100OFFHC Get $200 off The Right Way to Weight Loss program with code DRMOMPODRWTWL Take the Perimenopause Quiz Learn more about the Calocurb Supplement Click here to learn more about Dr. Elana Roumell's Doctor Mom Membership, a membership designed for moms who want to be their child's number one health advocate! Click here to learn more about Steph Greunke, RD's Substack Mindset + Metabolism where women can learn how to nourish their bodies, hit their health and body composition goals, and become the most vibrant version of themselves.  Listen to today's episode on our website Emily Sadri, is a double-board certified Women's Health Nurse Practitioner and Certified Nurse Midwife. She hails from New York City and obtained her graduate education at The University of Pennsylvania. She was drawn to midwifery, meaning “with woman,” or “to stand in front of,” because it was a practice rooted in relationship.  Emily believes that what women need, across their lifespans, is someone to walk alongside them—not to tell them what to do. Emily practiced in conventional medicine settings for a decade, and was continually frustrated by the restrictions inherent in insurance-based models of care. Medical providers across the spectrum are burnt out and over extended. She believes we are living in a care and wellness deficit—and that needs to change.  Emily founded Aurelia on the principal that transformational care is built on strong relationships. That begins with long appointments, and is maintained by trust and open communication. Emily is not unlike the women she serves at Aurelia—she's raising four amazing kids, balancing a career, and prioritizing her health.  She leads at Aurelia by breaking down norms and rejecting the idea that a woman's worth is derived from her productivity. Emily believes that women can have it all—and it starts with great healthcare, and one woman standing beside another, leading the way.  This Episode's Sponsors  Enjoy the health benefits of PaleoValley's products such as their supplements, superfood bars and meat sticks.  Receive 15% off your purchase by heading to paleovalley.com/doctormom  Discover for yourself why Needed is trusted by women's health practitioners and mamas alike to support optimal pregnancy outcomes. Try their 4 Part Complete Nutrition plan which includes a Prenatal Multi, Omega-3, Collagen Protein, and Pre/Probiotic. To get started, head to thisisneeded.com, and use code DOCTORMOM20 for 20% off Needed's Complete Plan! Active Skin Repair is a must-have for everyone to keep themselves and their families healthy and clean.  Keep a bottle in the car to spray your face after removing your mask, a bottle in your medicine cabinet to replace your toxic first aid products, and one in your outdoor pack for whatever life throws at you.  Use code DOCTORMOM to receive 20% off your order + free shipping (with $35 minimum purchase). Visit BLDGActive.com to order. INTRODUCE YOURSELF to Steph and Dr. Elana on Instagram. They can't wait to meet you! @stephgreunke @drelanaroumell Please remember that the views and ideas presented on this podcast are for informational purposes only.  All information presented on this podcast is for informational purposes and not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a healthcare provider. Consult with your healthcare provider before starting any diet, supplement regimen, or to determine the appropriateness of the information shared on this podcast, or if you have any questions regarding your treatment plan.  

In this episode, we honor the life and legacy of Krista Labbe, a passionate advocate for women's health, Certified Nurse Midwife, and U.S. Army officer, whose untimely passing in 2023 left a profound impact. Krista's journey highlights the potential risks associated with the copper IUD, particularly the under-recognized issue of copper toxicity. We explore the science behind copper metabolism, the unique insights provided by Hair Tissue Mineral Analysis (HTMA), and why blood tests alone may not detect hidden mineral imbalances. Through Krista's story, we uncover the serious health implications she faced, including severe anxiety, infections, and physical symptoms, which ultimately linked back to elevated copper levels. Join us as we raise awareness about this silent risk, empower women with critical knowledge, and emphasize the importance of informed consent when choosing birth control options. Also, we want to give a special thank you to Natural Womanhood (www.naturalwomanhood.com) for shedding light on this important topic. Contact: For more information about copper toxicity, please visit: www.coppertoxic.com For info about HTMA (hair test mineral analysis) please visit: https://www.mineralsandhealth.com/order To learn more about Krista's story, please visit https://kristallabbe.com/ To read the Natural Womanhood Article, please visit: https://naturalwomanhood.org/copper-toxicity-and-the-iud-depression-psychosis-and-death/ SPONSORSHIP OPPORTUNIES WITH THE HORMONE GENIUS PODCAST! If you, or a business you know, are looking to expand your reach and connect with an audience passionate about women's health and hormone education, we'd love to hear from you! Whether you're interested in affiliate partnerships or episode sponsorships, we have options to fit your goals. Reach out to us at thehormonegenius@gmail.com for more details and/or fill out the appropriate form below! Affiliate Form: https://docs.google.com/forms/d/e/1FAIpQLScB9KKcAhKnzrAGsmfw25AEUnyR5S9qylieqKTzgk06b-o9Kg/viewform?usp=header Sponsor Form: https://docs.google.com/forms/d/e/1FAIpQLSeC0PM0P7NguN2dduMSnHB-NViKfAxiLbahiRU9DeZPtiseUA/viewform?usp=sf_link Medical disclaimer: The information presented in this podcast is for informational purposes only and is not intended to be a substitute for actual medical advice from a doctor, or any medical professional.

Dr. Lorraine and Dr. Brie join HeHe to discuss the critical and often overlooked topic of obstetrical violence. In this eye-opening episode, they break down what obstetrical violence is, its impact on women globally, including psychological trauma and avoidable morbidity, and how it violates human rights. The discussion highlights the importance of informed consent, respectful maternity care, and midwifery as potential solutions. The duo also emphasizes the need for systemic changes within the healthcare system to prevent obstetrical violence and improve maternal outcomes. Tune in to learn about practical steps women can take to avoid birth trauma and the crucial role of midwifery in transforming maternity care.   Understanding Obstetrical Violence Examples and Impact of Obstetrical Violence Legal Recourse and Advocacy The Iceberg Analogy and Measurement Tools Respectful Maternity Care and Systemic Issues Transparency and Hospital Reporting Midwifery Care and Trauma Prevention Systemic Obstacles and Solutions Navigating the Complexities of U.S. Healthcare Challenges Faced by Healthcare Providers The Impact of Insurance on Birth Choices Midwifery Care and Its Benefits Policy and Systemic Barriers The Role of Consumer Advocacy Future Directions and Solutions Connecting and Collaborating for Change Guest Bio: Lorraine M. Garcia, PhD, WHNP-BC, CNM does research on the problem of obstetric violence in the US maternity care system and the public health and ethical duties to implement solutions. She also works as a Certified Nurse Midwife with experience in home birth, birth center, and hospital-based care. Lorraine is a reproductive justice advocate and frames most of her research with critical lenses from healthcare systems science, structural and organizational theories, and social justice in nursing. Her perspective on the systemic, normalized abuse and mistreatment of childbearing people is aligned with advocacy workers, interdisciplinary scientists, and all interested and affected parties working to end obstetric violence and achieve birth equity.   Dr. Brie Thumm is an Assistant Professor at the University of Colorado College of Nursing. She has been practicing midwifery domestically and internationally since 2001 when she completed her Masters in the Science of Nursing at Yale University. She obtained her MBA in Healthcare Administration at Baruch College in New York City and her PhD in health systems research at University of Colorado College of Nursing. Her area of research is perinatal workforce development to address disparities in maternal health outcomes and improve the well-being of health care professionals. Prior to her current position, Brie provided care at Planned Parenthood of New York City, served as the Assistant Director of the Sexual Assault Response Team for the Manhattan public hospitals, conducted mental and behavioral health research at the Rocky Mountain Regional Veteran's Affairs Medical Center, and led the clinical and research arms of the Maternal Mortality Prevention Program at the Colorado Department of Public Health and Environment. She continues to practice clinically at Denver Health. SOCIAL MEDIA: Connect with HeHe on IG    Connect with Lorraine on IG  Connect with Lorraine on LinkedIn   BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone!   LINKS: Lorraine's website: https://www.makingbirthbettertogether.com/ Lorraine's Online Store:https://makingbirthbetterstore.com/ Use code    References: Association of Women's Health, Obstetric and Neonatal Nurses. (2022). Respectful maternity care framework and evidence-based clinical practice guideline. Nursing for Women's Health, 26(2), S1−S52. https://doi.org/10.1016/j.nwh.2022.01.001 Beck, C. T. (2018). A secondary analysis of mistreatment of women during childbirth in healthcare facilities. Journal of Obstetric Gynecologic and Neonatal Nursing, 47(1), 94−104. https://doi.org/10.1016/j.jogn.2016.08.015    Borges, M. T. (2018). A violent birth: Reframing coerced procedures during childbirth as obstetric violence. Duke Law Journal, 67(4), 827−862.    Carlson, N. S., Neal, J. L., Tilden, E. L., Smith, D. C., Breman, R. B., Lowe, N. K., Dietrich, M. S., & Phillippi, J. C. (2019). Influence of midwifery presence in United States centers on labor care and outcomes of low-risk parous women: A Consortium on Safe Labor study. Birth, 46(3), 487-499. https://doi.org/10.1111/birt.12405    Chadwick, R. (2021). The dangers of minimizing obstetric violence. Violence Against Women, 29(9), 1899−1908. https://doi.org/10.1177/10778012211037379    Cohen Shabot, S. (2021). Why ‘normal' feels so bad: Violence and vaginal examinations during labour: A (feminist) phenomenology. Feminist Theory, 22(3), 443−463. https://doi.org/10.1177/1464700120920764   Cooper Owens, D. (2017). Medical bondage: Race, gender, and the oigins of American gynecology. University of Georgia Press.    Crear-Perry, J., Correa-de-Araujo, R., Lewis Johnson, T., McLemore, M. R., Neilson, E., & Wallace, M. (2021). Social and structural determinants of health inequities in maternal health. Journal of Women's Health, 30(2), 230−235. https://doi.org/10.1089/jwh.2020.8882    Davis, D. A., Casper, M. J., Hammonds, E. & Post, W. (2024). The continued significance of obstetric violence: A response to Chervenak, McLeod-Sordjan, Pollet et al. Health Equity, 8, 513-518. https://www.liebertpub.com/doi/10.1089/heq.2024.0093   Davis, D. A. (2019). Obstetric racism: The racial politics of pregnancy, labor, and birthing. Medical Anthropology, 38(7), 560-573. https://doi.org/10.1080/01459740.2018.1549389 Garcia, L. M. (2020). A concept analysis of obstetric violence in the United States of America. Nursing Forum, 55(4), 654−663. https://doi.org/10.1111/nuf.12482    Garcia, L. M. (2021). Theory analysis of social justice in nursing: Applications to obstetric violence research. Nursing Ethics, 28(7−8). https://doi.org/10.1177/0969733021999767   Garcia L. M. (2023). Obstetric violence in the United States and other high-income countries: An integrative review. Sexual and Reproductive Health Matters, 31(1), 2322194. https://doi.org/10.1080/26410397.2024.2322194   Garcia, L. M., Jones, J., Scandlyn, J., Thumm, E. B., & Shabot, S. C. (2024). The meaning of obstetric violence experiences: A qualitative content analysis of the Break the Silence campaign. International Journal of Nursing Studies, 160, 104911. https://doi.org/10.1016/j.ijnurstu.2024.104911   Hardeman, R. R., Karbeah, J., Almanza, J., & Kozhimannil, K. B. (2020). Roots Community Birth Center: A culturally-centered care model for improving value and equity in childbirth. Healthcare, 8(1). https://doi.org/10.1016/j.hjdsi.2019.100367    Howell, E. A., & Zeitlin, J. (2017). Improving hospital quality to reduce disparities in severe maternal morbidity and mortality. Seminars in Perinatology, 41(5), 266−272. https://doi.org/10.1053/j.semperi.2017.04.002    Jolivet, R. R., Gausman, J., Kapoor, N., Langer, A., Sharma, J., & Semrau, K. E. A. (2021). Operationalizing respectful maternity care at the healthcare provider level: A systematic scoping review. Reproductive Health, 18(1), 194. https://doi.org/10.1186/s12978-021-01241-5   Julian, Z., Robles, D., Whetstone, S., Perritt, J. B., Jackson, A. V., Hardeman, R. R., & Scott, K. A. (2020). Community-informed models of perinatal and reproductive health services provision: A justice-centered paradigm toward equity among Black birthing communities. Seminars in Perinatology, 44(5). https://doi.org/10.1016/j.semperi.2020.151267   Logan, R. G., McLemore, M. R., Julian, Z., Stoll, K., Malhotra, N., GVtM Steering Council, & Vedam, S. (2022). Coercion and non-consent during birth and newborn care in the United States. Birth (Berkeley, Calif.), 49(4), 749–762. https://doi.org/10.1111/birt.12641   Margulis, J. (2013). The business of baby. Scribner.    Mena-Tudela, D., González-Chordá, V. M., Soriano-Vidal, F. J., Bonanad-Carrasco, T., Centeno-Rico, L., Vila-Candel, R., Castro-Sánchez, E., & Cervera Gasch, Á. (2020). Changes in health sciences students' perception of obstetric violence after an educational intervention. Nurse Education Today, 88, https://doi.org/10.1016/j.nedt.2020.104364   Morton, C. H., & Simkin, P. (2019). Can respectful maternity care save and improve lives?. Birth (Berkeley, Calif.), 46(3), 391–395. https://doi.org/10.1111/birt.12444   Neal, J. L., Carlson, N. S., Phillippi, J. C., Tilden, E. L., Smith, D. C., Breman, R. B., Dietrich, M. S., & Lowe, N. K. (2019). Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: A Consortium on Safe Labor study. Birth (Berkeley, Calif.), 46(3), 475–486. https://doi.org/10.1111/birt.12407   Nelson, H. O. (2022). Conflicted care: Doctors navigating patient welfare, finances, and legal risk. Stanford University Press.    Niles, P. M., Baumont, M., Malhotra, N., Stoll, K., Strauss, N., Lyndon, A., & Vedam, S. (2023). Examining respect, autonomy, and mistreatment in childbirth in the U.S.: Do provider type and place of birth matter? Reproductive Health, 20(1), 67. https://doi.org/10.1186/s12978-023-01584-1    Oparah, J. C., Arega, H., Hudson, D., Jones, L., & Oseguera, T. (2018). Battling over birth: Black women and the maternal health care crisis. Praeclarus Press.    Salter, C., Wint, K., Burke, J., Chang, J. C., Documet, P., Kaselitz, E., & Mendez, D. (2023). Overlap between birth trauma and mistreatment: A qualitative analysis exploring American clinician perspectives on patient birth experiences. Reproductive Health, 20(1), 63. https://doi.org/10.1186/s12978-023-01604-0    Scott, K. A., Britton, L., & McLemore, M. R. (2019). The ethics of perinatal care for Black women: Dismantling the structural racism in "Mother Blame" narratives. The Journal of Perinatal & Neonatal Nursing, 33(2), 108–115. https://doi.org/10.1097/JPN.0000000000000394   Smith, D. C., Phillippi, J. C., Lowe, N. K., Breman, R. B., Carlson, N. S., Neal, J. L., Gutierrez, E., & Tilden, E. L. (2020). Using the Robson 10-group classification system to compare cesarean birth utilization between US centers with and without midwives. J Midwifery Womens Health, 65(1), 10-21. https://doi.org/10.1111/jmwh.13035    Smith, S., Redmond, M., Stites, S., Sims, J., Ramaswamy, M., & Kelly, P. J. (2023). Creating an agenda for Black birth equity: Black voices matter. Health Equity, 7(1), 185−191. https://doi.org/10.1089/heq.2021.0156    Thumm, E. B., & Flynn, L. (2018). The five attributes of a supportive midwifery practice climate: A review of the literature. Journal of Midwifery & Women's Health, 63(1), 90−103. https://doi.org/10.1111/jmwh.12707    Thumm, E. B., & Meek, P. (2020). Development and initial psychometric testing of the Midwifery Practice Climate Scale. Journal of Midwifery & Women's Health, 65(5), 643−650. https://doi.org/10.1111/jmwh.13142    Thumm, E. B., Shaffer, J., & Meek, P. (2020). Development and initial psychometric testing of the Midwifery Practice Climate Scale: Part 2. Journal of Midwifery & Women's Health, 65(5), 651−659. https://doi.org/10.1111/jmwh.13160  Thumm, E. B., Smith, D. C., Squires, A. P., Breedlove, G., & Meek, P. M. (2022). Burnout of the U.S. midwifery workforce and the role of practice environment. Health Services Research, 57(2), 351−363. https://doi.org/10.1111/1475-6773.13922    Williams, C. R., & Meier, B. M. (2019). Ending the abuse: The human rights implications of obstetric violence and the promise of rights-based policy to realise respectful maternity care. Sexual and Reproductive Health Matters, 27(1). https://doi.org/10.1080/26410397.2019.1691899    Yarrow, A. (2023). Birth control: The insidious power of men over motherhood. Seal Press.    Zhuang, J., Goldbort, J., Bogdan-Lovis, E., Bresnahan, M., & Shareef, S. (2023). Black mothers' birthing experiences: In search of birthing justice. Ethnicity and Health, 28(1), 46−60. https://doi.org/10.1080/13557858.2022.2027885  

Dr. Jessica Brumley, a Certified Nurse Midwife and President of the American College of Nurse Midwives, joins Dr. Dekker to explore the transformative impact of respectful maternity care. Dr. Brumley reflects on her journey to midwifery, inspired by a lifelong commitment to equitable and compassionate healthcare. Together, they discuss the importance of supporting normal physiology in birth, the guiding principles of the midwifery model, and the need for systemic change to foster respectful care in hospitals. Dr. Brumley also shares insights from her work with the Florida Perinatal Quality Collaborative, including initiatives to reduce unnecessary interventions and amplify patient voices. Tune in to learn how respectful care can improve outcomes, build trust, and why a “midwife for every community” could change the landscape of maternal health in the United States. (00:07:30) Equitable and Respectful Maternity Care Advocacy (00:28:57) Promoting Respectful Maternity Care in Workplaces (00:30:28) Creating a Culture of Respect in Healthcare (00:30:49) Cultural Respect in Healthcare Settings (00:34:24) Promoting Equitable and Respectful Healthcare Practices (00:43:11) Elevating Midwifery Practice for Improved Healthcare (00:44:47) Retention Strategies for Midwifery Professionals   Resources: EBB 324 – Blending Birth, Science, Technology, and Storytelling with Erica Chidi, Co-founder and CEO of LOOM EBB 332 – Advocating for Yourself during Prenatal Visits with Retired Obstetrician Dr. Leslie Farrington, Co-Founder of the Black Coalition for Safe Motherhood Read Protecting Your Birth: A Guide For Black Mothers in The New York Times. Learn about the International Confederation of Midwives (ICM) and the ICM's RESPECT Presentation (mentioned by Jessica) Learn about the Florida Perinatal Collaborative Learn more about Dr. Brumley and her work Learn about the American College of Nurse Midwives For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Rachel is a professor, an author, and a VBAC mom who is here to share her story from a traumatic C-section birth through a VBAC. This episode really dives deep into how picking the right provider is key to improving your chances for a VBAC. They give practical questions to ask your providers, more than just yes or no, to really get to know their birth philosophy and what qualifications and experiences your provider might have that would make them a better fit for VBAC chances. Rachel and Meagan also give a lot of validation and advice on how to start the process of overcoming birth trauma; it's reality and to not be ashamed of it. You're not alone. Through the many important messages of this episode, they both mention many times to trust your intuition. If something feels off, listen to that. And if a change in provider is necessary…it is never ever too late to change. Invisible Labor: The Untold Story of the Cesarean SectionHow to Naturally Induce LaborHow to Turn Prodromal Labor into Active LaborMembrane Sweeps for VBACHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello everybody! Welcome to the show! I am so honored to have Rachel Somerstein on with us today. She is a friend of ours from New York. She is a writer and an associate professor of journalism at SUNY New Paltz. She is an author of Invisible Labor: The Untold Story of the Cesarean Section.  And her writing has also appeared in the Boston Globe, The Guardian, The Washington Post, and Women's Health. She lives in Hudson Valley, NY with her husband and her two children and is here to share her stories with you today. Rachel had an unplanned Xesarean section with her first child and the experience was anything but routine. I know that there are many of us who have been through this journey and on this podcast, maybe listening today, that also had an unexpected experience and it may have left us with trauma, or doubt, or fear, or all the feelings, right? And so she is going to be talking to us today about her experiences, but then also we're going to talk about some guidance on how to find peace and to offer ourselves grace and to set ourselves up for a much better experience next time. We do have a review of the week, so I want to get into that and I'm going to turn the time over to Rachel.This review is by Deserie Jacobsen. The review title is “Thank You.” She actually emailed this in and it says, “This podcast and parents course is amazing. I am not a VBAC mom, but I have been listening since 2020. I binge listen near the end of every pregnancy to remind me of everything I need to remember in birth and process through my previous births. This time around I felt more prepared than ever before, having plans in place just in case. We were able to have a quick birth of my 5th baby. I love the education, passion, and love this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast, thank you.”Thank you so much Deserie for your review! Seriously you guys, I just love hearing that people are finding the information that they need, they're finding community, they're finding that they can do this too. Just like them, and all these reviewers and all the people that have shared their stories and all these reviewers you guys can too. This birth, VBAC, is possible too. Better experience is possible. A healing CBAC; it's possible. You guys, all it takes is getting the information, the prep, finding the provider, to have a better experience.Meagan: Alright Ms. Rachel, welcome to the show and thank you again so much for being here with us. I kind of talked about this a little bit before we started recording about how I think your episode is going to be so powerful and deep and raw too. You've got these feelings and these words. I love it. I love reading your book and I can't wait to hear it from your own mouth. Which speaking of book, can we talk about that a little bit? What kind of just inspired you, jumpstarted you into writing a book about this?Rachel: Well, I'm a writer. And I wrote an essay about my birth about two years after I had my baby, my first birth, my C-section. And I realized I had a lot more to say and also I heard from a lot of moms when that came out and that made me start thinking that I think there was a bigger project. Meagan: Absolutely. And an amazing project that you completed.Rachel: Yes.Meagan: And remind everybody before we get into your stories where they can find your book. I actually have it here in my hands. It's Invisible Labor. So where all can they find that? And we'll make sure that we link it. Rachel: Sure, thank you! Yeah, so it's Invisible Labor: The Untold Story of The Cesarean Section. And you can get it on Amazon, you can get it from Barnes and Noble, you can get it from your local bookstore, you can get it as an audiobook? Or you can also get it as an ebook.Meagan: For the audiobook, did you record it?Rachel: I did not. The narrator is Xe Sands and she did a great, great job. It sounds excellent. Meagan: Awesome. We'll be sure to link that. I think it's definitely a book that everyone should check out. There's a lot of power in that book.Rachel: Thank you.Meagan: And it's not even just your story. I mean there's a ton. Like if you go through the note section there's a ton of research in there, and history and studies, and so many really great things. Well okay, let's hear about the story that started the inspiration and behind this amazing book.Rachel: Sure! Thank you. So like so many moms, I had an unplanned C-section that I was completely unprepared for, which is another reason I wanted to write this book because I think a lot of people go into pregnancy just assuming they're going to have a vaginal birth and like me, I didn't even read the parts of the books about C-sections, I skipped them. Because I was not going to have a C-section. Which is whatever, hindsight is everything, right? But I had a totally textbook pregnancy. I switched to a different group of midwives and OB's about halfway through because I just didn't have a connection I felt with the providers in the first one. And frankly, I didn't have a connection with the providers in the second one either, but by that point, I was like well whatever, it's fine. Which I think is actually, if I could go back and do it again I would have changed that. But you kind of are like, I don't want to, could I possibly change again? And I think that for people who are VBACing, yes you can and sometimes you actually really need to, even like late on in your pregnancy, people will switch groups or providers even late in the third trimester, so. Meagan: Even if you're changed already, you can do it multiple times.Rachel: Exactly.Meagan: It's not a bad thing to find the right provider for you. It's not. Rachel: It's not. And It's hard. And you can feel like, Oh my god. Am I really going to send all my records over? It can feel like so much effort and it can really be worth it. I just wanted to say that as someone who switched once and then was like, Okay, I'm done, and wished I'd switched again. So anyways, it was late in week 39 I went into prodromal labor but I didn't know that prodromal labor even existed because nobody told me about it.  And it was my first baby. So I was like is this labor? I think I'm having contractions, these are not Braxton Hicks. And in the end, we talked to the doula I was working with, and in the end they ended up petering out. And at that, I think that that for me marked the beginning of, this is not going to look like the way I had expected it to look. And again, hindsight is everything. What I wish I had known at the time– and I think this is really relevant to some VBAC moms is that sometimes prodromal labor means that your baby is not in the best position for having a vaginal birth. And I can't exactly say oh I would have done this or that differently if I'd known it, but it would have helped me understand what I was going into with the labor and the birth. So anyway, I eventually went into labor in the middle of the night. It was exactly my due date and I knew it was different. I could just feel this is labor. And I was really eager to get it going quickly. And again, I wish someone would have said, “Rachel, rest. It's early. You're going to need your strength. You're going to need your energy however your baby is born.” And instead I quite literally was running up and down the stairs of my house to try to push labor along. Which is, I have compassion for myself, I understand why I was doing that. What I really needed to do was get in the bath, or I don't know, lay over the birth ball. Watch a silly movie, right? The feelings I was having were real pain and I was scared. But you kind of can't run through this, especially a first labor as we all know, those take a long time, right?Meagan: Yeah. And if we were having prodromal labor, our body may be kicking into labor, but still might need some time to help that baby rotate and change positions. Rachel: Exactly, exactly. And this is the kind of education that is so missing from birth classes. And that is one reason why this kind of podcast is so helpful because that's how I learned about these different things. I didn't ever learn about them from a provider being like, “Let's talk about what will happen in your birth, and let's talk about why you had prodromal labor.”So anyway, we went to the doctors office where we met a midwife and my doula for a labor check. And I was hardly dilated, I was at a 2 but I was in extreme pain. And I have to say, I have a very, very high pain tolerance and I now know I was having back labor. Meagan: Baby's position.Rachel: Exactly. And the contractions were like boom boom boom boom. They were not, I didn't have any rest in between them. Which again, I think my baby was like I gotta get in the right position, this isn't working out, I'm freaking out, ah! Plus my mom is running around, ah! Right?Meagan: Yeah. Rachel: So we went to the hospital and I was checked in and the midwife who checked me in was like, “Oh you're actually not even 2 centimeters, you're just 1 centimeter dilated.” And they checked me because I was in so much pain I think. And I don't know that that was necessarily wrong,  but again, no one was sort of explaining, “Here's what we think is going on.” And it's partly because I believe those providers thought I was exaggerating what I was experiencing physically. They didn't know me. Well, they didn't know that I'm usually pretty stoic. They didn't know that I'm not a squeaky wheel. And I wasn't like screaming or crying or pounding. I was like quiet and I was like I'm in a lot of pain.Meagan: An intense quiet.Rachel: Intense quiet. Exactly. But that doesn't look like what we think pain looks like to people. And the fact is that people are very individual and how they express pain especially during labor where you're already kind of like leaving the regular plane of reality.Meagan: Yes. Rachel: So an important takeaway is like, even experienced providers cannot read your mind and make mistakes in assessing what's truly going on with you. And this comes up later in my second birth, but my husband now does a much better job of saying, “You might look at Rachel right now and think she looks like she's doing great, but this is what's really going on with her.” And he does that in a way that's not like he's speaking for me in a way that's annoying, but it's like I actually can't advocate for myself, I can't express this. So anyways, I asked for an epidural. They said that the anesthesiologist was busy. Which may have been true, but may have been they were trying to put me off because I was hardly dilated. And they told me to get in the birth tub. And I remember hanging over the side of the tub and staring at the clock on the wall and being like, I actually don't know if I'm going to survive this hour. I was just in so much pain. Incredible pain from back labor that was incessant. Eventually he showed up. They hooked me up to all the monitors. At that point, one of the nurses was like, “Oh, you are having monster contractions.” Like the contractions that were being measured were so intense they were going each time to the edge of what was measurable. And now that the computer said it it was like oh…Meagan: You're validated now. Rachel: Exactly. Right. And the anesthesiologist, it took him three tries to get the epidural working properly which would echo problems to come. But he did, and it took away the pain. And then I was just in the bed and kind of left there. And the nurses and the midwife did not use a peanut ball, they didn't move me around. And obviously, listen, I'm attached to the monitors. You know you cannot really move that well, the belt slips, and that increases the chances you'll have a C-section. And there are still things that can be done. It's not like you're a loaf of bread, you just lay in a bed. But they didn't do that stuff and I wasn't dilating. The nurse and doula eventually basically were like, “Well, we're going to go out for dinner and we'll be back in a few hours and we're going to give you this thing to sleep and if you haven't dilated by the time we get back you're going to have a C-section.” And at that point I was exhausted. It's evening now, I've been up since the middle of the night. I'm totally like, what is happening with this birth? No preparation; I took birth classes, I read books, no preparation suggested that this series of events could take place. I felt completely abandoned by my providers, including my doula who I was paying out of pocket. And one thing that came up at this time also was I had this colposcopy in college, like scraping of cervical cells. I didn't hide it from anybody, I was open. And the midwife said well maybe that's why you're not dilating is because of this colposcopy.Meagan: Do you think you got scar tissue?Rachel: That's what she said. And I remember at the time being like why are we only talking about this now? Why has nobody brought this up in any of the prenatal visits that I've done? And I felt blamed. This thing about your body is defective. After a few hours when the midwife and the doula came back and I rested and it was quiet, I had dilated to a 9. And I think what that's about is that I had been in too much pain to dilate. I was so frozen up and tense and also extremely scared.At this point people are like, “Oh wow.” And finally my water broke,y water hadn't broken. So you know, things are kind of continuing and I am starting to actually feel even more fear and my room is getting really crowded with people. And the midwife asks me to start pushing. And I was afraid and I was excited. They turned on the baby warmer, and they were like, “Okay, your baby is going to come out.” And I started to push but I couldn't feel what I was doing. I had no idea. And the midwife was like, “Do you have an urge to push?” And I was like, “No.” The epidural that hadn't gone well from the beginning had then come down with a very heavy hammer and I felt total numbness. It was not helpful. I needed someone to have turned it off or something, or turned it down so I could feel an urge to push and feel how to push, where to push, what muscles to use. And at a certain point I could tell something was going not right and it turned out that my baby was having heart rate decelerations. So just to sketch the scene. At this point it's 1 o'clock in the morning, I've been awake for 24 hours. I'm exhausted. My husband is exhausted. Neither of us has any idea that things could have gone like this. The midwife says I think it's time to do a C-section. And I don't disagree with her. I don't even know what to think at that point. I'm also feeling tremendous fear. I was like I'm afraid I'm going to die, I'm afraid my baby's going to die. And the overall sense in the room…and people were like, “Oh no, you're going to be fine”. And the sense in the room was that I was hysterical and I was not in my right mind. Which I wasn't in my right mind; I had been awake for a long time, I'd been trying to have this baby, nobody really told me what was going on and I felt totally unsupported. Actually, my response was completely reasonable given the circumstances and nobody really attended to that and saw that and recognized that as completely valid. Plus, I don't have evidence to stack this up absolutely, but I have since come to find out that there is a medication that some laboring women are given to help them rest and one of the side effects is an impending sense of doom. And I have a friend who had a baby at this same hospital and had the same response after having been given something to rest during her labor. I could go back and look at my records and I may do that but I'm like, well that would explain also why I had the response I did. Meagan: Mhmm.Rachel: Anyway, we go to the OR. I hunch my back for the spinal that the anesthesiologist has to do a couple of times to get it right. I'm still contracting at this point. My body is still like, Come on, let's get this baby out. Let's get this baby out. And I'm so uncomfortable. And you know that advice to not lay down flat on your back when you're pregnant, but that's what you have to do when you're in the OR. The whole thing felt like I was going to choke under my stomach and very exposed like you are in the operating room. Meagan: Yeah, it's cold and it's bright and you're very exposed. And you can't move your body normally, especially if you've had a spinal. Rachel: And also in retrospect, again I'm like I cannot believe that the first time I learned what happened in a C-section was in my C-section. I really should have at least learned about this even though it would have still been scary and I still would have been surprised. So when the OB goes to operate, he starts his incision and I say, “I felt that.” And he says, “You'll feel pressure.” And I say, “I felt that.” And he continues operating and I was not numb. I felt the operation. And according to his notes..parts of this I don't remember…but he wrote it down and my husband has also told me that I was screaming, my legs were kicking. There's no question that I was in tremendous pain. And I was moaning and it was horrible. And it was horrible for the people in the room too by the way.Meagan: I'm sure. Rachel: Right? Like it's really important to say that. My OB didn't listen to me. That is a super common thing that happens in healthcare, especially for women. Especially for pregnant women. He's not a sociopath. He didn't want to be evil, but he didn't listen and the consequences were so steep and so dire. And I think that it was traumatizing to him and I know it was traumatizing to some of the other providers in that room, the nurses to watch this. He kept going and when the baby was born, which I don't remember, apparently they held her up to my face and they put me under general anesthesia and sent my baby and my husband away and stitched me up. Then I woke up in recovery. The doula and the midwife had gotten the baby to latch while I was unconscious and were talking about me without knowing that I was awake about her latch which really, really bothered me because it just underscored how it felt like I was just a body. And even people who were supposed to be there to take care of me and be tender and advocates, I felt they disregarded me. And under other circumstances I really would have wanted to breastfeed my baby like right away. But I wasn't even there to say yes I want to do this or no I don't want to do this. It was a terrible birth and I would not wish it on anybody. Meagan: And I think, kind of talking about what you were just talking about with breastfeeding and stuff, these people in their hearts and in their minds were probably like this is what she would have wanted. We're trying to help. But in whole other frame of mind over here, I'm not present. I haven't said those things. And I know you're trying to help and I know that's where your heart is, but I'm not okay with this. Rachel: Totally.Meagan: And I think sometimes as doulas, as birth workers, as any one of you listening, remember that words matter. Actions matter. These moms' feelings matter and it's sometimes in our minds we're trying to do what's best, but it might not be. Rachel: Totally. Absolutely. Yes and I again, it's so important to point out. Yes they were coming from a good place. They really were coming from a good place. But it wasn't the way that I felt it or experienced it. Meagan: And it left you with trauma and angst and heartache. Rachel: Absolutely. Totally. Yeah. Meagan: Well that definitely sounds like a really rough birth. And it's so crazy because it's like you went from not progressing to baby in a poor position, to getting an epidural. I love that you talked about that. That can be an amazing tool. A lot of people are very against epidurals, and there are pros and cons with epidurals. We've talked about those. Fetal heart decels is one of them. I don't think, maybe in this situation it sounds like a lot of other things happened; baby's position being one of the biggest ones. But that can really be a tool that helps you just relax and be more present and have less trauma. We talk about this in my doula practice of where there's a difference between pain and suffering. And pain, progressive positive pain that's bringing our baby to us that's one thing. But when we're suffering and we're so tense that our body's not even able to try; that epidural could come into great play. But again, we're not that loaf of bread in a bed and it is important to move and rotate. And it doesn't have to be drastic. It doesn't have to be crazy big movements. Just subtle movements to change the dynamics of the pelvis and to encourage our baby to keep coming down. So there were so many things that just went poorly but also went well, and then poorly again and then well and then real poorly there at the end. Rachel: And I think like to your point, I went into my birth I should say, I was planning on having an unmedicated vaginal birth. I was like I'm not going to have an epidural. And I think that if my providers had different skills I would have, I may have been able to have that baby vaginally. And I say that based on what happened in my second birth. So it's not just like wishful thinking, right? And I'm really glad I had that epidural. I really needed that. I was suffering. The pain I was experiencing was not productive pain. And an epidural can help you with suffering, alleviate your suffering. But it can't and doesn't substitute for emotional support. And I think that's what was missing for me, throughout that first birth. Even if I had gone on to have ok fine, a cesarean, or even a vaginal birth, I still think I would have been like that wasn't a good birth because I didn't feel emotionally supported. And an epidural can't do that. Meagan: Yeah. No an epidural cannot do that. And I, for anyone listening who supports birth, or even who are going for a birth you kind of mentioned it. You're in this other land and sometimes it's hard to advocate and open. You might be thinking something and you might so badly want to say it. It's right here, coming out. And you can't say it for whatever reason. It's a weird thing, it doesn't make sense sometimes but it can happen. But really being heard, validated, understood; which are so many things you weren't. Right? And when we're not heard and when we don't feel safe, and we don't feel supported, those things leave us with PTSD. In fact there was, in your book, I'm just going to read it. It says, “2022 study by anesthesiology and obstetrics professor Joanna and colleagues found that what's important about women who feel pain during childbirth is how mothers feel about their pain. And how their providers communicate with them overall…”You were communicating, and no one was communicating to you. “...feeling positively about pain and heard by providers protects a mother from developing PTSD.” And I mean it goes on which is why you need to get the book so you can read more about it. Rachel: Yep. Meagan: But really, feeling heard. Rachel: It's not just crunchy whoo-hoo feels good, feels right, sounds good. It really matters. And I have to say that I'm participating in and helping to work with providers on designing some studies about providing different pain options for moms during C-sections. We literally had a conversation about this yesterday. And one of things we were talking about is it's not just the pain. It's not just pain relief. It's also being listened to. Because there will be people who are like, I might say I'm in pain, but that doesn't mean I need an epidural or want an epidural. But I'm feeling pain and I want to be heard and I want somebody to…even if you can't express this. You can't even express it because you're the one having labor. What you're needing is someone to see you and look you in the eye and be like you're going to be okay. And I think as mothers we totally are experienced with that all the time. When your child is hurt or sick, part of your job obviously is to get them the help they need, but it's also to assure them this nosebleed is going to end. You're not going to have a bloody nose for the rest of your life. Which, when you're going through something really hard you can sometimes forget, right? And you're pointing out from the studies this helps to prevent people in birth, in labor, from developing PTSD. The stakes are really high. They matter so much. Meagan: When you were just talking, I don't know if you saw my eyes kind of well up a little, but I connected a lot with my first birth when I was clinging to a bed, literally clinging. And I was looking at my husband and I'm like, “Do something!” I had a baby in a poor position. I was being jacked full of pitocin. My water had broken, there was a lot of discomfort going on. I had told him I didn't want an epidural and he's like what do you want me to do? And I was like I don't know, I just need something! And I was terrified and desperate. And he was just like… It wasn't fair for me to put him in that position either but at the same time he was like I don't know, I don't know what to do, right? And the nurses were just like we'll just get you an epidural. And I was like no, I don't want an epidural. And then it just was like epidural, just went down from there. And I wish so badly that there was something else. Let's get you out of the bed. Let's get you in the shower. Let's give you some nitrous. There was so much more that I could have had, but wasn't even offered. And I think too, I needed someone to tell me that nosebleed was going to end. Rachel: Yes. Meagan: And it was going to end and it was going to come back every five minutes and it was going to end again and I was going to be okay. And I was going to survive that. And just hearing you talk about that, why my eyes got all welly, is that I don't know if I realized how much that impacted me until just barely. And here I am, my daughter is almost 13.Rachel: Just like how powerful these things that, I don't know, this is part of why we have these conversations. They shed different corners of light on our experiences that it's like oh my gosh, I didn't even know I knew that. And that's so why we, even though I'm not postpartum immediately, it's valuable for me to talk about it too; to hear what you're saying, you know?Meagan: Yeah. Ah, so after a not-so-amazing experience, going into that postpartum, you've talked a little bit about that in your book. Well, not a little bit, you've talked about that a lot. Tell us about that journey and then what led you to deciding on VBAC and ultimately going and having a VBAC. Rachel: So I should say, I was really…Talk about not realizing things right away. It took me a long time to figure out how traumatized I had been by that birth. And I was about two years postpartum and I was having a procedure for something else and I just completely, I had a panic attack. I had never had a panic attack before, I didn't know what it was and couldn't have explained what was happening. And when the anesthesiologist who did this procedure was like have you ever had any issues with anesthesia, which is exactly the question that should be asked, and I had said what had happened he was so taken aback. He was shocked and didn't know what to say and walked out of the room.Not in the way of, I'm abandoning my patient, but just like from his perspective here's this kind of routine thing. This patient is crying and shaking and talking about this very traumatic incident which I had not talked about. I didn't go to therapy. I had talked about it with friends and my family, it wasn't a secret, but I felt a lot of shame. I felt like I must have been this total freak of a person that this had happened to me. And after that I remember saying to my husband, I just don't know if I'm ever going to be able to get over this trauma enough to have another baby. And I didn't even know if I wanted another baby, like separate from the trauma. In therapy I started to see that I felt very stuck in my life and that included how and whether to grow my family. And that was actually because of the traumatic birth. It just like made this big block. I think one thing that's important to think about for those who have had a traumatic birth is that sometimes that can show up in your life in ways that you don't expect. Meagan: Yes. Rachel: And so to be compassionate with yourself about that and also to be open to that. We're in the era of warnings and trigger warnings and those are important, but sometimes for a traumatized person the things that are triggering or activating are not what you would think. Like for me, I couldn't watch a scene of a hospital birth even if it was happy without getting very uncomfortable and having to walk away and there wouldn't be a content warning on that. So it's just to say be patient with yourself. Accept that…don't, I guess if you've had a traumatizing birth you don't have to struggle against these things. As horrible as they might feel, as uncomfortable as they might feel it's normal and it's ok and it shows up differently for everybody. Rachel: Yeah so I had this big question and then I was like ok, it took awhile for me to be like I do want to have another baby. But I wasn't ready emotionally. And so I waited. And then about, let's see, October of 2019, I was like I think that I'm ready to try to have another baby. And we had met this midwife who lived in our community, who my daughter actually made friends with her niece at our public pool which is so beautiful. I ran into her one night while she was walking her dog. She was like your husband shared a little bit with me, if you ever want to talk. And this, I feel like, I could not be more grateful that this person came into my life. She just is, her skills are phenomenal. Just as a clinician in terms of trauma-informed care, and I've felt safe enough going to her for prenatal care to decide that I was ready to get pregnant. My joke is that I should tour high schools and be like it only takes once to have unprotected sex to become a parent. And I was really lucky that I got pregnant right away and at that point I was 37. So I should say I had my first baby at 33 and I got pregnant again at 37. And that's not always the case for people. Obviously it can take a long time and especially after a C-section, secondary infertility is real. Meagan: It is. Rachel: Yeah. Not talked about enough. Really not talked about enough. Meagan: There's a lot of things, right, about C-sections that is not discussed about. For personal, for the mom, for the individual, the infertility, adhesions, all those things. Just the emotional and the physical. Then even the baby. There's risks for the baby, the allergies, the microbiome getting messed up. All the risks, it's just not discussed. Rachel: No, it's really not. And you kind of only find out later if you've had a C-section and you've had a problem down the road that you're like, maybe that's because of my C-section. It's ridiculous.So we got pregnant and I was not sure if I wanted to have a VBAC, but I started thinking about it from the beginning. And I also was like, if I don't have a VBAC how am I ever going to get myself into an OR, I just don't know. And I really think that VBAC is the under-discussed pain point for moms. And I'm preaching to the choir here but we're talking about half a million moms every year have to make this decision, if it's even available to them. Meagan: I was going to say, if it's even offered. Rachel: If it's even offered. Which is totally not a given. But theoretically, they do have this decision and I really have not…I should say, in the course of writing this book, but also just being a mom who had a bad C-section and then had a VBAC, I hear from people a lot about their journeys just like on the playground. Every person I've talked to, they agonize over it. No matter what they choose, no matter what. Why is that not talked about more? I mean that part of what this podcast is doing that's so important, but I still can't believe how under the radar it is, yet it's such a big deal when you're going through it. So anyway, I told myself I did not have to decide right away about a VBAC or a C-section. My midwife was like you can totally have a VBAC, you can totally have a C-section. Even if you have a C-section you can keep seeing me. I was worried like oh would I get bumped out of midwifery care. One of the things I'm really fortunate about and that I think is really good about that practice is that she has a very close relationship with one of the OB's there. Like they kind of share patients, I should say that. And that's because she's worked with him for a long time and he really respects her clinical skills and vice versa. The other thing about her that's unique and that I didn't know how important it is she's a Certified Nurse Midwife, so she attends births in the hospital. But she previously had been a homebirth practice and at a birth center as a CNM. So her skills are, like I said are phenomenal. A C-section is truly like we have to do this. I've run out of my bag of skills or like the baby or mom's health suggests that like we need to do this now. She worked with me to work with the scheduler so that I saw her for every visit which helped me to learn how to trust her and she didn't pressure me. Either way she was completely open. She also worked with me to make sure that I could see her for virtually every visit so that way she earned my trust. And I got to show her who I am. She got to understand me which was really important to the birth. Meagan: Yes, which I want to point out. There are a lot of providers these days that are working in groups. And I understand why they're working in groups. They're overworked, definitely not rested. There's reasons why, both midwives and OBGYNs are working in these big practices. But the thing is it's really nice to have that established relationship but for some reason specially for VBAC it's so important to have that one-on-one relationship. So if you can, during your search for finding providers, if you can find a provider that is going to be like Rachel's midwife where she's just like I want to get to know you, I want to establish this relationship. Yes, we have this OB over here but I want to be your person. I definitely think it's impactful.Rachel: I totally agree with you and I didn't even know that was possible. And she works for a big group and even so she told the schedulers, hey make sure you schedule her with me. She didn't just do that with me by the way, it wasn't just a special favor for this traumatized patient. And frankly it's better for the providers too because they're not coming in cold. Like ok who's this person, and she's saying this. And what's her prenatal care like? What's her pregnancy like? Of course they're looking at the notes, but it's not the same. Meagan: It isn't. And I love that she said that. But I also want to point out that you can request that. If you're in a group and you can connect whole-heartedly with someone and you feel it's definitely who you need, it's ok to ask hey. I know that I am supposed to meet Sarah Jane and Sally, but can I stay with whoever. And maybe you might not get every visit, but if you can get more visits than only that one? It's worth asking. Rachel: Totally. And also then you know their style. So like she was not an alarmist. Let's say I was over 35; I had to see a MFM just because of my age. That went fine, but if something had come up, like let's say I had a short cervix or there was something I found in an appointment with an MFM specialist I would know her well enough to take that to her to be like, put it to me straight. How worried should I be about this? As opposed to maybe this one's an alarmist, this one is more like ahh let me put this in…And the only way you're going to learn about that is from meeting with them again and again. And for VBAC that's so so important. Meagan: It is. It kind of reminds me of dating. It's weird. I had said this with my provider when I didn't switch. I was like, I feel like I'm breaking up with him. Like he's my second boyfriend, it's just weird. It's not really boyfriend but you know what I mean. But it is, we're dating them. And anyone, in my opinion, can come off really great for that first date because they're wanting to make that impression. They're wanting you to like them. But the more you get to know them, the more they may show their true colors. And you also may realize, I don't think I'm the right person for you. My desires aren't something that aligns with you and so I don't want to put you in this situation. And so if we date our providers, “date our providers,” a little bit more than just one time it really will help us know. And like you said, if something were to come up you could have that trusted person in your corner, which is so important for VBAC, that you can go to. Rachel: Totally. Yeah. So yeah, so pregnancy went well. And then right as I entered my third trimester it started to be COVID. Meagan: Mhmmm. The joys. Rachel: Nobody saw that coming. And then you know, things for the entire society obviously went completely off the rails. Obviously something like COVID is, we hope, not even once in a generation. Once in a hundred years experience. But given all the stuff that was up in the air, boy was I glad that there was one provider who I trusted. Who I could be like ok what do I do, what do I do. And I have to tell you that she and my daughter's pediatrician…I'm a professor. So I should say I'm in the classroom with young people who, you get sick a lot anyways. They're living in dorms, like they're not taking the best care of themselves. So COVID was circulating, and we live right outside New York City, COVID was circulating early here and I have a lot of colleagues that ended up getting it. And both my midwife and my child's pediatrician told me early you need to stop going in person, it's too dangerous for you. And I trust my daughter's pediatrician a lot, you know we have a nice relationship and I really trusted my midwife. Right? So I followed that advice and was really fortunate because boy. You know what you don't want while pregnant? COVID. And you know what you really didn't want? COVID in 2020 when you were pregnant and nobody knew anything, you know?Meagan: Right? Rachel: So, the blessing in disguise was that I was able to work from home. And it was super stressful because I had my daughter and my husband was here and you know, my husband is a photographer…I mean the funny thing is that I ended up, not my head but my body, being in these different photos he ended up taking and my belly was getting bigger and bigger and we kind of had to hide it. I'd be holding a book, or cleaning something. It was an absurd, crazy, isolating, scary, and also funny time. You know the blessing in disguise was that I wasn't on my feet as much and I think that that was really good for me as a pregnant person. There is also data that preterm birth went down during the lockdowns because people got to stay home and they don't necessarily get to do that leading up to birth, which tells us a lot about what we need and the rest we need and aren't getting. So anyway, at first everything went virtual and then when I started going in again for my appointments I had met the OB who works closely with my midwife. And we talked about what would happen if I went over 40 weeks. And he was like well, we're not going to automatically schedule a C-section, we would talk about potentially waiting or induction. And I really appreciated having that conversation with him because I understood where he was coming from and it wasn't again like we're going to schedule a C-section right now. So we know if you get to 40+3 and you haven't had the baby, bing bang boom. And that was very important information about his risk tolerance and his stance. Just like with my first birth I went into prodromal labor a few days before my due date. I had had a membrane sweep with my midwife. My in-laws came to stay with my daughter and we went to the hospital on a Saturday night. I didn't know this but my father-in-law told my husband I think she's getting ahead of her skis. And he was right in the end. So we get to the hospital and my contractions stop. And I'm like oh no. And my midwife was like, they put me on the monitor to get a strip which is like you know, what happens. Meagan: Normal.Rachel: And my midwife was like listen, your baby, he's not looking that good on the monitor. I want you to rest for a little bit and let's see. So I'll check back in with you in like half an hour. And I was so upset. I remember being like I can totally see where this is going to go and I had learned about VBAC in terms of like what could increase the chance of rupture or not and I was like I'm going to end up with another C-section and I'm going to be caught in the net. I didn't even have a shot, is what I felt. And then she came back half an hour later and she was like, “He looks great. I think he was just sleeping, and if you want to go home you can go home.”  And it was like 1 o'clock in the morning. And I was like, “I think we should go home.” I just felt like he's not ready. He's not ready to be born.  And remember, I trusted her so much. She would not tell me this if she thought that there was something…Meagan: If there was something wrong. Rachel: Exactly. She wasn't trying to be my friend. She was my provider. And so it felt really weird to leave and come home and not have a baby. And I thought was this the wrong thing to do, because I live like half an hour from the hospital, and was like no this is it.And then everything was quiet for a few days. And then just like my first labor, my daughter, I went into labor in the middle of the night and I had intense back labor, and I knew like this is the real deal, here we are. And this time I tried to rest. I did like cat/cow and just like anything, child's pose, just anything to feel more comfortable. And I called my midwife at 7 in the morning and she was like, “Okay, I want you to come in and be prepared to go into the hospital from this appointment.” So we did that and at that appointment, I had a headache, I had higher blood pressure, I was dilated to a 6, and she said to me, “Listen. Just so you know, they're not going to let you go home. You're going to the hospital, no matter what if your contractions stop or not whatever. This is what's happening because of how dilated you are, the fact that you have this headache, this BP readings, whatever.” And I was like that's completely reasonable, I felt that way too. You know what I mean? But I really appreciated she communicated that with me so clearly and explained why. So I planned initially to try to have an unmedicated, vaginal birth. My midwife and I had discussed these saline boluses you can have in your, by your, what's it called. Like the triangular bone in your back? I'm totally blanking. Meagan: Your sacrum?Rachel: The sacrum. Yeah, that that can alleviate some pain. And very quickly the pain was, I found it to be unbearable. And I asked for an epidural. And the anaesthesiologist came right away and did a very good job. And the nurses and the midwife who were at the hospital were using a peanut ball and helping me move and really supportive emotionally. And I was still really scared, right? Because I had had this terrible birth before, I thought something would happen to me. And nobody treated me like I was exaggerating or you know like, unreasonable. And that mattered a lot. And I think what's important is you shouldn't have to have gone through a bad birth for people then to take you at face value. With your first birth, it should be the standard for everybody. Meagan: Such a powerful saying right there. Rachel: And they were wonderful, truly, clinically and beside.Meagan: Good.Rachel: And then my midwife surprised me by showing up. She was not on call, she came in at like 9 o'clock, no she came in at like 5 o'clock, like once she'd seen her patients and I was just like oh my god,  so moved to see her. And you know, I was pretty far along at that point and she kind of helped me get into different positions and then it was like okay, it was time to push. And they had managed that epidural so I could feel when it was time to push, and I could feel how she and the nurse were telling me to like push here, right? Like use this, make this go. The pain was really intense but it wasn't suffering, like okay, I'm getting instruction. And as I was pushing I could feel that it wasn't going to work. I was like he's not, his head…I could just feel it. Apparently he was kind of coming and kind of going back up, like his head forward and back. And my midwife was like do I have permission from you to try and move his head? I think his head is not in the best position. And I said yes, and she tried to do it and she couldn't. Her fingers weren't strong enough and then she went to the OB and she told me this later.She said to him can you come and move his head? He'd been trained by midwives in the military, by the way, which is one reason his clinical skills are so amazing.Meagan: That's awesome. Okay.Rachel: Awesome. And at first he apparently was like, oh she's a VBAC, like I can't believe you're asking me to do this. And my midwife, again they trust each other right, and she was like the baby's doing great and the mom's doing great. I really think this is going to work. And he was like okay. So he came in, asked my permission, I said yes and he moved my son's head. My water had not broken again, right? So it's like the same thing as the first one. And once he got in position and I started pushing my water broke in an explosion all over my midwife. That's why they wear goggles, now I know. And she went and changed her clothes. I pushed for 45 minutes and then he came out.Meagan: Oh my gosh. Rachel: It was amazing and I felt so proud and I was completely depleted. I was so high and also so low. And I think what's amazing to me is that it was almost the same labor as my daughter, which just tells me that's how my body tends to do.Meagan: Your pelvis. And some babies need to enter posterior or even in a weird position to actually get down. So that can happen. Rachel: Thank you. And also my water didn't break until the very end so there was buoyancy to be moved, right? And again who knows what would have happened if I had been with this provider the first time. Like maybe these decels really meant that my daughter had to come out like then. That is possible. And that first team did not have the skills of the second team. None of this was even brought up, wasn't even a possibility. And I should say that first birth, I didn't even mention this. The OB that gave me that C-section, later told me that my daughter's head was kind of cocked when he took her out. Which suggests that it was just like my son. And how I'm grateful for my epidural. I'm grateful for, you know, all the things that technological kept me safe, but it was these skills of facilitating vaginal birth that made the difference for me to have that VBAC. Meagan: Absolutely. And the hardest thing for me is seeing that these skills are being lost. Rachel: Yes.Meagan: Or maybe it's not that they're being lost, they're being ignored. And I don't know which one it is. I really don't know because I see people using them. So I feel like it's got to be there. But then I go to other births and I'm like, wait what? You're not going to do anything to help her right here? Or you know, it probably could have been a vaginal birth if we had a provider come in and be like we have  a little asynclitic head, why don't we change into this position and let me see if I can just ever so slightly help this baby's head turn. It just isn't even offered. Rachel: Yes. Meagan: And that's something that I think needs to be added to questions for your provider. In the event that my baby is really low and coming vaginally, but is in a wonky position, what do you do to help my babys' position change to help me have a vaginal birth. And then even further what steps do you take past then if it doesn't work and my baby's so slow. Do we do assisted delivery? What do we do, let's have this conversation. So if it does come up, you're aware. Rachel: I love that. Meagan: I was going to say if your provider says, I don't know/I don't really help, then maybe that's not your right provider. Rachel: And I think what's so smart about that framing is that it's not putting the provider on the defensive of like, what's your training, right? Then it's like, what is your problem? But you're actually asking about their skills and you're asking about their approach, without coming from a place of seeming doubt. Just like, I'm just curious. Meagan: Yeah. Like what could I expect if this were to happen, especially if in the past. Say your C-section was failure to descend, mostly based off on position, we know that this is a big thing. But if your past cesarean was failure to descend, ask those questions to your provider. What steps can you take? What steps can we do together, you and I, to help this baby come out vaginally? Rachel: Totally. And I think also, that way, let's say the VBAC doesn't work out, you won't then be looking back over your shoulder and being like I should of/could of/why didn't I/if only. And you know, what do you want out of your birth experience? Well a lot, but part of it is a sense of peace. Right? That I did the best that I could. That my team did the best that they could.Meagan: Yes. Yeah and really interviewing your provider. Again, dating your provider and asking them the questions, learning more about them and what they do and their view. Taking out the yes and no questions and really trying to get to know this provider and letting them get to know you. I think it's just so impactful. I also, kind of like what you were saying with your first birth, also learning the other types of birth that could happen, you know learning about assisted birth. This is a new thing. Learning if assisted birth trumps a cesarean for you. Would you rather go for an assisted birth, even if it may end in cesarean, would you rather attempt that? Or would you just rather skip that and go right to the cesarean. Really educating yourself and trying not to push off the scary even though it can be scary. Rachel: Yes, yes. I love that you're saying this and I was just thinking about this and talking about this with a friend; there's stuff we hope doesn't happen. But not talking about it or thinking about it isn't going to protect us from it happening, it's just going to mean you're not prepared. Meagan: Yeah.Rachel: If it does happen. And yeah. Meagan: It's a disservice to ourselves. And it's weird. And it's hard to hear those stories. It's hard to hear the CBAC stories, it's hard to hear the uterine rupture stories that we do share on this podcast. Kind of what you're talking about the trigger warnings earlier, yeah it might be a trigger. It really might. But if we know all the signs of uterine rupture leading up to, we can be aware. And it's not something to hyperfocus on. We don't want it to be like oh my gosh I have this weird pain, right now, I don't know. It's not to make you scared, it really isn't. It's to just help you feel educated. Kind of what you were saying too. I don't know what a C-section looked like until I was in my own C-section. Rachel: Yeah. I've been talking about this recently with an anesthesiologist, some anti-anxiety medicine which you might get during a C-section, can cause memory loss. That's a side effect. So the time to decide…Let's say you're not planning on having a C-section. And then you're having a C-section and you're really anxious, really reasonable. The time to decide whether to take that anti-anxiety medicine which might cause memory loss; you should have an opportunity to reflect on that and talk about that  and think about that not only in the moment when you're scared and should I take it right now or not. Meagan: Yeah.Rachel: It's just like that's not a good way to make a decision, you know?Meagan: Yeah. And also learning about alternatives. Okay, these are the side effects of this medication, and I don't think I'm willing to accept that. So let's talk about other medications and those side effects so we can see if we can switch it up.  They have a whole bunch of things in their toolbox when it comes to medication. Rachel: Exactly. Meagan: For nausea. You know I had a medication and it affected my chest. It went all the way into my chest and I had to consciously focus on my chest moving. It was the weirdest feeling. Rachel: Terrifying, yeah. Meagan: I wish I would have known the alternatives to that. Right? So having these educated discussions, learning as much as you can. It's hard and it's scary and it's intimidating to not learn what you don't want. It's understandable, too.Rachel: Completely, completely. But that's informed consent, right? The risks, the benefits, the alternatives. And to go back to the anti-anxiety thing. You might be like okay, what could you do for me non-pharmacologically? Let's say I have a C-section and I'm feeling really anxious. Can I have a doula with me there who's giving me a massage? Can I have a doula there who's maybe put some lavender essence on a washcloth to hold to my nose. Can the anesthesiologist hold my hand and tell me it's going to be okay? And then you start actually opening up real options. Like wow I can have a doula with me?Meagan: Yes. That is something that I am very passionate about. We need to get doulas in the OR way more than we are. And I understand that it's like oh we don't have PPE, or oh it's an extra body, and oh it's a very big surgery, like I understand that. But I have been in the OR a good handful of times. And I understand my position in that room. I understand and respect my position in that room. And I always let an anesthesiologist know, if at any point something happens where I need to leave this room you just tell me. I will leave. No questions asked. But please let me be here with my client. Please let me stroke her hair. Please let me talk to her when dad goes over to baby so she's not alone. When you were put under general anesthesia to be there by your side, whether or not you were waking up in the OR. Because sometimes you could wake up sooner, or waking up in post-operative. Let's get these people here. Let's play music. Let's talk to them. Let's communicate the birth.I mean with my first C-section, they were complaining about the storm outside, they weren't even talking to me, right? And it would have impacted my birth in such a more positive light if I would have been talked to. And I wouldn't have felt like, what's going on. You know and all those things, you talked about it in your book. This drape that is separating us from our birth, it's just wild. So one of the questions we ask when you sign up to be on the podcast is topics of discussion that you would like to share, and one of those things is you said, why it's important to balance preparation for VBAC with an understanding of the systemic forces that promote C-sections. We're kind of talking about that, but do you have anything else to say on that? Rachel: I think that there is so much self-blame for having a C-section, when you wanted to have a vaginal birth. And go back to pain and suffering, that causes suffering. And it's heartbreaking to see that and to feel that. And when I think about it, I think what's important to keep in mind is like there are the particulars of your experience, right? Like your providers had the skills or didn't. They listened or they didn't. Your baby had decels or didn't. Like all that is real. And you're not the first or only person any of that is happening to. So why are we hooked up to electronic fetal monitoring, EFM, as soon as we walk into the hospital? Well that is because of how technology reigns supreme right now in every aspect of our society, but medicine too. And also that like it's an efficient system and medical birth, medicalized birth is all about efficiency and making as much money as possible frankly. Meagan: And there's even deeper history, we talk about that in our VBAC course, about why that was happening around cerebral palsy and what it actually did for cerebral palsy rates. All of these things. It's pretty fascinating when you get into it and understand one, why they do it and does it work? Does it make sense? They do it and just became practice and norm, but it did it actually impact the things that, okay how do I say this. Does it impact the things that they were originally creating it to impact? Rachel: Right. Totally. And it's actually the opposite; it was supposed to bring down the number of C-section rates, or the number of C-sections, when the number was like 4.5% in the early seventies and it's just gone in the opposite direction.There's so much evidence that you use it and it makes you more likely to have a C-section. And so yeah, okay, not your fault. That's the system. And I don't mean it in this way like, that's the system, give up, lay down, don't try to make your own feet, but also just to accept that that's what you're operating in and that's what your providers are operating in too. Right? Use it as a way to let go of the guilt and the shame and the, I messed up. My body messed up. Meagan: Yeah. Because there's so many of us that feel that. Rachel: Yes. Meagan: And it goes into the next topic they were saying that I think really can help us walk away with less of, I messed up. My body messed up. My baby failed me. You know whatever it may be. And doing effective research about the hospitals and their employment patterns and the chances of you even having a VBAC. That does kind of go into the balls in our court where we have to get the education and understand. But even when we do that, even when we don't have the best experience, in the end we're still going to look back at it as we did, WE did, the best we could. Right? And it takes less of that blame on us in a way because we know we did everything we could. Rachel: Yes.Meagan: And sometimes it just still happens. Even if you have the doula. Take the VBAC course. Read all the VBAC books, listen to all the podcasts, understand all the risks. Sometimes it still happens. Rachel: Totally. And I mean I think about in my case, like let's say my midwife hadn't come in for me and my OB hadn't been the one who had been attending that night, maybe I would have had a C-section. Because maybe the people there wouldn't have known how to effectively move my son's head. Even though I like did my best and that's okay. It has to be okay because you can't kind of change it. And again, not to be defeat-ist. But to find peace, just to find peace. Meagan: Yeah. I wish that for our VBAC community is finding peace and giving ourselves grace along our journeys. Because we've had 100's of podcast stories and there are so many of us who are still searching for peace. And still not offering ourselves grace, and putting that blame on us, or whatever, right? Everyone's so different and again, we talked about this earlier, it's just different. But I would love to see our community offering themselves more grace and finding more peace with their experiences along the way. And I don't exactly know what that healing looks like and how that peace is found. Do you have any suggestions on ways you have found peace with a very very very traumatic experience that not only led to trauma in that experience, but even in future procedures, in future experiences you know. Do you have any tips on just, guidance on finding peace? Rachel: I mean, I struggle with this still. And it sounds counterintuitive, but I think like not pushing away your feelings. And in the sense of not wallowing, but also not like struggling against them, trying to quiet them, make them be like ugh I hate this. Ugh I hate that I feel this way. Ugh if only I could get over it. So I'll say like, when I go to the doctor now, I get really scared especially if it's a new person and my blood pressure goes up and sometimes my heart rate goes up and it just sort of happens. And I hate it. And there are times when I'm like ugh I hate this part of me. I just hate it.But then when I'm kind of more accepting and it's like, this is how my body responds. It's understandable that this is how my body responds. And I take a Xanax actually. I say that to really take away the stigma I think that still exists around medical trauma and taking medication to manage your symptoms. I take a low dose Xanax before I go to see a provider and it helps me with my suffering. And also just like accepting. Because also there's this saying, if you struggle against the feelings of suffering, then you kind of suffer twice over. Right?Meagan: You do. Rachel: So I would say that, and then specifically for people who feel they had a traumatic experience, I've found EMDR treatment to be very effective, to deal with stuff in the body. That was pioneered more to deal with people who've been in like combat trauma, but it's very effective for traumatic birth. Tapping is another thing that can be very effective. And you can find that online, like there are different…Meagan: I was gonna say, you can go to YouTube and google trauma tapping or anything like that, and you can actually find some pretty great videos for free on how to do that. And it's pretty wild actually how well it works. Rachel: It really is. Meagan: Sometimes it's like wait, how is this working? It really does work. Rachel: Totally. And also I would say like in terms of again, peace, I think it's really important to speak openly about what has happened to you. And to the extent possible, we're conditioned to be like I'm just going to tie this up with a bow and it's okay. Someone says to you, you've expressed something hard, and they're like oh I'm so sorry and you're like it's okay, I'm going to be okay. Like you don't have to worry so much about reassuring your listener. You can be like yeah I had this C-section, and I'm still kind of upset about it. And yeah, that's how I feel. You don't have to self-qualify that. You know, but my baby is healthy. But I'm okay. But I love my baby. We do that; there's a lot of pressure to do that. And it's okay not to do that. It's okay to be like these are my feelings. And two things can be true at the same time. You can love your baby, and you can also be like I'm not that thrilled with the birth. Meagan: Awe yes. Julie and I have talked about that for years. They don't have to be separate. They can go together. You can love your baby and feel connected to your baby and really not like your birth experience. And you can also, we have found that people prep and then they have a vaginal birth and they're like I actually didn't really like that either. So you know, they don't have to just always be separate. You can be really happy and really be upset at the same time. It's okay to have those feelings, right? I have had things in my life where I've done something and I'm like dang. I really like how it turned out, but I hated the journey to getting there. And that's okay. So I love that you pointed that out. Rachel: Yes. or if you think about how you feel on your children's birthdays. So like I have very different feelings on my daughter's birthdays then my son's birthday. I had a good birth with my son. And it was good not because it was a VBAC, but because I was respected and I felt safe. That's what made that a good birth. Right? Just to be totally clear. I'm really glad I had a VBAC, I'm happy I got what

If you want to gain referrals from doctors working with your demographic whether for HRT or using a GLP-1 drug, learn how to show what you do. It's not your certifications or your website. It's the art of communicating what you do and how you do it by demonstrating or by testimonials that will win you referrals.   My Guest: Emily Sadri is a Board Certified Women's Health Nurse Practitioner, Certified Nurse Midwife, and the founder of Aurelia Health, a modern telemedicine practice for women over 35. Aurelia Health provides comprehensive hormone replacement therapy and weight loss support with long visits and un-rushed care. Emily is passionate about making complex hormonal topics accessible and believes that great health starts with happy hormones and a balanced stress response. Questions We Answer in this Episode:  How can you, within your scope of practice, support the female clients you're working with in midlife? [00:08:58] What is attractive about a health and fitness professional for a provider so that you can be that? [00:11:57] What coaches do you refer to? [00:13:24] What is Emily's tip for success in working with this demographic? [00:13:50]   There you have it. This is a blue ocean waiting for you. Few coaches and trainers do this outreach to the medical community well. This is not an email campaign. This is getting to know one doctor at a time and letting them know you and what you do. You heard it here! To gain referrals you also may want to consider referring clients to others.  Connect with Emily and The Perimenopause Revolution Summit: https://www.flippingfifty.com/revolution  On Social: Instagram: https://www.instagram.com/emilysadri_np/  Facebook: https://www.facebook.com/emilysadri.np.ohio  Resources:  Business Scorecard: https://www.fitnessmarketingmastery.com/scorecard  Flipping 50 Menopause Fitness Specialist: https://www.flippnigfifty.com/specialist  Other Episodes You Might Like:  Coaching Client Nutrition within Scope of Practice for Revenue & Impact: https://www.fitnessmarketingmastery.com/coaching-nutrition-clients/ Is There a Boundary Between Your Personal and Professional Self? https://www.fitnessmarketingmastery.com/boundary-personal-professional-self/ Tools to Get Clients to Stick With Their Exercise: https://www.fitnessmarketingmastery.com/clients-stick-with-their-exercise/  Optimizing Hormones Early in Perimenopause: https://www.flippingfifty.com/optimizing-hormones-early

My Guest: Emily Sadri is a Board Certified Women's Health Nurse Practitioner, Certified Nurse Midwife, and the founder of Aurelia Health, a modern telemedicine practice for women over 35. Aurelia Health provides comprehensive hormone replacement therapy and weight loss support with long visits and un-rushed care. Emily is passionate about making complex hormonal topics accessible and believes that great health starts with happy hormones and a balanced stress response. Questions We Answer in This Episode: Why do you think there still so much confusion about hormone replacement therapy and if it's "good" or "bad"[00:18:56] You suggest there are downsides to hormone testing… and I'm curious about why you'd say so? [00:22:50] I'm also shocked to find some believe testing is unnecessary with estrogen and progesterone replacement therapy, that seems like a big fat game of trial and error and any woman on HRT knows that getting your cocktail right already is a course-correcting journey as it is - say more about these people who are shooting darts in the dark.. Who does that? [00:24:29] First of all, what is balanced? How do you know when all of the major hormones are "balanced"? [00:27:52] Do you think every woman benefits from testosterone replacement therapy? [00:34:26] What additional factors do you focus on with your patients to help them be successful with HRT? [00:35:08] Few women were optimizing hormones early in perimenopause a decade ago. But the health outlook for those that do stands to be significantly better than for those women who experience drops then boost it again. Are you doing HRT in perimenopause? Or Did you? Connect with Emily and The Perimenopause Revolution Summit https://www.flippingfifty.com/revolution On Social: Instagram: https://www.instagram.com/emilysadri_np/ Facebook: https://www.facebook.com/emilysadri.np.ohio Other Episodes You Might Like: Can I Still Start Hormones 10 Years After Menopause? Doctors Respond: https://www.flippingfifty.com/start-hormones-10-years-after-menopause/ What Women Need to Know about Hormone Replacement Therapy: https://www.flippingfifty.com/what-to-know-about-hrt/ Hormone Testing Started It: What My GI Doctor Suggested I Do Next: https://www.flippingfifty.com/hormone-testing-started/ Resources: 5 Day Flip: https://www.flippingfifty.com/

I am so excited to welcome Emily Sadri to the show to talk all things perimenopause! She's a Board Certified Women's Health Nurse Practitioner, Certified Nurse Midwife, and hormone expert who's helped thousands of women through this journey.  Emily is amazing at breaking down complex topics and making them accessible, and we got into the weeds on weight loss, insomnia, and how and why the loss of estrogen affects us so deeply. If you want more info, join the summit for free! I'll be speaking there:  https://perimenopauserevolution.com/?orid=16 North American Menopause Society: https://www.menopause.org/ (referenced during the interview) Read the show notes for today's episode at terricole.com/653

In another transformative episode of Health Youniversity, we dive deep into the maternal health blueprint that every woman needs to support her journey through pregnancy, motherhood, and perimenopause. Our guest, Emily Sadri, a midwife and women's health advocate, shares her powerful story of navigating burnout while juggling motherhood and a demanding career. Emily also offers actionable strategies for sustaining long-term health and well-being. Whether you're planning for pregnancy or looking ahead to perimenopause, this episode will inspire you to prioritize self-care and create a wellness plan that evolves with you.Emily Sadri is the founder of an innovative hormone Telehealth practice, Aurelia Women's Health, whose mission is to help women repair their hormones and lose weight with confidence and ease (and without dieting).Emily is a Board Certified Women's Health Nurse Practitioner, Certified Nurse Midwife and hormone expert who has helped thousands of women understand the complex transition from reproductive yeas to and through perimenopause, and regain their sanity, clarity and zest for life.Emily has a gift for making complex hormonal topics accessible and actionable, and she believes that great health starts with happy hormones and a balanced stress response.Website: http://emilysadri.com/  Register now for “The Perimenopause Revolution Summit – Discover the Path to Thriving Midlife” October 17-20, 2024, hosted by Emily Sadri. https://perimenopauserevolution.com/?orid=25 Visit Emily's new site, Aurelia Health, comes online on October 15th: http://aureliawomenshealth.com/   

message me: what did you take away from this episode? Ep 83 (http://ibit.ly/Re5V) Mimi Niles on Transforming Midwifery and Advocating for Women's Health in New York City@PhDMidwives #research #midwifery @nyuniversity #publichealth @nyumeyers @BirthPlaceLab @NACPM Research link - http://ibit.ly/dJvtOhttps://www.deviwomen.com/bioHow does one woman's journey from rural Gujarat to the bustling streets of New York City shape her into a beacon of hope for women's health? Join us as Mimi Niles, an inspiring midwife and assistant professor at NYU, shares her extraordinary story. From witnessing her mother's midwifery practice in the challenging conditions of rural India to her own transformative experiences in the U.S. healthcare system, Mimi opens up about the cultural dynamics, social inequities, and personal encounters that kindled her passion for midwifery and justice. Her reflections offer a unique lens on how deeply personal experiences can drive a lifelong commitment to serving marginalized communities.Ever wondered about the diverse paths to becoming a midwife in the United States? Mimi recounts her own journey, starting as a community health nurse in New York City, to earning her Certified Nurse Midwife credentials while balancing work, study, and family life. Hear about her pivotal time at a busy public hospital in Brooklyn, where she honed her clinical skills and deepened her understanding of underserved populations. This episode also explores the various certification routes for midwifery in the U.S., emphasizing the critical role that varied experiences play in shaping a well-rounded midwifery practice.Discover the transformative power of higher education and advocacy in midwifery. Mimi narrates her academic pursuits, from tackling the burnout of public health work to embracing a systems-thinking approach through her Master's in Public Health and PhD studies. We dive into her research on the evolution of midwifery, the importance of addressing systemic inequalities, and the impact of implementation science on advancing midwifery practice. Mimis' journey is a testament to the resilience and dedication required to push the boundaries of women's health and social justice. Tune in to be inspired by her unwavering commitment and innovative vision for the future of midwifery. Support the showDo you know someone who should tell their story?email me - thruthepodcast@gmail.comThe aim is for this to be a fortnightly podcast with extra episodes thrown inThis podcast can be found on various socials as @thruthepinardd and our website -https://thruthepinardpodcast.buzzsprout.com/ or ibit.ly/Re5V

Send us a textIn this episode, Cara and Missi are joined by Dr. Krsyta Ramirez Henry, a Certified Nurse-Midwife that works in a recently developed OB emergency department at a high-volume community hospital. Krysta and Missi compare and contrast the various triage presentations, protocols, and interprofessional communication that takes place in a busy triage unit. #MidwifeLife #ScopeOfPractice #InterprofessionalCare #PatientTeaching #EveryWomanDeservesAMidwife #TeamBasedCare

What are IBCLCs Afraid of? Episode 364 In this conversation, Lisa Paladino discusses her experiences, as an IBCLC and Certified Nurse Midwife, with 35 years of experience, and the fears that come with this career.. She talks about the responsibility of not missing any medical problems or lactation issues, the fear of not being trusted or taken seriously, and the concern of giving care plans that may not work for families. Lisa emphasizes the importance of developing a rapport with the families and providing education and resources to build trust. She also shares a case study of a baby with a tongue tie to illustrate the decision-making process and the art and science of being an IBCLC.Takeaways: Being an IBCLC is a high-pressure job with a lot of responsibility.IBCLCs fear missing medical problems or lactation issues and not being trusted or taken seriously.Developing a rapport with families and providing education and resources is crucial for building trust.Care plans should be tailored to the individual needs and capabilities of the families.The decision-making process as an IBCLC involves a combination of science and art.More From Tongue Tie Experts:To learn more, download freebies, and for the links mentioned in the episode, including our popular course, Understanding Milk Supply for Medical and Birth Professionals, click here: www.tonguetieexperts.net/LinksUse code PODCAST15 for 15% off all of our offerings.A gentle disclaimer. Please do not consider anything discussed on this podcast, by myself or any guest of the podcast, to be medical advice. The information is provided for educational purposes only and does not take the place of your own medical or lactation provider.

Expectant mothers have many decisions to make before they welcome a baby, like who will provide her prenatal care and where will she labor and deliver her baby. In this episode of Utah Weekly Forum, FM100.3 Host Rebecca Cressman is joined by Elaine Thompson - Certified Nurse Midwife and Family Nurse Practitioner at Intermountain Health Sanpete Valley. As a skilled provider in obstetrics and midwifery, Thompson shares the benefits of community hospitals where mothers can choose Certified Nurse Wives or OB-GYNs for pregnancy care and opt for low-intervention childbirths in smaller settings, closer to home, and with the safety net of advanced expertise and higher-level care if needed. Learn more about Pregnancy and Baby care options on Intermountainhealthcare.org.

In this episode of Health Youniversity, we are joined by Dr. Paul Quinn, a distinguished professor, author, and midwife with 30 years of experience. Dr. Paul discusses his latest book, Prenatal Possibilities, a unique cookbook designed for women and families during pregnancy and beyond. This book not only focuses on nutritious recipes but also emphasizes the importance of aligning the mind and body during pregnancy. With a deep-rooted connection to his New York upbringing and Italian heritage, Dr. Paul offers a refreshing perspective on prenatal nutrition. Tune in as we explore the misconceptions around prenatal care, the significance of holistic health practices, and how Dr. Paul's extensive clinical experience has shaped his approach to supporting pregnant women.Paul Quinn, PhD, CNM has been a nurse for close to three decades and a Certified Nurse Midwife (CNM) for almost two decades. Dr. Quinn has worked in the most diverse settings and had the privilege to meet, care for, and interact with the most dynamic, interesting, and insightful women. Possessing a PhD in nursing, he is a scientist at heart with a passion for putting research into action in ways that improve people's lives.More about Dr. Quinn PhD, CNMWebsite:  https://prenatalpossibilities.com/author/prenatalpossibilities/Certified Nurse Midwife for almost three decades Longtime employee at The Valley Hospital in Ridgewood, New JerseyProfessor in obstetrical nursing and nursing research at Dominican University New YorkAuthor of five books, all found HERE on Amazon 

When it comes to new parenthood and the care of moms and babies, Providence is “all in”. All Mothers. All Parents. All Births. All Babies. Our goal is compassionate and individualized care for all families, and we know that part of most pregnancy and postpartum journeys is breastfeeding and all that entails. We want to give you the information and advice you need when it comes to taking care of you and your baby during this special time.Host, Valerie Cordes, speaks with Maureen Andersen, Certified Nurse Midwife, Doctor of Nursing Practice and Master of Science in Teaching and Internationally Certified Lactation Consultant, and they explore the value of breastfeeding for you and your infant, how it affects your mental health, self-care and the importance of personalized support. So, let's navigate this together, one tiny step and one soothing lullaby at a time.    For more information and resources:Providence Women's Clinic-East PortlandMother and Baby Clinic-Providence Portland Medical CenterMother and Baby Clinic-Providence Willamette FallsMother and Baby Clinic-Providence St. Vincent Medical CenterProvidence Women's Health ServicesOther podcast episodes on this topic: Feeding body and soul | Hear Me Now Stories

Carrie Levine is a certified functional medicine practitioner, author, and owner of Whole Woman Health. A Certified Nurse Midwife, Carrie honed her skills in multiple Southern Maine locations, including Maine Medical Center in Portland, Miles Memorial Hospital in Damariscotta, and Women to Women in Yarmouth. She founded Whole Woman Health in 2014. Carrie's insights from her years on the labor and delivery floor translated seamlessly into a holistic approach to well-being. She emphasizes the importance of listening to women and encouraging them to trust their own bodies. Carrie's book, "Whole Woman Health: A Guide to Creating Wellness for Any Age and Stage," artfully integrates a brave acknowledgement of shared humanity with decades of experience. Join our conversation with Carrie Levine today on Radio Maine.

There is a lot that impacts how we experience the second half of our life. There is an incredible spiritual and emotional component that is often overlooked. Certified Nurse Midwife and author, Susan Willson, shares her wisdom with us and gives us a brilliant perspective on making the second half of our lives our best yet. You can find Susan and her book- Making The Most Of Menopause, hereYou can find Janel online at Mountain Rebalance or on instagram at @mountain.rebalance.janelThis podcast is for midlife women who wants to understand their body better and improve how they function and age. This podcast was inspired by time on the trails with other health expert friends and family, discussing, debating, and ultimately working through loads of health topics that impact our day to day wellness and performance. Janel is a board certified nutrition consultant, a certified functional nutrition and lifestyle practitioner, a doctor of natural medicine, and a lover of the wild. Janel is passionate about helping people understand their body better so they can improve how they function. Thinking functionally invites us to see how all the body systems are all connected, that each person is unique, and that all the things we do in our life impact health or dis-ease (and everything in between). Thinking functionally means we are always asking WHY. Work with me one on one or in my group or independent study programsSee podcast episodes on YouTube

Send us a Text Message.Welcome to our first breastfeeding-only Q&A with Trisha & Cynthia. Trisha is a Certified Nurse-Midwife and International Board Certified Lactation Consultant with thousands of hours of clinical experience. Today's episode follows the format of our regular monthly Q&A episodes, where women call in with questions and we wrap up with Quickies at the end, but this time it's your breastfeeding questions only. Today Trisha answers questions such as: Can I introduce a pacifier to my exclusively breastfed baby at two and a half weeks?Is it a nursing strike or weaning: Help! My eleven-month-old is refusing my breast. What is the best way to manage pumping for my exclusively breastfed baby when I am away?How and when do I introduce a bottle to my exclusively breastfed baby so that I can leave him/her with a caregiver?What are your thoughts on using the medication Domperidone with a diagnosis of Insufficient Glandular Tissue (IGT)?In our round of Quickies, we touch on leaking, supplements for increasing supply, prenatal hand expression of colostrum, alcohol and breastmilk, breast refusal, lip blisters, breast fullness and milk supply, and flat nipples.Please remember, that every mother and baby dyad is unique, and breastfeeding issues require an individualized care plan. Online appointments are available with Trisha by texting 734-649-6294.**********Down to Birth is sponsored by:Vitality: An athleisure brand made for women, by women, designed with style and comfort for pregnancy and beyond.Davin & Adley-- The perfect nursing and pumping bra combinedSilverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products to nourish yourself before, during, and after pregnancy.DrinkLMNT -- Purchase LMNT with this unique link and receive a free 8-day supply. Be sure to use the unique link to buy yours today.Use promo code: DOWNTOBIRTH for all of the above sponsors.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWNWork with Cynthia: 203-952-7299 HypnoBirthingCT.comWork with Trisha: 734-649-6294Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Have you ever wondered, “Why am I wanting a homembirth so bad when everyone else seems fine going into the hospital?” Maybe you're getting some flack from your family and friends about your decision to stay home and you need a confidence boost. Well today's episode was a powerful interview with Lori Morris a Certified Nurse Midwife. She has seen it all and in today's episode she is going to share the top 4 things that is wrong about the hospital system, especially when it comes to birth.   1. Rigidity 2. Routine 3. Real Damage 4. Not Responsible     Connect with Lori: go.yourbirthgodsway.com lori@yourbirthgodsway.com   Join the Homebirth Hub- Last Day to Join April 18th! - https://buy.stripe.com/9AQ7sWa257ZB2Ig6oL   Website: peacefulhomebirth.com    Join our community- Facebook.com/groups/peacefulhomebirth

April is Sisters in Loss Infertility Awareness Month!  All month long we will be highlighting infertility stories and journey's.   Black Maternal Health week was April 11-17 and Infertility Awareness Week is April 18-24.  This week we are talking about reproductive health. Did you know that some midwives specialize in high risk births and pregnancy after loss or infertility?  Today's guest is a Certified Nurse Midwife and founder of Sakina Health who partners with birthing families to inspire them to become savvy birthers.  After spending nearly two decades as a midwife with nearly 1000 births in the hospital, birth center, and home, Takiya Ballard knows what it truly means to offer a unique type of healthcare that is unbiased and respectful in every way.  In this episode we deep dive into the State of Black Maternal Health, we discuss the differences between midwifery and doulas, her podcast The Savvy Black Birther, and creating the right birth team for us as black women. This episode is for you to listen to if you want to learn how to create the right birth team for you, the differences of midwifery and doulas, and how you can take control of your reproductive health. Become a Sisters in Loss Birth Bereavement, and Postpartum Doula Here Living Water Doula Services Book Recommendations and Links Below You can shop my Amazon Store for the Book Recommendations You can follow Sisters in Loss on Social Join our Black Moms in Loss Online Weekly Grief Support Group Join the Sisters in Loss Online Community Sisters in Loss TV Youtube Channel Sisters in Loss Instagram Sisters in Loss Facebook Sisters in Loss Twitter You can follow Erica on Social Erica's Website Erica's Instagram Erica's Facebook Erica's Twitter

Kathleen Vandegiessen has been a Certified Nurse Midwife for nearly three decades, indicating her expertise in providing healthcare and support to pregnant women during pregnancy, childbirth, and the postpartum period. · Masters in Nursing 1995: Obtaining a Master’s degree in … Continue reading →

On this episode of the Mindful Womb Podcast, we are joined by Kiara Fair, an Certified Nurse Midwife who specializes in homebirth. Kiara brings an amazing perspective with her expereince as a labor and delivery nurse turned doula turned midwife. In this episode, we dive into the following:The difference between working with a midwife vs an OBAn overview of the different kinds of midwivesWhat questions to ask a midwife to find a good fitThe benefits and safety of homebirth Advocacy during pregnancy and laborNutrition and movement tips for pregnancyDon't forget to check out the blog postYou can find more about Kiara and her work at: www.fairmidwifery.com/   Connect with Kiara on IG @midwifekiaraResources mentioned:>>  FREE Birth Plan Template>>  FREE Clear Your Birth Fears Guide>>  A Path to A Powerful Birth Class***If these topics light you up, please rate and review the show on Apple Podcasts, Spotify, or wherever you're listening.After you review the show - snap a pic and upload it here - and I'll send you a little surprise as a thank you.Your feedback helps this podcast grow, and I am so grateful for your support!Disclaimer: The information provided in this podcast is for educational and informational purposes only. Consult with a qualified healthcare professional for personalized advice.

My guest today is Paul Quinn PhD, CNM  at The Valley Hospital in Ridgewood, New Jersey, 5x author, and Professor in Obstetrical Nursing & Nursing Research at Dominican University New York. Dr. Quinn is one of the only US male midwives / a Certified Nurse Midwife for almost three decades. His new book, Pregnant Possibilities, is a blueprint for women and their families during pregnancy. Resources/References Paul's website Prenatal Possibilities- HERE Facebook - HERE Instagram - HERE LinkedIn - HERE Episode 49: If you marry a midwife, does that make you a midhusband? Episode 19: What do frogs and rabbits have to do with birth in 1978? Two birth stories for the price of one with Robin Bradley, CNM Bly, K. C., Ellis, S. A., Ritter, R. J., & Kantrowitz-Gordon, I. (2020). A survey of midwives' attitudes towards men in midwifery. Journal of midwifery & women's health, 65(2), 199–207. https://doi.org/10.1111/jmwh.13060 Shout outs by Paul throughout this episode: Kathy Yuhas-Arflak Charlotte “Pixie” Elsberry, who passed away last year Lily Shah  Jeanne Murphy Stone Two others he would like to recognize but didn't mention Laura Hollywood (forgot her but you may know her from Nyack) Nila Cilmi (forgot her but she was amazing) Universities with midwifery programs mentioned in this episode Columbia University SUNY Stony Brook SUNY Downstate - You do not have to be a nurse to attend this program - there are other programs in the US that also offer this pathway including distance education options.  Comprehensive list of programs in the US (and additional info for aspiring midwives) Professional midwifery organizations mentioned in this episode American College of Nurse-Midwives (ACNM) American Midwifery Certification Board (AMCB) Mother Wit General Resources ⁠⁠⁠Thriving After Birth⁠⁠⁠⁠⁠⁠⁠ (an online course) ⁠⁠⁠⁠⁠Comprehensive Care⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠60 Min Consultation⁠⁠⁠⁠⁠⁠⁠: Use discount code- FirstConsult10%off Instagram: @mother.wit.maternity ⁠⁠⁠Exercise in the perinatal period: For healthcare providers⁠⁠⁠⁠⁠⁠⁠ (an online course) ⁠⁠⁠Support the show⁠⁠⁠

This episode is sponsored by HCA Midwest Health. One of the first of many decisions you'll have to make once you find out you're having a baby is choosing a healthcare practitioner. Some women choose an obstetrician, while others opt for a midwife. Today we are chatting with Kim Boote, a Certified Nurse Midwife with Kansas City Women's Clinic, part of HCA Midwest Health, to learn about the benefits of choosing a midwife. Meet Kim Boote Kim Boote, CNM, MSN, C-EFM is a Certified Nurse Midwife with Kansas City Women's Clinic seeing patients in Kansas City, Olathe, and Lansing, KS. She is affiliated with Overland Park Regional Medical Center. Kim is a member of the American College of Nurse-Midwives (ACNM), the American College of Obstetricians and Gynecologists (ACOG), and the American Society for Colposcopy and Cervical Pathology (ASCCP). She received her Bachelor of Science in Nursing (BSN) from the University of Iowa, her Master of Science in Nursing (MSN) from Case Western Reserve University, and her Nurse-Midwifery certificate from Frontier Nursing University. Kim and her family enjoy vacationing in warm climates where they can hike, snorkel, or just enjoy the ocean. She loves learning where all her patients have traveled to update her bucket list for new destinations. Kim has four kids that keep her busy! Connect with Megan and Sarah We would love to hear from you! Send us an e-mail or find us on Instagram or Facebook!        

Join me this week for a discussion with Certified Nurse Midwife, Davin Johnson! Davin and I discuss the role of the professional CNM and all that entails.

This episode features the delightful Jen Guthrie, a certified nurse midwife. We are discussing what a hospital birth looks like and debunking some myths. Abacela Winery

adrienne welcomes Queer, non-binary, gender expansive, Two-Spirit human, Sara Flores to Witch School. They get into hot springs, presence-ing, “where intention flows energy goes”, mother's backyard garden, picking red berries, making magic potions, being in a safe imaginary land, sacred kink, PLEASURE, surviving target violence, midwifery, the word “midwife”, unearthing what's behind all of this, witch hunts on Turtle Island, children feeling magic, accessing your own divinity instead of someone else's, the secret mission of this whole season being that we all have it, being specific, the plant you need is always nearest to you, yarro, spider medicine, not wanting to knock down wasp nests and safeguarding our attention! Sara Flores (they/them) is a midwife who strives to forward the legacy of those who protected and passed on Indigenous Sacred Technology and who see health and bodily autonomy as key aspects of individual and collective liberation. They are a Registered Nurse, Certified Nurse Midwife, and Reproductive Justice Health Nurse Practitioner by way of the cis-heteronormative, racist education model that they are determined to disrupt. Sara has experienced joy and community accountability as co-author of “Freeing Ourselves: A Guide to Health and Self Love for Brown Bois”, being a founding member of the Healing Clinic Collective which provides free traditional healing clinics throughout Occupied Huichin(Bay Area California), and being a member of The Intergalactic Council of Midwives, a council that enhances the spiritual fortitude of midwives.  --- ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SUPPORT OUR SHOW! - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.patreon.com/Endoftheworldshow --- ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TRANSCRIPT⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ --- Music by Tunde Olaniran, Mother Cyborg and The Bengsons --- HTS ESSENTIALS ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SUPPORT Our Show on Patreon⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.patreon.com/Endoftheworldshow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠PEEP us on IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/endoftheworldpc/⁠⁠⁠⁠⁠⁠⁠⁠ --- Send in a voice message: https://podcasters.spotify.com/pod/show/how-to-survive-the-end-of-the-world/message

In this week's episode, I am interviewing Andrea Phillips, ARNP, CNM, NMCP, a Nurse Practitioner and Certified Nurse-Midwife who specializes in reproductive and women's health and gender affirming care with a focus in sexual health and dysfunction. Andrea is the CEO and Founder of Spectrum Reproductive Health and Gender Affirming Care which she founded on Maternity Leave in November 2022. Spectrum is located in Bellingham, WA and provides in person care and telehealth services for WA residents. She prides herself on providing sex and body affirming care through a feminist, trauma informed lens and has sought additional education through the International Society for the Study of Women's Sexual Health (ISSWSH), North American Menopause Society (NAMS) and is a Menopause Certified Provider , World Professional Association for Transgender Health (WPATH) and the The Fenway Institute and she is proud to be a Health at Every Size (HAES) provider. She credits entrepreneurship for establishing her freedom and sanity, and is always happy to tell other providers- they can do it! In this episode, tune in to learn.. Why a traditional role didn't fit how she wanted to provide care How she built her private practice while on maternity leave The best advice she has for other NPs who want to start a practice Contact Information for Andrea: Website: https://www.spectrumreproductivehealth.com/ Instagram: @spectrumreproductivehealth Ready to build a successful private practice? Get the FREE training and Private Practice Startup Checklist here. More at www.nurseslivingthegoodlife.com

In this episode, Gina sits down with Heather Helton, a certified nurse midwife in North Carolina.  Heather uses social media to educate patients on pre-conception, conception, pregnancy, and more, as everyone deserves the same access to care and education to make informed decisions on their own experiences.  She shares how you can optimize your time with your OB provider, especially if you have limited time at your appointments with them, and how you can use other resources to provide you the general information about pregnancy and birth.  Heather shares how you can weed through misinformation on social media (and also how to figure out if your provider is not the best option for you).   In This Episode:  00:00 Introduction to the MamasteFit Podcast 02:00 Meet the Midwife, Heather 02:28 Heather's Journey and Philosophy as a Midwife 03:06 The Importance of Individualized Birth Experiences 04:00 Challenges in Clinical and Hospital Settings 05:01 The Importance of Birth Education and Advocacy 06:54 The Role of Doulas in Birth 07:59 The Collective Team in Pregnancy, Labor, and Birth 09:06 The Importance of Birth Location and Provider Choice 17:23 The Role of Social Media in Birth Education 19:39 The Importance of Evidence-Based Information 26:16 The Role of Research in Birth Preparation 36:01 Advice for Birth Professionals Using Social Media 42:41 Conclusion and Resources —— Heather's Links:  Find Heather's Practice Here: https://tp4w.com/heather-helton Heather Helton, CNM, MSN, began working in obstetrics in 2001.  As a Certified Nurse Midwife, Heather enjoys working in Triangle Physicians for Women's positive, collaborative and open-minded clinic environment. Originally from Iowa, Heather earned her Bachelors of Science in Nursing at the University of Wisconsin and has practiced at hospitals in Iowa and Illinois before coming east to North Carolina.  As a top graduate from East Carolina University's Masters in Nurse Midwifery program, Heather provides full-scope midwifery care to low and moderately high-risk women. She is a member of Sigma Theta Tau and Golden Key honor societies and was a member of Alpha Phi Omega service organization. Her professional interests include non-pharmacological therapies, deep-relaxation labor techniques, postpartum depression, and teen pregnancy. When not caring for women, Heather enjoys time at the beach, crafts, coaching her daughter's softball team, and spending time with her husband and two active children. Email Heather Here: heather@amodernmidwife.com  Find Heather on Instagram Here:  https://www.instagram.com/amodernmidwife/?hl=en Or her educational content being created during her doctorate program here: https://www.instagram.com/amodernmidwifemama/ ----- This podcast is sponsored by Needed, a nutrition company focused on optimal nourishment for your perinatal journey. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Use code MAMASTEPOD for 20% off your first order or three months of subscription.⁠ ⁠⁠⁠⁠⁠⁠⁠⁠ 

Megan Frank, who is a very recent graduate and a SOON to be Certified Nurse Midwife shares her very tumultuous journey as a midwife student. I encourage ANY one looking into midwifery to listen to this episode to understand the realities of what happens during the graduate program. Megan is happy to be done and excited to start working as a CNM, but it was a hard road for her to get there. Thank you to Megan for sharing her VERY real story

Born and raised in Chicago, IL, Dr. Leslie Sanchez, with roots in Puerto Rican and Mexican heritage, holds a Bachelor's, Master's, and Doctorate Degree in Nursing from the University of Illinois at Chicago. Her original plan was a degree in Business and Ecommerce and found her calling as a Certified Nurse Midwife. Boasting over seventeen years of expertise in Obstetrical & Women's Health, she has served as a Certified Nurse Midwife, guiding countless patients through their health and childbirth journeys. Dr. Sanchez is certified in a spectrum of specialties, including Electronic Fetal Monitoring, Inpatient OB Nursing, Maternal Newborn Nursing, Obstetric & Neonatal Quality and Safety, CPR, ACLS, and more. Her nursing practitioner license includes Full Practice Authority in Illinois. With a decade-long track record in both large institutions and private practices, Dr. Sanchez is passionate about continuous learning, frequently attending professional conferences to stay updated on current literature and evidence-based practices. Beyond clinical work, she is dedicated to education, serving as Adjunct Faculty at three prominent nursing programs in the United States, where she imparts her knowledge to Masters and Doctoral Students. Dr. Sanchez's mission extends beyond individual achievements. She aspires to champion diversity and inclusion in higher education, particularly among underrepresented and underserved students. Beyond narrowing the gap between minority and majority students and enhancing student scholarly achievement and retention rates, her focus is on improving the retention and success of underrepresented faculty. Her overarching goal is to shatter the glass ceiling, firmly believing that Representation Matters in Education, with the future of our children depending on it. Research shows midwives help improve outcomes for both parent and child.  Dr Leslie recently was featured in Wbez Chicago Environment and Public Health article advocating for midwifery practices and programs in IL.        

PODCAST EPISODE - REBEKAH WHEELER - TRAUMA HEALING #98 Join your host Sophia as she interviews Rebekah Wheeler, CNM working in the hospital based setting. They discuss the difference in care between hospital and home birth, how hospitals can be slow to change outdated policies, evidence based verse experience based informed consent, perinatal mental health, sanctuary trauma, uterine massage, birth control, and transport from home to hospital. Rebekah Wheeler is a Certified Nurse-Midwife, an educator, and an expert in birth trauma prevention and treatment. She has worked as a birth professional for almost 20 years, during which she has learned a lot about what helps support people to feel pride and a sense of accomplishment after giving birth, no matter how labor goes. She became a Perinatal Mental Health and Birth Trauma expert after seeing how little support there is out there to help people heal from difficult birth experiences. She offers birth trauma healing sessions virtually to clients anywhere, and in-person in the Bay area. Connect with Rebekah: •Website: http://birth-trauma-healing.com/ Listen here: IG: linktree in bio FB: https://anchor.fm/bornwild/episodes/Bekah-Wheeler---Trauma-Healing-e2c6kjo @sophiabirth @bayareahomebirth @bornwildmidwifery Stay Wild

In this week's podcast episode, Hallie reconnects with Lisa Paladino, a Lactation Consultant (IBCLC) and Certified Nurse Midwife, with over 30 years of experience helping new families to breastfeed. She is also an author, lecturer and advocate for tongue tie education, and women's health issues. Join them as they talk about the importance of considering mom's (or parents') well-being when preparing for a newborn's tongue-tie release procedure, the challenges faced by new parents, birth trauma, the intense pressure to do everything right, and the overwhelming amount of information available on social media.Their conversation also tackles the issues of over-diagnosing and under-diagnosing tongue tie in babies, offering valuable insights into how to prepare for a tongue-tie procedure and much more.If this episode has resonated with you in some way, take a screenshot of you listening, post it to your Instagram Stories, and tag Hallie @halliebulkin and Lisa @tonguetieexpertsFor more episodes visit www.untetheredpodcast.com Hosted on Acast. See acast.com/privacy for more information.

Midwifery is an important and integral part of the health care system. It involves understanding and caring for pregnant women and their families before, during, and after childbirth. Learn more about the type of care midwives provide from Liz Potter, a Certified Nurse Midwife at Enloe Health on the newest episode of Health Matters. 

In this episode, we explore the powerful practice of mindfulness and its transformative impact on the labor and delivery process. Join us as we delve into techniques that can help expectant mothers and their partners cultivate a sense of calm, presence, and resilience during this monumental life event.We'll be hearing from experienced mindfulness expert and Certified Nurse Midwife, Jen Moffitt. Discover how mindful breathing, visualization, and body awareness can alleviate pain, reduce anxiety, and foster a deeper connection between partners.Our guests shares practical tips, offering listeners invaluable insights on how to approach labor with a calm and centered mind. Whether you're a first-time parent or experienced in childbirth, this episode offers a fresh perspective on how mindfulness can transform your birthing experience.Tune in for an empowering conversation that will leave you feeling prepared, supported, and inspired to embark on this incredible journey with mindfulness as your trusted companion. Remember, you have the strength within you, and mindfulness is the key to unlocking it.https://www.mindfulbirthing.org/abouthttps://www.mindfulbirthing.org/resourceshttps://growmidwives.com/nobody-told-me-that-audio-files/- what is mindfullness?- mindfullness during labor- how to practice mindfulness while pregnant- mindfulness while pregnant- prenatal yoga- prenatal mindfulness- postpartum mindfulness- labor and delivery- what helps during labor and delivery- what do I need to know about labor and delivery?- how to prepare for labor and delivery?- how can my partner help me during labor and delivery?- how can my husband help me during labor and delivery?- labor and delivery support- labor and delivery preparedness - how do I prepare for labor and delivery?- preparing for labor and deliverywww.mamawearsathleisure.comIG: @mamawearsathleisureYouTube: @mamawearsathleisuremamawearsathleisure@gmail.comInterested in being a guest? Shoot us an email!- best parenting podcast- best new mom podcast- best podcasts for new moms- best pregnancy podcast- best podcast for expecting moms- best podcast for moms- best podcast for postpartum- best prenatal podcast- best postnatal podcast- best podcast for postnatal moms- best podcast for pregnancy moms

Esther McCant, founder and CEO of Metro Mommy Agency, opened up about her five pregnancies, which included a miscarriage that would push her to self-advocate with her medical provider.Esther's first pregnancy happened within the first few months of her marriage. Six weeks later, she learned that she had a blighted ovum and her provider prepared her to miscarry. She had the choice to let the ovum pass or go to the hospital for a DNC. She stayed home as long as she could but eventually went to the hospital. Esther recalled the doctor taking quite a while to see her, and when she did she insisted that Esther still needed a DNC even though everything had passed. She felt threatened by the doctor about the potential that she could bleed out. This interaction helped Esther to trust herself. She chose to leave and go home. The grieving process started; she became pregnant again within a few months. The hospital miscarriage experience led her to want to explore other birthing options. Her sister-in-law invited her to  her calming water birth; which helped her see a new vision. Esther found a midwife who resonated with her and a doula who could support her choices. The midwife was able to support her in a birthing center.Walking around the neighborhood of the birthing center helped move her labor along. Their family started to arrive and became overwhelmed. The midwife asked some of the family members to leave to clear the space. Her mother stayed and it was after the birth and looking at pictures from her doula that she was able to see the relationship she had with her mother in a different light. Her mother, who had only given birth surgically,  had an opportunity to bring healing for herself as she fed Esther and cared for her during her labor. Baby would arrive with a nuchal hand and in the OP position by squatting.The third pregnancy brought on changes that would impact her nutrition, wellness, and the birthing environment she desired; which included a water birth.  Feminine energy filled the birthing space by inviting her sisters-in-law. Her son's birth was challenging as she had back labor. She regrets not getting chiropractic care and having a doula this time. Postpartum was filled with engaging with other women as opposed to the more isolating experience she had after her first birth.They had moved from Florida to Alabama, and the difference in provider options was vastly different. In Florida, Esther could have a Certified Professional Midwife, a Certified Nurse Midwife, or a Licensed Midwife deliver her baby. Unfortunately, Alabama did not have those options at the time in 2014. Alabama has terrible birth outcomes and race relations. She could only deliver with a midwife if an obstetrician was present during the labor and delivery.  Esther felt low during the pregnancy because they were living with her parents and living paycheck to paycheck. Esther decided to leave the state when she was ready to give birth. She provided much of her prenatal care until she found a midwife in Tennessee. Her midwife helped her be more proactive about her health and nutrition; including lowering toxins in their environment and skin care. Postpartum preparation was top of mind as she would be traveling to give birth.When Esther thought she was in labor they made the two-and-a-half-hour trek to Chattanooga to no avail as the baby was not ready. They turned the trip into a babymoon and would make the trip again a couple of days later. Esther and her husband brought the kids along to meet up with her family who would care for them. They didn't make it there on time due to a flat tire problem. Esther gave birth within 6 hours of leaving their home and although she felt distracted by having the other children there and wondering where her family was. Esther's Haitian roots welcomed the Haitian bath, teas, and essential oils, and started the restoration process with her mother coming to support her.When Esther had her fourth son, she was a trained birth doula. She envisioned a waterbirth with her partner,  two midwives, and two doulas present. The birth and pregnancy were heavy in dealing with the ongoing race issues in our country and the experiences of Black men and boys. Giving herself space to release those feelings during long labor allowed her to relax in her body and give birth smoothly. Her vision would come true as she delivered her son in a haze of joy.Adding value to herself and the clients she serves now catapulted Esther to take a deep and intentional dive into more doula training and become a Certified Lactation Counselor. Additionally, she serves other doulas in the country as a mentor in birth work and business. Resources: Metro Mommy Agency | serving women with support and education to navigate through their journey into motherhood

Sarah Waldron is a Women's Health Nurse Practitioner and a Certified Nurse Midwife who started out in High School volunteering in L&D, was pulled into a room to watch a birth and was hooked! After becoming a nurse, her path to midwifery was not linear. Along the way, she worked in Med-Surg and pediatric emergency care but her experience in these different areas of nursing has been invaluable in her work as a midwife.  After many successful home births, Sarah opened her own practice: Wildflower Birth and Wellness. She addressed my safety fears head-on. As a NICU nurse, I was initially skeptical about home birthing, but Sarah's matter-of-fact approach, passionate confidence, and ability to up-triage when necessary took the fear out of the process. And then there's the topic of breastfeeding (Sarah was actually breastfeeding her newborn during the interview) YAY! Her patients meet with an IBCLC before giving birth to ensure they have all the information and support they need.  I appreciate Sarah's comprehensive and holistic approach to patient care. Her dedication to her patients is clear, and her passion for her work shines through. In the five-minute snippet: are these clothes multiplying? For Sarah's bio, go to my website (link below).Sarah's website: Wildflower Birth & WellnessOther great links:12 books to read on midwiferyCalifornia Nurse-Midwives AssociationAmerican College of Nurse Midwives     Association of Women's Health, Obstetric and Neonatal (AWHONN) College of Obstetrics and Gynecology (ACOG)Postpartum Support InternationalThe International Confederation of MidwivesBreastfeeding Report CardContact The Conversing Nurse podcastInstagram: https://www.instagram.com/theconversingnursepodcast/Website: https://theconversingnursepodcast.comGive me feedback! Leave me a review! https://theconversingnursepodcast.com/leave-me-a-reviewWould you like to be a guest on my podcast? Pitch me! https://theconversingnursepodcast.com/intake-formCheck out my guests' book recommendations! https://bookshop.org/shop/theconversingnursepodcast Email: theconversingnursepodcast@gmail.comThank you and I'll see you soon!

Shaina French is a Certified Nurse Midwife. She joins us on SPFPP this episode to talk about a Team approach to health care. We discuss time restrictions and workload providers have to navigate in order to meet the requirements necessary to be able to take insurance, and what we're paying for in order to get that extra time and quality of care from those who opt out of taking insurance. Overall we discuss bias and stigma, and that communication and awareness are essential to the quality of care someone is receiving and able to give. Patients and providers both have needs and we discuss how social media CAN potentially meet those needs, even though simultaneously it could cause different challenges. We discuss the importance of a referral list and I inquire on bias vs identity compatibility which speaks to one's scope of practice. Talking about sex in the doctor's office presents a number of challenges that can be resolved by having practice talking about sex in the doctor's office, and that is one of the things your donations to SPFPP support. Connect with Shaina on Instagram at 1whiskeytangofoxtrot. Shaina (she/her) is a Certified Nurse Midwife and Sex Counselor with 16 years experience specializing in gynecological care and the care of pregnant/birthing people. In the last half of her career she has focused her skills on assisting her clients in addressing their sexual health concerns, such as navigating vulvar dermatological problems and in individual or partnership counseling sessions for low libido or lack of orgasm. She uses a biopsychosocial approach to tailor treatments to each individual in a shared decision making model of care. She is an Accredited Sexual Healthcare Provider ™ , Kink Affirming Practitioner ™ and Fellow in the International Society for the Study of Women's Sexual Health (IF). She currently is caring for birthing clients in hospital only, but coming this fall will be returning to in office sex medicine/gynecological and sex counseling care. Stay tuned to her Instagram for details @1WhiskeyTangoFoxtrot or contact her at shainafrenchwtf@gmail.com

We are so honored to have today's guest, Henci Goer, joining Meagan today. Henci has made it her life's work to help women make informed decisions about their care in the birth space. She has written multiple books, received countless awards, and has made current obstetric research more accessible to women worldwide. Henci defines uterine scar separation and talks about what factors may contribute to or help prevent this from happening. Meagan and Henci talk extensively about VBAC, VBA2C, birth plans, induction, and epidurals all using evidence-based research. We love that Henci's mission is to empower women and families to make the choices that are best for them. Here at The VBAC Link, our mission is the same!Additional LinksHenci's Blog: Is VBAC Safe?Henci's WebsiteLabor Pain: What's Your Best Strategy? By Henci GoerOptimal Care in Childbirth: The Case for a Physiologic ApproachNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsMeagan: Hello, hello. Welcome to The VBAC Link. This is Meagan and you guys, we have an amazing, amazing, amazing episode for you today. This episode has actually been kind of a long time coming. We have our friend, Henci Goer. She is just a wealth of knowledge. You're going to absolutely pick this episode apart. I know it. You're actually probably going to want a notebook so if you're one of the listeners that goes on walks or is driving, you might want to press pause or listen to it and come back with a notebook because I know you're going to want to write these stats down. We're talking about uterine scar giveaway, you guys. I know that this is something huge. All of our listeners, every single one of our listeners that has had a VBAC is aware of uterine scar separation so this is going to be a really great episode filled with wonderful evidence and all of the things for you. So buckle up. It's going to be amazing. Review of the WeekBut of course, we have a Review of the Week so I am going to quickly share that with you. This review today is actually on our How to VBAC: The Ultimate Parents Course. This is from Rosie. It says, “As someone who had an unplanned Cesarean myself and as a doula, I really appreciated how well-balanced this course is. There's no shaming. There's no bias. It's just the facts.”Thank you, Rosie. I'm so glad that you are enjoying the course or have enjoyed the course. And if you didn't know, we do have a How to VBAC Parents Course and a Doula Course for all of you birth workers out there who want to learn how to support your VBAC clients. We have this course. You can check it out at thevbaclink.com. Henci GoerMeagan: Okay, Ms. Henci. I am so honored to have you on the show today. I mean, really, it seems like we've been talking for months. I really think it was the beginning of the year, right? Henci: Something around there, yeah. Meagan: Yes. Oh my gosh, it's been so long. Just for anyone out there who wants to know a little bit more about Henci and why we are having her on the show today, she actually started out as a Lamaze teacher and a doula. Her life's work soon became analyzing and synthesizing obstetric research in order to give pregnant women, birthing people, and birth professionals access to what continues to be optimal care in childbirth. Just that right there, that little bit right there, I'm telling you guys, it really is her life's work. If you Google her name, you're going to find a ton of research. She's an author of four books. Four books, you guys. Labor Pain, What is Your Best Strategy?, Optimal Care in Childbirth: The Case for Physiological Approach with co-author Amy Ramana– is she on MSN and CNN or has been mentioned? Tell me about that. Henci: She's a nurse-midwife. That's Master of Nursing. Meagan: Oh, I was thinking CNM in my head. MSN, so what is that? Henci: It's a Master of something. I don't know what that degree is. She's a nurse-midwife. Meagan: She's a CNM. Certified Nurse-Midwife, yes. In my head, I read CNM. The Thinking Woman's Guide to a Better Birth and Obstetric Myths Versus Research Realities. You guys. In addition, she has written numerous blog posts, articles, given lectures around the world, and here she is today on our podcast. I'm so honored. In recognition of her work, she has received among so many others, the American College of Nurse-Midwives' Best Book of the Year. Henci, congratulations on that. Henci: Yeah, that was a thrill. Meagan: That is amazing. Lamaze International Presidents Award, DONA International Claus– Henci: Both of their memories are a blessing. Meagan: I know. Seriously, a research award on that. Life Achievement Award, I mean, you guys. She has so many awards and here she is to talk with you, Women of Strength, all about one of the biggest topics in VBAC. Right? Uterine separation, also known as uterine rupture. When I started talking with Henci, I love that she was like, “You know, I don't love to call it uterine rupture. It's uterine separation.” I have really grown to love that over the last few months that we have been talking. Yeah, so let's talk about it. What is uterine scar separation, Henci? What is that? Henci: Well, before we get started because I think we are going to be giving a lot of information. I want to emphasize that one of the things that took so long is that what we decided to do is that I would do a blog post that had all of the detailed information in it.Meagan: And it does. Henci: So, not to worry. I imagine that with the notes for the podcast, you'll post a link to the blog post which will have detailed numbers in it. My life's work– and I love the review of your course because just sits where I sit. My life's work has been wanting to give women and birthing people the ability to make choices having all complete, accurate information on the pros and cons of their option which is really difficult to get as you probably know and your people probably know. Meagan: It is. Yes. Henci: What they choose to do with it, it's just that I'm there for the information. No judgment. I'm here to help people decide they want to plan a repeat Cesarean. Whatever it is, I want people to have accurate, balanced information to the best of my ability to create a space where they can make the choice that's right for them and their families. Meagan: Absolutely. I love that so much and that is really what we are here about at The VBAC Link. There's no shaming in choosing a repeat Cesarean. There's no shaming in choosing an epidural over unmedicated, right? There's no wrong way to birth, but the most important thing to us here at The VBAC Link is that you know the facts, you know the options, and you choose the best route for you. Henci: And then the other piece which is part of my work as well is to go beyond the information and say, “So now you have this information, what can you do with it?” What are the tips, ideas, and recommendations that will help you craft a plan that will help take you in the direction that you want to go? I'm very careful. This may be one of the more important things that I say to your group and it's not informational. I'm very carefully not saying “goal”. I think it's very important to distinguish intention from goal. Goal assumes that you have you get somewhere and if you don't get to that place then you failed, right? The intention– is this is the direction that you want to go in?To have that in mind helps you, first of all, to plan the journey in a way that's most likely to succeed in getting there, but it also helps you have your priorities so that if things happen along the way, you're able to be flexible to know what's really important, to navigate the space, but to understand that sometimes life has other plans so if you don't take anything else away from what I say today, please take away that because I think that's really key. Meagan: Yeah. As a doula, when we're doing prenatals with our clients, a lot of people will be like, “Can you help me write a birth plan?” I love the idea surrounding birth plans. Let's have this idea of how we want this birth to go, but I like to reference it more as birth preferences. “Here are my preferences and I'm going to label them from A to D, most important to less important, and have this idea and this plan, but then also know that there are other options and it's okay if I choose those. It's okay if my birth goes another route because I have these preferences and we're going to do everything we can to have them, but we know it doesn't always pan out that way. We know that. Henci: I think too that something has gone wrong. I talk about this in the introduction to my latest book. I think “plan” has gotten a bad rap. So a plan isn't a laundry list or a blueprint. It's more like, “Are you planning for a career? Well then, you're going to decide what you're going to do to take steps in that direction. Are you planning a vacation?” But it's not something that has checkboxes on it. Meagan: It's not a list. Henci: I think, if I may be so bold, the problem with preference is that at least, I think especially if you talk about preferences to medical staff, it becomes like, “Well, I think I'd rather wear a blue gown or have chocolate ice cream instead of vanilla.” It doesn't have the same strength as saying– Meagan: “This is my plan.”Henci: And that can be internal to the woman or the birthing person. But yeah, let's get into the meat of what I want to say today. Meagan: No, I love that message though. I do love that message. I think it would be really good if we did stop because the reason why we change “plan” is because if things don't go as planned, we failed. That's how our minds work and it's not how it is, but that's how the world has–Henci: Right, but this I think is what happened when birth plans became a thing in the medical environment. It became a checklist. But when you say, “I'm planning a vacation,” if your plane flight gets delayed and you miss your connection to the cruise boat, you don't say, “Oh, I failed.” Right? Meagan: Right. Henci: It's a plan. “All right. How am I going to get to Costa Rica?” It's a very different mindset and I'd just like to relieve the audience from the idea that a plan is too limited. Meagan: Yeah. I love that. I love that. Let's talk about how when we are planning to have a VBAC and when we are going for a trial of labor after a Cesarean, we have a lot of providers talking about–Henci: I'm going to plan a VBAC trial. I think language is just so key to all of this. Meagan: Right? I know. Henci: A trial suggests that– Meagan: We're trying. We're trying. Henci: The other word that I'd just like to take out is “success”. You either plan a VBAC and have a VBAC or you plan a VBAC and you have a repeat Cesarean. Meagan: Like you say, those words are so important. We talk about VBAC and TOLAC language in our course and talk about how you might hear TOLAC and that actually might be triggering. It is to a lot of people because you are like, “I'm not trying to do anything. I'm going to have this baby. My goal or my plan is to have a vaginal birth after a Cesarean.” I don't love trial, but we talk about how that is how medical professionals will label it so we try to get comfortable with the term TOLAC so when we hear it at birth, we're not triggered, but knowing in our minds, we are planning to have this VBAC. So when we are planning for our VBAC, one of the number one things that focuses on that from a lot of providers is uterine separation. Henci: Right and even there, the language that the medical practitioners use is right with the language of failure. So let's even take that. You hear, “What are my odds of–” even if they don't call it uterine rupture? The thing is that there are a couple of really big studies, like 50,000 because now we have these big databases and in one of them, the likelihood of the scar giving way was 5 out of 1000 and in the other one, it was 3 out of 1000. What you have to think of is, in one of those studies, the odds were 995 out of 1000 that you wouldn't have a problem with your scar and in the other one, it was 997 out of 1000 that you would not have a problem with your scar. The other thing that people have to understand is that even if you do, even if the scar gives way, yes, it's an emergency. The odds of having something bad happen to your baby– Meagan: Catastrophic, yeah. Henci: Catastrophic happen to your baby are again, 997 out of 1000. When that problem happens with your scar, 997 times out of 1000, your baby is going to be just fine. You're going to have an emergency Cesarean, but your baby is going to be fine. Meagan: Usually Mom is fine too. Henci: Yes, absolutely. So you have to think in those terms so that the numbers are very low. The thing there is that it's a general number. Meagan: Right. It is a general number. That is something that we really, really need to keep in mind. This is a general number. Henci: I want to drill down and look at some things that affect that number. The first one, and don't worry, I go into details and give all of the numbers in the blog post. The first one is what I noticed when I started doing the research for this is that you have two factors that pull in opposite directions. One of them pulls towards having a problem with the scar and that is the use of induction or augmentation. The other pull in the direction of not having a problem with the scar and that's having a prior VBAC. Before we get to, “Well, my last baby was big. Does that increase my chance because I might have a bigger baby this time?” Those two things are key and one of them, you sort of have control over. Meagan: Yeah. Yeah, not inducing. Henci: What I can tell you is that it's pretty clear that the stronger the stimulus to the uterus, the more likely you are to have a problem with the scar. In other words, particularly the highest risk is if you are induced at all just with oxytocin and then if you're induced or augmented, it really goes up– this is really the key point– if you are induced when the cervix isn't favorable for labor and they give you an agent. Meagan: To help soften the cervix and get you ready for induction. Henci: Right. It does a great job of softening the cervix, but there actually may be a reason why the agents that soften the cervix are problematic for the scar because the cervix is made of connective tissue. What those agents do is that they cause the cervix to soften by pulling in water and softening the way you'd wet a sponge. Meagan: I love that analogy. I've never thought of that. Henci: Guess what the uterine scar tissue is made up of? Connective tissue. That could be where the problem is. But anyway, so the more you augment the uterus, the more likely you are to cause a problem with the scar if the contractions are stronger and longer and for longer periods of time. One thing to keep in mind is that induction is never an emergency or a necessity. If, for example, you do have a medical issue like your blood pressure is going up, there's a real reason that induction and getting the baby out sooner rather than later is possible. I'm going to put this on the back burnerhere are studies that show if you are really careful to induce to mimic as much as possible what the body does naturally, you can induce without overstressing the scar. That's something to say if, “Oh my god, if my only choice is induction or a repeat Cesarean, I guess I'd better choose repeat Cesarean,” then I would say, “Yes, there are ways to do this.” Like the wicked witch says, “These things must be done carefully.” That's one thing. The other thing is that there is very strong evidence that if you have had a VBAC, you are much less likely to have a problem with a scar. Having a prior vaginal birth, a vaginal birth before a Cesarean doesn't seem to have as much of an effect on that, but if you get a VBAC under your belt, you are very, very likely to go on having uneventful VBACs if you choose to have more children. Meagan: Why do you think that is? Just because the uterus has progressed and it has pushed a baby out? I read that question a lot and in my head, I know there is a showing that you are more likely, but in my head, I'm like, “Why? Why is it exactly why you are more likely to have a VBAC if you've had a vaginal birth and if you've had a VBAC, you're less likely to have separation when the uterus is doing the same chemical functionality?” It's contracting and squeezing and pushing a baby out.Henci: If that were true, then it wouldn't make a difference whether you've had a vaginal birth before you've had a Cesarean or you've had a VBAC after you've had a Cesarean. Meagan: It's really weird. Henci: So I have no idea. I'm just the literature lady. I just can tell you what the research says. Meagan: Yeah. Right? I don't know that either. I can't figure it out myself either. I don't understand why. Yeah. Okay, I had a vaginal birth and then I had a C-section and then now I don't have as high of a risk. It's just interesting. It's really interesting. Henci: Yeah, certainly. If you have had a VBAC, for anybody to say, “Oh, we just don't do VBACs and you really need to have a repeat Cesarean,” your best option is to plan a repeat VBAC. I mean, that is a really strong link there. Meagan: Right, but we're not having providers suggest it. We're still having providers saying, “It is your best option to have a scheduled repeat Cesarean.” Henci: Do they say why?Meagan: We have people writing all over. One, we just don't support it. Two, the vaginal birth that you did have– say if they had a vaginal birth– wasn't until 41 weeks so if you have a baby by 39 weeks, it's fine. You can have that but after 39 weeks you can't. Henci: Yeah, that's what I call a Cinderella VBAC. You can have a VBAC if you go into labor before 40 weeks and if your previous baby wasn't too big and if you make progress in labor, but you know, the basic reason is, “We don't do VBACs here because we can't handle obstetric emergencies.” Oh, wait. Let's think about this. You're a hospital. You have women coming in in labor. Some of them have high blood pressure. Go down the list and you're saying that you can't handle an obstetric emergency 24/7? You shouldn't be doing births here. Meagan: You shouldn't be having babies here. That happens a lot where you've got more rule areas like, “We can't support VBAC because we can't handle an emergency Cesarean.” It's like, “Well, if you can't handle an emergency Cesarean, then that's a big concern for anyone to give birth because VBAC or not, we know emergent Cesareans can be needed for first-time moms.” If they can't handle a VBAC Cesarean, then how are they totally able to handle someone who has an emergency Cesarean just in general?Henci: Unfortunately, this isn't something that your audience can change. They're not going to talk that hospital into changing, so it just hurts my heart that people are put in this sort of form of dilemma where they don't have a good option. They have a least worst option. Meagan: They feel stuck. That is the same thing with me. It hurts my heart that so many people feel so stuck out there. We have mamas that travel out of the country or out of the state just to find somewhere but that option isn't for everyone. So it's really hard if you feel stuck and you're not feeling supported in your community. So yeah. It hurts. That's a whole other type of podcast. Henci: That's a whole other topic. Meagan: Yeah, so let's talk about what uterine separation is. We talk about uterine separation. I'm going to use the word that a lot of providers use as rupture. So when we hear this really big word, when I picture a water balloon breaking– Henci: That's why I don't like that word. Meagan: That's what we hear. That's what we hear. We hear “rupture” and that's what I hear is a water balloon breaking and popping. That is really terrifying to hear and to think of when in actuality, it's not usually how that happens, right? Henci: Right. Meagan: Our uterus doesn't just break open and explode. It doesn't so let's talk about separation. What does it mean? What does that mean? And there are multiple types of separation. Henci: Actually, it's been interesting to see because I've actually been involved in this work since the 1980's so to watch the evolution when VBAC started coming in and went out again, as the research has grappled with an agreement on a definition of exactly what that meant because they find this all the time in repeat Cesareans that little windows can open up in the scar. It's not a big deal. Scars are tough. They don't cause any problems so what they finally ended up with is the scar completely gives way to form an opening in the uterus between the uterus and the abdominal cavity. That would be in combination with symptoms, usually heavy bleeding or the baby being in distress. Meagan: Or baby going high up. Henci: There is no clinical significance to a window. There are no symptoms. Nobody is hurt. Nobody is at risk, but if the scar gives way to the extent that there is heavy bleeding and in very rare cases, the baby or part of the baby can actually be in the abdominal cavity, that's a scary situation. Meagan: Yeah. Yeah, and talking about the uterine window– as she was saying, it's where it thins out so we've got this thinning. The crazy thing is that there really aren't any symptoms. Henci: There are none. Meagan: You really wouldn't know if you had a uterine window unless you were opened up. Henci: Unless you had a repeat surgery, yeah. So there is the interesting thing about that. One of the things they tried to do– and I hope that none of the doctors they are encountering are doing this– was they thought, “Hmm. Why don't we do an ultrasound to see how thin the scar is? Maybe that will help us predict whether the scar will give way.” It turns out and there is absolute agreement on this that you can't use that. It isn't accurate enough to tell you anything and what's more, the correlation in that study was when she was pregnant, we did this ultrasound and we measured the thickness of the scar. Then, when they had their surgery, we looked to see if in fact there was a problem with the scar. They found some little windows, but that didn't mean they would have had a problem if they would have gone into labor. So that whole idea of, “We have some way of predicting when the scar will give way so that we can advise whether it's a good idea to try a VBAC,” all of the studies that have been done of that have said that they aren't accurate enough to be used to counsel a person about VBAC. So anybody that's using that one is not scientific. Meagan: Yet we get those messages all the time. “Hey, my doc said I can't have a VBAC because my uterine thickness is too thin.” We get that reason all of the time, being told that they cannot VBAC because of that. It's so disheartening when we've got evidence showing certain things, but we have providers not following evidence-based information. Henci: Yes. You can always find a reason to do something you don't want to do. Meagan: Yes. That is what I was going to point out too. Sometimes when we have providers saying things that are completely opposite of what evidence even says or just don't support evidence in general. We got a message saying that they had a 60% chance of uterine rupture. Henci: Oh sheesh. Meagan: Yeah. They said that their uterine scar would give way 60% of the time. I'm like, “No way. No.” Where do we even get that? But a lot of the time, these providers are, like you said, saying things because they don't want to do things or they've seen things that make them scared so they put people under this general umbrella and they're like, “Oh, you've had a C-section. You're under this umbrella and this umbrella is not going to let you have a VBAC.” Henci: I have a dear friend who was interested. She was a marriage and family counselor and she was doing work with PTSD, child-related PTSD. We were sitting at a conference and there was an obstetrician who was lecturing who started actually talking about an emergency birth where things went wrong and she actually started to tear up. My friend had an epiphany. She said, “Oh my god. It's not just women who develop PTSD.”Meagan: Yeah. It's these providers. Henci: It's birth professionals as well and if you've been at a crisis birth even if everything turned out right, but if it was that sort of an emergency, “Oh my god, we might lose this mother or we might lose this baby,” that's going to change the way you practice because what is the signal effect of PTSD? It's intended to be protective. Your brain says, “I never want to be in that situation again. What do I need to do to avoid it?” Meagan: Right. Henci: I have compassion for that, but it doesn't help your audience who is stuck with these people who have no idea what is actually driving their decisions. Meagan: Right. I guess I want to mention that just because sometimes I feel like, and even on this podcast, we're guilty of saying things that make it feel like we're painting bad pictures of providers and putting them in a bad light. That's not the goal here in this podcast. That's definitely not what we want to do but we do know that a lot of people have been let down. Henci: Yeah. Meagan: I mean, here's this failed word but there are a lot of people out there who have been failed. Henci: They've been failed by their care provider. I will use failed in that case. Meagan: They've been failed by the staff or by their care provider or their location. A lot of the time, it's really hard because we don't know what that other person has experienced. We hope that those professionals will work through those and stop putting these general umbrellas over people, but we know that it's probably not going to ever stop happening. Henci: No, unfortunately. But I want to move back to how we just talked about a case where the research doesn't back up what the doctor says, but I want to talk about a couple of cases where- and this is where being more critical of what the research has to say. It does on the surface back doctors up. So now let's get into some of the categories for induction. The big one is, “We don't want you to get past 40 weeks because we know that with longer pregnancy duration, there is more chance for scar rupture.” That sounds good and it's actually in the research, but here's the catch. Underneath that is what happens at 40 or 41 weeks? They induce labor and there is research that shows that the reason that you get more is that all of the scar ruptures were in induced labor. We know that induction increases the risk of scar rupture. It creates the illusion that it's pregnancy duration. It's not. It's pregnancy management. The other one where that happens and it's actually in the research is women who are expecting a big baby or they think the baby is big. Meagan: Suspected big baby. Henci: First of all, if your doctor says, “Oh, you know. This baby is going to be on the big side. We did the ultrasound. I've been feeling your belly.” You might as well flip a coin because there is a 50/50 chance that that is incorrect and your baby isn't going to be on the big side. So number one, they may be anxious about something that isn't even true. Meagan: It's so true. Henci: The second thing is, then what happens next? Let's induce before the baby gets bigger. So again, you find an association between VBAC labors with bigger babies and an increased risk of scar rupture but that's not the root cause. The root cause is those laboring women were induced. So that is something to take into account when you hear those things and again, I've got the numbers. The reason I keep coming back to the importance of the blog post is one of the things that I think is less than helpful is vagueness like, “There is a chance.” The first question I'd have is, “How big?” so I wanted to as much as possible give people the numbers so that they can do what feels right for them but also know how those numbers are distorted by management. The VBAC rate itself is distorted by management because VBAC studies outside of the hospital coming from home births and birth centers show a VBAC rate in women who have not had any prior VBACs– the first birth was the Cesarean and this is the second delivery. The VBAC rate was 81%. Out of the hospital-based studies, they range up to the low 70 percentile, but the hospital studies don't get up that high.Here's the important thing. If it's at all possible, find a care provider who's really comfortable with VBAC and knows how to manage them because where do you see the bad outcomes? To a huge extent, they're in labors that were induced and labors in which there was a problem with the scar which is much more likely if they were induced or augmented or she wasn't given enough time and then she went to C-section.The complications happen in C-sections so the more you are able to have a birth that proceeds at its own pace with no stimulation and there is a spontaneous vaginal birth, your birth by your own efforts, that's when it's minuscule in terms of having complications. Meagan: Right. It's so hard because yes. We talked about this earlier. Oh, we've got hypertension and oh, we've got this thing and we have options. Do we induce or do we have a C-section? It still is very possible to have a VBAC with an induction. We're just talking about uterine giveaways and the chances. You increase your chances by choosing to be induced. That doesn't guarantee you're going to have that happen or anything but you have to know walking into it, “Okay, I have this, this, and this, and I'm going to choose to induce.” You have to know the risk that you are taking. We have to weigh out the risks and say, “Okay. I know it increases a little bit. I'm comfortable taking that risk or I am not comfortable taking that risk.” Henci: Right. Or how can I minimize my risk? Because it still is possible. You have to do it diplomatically but if you have a care provider who is willing to be flexible and is like, “Yeah, I'm not sure about this one,” but you're able to have that conversation where you feel like they can hear you and you're going to be respectful and hear them, then I think there's a lot that can be done. You can say, “No or not yet.” Meagan: Yep. We just made a post on Instagram and Facebook about that saying, “I appreciate the time that we just took. I'm going to choose to wait” or “Thank you so much for that, but I'm not going to do that.” Henci: The other thing I would suggest if you're in a situation where you're saying no is to have a discussion around which new information would change your mind because that again creates space with, “Oh, I don't have one of these patients that's just being difficult,” but to say and talk about, “If my blood pressure goes up–”. I don't know what it might be, but to have a conversation about under what circumstances might you consider changing your mind. Meagan: Right, yeah. It's powerful. Conversation and information are powerful. I always encourage someone to ask questions and to get their research. If we have a provider saying you have a 60% of uterine scar giveaway, let's talk about that. “Wow, that seems really high. Is there any way that you can provide me with that information so that I can study that and see what's comfortable for me?” And then you'll look and it and go, “Oh, there aren't statistics showing that I have that? Okay.” Then you might make a different choice, but if you just hear that number and don't ask any questions, then you automatically might say, “That seems really scary. I'm not even going to go there.” We have these myths and these numbers and if we don't ask for information, we're doing ourselves a disservice. Henci: I've got the American College of Obstetricians and Gynecologists practice bulletin. I wonder if there is any way– I mean, a summary of recommendations and conclusions backed by level A evidence, good and consistent scientific evidence. The first one on the list is, “Most women with one previous Cesarean delivery with a low transverse incision are candidates for and should be counseled about and offered TOLAC.” Meagan: Yes. Henci: My eye goes down and I want to talk about women who've had two prior Cesareans. I know we wanted to talk about that. Meagan: We do want to talk about that. Yes. Henci: I will say that they're not enthusiastic about it, but nonetheless, this is under level B evidence which is limited or inconsistent scientific evidence, and what it says is, “Given the overall data, it is reasonable to consider women with two previous low transverse Cesarean deliveries to be candidates for TOLAC and to counsel them based on the combination of other factors.” They have all of these VBAC predictions which I'm just going to be blunt, they're crap because they're evaluating the wrong thing. What they should be evaluating is the doctor's propensity to care for VBAC and their confidence in VBAC. Then you'd get the numbers that would really correlate with whether labor would end in VBAC or they wouldn't. Meagan: Right. Right. I know. Then just going one step further, vaginal birth after two Cesareans, then we've got people talking about vaginal birth after three or more. There's no evidence in there because we're not doing them very often. Henci: The evidence is not there for three. It is there for two, although again, you can get very low, again, the equivalent of sort of the average. There are some Israeli studies where there is a very large population of women there who have large families so you do get people with two Cesareans, but the thing there is they need to be managed carefully. In one case, it was like, “We don't do inductions other than by rupturing membranes in someone whose cervix is ready to go.” There are ways to do that. But what I wanted to say is that now here's a case where you have to look at the other side which is that there are studies that show there are consequences because as you accumulate uterine scars, the complications in subsequent pregnancies go up. So when you get to two prior Cesareans and there are studies that looked at the branch in the road. You had two prior Cesareans. Did you plan a VBAC or did you plan a repeat Cesarean? And guess what? The severe complication rates were identical. It was an identical rate of hysterectomies. There was the same rate of perinatal mortality so it's not like, “Oh, I'll just choose that safe third Cesarean.” There are increased risks, but there are also increased risks to taking another Cesarean on board. Meagan: And then to add to that, future pregnancies. With each Cesarean that we have, we have also risks in future pregnancies that are not discussed when we're counseling in this medical world from what we're finding. We're being counseled for VBAC. We're being counseled about the risk of uterine separation and the VBAC issues, but we're not talked to about the blood loss or the risk of hysterectomy. We're not talking about those things. Henci: Or chronic pain. Meagan: Chronic pain or dense adhesions or placenta accreta. We don't talk about these issues or even deeper issues. We're not talking about them. That is where I think is one of the places we're going wrong in this medical world. We're not truly counseling on all sides of things to really give people the opportunity to make that really informed decision. We're kind of just prefacing over here, but like, “Oh, but we could schedule your baby's birthday and get your hair done the day before because you know exactly when your baby is coming.” We're not counseling. Like you said, there are issues and there are risks. So with VBAC after two C-sections, through your education and ACOG not saying, “Yeah, go for it for sure, for sure,” But they're saying, “It should be reasonable.” Through your uterine scar separation research, is it substantially larger? I know there are going to be numbers in the blog and we talk about it in our course and things, but is it like you have a 0.4% to what? To 10% if you've had two to 1%? We've got people being told things all over the place. I guess my question is through your research with VBAC after two Cesareans, we're going to specifically talk about two Cesareans here, is it increased and truly that much higher? I mean, I know the answer, but let's talk about it. Is it really that much higher or is it pretty low statistically? Henci: Well, I actually turned to that page in the blog post and I had a couple of different studies. There was an increase in both studies. It was quite small. The difference in these studies, I really think, had to do with the fact that in one of the studies, that was the one where they would only allow the rupture of membranes as a means of induction. So in one case, it went from 3 per 1000 with planned VBAC after one Cesarean to 6 in 1000 with planned VBAC after two Cesareans, and in the other one, it went from 7 to 1000 to 16 per 1000. But that's still a 98% chance of not having a problem with your scar. Meagan: Right. Henci: The thing is, there is a consciousness, but if you're planning a large family, that maybe I think a lot of care providers will say, “Well, if you're only planning on having two children, it really is not that big of a deal to have another Cesarean.” But the thing with that is that I think it is really important to understand that you may plan to complete your family with two children. That doesn't necessarily mean that's what's going to happen. Meagan: That's true. That is so true. Henci: I think unless you or your intimate partner are planning on doing something permanent about your fertility, you have to consider the fact that you may choose to have another baby or you may find yourself pregnant and decide you're having another baby. Meagan: Right. Henci: I think you always have to take that possibility into consideration when you're making that first decision. Personally, this is totally my opinion and my judgment. No pressure here. I think the best thing that you can do is get off the Cesarean track if you can. Meagan: Mhmm, yeah. I mean, it really is. There's proof in the pudding that a vaginal birth is the ideal route in the long run overall. Henci: Yep. Meagan: I guess as we're wrapping up here, let's talk a little bit about, well, how you do you decide? How do we decide? Henci: I know that I wanted to get to something because we talked about this. I wanted to get to the epidural issue. Meagan: Epidurals yeah. Let's talk about that too. Yeah. Henci: What you are saying is you're hearing both sides. One is that you can't have an epidural and the other is that you have to have an epidural. Meagan: Literally, they say that you have to have an epidural to have a VBAC. Some of them are like, “Well, yeah. You can VBAC. Just know.” I feel like it's used as this fearful thing. “Just know that you can't have an epidural so you're going to have to go unmedicated.” Henci: Let's take care of that one that you can't have an epidural first because that's the easy one. Again, I go back to ACOG. Level A evidence. “Epidural analgesia for labor may be used as part of a TOLAC.” I mean, I was jaw-droppingly shocked because it's at least two decades since that myth about, “Oh, we can't give you an epidural because then we won't know if there is scar separation.” So that is totally bogus. But let's get to the, “You have to have an epidural.” The thing about that is that there are two problems, I think. First of all, the idea is in case there is an emergency, we can deal with it faster. The thing is, an epidural is problematic in a couple of ways. One is, one of the more common side effects of an epidural is that there is a drop in the mother's blood pressure and the baby's heart rate. Guess what is the best predictor that the scar has given way? The number one predictor that the scar has given way– and again, in most of those cases, it hasn't but nonetheless, it's a better predictor than pain, is the baby's heart rate. You are adding, number one, something that will possibly provoke concern and a Cesarean you don't need. But the other thing is that it interferes with mobility. I think the number one reason– I mean, you want everything in your favor in terms of making good progress and an epidural interferes with that. Plus, you then have the problem of epidural fever because obviously, they want to give you that epidural early. You'd maybe have it for hours and then you'd start to develop a fever and they'd be like, “Mmm, it's time to get the baby out.” An epidural actually decreases your chance of a VBAC. But about the emergency piece, the thing is if you have a sterile water lock where you've got the business end of the IV, the needle is there but it's not hooked up to anything. Meagan: Are you talking about the “just in case” epidurals? Henci: Right, the “We want you to have an epidural because of the emergency possibility. We'll already have you anesthetized.” We first talked about, “We've given you a procedure that may lead to an unnecessary Cesarean,” and they decreased your probability of progressing to a vaginal birth. So that's already like, “Umm, really? Do you want to do that to me? Why?” The answer is, “Well, in case there's an emergency.” You can do a spinal a lot faster than an epidural. It is perfectly possible to get you numb within a very short period of time and sufficient to do the Cesarean surgery. It really is kind of bogus. Meagan: Yeah. I want to talk about this too because if it is a true, serious, serious surgery where we've got minutes if that, we're going to usually be put under general anesthesia. Henci: Well, that's a possibility too. Meagan: Yeah, so that's the thing. Henci: The other thing is that I also want to move into that gray zone of, well, I just talked about the drawbacks of having an epidural, but I mentioned that there's a fair number of members of your audience who are thinking, “I'd really like to have an epidural.” For some of them, depending on what their first labor was like, it may have been like, “I can only contemplate VBAC if I can also contemplate having an epidural.” This is where my new book comes in. The full title is, Labor Pain, What's Your Best Strategy? Get the Data. Make a Plan. Take Charge of Your Birth. In that book, I give all of the evidence, pros, and cons of all of the different other methods of do-it-yourself comfort measures to epidurals and then the last chapter is again, the fork in the road. You would like to avoid an epidural and here are all the ways of doing that, and you would like you plan an epidural. You want to make an epidural plan A and then here are all of the ways of maximizing your chances of having one that goes smoothly. I don't think I need to go into all of the details here on the show, but if anybody is interested in finding out more about the pros and cons of their pain-coping options including epidurals and how to plan to avoid an epidural if it is plan A or the reverse, then I think my book could be helpful. Meagan: That is amazing. Just to let you guys know, we're going to have so many things in our show notes here. We're going to have, of course, the blog with all of the numbers going deeper into what we're talking about today. We're going to have a link to all of her books because I think it is important to know things from all of them. Henci: I mean, I would actually stop you because I think Thinking Women's Guide was a great book. It was published in 1999. Meagan: Yeah, so it's a little older. It's a little dated. Henci: Optimal Care was really intended for birth professionals. Meagan: We have a lot of birth professionals. Henci: Even that was in 2012. Meagan: We have a lot of birth professionals listening. Henci: So I really want to preface the new book. It's been out less than a year so it's really current. Meagan: Mhmm. We're definitely going to have that number one. I haven't read it yet, so I'm going to read it myself because I think it's important too. I know you and I trust you but I want to know even more so I can keep referring it out and also learn by reading it myself. Henci: Yeah, I think you'll get some ideas for your classes. Meagan: Yeah, for my clients, and keep referring them out. I mean, you guys. The more information you have, the better. The more knowledge that you have under your belt as you are entering into these births, it's going to help you along the way. It's going to help you feel more prepared, more educated, and more confident. Right, Henci? Don't you feel like confidence is something that no matter what, VBAC or not, just with birth in general that we need? Henci: That's why the name of my new series– I'm working on a book on induction– is Take Charge of Your Birth. You can't take control of your birth because you don't know what's going to happen. Life happens. But you can take charge in terms of having the information, having thought through what is really important to you, and there is actually research on this. Feeling in charge is the key component in having a positive experience. If you felt helpless, if you felt like you didn't have any say in what was going on and you were scared and you didn't feel supported, you could have a lovely, uneventful vaginal birth and be traumatized. If you were in charge, you were a full participant in all of the decisions, you felt like your options were presented, you made the best choices you could, the people around you were encouraging and supportive of what you were trying, and you could have a very difficult experience in terms of what actually happened and it would still be a positive experience. Trauma is a very personal experience. It's what you feel in the moment. No one can say of you that you shouldn't have been traumatized by that birth because it wasn't traumatic enough. It's subjective. Meagan: Right. Right. Henci: But as a whole, feeling like you are in charge is powerful.Meagan: It's really powerful and there are actual stats behind that. My second birth didn't go the way I desired. I still to this day believe that I wasn't allowed enough time or wasn't given enough resources that I deserved. But at the same time, once the decision was made to have a second Cesarean, a repeat Cesarean, there were a lot of things that I communicated. I took charge at this moment. “If this is how it's going to go, this is what I need and want.” My providers were really receptive to that. With my second Cesarean, although still not desired at all or even felt that it was necessary, I actually have a very different viewpoint on it because I was actively involved in that birth and in the decisions that were being made. Again, even though I didn't feel that the decision that I made for the repeat Cesarean was really warranted, it was a decision that I made. I accept that. The other decisions along the way, I literally can look back at that birth and say that it was healing. A lot of people are like, “Wait, what? You're saying that you didn't want your second C-section but it was healing?” I can say, “Yeah, absolutely. It was healing because I was able to really participate in this birth in a different way.” I just think it's so powerful because I could have looked back with a lot of anger and hate. I probably could have beat myself up even more, but I viewed that as a positive, healing experience. I think that's what I needed to end my C-section journey. I needed that birth to say, “Okay. This is a better experience. I'm ending the C-section journey now. VBAC from here on out, but I needed this experience to have a different view on the C-section experience as a whole.”Henci: I think I heard something else which is key and correct me if I'm wrong, but it sounds like when you agreed to the second Cesarean, you were making the best decision that you could at that time. You still had a decision. It sounds like you weren't sort of bullied into the repeat Cesarean. It sounds like there was a discussion and you felt like, “Yeah, I think I'll go along with the repeat.” I think that's key too is when you do make a decision and it is your decision and you can own it, I think that helps too because later, you can say, “You know, if I were in that same spot again, I might do something different. I've learned something from that. But you know what? That was also what made sense to me at the time and now I can let go of it.”Meagan: Yeah, you know, when I got my op reports when I was going to interview all of the providers for my VBAC after two Cesarean baby, which I wasn't even pregnant, but I started interviewing before, I was reviewing my op reports. As I was reading them, I did get a little triggered and I got a little bit angry. My husband looked at me as I had a tear rolling down my face saying, “These were unnecessary.” He said, “Babe? We made the best choice we knew at the moment with the information that was given to us at the moment.” Henci: Mhmm. Meagan: He said, “Do not ever shame yourself for making these choices because you were not given the information and you were not in a space mentally where you could be in that– oh, the statistics say–”. Right? That's one of the reasons why I think doulas are so important because they can help remind you of those things, but I wasn't in a space where I could go through my journal of information and say, “Oh, but this and this.” I was given these facts, this information, and I made a choice based off of the information that I was given. I can never shame myself for that. When he said that, I was like, “You know what? You're right.” I would go back and do things differently if I were to look back. If I were there again, I probably would have made different choices or I would have done different things, but I'm loving the journey that those experiences have given me and brought me to. Does that make sense? Henci: Yes. Meagan: This journey that I'm on right now, I probably wouldn't be on if I didn't have those experiences. I wouldn't be with all of you here today talking about VBAC and repeat Cesarean and what the evidence shows and sharing these absolutely amazing stories and bringing on these incredible professionals without those experiences. So yeah. I had two births that I didn't desire the outcome of the Cesarean, but I will be forever and ever grateful for those experiences. Henci: I will add that I wouldn't be who I was here today if I hadn't had an emotionally very negative experience. I talk about that in the prefaces of who I am today and why I wrote the book and the difference between my first birth and how I experienced my second. Well, the first one, I was delivered. The second one, I gave birth. That in a nutshell is the difference between the two and that started me on my journey. I wanted other women and birthing people to know that the choices that they made were crucial to how they were going to end up feeling about themselves, their partners, their babies, and their everything, that it was not trivial, and making my life's work looking at the research, because that's my skill so that they would have that information. Information that I didn't have until I started reading stuff after my first delivery. Meagan: Yeah. That's how a lot of us doulas and birth professionals start based on an experience where we want to help people have a different experience. We want to empower people. Henci: I'm so glad that you're in the world. It sounds like you are doing a great service for a lot of people out there. Meagan: Aww, well thank you so much, and likewise. You are incredible. All of your blogs are amazing. Seriously, people could spend hours and hours and hours on your blogs just picking apart the information and the stats and putting these large studies into English because honestly, that's one of the hardest things about studies. You go through and you're like, “I don't even know what this means. Can I just get a clear conclusion?” But your blogs make sense. They're English to me. Henci: Oh, thank you. Meagan: I know they will be for so many of our followers as well. Well, thank you so much for being here today. Seriously, I am so, so grateful. If you guys want to go follow Henci, like I said, we're going to have all of the links for all of the things in the show notes but you can also go onto Instagram and Facebook @takechargeofyourbirth.Henci: Yes. That is correct. Meagan: Or hencigoer.com. Henci: And actually, I think there are places on social media but if you go to hencigoer.com, you can also sign up for my newsletter. I have a monthly newsletter. Meagan: That's what I was just going to say, hencigoer.com. Like I said, we'll have this in the show notes. Go in there. Sign up for the newsletter. Sign up for all of the amazing things that she's putting out because you really are. You're a wealth of knowledge and it's really so fun and I'm so honored that you took the time today to be with us. Henci: Well, it's been my pleasure to be here. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Caitlyn Schollmeier, a certified nurse midwife in training, has an impressive background that includes serving as a medic in the Air Force and competing in beauty pageants. Despite not working as a labor and delivery nurse, Caitlyn has amassed a substantial social media following, where she shares her thoughts on the birthing system and other topics. Caitlyn has faced criticism for her participation in beauty pageants, with some viewing it as contradictory to her feminist beliefs. However, she sees pageants as a form of personal development and a way to challenge herself and that women should be able to pursue whatever interests they have, whether they align with traditional expectations or not. As she continues to advocate for women in the birthing system, Caitlyn embraces the idea that women are complex and multi-faceted beings who can pursue various passions. She believes feminism means challenging societal expectations and allowing women to pursue their interests without judgment. She notes that even those who claim to be feminists may still try to impose their own beliefs on women, instead of allowing them to define their own paths. Visit the show notes for more: ⁠https://www.BelovedHolistics.com/podcast/127Learn More & Connect with :Instagram: https://www.instagram.com/caitlyn_schollmeierTikTok: https://www.tiktok.com/@themodernmidwifeSponsorship made possible by:AHCC - code BELOVED for 10% off on Immune Intel⁠⁠BIRTHFIT⁠ - code BELOVED to get one month FREE in their B! Community!⁠BiOptimizers⁠ - code BELOVED for 10% off the only sleep aid you'll ever need!FullWell⁠ - code BELOVED10 for 10% off the best prenatal vitamins and men's virility vitamins on the planet!⁠Organifi⁠ - code BELOVED for 20% off their Glow blend!⁠Rosemary Meran, CIHt⁠ - Soul Connections offers one-on-one sessions (virtually or in-person) that support deep transformation and bonding between mothers and their unborn babies.Connect with me:Instagram: ⁠https://www.instagram.com/nathanrileyobgyn/⁠TikTok: ⁠https://www.tiktok.com/@nathanrileyobgyn⁠Beloved Holistics: ⁠Shop⁠Medical Disclaimer: The Holistic OBGYN Podcast is an educational program. No information conveyed through this podcast should be construed as medical advice. These conversations are available to the public for educational and entertainment purposes only.Music provided by EdvardGaresPremium / Pond5

I am so happy to sit down with Evelyn Resh for today's Q&A! Evelyn is an expert on all things sexual health. She is my mentor, a Certified Nurse-Midwife, sexuality counselor, writer, speaker, and she also works at Planned Parenthood.   We are answering your questions on topics related to sexual health, including sexual health dating advice, choosing the right sex toy, defining libido, introducing erotic affection, intimacy communication, and much more. Evelyn us sharing her knowledge, expertise, and pearls of wisdom with us so you don't want to miss this!   Get full show notes and more information here: https://soniawrightmd.com/145  

Last week, Sue Becker had a fabulously enlightening conversation with Lori Morris, and this week, Lori gets to ask Sue the questions! Lori Morris is a Certified Nurse Midwife, Navy Veteran, Podcaster and very busy mom of 3, yet she still finds time to mill grain and make bread for her family. In this episode, Sue Becker and Lori continue to discuss the benefits of freshly-milled grains before, during, and after pregnancy. In these two, back-to-back episodes, Sue and Lori discuss the rise and fall of birth defects, vital nutrients needed during pregnancy, pre-eclampsia, folic acid, tongue tie, and much more! Follow us on Facebook @thebreadbeckers and Instagram @breadbeckers. Lori Morris' Podcast, Your Birth Gods Way on Spotify: https://open.spotify.com/show/51CaXPKHdrpJjuLhOhN77k?si=akwdm5P4SXGTyWXiGlXYfg For more information on the benefits of REAL bread - made from freshly-milled grain, visit our website, breadbeckers.com. Also, watch our video, Only Real Bread - Staff of Life, https://youtu.be/43s0MWGrlT8. *DISCLAIMER: Nothing in this podcast or on our website should be construed as medical advice. Consult your health care provider for your individual nutritional and medical needs. The information presented is based on our research and is strictly that of the author and not necessarily those of any professional group or other individuals.

LISTEN In his From the Heart segment, Dr. Paul returns and opens up with us about his experience caring for his mom during her final days. He recounts her bravery in the face of death, reflecting on her legacy of wisdom and courage that can serve as an inspiration for all of us. One message she left behind is one we can all take to heart: Who you listen to determines what you hear, where you stand determines what you see, and what you do determines who you are.— Dr. Paul's Mom In [...]