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This is the Birth Baby and Life Podcast with Kristen Burgess, and we're looking at the shadow systems behind modern pregnancy and childbirth care in episode number one hundred and sixty four.

Welcome to the Birthbabylife.com podcast, the tips, tools and Straight Talk. You want the pregnancy, childbirth and bringing up baby. And now you'll host Kristen Burgess.

Introduction

Hi, this is Kristen Burgess from NaturalBirthAndBabyCare.com. Today we are going to talk about the foundation of the system that guides pregnancy and birth and even newborn care, postpartum care, all maternity care, which is the scientific official term for the care surrounding motherhood. We're going to talk about the systems that underlie that. 

Most moms-to-be assumed that prenatal care and hospital childbirth procedures or even midwives childbirth procedures are based on the research about what's best for mothers and babies. The whole reason that we have this care system and everything that they do within the care system is meant to make sure that pregnancy and birth are safe. Right?

There is a little bit of truth to that, maybe there's more than a little bit of truth to that, but the real driver behind care practices and especially procedures done during childbirth may surprise you.

So I'm going to cover some more details here. What's the real motivator?

It's Not Money - At Least It's Not Generally Profit.. but it May Impact Your Care Provider (even if she's a woman)

OK, here's a hint. I'm not going to tell you that the real motivator is dirty capitalists. I'm self-employed, so I don't hold the popular line about capitalism right now.

But I do think there's some truth to the fact that this system tends to be a male driven system and it has some grounding and power and control. But I think that when we look at it, all people try and exert power and control in various ways.

We as women need to be aware of this, and we also need to be aware of how other women may even be influenced by this system. I say that in particular because sometimes when you look at you would assume that if you seek care from a female, that care is going to be more in tune with you and more woman centered.

And while that may be true for many women, it's not always true, especially when you see a woman who is feeling pressure from an outside system either to conform to the system or to excel and advance within the system. And that comes before what might be woman centered or even a more woman centered, patient centered model might seem to be weaker or less career focused, even though there's a lot of myths.

And that and I'm sure that I'm going to get into that on some of the mothering resources and podcasts that I do coming up, because it's not unique to obstetrics, it's not unique to maternity care. It faces professional women everywhere face this. But I want to point it out because it is something that may influence. There are misconceptions on how these systems run. And there it's also not necessarily true...

When we look back in the past, for example, to the family doctor who would travel around to see everybody on the frontier or back. And, you know, back in the day, there were more relationship based approaches than we don't really have relationship based care today from males or females. But so I'm not making a necessarily a commentary on male or female. I'm just pointing out that as I talk about this system, some of you may default to saying, well, I'm going to choose a woman for care. So that won't be relevant to me. And I want you to realize that it is relevant to you. And you need to look

At

Your caregiver and the place that you've chosen to give birth through this lens to see if does this lens influence things? Is it not influencing things? Is it coloring things? Because I want you to go into this with eyes wide open, which means that you should not go into it with the assumption that all of this is evidence based care, that's primary focus is on what we know keeps mothers and babies safe, because unfortunately, that is not the reality of the system that we are in. So the real driver behind care today is not really profit and power.

It is risk

Mitigation. And I will come back in touch a little bit on profit and power at the end. But I want to talk about risk mitigation right now because it may not be something that you've ever thought about. You may be thinking, OK, Kirsten, you said this wasn't about the safety of me and my baby, but when you say risk mitigation, that's exactly what I think about. And that and that's right. Risk mitigation is lowering risk. But in the maternity care system, risk mitigation is not the risk to

You and your baby.

That's not the risk that they're trying to to lessen. It is risk to the hospital and risk to the insurance company that they are trying to lessen.

It is risk

To them because they don't want to be sued and the insurance companies don't want to have to make big insurance payouts. That is why a C-section is often the preferred choice for moms and babies, because not because they feel like a C-section necessarily makes mom and baby safer.

We know that

The World Health Organization says a good C-section rate is 12 to 15 percent. We know that when we look at

Many

Long standing birth centers and midwifery practices, we see a C-section rate of some somewhere around two to five percent. So if the World Health Organization says the ideal is 12 to 15 percent and what we see in well-run woman centered practices can be as low as two to five percent, meaning, yes, sometimes we do need C sections. Sometimes they are lifesaving.

But when we look at those norms as to what percentage those sometimes might be compared to the caesarean section rates that we see, which are twenty five percent. Thirty three percent in some jurisdictions, 80 percent, 90 percent, just almost unbelievable. But even the twenty five to thirty three percent or 40 percent that we see in many states in the United States is mind boggling when you consider what is needed, quote unquote. Because what we assume with the World Health Organization statistics

Is that

That is the percentage of caesarean sections needed

In order to ensure

Mother and baby are safe. That's the assumption that we make when we look at them. So if when we look at a given hospital or a given state or a given country or county, and we see a C-section rate that is twenty five, thirty 40, 80 percent, those C sections are being done for some reason other than mother and baby safety. So a C-section is the preferred choice for risk mitigation for a doctor, a hospital, an insurance company, because when the doctor does a C-section, the doctor and hospital can say, see, we did everything possible. We did a cesarean section, we did everything possible. So if a baby is quote unquote damaged, they don't get sued for big bucks because it looks like they did everything possible. And sometimes if if a mom is damaged, it can look like that to the one of the sad, sad facts of this system is that ultimately mothers do not matter very much.

And again, I will talk

More into that in future podcasts. But it is a sad truth that we see that moms just don't matter. So really, the gold standard

Is

That we have a living mother.

And I I'm being

Really blunt because my job is to tell you my job is to help you look at this with your eyes wide open. It's not to sugarcoat things. It's not to candy coat things or make them easier to wrestle with while you're pregnant and you don't want to hear these hard things or you don't want to think that there's any motivation behind what's going on. This is also a good time to point out that

I believe when you look at

The individual care provider, when you look at an individual

Doctor, an individual midwife,

Most of the time this is not how they're thinking. They're not thinking, how do I mitigate risk and how do I make sure that these women don't sue me,

Though I've

Been party some to some backroom conversations. And and that does happen

If

I take X, Y, Z client or X, Y, Z client, do X, Y, Z thing, I greatly increase my risk of a lawsuit. If something doesn't go perfectly, this client would not hesitate to sue. Therefore, I will not do that. And that's a care providers, right? That's their prerogative. But it's also important for you as the consumer, for you as the birthing woman, and for you who ultimately holds the power in this relationship, that's for you to know so that you can make a decision that resonates with you and is right for you. That doesn't mean that I believe that mothers will make foolhardy decisions. I believe that mothers will almost always make the best decision for them and their baby, even when they're struggling greatly with other things going on. Mothers prioritize themselves excuse me. They prioritize the baby's health often to the exclusion of their own health, which is something else that we can tackle in the future. But I so I don't believe, though, that systemically we're seeing care providers come from this paradigm of, oh, my goodness, everything that we do is is out of risk mitigation. Most care providers truly believe that they are doing the best for mother and baby,

And many of them may have an inkling.

Of how these shadow systems impact their thinking or impact procedure or policy, but on some levels, it's there is a cognitive dissonance and if you fully acknowledge the system under which you are functioning and the impact that it may have. That hurts because you realize that you've cost a lot of trauma that was perhaps unnecessary and people don't want to deal with that. And so there's a cognitive dissonance, there's a denial of what happened. It's very hard to take responsibility for causing pain or harm to somebody else. And so they just don't even think about it. So your care provider can have complete sincerity and really and truly believe that they're doing the best thing. Another thing that plays into your care providers positioning is the fact that they were likely taught something in medical school during residency in midwifery school. And they may not have thought much beyond that. They may not have thought deeply into that because you've got a textbook. A textbook is authoritative. The textbook says do X, Y, Z. And it may have citations, but very rarely does a textbook say, why don't you stop and take some time to review all the research and ponder this, your care provider may have one particular area that they're interested in and therefore they've done a lot of research.

But when we look at it, you go through school, you've all been through school, most of you, unless you're homeschooled by somebody who really encouraged you to think for yourself, you went through school, you learn from teachers and textbooks. They were authorities. They told you what to do. They told you how to think, and then they dispatched you into the world. And it's the same for providers. And then they get into the world and they're very busy. And keeping up with the latest research and looking at how things are changing may not be a big deal to them. It may not become a big deal until the evidence is so overwhelming that their professional body issues bulletins about making changes or until consumer demand is such that they begin making changes. A good example of this is delayed cord clamping. For whatever reason, delayed cord clamping has become something that consumers are demanding much more. And so now we're seeing a lot of research on delite core clamping and we're seeing care providers begin to shift what they do because consumer demand is so great. We saw several decades ago when dads weren't in the delivery room at all and now dads are always in the delivery room again because consumers demanded something.

So you do see shifts

When there's consumer demand or when something becomes so overwhelming that a professional body takes notice. For example, professional bodies have started to take notice of the fact that the C-section rate is super high in many jurisdictions, not at all. And some it's just skyrocketing and nobody cares or serves them for it to be high. But in others, we're seeing official policy that is saying, OK, this is really high, what are we doing? So we see things adjusted. For example, Friedman's curve, which is a really old model for how labor should progress. It's a quote unquote textbook labor follows Friedman's curve. And what we've realized now is that, oops, women's bodies don't always function along Friedman's curve. Friedman was a man he wrote decades and decades and decades ago. In a controlled environment, this may not be how real women really have babies. And we've seen some changes, for example,

Quote unquote,

Latent stage of the first stage of labor. So the first stage of labor is while you're dilating and it's divided itself into three stages, which is the first stage or latent stage. Then there's active labor, the second part of the first stage, and then there's transition, which is when you're

Your

Last couple of centimeters of dilation and your body is transitioning to pushing. So hopefully that wasn't too overwhelming if you needed a crash course on how obstetrics conceives of labor. But what we see now is it used to be the active labor, quote unquote, was begun at two, three, four centimeters.

And now the official

Guidance, even textbook guidance is shifting towards six. Up to six centimeters is latent. And then after that is active. That's a good shift and a shift where we see a professional body and research is beginning to make inroads, beginning to change something. But that is very slow. And again, there are other things that don't shift until mothers start demanding delayed cord clamping. Ve Back is another one where maternal demand has made a lot of shifts, slowly is making shifts. So we do see all of those factors plan and those can impact care providers. But often they're just going on autopilot based on what they were taught until some of those things come in or until they begin to have that niggling feeling within themselves that something isn't right. I have a whole bunch of young, healthy moms coming to me and we're doing tons of C sections. Why many care providers will come to that question on their own and change. All of that is to say that when we look at what Impax care providers, I'm not saying that this shadow system is directly what is on their mind and what they are thinking about. They may be thinking about other things or they may simply be on that autopilot default, what they were taught, the conditions of their teaching hospital or their apprenticeship.

And they don't think

Beyond those things as a consumer. We think beyond those things because to them they may be doing what they're taught and then procedures that are that are going on with hospitals and policies and will come back to this in a minute. But also legislation which greatly impacts, especially midwives,

Is

Focused more on risk mitigation on that global level. How do we lower risk to the hostage?

How do we lower risk to

The insurance company

And.

What going back to what I said earlier,

It's it's

All centered on the baby, and so they think if they do everything they can for the

Baby, nobody will get mad, nobody

Will get mad enough to sue. And that is the bottom line. Nobody will get mad enough to cost them money. And that is the bottom line.

So women, you and I, we are left to struggle. Many women with

Profound birth, trauma and even physical injury. Even if we look at a caesarean, a caesarean is so common today that it's not really

Even thought about for what it is.

A Caesarean section is a major abdominal surgery. It is literally cutting through skin fat deposits and multiple bands of muscle and tissue

Through

Bodily organs, the uterus in order to take the baby out. And it is a gift and a life saving surgery when it is

Needed, unequivocally, but

When it is not

Needed or

When it is done simply to mitigate the risk of litigation. We are doing a major surgery that for many women has a long lasting impact

For no reason,

And it is not just cesarean. There are many other policies and procedures, some that even seem trivial or innocuous,

That

Have a profound

Impact on women. Even the fact

That there are policies and procedures that are universal

That women may not want

Has a profound impact because it has the impact of stripping away your

Voice when

You are told that because of X, Y, Z, and that X, Y, Z may simply

Be that

You happen to be a pregnant woman because you are X, Y, Z, you must submit

To

One to three that strips a woman of her voice. That strips you of a level of autonomy, that strips you of a level of dignity. And there may be difficulties with that.

I've had eight babies and all of them with

Midwives now I've seen jobs here and there throughout various pregnancies for various reasons, never on an ongoing basis. But I've had eight babies with midwives, and I can think of times that policies and procedures caused me stress, even significant stress.

I've been doing

A lot of reflecting on my journey through my baby's births and how I got from where I was when I was pregnant with Cassity, my first to where I am now with our youngest being Phenix at three. And I've been thinking particularly about Galen's birth because it was an interesting dichotomy, a linchpin birth for me in many ways, I would say that my first three births were

Good births, but I felt

Overwhelmed at points during those births. And afterwards, when I looked back, there were things that happened in those years that that were not terrible, but that I wasn't satisfied with and that I kept seeking wondering why, if natural birth is supposed to be just natural, did it not feel natural or did I have these little things at the back of my mind that bothered me?

Like, why?

Why couldn't I give birth without quote unquote help? And feeling like that help meant that something like in mean because there were moments in my birth when I wanted help that didn't feel like that. For example, just before I started pushing, bringing out my third baby,

I

Really wanted my midwife support. Things were super intense. My water was about to break and I just looked pointedly at her. I was in the bathtub, looked pointedly at her, and she came over to me and she just maintained eye contact with me. And that was a powerful moment because then I wanted, needed and welcomed just that emotional support, that nonverbal, powerful connection that I had with this woman who had been an awesome mentor to me. And that that support, that holding that space, that being there for me was exactly what I needed in that moment. But there were other points. For example, the fact that my babies didn't seem to, quote unquote, come down like the fetal ejection reflex just didn't seem to work. And I needed my midwives, quote unquote, help to get my baby out. That that was a totally different feeling. And it left me like, you know, what, what is going on there? And it left me seeking. So we come back to Galen's birth, my fourth baby's birth,

Which was

An interesting birth because that birth had the single

Most.

Probably traumatic

Moment

In any of my births for me, the the moment that stripped me of the most power and undermined me of the most confidence in myself, and that was a routine procedure, a routine vaginal exam. Now, I had had vaginal exams. I'm pretty sure I know in Cassidys birth and in ASHers birth, maybe not in Brennan's, but I had had vaginal exams and previous births, but it just it wasn't quite the same. So with Galen's birth, I didn't want the vaginal exam. But I consented to it anyways and to my midwife, it wasn't a big and overbearing thing. I hold no grudge against her, really. If anything, I look back upon it now as a moment that I realized was a profoundly traumatic and paradigm shifting moment for me. But it you know, for her, it was just routine. It was just the way that she did things. Again, we're going back to this is the way that you were taught. And so this is what you keep doing and you don't really give it much thought. So the reason that she did it was to gather information. So she gathered the information that I was three centimeters dilated.

Now, what happened

Would prove that that information was absolutely useless. And it's one reason why I'm not a fan of vaginal exams. And we can talk about that in another podcast. But sometimes it's a good demonstration of the fact that sometimes our procedures and things are absolutely useless. But the information was absolutely useless and in fact, it was damaging because it informed my midwife that I was only three centimeters, so she thought I had a long way to go. So she went

Home.

It told me that I couldn't trust my body because I was not feeling sensations. That said, you're only three centimeters dilated. A few minutes ago, I told you

That that's still, quote unquote, latent

Part of the first stage of labor. That's still

Early labor.

To put it in layman's terms, things are supposed to be pretty easy. You're supposed to go about your normal day. You're supposed to be able to sleep and relax or at least kick back and watch a movie and enjoy yourself. And while being a little bit giddy and excited because you're about to meet your baby. But that was not what I experienced. We went upstairs to try and go back to bed and I could not sleep. In fact, I could not even stay laying down. There was just no way I could do it. I would lay down and then as soon as a contraction would start, I had to scramble up. I would scramble up because I just couldn't deal with the intensity of it, so finally, Scott, who had more faith in my body than I did at that point because I was second guessing myself, encouraged me. Let's go back downstairs again because you seemed more comfortable down there. So we went downstairs where the birth ball was, where the couch was. I was also shivering uncontrollably, which now, in retrospect, I know means that a lot of birthing hormones were reaching a crescendo or a peak in my body. A lot of not every woman experiences this, but a lot of women will get the shakes when those hormones are so heavy because a lot of adrenaline is pumping at that point. You get you get shaky. Kind of like if you have too much caffeine,

You get shaky.

So Scott kept bumping up the thermostat. He even put me in his bathrobe because I was shaky and just things were so intense. And I can remember going to the bathroom, walking across the den to the bathroom and going to the bathroom and then coming back in and like there had been so much bloody show in the bathroom. And I remember Scott commenting that, you know, these are not stopping. They were one on top of the other. Again, I'm in this place of second guessing myself. Scott convinced me, get in the tub, which I was reticent to do because I thought it might slow down labor since I was so early in labor and I didn't want to do that. But he finally convinced me to get in the tub and I had a contraction that felt a little funky.

It was a little bit

Of pushiness on the end. And then the next contraction, my water broke and then the next contraction, my body pushed Gailen out. The fetal ejection reflex worked. The point of telling you that story is to show you the very interesting contrast that happened within that birth and that it had the singularly most disempowering and undermining moment of all of my labors.

And then it had

What was arguably the most empowering moment of all of my labors. When my body birthed my baby with no midwife in sight. Scott had called her in the in the break between the contraction with my water breaking and when I pushed gamelan out. So she arrived about seven minutes after he was born because she didn't live very far from us, thank goodness. But I birte that baby and pulled him up, asked Scott help me with the baby.

He was completely just

Shocked, you know, who knew that a baby was coming right then. But it was so empowering for me. And another thing that had been empowering for me was I had reached inside trying to figure out what was going on, just kind of instinctively. And I felt the curve of my baby's head and I can still kind of feel that phantom baby's head on my fingers. It was such a profound moment to feel the curve of my baby's head inside of me and then to pull him up into my own arms. Such a powerful, powerful moment.

And it it helped

Birth and meet and grow and meet the passion to look beyond the routine, to look beyond the system, and also to understand the deep importance

Of

Birthing the deep importance of pregnancy. We're going to explore this more in the next podcast episode. So I don't want to go off on that rabbit trail completely. But this is a deeply important time.

And one

Of the problems with a system that looks only to mitigate the risk of

Litigation

Is that we completely

Overlook the deep layers of what

Goes on through this experience for women. From my experience, there wasn't physical trauma, so to speak, but there was plenty of emotional anguish. There was undermining of myself during the labor and there was the fallout and the processing and the healing that I needed to do after. And that was just for what is ultimately a trivial procedure, a vaginal exam. For some women, that might not be so trivial, such as women who have experienced sexual abuse or any type of abuse or trauma, because when you've experienced abuse or trauma, things can trigger and in terrible ways and in unexpected ways. And then you're back in that moment and it's very difficult. And we just have a culture of pregnancy and birth care that is not really built to even acknowledge that. And it's not really built to even acknowledge how profound this journey is for mothers. And that's why. It's so important to get past just a healthy baby, and again, we're going to come back to this in the next podcast episode. It's important to move past, oh, you have a healthy baby, be quiet, which is kind of a way to say shut up because we don't want to deal with your messy feelings. And it's also kind of a way to say we achieved our goal, which was to deliver the product, a baby

To a living mother who is

Seems by outward appearances to be OK. And therefore we're done. We're done here. We've achieved what we wanted. So this entire system is really mixed up and that you do have a legitimate desire by many practitioners to help women have healthy babies, to assist them in this joyful transition and a wonderful time in life. But you also have a system in the background that is not focused on that,

Or

Even if it's ostensibly focused on that, it's not truthfully focused on that. And that system has an enormous level of clout. It has an enormous level of influence. It is a machine. And pregnancy and birth are about relationships and humanity and

Change

Changing roles for the woman. It's such a huge thing

That

When that system is blind to that we end up with difficulties for mothers and babies. And so that's why you really need to understand that system. You are often given this narrative that you made a valiant sacrifice for your baby and your care provider took steps to save your baby, and you're supposed to kind of just settle for that. And that is the narrative that if you listen to women's birth stories, even decades on, you will hear that narrative because it's the only way that most women can resolve what happened to them, because otherwise it involves acknowledging so much emotion and so many feelings and so much pain that most of us just shut down instead of doing that. It is difficult, it's a tragedy of the system and is messy, human beings are always messy, emotions are always messy, and rites of passage often

Involve a

Lot of shifting of ourselves and sometimes pain and change in pregnancy, motherhood and birth. Those are as a rite of passage right there. But people don't necessarily want to dig into that and

And to you

Don't necessarily want to be stuck in the hard things. You want to pull the strength from the hard parts of the journey and carry that forward. But you can't get to the place where you're ready to carry that strength forward if you don't allow yourself the space to acknowledge the enormity of what you went through. And the truth is, is that we should have a system that helps guide mothers and babies through this without all that level of collateral trauma that we might not need to have if the system truly focused on the needs of mothers and babies and not the needs of institutions to avoid litigation. I mentioned briefly earlier, too, that a big part of this is politics and politics really plays into the same system.

Maybe.

Maybe even in a scummy your way, to put it

Bluntly,

Because politics goes from the point of view of the valiant

Savior,

We are going to put these things into place because we need to protect women from these unethical, unprofessional people who might take advantage of them and end up causing great damage or even death to them and their babies. So we have to legislate away all of these dangerous criminal individuals so that only the saviors can be their. And so politics may not have that same

Apparent

Bias that we see with risk mitigation from insurance companies and hospital policies.

Instead, it's yes,

It's even kind of worse because they come from the perspective. Really overt perspective of where saviors

And we're

Protectors and in doing that, they often

Greatly,

Greatly trample on a mother's dignity, autonomy and her rights because they often legislate out options for women such as midwives who really focus on women's center care, midwives who want to give their clients the option about procedures and policies and testing midwives who want to trust women. Because women want to have healthy babies, they want to have safe experiences. And if they have an experienced midwife who says, I really think this situation is no longer safe and here is my recommendation, they are going to trust her. Most women are not foolhardy. I think very few midwives are foolhardy. There are probably some midwives who don't have the best training, just like there are obstetricians who graduated at the bottom of their class.

Those people exist,

I'm not minimizing that. But it's also important to realize

That

When we try and institutionalize away all risk and legislate away

All risk,

What we end up doing is ending up. Undermining the freedom and the confidence of mothers, and we often end up causing collateral damage and even profound trauma for women who feel like their voices were stripped away, for women who feel like there was something wrong with their body, even though there probably wasn't. And with women who feel like they've been betrayed

On

Multiple levels. That is why I want to tell you about the system not to dishearten

You, not

To cast in a negative

Light the system or

Individual providers, so to speak, but more to help you

Look at

What is going on in the background of a system that has

Been created.

With a the unrealistic expectation, especially in the case of politics and legislation and another aspect of politics that we don't want to forget is that many groups lobby in politics, for example, obstetric bodies, lobby and politics because they want to get rid of their competition or because they have a bias against another group like midwives. And so your legislator may be influenced by powerful bodies that may hold purse strings or hold sway and influence in another way. So when we look at legislation, there could be players who

Hold political clout,

Who are influencing in ways that may not be in the best interests of mothers and babies. And we look at legislators who are trying unrealistically to legislate away all risk and end up legislating away freedom when they do that. And then in the case of the hospitals, you know, we have this

This

Bias

Towards

Removing all of their risk.

And again, it cuts out what we need

For mothers and

Babies.

It cuts out that freedom, that autonomy, that dignity to make your own decisions. And we could have a system that looked very different. We could have a system that accepts risk. And in some ways, we do have a system that accepts risk, ironically, because if a doctor loses a baby or even loses a mother, he may ultimately get sued. But probably everybody's going to say he was a doctor who did the best that he could. Oh, the hospital lost so and so. And, oh, that was a tragedy.

We mourn,

Whereas if a midwife loses a mother and baby, you know, she's much more likely to end up in jail because she's an evil criminal. And so, again, we have this system that can accept that it can't completely remove risk. But for some people, in some cases, it wants to try and get rid of all risk, because if there's any risk whatsoever,

Then,

You know, that person is a criminal and that's just not truthful. That's not life. Life comes with risk. Pregnancy and birth come with risk. I like the late Carla Hartley said birth is as safe as life gets. I think that was Carlye could be wrong, so if I'm wrong, you'll email me and

Let me know, but.

It's just really important to understand that all life comes with risks and so does pregnancy and birth, as much as we would like everything to be perfect, and when we try and make it completely risk free, we may also remove freedoms. And I want you to understand that, and I've stated that several times now. So go ahead and wrap up the podcast.

But I hope

That this podcast hasn't been too discouraging to you, but has been eye opening to you and has given you a lens through which to look at everything and make decisions and not to necessarily confront providers on this. Again, a lot of this is unconscious and it runs in the background or it's simply systemic and they may feel oppressed by it as well. But it's something to be aware of and to work with and to think about as you consider policies and procedures and ways that your voice and desires and your power and strength may or may not be honored throughout your pregnancy and birth experience. All right, ladies, I am going to finish up now. Like I said, we're going to explore a lot of really cool topics over the next several weeks of the podcasts of planned out, a series that I feel like will be really compelling. And I'm also going to do some blog posts that help complement this. So definitely check that out. If you are not on the mailing list, you're definitely going to want to get on the mailing list right now. Trust birth 101 dotcom, go to trust, birth one zero one dotcom. That will get you on the newsletter list. So you'll get updates about new podcasts, new blog content. I also have a new webinar that I'm working on on creating a sacred birth experience for your next birth. And it talks about healing from previous births and and just creating that sacred second birth of that sacred next birth. I'm really, really excited about that series, are that webinar master class, whatever you want to call it. So definitely get on the list so that you get information about that or you can get information about the replay for that. I'm hoping to do it a few times in the next few weeks. So trust birth one on one dotcom and I will talk to you next week. Have a blessed week.