What do you do when your doctor doesn't support natural birth and keeps pushing tests and interventions you don't want? Today's episode goes over practical strategies for building your confidence and having open, respectful conversations with your doctor. Listen in to find out exactly what to do.
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Podcast Transcript
00:00:00
Hey, Mama, today we are going to dig into how to talk with your doctor when your doctor is not supportive of natural birth.
00:00:09
My name is Kristen Burgess and I work with pregnant and new Mamas who want to have a healthy pregnancy, who want to have beautiful natural births, and who want to intentionally create a home that is happy and peaceful and filled with the laughter of a healthy family. Now, when I opened this episode, I said we're going to talk about doctors who are not supportive of natural birth, and I realized that there may be some midwives out there who aren't supportive of natural birth.
00:00:34
But I suspect that this is more often an issue with the Doctor Who's just your standard run-of-the-mill OBGYN and likes to do things the way they do things.
00:00:44
So that's why I'm using that terminology Doctor. And one thing that running the Facebook group has let me see is that a lot of women are really dealing with this, this issue that you want to have a natural birth and that's what you're shooting for, but.
00:01:00
There are all these protocols and interventions in this, that and the other that are just standard and they may be because they're just standard or they may be because you have something that gets flagged as a risk, like you're 35 or older or your baby was conceived via IVF or any number of things you are.
00:01:20
Your BMI is high. There are many things that can lead to this automatic classification of risk, which leads to an automatic cascade of interventions that may or may not need to happen and.
00:01:35
I've really gone into a lot of depth on the past couple of podcast episodes. I'm really going to go into a lot of depth on the episodes that are coming up and also on the live videos every week. If you're not in the Facebook group, jump into the Facebook group. Even if you can't make the video live. When I do it each week, you can always watch the replays.
00:01:56
And that is just a gold mine. A lot of evidence based information and information that is going to help you to realize that some of these things that we may have thought of as complications.
00:02:10
Or that automatically qualify you for this cascade of interventions may not need that, or at least deserve a trial of trying something different. So those are going to empower you. But on this episode.
00:02:24
I want to talk specifically about how do you talk with your doctor?
00:02:27
How do you work with your doctor, when you're in that situation.
00:02:31
And I realize that some of you feel like you know, Kristen. I'm really limited by where I am geographically and the care that's available to me. And So what do I do? So I'm hoping that this episode is going to give you some practical ideas for how you dialogue with your provider and how you handle things. And also, we'll talk about making the decision to look for another provider as well, because sometimes that's what's needed. But we're going to talk about a lot of things on the way to that point.
00:02:58
I've made the first tip for you that I have, I've made this point a number of times as we've talked about dialoguing.
00:03:06
A lot of the past several podcast episodes have really been about digging into your needs and your wants and also communicating those to other people, and so I've touched on this in other podcast episodes as well and I I want to say it again and that is talk to your doctor early and often. I think so often an OBGYN is selected because that's just what you do. You get a positive pregnancy test.
00:03:37
And then you make an appointment with an OBGYN that takes your insurance, or an OBGYN that is in your national healthcare network and is the first one on the list, or is who you are assigned to. You know, it's just that's just what happens. We almost default into it and like and in the.
00:03:57
Area that I'm in, there's two OBGYN practices. And so you go with one or the other and you get those doctors and they kind of know that they're the only show in town. And that's the way that it is. So there's not.
00:04:11
And then and then you go in and especially for you, if you're a first time mom, you you really don't know a lot and you don't know what you don't know. And that's probably the most dangerous thing because they have this battery of tests and procedures and protocols. And they just heard you right through it.
00:04:31
Because that's what's easiest for them.
00:04:34
And as a student midwife myself, I know that even as I work through my academic studies, and we're.
00:04:41
Looking at these different things like we're working on things like getting our forms ready for clients and and developing our procedures and protocols and those things are important because they help you make sure that you're not missing anything.
00:04:54
And they help you give evidence based care, but when they're accepted blindly or when they're put in place with.
00:05:04
Out an eye towards evaluating them on a periodic basis, that's when you have problems and that's where really we are with a lot of this is you know we just do it this way because that's the way that we've done it for decades or we do it this way because you know this is the the fact sheet that we got from some drug company on some.
00:05:26
Is it because we did in depth researcher because we looked into this or we really pondered this? I know that's what I appreciate about my midwifery. School is as I have to do all of my protocol sheets up for testing and things like that that I might offer to my hypothetical future clients. I have to sit down and really think about.
00:05:47
Each one of those things like I have to say, what is the purpose of this testing and what is the evidence?
00:05:54
Because I'm not in the camp that modern testing and interventions and things are a bad thing, I think we have so many gifts today as pregnant women in the time that we're living in and the time that we're growing our babies in and the time that we're birthing in because we we do know so much more.
00:06:14
And we do have an abundance of evidence over many things and more and more evidence continues to come out, some of it higher quality than others. But really, we live in a time that's blessed and a time when.
00:06:29
We can really do so much for moms and babies, and I believe that it's good to look at what's offered and say, OK, is some of this useful, some of it useful sometimes is some of it useful all the time.
00:06:41
And I'm getting off on a bit of a rabbit trail here, so I'll try and rein.
00:06:45
Myself in but.
00:06:47
What I'm saying is having those protocols and procedures and things that you offer as a provider isn't a bad thing, but when they're offered mindlessly or when they're offered in a compulsory way, like you better do this because I say so or else you know, I'm going to be.
00:07:02
Aggressive and nasty or passive aggressive and nasty to you.
00:07:06
You know, at at worse or I'm going to treat you like you're a moron or an idiot or an uneducated hippie hillbilly. You know, those things are just disrespectful and ridiculous. And if that's the attitude that your care provider has, you want to pick up on that pretty quick, they should not feel threatened by you.
00:07:26
Choosing to be informed and they should not feel threatened by you being curious and will come back to curiosity I actually.
00:07:34
Talked about curiosity and awe and that sort of thing. When I talked with you about talking with your birth partner a few episodes ago, and that can be really helpful. So the more you talk to your doctor, the more you're going to understand his or her point of view, which is why it's so important to do. You want to make sure that y'all are on the same page.
00:07:55
And you don't want to ignore your.
00:07:57
Thoughts and intuition on?
00:07:59
If you get a feeling that your care provider is just not going to be on board, that's something to pay attention to. Now. It doesn't mean that it's the end like I had to go in for some testing when I had my third baby. We were wondering if there was some stuff going on. I'm RH negative.
00:08:19
So we were wondering if there was some stuff going on and I'll link to a podcast episode about RH negative and Rhogam and stuff. If you're in that situation as well. But anyways, I had a little bit of testing done and needed to have that done at the local OB.
00:08:31
'S office, my midwife referred me.
00:08:34
And ended up having a.
00:08:37
Having his help to get my postpartum rogam shot, which is really nice. But anyways I went into that appointment and you know, it was clear that there was this sense of begrudging this really on his part about helping out and all of that. And I took my my doula and with me, who was one of my midwives apprentices at that time.
00:08:59
And so she was also a doula. But the OB was quite familiar with her because she had had dual clients at the hospital before. And so there's a little bit of this kind of begrudging respect. And I could sense that. And I could sense that he.
00:09:16
That he didn't necessarily agree with my choices and that he would have done it differently or chosen differently, had he been the one making the choice. But I could also tell that he was.
00:09:31
You know, he realized that this was important to me and that I wanted to do it the way that I wanted to do it. And I think to him.
00:09:40
It wasn't his preference, and he felt like there could be some risk and that his way maybe would be less risky, but at the same time he was also.
00:09:51
Acknowledging, you know, he acknowledged that the way that I wanted to do it was most likely perfectly safe and reasonable. And so he resigned himself to being supportive, if not like Rah rah. Yes, I'm on board with it with like, OK, well, she's going to do it her way. And even if I wouldn't choose to do it this way.
00:10:11
I think it's still a reasonably safe option, so there was this.
00:10:14
Resignation in him, but.
00:10:17
What I'm saying is, even if your provider doesn't seem to be on board, like Happy Go lucky like whoo. Yeah, girl, let's do this. You got this but.
00:10:27
Is resigned to supporting you and.
00:10:31
Maybe a little begrudging, but still seems to be willing to be hands off if that's what you desire, then that could be workable and for me maybe I would have felt differently or advocated harder if I knew that I was going to be going to the hospital and this was going to be the doctor that was going to be there.
00:10:51
During my birth.
00:10:52
Some time, but I knew that I was planning a home birth. I was still totally 100% OK for a home birth. And you know, I knew that if I ended up transferring to the hospital, this was the doctor I was going to deal with. But it was a low likelihood that that was going to happen. So that also colored my perspective. But I do believe, and I've worked with a lot of clients who have needed to have hospital births.
00:11:13
And this is just kind of the place of, you know, I respect your opinion. You will respect my opinion and I'm just going to be hands off, unless I really see a need to step in and do something different, but I'm not going to be overbearing or try and push my point of view on you as long as things are progressing, I can deal with.
00:11:33
You know your funky hippie stuff or your funky.
00:11:35
Natural birth Mama stuff.
00:11:38
If you realize that your doctor is at that place, then probably you're OK.
00:11:44
But if you realize that there's just a lot of tension and animosity and a lot of butting of heads and a lot of you know, well, we need to do this, and we must do that. And you don't feel so good about it that that can be a problem.
00:11:59
I want you to.
00:12:01
Think through your situation. There are so many aspects of the decisions that we make during pregnancy and ask yourself what's really.
00:12:13
In your situation, like to you the place that you give birth may matter a lot. It did to me. Your health coverage may matter, you know? Can I afford this or not? Consider each thing and its relative importance to you and some of it you may decide.
00:12:32
Is not so important and some of it you may decide is more important. I do know something from doing an addition.
00:12:40
Stewarding the Facebook group for over a year at this point. Another thing that I've done is I've done quite a bit of one-on-one chatting with moms, either through Facebook Messenger chat.
00:12:53
Or on the phone. And so I offered this up as a word of caution for for you, if you say, well, I'm the one that's just going to compromise and sit back because of my care provider or because of my partner or my in laws or my parents or whatever.
00:13:10
I have talked to a lot of women who the interesting thing to me is usually they're coming to me on baby three or four or five.
00:13:19
And they realize, you know what, I I just went with the flow and I I did what they thought was best or I did what the system said was best or just what was kind of standard thoughtless maternity care, which is what most women get.
00:13:34
And I just don't want to do that again this time.
00:13:38
And I still remember a mom that I talked about on the phone who said, you know, I had a standard run-of-the-mill vaginal birth that everybody thought was pretty good and.
00:13:48
But what she said is still kind of haunts me, she said.
00:13:52
It was transformative for me, but not in a good way.
00:13:57
And so I say that not to scare you, but to let you know before you decide I'm going to be the one who says, OK, I'm just going to go along with what they want, and I'm going to be the one to compromise that. It may have an impact on you.
00:14:14
Down the line that.
00:14:19
You don't foresee now because our culture is so focused on will you have a healthy baby? Will you have a healthy baby? Will you have a healthy?
00:14:27
Baby, well, you have a healthy baby.
00:14:29
And that's like the sum total is. If you have a healthy baby, sit down and shut up. Why else will?
00:14:34
We talk about it.
00:14:35
Anymore. And that really is a way that.
00:14:38
We silence moms and.
00:14:40
Women and your thoughts and feelings. So as you're considering what's important to you and and pondering because there may be some things that that aren't as important and some things that are things that you are willing to advocate more strongly for. I want you to really sit down and consider your feelings and decide.
00:15:00
You know what is OK with me to let go? What is OK for me to compromise on? What is OK for me not to. Because you need some clarity about those things. And This is why I talk about.
00:15:13
Giving space to your thoughts and intuition, even just within yourself, pondering over those things and wrestling with those things. And if you want to talk with somebody about those things, you know, you could shoot me an e-mail christian@naturalbirthandbabycare.com we can jump on the phone and have a chat for a little bit and then you know, if you want support ongoing.
00:15:33
Support. I do have slots open in my coaching but.
00:15:38
You know, it's just something that sometimes you need somebody to talk through, but sometimes just wrestling with it with yourself and journaling through it can help you think through these things and realize what's really important and realize this really doesn't feel good to me. And I need to think of a way to handle it. So getting clear on those things.
00:15:58
And help you with getting clear on how to communicate with your provider about them. Ultimately I want you to remember that you are the consumer and you call the shots on this and it's your body and your baby. Like if they can't.
00:16:16
Bully you, I mean consent still applies when it comes to being pregnant and giving birth. You know you still get to say it's OK for you to touch me or no, it's not OK for you to touch me. And certainly when it comes to doing medical procedures to you, you have the right to say no.
00:16:34
So just keep those things in mind as you consider that like you are the one who is coming.
00:16:41
As the person who has the final say.
00:16:44
And it is true. I had one one mom in the group who felt like, you know, she was going to get fired by her OB practice. If she stood her ground. And I realized that that can be something that, I guess for me, it doesn't feel as scary because at this point, I've had a lot of babies. And I'm like, OK.
00:17:04
You know, I'll just have my baby.
00:17:06
But I also think that there's definitely something to having a supportive care provider and having that pulled out from under you because you didn't want them to do a particular prenatal test, which I think is actually what was going on with this mom is really unsettling. And so you do want to think through what are the implications of this, but ultimately.
00:17:26
It's your body. It's your baby. We don't live in totalitarian regimes where they just force you into having this test done so, or having this induction done or whatever you get to make decisions and you get to be the one who gives that final consent. So keep that in mind.
00:17:47
Now a good way to think about this.
00:17:52
A good way to conceptualize this is, I think, through shared decision making. So you're the one that calls the shots. They have expertise, but you share decision making. I really like and I'm going to link to them below.
00:18:06
I really like the interviews that I did with Hannah, and they're one of the things that I linked to the most and chats with Mamas and in the Facebook group is the Hannah interviews. Because I just love that you get to hear her. She I'm interviewing her, but she's talking and giving.
00:18:26
A demonstration, so to speak, of how she.
00:18:29
Talked to her doctor.
00:18:30
And you get to hear her tone of voice. And I think that's priceless, especially if you know that you need to have these conversations with your.
00:18:40
Remember I talked about being curious and I think also being respectful is really important. You want to be respectful of your care provider, but being curious and respectful can go a long way and having that tone of voice that is confident but respectful but curious and that.
00:18:59
Mix of you know, I don't think I'm going to.
00:19:03
Have that done.
00:19:03
Right now or?
00:19:04
Yeah. What? Why don't we do that?
00:19:07
Not in a ditsy way, but in a genuine curious way, is really powerful, you know. Remember that your care provider is an expert like your doctor probably has a fair amount of experience, though with that, remember that they may be colored by their experiences or by their own paradigms, like for example, if they had a challenging birth last week, they may.
00:19:27
Maybe extra precautious and they may have had a challenging birth that had like a once in a lifetime complication come up.
00:19:35
And they're going to suddenly start.
00:19:36
Seeing that around every corner and that's one of the reasons why I'm grateful for medical care, is because you do sometimes have complications that are legitimate and that come up and moms and babies legitimately need help. But that's not the vast majority of births. And you don't necessarily want a care provider reading into your situation. What happened with another woman who's not you.
00:19:57
Who lives a totally different lifestyle than you and you know whose only likeness with you? Maybe that demographically you all are in the same age range and that you know you can't be lumped in with that so.
00:20:10
I do think it's important to consider what their paradigms may be colored by, and also that for example like OBS rarely receive any sort of nutritional training whatsoever, so they don't think about pregnancy or pregnant Physiology or anything like that through a nutritional lens. So that look, look at the shortcomings and limitations of their training as well as their expertise.
00:20:34
And their, you know what might be influencing?
00:20:39
But having said all that, they have a lot of expertise. They're also hopefully doing debriefing and that sort of thing to help them like professional development to help them continue to learn and grow as a professional, to continue to debrief and analyze difficult situations that they went to through so that they can step aside from those.
00:20:58
Learn from them, but not carry that into every other birth or pregnancy going forward.
00:21:04
So we're going to assume that your care provider is, you know, is having that kind of a rigorous.
00:21:09
Professional development and professional growth path and that they have perspectives that are valid for you to consider. So that's where we're coming from. With this shared decision making is that you consider their input and their expertise and you also consider your knowledge of you and what you know because there could be times.
00:21:31
And you've researched something and you really may know more than your care provider because they just have.
00:21:37
Research a lot of parallel to this is in like say, in the legal world. Like if you had a teenager or something who got into trouble with their friends and they ended up arrested and.
00:21:48
They're assigned a public defender, right? Your job or their job. But maybe your job if you're the concerned parent is going to be to research everything that you possibly can, because even though the public defender is an attorney and has expertise, you're going to care way more than that public defender.
00:22:09
And you're just, you know, you care so much about your kid and you have the time and energy to do this research and put this in and then take this information to the attorney and say, look, is there anything here that is going to be helpful to us?
00:22:22
When we get.
00:22:23
In the courtroom. So that's it's similar in a medical situation is you know you're provider may be up to their ears and expertise.
00:22:30
Or they may be more of a General practitioner, which really an OBGYN is a general general kind of practitioner.
00:22:37
But if you really do end up researching, are looking at the latest studies and that sort.
00:22:41
Of thing you may.
00:22:42
Be digging more into the research in a given area than they've touched on in a while, because even if they're doing continuing education one year, they may do neonatal resuscitation and the next year they may do hypertension and pregnancy and then one year they do cannabis and pregnancy, you know.
00:22:57
Maybe they're doing one or two topics a year, but that leaves so many other topics so you.
00:23:02
Have a situation going on with the topic that they haven't gotten around to in a while or they're an older practicing OB and they haven't like, say, for example, cannabis and pregnancy. They haven't even thought about, Oh my gosh, I should probably look at this or a lot more pregnant. It used to be that pregnant women were rarely on prescription medication because just look again talking demographically.
00:23:22
At the age range of pregnant women, usually there's no you know you're not on medication. However, that's changing because a lot of women are on medication, antidepressants and that sort of.
00:23:33
And some care providers, they just haven't done a lot of research on that or how that impacts pregnant Physiology. And the research too, is just starting to come around. So again, if you are a passionate advocate for yourself, you may have done this research. And so that's where that shared decision making.
00:23:52
Comes in is you take their expertise, which could be general expertise. It could be that there's a lot of expertise that I remember talking with.
00:24:02
Perinatologist maternal fetal medicine specialist from downstate, who had been practicing for a long, long, long time. He may have even passed away at this time, but you know he really was a specialist in women who had heart complications during pregnancy, so he knew a lot. So if you were a woman with that issue.
00:24:22
Going on and you could see him, then a you probably had a great opportunity to have a natural birth because he was really supportive of that for.
00:24:29
His Mamas, but.
00:24:31
That you also you know you would have.
00:24:34
Somebody that you?
00:24:34
Knew had that expertise and the two of you could talk. So all of this is really to say that shared decision making is this this.
00:24:43
Paradigm in this construct, where you're coming together to share information and you're coming together, not necessarily as professional peers, but you're coming together as rational and intelligent adults who both have their own a expertise to bring as well as a thirst for knowledge and a passion for their health.
00:25:03
And the curiosity and an openness, and perhaps the time and resource to drill down.
00:25:09
And then also you are bringing your thoughts and feelings and what you want as you go through this transition to motherhood, which is far more than just the simple physiological process of growing your baby. It's a spiritual process, too. And so all of that is coming in kind of in a holistic way to.
00:25:28
You know to be part of this pregnancy. And so all of that is really stuff that you have on your mind as you're thinking about talking with your doctor, and that's also helping you be respectful and in in the positioning that you think about that, you're going to have with your provider. So again, that talking early and often.
00:25:47
Is important because it helps you realize where is your care provider and are they open and receptive to this kind of dialogue. Remember, be curious when you talk. Ask about everything with earnest curiosity, even if you know why they're going to do a screening at 12 weeks and you're OK with it.
00:26:08
Ask about it. Even if you know that you're going to decline it, ask about it. Say you know why do we do this? What information is this going to give? What are the benefits of doing this? What are the downsides of doing this? If I choose not to have this testing done, how could that impact my pregnancy and my baby?
00:26:27
And you can also ask questions that can help your doctor know where you are. Like if I found out that my baby had a congenital defect or chromosomal disorder.
00:26:38
I would still want to carry the pregnancy to terms. So what are the benefits of knowing if this is going on or not and that can help you make decisions based on your situation and your thoughts and your feelings on what you want or what you don't want for your pregnancy. And it also gets your doctor used to this woman.
00:26:59
Going to ask about everything you know she's going to want some of my time and she's going to want some of my expertise. She's not going to just be satisfied with me coming in listening to the baby fussing at her about her weight gain for a few minutes and then leaving.
00:27:12
She really wants to know. She's really curious. She's not just.
00:27:16
Like, oh, when's my?
00:27:17
Ultrasound book it I want to.
00:27:18
See my baby and then.
00:27:20
You know, OK, I'll show up.
00:27:21
At the hospital and tell me when I can get my epidural like it's just not going to be that kind of a.
00:27:25
Pregnancy and assess how your doctor.
00:27:28
Seems to deal with.
00:27:29
That because that's important. But one of the things about being curious and earnest and really asking those questions that are probing questions, but they're not asked in an obnoxious.
00:27:40
Manner they're asked in a curious.
00:27:44
Awe filled wonder manner. It's like I think about with my kids, when even when I'm in a hurry.
00:27:51
And want to move on because I have a task list that's perpetually a mile long. If I see that they're in a situation where there is awe and wonder.
00:28:03
I am much more likely to stuff my feelings of irritation and annoyance and impatience aside.
00:28:09
Because I want to hold the space for that.
00:28:12
And I think it's the same way with a care.
00:28:14
Provider when they see.
00:28:16
That you're coming from this place of earnest curiosity and with.
00:28:20
A little bit of.
00:28:21
Awe about what's going on in your body and true desire to understand what something can tell you or what the limitations.
00:28:28
Of it are.
00:28:29
You know, it helps lower their defenses.
00:28:32
And it they realize that you're really thinking things here and that you're considering you're not just blanket. Nope. Nope. Nope. Don't want that. Don't want that. Don't want that. You know that. You're just. Really.
00:28:42
Being intentional about this, you're not just reacting. You're not just attached to a certain paradigm, even if.
00:28:49
You've even if you're like Christian, well, my provider is attached to a certain paradigm, but if they get the feeling that you're curious and open to listening to them and really pondering and considering things instead of just a blanket. No, no, no.
00:29:03
They're going to be more likely to work with you. This all just opens the door for honest dialogue. And remember, just like I talked about a minute ago where I was giving those hypothetical questions around, say, 12 week testing.
00:29:17
If you ask your care provider, open-ended questions rather than like yes or no questions or questions that can be answered with, here's a fact sheet on that.
00:29:25
Or if they give you a fact sheet, another thing with my midwifery school is we do.
00:29:29
Make fact sheets hard.
00:29:31
Protocols and procedures, but the intention is, is that you give that fact sheet to the parent, kind of as a cliffs notes for later.
00:29:38
And then for.
00:29:39
Those of you who don't know what Cliffs notes are, I don't know if they.
00:29:41
Still, even have Cliff notes in this day and age, but that's like.
00:29:45
A summarized version of a work of literature.
00:29:48
Or a poem or.
00:29:49
Something that you could get to help you. Some people just read the cliffs.
00:29:52
Notes, but you.
00:29:53
Know if you read it to help you understand, say, a work of art or or excuse me or like a piece of literature or something. So the close.
00:30:00
Notes version would be.
00:30:02
You know, just giving it to them so that they have that to reference later, but you're actually going to talk this through. Like, again, we're talking about my midwifery handouts that I'm working on right now or so. If I'm speaking with a client, I can really talk this through with her or with them if she's with her husband or.
00:30:20
Owner and make sure that they understand and then when they go home and are talking about it on their own time, they have that sheet to refer back and jog their memory in that sort of thing. But you want a care provider who's going to give you that kind of respect because that's what it is, is respect and talk with you about things. So ask.
00:30:40
Open-ended questions, and even if they're going to give you a handout or something like that, don't take just. Oh, it's all explained in here instead, say can you give me a minute just to skim this and ask any questions that come up? Or if I take this home, can I call you back?
00:30:55
And talk this through with you or at my next appointment. One of the things I think I've mentioned I had issues with a kidney stone actually over a year ago at this point. And then this past summer, I decided to have them take the kidney stone out and my doctor, even though I feel like we still don't under necessarily 100% see eye to eye.
00:31:15
Was really respectful and was willing to talk with me on the phone a couple of times when I had questions and things that I really needed to talk through with him and understand.
00:31:26
You know, he was willing to to get on the phone with me. I felt like his nursing staff was a little bit.
00:31:30
Impatient with me because.
00:31:32
When I was talking to the one nurse, she was finally like, do you?
00:31:35
Want me to have the doctor call you and I?
00:31:37
Said yes and.
00:31:38
So he called me and was just really, really, really respectful and.
00:31:42
Listened to me and I knew that.
00:31:44
I could tell that he thought that maybe I was being a little bit over the top, but he was still really respectful of me and I appreciate that. And I think that's what we should look for.
00:31:53
With our care providers.
00:31:54
So if you're talking with your care provider and they want to do something, maybe not necessarily standard testing, though this could apply to that.
00:32:04
But if they want to do something in intervention or something because of something that's going on with you, you can ask them if they've considered alternatives and you may choose to share research with with them, just like I talked about a few minutes ago where I shared that if you you may be more invested personally into whatever this nuance is.
00:32:25
Of your unique pregnancy and birth, then they've had time to revisit in their continuing.
00:32:33
And so you may be able to educate them. So if you've done research, you can share that with them. So much of what we know now about natural birth and about pregnancy Physiology and that sort of thing is evidence based, like natural birth, as Doctor Sarah Buckley calls it ecstatic birth. I can.
00:32:51
Link to her.
00:32:52
Podcast interview. I'm just going to make a note of that.
00:32:58
But you know, she talks about ecstatic birth and how, like, physiologically that's there's a reason that birth is meant to be an ecstatic experience for mother and baby. You know, that's evidence based.
00:33:13
So when we look at the fact that.
00:33:15
So much of what we.
00:33:16
Want as pregnant and birthing moms is evidence based, then there can be a sharing of that research with your provider. You could share abstracts and references from papers that you've pulled up. You know an abstract is a short summary of the entire.
00:33:33
Paper and if you share the abstract and then the reference, they could go pull that journal article up on their own.
00:33:44
Those are things that you can share. Another thing that you could consider if you're if you're looking for evidence and you want to share with the provider, is the Cochrane Collection is a database of meta analysis. They cover all kinds of different topics, not just pregnancy and birth, but they've done a lot on pregnancy and birth.
00:34:04
And they also evaluate studies for quality. So if there's a Cochrane conclusion.
00:34:11
Then it's usually based on studies that are of relatively good quality, and that's a good thing. The the Cochrane conclusion would be a good thing to share with the care provider, evidence based birth Rebecca Decker's website. I can link to that as well. She does articles on a lot of touchy subjects, and she also really focuses on the quality of research.
00:34:33
And explains the quality of the studies that she's referencing. So that could be, you know, if you find an evidence based birth article that supports your position or talks about why your position is a viable position amongst others, that could be another good.
00:34:49
Thing to share with your provider, so don't be afraid to share your research either. Abstracts of journal articles that you found or Cochrane collection, meta analysis, conclusions, or evidence based birth conclusions. Again, when we're looking at those good evidence based sources that really.
00:35:09
Evaluate the quality of studies then that can really speak volumes to a provider. And again remember, don't make the assumption that they know this and they're just ignoring it because.
00:35:20
You know, it's always better to make the assumption that, well, and they're continuing education amongst the 50 million different.
00:35:25
Topics that they need to cover.
00:35:27
This isn't one that.
00:35:28
They've gotten back around to, so let me talk about this with them. And again, just that earnest curiosity, that all that wonder like, you know, look what this is what I found because, you know, it's I'm you could even sometimes you could even play.
00:35:41
Oh my gosh, you know, I know it seems silly, but I've just done this Mama bear mode and I feel so protective and I know that a good birth experience is a good start for mothering, for me, and healthy for my baby. And so I've just been kind of going crazy with the.
00:35:54
Search and I found some really interesting things and I would love to share those with you. Can we take just a few minutes here and flip through these abstracts? You know, that kind of an attitude can again be compelling, especially if you're sitting right there with the abstracts in your hand. And again, I wouldn't necessarily take well, I'll take these and.
00:36:13
Read them.
00:36:14
If that's what gets said, then say OK what time tomorrow or what time this week can I call you back for us to talk about this?
00:36:24
Because you don't.
00:36:25
Want that research to go end up on their desk or in their briefcase? Never looked at it again, and especially if you're early in your pregnancy, when your prenatal appointments are like a month apart. I don't know that I would take let's talk about it at my next appointment. If you're at the end of pregnancy and you have an appointment every week, maybe.
00:36:44
But otherwise it would be. You know, when can I call you so that we can talk these things over because this is really important to me.
00:36:53
That means that your provider is hopefully going to sit down and take 10 or 15 minutes of their time to skim through the information that you've given them, and then be able to talk with you about it. And I think that face to face right there can be good, but I also can respect that a provider may decide, you know what, I actually really want to look at this.
00:37:15
And maybe look at some opinions from colleagues and that sort of thing too.
00:37:19
As a student midwife, I'm a member of some midwifery groups on Facebook that are kind of peer reviewed groups where if a midwife has something going on with the client, sometimes she'll post there to get help from the midwife collective. You know that collective midwifery, brain. And so if your provider wants to do that or talk with other providers in the practice, I don't think that's.
00:37:38
A bad thing?
00:37:39
But it's a thing of OK, let's come back and talk about this at, you know, in two days or three days or whatever. So you know, when this week can we talk about this or if it's late in the week, you know, when next week can I call the office and talk this through with you?
00:37:56
Another strategy that can work is asking your provider to trial something. So for example, if you're showing signs of gestational diabetes or high blood pressure, or baby seems to have fetal growth restriction, these are a lot of topics that I've talked about recently on the podcast and live videos.
00:38:15
But if something like that is going on, ask your care provider if they're willing to trial something so.
00:38:22
Can we try? You know, I've. I've done a lot of research and believe that diet could really make a difference. Could we could I just try this diet protocol for a couple of weeks and then we come back in and reassess and see what's going on?
00:38:36
That can be something that could be really powerful during labor and birth. I think it can be harder, but it can work. So one compromise that I've had a lot of my Mama baby birthing students make is for a hep lock during birth rather than having to have an IV. They have the hep lock put in, which basically just leaves an open line.
00:38:57
Usually it's in your.
00:39:00
So that you don't have to be tethered to the IV, but if they needed to start an IV, they could do it basically instantaneously. And so it may be a little bit uncomfortable, but it's not being tethered to an IV, so there may be a compromise or a trial. Intermittent fetal monitoring might be one. Or you know what.
00:39:18
Let's try letting me be upright.
00:39:21
Those are things that you can talk about and we don't have time to go into a lot of those. I I talk about a lot of this stuff in Mama, baby birthing, specifically, talking about birth, because it's a childbirth class. But there are a lot of things that you can talk with your provider about. Can we compromise? Can we meet in the middle? And again, this comes back to what's really important to you and what.
00:39:43
Feels really important to you. What you're willing to compromise on or meet in the middle on, but those can be ways to help get buy in from your provider.
00:39:53
One of my biggest tips I talk about this among baby birthing a lot for birth is really to wait to go in because if you wait to go in and don't get to the hospital until your labor pattern is really well established and you're really working hormonally, it's much less likely that things are going to stall. It's much more likely that they might.
00:40:13
Actually speed up.
00:40:15
And there's just not as much time to be fussed with and messed with. And if there is a little bit like they want you to be on the fetal monitor for 20 minutes, it's probably not going to interrupt things as much, even though it may be pretty uncomfortable and it's just waiting to go in until things are really well established. It's just one of the best tips that I can give for being able to have a natural birth with this.
00:40:38
Little intervention and futzing as possible.
00:40:42
And then please, I I already touched on this a little bit, but remember you do not have to consent to inductions and things like that that you were adamantly opposed to. You don't have to say, OK to them, you get to make the choice that's right for you and for your baby and especially if it's really questionable.
00:41:02
Like weird early inductions and that sort of thing. Then you don't have to consent. You could ask for a second opinion, you could call somebody up, you could connect with another OB in town, you could call a midwife in town. There are many other things that you could do.
00:41:20
So let's just talk for a few minutes and then we'll wrap up. But a few minutes about choosing to switch care providers like I know that sometimes, probably most of the time, the biggest thing that I hear is either a there's nobody in my area which totally may be legitimate or B it's that, you know, my insurance.
00:41:40
Won't cover that provider and I will say I I I'm sure I've said it before but.
00:41:46
You know, I lived in abject poverty when I had my first three babies making less than 12,000 U.S. dollars a year, which might be wealthy in some regions of the world. But it's it's a pretty, pretty, pretty low amount to get by on every year. And I still paid for my baby's home births.
00:42:05
Out of pocket because it meant that much to me, whereas Medicaid would have covered me going to the hospital and having my baby there, it was just important to me to have the birth that I wanted on my terms. And so I found a way to make that happen and it took some creativity and it took some frugality in other areas.
00:42:25
And it took a midwife who was willing to work with me on it. But.
00:42:31
I you know that was important to me. And so I chose to have a midwife for my births and I did what I needed to do to make that happen. So that one is really just, you know, the the time worn, perhaps saying of where there's a will, there's a way. But, you know, maybe believing that.
00:42:51
That this is a possibility for you is really the key, and I've, you know, I've worked with clients all over the world. One of my Mama baby birthing clients was in.
00:42:59
And she really didn't want to use the midwife that that was there for her. She was from the UK. She was an expat living in France and she really wanted to use the UK midwife. And so she arranged for, like, a private midwife from the UK. She arranged for her vacation in France.
00:43:19
For a little bit of time around her due date and come and be with her when it was time for her to have her baby.
00:43:24
And that's not.
00:43:25
The only woman that I've ever heard talk about, like flying a midwife and for a vacation where oh, there's going to be a baby coming. And I realized that part of that is OK, well, when is the baby actually going to come? And is it going to coincide with this time that she's?
00:43:37
But again, that's just a way of saying you know where there's a will. There's a way. I've also had clients who had literally no other options. And so they went with an OB and they did one-on-one, consulting with me to be able to get another perspective and to be able to bounce ideas off of other people or, you know, off of me and have my help with research and that sort of thing. And that worked.
00:43:58
Moms choose and assisted births as well, so there are just a number and a variety of options for you to get the support that you feel like you need, even if you're in a situation that you think may not be ideal. So sometimes thinking.
00:44:10
Outside the box.
00:44:11
Can be really helpful for you. One of the one mom that I worked with one-on-one was a military mom and she saw an Obi all throughout her pregnancy and she had a super easy first birth and didn't want to go to the hospital for the 2nd baby, but it was a military base and she did want to, you know, not get into a lot so.
00:44:32
She had her second baby. Nice and easy in the bathroom, and then had her husband take her and the baby to the hospital and they called on the way and said the baby came too fast and you know, I don't think they got too much questioning. They got checked over for a few hours and then got sent back home. So again, moms do it in all kinds of different ways. And I'm not necessarily saying you should or shouldn't have an unassisted birth.
00:44:52
I think you do what's right for you.
00:44:53
I think that many times having a midwife or a provider's wisdom is ideal. I think that, you know clearly, I believe in the profession of midwifery as a profession that is there to serve. But I also think that some women choose unassisted birth and that's, you know, that's OK.
00:45:10
Too, but I think that whatever you do, do it with eyes wide open. So I I know negotiation can only get you so far. And sometimes you realize that a provider is really not a good fit for you and you. I just want you to know that you can change providers at any time in your pregnancy, even late in the game.
00:45:30
Take care of yourself throughout your pregnancy. I've said this often before, but even if you see your care provider for every prenatal appointment, that's only a handful of prenatal appointments, maybe 10/12/15 appointments, maybe a few more. If you're high risk, but you're going to be pregnant for 280 days, 280 plus.
00:45:48
So on all of those days that you don't see your provider, who's in charge of your prenatal care, you are. So take good care of yourself and be aware and knowledgeable. That's why my Mama, baby birthing classes, which if you want to check out more information about those, head over to Mama. Baby birthing.com. Ma AMA. Baby birthing.com. I would love to have you in the class.
00:46:07
But Mama, baby birthing classes have information about nutrition and a healthy pregnancy. You know you need that information and you need to have that when you're pregnant because you're taking care of yourself every day. So take excellent care of yourself throughout prep.
00:46:24
And also realize that your records are yours, like if your care provider has prenatal records.
00:46:29
You have the right to request those records at any time for your information and your files, and then those are records that you can request to be sent to another provider at any time. Now for finding a provider. I know this episode is already long, so I did a podcast episode recently on finding a care provider and that can be a good one.
00:46:48
Look for a provider in your area. If you're hoping to find somebody new in your area. Referrals are always good. Searching online to see what other people in your area have done, or what they've said on forums and that sort of thing can be helpful. But.
00:47:03
Check out that episode.
00:47:04
On choosing the right provider for you, because I give you a lot of information in there.
00:47:08
And then remember to just like in my story, sometimes money is the issue and so talk to your provider or provider that you're considering and ask them.
00:47:19
You know, especially you may think if you're changing in late pregnancy to a midwife or something and she wants all the payment by the birth, then you can ask and see. Is there a way that we could negotiate something? Could I give you all the checks up front dated for particular days and then, you know, you just deposit them in the future, some midwives are going to be up for that.
00:47:40
Some are not. Some are going to be up for bartering, some are not. So you know, you gotta realize that one thing going on with these providers and particularly midwives is you know they're.
00:47:52
They're they're running a business that could be supporting their family as well. And so that's something to keep in mind, but never be afraid to ask because you don't know if you don't ask.
00:48:02
So never be afraid to ask and explore the possibility of negotiating a contract that might give you a little.
00:48:09
Bit more time.
00:48:09
To pay or.
00:48:11
Being able to put down a significant down payment or that sort of thing.
00:48:15
To be able to help, and don't forget to explore if you may not have realized it, but Oh my insurance or cost sharing plan or something really well Co.
00:48:23
So take a look at those options as you consider if you need to change your provider and it doesn't have to be a big dramatic thing with your previous provider, it could just be you know what? I've realized that we're not the best fit and I found another provider that I think is I wish you well. Let me know how to get.
00:48:40
My records on the.
00:48:41
Way out. It can be just that.
00:48:43
Simple. It doesn't have to be acrimonious or finger pointing or anything, because each provider is going to be well suited for somebody while other provider may not be as well suited. So that's just something to consider.
00:48:54
OK.
00:48:56
So we've talked about talking with your provider, being curious and respectful how to present research, why to present research, how to ask your provider to, to really seriously consider things, and how you can respectfully follow up with them on that. And we've talked some about ways to consider switching providers and that sort of.
00:49:17
So I hope all of this information has been helpful for you. If you want more information on understanding interventions during pregnancy, understanding interventions during birth, understanding complications. When does a complication mean I need this? When does a complication mean I need that? When is it safe to say let's wait and see expectant management?
00:49:36
Is the term for that during pregnancy and birth when is expectant management OK? When is an intervention a reasonable choice? Those are all great questions to ask.
00:49:48
And those are all things that I go over. And Mama, baby birthing. So in addition to teaching you the techniques that you need to have for birth, how you handle your, your contractions, your pressure waves, your rushes, whatever you want to think of them as all of the good information on that, how to help your birth partner help you during birth, how you both can be on the same page.
00:50:07
What to do? I talk about all of that. And Mom, baby birthing. But I also really go over dialoguing with your care provider understanding complications and interventions because all of that is going to help you so much to just be educated and to be able to have these high level, curious, respectful but also deep and.
