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From Hollywood to Healing: A Midwife's Spiritual Experience · Fit As A Fiddle

• 0:00
  SPEAKER_00: At 28 weeks, if the baby is breached, they'll do the external cephalic version at 28 weeks.
• 0:07
  SPEAKER_00: And here in the Western mind, we're like, but that's so early because there's the baby can still keep flipping around.
• 0:13
  SPEAKER_00: But what they do is they'll do the external cephalic version.
• 0:17
  SPEAKER_00: And then what they'll do is they'll put a band, like a binder, at the top of their, at the top of their belly to almost as if pinch the belly to constrict the space so that the baby doesn't flip back around.
• 0:31
  SPEAKER_01: Hello everyone.
• 0:32
  SPEAKER_01: I'm your host, Dr.
• 0:34
  SPEAKER_01: Sneha Ghazi, a physical therapist, course creator, and mom.
• 0:38
  SPEAKER_01: I own Sneha Physical Therapy, a private practice in New York City, and created the course Master Your Public Floor to help you transform the way you think about and move your body.
• 0:49
  SPEAKER_01: Use discount code FIT20 for a special 20% discount exclusively for my listeners at the link in all show notes.
• 0:56
  SPEAKER_01: Each episode brings phenomenal guests in the health and wellness space who share inspiring tips and tangible advice.
• 1:04
  SPEAKER_01: All things health and wellness starts right here.
• 1:08
  SPEAKER_01: Hello, everybody, and welcome to this week's episode on Fit as a Fiddle.
• 1:13
  SPEAKER_01: Our lovely guest today is Marisol Montoya.
• 1:17
  SPEAKER_01: She is a recently certified nurse midwife, and she's also a holistic nurse who graduated from New York University recently.
• 1:25
  SPEAKER_01: She has worked as an LD nurse.
• 1:27
  SPEAKER_01: She has a wealth of information on birth itself.
• 1:30
  SPEAKER_01: And one of her biggest passions is bringing birth justice and just in general wellness to Indigenous communities.
• 1:37
  SPEAKER_01: And I think it is wonderful that we have her on the show because we actually have never had someone on the show with the perspective of a labor and delivery nurse who's really been on the ground helping people give birth, like in the moment.
• 1:53
  SPEAKER_01: But at the same time, she's been recently, you know, gotten the opportunity to study to be a midwife, which is which are two different professions, but there's so much intersect in terms of how they help humans give birth into this world in beautiful ways, in natural ways, in ways that bodies are meant to, which looks very different from person to person.
• 2:17
  SPEAKER_01: But the role of this profession is to tailor wonderful wellness and care to birth.
• 2:24
  SPEAKER_01: And so I'm really excited, Mary Soul, to have you come on the show and talk to us with this perspective.
• 2:29
  SPEAKER_01: So thank you for joining us.
• 2:31
  SPEAKER_01: Thank you for the invitation.
• 2:32
  SPEAKER_01: I appreciate it.
• 2:33
  SPEAKER_01: Absolutely.
• 2:34
  SPEAKER_01: Firstly, I'd like to let you have a chance to um give a little broader introduction on yourself and what brought you to the space.
• 2:41
  SPEAKER_00: Well, if I'm going to share my story, I must start my story with saying that first and foremost, I'm an artist.
• 2:49
  SPEAKER_00: That's where my story begins.
• 2:52
  SPEAKER_00: I am now into my third career.
• 2:56
  SPEAKER_00: And but to discuss and talk about my first career is going to be very important to set up how I even got to where I am right now.
• 3:06
  SPEAKER_00: So I am uh I'm an artist.
• 3:09
  SPEAKER_00: Professionally, I was a filmmaker.
• 3:11
  SPEAKER_00: So I uh graduated from the University of Southern California, the film school there.
• 3:16
  SPEAKER_00: And I then went on to work in Hollywood as a um cinematographer.
• 3:21
  SPEAKER_00: The beginning of my filmmaking career, I worked as a cinematographer and then I integrated um video editing towards the end of it.
• 3:29
  SPEAKER_00: In the beginning of my career, I worked on music videos and then I transitioned into working on documentaries.
• 3:35
  SPEAKER_00: And it was around 2009 when I received the message that I was it I had come to a point where I was ready to wrap up that career and open myself to something new.
• 3:51
  SPEAKER_00: So in 2009, I was in Los Angeles selling all of my equipment, wrapping up that part of my life that had been 11 years and all I knew, and really the only reason why I was living in Los Angeles at the time.
• 4:07
  SPEAKER_00: And I had a conversation with God that went something like this and said, God, thank you so much for this experience, for entertaining my teenage fantasy of being of working in Hollywood and living as an as an artist.
• 4:24
  SPEAKER_00: That was really cool.
• 4:25
  SPEAKER_00: It was really fun.
• 4:26
  SPEAKER_00: But I it is also clear that that is not what I'm supposed to do.
• 4:31
  SPEAKER_00: Now add something to the story that at the time in 2008, we had the industry, the filmmaking industry, had the writer strike.
• 4:42
  SPEAKER_00: Then in 2009, we had the recession, and then in 2010, we had the actor strike.
• 4:46
  SPEAKER_00: So the industry was collapsing because we had no writers, we had no investments, and we had no actors.
• 4:52
  SPEAKER_00: And so at the time, there was no new production.
• 4:55
  SPEAKER_00: And and the there was a downward shift in the market where all the studio people were flooding all of the independent filmmakers out of their market.
• 5:05
  SPEAKER_00: And at the time, I was an independent filmmaker.
• 5:08
  SPEAKER_00: And so I had nowhere to go but to work on reality TV because that was the only content that doesn't really require a lot of writers, it doesn't require a lot of money, and it doesn't require a lot of actors.
• 5:19
  SPEAKER_00: And so if anyone looks back at that time when they look at films or when they look at cinema production, there all the serial uh episodic uh shows were just doing reruns at the time, but there was a boom in reality TV.
• 5:37
  SPEAKER_00: And that was something I didn't feel like I could do.
• 5:40
  SPEAKER_00: I couldn't, I couldn't be involved in something that I felt was junk food to our social culture.
• 5:46
  SPEAKER_00: And so I just couldn't continue working there.
• 5:48
  SPEAKER_00: So I have a conversation with God and I said, all right, well, you you have entertained my fantasy.
• 5:57
  SPEAKER_00: You tell me what it is that you want me to do, and I and I will just follow.
• 6:02
  SPEAKER_00: And I sat in that inquiry for three years, and I went through all the phases of feeling hopeful that I would get a message and and and some guidance on what I'm supposed to do next, and then and then starting to become impatient, and then starting to doubt that this was gonna work, and you know, all these things.
• 6:18
  SPEAKER_00: In that time, I moved from Los Angeles to New York City, and it was about February of 2012.
• 6:24
  SPEAKER_00: I remember it was a freezing Friday night in February, and I was living in Harlem at the time, when one night I was lying in bed meditating when I felt a presence hovering over the right side of my body.
• 6:40
  SPEAKER_00: Now, this is the first time that had ever happened.
• 6:42
  SPEAKER_00: I've known people who have had encounters with spirits, or some people may call them ghosts, or an energetic presence, but that was my first time feeling this.
• 6:55
  SPEAKER_00: And yet I didn't feel scared.
• 6:57
  SPEAKER_00: There was something familiar about what I was experiencing, the energy that I was experiencing hovering over the right side of my body.
• 7:04
  SPEAKER_00: So in my mind, I asked the presence, What are you?
• 7:10
  SPEAKER_00: And when I asked that question, it I got two replies.
• 7:14
  SPEAKER_00: The first reply was, I am you in the future.
• 7:18
  SPEAKER_00: And so I was like, Oh, well, no wonder you feel so comfortable and familiar.
• 7:22
  SPEAKER_00: You're me.
• 7:23
  SPEAKER_00: And the second reply I got was, I am a midwife.
• 7:27
  SPEAKER_00: And so I'm laying in bed thinking, wait a minute, if you are me in the future and you are a midwife, and applying what I will remember learning from high school math, where if A equals B and B equals C, then that must mean that A equals C.
• 7:43
  SPEAKER_00: So then I asked, if that is true, if both of those are true, are you saying that I am going to be a midwife in the future?
• 7:51
  SPEAKER_00: And the second I asked that question, the energy that was hovering over the length of my body, it it kind of collapsed into a ball and just would immediately I felt it enter my body through my umbilicus, and I could feel the sensation spreading through my body, through my veins.
• 8:13
  SPEAKER_00: And what I got from that sensation, from experiencing that, was a confirmation that yes, and this is the answer to your question, now go.
• 8:23
  SPEAKER_00: And it was very hard for me to believe because many reasons internally why I would why I thought this cannot be true, like for me to be a midwife doesn't make sense.
• 8:37
  SPEAKER_00: Now that none of this is making sense, and so initially in the first month, I kind of ignored it or tried to ignore it, tried to ignore it as the big is is the key.
• 8:50
  SPEAKER_00: But it was something that just kept tapping at my shoulder and it wouldn't give up on me.
• 8:54
  SPEAKER_00: And so then I had to pay attention to it, and I said, okay, finally, finally, what what is it that I'm to do?
• 9:02
  SPEAKER_00: And I found myself in a um a hands-on beginners midwifery workshop that was led by a home birth midwife from San Francisco who was living in Brooklyn at the time, and she was just giving a uh a beginner's workshop in learning what midwifery is, weekend workshop.
• 9:24
  SPEAKER_00: So I went.
• 9:25
  SPEAKER_00: Now, granted, this was I had I received that message in February.
• 9:29
  SPEAKER_00: This workshop is now in the first week of May.
• 9:32
  SPEAKER_00: I go, it's a room filled with doulas who either want to become midwifery assistants or are considering becoming midwives themselves.
• 9:41
  SPEAKER_00: And I am the only non-birth worker in the room.
• 9:46
  SPEAKER_00: And I make that clear that I am a filmmaker, don't really know what I'm doing here, but I'm being led here.
• 9:52
  SPEAKER_00: So here I am.
• 9:53
  SPEAKER_00: And at the end of the workshop, I received a very strong affirmation and confirmation that yes, this is really what I'm where I am to be.
• 10:03
  SPEAKER_00: So I decided, fine, if this is, if this is what my purpose is, I will follow and I'll see where this goes.
• 10:12
  SPEAKER_00: So by June, I was already enrolled in my prerequisites to Ford Nursing School.
• 10:18
  SPEAKER_00: Now, in that time, I had to then research the different ways of becoming a midwife.
• 10:24
  SPEAKER_00: Now, in the United States, there are three types of midwives.
• 10:27
  SPEAKER_00: One is a certified, uh certified professional midwife.
• 10:31
  SPEAKER_00: They go to more of uh think of it as like a trade school, just an immediate midwifery school.
• 10:37
  SPEAKER_00: They learn midwifery and and and they can become certified professional midwives.
• 10:43
  SPEAKER_00: The second type of midwife is a certified midwife.
• 10:46
  SPEAKER_00: That is an individual who has a bachelor's degree in something, and then they decide to go and do a master's degree in midwifery.
• 10:56
  SPEAKER_00: Their bachelor's degree can be anything.
• 10:58
  SPEAKER_00: It could have been film and or it could be um biology or it could be English literature or whatever, it doesn't matter.
• 11:08
  SPEAKER_00: They do a master's in midwifery and they sit for the national certification, the board exam, and they are a certified midwife.
• 11:17
  SPEAKER_00: Then there's a certified nurse midwife.
• 11:20
  SPEAKER_00: That is someone who has a bachelor's in science in nursing, who with their registered nursing license then applies to a midwife-free master's program and sit for the exact same board exam that the certified midwife sat for, but that their certification is as a certified nurse midwife.
• 11:46
  SPEAKER_00: So three different types.
• 11:48
  SPEAKER_00: Now, when it comes to the what the what the US recognizes, if I remember correctly, and these numbers may have changed by since last time I looked, but at the time, only 27 states in the United States recognize a certified midwifery license.
• 12:06
  SPEAKER_00: Um, but all states recognize a certified nurse midwife.
• 12:11
  SPEAKER_00: And then when it comes to the three different types of certification, not all um practices will recognize all of them.
• 12:22
  SPEAKER_00: So, for example, a certified professional midwife probably most likely will not be allowed to work in a hospital, let's say here in New York City.
• 12:32
  SPEAKER_00: Maybe somewhere in the South, I don't even know if hospitals uh will allow or hire a certified professional midwife.
• 12:40
  SPEAKER_00: So they are the they're the midwives who are most likely to work home births or maybe even birthing centers.
• 12:48
  SPEAKER_00: And so at the time, when looking at the three different routes of becoming a midwife, I figured, well, I don't know where I'm going to be when I'm in my late 50s.
• 12:58
  SPEAKER_00: So why don't I just set myself up for the most flexible route and I'll become a certified nurse midwife, which is what put me on the route of becoming a nurse.
• 13:06
  SPEAKER_00: So I did my prerequisites for nursing school.
• 13:09
  SPEAKER_00: I then uh went and did an advanced nursing program because I already have a bachelor's in something else, so I could do an advanced nursing program.
• 13:19
  SPEAKER_00: And when I came out, I wanted to immediately work in labor and delivery, but you know how life just doesn't really go so linearly.
• 13:28
  SPEAKER_00: I ended up as my first job working in the emergency department in the South Bronx.
• 13:34
  SPEAKER_00: And I would say that that was the most scenic route of getting to where I am, but an important, very important to my story because I now, in hindsight, realize how incredibly important it is to have that critical care and the emergency training when working in labor and delivery.
• 13:56
  SPEAKER_00: So I worked in the emergency department, both in the adult and in the pediatric emergency department, for four years, before I transferred to become a labor and delivery room room nurse, which I did in 2020.
• 14:13
  SPEAKER_00: Um the transfer was interrupted due to COVID.
• 14:17
  SPEAKER_00: So I had transferred to labor and delivery, but then COVID happened.
• 14:21
  SPEAKER_00: And because I'm an emergency room department trained or emergency department, yeah, emergency trained nurse, I was called back down to the emergency room to surf during COVID.
• 14:32
  SPEAKER_00: And then once the the peak happened, uh, then I was uh able to go back to labor and delivery and continue my orientation there.
• 14:43
  SPEAKER_00: After working uh labor and delivery for a few years, um, I then applied to for my midwifery, uh, my master's in midwifery, went to got into NYU, uh New York University, and completed that, graduated in May of 2025, and then passed my boards in August of the same year.
• 15:05
  SPEAKER_00: And so that is that is where I am in terms of that.
• 15:10
  SPEAKER_00: Now, I'm in a I'm in a place right now where I'm in that transition phase of looking for my first job as a midwife.
• 15:17
  SPEAKER_00: And I would say that what has come through for me is in all of my experiences, a greater understanding of where I want to work, who I want to work with, and what I'm looking for.
• 15:32
  SPEAKER_00: And so I think ultimately I would love to work in a birthing center.
• 15:39
  SPEAKER_00: However, we in New York City only have one left.
• 15:44
  SPEAKER_00: Once upon a time, we used to have, I think, four, but they all quickly closed down.
• 15:50
  SPEAKER_00: Why?
• 15:50
  SPEAKER_00: Because birthing centers seem to be a what would I would imagine a popular choice amongst a good population here in the in in in New York.
• 15:59
  SPEAKER_00: I I come uh, you know, when I was doing my clinical rotations it in in mid or school, I came across so many people who the way they describe their experience, I had to ask them, like, why are you going to the hospital?
• 16:11
  SPEAKER_00: What what it sounds like, what you really want is a birthing center.
• 16:15
  SPEAKER_00: But then we were faced with the reality that, well, no, there are no birthing centers, or there's one, and it's all the way in Tinbug 2, South Brooklyn, and these people are in Manhattan.
• 16:24
  SPEAKER_00: It's just, it's not, it doesn't really seem like they have many options here in in New York, which is unfortunate.
• 16:33
  SPEAKER_00: And it also reminds me of um, I went to Califor Northern California just last year uh because I wanted, I went with the intention of scoping out the midwifery industry in Northern California just to consider, you know, what if I moved back to California?
• 16:51
  SPEAKER_00: And I interviewed several midwives.
• 16:55
  SPEAKER_00: I interviewed a director of the uh midwifery department at UCSF, and I interviewed the director of the last standing birthing center in San Francisco, and I interviewed um a midwife from a private practice and a midwife from another hospital practice.
• 17:12
  SPEAKER_00: So I got a pretty good spectrum.
• 17:15
  SPEAKER_00: Oh, in a in a in a home birth midwife, I got a good spectrum of all the different um places that midwives can work.
• 17:23
  SPEAKER_00: And just like in here in New York City, San Francisco Bay Area, they are experiencing the exact same thing, which was a closure of all of their birthing centers, except for the last one, which the director did share with me that it was on the verge of closing down in 2022.
• 17:42
  SPEAKER_00: And what is causing the closure of all of these birth centers?
• 17:46
  SPEAKER_00: It is comes down to reimbursement.
• 17:48
  SPEAKER_00: They are having a hard time staying afloat financially because they are not getting the re reimbursements from the insurance companies that will cover them fully, or um it becomes unaffordable for people who may not have insurance or uh you know it it just basically comes down to they just cannot keep themselves open financially.
• 18:20
  SPEAKER_00: Is it some part of it due to legislation or laws affecting the way they practice?
• 18:26
  SPEAKER_00: They didn't really say that, at least not in big cities such as San Francisco Bay Area and New York City.
• 18:34
  SPEAKER_00: I do know that that is a reality for birthing centers that are in other conservative cities, states.
• 18:44
  SPEAKER_00: Um, I you know what comes to mind right now is a birthing center in Memphis, Tennessee, where they are heavily affected by the laws um there.
• 18:56
  SPEAKER_00: It is a conservative red state, and uh there's a lot of services that that birthing center would like to offer, but are not able to because of the laws in that state.
• 19:10
  SPEAKER_00: So I know that they are they're struggling um there, but that's that doesn't seem to be the reality here in a city or a state like New York and in California.
• 19:20
  SPEAKER_00: Um, another thing that came through for me when I was doing my clinicals in midwifery was I remember specifically, and this was pretty wild because while I was in midwifery school, I was also working full-time.
• 19:34
  SPEAKER_00: So I am working full-time as a labor and delivery room nurse in the South Bronx, which is serving a majority uh Hispanic and black population.
• 19:46
  SPEAKER_00: They're immigrants, they are, they have very low resources, low resources, low education.
• 19:55
  SPEAKER_00: Um what else?
• 19:58
  SPEAKER_00: You know, every social determinants of health applies to them.
• 20:02
  SPEAKER_00: Meanwhile, I am doing my intrapartum clinical rotation at a hospital in Sunset Park in Brooklyn, which is serving a majority Hispanic population, low resource, low education, every social determinant of health applies to them.
• 20:22
  SPEAKER_00: But what I found so interesting in the time that I was hopping back and forth between the South Bronx and South Brooklyn, serving what appears on paper to be exactly the same type of people, but the experience that I was having couldn't have been far more different and completely opposite from each other.
• 20:43
  SPEAKER_00: What I was seeing in the population in South Bronx, which was a more indigenous population, it was majority Mexican, Guatemalan, Ecuadorian, and Peruvian.
• 20:52
  SPEAKER_00: And when I say indigenous, I mean indigenous.
• 20:55
  SPEAKER_00: I speak Spanish, but what they were speaking was not Spanish.
• 20:58
  SPEAKER_00: It was their dialect.
• 20:59
  SPEAKER_00: It was either Quiche or Guanifera or whatever dialect they were speaking.
• 21:05
  SPEAKER_00: And they would come in in their traditional garbs of, you know, I remember a Peruvian woman, her mother, came in with a poncho with these like bright colored flowers all over, embroidered all over it, with a with that little hat that I don't know what the name of the hat is, and just you know uh appearing very indigenous appearing.
• 21:32
  SPEAKER_00: And whereas meanwhile in the South Bronx, the population I was serving there was um majority Caribbean, so Dominican, Puerto Rican, a sprinkle of Mexican, but it's really pretty much Dominican and Puerto Rican.
• 21:49
  SPEAKER_00: And what I found so interesting about hopping back and forth between this the the diaspora of the, you know, the Hispanic diaspora was how.
• 22:00
  SPEAKER_00: How when I was in Sunset Park, the labors were textbook functional, just like a textbook.
• 22:08
  SPEAKER_00: I mean, I I could go in every four hours when they're in latent labor, and there would be some progress.
• 22:14
  SPEAKER_00: There was their labors were so functional, very which required very minimal intervention.
• 22:20
  SPEAKER_00: Um, and was there there weren't that many C-sections, which meant I was able to attend a majority, almost all the deliveries.
• 22:29
  SPEAKER_00: I was guaranteed at least one to two deliveries a day in a 12-hour shift that I was working there because things were just moving as they are as physiologically they're naturally supposed to move.
• 22:41
  SPEAKER_00: And then I look at my population in the South Bronx, and labor tends to be more dysfunctional, uh, things that they which requires more interventions, which puts them at higher risk of a c-section, which I am I am running into a C-section or in the OR for a C-section more often there in a 12-hour shift than I was in Sunset Park.
• 23:03
  SPEAKER_00: So then I had to look back and like, what is the difference?
• 23:06
  SPEAKER_00: Because on paper they're exactly the same.
• 23:09
  SPEAKER_00: You know, this population is high risk due to, you know, the social determinants of health, or maybe just some health-related issues, but so is this population in Sunset Park.
• 23:20
  SPEAKER_00: So what is it?
• 23:22
  SPEAKER_00: What's going on?
• 23:23
  SPEAKER_00: And then I realized that what is different is how they experience or how they prepare for pregnancy and for labor.
• 23:37
  SPEAKER_00: And what I realized is that when I would walk into my patient's room when I was in Sunset Park, and I would say introduce, introduce something.
• 23:47
  SPEAKER_00: Let's say, you know, let's say we want to, let's say we're doing an induction, or let's just say we're augmenting a labor, and I would explain something.
• 23:56
  SPEAKER_00: There is this trust or this awareness, like they had an awareness of what could potentially happen.
• 24:06
  SPEAKER_00: And I had to wonder, like, why is it that they seemed so far more prepared than my population in South in the South Bronx?
• 24:13
  SPEAKER_00: And what I came to realize is that I in the in in those communities and in the indigenous communities, there is more of an sharing of people's experiences amongst the women there.
• 24:28
  SPEAKER_00: So these are the cultures that are more likely to sit together as women or at multi-generational gatherings and openly talk about their pregnancy, labor experiences, breastfeeding, or really anything about what being a woman is.
• 24:50
  SPEAKER_00: And they are the they're they are the experiences uh or they are the culture, in their country, the breastfeeding rates are very high.
• 25:01
  SPEAKER_00: Um which brings me to this experience.
• 25:05
  SPEAKER_00: I just got I just got in from Guatemala four days ago, uh, where I was in a mountain town in the northwestern part of Guatemala in the mom community.
• 25:18
  SPEAKER_00: So mom is the is the Mayan indigenous Mayan community, uh, where I was living in a birthing center with seven Mayan mom uh midwives, and I was there to learn from them, learn how they do, learn how they serve their communities and their practices and their ancestral traditions and their culture, and also about their history.
• 25:52
  SPEAKER_00: And what I learned that an expert from the um an expert in maternal child health came to talk to us about, you know, all the initiatives that the Ministry of Health in Guatemala um is pushing forward and the the the laws that affect the maternal child health um well-being in Guatemala, she came to talk to us, and what I learned is that there is an extremely high breastfeeding rate, they push breastfeeding so much, especially in the indigenous communities, whether that's mom or kiche or there's other communities that I didn't really learn too much about, but they are there.
• 26:30
  SPEAKER_00: And they and in the time that I was there, sure enough, I was watching women walk down the street of the village breastfeeding, openly breastfeeding as she's walking, or um sitting in a park openly breastfeeding.
• 26:45
  SPEAKER_00: And in the and the children are exposed to that, they're just playing around while this while while the women are breastfeeding.
• 26:52
  SPEAKER_00: And I think back to my memory of when I was nine, 12 years old in Colombia.
• 26:58
  SPEAKER_00: My family is Colombian, and I remember being in Colombia, and I remember being a child and watching my older cousins breastfeed openly, and while they're breastfeeding, talking to my mom and talking to my aunts and talking to my other female cousins in the room about their experience breastfeeding, their experience with their labor, their experience with their pregnancy, their experience with their other pregnancy and their other labor.
• 27:24
  SPEAKER_00: And for me, it's like that's how I came to learn about this that if I were to be a patient pregnant in a hospital and someone were to walk in and say this, it wouldn't be for a knowledge to me, because I've already heard so many stories of other people's experiences.
• 27:44
  SPEAKER_00: And that's what I think is happening in Sunset Park with those cultures, is that there's more of an openness in a conversation, therefore an informal education about what to expect, that when they arrive, they arrive willing to trust their bodies, willing to trust the process, and then therefore willing to trust us.
• 28:06
  SPEAKER_00: And things just run, move far more functional than let's say, now let's go to the South Bronx.
• 28:15
  SPEAKER_00: What I experience as a South Bronx is there, there's a culture there of, oh, we don't talk about that.
• 28:23
  SPEAKER_00: And and and then they even say, um, de eso no se habla, which is Spanish for saying, we don't talk about that.
• 28:31
  SPEAKER_00: So what I'm gathering from my patient population in the South Bronx is that they're not talking to each other about their pregnancy, their labor, or breastfeeding or anything.
• 28:43
  SPEAKER_00: They're I also am what I'm getting from them also is that there's a lot of trauma, either from a past of either from a pregnancy or a labor that they had in their country.
• 28:57
  SPEAKER_00: Um, and what I'm experiencing when I'm working with them is I'm experiencing a lot of their trauma.
• 29:04
  SPEAKER_00: Now, when trauma happens, um, it it causes, it can cause a stall in labor or dysfunctional labor.
• 29:13
  SPEAKER_00: Now, in labor or the body has a nervous system and there it is, it can either be the sympathetic nervous system or the parasympathetic nervous system.
• 29:24
  SPEAKER_00: Now, the sympathetic nervous system is the fight or flight.
• 29:28
  SPEAKER_00: The parasympathetic nervous system is the rest and digest.
• 29:31
  SPEAKER_00: For labor to be functional, the parasympathetic nervous system needs to be dominant.
• 29:38
  SPEAKER_00: If a person is in fight or flight mode, it is actually going to cause for labor to either slow down, become dysfunctional, or stall completely.
• 29:48
  SPEAKER_00: This is seen in animals.
• 29:50
  SPEAKER_00: If animals go into labor and they don't feel safe, they will actually stall their labor, find a safe place, and only when they get to that safety will labor actually resume.
• 30:01
  SPEAKER_00: I remember watching um The Ice Age 2, you know, Disney, the Ice Age 2.
• 30:08
  SPEAKER_00: And in the Ice Age 2, the woolly mammoth is now married.
• 30:12
  SPEAKER_00: I think the wife's name is Peaches, I'm not sure.
• 30:15
  SPEAKER_00: But Peaches is pregnant, and somewhere in the movie, she goes into labor.
• 30:22
  SPEAKER_00: But at the time that her labor starts, there's an avalanche happening.
• 30:26
  SPEAKER_00: So so the animals are running trying to trying to uh survive this avalanche.
• 30:34
  SPEAKER_00: And in the movie, Peaches turns to her husband, the woolly mammoth, and says, I need to go over here so that I can do what I need to do.
• 30:44
  SPEAKER_00: And so she leaves the woolly mammoth and the other little animal, what is it, a ferret?
• 30:50
  SPEAKER_00: I forget what animal that is, but leaves them to do the deal with the avalanche and the disaster.
• 30:57
  SPEAKER_00: And she goes and finds a cave that is protected by the the the avalanche that's happened.
• 31:04
  SPEAKER_00: And once she gets in the cage, is when her labor then resumes and she's able to birth her baby.
• 31:14
  SPEAKER_00: And it's the same in humans.
• 31:16
  SPEAKER_00: So I what I'm finding is that in the South Bronx, there's a lot of trauma, there's a lot of lack of education amongst themselves.
• 31:26
  SPEAKER_00: And then therefore, they come when they come into the hospital, they don't trust their bodies, they don't trust the process, and then they kind of, in essence, don't trust us.
• 31:37
  SPEAKER_00: And it leads me to I remember to a memory that I had.
• 31:42
  SPEAKER_00: It was my last day of my interpartum clinical rotation in the population in Sunset Park.
• 31:49
  SPEAKER_00: And the day before, I had I had worked two days in a row.
• 31:53
  SPEAKER_00: So I the day before, at the end of my shift, there was an indigenous Mexican woman that came in.
• 31:59
  SPEAKER_00: Um, I forget what her complaint is, but I do remember I had to and I needed to admit her because her blood pressure was high.
• 32:05
  SPEAKER_00: So I was admitting her for an induction due to elevated blood pressure.
• 32:09
  SPEAKER_00: I think she was developing preeclampsia, or maybe not, maybe not pre-eclampsia, just elevated blood pressure.
• 32:15
  SPEAKER_00: And I started the induction with her, said goodbye, came back the next morning, and first thing in the morning, she was the first patient patient I went to go check in on.
• 32:27
  SPEAKER_00: And when I walked in, I ch I did a cervical exam on her.
• 32:32
  SPEAKER_00: And at eight o'clock in the morning, she was fully dilated.
• 32:35
  SPEAKER_00: And so I said, Well, you know, if you're ready, well, I'm ready.
• 32:38
  SPEAKER_00: So you let me know if you want to start pushing.
• 32:42
  SPEAKER_00: And there was something about it was almost as if there was something about attending her delivery.
• 32:50
  SPEAKER_00: It there was an energy in the room.
• 32:53
  SPEAKER_00: There was some an energy that she was exuding.
• 32:56
  SPEAKER_00: There was just something about that delivery that at the end of the delivery, safe mom, safe baby, that has been ensured, that I kind of stood back and I said, I think, I think I have found the population I want to work with.
• 33:14
  SPEAKER_00: I want to work with more people like you.
• 33:17
  SPEAKER_00: And it wasn't her specifically, it was just the fact that I had such a positive experience working with the indigenous communities in Sunset Park that it became very clear to me this is who I want to serve.
• 33:32
  SPEAKER_00: And not only want to serve, there was something about that particular delivery that confirmed this is, I think, where I am supposed to serve.
• 33:40
  SPEAKER_00: So it brings me to the story of how I ended up in Guatemala in this with the mom community learning under the mom midwives.
• 33:56
  SPEAKER_00: Um, I went there, uh, I spent two weeks there, just arrived four days ago.
• 34:03
  SPEAKER_00: And it was, it was a really, I mean, it was a it was a wonderful experience because it I got to learn um ancestral traditions, which some of it I can see being applied here, and some of it I could see the institutionalized medical healthcare system not agreeing to any to to to some of it, of course, because some of it is like, no, we're not, this is not um evidence-based or or or scientific.
• 34:38
  SPEAKER_00: But there's many beautiful traditions that that that they bring into their practice that they offer their community that um that uh that yes, I feel like I feel blessed to have been able to have the opportunity to to study under and learn under the the mom midwives.
• 34:59
  SPEAKER_00: And it it energizes me to come back to New York now looking for my first midwifery job and really inspired to work with the indigenous communities.
• 35:11
  SPEAKER_00: And that's what I hope, I hope I can I can do.
• 35:16
  SPEAKER_00: So that's my story.
• 35:18
  SPEAKER_01: That's firstly an incredible, incredible story.
• 35:21
  SPEAKER_01: I had chills like half of that time, especially with the idea of this profession being a calling for you, and you know, finding your purpose through that.
• 35:32
  SPEAKER_01: I think that's simply amazing.
• 35:34
  SPEAKER_01: And I think all of your past experiences, obviously, as for most people brought you to where you are, but not everybody has the insight, the awareness.
• 35:44
  SPEAKER_01: I call it the blessing in some ways, to integrate all of that and experience life in a purposeful way.
• 35:52
  SPEAKER_01: So personally, all of that is amazing.
• 35:55
  SPEAKER_01: Um, I well, I had like a lot of thoughts and comments and things I wanted to touch on, but most recently you just said that there were some practices that you saw in Guatemala that you don't that you do think could be applicable and some things that don't.
• 36:08
  SPEAKER_01: I'm curious, what are some of those things and why do you think that they would or would not work here?
• 36:14
  SPEAKER_00: Yeah.
• 36:15
  SPEAKER_00: Well, so I would say, okay, let's talk about what can be applicable.
• 36:21
  SPEAKER_00: They use a lot of plant herbs to heal.
• 36:26
  SPEAKER_00: Um, I think that can be applicable.
• 36:28
  SPEAKER_00: Do we need the do we need so much pharmaceuticals?
• 36:32
  SPEAKER_00: No.
• 36:33
  SPEAKER_00: If there is an herbal version of it, you know, I why not?
• 36:38
  SPEAKER_00: And it works, why not?
• 36:40
  SPEAKER_00: Now, I think here's the problem with with their ancestral traditions and what they're practicing now, is that I don't think there's enough studies on it, on it, the efficacy and and and the results of it to really know or to really claim is it evidence-based to use an herb, this combination of herbs to treat a UTI, or this combination of herbs to treat uh to help with lactation, or this combination of herbs to treat a hemorrhage, or um, you know, whatnot.
• 37:13
  SPEAKER_00: I don't think those have been studied.
• 37:15
  SPEAKER_00: So unfortunately, it there it's it's in a it's in a position where we can't really say, well, no, this is better.
• 37:21
  SPEAKER_00: Well, we don't know, you know.
• 37:23
  SPEAKER_00: Um, but I do think that the the their use of herbs and plants to treat almost everything is a wonderful tradition that I can see bringing some of it in to supplement or complement what we have going here in the Western, in the in in a in the Western world.
• 37:45
  SPEAKER_00: So that's the that's one thing.
• 37:47
  SPEAKER_00: There's a lot of spiritual traditions um, you know, around the baby or around the mom, that um I think if anything would help um calm the nervous system or soothe the anxiety or address any trauma.
• 38:04
  SPEAKER_00: I mean, we have um psychotherapy and and and we have all we have our methods, but there's also the spiritual component that I don't I don't think in the Western world we bring it in into our experiences enough.
• 38:20
  SPEAKER_00: Now, individually, everyone has their religion and everyone has their spiritual practice, and so so that's great.
• 38:26
  SPEAKER_00: But for it to come and be led by a midwife as an I am bringing this, I'm I'm going to incorporate, but really make it a big part of of that person's experience, it'd be wonderful for for midwives to feel more free to bring to incorporate that.
• 38:45
  SPEAKER_00: Now, being in a city or in a in a city like New York City and in this in the United States, where every there's so many spiritual practices and religions, it that it just it wouldn't be possible.
• 38:57
  SPEAKER_00: But in a community that is all of the same spiritual, the you know, subscribe to the same spiritual practices because they're all mom and they're all you know, it's more homogenous, it's it's a lot easier.
• 39:11
  SPEAKER_00: Now, what would not I could do not see if flying here in the United States is, for example, when a patient is in labor and if they begin to hemorrhage, choosing oxytocin as an intervention is their third option.
• 39:35
  SPEAKER_00: Here in the United States, oxytocin is pretty much administered sometimes before the baby's fully out.
• 39:42
  SPEAKER_00: Um some people, some doctors that I work with as a nurse, some doctors prefer it, you know, for the for the pitocin, the oxytocin to be to start the postpartum pitocin, this is, for it to start as the second the the shoulder, the baby's shoulders are out.
• 39:58
  SPEAKER_00: Some people want it to start in being administered when the placenta comes out.
• 40:03
  SPEAKER_00: Some people, I mean, but it it is pretty much immediate when the pitocin starts to get um administered.
• 40:10
  SPEAKER_00: Now, for those listening, pitocin is administered postpartum to help contract the uterus, because I think it's 70% of any postpartum hemorrhage is due to atomy, which means loss of tone of the uterus.
• 40:22
  SPEAKER_00: And therefore, if we can give a drug, that will automatically cause it to firm or contract down, then we prevent hemorrhage.
• 40:30
  SPEAKER_00: Well, in the mom community, it's the third option.
• 40:34
  SPEAKER_00: Their first option is to give them a tea.
• 40:37
  SPEAKER_00: So there's two midwives working at the birthing center.
• 40:40
  SPEAKER_00: So while one is watching a hemorrhage happen, the other one goes and prepares a tea.
• 40:45
  SPEAKER_00: And then they they give the patient a tea.
• 40:48
  SPEAKER_00: And then there's another drink, which is like a cornmeal mixed with water and and sugar, and then they're given that.
• 40:56
  SPEAKER_00: And then if those two don't work, then they're given Pitocin.
• 40:59
  SPEAKER_00: And so I was like, well, this is very interesting approach to a hemorrhage.
• 41:05
  SPEAKER_00: Could I see the United States adopting this?
• 41:08
  SPEAKER_00: Absolutely not.
• 41:09
  SPEAKER_00: You know, don't say this happening ever.
• 41:12
  SPEAKER_00: No, no, no, no, no.
• 41:13
  SPEAKER_00: We're not waiting five minutes for water to boil for her to drink a tea, for the plan to take effect, then to reassess, to then to make a corn-based drink, to then reassess, to then give patois.
• 41:26
  SPEAKER_00: And we're not doing that here in the United States.
• 41:28
  SPEAKER_00: So that's an example of one thing I do not see um it translating.
• 41:34
  SPEAKER_00: Another thing also was um, I I was I was observing the midwives during a postpartum visit.
• 41:42
  SPEAKER_00: And um this is twofold.
• 41:47
  SPEAKER_00: In the postpartum visit, they were also assessing the baby, and the midwife found that the baby had sunken fontanelles, um, a sunken fontanelle.
• 41:56
  SPEAKER_00: And so me and my trained western mind, or yeah, western trained mind, a sunken fontanelles is is dehydration.
• 42:07
  SPEAKER_00: So let's hydrate the baby.
• 42:09
  SPEAKER_00: Well, for them, sunken fontanelles is they did not talk about dehydration.
• 42:16
  SPEAKER_00: And what I'm I'm forgetting right now on the spot what what they attributed it to, but what they do to address the sunken fontanelles is they do this practice.
• 42:28
  SPEAKER_00: It's it's a it's um it's a spiritual practice where they take the baby and they flip the baby upside down over a bowl.
• 42:37
  SPEAKER_00: So there's a bowl of water, and they take the baby and they flip the baby upside down, and they kind of do a motion, a downward motion with the baby, and they repeat it nine times while speaking to the baby.
• 42:51
  SPEAKER_00: Um, they say the baby's name and they do this downward motion with the baby over the bowl of water nine times.
• 42:59
  SPEAKER_00: And that is how they treat sunken fontanelles.
• 43:03
  SPEAKER_00: Does it fix it?
• 43:05
  SPEAKER_00: I have no idea.
• 43:06
  SPEAKER_00: Okay, I have no idea.
• 43:08
  SPEAKER_01: I mean because I didn't Alice was looking.
• 43:13
  SPEAKER_00: I didn't get to sing.
• 43:14
  SPEAKER_00: Yeah, I don't know.
• 43:16
  SPEAKER_00: I mean, they say it works, but this is this is their experience of like, yep, that fixes it.
• 43:22
  SPEAKER_00: Um, but I didn't I didn't see this baby again.
• 43:25
  SPEAKER_00: Like the baby didn't come for a follow-up.
• 43:27
  SPEAKER_00: And if a follow-up was scheduled, I mean I'm only in this birthing center in Guatemala for two weeks, so I didn't really get to see a follow-up.
• 43:35
  SPEAKER_00: Um, but that's what they do, and that's what they believe, and that's how they that's how they they care for Sun Confontanelles.
• 43:43
  SPEAKER_00: Now, another postpartum um another postpartum tradition that they have is which I think is a beautiful is a beautiful tradition, is they have what I am going to describe, it's it's called a A choo.
• 44:01
  SPEAKER_00: C-H-U-J.
• 44:05
  SPEAKER_00: And the best way I can describe it is it is a sauna with a hamam.
• 44:12
  SPEAKER_00: Take a hamam, put it in a sauna.
• 44:14
  SPEAKER_00: What is it?
• 44:16
  SPEAKER_00: Oh, a hamam is like a it's a it's a it's a bathhouse that is popular in um Middle Eastern countries.
• 44:25
  SPEAKER_00: So I came across a hamam in Turkey and I I was in a hamam in Morocco.
• 44:31
  SPEAKER_00: Um and it's in it's a it's a bathhouse where the women, well, there's a men's section and the women's section, but I could go in and in Turkey the hamam would there there was a woman who would scrub me down.
• 44:45
  SPEAKER_00: Uh whereas in Morocco I went in and I could bathe myself, or I could also hire a woman to scrub me down.
• 44:55
  SPEAKER_00: That's a hamam.
• 44:57
  SPEAKER_00: But this is and and and in the Mayan culture, and in the in the Mayan communities, every single house is built with a chew.
• 45:08
  SPEAKER_00: It's almost as if we have a bathroom, they have a chew.
• 45:12
  SPEAKER_00: And that is where they that is actually where they bathe.
• 45:15
  SPEAKER_00: All of the mom people bathe in a chew.
• 45:20
  SPEAKER_00: So on Wednesdays and Saturdays, everyone goes into the chew and they bathe each other, so they scrub each other down, and it's and it's but it's a sauna, it's hot, it's very, you know, they have a big barrel of water and then they have rocks hotly with a fire, and they're pouring water on the rocks, and it's just, you know, creates a lot of steam and it's very hot, and they're rubbing each other down.
• 45:44
  SPEAKER_00: For a postpartum visit, the midwife goes to the patient's house, and on day, I think it's day three, they take the woman into the tru.
• 45:57
  SPEAKER_00: And there's this whole ritual that they do for the woman.
• 46:00
  SPEAKER_00: They bathe the woman, there's these um plants, these leaves, these little branches, I guess you could say, where they kind of slap the woman's body, kind of like I think I saw I've seen that in a Russian, um, in a Russian bathhouse, where they, you know, slap the woman's body.
• 46:18
  SPEAKER_00: And then to address um any lacerations uh that may have happened, occurred during during childbirth, they do what's called a sople, which is in in English, it's basically a blow, where the and the midwife is in in this tru with them.
• 46:40
  SPEAKER_00: Both people are nude, um, but the midwife is doing all of the the the whole treatment on the woman.
• 46:47
  SPEAKER_00: And the blow or the sople is where the the postpartum mom goes gets down on on hands and knees, more like forehead and knees.
• 47:01
  SPEAKER_00: So her her her pelvis is is is is up, and the midwife takes in the hot air from the rocks and blows into her vagina.
• 47:14
  SPEAKER_00: And she does that about several times.
• 47:18
  SPEAKER_00: And what that what they believe is that that that that blowing of the hot hair air into the vagina helps heal the lacerations, but also helps in like contracting the uterus, almost like bringing the the uterus down forward.
• 47:37
  SPEAKER_00: If if I am the midwife blowing into a person's vagina, it would bring the uterus forward, but then anatomically it would bring the uterus down.
• 47:46
  SPEAKER_00: And that's our tradition.
• 47:48
  SPEAKER_00: Um that's sometimes America, but that's not happening here.
• 47:53
  SPEAKER_00: No, no, exactly.
• 47:55
  SPEAKER_00: Exactly.
• 47:56
  SPEAKER_00: So there's a couple of things that translate, you know, that can be brought over.
• 48:00
  SPEAKER_00: Um and then then there's some things that like, you know, yeah.
• 48:05
  SPEAKER_01: Oh my god.
• 48:06
  SPEAKER_01: Marisol, I want to hear, well, you know, listeners only get uh like one more minute with you, but I'm gonna get like unlimited time because we're gonna get coffee and dinner in the city, and I want to hear so much more of all these wonderful details about this trip and about these practices.
• 48:22
  SPEAKER_01: I find it so interesting, so fascinating.
• 48:25
  SPEAKER_01: I come from an Indian culture, so we have our own, you know, spiritual practices and ideas around birth.
• 48:31
  SPEAKER_01: And I love, love hearing what other people um, you know, kind of bring into this space as well.
• 48:37
  SPEAKER_01: Um, is there are there any last words you want to leave with our listeners before we end our time today?
• 48:42
  SPEAKER_00: Anything you want to share?
• 48:43
  SPEAKER_00: Yeah, and and I think I think you just led right into it, and that is recognizing the importance of recognizing that every culture has their spiritual practices, their rituals, and how important it is to honor that.
• 48:58
  SPEAKER_00: And I think if I if I take, if I take, you know, something else from this trip in Guatemala, where I am there interested in what they have in their ancestral practices, but also with the you know, realizing that I have a skeptical Western mind of like, I don't see how this really works or how this really relates.
• 49:18
  SPEAKER_00: But then the things that I that I did see um that that their beliefs.
• 49:23
  SPEAKER_00: One last thing that they that they do that they do there is when if a baby if a at 28 weeks, if the baby is breached, they'll do the external cephalic version at 28 weeks.
• 49:36
  SPEAKER_00: And here in the Western mind, we're like, but that's so early because there's the baby can still keep flipping around.
• 49:42
  SPEAKER_00: But what they do is they'll do the external cephalic version, and then what they'll do is they'll put a a band, like a binder at the top of their at the top of their belly to almost as if pinch the belly to constrict the space so that the baby doesn't flip back around.
• 50:00
  SPEAKER_01: Interesting.
• 50:01
  SPEAKER_00: And so I was like, that is interesting.
• 50:02
  SPEAKER_00: Someone should study the the outcomes of or the benefits and and and uh outcomes of doing external cephalic versions at 28 weeks rather than waiting for 36 weeks.
• 50:16
  SPEAKER_00: Like that's a great study, right there, if anyone's interested.
• 50:19
  SPEAKER_00: Great study.
• 50:20
  SPEAKER_00: And they and and they just and and one, it's easier to do when the baby's smaller and there's more room for the baby.
• 50:25
  SPEAKER_00: Two, it seems like there's less complications.
• 50:28
  SPEAKER_00: Like they don't seem that concerned about you know the cord snapping or or or the placenta being separated.
• 50:35
  SPEAKER_00: I mean, it just they did it right before my eyes, and it just seemed so easy to do.
• 50:41
  SPEAKER_00: Whereas when I see my my OB doctors here try attempting one at 36 weeks, I mean, they're struggling, they're really having to get in there and change.
• 50:52
  SPEAKER_00: Yeah.
• 50:52
  SPEAKER_00: So with that said, being there just it helped me realize how, you know, there are different practices and there are different beliefs.
• 51:02
  SPEAKER_00: And it is important as a provider in a country, in a state, in a city where there is a melting pot of different beliefs and and traditions and and spiritual practices, especially when it comes to around birth, how important it is to be culturally competent.
• 51:22
  SPEAKER_00: But if you don't know, just be mindful of honoring what they have, even if it doesn't make sense, even if it just is so not evidence-based.
• 51:32
  SPEAKER_00: It's important to them.
• 51:33
  SPEAKER_00: And it's if it if it helps them feel comfortable, feel trusted, or feel like they can trust their provider, because at least the provider is like, yeah, whatever you've got going, you do you.
• 51:45
  SPEAKER_00: I'm just here to support.
• 51:47
  SPEAKER_00: It helps them feel like, okay, I'm seen.
• 51:50
  SPEAKER_00: My spiritual practices are seen, and I can drop into my parasympathetic nervous system and allow things to flow.
• 51:59
  SPEAKER_00: So I just want to remind all providers to just remember everyone does it differently.
• 52:08
  SPEAKER_01: Yeah.
• 52:08
  SPEAKER_01: Well, Mary Stall, thank you so much for your time here with us, for sharing your story, your incredible story.
• 52:16
  SPEAKER_01: I can't wait to hear more.
• 52:17
  SPEAKER_01: If listeners want to get in touch with you, ask you questions, or learn more about the work that you do, where can they find that information?
• 52:24
  SPEAKER_01: What's the best spot?
• 52:26
  SPEAKER_00: Great question.
• 52:28
  SPEAKER_00: I keep a pretty low profile, but I'm on LinkedIn.
• 52:31
  SPEAKER_00: So you can look me up on Miris Almontoya at LinkedIn.
• 52:36
  SPEAKER_00: The show notes for people to get in touch.
• 52:38
  SPEAKER_00: Thank you so much.
• 52:39
  SPEAKER_00: And if you see, if you see on LinkedIn, you know, filmmaker, graduate from US, that's me.
• 52:43
  SPEAKER_00: That's the yes, I'm a filmmaker.
• 52:45
  SPEAKER_00: I love it.
• 52:47
  SPEAKER_00: Somewhere down the profile, you'll see, you know, nurse and then you'll see midwife.
• 52:51
  SPEAKER_00: But yes, that's you, you're on the right page.
• 52:53
  SPEAKER_01: I love it.
• 52:54
  SPEAKER_01: All right, thank you so much.
• 52:56
  SPEAKER_00: Thank you so much.
• 52:58
  SPEAKER_00: I appreciate it.
• 52:58
  SPEAKER_00: It's lovely talking with you.
• 53:00
  SPEAKER_01: Thank you all for tuning in and investing in yourself and your well-being.
• 53:04
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• 53:10
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• 53:13
  SPEAKER_01: Don't forget to use your exclusive 20% discount code FIT20 when you sign up for our signature course Master Your Public Floor, linked in the show notes.
• 53:24
  SPEAKER_01: See you again next week with an exciting new guest and topic.