Latest / The Birth Lounge Podcast / Ep. 499: Is Your Provider Really Trained in Breech Birth? Your Options for a Vaginal Breech with Betty-Anne Daviss

Transcript

Ep. 499: Is Your Provider Really Trained in Breech Birth? Your Options for a Vaginal Breech with Betty-Anne Daviss · The Birth Lounge Podcast

0:00
midwives that are bringing the breech back because obstetricians, don't necessarily wanna do it.
They still have their head attached to the idea of forceps.
I often say only person who- stuck head in the room when you're having a breech is not the baby's stuck head, it's head of the OB who thinks he has to use a maneuver that is 400 years old.
Hello, and welcome back to another episode of The Birth Lounge Podcast.
All right, you guys, I'm back at it with the breech talk.
I can't let it go.
I really can't.
You know why? Here's the thing.
Here's why.
I am, like, so committed, utterly committed, deathly committed, fight till the death.
I will literally...
This is the hill I will die on.
That's what I mean by that.
Like, this is the squeaky wheel that I'm gonna be.
We are doing too many cesareans in this country.
I am so committed to reducing that.
When we look at unnecessary ones, breech is such a low-hanging fruit.
It comes with simply training.
And it really is.
It really does come down to that.
Properly training providers, that's it.
We don't have to do much to achieve this.
We just have to be open.
The trainings exist.
The knowledge is still here, and the data is as well.
And so because we have the skills and because we have the data, now the only thing that's missing is disseminating this information Because once we have a system that is full of confident providers that have been properly trained and can safely, for mom and baby, deliver breech babies, now we have reduced the C-sections that were done for breech babies, for twin babies On both sides too, from provider preference and from mom preference.
So once we have these providers that are trained and we have a system that is properly set up to support these women We can start to educate women that there's a safe place to do this Of course, if you're listening to this podcast, you've started at the other end, right? You already know that breech is an option and can be a very safe option, provided that your provider is properly trained, obviously.
Um, in this episode, we're actually gonna talk about that.
We're gonna talk about what happens when breech births happen with providers that say that they are trained in breech but really aren't.
It looks a little different in the hospital than it does like a home birth, and we're gonna talk about both of those We're also going to talk about how to have the conversation with your provider that you want something different and what are your options when you are sitting in this prenatal appointment and you're sharing what your goals are and they're not aligning with your provider.
How do you navigate that situation and how are you supposed to know what your options are? Today I am so excited to be being joined by a midwife, Betty-Anne Daviss, who I've known for a couple of years, and I have gotten the opportunity to learn from her a couple of times and share in some birth spaces with her.
And I've learned so much, and I wanted to have her on to talk about the intersection of how breech and human rights intersect and where your power comes in in this story because I think a lot of times in the hospital system, we're met with this stonewall of, "You're having twins.
One of them is breech.
You have to have a C-section.
You're having a breech baby.
We don't allow that here.
We don't deliver breech babies here.
You have to have a C-section."
And this is so unfortunate because it's neither true nor ethical to do that.
Breech birth is safe.
It may not be safe with that provider or at that facility 'cause there are no trained providers or they're not set up for it, but that doesn't mean that breech birth isn't safe.
We have to do a inventory of, is this fear that is circulating around breech birth mine? And I think when you're sitting in your prenatal, you can really evaluate that.
Is your doctor sharing fears that they have that they have learned, regardless of whether they've actually seen them or they've just heard about them? Or is this truly a fear, an instinct, an anxiety, something in your brain, heart, soul that is coming up for you? That is super important because if the first one is true and it's your provider's fear, then the answer there is to find a provider that's not scared of breech birth and is trained.
You know? It's not always as easy as that, obviously.
Breech-trained providers in the US are far and few between.
They really are.
Um, and it's super unfortunate, although I have hope that we can expand that skill to more midwives.
I really do.
I just think we have to keep pushing.
That's gonna be part of today's talk.
Betty Anne has been a midwife for over 50 years.
She has done clinical research and published medical journals on hemorrhage and home birth and upright vaginal breech birth and VBAC.
She's talked at conferences.
That's how I met her And she's also done trainings all over the world for breech births specifically So today we're gonna kinda talk about that.
We're gonna kinda talk about breech birth, what you need to know to prepare for your conversation with your provider, and how to evaluate if your provider is the right fit for your breech birth or not We don't directly talk about this today, but I think this episode is probably gonna give you some good clarity too on whether breech birth is right for you or not.
I'm a firm believer that just like home birth, free birth, anything really, it's not for And I want you to be really clear with yourself because it is just so important for you and, and your baby and your birth experience, all of it.
Longevity That you are choosing a birth plan and path and making your decisions based on what feels most aligned to you.
All right, you guys, without further ado, Betty Anne, welcome to the show.
Thank you.
I'm so excited to have you here.
this isn't our first breech conversation on this show.
I am one of the ones that are a little bit louder online about breech birth when it comes to the doula community.
I am always highlighting that breech is an option.
Breech birth is an option.
It obviously takes a conversation, especially here in the US, which obviously you're in Canada, but we always have to make sure that our provider is trained in breech here 'cause, I mean, and I think that's a conversation everywhere, but particularly here in the US, trained, and that's kind of one of the most frustrating things.
But then I find that when a woman does find someone who is trained in breech, quote-unquote, And I say quote-unquote, your and I's definition of trained is hands off, we're not intervening, we're letting that breech baby come, and we'll intervene as needed, right? Very midwifery style.
I think a lot of times in the hospital when you ask someone are they trained, an obstetrician specifically, and, and hospital-based midwives, they're thinking on your back, extraction, in the OR, possibly making you have an epidural.
But yes, I can deliver a breech baby.
So quote-unquote, I'm basing this conversation on your definition of trained and my definition of trained.
So I think when women find a hospital-based provider, they then are met with all these roadblocks, things like, "Well," kind of like what I just said, "Well, I can deliver a breech baby, but you will have to have an epidural.
I only deliver people who have epidurals," or, "We have to do it in the OR just in case an emergency arises."
Right? And so I think the conversation I'd like to have today is what power do we have as women birthing in this system that is sometimes gonna accept our breech baby, and when they do, there's all these roadblocks that come along with it.
I'd love to kind of talk about the conversations that women can have with their provider, because I'm finding that women have the knowledge to speak up and they say, "But I want to birth a breech baby," and then they're met with roadblocks, and they actually don't know where to take the conversation from there.
Okay.
And that's how- what I- they're finding themselves.
Yeah.
you want to talk, me to talk about.
Okay.
Yeah, yeah.
So, maybe I'll just hand it to you at this point, and you kinda tell us the base, and then we can go into specific conversations and examples.
So you've caught me at a very interesting time.
I've, I have been practicing for 50 years, and I have been doing breeches during that time, not always in Canada in a hospital.
I have been outside in different places.
I, I was originally trained by traditional midwives in Guatemala, and, but I have come to the conclusion after working with one organization where we were doing, a one-day course.
I've come to the conclusion that a one-day course teaching people, especially people who don't have, credentials to practice, with, a healthcare system that is working with them, like CPMs who are doing breeches at home who have been trained and actually have some experience and had experience with other people.
I feel quite comfortable if they want to do them at home if there's nothing else available, right? but what I've- what has happened, and I've had some several conversations with David Hayes about this, he has left an organization that he was with previously because he found that they were having two They were teaching just one-day courses, really pushing, people to do it.
And although he does breeches at home, he was finding that they were having two and three bad outcomes a month at their peer reviews, and he started getting to the point It was just about a year and a half ago he's made a decision to break with that organization, and he's actually setting up a beautiful little center in Mexico.
And, some Canadians and Australians are actually collaborating with him on this.
and so we're setting up a new course called Breech POWER Course.
And POWER stands for, Program of Online.
So O st- the P stands for the program, O for online.
W stands for workshops or conferences where you get that one or two days of training.
But then the E stands for experience because we're trying to send people to places where they will get some experience, and whether that be Frankfurt or the place that David's setting up.
We also have another place in Brazil to which we're sending people, and we're just setting that up right now.
because what we realize is people start to, If you give people, a false sense of entitlement to do this and a false sense of ease with it because you say to them, "Oh, the data's good on the upright position," but you forget to tell them that the data is really good on the upright position in places, in settings where there are trained practitioners who really know what they're doing.
And I, I mean, I have done, breeches at home.
Presently, I have privileges at a hospital in Ottawa to do breeches as a primary care provider.
In, in Canada we say I'm an MRP, the most responsible person.
So people come to me and they send me breeches.
the midwives and the physicians send me, breeches, and the doulas.
Sometimes the, the physician clients are coming because the doulas have suggested to the physicians this is probably a better place for her to go because at your hospital you're not doing a lot of breeches, and we're The midwives are doing about 90% of the breeches at our hospital.
It's called L'Hôpital Montfort.
It's a French hospital.
And we have had very good success.
We've had, in the last 100 breeches that have approached us, well, several I mean, you know, since 19...
That's actually...
I'd say our data from about 2010 is no negative sequela, that's long-term, no perinatal mortality.
But I have seen that, the only damage that I've seen is actually, when I'm not the MRP, and the only damage I've seen is from the use of forceps.
And for that reason, I have made the decision to, continue really pursuing this history of forceps because it is quite fascinating.
we're gonna we're actually having a conference November 21st and 22nd in Toronto, and it's at Sunnybrook Hospital, which is the home of the infamous term breech trial, which is the study that put the nail in the coffin for vaginal breech births around the world.
It was a study done in 26 countries, 121 centers, and at first it looked like they were having bad outcomes, and then They, because they, you know, perinatal mortality, actual death of a baby is really uncommon.
And so the reason they did this study was because they thought, "Wow, we better, you know, check this out."
But we can't...
It's too expensive to do a randomized control trial if you don't actually include something other than actual death of babies.
So they, they, they had another category called short-term serious bad outcomes, morbidity.
And, and as a result of that, they, um, what, what they, what they found was they had very low APGARs, and they had some very short-term bad outcomes.
So they categorized those with perinatal mortality, and it made the study look very terrible.
But what we've come to realize since that time when they did a two-year follow-up of the, high-resource countries and their, outcomes, they discovered that was not very much difference between whether you're planning a hospital or, sorry, planning a cesarean or planning a vaginal birth.
So we've taken it from there.
And the thing about Canada, and I know Canadians pride themselves on collaboration, right? And I've been a home birth midwife for 50 years, like I say, and I have worked in the States, and I've worked in Canada.
And written a few pieces on the difference between American and Canadian feminists, and it's a kind of an interesting thing.
I wrote it in one of the books we called, Birth by Design.
It was done in 2006.
Ray de Vries was the, one of the main, editor of this book.
And what I said in it was that Americans feminists always tended to have heroines in their movement.
They've always...
They've Gloria Steinem and Betty Friedan and like...
But Canadians tend to not do that.
They tend to shy away from creating heroines because we don't have the Hollywood kind of way of seeing things.
And in fact, if any of us start to become too well-known, you're, you're questioned and, suspect that you're drawing too much attention to yourself.
This is just a different way of, of viewing the world.
And so what I found is that actually to our betterment to try to be cooperative.
And we also, as Canadian feminists, tend to want to use our bureaucratic structures, our, various government organizations, our various government legislatures in, in our situations.
In, in Canada, health is a provincially run, entity.
And so we have approached our, we did...
I mean, my husband and I are, are, have done a lot of work in the States.
We, we tried to approach legislatures across the States, after we put out the CPM 2000, very large health study, or sorry, study on home birth.
was a prospective, study.
It was the largest prospective home birth study published in a medical journal at the time.
we published it in 2005.
And we really wanted to do a collaborative thing, but it was, it was quite difficult because we find that in the States, things are quite polarized.
And ACOG, even to this day, continues to have anti-home birth legislation.
In Canada, the Society of Obstetricians and Gynecologists of Canada decided to rescind their anti-home birth policy in 1997.
And that's because midwifery became legislated in Canada in, in Ontario in 1993 and 1994.
We started, having midwives, and it's a requirement of our midwives in Canada that we offer both home and hospital birth.
And the rationale behind that is that we are supposed to be offering informed choice and evidence-based care, and you can't do that if you're not offering home birth, but also if you're not offering hospital birth.
Mm.
So to get back to the, where I am here around the breech issue, most women I find in Ottawa anyway, and this is not necessarily true in Southwestern Ontario where there are more Mennonites and where there are more, free birth movement is alive and well.
But in Ottawa, most of the women approaching us do not actually want a home birth if it's a breech.
Home birth for a non-breech, absolutely, we do lots of home births.
We have a birth center as well.
And that is all, by the way, paid for by our government.
Like, our home births are paid for by our government because we are responsible actors.
But with breeches, they usually want it in hospital.
So our next story with that is we I had to approach, my head of obstetrics about getting privileges to do breech.
And it becomes really hard for physicians when you're entering into their territory, which they feel the hospital is for them their territory, that, that a new profession on the block that doesn't have forceps capabilities could possibly think they could do breeches But we had Because it was a French hospital and because the head of obstetrics, his name is Dan Morrow, I have mentioned his name several times.
He and I have gone on CBC together to talk.
He just recognized at one point that it was the right thing to do to give me breech privileges because the docs at the time, and this was 2009 was when I first started working, with the data we were getting from Frankfurt and the, the types of, positioning they were using, the types of maneuvers they were using.
he just realized it was responsible to him to give me privileges so that I could teach physicians.
And after I taught them for four years with the new types of maneuvers, it wasn't new for me to do upright breech birth, but it was new to develop, some of these maneuvers that Frank was doing.
One of them was this, the Frank Nudge.
it's name has been obfuscated, I don't know what, how, what term you'd call it, by, by two other organizations who like to use the term shoulder press.
But when we developed it, I named the Frank Nudge because it's named after Frank.
And, David at one point said, "Well, I don't like to name maneuvers after dead white men."
I said, Frank's not dead.
Frank Lupin is alive and well."
What about living white men? Well, and also William Smellie, named them after, you know, named the, Smellie-Veit's or the, sorry, Marissaux-Smellie-Veit's, after, Francois Marissaux, William Smellie, and, and, Veit who was a German who worked in the 1800s.
But, what happened was, head of obstetrics just had faith in me and, and really worked out.
It's very much worked out.
So we have had, as I said, we've had good success, and what's starting to happen now is not only do we have home birth legislated right across the country, women are supposed to have the right and ability to access home birth, but now we're moving into the breech issue.
And it really is the midwives that are bringing the breech back because obstetricians, don't necessarily wanna do it.
still have their head attached to the idea of forceps.
I often say only person who- stuck head in the room when you're having a breech is, is not the baby's stuck head, it's the head of the OB who thinks he has to use a maneuver that is 400 years old.
You know, 3 or 400 years old.
And that is the use of forceps originally, suggested by William Smellie.
Mm.
And these were forceps were very high.
They were like way up into the, past the place where the baby's engaged.
Like, like, way they depict them anyway.
I don't know if they actually used them that way, but they must have damaged a lot of women.
And, we have just discovered that, we don't have to use forceps.
We hardly ever need maneuvers.
56.3%
of the breeches we're doing the, in Frankfurt anyway, that when we did the data there, fell out with no maneuvers at all.
So my husband Ken Johnson, is an epidemiologist, and he and I in 1990, 1990, '91, went to study at the National Perinatal Epidemiology Unit, and that was the unit in Oxford where Ian Chalmers, from Britain, Murray Enkin, who is a Canadian obstetrician and epidemiologist, and Mark Kierse, who was an obstetrician and, epidemiologist as well, had, had brought together this very amazing, two volumes of randomized control trials all put together in one place about all the different, obstetric controversies.
And in that, attempt to, to put some research and evidence to the table, or bring it to the table from, obstetrics, they, they managed to really, help people understand all the procedures that were being used that were not needed, and all the procedures that were being used that made sense, that, that actually were evidence-based, and we had a few things when lights went on.
For instance, they used to do, physicians used to do vag exams every time a woman came to them who was pregnant, especially in the last few months, just to make sure the cervix wasn't opening, and I'm thinking, "Eh, I wonder if that was opening the cervix."
You know, like, but, but anyway, they found that it wasn't fruitful.
There was no reason for it.
And one of the things they didn't study, though, is forceps for breech, and that is what I've been concentrating just on the last five years in particular because...
Well, the last 13 years, I suddenly discovered that my hand can go into the mother's vagina and get the head out if we- if it's really stuck.
But I've only needed it five times because- In 13 years? Yeah, and all the other, all the other maneuvers we use, or just the positioning is enough to get the baby out.
But, but what happens is, the obstetric world still thinks that that's the fear and that that's the thing they're going to be sued over.
in particular, one of the problems that's occurring around forceps is that the, Forceps were developed at a time and particularly promoted, especially in North America for breech.
Joseph DeLee in the 1920s put out, a book.
I've actually got a copy of his old book, and he felt that forceps should be used routinely and prophylactically, with every breech.
And I talked with Andrew Bisits in Australia, and he said, yeah, he used to do that too be- before 1994.
He would do it prophylactically, and that was for them to keep up their skills.
And then when Andrew moved from Sydney to, Newcastle, he discovered that they used this thing called the Mauriceau-Smellie-Veit maneuver, okay.
So, when the baby's coming down, okay, here's the pelvis, okay? And here's the baby coming down breech, okay? And body's already out.
Don't forget that this baby's coming out- Yeah, the body's out.
Yeah.
So just the head is in- for people visualizing it so what happens is Maorisol Smellie deed, what they do is they go in, okay, gonna leave my pelvis here.
They go in and they grab the head at the top, and they grab it, they try...
They used to do it with the mouth.
Now we do it this way.
They just bend it so the head will come out, 'cause you have to have the head bent, flexed in order to come out.
And so Andrew discovered when he went to Newcastle that that's what they were doing there instead of forceps, so he stopped using forceps.
And then when he went to upright position and he found out about how to do that through Maggie Banks, who was somebody who wrote a book on breech about the upright position, like, years ago, he thought, "Oh, we'll try that."
So, and he hasn't used forceps since 1994 And haven't used forceps ever.
I was actually going to learn how to use them when I went to Frankfurt and when I first went to try to find out what they were doing and how they were doing it.
I thought I was gonna have to use forceps, and they told me, "Well, we don't use forceps for breech whether it's on the back or upright," because they just don't do that in Germany 'cause they used to use the Block maneuver, which is a whole nother maneuver.
So while Europe was charging ahead while the US and Canada as its kind of surrogate person at the, at the time unfortunately, they were, Pipers invented forceps, special kind of forceps that, they found particularly nice.
And I found an old military video that shows, a physician stroking these forceps like, like a received, his new violin and he-- 'cause, I say that because my, grandson, grandson went to violin lessons, and, he went with a little girl.
And the little girl, just wanted to get the instrument out to play and try to make music.
My grandson, he wanted to, he kind of felt the instrument.
He's looking at how it worked.
He wanted to see all the parts of it, and that was his interest.
It was the instrument itself, right? And found that this was very clear with this, this physician, his name is Dr.
Denon, in 1963.
There's a video of him stroking these forceps for about the first third of the video.
He doesn't even describe how to use them.
He's just showing how beautiful they are.
And I'm going, I so think that's not beautiful because I've seen them used, and I've seen them cause damage.
And guess what? Your hand, if it's not a huge male hand, fits into the mother's vagina, and you only need one.
You don't need two.
Like thought at first I needed like salad tongs, like forceps, but I found that usually the head of the baby's either turned this way or this way.
And so I discovered one day that you can just go in like this.
You can bring your right up to this.
You can rotate it and flex it and bring it out, and it's worked for me.
And, we have spread that all over the world, and, I've spoken at conferences all across Europe, China, Australia, the States, South America I haven't actually done this in Africa, but it's, it's moving.
Like, people are starting to get that they don't need to actually use forceps for breeches.
Mm.
And when you realize that, that's when you realize that an obstetrician does not have to be in the room when you're doing a breech.
Mm.
You wanna know something that so many people have big opinions on and I was so not ready for it? Laundry detergent So I knew I was gonna switch to, like, a cleaner detergent in pregnancy, and definitely once my baby was born.
And I made the mistake of asking the internet, like, "Hey, what clean laundry detergent do you, uh, use?" And boy, the conversations that ensued, I just was dumbfounded, honestly.
People have so many big opinions.
People have tried all sorts of detergents.
I knew there were gonna be so many out there, which is why I asked, and it basically boiled down to two different really big brands, and I'm gonna tell you the one I chose, because I love them so much.
I'm actually not getting paid to put this out on the podcast.
If you buy through my link in this podcast, I'll get paid.
But just to say this, I'm genuinely telling you because this is a conversation that happens a lot in my DMs, and I wanted you to know what our family chose to use for laundry detergent that is truly free Now, if you've never been down the laundry detergent rabbit hole, let me save you some time.
I'll just tell you what it's about.
Basically, two really big problems with laundry detergent.
A lot of them have hormone disruptors, which you obviously don't want if you are a woman, and you especially don't want if you are trying to get pregnant, and then you, like, double especially don't want if you are pregnant, and then you don't wanna put that on your baby.
Okay, so that's the first problem.
The second problem is a lot of laundry detergent companies will only give you a little bit of laundry detergent, and the rest of it is water.
And so there's a question of actually how clean does it get your clothes, and also, if it's disrupting your hormones, should we opt for something cleaner? In our home, we chose yes.
So I went with Truly Free because their laundry lawn is plant-based, it's dye-free, and it is available in completely unscented.
I knew that that was super important to me when it came to the laundry detergent that we were gonna wash our baby's stuff in My DMs were completely filled, you guys, and one question just continued to come up and that was, uh, it doesn't clean my laundry, so I can't find one that doesn't, you know, leave a film on my laundry, or I don't feel like my laundry is actually clean, except for one, and that was Truly Free.
And for me, that is what tipped them over the edge I knew that I wanted a safe detergent.
I knew that my baby needed to be safe to be wrapped in blankets and sleep on sheets and have their clothes washed in this.
I wanted it to be unscented, dye-free, and most importantly, it needed to clean our clothes You can use Truly Free as a liquid, or I just use it as a powder And one final thing that I absolutely love is that when you order Truly Free, you get hundreds of loads in your box.
I've had my box for four months now, and we are only about a third of the way through the box, and I have a baby, so we're doing laundry constantly.
Honestly, if you're looking for a good, safe option for your family that's gonna protect your hormones and are safe with your baby, go to trulyfreehome.com
and use the code HEHE to save on your order of laundry detergent right now.
That is trulyfreehome.com
using the code HEHE.
But back to should you be doing that at home or hospital, really depends on whether that, what that mother wants.
And she has to be well-educated about that because you do need to have somebody who has experience.
So if you've got someone like Diane Goslin in Pennsylvania who's done like 750 breeches, I would feel safer with her doing a breech at home than going into a hospital that's not very, open to doing breeches.
But if you had Diane If Diane was given privileges to do births in hospital, there would probably be women who would choose her- Mm and would choose that hospital to go to.
Mm.
And that's what we do in Canada.
We are much more collaborative than the States has been.
We're finding that the, the Really in, I'm not sure if I said this because I've said this on another, a video that we put out on Instagram, but there are midwives in Vancouver, Victoria, of them in BC, Edmonton and Calgary in the Alberta which has decided to stay in Canada.
Halifax and in, Charlottetown, which is the capital of PEI, and in Ottawa where collaborating with the obstetricians.
And in some places, the midwives are acquiring privileges themselves to do it with or without the OB in the room.
In other places, the OB still thinks they should be in the room.
I'm hoping that eventually when they recognize that the midwives and they both have the same capabilities, that they can be on call for each other.
Like, that's working in Canada.
And, and part of the reason we're having this conference is, Toronto at Sunnybrook, is we're trying to encourage that even more.
And what's really fascinating to me is it's the family medical residents that approached us to do this conference.
Hmm.
Because they are watching births occurring in their hospitals that they realize should be done in a different way.
And although they're family physicians, they're not obstetricians, they have breech within their scope of practice, just as all midwives do, and therefore they should be, allowed to do it.
If the obstetricians in any jurisdiction have decided to become de-skilled, only want to do cesareans, they need to step aside and let those of us who are interested and want to offer clients, and usually it's midwifery clients, the right to have it done in hospital or at home.
And so that's our strategy right now.
And I'm doing them almost, almost all the ones, almost all the women who approach me want a, want a hospital birth.
And some of the midwives now feel like we shouldn't do it at home at all, and I'm not really of that bent, but I do feel that, l- like to have our, uh, w- who, who we have in the room with us is not a pediatrician, but we have neonatal nurses or, or respiratory therapists, because we do find a lot of these breeches have very low APGARs.
Typical APGAR of a breech is, can be two and nine.
Like, they come out and they're gone.
That just happened on the weekend.
Now, that sounds a lot- So- That, that sounds very scary to people who are like, "Okay.
Well, right there I wouldn't want to have a breech baby vaginally, 'cause I don't wanna take the risk of a two APGAR.
I'd rather just have a C-section."
For someone who is thinking that, what do you say? And this is not someone who is choosing a C-section because they've determined it was them.
It's because they are scared of that bad APGAR.
Okay.
So I'll describe to you why we're no longer scared about APGARs for breeches that are low.
So if you've got a head down baby and you've got an APGAR like that, I go, "Whoa.
What's wrong with this baby?" But if it's a breech It's very normal to have low APGARs at the beginning,.
so I've had a conversation, let me give you an example.
I've had a conversation with, Barbara Harper, who's an old friend, uh, who does, water births.
I think I did water births before Barbara Harper, but she took off with it in a major way across the...
I did my first water birth.
Hey, we, we'll have a little, should ask her.
first water birth was like 1982.
and it was up here in, in the countryside in, in, in Quebec at a time when there was no boundary between Quebec and Ontario for midwives.
We just practiced anywhere.
but Barbara says she's studying the astronauts now, as everybody does.
Robbie Davis-Floyd also studied the astronauts, thinking about liking the analogy that when they, when they're at- they're going on the moon, they're still tied to their, like an umbilical cord to their spaceship.
one of the things you, you notice when they go up, they've got this big round circle around their head, right? And the reason for that is because that big globe protects them from the atmosphere of the, of the moon because their head would implode if they were in that atmosphere because it's not normal to us.
So with a breech baby as they're coming out, the body comes out first and, acclimatizes.
If they're coming out headfirst, then the, the head acclimatizes.
But when they're coming with the body first, the head is not quite ready yet.
it comes out and it hasn't had the same ability to kind of-- for the babies to kind of when they first come out with their head out, right, they, they start gurgling, and don't usually open their eyes yet, but acclimatizing to, to the new atmosphere.
And so we think that one of the reasons why breeches have a lower Apgar is of course because the head comes last.
So you have to give them a chance.
It's like a water birth also.
If they're in water they're not gonna breathe yet.
And what that means is the first Apgar might be lower because they're not ready yet to breathe.
But it doesn't mean that they're not okay.
Usually the heartbeat's fine, and so it's a really, the understanding you have to get is that they often develop something called respiratory acidosis, which is when there's occlusion of the cord, meaning the cord is coming down.
Here's a-- pretend this is the cord from my computer.
And, and it's pinched somewhere, and it's sometimes pinched more with the breech because if the head comes out first all the rest of the body is behind it, right? But if the body comes first and, and as it's coming down or even before it just comes out we get a lot of D cells, and I have learned to ignore largely D cells in second stage because the baby-- if the baby's imminent we're good.
If I see a lot of D cells and tachycardia and terrible, heart tone in first stage I'm likely to go to a cesarean if things are not happening quickly, just like any birth, any other birth.
And we take fewer chances with breeches.
We're, we're more conservative for sure.
But with the second stage usually they're coming down quickly.
They might be whacked out at the beginning.
They might even have some of this respiratory acidosis.
But It's very short term.
Metabolic acidosis is a different thing, but even if metabolic acidosis, they've shown that even if they have metabolic acidosis, it doesn't, it clears up essentially, usually.
So there's all these different parameters, for breeches that have to be applied in a different way.
When I, when I went to Frankfurt about, four years ago, one of the docs said, "You know, we should start doing APGARs on breeches at two minutes instead of one minute."
Well, I was gonna ask about the five and 10-minute APGAR.
Are they back up to normal and where you typically would expect a stable baby to be? Yeah, usually.
Yeah, and usually the APGAR, APGAR is too.
Yeah.
Yeah.
Okay.
And if they're not, then sometimes they go on CPAP.
They have more CPAP as well than, than head down babies.
We just think it's better for them.
I've had in the last, 100 births or so, I've had two babies go to the NICU to be, more extensive, care.
But one of...
Both of those were actually earlier on in my career.
One of them was, when I was doing a birth, I had to take over for an obstetrician because they'd never done a breech before.
The baby was very large, two feet came out first.
The, the baby's arms were around like this.
Hmm.
And I was trying to do the maneuvers that I had learned in Frankfurt.
And then I got the baby out, but the baby needed cooling actually.
Hmm.
And another one was where we mistook the mother's heart tone for the baby's heart tone, and that's also a very, difficult situation.
And felt, at the time, very betrayed by the, electronic fetal monitor 'cause I thought, "You know, if we'd been just auscultating this baby, it might have been that would've, we would've caught this."
But, nevertheless, you, you can catch it on the EFM.
that just happened to us again on the weekend actually, but we were more astute.
We, we now have three midwives at every birth, so one person is watching the monitor, one person is taking notes, and, and, one person, yeah, and then there's somebody catching the baby with me.
I try not to catch anymore.
I'm trying to get the midwives to do it.
So we've had midwives who have done between, between 20 and 30 breeches with me, which is great, 'cause they're learning.
Yeah.
Yeah, I mean, it's a dying skill, right? I talked about in the beginning that it's so hard for us here in America to find providers that are breech, breech trained, confident in it, and not the ones that are, like I say, trained, but are gonna force you to do birth your way, their way.
You know, force you to be in the OR, have an epidural, extraction.
I think that's probably one of the toughest things about having a breech baby in the US for us, facing us right now, is that even if you find someone that's trained in the hospital, because much like you're describing in Canadian women, very few women here in the US, I find, want to have a breech baby at home.
The ones that are open to breech birth and the conversation of, you know, should we have this baby vaginally are almost always thinking only in the hospital setting, and they, they just couldn't be open or, or they don't want to be open to the idea of a home birth with a breech, which I totally, I respect.
I probably would have a breech baby at home.
I've seen good breech outcomes, though, and I, you know, have hung out with people like you and Dr.
Rixa and, Dr.
Denny and Dr.
David, like, all the people that are doing the trainings.
That's where my breech knowledge comes from, and so I have a lot of confidence in breech, but I think that the fear definitely outweighs even the curiosity here in the US, and it sounds like you guys are light years ahead of us in Canada, that not only is the curiosity there, but the eagerness to learn and the openness from your organizations that are doing the governing.
Like, you have the cooperation, you have the ability, and here, maybe you, met her here.
I won't use her name 'cause I wanna make sure that we obviously keep her safe, but there is an OBGYN that I have become friends with, and I first met her at the, the breech conference, and, she had attended a couple years.
Wait, which, which breech conference? Dr.
Nathan Riley hosts it, so, Okay it had started in Kentucky.
The first one or the second? Yeah, the first one or the second one? I met her at the second, but we had been, I had been to both, yeah.
and she, she wants to learn, or she's, she's learning breech, right? She's going to these conferences.
She's being trained, but her hospital is penalizing her.
Penalizing her.
And her coworkers are writing her up and turning her in, and it's really, really unfortunate because that collaboration that you guys are experiencing and the way that you're really able to hone in on honoring women's autonomy and their right to choose is really not happening here for those reasons.
Well, say that, I didn't have a hard time at the beginning because as soon as, my dream beautiful collaborative, head of obstetrics retired, I had quite a bit of trouble because, people were thinking, "Okay, now maybe we could, cease all of this nonsense going on."
And we, we made it through that because there were reviewers of my practice, and it was fine.
They came up with she should continue, so yeah.
It's just crazy not to want to help women have a breech baby vaginally with as little intervention as possible when we know how Just life-changing a C-section can be, right? There's like the physical aspect, the mental aspect.
There's the, the impacts on the baby, the long-term impacts on mom.
We just have so many things.
Not to say that vaginal breech birth doesn't come with risks, 'cause it does.
We just talked about a number of them.
But when a woman says, "I would rather take on these risks than those risk," it is really insane to me that the systems not only don't support that, but they almost, especially here in the US, I mean, I'm thinking particularly of bans.
"Oh, we, that's banned.
We can't do that here.
We can't...
We don't allow people to have breech births vaginally here."
It, it's like they are intentionally going against us to intentionally not support it Well, any physician will tell you that the reason they don't wanna do it, it has to do with liability.
Mm.
And certainly, the last I looked, 70% of OBs in the United States were being sued at some point in their career, which is high, right? In Canada, the, the Society of Obstetricians and Gynaecologists of Canada made it very clear when they rolled out their new guidelines that they would protect their physicians if they got the experience they needed and started doing breeches.
They, they wanted to make them aware that they were gonna protect them, but it didn't help any.
And so I think a lot of it has to do still with the bother of having to learn breech, which is funny to me because I lived during the days when if you did breeches, that designated you as a, an advanced obstetrician who really knew his stuff, right? And it was something to look forward to and something to be proud of.
And now it's, they try to paint it as something that's foolish.
And you know, I, we had a, I had a situation recently where I had a, I was taking care of an older person who had an operation, and he was really having a hard time, came home from the operation.
He wasn't supposed to take any walks.
It was a back operation.
And, we were trying to figure out why it was that he just went ahead and kind of ignored the, the, the orders of the doctor, and I realized that he, he likes to have a You know, when we talk about the childlike or it's, it's the child in me, my child self that is, that is doing things? But I think that what's happening is sometimes you have a childlike behavior, but sometimes it can turn into a childish behavior.
Mm.
And the two are very different.
And when women are trying to have a birth that is one that they feel safe with and they feel safer in their home and it's not a breech, I think...
And, and they're VBAC.
We do lots of VBACs at home here in, in Canada.
I think it's a very, they're tapping into their openness, their endorphins, their sense of awareness of what happened last time, and it's not childish.
They are, they are actually looking at the evidence.
not being immature about this, 'cause childish means you're somewhat immature.
You're just, going against the grain just, 'cause you want to.
You wanna throw a tantrum.
But, there's a lot of judgment In the childish category compared to the childlike category.
And I think that if we could like I think, I think the free birth movement is a really good example of that.
Like, if someone's having a b- baby, I mean, I, you know, I had a client who came and had her second baby with me 'cause she really wanted to have her babies with dolphins in, in, in Florida, but I was the next best thing.
And she had her baby, in a pool at our cottage, with the lightning going.
And, and then the next time she was pregnant, wanted to have the baby outside again, but it was February in Canada So I found her a Guatemalan midwife, and she went down to have her baby down in Latin America.
And but she has very good births, and she knows that, and she's very confident in herself.
And I think that it's not silly.
But when you're having your first baby, and you're, You have an IUGR baby, a baby that's, small for dates, and you have something presenting possibly that might require more maneuvers than you bargained for.
You're, you're putting yourself a little bit more in, in jeopardy.
And, fact of the matter is, if you have also had a racialized woman here, several months ago who had had a, a cesarean twice, once with a midwife, once with an OB, and she was not gonna have the next baby, in the hospital.
and there were some really tragic things that occurred around that, but I think that we worked out some, things with, for her next baby between her doula, between the midwife, she didn't want a lot of any kind of monitoring.
But I think, um, w- we did a collaborative thing together, and I, and I, and I think that, you need to work around those things.
you have to.
And, and, and the OBs at some point figure that out.
Uh, some do, some don't.
At my hospital they're pretty good.
I mean, we just did an induction on the weekend, and the Society of Obstetricians and Gynecologists does say that, we should be able to do induction for women, for instance, who have had ruptured membranes, and a third of the breeches end up with ruptured membranes.
this is part of the reason why we're, we're doing this, this breech power course.
It's a, it's a course that's not just talking, like, about the last seven minutes of the birth, which is what has been happening to date with these very short courses.
we're talking about management, the best way to manage, whether you should be using electronic fetal monitoring, when you should be using that.
Should you do induction? Should you not? Should you be clamping the cord? Obviously not at the beginning, if the baby's not breathing.
Um, but, all those controversies, that's what we're covering in this course.
We're also covering it at this conference, November 21st and 22nd.
I wanna put in that plug again.
And the reason for that is, thing So induction is a really good example.
The Society of Obstetricians and Gynecologists Canada made a decision after actually, after I wrote them and said, "Look, I've had..."
In their first guidelines they said, "We're not gonna do inductions.
No, that's not gonna be permitted."
And I'm going, "Okay, I got women going 42 weeks and three days.
I've got women with ruptured membranes."
looks like from the Frankfurt data now that about a third of women who are breech end up with ruptured membranes, and then many of them go past 24 hours.
And then what happens is most of the care providers go, "Oh, well, it's time for a section."
And I'm going, "Wait What about induction? But, we haven't been able to get induction, and so they've been going two and three days because they do not wanna go into the hospital because I'm only allowed to offer them a cesarean.
So, we just had our first induction on the weekend, which was great, and, and the OBs on call, they were really, really helpful.
Said, "You know, Betty-Anne, like, at this point, like, the midwives seem to have more experience than we do in these areas.
If you wanna do it, we don't wanna be involved," right? "But if you wanna go, you know, do what was within your scope of practice," and it's within our scope of practice to use oxytocin.
and so we did it, and it was a successful birth, and it was fine.
But I mean, we saved this woman a cesarean, right? And she, that's what she wanted, and it was not unreasonable.
It's not, it's not unreasonable to do something which you have data on.
Like 74% of the breeches, that are happening in France and Belgium according to their PROMOTA study, 70% of the breeches that have not been induced are augmented.
So that's, excuse me, that's a lot of oxytocin on board there.
And most of our births are, have no oxytocin.
There's no epidural.
we have, the, the, it's totally natural, and women have really, they take an, a four-hour seminar with us, so they know all of the, pros and cons of all the various maneuvers and the types of management we might use with them.
And, it works.
But when it comes to ruptured membranes, a lot of them really do want induction after they've been in, you know, in the community for a few days.
And so at the point where I'm going, "Okay, yeah, it should be offered."
So we've- So- crossed a new bridge.
Yeah.
I mean, look, I...
You guys are so far ahead of us over there.
It's like we've gotta just Get our foot in the door to have these conversations, much less think it out and do things Well, well that great hospital at Reading, Nicole Chaney led out in that, it's beautiful, conference in Pennsylvania, in Philly, last year around this time, and it was terrific.
And the people did come together at that point.
I was hoping something was gonna come from that.
I don't know what, what did.
But it's, yeah, it's very few hospitals.
I mean, David and I went up and down the California coast, and we went to Sacramento and San Diego and Where are you located? In Boston.
Oh, in Boston.
Yeah.
We haven't been to Boston.
Come on, I'd love to get more breech providers.
We're only about 10 hours away, eh? Like- Yeah like an hour and a half from the border.
Yeah.
Yeah, come on down.
I mean- Anyway we love it.
Yeah, we have a situation, at that situation, we thought that we were gonna...
Like, we went into the hospital in San Francisco and Sacramento and, and it, and they still didn't pick up on it.
Mm.
But one, but then there was an OB that, there's been a lot of, every time that if there's a bad outcome with a breech, unfortunately- The hospital just closes down the breech team.
And it's so ridiculous because what if you have a maternal mortality because there was a breech? Or because there was a C-section, or there, there are bad things- That's what I was- happen with, with head-down babies all the time, and you don't shut down your maternity ward.
That's right, and that's what I was gonna say.
We have had that situation occur, I won't tell you what city, but it's in Canada, where a, a mother died from a cesarean section.
And they did not, after that, pick up on doing breeches.
Instead, it made them more nervous, which is very sad.
And it's very similar to this thing about forceps.
When there's been damage from forceps, rather than think, "Maybe there's another way to do this," and looking at it, it's, it's really hard for physicians to, step back and say, "Maybe, maybe we should look at another way rather than use forceps again."
Because forceps are not even used very much for head-down babies anymore.
I mean, it went down people are doing cesareans more.
And, and it's even worse for the breech situation, 'cause there's fewer breeches and even fewer breeches that need forceps.
So physicians just do not have the same amount of ability they did before.
That's why I'm trying to help them get off forceps.
That's where the physicians really do need to learn from the midwives and from the, research we did in Frankfurt about how to go forward.
So for someone who has found a provider who's willing to have this conversation in the hospital, of course, it sounds like one of your best options is to get out of the hospital in the US maybe.
We don't have a ton of options, but also you're taking on a bunch of risks.
Let's just focus on the hospital 'cause that's where, that's the most questions that we get.
How can we have these conversations with our provider if they are saying, "I'm only gonna do breech this certain way," does that tip you off, like, okay, maybe this isn't a good fit because this provider isn't truly trained? And we talked about the risks that, you know, comes along with having a provider that's not truly trained, or is there a way that throughout, let's say, eight months after you find out you're pregnant, you, well, you wouldn't know that you have a breech baby at that point.
Golly, we have such a short amount of time, too, I guess, is the thing, that it's not really enough time to get anyone trained properly.
What do we do, Bettyann? If, if we're sitting in our prenatal- Well- and our doctor's saying, "I only will do it this way," now where does a woman take this conversation? Well, that's why in your in the States, women are having more and more home births.
Yeah.
And that's where they head.
And, and the physicians, it's time for them to really wake up and, and get that.
And a lot of physicians will say, "Oh, well, we're not gonna they're stupid enough to have a home birth," that they're gonna do that, which is in their mind, childish behavior, when in fact, for the mother, especially if she's, it's her second baby.
Mm-hmm.
For her to be having a breech birth by cesarean when she had a four-hour labor the first time round.
An example of that is Robyn Guy who started the Coalition for Breech Birth.
She lived here in Ottawa.
The Coalition for Breech Birth was started in Ottawa many years ago, 2004 or 2006.
And it was because Robyn had that situation.
We actually had a doctor And at that time I didn't have privileges to do breeches.
I was willing to do her at home, but she didn't actually do that.
She didn't actually call me about it because she had arranged, we had arranged for her to go in to have a physician birth.
She went in and he wasn't on call and he wouldn't come in.
And that's what happened to me a few times also at my own hospital and at one point I said, "Look, will you just let me do this because if, if you guys are not gonna come around on this, like mothers are asking me to do these at home and I want to have privileges at hospital."
That's what's also happening in Alberta.
a lot of midwives doing it at home, but they are asking for hospital privileges.
And I think that's where it is.
Like I think midwives across the States and Canada, need to start getting privileges because the OBs have de-skilled themselves.
And, and if you study anything about the professions, and I did do that.
I did it as my, MA degree was called From Social Movement to Professional Midwifery Project.
But I was worried about us getting too medicalized so I said, "Are we throwing the baby out with the bathwater?" And what I was saying is that, you know, we have this, had this great social movement in the '70s and '80s, and '60s as well, and, and when you get legislated sometimes the activism goes out the window and it's really important to keep that activism going.
So one of the challenges I have right now to the, people coming to the course and especially to this conference on the 21st and 22nd, as I've said to them, everybody, Canadians are collaborative.
The first step to collaboration is communication.
If you can communicate with somebody in your hospital, not in your profession, but another profession, so if it's a midwife, if she talks to either a family doc or an obstetrician and invites them to the conference, we will honor the attempt at communicating, and we will allow them to come each for $400 instead of $500 for the weekend because our course is not about making money.
Our course is about creating collaboration among all the professions that have vaginal breech birth in their scope of practice.
And it is in most people's scope of...
for midwives, family docs and obstetricians, it's all in their scope of practice.
But right now in Toronto, it's the family docs that are taking the lead, and it's perfect 'cause they're right in the middle of the OBs and the midwives, right? And so we're going, more power to you, but the midwives that are really...
It's the midwife clients that are continually asking for these births.
So just time, yeah, that we all worked on this together.
Yeah.
Oh my gosh, I love that.
What a beautiful way to wrap up is that this entire conversation is driven by women.
It's just us learning to speak up and say, "I want this type of birth, and I want you to have the skills to be able to do that, and I want this to be allowed at this hospital.
And honestly, if you don't, I'm gonna have to explore other options."
And the hospital doesn't want to hear that.
Your doctor doesn't wanna hear that.
you know, and, and it's not about punishing them.
It's just simply about holding your power and saying, "I know that there are other options, and I'm not gonna be forced into a checklist of things to do because you're scared of breech birth," you know? And I do think something that came up for me, and I just wanna leave this with you guys as we wrap up here, is that one of my favorite parts about being in rooms that we're talking about breech birth and twin deliveries and, you know, home birth.
You and I were just, together at the Allowed to Birth, premiere.
Those spaces are filled with such deep wisdom and such compassion and so many pattern recognizers.
You got people who can just pick out a pattern, and they, they have the tools and the knowledge and the ideas of how to fix these things.
And for me, it really banishes all the fear.
And want, if you are out there listening and you're an L&D nurse, or you're an OBGYN, or maybe you're a hospital-based midwife, or maybe you're a home birth midwife and you are fearful breech birth, I encourage you to just expose yourself to people who practice breech and deliver these breech babies and are very uh, knowledgeable about this You will learn a lot of that fear was given to you, and it's not actually yours to carry, and that Yeah, it's cultural knowledge...
It's what? It's cultural.
Yeah, absolutely, and it's passed down to you without you ever seeing real evidence of that fear being true.
But what we do have real evidence of is the data and how good breech birth can be if we have the access and properly trained providers.
And you guys, it is just, I leave those events, ah, high as a kite, just, like, on hope.
Yeah, I wanna do another hopeful thing.
I think people should look at my book.
Oh, yeah.
'Cause this, this- Please tell us about your book.
So this is called Birthing Models on the Human Rights Frontier.
Is it backwards? Can you read it? No, no, we can read it.
Yeah.
Okay.
Birthing Models on the Human Rights Frontier.
And these are all women.
These are actually all women in, in my community.
This, they're standing in front of the, this, statue that is called Veritas, which is truth.
And because this is a book called, it's saying, Birthing Models and the Human Rights: Speak the Truth to Power, because, Henry Foucault, right, who originally said that he thought that...
Michael Foucault, which He says you...
the person who is really strident is somebody who uses his freedom and chooses frankness instead of persuasion, truth instead of falsehood or silence, the risk of death instead of life and security.
We're doing that in Ukraine right now.
criticism instead of flattery, and moral duty instead of self-interest and moral apathy.
And this whole book is, like, 16 communities from China, the, the midwives in China, to, Jenny Joseph's work in Florida, to the Inuit who have just decided to-- they just decided to replace the, white male person in charge of their health facility in Puvirnituq in, like, 1980s, early '80s, to replace it with an Inuk woman.
And it's, it's got a chapter on Afghanistan.
Chapters on the, places in Africa where they have replaced the doctors who have been, using all of their skill and, knowledge, just a few months, and then they leave and go to their colonial country and practice there because they get more money there.
So they've started-- They've gotten wise, and they're teaching clinicians to do cesareans.
Like, just beautiful stories.
Also Robin Lim's place in, in, in, Bali.
but this whole book is talking about how progress is not measured by whether or not Uh, there, there's a progress in, in, in economics.
It's more, progress in whether human rights are happening in your jurisdiction and in your country.
And Canadians tend to be thinking, well, our prime minister has recognized Palestine as a jurisdiction, amazingly.
It's about time.
And it's like, all of, all of our social activism as midwives is intimately connected with the activists around the world around climate change, around the environmental problems, around issues of, of militarism, sexism, all of these issues.
They're, they're all very much connected.
And, and so one of the things I do in both, both the intro and the conclusions to this book, I talk about that.
I talk about how we have to get together as activists to, to, to change the world 'cause, that's what I always say wanna do, that I...
My mission in life is to do nothing short of changing the world.
But we're doing it one birth at a time, and, and it's working.
Yeah.
Yeah, you're doing it.
You're definitely doing it.
I, I'm so grateful that our paths crossed several years ago at that first breach conference.
I remember standing out in the line to get food, and you were just in front of me, and I thought, "Wow, this is such a really cool intersection.
I'm so glad that I got to be around this person."
And then our paths have just crossed several times since then, and I just feel very lucky to be able to share this space and learn from you and, and to share your message and to, to get this knowledge out to people who are eager for it, but sometimes it can feel really hard to be on that search for knowledge about breech birth and what your rights are.
So if people wanted to grab your book, where can they find it? Where can they grab that? you just go online.
It, it's with Rutledge, so you go, go birth models that work, and get it from Rutledge because if you're getting it from Amazon, it's a secondhand thing.
Oh.
Well, you can get it on Amazon, but, but Rutledge is the name of the publisher.
Okay.
Cool.
Betty-Anne, if people wanted to follow along with your work or learn from you or connect with you, is there a way for them to do that? Uh, probably go to the Breech Power Course.
There, there's, we have two websites.
We have one that talks about, straight line obstetrics, which is about trying to undo the Friedman curve and, and trying to follow this straight curve that no one ever really needed.
We collected data on that from the, with the Midwives Alliance of North America years ago.
And so that issue is, just about things other than breech are, at our understandingbirthbetter.com.
But if it's about breech, go to breechpowercourse.com.
It's all one word.
Cool.
So understandingbirthbetter.com
or breechpowercourse.com.
You'll find what I'm doing there.
Amazing, and Routledge for your book.
Okay, we'll link all of that in the show notes for you guys.
You guys don't have to remember those websites.
We'll link it for you.
You can grab it down there.
You also know about this other book I've got out, got a few books out.
We've got, we've also just put out a book, on traditional midwives, Robbie and I.
Oh.
there's also And wanted a chapter on traditional midwives in North America, and she didn't wanna do it, and she was the lead author on that one, so I wrote a whole chapter, and then she said, "I'm not gonna include it."
So that's gonna be another little thing I'm gonna do soon.
But there's also another rethinking book that I have, the Rethinking the Physiology of Vaginal Breech Birth.
Oh.
Which is, it's not a glossy thing.
I- Breech Without Borders has a beautiful book out which has lots of pictures, but this is a very succinct book.
It's this one.
I'm sure you know it.
It's the Rethinking the Physiology of Vaginal and Breech Birth, and it's got the history and the research and the politics and, and the histories, especially since we...
Well, the ancient history, but also just two pages of that, since we started working in Frankfurt and since we started bringing back the, breech, breech birth Oh, my gosh.
I love it.
So many resources.
Thank you so much for being here and sharing your wisdom and talking with us.
feel like I should have you back on to talk about the Friedman curve.
So we can do that in another episode, 'cause I think that's a really fascinating topic, too, and something that, I'm sure you found just kind of hijacks our birth, especially in the hospital system, to put women on a time clock.
Okay, anywho, we're out of time today, you guys.
We don't have time to go into that, but I promise, I promise I will bring Betty-Ann back on for another episode so that we can talk about that.
I will see you in the next episode.
Be sure to follow Betty-Ann and her research, and grab her books, and you can find me on social media @tranquilitybyhehe or the.birth.lounge.
Until next time, head to your app store and download the Birth Lounge app for evidence-based childbirth education and postpartum support delivered straight to your phone.
Bye.
Bye.
Thank you.
Thank you so much for tuning in today.
I love hanging out with you, and it is an honor to be your go-to gal when it comes to preparing for your baby.
If you've enjoyed today's episode, please leave a five-star review and tell others why they should be listening to the Birth Lounge Podcast too.
You deserve to have a birth that you love with a provider that values your autonomy and respects informed consent without all the trauma that you so commonly hear about on social media.
New episodes air every Wednesday and Friday.
Hit that follow button so you never miss an episode.
I'm HeHe, and this is the Birth Lounge Podcast.