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Reframe Your Birth Story & Empower Your Birth · Fit As A Fiddle

• 0:00
  SPEAKER_00: But you didn't know to get in the tub or you didn't know to get in a polar bear needs chest position.
• 0:05
  SPEAKER_00: You know, I took care of a lot of my family and friends and people around the world.
• 0:11
  SPEAKER_00: And I would literally sit with them on the phone for an hour as I helped them turn their baby.
• 0:16
  SPEAKER_00: And then all that back labor went away.
• 0:19
  SPEAKER_00: And then they slept.
• 0:21
  SPEAKER_00: So you didn't sleep and you were so powerful that another 15 hours later, of course you needed a productive epidural.
• 0:30
  SPEAKER_02: Hello, everyone.
• 0:31
  SPEAKER_02: I'm your host, Dr.
• 0:33
  SPEAKER_02: Sneha Ghazi, a physical therapist, course creator, and mom.
• 0:37
  SPEAKER_02: 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.
• 0:48
  SPEAKER_02: Use discount code FIT20 for a special 20% discount exclusively for my listeners at the link in all show notes.
• 0:56
  SPEAKER_02: Each episode brings phenomenal guests in the health and wellness space who share inspiring tips and tangible advice.
• 1:03
  SPEAKER_02: All things health and wellness starts right here.
• 1:07
  SPEAKER_02: Welcome to this week's episode on Fit as a Fiddle.
• 1:10
  SPEAKER_02: Today we have a very unique episode for you because it's less of a learn about somebody's work only and a bit more about learn about somebody's work as it relates to my birth story.
• 1:22
  SPEAKER_02: Because today on the show we have Risa Klein.
• 1:25
  SPEAKER_02: She is a certified nurse midwife and the founder of Manhattan Midwife.
• 1:29
  SPEAKER_02: We crossed paths like three to four years ago, I want to say.
• 1:34
  SPEAKER_02: And we realized that at that time I was actually trying to get her on this podcast.
• 1:39
  SPEAKER_02: Both of us couldn't make it happen for various life reasons.
• 1:42
  SPEAKER_02: And then, lo and behold, just a couple of weeks ago, we crossed paths again professionally.
• 1:50
  SPEAKER_02: And we were connecting and we both figured out somehow that she was supposed to be on this podcast, and that's how we first met.
• 1:59
  SPEAKER_02: So everything's coming to full circle, Risa.
• 2:02
  SPEAKER_02: And thank you so much for making time for this episode and making time for our listeners.
• 2:06
  SPEAKER_02: Thanks for being here.
• 2:08
  SPEAKER_00: Yes, yeah.
• 2:09
  SPEAKER_00: Thank you so much for inviting me.
• 2:10
  SPEAKER_00: I'm so excited to be here.
• 2:12
  SPEAKER_00: Thank you.
• 2:13
  SPEAKER_02: I love it.
• 2:14
  SPEAKER_02: So let's first um give an opportunity for the listeners to get to know you a little bit.
• 2:18
  SPEAKER_02: So um please go ahead and tell them what you did in the past, what you're doing now, how that connects, and why you're so passionate about it.
• 2:28
  SPEAKER_00: Hmm.
• 2:30
  SPEAKER_00: Well, I was a TV news producer before I became a midwife, but I gave birth to my daughter, and that was the greatest production ever.
• 2:38
  SPEAKER_00: And I realized in my life I would much rather have my name on a birth certificate than scrolling down credits on a TV or a feature film, which I've worked.
• 2:48
  SPEAKER_00: So my journey led to Columbia University becoming a nurse midwife.
• 2:53
  SPEAKER_00: And for 10 years, I was a home birth midwife.
• 2:56
  SPEAKER_00: And then after doing a home birth and then having the physician I was working with, the late Andrew Garber, call me and say, Your twins are six centimeters, get to the hospital.
• 3:07
  SPEAKER_00: At that point, I uh was able to midwife and deliver those babies uh two boys.
• 3:13
  SPEAKER_00: But then at that moment, I made a decision.
• 3:15
  SPEAKER_00: I can't be at home and hospital at the same time, and I decided I'm gonna bring my home birth heart and hands and wisdom to hospital.
• 3:23
  SPEAKER_00: So that is what I did.
• 3:25
  SPEAKER_00: So for 20 years, I had my own practice, Manhattan Midwife, attending women at home, then hospital, and birth center hospital.
• 3:36
  SPEAKER_00: It was a phenomenal journey working with people from all over the world, all different socioeconomic statuses, military.
• 3:45
  SPEAKER_00: I mean, I just was blessed to uh attend all these people.
• 3:50
  SPEAKER_00: So uh my passion to empower mothers and to have low intervention and high satisfaction was always my goal.
• 4:00
  SPEAKER_00: Every woman, even with her first baby, doesn't deserve to have trauma.
• 4:06
  SPEAKER_00: Now, if she's had prior trauma, that's fine.
• 4:09
  SPEAKER_00: We talk about it.
• 4:10
  SPEAKER_00: So my practice really was about helping women, mothers feel emotionally grounded.
• 4:16
  SPEAKER_00: So in my journey, uh, right now what I'm doing is counseling mothers who have had either a challenging first experience or second or third birth experience, figuring out medically what happened, what was the chronology of events, how did they feel, what was going on?
• 4:35
  SPEAKER_00: So this is something that I do uh virtually primarily, but also in person.
• 4:40
  SPEAKER_00: And also um I work in the legal world, also going through medical records.
• 4:46
  SPEAKER_00: So that has put me in a position where I am even more passionate to help mothers figure out how they can be empowered and not have mistakes or challenges occur in their birth so they don't end up with a terrible outcome.
• 5:04
  SPEAKER_00: So right now that is what I'm doing, and I've been working on a book that I'm writing, so that's also just dating.
• 5:11
  SPEAKER_00: So I'm passionate about teaching women how to make sure that they're asking the right questions and understanding if they did have a birth experience and it was challenging or stressful, how could we in fact talk about it?
• 5:27
  SPEAKER_00: So we use that as a foundation of wisdom and learning, understand chronologically what happened medically, medical decisions that were made, so then they can have their next baby and understand these events so they don't repeat them and can have every baby teaches us how to have even more of that mother heart and to make new decisions.
• 5:48
  SPEAKER_02: I love that.
• 5:49
  SPEAKER_02: And I think that your work is especially, especially important right now because we have a very changing landscape of birth justice, birth rights, uh, birth awareness, honestly.
• 6:03
  SPEAKER_02: Um, I would love for you to speak because I think this is the most important like trajectory is how did how did birth happen most of the time in human history?
• 6:14
  SPEAKER_02: How and why did that change?
• 6:15
  SPEAKER_02: And then this very interesting landscape because you worked for 30 years plus in New York City.
• 6:21
  SPEAKER_02: Um, what did that look like when you were actively um attending births and helping families?
• 6:28
  SPEAKER_02: And how is it shifting right now?
• 6:30
  SPEAKER_02: Could we just talk about that to listeners?
• 6:32
  SPEAKER_02: Because most people, I until I was in this field, I had no idea.
• 6:38
  SPEAKER_02: I was like, we just go to the hospital, get IV'd up, and then the doctor rips the baby out of your body, right?
• 6:43
  SPEAKER_02: Like that's what's supposed to happen because that's what we're fed with media, and that's what that's just kind of like how this world works right now.
• 6:51
  unknown: Yeah.
• 6:51
  SPEAKER_02: So I'm just curious if because you're so knowledgeable about just the trajectory and the history of how this has evolved and how it's evolving, can you explain that a little bit more to the listeners?
• 7:02
  SPEAKER_00: Yeah, I feel that um, well, to set the stage, if you notice, uh not wearing a watch.
• 7:09
  SPEAKER_00: Okay.
• 7:10
  SPEAKER_00: So that's really a premise for in life.
• 7:15
  SPEAKER_00: How do we go about doing anything in our lives?
• 7:18
  SPEAKER_00: Are we rushing or are we really being fully present?
• 7:21
  SPEAKER_00: And, you know, hundreds of years ago, there was no technology.
• 7:25
  SPEAKER_00: People came over, you know, they called their family members over when they were having babies, or, you know, the granny or the grandmother or the auntie who knew how to deliver babies, and people had their babies.
• 7:37
  SPEAKER_00: There wasn't this um announcement worldwide about what birth was like.
• 7:43
  SPEAKER_00: People just knew within their communities.
• 7:45
  SPEAKER_00: I think it was just so much more personal, and you had to have your baby and go out and work or feed your family.
• 7:53
  SPEAKER_00: Um, in the 30 years, I mean, when I started, I became a childbirth educator because of what I learned from my birth.
• 8:04
  SPEAKER_00: Because when I showed up nine centimeters, guess what this backup stranger doctor did?
• 8:10
  SPEAKER_00: He just kept looking at his watch.
• 8:12
  SPEAKER_00: What about looking at me?
• 8:14
  SPEAKER_00: So, in I think between health care, life, um, social media, people always rushing to get somewhere.
• 8:26
  SPEAKER_00: Well, if you rush to get somewhere when you're gonna have a baby, you're gonna end up with problems and lots of interventions, especially if you pick a provider that's always looking at their watch or giving you five, six minutes, and three minutes of those six minutes are with a tech doing your vital signs.
• 8:47
  SPEAKER_00: So, what I've noticed over the years, because coming from home birth, especially, and being in six hospitals in my day, not to mention being in a leadership position in one of the hospitals, seeing how the system works.
• 9:07
  SPEAKER_00: And believe me, you know, we talk about disparities um in social, racial, economic proportions, rural, urban, but you know, a baby doesn't know a rich mother versus a poor mother, really.
• 9:24
  SPEAKER_00: All it knows is that it wants to be born, and how is it going to be born?
• 9:30
  SPEAKER_00: So I think what's happened in our medical system is that people are picking providers that might not, and it might not be their fault, because I love doctors.
• 9:41
  SPEAKER_00: You know, we need them to do cesarean sections when medically indicated.
• 9:45
  SPEAKER_00: But if you look at the medical research, uh, almost one in three women are having a cesarean, and it's not necessarily medically uh uh for medical reasons, medically justified.
• 9:58
  SPEAKER_00: So we have to really stop.
• 10:01
  SPEAKER_00: And I believe that, and what happened in my practice is that before you even get pregnant, you speak with somebody like me or someone in your community that could really help you discuss your fears, your concerns, what your first birth was like, and listen.
• 10:21
  SPEAKER_00: Because if they're on the phone, if they're texting, guess what they're gonna do at your birth?
• 10:26
  SPEAKER_00: They're gonna be, they're not gonna change character.
• 10:30
  SPEAKER_00: So I think that that is what's happening, that people are too busy to really make educated decisions on their provider.
• 10:39
  SPEAKER_02: Did you ch see a change in the way that providers or the birth system operated from when you started to how it's operating now?
• 10:49
  SPEAKER_02: Or does it seem pretty much the same to you?
• 10:53
  SPEAKER_00: Yeah, I think that it's gotten more disconnected.
• 10:56
  SPEAKER_01: I think that's more disconnected.
• 10:58
  SPEAKER_01: Oh my god.
• 10:58
  SPEAKER_00: Yeah.
• 10:59
  SPEAKER_00: I think that there's a di because of what we're talking about, um, there's a disconnection between the women and their provider.
• 11:08
  SPEAKER_00: And we don't know sometimes who will be between our legs when we have our baby, basically, right?
• 11:13
  SPEAKER_00: So you're getting a stranger at your birth.
• 11:15
  SPEAKER_00: So how do you trust that person?
• 11:19
  SPEAKER_00: It's very difficult to do that.
• 11:21
  SPEAKER_00: And yes, we love our doolas, I love doers, but there's a lot of education that needs to go into place for them to keep somebody grounded so that the woman doesn't get basically derailed um in her labor.
• 11:35
  SPEAKER_00: So I believe that the system has gotten so disconnected that women get even more disconnected from their baby.
• 11:45
  SPEAKER_00: They're forgetting that they're having their baby.
• 11:49
  SPEAKER_02: That's really interesting.
• 11:50
  SPEAKER_02: Um one more question, but we'll dive into my birth in a second.
• 11:55
  SPEAKER_02: In a utopian world, we're gonna just talk about New York City because that's where we're both anchored right now.
• 12:03
  SPEAKER_02: Um, and there's like something like 10 million people in this island, something like that.
• 12:09
  SPEAKER_02: Um what in a utopian society, what would birth look like in this little island given the structure, what would be perfect if you could wave a wand and fix everything and make it so that it served humankind, let's put it that way.
• 12:28
  SPEAKER_00: I think that we would I know because this is the way my practice worked.
• 12:33
  SPEAKER_00: You know, I had a small people called it boutiquey, but um an individualized practice.
• 12:41
  SPEAKER_00: So providers know their patients.
• 12:43
  SPEAKER_00: They don't have to have the patient come in the room and literally look at their computer to know the patient's name.
• 12:52
  SPEAKER_00: You see, and you know, I um always want to make sure that the mother feels heard and respected and that the provider isn't focused on double booking appointments, which is what most, you know, it's about the money, you know, how do we make money?
• 13:10
  SPEAKER_00: And of course, we need these incredible hospitals.
• 13:13
  SPEAKER_00: I love hospitals uh for women who need to physically, uh, due to physical conditions and diagnoses, need a hospital.
• 13:23
  SPEAKER_00: You know, just in a utopian society, I'm not only talking about vaginal, I want to advocate for cesarean when they're needed.
• 13:30
  SPEAKER_00: You know, I once had a woman who uh had two uh home birth transports um and ended up with cesareans and she heard about me.
• 13:39
  SPEAKER_00: I do but did VBAP my entire uh uh delivery career for the appropriate medical candidates, of course.
• 13:46
  SPEAKER_02: Sorry, I'll just say VBAC for those people who don't VBAP means thank you.
• 13:51
  SPEAKER_00: VBAC means vaginal birth after cesarean.
• 13:54
  SPEAKER_00: So the guidelines are that the American College of Oppositions of Gonycologist says that it's medically correct if you so desire to try for a trial of labor after cesarean, known as a TOLAC T-O-L-A-C, to then have a VBAC.
• 14:12
  SPEAKER_00: So um I was known in the community for that, and she had two sections, and I empowered her on the phone, she was emotional, and she came in.
• 14:23
  SPEAKER_00: But when I saw her, she had a pelvis like a man.
• 14:27
  SPEAKER_00: It's called an android pelvis.
• 14:29
  SPEAKER_00: Beautiful woman.
• 14:31
  SPEAKER_00: And in the course of us working together, I knew intuitively it was a boy, her first two were girls, and guess what?
• 14:39
  SPEAKER_00: She labored till fully dilated with me, unmedicated.
• 14:45
  SPEAKER_00: I let her push once or twice, she felt the head, her husband felt the head, and we walked with joy into the operating room.
• 14:54
  SPEAKER_00: And then when I put the baby on her chest, she looked at me and she said, This was the best birth that I ever had.
• 15:01
  SPEAKER_02: Oh.
• 15:02
  SPEAKER_00: And that was because we had a connection the whole time.
• 15:06
  SPEAKER_00: She understood in her case now what happened, why the other two uh providers uh did not explain why she couldn't get a large baby boy out of her pelvis when she couldn't even get two smaller girls out of her pelvic inlet.
• 15:24
  SPEAKER_00: It wasn't her fault, it's just her pelvis.
• 15:27
  SPEAKER_00: So when I advocate for this utopian world, I want to say that why did that happen?
• 15:34
  SPEAKER_00: Because there was a connection, there was a relationship.
• 15:37
  SPEAKER_00: And also, um, when you know somebody prenatally as a provider, you can help them during the birth.
• 15:46
  SPEAKER_00: Or you could share with your providers really what's going on with her emotionally.
• 15:52
  SPEAKER_00: That's really what my whole book is about.
• 15:54
  SPEAKER_00: So, how do we really help people?
• 15:56
  SPEAKER_00: And I think that if somebody feels cared for, I mean, yeah, I mean, I've had people transferred to me, uh Sneha, in their late third trimester, afraid they were going to be sectioned.
• 16:08
  SPEAKER_00: I've had people fly in from around the world to have a VPAC with me because they knew of my technical and clinical skills of, for example, how to turn a posterior baby and when to do it, and my very low cesarean section rate.
• 16:23
  SPEAKER_00: Um, so yes, you know, having somebody who, oh, I squatted in my first birth, I have to squat, you know, with this one, but the baby's not coming and there are fetal deceler heart rate decelerations.
• 16:34
  SPEAKER_00: And then I look in her eyes and say, You came to me, yeah.
• 16:39
  SPEAKER_00: And she'll say yes.
• 16:40
  SPEAKER_00: And I'm saying, your baby doesn't like a squat right now.
• 16:43
  SPEAKER_00: Let's get on your side or let's get on all fours.
• 16:46
  SPEAKER_00: So we have trust.
• 16:48
  SPEAKER_00: So in a utopian society, having trust, knowing that your mama is going to listen to you, and being able to actually, you know, follow through with the mother after the birth, keep that relationship.
• 17:01
  SPEAKER_00: You know, I've delivered sometimes three, four babies in people's families because we've had such great relationships.
• 17:08
  SPEAKER_00: So I think that um every mama needs to keep that in the back of her uh mind as she uh journeys to find her providers.
• 17:20
  SPEAKER_02: And that's a great segue.
• 17:21
  SPEAKER_02: Well, I don't know where you want me to start with my birth story because you know how people's birth stories can get.
• 17:28
  SPEAKER_02: Um so I'll let you ask me some questions to get started, then I'll I'll go from there.
• 17:32
  SPEAKER_02: What would you like to know?
• 17:33
  SPEAKER_00: Okay.
• 17:34
  SPEAKER_00: I think that the very first question is, and which you know, I I really want your listeners to hear this is I want to ask you, what was the highlight of your birth?
• 17:44
  SPEAKER_00: Let's just start with that, because I think that once we go there, it'll be easier to then look at some of the challenges that occurred.
• 17:53
  SPEAKER_00: And you might even discover that some of what you thought might have been the norm was actually um a system in disarray.
• 18:04
  SPEAKER_02: Okay.
• 18:05
  SPEAKER_02: I think the highlight, other than obviously holding my baby, I think that's like a given.
• 18:10
  SPEAKER_02: I think the highlight of the births was probably a combination of me being able to be in my home and in my space laboring because it was very, very, very long.
• 18:22
  SPEAKER_02: Um, by the time from my first contraction and beginning of early labor to when baby came out was something like 45 something hours.
• 18:33
  SPEAKER_02: Um okay.
• 18:34
  SPEAKER_00: Well, thank you for we're gonna talk about 45 because that we're gonna break that down into when you really were in labor as opposed to other parts.
• 18:43
  SPEAKER_00: So exactly.
• 18:44
  SPEAKER_00: Thank you.
• 18:44
  SPEAKER_00: So you were home laboring.
• 18:46
  SPEAKER_02: Okay, so I was home and it started kind of in the middle of the night, and I was like slowly, very, very slowly ramping up and then um just being able to like okay.
• 18:55
  SPEAKER_00: So this is what we're gonna do to make it really fun.
• 18:58
  SPEAKER_02: Okay.
• 18:58
  SPEAKER_00: You ready?
• 18:59
  SPEAKER_02: Yeah.
• 19:00
  SPEAKER_00: So I want to reframe this for you.
• 19:02
  SPEAKER_00: That's what we're talking about.
• 19:05
  SPEAKER_00: So remember, why was it slow?
• 19:08
  SPEAKER_00: So we're I want to reframe slow, because slow inherently to the word slow means it's not fast enough, as we have just been discussing.
• 19:18
  SPEAKER_00: So I want to reframe it that perhaps it was exactly what your baby needed, and maybe what you needed, because could you imagine giving uh contractions two minutes later a baby drops out?
• 19:31
  SPEAKER_00: That would be emotionally too big of a shift.
• 19:35
  SPEAKER_00: So I just want to interject that I'm not really so sure it was slow.
• 19:41
  SPEAKER_00: I think it was just right.
• 19:42
  SPEAKER_00: Perfect that's out.
• 19:44
  SPEAKER_02: Yeah, I think I think that was that's a that's a perfect way to rephrase it.
• 19:47
  SPEAKER_02: Um, but yes, to highlight the highlight was being able to be in my space and do the things that I love and be in my environment with the things that I love and being in my backyard and experiencing that until a certain point where then it was starting to get energetically depleting, which we'll talk about.
• 20:04
  SPEAKER_02: Um, but then I think the second part that was the highlight was when we walked into the hospital room eventually that I ended up giving birth in.
• 20:13
  SPEAKER_02: Um, my husband knew to take out the like picture of us, um, like him holding my belly when I was pregnant for maturity shoot, and like just like a few things that I just really loved and that I needed to be able to see.
• 20:27
  SPEAKER_02: And then just settling in there and playing my playlist and just going into full birth mode.
• 20:33
  SPEAKER_02: I think those two pieces I are always very um like the sweetest memories, other than of course holding my child, like that's the number one.
• 20:42
  SPEAKER_02: But yeah.
• 20:42
  SPEAKER_00: Yeah.
• 20:43
  SPEAKER_00: So thank you for sharing those highlights because we're gonna weave them in how do we prepare you if you choose to have another uh baby and expand your family to make these subtle changes coupled with uh having people who are listening make shifts.
• 21:00
  SPEAKER_01: Yeah.
• 21:01
  SPEAKER_00: So when you were at home laboring, and then you shared the word energetic.
• 21:08
  SPEAKER_00: Now you're a healthcare provider, so I understand it, but I want to look at the words you until you got energetically depleted.
• 21:17
  SPEAKER_00: Now, besides um it happening to you during labor, when else have you been energetically depleted?
• 21:26
  SPEAKER_00: Like, where does that phrase come from?
• 21:29
  SPEAKER_00: Because I want to make sure that we can take it, write it on a little um sticky note, post it, and then roll it up and toss it in a garbage can or burn it, because that is a phrase that is real, how you felt.
• 21:45
  SPEAKER_00: I want to help you understand it, recognize it, and reframe it.
• 21:52
  SPEAKER_02: Okay.
• 21:53
  SPEAKER_02: So energetically depleted, and I cause like the first several hours.
• 22:00
  SPEAKER_02: Today felt energizing, exciting, comforting, and all the like I can say like a million positive adjectives for that.
• 22:11
  SPEAKER_02: And then I think that after the first like 20 hours of experiencing contractions, I think when it hit the 24 hour mark, which was I think around like 20.
• 22:23
  SPEAKER_02: So I I'm I can't remember exactly.
• 22:25
  SPEAKER_02: I don't have my whole like I like wrote some stuff down, which I don't have, I don't know where I put it.
• 22:29
  SPEAKER_02: Um but I ended up tracking my contractions when they started getting stronger and more frequent.
• 22:36
  SPEAKER_02: And then I had whatever that pattern was that I needed to be like, okay, let's just go in because it's been a day.
• 22:44
  SPEAKER_02: Um, let's just see where we are, just to figure that out.
• 22:48
  SPEAKER_02: And I don't know if that was the right thing to do or not at that time, but obviously, first time, don't know what's happening.
• 22:53
  SPEAKER_00: Um, so I went in and I remember so now we're going to we're gonna do this chronologically because that's exactly how you're gonna be able to see things maybe in a new perspective.
• 23:05
  SPEAKER_02: Yes.
• 23:06
  SPEAKER_00: So for 20 hours, you're comforting, you're energizing.
• 23:11
  SPEAKER_00: However, you said you really didn't know.
• 23:14
  SPEAKER_00: Yeah.
• 23:15
  SPEAKER_00: Now, what I want to share is that you're supposed to know because you speak to your provider about your contraction pattern and what is it?
• 23:27
  SPEAKER_00: So for me and my practice, I always share, call me, don't wait 10 or 20 hours, because if it's a padromal labor, or for example, if the baby's malpositioned, if there's a hand there, if you're feeling it in your back, if the contractions are a certain pattern, I know I'll either have you come to my office if it's during the day, so I could just check so that you know we can hear the baby's heartbeat and you know, or so we could stop it, you know, like I could put you in the tub and stop it.
• 24:00
  SPEAKER_00: If these are short contractions and not um, I don't want to use the word productive.
• 24:05
  SPEAKER_00: I'm gonna say that they don't change your cervix.
• 24:08
  SPEAKER_00: You know, you're working so hard, we're not gonna minimize what you were doing in those 20 hours.
• 24:14
  SPEAKER_00: But the question is, what happened between the onset of contractions and you getting to the hospital after 24 hours and you, oh God, I wish I knew you that, you know, to get a hug from your provider to know where you were so that it's not a mystery.
• 24:34
  SPEAKER_00: So you're laboring at home and the contraction pattern starts a certain starts a certain way.
• 24:44
  SPEAKER_00: Like for example, I once had somebody who was contracting five minutes apart for about 20 hours.
• 24:54
  SPEAKER_00: I'm just your pattern, because that's a very important clue that maybe again we can't go back, but having a communication with your provider can, as you described, keep you energized as opposed to energetically depleted.
• 25:17
  SPEAKER_00: So in those hours, you became depleted because you said you really didn't know.
• 25:24
  SPEAKER_00: And thank you for sharing that, because most women don't know what is happening.
• 25:30
  SPEAKER_00: And I wish for you that you would have known that your baby was either posterior, transverse, asynclic in a position that was causing contractions, but they weren't effective.
• 25:43
  SPEAKER_00: And it took 20 hours for it to start to get hard.
• 25:47
  SPEAKER_00: So, what do we do in those early hours?
• 25:50
  SPEAKER_00: We can do a lot.
• 25:52
  SPEAKER_00: We could talk to our provider, and then we could also now not this, you didn't do anything wrong, by the way.
• 25:58
  SPEAKER_00: You did everything right.
• 25:59
  SPEAKER_00: But in my as sitting as a provider, I hear your story, and you know, I've worked with thousands and thousands of people.
• 26:06
  SPEAKER_00: I hear these birth stories, and I'm like, where was your provider?
• 26:11
  SPEAKER_00: Who gave you information?
• 26:12
  SPEAKER_00: And you don't have to have a home birth to get that information.
• 26:16
  SPEAKER_00: You could most women don't give birth at home.
• 26:18
  SPEAKER_00: So, how do we get that information?
• 26:21
  SPEAKER_00: So, my heart to yours is about for moving forward, knowing, oh, my midwife or my physician, depending on you know, your preference and your medical situation, has told me that this is X.
• 26:36
  SPEAKER_00: For example, this is predromal labor.
• 26:39
  SPEAKER_00: I want you to get in the tub and stop it.
• 26:41
  SPEAKER_00: I want you to get upside down in a polar bear position.
• 26:44
  SPEAKER_00: I've done that with people all over the world, actually, calling me and getting them out of this long, ineffective but annoying contraction.
• 26:55
  SPEAKER_00: So there's a lot that we can be proactive in.
• 26:59
  SPEAKER_00: And you were so strong to just be going through those contractions.
• 27:04
  SPEAKER_00: And I really admire you and not having had the support that you really needed.
• 27:10
  SPEAKER_00: So I hope that this is helpful in receiving it somewhat.
• 27:14
  SPEAKER_02: Totally.
• 27:15
  SPEAKER_02: Um, I like everything that you said.
• 27:16
  SPEAKER_02: I was trying to see if I could pull up that document that pod where I wrote some notes, but all I see is not the right one, which is just a whole bunch of numbers with my contractions, which is not helpful right now.
• 27:26
  SPEAKER_02: Um, anyhow, so then I went in.
• 27:29
  SPEAKER_02: I call I called after like whatever how many of our hours it was, almost a day.
• 27:33
  SPEAKER_02: And then they were like, because I was like, hey, like here's what I'm thinking the pattern is.
• 27:38
  SPEAKER_02: The provider, the one um provider that I really liked got on the phone and said, why don't you just come in?
• 27:43
  SPEAKER_02: We'll check it out.
• 27:44
  SPEAKER_02: So I go in, she texted out, and then I was only a couple of centimeters dilated.
• 27:48
  SPEAKER_02: It was like three or four.
• 27:49
  SPEAKER_02: It was not um something that they thought that I should stay in the hospital for.
• 27:53
  SPEAKER_02: So then they sent me home.
• 27:55
  SPEAKER_00: Oh, okay.
• 27:56
  SPEAKER_00: So can we reframe it?
• 27:58
  SPEAKER_00: Because I want to be able to catch these moments so that we can heal your birth as we go along as it happened.
• 28:08
  SPEAKER_00: So I want to share.
• 28:10
  SPEAKER_00: Um, God bless you.
• 28:13
  SPEAKER_00: So you waited many, many hours to call them.
• 28:18
  SPEAKER_00: I want to encourage all your listeners.
• 28:21
  SPEAKER_00: You have to call as soon as you feel you're in labor.
• 28:25
  SPEAKER_00: You want to get that connection.
• 28:28
  SPEAKER_00: Also, if somebody calls me early enough and you know, I'm in my office, come, here's a hug, or go out to lunch, go out uh to dinner, have breakfast, come see me.
• 28:40
  SPEAKER_00: Let's check on your baby's heartbeat.
• 28:42
  SPEAKER_00: And this way you can go home and I can palpate your abdomen and see where the baby's face is.
• 28:48
  SPEAKER_00: Because for me, um, that was one of my hallmarks and knowing what to do with somebody so they don't have hours of predromal labor with a malpositioned baby.
• 28:59
  SPEAKER_00: Not that it's bad, but babies have their little way of figuring things out.
• 29:04
  SPEAKER_00: So if had you called earlier, maybe that could have happened.
• 29:08
  SPEAKER_00: But I want to say something.
• 29:10
  SPEAKER_00: You said that you were only a couple of centimeters.
• 29:13
  SPEAKER_00: Guess what?
• 29:14
  SPEAKER_00: Hooray! Let's see, I was three, two to three.
• 29:20
  SPEAKER_00: I was three to four.
• 29:21
  SPEAKER_00: Like, wow.
• 29:24
  SPEAKER_00: That is a triumph.
• 29:26
  SPEAKER_00: I need you to know that when you tell your story again.
• 29:30
  SPEAKER_00: I was three.
• 29:32
  SPEAKER_00: Now, what was the effacement?
• 29:33
  SPEAKER_00: How thin or thick was the cervix at that point?
• 29:36
  SPEAKER_01: I just don't remember.
• 29:38
  SPEAKER_01: I'm sure I wrote it down, but I just don't remember.
• 29:41
  SPEAKER_00: Okay.
• 29:42
  SPEAKER_00: So effacement, the thinning of the cervix, is more important to me than dilation.
• 29:50
  SPEAKER_00: Why?
• 29:50
  SPEAKER_00: Because it's like having a turtleneck sweater.
• 29:53
  SPEAKER_00: You know, it's all the way up here, the cervix.
• 29:55
  SPEAKER_00: And then as the contractions work, which yours were, they work to bring the turtleneck into a mock and then a scoop neck.
• 30:03
  SPEAKER_00: So they, you know, it gets progressively shorter and shorter, that cervix.
• 30:08
  SPEAKER_00: And when the cervix gets shorter, it gets softer, because that's from our hormones of pregnancy, the oxytocin, the contractions, the horizontal and vertical contractions, are working to open the cervix.
• 30:22
  SPEAKER_00: So I would say, without being there in your story, you were probably at least uh probably 80% thinned out.
• 30:32
  SPEAKER_00: 100% is where it's paper thin to be even two to, you know, to be three.
• 30:38
  SPEAKER_00: So that tells me that you were amazing to come in at that point.
• 30:44
  SPEAKER_00: Then the other piece that tells me is, well, where were you feeling this energy?
• 30:50
  SPEAKER_00: Was it in the back?
• 30:52
  SPEAKER_00: Was it in the front?
• 30:54
  SPEAKER_02: I don't know if I remember.
• 30:56
  SPEAKER_02: Oh, in the back, in the back, yes.
• 30:58
  SPEAKER_00: Ah, okay.
• 30:59
  SPEAKER_00: So you had a classic posterior right or left presentation that it was in the back, and that's why you had all those hours.
• 31:07
  SPEAKER_00: But your pelvis um is um, you know, because I've met you.
• 31:12
  SPEAKER_00: Your pelvis is a nice um pelvis.
• 31:15
  SPEAKER_02: Uh well, thank you so much, Risa.
• 31:18
  SPEAKER_02: Thank you for the compliments on the pelvis.
• 31:21
  SPEAKER_00: Yes, yes.
• 31:22
  SPEAKER_00: So, although I didn't palpate your hip diameter, but I could tell.
• 31:26
  SPEAKER_02: You could always another day.
• 31:28
  SPEAKER_00: I mean, I know I learned I learned about pelvises, the midwife Valerie, who taught me we went down to Mott and uh Bleecker Street.
• 31:37
  SPEAKER_00: We went at a cafe and we she was testing me.
• 31:40
  SPEAKER_00: We were look we were like pelvis watching, could you imagine?
• 31:44
  SPEAKER_00: I love that.
• 31:45
  SPEAKER_00: I yeah, so it really um um not everybody understands pelvises, but anyway, moving forward, the main thing that I do want to say is that you were blessed be three centimeters for wherever you were.
• 31:59
  SPEAKER_00: We don't know your effacement, but that's where you were.
• 32:02
  SPEAKER_00: You were feeling pain in your back, and that's the clue, even if somebody isn't um technically skilled or trained, because midwives are trained to feel in a way I think that many obstetricians, they're they're amazing, but what position really is the baby in?
• 32:22
  SPEAKER_00: We have to really know what that position is so that we can manage our patients and what positions that they're in.
• 32:30
  SPEAKER_00: And I've had doulas, I love doulas, but you know, a hundred years ago, somebody kept their patient, my patient squatting the whole time and she didn't dilate.
• 32:39
  SPEAKER_00: And finally I realized, no, let's not get her in a squat, because if you squat, you're closing off the pelvic inlet.
• 32:46
  SPEAKER_00: A squat opens the pelvic outlet.
• 32:48
  SPEAKER_00: So I explained um respectfully to the doula, this is a great position for when somebody's fully dilated, not when they're five centimeters.
• 32:57
  SPEAKER_00: And then wouldn't you know she dilated much quicker once we got her out of that squat during her um first stage labor?
• 33:05
  SPEAKER_00: So you were three centimeters or so, and then what did they tell you?
• 33:10
  SPEAKER_02: They said, um, I think it would be better if you just go home and relax and spend some more time in your labor and come back in, give us an update in a couple of hours whenever you feel like your contraction pattern was hitting whatever three, five, five.
• 33:27
  SPEAKER_02: What is it supposed to be?
• 33:28
  SPEAKER_02: I forget.
• 33:29
  SPEAKER_02: It's like blocked out of my memory now.
• 33:30
  SPEAKER_00: I mean five, one, one, but there's no one, but I don't go by that.
• 33:33
  SPEAKER_00: You could probably tell.
• 33:35
  SPEAKER_02: I know, but they were like, go by the five-one one pattern and they said that.
• 33:39
  SPEAKER_02: I think something along that line.
• 33:41
  SPEAKER_02: Yeah.
• 33:42
  SPEAKER_00: So what I want to reframe it is that I would have looked you in the eye and given you a hug and said, Would you like to go home or would you like to stay?
• 33:52
  SPEAKER_00: And I'm here for you.
• 33:54
  SPEAKER_02: I think I did want to go home though.
• 33:56
  SPEAKER_02: I really did.
• 33:58
  SPEAKER_00: Whatever your answer is, is the right answer.
• 34:00
  SPEAKER_00: But you said they said to go home.
• 34:02
  SPEAKER_00: So I need to make sure people understand it's not their decision.
• 34:06
  SPEAKER_00: It's your decision.
• 34:08
  SPEAKER_02: No, of course.
• 34:09
  SPEAKER_02: And I did know that because I, of course, I work with pregnant women and I work in New York City, and so I know what's medically suggested versus required are two different things.
• 34:18
  SPEAKER_02: And I was aware that any interventions that are presented or any decisions that were presented were always my choice, unless it was um, you know, jeopardizing the health of the baby or myself.
• 34:29
  SPEAKER_02: And I knew it wasn't there, but they were like, here's a suggestion.
• 34:31
  SPEAKER_02: You they even offered, they were like, you can stay, or we could we suggest maybe go home and spend some more time, call us back.
• 34:37
  SPEAKER_02: And I think now I remember, I think I was really close to that pattern.
• 34:42
  SPEAKER_02: And then I called, and then they were like, the wonderful physician, the OB that was on the phone, was like, that's awesome.
• 34:47
  SPEAKER_02: And she was very sweet.
• 34:48
  SPEAKER_02: And she said, Why don't you come in?
• 34:50
  SPEAKER_02: You've been doing it for a while.
• 34:51
  SPEAKER_02: Let's get checked, let's see what's happening so that we can move forward.
• 34:54
  SPEAKER_02: But by the time I took the 20-minute ride to get to the hospital, 25 minutes or whatever it was, um, the pattern had completely it was like flopping all over the place.
• 35:04
  SPEAKER_02: And then I came in, I was like, I'm here, I might as well see what's happening.
• 35:07
  SPEAKER_02: They told me what was happening, and then they presented both options to me.
• 35:11
  SPEAKER_02: But they were like, since you are not, um, you know, we could you, if you want, you can go home and spend some more time if you feel more comfortable there, which I did.
• 35:19
  SPEAKER_02: So then I went back home, and then basically for the next 15 to 20 hours, again, something along like 15 hours, something between 15 and 20 hours, it was the non-highlight piece of the labor.
• 35:34
  SPEAKER_02: It was drain, that was the energetically draining piece that we'll get to now, which I'm sure we'll reframe in a moment.
• 35:40
  SPEAKER_02: But what to describe it, essentially it was um because I hadn't slept and it was because I couldn't eat a ton of food.
• 35:47
  SPEAKER_02: I just didn't feel like eating, eating, eating and refueling.
• 35:51
  SPEAKER_02: My body just didn't have the sleep.
• 35:53
  SPEAKER_02: I was drinking water, but I just didn't have the fuel through sleep and nutrition to feel lively and excited anymore.
• 36:02
  SPEAKER_02: I was starting to get a little pooped and drained.
• 36:06
  SPEAKER_02: Um, that kind of like it's something that that would happen if you've gone on a long hike, but then you came home and somebody said, now you have to deep clean your whole house and do a whole bunch of other stuff.
• 36:20
  SPEAKER_02: And this is just the beginning.
• 36:22
  SPEAKER_02: You haven't even gotten to the main event, but you've just hiked for 15 hours.
• 36:26
  SPEAKER_02: It's like, okay, well, the hike was beautiful.
• 36:28
  SPEAKER_02: I saw the sunset and it was great.
• 36:30
  SPEAKER_02: And then I came come back, and it's like, no, no, you're not even, you're not even close.
• 36:35
  SPEAKER_02: And I and then I got tired.
• 36:38
  SPEAKER_02: And then I went back to the hospital after a certain point just because I realized that I needed to go to sleep.
• 36:43
  SPEAKER_02: And I knew that I needed to rest and that I could, I felt confident in my abilities and the baby was getting ready, but I just knew that I just needed sleep.
• 36:53
  SPEAKER_02: And I knew that the only way that I was gonna sleep, if they stuck me with that epidural and I knocked out, which is exactly what happened.
• 37:01
  SPEAKER_00: Yeah, yeah, yeah.
• 37:02
  SPEAKER_00: Thank you for sharing that.
• 37:04
  SPEAKER_00: Um, when you um returned to the hospital, what was your dilation?
• 37:09
  SPEAKER_02: I think it was like closer to like five, six.
• 37:12
  SPEAKER_02: It was like still not like it was definitely not like eight, nine, ten.
• 37:16
  SPEAKER_02: It was like maybe on the like mid five range, definitely like one or two levels higher than when I first walked in.
• 37:23
  SPEAKER_00: Yeah.
• 37:24
  SPEAKER_02: Um, and then I got the epidural and so I'm gonna reframe.
• 37:27
  SPEAKER_00: Okay, go ahead.
• 37:28
  SPEAKER_00: Ready?
• 37:29
  SPEAKER_00: Okay.
• 37:30
  SPEAKER_00: Um so yes, it is physically exhausting because here you are, this beautiful loving mother working to birth your baby, and you're home alone for another 15 hours.
• 37:51
  SPEAKER_02: Well, my husband lives with me.
• 37:52
  SPEAKER_00: Well, yes, with your husband.
• 37:54
  SPEAKER_00: Uh but I want to say that that is a long interval of time for me as a provider to not hear your heart rate, knowing that you live 25 minutes away from my hospital.
• 38:10
  SPEAKER_00: So, with that said, the question is what kind of communication did you have with your provider while you were home for that second part of being home and laboring?
• 38:24
  SPEAKER_02: I don't think I called them at all.
• 38:26
  SPEAKER_00: Okay.
• 38:27
  SPEAKER_02: I don't think they checked in on me.
• 38:29
  SPEAKER_02: Maybe they checked in on me once.
• 38:31
  SPEAKER_02: I'm not sure.
• 38:32
  SPEAKER_02: But if I if they did, I was kind of getting a little zonked at that point.
• 38:36
  SPEAKER_02: So I don't think I remember.
• 38:38
  SPEAKER_00: Right.
• 38:38
  SPEAKER_00: So I, and you know, you're a provider, so I'm not surprised.
• 38:42
  SPEAKER_00: Uh, because us providers, we manage ourselves often.
• 38:46
  SPEAKER_00: And how do we, not only as providers, but as you know, any patient, whether it's a midwife or an OB or an internist or whoever you're going to work with, how do we surrender to this person to trust them?
• 39:02
  SPEAKER_00: And this tells me, again, because I of the relationships of trust that I've had and what my signature, you know, Manhattan midwife, what I was known for in labor, is call me in an hour.
• 39:18
  SPEAKER_00: Let's talk every hour.
• 39:21
  SPEAKER_00: But somehow, and we can't go back, but I want to empower you to know that the art of communicating with your provider can make all the difference in the world regarding how your labor will unfold.
• 39:36
  SPEAKER_00: And you didn't have that information.
• 39:38
  SPEAKER_00: So to be at home, even from a from a fetal heart rate standpoint, and there's no, you know, um, I am saying that this is clinically unacceptable.
• 39:49
  SPEAKER_00: It's a deviation of standards.
• 39:51
  SPEAKER_00: When somebody is in entering early labor, you need to auscultate a fetal heart rate.
• 39:57
  SPEAKER_00: You have to lit, meaning you have to listen to your baby.
• 40:00
  SPEAKER_00: You know, maybe the mother is dehydrated.
• 40:02
  SPEAKER_00: We have to check on these things.
• 40:04
  SPEAKER_00: So if you wanted to go home, then I would say, come back in three hours.
• 40:10
  SPEAKER_00: Because then I can look at you in the eye and you're gonna tell me you're tired.
• 40:17
  SPEAKER_00: Because I know that you are probably shocked.
• 40:20
  SPEAKER_00: I'm home for 15 more hours and I'm only five now.
• 40:25
  SPEAKER_00: How could that be?
• 40:26
  SPEAKER_00: Well, I'm gonna tell you why, because of the position of your baby.
• 40:29
  SPEAKER_00: You didn't do anything wrong, but nobody figured out what you should be doing.
• 40:34
  SPEAKER_00: Because many women, um, if they're not told based on where the position of the baby is, just might in fact be in positions that are going to keep the baby in these um positions that are not optimal for what's known as maternal, um, you know, optimal maternal fetal positioning.
• 40:55
  SPEAKER_00: So this was just really you, you or your baby needed to be tweaked a little bit to have gone through all of those hours.
• 41:03
  SPEAKER_00: And even though, yes, your baby probably came out breathing and lively and had so much stimulation from the labor, but you could see that you really weren't in active labor until you got to the hospital the second time.
• 41:21
  SPEAKER_00: All of that beginning work had somebody seen you, or if you had, it's not your fault, but if somebody would have said, come to the office, let me see, let me check on you, then we could have saved you those extra, you know, those early 15 hours.
• 41:35
  SPEAKER_02: Yeah.
• 41:36
  SPEAKER_00: But you didn't know to get in the tub, or you didn't know to get um in in a in a polar bear knees chest position.
• 41:44
  SPEAKER_00: You know, I took care of a lot of my family and friends and people around the world.
• 41:49
  SPEAKER_00: And I would literally uh had they had exactly what you had and sit with them on the phone for an hour as they as I helped them turn their baby.
• 41:59
  SPEAKER_00: And then all that back labor went away.
• 42:01
  SPEAKER_00: And then they slept.
• 42:03
  SPEAKER_00: So you didn't sleep, and you were so powerful that another 15 hours later, of course you needed a productive epidural.
• 42:12
  SPEAKER_00: Of course you did.
• 42:14
  SPEAKER_00: Because then the alternative is you wouldn't have been able to push, you would have had caesarean.
• 42:18
  SPEAKER_02: I now knew that, which was why I was very aware.
• 42:21
  SPEAKER_02: And when I walked in, they offered me, well, they didn't offer the oh, there's a whole another conversation about the provider that I ended up seeing.
• 42:30
  SPEAKER_02: It wasn't the one that I called the first time.
• 42:32
  SPEAKER_02: Unfortunately, it was um, and we'll just get to this last piece now.
• 42:36
  SPEAKER_02: Um, yeah.
• 42:37
  SPEAKER_02: I know we're come we're coming to an end here.
• 42:40
  SPEAKER_02: But the provider that I had seen, there was like about eight to ten providers that throughout my pregnancy I went in in that particular team of obstetricians, and I booked an appointment with almost every single one of them, some twice.
• 42:53
  SPEAKER_02: And there were like all but one wonderful people, and I really enjoyed the care and I loved it.
• 43:00
  SPEAKER_02: But there was only one provider that I remember walking in, and she was like turned away from the computer, turned away from me, looking at her computer, said, Hi, come in, went back to her computer, said, Can I help?
• 43:12
  SPEAKER_02: What can I help you with?
• 43:13
  SPEAKER_02: Do you have any um things, complaints?
• 43:15
  SPEAKER_02: How's everything going?
• 43:17
  SPEAKER_02: And I said, Well, you know, I've just been having like this sniffly, like I don't feel sick, but just having congestion for like almost three weeks straight.
• 43:25
  SPEAKER_02: Um, I've just been doing all the home remedies, no cough, nothing else, just a little stuffy and congested.
• 43:31
  SPEAKER_02: And then she turns around and she looks at me and she goes, Did you go to urgent care and get a full respiratory panel?
• 43:38
  SPEAKER_02: And I said, No, I didn't.
• 43:40
  SPEAKER_02: And she goes, Well, you didn't help anyone or yourself then, did you?
• 43:44
  SPEAKER_02: And she turns back around and looks at the computer and starts typing.
• 43:47
  SPEAKER_02: And my husband and I, we both like because we were we always know what's going on with each other and we vibe with each other very well.
• 43:55
  SPEAKER_02: We looked at each other and we we both gave each other the W T F look.
• 44:01
  SPEAKER_02: And he gave me the same look back, and we both shook our heads, and we're like, all right, we're just gonna get this over with because I'm feeling great.
• 44:08
  SPEAKER_02: We were gonna go get lunch after that.
• 44:11
  SPEAKER_02: The best tacos in New York City in the in the Upper East Side.
• 44:14
  SPEAKER_02: So we we went, we had a great, I was like, let's just pop in and out of this situation.
• 44:18
  SPEAKER_02: I'm probably never gonna see this woman ever again.
• 44:20
  SPEAKER_02: Unfortunately, of course.
• 44:22
  SPEAKER_02: I walk in with the second round after the five centimeters dilator.
• 44:27
  SPEAKER_02: And I walk in, and then you know, she's there.
• 44:30
  SPEAKER_02: As I walk in, I mean, she was trying to help.
• 44:33
  SPEAKER_02: So she goes, obviously, you've been labor in labor for a really long time.
• 44:36
  SPEAKER_02: She knew what was going on, and she said, We're gonna give you, um, we're gonna induce you now.
• 44:42
  SPEAKER_02: And I just looked at her and I said, I didn't come in here to be induced.
• 44:46
  SPEAKER_02: I came in here for an epidural and a nap.
• 44:48
  SPEAKER_02: And she literally gave me a rebuttal.
• 44:52
  SPEAKER_02: And I looked at the um the nurse who was with me, and uh her and I were had a great energetic communication.
• 45:00
  SPEAKER_02: In fact, her name was uh um a Hindu goddess's name.
• 45:04
  SPEAKER_02: She wasn't she wasn't a uh, you know, from our culture at all, but it was just happened to be like a Hindu goddess's name.
• 45:10
  SPEAKER_02: And I was just like, this is great.
• 45:11
  SPEAKER_02: I love this woman, it's wonderful.
• 45:13
  SPEAKER_02: Um, and her I she looked at me after the uh Obi left and she said, Are you sure?
• 45:19
  SPEAKER_02: It's whatever you want.
• 45:20
  SPEAKER_02: We want to make you comfortable.
• 45:21
  SPEAKER_02: And she was very sweet.
• 45:22
  SPEAKER_02: And I said, I got this.
• 45:24
  SPEAKER_02: I just need the epidural.
• 45:25
  SPEAKER_02: Please called um the anesthesiologist.
• 45:28
  SPEAKER_02: I just need to pump to go to sleep, and I'm gonna be fine.
• 45:30
  SPEAKER_02: So then I got the epidural.
• 45:33
  SPEAKER_02: I asked the person to give me the concoction that would allow me to still be able to move, and he did, but the provider, my OB was there, and she said, You don't need to move.
• 45:46
  SPEAKER_02: Why is that important to be able to move?
• 45:48
  SPEAKER_02: And I'm like, Does this woman even know anything about birth?
• 45:52
  SPEAKER_02: And I just I kept brushing her off because I was like, I have my little Hindu goddess, uh, wonderful nurse here.
• 45:58
  SPEAKER_02: I don't need you right now.
• 45:59
  SPEAKER_02: So I kept ignoring everything that she was throwing at me.
• 46:02
  SPEAKER_02: Um, got the epidural, anesthesiologist and I went on a banter.
• 46:06
  SPEAKER_02: My husband said, the second you got the epidural, you went back into full joking, having a good time.
• 46:12
  SPEAKER_02: I was talking to him about my patients.
• 46:14
  SPEAKER_02: I was like, I know you gotta go.
• 46:15
  SPEAKER_02: Okay, fine, you can get out of here.
• 46:17
  SPEAKER_02: Uh he came back and checked on me.
• 46:18
  SPEAKER_02: It was very sweet, took a nap, woke up.
• 46:21
  SPEAKER_02: What or I think maybe while I was sleeping, maybe the water broke.
• 46:24
  SPEAKER_02: I can't remember.
• 46:26
  SPEAKER_02: Water broke, baby came out in 45 minutes.
• 46:29
  SPEAKER_02: But, and and and I remember this this woman, the nurse, uh, looked at me and she said, I'm so glad you trusted your intuition that you just needed to sleep.
• 46:38
  SPEAKER_02: And you woke up and everything went so smoothly.
• 46:40
  SPEAKER_02: And I said, I know.
• 46:41
  SPEAKER_02: Um, but I remember the first within the first 10 minutes of me actively timing my contractions, urine contractions with the active pushing.
• 46:53
  SPEAKER_02: Um, my per within 10 minutes, the provider looks at me, my OB, and she said, This is taking too long.
• 46:59
  SPEAKER_02: She's missing her contractions.
• 47:01
  SPEAKER_02: And she took her gloves off and took, put them down and walked out of the room.
• 47:04
  SPEAKER_02: I ignored it because I had my wonderful nurse and had actually written in my birth plan that I didn't want any medical students or any other people.
• 47:15
  SPEAKER_02: I just wanted my provider, my nurse, and my husband to be with me in the room.
• 47:20
  SPEAKER_02: And that's what I had wanted.
• 47:22
  SPEAKER_02: But oh my God, I had two very wonderful medical students holding up my limbs, giving me neck massages.
• 47:31
  SPEAKER_02: They were so sweet.
• 47:32
  SPEAKER_02: And I initially was like, why are they here?
• 47:34
  SPEAKER_02: It clearly says it on my birth plan that I didn't want them here.
• 47:37
  SPEAKER_02: Why are they rounding on me?
• 47:39
  SPEAKER_02: Why is this happening?
• 47:40
  SPEAKER_02: But the second that they walked in, I was like so thrilled.
• 47:44
  SPEAKER_02: We had the best time ever.
• 47:45
  SPEAKER_02: Birth was great, baby came out, baby was great.
• 47:48
  SPEAKER_02: Everything was beautiful and great after that.
• 47:51
  SPEAKER_02: Um yeah, it's just interesting how that I want to just quickly touch on why is it that the OB was the one OB that I didn't want to be my OB.
• 48:01
  SPEAKER_00: Well, well, I could share with you in my career, and this is what I've heard, that that is the law of averages.
• 48:12
  SPEAKER_00: It's just statistically, it's karma.
• 48:14
  SPEAKER_00: It's your karma.
• 48:15
  SPEAKER_00: It's just karma that the one person that you don't like, whether it's the hairstylist or the OB or even the midwife, the one person you don't get along with, guess what?
• 48:27
  SPEAKER_00: You get them.
• 48:28
  SPEAKER_00: That is a lesson for you to learn.
• 48:31
  SPEAKER_00: What was it about it?
• 48:32
  SPEAKER_00: Because when you go into a practice with eight to ten providers, statistically, you're gonna get someone you don't like.
• 48:40
  SPEAKER_00: And you have to meet with all of them.
• 48:42
  SPEAKER_00: I mean, that's why I had a solo practice all these years.
• 48:45
  SPEAKER_00: And when I wanted to hire other midwives, people would be like, no.
• 48:48
  SPEAKER_00: And then when I was in a hospital, people would just come for me and I'd be like, no, I have other midwives, and it's really challenging.
• 48:56
  SPEAKER_00: So, yes, you got the woman who told you you're taking too long.
• 49:03
  SPEAKER_00: So if we link that with our discussion earlier about why is this happening, where did that doctor learn in her training that that's what you say at the bedside to an amazing woman like you who was in labor for two days instead of guiding you and coaching you?
• 49:24
  SPEAKER_00: That is just the lesson that you have now to share with your clients.
• 49:30
  SPEAKER_00: Don't don't be like me.
• 49:32
  SPEAKER_00: Don't be in a practice with all these people.
• 49:35
  SPEAKER_00: And especially if you're not gonna like somebody or few of them, chances are like me, you're gonna get them and you're gonna be face to face with that energy.
• 49:46
  SPEAKER_00: And, you know, maybe we don't know her personal life.
• 49:50
  SPEAKER_00: Maybe she, you know, her son was sick, or maybe her mother was in hospice, or like we don't know what her thing was, or just from the prenatal visit you saw, that she just had no bedside manner.
• 50:02
  SPEAKER_00: So she's really in the wrong profession, if you think about it.
• 50:05
  SPEAKER_02: Totally.
• 50:06
  SPEAKER_02: My husband and I talked about that when we walked out of that first uh OB visit that was um prior to any of the labor.
• 50:13
  SPEAKER_02: And we both said, you know, people like that who can't have empathy and connection and like I would never dare, I couldn't imagine if a patient walked into my office, if they were like, hey, yeah, this is what's going on.
• 50:27
  SPEAKER_02: I mean, the number of times that a patient comes to me and goes, I didn't do any of my exercises, it's the first thing that sometimes they say because they feel guilty, because I give them all this motivation accountability.
• 50:37
  SPEAKER_02: I check in on them, and they're like, you know, listen, I didn't get to it.
• 50:41
  SPEAKER_02: I didn't, I'm just gonna be honest, I didn't do my exercises.
• 50:44
  SPEAKER_02: I couldn't imagine being like, Well, why are you here?
• 50:48
  SPEAKER_02: That doesn't help either of us.
• 50:50
  SPEAKER_00: That right home.
• 50:52
  SPEAKER_00: That is that is patronizing.
• 50:55
  SPEAKER_00: But sometimes women are picking providers that are patronizing.
• 51:00
  SPEAKER_00: And then the question is why or how?
• 51:02
  SPEAKER_00: You didn't consciously pick her, but you were certainly aware uh that she was there.
• 51:07
  SPEAKER_00: I I want to get back to five centimeter epidural because I think a lot of people wonder about that.
• 51:14
  SPEAKER_00: That is the onset of active labor.
• 51:16
  SPEAKER_00: And because you were working so hard for so many hours, good for you that you had the epidural.
• 51:22
  SPEAKER_00: I just want to empower you that that really helped you.
• 51:25
  SPEAKER_00: You knew what you needed, and I love epidurals for those reasons.
• 51:29
  SPEAKER_00: Um, if you get an epidural too early, that could slow the labor.
• 51:34
  SPEAKER_00: She used a term that was inappropriate.
• 51:36
  SPEAKER_00: She wasn't inducing you, she was augmenting your labor.
• 51:39
  SPEAKER_00: There's a very big difference.
• 51:41
  SPEAKER_00: Induction means there's no labor.
• 51:43
  SPEAKER_00: You were in labor.
• 51:44
  SPEAKER_00: So she was minimizing all those hours of your hard work.
• 51:48
  SPEAKER_00: And look at you, you you pushed for 45 minutes for first time, mom.
• 51:53
  SPEAKER_00: Amazing.
• 51:54
  SPEAKER_00: Because she wanted to give you Pitocin.
• 51:56
  SPEAKER_00: That's what induction or augmentation is, and you just needed to sleep.
• 52:01
  SPEAKER_00: So Mazel Tough.
• 52:05
  SPEAKER_02: Thank you.
• 52:06
  SPEAKER_02: People always ask me, like, you know, is that a traumatizing labor for you?
• 52:09
  SPEAKER_02: Was that really hard?
• 52:10
  SPEAKER_02: And honestly, that's not the perspective that I've had of it.
• 52:15
  SPEAKER_02: Like, I know that there were elements that were challenging or difficult, or that I would have wanted it to go a different way if I could wave that magic wand.
• 52:24
  SPEAKER_02: But overarchingly, I don't think that I look back and go, like, that was awful, that was traumatizing.
• 52:30
  SPEAKER_02: I didn't feel like, I don't know, I just feel positive when I look back on it because I feel my baby girl.
• 52:37
  SPEAKER_02: And that was like the most important thing.
• 52:39
  SPEAKER_02: And I was able to have agency in certain elements to be able to advocate for myself because I knew something about something.
• 52:45
  SPEAKER_02: I don't know, half or even 90% of what you know when it comes to actual birth.
• 52:50
  SPEAKER_02: I don't attend births and the first birth I attended was my own.
• 52:54
  SPEAKER_02: Um, so then I think there's a lot to say about being there and understanding it in that capacity.
• 53:00
  SPEAKER_02: Uh, you can read it in a textbook, you can take lectures and courses on it, but it's really, you know.
• 53:06
  SPEAKER_00: I think that I think that what to take away from this is that you worked hard, but I believe that you were lacking communication from your provider.
• 53:17
  SPEAKER_00: And maybe because intuitively maybe you didn't trust them or you took it upon yourself to manage yourself.
• 53:24
  SPEAKER_00: But I think that having that communication is important.
• 53:29
  SPEAKER_02: Fantastic.
• 53:30
  SPEAKER_02: Would you like to add anything else for listeners as the final parting words?
• 53:35
  SPEAKER_00: Um, yes, you know, I'm so grateful to you for uh sharing your birth story with the public and giving me a chance to really show the audience what uh going through medical records, talking about birth, reframing birth experiences, empowering women, and also helping uh mothers to understand that there's a clinical aspect, a very important clinical aspect to prenatal care.
• 54:02
  SPEAKER_00: And that also includes the early hours of labor.
• 54:06
  SPEAKER_00: And your story really exemplifies truly the importance of when picking a provider, also making sure that there is uh room for communication, consultation, early fetal auscultation.
• 54:19
  SPEAKER_00: I love to see my mamas when they're in early labor, so I can look them in the eye and check in and see what's on their mind and what's in their heart, and also listen to the baby's heart rate and make sure that everything's okay.
• 54:32
  SPEAKER_00: And then if all's well, send them out to a movie and dinner and you know, have a wonderful early labor.
• 54:39
  SPEAKER_00: So um, you know, in addition to fetal positioning, to knowing that, because fetal positioning can also impact the duration of labor, which as you see in your case, uh, that was an example.
• 54:51
  SPEAKER_00: But thank you for giving me an opportunity uh to do what I love to do, helping empower women.
• 54:57
  SPEAKER_00: I hope you came out of this empowered and having some other uh perspectives through a midwife's lens of uh prenatal care and management.
• 55:08
  SPEAKER_00: If people want to reach me, they could find me on my website, www.manhattanmidwife.com, and they'll be able to learn about my practice, doing medical review, birth consultation, and there is a contact page that they could reach me.
• 55:24
  SPEAKER_02: Love that.
• 55:25
  SPEAKER_02: I absolutely came out of it with a different perspective and lens.
• 55:28
  SPEAKER_02: And thank you so much, Risa, not only for your time, but your experience and expertise and how well informed you are in this space and providing that to our community.
• 55:37
  SPEAKER_02: So thank you for being here.
• 55:38
  SPEAKER_00: Thank you so much for being here for our community as well.
• 55:42
  SPEAKER_02: Thank you all for tuning in and investing in yourself and your well-being.
• 55:47
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• 55:52
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• 55:55
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• 56:06
  SPEAKER_02: See you again next week with an exciting new guest and topic.