Latest / MyMaine Birth / 12. Mid-week midwife edition, Ariel from Saco River Midwifery in Saco, Maine

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12. Mid-week midwife edition, Ariel from Saco River Midwifery in Saco, Maine · MyMaine Birth

• 0:01
  Speaker 1: I'm Angela and I'm a certified birth photographer, experienced doula, childbirth educator and your host here on the my Maine Birth podcast.
• 0:09
  Speaker 1: This is a space where we share the real-life stories of families and their unique birth experiences in the beautiful state of Maine, from our state's biggest hospitals to birth center births and home births.
• 0:22
  Speaker 1: Every birth story deserves to be heard and celebrated.
• 0:26
  Speaker 1: Whether you're a soon-to-be mom, a seasoned mother or simply interested in the world of birth, these episodes are for you.
• 0:34
  Speaker 1: Welcome to episode 12 of the my Main Birth podcast.
• 0:39
  Speaker 1: It is a midweek midwife edition of the show, and today's midwife guest is Ariel of Saco River Midwifery.
• 0:48
  Speaker 1: She is here to share about her two birth stories as they intertwine with her life's calling to become a midwife.
• 0:55
  Speaker 1: Hi, ariel, welcome to my Main Birth.
• 0:58
  Speaker 1: Hi.
• 0:59
  Speaker 1: So, to get started, will you share a little bit about you and your family.
• 1:04
  Speaker 2: So it's me and my and my spouse, and we have two girls, and both of whom were born at home and have spent their whole lives with their mom being a midwife, which is either the most adventurous childhood or the hardest one, I'm not sure, but I was away from them for three days this week for a birth, so, but I think they're they're used to that by now.
• 1:29
  Speaker 2: Yeah, my oldest is 11 and my youngest is about to be seven next month.
• 1:36
  Speaker 1: So today you're going to be sharing about your birth experiences and also about your midwifery journey.
• 1:41
  Speaker 1: Why don't you go ahead and start wherever it feels?
• 1:44
  Speaker 2: right to you.
• 1:45
  Speaker 2: Yeah, I guess they all kind of like flow together.
• 1:50
  Speaker 2: I became a doula about 15 and a half years ago.
• 1:55
  Speaker 2: I was in a really serious car accident and after that car accident I started learning more about different kinds of alternative medicine and holistic health care, mostly just part of my recovery from the car accident, and it weirdly entered me into a whole new realm about different kinds of health care that I didn't know about previously.
• 2:17
  Speaker 2: I had always been really passionate about reproductive health care and reproductive justice.
• 2:22
  Speaker 2: I'd been really involved in a lot of things in high school about that as well, and but I didn't know anything about birth other than that like people went to a hospital and they had a baby and that's, that's what birth is.
• 2:36
  Speaker 2: And in meeting more people that were more involved in I hate the word alternative health care because honestly like to just imply that it's the alternative to this mainstream thing, but I don't see like any of that is fringe and I don't think it should be treated as such, but maybe more like holistic health care and looking at like people as a whole person.
• 3:00
  Speaker 2: You know, body systems are not separate.
• 3:03
  Speaker 2: The things that are happening in our lives are not separate from our health and our well-being, meeting more people in that realm and learning, learning about different professions.
• 3:11
  Speaker 2: And then I met somebody who um had a doula at her birth and I immediately was like, oh, I'm very interested in this, um, and I decided to do a doula training um in israel, where I lived, uh, where it where it's a much longer process there.
• 3:27
  Speaker 2: So, like often in America, it's people go for like I know it's like donut, it was like a weekend course plus other experiences.
• 3:35
  Speaker 2: But there was a nine month training program that I was in and the summer before the program started we had a bunch of required reading to do and my spouse and I were on a road trip actually in in America and I read all these books and I read half of them out loud because I was getting very passionate about it.
• 3:51
  Speaker 2: And I read Spiritual Midwifery by Ina May and Hencie Goer's Thinking Woman's Guide to Childbirth.
• 3:57
  Speaker 2: I read Birthing from Within.
• 3:59
  Speaker 2: I read just a lot of things that I was like, oh wait, we're, we're doing a lot of things wrong, I think.
• 4:05
  Speaker 2: Why doesn't everybody know about this?
• 4:07
  Speaker 2: Why doesn't everybody talk about this?
• 4:09
  Speaker 2: And I was very excited to become a doula.
• 4:13
  Speaker 2: And then I went to my first birth, which were friends of mine were having their first baby and had very graciously said I could come and be their doula, and it was a very difficult birth.
• 4:24
  Speaker 2: It was a lot of challenges and it was.
• 4:27
  Speaker 2: There were a lot of things that were very difficult to witness about how she was treated, like a lot of lack of autonomy, lack of collaborative decision-making, and by the time the baby was born, I just remember the parents just felt like these things had just happened to them and there had been no real like decisions.
• 4:46
  Speaker 2: It was always just like this is happening.
• 4:48
  Speaker 2: Now this is happening, and I remember being so saddened by that after having read all these things and thinking like, wait, there's a different way, why is this how this works here?
• 5:00
  Speaker 2: And I felt very immediately that my calling in life was to become a midwife.
• 5:04
  Speaker 2: I was in college at the time for linguistics and I thought very immediately that my calling in life was to become a midwife.
• 5:11
  Speaker 2: I was in college at the time for linguistics and I thought I was going to go into academia and I was like, oh wait, no, this is what I'm meant to do.
• 5:13
  Speaker 2: And after working as a doula for two years, I became pregnant with my first child and I was working with throughout my whole pregnancy.
• 5:23
  Speaker 2: I was working as a volunteer with a shelter for women who were refugees from Eritrea and Sudan from the civil war there, and it was the only shelter in the country that would take pregnant refugees and we were a team of volunteers that were working very hard to get them care and support, very hard to get them care and support.
• 5:44
  Speaker 2: We had a lot of barriers for that financial, obviously, but language, culture, you know, trying to integrate people into a medical system that they'd never experienced before, who are separated from their country, their culture, their languages, their families.
• 5:59
  Speaker 2: I met women who had to leave children behind in order to escape.
• 6:02
  Speaker 2: There was a lot of trauma and it was a lot to go through while I was also pregnant and I had a very difficult pregnancy with uh, I had hyperemesis with both of my children, so that was hard.
• 6:14
  Speaker 2: But my experience of working with those women and supporting them through their pregnancies and their their birth experiences, um, it was really a very pivotal moment in my life where I really knew that my journey was to become a midwife and that my drive as a midwife was that we must make birth better, that this most intrinsically human of experiences to create more humans, right, to bring forth life, I mean, reproduction is, like the, the most basic function of all, all organisms, right, and if we, the way we treat people during that process, stays with them for the rest of their life, this, you know, deeply impacts all parts of their being, um, and it deeply impacts that that new person, you know, we may not remember, obviously like I don't know anybody who remembers their birth but I deeply believe, like the way we are born matters, the way we give birth matters.
• 7:15
  Speaker 2: And if we are giving birth in, in situations that are unkind or that, worse, or cruel, are devoid of compassion and love and respect and care, then we're we are harming, our, we're harming, like, our social ecosystem in so many ways.
• 7:34
  Speaker 2: Michelle O'Donnell, who's a famous obstetrician from France I've had the the blessing of, of meeting him in person and hearing him speak and he often talks about how the hormone of birth is oxytocin, right, and oxytocin is the love hormone and the feelings of love that one has during that time is so intrinsically important about our moving through birth and moving through labor, birthing our child, bonding with our child, and that so much of what is being done in modern medicine with the birth process is really like trying to remove love from the equation and manage everything in a synthetic way and disassociate from those most primal human aspects of reproduction.
• 8:23
  Speaker 2: And you know, he questions like if we're taking love out of the equation, what is that going to do?
• 8:29
  Speaker 2: What is the what is like the the down, the downfall of that with humanity?
• 8:35
  Speaker 2: If we continue to try to do that, to take to take love out of the equation of being born and that has always really resonated with me very deeply there's absolutely a place for interventions, there's a place for, you know, synthetic oxytocin, for Pitocin, like.
• 8:51
  Speaker 2: I'm not against any of those things, I've I've seen them be incredibly important tools, but I don't believe that they should be the standard of care in all situations.
• 9:02
  Speaker 2: I don't.
• 9:02
  Speaker 2: I don't believe that birth is is pathological and midwifery care at its foundation really, you know, believes that birth is a normal event and we should treat it as a normal event until or if we are proven otherwise.
• 9:16
  Speaker 2: And then you know, then we act.
• 9:17
  Speaker 2: But intervention should not be preemptive.
• 9:20
  Speaker 2: You know, we should intervene when it's necessary and not because we're supposed to or because we we think we should, or because we're impatient, or you know, and so much of how medicine works.
• 9:32
  Speaker 2: Is the attempt to standardize care Right?
• 9:34
  Speaker 2: So everybody must have the same thing?
• 9:36
  Speaker 2: Well, birth can never be the same for everybody and no birth can unfold exactly the same.
• 9:42
  Speaker 2: So an attempt to standardize it would mean that you're trying to take away the individuality of that experience.
• 9:47
  Speaker 2: And you know, I think, as Michelle Don says and he wrote a book called birth in the age of childbirth, in the age of plastics, and you know it's very much that that's thing like how do we just take all these other factors out of it and make birth mechanical instead of human?
• 10:06
  Speaker 2: And I think that we're seeing very much right now how much that is harming birthing people and women, and not just in this country but across the world, but especially in America, where we're one of the only nations on earth where it's becoming more dangerous every year to be pregnant and give birth.
• 10:24
  Speaker 2: And for some reason that's not appalling enough of a statistic to create, enough of an urgency to change something.
• 10:32
  Speaker 2: And it's clearly not about a lack of resources, because we have the most resourced healthcare system in the world and yet somehow we are killing people and we're killing them because we're trying to take the individuality out of care.
• 10:47
  Speaker 2: If you have seven minutes with a provider and they can't really get into the specifics of your lifestyle, your family dynamic, what is your social support system look like?
• 10:56
  Speaker 2: What are your resources?
• 10:57
  Speaker 2: What is your housing look like?
• 10:59
  Speaker 2: What is your income?
• 11:01
  Speaker 2: All the things that we know impact people's health and wellbeing and we can't do any of that.
• 11:07
  Speaker 2: And then we are like, why is everybody getting sicker in their pregnancies?
• 11:10
  Speaker 2: And then why are these people who are sicker in their pregnancies having more, you know, serious outcomes?
• 11:15
  Speaker 2: Right, because we're not good at at preemptive healthcare in America.
• 11:20
  Speaker 2: We're good at interventional healthcare right, we're good at like, okay now, even emergency, we have to handle it, but we don't really do anything before that point and that's really leading us to become terrible at taking care of people.
• 11:37
  Speaker 2: And I knew that I was witnessing that and I knew that I did not want to do that.
• 11:39
  Speaker 2: I didn't want to become an obstetrician, I did not want to further the way the system was going and I wanted to figure out how do I be a part of a different paradigm in maternity care.
• 11:50
  Speaker 2: And with everything I was witnessing and everything I knew, I knew I didn't want to birth in the hospital.
• 11:56
  Speaker 2: So when I had my first child I knew like from the moment I was pregnant, I was like I'm going to have a home birth, I want a midwife.
• 12:03
  Speaker 2: I don't like what I'm seeing, what's going on and I don't want to be a part of it.
• 12:08
  Speaker 2: And I learned pretty early on that I couldn't tell people that that was my plan, because as soon as I did I'd be told like it's too dangerous, what if?
• 12:15
  Speaker 2: What if this, what if this, what if this?
• 12:17
  Speaker 2: Everybody had a what if?
• 12:19
  Speaker 2: Everybody was convinced that something would go wrong.
• 12:23
  Speaker 2: Or they wanted to tell me I can't, I can't handle the pain, or you can't handle this, or you know, it was a very.
• 12:30
  Speaker 2: It was really demeaning in a lot of ways to constantly just be being told that like you won't be able to do it.
• 12:36
  Speaker 2: And I'm like, really because women give birth every day all over the world and if we couldn't do that, we wouldn't exist as people.
• 12:44
  Speaker 2: So so why is everybody so convinced that it's their job to tell me that I can't birth my baby?
• 12:49
  Speaker 2: That makes no sense to me, and everybody had a story of their sister, their cousin, their friend who almost died giving birth, and that's the reason you have to be in the hospital.
• 13:02
  Speaker 2: But I had also learned from my experiences of being in the hospital of how often those complications and serious outcomes are a result of intervention that may not have been necessary or was overused, you know.
• 13:19
  Speaker 2: And what was that causing as well, and I had a lot of skepticism about, you know.
• 13:25
  Speaker 2: Does everybody need to be induced?
• 13:27
  Speaker 2: Does everybody need, you know, an IV?
• 13:30
  Speaker 2: Does everybody need to have a C-section?
• 13:33
  Speaker 2: Like that doesn't seem normal.
• 13:35
  Speaker 2: Why is that what's happening?
• 13:36
  Speaker 2: And that isn't to say that emergencies don't happen.
• 13:39
  Speaker 2: I mean, I've been a midwife for eight years.
• 13:41
  Speaker 2: I'm aware, well aware, that emergencies happen and and and that terrible things can happen, but it's not, it's not the norm, and it's definitely in our culture, become the norm, like we believe inherently that childbirth is unsafe and that bad things will happen, and I think that's because that's becoming the birth story that most people have.
• 14:04
  Speaker 2: But instead of questioning like why is that the experience?
• 14:08
  Speaker 2: We're just saying birth is dangerous and we need more intervention to make it safer, and not questioning if these interventions are making birth less safe.
• 14:17
  Speaker 2: And there's pretty good data that shows that some of the interventions that we have as standard care are indeed creating harm.
• 14:31
  Speaker 2: I was reading something lately that was talking about this idea that we have to do all this perineal counterpressure when the head is emerging to prevent tearing actually is more likely to cause tearing because you're actually putting more pressure on the tissues externally and not allowing them to expand Like that makes sense.
• 14:44
  Speaker 2: You know all the things that are done in birth that assume that like nature doesn't know what to do is always very interesting to me and I've I've witnessed that so much, and in a hospital setting and I mean it can occur in any setting, with any provider, but definitely in the hospital there's a strong culture of like we must be hands-on, we must do these things, and sometimes I see especially residents and they're they're doing all the cardinal like the hand maneuvers for birth that they're taught, and I always think to myself, what if they actually witnessed a birth and they just sat back and they didn't do that and they got to experience the firsthand knowledge that a baby can actually be born and restitute and do all the things without somebody manipulating their head while it's happening?
• 15:33
  Speaker 2: And would that change their perspective?
• 15:36
  Speaker 2: Because I understand, if you've only ever seen that, maybe you believe that that is what must be done.
• 15:41
  Speaker 2: But we also know that if we start to mess with the baby while it's attempting to navigate through the pelvis, maybe we're going to cause a shoulder dystocia, maybe we're going to cause something to go wrong, because why did we have to touch them during that process?
• 15:56
  Speaker 2: They're doing it, and part of being able to sit back I really view it like my job is to sit back and watch and wait, clearly, know, clearly.
• 16:04
  Speaker 2: If I see like, oh, this is not normal, then yes, I'm going to intervene, I'm going to do it very quickly and that's what I'm trained at doing.
• 16:13
  Speaker 2: That's where my skill is to do.
• 16:15
  Speaker 2: But my skill is not to pull a baby out of somebody, because that's that.
• 16:20
  Speaker 2: They're just coming on their own and we should allow them to do that and we should allow them the time to do that.
• 16:30
  Speaker 2: And I, every time I read studies that try to prove one way or the other, I kind of have to laugh because I think, like, why can't nature just be the baseline?
• 16:36
  Speaker 2: Why do we have to prove that nature is okay in order to stop intervening?
• 16:41
  Speaker 2: It's like we have to prove the intervention is wrong, to stop the intervention from happening.
• 16:45
  Speaker 2: And it's like, well, why did we intervene?
• 16:47
  Speaker 2: But yeah, I.
• 16:49
  Speaker 2: So I I knew I did not want that and I I wanted a home birth.
• 16:54
  Speaker 2: I wanted a different kind of care.
• 16:56
  Speaker 2: In in Israel, it was definitely more outside the norm to have a home birth in the health the we have socialized healthcare there, but it doesn't pay for a home birth, and we were young and did not have a home birth in the health the.
• 17:04
  Speaker 2: We have socialized healthcare there, but it doesn't pay for a home birth, and we were young and did not have a lot of money.
• 17:08
  Speaker 2: So it was a huge financial decision for us to make that investment, but I felt like we weren't just investing in like an experience.
• 17:14
  Speaker 2: I think a lot of people view home birth as like an experience, and by I feel like the people that view it that way are people that have a negative opinion on it, that, like people are doing this, you know, to have these pictures of them sitting in a tub, or they're doing it for some aesthetic or you know, or some sort of experience that, like the maternal experience, is more important than infant safety, and I think that's so silly because for me, it was really about investing in my holistic health as a human being and as a woman and as a mother, holistic health as a human being and as a woman and as a mother, and I'm so grateful for it because I had a nine pound baby for my first pregnancy, which I'm six feet tall, so I don't it was not a problem for me.
• 17:55
  Speaker 2: But I know that, had I had had a planned hospital birth, that the standard of care would have been to do an ultrasound when I was admitted in labor and they would have said, based on estimated fetal weight, most likely they would have recommended a C-section.
• 18:07
  Speaker 2: And that was just the standard of care in that scenario.
• 18:10
  Speaker 2: And what a shame, because I didn't need a C-section and if I would have needed one or it would have been necessary, it would have been available but it wasn't necessary.
• 18:20
  Speaker 2: So I was very grateful.
• 18:22
  Speaker 2: I also had a very long labor.
• 18:23
  Speaker 2: I had a very long labor, I had a very slow labor.
• 18:27
  Speaker 2: I'm sure, given the culture of care where I was in the environment that existed there, you know, there would not have been a very high tolerance for a primate to be in labor for that long without saying I have to be on pitocin or we have to do something else, being able to be in my own space was so important to me.
• 18:48
  Speaker 2: I had a lot of medical trauma and the idea of having a lot of strangers around me or touching me or being close to my body would have felt very unsafe for me, and so I really truly felt safest to be home.
• 19:03
  Speaker 2: It wasn't just like I need to be home to avoid intervention.
• 19:06
  Speaker 2: It was like I feel safest to birth my baby in this environment.
• 19:10
  Speaker 2: I felt unsafe if I would have to be in the hospital, and I honor and recognize that is definitely not true for everybody and I feel very strongly people need to birth in the place where they feel safest, with the support people that they feel safest with, and for some people that might be in a hospital with an obstetrician and all of those kinds of resources, and for some people that might be a free birth on their own, you know, and everything in between, and that it's really, really important that we protect that level of choice, because I also believe that that's what makes birth safer and improves our outcomes.
• 19:48
  Speaker 2: We have been dealing with something over the past few months in Maine about a bill that would potentially harm midwifery in Maine, and we've been successful right now at pushing back on this bill, but we know these things come up all over the place.
• 20:02
  Speaker 2: It's not going to be the last time and the infringement upon our bodily autonomy is as as women in America right now is horrifying, and I believe all these things are very much tied together.
• 20:14
  Speaker 2: You know, to tell us what we can and cannot do with our reproductive destiny and to tell us, you know, where we can give birth or with whom we can birth.
• 20:23
  Speaker 2: Right, it's all about control and none of that control leads to healthier populations.
• 20:29
  Speaker 2: It's not.
• 20:31
  Speaker 2: We know that, so it's not my personal opinion.
• 20:35
  Speaker 2: Like there's a lot of statistical data on that.
• 20:38
  Speaker 2: And places where women have the least amount of options regarding their, their reproductive choices they have the worst health care outcomes, and that's fact and we need to protect that.
• 20:48
  Speaker 2: Have the worst healthcare outcomes, and that's fact and we need to protect that, and I believe in that very strongly, because we need to have the right to choose what's happening with our bodies and how those things take place.
• 20:58
  Speaker 2: I had a beautiful home birth.
• 21:00
  Speaker 2: It was long and slow, but it was great.
• 21:04
  Speaker 2: I was so happy about it.
• 21:07
  Speaker 2: I I felt like I needed a lot of time during my labor process to move through different things emotionally and and release those things, which was a very powerful lesson for me later, as a midwife too, to really understand, like, how much comes up psychologically in labor.
• 21:25
  Speaker 2: You know we're, we're literally walking this up psychologically in labor.
• 21:31
  Speaker 2: You know we're, we're literally walking this, this path between life and death and existence, and it is, I really just believe it is the most, it is the most sacred and holy of spaces to exist in.
• 21:39
  Speaker 2: In that moment we're quite literally a portal for life and we're we're in that time in um, in I I'm jewish and in in Judaism, when a person is in labor, they are considered to be between worlds and I think that is very true, you really are, and that should just be so deeply respected and treated with such incredible reverence and dignity.
• 22:06
  Speaker 2: And any time that that is not given to a person, we're really dehumanizing them and that will affect them forever.
• 22:14
  Speaker 2: In my 15 years of birth work, I can't keep track of how many people, especially older women like grandmothers, elderly women, that when they hear that I'm a midwife, they just want to tell me their birth story.
• 22:26
  Speaker 2: They just it just pours out of them, and so many of them have said that they never were able to talk about what happened to them and so many of them have very traumatizing stories of how they were treated and how they weren't listened to.
• 22:41
  Speaker 2: Um, especially people who birthed in like the fifties and sixties in America and weren't told what was happening to them, weren't given any options, had you know, sometimes really horrifying things done to them as well, especially with like scopolamine and the twilight sleep and all these things.
• 23:00
  Speaker 2: And these stories just pour out of people.
• 23:03
  Speaker 2: Because we also don't give people this, the space to process those stories, we just tell them you had a baby, your baby is fine, be grateful, and we discount the experience that that has on the person who gave birth and and how that will carry with them for the rest of their life and how that will shape them as a parent and how that will shape them through everything.
• 23:26
  Speaker 2: You know, our, our birth stories are our most impactful, important, you know, stories of our lives.
• 23:34
  Speaker 2: Sometimes it's a, it's a transformation that nothing else can replicate, right?
• 23:40
  Speaker 2: So people will always remember how they were treated.
• 23:43
  Speaker 2: They may not remember all the details of their birth, but they will absolutely remember if they felt safe or not, if they felt like they were respected or not, if they felt like they were listened to or not, and I knew that I felt very called to be a part of like.
• 23:57
  Speaker 2: We must change that.
• 23:59
  Speaker 2: That should not be the norm.
• 24:00
  Speaker 2: It should not be the norm to feel traumatized by giving birth and then told that you can't talk about it.
• 24:07
  Speaker 2: So after my daughter was born, I had a really difficult time postpartum.
• 24:12
  Speaker 2: I felt very isolated.
• 24:14
  Speaker 2: I really didn't have a lot of support or enough support, and I didn't have enough people around me helping me understand that what I was experiencing wasn't normal.
• 24:24
  Speaker 2: So I really felt like it's just me and I'm having too hard of a time being a mom.
• 24:29
  Speaker 2: Instead of understanding that I was experiencing postpartum depression and nobody screened me for it.
• 24:35
  Speaker 2: Unfortunately, nobody talked to me about it and I just and it just got worse and I just thought I'm just.
• 24:42
  Speaker 2: Why am I struggling so much to be a mother?
• 24:44
  Speaker 2: Why is this so hard?
• 24:47
  Speaker 2: But I also knew I wanted to continue my pursuit to become a midwife.
• 24:51
  Speaker 2: So we moved to America so I could go to midwifery school here.
• 24:55
  Speaker 2: Before I started midwifery school I became a certified lactation counselor educator because I also really struggled with breastfeeding and I thought why can't we get more help with this?
• 25:05
  Speaker 2: This is so silly.
• 25:07
  Speaker 2: I'm asking for help and I still can't find enough support and I said I got to do something about that because this should not be that difficult.
• 25:14
  Speaker 2: And I ended up breastfeeding my daughter for three and a half years and it was a really important relationship for me to have.
• 25:21
  Speaker 2: But I did have some trauma from it about how difficult it was for so long and why, and feeling very isolated in that because nobody was offering support.
• 25:32
  Speaker 2: They were just telling me to give up and I think because most people didn't know how to offer support and it wasn't until she was older.
• 25:39
  Speaker 2: And then I found La Leche League and that was very impactful.
• 25:43
  Speaker 2: But once we were in America and I finished that course, we moved up to Washington state so that I could apprentice with a midwife there and I had a really immersive experience working with her.
• 25:59
  Speaker 2: She's an elder midwife that's been practicing since the seventies and it was, I think.
• 26:07
  Speaker 2: And it was, I think, a really good education for me in a different perspective of midwifery as well and being trained by somebody who became a midwife in a different time with different resources and different expectations as well, and everything was always really hands on and everything was always really hands-on and we learned.
• 26:28
  Speaker 2: You know I learned to do.
• 26:29
  Speaker 2: I always felt like I really good at palpation because everything was hands-on and we never used a Doppler unless somebody, like until someone was in labor.
• 26:38
  Speaker 2: Everything was really just grounded in in respect and love and care and it was a.
• 26:45
  Speaker 2: It was a wonderful experience.
• 26:47
  Speaker 2: And then I got accepted to to birthwise and we moved to Maine because I was feeling like it was not going to be possible for me to become a midwife through the pet process with a toddler.
• 26:57
  Speaker 2: That that became really clear to me that that was not enough structure to to keep moving forward.
• 27:05
  Speaker 2: So we moved to Maine.
• 27:06
  Speaker 2: I went to BirthWise.
• 27:07
  Speaker 2: I did my preceptorship at a birth center in New Hampshire, which was great because I knew I really wanted my preceptorship to be very different than the other training that I had had.
• 27:18
  Speaker 2: When I started school I had already finished, if you know about, the NARM exam.
• 27:23
  Speaker 2: To become a midwife you have to have certain numbers of experiences and I had already finished all of my observe and assist numbers at that time.
• 27:30
  Speaker 2: So I came into school with a little bit more experience of attending births and some of my classmates.
• 27:35
  Speaker 2: So when I did my preceptorship I started as a primary student under supervision and I knew that I really wanted to be in a different kind of environment and experience a different kind of midwifery there.
• 27:48
  Speaker 2: And it was nice because then I had three preceptors at the birth center and one was a nurse midwife.
• 27:54
  Speaker 2: So I got to see different styles, different approaches to things, bit of a different population that was choosing birth center birth versus home birth.
• 28:02
  Speaker 2: And at the very end of my preceptorship I got pregnant with my second child and then had to stop.
• 28:09
  Speaker 2: I well, I was done, but I had to stop going to births for a while.
• 28:13
  Speaker 2: I was sicker in my second pregnancy than my first, unfortunately, and I had my second daughter, uh, six days before I graduated midwifery school.
• 28:23
  Speaker 2: So she came with me to graduation, which felt like a really the ultimate full circle experience.
• 28:31
  Speaker 2: And toward the end of my pregnancy I started another.
• 28:38
  Speaker 2: I had started a midwifery practice with another student who is also graduating, that we had already completed all of our requirements to graduate, but graduation is only once a year and I did not really take a maternity leave, which I've always regretted because you don't get that time back and even midwives need people to care for them after they give birth.
• 28:57
  Speaker 2: And my my daughter came, uh, 15 days after her estimated due date.
• 29:06
  Speaker 2: So it was a very long pregnancy and I I was very excited at first to feel much better postpartum than I had after my first.
• 29:18
  Speaker 2: But a few months after she was born I did develop postpartum depression again.
• 29:23
  Speaker 2: I felt it was a gift to be able to recognize it that time and to know like, oh, this is not how you're supposed to feel.
• 29:31
  Speaker 2: I think the hard thing the first time was that it happened so immediately with the birth that it's so difficult then to know something feels different.
• 29:40
  Speaker 2: Because I was a first time mom, how do I know that you start to feel any different?
• 29:44
  Speaker 2: I just thought you're supposed to be sad and overwhelmed all the time, feel any different.
• 29:50
  Speaker 2: I just thought you're supposed to be sad and overwhelmed all the time and being much more aware of it.
• 29:57
  Speaker 2: The second time was good and I chose to go on medication, which I feel like was a really important thing, and I've tried to do a lot with the families that I've worked with to reduce that stigma, because people don't want to talk about postpartum depression.
• 30:08
  Speaker 2: I think we still treat it as something that's shameful, as if it's somehow somebody's fault and it's not.
• 30:13
  Speaker 2: So I like to be very open about it, because nobody was open about it with me and when I was experiencing it.
• 30:20
  Speaker 2: It's very scary, and it can be very scary to have thoughts that you know are not okay to be having, but also that if you tell anybody that maybe something bad will happen to you or your baby and unfortunately in America we also see that that sometimes plays out that way People say I'm having these thoughts, I need help, and then they call CPS and take their baby away, and that's not solving anything for anyone.
• 30:42
  Speaker 2: It's not helping them feel safer, it's not getting them the care they need, and so I like to talk openly about it with people, because it's just like if somebody had preeclampsia in their pregnancy, is that their fault?
• 30:55
  Speaker 2: Do we blame them?
• 30:56
  Speaker 2: Do we shame them?
• 30:57
  Speaker 2: No, we tell them oh, my goodness, it's not your fault, it's okay.
• 31:02
  Speaker 2: But for some reason, if somebody says, well, I have postpartum depression or postpartum anxiety, it's like, oh well, what's wrong with you?
• 31:08
  Speaker 2: You know why don't you love your baby?
• 31:09
  Speaker 2: Why don't you?
• 31:10
  Speaker 2: Why aren't you happy?
• 31:11
  Speaker 2: You know why aren't you so excited to be a mom and we really negate the experience that this is not within their control.
• 31:19
  Speaker 2: So I've also always been very I've been very passionate about postpartum mental health disorders for those reasons as well, because I think I really like to say like I survived postpartum depression twice.
• 31:32
  Speaker 2: I didn't live through it, I survived it because it is also one of the leading causes of maternal mortality in America, and we're not doing enough to address that either, or to talk about it or to offer enough support.
• 31:45
  Speaker 2: We don't have the village.
• 31:46
  Speaker 2: It's not coming to feed us and care for us and hold our baby when we need a break.
• 31:51
  Speaker 2: So I feel like the more we talk about that, though, and we talk about it openly that we can change the consciousness around that and we can hopefully shine a light on how important it is to have that community and have people show up for you.
• 32:07
  Speaker 2: When you say like, hey, I'm not doing good, I need help, but I know so many moms are they're afraid to say that.
• 32:12
  Speaker 2: They're afraid to say that everybody sees you and says like, how are you doing?
• 32:16
  Speaker 2: And then you're like great, and you know, maybe, but maybe you don't feel great, but you're scared to say that you're not feeling great.
• 32:22
  Speaker 2: So I think it's important.
• 32:25
  Speaker 2: I wish more people would really talk openly about it and that providers would have really open, honest conversations with their patients about it, because just having people fill out the Edinburgh scale, the questionnaire, is not addressing the realities, and there's some good studies out there too that show that often people fill out these studies or fill out the surveys but then, like, even if it clearly shows that this person is experiencing like a postpartum mental or a postpartum mental health disorder, nobody does anything, and that the most common time that it's identified is actually by pediatricians, not the mother's care provider.
• 33:05
  Speaker 2: Because if you give birth in a hospital with an OB, you might see them one time postpartum, right At six weeks or seven weeks or eight weeks, and if you have a 10 minute visit with them, are they really going to do something about it?
• 33:19
  Speaker 2: But if the pediatrician sees you three times, they might notice something or they might ask you about it, but also, they're the pediatrician, they're not your provider.
• 33:27
  Speaker 2: So what are they doing about it?
• 33:28
  Speaker 2: They're not sending you somewhere either, you know.
• 33:31
  Speaker 2: They just hand you a list of resources and tell you to go get help.
• 33:33
  Speaker 2: That's not helping people.
• 33:35
  Speaker 2: So I feel like I I had a lot of different experiences and having my own children that really helped shape me as a, as a midwife, and to see that perspective of like oh, why is this like this and why are these things missed?
• 33:53
  Speaker 2: To understand those things myself, and yet I still couldn't get the help that I needed when I knew that I needed it was.
• 34:02
  Speaker 2: Yeah, because it's like if you are in a position of so much privilege to understand all these things and to know how the system works and to know what's available, and yet you still can't get it when you need it, what does that?
• 34:14
  Speaker 2: I mean?
• 34:14
  Speaker 2: It only teaches me like, oh my God, the people who aren't in the, who don't know, who don't know what the resources are like, they're definitely not getting it and that's really unsettling.
• 34:27
  Speaker 2: You know, I see them.
• 34:30
  Speaker 2: You know I see people get asked those questions and then, well, what is anybody doing about it?
• 34:34
  Speaker 2: Right, are they?
• 34:35
  Speaker 2: Are they sending a social worker, like to come hang out with you at home and see how you're doing?
• 34:41
  Speaker 2: Or visiting nurse?
• 34:42
  Speaker 2: Are they sending?
• 34:42
  Speaker 2: You know, is everyone getting a postpartum doula to come make them a meal?
• 34:46
  Speaker 2: Like no, so how are we taking care of people who are at risk, and that's that's another thing that I I just feel like there's so many layers to the system, right from from before you get pregnant to after your baby is born, that we're just failing people and it's so upsetting to watch.
• 35:06
  Speaker 2: So last year, in in the fall I, I decided that I was going to apply to grad school to get a master's in public health and maternal health, because it's really like policies that are killing people in America of resources.
• 35:31
  Speaker 2: Like we have money, we have the things we don't.
• 35:32
  Speaker 2: Yes, there are places where they're like maternity care deserts, for sure, but we're not, like you know, dealing with a system that like, oh, we can't even get medications, you know, or we can't get electricity and I follow very closely this birth center in Haiti called Mama Baby Haiti, and just the things that they deal with.
• 35:47
  Speaker 2: I can't even fathom sometimes how they carry on and what an incredible life-saving force they are for their community there and they can't get the most basic of supplies.
• 35:58
  Speaker 2: Sometimes, you know, and in America, like we have everything, I mean, sometimes I freak out at the amount of stuff just getting thrown out at the hospital because I'm like, ah, you don't even know they can't get running water and you're just like, yeah, what's another one?
• 36:14
  Speaker 2: Toss it in the trash and, um, you know, but we can't keep moms and babies safe in this country, like that's.
• 36:21
  Speaker 2: That's unacceptable.
• 36:23
  Speaker 2: So I am, I'm I'm starting um my sabbatical soon from my practice.
• 36:28
  Speaker 2: I have one more baby due right now and then I'll be in school in the fall, because I've decided like we've got to change these policies.
• 36:39
  Speaker 2: This isn't working.
• 36:39
  Speaker 2: Do we need more studies to tell us why people are dying and we do nothing about it?
• 36:44
  Speaker 2: I just watched a congressional hearing about it and it's like it's not, like we don't know, we know and for some reason, we literally just do nothing and I don't understand that.
• 36:56
  Speaker 2: Not even to speak of the disparities based on race and socioeconomic status.
• 37:03
  Speaker 2: And you know, rural versus urban locations, like the disparities in healthcare in this country, are so insane to me.
• 37:11
  Speaker 2: That should not determine whether or not you live.
• 37:15
  Speaker 2: That's so unacceptable.
• 37:18
  Speaker 2: So we clearly like we need more people to change the policies, because the policies are dictating this care and the care is not adequate.
• 37:29
  Speaker 2: Yeah, I completely agree.
• 37:32
  Speaker 1: So how long will it take for you?
• 37:34
  Speaker 2: to get your master's in public health A year.
• 37:36
  Speaker 2: I got into an accelerated program at Harvard because I've been a health care provider for a number of years already, so I'll be in a cohort of all people who are like mid-career professionals, which I'm really excited about was a big part of why I wanted to be in that program.
• 37:52
  Speaker 2: I knew that I wanted to be with other people that know exactly what it is they want to change in the system, and not people who are like, not yet familiar enough with the system.
• 38:02
  Speaker 2: I want to be with all the other burnt out health care providers who are like, screw this, we have to change it.
• 38:08
  Speaker 2: Burnt out healthcare providers who are like, screw this, we have to change it, because those are the people that you want fighting for policy.
• 38:13
  Speaker 2: You know, the people who know how wrong it is to be honest not that it should be like that, but it is.
• 38:18
  Speaker 2: So I'm really hopeful, like that I'm going to be able to access those things and and work on those kinds of projects To hopefully create real change, because you know every day that we're not doing that.
• 38:35
  Speaker 2: People are dying and that's wrong, and I think even just to not focus on, like, the mortality, but people are being harmed by it every day.
• 38:45
  Speaker 2: You know, like I was saying earlier, it should not be that the normal birth story is one of trauma, you know, and we need to change that and we have to change that with you know a very different approach to care and one that's not grounded in uniformity but really grounded in in honoring the individual and protecting the individual.
• 39:09
  Speaker 2: Experience and our system has become such that it's, you know, it's very mechanized, it's very like factory-like, right.
• 39:17
  Speaker 2: That's how we try to guarantee quality with every outcome, but we're not getting the quality with every outcome.
• 39:23
  Speaker 2: So clearly, the more we try to create a uniform way to care for people, we're unintentionally creating more harm.
• 39:32
  Speaker 2: And I think that's what's so beautiful about midwifery care is that we're so focused on the individual.
• 39:38
  Speaker 2: And how do we care for the individual?
• 39:40
  Speaker 2: And that's really what I love about my practice is I just I really get to know people.
• 39:46
  Speaker 2: I, I know who they are, I know their family.
• 39:50
  Speaker 2: I, you know I, you know I, I know where they live, I know, I know what they need, I know what resources they have and don't have.
• 39:57
  Speaker 2: We talk about postpartum planning.
• 39:59
  Speaker 2: We talk about you know all these different things and we give them the space to talk about it.
• 40:05
  Speaker 2: I know their other children, I know their dog, because that's their part of their life.
• 40:10
  Speaker 2: This is all going to be part of their experience.
• 40:12
  Speaker 2: You know, I sit with their mom at their birth.
• 40:15
  Speaker 2: I love that because I know them.
• 40:19
  Speaker 2: I know how to help them as much as I can.
• 40:22
  Speaker 2: I know what resources they might need.
• 40:25
  Speaker 2: I know how to help fill those gaps when I can.
• 40:28
  Speaker 2: But it's also very hard because you have a tremendous amount of responsibility in that way.
• 40:34
  Speaker 2: Then you know it's I won't lie, it's there's a lot of burnout to carrying all of that liability on your shoulders and not being able to share that with others.
• 40:44
  Speaker 2: You know, certainly in the hospital there's there's a whole team of people that share that together.
• 40:49
  Speaker 2: And at home it's, it's me and I take that so seriously and I take that with my whole being.
• 40:56
  Speaker 2: If birth does not unfold the way that somebody had envisioned it and I know how they envisioned it because we've been talking about that for months I feel it so much in my heart because I want everybody to have what they envisioned.
• 41:10
  Speaker 2: But I also recognize that, like, birth does not always unfold in that way.
• 41:15
  Speaker 2: Plans sometimes have to change, we have to adapt to things that we weren't expecting.
• 41:21
  Speaker 2: But I just, yeah, I, I care for people so much and I I want them to feel so good about things, even if it's not what they had exactly envisioned or planned for.
• 41:33
  Speaker 2: But I want them to feel good about it Because I think when people feel that their autonomy was respected, that they were leading the ship, they were making decisions, they had the opportunity to really be conscious about those decisions, not just like will you consent to this right now, sign this thing?
• 41:53
  Speaker 2: You know that then, even when it's not exactly what they had planned for, envisioned for that they can feel at peace with it.
• 42:00
  Speaker 2: I think often the trauma comes from people, not just a birth that wasn't what they expected, but when they felt like nothing was in their control, that they weren't even like a part of what was happening.
• 42:11
  Speaker 2: You know, even though it's happening to them but I've seen that too much, unfortunately you know where nobody's asking you things, nobody's just slowing down and explaining it and talking you through it and explaining to you what your, what your decisions are.
• 42:28
  Speaker 2: That's often, I think, when people feel really traumatized, because they feel like everything was happening to them, not with them, and I think, no matter how a birth unfolds, that's always like a very main focus of mine.
• 42:43
  Speaker 2: I always want people to really know what's going on.
• 42:47
  Speaker 2: Why, what decisions can we make at this point?
• 42:51
  Speaker 2: What do those options look like?
• 42:53
  Speaker 2: What decisions can we make at this point?
• 42:54
  Speaker 2: What do those options look like?
• 42:56
  Speaker 2: And in the very, very rare moments where there truly is not time to have those kinds of discussions, I feel like the benefit of having built these very deeply personal relationships over nine, 10 months of care is that, in that moment, if I say that this must like we need to do this and we need to do it right now, people trust me.
• 43:12
  Speaker 2: They trust that I'm making that decision.
• 43:12
  Speaker 2: If I say that this must like we need to do this and we need to do it right now, people trust me.
• 43:14
  Speaker 2: They trust that I'm making that decision with their best interest in at heart and that this was absolutely the most necessary thing to do in that moment.
• 43:22
  Speaker 2: Because they know that I I trust them and they trust me, and that you know that consent has happened as a part of our you know, being a team together through their pregnancy and birth, and that I'm not going to do something to them that wasn't necessary in an emergent situation and that if it's not an emergent situation, then they have the time and autonomy to make that choice about what they want and don't want.
• 43:51
  Speaker 1: Yeah, absolutely.
• 43:53
  Speaker 1: Is there anything else you'd like?
• 43:55
  Speaker 2: to add.
• 43:55
  Speaker 2: Well, I think I'm in a moment in my life when I'm really like reflecting on, like, what my career has been and where my journey has been.
• 44:03
  Speaker 2: Now I'm gonna get emotional too, because it's a lot like now.
• 44:08
  Speaker 2: I have this one birth left right now before I start school and I really feel like I'm sitting on my own precipice to go through my own portal.
• 44:20
  Speaker 2: I've had a lot of people like when are you coming back?
• 44:22
  Speaker 2: Because that's when we're gonna have another baby.
• 44:26
  Speaker 2: I think the truth is right now I don't know.
• 44:28
  Speaker 2: I'm very open to where things take me.
• 44:31
  Speaker 2: I think I will never not be a midwife.
• 44:35
  Speaker 2: I think, for as long as I live, midwifery is not a job.
• 44:39
  Speaker 2: You know, it is like a role that we have.
• 44:43
  Speaker 2: It's as much as I will can never not be a mother.
• 44:46
  Speaker 2: Now I really believe, like I will always be a midwife.
• 44:49
  Speaker 2: It's it's really like the lens that I see the world through always be a midwife.
• 44:53
  Speaker 2: It's it's really like the lens that I see the world through.
• 44:56
  Speaker 2: So, but I don't know when I will return to practicing um and how that will look exactly.
• 45:02
  Speaker 2: But I am really passionate about creating low barrier access to better prenatal care.
• 45:10
  Speaker 2: I really truly believe that that is something that can have a dramatic impact on birth outcomes in this country.
• 45:18
  Speaker 2: You know, we we kind of are just at this point where it doesn't matter if people get sick because we'll just induce them, and I mean, that should not be how things are happening.
• 45:26
  Speaker 2: We need to have really holistic prenatal care and that should be the foundation, not the exception.
• 45:33
  Speaker 2: So I'm really passionate about bringing that sense of what midwifery care looks like, that that needs to become far more accessible to the greater population and that needs to be integrated into the larger system of maternity care in this country.
• 45:50
  Speaker 2: So I'm really driven to be a part of making that happen and I'm excited to see what will come next and the things that I'm going to get to work on in school and the opportunity to work with people who are coming from all over the world to be a part of this program, because we all want the same things to improve maternity care.
• 46:14
  Speaker 2: And, yeah, I'm just really excited right now about what that opportunity is going to look like and and you know what will what will happen as a result of it.
• 46:24
  Speaker 1: Yeah, I'm so excited to see what you do with that.
• 46:26
  Speaker 1: You've already put in a lot of work, along with others in the birth community here in Maine on the bill LD 1205.
• 46:33
  Speaker 1: Do you want to share a little bit more about that?
• 46:37
  Speaker 2: Yeah, so right now it has been postponed to the next session.
• 46:42
  Speaker 2: It won't be heard this session, which took a tremendous amount of work.
• 46:47
  Speaker 2: But I think we've shown that the midwifery community is strong and you know we're not going to go silently about anything.
• 46:55
  Speaker 2: We're quite tenacious and we're quite determined to continue to serve the families we work with and to continue to improve birth outcomes here in Maine and that, when we look really closely at the data, that we have wonderful outcomes, we are creating a system of of really wonderful care that is supporting families and leading to really positive things for them.
• 47:22
  Speaker 2: And we're going to continue to do that and we are not going to, we're not going to just be stopped because you know large corporate medicine doesn't like that.
• 47:35
  Speaker 2: I feel very, very strongly about those things, like I was talking about earlier, about autonomy and the right to make your decisions about your reproductive fate.
• 47:44
  Speaker 2: You know we must, we can't legislate where people can have their babies and how and when, and any attempt to do so I really think is going to be met with a tremendous amount of pushback and I think maybe the people that proposed that bill didn't really realize how hard people were willing to fight for that and maybe they thought it'd be a little easier for them to take away some of those rights.
• 48:05
  Speaker 2: But I hope that that message is coming out really loud and clear to them that it's not going to go that way here and I don't want that to go that way in any state in America.
• 48:14
  Speaker 2: So I hope that you know especially all the states that are working so hard continuously to get midwives licensed, to give them access to basic resources, to protect birth, you know, place of, to protect the choice in place of birth, all of those things.
• 48:32
  Speaker 2: It's incredibly important and we need to keep fighting for that on a really large scale and I'm hoping that it's there's that.
• 48:41
  Speaker 2: I am not a native Mainer but I know the saying as goes Maine, so goes the nation.
• 48:45
  Speaker 2: So I really hope that this was the first bill of its kind as far as any national organization was aware of and you know it was here in Maine and I really hope that it sends a really good message far and wide that we're not going to let it happen here and we're not going to let it happen anywhere.
• 49:02
  Speaker 2: Yeah, totally.
• 49:05
  Speaker 1: Well, thank you for all of your work pushing back on that, and thank you so much, ariel, for sharing your story today.
• 49:12
  Speaker 1: Yeah, thank you, it was great to talk to you.
• 49:15
  Speaker 1: Before you go, I just want to remind you I have a ton of resources for pregnancy and birth If you're pregnant, whether you're a first-time mom or if this is your fifth baby.
• 49:25
  Speaker 1: I want you to check out the show notes, because I have some free trainings and free downloads that you can sign up for, as well as the link to access my labor of love, a comprehensive, self-paced online childbirth education course.
• 49:39
  Speaker 1: I created this course specifically for moms who don't want to be told what to do, regardless of where you're birthing or who you're birthing with, and I'd honestly love to teach you everything that I know so that you can prepare for an autonomous birth experience and prepare to step into your role as the leader of your birth journey.
• 49:58
  Speaker 1: So click to the show notes, check out all of those links and, if you ever have any questions, feel free to DM me at my main birth over on Instagram.