Down to Birth

#90 | March Q&A: Ultrasounds; VBAC Providers; Vaginal Exams; PPD in Pregnancy; Exploring Home Birth; Distraction Techniques in Labor

March 31, 2021 Season 2 Episode 90
Down to Birth
#90 | March Q&A: Ultrasounds; VBAC Providers; Vaginal Exams; PPD in Pregnancy; Exploring Home Birth; Distraction Techniques in Labor
Show Notes Transcript Chapter Markers

Our March Q&A episode is here!  We begin with a discussion around the use of ultrasound measurements in pregnancy to determine your baby's size and weight at birth (hint: a baby that is measuring long is likely to be taller than average not macrosomic); we discuss when you might consider changing providers for your planned VBAC birth; can a mother experience postpartum depression (PPD) while still pregnant? What about the use of distraction techniques in labor and how does that impact hypnobirthing techniques? Do I need more Ultrasounds in pregnancy after the anatomy scan, and how will I know that everything is going ok? How about vaginal exams in labor? Are they really necessary and if so, how many? Finally, do you have any recommendations on how to prepare for home birth before being pregnant?

As always, thank  you for your great questions and please continue to submit them through our website or in Instagram!  See chapter markers for specific questions in today's episode.

#60: Love + Marriage + Baby: Interview with Maggie O'Connor, LMFT
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I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

So Trisha, I just got a text from a woman in my current class. I want to share it with you.

Let's hear it you always get great stories. Yeah, this one is good for you because you're a home birth midwife. And I know you don't hear these a lot. She wrote, blah, blah, blah. Okay. Last Thursday, I had a sonogram. And this doctor I'm not in the care of at the sonogram came in to tell me she thought an approximate weight of three pounds four ounces was too big for 29 week, baby. It was awful. She scheduled me to return in four weeks and wanted another gestational diabetes test. I passed the gestational diabetes test with a nonfasting number of 106 and turned around and canceled my April 1 sonogram this week after our session on Sunday feeling so much more in control and content with the baby's growth. That was also after the practice refused to let my husband Join me for this for the imaging after they said we have a concern. The doctor didn't even attempt to ask questions about genetics, birth weight of my husband or me at birth, or our height. Both my husband and I are five foot 11. Then I found out the baby weight was measured off of the estimation of the limb size. I had to laugh, obviously, we were likely to have tall kids. So they use the femur length, I take it and did an estimate. And then they came out and said we have a concern. It seems we're going to have tall children like you are right.

Like what what are they hoping that she's going to do stop growing her baby so nicely. I mean, she doesn't have gestational diabetes. So there's there's not an issue there. She's tall, her husband's tall, her baby's measuring tall. She's gonna have a tall baby, or longer than average baby. We talked about this all the time. I mean, so what I know, it's like you said, what are they going to do about it anyway? It's just the whole thing is ridiculous. even talking about it is ridiculous. fetal positioning is where everyone should be putting their focus. And that's, that's right. That's the whole point of it. Yeah, you know, they this whole the fear around big babies is so all consuming. And we just need to break it down and think about we've talked about this in our last episode on gestational diabetes, that the problem with babies that are too big is the potential risk of shoulder dystocia. Right, which happens when you have the, the way a baby lays down fat in the body and where they get bulky. That's really different than just a big baby. Yeah, what they really should be talking about is, you know, if you if your baby's going to be larger than average, it's going to be extra important that you pay attention to fetal position your your body mechanics and late pregnancy and optimizing the baby's position for birth and making sure that you have upright and mobile labor. And you know, making sure that we're not doing things that are going to inhibit your baby doing things in your labor that are going to inhibit your baby from getting in the best position for birth, the it's like the average American woman or someone giving birth in this country is going through pregnancy, hearing, we don't want your baby to be too big, we don't want your baby to be too big. And as soon as they give birth, what they hear for the next few years is we don't want your baby to be too small. We don't want your baby to be too small. It's just it's ludicrous. There are bell curves for with good reason. And everyone's trying to get everyone at the 50% mark. There are medical indications for certain things. But none of the things we've talked about so far are medical indications of anything.

And what really needs to happen is that practitioners need to become more skilled and adept at attending the bursts of women whose babies might be bigger than average. And how to best manage those labors without just forcing induction. I mean, that's the that's the thing that they want to do. That's the intervention is well let's get this baby out sooner because why We can schedule it to we're under, we're controlling it three, you know, get paid a little more. I mean, lots of good reasons. But really what they need to do is be better at managing labors where babies are a little bigger and talk to women about fetal positioning during pregnancy, which seems to never come up. All right, let's jump into our q&a, shall we? Yes. All right.

The first one is on VBAC. And we are getting a lot of these questions. But Kip, clearly, people have a lot of questions about VBAC. I switched to a new ob who promotes feedbacks. She's great, except out of the five office visit, she's only been to about three of them. any of my friends that had her as an OB did not have her deliver their baby. I asked if she is not at my birth, who will support my VBAC? She told me Everyone in the practice supports them. However, I use the same practice with my first and I ended up in a C section because I was failing to progress. So I don't trust them all that much. And I'm being getting to not trust her. Should I find a new ob? I'm 25 weeks.

Yes. Next question. Well, here's the here's the thing. We can't tell you whether you need to find an OB but we would certainly say shop around I'll just tell you what jumped out at me. It's kind of a thing that we all sometimes say not just Trisha and me, but when you've had when you're planning a VBAC, or step one is frequently don't give birth with the group that gave you the C section. That's just there's too much there. Whether they're justifying the C section, whether they're too pro c section, it's just a very good starting point, not to mention any of the emotional stuff that you are, without question carrying at least on a subconscious level, if not both conscious and subconscious, about seeing their faces and remembering how you gave birth with them. So just wiping the slate clean as much as possible is a really great way to go. You specifically said you don't trust them. Enough said You said it yourself. You don't trust them. Trisha, what do you want to say?

I totally agree. The biggest indicator of success with a VBAC birth especially is your provider being supportive and having that trusting relationships especially when it comes to VBAC, you really have to have that confident and trusting relationship with your provider.

Yeah, yeah. And good luck. We'd love to keep hearing from you. Okay, this one says, I'm not sure. But I think I might already have quotes, postpartum depression, even though I'm still pregnant. My husband works long hours, but he isn't very helpful. Anyway. I asked him to help me around the house, but it's never long before I have to ask again. He seems to intentionally do the bare minimum, I'm very lonely. None of my friends are pregnant or have babies and COVID isn't helping? Is it possible to get postpartum depression before giving birth? Or does this mean that I will get postpartum depression after I give birth? It is true that a fair percentage of women who end up with postpartum anxiety or depression showed some symptoms in pregnancy. And that's because isolation is at the core. I mean, that doesn't mean that's going to happen. But it's really good that you're recognizing this. Agree. I also want to just point out that I noticed that you said, Your husband helps you with housework. That says quite a lot about your relationship and how you look at it, and maybe how he looks at it too. I think it's really time to have a conversation with him in advance of having the baby so that you guys can basically renegotiate housework in your in your home and those expectations, who is going to do what after the baby's born because your hands are tied almost all the time. And housework gets really difficult, and can be the cause of some petty struggles or big arguments between couples. So I would definitely approach this issue now before you have the baby. And I think the best thing is to make it so that you don't have to manage him and ask him anything, but let him maybe pick several jobs that he's comfortable, completely owning. In that first year after the baby is born, whether it's grocery shopping, vacuuming laundry, whatever it is, but something that you don't ever have to stop and ask him about, but that you can just trust will get done. I think there's no question you're going to need support because it sounds like you already could use a lot more support. So I would start by talking to him. But I would also talk to a professional and see if you can work with someone starting now. I would also include people in your network, your family, friends, you trust even friends of friends who might be supportive to you. Because the idea really is just to keep talking until you find the people who will be looking out for you. checking in with you or looking out for you and making sure that you're getting the support that you need, whether it's from your husband or or outsourced. But it's not an option for you not to have support. It's really important.

Yeah, so I would just add to that, that. I agree that feeling this way now doesn't necessarily mean it definitely doesn't mean that you're going to definitely have postpartum Question after birth, and whether or not it's an actual risk factor, because we don't really know your past medical history, if you've never had anxiety or depression before, then you don't know maybe this isn't a risk factor. Maybe this is just a year of being in COVID, in isolation and pregnant and not having friends that are pregnant, and actually just really some relationship stuff. That's, you know, getting to you. So because isolation is the root cause and you're already identifying it now pregnant, it is going to be really important to take all the steps to prevent it getting worse postpartum, because it just naturally does when we're home with a baby alone all the time. But I also just want to address the relationship stuff, because if you're having these issues now, now is the time to really set new rules. In our episode with Maggie, we talked about how the old contracts need to be torn up and new contracts about who does what in the house and how we work together needed to be need to be developed. And one of the reasons that new parents run into so many relationship challenges and grow distant after a baby is because they don't do that work prenatally, they don't put those new rules in place. So if you are already struggling with this, now, it's especially important to sit down with your partner and talk about the ways in which you're feeling that he's not there for you or the ways that you're feeling that he's not, you know, addressing your needs, and make sure that you have a plan for how those needs are going to be met after the baby arrives.

And I'll just add that Trisha just made a reference to our episode with Maggie, but I just want to give the details that she's referring to Episode 60. It's called love and marriage and baby interview with Maggie O'Connor. We'll include the link to that in our show notes. All our episodes are on our website down to birth show.com. So it's a very convenient way to find the content you're looking for quickly. But again, we will include the link to that episode in our show notes.

Alright, on to question three. A question I have is in regard to a form of distraction I heard about from a mom's group, someone recommended that a laboring mother hold a plastic comb in her hands and squeeze it during searches. It's supposed to pinpoint acupressure points for the mother with something like this counteract the mother's HypnoBirthing breathing exercises, or is it something that I should consider?

First, I've never heard of that. So I'm no expert or knowledgeable person to comment as to acupuncture points, or acupressure points. Maybe Trisha can after. But with respect to HypnoBirthing, I would have to say it does counteract what you're doing and HypnoBirthing I'd like to say it doesn't. But here are my thoughts. And you know, just just do what again, hear Everyone, listen to yourself, do what feels right to you. But I want you to just consider some things right now. You know, I've heard of methods where people are told to focus to stare at the painting on the wall. And look at how you know the little, the little detail in the painting and the stroke of the paint and just focus, focus, focus on something or stare at the lampshade and just try to look at every little fiber of the lampshade and keep your mind on that instead of on childbirth. And I'm sure that might be fairly effective. But HypnoBirthing is about going within it's about a greater connection to what's happening. In addition to that, it's about tuning everything else out. So anything outside of your skin is what's to be ignored. Labor isn't what's to be ignored. And the only other thing I want to say is the techniques and HypnoBirthing are about keeping a relaxed physiology because when we do that, we're creating more oxytocin, which keeps you more comfortable, and allows you to dilate more quickly and prepares you for a more enjoyable bonding experience and better oxygenates your blood for your baby. So any kind of tensing I mean if it feels right to you, and I'm not talking about after your 10 centimeters because we do tense because we get a surge of adrenaline at that point. But any kind of tensing is not something we're going for in HypnoBirthing. We always want to be more relaxed. We basically want to think of the body in terms of the word limp. Trisha, do you have anything to add about this method? Have you heard that before? I never have.

I actually I feel like I came across it recently somewhere on social media and I kind of chuckled because I think it's more or less about acupressure points. Sure a comb with all those fine comb with all those little teeth is going to hit some acupressure points on your hand. But acupressure is more about being specific, you know, working certain points. So I don't think it's so much about that is it is about the sensation of all those little teeth of the comb in your hand distracting you giving your brain a different sensation to focus on than the contraction. So maybe that works for some people. I'm thinking about it separately from HypnoBirthing. I'm just saying as a distraction technique for you know, getting your mind off the contraction and putting your focus on something else a different sensation. Maybe you try it. I kind of feel like in the intensity when labor really hits its most intense point you're gonna just want to be like Throwing that comb out the window, because now you're just really focusing on two different parts of your body that are being overstimulated. I just remembered when I was in labor with Vanessa, you came up to me and my eyes were closed. And he whispered. Now, Cynthia, I just want you to focus your cervix stretching around your baby's head. Was that helpful or not? You know what it was? And I tell that story in my class a lot, because I remember thinking, whoa, oh, and then I thought, you know what, it sounds funny. But I realized that whenever I was in labor with my son, and in that labor with my daughter, it's, it's, it sounds crazy, but it's easy to forget, there's actually a baby in this dance with you. Yeah. And it helped me to think, Wow, there really is a my baby is really coming to me now. So from the moment you said that, that's what I was picturing. So anyway, I just want to emphasize that you two were bringing me within. And that's what HypnoBirthing is about. It's not like we're trying to escape or think of anything but this, but I will say, while you're going within the most delightful, wonderful thing that feels a lot better than squeezing a comb, which I would never do personally, is to have a cold washcloth on your forehead feels amazing. If you're in water, effleurage, someone pouring cups of water over your shoulders feels incredible. But the cold washcloth can work anywhere. And that does help to draw the focus, but the focus is still always within. And then it's for your partner to manage everything outside of your skin. You have the harder job. But they have more to manage that. I think those are my thoughts.

Yeah. I love what you just said. Because why not? If we're going to focus our distraction, why not focus our distraction on something that's comfortable and not annoying. So I think it's the same concept, the the water, the cold washcloth, the gentle touch the massage, I mean, these are all things that we do for women in labor to help them take their focus off the contraction and put their focus on something else. But why use a prickly comb? That's just sounds annoying.

Yeah, at best. And there's something called light touch massage, which is wonderful. So I would say, you know, combs are handy when you want to comb your hair.

How about this? If you're hearing this question, and you have experienced with this, and it worked for you, we want to know, oh, that's a good idea. Yeah, we're open minded. You know, that's true. It works tell us well, it might work for somebody, everything works for somebody. It's just it's not in line with HypnoBirthing. And it is one of my clients who sent in this question. So I would have a hard time telling her to go for it with the balance of saying now let your body go limp and go within. Right. It doesn't seem to work so well. With HypnoBirthing. You made a good point about acupressure points being targeted. It's not random. You're not like throwing darts. Like maybe this a hit a good point. And then what happens when you hit that point, like, right? It's a little more strategic than that. It's more strategic. Each point has a has a direct channel. Alright, is fun question though. Boy, I I don't want to have those. It's funny because it's her question started with I've heard of a form of distraction, and in HypnoBirthing it's all about methods of focus. It's truly a contrary approach to to the question. It's overwhelming for women to hear all these things, you know, they want to do what's going to work and feel free to try everything pack a comb in your bag. You know, we're always looking for that magic bullet, you know, what's the thing that's gonna just like, there's no right or wrong answer. It's just like, I wouldn't know how to teach it with the HypnoBirthing methods. And you know, if you make it work, then be sure to tell me about it so I can learn about that. All right, next one.

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Okay, the next question says, I just had the anatomy scan. And my doctor basically congratulated me and told me I won't need any more ultrasounds during the rest of my pregnancy. This makes me feel anxious. First, I love seeing my baby and I can't believe I have to go for months without looking at him. Second, how do they really know everything is fine? Isn't it best if they keep tracking him?

Well, I just want to Say Hooray for this doctor who's not gonna make her have any more ultrasounds because that means, you know, this is somebody who's not going to be measuring in saying your baby's too big or your fluids too low or bla bla bla bla. So generally once you have the anatomy scan and everything is normal, yes, unless something else comes up in the pregnancy that alerts your midwife or ob to a problem, you don't need any more ultrasounds. So, no, you don't need to keep checking on the baby. Usually, when we over check, we find things that we don't need to find.

That's exactly right. ultrasounds are linked to people getting induced unnecessarily or being given some misinformation, sometimes I think it's a really good sign that you might be with a pretty evidence based practicing provider. If they're telling you, you don't need any more. And if you do need more than you'll know,

right, something might come up later in the pregnancy that will require an ultrasound to check out. But if it doesn't come up, then I think that's fabulous. As far as seeing your baby. Of course, there are many ways to connect with your baby without visually seeing them on ultrasound. So I think you know, focusing on some of those things that you can do at home, just tuning into your baby's movements, trying to learn their position, communicating with your baby through dreams, through meditation, through yoga, talking to them when you're in the shower, playing music for them dancing with them, reading the poetry. I was gonna say that this reminded me of something else. If you have an ultrasound every two weeks, then for 13 days in between those ultrasounds you can panic if you want to, but like that you have the best information you could possibly have. So maybe this is an opportunity to practice trust, you'll have to learn that lesson one way or another as a parent.

All right, next question. I hate getting vaginal exams during pregnancy and dread having my OBS constantly put their hands inside me all through birth? How often do they really need to check? I guess I just want to say first of all that, you know, you should never have an a vaginal exam without consent and agreement. In some cases, women have a history of sexual assault or violence and vaginal exams can be extremely traumatic. And in if that's not something you have disclosed in your prenatal care, or your provider isn't aware of a vaginal exam during labor can just create a traumatic birth experience. How often do they really need to check this is a discussion that you can have with your midwife or ob prenatally and expressed to them that you either don't want any vaginal exams unless they're absolutely indicated, or you know, the least amount of Agile exams possible if you are in labor, and your provider is suggesting that they need to examine you. If you in that moment feel like you can't handle an exam, it's okay to say no, absolutely. What I tell my clients is this, it's reasonable for your provider to check you when they first see you. So if you're having a home birth, and your home birth midwife arrives and wants to check you, it's not unreasonable for her to check you then. Or if you get to the hospital or the birthing center, it isn't unreasonable for them to check you. In fact, at a birthing center, they, they really like to do it because they want to make sure you're in very active labor before they admit you. And then it's not unreasonable for them to check you one more time, which is when they hear you grunting and bearing down, they just want to make sure you're at least nine and a half or 10 at that point. But rational exams are complicated emotionally as well. Trisha, I don't expect you to remember this. But there was a moment during my labor with Vanessa, you and Amy were there as my midwives and the whole labor was five hours or so. Amy arrived first and checked me and I was at six centimeters. And then a couple a few hours in. There was a moment where she came up to me in the tub and said, you know, you just want me to check you and see where you are. And my response was no, because I can't bear to hear anything but 10. So it plays an emotional game with us. Or we get discouraged, like, well, you're still you're still six, like what I'm only six. So you they're complicated. They don't even have to tell you how many centimeters you are.

Yeah, I mean, the vaginal exam for the provider is convenient, and it's helpful information, but it's mostly for their benefit and sort of managing the progress of the labor. For some women, they don't mind it, and they're happy to know if they've dilated one centimeter over the last two hours. So if you're that woman and you don't mind the vaginal exam that actually is encouraging you then great, but if it's something that feels like it's going to be emotionally harmful, or as we said with a history of any kind of abuse, or vaginal, chronic vaginal pain, even if it's anything that's going to make you feel physically uncomfortable, there are ways to continue to effectively manage the labor and not have adult exams, you're right, it is typically for them. And that's one reason that we have such a high rate of C sections due to failure to progress, or such high rates of augmentation of labor augmentation with pitocin. Then I also wanted to add after what I said earlier, you don't have to have any, as Trisha said, my own mentor has a general practice and has served over 2500 women at home births, so far, a general practice have not ever put in her hands inside of a woman throughout labor. Now I can think of one case where she does and I'm sure there might be a few. But like, if fetal positioning seems to be an issue, she has an adjusting method where she can put her hands in and feel by the fontanelles, the front one being a diamond and the back one being a triangle, she can adjust the head slightly, and it can allow for a very quick, easy birth after she makes that adjustment. But otherwise, she just keeps her hands out. I asked her about this once I said, How come you don't like to do vaginal exams. And she said, she said, Cynthia in labor, everything is supposed to go down and out. And nothing is supposed to go up. And in? Well, who can argue with that?

I mean, I think it's a rare provider who will attend births without doing any vaginal exams, I have to say, as a as a provider, it's really, it takes a lot of patience and trust, you know, when you get to a birth, and you need to know when to call the birth assistant, you need to know if you should fill but start filling the tub if you should prepare the newborn, you know, start warming the blankets there lots of reasons that we need to sort of gauge where labor is, and vaginal exams are a great way to make that assessment. So they're helpful for sure. For the provider. I'm just saying that if it is something that is, really, if it's something that it really is uncomfortable for you it is possible to you can say no, you can always say no, you have to agree to a vaginal exam before your provider does one and you can manage a birth from start to finish without ever doing one. It's just not. It's a lot more, it's a lot more challenging for the provider. Do you agree, Trisha, that two is reasonable in many births?

Yeah, I think what you said about you know, one at one to assess where you are in labor and one to ensure that it's you are fully dilated, that's reasonable. But if for some reason between the first one and that last one, there's a, you know, 24 hours in between, you're probably going to want to do another one somewhere in there just to see if things are moving at all.

And it can be helpful to see if the cervix is swollen. And if that's why the labor is very long, or something like that. I mean, it occasionally does make sense.

Yes, in the case of like a pushing phase that's taking a long time, it is actually important to make sure that you're not damaging the cervix by pushing on a non fully dilated cervix on a cervical lip, or something like that. But as I said, and you know, many women, their babies are just coming down and they're feeling that urge to push and you can you can sense that the baby is low in the pelvis, and it's through the cervix, and you don't need a vaginal exam to know that not always.

Someone would get them all during their prenatal visits. I mean, it's there's sometimes it's really prevalent well, or they might get it, they might get it from 37 weeks on every week, let's see how your cervix is progressed. Some women really want to know that they they're happy to have it. So this is it's very personal.

Alright, the next one says, do you have any advice for women who are interested in getting educated before pregnancy about home birth.

So my advice on getting educated about home birth and pregnancy is to really just look at the data on the safety of home birth, and to look at midwives in the area to meet with the midwives in the area who provide home birth. We know that home birth is a great option for low risk healthy women. There have been enough studies now to demonstrate that the outcomes for babies and moms are excellent in home birth, planned home birth, home birth is meant to be a team effort. So it's important to have your home birth midwife who is collaborating with us, you know, has a backup plan in case you need additional medical intervention or in case you have a hospital transfer coordination of care is one of the reasons that, you know, helps keep Humber safe. Yeah, I mean, we're all about home birth. Right. Cynthia, do you have anything to add to? Well, yeah, I would just say that anyone who's interested in home birth is likely coming from a place and if they aren't, then their partner is of really wondering how safe it is. And there's no one to better answer that question than a home birth midwife. So just call whoever you have in your area and go for consultations and ask them those questions that you're kind of afraid to ask say, Well, what you know, what
do you do if the cord is around the neck? What do you do if I'm hemorrhaging? What's the plan if we have to get me to a hospital, and they're used to answering these questions, you won't offend them, you won't surprise them they've heard at all and you have every right to feel assured they will have answers to this questions. You just reminded me of the conversation we were having with Christie yesterday on our IG Live. She wanted to have a home birth, but her husband wasn't into the idea. And you know, she said, I think he's just afraid. And I said, we said, Yeah, but of course, that's the reason. And it's the fear around home birth being unsafe and not realizing homebirth. midwives are very well trained on how to deal with all the, you know, the things that can go wrong in pregnancy, and they come with supplies and medications to manage some of the complications that could potentially come up, whether you're at home or at a birth center, or in a hospital, there are very few things that happen in birth, that are absolute emergencies, where we're talking, you know, minutes between a good outcome and a bad outcome. And even in the hospital, sometimes those things don't have the best outcome and homebirth midwives are particularly good at trusting when the birth process is still in the range of normal. And when it's moving to a place of indicating that things may not be going well. They're so skilled at that, because they they know they have to make these decisions, they have to make timely decisions of when to transfer care. So their understanding of what's normal is actually this very wide circle, which helps mothers have better birth because we're not intervening when we don't need to intervene.

Right and then Instagram Live yesterday that we did with Christie, she was saying that her husband said absolutely not to a home birth. And my comment to her was when a partner says Absolutely not. It's evidence that the work hasn't been done yet. Because when you really research all the options you have respect for all the options. If you think homebirth midwives are out there being reckless and crossing their fingers and saying, you know, we're pretty sure this is going to go well, I promise you you don't know what's going on in this industry, because society is going to err on the side of favoring a doctor when things don't go well. But not a home birth midwife says she has to do so much more to protect yourself to protect the line of work to make sure you're safe. And you'll be impressed and surprised at their qualifications. And they show up with an oxygen tank and they're bad pitocin in case there's hemorrhage, a stronger drug right Trisha in case the pitocin isn't effective. We just wait there's the more you learn about home birth midwifery, it doesn't mean it's right for you. But at least you'll have respect for the field.

And just to add to that, one of the other things we said yesterday is that, you know, a woman should give birth where she feels the safest. So if if she does feel safe, giving birth at home and has the appropriate care, then that's the safest place for her to give birth. If she feels like a home birth would be great. You know, I love that idea. But you know, mentally she's just not really there and your partner is not really there, then maybe it's not the safest option for you. If you feel safer in a hospital or birth center that that is where you should be giving Yeah.

If you're not feeling a little curiosity or inclination toward it, don't waste your time researching everything. But if you're curious, I do think you owe it to yourselves to to get some more information. So I love it. She's preconception and she's already looking into this. It's just great. Just right on the ball, once a month before most of us. Well, thanks for the great questions.

Also, just many of you probably don't realize that we have postpartum groups that are offered and prenatal support groups. As we're always saying that this is meant to be a community we want to hear your personal stories. We love it when you communicate with us. And if you're interested in joining a prenatal or a postpartum support group, just send us a message through the website or Instagram and we will give you all the information you need to join the community.

If you enjoy our podcast please take a moment to leave us a review on Apple podcasts and share a favorite episode or two. You can follow us on Instagram and Twitter @downtobirthshow or contact us and review show notes at downtobirthshow.com. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and  as always, hear everyone and listen to yourself.


Quick story on the use of ultrasound in pregnancy for estimated baby size
I'm planning a VBAC and beginning to not trust my provider. Should I switch providers?
I'm not sure, but I think I could already have postpartum depression even though I am still pregnant?
Will using a distraction technique in labor (like holding the teeth of a comb) interfere with hypnobirthing techniques?
Will I need any more ultrasounds after the anatomy scan?
Do I need vaginal exams in labor and if so how often?
Do you have any advice for women who are exploring home birth but are not yet pregnant?
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