#344 | November Q&A: Birth Partners, Postpartum Rage, VBAC, Infant Gas, Baby Names, Placenta Accreta, Endometrial Biopsy, Choosing Homebirth, Physical Boundaries with Your Toddler

Welcome to the November Q&A! Today, we start with a topic that always stirs strong feelings—birth partners. From the gestures that truly helped to the ones that fell short, we chat about your experiences of your partner's support, presence, connection or not.

Next, we respond to an emotional call for help from a sleep-deprived and emotionally exhausted mother whose husband threatens to call the cops on her for how she handled an overwhelming moment with her toddler. 

Today's episode includes a special guest appearance from Nancy Wainer, world-renowned midwife and the woman who coined the term VBAC. Nancy answers a listener’s question about an anterior placenta in a planned VBAC and explains what her decades of experience tell us about how placentas behave in utero. We also discuss endometrial polyps and whether a biopsy could affect future fertility, how to handle conversations about home birth within a hospital work environment, and how to choose a midwife when you have numerous options and like them all. 

In Quickies, we cover making baby-wearing more comfortable, the myth that labor “starts” at one centimeter, chiropractic versus pelvic floor PT in pregnancy, relieving newborn gas, timing big changes during teething, postpartum nutrition, and even whether to skip airport scanners while pregnant. We end with each of us pondering which baby names we’d choose today and our favorite ways to spend a slow morning at home.

VBAC: How to Plan for Success

#257 | Labor & Delivery Nurses' Roundtable: How Their Hands are Tied to Doctors' Orders

#273 | Special Q&A Featuring Nancy Wainer on VBAC and More

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Transcript

I'm Cynthia Overgard, birth educator, advocate for informed consent, 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 Show. 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.

Okay? Happy November. Happy end of November. Yeah, almost December. Here we go. Here we go. So, so what is on the agenda for our opener today? I don't know. You're up to something and you're smiling and smirking. So what is it?

Okay, well, well, first of all, we're gonna debut the readers. Oh, I love them. Do you like I knew you would have a really great pair of readers one of these days. And those are great. They look great. I love them on you.

I'm not increasing the font on my phone. I'm just doing this. I didn't do that either. I thank you. I'm holding out it's still tiny. No, they look great. Normal font, okay, but people have to go on YouTube to see you now.

Oh, yes, okay, head on over there. You can get a glimpse at my Warby Parker's. Yeah, they're fabulous. Okay, let's talk about birth partners. Let's talk about what they did or did not do that you loved or hated in labor. This was a Instagram story we did a while back, and as usual, we got inundated with replies, so we will choose a few to discuss, but there were some good ones in there that I thought we should share. You mean, women have things to say about their husbands, occasionally. Okay, it seems that they do occasionally, some nice, some not so nice.

We did a funny story years ago. We should do it again, something similar, like, what's the craziest question your husband asked about pregnancy or birth? And they were so do you remember we did that in 1q A, and we were laughing so hard. Do you remember that one? I kind of, there's like, there was a guy who didn't know what that like, basically, that placenta has existed. So, like, oh yeah, baby was born. This massive organ came out of her body. He was like, what's that? Oh yeah. And a few people asked about whether or not they were going to hurt the baby if they had sex with their wife. I do remember that Yes. And I know a midwife in Westport who always says, and I tell those men, don't flatter yourselves, the baby won't even notice. The nerve to say that to men. Don't flatter yourselves. I mean, surely things are shaking around. I It's not a totally ridiculous question. Babies are used to bouncing around. I mean, that's normal. When you're walking and moving, you're they bounce around. They like it, okay, but you're not going to hurt them. Well, protected, that's the point. You're not going to hurt the baby, that's the point, right? No harm.

Okay, okay, all right, let's hear about what partners do and do not do in labor. That drives women crazy or they love Okay, so here we go. How he never takes his eyes off me the entire time. His attentiveness is my safety. Oh, okay,

go on. I mean, no one wants to hear that you picked one nice, very nice.

Good job. Good for you. Oh, my God, my hubby kept trying to I'm just, I'm just kidding. I always say that's like the most important thing for a man to do, eye contact. So perfect. Stay off the phone. Okay, no. Phone kept me hydrated. Let me lean on him, rubbed my back for 15 hours straight, just loved on me. Oh, my God, my husband kept trying to feed me, and I yell at him. When the doula did, I would eat it. Wait a minute.

He kept trying to feed. She wouldn't.

She wouldn't take food from her husband, only from the doula. All right, this should be first question, like asking men, what did your wives do in labor? That was just kind of inexplicably crazy. That's one of them. She wouldn't take what didn't make sense, but she took it from the doula, and she's justifying it by telling it to us. Okay, poor guy, dude, I give you I don't know. Okay, instinctively, instinctively move to hold me and look in my eyes instead of catching the baby. Oh, I've heard a lot of a lot of this, where men in the plan is that the man is going to catch the baby, and in the moment, they change plans, because just something, you know, they just get the sense that the mother needs them close to their face, so they stay near the mom, or they stay in the position that they're helping, and they relinquish catching the baby, which I think is really sweet.

They're so madly in love they can't tear themselves away from their wives and forget that a baby is being born. Very nice next this, like we should have these on our Valentine's Day episode. I don't know what's going on here.

What else? Ooh, well, that was a better idea. I didn't think of that.

If they're all about gazing into eyes.

Well, you know what? There's about 400 responses here. So if I want to do a repeat on Valentine's Day, we can, we have enough. We can. Let's, let's hear this entire episode. He stopped an episiotomy from being done without my consent. Good job. My husband did everything because my midwife didn't make it. He even did all the cleanup. Good guy, my husband only asked me questions that could be answered with yes or no. Did he take your course? No. Because I say, Don't ever ask the medical provider yes or no question. And to the women, I always to the men, with respect to communicating with the women in labor, I say, don't ask her a question that she has to answer. Do. They should say, like, let me know if you need more water. So that guy didn't take my class if he only asked her yes and no questions.

My husband started brewing coffee for the midwife, and the smell was killing me. I've heard that yes, definitely. That can happen. The midwife was probably really grateful, but I don't know. Take it outside. This one is not the husband of the year arguing with me about stupid stuff throughout labor instead of just doing what I would ask. Why are we arguing in labor? There's not time for that. Yeah.

The problem is she's going to remember that now, forever, forever. It changes her birth story for her.

I hated that my husband kept staring at me and asking if I was okay after I said, not to would be really irritating. Look away. Look away. Go away. Maybe, maybe you need to just leave the room.

Well, guys don't know what to do, like there was half of them are loved for staring at their wives. And then you have a woman who says, Stop staring at me. Well, she told him, and he kept doing it. So, I mean, what? How is he not going to look at her? How is he not going to look at her with look at the wall. It's that's a tough that's a tough order. Don't look at me. I mean, look, she should be honored, but that's really tough. Imagine being a doula and your clients saying, Don't look at me. Would be like, What am I supposed to do?

Step out of the room. Some women want to be alone. They did such a risk for a man to leave his own the birth room. Imagine I'm just gonna step out of the room. I'll be right outside the door if you need me, just holler.

I'll come in with my hand over my eyes so that I'm not wearing marriage I come back, put a mask on. All right. Let's go on.

Okay, let me just make sure I don't miss anything good. Here we go. My ex in all caps, my ex husband napped for most of my early active labor and watched TV. Emphasize x that is really common.

I mean, I that's why the divorce rate's so high. I preemptively tell men to not kill time and watch TV unless she instructs you to occupy yourself.

Pro Tip for any husbands listening what you do or do not do in labor is something that your wife will remember for the rest of her life. It is a very impressionable time.

The weird thing for guys is that they're led to believe, from every movie and TV show that ever depicted birth, that birth is eventful and birth can go on. The most normal birth ever, just goes on and on and on for hours and hours. Time to eat hours later, time to sleep a little time to eat again. It just goes on and on. So they're not prepared to have to wait a long time, and their expectations are all messed up. So yeah, that's what happens.

My husband froze. He stayed quiet. He didn't know what to do or say after we had done countless hours of education, which he says he forgot, and he left it up to me to advocate for myself. This left me doubting him, resenting him, almost hating him with horrible postpartum depression and anxiety and rage, maybe we need a husband, birth preparation, course.

Well, that is part of our work. That's not enough, is what I'm saying. Okay, that means it's cultural, right? So we need to change society. That's what we're doing. We could probably influence the divorce rate by like 20% this one got cut off, but I still think it's worth reading. My husband and my mom having full on conversations in the middle of difficult, hard contractions.

So annoying. Stop it. So annoying. Stop it. Like when she is in the middle of a contraction, everybody needs to discontinue whatever they are doing, don't talk to her, don't talk to each other. Have reverence for the moment.

I don't understand people who don't have reverence for other people like that, like people who are noisy when someone else is sleeping, or they talk in a normal voice when someone else falls asleep near their like in their presence practicing yoga in labor. How do you just, I don't understand that at all. How do you not most of us quietly, just do things respectfully. Most of us are considerate enough to not like talk when another person is talking like imagine now talking when they're in the middle of giving birth or contracting. I cannot imagine. Here we go, the one we've all been waiting for, the last one. My husband quietly scooped away all my poop with a fishnet while pushing in the tub. Now this is true love.

That has to be the last one.

Yes, that's the last one. All. Right? Because every man should do that ending on a bang. All right, by the way, super good for your baby poop in the tub.

Oh, because of our episode in September, you get that rectal bacteria all over them. Oh, my God, look. I could barely muscle my way through that episode when we did the interview. I love that episode. I know we got so much good feedback on it. I was like, Wow, you guys are all tougher than I am. That was a very hard conversation for me. I was very happy with the response. All about the poop. Oh my gosh. All right, on to the episode. Let's go. Hello.

I am a mother of a toddler who is two in a few months, and she still is not a great sleeper. We've learned our house has some mold that has definitely been affecting me for over a decade, and I'm afraid to vex her sleep. We had a rough night. Last night, I was trying to get my husband to help me pin her down to snot sucker her little cold, sniffling nose. After over two hours of not being able to sleep because she kept snorkeling and will make a nurse. And I'm so tired of her teething nursing latch as a 22 month old has never been a great latch to begin with. And he saw me just, you know, he thought it was too aggressive kind of shake her and just throw her against the pillow, a little bit like when I say throw, I mean literally, lift her at two inches and just straighten her out so I could pin her arms down after he refused to help me hold her down, and I had to try to use the pillow, and it's violent, and it feels horrible, and she's screaming, Mama, no, but it's because she doesn't want her nose not suckered. So I just would love to hear any other mother's story, like a moment of weakness, because she's like, threatening to call the cops if I ever do that again. And I'm like, I'm like, I'm not going to do that again. It's not a pattern. It's just a momentary weakness at four o'clock in the morning, and I haven't slept in two years and developed hospital notice postpartum, and I've been a mess for a couple of years now, and I don't think he understands, so I'm just holding on by a thread, and I don't think he'll play this if I'm sobbing on the air, but maybe he will. But I would just love to know, yes, I know I need therapy, but like, Don't does everyone have these moments where they just yell a little too loud at their toddler, or just something, I didn't hit her, like she just acts like I brutalized her, and I'm so overwhelmed. So I don't have other friends to talk to you at this stage in my adult life. So your show is just such a little moment of like sociality in my very lonely life that I look forward to every Tuesday. So thank you so much for all the work you do. Oh god, I'm honest. I'm leaving this now, but hopefully it'll resonate with somebody else who is two years deep because third trimester sleep was also utter bullshit. So I'm just exhausted, and we'll have some advice. Thank you so much. Wow. Okay, well, gosh, if we have ever thought about discontinuing the down to birth show now I know we will never do that. This poor woman I feel I just want to, I just want to sit her down and talk to her, have her over.

I already reached out to her. I already told her about resources we have for her that I'm going to send her, and I already invited her to my postpartum group, just like to join us.

There is so much that she needs outside of therapy. It's not therapy that she needs is she needs support, sleep, community, she needs a break.

That's exactly a point I was going to make. It's not that she needs therapy. No therapy is a therapy, in my opinion, is a risk. It's going to change things. It can help, but it can hurt. And I only say that because I think that you need a therapist whose emotional intelligence exceeds your own. So that's one thing. And the second is, I've had so many women in my support group who were in therapy for years and years and years, and they were just stagnant. And the therapist should be change agents. So if you go to one, it has to be someone outstanding, but that's not what she needs. It's exactly it's exactly what you said, Trisha. A couple of other points I really want to make, shaking the baby, okay, it's a two year old, but in my opinion, yes, that is a an early red flag. That is something, for example, like I've always thought about these issues. I've talked to enough women, I've pondered enough things in my life. Like, just to give an example of where I'm coming from, I would never associate with a man who, let's say, was angry and slammed a door really, really hard, or, like, punched a pillow really hard. It's only a pillow, it's only a door. But I would be like, Whoa, he's taking out his emotions physically. And to me, that would be a red flag that would feel scary to me. So if a mom is doing that with her baby, first of all, she said, Is this normal? Does every mom do this? I kind of, I mean you and I have put things out on Instagram and said, tell us about something you did or physically did. And we got back hundreds of things. Of women, couples sent themselves to hospitals, knocking over high chairs, intentionally breaking their engagement rings. One on the podcast banged her own head against the wall, but this is a cry for help. So yes, the husband is right that it is definitely a warning. It's not a warning that the cops have to be called. They're not going to be any help. It's a warning that he and others around her need to do way more. She's at her wit's end, and she asked him for help. Now, I don't know if she needs to clear her child's nose for a cold. She's desperate, looking for the child to sleep, but she asked him for help, and he didn't help. So I think her resentment toward him is what made her react physically with the baby again, what she didn't do, what she did, was not much, according to her description, but clearly this is a woman at the end of her rope, so there's always a risk for a baby if a woman is at the end of her rope, and regardless of what she actually did in that moment, his response was the most inappropriate, right? I mean that, like you said, that is her. That is her, almost having no self control, which happens when you reach that stage of such sleep deprivation, such exhaustion, such fatigue, and just zero patience. And you know, she has, obviously has some of the postpartum rage symptoms, like the last thing he needs to be doing is telling her that she's doing the wrong thing and that he's going to betray her by calling the cops. First of all, her baby's 22 months, and the nursing is driving her crazy. It's time to wean. She needs to wean, and she needs to start getting herself some sleep. The baby's cold and congestion. I mean, this is going to sound silly, but an air filter, a humidifier, I mean, these, if these things are causing the baby to wake up or the toddler to wake up multiple times a night, there are little interventions that you can do to help sleep if the if the toddler starts sleeping better, she starts sleeping better, all of this is going to be much easier to deal with. She needs support. So very glad. She's joining your support group.

I hope so. I invited her. I can't imagine how many women heard her and were crying too. I think we're going to probably hear from a lot of women after they hear that, and I really want women to watch our postpartum rage workshop, because we shared lots of stories, and we shared exactly how to identify it, what to do about it. But the big takeaway is support her husband is falling short. I don't know why it's so hard for some men to just put their big, strong arms around her. And that's what we love about men. It is, it really is what we love about men. You know, women are a beautiful thing, and men are a beautiful thing. And men are beautiful for their big, strong arms, you know, and like to hold her and say, it's gonna be okay. Like, we're gonna like, we'll get through this. You're doing you're doing great. You're doing okay. Because when you make her feel like the risk, you make her the woman who's given everything to this baby for two years, you make her feel like the enemy to her baby, the risk to her baby. That's going to make any woman going crazy, because she's drained everything out of herself to keep this baby alive, and now you're making her feel like she's the risk to the baby. It's just so I feel so much for her because he doesn't understand what it is that she needs, but I do want to make clear she needs something we can't just poo, poo this and say everyone does that. Sometimes this is a definite cry for help, and he should be the first person to recognize it. So we know she's listening. I already reached out to her earlier. I can't wait to see if she got back to me yet, but please reach out to us. She should also know that while this is red flag type of situation, she is not alone. You know, there are other moms experiencing this. Yeah, they're crying, listening to it, because they've been there exactly and then going through the whole guilt shame cycle, you know, how did i How could I do this to my child, and just feeling horrible, which just keeps us stuck in the pattern. So she was really brave to call in. I know I'm so happy that she did. You know, thank you, and we're here. So please reach out again. I messaged her, and hopefully I'll be hearing back. I'm pretty sure we will, and that means why we're here. Hi.

My name is doula. Bailey Garvin. I am 20 weeks pregnant. I just had my 20 week anatomy scan and found out I'm having a baby boy. This is our second. Our first is also a boy, and he's a C section. And they told me at my anatomy scan that I have an anterior placenta, and because of that, with my previous C section, that we'll just have to do another ultrasound around 30 weeks to ensure that the placenta is far enough away from my C section scar that it's safe to do a vaginal birth, and I'm planning on doing a birth center birth, and so that has just kind of made me really. Really nervous, a little anxious, and I just am doing a lot of prep work, and I would just hate to get my hopes up and then get to that 30 weeks and have them tell me that it's too close to the C section scar and have to just do another C section. So I'm just curious what the science is behind that, what the research shows and about how dangerous it is if the placenta is too close to the C section scar to still do a vaginal birth, and then also how common it is for an anterior placenta to stay too close to the C section scar. Thanks for everything you do. I listen to every episode, and it's helped me a lot as I prep for my V back. Thanks.

Well, we are very close to the world expert in VBAC. So, you know, I reached out to Nancy Weiner this morning, for any new listeners who don't know who Nancy Weiner is. She's a world famous midwife. She is the woman who coined the acronym V back, vaginal birth after cesarean in her book Silent knife, published in the 80s, written up in the Wall Street Journal as the Bible of cesarean prevention and awarded by the American Library Association. So she is a home birth midwife of many decades, and she's my go to person for things like this, and she is extraordinarily pro home birth and anti ultrasound. So you're going to catch that in her response before I play her response, Trisha, because she just texted me that she sent me a whatsapp recording. Do you want to comment on this first or yeah,

I'll just say something really quickly. First of all, it's only an issue if the placenta is embedded over the C section scar. It doesn't matter if it's near it. So this is just again, another example of the, you know, the overuse of ultrasound and creating unnecessary worry for a mother and potentially influencing a mom to choose a C section when she might not actually need it, because the risk is really just that if the placenta has attached over the scar. The placental attachment can be abnormal and can be can cause excessive bleeding when it detaches. So if it doesn't attach to the uterine wall, normally, it gets adhered to it. It's called placenta accreta, and that is a serious medical complication, and that does warrant being near an or when you give birth, but if it's not attached over the scar, there's nothing to worry about. And of course, it's you know, as the uterus grows, it moves further away from the incision. The C section incision is very low in the uterus, so just because it's anterior doesn't mean it's over the scar.

One thing I like about our podcast and saying Here everyone listen to yourself, is that it's okay when you and I have slightly different perspectives on things, and it's okay when Nancy does, and that's why I prefaced the whole thing with saying she's very anti ultrasound, and she's done a lot of research on it. So it's not just out of nowhere. We have a great workshop on Patreon on ultrasound. I would point anyone concerned about ultrasound to that workshop, by the way, that was very well researched. I think I'm very proud of that workshop. I think it's really useful to those research. It's in our shop on Patreon, and very valuable if you want to understand the controversies. But Nancy has attended around 3000 births and advised all of those women not to get ultrasound. Now many did anyway, because they wanted to, but she also specializes in V back and has had probably a couple 1000 women have V backs, and her baseline advice is, don't get any ultrasound. So it's just interesting that this is a she's on one end of the intervention scale. So let's hear what she says to this, and then our listeners can just, you know, formulate what they would do in the search situation.

Hi, Cynthia and Trisha. It's Nancy. So first of all, I can't tell you the number of times when one of the women who has come to me has told me that they were worried, that the doctors were concerned about the position of the placenta. Placenta are so smart. They know they have to make way for a baby. They migrate up the side of the uterine wall as the pregnancy progresses. I am not a fan of ultrasound for so many reasons, as you know, and thankfully, more and more individuals are getting on this. I don't want to call it a kick, but that this is not just a benign way of getting a view of the baby. So if somebody has had one, I tell them not to have a second one, if possible. And if they've had two, not to have three. There are women who come to me who have had six and eight and 11 ultrasounds, and I just, I just shake my head in concern as well as disbelief. So I think it's important just to leave the babies undisturbed and in a peaceful environment and wish to grow. I. There are those of us who worry that repeated ultrasounds may actually negatively influence actually where the placenta decides to live. In the first half of the pregnancy, the uterus is still relatively small, and so wherever the placenta is, it looks as if it's taking up a lot of space or the wrong space. But as the pregnancy advances and the uterus gets larger, it becomes apparent that the placenta is just fine in the short amount of time that it's taking me to respond to this question, many, many babies have been born across the planet, most of whom, to their benefit, never were sonicated. Birth works. There wouldn't be billions of people here if it didn't. So why do doctors assume that the placenta will be in the wrong place, rather than affirm that it will be fine, as it will be in almost every situation, and if there is a problem, there is usually some advanced notice, such as spotting or bleeding, or if the baby doesn't drop, if the placenta is in the way, the baby won't be able to drop or engage. However, I want to tell you that my 2v back babies never dropped, but they are here, grown adults. So there goes that myth. But somehow, the Great Spirit which designed this whole scene seemed to know the placenta have to be in a place that allows the baby to come through, and also the placenta has a different sound than the baby. So even if there is a question, we can generally ascertain the position, even with just a fetus scope. I hope this answer, quick as it is, helps. Lots of love to everybody. Bye, bye.

I love her answer. So let me just give the data on this too real fast, because the risk of having a placenta accreta with one prior C section is 0.3% that's pretty darn small, three per 1000, right?

We're talking about an extremely rare situation. Now, if you have a placenta previa, where this the placenta does actually implant over the cervix, the risk is greater. But as Nancy said, if you have a placenta previa, you're going to likely have symptoms, or it's going to be discovered in labor. And you change plans, you know you can change plans in labor, that's okay, but this should definitely not preclude her from planning her birth. However she intended to have it good, and I forgot to tell everyone we did two fabulous episodes with her in I believe it was July of 2023, remember those? Yes, absolutely great. Was that, though we did three?

No, I recall did too, though she may have answered other questions in other Q and A might be what I'm thinking. The first one was basically her life story, which is fascinating, and her birth stories. And the second was a VBAC Q&A so go check those out, and we'll move on to the next.

Hi, Cynthia and Trisha. So my partner, who's a woman, recently had a transvaginal ultrasound where they noticed some endometrial lesions, which they think are polyps. And my partner's doctors, who naturopath, recommended that she go see an OB to talk about doing a biopsy of one of these polyps, and I know that the OB will talk a lot about the risks of not doing a biopsy, but I haven't been able to find any information online, like research wise, about the potential risks for a future pregnancy or risks to the uterus itself of doing the biopsy. Like, what are the risks of doing the procedure? Because I know we'll get a lot of insight about the risks of not doing the procedure. So yeah, my partner and I are going to want to conceive eventually, and I feel a little fearful about the idea of going in and snipping out a piece of the uterus, even if it's a polyp. But I don't know if that fear is misguided, because I can't find any research, so wondering if you guys know anything about that, and yeah, would be grateful for any info you can share. Thanks so much.

Bye. Well, the main concern here is ruling out endometrial cancer. So if there's an abnormal growth in the uterus, then they and they want to biopsy it. It's because they want to make sure it's not cancerous. You can have a fibroid, you can have a polyp, and it's not going to really be harmful, but obviously a cancerous growth inside the uterus would be harmful. So I guess they could consider her risk factors for endometrial cancer, and if they feel really confident with that she's low risk for that they could wait and assess over time. I don't think an endometrial biopsy is a really substantial risk to a future pregnancy, but of course, we know just that. You know, we know leap procedures and things that seem fairly benign. Can impact labor. I mean, there is a very small risk of infection, pain, excessive bleeding, uterine perforation would be a big risk that's very rare and unlikely to happen if you go to somebody who's very experienced doing this for the most part, I don't think that this is a major risk to a future pregnancy.

Hi, Cynthia and Trisha. I'm calling because I need some advice. I'm newly pregnant with my first after two years of trying during this journey, I have been educating myself on all things first, and have decided to have a home birth. My question is, what do I say to people when they ask where I am, quote, unquote, delivering. For some context, I work in a hospital in surgery in a major city, I'm sure to be met with disbelief and skepticism if I answer honestly. I do not want to outright lie about having a home birth, as I don't want to manifest an undesirable outcome. However, I don't want to be defending my choices to work according to his whose opinions I don't really care about. I appreciate any input you two may have.

Thanks. Well, one of my favorite episodes that we have ever done was the nurses roundtable, Episode 257, and whatever this nurse does, she should listen to that, because I remember the first nurse in that episode, had a home birth, and also had to deal with the fact that she was a labor and delivery nurse, and she opted for home birth. And I know she talked a little bit about how she managed that, but it's a tough situation, and kind of work culture is very powerful, and we're close friends with people at work, and obviously everyone wants to talk about your upcoming birth plans when you're pregnant. So what were your thoughts?

Trisha, I mean, my first thought, I think it depends on how comfortable you are setting boundaries with people. I think you know if you're if you feel uncomfortable with a firm boundary of just saying we're not discussing where we're giving birth. It's our private information. Then do that nobody needs to know. They don't have to know. You can just or you can say we're undecided at this time if you if you definitely know that, you do not want to defend your choices. Sadly, many people have to defend their choices around home birth, then I would choose one of those two options. If you could find the courage within yourself to simply say, we're having a home birth and end the conversation. That'd be my number one choice. They don't need to, they don't need to have further follow up questions to that. They can have their judgments. They can have their opinions, and you can change the topic.

I remember when I worked at MasterCard, I was pregnant with Alex, and I was so happy about our decision to birth in a birthing center. And I happily told people I worked with my plan, because it came up all the time, like the HR person was walking by and would come into my office. Oh, how you feeling? And then she's telling me about her births and asking me about mine. It just, it, just, you can't help but it's coming up all the time. And I did tell people our plan, because I was so happy about it, and it was very distressing hearing their responses. There was no stopping it. I couldn't just put an end to it. There were, they were really distressing. And I would go home and call my mom and recount to her the crazy things people said to me. And one day, my mom, God bless her. She just, she just made me laugh. I don't remember, but she saw the humor in it, because the more calm and centered and certain I was of my birth plan, the greater extremes women seemed to go to try to get a rise out of me. Yeah, I can see that. So I still remember some of the crazy things women said to me and my mom, just, she just, she just got me laughing. And I remember one day we were just laughing and laughing, and I was thinking, oh my gosh, I'm laughing at this. This was really shaking me and scaring me. So I do understand, but it's even harder for this woman because she's in a medical community where the vast majority of anyone working in that environment truly believes they know more than the rest of us on anything related to health care, even though their specialty is medicine and intervention. But they truly believe they know the most about nutrition, which they don't study, or physiologic birth, which they don't study. So you're dealing with that I don't know in many cases, it's that overconfidence or even arrogance, it's certainly judgment. So I don't know what to tell her. I think what you said about buying time and telling them you still haven't decided is a good tactic. I know it seems like if she had more courage, she would tell them her plan, but I really don't think it's necessarily a matter of courage. I think that we hate defending ourselves, and it's it's worth feeling stressed over and resentful over at times. And you know, some of us know how to avoid the conversations that are just going to get nowhere and they're just going to distress us. We just wisely know how to avoid certain things. And I think that's where she's coming from. So I wish i had i. A good answer, but I want to point her to Episode 257 because she's not alone. There are many nurses who home birth, and they have to navigate their way, their way through this.

You can also test it out on people that you don't care as as much about. So, you know, say it to say it to strangers, and then just learn to practice that confidence. So the courage kind of comes from feeling really confident in your choices, and kind of learning how to just understand that other people's opinions are none of your business, like they're asking you're answering, and what they want to do with that information is up to them, and you can just move on from it. So start with, start with people that you care less about, what they are going to judge and think and build your way up or remain in the position of undecided. And that's fine, yeah.

And just one more point that is coming to me now. It's that if she were to tell people in the hospital environment that she's planning a home birth, it would be easy for them to assume that she doesn't have respect for hospital birthing. Maybe that's true, or maybe not, but there's something to be said for having respect for hospital birthing. It's just I don't think that's my first choice, that a hospital birth is in my birth plan. She could say it's Plan B, like, Thank God for the hospital. We're ready to switch to the hospital in late pregnancy. If something comes up in labor, at the first sign of anything come up, thank God for the hospital. Yes, I believe in hospital birth, but not as a first choice. I believe in being outside of the hospital as the first choice, so it doesn't have to be so black and white as people make it out to be, like, you don't believe in birthing in a hospital. Who said that? And you know that's very true. But what I also don't wouldn't want her to do is to try to give them the research. Well, they've done research, and it actually shows that it's no say that you don't need to. That's the one thing she should definitely not do. We can't tell her exactly what we she should do, but we can definitely tell her Don't do that. You do not to. Need to explain your choices to people. If people are interested in learning about why you might be choosing home birth, let them go figure it out on their own. Let them take the time and energy to do the research. And because you you know they will be curious. They will be like, Wow. I wonder why she's choosing her home birth. What is she? People are curious about this thing. And when you, when you do something that's a little radical or different, people are always a little curious. There's curiosity in their judgment. And let them be. Let them, let them figure it out. Don't explain yourself. 

Hey, Cynthia and Trisha. This is Lauren, huge fan of your show. I'll get right to it. My question is about hiring a midwife. I'm pregnant with my second baby. Wants to do a home birth. My first is a hospital birth. And in the state of Georgia, they don't license midwives, so it's kind of, one of them said kind of a free for all. I've interviewed about six or seven, maybe, and they're so different. There's certified midwives, and then there's traditional midwives, which I know I think you've said you don't really have a preference, but my question is just how to really narrow it down, like I'm finding them on the phone with them for an hour, asking all these questions, and it seems good, and I just don't know how to how you know it's the right one with something like a home birth or an hour away from a hospital. So if I had to do a transfer, it would, it would be, obviously a hard drive. There are some that are far more experienced, but maybe not as bubbly personalities. And then there's the exact opposite. So any tips you may have on knowing it's the right one, also, I wanted to mention, really quick to Cynthia, almost none of them know their transfer rate. Some of them said I can get that number for me for you. Some of them said it's maybe eight to 10% but most of them don't know their transfer rate, so it's just a common theme I'm finding. So yeah, any information you have would help. Thank you so much. And I just want to say at the end, in case you want to edit this part out, I just love your guys' show. My whole entire first pregnancy. She's almost two now, I listen to it, and I had a really amazing hospital birth because of your show and what you guys do. So thank you so much. I appreciate it, and I hope to hear any answer. Thank you.

Bye. Now, why would we edit that part out?

That was so good beginning, the question, I'm just so glad to hear it. It was so sweet. So what are your first thoughts? Okay, well, there were a lot of questions in there, so I kind of got to think back. But the thing that like first came to me was, I personally am going in choosing a midwife for a home birth. I'm going with experience over connection. Mm. I would prefer that. I would rather have a more experienced midwife than the one that I feel most connected to, because she said, you know, some of them are really nice, but don't have a lot of experience, and some of them have a lot of experience, but don't necessarily have the right vibe. So if you're picking between those two, that might not be how you feel.

I had a couple different thoughts on that. I don't have a strong response to that. However, what she said was some of them have more experience, and some are more more bubbly, and you don't really necessarily want a bubbly midwife. Sometimes you'll find an outstanding midwife, and she is going to be very calm, and that's exactly the energy you want. So I'm with Trisha on the experience, though I do have one more point to counter it a little bit, but I'm with Trisha, of course, on the experience, unless you feel something negative, like if you pick up on ego. That always worries me. I don't like when someone comes from a place of ego. I know a midwife who was attending a woman in labor, and the doula told me at one point, the midwife shook the woman's legs a little and said, Relax these legs. These legs are mine right now. And I was just like, What the heck is that? And you could see that personality coming out from time to time, I would run like heck from anyone like that. So I'm with Trisha that unless there's a negative feature in her personality, you might as well go for the experience. It sounds like it's honestly, I think you have all good options, and you probably can't make a wrong choice. The only caveat I had to this to complicate your decision regarding the experience personality. Thing is that ina May says in one of her books, it's the only line of work where experience doesn't have an impact on outcomes. And she, like Nancy Weiner, brand new midwife, her first Birth Number Birth Number 155 Yeah, Birth Number 155 was her first transfer as a brand new midwife. So I think that's an interesting point too. Like an ANA May says birth is so inherently successful, it's the only line of work where it just tends to work either way. But yes, I think experience is incredibly comforting, and that does make us feel safer.

Well, she's an hour away, yeah, from a hospital. So that's another factor in that experience, decision, decision. Of course, every midwife, no, I had to be a first time midwife at a home birth. And every midwife has, has to be that somebody has to pick the midwife for the first time, right? That has to happen. But usually, if you are a inexperienced midwife, you are attending the birth with a more experienced midwife. So look also at who the birth team is, if, if you really deeply connect with a midwife who's two years into practice, or six months into practice, two years is actually a good amount of time you know brand new in practice. Who is she working with, who's going to be on her birth team? So that you can feel like you have a little bit more you need that solid decision making if you're an hour away from a hospital. You need somebody who's seen a lot so they know when to make the right call if a transfer needs to happen. So that's where that comes from for me. I mean, she said she's got like, eight different people she's choosing from. So you can, you can. Where does she live? I don't know, we hear enough stories of people who have had very bad midwife experiences. So we know that there are midwives out there who are not practicing in the way that we would want a midwife to be at one of our births. So you do kind of have to filter. So I would start there, and then I would meet them. I think a phone call is not the same. I would meet them in person and see how your energy feels. And I do think they should know their transfer rate. Because if they really don't know that, that's not even something that they should really have to know by looking it up, that should literally be kind of in their head, they should have a pretty good idea of that. Well,
about the transfer rate. Yes, they they probably do have a pretty good idea of it. They probably did give her a pretty good idea. I'm glad they didn't fabricate something they could have easily just lied. I think doctors do that all the time. When they're asked their C section rate, they just, I think they pull it out of nowhere, and they just want to give a nice low number. So rather than asking the transfer rate, I think that's just very reductionist. You know, I just think it's like oversimplifying something. I think it makes more sense, particularly given how far she is from a hospital, to say, what are like the what's the most common reason for transfer? Now, we know statistically, it's just labor is just going on and on and nothing's really happening, but what are the most common reasons for transfer, or what could come up that's not terribly uncommon, but like, what could come up that might cause you to suggest a transfer. That's a reasonable conversation, and it might give you more than just asking the transfer rate, like, Oh, she has an 8% rate and she has a 14 so look out. I think that doesn't tell you anything.

I think that is an essential. Question in an interviewing a home birth midwife, you have to ask that question, both in pregnancy and in labor. Oh, yeah, what reasons would you try? What I you know, transfer out of your care, right? That's true. That's a very important one. I true. Truthfully, I think she has a lot of good options, and she probably can't make a wrong decision. Odds are very high her birth will go well, regardless of which of these good midwives that she already interviewed and liked she ends up hiring. All right, I do believe, Trisha, it's your favorite time of the episode. All right.

Quickie. Quickies. Let's see they keep rolling in. I haven't looked at them now for our December episode, anyone hearing this within a week of this episode coming out, call and leave us a message. Wish us a happy new year. Tell us a story. Tell us anything about how the podcast has affected you, or anything you want to say to us at all. I think it'd be fun to play a bunch of those in our New Year's Eve episode. Just some casual Hello. Here's who I am. I'm a listener. That would be really fun. So if anyone is willing to just pick up the phone and leave us a message, Trisha and I will sit down together and listen to them, and if the sound is a good quality and etc, it'd be really fun, I think, to put them together and play them on December 31 because that is a Wednesday this year. I love it. 802-438-3696.

All right, call them in. Let's hear it. Moving on to quickies. How can we make baby wearing more comfortable and less uncomfortable and awkward experience. Yeah, it always feels awkward.

Yeah, it feels awkward for everybody at first. It really is something that you get a lot better at as you practice or just go to the Baby Bjorn. That thing is so simple and easy and comfortable, and it was pretty much always my go to. I mean, I love a ring sling, I love a wrap, but they are definitely something you have to get comfortable with, especially the wraps. I started with a Baby Bjorn. I went to a ring sling, and I always threw over my left hip to the side with Vanessa. I ended up going to one of those wraps that I used to think were ridiculous, like a 20 foot piece of fabric, amazing comfort. I mean, I could have worn that thing all day long doing anything. I felt like I could go running with that thing on. So try that one. Don't give up, because once you learn how to do the wrap there, I think they're incredible. And the baby is centered, and you're keeping your body centered so it doesn't become a chiropractic issue. They're very comfortable. Yes, I love them, but the Bjorn is just so easy in and out. You know, take the baby for dads, good for Dad moms. Well, yes, but they might put less time into the learning curve.

All right, my midwife said labor doesn't start until one centimeter dilated, true or false. This is a midwife that you might not have a good experience with. Yeah, that doesn't make any sense. No, of course, it doesn't. So that's not true. False. You can be one centimeter for a month before Labor begins.

I was four centimeters days before Labor began. Absolutely true.

If you could choose only one would you do? PT or chiropractor during pregnancy? Kind of depends on the issue.

Does she mean pelvic floor? PT, I'm not sure. That's why. I mean, it kind of depends

on the I mean, I think, yeah, I think that if she means general, PT, if there is no issue, I'd probably do chiropractic, just because there's so much good work they can do with the pelvis, and if it's pelvic floor. PT, that's pretty valuable. Think that can do a lot. So I don't know why do we have to choose? And it also depends on the chiropractor, whoever's more experienced with anyone else, they're a dime a dozen. But if you go to an incredible one like they're they're so valuable. So you have to find the right one. Just depends.

What are your quick tips for relieving newborn gas? Baby is one month old. Is it just inevitable? Well, yes, a lot of baby gas is inevitable. You are not going to get away without a lot of gas. Baby's digestive systems are extremely immature, right? They're just developing so they get hiccups really easily. They spit up really easily. They all have gas. Every baby has gas. It's just part of the process, but sometimes the gas is excessive. That's definitely true. I love a warm bath for the baby. I think that can be really helpful. The boreon Camilla homeopathic can be really helpful. Little tummy exercises can be helpful. And then there's so much related to feeding that I can't go into this is a quickie, but I guess the quick answer is yes, it's normal. We are currently going through bad teething. Is this bad timing for big changes like. Night weaning or potty training? Definitely. Yes, one thing at a time, let the let the teething pass before you try the next big intervention. I am desperate for a home birth, but my hubby doesn't want it. He's okay with a birth center. Do I take the win meaning the birth center? I guess.

No, no, you have to birth where you feel safest. And I think the next step. And of course, I've talked to so many couples in this exact situation, I think the next step is for you and your husband to go have a consultation with a local home birth midwife or two, and then talk together afterwards, and he can ask all the questions that make him feel so concerned, because it's rational that he has concerns, and it is great that he's open to a birthing center, but you do have to feel at peace later, and even if your birth goes beautifully at a birthing center, you don't want to have that feeling like I should have done the home birth then. So take the next step together. Have fun with it. Have a conversation after and see where it takes you.

Here's a fun one. If you had a kid today, what would you name them? Boy or girl name? We have to come up with both. Boy Names are so hard, I don't think I could come up with one.

That's a better question for you, because you like really creative names, and I like classic names, usually, what would yours be? I don't know. I have to think about it. I have no idea.

I kind of like old fashioned names. Oh, you do, yeah, okay, I think I would. I think if I had another like Lucille. No, not Lucille, okay, maybe something like Elizabeth, Catherine, no, no, no, never, no, no, sorry. Oh, never, sorry, never, sorry.

People, don't worry. All of our listeners,

I love all the Elizabeth gatherings. I know several listeners were named Megan and Lindsay. There was another name too. I forgot the third one. There was another one. What are you leaning toward?

Penelope. Penelope. Think that's kind of cute.

Wow, what's the nickname for Penelope? Oh, I don't like yeah, Penny. I don't like that. Oh, that's the nickname, of course. Penny, never mind. Okay, I'm thinking, I really don't know. Let me think there are names I really like every now and then. But Oh, Courtney, that's the third one. That's the third most common name of our listeners, Megan Lindsay and Courtney are just like, how do you know that? Oh, because remember, don't you remember, a few years ago we were getting when we got all of our questions in, I said, Didn't we just hear from a Megan? Didn't we just hear from a Lindsay? And if you look back at our guests, and you know, young professionals or birth story women, there are so many Megan's and Lindsay's and Courtney's. There are so so so many, of course, of varying spellings.

Whatever name I choose, I would use a traditional spelling. I'm not really into all the changes in the spelling of some of the names. No.

Well, Megan traditionally has multiple spellings. One is more Irish like so I think the -gh is more Irish, and the American way is just like the Megan.

I kind of like Beatrice.

Oh, okay.

I think that's cute. Don't ask me about boys. I don't know what I would do if I had another boy. North is the only boy name I may ever had.

Yeah, I gave I just don't, I just don't know next time. Okay, if only I could think fast on my feet. I could, I could have a podcast. The personal questions just tripped me up so much. I'm, like, so scared of saying the wrong answer. We're later, I'm gonna say no, no, I said the wrong name. That's the one.

Okay, fine.

Oh, I love the name Gregory. That's a nice one. I love Gregory. I love Gregory, yeah, yeah. Alex's middle name is William. I love that. And I didn't count that because it's already my son's middle name, but I love the name Gregory. Yeah, that would, that would almost definitely be the name I would go with if I had another boy. There we go. And I've almost never met a Greg I didn't really, really like I have. I've had a number of friends named Greg or clients like the husbands of couples, you know, couples who took my class. I've just loved a lot of Greg's that I've met. But I do love the name Gregory Peck, the most handsome actor who ever lived. I mean, it's also makes it a plus. I don't think I know any Gregs. I love the name Gregory, Greg. Yeah, okay, I need to meet a Greg. I know the problem here. Here we go.

She just put her glasses on everyone like I know the problem. Why can I not read? Why can I Why is this taking me so long, this little font?

Geez. Reality.

Will milk supply be strong with a newborn. If you are still nursing one year award, a one year old and your supply is low, well, you know, at one year, your supply is not going to be robust like it is with a newborn. And yes, absolutely, after you have a baby, your milk supply comes in all over from the beginning, right? That's the shift in the hormones that cause the milk. Explode to come up. So when you lose all that progesterone or pregnancy, your prolactin levels rise, and yes, you will have abundant milk production despite whatever your milk production is. Now, breast pump recommendations for first time moms. I really like the baby Buddha. I think it's a great breast pump. I think it's portable, it's strong, it's effective, it's inexpensive. It meets all checks, all the boxes for me. So that's what I would recommend. What would be your most important nutrition tip for postpartum recovery and weight loss?

Algae? I would Yeah, algae is good. I would just say nutrient dense food. Just think in terms of nutrient dense food and like, make yourself a salad with an avocado on top and just eat. Eat. Feed your body. Don't be afraid of calories. Focus on nutrition, and you don't have to be perfect, and you don't have to feel guilty when you deviate. But keep focusing on nutrition, and please remember that we are not expected to lose this baby weight in the first six to 12 months, it really doesn't start to happen. Oh yeah, you will almost a year. Yeah, you won't okay. So set our expectations correct.

The body's holding on to it for a reason. The body will do it when it's ready. It will shed the weight when it's time.

Here's an interesting one. How old is too old to keep having babies for men and women, in your opinion? Oh, there's no number. Yeah. I mean, I don't have a number to that either. There's no number. I saw something. I can't believe this could possibly be true, but something popped up in my Instagram feed that said that a man fathered a child at 95.

Isn't that so wild? It didn't Tony Randall didn't Tony. Randall father a child. Didn't Robert De Niro just have a child. Maybe, I don't know understand how sperm doesn't age. I don't understand how there's not an impact. But to me, the only factor is how long you're going to be around once your baby is born. I mean, I've had women in my class up to age 48 and every age between 18 and 48 and to me, that's the only thing it's like, if your body conceives, then I trust the body to breastfeed and to to give birth if the body conceives, particularly if it's natural conception. But you know that the whole thing is like, Well, how do you feel about that? How vibrant Do you want to be when your child is 2030, years old? It's personal, personal.

I agree. We can't put an age on that. What's your favorite way to spend a slow morning at home? I don't mind. I have a lot of books on my coffee table, and I have my hardcover journal because I'm taking notes from one of the books. So when I do have time to myself, especially in the morning, I really like to read and do my my my work, like my personal work. I really enjoy that. And in my mind, I'm always going to read at nighttime after dinner, but the truth is, I just get I just get tired. Otherwise I start reading till I get sleepy. But I like to read in the morning. I think it just sets a really nice beginning to the day, and you retain the information so much better than if you read it at night. You think, oh yeah, I know for me, for sure, I do. I'm reading a Joe Dispenza book right now, and it requires note taking. Yeah, I recommended it to you. You did? Yes, which one breaking the habit of being yourself, that's not what I'm reading. Oh, becoming supernatural is the one I told you my son liked the most well, because I recommended that to you too. That's Alex's favorite, but I'm taking notes because it's so complicated, and anything scientific, I have to work harder at. I have to, like, study it, repeat it, and it's so scientific. Oh my god, so scientific. Yeah, so I have pages upon pages of notes, and it's great. It's very satisfying and it's very enjoyable, but that's actually what I really like to do in a slow morning. What do you morning. What do you like to do? It's always the same.

You got to make a cup of it involves really good hot coffee, okay, and a bath. Oh, bath. Of course.

I might also sit by the fire, chat with the family, nice but pretty consistently, if I'm alone, then it's definitely the coffee in the bath. It's the bath with the Epsom salts, very hot and essential oils, and no phone, no phone allowed in the bathtub, 25 minutes, max. Except sometimes on Sunday, I go longer. Okay, let's see anything else. We got a lot here. We have a lot of personals this time. I have to save some for another day. Do you believe in horoscopes? I think it's fun.

That's exactly what. I think it's a lot of weight in it, but I enjoy it. It's good. It's pretty accurate for me as a Libra. Like, yeah? I mean, very fair, very social, yeah, it's fun.

I think I'm more as you, as you get older, you move more toward your rising sign. So I'm a Virgo. I think it was very Virgo in my younger days.

What's your rising sign? I think cancer. Oh, I love cancers. They're so they're so easy to get along with. I've never met a cancer that was. And easy to get along with. I know so many cancers, it's a great sign. So I guess, yeah, listen to me talking with so much validity about this. I'm like, it's fun. I'm like, Oh no, I love cancers. There's I have things like, exactly Libra. So okay, so you read your horoscope every day.

No, are you? I never read my horoscope, okay, but when I was growing up, I was always very fair. And my dad would be like, That's my Libra. That's my and, you know, Libras love peace. They love harmony. They're very diplomatic, yeah, so I think that it fits.

Okay, we have to answer this one. Do I need to avoid airport security radiation while pregnant. I do not go through the machine. Pregnant or not, I always request a pat down.

They're happy to oblige. No doubt, it's always a female.

Female gets a female every time, unless I'm running, what does a lady have to do to get a pat down around here,

all right, so I would say, avoid it. Yes, avoid it. That's great. My kids. Drives my kids crazy. They're very embarrassed, yeah, because you want to pat down and then, like, get a room, mom.

Okay, what's the best episode to recommend to someone new to the podcast. Think childbirth 101, didn't we have an episode called something like that, evidence based birth 101, the red flag series are good, yeah, first three questions to ask your provider, that's a good one too.

Red flag series starts with episode 118, Q and A's also just Q and A's are good. You get a nice little taste of our personalities and our our vibe. Thank you for not saying the poop episode. Trisha, nah, that's not a starting place. It's not listener, it's not a starting place, and hopefully it's not an ending place, because it was near an ending place for me, wait till you see what we have coming up. Oh god, you serious? All right, who's on the calendar? I'm not saying yet. To find out. All right, to find out, booked somebody.

All right, I think that's enough for today. There's more, but we'll save some for another time.

All right, well, that was great again. Give us a call. Leave us a message for next month's Q A because that'll just be fun. We just want to relax, not do so much planning and work and hear what you guys have to say. So tell us about you. Tell us where you're from. If you want to WhatsApp us, if you live in another country, that's fine too, but just share something about yourselves. Say hello, offer some New Year's wishes to the community, and that would be really fun. So I hope we'll get calls, because if we get enough, we'll compile them into a fun little episode, but try to send them in no like but in early December, so that we we have time to do all that and and some personal questions are always welcome as well for that episode. So ask us anything, and don't forget, if you love the show, please, please, please, please, give us a five star review on Apple podcasts, just a tap of the button. We're not so quick now. So that's it takes 10 seconds and makes a world of difference for getting the show pushed forward so more people can find it. 

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. 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.