(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.)
Welcome to the birth prep podcast. I'm Taylor, your birth bestie, who's here to support you as you plan and prepare for the unmedicated birth of your dreams. If you're ready to ditch the fear, conquer the hospital hustle, support that bum and bod, and walk into the delivery room like the HGIC you were born to be, then buckle up, babe.
This is where it all goes down. Hello, hello, and welcome back to the birth prep podcast. Today, we're going to get a little spicy, okay? Because I keep seeing this time and time again.
I did it myself. So if you're feeling called out, it's okay. You're not alone.
And also, I cannot stand by and watch this keep happening to my ladies out there, okay? So we're going to talk about the number one mistake that I see women making with their providers. And it's not not asking enough questions or not having a birth plan. It's this, hiring a provider and never pressure testing the partnership.
We assume that they're sweet and nice, and they've got good bedside manner, and they sound supportive, so that equals support for an unmedicated physiological birth experience in the hospital. And that's not always the case, right? And that could be the case. Absolutely, it could equal that down the road, but you don't want to wait till birth to find that out.
So we're going to learn how to pressure test the partnership today. Because nice doesn't always equal supportive. If you've been confused by mixed messages or blindsided late in pregnancy, been there, done that, this episode is your fix, okay? I'm going to give you exact questions to ask, what real alignment actually looks and sounds like, some red flags, some green lights, some scripts for late pregnancy changes, or when you can't switch, because I understand that some of you are in that position, like, okay, I want to switch, this doesn't feel aligned, this doesn't feel like a good fit for me, and for what I'm trying to pull off, but I'm 38 weeks pregnant, I only have this hospital available, and this provider available, or this, you know, this thing is going on with my insurance.
Whatever the case may be, I understand that some of you are in that position, so we're going to talk about that too. We are going into the nitty gritty of all this so that you can walk in like the true head girl in charge that I know that you are. Now, let me know if this sounds familiar, okay? Because this was me.
We pick whoever our friends used, or it's close to home, or they seem nice, or they feel safe, or we picked the first person that had an available appointment for, that took our insurance. Whatever the case may be, we might not have put in much effort into choosing a provider. And I joke, but it's not funny, but I, at one point, put way more effort into choosing appliances for my kitchen than I did choosing a provider that was going to quite literally attend my birth.
Like, way more. And I know you guys are in the market for strollers, and car seats, and cribs, and all these, you know, seemingly big purchases that are important, and I'm not saying they're not important, but like, how much more important and how much more big of a purchase is the provider for your birth experience? Like, let's be real. I know y'all are all up in those Amazon reviews, okay? I know y'all are asking, oh, hey, what double stroller did you use for your 202, and what car seat is your favorite car seat? Which one has the best safety ratings? Which one, blah, blah, blah, blah, blah, all those things.
I know you're asking those kind of questions, but I am hard-pressed to find many mamas that are doing the same for their provider. And if you are new here, and you don't know what I believe about providers, I believe that that is the most important decision that you can make for your birth experience, far more than your birth location, far more than your pain management methods, far more than any other choice you're going to make that day, your provider can make or break your birth. So we pick this person who we didn't really do our due diligence on, okay? And everything's going great, they're so nice, they're so, you know, seemingly supportive, all the things.
And then we walk into our 36-week appointment and we hear, oh, well, we don't allow intermittent monitoring, or our policy is IV fluids and no eating and blah, blah, blah, all the things, right? And that is a super big red flag. But at that point, okay, you see this giant waving red flag and you're 36 weeks pregnant, you're like, I could quite literally have this baby like so soon, and I'm just now getting this information, like literally at the end. Likeability does not equal labor support.
Another reason that I see this mistake happen is because we've been conditioned to be good girls to be good little patients, not informed clients. We are not taught to have a consumer mindset when we go shopping for our provider. We are not taught to have a customer mindset when we are attending prenatal appointments with this provider.
They work for you, babes. Add in insurance hurdles and practice culture and hiring one person, but knowing anybody can be on call that day to get your baby. And you just are walking in like, okay, am I even going to be supported here? So reframe this with me.
Okay. You are the client, not the case. Your provider is a teammate, not your boss.
You're hiring for a very specific job. And the one that you are hiring for might look a lot different than what they're typically hired for, right? You are hiring them to support you in a physiological, unmedicated birth, in a hospital setting. And those are honestly really rare.
And I hate that about birth, right? Because that's the way we were designed to give birth. So it would make sense that that would be the majority of births, right? But when you look at the statistics of the amount of women getting epidurals or pitocin augmentation or other assisted ways of delivery and things like that, C-section rate, it's one in three in the United States. These are big, huge numbers.
So when you look at all the stats and data, you're like, okay, wow. Actually, not many people are pulling this off. I'm trying to pull something off that my provider may have never even witnessed before.
When you understand that you are aiming for such an atypical result, you are going to just come to the conclusion pretty quickly that you are going to need to show up in a very atypical way. The way I teach you guys how to show up is not the way that most women show up, but that's what you have most women going in wanting an unmedicated birth experience because there's so many benefits to it, right? We know the benefits, but you have so many women leaving with something totally different, something they absolutely didn't have planned. And I'm not saying they did it all wrong, but we have been taught to show up in such a way that does not get that result.
Inside the birth prep course. I talk all about the perfect for you provider. There's no perfect provider out there.
Like not everybody should go to this one provider because they're the most perfect provider ever. No, it's whatever is perfect for you because we all want different things. We all want to be supported in different ways.
We all need different things. So I teach my students on how to find somebody that is aligned with them. And alignment has three layers.
Most of us don't go past the first layer. Okay. We're like, Oh, okay.
The values line up. So that checks the box and we're aligned. We're going to go a little deeper, but first and foremost values, they believe in shared decision-making and physiological birth and the value of life, whatever your values are, insert those here.
And you're wanting to find somebody that aligns with those values as closely as possible. If those basic values don't match up, odds are the other stuff isn't going to match up. The next layer is the process.
This is their default flow from triage to your room to pushing to afterbirth, the whole beginning to end of the journey. You're wanting to understand their induction culture, their cesarean tendencies, episiotomies, pitocin, IV fluids, et cetera, et cetera, et cetera, all those choices here. What does their process typically look like? We want somebody that has a process that is productive for an unmedicated birth experience.
So we want somebody that is prioritizing mobility, different labor positions, maybe intermittent monitoring so that they're checking only once in a while, instead of having you hooked up to seven different machines, somebody who understands benefits of laboring at home as long as possible, someone that treats cervical checks as optional, not mandatory. And if you're new here, mandatory cervical checks do not exist, even if they tell you otherwise. So not only do we want similar values, we also want somebody that has a similar process to what we are trying to accomplish.
And then the final layer of this is receipts. Okay. We want the receipts, baby.
If you ask, Hey, how do you support an unmedicated birth experience? They shouldn't stutter. They shouldn't skip a beat. They should be able to give you all the information because they should know that if they're supporting unmedicated birth on a regular basis, that's what they're telling you they're doing.
They should be able to back that up with their words. Their statistics with their practice should be able to back that up as well. I'm sorry.
I am hard-pressed to believe that you support unmedicated births on a regular basis when your cesarean rate is 62%. So we want someone who has similar values to us, who has a process similar to what we are trying to accomplish and who has the receipts to back it all up. If any one of those is missing, you don't have alignment.
You have vibes and that might feel real great during your prenatal journey. But when you get to the birth space, vibes do not get you very far. A lot of you already have a provider.
So we're wanting to pressure test that provider patient partnership. That way you can know as soon as possible, if this is the provider for you or not, because as somebody that hired that person, you can also fire them and hire somebody new. And I promise you it's a lot better to do that at 17, 18, 19 weeks versus 36, 37, 38.
Not that it's not possible that far along. If the baby is still in your body, it is not too late, but it does get a lot more difficult. So I'm going to go over some questions that I believe are going to help you figure out if you guys are in alignment or not.
You can ask all of these in one visit. You can sprinkle them out over the next couple appointments, whatever you want to do. If you want answers now, if you're like really late in the game, you're like, I need to know these things ASAP.
You can pick up the phone and ask to talk to this person during their office hours or schedule an appointment specifically for like, kind of like an alignment visit. If you haven't hired a provider, consider a console before you ever even hire them to see if you guys are aligned or not. You do not have to read these off word for word, but I want you to understand the common thread throughout these questions.
You are asking specific questions that are going to require more than a yes or no answer. And that are going to allow you to listen for specifics to help you make an informed decision. So we're not talking about, hey, do you support unmedicated birth? How easy is it to say, yeah, we do.
Absolutely. We totally support unmedicated birth. But what information did you truly get in asking that question? So let's rapid fire through these.
First, can you walk me through how you support, how you support an unmedicated birth experience from triage to pushing to afterbirth, the whole nine. You're going to want to listen for specifics here, intermittent monitoring windows, freedom to move different pushing positions to when is intermittent monitoring appropriate in your practice. And if it's vague and you want to get more specific, say, okay, can you tell me what that actually looks like? If baby is looking great, does that look like 20 minutes on 40 minutes off? Does that look like coming and getting my vitals every hour? Number three, what's your approach to IVs? Are you comfortable with just a hep lock? You get to decide what you want to hear here, but most of us wanting an unmedicated birth in the hospital probably want to hear, yes, we can place the same lane lock so we can keep you mobile.
If you were opting for some sort of treatment that is usually delivered via IV, then you should be able to have that administered and then get right back to your hep lock. Number four, how do you feel about movement and positions? Upright position, sideline, you can get specific hands and knees using the toilet. Just basically you want to know, do you make everybody get on their back when it's time to push? I will be choosing what's most comfortable for me in the moment, but I want you to know right now that doesn't look like pushing on my back.
You can even take that a step further. What does the hands-on support look like for that? Number five, what's your policy on cervical checks and how is consent handled each time? Walk me through your typical informed consent for a cervical check. I know they're not mandatory.
I want to know how it's going to be dealt when it's offered to me. If they sit there and tell you they're mandatory, red flag. Number, I don't even know, six, I think.
How do you manage the third stage? Do you have a physiological weight versus routine active management? How do you tailor that depending on the situation? I hate to break it to you, but most women are receiving Pitocin without consent after their labor is over to be active management, quote unquote, for the possibility of hemorrhaging. Instead of waiting and seeing what your body needs, it's given routinely. You should be a part of that decision-making process.
I don't care what you choose. I don't care what you and your doctor decide are best for your situation. You should be involved.
Number seven, what are the common reasons you recommend induction here and how do you individualize that for low-risk moms? Again, you're looking for information about how they operate, how they typically handle things so that you can decide, okay, this person sounds like it's going to be easy breezy. I'm going to get what I want here, or gosh, I'm going to really have to put up a fight to get what I want in this experience. This one could be very telling.
How do you collaborate with doulas and birth partners? Listen carefully to what they say. Oh, we don't really like doulas working with us, or we only work with a set of approved doulas. Even if you're not hiring a doula, this question I think is very, very telling.
Last one I have for you today is if I arrive very close to pushing, what is your minimum monitoring? How do you protect mobility at that point? All these questions are going to quite literally force them to paint a picture for you, and that's what we want. We don't want vague answers. We don't want empty promises.
We want to know, okay, this person knows what they're talking about. This person has receipts to back it up. This person really feels like they're going to be a good choice for us.
Listen for controlling language. Sounds like we don't allow, or policy says, or everybody just gets, or even like jokes about unmedicated birth, dismissive language like, oh, we'll see, or well, most first-time moms. Partnership sounds like, well, if baby's looking great, we can X, Y, Z, or let's decide that together, or we really like to individualize, and that could look like X, Y, Z. It comes with details, not fluffy nonsense.
Also ask around, especially if you're seeing multiple providers in the same practice, ask the same questions, ask the nurses the same questions here and there. Are nurses mentioning showers, or tubs, or birth balls? Ask different questions to different people. Are you getting consistent answers? Because the culture matters.
My original providers with my first couple kids, I had four OBs that I saw in rotation, and I really liked one of them, but disliked three of them. At the end of the day, she was the exact same. She just was way better at bullcrapping me at the bedside.
Honestly, after experiencing things, she was probably one of the worst ones. If I had paid attention to the culture of the practice versus the individual, I would have been truly informed. So some quick red flags to look for are things like, we don't allow intermittent monitoring, or the pressure for induction, or AROM, without individualized reasoning, the mandatory IV or bed confinement because of quote unquote policy, or things like condescending tone when they're answering your questions.
Well, you can try unmedicated, but dodging questions about group culture, or outcomes, or whatever you're asking about. If you're seeing multiple red flags, you're probably going to want to fire that person and find somebody that's better aligned. But let's talk about some green lights.
Explicit, shared decision making. Somebody that honors your opinion, and that wants to know what you want, and that wants to work with you. Someone that is going to hear you use your brain method.
What are the benefits? What are the risks? What are the alternatives? What does my intuition say? What if we do nothing or nothing yet? They're going to welcome that. They're not going to be like, well, this is crazy. Why are you even asking all these questions? You don't know what you're talking about.
You're not a doctor. Welcoming those things, taking the time to answer your questions, taking the time to sit with you, and help you make an informed decision about your care. We love that.
Big fat green light. Comfort with intermittent monitoring and mobility. When you actually understand the statistics and the risks versus benefits, I don't understand why a provider wouldn't be comfortable with those things, except for control reasons, or policy reasons, or wanting to do things the way they want to do them, making things as easy as for themselves, or covering their butt, whatever the reason may be.
But you don't want somebody that's operating out of that mindset. You want somebody that is going to support you in a way that is backed by evidence. What evidence tells us that continuous monitoring literally does not improve outcomes, and puts you at higher risk for unnecessary interventions.
Not to mention how it's impacting you as a patient, sitting there connected to all these different machines. Trust me, I've been there, done that. It's not a fun time, and it absolutely is going to mess with your hormonal balances that day, which are kind of really freaking important.
Anyways, stay on task, Taylor. But somebody who's comfortable with that, or even encourages the intermittent monitoring, encourages mobility when possible, green light. They encourage varied pushing positions.
Backlying is optional, not their default. They understand the benefits of getting into different positions, especially if things have stalled. They offer non-pharmaceutical coping mechanisms like water, birthing balls, peanut balls, birthing stools, anything that you decide to bring for your personal little toolkit.
They respect those. They're doula positive. They speak of their nurses as true teammates.
They're not like, oh my gosh, we're the doctor. We know best. What we say goes, blah, blah, blah, blah, blah.
And I want you to hear this right now. If you're hearing mostly red flags for your provider, the one that you chose, that's not failure, honey. That's information.
And you get to choose to do with that information what you will. But please don't sit here, oh my gosh, I chose the wrong person. Oh my gosh, I should have done better.
Oh my gosh, blah, blah, blah, blah, blah. Those thoughts are not helpful. Say, OK, this is great information to have.
I'm so glad I have it now, instead of in my birth space, or instead of after the fact. I'm glad I have it now. Now I can move accordingly and make an informed decision.
One question that I get a lot is like, Taylor, do I need to figure my whole birth plan before I have a consult, or before I start asking these questions at my appointments? And the answer is, absolutely not. But there are six things that I really think you should at least ask about and be informed about as soon as possible. And you don't even have to have your decisions made on these.
I just want you to understand where your provider stands, so that as you are gathering information, and as you are understanding what you're looking for for your experience, and what you might be putting on your birth plan, you can then act accordingly. Admission timing. So this is when you would arrive at the hospital to get care from your provider.
Most of my unmedicated girlies want to labor at home for as long as possible, so they are aiming to arrive pretty much deep in active labor. Like, by the time you roll up, they're going to have no question, oh, this girl's on labor. Second, we have monitoring.
And we've already talked about this, but most of you prefer intermittent monitoring whenever possible. Third, we have IV access. We've talked about this too.
Hep lock, unless treatment is needed, is the typical unmedicated choice. Number four, movement. We want unrestricted, upright whenever possible, letting gravity do its thing, practicing pelvic opening positions, things that are going to really help baby engage and get to where they need to be in order to be born.
Five, we have cervical checks. These should be in any way, shape, or form, whether you're going unmedicated or not, by request or consent only, and at a minimal frequency. Can you imagine with me for a second? And I know you've had sex, okay? So we're not going to get weird about it.
But can you imagine if you were having sex with your partner, the oxytocin is flowing. You're having a great time. We're getting in the mood.
Everything's great. And then somebody comes in and shoves their fingers up you to just see how things are going. Like, dang, I was going to get there.
You just needed to leave me alone for a little bit. Babe's birth is the exact same way. The exact same hormones that you're experiencing in the bedroom with your man are the same exact hormones that are present during your birth experience, literally driving those contractions.
I try not to say it all the time because it's such a hot take, but I don't think that you can Google oxytocin and tell me that birth is supposed to be a terrible time. I think how much we've disrupted the process is why we have such a terrible time. I think fear being present in the birth space and fear being quite literally taught to us from such a young age that birth is supposed to suck and it's just this thing that you have to survive and everybody does it.
You just got to get through it. That kind of language about birth, I think, has quite literally created a very painful experience for most women. Anyways, I will stop beating that dead horse.
Cervical checks are optional, okay? And they should be by request or by consent only. And then finally, I want you guys to ask about the third stage of labor. First is labor.
Second is delivery. Third is afterbirth. This is where you're delivering the placenta and entering into your postpartum experience.
Decide on if you want physiological or if you want active management in advance. And again, you don't have to decide before you start asking these questions. You can just see, what does my provider typically do? What does afterbirth look like? Are they shooting everybody with Pitocin through their IV without their knowledge and then pulling the placenta out by your umbilical cord, cutting the cord as soon as the 30 seconds is up, calling it delayed cord clamping? Or are they more hands-off and let things unfold in their own timing, only intervening when it's absolutely necessary? So you don't need to make the whole plan.
You don't even have to decide on these things. Just ask these questions. Ask about these things.
Understand your provider's stance on these. If you have done the work of pressure testing this partnership and you decide, oh my gosh, this person is not the person for me and you either need to switch or you realize, okay, this person is not for me and I am stuck here and I can't change this experience for whatever reason, right? There's so many reasons that could be. This last little section is for you.
First, if you need to switch, even at 37, 38, 39 weeks pregnant, here's what you're going to say on the Hi, my name is blah, blah, blah. I am X weeks pregnant and I'm planning an unmedicated hospital birth. I'm looking for a provider who supports intermittent monitoring, mobility, consent-based cervical checks, and varied pushing positions.
X, Y, Z, insert whatever you're looking for here. Do you have room for a quick alignment visit and potential transfer? If they say no, okay, totally understand. Do you recommend anyone locally whose practice culture fits what I'm describing and just start the hunt? You might have to call literally 10 people in the area.
I don't know. I hope it's an easy process for you. I hope you find the most perfect for you provider.
I really truly do, but you might have to put in some work and energy here. Once you find somebody before you actually hire them, please pressure test that partnership. You want to make sure they're able to walk you through an unmedicated birth flow from triage to labor, to delivery, to the afterbirth experience.
What does that actually look like? And if you can't switch, here's what I'm calling the stay and steer plan. When you are admitted and it's time to have your baby, you are going to tell them what you're looking for. Like we're aiming for intermittent monitoring and lots of movement.
If baby looks great, can you help us protect that? You're getting our little nurse allies on your side. They're doing the majority of the work anyways. I strongly urge you to delegate this to one of your birth partners.
He or she should be ready to give a quick rundown of your birth plan in a nutshell. Hey, here's what we're looking for. We could really use your support.
Is this something that you're on board with? And if they're not on board, if they're snarky remarks, or if they're going against exactly what they just told you they would do, make sure you know how to advocate for what you want and how to fire people from your birth space. Another thing I want you to be ready to do is press the pause button. Okay, thank you.
We're going to take 60 seconds to breathe and decide. We're going to chat it out real quick. Then we'll let you know.
This sounds great. Thank you for the information. Can you tell me more of the benefits of what you're recommending? Can you tell me the risks of what you're recommending? Can you tell me what would happen if we just watched and waited? And then I want you to get really good at asking for evidence.
Could you please share the specific clinical reason for this recommendation right now? If baby is reassuring, we'd like to wait 30 minutes and then reassess. If you're having issues, for whatever reason, you're going to want to escalate up the chain, right? So if you're having an issue with a nurse and you're just not seeing eye to eye, or she's being very disrespectful, or she's laughing at your plan, or just being very dismissive, whatever the reason, right? There's so many reasons. There's so many things.
Just be respectful about things, right? You don't have to be caring about things, if you will. But just like, hey, could we loop in the charge nurse so that we can make sure we're getting our individualized care while staying safe here? And then make sure your partner is prepared to advocate for you. Remember that they are there to guard the vibe, watch the clock, press on your hips, run interference, whatever the case may be, whatever you've got to delegate to your partner that day.
Make sure they are ready for action. Before I close out, I just wanted to quickly role play some different little scenarios that happen pretty often. And I just want you to see what this looks like in real time.
So let's say you are being offered an induction for being overdue. Your provider comes in. Hey, you're 40 weeks and four days.
We're going to recommend an induction. We're going to get you on the schedule because you're overdue. You're going to use your brain, your B-R-A-I-N.
You're going to say, OK, great. Thanks for letting me know. Can you please explain the benefits for me and baby today? Can you talk about the risks a little bit? Can we talk about alternatives like additional monitoring, like non-stress tests and expectant management? Check in with your intuition.
And you don't have to be like, hey, my intuition is telling me to wait. You just be like, I've decided to wait while everything looks great. We're going to choose to do nothing right now.
Can we keep an eye on baby and reassess in a few days? Scenario number two, continuous monitoring because policy. The nurse comes in, says, hey, we really need you on continuous monitoring now because that's our policy. I know that's what you want.
I know that's your birth plan. You don't want to do it. But we do that for everybody here.
If baby's looking great, I'd really prefer intermittent monitoring so I can keep moving. If there's an actual concern, I'm open to continuous monitoring for a period and then reassessing. They just checked everything in triage and everything was great.
So I'm totally comfortable with continuing laboring without being monitored the whole time. We can check again in about X amount of time. And then scenario three, pushing flat on your back.
So you've informed your team, hey, feels like baby's coming, kind of have the urge to push the providers on the way in. The staff is like, OK, great. Let's get you into position.
Go ahead and lay on your back. You say, oh, no, thank you. I push best in an upright or sideline or hands and knees or whatever insert position here of your choosing.
If we need to try on my back later, we can. But let's start with what's working for my body. So these are some real life scenarios that I see on a regular basis where a lot of women deal with pushback and I need you guys to be prepared for pushback, especially if your provider is not aligned with you, especially if you didn't have time to pressure test the relationship.
This is so important. And the shutouts, I put my what to expect prenatal guide in there for you guys. If you want to grab it, it's free.
There's a bunch of stuff in there. It's really helpful, especially if you are early on, if you never had a prenatal experience before, talks about all the different tests that you're going to encounter, have the opportunity to opt in or opt out all the different things that are going to happen at a prenatal appointment. Typically.
And you know, basically what to expect, but there's a section in there all about choosing a provider. So I want you to check that out. And there is a list of questions to ask your potential provider.
You can screenshot that and bring it with you to your appointment. If you want to those paired with the questions that we cover today, if you jot those down, put them in your notes or something, those are really going to kind of force your provider to paint a picture for you. So you're not going in blind, you know, exactly the kind of person that you're dealing with exactly the kind of provider, exactly what kind of values that they have exactly kind of process they typically go through and exactly what kind of receipts they have to offer you.
I'm also going to add the link for the birth prep lounge. So you can join me for birth prep power hour every week. This week, we're diving deeper into this topic.
We're going to be talking about red flags, green flags, and some hard conversations that we need to have with our providers. You can bring any questions that you have to, and I will be there to answer those for you. And if you really want to set yourself up for success, check out the birth prep course.
That is quite literally everything that you need in order to prepare for this experience, how to choose the perfect for you provider, how to navigate the hospital hustle, how to prepare your birth squad to best support you that day, understanding all the decisions that need to be made and the common choices for those decisions, preparing your mindset to support the work that your body's going to be doing, understanding the work that your body's going to be doing all the different hormones at play and how to best support those. So many things I could go on and on. It's literally everything that you need.
You can get more information or the link to enroll in the show notes. And if you have any questions at all, my inbox is always open. And I think that's all that I have for you.
Okay. Now that you know about this number one mistake that women make, I don't want to catch you making this mistake. Okay.
You promise? All right, good. As per usual, it was a pleasure hanging out with you. I'm looking forward to chatting with you guys again next week until then as always happy prepping.
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