How to Prepare for the Birth You DON'T Want with HeHe Stewart

Imagine walking into labor and delivery prepared with the knowledge and confidence to advocate for the birth experience you've envisioned. That's exactly what HeHe Stewart, from Tranquility by HeHe and The Birth Lounge, is here to talk about. We talk about ways to turn the often overwhelming task of birth planning into a strategic, thoughtful process, giving you the upper hand in navigating your unique situation.

Crafting a birth plan isn't just about putting preferences on paper—it's a vital exercise in critical thinking and assertive communication with your care providers. In our conversation, we discuss the misconceptions surrounding birth plans and highlight their role in achieving a satisfying birth experience. Starting these conversations early in prenatal care can significantly influence the labor process, helping to maintain autonomy and minimize unnecessary medical interventions. We also dive into effective communication and focus on fostering a collaborative environment with your healthcare team, which can lead to a less stressful birth experience.

HeHe and I also talk about preparation for a low-intervention birth within a system that often leans towards medicalized birthing practices. We apply many of the concepts in this episode to VBAC specific situations including comparing the difference between VBAC tolerant and truly VBAC supportive providers.

After listening to this episode you'll be ready with the tools needed to clearly communicate your wishes and navigate the birth process with your team, ensuring your voice is heard every step of the way.

Connect with HeHe:
https://www.tranquilitybyhehe.com/
https://www.thebirthlounge.com/
https://www.instagram.com/tranquilitybyhehe
https://www.thebirthlounge.com/DadDaze-freebie

https://thehannahgill.com/firststeps

• First 3 Steps to VBAC Guide: https://www.thehannahgill.com/firststeps
• Quiz - Is Your Provider VBAC Supportive?: https://thehannahgill.com/quiz
• Doula VBAC and Repeat Cesarean Guide: https://www.thehannahgill.com/newdoulatips

Chapters

• 0:00 Childbirth Education and Advocacy for Families
• 14:52 The Importance of Birth Plans
• 22:44 Navigating Birth Conversations With Healthcare Providers
• 31:33 Empowering Birth Preparation and Consent
• 38:41 Preparing for a Low Intervention Birth
• 41:59 Effective Communication in Birth Planning

Transcript

Speaker 1: 0:00

Hey everyone, I am so excited for today's guest on the show. For those of you that are in the birth space whether you are a birth worker or a parent that has gone through birth education of any sort, you will probably know who she is. So he, he, Stewart is the founder of tranquility by he? He maternity concierge, the creator of the birth lounge and dad days, a birth prep course for fathers. With a master's degree in human development and family studies and 10 years in the family life education field, he? He helps women prepare for childbirth with research backed education and expert support to have a confident birth experience while feeling informed and in control of labor without fear or coercion. She is also a pro with preparing for postpartum, helping you master feeding your tiny human and understanding newborn sleep. She and her team serve pregnant people and their families across the U? S and internationally with prenatal, birth and postpartum care. He hosts the birth lounge podcast, which has over 60,000 listeners in over 28 countries. The show features leading experts in pregnancy, women's health and childhood development, so parents can understand how to have an informed and confident birth.

Speaker 1: 1:18

If you are preparing for a VBAC, I have put together a free guide to help you in your preparation. It's called preparing for a VBAC your first three steps to an empowered birth experience. This guide will walk you through the first three steps that you need to make on your VBAC preparation journey and it'll make the whole process a lot easier and more straightforward for you. So if you want to grab that guide, go to the Hannah gillcom board slash first steps. Again, that is the Hannah gillcom board slash first steps. I'm your host. Have you on today.

Speaker 2: 2:19

Hi, I'm so excited to be here.

Speaker 1: 2:22

So, to get started, can you just do a little bit of a background on how and why you got into childbirth education, because I know all of us wind up here for different reasons. So what was your motivation behind becoming a childbirth educator?

Speaker 2: 2:39

Yeah. So I actually started in early childhood education and I really focused on infant and toddler development, and when I worked with infant parents, I learned that those first few weeks were super hard after birth. So I dove into why. Why was that? And I found that, yes, those weeks are hard, but something that I didn't expect was so many people come out of birth feeling broken from their birth. Well, I didn't know anything about birth, so I dug into why. Why was that? Why did people feel that way after birth?

Speaker 2: 3:23

And that has kind of led me to being a doula. And then I grew my team here in Boston and then people started asking outside of the Boston area like I want to work with you, I want to learn from you, I want you to be at my labor, and so it really allowed me to kind of expand what we offered in order to have that bigger reach and that bigger impact to help people kind of all over. So much of our education is based in not only how to have the birth that you want, because that is obviously super important, but how to avoid the things that you don't want. Right, we are going to go into your birth like prepared a little differently than what the hospital childbirth education traditionally teaches.

Speaker 1: 4:12

So I I love that aspect because I focus a lot on VBAC, because I had a VBAC myself, but also not just VBAC but cesarean prevention in general, and I think that is such a big topics like what you don't want, and most people don't go into their first birth especially thinking, oh, I just, I want to prevent a cesarean. They go in thinking, okay, I don't, I want to go either medicated or unmedicated. They don't think about some of like the bigger implications. So yeah, cesarean prevention and kind of going into what you don't want is an aspect that I like to focus on a lot too.

Speaker 2: 4:49

Yeah, I think there's a real disconnect and it's it's, you know, like cognitive dissonance, that most people realize 33% of American women have C-sections but nobody thinks they're part of that 33 percent, like everyone's like, oh, but it's not gonna be me, right, and at the end of the day it's got to be somebody. So it very well may be you and the. You know the part of the system that is both good and bad. Good because you have control, we know about these things, we can prepare for them. Bad because, unfortunately, this is how the system is set up those 33% it is. It could be anybody, you know. It could be the person who has prepared the most, read the most books, done all the things, and sometimes the system just gets you. And then there are people who do absolutely nothing.

Speaker 2: 5:41

They literally just walk in, have a baby and the system is totally fine to them and that is just, unfortunately, that is the system, and so you get to decide how you prepare for that, and I encourage people to prepare by understanding how and what leads to the things that you want to avoid, and then you know what to do or not to do or in what order to do things, depending on the situation.

Speaker 1: 6:07

Yeah, so do you. So what would you say as far as, like, educating women and families on preparing, what would you say you're most passionate about? What's the number one thing like, ok, this is something they really need to know. Or this is what I just could talk about all day with with families as I'm working with them?

Speaker 2: 6:27

this is what I just could talk about all day with with families, as I'm working with them, I think, to speak up and advocate for yourself, because that, at the end of the day, is the answer to preventing almost all iatrogenic trauma. Right, that speaking up part is, oftentimes, too, the hardest. So it's such a crossroads, I mean, it's crummy, because you're like, oh, this sucks, I really want to say something because I don't want to do this, or I want to say something because I want to do this and my provider hasn't shared that option or hasn't suggested that, or maybe I found it on my own. But also, if you can do that really hard thing, then you get to keep your power, because at a birth, in the labor room, the power lies with the person that's making the decision, and there has to be that person. There has to be a captain of the ship always, and so it can either be or, many times, it is your doctor, or it can be you.

Speaker 2: 7:34

And so the minute that we give over that control of letting other people make decisions for us rather than being, you know, a consultant, a guide, someone that you know is very educated, and we respect their opinion, their clinical suggestion, your doctor is not the enemy. They just have a. They have a practice, they have a protocol, they have hospital protocols to answer to. They have insurances to answer to. They have. There's a lot of things that your provider is doing for the hospital or for their job, and you have to find a place where what you want and what your provider wants blends, which is also another important thing Finding a provider that is aligned with you. There's so many flavors of providers out there.

Speaker 1: 8:26

Yes, there are, and there's so many options that people don't even like. Some people might not know that midwives are in hospitals, or some people might not know that there's a difference between an MD and a DO, there's just. And then there's like family medicine and there's so many different people you could have on your birth team supporting you. So there are those different options there you could have on your birth team supporting you. So there are those different options there.

Speaker 1: 8:50

And you mentioned like advocating for yourself, and I know that a pushback that I get from a lot of people is like, well, how am I supposed to advocate for myself when I'm in the state of in the middle of labor, basically, and I'm in that like mental state. So I want to touch on like having like building a birth team as far as like a partner or doula or someone else that's there with you, because those individuals can also advocate for you if you are not in the capacity to do so, and I also know that a lot of people can't either afford or they don't know what a doula is. So preparing the partner is such an important thing to have them have know your wishes and know what you want and know how to advocate when you may not be in the capacity to do so. So how can we prepare our partners to be the advocate if we don't have anyone else there?

Speaker 2: 10:08

Yeah. So I think that this is true for both your work with your partner and your work with your provider. It starts before you're in labor, right? So one of my favorite key phrases that I tell the people in the birth lounge is the longer your runway, the smoother your landing. So the longer that you can prepare, the longer runway you have to make the decisions you want, do the research you want, educate yourself on all the choices. There's so many choices that can be made, right, and you you want to do this incrementally so you don't feel overwhelmed. So start early, like really early, as soon as you find out you're pregnant and you you settle in a provider, find a provider that you like, don't be afraid to switch, and when you find somebody that you like, start asking questions about your birth, about hospital policies, about their philosophies. With your partner you're going to I mean, they can come to your prenatals. If you want, you can model it for them. You guys can do it together. They can actually help hold space for you.

Speaker 2: 11:16

One of the best things you can teach your partner is how to pause the room, and this simply just means literally just pause the room and they just say like, hey, can we pause for 10 seconds to let Hannah like get, get her mind straight for one second. And then they turn to you and they say, hannah, you look really stressed out. Do you want like a few minutes, are you okay? Do you want to take some few deep breaths Like, what do you need right now? Pause the room, that's it. That's all it takes for partners. Be honest with your partners about what you want. They can't advocate for something that they don't know you want. They're not a mind reader, so it's really important that you loop them into these decisions Now. You have to be prepared for them to have their own opinions. They are going to have feelings about these decisions.

Speaker 2: 12:06

This is their baby too, you know. And so be prepared for hard conversations again, while we want to do it months before your birth, so that you have time to have these conversations. You don't feel rushed, you don't feel like it's now or never. You know you have the time to each do your individual research. Come back together, have you know more discussion. It is a, I dare say, enjoyable process, like you really get to know each other on a deeper level and start to truly make this energy, that is, it belongs to the two of you. You're you're making decisions for a whole new human.

Speaker 1: 12:44

I love that aspect because I feel like the majority of the time it's the woman giving birth that's doing all the research and all the education and figuring it all out.

Speaker 1: 12:53

So looping your partner in is so important and I had to do that a lot when I was preparing for my VBAC, because it was I was the one that experienced the majority of the trauma and the issues with my birth the first time around and my husband didn't understand, like my why and my motivation behind wanting a VBAC. So I really had to loop him into that and have him understand, like the severity of the trauma and and why I was wanting what I was wanting and why I wanted to do that. He was like like so confused he didn't know what that was either. So just looping him into that and having those conversations, like you said, you'll get to know each other so much better and what your fears may be or like what your desires may be for how the pregnancy and birth are gonna play out.

Speaker 1: 13:36

So I really I do wanna emphasize like having those communications way ahead of time. And one thing that I talk about with clients and you could have some insight on this too is birth plans, because with my first I was going to make a birth plan because I read it in a book and I was like, okay, I need to make a birth plan. But then so many people I talked to said, oh, if you make a birth plan, you're just making a plan to walk into the. That that was literally said to me, and so I didn't make a birth plan my first time. I just knew I wanted to go on medicated and I did end up in the OR. And the second, time yeah.

Speaker 1: 14:13

And the second time around I made a very explicit, very detailed birth plan, discussed it with my partner, discussed it with my provider way ahead of time and I ended up with a VBAC. So I'm a big advocate for birth plans, but also knowing that it's not like dead set If I don't have this happen, then everything is bad but making a plan a and then making a plan B if you need to pivot and knowing what your options are if you do need to pivot. So how do you feel about birth plans when you're preparing people for pregnancy and birth?

Speaker 2: 14:48

Yeah, I just want to say like hell yeah for your VBAC, great job. Okay. For birth plans, I think that what you just described is a perfect example of how that like negative hearsay does not align with the data. So research shows that people who do make birth plans actually do achieve more of their goals and they have happier experiences, meaning they look back on their birth and feel happy and pleased and you know they are happy with their birth. We opened the episode with my why of like, so many people were broken. So if you're not part of that and you didn't make a birth plan, consider it this time.

Speaker 2: 15:27

So a birth plan forces you to kind of do a couple things research things because you got to make decisions. You have to put something down on your birth plan, right If you have other people in your room and hopefully you're doing it with your provider and your prenatals but having discussions with other people, so you get other opinions, you get to hear the people who help you make decisions and what their thoughts are, and you can ask for feedback or you don't have to, and then you know it also gives you that almost a roadmap, a guide when you're in labor because, don't forget things are tense and or intense I'm not going to say tense, intense in labor, and so your partner is going to be having an experience. You're going to be having an experience, and then your medical team is going to have their own experience. Hopefully it's synergistic and everyone's working together and it is just beautiful and grounding and centering whoever's having that baby and their partner. Those are the people that need to be centered. We don't always find that in the hospital. That's why it's really important to find a provider that's aligned with you. Um, you know, doesn't always happen.

Speaker 2: 16:35

In making your birth plan, you become confident in your decisions. You become informed about the things that you want and you don't want. And then now we've looped back to what we said earlier about you want to plan for the birth you've had. Sure, yeah, like absolutely, but also the birth you don't want, and that's what a birth plan does. You're going to learn the things that lead to a C-section so that you can either do certain things aka movement in labor, whether you are unmedicated or have an epidural, or things not to do, aka amniotomy or staying still after an epidural, or have an epidural that's way too high and not asking to adjust it. There are a ton of things that lead to C-sections that we have control over. Not 100% control, we'll never have 100% control of labor, but as much control as we have.

Speaker 2: 17:32

That's what a birth plan has the potential to teach you, and I think that people will take it in varying degrees of seriousness. And so you know you're you're people like me, type A, really organized, want it all typed out, want to think through every situation. That's how we're going to treat a birth plan. And then you have people like one of my best friends could not even be more relaxed in life, like let's just take it day by day. That's how she's going to walk into birth. It works for her right, I think. Whatever floats your boat when it comes to birth plans works, but just know they are evidence-based. So don't think that they're a waste of time or that they are a quick trip to the OR. That's ridiculous, that's crazy.

Speaker 1: 18:20

That's crazy, I know. And one thing I always, with my own experience and with my clients, I tell them if you make a birth plan, take it into one of your prenatals and discuss it with your provider and be like can you look at this? So my OB even put she put mine in my chart. We discussed it ahead of time because I knew like VBAC was going to be a very specific thing and things that I wanted, so we discussed it ahead of time. She knew like VBAC was going to be a very specific thing and things that I wanted, so we discussed it ahead of time. She was aware of it. And then I brought a physical copy into me and with the hospital and I talked to my nurse about it before we did anything. I was like can you please look at this, let's discuss this, because it's one thing for you and your partner or your doula to like know your birth plan, but if, if your provider and your birth whole birth team don't know what you want, then how are they supposed to honor that?

Speaker 2: 19:07

Yeah. So I also think it's really important to start early with this as well. Let's say, you bring it in at 38 weeks and you get through just like one or two questions and you're like, oh my God, I have a whole page of birth plans and you know you have your baby the next week. Whoops, If we start early 32, 34, 36 weeks take it in, because we know that the system is not set up for your provider to spend 30 minutes with you, we are getting eight minutes with these people 10 and 12.

Speaker 2: 19:36

If we are lucky. I know some providers really do spend as much time and for those we really appreciate it. They're just far and few between right and the system does not set up for your doctor to do that. So I don't think it is your doctor making the decision to not spend time with you. The system is really not set up for them to spend a lot of time with you. So if you know you've got eight minutes with them, go in with it weeks before your birth so that if you get eight minutes this time, maybe next time you get 12 minutes. Maybe the time after that you only get seven minutes. That's kind of a short one, but then the time two times after that maybe you get 10 minutes each time, like now.

Speaker 2: 20:13

We have accumulatively spent about an hour planning your birth and really talking about these things. You know being flexible too with your birth plan is really important, not in terms of giving up or into things that make you feel uncomfortable or unsafe. That's not what I'm talking about. People are going to have their own boundaries and you should hold firm to your boundaries so that you feel safe. Or change providers. Change hospitals, change facilities, change places. Go to home birth If you want to go to a birth center. There, you know you, you have options. It is so important that you birth at a place that is aligned with you.

Speaker 1: 20:55

Yeah, completely agree. I completely agree and I I like that you mentioned not giving in or not like being coerced into changing your plan, but just knowing the options for like if an emergency arises or if something needs to pivot. So I always have talked to clients about like I would. If you're making a birth plan, I recommend making one for a vaginal birth and one for a C-section, because if it gets to the point where, yes, we know a C-section is needed, what do you want that experience to look like?

Speaker 1: 21:29

Because, especially for people that may have never had a surgery, they're going to be all kinds of thrown off going into an OR not knowing what the options are, not knowing that, oh, I could have my drape lowered or a clear drape, oh I could have skin to skin in the OR. So knowing, like, what your preferences would be if this were to happen, kind of makes you be more prepared for ahead of time, especially mentally, going into that process.

Speaker 2: 21:50

And that's what I mean by so much iatrogenic trauma could be prevented if we prepared people. Better is, if you know what to expect, it's very hard for trauma to happen. It's not that you know you're happy to have a C-section, but you knew it was a possibility. And if we've prepared people correctly, they kind of saw it coming, because we can kind of see when things are headed that direction in in you know, with the respect that there are very few cases of true, true, true emergency where like shit hits the fan all of the sudden and boy, where did that come from? And like wow, just what happened? Right, most of them are not like that. Most of them we can kind of tell that this is where we're headed. And so if we've really prepared people for that, it's going to be hard for trauma to happen, and I think that's really really important for people to think about.

Speaker 1: 22:45

Yeah, I, for my first birth I had, I did not prepare for a C-section. It wasn't on my radar and that's where most of my trauma came from was like I felt so shocked and confused on why a C-section was happening and that it was a possibility for me. Because, like you said, yeah, 33% of women are getting C-sections but no one thinks it's going to be them.

Speaker 2: 23:05

Yeah, yeah, yep, yeah. I think that you know people shy away from the hard conversations in pregnancy because it's scary and they don't want to think about having a C-section or they don't want to think about what a NICU stay might be like. But I can tell you anecdotally, the people that are open to having those conversations prenatally and learning just a little bit about what to expect and kind of what it's going to be like if they find themselves there, experience so much less trauma, not zero trauma. I mean, it is traumatic anytime. You need a surgery and you didn't think you were going to and you don't have two weeks to prepare yourself, right? You have a matter of let's call it an hour, guess what. You're having surgery in one hour, like that's a lot right.

Speaker 2: 23:54

Yeah, it is a matter of let's call it an hour, guess what. You're having surgery in one hour, like that's a lot right. It is a lot to hear. Okay, we have to keep your baby, they're going to need a little bit of support and we have to keep them right. And Nick, you say, is always going to have some trauma. But the massive amounts of trauma that I see is the difference between the people or in in between people who do prepare and have these conversations and don't is just crazy, it is insane.

Speaker 1: 24:19

Yeah, I love that you brought up the NICU stay, because my VBAC baby, my daughter, she ended up in the NICU a week after we were already home.

Speaker 1: 24:28

She had some issues and we had to go in and she was admitted to the NICU and that is not something I at all prepared for because I was so focused on just getting my V back I wasn't thinking about after the fact.

Speaker 1: 24:39

So I like that you brought up NICU because that's something that no one wants to think about their baby being in the NICU. But we know it's a possibility for any baby it doesn't matter if they're preterm, postterm, right after birth or a week later like that is a possibility. So, knowing how to navigate that and those plans as well and you had mentioned earlier when we were talking about advocating and discussing things with their providers so what do you feel like from your experience, is the best way to kind of discuss these things with their provider and communicate your wants and needs, because a lot of people they think that they're like going to be like fighting and arguing and they don't want to have that confrontation. So what are ways you can present these things to your provider in a way that makes it more collaborative versus a one-sided thing.

Speaker 2: 25:31

Yeah, so I think you have to remember they are just another adult. This is just a conversation. You're not asking anyone's permission, they are not an authority over you, and so you're just asking questions. You're just exploring their philosophy. So what might a topic be that someone discusses with their provider? And I'll talk it out?

Speaker 1: 25:52

So, for example, for VBAC specifically, or even just for like induction, let's go with induction because induction is so prevalent right now. So just like if an induction is needed or say you don't want to be induced, and they're suggesting one, maybe not for a medical reason, but like inducing at 39 weeks, type of thing.

Speaker 2: 26:12

Okay, so let's do 39 week induction for no other reason other than your 39 weeks. So this is an elective induction, is not medically necessary. It might look like your provider talking to you let's call it 38 weeks and they say, okay, next week we really are in. You know we're suggesting an induction because you'll be 39 weeks and you go, oh, you know we're suggesting an induction because you'll be 39 weeks and you go, oh really, is there a reason for me to be induced? I need like, is there a medical reason? And they say, no, no, we're just. You know, we recommend it to all first-time moms that we induce at 39 weeks because we show that it actually reduces your risk of C-section. A really great question there would be by how much? And hopefully they have the hard numbers and it is about 17 to 21. So that's kind of negligible, especially for someone who doesn't want to be induced, and so you can just share that with the and them and you can just say, to be honest, you know, I don't know that I'm so impressed with those numbers and I do have a strong preference that I wait for spontaneous labor. I'm not against induction, but I don't think I'm ready next week and they may say something like you know, we just want to keep your baby healthy and we just know the 39 week is a lot better than any other time. If you don't agree with that, you can be honest and say I'm not sure I necessarily agree with that, but I do agree that at some point induction is, you know, on the table. I'm hoping to make it to 40 weeks before we start talking about induction. I'm hoping to make it to 41 weeks before I'm open to the conversation. So you don't even have to invite them back to the conversation. You can even say I am hoping to make it a 41 weeks before I'm open to discuss an induction again, and I will let you know when I'm ready for that discussion.

Speaker 2: 28:05

You could, even if you have a provider that you feel like doesn't really respect you, you could even tag on. Please don't ask me about this again and if you don't mind putting it in my notes so no one else in the office does, so feel free to set boundaries, but again, it's a kind conversation. They don't have an authority to exert over you. They are. They're your expert. They're your expert. They are your counsel. They are someone who is highly educated in this, but also is practicing a medical model of care.

Speaker 2: 28:36

So if you're someone who leans a little bit more, less intervention, or maybe you are more appropriate for midwifery care, maybe you are more appropriate for midwifery care but you can't find any midwives in your area. Maybe you don't want to have your baby in the hospital but you don't have any other option because you live in rural America and your next closest hospital is three and a half hours away. There's a lot of restrictions that can go. So, depending on the provider that you find and you settle down with is going to kind of dictate how you have these conversations. But start with questions right, and then you can get into your boundary setting.

Speaker 2: 29:14

Hospital policy is going to come up a lot in these conversations because your provider is trained to tell you what hospital policy is, and so they may even slap you with well, it's hospital, get an induction, and in that case you can just say like, thank you very much for informing me. I am going to be declining and I feel confident in that. I feel informed of the risk and I'm comfortable with those. There are a ton of things you can share with your provider to let them know. I came to you because I trust you and I do respect what you're saying, but I disagree and I'm going to be choosing something different, and it's neither a reflection on you or my responsibility, but I feel informed of the risk and the benefits and I'm choosing this and I'm confident in that right and that's the ultimate goal when communicating with our providers, both prenatally and in labor.

Speaker 1: 30:05

And I always want to touch on to like make sure, when you're when you're making these decisions, if something is presented to you, whether it be induction or any other intervention if you don't feel informed about the risks and benefits, ask your provider to explain those to you, because we know there are some situations I'll use VBAC as an example like they'll say the risk of uterine rupture, but they won't bring up the risks of repeat C-section. So make sure you are truly informed, because that's part of informed decision making being informed about all the risks and benefits of both options, whether it be induction or anything like that. And I don't feel like, for example, I had an induction on the calendar scheduled for my first birth but we never went over all the risks of induction or like the drugs they would be using or anything like that. So just knowing ahead of time, like what those risks and benefits are and making sure you are confident in them before making a decision and don't be scared to ask your provider to explain those to you fully.

Speaker 2: 31:05

And you also don't have to make a decision that day. So one of my favorite sentences is thank you for informing me about this. I don't feel prepared to make that decision today, but I'm going to go home and look it up and I will call you guys tomorrow with my decision, or I will let you know next week with my decision. I will put it in my portal whether I am going to agree to this test or not. Whatever it may be for you.

Speaker 1: 31:34

And that, yes, because especially like when someone's sitting there staring at you, that is not, you're going to be like nervous, Even if you like know your decision right there.

Speaker 1: 31:41

Like someone's staring at you like, okay, what's your decision here? Like that's, that's a little nerve wracking. And that's another reason bringing up preparing early because if you're in the middle of labor and someone's like, okay, we need to break your water, we need to use pitocin, and they're staring at you like what's your decision, Like that's another excuse to be like, okay, can we take a minute, Can you? Can we have some alone time to discuss all of this? So someone's not like staring you in the face, like, okay, we need your decision now.

Speaker 2: 32:09

So you know, I know we're kind of laughing about this, but to turn it really kind of honestly and truthfully is that is borderline, not consent, because consent means you have to be able to say yes or no freely, and if you are, you know, under duress, essentially, someone is staring you down, you know they want you to either say yes or no, depending on what they want, and you and your heart and your gut don't want that. You're not going to feel. A many people are not going to feel okay or confident enough to say the opposite of what their provider wants in that moment. And so, yeah, I think a pause is the only appropriate thing to do in that situation. You have to break that tension of okay, we've taken the safety away from this person to decline, whatever it is, and that's not consent. You have to be able to accept or decline consent. You have to be able to accept or decline, and without both of them, equally and fully free of any sort of, you know, interference, then it's not consent, and I think a lot of times that's what's missing in the medical community and, honestly, that's where so much trauma comes from and that's also what I mean about handing over your power, so that, right there is pivotal. Also, what I mean about handing over your power, so that, right there is pivotal.

Speaker 2: 33:40

It determines who is going to be in power in that room after that moment, and if your partner can pause the room and just say, oh, can we just actually have five minutes to think about this, like it just feels like Hannah just needs a minute. I can see it all over her face. We just need a few minutes to talk about this and you leave it at that and the hospital staff needs to empty your room, they need to go out and you need to be able to reset, and that is how you keep your power. And you guys think about it. Maybe you call your doula, maybe your doula is there, you have a discussion, maybe you don't have a dual and it's just the two of you, and then you call your providers back in and now the power has remained with you and you say, okay, thank you very much. We obviously are kind of caught off guard by making this decision, but right now we're deciding to do what you said. Do this instead, do nothing, and I'd like to take a nap. Whatever it is, yeah, pivot completely.

Speaker 1: 34:35

Yeah, and I think a big thing too. When making these decisions on kind of getting an idea of like okay, how serious is this decision I am making, one of the questions I always ask is is there any danger to me and my baby right now? Are me and my baby healthy and safe right now? To know, is this like an emergency, like is this something that's even up for discussion, or is this something that it's just like coming up as an option but it may not be prevalent and important to do at this very moment? Because if they say like yeah.

Speaker 1: 35:10

I don't know if it's like, okay, we need to get this baby out as soon as possible, let's schedule an induction for four days.

Speaker 2: 35:16

Well, that's right Like okay, what's the emergency Right? What is the emergency? Remind me.

Speaker 1: 35:24

Yes. So it's different if they say, okay, we need to get this baby out now, like we're doing a C-section now, versus let's schedule an induction for four days. So just like, look at that, like the conversations, and like what they're saying and and just make sure you ask is there a risk to me and my baby right now? Are we healthy? Are we stable? Like what's what happens if we don't do anything, type of thing.

Speaker 2: 35:43

Look, we just recently had a client that scheduled a C-section per her doctor's recommendation but it was a week later than her doctor had recommended. So she felt like she had already kind of pushed the envelope there and they scheduled her induction, her C-section, for a specific time. She showed up two hours before that because that's what they had requested, and she got her C-section 11 and a half hours after the time she was scheduled. She had not eaten for nearly 24 hours because of the prep for her cesarean. She is pregnant. She has a child inside of her.

Speaker 2: 36:25

Has not eaten for nearly 24 hours, that's how you know, it's not an emergency.

Speaker 2: 36:30

That's how you know Go home, go home. That is the thing, and that is what you had asked. Like. What is the power of a birth plan? That's it. The birth plan tells you how do you avoid doing these things Right and I also think that that's the benefit of hiring a doula is you have that person to run these things by. You will never, ever, ever, ever be able to predict every situation that can come up in birth, but you can have someone on your side that has seen a lot of them and that's a doula and they can help you step.

Speaker 2: 37:10

They can help you step. They can help step you through a lot of these situations on the phone, video, in person, I mean a doula can look like whatever you want now.

Speaker 1: 37:23

Yeah, and I'm a, I'm a doula and I would still get a doula for my own birth, because I can't doula myself.

Speaker 2: 37:28

Definitely, definitely. People, always joke like ah, you're going to know exactly what to do when you have a baby. I'm like no I literally will not do this by myself, absolutely not, no way, because you're not even everything you know like could just go out the window.

Speaker 1: 37:44

You could just be like, okay, this has left my brain because I'm focused on giving birth right now. So, yeah, I will never birth again without a doula. I don't care if it's my 10th baby.

Speaker 2: 37:53

Never, never. I love it. Yeah, yeah, you know there are ways that you can really set yourself up to thrive and and have a positive experience, even though we know the system is a little bit broken right now.

Speaker 1: 38:10

So what would your top tips or your suggestions be? To someone say, I don't know if it's like a first time mom, or even a mom on their second or third birth, who's just unsure about taking the childbirth education course or like doing this preparation, maybe you said they're like your friend, that they just want to ignorance is bliss, they just want to walk in and do it. Why this is such an important thing?

Speaker 2: 38:33

I don't know that you're going to love my answer, but my answer is if that floats your boat, then I trust you. I trust you that you know how to best prepare for your birth. What I will tell you is the system is not meant for people to go in and be autonomous. So if you think you're going to fly by the seat of your pants and you're also going to have this beautiful hands off, like autonomous, like woo birth, birth sister, it ain't going to happen. Those two don't go together. Now if you think you can fly by the seat of your pants and have a good birth no matter what happens and you're like that's just kind of how you live, I trust you. But if you are hoping for a low intervention birth that is hands off, that your provider really honors your autonomy and respects your final word, you need preparation. You do. The system just unfortunately, is not set up for that experience and so a lot of times you're educating the people around you on expectations and how to achieve that type of birth.

Speaker 1: 39:37

And I love that because I agree, like, I think it's up to each individual person to decide what they want to do for their prep, but knowing what type of birth you want is going to affect and impact the prep. You should be doing so, like you said, like if someone doesn't care, they want to go in, they want to get all the things happen, they want all the interventions, they they want to schedule a C-section.

Speaker 1: 40:00

Yeah, or like whatever they want. That's fine, but, like you said, if you want a specific type of birth, then you should probably plan to have that specific type of birth.

Speaker 2: 40:11

And how to avoid the things that pull you off of that course. Your goal is to not have a C-section. You know that labor arrest or stall of labor, labor dystocia they call it all sorts of things is one of the main reasons of a C-section. Now you should learn I call it unlearning that. You should learn. What do you do to avoid that? You keep moving. You're upright. You go unmedicated as long as possible.

Speaker 2: 40:41

Once you get an epidural, you're still upright, you're moving right you're opening your pelvis, you're using that peanut ball, you have your epidural on a very, very low dose something that is tolerable. That you feel the pain relief, but also, hopefully, that you have control over your legs, that you are somewhat mobile. We want you to be able to get in different positions and you have control over the epidural. A lot of staff won't tell you that. A lot of hospitals don't present it that way.

Speaker 2: 41:07

A lot of times there is discussion that there is a policy that you have to either call the doctor or the anesthesiologist back, and that is often presented as a burden. It's okay. You can totally ask them to call those people back, especially if you think an epidural that's too high is going to cost you your vaginal delivery. Call that person back. Tell them I am scared, this is too high. I'm telling you right now please turn it down. I have goals of a vaginal delivery and I feel like this is too high. Perfect, that's all you need to say. They have the ability to turn it up and down and once you say that, they should be able to do that easily. They understand where you're coming from, they understand why and you gave them a solution. You know they may talk to you a little bit about the risk. If you're okay with those risks, then say perfect, I'm okay with that. Please turn it down.

Speaker 1: 42:00

Yeah, I think, across the board, just communication, clear communication, as much as possible on both sides, from you and your partner, from your birth team. Just having that clear communication can prevent so much.

Speaker 2: 42:12

Just like uncertainty is just having like awareness and that consent and that information that you need and just being able to understand what's happening in in the situation and most of the time you're going to encounter people who are really receptive to this and they love the information, and you're even going to encounter people who like truly sit down and really get to know you. It is. You know it's crummy when you encounter people who are cold and abrasive and don't care about these things and are not receptive to this communication. If that makes you feel unsafe, you should change providers. You should ask for a different provider or a different nurse. I will caution you some hospitals during the night truly only have one OB on staff or one midwife on staff. So you know. Another thing you can talk about in your prenatal is you only have eight minutes. Talk about what does staffing look like overnight in the hospital. What does staffing look like in the daytime in the hospital Overnight? Where do you come in? In a lot of hospitals it's different than the daytime doors. You should know these things. What is the phone number I should call when I go into labor? A lot of times it is different than the front desk of the L&D or where you make your appointments. These are things that you can ask in those earlier prenatals in. You know, let's call it. 16 to 24 weeks.

Speaker 2: 43:37

You've got a bunch of odds and ends to kind of clear up so that you have a clear idea of what you're walking into the hospital policy Am I allowed to birth in other positions other than my back? Hopefully, your doctor says you're not allowed or allowed to do anything. You can do whatever you want. But you might ask the question of what positions do you recommend? Hopefully, your provider says whatever you want. A lot of times they're going to say on your back and you can say okay, what if I have a preference, like a really strong preference, I don't want a birth on my back.

Speaker 2: 44:11

This answer is going to be very telling to what you might encounter in labor. Are you going to encounter providers who say like, okay, sure, it's easier for me to see when you're lying down, but if you don't want to be there, you can do something else. You know that. Okay, they're probably going to try and get me to be on my back, but I'm not going to face too much pushback staying on my hands and knees. But if they say like, oh, yeah, you have to be on your back for sure, like it's hospital policy. And you're like, okay, I have strong feelings and they go, yeah, we're really sorry. You can labor in any position, but when your baby actually comes out you have to be on your back. You can bet your bottom dollar. You're going to face a lot of pushback in labor.

Speaker 2: 44:47

They are going to truly try and get you on your back. It doesn't mean it's good or bad or that provider is good or bad. It just means this is what you're likely to encounter. So you better prepare for it. You better know how you're going to respond. Are you just going to say I'm not going to do it? Are you just going to ignore them? Are you just going to shake your head? Are you just going to stay on hands and knees and push your baby out and somebody just better catch it? It's up to you. So use your prenatals, along with your birth plan, to kind of evaluate whether your provider is truly aligned with you. And that's even more important if you're a VBAC right First you know VBAC tolerant versus actually VBAC friendly.

Speaker 1: 45:29

Yeah, like they're actually supporting you versus like, well, you can try. Totally Like okay, I'm not going to try.

Speaker 2: 45:37

I'm going to have a V-back. Do you know how to support me in that, or do you not like be serious?

Speaker 1: 45:43

Yeah, that's a. That's a big one too, because we know there's always like extra rules and stipulations that a lot of doctors put on V-back. So, yeah, knowing what your provider is going to do and if there's going to be like a bait and switch, like, use your prenatals use that time when you're pregnant to get a good idea.

Speaker 2: 46:06

Yeah, absolutely, and ask deeper questions, oh sorry. Ask deeper questions, so don't take surface level answers, for you know, if that doesn't suit you, then ask more questions. Don't let your provider make you feel like you can't ask deeper questions, because you deserve to have all the information exactly what you said about what you can encounter in birth, so that you don't encounter a bait and switch. So many people ask the questions in prenatals and they get into labor and they're like wait, this isn't what you told me and there were more questions that could have been asked.

Speaker 1: 46:36

Yeah, so is there anything else that you really wanted to talk about today, or maybe that we missed?

Speaker 2: 46:44

or haven't covered? I don't think so. Being prepared for your birth is the way to prevent birth trauma. It truly is. Some birth trauma is unpreventable. It's just natural, it just happens in human life. But there's a lot and it's called iatrogenic that is caused by decisions that are made in labor and those can be avoided. And a lot of it can be avoided by being prepared, making that birth plan, having these provider discussions early, having partner discussions early, making sure all the people in your birth room understand your goals, understand your why and understand your expectations of how you wanna be supported in reaching those goals.

Speaker 1: 47:25

So, hehe, if someone wants to work with you or if they wanna see what you offer or connect with you online, how can they do that?

Speaker 2: 47:33

If you wanna work with me, you can find me at tranquilityilityByHeHecom. There is a space for you to submit your due date and some information about yourself so that we can support you there If you are interested in finding out what I'm about. Instagram, TikTok, just Tranquility by HeHe. And then I do have Childbirth Education and it's the birth lounge. It's a fun place to hang out and find all the information that I like to say. Your hospital childbirth education won't teach you, because it truly is. How do you have the birth that you want and also avoid the things that you don't want and advocate for that through the system?

Speaker 1: 48:05

And he also has a podcast called the birth lab.

Speaker 2: 48:08

Oh, I do, yeah it's true, I do have a. The birth launch podcast is also a really fun place to hang out too.

Speaker 1: 48:14

So check it out over there. I'm a huge podcast fanatic, so I listened to way too many podcasts. So, yeah, go check out her show as well. So thank you so much for being here. Hehe, I appreciate you coming on. It was a wonderful conversation today.

Speaker 2: 48:28

Thank you so much for having me. This was a blast. I appreciate it.

Speaker 1: 48:34

You just finished another episode of Motherhood Flow. For more, head over to thehannagillcom or on Instagram at thehannagill. As a reminder, this podcast is provided to you for educational and entertainment purposes only. It should not be considered a substitute for medical advice. Until next time, keep flowing.