Bianca Sprague: Guardian of the Birth Experience

When Bianca Sprague, the trailblazing founder of Bebo MIA, shifted her career aspirations from OB-GYN to becoming a doula, the landscape of birth and parenthood began to change. In our heartfelt discussion, Bianca shares the pivotal moments that steered her towards doula work, including her mother's home birth and her own challenging entry into motherhood. Her story is a testament to the power of empathy and the profound need for supportive birthing practices that honor the individual experiences of parents. As we explore Bianca's journey, she illuminates the stark contrast between the impersonal hospital births she expected and the deeply nurturing doula-led experiences she now champions.

The complexities of parenting and the evolution of gender roles within it were another rich vein we mined during our conversation. Bianca's intimate reflections on blending professional pursuits with the demands of raising children shed light on the delicate act of balancing these worlds. She advocates for self-care and sleep as non-negotiable pillars of well-being, not indulgences, and shares how her own evolution as a doula trainer and mentor is informed by her commitment to continuous learning and adapting within healthcare.

Our episode takes an expansive look at childbirth, from respecting every parent's unique birth plan to the importance of patient-centered care in medical settings. Bianca's insights into the often overly clinical approach to labor in hospitals are especially enlightening, stressing the need for healthcare providers to step back and support rather than control the birthing process. Through her experiences and those of the families she supports, she encourages a reevaluation of the concept of pain in childbirth and the empowerment of birthing individuals to have more agency in their experiences. Join us as we unravel these topics with Bianca Sprague, whose wisdom and passion for improving birth experiences are truly transformative.

Read more about this episode and connect with Bianca at:

https://bebomia.com/bjp/

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Transcript

Speaker 1: 0:28

Hello, today I have with me Bianca Sprague. Bianca is a doula currently in Nova Scotia and she founded the globally recognized Bebo MIA doula program. Bianca is here to share her inspiration for becoming a doula and how training as a doula helps banish the bad mom fears and makes you feel like a better parent. We are also going to discuss the rising need for doulas and how doula care transforms family experiences. Bianca, welcome and thank you for joining me.

Speaker 2: 0:59

Thank you so much for having me.

Speaker 1: 1:00

I am so excited to hear about your experience that led to this amazing program and how you help birthing parents and people that are wanting to become doulas to make that transformation in their life.

Speaker 2: 1:15

Yeah, I have a lot to say about all of those topics. Oh, I'm so excited. Let it roll.

Speaker 1: 1:21

How did this start for you? Let's start from the beginning.

Speaker 2: 1:24

Yeah, okay, well, that's an excellent way to start. My plan was always to be an OB-GYN. As long as I could remember I saw my sister. My mom had an illegal home birth back in the mid-80s and I watched my little sister being born and it was transformative to watch how powerful and I mean I get a little nervous about it now because she was essentially a free birthing be back, I sweat a little bit when I think about it and it was great and it was magical and I felt changed from the experience and so I always thought OB-GYN. I don't know why, especially because there wasn't an OB-GYN present at that birth, but to me it was like the logical next step and I ended up getting pregnant, probably eight years earlier than I planned because of a health scare. I've also since learned to ask more follow up questions, but my daughter's here and I really I mean I could talk a lot about my birth.

Speaker 2: 2:17

I found it really frustrating to I had to work too hard to have an uninterrupted experience and I felt really confident with what I was doing and I couldn't get midwives, so I couldn't have a home birth at the time and so I was birthing in the hospital and I still had a reverence for the hospital system because I imagined my life there and I was in my mid-20s and so it was complicated. But my experience birthing I was so shocked that I was like, why are you all bothering me? Like, why do you keep turning my lights on, why won't you leave me alone, why do you keep pulling me out of the bathroom, why do you keep putting me in the bed? And I was having this almost like clash of what I imagined births, which was this home birth that I witnessed. That was profound, a reverence for the space I was birthing in.

Speaker 2: 3:01

And yet my experience was like not syncing up because I realized it's not the environment to have an uninterrupted, physiologically intact birth. So I got as close as one could as an unsupported, no family 26 year old, and it was really what happened to me after, because I was mostly irritated that I had been messed with in my birth, that they just they didn't understand what my goals were. And I had a really traumatic immediate postpartum because I had an unmedicated birth that was really long. It was for like 52 hours of active labor into transition and pushing like really long. But I was doing it. I felt really powerful in what I was doing. And it wasn't until the actual the OB-GYN came in and he did an unmedicated repair. He was so. He thought I had an epidural, because everybody in the hospital I birthed with.

Speaker 2: 3:53

They have about a 99.9% epidural rate. Even though I was flagging like I'm unmedicated, he was not listening. He was very aggressive. He used instruments at the end, even though I requested not for the delivery of my daughter. I had significant tearing and then, as I say, the baby was taken, like it wasn't what I imagined of, being put right on my chest and I had a repair with no freezing and so that was like a million F-bombs of garbage so that part I can like loop on, and that they just like. The door was open and tons of people were in the room and I felt suddenly like really vulnerable again.

Speaker 2: 4:32

I was really modest up into this place and so I didn't have that modesty feeling when I was in labor. But once the baby was out, obviously your hormones are different You're like back in your body, your front to low kicks back in, and so I felt that's really where the violation started. And then when I got home I lived in an unsafe partnership which I was very clear I needed to get out once my daughter was born. But I remember feeling so confused because I knew for sure I didn't want to be an obi-kind, because that relationship to birth was like I would never do that to somebody else. And so then I was like no, what do I want? What do I do now with my life? And I remember pacing with my daughter, feeling such rage and such confusion and knowing that I had a role of being her mom. It was like it was an important role. I understood that.

Speaker 2: 5:23

I also felt confused because I didn't know her and I didn't. I mean now I've worked with thousands and thousands and thousands of parents over the last almost 20 years and so I know all of it is normal. But at the time I was like why do people get so excited and like fall in love with their babies? I felt like a deep responsibility for her and to her. But I was like I don't actually really know her. I don't even know if I like her, I don't dislike her.

Speaker 2: 5:49

But I was like this is a person I don't know that I'm with all the time, and so I remember feeling a lot of shame around that. And then, as she got like a tiny bit older like we're still in the weeks measurement I felt like just such extreme loneliness in that, because you know, after days your friends stop coming, people stop texting and calling, they drop off the gift. That doesn't make sense because 20 year olds don't know what to take their friends. So I got like weird stuff that's not cleaning my house, making me meals, taking the babies so I could shower, like those are the things anybody here wants to celebrate their friends. Do those things.

Speaker 2: 6:26

But I that's really what is needed support, support, support and support, more than just those first days. And so I had this like swirl, and it launched me into this creativity and this. I had to solve it. I had to solve it and it felt very, very urgent and so I started a business. Do as I say, not as I do go back to bed, get people to love and support you. Do not start a business. But that's what I did, because I also did have an urgency of, you know, getting out of domestic violence, and so I actually fell immediately in love with my business. So I went out and I did a doula training and I struggled for a while with my ego being like, well, now I'm just a doula and I was going to be the surgeon in the room, and so I struggled. I struggled for a few years actually, with that concept until I was like you know, my job is to protect birth and this is. This is important.

Speaker 2: 7:18

And as Gray was that's my daughter as she started aging with my business, I had these new, new, unique challenges is that I felt really passionate about my business again. I felt deeply responsible for Gray and she was with me and I co slept and work everywhere and I was feeding from my body and I thought I was like doing all of the markers, but I also really struggled because I didn't like making applesauce, I didn't like going to lessons, I didn't like baby droppings, and so I actually thought I was a bad mom and so I was like I'm doing all these things that are like the hardest versions of parenting is upholding attachment parenting, attachment science based parenting, not the intensive mothering model, not the like hyper helicoptering. So anybody, I'm really intentional about the language I'm using, because there's a type of quote, attachment parenting that is actually, I would say, probably not in the best interest of the parent, nor the child or children. But I was deeply committed to raising my daughter and in honoring her as a human, at the same time honoring myself as a human, and which is really hard to do and in this water we swim in and so but I I very quickly my client roster filled like very, very rapidly and I just threw myself into that community and I just started talking to parents.

Speaker 2: 8:37

What did you wish you had? What are you suffering with, what? What makes you so sad? Because I had so much and I kind of initially wanted to make sure I wasn't just really whiny. What's wrong with me? Like start with self validation and move forward, like does anyone else hate this? Like raise your hand and just if you hate this, because I mean the work of mothering and the and the relationship of mothering are the two buckets and they've been collapsed right. So we think being a mom or being a parent for any queer gender expansive folks, that it is signing up for swim lessons and remembering the shoes are too small and booking pediatrician appointments and buying birthday things and dropping off cupcakes at the bake sale like that is not mothering, that's just you're wearing me out, just talking about it.

Speaker 1: 9:24

I'm going to raise my hand and say I hate it too.

Speaker 2: 9:29

I hate it, but we call that being a mom, and I was like that's not, that's a job. Being a mom or being a parent is like sitting and making eye contact with your kid. It's listening to them, it's playing in a way that you're like intentionally playing with them, not like okay, which doll do you want me to hold or which Legos do I get to touch and then where do I have to put them? Like really like watching your kid explore and discover and instilling values and all of that stuff. And I want to pause if anybody's like, oh, it's time for that exactly. Yes, you're right, you're right, and that is. That is parenthood. But unfortunately, due to, you know, the patriarchy, capitalism, like fill in the blank. We think all this running around, busy work that our children watch, and they watch who's doing it and they watch who's not doing it, and then our children, being raised as boys, see that their dad doesn't do it and their mom does, and then girls watch it, and we're just going to make these clones. So I started really looking at this intentionally being like I do not want this, I don't want to do it, so I'm I'm going to protest and not do it and I'm going to do the things that I do really like and I all honestly I didn't know how to really like show up for gray and love my business, so I mostly just like avoided one and did more of the other, and so I felt a lot of grief. I still feel tons of grief about that that I was like I will not do the work of mothering, but I also didn't fill it up with the relationship party there, because nobody else showed me how to do that part. I thought being a mom was just a lot of tasks. And then you chalked it up at the end of the day and you were like I was a good mom because I did that list and so I started getting really intentional about that part and learning more and trying to do better. And on it spoiler alert, if anyone's like in the underteens I'm I'm only getting the hang of it now that she's a year and a half away from going away to university. So it took a very long time and that was with me a hundred percent of my waking hours being doing this work, both personally and professionally. So I just, if anybody just wants to take this as an intention and it will kind of kick it off there.

Speaker 2: 11:38

So my business started just shifting and growing as a, I was problem solving for parents and problem solving and healing for myself and I started, you know, really understanding empathy because I've listened to my clients. And then I'd go home and be like I'm not doing that at home. It like lit up these places that I was like I patiently listen to my clients, I never doubt them, I never challenge them, I never be like, but last night you did this, like I'm just like here's where we are and this is real and I'm gonna love you through whatever. But yet I'd go home and do the opposite and so I. It was a really great.

Speaker 2: 12:13

There's probably one of my favorite lessons of this work of listening and not challenging and seeing that something great wanted yesterday, it's different today and not to like get her. Gotcha and I and these gifts just started happening as I was working with families and figuring out how I could change the face of not only keep them protected through their birth, but also change their experience as parents, so that we don't just keep cranking out these exhausted, not present, not self-care and I don't mean self-care in the sense of massage and pedicure. I mean that can be if you want, but like, truly it's taking a breath and seeing how you feel about your life and your day and seeing rest as valuable and critical and like sleep, y'all is critical. We always list what it keeps us alive and we list like oxygen, food, water, but I'm like, and sleep is that critical as well. And so these were these beautiful gifts that just started kind of unwrapping as I was going through this simultaneous journey of raising a kid and growing a movement that was protecting parents yeah, that is so amazing.

Speaker 1: 13:24

Wow, I feel all of that. So how do you start like? Are you currently practicing as a doula as well, or are you training doulas mostly?

Speaker 2: 13:34

yeah, I've gone in and out of retirement three times. I've come back out of retirement serving clients only because I really want to see what happens in another province, because it's a completely different system and I think, just the curiosity in me, I want to, I want to practice in this system that I'm currently living in so but I I train full time, but I did.

Speaker 2: 13:57

I had probably a six or seven year period where I was training full time and practicing full time and I think it's important that folks who are teaching in a field also stay as fairly active in the field, because stuff changes. I mean, I still in the parenting side of it. I've pretty much stepped back outside of you know, talking about mental health and bringing joy back to parenthood. But there's products that people will post and they're like what do you think of this? And I was like I haven't been in the kids story in eight years. So yeah, I don't know about that. But as far as seeing practices and trends and what are doctors doing, what are midwives doing, what happens with GP specialties, our nurses fighting back on a certain concept that doctors are, you know, digging their heels in, these are the things that you can only see what's happening currently, if you're very active in that space.

Speaker 1: 16:29

Yeah, I agree, I am at the point where I'm like, oh, I need to take a step back from the physicality of nursing. But I always say I have to do at least one day a week because everything changes. Everything changes. You leave for a week and you come back and everything changes.

Speaker 2: 16:44

So I totally see where you're at and you do you mainly do hospital or are you doing homebirth and so I personally my personal brand, I position myself as almost exclusively hospital births and I do that because the type of clients. I have two main types of clients. One is like really type a professional women, and so they do a lot of like how do I do this? And fast, and I, they need, they need somebody that's like, yeah, yeah, totally type A, love a checklist and getting in there, and then I'm like, okay, so you can't, actually this is a magical thing you're about to do and you can't. Requires magic. Yeah, requires magic.

Speaker 2: 17:22

And so I do a little bit of a bait and switch. But I'm because I'm also super type A and I do things fast and I talk fast and I love a checklist, and so I'm like, yeah, we'll do it, like fast, fast, fast, and then I go in. I'm like, okay, so, so this is how we have to do birth together. So that is my one demographic. And then I serve queer clients. I try almost exclusively but and then just kind of like pepper in straight folks and so I serve lesbian two parent families and it's my specific demographic and there tends to be a belief when you've had a long, high intervention fertility journey which queer people have to have because we're queer, so that there tends to be a more leaning towards hospital birth, because somehow they've had a like it wasn't easy in, so it's not going to be easy out. We also do a lot of work to check in before we choose our birthing location to be like you know how did we land in this place?

Speaker 1: 18:17

You get to do whatever you want.

Speaker 2: 18:18

And so, because of those two demographics, I find I have chosen to protect in the space that actually requires the most protection. Home births don't require as much. I think they're magic. I love my home births. That I've done. I've done lots and lots of them. But I want to make sure people are safe in a system that, for a multitude of reasons policies there's never enough nurses and they expect nurses to do the job of 15 people, which is inhumane. And so, because of that, there's a lot of role for somebody, the need for somebody who's trained in reproductive health to have that continuous care.

Speaker 1: 18:53

Well, in addition, when you bring somebody in, a peer support person that you know well, the additional people that come in, like I feel like I'm invading someone's space and sometimes, if I haven't really gotten to know them I mean I have 12 hours sometimes, sometimes less, because it just depends on the turnover if I've taken another patient I feel like it is so much better to have somebody there that knows you, that you've developed a relationship with and that's not always your OB, because that's, you know, the practice is routine, that as well.

Speaker 1: 19:22

Yeah, also that you'll see them at the end.

Speaker 2: 19:26

Yeah, and it might not be your OB. You guys, I had an OB Dr H, we'll call him who followed my pregnancy back in 2006 and 2007. And I practiced in the same hospital. Most of my clients birthed at this one hospital in Toronto and I had attended probably 80 births before I ever saw the OB who followed me in a rotation. So not only did I not see him at my birth, I took about well 80 births at least Before I ever saw him again. And I actually thought I dreamt him because I was like how I've been at this one hospital so many times, 80 births at one hospital, because there's I don't know 10, 15 hospitals in Toronto that you could birth at. And I was like, oh, he's real.

Speaker 1: 20:19

And friends. That is normal, so you've got to love the practice.

Speaker 2: 20:22

Yeah, it's not your doctor walking in the number of times I've said that to people in consults and they're like so you probably won't see your doctor and they're like what it's like? Yeah, there's 18. Unless you have a specific agreement with that doctor.

Speaker 1: 20:35

If that doctor has said I will be there, no matter when you give birth, I will drop everything, I will come back for my vacation. I will do all of these things. Unless you have that in writing, you are not getting your doctor, it's just you will not see your doctor.

Speaker 2: 20:49

I mean that I do want to fly here in Canada when you have your family doctor who's got an obstetric specialty so they can attend. You will always see that doctor because I've had any of my clients with it and the care is actually really wonderful. I always it's probably my favorite is actually working with GP over all the types of people who will catch baby. But I've seen like a couple of them that have literally rushed home from their cottage or come in in a suit or come in like clearly not intending that their client would be in labor, because they come back for all of your birth.

Speaker 1: 21:23

That's amazing, yeah, because general practitioners are declining. The rate of general practitioners are declining in the United States. I don't see it as much, but I know that they exist. I just have never actually worked with one. But we do have some private practice physicians. But then again, I mean they're going to try to get there for your birth, but they will find practices to cover them. So unless you schedule an induction, and still because if you have a five day induction your doctor's not staying for that, I'm sorry.

Speaker 2: 21:53

Yeah, it's nice to see someone familiar and because I was so active I'd so so many clients with, like in my 20s and 30s, I love the relationship I had with the nurses because I would come in and they would just like hat tip and like tell me what room I'm in, and then they just knew Bianca will call me when any of these things happen and because the less people coming in and out of the room, we actually see better outcomes.

Speaker 2: 22:17

And so because I had had that trust with the staff at the hospital, it was really great because I was like could truly provide that uninterrupted, continuous care, because they had that trust with me and so they knew if any of these things happened and I would be charting, you know, for my clients and it was, you know, just the way I did my practice.

Speaker 2: 22:37

It was really really nice for my clients and so word of mouth was great because people would be like, oh, bianca was like pretty much the only one there the whole time, which is atypical for a doula. But it was because of this foundation that I had built and so they knew just keep that door closed and don't open it, especially because I had a really, really high unmedicated birth rate with my clients, mostly coincidentally, just because they felt like safe and calm, and they were surprised that it didn't have the sensation because we stayed out of that fear, the fear, tension, pain cycle, and so they were like, oh, I thought it was going to be way worse than that. I was like, no, that's that, was it, that's birth.

Speaker 1: 23:13

Yes, I want to go back to the fear tension pain cycle at some point, but you can doggone it whenever you want, yes, but I want to touch on the importance of doulas that are specifically prepared to take on everything that entails a hospital birth to serve their client rather than an agenda. And I recognize, because I don't always love the way that we do things in the hospital, but I feel very empowered to make sure that the way that I try to exert change isn't in an argumentative way. I have, in the past, been argumentative, I have, yeah, and that we've all done it.

Speaker 1: 24:00

I have been called out on that. Yeah, Because in the beginning I was very outspoken. I'm still someone outspoken when I need to be. I mean, I have an entire platform now so I feel less obligated. You could do whatever you want Right, but I find that in general relationships with current births and current providers, that doesn't have to happen in the room that isn't the space for that.

Speaker 1: 24:23

No, we don't need to be doing this in front of the patient Right now. We just need to be focused on this person and how to have the best birth with the people that are in the hospital, with the hospital policies, and work with all of that in order to give the most uninterrupted care possible and keep people in this normal cycle scope, you know, so that everything looks copacetic, so that nobody wants to come in the room and change things.

Speaker 2: 24:48

Yeah, yeah, For sure. I love that. You said that so just like it's going to sound like a really nice plug for my doula training. But the reality is most doula trainings are a crash course weekend.

Speaker 2: 24:59

And that was one of the problems that I solved because I went through that but I had my pre-med done and so I was like that was not enough If I didn't have that invitation. That is not enough to go into a medical field. Even if we do not have to do medical care, you do need to know. If somebody's talking about blood pH, I need a doula to know. If their client looks at them scared, what does that mean? I want them to know all the tests, all the procedures. I want them to know how the hospital equipment works. I want them to know what the terms mean. What is slang in the hospital? I want them to know how to work with hospital staff because we're in their house Doulas and doulas out there listening, we are in their house. We might not like their house, but we're in it. Right, and that is not the like what Kelly just said. It is not. The platform to make change is not in the birth room with a client. That's where you protest.

Speaker 1: 25:49

That's where you let it write.

Speaker 2: 25:51

That's where you do your thing. You take it to the administration. You do all of that after the birth, and so in my training it's a four month while you're in school, and then it's about a year and a half after that of your practicum and your certification package. Because I want people to know the magic of birth and parenting and fertility, I want them to understand the medical deeply and feel confident, so when they go in there they don't have this like I don't know where I fit in this space. So they, like very clearly know their scope and their role and then how to take care of the informational, emotional and physical care of their clients, including, you know, a deep understanding around mental health and how that plays into our physical health and experiences. And so it's such a comprehensive training. And it came from the fact that I watched how doulas worked in a way that I was like, oh we, I wish people were better trained, because I don't want them going out and doing this in the space, because then people talk badly about doulas, like most doctors and nurses are like, oh, we don't really like doulas because XYZ and that's not going to serve, like we can't have somebody who's there to protect. It creates the optics of like somebody is really good and somebody's really bad, and that's not going to work for protecting birth and the role of every person that they've committed there, even though sometimes it's gotten a little complicated with, you know, when we've got a fiscal involvement and the tiges involvement, it's backed up the waters. But we all claim to be there to protect the birther and the baby, and so if we could hear one another, we can do way better for them.

Speaker 2: 27:25

And so the doctors. Unfortunately, as it became a surgical specialty, they lost the magic. The hospital loses the magic because the hospital is there for sick people, not for birth. And so you know, knowing these kind of elements, we do need somebody in there. That's like it matters if the lights are on. It matters if we're debating in front of a client slash patient. It matters if people are chatting about something else, like there's a person coming into the world right now I don't care that your car didn't start this morning, like, take it out in the hall.

Speaker 2: 27:54

And so I had to learn what worked, what didn't, what made me feel good after, like when did I walk out and be? Like? Everybody won in that situation? The conversation stopped. Nobody felt shame and my client didn't have their birth interrupted, and so it took me a lot of trial and error and obviously with humans it's infinite number of possibilities but a general concept, theory, kind of method of how we can keep our ego out of the space as healthcare practitioners truly serve our clients as well as correct and commit to change.

Speaker 2: 28:26

We all need to be committed to change, but I know as a fiery younger person those are actually the markers of why I retired to a couple times was because I did it the wrong way and I either stayed quiet when I felt like a lot of shame when obstetric violence happened or I popped off in the time that I was like that was their birth. That wasn't my activist platform. Grab your megaphone and take it some other place. Now I will always literally use my body and force if there's human rights violations. That's like that's a no go for me.

Speaker 2: 28:58

So if my clients have said please stop touching me or you can't do that, and somebody continues to do it in any capacity, that's where I'm like deeply committed to be like they actually said stop, because anywhere else if somebody says don't do that to me, we have to stop doing it. But we have to be working as a team and I think it's really important that you highlighted that, because as a younger person also did the same thing. But like we cannot debate stuff, we cannot lead, guide for change. These are sacred moments. These are one time. It's that one time these parents are going to be birthing that child and meeting them and meeting them. They're meeting their baby. That's important, that matters.

Speaker 1: 29:38

Yeah, and even though, like, even if it's like the hundredth time for me, that doesn't matter. I want to validate that for you, because there are times that I've popped off, there are times that I have not said stuff, there are times that I didn't even know, like that, I've just been so trusting of the people that were above me and quote unquote or the people that were more experienced than me that I didn't even realize that there was another way to do things and that it was just like. This is how it's done. I mean, I remember my first cervical exam when I was pregnant was incredibly painful, but for me I didn't feel violated because I wanted to know where I was at and when I went in to become a labor and delivery nurse, people that I was working with.

Speaker 1: 30:25

Now this has changed significantly, but this is like eight years ago not a lot of time, but eight years ago they would come in and sometimes they'll still say it, but then I try to reframe it I need to check your cervix, and then they would proceed to check the cervix and patients would express the need to stop, and I was taught to just go ahead and get it done to minimize trauma. That was what I was thinking. Yeah, which getting something over with. And I mean there is a delicate balance. You can stop and say I'm almost there and this is going to be very uncomfortable. But if you want, if you truly want to know where your cervix is at, if that is your desire, or if you want to have that information so we can decide how to proceed, then may I proceed. But continuing without consent it's not good, yeah, I mean.

Speaker 2: 31:14

And then it's full trauma, like anytime. Somebody just continues doing something to me when I say stop, it's violating and most of the things I'm going to say we, because it's the field of reproductive health injustice, even though I'm passionately on the other side of this, but like the idea that most of the things that happen, they all feel urgent to healthcare providers in the hospital and so I'm like we actually never need to touch a subject Like truly.

Speaker 1: 31:41

I know that people say like I don't know.

Speaker 2: 31:43

But we don't. And so when we're in the OR, if somebody says, I can feel that there's an immediate action, because that means the freezing is not working, like you know, and we jump to action because we don't want that. But literally outside of that, there's not a single thing that we couldn't just stop and be like okay, well then we just not going to know. Or like okay, then we don't get the IV. Or like okay, then, like there's, there's nothing and nothing is that urgent. Yeah, that's not, that's urgent.

Speaker 2: 32:11

And unfortunately, the nurses are truly getting the brunt of it. And so, kelly, as a nurse, I see you and I see how it's actually policy that goes down to administration, that goes down to the president of the hospital or hospital system, that goes down to the board, that goes down to the doctors that go, and then it drops down. And so all this urgency, all this risk of litigation, all this busy work, all this charting, all this client care, all this responsibility lands on women mostly, who are put in this caring role, who are the least paid of the, of this hierarchy. And then doulas are considered quote below them and we're paid an eighth of what a nurse is paid, and we never know when our shift is going to end. Nurses are like, well, it's done, bye, like I could be, like I might go home tonight, I might not be home for two days, and so this is the system, and really we're having these like complicated urgent feeling, sometimes opposing goals, with a birthing person in the room, and it's because of all of these other pressures.

Speaker 2: 33:13

And so I watch nurses and I'm like, oh, this sucks, because I'm feeling mad at you right now, and it is. I very quickly can pivot to be like it's not you, it's your charged nurse, who's then got this nurse? Who's then got this doctor, who's then got this policy? And all of it is is pulling in the wrong direction from what we should be honoring around birth. I mean, all of it pulls in the wrong direction, even from what the World Health Organization recommends. All of it's pulling against ACOG, and in Canada that's the SOGC, which is the governing bodies for obstetrics, and so when we truly step back, we're not even following the guidelines that are evidence based, that are outlined, and so, anyway, I could go off on like a million tangent, but well, there are ways to.

Speaker 1: 33:56

I guess what has taken me the eight years of practice or maybe less, because I think I realized this a couple of years ago and that's why I'm doing this right now is there are gentle ways to establish trust with the charge nurse, with the medical provider, whether it's the midway for the OB, with the patient, to be able to start to find out what the patient wants. Because if the patient wants to go up on the pit and get the baby out, okay, that's your choice, right, that's their choice.

Speaker 1: 34:25

But if that's not their choice, well then there are specific questions that you can ask in a way that is not threatening, so like if the baby looks great, you know, you can say, well, what's the urgency here? You can say they want us to keep going up on the pitocin, but they're contracting every two to three minutes and the baby looks good and we've progressed from four to six centimeters. Like what? Maybe we can just hold off, let's just check. Why don't we just check in a couple hours? Yeah, you know or don't. And then when patients are saying when are you going to check me next, then my answer is well, you let me know when you feel some pressure, I'll watch the baby for science, that you're ready to deliver. And if a baby delivers in the bed, who wonderful? Yeah, totally, that's what they're supposed to do. We're here to have a baby.

Speaker 2: 35:06

Yeah, and it's interesting because I teach my clients just like questions, to be informed and I never care how people birth. Like literally there's a menu that's so long you tell me what you're choosing, there's literally no best way to birth. There's the best way for that person or the ideal way for that person and I learned this the hard way, y'all.

Speaker 2: 35:28

Oh my God. I thought in my mind when I started, obviously like home birth was the best birth, and it wasn't until I like I'm laughing, I feel a lot of shame about it but it wasn't until I had a couple of people that I encouraged them to stay until it was too far for them to go and they birthed at home, and it took not one but twice of this happening of my clients. After being like, I feel tons of grief that I birthed at home. I wish I got to the hospital.

Speaker 2: 35:56

I really wanted to birth in the hospital and I feel really sad and I'm struggling and I'm seeing a therapist Now. I didn't like push them to that point. They also had three or two or three midwives there. They had a partner there, Like I was, but I was. I contributed Part of the team.

Speaker 2: 36:09

We're almost there. Do you know what? Do you know what? We're at? Eight centimeters, you know, even though we were so close to the hospital that they could have got there and they could have pushed. That's what they wanted. They wanted to birth in the hospital, for whatever reason, and it's none of our business, it's there and it's how they felt in that moment. And it took two times of clients being like I hated my birth because I didn't get to go to the place I wanted to go and I was like the hospital. You birthed at home and they were like I wanted the hospital and I learned in those moments that I do not know what's best for anybody and what I would have deemed best for me was it's not. And so people would feel grief from unmedicated births, which everyone is like. I had an actual birth. Some people feel grief. You had a guest on your podcast that felt a lot of grief about her unmedicated birth.

Speaker 2: 36:59

That it was just a precipitous labor and she had the baby, and that an elective C-section is the most empowering amazing things, unmedicated, to a certain point, just nitrous birthing in the water, not in the water. There's an infinite number of births and I think that it took me a while to learn that, standing back and letting people birth how they want. But unfortunately, when you go in the hospital, the likelihood of you having a very cookie cutter birth is just so profound.

Speaker 2: 37:30

So I do teach my clients to ask questions, not to be challenging, but to like get information, as you should when we're going through anything about our body and our children, and so I know in I think every hospital in Toronto and I've supported birth in I don't know 18 different hospitals in my career and when client, when they're like so we're going to put an IV to start pit, or oxytocin, pitocin, centocin you might have heard all of those terms. Everybody listening Kelly knows all about it.

Speaker 1: 37:57

So that was where all of you listening?

Speaker 2: 37:58

not for Kelly. And so when they're like we're going to start pit and my clients go, oh, tell me about that. Like what? Why? What are the benefits, what are the risks, the number of doctors, doctors, you guys that are like, well, everybody gets pit. And then they look at me. And then the doctors always look at me because they think I'm the one that's going to, like, mess up the system here. And I'm like, guys, do you like that answer? Are you ready? Do you remember what pitocin is? Do you have follow up questions?

Speaker 2: 38:23

Because everybody gets pit is not a good enough answer to do a medical treatment, especially when we now know Dr Michelle O'Don's research on what's happening to our brains with prolonged exposure to pitocin, when we have just been using it so fast and loose for extended period. It's one of the contributing factors for our struggling for vaginal or pelvic births. It's one of the reasons why we're having issues with feeding from our body or milk supply. It's why we have a rectile dysfunction. All of this is literally this atrophying of our brains from having this synthetic version of oxytocin, which is like fascinating research. And so when I look at these doctors, I was like there's actually a lot of risk for you saying, well, everybody gets it. It does have really great perks in that it leaves our system really quickly and we can turn it off and if the baby doesn't like, there's some good things that we other things. Once that trains on a station, we're a little more on it.

Speaker 2: 39:19

But everybody getting something is not a reasonable because, for sure, pit is going to probably be a full stop barrier for somebody having an unmedicated as far as pain management birth. And I've had clients who, for their reasons, can't have narcotics or choose not to, in which case the epidural is off the table for them. So I have seen pitocin used without any other pain management. But I think people need to know, just so you know, if you start pitocin, you will probably almost 100% need an epidural. And so when we're saying it casually, like well, everyone gets pit, let's just get that IV started. That's where having a doula there to just slow it down, to be like should everybody have this? Because it's not advised for every birth, or to walk in and get pitocin, it's not advised for every birth, or to get even an IV put in, or to get regular cervical assessments to birth on our back, like there's all these things that all the governing bodies are saying that that's not the right thing.

Speaker 2: 40:17

But it's very interesting to see the practice based care that happens. Just because it is, it's passed down right, like that's what? Yeah, so I was trained, and then that's the next person trained and I mean it takes a very long time. Look how long we had twilight birth. Look how long apesiodomies were regular. Look how long. Like it took decades. I mean I bet you didn't learn that active labor in nursing school, active labor shouldn't start until after six centimeters.

Speaker 1: 40:43

We adjust, actually, because I went back to nursing as a second career, so I graduated in 2013 and they just started talking about the change that was coming. That was active labor at six centimeters, so it was just like right on the cusp, but it didn't actually happen in the hospital.

Speaker 2: 41:00

No, no, it's hard to find. I correct people all the time.

Speaker 1: 41:08

One of the things that I like to distinguish is the difference between an IV port and actually getting hooked up to something.

Speaker 1: 41:16

Oh, please explain that to everybody so while it is important to walk in the room and say, may I start your IV, you're going to get some pushback by your superiors as a nurse if someone says no, because that is kind of just part of the first steps is getting the IV port so that if there is an emergent need for medication that goes in the IV. That can stop whatever negative things might be happening in your labor. We have that access earlier rather than later when it's an emergency. But that does not mean that you ever have to have something hooked up to it if everything is going well. So if you come in an active labor you're contracting, doing all of the things progressing, going to have your baby without any interventions, having that IV port there doesn't mean we're going to do anything.

Speaker 1: 42:15

We may want to offer you some pitocin in the IV after the fact maybe, which can be declined if your uterus is doing the things that a normal uterus will do after delivery. You may also, if you are unmedicated, have the option. Well, I guess unmedicated you wouldn't really need the IM pitocin. But if you wanted to avoid extra fluids then you can request the IM pitocin, which is when it's injected into the muscle, that's the protocol here, but how did the IV?

Speaker 1: 42:46

port. Oh is it.

Speaker 2: 42:47

Oh, that's good. Yeah, I am a dose of pit at the birth of the posterior shoulder.

Speaker 1: 42:54

Oh nice IM pit. Oh gosh, that's so good.

Speaker 2: 42:57

Yeah.

Speaker 1: 42:58

Because the amount of fluids that we give people I mean it's one of the hospitals I work at we give over the four-hour period a 500 ml, which I'm not as concerned about that, but like to give two. We used to give two bags of pit and just bolus it and they had like 20 or 30 million units in it. That's too much.

Speaker 2: 43:19

Yeah, and there's a lot of interstitial fluid. We have so much puffiness.

Speaker 2: 43:22

I mean so when we talk about the IV Puff is probably with breastfeeding, oh, there's so many things, and just people feel crappy, like you're just your puffy, yeah, puffy itself. And so, like the IV is a really great example because I tell my clients that I mean I obviously teach them the difference between port and then a line being like actually running. But if somebody's like has had an uneventful pregnancy, they've been regularly monitored and they have no intention of having like they're going in, you know, spontaneously. So somebody went into labor. Naturally they don't. They don't plan on having an epidural and not in like I'm going to try, but they're like epidural is not part of my plan. That's where we see those like falling down, where people like I don't want the port in because they can be uncomfortable. You lose mobility, yeah, and so there's especially a lot of the birthing positions, because if you're unmedicated, you want to be able to be on your hands and knees, you want to be able to be holding the edge of the tub, and so that, depending on where the where the site is, and so those are the moments where we can, as a team, come together and be like I'm hearing the pressure from your charge nurse and this is because we were in a practice-based care rut. We're in practice-based because there's emergency situations, we'll go down to the ER. They never have ports ready for them and they see, really they see crisis situations Like there's. People are used to crisis care in a true emergent situation and the rest is a convenience thing. And then for my clients, when they're like, oh, I plan at this point to have my epidural, then I'm like part of your triage will be putting your port in because it's part of your plan. You've chosen this, and part of having an epidural is you have an IV.

Speaker 2: 44:56

And so I think that if we could start coming together on all the sides of like the vested interests and really stepping out to be like why is this important? Because what's happened in obstetric care specifically is that there's so much risk mitigation and they just keep adding up, and so all these things are to mitigate all these risks. But really the act of doing 15 things to mitigate risk for sure leads to risk, and so that's why we have all these really great tools, but birthing outcomes have never been worse. And so if we step back and we're like, all right, everybody, so we're doing all these things to avoid harm, yet for sure birthers are saying I felt trauma. These things happen. I felt pain, I felt scared. I didn't get to choose it, things got away from me.

Speaker 2: 45:45

So we're having that universally reported. Very few people are leaving their births being like that's great, they're like my baby's alive and I should be grateful, and that cannot be the threshold. So we're looking at this. So that's why, as a birth worker, when I get to step back without the pressure of administration policy doctors, chart, nurses, unions I get to step back and be like okay, so this isn't working. This isn't working for anybody. If what's gonna have to give here, is it gonna be that we don't put the port in? You gotta stop hassling your nurses when they go into the different rooms because their patients can decline this and in the case of a crisis which are so rare, like a true crisis.

Speaker 1: 46:25

Well, depends on where you're at. If you're at a high risk center, they're not for you, oh for sure, but for sure that's part of the problem with the high risk delivering low risk people.

Speaker 2: 46:33

I know, stop doing that. Hospital systems. I was in the highest risk hospital in Toronto because everyone was like, oh it's fancy. You know Mount Sinai Hospital, it's the best one there and so I meant, cause I didn't know and I was like, oh, everyone's saying you wanna have all of the options, just in case.

Speaker 2: 46:51

but they're gonna give you all the options, they're gonna give you all the options, I know, and so it's so complicated and unfortunately nurses get a lot of the brunt. I'm just gonna keep praising you, kelly, because Well, thanks, I appreciate that.

Speaker 1: 47:07

Well, and here's what I'm learning I've been talking to friends and colleagues that have been doing home births and trying to advocate for low risk birth in a more medical setting.

Speaker 1: 47:17

And I have a friend that's actually opening a low risk birth unit at a Huit Hospital and I am really excited to learn more about how we can, in a high risk hospital where we're opening a low risk birth unit, how we can merge that care because that's gonna decrease trauma. And I'm learning about how to keep people in the low risk category and then when we can start taking steps towards that so that we don't cause we push the limit so much at a hospital because you get these high risk people that come in that are trying to birth and there's such high risks that you have to have all of those things in place. And then the OR is so close that we're gonna help them try to have a vaginal delivery even though the risks are getting higher and higher and higher. And then when we have to tap out, we tap out and we go run to the OR. Ideally we're not running. Ideally we can tap out in a Sontor on over.

Speaker 1: 48:09

Right, exactly, is this urgent or is this emergent? Is this emergent emergent? Is this stat? Is this stat stat? You know, like that's, we start getting these crazy levels, that so then, because thankfully we have the ability to afford a vaginal delivery to someone who is so super high risk that it would not otherwise be possible, we're treating everybody that way, yes, and that is unfortunately leading to trauma. But you know, the path to hell is paid by good intentions and that's where we're heading.

Speaker 2: 48:39

So, yeah, well, and it's. And I know, I know this because, depending on what's personally in my like, my personal anxiety, I do a lot of like. I can't carry that in, but like I'm a human person going into a space, you are, I know, I think, a human experience. I know I give different advice. I mean I try, I really try not to, but I know that I'm like way more like well, you should just keep the monitor on, or like you know what. We haven't had a check in a while. Let's call the nurse in with the Doppler. When I'm feeling personally anxious about things unrelated to that, I feel very risk averse. If the nurse is like, so we know we're noticing some D cells. I know that I'm like, so there's some pink flags. Versus when I feel really calm and rooted, I'm like. These are fine.

Speaker 2: 49:22

Most birth is boring and unfortunately nurses who witness the most part of labor and birth of anybody in you do more than midwives labor and delivery. Nurses outside of doulas see the longest amount of labor and delivery, but very few nurses have seen what a truly uninterrupted labor and delivery can look like, and so I've had some of the busiest hospitals in Toronto. I can think of like five or six nurses that have said my clients were the first uninterrupted, unmedicated birth they'd ever seen. And so we have people that are trying to protect birth that actually don't even know what uninterrupted birth looks like Like. I've had clients that slept and the Doppler was showing some D cells, as in like the baby was low and she was asleep unmedicated because she had just put herself in this relaxed state and she had no sensation, and we were like, oh hey, sarah, could you just like maybe give a little push? Do you feel a bit pushy? Cause everything her belly was low, you know. The line on her back was up Like all the indicators was what's happening here, and she was still occasionally kind of like like lying on her side but for all intents and purposes was napping.

Speaker 2: 50:40

And then afterwards there was sort of first baby and she was like, do you know? I really thought this was gonna be like a thing. I was like, no, this is possible. I mean, it's not for everybody. So I don't want to paint a picture that if you don't get where you're napping, that you did something wrong.

Speaker 2: 50:56

Every single labor is gonna be felt by the body differently, but nurses don't get to see that and the doctors that we've put in charge are surgeons. They don't even get training about menopause. They don't know about infant feeding. They actually don't know the bigger picture about reproducing bodies. They know surgery and so they got trained with cardiologists and with general medicine and like they learned about cutting and it's probably really thrilling cutting into people's organs and this Godlike state but they should be lifeguards, right?

Speaker 2: 51:28

And so, if we use that analogy, most people swimming, your lifeguard doesn't come and like move your arms and legs. That would ruin your experience of swimming. They're there, you know, if they were like, but I can. But what about this flutter board? What about if I put a pool noodle under you? What if I held your arms and you just kicked your legs Like you'd be like I was actually really liking the freedom of swimming. But they should be there if we're struggling or drowning or we got tired or you know. But and that is truly what birth support should look like the practitioner in the room One of my this Dr Ables. He's a GP. I don't know if he's still practicing. He's a GP who catches babies in Toronto. He literally stands and nobody can see me, but I've got my arms crossed.

Speaker 2: 52:15

And he leans against the wall and the nurses, like he has his privileges in the hospital and the nurses come in as if you know he's the primary care practitioner there and he'll be like we're good, and the nurses will come in and they'll do like the things, like you know, whatever needs to be done, some of the charting and stuff. But if anybody goes to touch, goes to touch the birther, they'll be like nope, nobody, nobody needs to touch her. And I've seen my clients. I get so excited when my clients have him as their healthcare provider where they literally have no touching, nothing, nothing, nothing, nothing, nothing until the apcar.

Speaker 1: 52:48

Nobody touches them.

Speaker 2: 52:49

He's like there is no reason for us to touch. He's taken a doula training, he's taken hypnobirthing, he understands lactation and he's like nobody needs to ever touch for a medical reason. He's like I'm literally just here and he stands with his arms crossed, he doesn't leave, he doesn't go nap, he like just watches. I mean, at the end he's not there the whole time, but he's like around the whole time and I'm always like this is amazing, but we're taught to do things Right. You walk in the room and you're like what should I do? I should Something's happened.

Speaker 1: 53:19

Let me just tell you the throwing of the bulb syringe. Every time a baby is born, like the handing of the bulb syringe, throw it across the room. We don't need it. You don't need it, you don't need it. Babies have been breathing since the beginning of time. We didn't suction their nose, we didn't.

Speaker 2: 53:36

None of these things. So when I think of this low risk ward that your friends is part of, it makes me very excited, and I always get too excited because I think that we might maybe adopt countries' policies who have the best success rates, like we could look to some of these countries that are doing this well. So there's some parts of Europe. There's parts of Latin America. Unfortunately, we always publish the hospital parts of countries that redeem less valuables based on their GNP, but those countries, when we actually go to traditional birthing practices, have incredible birth stats and their hospital stats suck, but so do ours Like. So we're not one we shouldn't be like. Maybe we're doing something wrong. Yeah, we're doing, we're for sure doing something wrong. So I always get really excited because there was a new hospital in Toronto that had the same thing. There was a hospital called Women's College in Toronto and they were moving and they were building a brand new hospital like a new build, not like a reno, and I was like shit we could do. Oh, sorry, can I cuss?

Speaker 1: 54:34

Yeah, ok, I just think the bar goodness is.

Speaker 2: 54:37

E. This is brand new hospital and I was like we could do anything. Like I hope you guys went to Norway, I hope you went to the UK, I hope you went and talked to traditional practices. I hope you went to the Middle East and saw things there. I hope you went to parts of Africa that are like protecting fiercely some of these practices. Like I hope you went and did some stuff, because you guys have a billion dollars and you get to build whatever you want. And then I walked in and I was like it's the same as every other hospital, just modern colors and a better mini fridge next to the thing.

Speaker 2: 55:09

Because imagine if we took the beds out of hospital rooms. The research that it's been done. So there's research. The outcomes were profound. They were profound around the less interventions, powerful birthing. Like people just didn't want to like stand and watch. People stayed closer when they were actually there for help or they just didn't come in the room. Magic happened.

Speaker 2: 55:32

But when you talk to practitioners they're like, oh, but how would I? How would I? And I was like maybe we center the patient and not do it in the weird way of centering the patient, because if I'm comfortable, I'll be able to do better care because it's still not centering the patient. But when I hear these things I always assume we're going to maybe take, do the right thing and like find some information and go. We have studies. It's not like I'm sitting here as a hippie idealist being like what if we took the beds out of the room? I was like we have the research. I'm literally. Everything I'm talking about is statistically proven, evidence based. It's not my feelings of magic and unicorns and like what would happen if the OR actually went out five degrees. I know what would happen better outcomes for surgical birth. Babies would not be cold. They would not be cold. We would not have some of the infections we have. There'd be general like wellness. We have the research y'all and yet we still keep the room at the place where we know it leads to poor results. That's crazy to me. So when I think go into my protecting the birth space, I want to believe the hospital is there to serve my clients, but like the OR is not at the right temperature, so I just it creates doubt and so I want to.

Speaker 2: 56:49

I always am wildly respectful of the practitioners I work with again, unless there's human rights violations and I'm like where's the entry point for all of us to hear one another and to pull the stats? Because, like I said, there was an interdisciplinary board that we had a six year. We had funding for six, seven years of tackling HIV in Canada for reproductive health. So, as it was interdisciplinary, so I came as a lactation and as the dual representative on this panel and so we had like folks fly all over the world. Like the meetings were huge, they were like a really big deal and we were doing longitudinal research on what does it look like from conception with horizontal and vertical transmission, so like from partner to partner and fertility, or to baby and birth, or and then it's illegal to bring your baby to the breast or chest in Canada If you are HIV positive, regardless of viral load. So there was like a lot of things to tackle there, of like how do we take care of families living with HIV?

Speaker 2: 57:46

And I remember one of the first, one of the first meetings and I felt really intimidated because I was still in my like paradigm shift of feeling less important than a doctor and all these doctors with profound placenta, the type of research. They were like this room of geniuses and me Well, I'm a genius too, but in my shift you are, and so I remember sitting and, and so we were. One of the things we want to talk about is how do we support parents in getting formula that was unbranded, because what happens? What happens? Because you can't even bring baby to your chest, it's illegal. And so, because a lot of people don't disclose their status, even to their family members, if their viral load is low, there'd be no reason I'm talking to their partner, but like to extend a family that they would know their HIV status, and so they were all talking about it in such a like, a cold way, and I remember saying well, there's some shame and confusion if they haven't disclosed their status, and so it's not just about you know these things, and the whole room went silent, like that.

Speaker 2: 58:42

I dropped this profound thought of humanity that I was like so what's our plan around supporting people who haven't disclosed and having formula come because it's free for families with HIV. The formula is free because they can't feed from their body, and so it gets shipped out by this nonprofit. But I don't want an infomail box showing up at their house, because then people it's signaling that they're not feeding from their body and I don't want them to have to, you know. So I brought some of these things and the room went silent, like I had just like cured cancer or something, and it was, and I was like, no, this is. They're like wait, who are you?

Speaker 2: 59:19

I was like the only non-doctor in the room and for some reason, the one that remembered the people that were serving, because it's cool, like I can't wait to see the stats and the research of what happens with placentas, with HIV, I can't wait to see what the different types of birthing methods do for vertical transmission. There's stuff that I'm really excited to participate in and these are families that we're talking about. There are humans involved. There's human involved. And I couldn't believe that because I kept thinking what am I going to add to this conversation? We've got 28 or 35 of these like genius, researchers and OBs, and then I don't know, I was like, oh wow, what are we going to do about this? I was like, well, at least it's on the docket. Yeah, great Addable at point.

Speaker 2: 1:00:10

There you go yeah, at least it's on the pinboard there.

Speaker 1: 1:00:14

Yeah. So I want to go back to this tension pain cycle. I forgot the other three points that you talked about. Yes, fear, tension, pain, tension, pain cycle. Because I tried for a natural birth my first time and it got to be too painful, probably because I didn't feel empowered to do the positions that felt comfortable, and then also because I react to my perceived pain with tension. It doesn't matter if it's a headache, it doesn't matter, that's just my body's reaction and I've come to recognize that I am probably that person that would always need nephadiral. But for people that want to prepare for trying to mitigate the or trying to get into that cycle and like kind of shake it up, yeah, and not perpetuate the fear, pain and tension, what can you offer? That doesn't just happen necessarily, unless you've already done the work.

Speaker 2: 1:01:11

Okay, here's my thoughts on pain, because this is all the time. So, like you, I'm a white knuckle. I've received some sensation and then I'm like tackling it. So I tackle it like I can conquer it, and then you're tackling it, but feeling like I'm going to lose this battle. This is going to be too much for me. So, but it's this. We're doing exactly the same thing that's going to lead to not a great outcome for us, an outcome that we're suffering within, and I don't even mean about birth.

Speaker 2: 1:01:41

And so when, specifically with birth, because a lot of times we talk about pain is this general thing? So we liken injuries, headaches, other surgical experiences we've had broken bones and we try to talk about how? Where does birth fit into this hierarchy of pain I've experienced, which is hard to name for anybody. And so what I first like doing with my clients is explaining that let's think about this the hand over here that's got the birth sensation. Let's first just use the word sensation, and it's not because I'm trying to be like there's no pain. I just like for the sake of let's first use this tool to tease them apart. So injuries are pain and they're signaled because our body is in a crisis. So, like we need to change, we need to have care. It's like it has a reason for signaling pain to our bodies Birth. The pain is actually coming from the type of sensation that we're experiencing when we're tense, because we're prepared for it, as pain as the word we're using. So our body is already prepped and we're like, oh, that time I broke my fingers playing basketball. That time I slammed my hand in the car. That time I had to have my appendix out. That time my wisdom to start. Like we're ready for that, which is already because we have an actual, really great system, if it was allowed to just do what it wanted to do. So first we're going to talk about the self. If we could start just imagining it as sensation, it leaves space for us to understand why a lot of people have a sensation that they would deem as like negative or overwhelming, and that's so.

Speaker 2: 1:03:24

The uterus has the different layers of muscle groups and one group is doing its job of squeezing and it's going to happen, no matter what. It's like throwing up, like you can't stop it. It's an autonomic function and the other one is tied to it can stop based on us being scared. So we're simple. I mean, we're very complicated animals but, like any other animal, their labor stops if they feel scared and they need to go somewhere else.

Speaker 2: 1:03:51

We, unfortunately, for the most part, don't have a lot of options about where we burst, and once we're at the hospital, it's really hard. I mean, I have had clients that are like this isn't for me, and they pivoted because they were like I don't like it here, this doesn't feel good, you're being rude or whatever the situation was, and I'm like scrambling behind me like wow, okay, what's our plan here? But for the most part we can't change birthing location, and so we have this concept that the one muscle group is working away into a tight, closed other muscle group because we've tensed up and so our longitudinal muscles and our and our round muscles are going in like opposing forces almost, and it's that pressure of ones pushing down to a tight, closed muscle group that we actually have a lot of the sensation that we clock as pain. Now, that's the south, and so, if we have the ability to feel safe and relaxed, all of our hormones and muscles are working in unison.

Speaker 2: 1:04:46

Unfortunately, the environment that most of us birth in is not set up in a way that that protects the intimacy and vulnerability of birth. So a lot of we should really be birthing in a similar experience that we like to have sex in, and sex like leading to orgasm kind of like, where you feel safe enough to, especially for folks with internal sex organs or women, we require a very emotional and physical combination happening, and so our birth environment of being like cold, watched strangers, lots of people there, scared discussion of pain, being like first and foremost, like how's your pain? We're prepared and birth feels like everybody's going to die at any minute. That's how it's presented to us. So we actually are born not scared of birth. We're taught to be scared of birth and so we have this perfect storm of all of our muscles working not in unison. We don't get the opportunity to have those hormones flood because you know a lot of the things like even ptosin interrupts those natural pain, those pain protecting hormones that we have, because ptosin, the synthetic version, does just the mechanical but it doesn't cross the blood brain barrier. So we don't get that feel good, we don't get that flood.

Speaker 2: 1:06:03

Our frontal lobe doesn't turn off in the hospital when people talk about time, when they toss questions, like you know, nurses come in and it's because it's the environment. So it's not, it's just what we do. We come in and we're like, hey, what are we having in here? How's everyone feeling? Did you get a chance to eat all of those things? Create more sensation because we're now using our frontal lobe, our thinking place, when we should be checking out and having no concept of time. Like I cover clocks at home births because I'm like I don't want you to know how long it is and at the end they'll be like that must have been like 45 minutes and I was like it was seven hours. But that's what we want. We want labor land and that's when our body is physiologically doing what it is supposed to do.

Speaker 2: 1:06:47

So the fear tension pain cycle was discovered when a UK doctor during the war, dr Grant Lee Dick Reed, who is a terrible human I always just need to follow up with that. He hates women and for some reason he's got a lot of reverence in the birth worker community because they just remembered this contribution. But his rest of his lifetime he was a shitty, shitty man. He did. He did ponder why did women in hospitals because he was a young doctor why did they in hospitals have so much theatrics and yelling and drama, and why was it such a crisis?

Speaker 2: 1:07:23

But yet when he went into areas impacted by war, women were birthing and it was like a kind of non-event, like they were short, they didn't make a lot of sound, there was, there was no crisis. He actually like didn't see crisis in birth, but every birth in the hospital was a crisis. And so he started exploring what is different, even though this one should be the most ideal situation in a clean, safe hospital, and you're birthing in war-torn, with active fighting around you and you still have uneventful birth. And it was because birth was not treated as a prepared travesty with all this pain and suffering. Like I had a really, really long unmedicated labor and I'd say there were stages that I could kind of remember as like painful, but mostly I was tired, because we're also really sedentary and so it's a bit wonky to be like don't ever move your body and now expect your body to do this very physical thing.

Speaker 2: 1:08:19

And so there's lots of things that could be about the individual, about the system and about the environment. But really, if we just started with the concept of, it might not be painful just as planting the seed and it's not to fight against. You know 200 years of what we've been taught as far as birth as a emergency and birth is in the hospital and hopefully you and the baby will survive it. We could plant that. It could be something else. I mean, we have women have orgasms during birth. They literally perceive contractions as rolling orgasm and that was just because they're the exact same hormones and sometimes I tell my clients that. But it's not to be like maybe we'll have this like super woo, woo, orgasmic birth, but just to be like. More things are possible than you screaming lying in a bed. Well, everybody's like frantic around you, the lights are on and maybe you'll survive it.

Speaker 2: 1:09:09

But unfortunately that is what birth looks like right now and if people had the opportunity to see that it might not be that we could open up transformative birth and with just simple changes. Like I never use the word pain with my client unless they say pain to me. I say how are you feeling? What's the sensation like? Where are you feeling? Fill in the blank. But if they say, oh my God, it hurts so much, there's so much pain in my back, I'm not going to be like, so you're having some sensation. I'm like, okay, let's talk, let's deal with the pain in your back and I'll say that word back to them.

Speaker 2: 1:09:40

But, like, I encourage them to let their care providers know when we get to the hospital. If you don't want them to use the word pain, or if you have words that you'd like to use, just let them know and have them put it on the door or something just to be like. Could you try using this sentence instead and it's not a big shift for care providers, just to be like, don't ask me how I'm feeling or don't ask a question when you come in my room.

Speaker 1: 1:10:03

I'm a bad nurse in hospital settings or in hospital perception because I'm like not doing pain levels.

Speaker 2: 1:10:10

But what is the pain level and what information are you going to get?

Speaker 1: 1:10:13

I'm like I don't care, they'll tell me if they want me to fix the pain. This isn't a surgery, this isn't. I mean, I don't go up when somebody's in the bathroom and say what's your pain level? If you're eating dinner, I'm not going to be like. So what's your pain level right now?

Speaker 2: 1:10:30

But like your level of fullness, like if I said to you I'm at like six out of 10 level of fullness what would it do for you?

Speaker 1: 1:10:37

I would like some more broccoli. Yeah, I would like some more broccoli, and it's just dumb.

Speaker 2: 1:10:43

People are like I'm at a four and I look around being like so what changed for anybody now that we have this arbitrary number of this person's version of a four, because your version of a 10 and my version of a 10 could be completely different. And I know they have the happy face charts. They go like happy to like super sad on the walls and I'm like what is?

Speaker 1: 1:11:01

super sad for you.

Speaker 2: 1:11:03

What are we learning about this when you point to that face Like.

Speaker 1: 1:11:07

I tell people that you're going through a wood chipper with your whole body on fire is 10. So nobody ever gets there.

Speaker 2: 1:11:13

But sometimes we have practitioners ask and I'm like they haven't had a girl, what are our options? So if they come in and say a six, what are you going to do differently for them? And you guys, there's sensation with having a baby. There's sensation and this drive to have an effortless, no sensation experience. I was like there's lots of things that need to happen. We need to be able to feel that Our babies need to go through the compressions of labor to finish the cardiopulmonary development. Like there's a connection, there's an urgency. We learn, there is an intensity. The system is like that for a reason.

Speaker 2: 1:11:50

So how do we take out suffering, because nobody should suffer in their birth? How do we take out suffering without sensation? Because we're trying to remove all of it and we're birthing them, we're going into parenting them. How do we connect to the fact that there's a lot with child rearing and there's a lot child rearing in our society because we're so deeply involved in their physical, their emotional, their religious? Like we've got all these markers of intensity, one of my favorite stats that I just learned. No, I've learned it for a long time, but I've heard it again and it came back like new information At home moms in the 50s. So people who did not have paid labor out of the home spent less time with their children than work out of the home moms today. I'll say that one more time At home, full time, not doing paid labor. In the 50s, mothers spent less time with their children than full time working out of the home mothers do today because of the intensive mothering model.

Speaker 1: 1:12:55

Yeah, that's what occurs. I mean, if you look at, like the leave it to beaver, the kids are just off doing stuff. That's the whole premise of the show I am, you know, june's not in a lot of scenes, I'm not going to. You know, like let's point that out, and dads at work, june's just bacon pies and beaver and Wally are just getting into trouble.

Speaker 2: 1:13:15

You really know the show, that's normal. You remember all the names, yeah, I used to watch a lot of it.

Speaker 2: 1:13:20

I was like beaver and the mom June. I could have grown up with them. I remember I found my paternal grandmother. Oh man, I take a lot of guidance from her. She's dead and I can still like feel a responsibility to what her purpose was on this planet.

Speaker 2: 1:13:35

But she was one of the first classes of women allowed in the University of Toronto Medical School during the war. She was tall and she was beautiful and she was probably gay. Sorry for putting that on a podcast, grammy. She was probably gay and she You're letting her live her truth right now. Yeah, there we go Living through that.

Speaker 2: 1:13:52

But she and she got into the U of T Medical School and the varsity basketball team. She was like really messing up the space here in the during the war, cause the boys were still all over fighting and then they came back and they kicked out all the women. So she was halfway through her medical school and she got kicked out, cause all the boys took the spots and then she had to go just get a masters in social work. So she got to do nursing or social work that's what they would let her transfer with and so she ended up with a masters in social work, which I mean I can feel her rage because anytime the patriarchy steps on my toes or like says I can't do things or doesn't give me funding for my business, I rage like my rage. I have a whole podcast about rage y'all, and so I can feel her anger Anyway. So I love her a lot and I feel like we're really deeply connected to her the older I get and understand her experience.

Speaker 2: 1:14:42

Instead, she had these six children a husband that she hated, who was quite lovely and soft, but it's complicated, and I found her notes, so she used to have these letters.

Speaker 2: 1:14:51

She would leave if she had to have somebody come help her at the house, and so she had three little kids.

Speaker 2: 1:14:57

My dad was the middle of bringing it back to motherhood, I promise, and she left this note that said walk Allison to kindergarten, close the gate and leave Tommy, my dad, out in the yard, put Douglas in the pram and just make sure you rotate the pram at like three hours or something, just to like check if the sun's in on the baby and otherwise.

Speaker 2: 1:15:20

And then her list of chores whoever was looking after her, the kids for these like one off days when I don't know life happened and they eat at this time and make sure they're eating dinner at this time, and like that was the full care. Instruction was like put the baby in the pram and rotate it out of the sun, but you were essentially hands free, like the kids who were like gonna stay alive, and then Allison had to be back inside at sundown, which I'm assuming if the baby was outside it was probably pretty late, so it would have been summer months, so like she had to be in at eight and I was like and they probably had a wash up teeth brush and then you were put to bed and that was an at home parent.

Speaker 1: 1:15:56

That's what it looked like. Baby's figuring out how to roll over by himself and tell me time, I guess I better do this, and now there was a big emotional gaps not met.

Speaker 2: 1:16:07

So I don't want to be like why don't we take a page out of that? We've learned a lot and we can do better, but we're still not really focusing on the emotional. We've just made a bunch of work because, yeah, tasks we're still not because that's what it were, but like that's what mothering looked like. Yeah, one day we'll get it right maybe. Well, there are places that have got it right and we couldn't be further from that mark. Yeah, for sure.

Speaker 1: 1:16:34

I kind of want to circle back to that fear, pain, tension cycle Because I feel like that's a huge obstacle for people. And people ask me and I just kind of want to get your take on it birthing people will come in and say I'm not as strong as someone who can do this without medication. And I've noticed not just the cycle of tension and fear and pain, but also everyone's anatomy is different. And coming from a place where and there's a couple of places I want to go with this coming from a place where both my kids were oxyput transverse and the sensation of that in the pelvis, that's a lot. And also patients that I have that have babies that are OP, so oxyposterior, so they're sunny side up the back of the head is pushing against the back of the sacrum, which is bone on bone pain and the sacrum is really painful.

Speaker 1: 1:17:25

Yeah, it's real bad Pressure, lots of intense sensations. And then when people ask me what sensations I felt when I asked for the epidural because they're asking me at what point to get the epidural and so when I got it, I say what I felt like was really intense contractions. So the smooth muscle sensations were like if I were having diarrhea from food poisoning and the entire body contracting in on itself in response to that expulsion sensation. Plus, if you've ever just like really rammed your toe really hard against something like that bone pain or maybe the sensation of something heavy rolling over your toe and you can't pull away from it Because your instinct is to pull away from it, yep, those are the ways that I describe those sensations. So then having to move through that and tell yourself that, even though those are sensations you felt before in a negative context, to be able to reframe that into this is not harming me In the context that if the baby's malpositioned, maybe we do need to do something about it. 100%, how would you advise? 100%, yeah, so, Please advise.

Speaker 2: 1:18:47

Yeah, so I would encourage you, because you get to be in the front seat of a lot of people's birth, rather than trying to liken it to another sensation, because I can't even think of a sensation. Actually, when you said the rolling over and you can't pull away felt the closest as far as the fact that you can't stop it. You have to move into it.

Speaker 2: 1:19:09

And so I liked that. So let's build on that and instead what I would say. So the two things. Let's put OP just to the side for one second. For sensation, if you say they're gonna be waves of feeling, getting them ready for the wave, and we're going to give you lots of tools at the peak of the wave and you're gonna have one or two breath that are gonna feel more intense and then it will stop and that's setting them up to be like, oh, I can do something for one breath. It's really the peak of a perverse surge or a wave or a contraction is very short and nobody unless they've chosen this, so like I'm a person who just wanted to not be touched, which is weird because I can never get touched enough.

Speaker 2: 1:19:48

I'm always like who wants to touch me, of my wife and my daughter.

Speaker 2: 1:19:51

Who's up next to rub me and tickle me and massage me. But in labor I was really like I don't want to be touched right now, which I probably. If I had had somebody that was safe, I might've changed that. But anyway, I do have clients that are like I actually feel really powerful doing this on my own, and so when we think of that wave, most people will need love of some kind. So they'll need a stroke that works with that wave, and so I find the things that they really like.

Speaker 2: 1:20:19

So that might be something that I run my hands really softly down their head and shoulders so it gets those goosebumps, it gets that oxytocin going. Anything that gives you that prickly neck head delicious feeling. It will require that and that kind of feel good. So nobody should just be white knuckling their surges or their contractions or their waves. And so that's where birth support, because a lot of times people are like standing watching them in the bed suffering and like that's terrible and that's where we get into pain. That's where I'd be like yeah, this is like stubbing your toe, because when you stub your toe you're like and you're waiting for it to come down.

Speaker 2: 1:20:55

And you're like I did something recently and it was taking too long to come down that I almost started feeling panicky, like you know where your like pain starts.

Speaker 2: 1:21:03

I can't remember what it was but I was like, oh my God, oh my God, it's still not down. It's still not down and I was like panicking. But if you had to have that every two to seven minutes for one minute to 90 seconds, that's really terrible and that's where we see suffering because we don't know how to take care of birth. And so if we even had the concept of like your people, who you've chosen to have in this room so hopefully you feel safe around them, can do something, and now for you they might, because it's pretty intimate to just jump in and start giving people goosebumps with types of touch. But that's where we can have positive and really like dropping into yoga voice, being like you have one more breath and cause. A lot of times we're doing like a fast care. I can imagine I get the benefit of standing there for 25 hours, but you have like an in and out and so just reminding every time you walk in.

Speaker 1: 1:21:52

Two or three contractions, yeah, yeah.

Speaker 2: 1:21:54

And so you just, every time you walk in, that you can't add more stimulus to the sensation, like your role would be like charting where they are, maybe not even looking at the toco, so that you can just like start feeling. What is that like? Like, what does it feel like if I didn't have a machine to tell me what was happening with their uterus? And then, just reminding them this one, they all be gone. And regular position changes leads me into the OP part. Because we did. I did it like I was the researcher, wasn't it all? I've read it.

Speaker 2: 1:22:25

There was research that showed most people walking into the hospital have a baby in an OA position and it's lying in the bed that babies go OP, obviously because their back is like the heaviest part in the hammock and so they just swing around.

Speaker 2: 1:22:38

And so we're running into these, like you know, epidurals, which are a wonderful tool.

Speaker 2: 1:22:44

Get on with your bad self, and that's part of your plan, and I have a whole handout. That's great, that like rotates you all the way around, including hands and knees, if you have the strength to do it, or enough, support people around you so that we don't have babies in OP, because for sure we're gonna get the forceps or vacuum in there, for sure we might get so close and then we're going to the OR and so a lot of times, if we're sedentary because we're told to like rest a lot in our last few weeks, like really slow down, your body's naturally gonna slow down, but we have to also keep baby in a good position, because no other point in history did we spend as much time sitting as we do right now, or in our driver's seat, which tilts our pelvis, like all these things. That puts babies in an OP position, and OP babies lead to a lot of sensation. It's agony. You get coupling, like literally your contractions start and then go down and then start again and go down.

Speaker 1: 1:23:39

It's not fun.

Speaker 2: 1:23:40

It's such a tease and they're so close together and they linger forever. And but it is because we're having these interrupting moments that our body doesn't get to do what it's supposed to, which then unfortunately makes the system look like nobody knows how to do it, because everybody's got OP babies and nobody's labor is going at the right, you know, one centimeter an hour, but it's because it's not allowed to do. Our hormones aren't working great. We're not moving our bodies. And that does not mean fitness y'all. It means literally movement standing up, walking, going in water, flutterboard, swimming, stretching, cat-cow, having a prop in the car if you drive for a long time.

Speaker 1: 1:24:22

Literally just moving. It's the pelvis. The pelvis has to move. The pelvis has to move Like this Mm-hmm, and so, like you know this, like, oh, I'm doing all these things that you can't know.

Speaker 2: 1:24:32

All these two can see I get on.

Speaker 1: 1:24:34

I get on on lives on Facebook and Instagram and just take a pelvis and I'm like guys, this is what you know like twisting, moving, lift one side, lift the other side, lift the sacrum, tilt the sacrum. All of these things, all the positions.

Speaker 2: 1:24:47

It's all dynamic and so in birth we should be doing the same thing, and so there's very few positions in the bed that are awesome.

Speaker 2: 1:24:54

We can use the bed as a prop. I love like I teach a whole class of like what you can do with a hill round bed, of like a million things, and so they're very cool for a prop because we do have a lot of flexibility with it. But for people who are waiting, either because they want an epidural at a certain point, or you're attempting to not have an epidural at all, or you for sure don't want to have an epidural being in the bed is not going to be your friend. And so because we want our pelvis moving and because rocking and swaying and squatting and sounding these are things that actually stop the sensation, because if we are prepared for the pain and we get tense and then we're trying to make it through and like hope that 60 seconds ends. That is really why people are like you know I heard about this other person that did it and unfortunately, people that are really loud about unmedicated birth talk about it in like a really marathon way. Now I always qualify, saying I had a long labor, but it didn't feel that long. Those were the numbers on my chart. I talk about it in a way that I was like it's pretty boring and the people that have really boring births don't talk about the boring births because as soon as you say, oh it was fine, nothing happened, nobody wants to hear it anymore. We want to hear like I would start giving birth in the elevator and then they had to do a C-section right there and then my baby was dead for three minutes and then they brought it back to life and then I got an infection and then another baby came out. Like nobody wants to hear that. You were at home and then you actually were comfortable enough. You just stayed at home and it was seven hours and there was like maybe 30 seconds that felt really uncomfortable and you cried a little bit after. But, like, I've seen hundreds of those births and they don't even tell their birth story because that's boring. That's like maybe, like so I went grocery shopping and here's what I got.

Speaker 2: 1:26:37

But birth is boring. It's boring and it should be boring, because the actual experience of a baby coming into this world is magic. We don't need the whole thing to be a spectacle. There's a person that was in your body. You grew an organ, and then you grew a person, and then it was born, and now there's another person or people on this planet. That's the focus. That's literally to be like, but instead we're like oh, and it's a boy, because we have. We want this like drama of the birth process and I would love to stray to be like how do we make birth as boring as possible so that we can be like you have a human that's alive and you have to launch into this world as a resilient, kind, competent person. So that's what I say about that. I love it. That was perfect.

Speaker 2: 1:27:32

And so it is possible to have a really boring, low sensation birth that you feel very tired from, but it's just the move, it's just the reality. You've got to get out of a bed or do lots of fun things in the bed. There's lots of things, but our, our malposition definitely needs to be fixed. Op babies don't don't do great. So, like lots of different position changes, hydrotherapy is our friend. There is a tub available to just even labor in its magic.

Speaker 2: 1:27:58

I just did a whole workshop last week and it was profound with Barbara Harper. She's like the leading expert on water birth. She trained me in like 2009 and it was really fun to have her come back a million years later and she's delivered or supported, not delivered. We don't deliver babies. She supported, I think, in 78 countries birth, water birth. She's been doing this for 67 years and she was just talking about like it's the most gentle gateway for babies to be born. She's so passionate about it and has seen beautiful, boring, profound births where people are leaving with their psyche intact and no trauma and no tears, and babies that just get to be gently guided into this world rather than coming out with a scared parent and lots of scary and cold and uncomfortable and it's jarring. It's jarring for our babies, yeah, and everyone.

Speaker 1: 1:28:50

Yeah, for everyone. Yeah, Well, Bianca, this has been amazing I. Is there anything else that we didn't touch on that I feel like we could talk forever.

Speaker 2: 1:28:59

I know we really could. No, I just think that, if anybody here you know, one of the gifts of your birth experience no matter how many you have is a lot of people are very drawn to birth work because they either had a really profound birth and they want to make sure everybody has that birth, or they had a terrible birth and they want to make sure nobody ever has that birth. And I just from my personal experience, as well as training thousands of women and queer folks around the world. It's very healing if you don't know what to do with this energy and it doesn't mean that you have to go now and be like a full-time birth worker. People take this information and they find a way to do healing work in their community and for themselves and for their families.

Speaker 2: 1:29:41

And we teach in our training. It's not just at the end, assuming everybody is going to be a doula. We literally have a the whole time you're in school. We teach all the ways you can start a movement. You could bring this as a writer, how you could talk about this with graphic design and how you can make movies, Like all the art forms with it. Starting a nonprofit working in policy.

Speaker 2: 1:30:00

We have people at the other end of our training go out and do magical things, but mostly for the individual. It gives you a chance to do something with this energy that's in you and it will just kind of bounce around, leading to either grief or shame or disappointment or depression, anxiety, and it gives you a channel to really get out there and put it to use, because it's a really good fuel. So I think I would love to just kind of part with the concept of there is something you can start exploring for healing and for making your contribution for yourself and your community and your children in a really unique way. That's pretty flip and magical. Yeah, I love that.

Speaker 1: 1:30:41

That is so true. Wow, yeah, that's great. I think there's so many people out there that have been through this experience that can do so much with it, and I think it's great that you're focusing on just kind of letting people find their way to bring that magic to everyone else.

Speaker 2: 1:30:58

Yeah, there's a lot of ways. There's really cool movements. I just I love what our alumni does and you can make a living wage. Actually, today I was doing interviews of students and one of our students she just finished her program last week and so she was still in her program when I talked to her. She got eight clients in a week, like booked eight people, and so I was like that's at least $10,000 of revenue and eight families whose lives you're going to change. And then I just talked to another student this morning who was in her first year and she's had a $30,000 month of her business Wow, of classes and programs. That's amazing, I know that's amazing. And so there's earning potential there too, which is pretty magic to know that you can have a job, that your kids can be home with you. You're changing the world, you're doing something with all these feelings that you have, and I've always exclusively supported my family through dual work and classes. I love that. That's awesome.

Speaker 1: 1:31:51

Yeah Well, bianca, if there's nothing else, then I'm going to go ahead and wrap this up and just say thank you so much for joining me. This has been so inspiring and educational and wonderful, and I love what you're doing in the world.

Speaker 2: 1:32:06

Thank you so much for having me, and if folks want to read more about our interview, you can head over to babomiacom forward slash bjp for the birth journey podcast and find out more about you and I. And there's a discount out there too. Bjp 15 will give you 15%. I hope all of our programs and offerings Awesome.

Speaker 1: 1:32:26

Thank you so much. What a great opportunity. Thank you so much for having me, Kelly.