Birth Journeys: Lifting the veil on the birth experience
Did your childbirth experience go as planned? Then The Birth Journeys Podcast® is for you! We share powerful and transformative birth stories that illuminate the realities of childbirth. Hosted by a labor nurse and prenatal coach who specializes in transformational coaching techniques, this podcast goes beyond traditional birth narratives to foster healing, build trust, and create transparency between birthing individuals and healthcare providers.
In each episode, we dive into essential topics like birth preparation, debunking common misconceptions, understanding hospital procedures, and promoting autonomy in the birthing process. We also bring you the wisdom and insights of experienced birth workers and medical professionals.
This is a safe and inclusive space where every birth story is valued, honored, and deserves to be heard. Join us in exploring the diverse and unique experiences of birth givers, and discover how transformational coaching can empower your own birth journey.
Contact Kelly Hof at: birthjourneysRN@gmail.com
Birth Journeys: Lifting the veil on the birth experience
Neri Life Choma: Revolutionizing Childbirth Through The Birth Coach Method
Discover how to transform your childbirth experience with insights from Neri Life Choma, a seasoned childbirth educator, birth doula, and the visionary behind the Birth Coach Method. We delve into the emotional and mental readiness that modern childbirth demands and explore how traditional methods may no longer suffice. Neri shares her vast experience, emphasizing the significance of aligning internal motivations with birthing plans and preparing for potential medical interventions. This episode promises to offer a fresh perspective on childbirth preparation, especially for those facing high-risk pregnancies.
What if societal expectations and medical interventions are shaping your childbirth experience more than you realize? Explore this provocative question with us as we discuss the disconnect between patients' goals and their preparation. Neri and I reflect on personal anecdotes and underline the importance of emotional and mental preparedness. We also touch upon the evolution of menstrual management and how it impacts women's readiness for natural childbirth. Honest and realistic discussions about birth experiences are crucial, and this episode champions just that.
Join us for a deep dive into the dynamics between doulas, nurses, and obstetricians. We highlight the necessity of collaboration and patient-centered care, advocating for the unique roles each professional plays in enhancing the birth experience. Learn practical tips for building patient rapport and strategies for reducing cesarean rates through effective coaching. From fostering self-awareness in expectant parents to the broader impact of transformational coaching on everyday life, this episode is packed with valuable insights aimed at empowering birth support professionals and expectant parents alike. Don't miss this enriching conversation with Neri Life Choma, designed to revolutionize your approach to childbirth.
Connect with Neri here: https://birthcoachmethod.com/
Buy Neri’s book The Art of Coaching for Childbirth here: https://amzn.to/4dDcxTd
Follow The Birth Coach Method on Instagram: https://www.instagram.co
Join the Bump & Beyond Online Community for moms & moms-to-be!
Coaching offer
Kelly Hof: Labor Nurse + Birth Coach
Basically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!
Connect with Kelly Hof at kellyhof.com
Medical Disclaimer:
This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman’s medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.
Hello, today I have with me Neri Life Choma.
Speaker 1:Neri is a veteran childbirth educator, birth doula and doula trainer, author of the Art of Coaching for Childbirth and founder of the Birth Coach Method.
Speaker 1:Neri has worked with thousands of individuals and couples as they prepared for the transformation of giving birth and becoming parents for the transformation of giving birth and becoming parents. During her 24 years of practice, she directed and managed programs at two birth resource centers. Her work with parents has been enriched by continuing her education and becoming a transformational coach, hypnotherapist and NLP practitioner. Today she trains birth support professionals with the new framework she's developed, showing them how to integrate principles and strategies of transformative coaching into birth and postpartum support. Neri also happens to be my mentor and teacher, and I'm currently in the process of getting my certification in the birth coach method. Today she's here with me to talk about something that is a passion for me as well the inner game of childbirth, prenatal coaching to overcome the internal resistance and success blockers so one can achieve their desired experiences. For more info on how to work with Neri, visit birthcoachmethodcom. And that will also be in the show notes, neri welcome, thank you.
Speaker 2:Thank you. Thank you for having me.
Speaker 1:Thank you for joining me. I am so honored to have you here and I am so honored to be in your program and I just absolutely fully endorse and love and support everything that you're doing in the birth community.
Speaker 2:Oh, thank you, Kelly. It is such an honor and also quite a life achievement to have nurses and doulas attend the same program together and have the juicy conversations right that we have in the program. So it's been just wonderful to have you in the program and thank you for your support and appreciation for everything that I do.
Speaker 1:Yes, and I would recommend that more nurses come and take your program, because I feel like one of the biggest challenges as a labor nurse is helping people who have shown up in the birth space that aren't necessarily prepared emotionally, or those who are prepared, how to help them with that process and how to understand where they're coming from.
Speaker 1:We are so hung up on the medical part, which is important, don't get me wrong Especially if somebody is there, like my community that I work with is mostly high risk. So being able to integrate the things that you teach is so helpful, because there are so many challenges that my patients are facing, and also I want to be able to prepare people in advance people in advance, and so having the ability to use the resources that you provided and the strategies that you've taught to be able to help people prepare for whether it's a physiologically straightforward birth or if it's something that might be a little bit more challenging, the strategies that you teach help us kind of rewire the brain to be able to handle the experiences that occur in birth, whether they are well, let's just be honest, birth is never exactly how we imagined, so absolutely never, and I think this is one of the biggest challenges, especially for millennials, who are the people that are giving birth right now.
Speaker 2:They grew up with a very packed schedule and everything was planned so carefully by their parents Me, my generation, guilty as charged and they need to just show up for a very unpredictable experience. Show up for a very unpredictable experience and I loved it that at the very beginning I don't know if you even noticed it when you just started talking about your work with your patients you were talking about showing up, which is a phrase that works so perfectly to explain the value of transformational coaching. Because it is about showing up. It is about performing at the peak of your ability and going through this very unpredictable, challenging, chaotic, sometimes horrific experience that at some point also involved pain, right, and it's taking you totally out of your comfort zone, and sometimes I want to say you know, the first half of my career before I became a transformational coach no-transcript, the concept is a little bit deceiving, just bear with me.
Speaker 2:Yes, it is in our nature to give birth vaginally. However, the experience of going through vaginal birth for a modern woman is not natural. It's not part of her everyday life and in this respect, it's not natural. And it's funny that we were talking about natural birth and we were talking about the natural birth movement and, at the same time, we were all using the metaphor that childbirth is like a marathon run. Well, do you think running a marathon is natural to anyone? It is so not natural. You need to emotionally, mentally, physically prepare for this run and, in this respect, just telling our students and our clients your body was designed for it, it's natural for your body. I must tell you, in the last 10 years, I feel that it is deceiving.
Speaker 1:I agree, and I also think that we both. I just remember I think it was in lesson one or two when we both had this moment where we've looked back on our career and realized that the way that we prepare or communicate about birth wasn't necessarily the healthiest way.
Speaker 2:And I feel guilty for that.
Speaker 1:I do too.
Speaker 2:There is a saying in NLP the first assumption that keeps coming to mind is everyone is doing their best with the resources available for them. So it has to do with the way that I was trained. It has to do with the fact that I'm a dinosaur in the field and I know it's funny, but I am a dinosaur in the field. So, being a dinosaur in the field, I'm one of the pioneers, you know, in my motherland, you know, when it comes to being a doula, even no one knew what is the doula and philosophy was the philosophy of really opposing the medicalization of childbirth right? And so we've come a long way. Are we ready to start having a new conversation around birth? And this is the one thing that happened to me when I actually really had a crisis, a professional crisis, and I share it in every masterclass and free webinar that I teach, and I share it in my program and I say look, my transformation started with a professional crisis, you know. So I've been a labor doula and a charter educator for about 14 years when I just ran into such a professional fatigue and burnout and also doubt, self-doubt, that what I have to offer, what I bring to the table, isn't working, and the reason that I got to this wasn't really relating to the fact that my personal doula clients were not having a good experience. Well, they didn't. More and more of them started taking epidural, more and more of them started being induced. But overall, generally speaking, if you look at what happened in our field from the 70s, when the natural birth movement started to come to life, and from the 80s, when it was not only childbirth educators talking about natural birth but also the emergence of doulas in the United States, if you look at what happened in reality a dramatic increase in epidurals, a dramatic increase in medical interventions, and so I think that to just be the resistance, the resistors, you know, the natural birth fighters, the protectors, the warriors and think that it's all the fault of the medical system, all the fault of the medical system. It's really simplifying what's going on, because what's going on is everyone and I'm talking about everyone, those who practice within the medical system and their patients everyone is coming from fear. It goes end in end, and so fear is just increasing fear, increasing fear, and everyone is just struggling around fear and everyone is performing out of fear, and it's not. You can't be at the peak of your performance when you come from fear and I'm talking about nurses and doctors and I'm talking about my clients, but your patients, right, that was my understanding, and it came out of having a real crisis.
Speaker 2:I was exposed to matter how I tried. You know, there was so much fear that was projected and instilled in this childbirth. I was just, I felt, I guess I felt like I'm suffocating and can't really show up as a doula in the room and it ended up in having pneumonia and being in bed for two weeks, wow, not being able to breathe. And I knew that it was the result of this birth. I knew that I just I couldn't handle it. I didn't handle it well and I, you know, in those two weeks I looked at what's going on around in my beloved field for support and I was like you know what, nothing that you're doing is working because look at reality, whatever promise you promise to deliver, it's not working.
Speaker 2:So many of them are not getting to achieve their desired experiences. So many of them are not getting to push through, show up. You know? Which reminds me I just had a conversation with a client last week and I think I was sharing it also in the last meeting that we had in the Transformational Bar Support Coaching Program. You know, clients that I work with don't always understand. They need to show up for the experience and I ask so how are you going to show up for this experience that you desire? And they do not know what I'm talking about.
Speaker 1:Well, there's so much dissociation.
Speaker 2:Yes.
Speaker 1:And I don't think people even realize what that is. I didn't. I was doing so much dissociating as a labor and delivery nurse in parts of my labor and birth and I didn't even know it until somebody in the mental health field told me what it was yes, there is a lot of dissociation when we talk about your patients.
Speaker 2:There's also a disconnect between their internal motivations and external motivations. Yes, right, this is huge, this is big, you know. So the external motivation says the brain is really bad for me, right. The external motivation says bad for me, right. The external motivation says natural birth is ideal, natural birth is the best. The external motivation says I want to move freely and change positions right. These are all things that they hear.
Speaker 2:But what about checking? You know about my mindset, my internal motivation? If it's really me, how is it aligned with my lifestyle, with the choices I make in my life, for example, going through a natural childbirth and being a person who, since 12 years old, since you got your period, being treated with hormonal contraceptives because your family doctor asked you if you have pains when you're getting your period and you said yes, and they said you don't need to. Here are some hormonal contraceptives to alleviate the pain. Not to have sex, of course. I know, because it happened to me with my daughter. I know that I went to a physical normal physical with a 12-year-old girl and she was offered immediately hormonal contraceptives so that she won't have to deal with her period. She won't have to miss a day of school, she won't have to miss, maybe, a swim team. And I was thinking to myself oh, that's wrong. Now take this woman. She is now 27 years old. If she was treated with hormonal contraceptives, she never experienced herself bleeding. She's never experienced menstrual cramps. She hasn't been.
Speaker 2:With the monthly practice that I had for childbirth as an ex-generation right, I had a monthly practice for childbirth. I had to practice my breathing. When I went through cramps, I had to go to the shower. I had to use the hot pillow. I had to practice some visualization. I was staying in bed. It wasn't so awful to stay in bed, you know, for a few hours and rest. When I was even in pain, when I was ovulating, I even knew every month which side I'm ovulating from. Right now you take this current birthgiver that went through very different life and now talking to her about natural childbirth. It's deceiving. We really need to be honest. I want to be honest with her.
Speaker 1:Yeah, and I come from a different side where I believe that let's keep it as natural as possible and overcome the resistance when a medical intervention is necessary, when the risk is greater than the reward for continuing with a completely natural labor. And by completely natural I don't mean that you can't have a natural delivery while receiving medical treatment, For instance, if you have preeclampsia. I have seen women birth naturally on magnesium.
Speaker 1:It can happen it does take a whole lot of emotional preparation and I didn't have words for what I was seeing until I started your program. I noticed so I've been in the medical field for about 25 years as well. Just, I wasn't in the labor and delivery like full, full in it until about eight years ago and what I've noticed is patients come in, like you said, with that disconnect between their goals and like how they plan to show up for their goals. And, for instance, I'm thinking of someone that that has severe preeclampsia, like their labs show it. Their blood pressure is out of control.
Speaker 1:And I see like some of the most extreme cases that really stick with me are denial, continuing to say, oh no, this is white coat syndrome. And I'm there trying to explain. Well, it's not white coat syndrome when you've maxed out your blood pressure medicine and you're still having this severe range blood pressure that puts you at risk for stroke, that puts you at risk for seizure. And we need to give you this treatment of magnesium to prevent seizure and the possibility of a blood clot in your brain or your placenta and having patients believe that that is the end of their natural labor because the potential of the magnesium stalling out the contractions is what they're stuck on and the potential that the Pitocin is going to be too much for them to handle if necessary. They're already going down this path of failure in their brain without preparing for the possibility that they could actually continue to succeed or have a wonderful, miraculous birth with help from modern medicine. Right, because both can be true.
Speaker 2:Right and I feel that it's a little bit the result of the discourse. So in coaching, the language really matters, the words used, they really matter. You know, it is a conversational practice and the words that we use in our internal conversations and the words that we use when we speak to others, those matter. They build a story, they build reality. Words build reality right. And so one of the things that I really really loved about coaching is that when I started the very beginning, just understanding the origins of transformational coaching, life coaching, actually the whole profession of coaching, I learned about Tim Galloway saying the opponent within one's head is more formidable than the one on the other side of the net, and to me it felt like a miracle. I was thinking to myself Kelly, this is exactly what you're talking about. I believe that for many, many years, birth support professionals really saw the medical system as the opponent at the other side of the neck.
Speaker 1:Yeah.
Speaker 2:And failed to realize that there is a bigger one, a lot more formidable one, which is inside our heads, right and so talking like this, having a culture that looks at the childbirth experience, you know, with these oppositions, these dichotomies between natural birth and medical interventions or the medical approach to birth, it builds reality. So you're meeting patients that grew up into that. We can't have a natural birth because this is how we were trained to believe, and then it's time for us to stop and take a look at our words. First of all, I would call it physiological birth rather than natural birth. I haven't used the term natural birth for years and years, and years now, because I just realized no, not natural, so physiological birth. Now, what does it mean to have physiological birth? How do people show up to physiological birth? What is the environment that they want birth? What is the environment that they want, and since when?
Speaker 2:Being pragmatic is a curse or something that is failure or something that is perceived as being wrong, even if, in cases where I worked with clients that didn't have preeclampsia, didn't have any major conditions, but their births were stalling for 40 hours, do you think that the decision that she needs a pejoral and she is changing her mind, asking for a pejoral? Because she really exhausted all the resources that she had. She used all her resources for the last 40 hours. She used them, that's it. She's got no mental capacity, not emotional capacity. She was working so hard, she was doing everything that she could.
Speaker 2:The decision that she's not taking epidural, that was a good decision from 40 hours ago. How can it be the good decision right now? How can it be a failure to ask for epidural? Why is it not under being pragmatic and adjusting the plans according to what is in the surface, according to what becomes possible for us? So, one of the things like we have in the program, we have a coaching exercise that helps to work with clients through the process of acceptance and adjustment. And you need the tools, you need the coaching tools, you need the structure, you need the questions and you need to see that your conversation is following a certain structure and leading to the more pragmatic decision. That doesn't feel like failure.
Speaker 1:Yeah, the key is that it doesn't feel like failure. Right Right, doing what's right for you does not have to. It's not failure.
Speaker 2:Absolutely not.
Speaker 1:And we don't have to abuse ourselves in order to be successful.
Speaker 2:Absolutely not have to abuse ourselves in order to be successful? Absolutely not. And also, you know this whole advocacy is big in our field. So birth support professionals call themselves advocates. What are you advocating for? Are you advocating for a certain experience or are you advocating in the best interest of your client and are you advocating for them? Is it possible? Is it possible I'm just sending it out there in the world, you know is it possible that sometimes we need to advocate for a cesarean rather than an ordeal that is going to be traumatic for this person? Is it possible? So I feel that coming with an agenda that is not the client's agenda and not asking them who they are, what motivates them, why are they choosing what they're choosing and this is the power of prenatal coaching we almost like reversing the direction.
Speaker 2:Everything that I was taught about prenatal is that I need to educate. I need to educate them about the process and about the phases and about the positions and about the medical system. I needed to deliver a lot of knowledge so that they will be able to achieve a good, healthy experience. Is it possible that maybe allowing them to inform me about who they are is a better way to have a healthy, good experience, maybe asking questions. It's like really redirecting the whole conversation to be around not them asking questions and me as an expert answering them, but doing the other way around Me. Asking them questions, they answer, where around me. Asking them questions, they answer. Then they get to first be more in touch with who they are. What are their beliefs, what are the mindsets that they have around their childbirth, what are their motivations, what are their challenges, what strength are they going to rely on? They need to hear it. They need someone to have these conversations with them right. They need to hear it. They need someone to have these conversations with them right. And when I'm listening to them, they get the practice of being the expert and this is huge, so that when you meet them in L&D they already have agency, a sense of agency that I help them build by conducting those prenatal coaching conversations and putting them in the expert seat and having them practice saying who they are and what they want and what they need right.
Speaker 2:This is an agency that actually, if you think about the doula, which is another agent in birth support, she's not going to have to do the fighting and the wars you know and being the protector and being in between. No, your goal is to really get your client ready to feel strong in their ability to talk to their caregivers and tell their caregivers what they want. And let's say that this client of mine is being told that she needs some medical intervention, having her ask so why do you want to do this intervention? What are the benefits of this intervention? You don't need to be the warrior that protects this client if you helped her build her agency and sense of expert. I'm an expert in my life and here there's already one professional that I was talking to that was asking me questions and really, really listening to me, active listening and helping me find what I want and make good choices. I can trust that the nurse is going to do just the same. So you need to build this, because it's not what's going on in our culture right now.
Speaker 1:Yeah, everybody's showing up to fight and it's problematic If you're showing up. Like you said, fear begets fear, right? So if you're showing up in fear and you're defensive and you're talking to your medical team, or vice versa, right, there's fear on the side of the medical team as well, and we can talk about that in a minute. But if you're showing up, then your medical team will feel like they need to emphasize the need for the intervention more, which usually leads to more fear. The risks become the focal point, not the benefits. We've already explained the benefits of the procedure.
Speaker 1:But if you don't do it, let's talk about the risks and try to persuade somebody to do something that they're not feeling secure about, but if they've already gone through the work and already done the internal work that needs to be done to really know what you're aligned with and really know what kind of outcomes you want, when something comes up that was unexpected as does in all of life and all of parenthood you're never going to make it through unscathed. I promise Something's going to happen, someone's going to skin a knee at some point and you have to make decisions on how to handle it. You can't just pretend it's not happening and so being able to work with your medical team without feeling threatened is so important in the old school natural birth way, without realizing that we all need to work together and become a team and mentally prepare for that. Then it does end up being kind of an adversarial situation where maybe the doula and the medical team are fighting, which is icky, especially if you're the patient or the client that's sitting in the middle of that.
Speaker 1:The other thing that I've noticed since I've started working with you or even since I started realizing that this change needed to happen and then I sought out your program because I realized it I've noticed that when I'm in an emergency, in a delivery, it's a more calm situation and if people are starting to get elevated, I can have conversations with them relatively quickly now to remind them that we don't have to act in fear. We're all on the same team, we're all working together and we're going to get through this and everything's going to be okay and we know the next steps. We've trained for this. We can think clearly, we can work together and we don't have to fear the next stage. We can anticipate without fear.
Speaker 1:And we can do all the things we need to do. It's a much better environment, Even with other nurses, doctors, patients, anybody that has a tendency toward high anxiety it still works and it makes life so much easier.
Speaker 2:It's very rewarding to hear you reflecting on how the transformational coaching strategies and tool help change even the conversation between the teams. You know the staff members that you work with. You know something you've never shared before, so thank you for that.
Speaker 1:Oh, I thought I had, but maybe maybe it was in my head that I shared it.
Speaker 2:I thought I had, but maybe it was in my head that I shared it. Very rewarding for me to hear that that it's not only changing the dynamics and build a better partnership which is my goal between you and your patients, but that it actually creates a better partnership between you and the other staff members that you work with in situations of emergencies or in moments of stress. It's very rewarding for me to hear that.
Speaker 1:Yeah, and that's another reason that nurses should be looking into the birth coach method. Because we are birth coaches, that's what we are as nurses Do you look for birth coaches.
Speaker 1:Nurses are birth coaches, and whether you plan to use it in private practice or in the hospital is irrelevant, because you need the skills and I can tell you these are not skills that are given in medical school. They're not skills that are given in nursing school. The hospitals are not providing us with these skills. It's not conflict management. That's different, and I think that's what the hospitals think it is. It's not conflict management. That's different and I think that's what the hospitals think it is. It's not because we're not in conflict. We don't need to be in conflict.
Speaker 2:It's not at all about being in conflict. So here's the thing when you find yourself in conflict, you have a tendency to think about differences in opinions to think about differences in opinions.
Speaker 2:But here's the thing If you build good relationship and you invested in building rapport with the other person, you can go together, work together even through differences of opinion, together, even through differences of opinion. So and it's a huge, and this is something that I tell all the doulas that I've trained and everyone that come to my programs Look, nurses have sometimes two minutes to build rapport with patients. You spend some hours with them prenatally. Well, as a side note, I would say that I think that the way that doulas are trained in many places, to believe that two meetings with their clients are good enough to show up at a person and support a client, I would say this is still old school. Why is it old school? Because there is a belief, a hidden belief, that no one is talking about, that you can just come to your client's birth with the toolbox of a doula, whatever toolbox it is. You know aromatherapy and physio balls and massage balls and ribosomes and changing positions and breathing techniques and relaxation, everything which I work with, and I know it but to assume that you can just show up to the birth with the same toolbox again and again and again, without really providing client-centered care, that's a huge mistake, because then you're doing the same thing that the doctor is doing Yep, a box that calls obstetric gynecology without seeing this specific patient, right, and so if a doula is doing the same thing, not really taking the time to learn who this client is which is why I think that we should have a series of prenatal coaching conversations with our clients, right, and so this is. Like you know, I started from one thing, I took it to another thing, because I think this is one of the things that I love about coaching is that it helped me really not to assume that I can just show up at a birth of my client with the same toolbox, with the same routines of care, because, hey, that's exactly what nurses and doctors are doing. My clients do not need another agent that is doing just the same thing. You know, here is how you go through birth One, two, three, four, five.
Speaker 2:No, we have so many different ways to go through healthy, normal, satisfying birth experience. How about learning who this client is so that we can support her through her very unique journey and experience? How about learning who this client is so that we can support her through her very unique journey and experience? Right and that's another thing that when doulas emerged, there was kind of like an internal conflict or an internal dilemma in our profession because it was clear to everyone that we are accountable for the quality of the experience. Right, doulas are totally free of liability to the safety. Totally right, we bear no liability. It's a privilege, it's a huge privilege, it really is.
Speaker 2:So we were supposed to focus on the quality of our clients' experiences, not on the medical practice, not on the medical aspects, somehow along the way the doula profession evolved. Now, along the way the doula profession evolved, I find online conversations in doulas groups that are very clinical, going very deep into clinical information, and I'm telling myself you're deviating from your power. Yeah, if you're going to try to stand in L&D and advocate stating that you are familiar with a better obstetric practice, you're going to lose the game here. You're losing the game immediately, because who do you think your clients are going to follow? An obstetric gynecologist that studied how many years?
Speaker 1:Or a doula. Well, I've seen it both ways and that's the sad part. And not because a normal physiological birth isn't the goal, but because a doula is not necessarily medically trained. I say not necessarily because the doula training is non-medical. There may be doulas who are also medical, I'm not talking about that. But also, if you're in the role of a doula, you should not be using your medical training, because then there's liability. There you become liable.
Speaker 2:Absolutely I agree with you so.
Speaker 1:I've seen doulas turn off the Pitocin. I've seen doulas mess with the monitors. I've seen doulas start pushing with patients. I've seen doulas administer medication and supplements during deliveries and doulas taking power away from their patients, and that is highly concerning for me because to me, that constitutes an abuse of power, just like doing things without consent as a medical provider is an abuse of power. So, from both ends, we are all guilty of doing what is not in the best interest of the patient. What you are trying to, how you are shifting the narrative, is we need to start turning inward and looking towards the patient, both of us not standing in our little silos, not clutching each of our toolboxes right. The patient doesn't need all these toolboxes. They need support, they need patient-centered care, and that's supposedly what hospitals want.
Speaker 2:Right.
Speaker 1:We aren't given the, the tools to, so to speak, to provide the patients, and you're doing that.
Speaker 2:But I think that nowadays, even doulas are not getting enough tools. And I, I love my profession and I love doulas. I love doulas. I want to see them gain higher professional status.
Speaker 1:I want to see them gain higher professional status.
Speaker 2:I want to gain power. What I'm saying is doulas, power is a transformative power, it's a conversational power, it's the power of really. It's prenatal power that the nurses do not have and the obstetricians do not have. That's the dualist power. The more we try to bite pieces or enter the territory of the power of doctors and nurses, the more we lose, if you ask me, the more we lose power because it's not our natural power. It's not our natural power. It's not what we're bringing to the table. What we bring to the table is the time we spend with our clients before you know, the rapport that we build, the trust that we build, getting to understand them, being able to build their confidence that what they know about themselves is important. You know, like so many of my clients are surprised when I tell them you know, the system is really interested in building partnership with you.
Speaker 2:The system now knows that partnership between doctors, nurses and their patients is leading to a safe care and they go really Because in their mind, in their mind sometimes, very often, they think that they're hiring me to protect them from the system. So, having the prenatal conversation that actually says, hey, hold on a moment, I want you to know something about the system. They might not have the best tools the prenatal conversation that actually says, hey, hold on a moment. I want you to know something about the system. They might not have the best tools, but we can show them how to do it. I will be there to show you how to do it.
Speaker 2:I will be there to provide the tools, but I need you to know that the medical system recognizes that patient-centered care is safer. That building a partnership with patients and with their family members leads to not only high-quality care but to a safer care. That patient engagement is really important now too. So we're not opposing. So when they hear that what we're bringing to the table is not opposing the medical system but actually is helping the medical system and this is how I train doulas when they hear that all the coaching tools are actually serving the system, the energy changes, and now we enter L&D as a doula or as a patient building rapport in moments right, because we're not guarding, we're not protected, we're not like you did this.
Speaker 1:Yeah, we're not fighting each other, we're not clutching our toolboxes.
Speaker 2:Right, and you mentioned before something that I really appreciate, also about knowledge. So here's the thing about knowledge. We used to think that we need to educate our clients. I think that nowadays they have Dr Google, dr YouTube and Dr Facebook on speed dial, yes, yes, and what we need to help them do is actually sort out the information based on who they are and what's right for them.
Speaker 1:Yeah.
Speaker 2:Customized care, and this is setting them up for success as parents as well, because even as parents, they're going to read so many opposing views. As parents, they're going to read so many opposing views. Think about sleeping. There is sleep training. There is the family bed. There is oh my God, no, babies are not going into your bed. There are so many opposing views. There is the continuum principle.
Speaker 2:You know where they tell you that your babies need to be on you for nine months. You know, just like monkeys, and I'm like okay, look, if they read all those books and if they Google the keywords and find all those opposing views and schools to how to do things and they don't sort them out based on who they are, they're going to get lost right out based on who they are. They're going to get lost right. So it starts prenatally. It starts prenatally. So, like, take the very naive thing you were talking about. Well, I don't even want to think about doulas who are attaching the pitocin and increasing it, but you know what? Let's talk about a more naive situation, less harmful, that is sought to be within the practice of the doula.
Speaker 2:Your client's water broke. Are you telling her to stay home? Are you advising to stay home. Here's how I was trained. I'm going to be honest with you. The way that I was trained 24 years ago was clients are more likely to get infected in hospitals rather than at their home, where you know the microbiome is theirs and the bacteria is theirs and their body is familiar with these bacteria. So when their water breaks, they better stay at home rather than going to the hospital, especially if they don't have contractions yet. Right and so first of all, you tell me telling a client to stay at home after breaking of the waters does this have? Does this advice carry liability?
Speaker 1:I mean, I would think so carry liability.
Speaker 2:I mean, I would think so Me too, how I was trained. But I was also trained to say that my service bear no liability. So there is a conflict, an internal conflict in the profession, and I'm not blaming or shaming anyone. I'm really trying to recognize things and help them surface and help us all rethink and reinvent birth support, because we can do it. I sign every email of mine let's reinvent birth support together, because I really feel that it's time for us to reinvent birth support and we can do it so much in so much better way.
Speaker 2:So your client's water-brained? Okay, let's verify, let's follow code. You know, see that we. But then let's ask so, how do you feel? How do you feel about this? What do you want to do? How comfortable do you feel staying at home? Would you feel more calm at a hospital being watched, or would you feel more calm staying at home? Okay, I hear you. You say that you feel that you're going to be more calm going to the hospital.
Speaker 2:Let me just share something about what's going to happen in the hospital. You're going to get there. The staff is going to think that you came so that they will take care of you. You cannot show up at the hospital and not being taken care of by the staff. That's not an option. When we show up at the hospital, it means we need medical care. So let's think about it. Do you need medical care? This conversation it needs to happen prenatally and then when the things happen and the water breaks. You know, the clients are just so well prepared mentally, emotionally You've already been through so many conversations with them understand who they are, understand how their thinking process work, understand what triggers them, what are their motivations. You need all that so that they can really go through labor and delivery smoothly, you know with a lot of agency.
Speaker 2:You know that's what you're trying to do.
Speaker 1:Well, I think one of the things that I try to offer is to help clients find providers that they align with. First of all, let's not go to a provider that prefers a lot of interventions if that's not what you want. But if you feel safer with a lot of interventions, then that might be the best provider for you. But also, these are conversations that we could be teaching the client how to have with their provider so that they know what to expect. And the moment. So often I work with midwives and doctors, obviously because I'm in a hospital, but the midwives will get calls all the time. I think my water broke. Okay, well, are you in labor? What color is the fluid? Are you group beta, strep positive? And then we talk about what you want. What is the timeframe that we have to consider coming to the hospital? There's a lot that goes into it. It's not just a stay home or don't stay home, and there's a lot to consider.
Speaker 1:And then we have kind of the timeframe of when we would like contractions to start, so that we don't get to the point where our water is broken for so long that we've increased the risk for infection which, if you're giving birth in a hospital, then the NICU if you have one or the pediatricians will then, after a certain amount of time with your water broken, want to start doing interventions after the baby's born to make sure that the baby doesn't have signs of infection and that might look like the baby getting heel sticks.
Speaker 1:Everything has a result that it's important to be aware of and to be able to make informed decisions about, because I know that when my baby was getting heel sticks it was traumatic for me and while I recognize it was necessary because we were looking for Billy Rubin and there was risk and he was yellow and it was slightly high and so we had to continue to do heel sticks. Having to do that because I chose to stay ruptured for a certain amount of time, hypothetically, and that's the only reason that my child's getting heel sticks that wouldn't feel right to me and I would want somebody to help me work through that. I believe that not having thought about how those things might affect you and how you might choose one path or another, having not talked about that beforehand, I think that leads to trauma, because when you're hit with the heel sticks that you weren't anticipating, because you made a choice that felt better at the time, but it wasn't fully informed. That leads to trauma.
Speaker 2:So here's the thing we can't anticipate prenatally every situation that our client is going to encounter and there's not a lot of point in trying to be prepared even for every situation. So what we actually build in the prenatal process and this is why it's so important is the practice of looking in, finding what's your priority being able to make choices, being able to have agency, being able to have agency, being able to make adjustments. We build it conversation. We can't really prepare for each situation, but you know, your clients are they. They have a practice which no one actually told us to think about.
Speaker 2:Think about my clients, your patients. They go through the school system for so many years and no one has those conversations with them about who they are. Everybody's delivering, delivering, delivering, thinking that they are an empty container, right, and no one really helps them to form a sense of agency of this is me. This is where I begin, this is where I end, this is my belief system and it is okay if I think different than the other person. These are my priorities. I prioritize my baby not getting heel sick. This is my priority.
Speaker 2:If I have to have a cesarean, so that I will prevent it, this is what I'm going to do because that's my priority. If I have to have a cesarean, so that I will prevent it, this is what I'm going to do because that's my priority. I've heard clients you know at the moment that you open even the conversation saying I'd rather have a cesarean than have a vacuum. Someone needs to create this self-confidence and agency to say it, and that's how you go through life and how are you going to be a parent without it? Exactly. So, the way that I look at it, prenatal coaching conversations are setting them up for success as parents, as people. Right? If the woman doesn't know how to advocate in L&D for herself, do you think she's going to know how to advocate for her child?
Speaker 1:It's so much harder too. There's so much more emotion involved when advocating for your child.
Speaker 2:So I see a continuity here, right, a continuity of pushing through moments of fear, pushing through moments of doubt, with what I know about myself, with what I know about my partner, having a system that helps me to deal with conflicts, to deal with situations that were unpredictable. This is what we build. We build it. It's funny I say that we're building it through the process of preparing for childbirth. It's not only building them as parents, I think it's building them as people. One of my students who came to the Transformation on Birth Support Coaching Program telling me that she had to go to the bank to ask for a loan and she was practicing everything that I taught her and she got the loan, even though she knew she went there thinking there's no way that she's going to get the loan because she's not a good fit, you know, and they can't trust her. But she was practicing everything that I taught her about mirroring, about representational systems, about you know everything about creating rapport and she got the loan. That's amazing, right, it's pulling you for life. It is so crucial, so crucial. So it happened to me the way that things happen where you know, I saw I was telling you about the crisis that I went and the self-doubt began, with a huge lack of faith, losing my passion. I didn't lose my passion, actually, because if I were to lose my passion, I wouldn't go back to being a birth support professional. And I did.
Speaker 2:Eventually, I was thinking about a career change, going into transformational coaching, and I took a year long program and throughout the year I was thinking about a career change going into transformational coaching and I took a year-long program and throughout the year I was beating myself and I just kept thinking, ah, if I only knew how to do it when I practiced as a doula. And then one day I shared it with my teacher and she felt that I'm, you know, beating myself and she says, mary, hey, hey, you're really unfair to yourself Because, remember, we're saying everyone is doing the best with the resources available for them. You were doing just the same. You didn't have those resources. You didn't have all those coaching exercises, all those coaching strategies. You were trained differently, with a lot of hands-on support tools, not so much with conversational coaching skills. Stop beating yourself, let's think how you can do things differently.
Speaker 2:How about writing your final paper for the course about that? And I thought to myself, wow, I can do that and it became my book. So the art of coaching for childbirth is actually well. Of course, I worked on it a little bit more and it's already in its second edition, so a lot more has been developed since I wrote it as my final paper.
Speaker 2:But that's exactly what happened in transformational coaching all the exercises, all the structures, all the models of leading conversations, everything that I've learned, all the strategies and I thought, okay, now I'm going to have this in my field. How am I going to work with my clients? And it's not hands-on, so it's actually prenatally, or you can also lead those transformative coaching conversations in the postpartum period, right, and you also create a continuity because you started working with them prenatally instead of them working with another postpartum doula. You need to work with the same professional who actually already took so much time to learn who they are and what's working for them, and then you continue working with them and building the same capacities abilities in the postpartum period. And so I took everything and just it ignited my passion to birth support and it's amazing that I didn't even know that the result of it is going to be that I'm going to spend a third of the time with my clients in labor. I didn't know that. That was a nice surprise.
Speaker 2:So I started focusing on a longer prenatal coaching series. Not two meetings, sometimes six, sometimes seven. But you know what it's such a quality time that you spend with your clients. They're not in pain, there is no stress. You're sitting together, whether on Zoom or in your practice, and you have juicy, impactful, result-oriented conversations. You follow up on things, you follow up on actions that they need to take. You know also coaching our clients to understand that talking about things or writing them down is not enough. There has to come a question what actions are you taking? And I, when I work with nurses, I do the same thing. I teach them the same thing.
Speaker 2:So when I go to nursing workshops and they say, well, clients are coming with a big birth plan, very long birth plan, very detailed birth plan, but it's obvious that they don't know how to go through this experience, that they wrote and I say, okay, so did you have a conversation about that? What did you do when you got the birth plan? When they handed you the birth plan, what did you do? Well, I read to see if we can approve everything and I said, well, that's not the idea. The idea is not to just scan through the birth plan and think about whether or not you can allow the clients to go through labor, the way that they write. The idea is to have a conversation and get to know them. They're giving you a document that is telling you who they are. Now let's go through a conversation based on this birth plan, for example, you can ask them. So tell me three things that you did to prepare for this experience.
Speaker 1:I love that. Step one I downloaded a birth plan. Step two I checked off boxes. Step three I printed off the birth plan.
Speaker 2:I am loving expectant individuals. I do not try, I'm not trying to put them down, I'm really trying to elevate them. I am too, and also this is what I see not try. I'm not trying to put them down, I'm really trying to elevate them.
Speaker 1:I am too, and also this is what I see every day and we need to change it. It needs to be changed. We can do better.
Speaker 2:The role of the child recitator and the doula. That was their role, because that's what I do. So what actions are you taking so that you will be able to achieve it? What skills are you building so that you will be able to? Whether it's advocacy skills, whether it's coping technique skills, what are you doing? What steps? So, during a longer transformational coaching series, I also assign or design with them actions, and you know we follow up on those actions. The next time that I see them, I ask them.
Speaker 2:So tell me about this area of practice or these actions that you were committing to last time. How did it go? What did you do? How do you feel it empowered you? What was the gain in doing it? So you build them up, you know, toward being able to perform in the way that they want to perform. And I love I use the word to perform because it's coming from the coaching world.
Speaker 2:So the coaching world is all about increasing people's performance level, helping them show up, helping them perform at the peak of their abilities, with what becomes possible and available for them. Right. But we're doing it not only in childbirth. We're doing it in all other areas of coaching, whether it's career coaching or relationship, coaching or it doesn't matter in what field. We are increasing performance, level and accountability without attachment to the outcome, and this is something that I really want to stress here. We're not attached to a certain outcome. We're attached to the level of performance, and I'm using the coaching terminology.
Speaker 2:But I want to talk about Penny Simpkin, the biggest teacher that taught all of us, and we lost her this year. So it's really important for me to say Penny our beloved Penny was talking about. Her studies were showing us that birth giver satisfaction is found in how they feel that they were conducting themselves, not in what became available for them in their birth experience. Whether they took a vigil or not, whether they ended up having a juice, whether they ended up having a cesarean, this is not where their satisfaction is found. It's in how they feel that they were conducted themselves. So it's without attachment to the outcome.
Speaker 2:When a birth giver had a prolonged prenatal coaching series and she's learned how to conduct herself and she has taken actions toward achieving, she knows that she took all the right actions so that she could achieve her desired birth experience and even if it didn't end up being exactly what the birth plan was asking for, she's going to feel good. She's going to feel good. She's not going to feel like a failure. She's not going to feel like her birth experience was stolen from her, like things were imposed on her because she was engaged and she was part of the decision-making process. She had agency in how it unfolded and that's the most important part.
Speaker 2:So I find so much value in prenatal transformational coaching and birth giver satisfaction, because Penny was saying just the same. Saying that birth giver satisfaction relies on how they are conducting themselves is just as saying how they perform during their birth and toward the experience right. So it bears so much value, not to mention the value that it brings to the to-do list themselves, who get to spend less hours in L&D, who their work is less hands-on and is creating less fatigue, you know, less burned out, because their clients are so much more prepared to cope and to advocate. Just the same.
Speaker 1:Yeah, I totally agree, and something that was coming up for me was your work with nurses and talking about how to approach the birth plan. My colleagues are some of the people that listen to this podcast the most. And when my colleagues are being trained I'm a preceptor for nurses and I have other colleagues that are preceptors for nurses and oftentimes they'll say, listen to Kelly's podcast, because she talks about, you know, the pelvis and how to achieve alignment and all this stuff. What I want new nurses to understand is, when a mom comes in and she has her little birth plan checked off but hasn't put in any action to try to achieve that, what can we say to empower and support in the moment where we are also trying to empower and support other patients?
Speaker 2:I love it and thank you for asking me that. Here's the thing you can't empower before you build rapport. Right, they're not taking anything from you. They don't know who you are, right? Right, you're a stranger, exactly. Right, you're a stranger, exactly, and you're an expert in obstetric gynecology. So first of all, let's build their trust that you're an expert in empowerment.
Speaker 2:So the first thing that I'm saying is I see nurses talking to their patients, attending to the computer at the center. I know it is a huge demand, I know that you need to record everything, I know, but asking questions and looking at the computer is not building rapport. I also see nurses entering the room when the client is moving because her body is asking her to move and she's breathing and she's huffing and puffing, and they go inside the room and they stand in front of her like this. This is not building rapport. Your client, your patient, is moving, standing in front of her for two minutes. I ask for two minutes of your time. It's not an exaggeration, right? Two minutes of your time. Wait with the computer, enter the room, start moving with her Mirror, her Start making this connection. You know they say how does it go? This thing? You need to walk in someone else's shoes, mirror, start working with them, breathe with them, make rapport, make rapport, make connection. First of all, don't even start talking, don't. If there are any physical barriers between you and the patient, you can't empower them. So if, unfortunately, the room was designed so that the computer is here, the bed is here and the patient is there, you can't. You have to find a way to be with the patient in the same space. Yeah, so we can either have the client go around, come to us, you know like really go hold hands, move with them a little bit, and they say let's continue doing it next to the computer. I'm going to continue breathing with you, we're going to continue moving, but every now and then, between contractions, I'm going to just attend to the computer and when you have a contraction I'm going to continue doing it. And then you build something, you build connection, you build rapport. Now, after that they hand you their birth plan. Because actually what I know is the birth plan is the last part. You know, like after you put everything here, you did the admission, you know, comes the birth plan. You're asking for the birth plan. They do have a birth plan. You say this is so wonderful that you're mindful about your birth and you wrote a birth plan. It's a great vision. But here's the thing it's a vision and sometimes not all the details of a vision are put in place. Details of a vision are put in place, but the vision can still remain a positive and a good and a healthy one, right? Did you hear me talking about the metaphor that I? I use this metaphor with my birth clients. I tell them so here's the thing.
Speaker 2:I went to Trader Joe's and I had a full list of 15 things and four of them I couldn't find on the shelf. They missed them. But on the way to Trader Joe's I saw a rainbow, the best rainbow I've seen this winter. And at the store I met an old doll that I didn't see for so many years and we exchanged phones and we said we're going to get together next week. Was that a good visit at Trader Joe's or not? You tell me, definitely good, definitely One of the best. I don't care about those four things that I didn't find on the shelf, right? About the experience, right? So we don't get attached to the details.
Speaker 2:So that's a coaching conversation that a nurse can do Absolutely All the components of an excellent coaching conversation. It has metaphor. Metaphors are working so beautifully in coaching. It has metaphor, it clicks right in. It's like oh yeah, this can be a good, positive experience, even if I need Pitocin.
Speaker 2:So right at the get-go, saying this is so great that you have a vision for your birth and just like any vision, just remember, it's a vision, it's an experience and it's going to be great, even if some of the details here are not going to be met. How do you think about that? So that's one thing. The other thing, as I said, I think that we want to ask the patients how did they prepare themselves for this experience? I think it's an important question that reflects to them. If they have prepared very well for this, they're going to tell you we've been to a chopper's education class, da-da-da-da-da, okay, great. Tell me, for example, I'm talking about those patients of yours that want to achieve natural, physiological, healthy birth without interventions. Tell me three things you're going to rely on and I'm going to write it on the whiteboard here.
Speaker 1:I love that. That helps nurses so much too, because you know that whiteboard is being looked at by the charge nurse and the administrators.
Speaker 2:Let's write three things or, if you have more, tell me more. What are you going to rely on during this birth experience that is going to make you achieve your birth plan? Write them on the board. It's creating continuity with the next shift. If there is a next shift, right. Everyone goes into the room, can look at it and see, and and you build accountability in L and D, right yeah. Ability to really push through and achieve things Right yeah. So here's the truth. The system is really interested in reducing cesarean rates.
Speaker 1:Yeah.
Speaker 2:Vaginal birth initiative is all across, right. It doesn't matter which city or state, right? We're all interested in reducing cesarean rates, and so I'm asking myself who is your ideal patient that you need to focus on to reduce cesarean rates.
Speaker 1:The one that has the plan.
Speaker 2:And it's actually not the one that came without a plan and it's not the one that is high risk. It's the one that had the plan and wrote in it that she would like to have a physiological, natural birth. She's not a cuckoo that you need to ignore. She's not the one that you need to think, ah yeah, the moment that the contractions are going to be very strong, she's going to aspiropedrola. I know I've seen thousands like her. No, she's the one you need to focus on. She is the perfect candidate to reduce cesarean rates. Right, you don't dismiss her, right? I think that, unfortunately, the system is not focusing on her, but this is who you should focus on if you are really interested to reduce cesarean rates and increase vaginal birth. Yeah, right, I agree. And so you focus on her and you find the time to go more into her room, more often than the others, actually, and you find the time to engage in conversations with her. You know, I'm really impressed with the fact that you want to have a natural birth. What motivated you? Then, when she has doubts, you tap on this motivation and you say remember how you told me that you want to Remember how you told me that it's so important to you. So here's the thing I'm going to help you achieve the first plan because I know how important it is for you too and you repeat her motivation. And then you say we're just going to make a short-term plan for the next 20 minutes, yeah, and you break the whole process to short-term plans. So for the next 20 minutes we're going to do this.
Speaker 2:Usually it lasts for 40 minutes. They don't even notice, they go right. You show the partner what to do. You don't have to be there. Engage the partner, show them what to do and then leave them and then say I'm going to come check on you. But here's the thing I know how important it was for you to repeat her motivation. She needs to hear it. She needs to hear it time and again. You know this is a nurse who's a coach. If you ask me, that's a nurse who's practicing coaching, right? So I'm hoping that all the nurses that are listening to your podcast are writing down.
Speaker 1:Write it down, take notes, listen to it again Build rapport with mirroring.
Speaker 2:You can go to YouTube and see what's. And, by the way, Kelly, I have an online program for nurses. I know there is an online program that provides them with 11 CEUs because I'm approved by the Board of Regents of Nursing. My program Birth Coach Method programs are approved by the Board of Regents of Nursing, so I'm giving CEUs so they can either join doulas, which I think. I want to ask you, why didn't you take the online program for nurses?
Speaker 1:Because I wanted to be able to. I wanted to be able to be a birth coach, like a prenatal birth coach, because I felt like waiting till they get to me in labor and delivery was not necessarily as helpful. I mean it is, I can do something with it, but I'm not with them the whole time. I'm also not necessarily with them the whole shift. My other patient might deliver. So I felt limited in my scope when I'm at the bedside. And I wanted to be able to provide prenatal coaching because I've taught prenatal classes and I didn't feel like they were helpful. The knowledge isn't helpful.
Speaker 2:There is a saying that I love. You know it, but your audience doesn't know it. But what I say is childbirth education is good if your client is about to deliver knowledge, yeah. To deliver a baby coaching is better, right. There is no value, almost there is very little value in learning about, right. There is very little value in learning about, right. But being coached how to push through and be with the experience of childbirth, that's meaningful, right. So that's what I say. You know, like the knowledge doesn't really build the capacity to be with the experience, yeah, or to, by the way, make good choices. So, for example, assuming and I was everything that I say, by the way, it's really important for me to say that everything that I say come from mistake, that I feel that I've done.
Speaker 1:Oh, I can say the same thing for me.
Speaker 2:I am not judging, not shaming, not blaming anyone who still practiced in a certain way, because I was doing it for so many years before I became a transformational coach and decided to just bring it into birth support and started doing things differently and then wrote the book and blah, blah, blah, blah and all that you know, like I was doing the same thing. But assuming that if I'm, as a childbirth educator, going to tell the couples that sits with me about the risks of taking a pedural, then it's really going to help them to avoid a pedural. Huge mistake, huge, big, big. All of us know we need to exercise daily or exercising. All of us know we are not supposed to drink alcohol. All of us know we're not supposed to eat sugar. We know so many things. How are you telling us to conduct ourselves differently in our life?
Speaker 1:No.
Speaker 2:It's not Right. So knowledge, you know knowledge doesn't help us make better choices and engage in better actions. Coaching does, because it's igniting on motivation, it helps set up priorities, it helps to adopt better perspectives, get rid of mythology, get rid of perspectives that do not serve us, create new habits of thinking, creates new habits of doing. It's all about coaching, it's not knowledge right.
Speaker 2:So I even assumed that, oh my God, if I was sitting. I was a childbirth education for so many years and I sat down time and again and during the reunion, when I met those couples, so many of them took epidural. Because the decision to take epidural is not related at all to what you know about epidural. It's the result of fear. So if you want to reduce epidural rates, you need to work with the fear right. It's not about knowledge and that's a huge, huge shift that only transformational coaching really brings in to birth support.
Speaker 1:I agree and I feel like that's what is missing in medicine. It's what's missing in nursing. It was what was missing from birth education and doula care. We have to. It's not even just about customizing it to the client, because that feels like you're telling them what they want to hear. They're making the discovery on their own when they're going through transformational birth coaching, they're learning how to trust themselves and go inward and find the right answers for them in their life. It's not just birth, it's just it's showing you how to do that in life, and it's so valuable and I want to say it can be challenging for the birth support professional herself.
Speaker 2:I know that there are clients that I'm working with that challenge my belief system. So, for example, even right now I was sharing just last live sessions that we have, because we have live sessions every Wednesday and I was actually consulting with my group of students because I'm extremely challenged. I have a client that is hospitalized already for 10 days. She is scheduled for an induction on July 24th and she doesn't. She's she. Everything that she says is by the book, but everything that I get on my skin is she is not going to show up for the induction. She is in a lot of fear and I can't even coach her through.
Speaker 2:The challenge is that I'm asking myself well, if you feel, if your gut and your skin I'm a very intuitive person Everything tells you that this induction that is going to happen on July 24 is going to be so traumatic for her because she is not, she doesn't have the resources to show up for it. Why aren't you just surrendering to a cesarean? And do I need to ask her that? As a coach, do I need to be the one who opens the door and say, hey, you know, I've been coaching you for so long and I feel that there is a barrier, there is a resistance, and I don't feel that we were really successful to getting you to a place where I know you're going to show up for the experience, and yet the staff is giving you either a cesarean or an induction, and you choose induction and I don't understand why Do I ask her as a coach or not.
Speaker 1:I think you can. I think it's just a matter of how you word it.
Speaker 2:It's very challenging because, of course, it's a first birth. The last thing that I think is good for her, for anyone Right and this is their end raises. So it's a major abdominal surgery. And then what about her second birth, if she wants to have another child, you know, and a VBAC, tolac, vbac, whatever comes after that, but then I don't know. I also feel that she doesn't have the resources and the capacity to show up for an induction, which is a very long process.
Speaker 1:I mean, what I think I'm hearing you say is that you believe that she'll probably end up in a C-section anyway Probably probably, and so how much more traumatic is that going to be and difficult to heal from, when you've been through the labor process and then end up in a C-section?
Speaker 2:There's also the emotional aspect, that the only reason that she doesn't choose right now to go with a cesarean in my mind, the way that I read her, the way that I work with her, is that she knows from an external motivation that she shouldn't. It's the should.
Speaker 1:Shouldn't trust herself.
Speaker 2:Yeah, so coaching is not easy.
Speaker 1:No, it's not. I very much identify with working with a patient like that, because I have that a lot in the hospital, because we have these severely high-risk people that come in and they want what they think they should want Exactly.
Speaker 2:They want what they think they should want. I loved how you phrased it. I love it. They want what they think they should want.
Speaker 1:Then later, when they have the experience that they think they should want. They didn't like it and that is so sad. I want my patients and my clients to be in love with their birth experience because they have made the decisions that aligned with their values.
Speaker 2:Exactly, exactly, the birth story of a woman. It goes for generations, yeah, and if she feels bad and feels that things were imposed on her, and if she feels that it was traumatic, it builds also our collective awareness at the end. And it is so important that she feels she is not only cared for but also listened to, that people ask her questions and we're really interested in her psyche, asked her questions and were really interested in her psych and how she feels about things and what will make her feel better, and that those people come with zero agenda. They can say well, of course, major abdominal surgery is less healthy than an induction that might end in a vaginal birth. However, for an induction you will need to show up. For a caesarean, you do not need to show up you show up differently, you show up differently.
Speaker 2:Yeah, you need to surrender.
Speaker 1:Yes.
Speaker 2:There's no performance Correct From your end for an induction. You need to show up long it's going to be a long time. It's going to be uncomfortable, um, you're going to be restricted for many hours.
Speaker 1:You need to show up yeah, yeah, I agree well this has been such a wonderful conversation and I knew it was gonna be a long conversation and I'm so happy about that me too.
Speaker 2:Me too, I want to say you know, the last thing that I want to say is it's a set of strategies, is a set of strategies and coaching exercises. That what I was doing is taking coaching exercises from the field and adopting them and designing them to be suitable for our field, and it's not easy. You need to, just like any other skill, if you want to build this skill, you need to learn and practice, learn and practice, and that's why we're meeting weekly and that's why you can also subscribe, like you subscribe to continue showing up and continue practicing, because you're really building a new set of skills.
Speaker 1:Yeah, and it's. It's a for, at least from the medical perspective. It's a change in the way that you think and I had in my heart that change, like I knew I needed to reach out and find those resources because I knew what we were doing wasn't working, and so I just think it's so important.
Speaker 2:Thanks so much. Yeah, I appreciate the fact that you saw the program and it was so beneficial for doulas in the program to hear the perspective that you and there was another nurse in the program right and you were both bringing the perspective that comes from the medical system. I think it was so delicious.
Speaker 1:Yeah, it was great. We had some great conversations and I mean it's it's something that I will be continuing because I want to keep having conversations like that, like I need that reality check I need to check in with, because it's so hard to go to the hospital and have all the things happen that happen and they just, you know, be out there alone.
Speaker 2:You're amazing. Thank you, you too. You're amazing. Thank you, you too. Patients are very, very lucky to have invested and so passionate about bringing your highest purpose and your best care. It's very inspiring.
Speaker 1:Well, thank you. I mean, I'm inspired by you. So thank you so much.
Speaker 2:Thank you, Kelly.
