#284 | September Q&A: The Midwife-Client Relationship; Ghosting Your Induction; 2-Step Delivery; Postpartum Resentment; Platypelloid Pelvis; No FER

September 25, 2024

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Welcome to the September Q&A episode with Cynthia & Trisha. Today, we begin with discussing the problem of increased reliance on Google searches and googling our way to answers that require deep introspection and self-trust rather than an automated and potentially biased and generalized result.

In our first question, Cynthia & Trisha debate one woman's question on whether or not she should stay with a midwife she does not feel emotionally connected to or fire her late in the game and choose free birth instead. 

Additionally, we answer the following:

  • My midwife is making me feel very uncomfortable about my weight gain. How much focus should be put on weight and nutrition in pregnancy? 
  • My home birth midwife told me her home-to-hospital transfer rate is 30%. Is that too high, and if so, what should I do about it?
  • What happens if I don't show up for my induction, and should I do this if I don't want to be induced?

Later, in the extended version of today's episode available on Patreon or Apple subscriptions, we discuss: 

Two-step delivery: what it is and why we don't like it; Pushing your baby out when you have no urge to push; Rupturing of membranes and the potential impact on causing a baby to rotate from an anterior to posterior position; What it means to have a platypelloid pelvis and if any pelvic shapes make vaginal birth impossible or more difficult?

Finally, we close with a round of quickies on the following: nipple shields; eating placentas and likening it to cannibalism; height and big babies; holding clingy babies; flying at 35 weeks; resenting sleeping husbands; prolapse after birth; making a twin pregnancy happen; morning sickness; timelines for breastfeeding babies getting back to birth weight; and personal experiences with terrible haircuts. 

#87 | Postpartum Rage: The Outburst-Guilt-Shame Cycle

#272 | Nancy Wainer, CPM and Pioneer of the VBAC, Shares Her Journey from Mother to Midwife

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

Livestream: Postpartum Rage: A Deep Dive into postpartum rage, why it occurs, and how to understand and break the cycle. Available on Patreon.

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View Episode Transcript

I am curious. Can you talk to me a little bit about Two Step deliveries, like delivering the head and then waiting for the next contraction? Are there any pelvic shapes that actually are an indication for cesarean section? My one regret is allowing the midwife to break my waters just prior to pushing, could the breaking of the waters caused my baby to actually spin to sunny side up?

Have you ever had a terrible haircut, and if so, when and what was it? Sinead O'Connor was also buzz cut, and I really liked her music, and so I thought I should get a buzz cut. She took me to get a cutter. She probably actually cut it herself, because she usually did that. She probably did. I think that might be correct.

So she buzzed off all your hair, and

-- it looked horrible, and I had to go to school the next day, and everybody called me a boy. That's why we need parents to stop us from doing stupid things, not to grab the buzzer. I mean, you know, who knows? Maybe it made me tough.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hello, well, hey,

Welcome to the September Q&A.

All right, I love September.

A lot of we get a lot of you as well, which is the fun part, getting your questions. So I love it.

We love your questions. Do we have? Oh, should we tell everyone what we just did? We did the postpartum rage. That was excellent.

Yeah, it's a very, very underserved area, postpartum rage. And we did this on our Patreon platform, and it's all available for replay. So come check out our Patreon page. You have to join tier three to get full open access to 100% of all of the content we've ever produced for $22 a month. So if you sign up for a month, you have full access to literally dozens of our workshops, the most recent of which is the rage live stream. The previous one we did was on libido, so you can just consume all of that content in your first month there. And you also have our whole library and history of extended Q and A episodes, which will include this very one. So let's just make a quick comment on rage. If you have ever felt the urge to scream at your baby. Have screamed at your baby, have thrown something at the wall, have kicked in a door, have, you know, punched your husband. These are real things. Or, you know, shook the car seat trying to get your baby in. Like, these are all real things that women experience. They are all under the category of postpartum rage, and there's an explanation for it. It isn't just that you're having, you know, a bad day. So please do if that resonates with you, if that feels like, oh my god, whoa. Well, other women are experiencing this too, please do go check that out. Also, there is a great episode. We do have an episode on this that you did a little mini that is way back in the 80s. It's like 82 or something. That's a good way back in the 80s. I was like way back, way back in the 80s, when we had first started this podcast in 1984 --

We'd be bigger than Joe Rogan if we started that long ago.

The most important thing about rage that I think we offered in the workshop is when to know it's something to be really concerned about. When is it a crisis versus when is it your expression of stress? And how are you expressing that stress? And then most important, what to do about it. And unsurprisingly, this often will involve needing to get your partner and support system involved if rage is bad enough. I mean, again, we gave examples and we gave some red flag cues. It is a whole family responsibility. It's not only yours, so do please get that information. It's truly almost impossible to get that kind of information anywhere. It's very, very underserved, and it is affecting we had hundreds and hundreds of women provide us with examples. A few sent themselves to the hospital. I mean, very serious things. One woman took a hammer and hammered an entire wall in her home with her stress. Another one purposefully dented her own. Our door. These are, this is a serious thing, Trisha. If you go to your OB or midwife to talk about it, or your general practitioner or anybody, they're probably just going to say, you're just a tired, stressed out Mom, what do you expect? Like, that's the response you're going to get. Nobody knows what this is. Nobody knows the cycle around it. And understanding the cycle around it is the trick to getting out of it. And in my years in my postpartum group, I've worked with many women with rage, and have sincerely seen them all come through it with the strategies that we've talked about. But is nothing to take lightly, and let's not even mention, and I said this at some point in the in the 75 minute workshop. It's not just a matter of whether you'll, quote, do anything harmful. You're suffering. That's when people should start taking you seriously. You're already suffering, even if nothing horrible comes of the rage. But we this is an area we just need to do a lot more for women. So go check that out at patreon.com/down, to birth show, we have so much content and education and entertainment and and and connection for everyone, and it is so available for the taking, and it's so attainable. Alright, so with that, Trisha, are we ready to jump in and get to our first question? Yeah, I thought I would just share something real fast that came into came in to us through Instagram Stories yesterday, because it just sort of like really surprised me how much women lean on Google to answer questions that really need to come from within themselves, and how little you know trust like how the internet and social media is just breaking down our trust within ourselves as women. And there's so much to be gained from social media accounts like ours, for example, but there's also so much that it does to harm women's instincts and self trust, and this just was a very, a very good example of that for me, this woman wrote in asking us if we have any any content or can recommend any accounts about having three children and sites that might discuss having Three children in a positive light, she said, I just Googled it. What I guess she Googled, should I have a third child? Should I have a third child? Yeah, I just Googled it, and it basically shot me down. Sadly, it feels like our country is not lifting up people who want to have multiple children. And then she screenshotted what Google told her, which said, basically, working parents with three young children may face a variety of challenges, including time management, child care, household management and being present. Working parents can try to be present for their children during their waking hours. For example, leaving early on a Wednesday to pick up a child, a child from school or take them to appointments can be a good de stressor in households where the father works full time and the mother works part time or not at all, the distribution of labor may be less balanced. Finding the right child care can be a challenge. Basically, you know, Google's telling her don't have a third child. Is too stressful. Well, this is what we were this is what we get when we turn to Google for a very intimate personal life decision. Yes, you mean you can't ask your friends and take a poll. You can't get a room full of family members together and say, raise your hand if you think I should. You have got to sit with the initial discomfort of getting quiet, stopping the thinking mind, because I promise you, you're going in a cyclical thought process of I should and I shouldn't, and here's why I should and here's why I shouldn't. You can't make a list of pros and cons. You also can't do any of these things when you're making the decision to marry someone. You can't make a list of pros and cons. You can't go in a cert. You have to get quiet, and you have to listen. The answer is, there?

We Google everything. We have a question, we type it into Google instantly. Is this a red flag in a person? Should I trust this? Should I have three children? What does it mean if my you know, right knee hurts like we have to stop doing this, because Google is generally showing us the most extreme and usually negative situations. It usually shows us like the outliers, and for something like this that is completely about your own feelings, your own self, your own world, your own inner world, your own family, Google is not going to be the answer. So I just they've had, they've done a lot of little tests with Google. It's heavily biased. It's heavily the algorithm is heavily biased. It feeds certain answers, and they really have been called out for it on something. Is, but, you know, it's, it's bad, like, that's why, who, what is it brave? Everyone says, like, go to brave instead, because it's not doing that and it's not, I don't remember. They're all, I don't even know what Brave is, but, oh yeah, no, it's, it's, it's an, it's definitely a superior search engine, but I can't remember why. There's a lot of reasons to it, but it's like privacy and but also the algorithm isn't manipulating you, and unfortunately, with Google, it is. So Google might have an intention to encourage the western world is being strongly encouraged to have fewer children, and Google is biased in that way. Yeah, Google will do that, and we're not saying you should have more children, because who knows if you should. You have to get quiet to ask yourself if you're done or if you're not done, that's all you can do. We all go through it at some point, and it's I just wanted to make the point. I wanted to make the point that we need to be really careful with how much we turn to social media and Google for answers that we want a quick answer to. But the answers are generally not quick. They're deep within and they take self reflection, and we break down our self trust every time we go to an outside source for a quick answer like that. So resist the urge to Google whether or not you should have a third child.

You know the whole many other things, the whole fact that we don't say search, but we say Google. And I do it too. I remember when it started years ago. I remember we would say Google it, and everyone's like, Google it. And we now, we now don't even we presume that all searching means Googling, and Google has become a verb, Googling and Googling. Yes, that's the problem. Everything has power, the power of the power of language. All right, let's moving on.

Let's get into our questions.

Hi, ladies, I had a question about connecting with your midwife. My question is, my new midwife team is, is great in the sense that they're very, very highly recommended in the community. I fully trust them in their capabilities and their profession, and I've been told that the specific midwife is is the one you want at your birth, because she's going to be the one that can really address issues and support you, and she'll be great in that sense, professionally, but in the sense of connecting with her. I have no connection. Every appointment I go, I don't really want to go. It's kind of quiet, you know, like we haven't bonded, we haven't connected. She doesn't check in on me. So I feel very disconnected. I will also say that my spouse is on a deployment right now, so I'm also kind of just going through this pregnancy very alone anyway, so I'm just kind of wondering if there's anything I can do to kind of better this connection, or if I just need to let it go and let this be my own journey by myself and know that I will have her there for, you know, just attending the birth and making sure everything's okay. I have no concerns about her capabilities as a midwife. I think I'm just a little bummed that I don't feel connected and just hang on. She had a follow up. It's right here.

I'm I'm really feeling disconnected from my midwife at this point. She canceled one of my appointments recently due to being at a burst, which I totally understand, but then she was unwilling to work with my schedule to get me in again. The next time I could see he would be six weeks later, and I'll be about 37 or 38 weeks by that point, that's kind of how I feel right now. I feel like this midwife just really doesn't care, like she doesn't know me. I don't feel connected with her. She truly does feel like a stranger, and I'm just at this point, I'm really wondering if rebirth would be something I'd be open to. Everything has been perfect up to this point, this baby at me, and I can see myself calling her in labor and then being frustrated with her being present because she feels like a stranger in my home. I know Trisha had an accidental paper, and in that moment of listening to her story, I was like, That sounds amazing, just me and my zone and my baby, my thoughts on this are that this for this is a shame. She her into, you know, Sharon stinks. She didn't, she didn't feel a connection. But I don't think that free birth should be chosen for this reason. I think the women for whom free birth is the safest and best option. Are convinced they don't need anyone there. I don't think that it's the same thing when a woman chooses free birth because it's free, because it's there's no cost, or because they're avoiding the one and only option they have. I just, I just don't think that's the path to. Free birth. I think it's, it's a real bummer. I think she should probably hope that it ends up coming out like you're like your third did Trisha, but I would, I would say, don't opt out of medical care because you don't feel a connection. I just, I just don't think that's the I don't think that's the right vibe. Doesn't feel like the right option. What do you? What do you? What does your gut tell you? Yeah, I think given where she is in her pregnancy at this point, I mean, of course, it's never too late to switch providers, but it is going to be hard for her to find somebody that she feels that safe and trusting with this late in the game, because that takes time to like, build that relationship. So you know, she's not with a provider with a ton of red flags that you must run from. That's not, that's not this scenario. We do encourage moms to change those providers late in the game when you need to run from red flags. This midwife doesn't sound like she has a lot of red flags. It's just that they're she doesn't have that cozy midwife. You know, friend, want to have a cup of tea with you feeling, which is unfortunate, because that is one of the beauties of having midwifery care, is that it usually can feel like that, but it doesn't always. She did say, you know, maybe it's my just that, because it's my second pregnancy, and I don't really feel like going to prenatal appointments, that can be very true. I mean, I think I went to three prenatal appointments, if that you know, in my second and third pregnancies. I mean, of course, I am a midwife, so it's a little bit different. But you just, I didn't feel the need to have that warm, cozy feeling with the midwife for my second or third pregnancies. I literally just wanted somebody there to oversee the birth in case something went wrong. And so she sounds like she's kind of in the same boat, like, go into labor, call your midwife, let them know, but you know, she can come late in labor, and maybe she just is in the back corner of the room, and you do either your thing on your own, and she's literally just there to oversee, you know, if anything is needed, like, that's kind of the ideal birth to me.

I think what's happening for her is that, because I relate to her from my first birth experience, I think what's happening for her is that she's feeling like the midwife doesn't care about her. I think she feels the midwife is indifferent toward her. And that's a very painful thing to feel. So one thing to not feel like to want to be friends with your midwife, and isn't happening. But I think she's feeling, oh, she doesn't even really care about me. And I think that that's if there we're presuming this whole time there is no other option, no other person to hire. But I think that's where the work is to just the mental framing of getting what you need from her and having that safety net and careful of the story about whether she does or doesn't care about you, because that's going to make you feel worse.

My suspicion is that it isn't that, that this is just this midwife's personality, that she's a little bit more some midwives are a little more distant. They're just, you know, she she said right in the beginning, this midwife is the best midwife skill wise, which is great. That's that's what you want. And it probably isn't personal. It probably is just this midwife's personality. And she asked if, you know, maybe she should say something to her. I don't think that's a bad idea at all. She could just say, I don't think she should say anything to her. You do sure she could say, I

What can she say? It's so awkward. I mean, I agree. It's not personal. I think she could say, I think just to feel like you're my wife doesn't care about you.

Is what hers she could say, I feel a little sad that I didn't feel like this relationship was as close and connected as I hoped it would be throughout this pregnancy. So I feel a little bit unsure about how you will be in my space. It feels like we're strangers a little bit, and I hope that when you come into my space, it can feel differently, the midwife is going to come for a home visit. That's a perfect time to have that conversation. You are. You know, in my home, for the first time, I have sort of felt like this relationship is a little distant. I don't want to feel like you're a stranger when you come into my home at birth. Is there any thing can we and then she should say, can we just hug it out? Yeah, she could Yes, I conversation the midwife. I'm afraid. Why? Because it's a risk? Why because the because it's a risk. You're dealing with a human being who already sounds like she's got some coldness to her and some lack of emotional intelligence. And you're you're encouraging this mom to speak to her as though you are the midwife on the other end of the conversation and you are not. And what if she says, Well, I feel like you've been cold to me. Well, you canceled your first appointment twice. Anything can happen. It's a risk right before she gives birth. So it also clears the space if she doesn't want her at her birth?

Yeah. I mean that is, that is where she has to do some work, does she my main I don't need this is a tough situation. My main thing is, I think free birth is the right path for the women. It is right for and i There are too many women who say, Oh, I just want to run from this provider and have a free birth. Or I don't want to pay for the birth or it's too much money to give birth free. Birth inherently comes with a ton of responsibility, and at the end of pregnancy, it's a heck of a decision to make. And yeah, and then the other thing is considering, assuming you don't have other options, I think you need to get your head in a space of seeing her for the role for which you're hiring her, and being at peace with it, because this mom did say she thinks she's a good midwife. I had the midwife I prayed I wouldn't get at my birth. And she was not great. She was not great. She you know, after the birth, I was like, jeez, like, you, can you just show a little warmth or joy or icon that give me something here, anything but, but she did the job well. And she only said two things during my birth, and they were the two things that really got me well. She said one thing really, she said there's relief on the other side. She did her job well and and I saw her role serving me when all was said and done.

So exactly to my point, it didn't have anything to do with how she felt about you, and it had everything to do with her personality as a midwife and she that's why I said, I think this mom feels like the midwife doesn't like her. I definitely don't believe that the midwife doesn't I think that. I think we get hurt, because when people have cold personalities, it feels personal. We sit there with our insecurities thinking, oh my gosh, they don't like me, but really, they're going around their lives with these rather unpleasant personalities. And I never thought it was personal. I wasn't in the I wasn't in the thinking of like, what have you done to offend the midwife? I think that the midwife just doesn't have a great personality, and it happens a lot, and I would still recommend that she have the conversation, if she feels that that would help her tell us we want to know, tell us afterwards how this goes. Please. Yes, she has to call in.

We must hear the follow up to this.

We must that was a tough one, tough one. Who knows.

Hi, ladies, I'm 41 years old, and I'm currently 21 weeks pregnant with my fifth baby. I've always gained 50 pounds of my pregnancy. I've gained 17 pounds so far with this one, and I was not overweight pre pregnancy. Have never failed a glucose test or had any issues with my pregnancy. All of my babies have been six pounds at birth. I have a new midwife, and this will be my first time having a baby outside of a hospital that midwives have attended all of my previous birth. My new midwife is very focused on nutrition. He's requesting that I keep a food log, and is concerned about my weight gain so far, they already eat well better than my previous pregnancies, and I actually feel pretty proud of my ability to make healthier choices. This time around, I take needed vitamins. My labs show no deficiencies anywhere. The only problem I've encountered is low blood pressure with my current pregnancy, tracking my food along with my midwives, constant pressure regarding my weight and diet has actually made me feel worse than I ever have before regarding my changing body and weight. I do not want to feel ashamed of my body, especially when it's doing exactly what it was designed to do. I'm growing a healthy baby, and my weight and diet are great for me. How much focus should really be on nutrition during pregnancy?

That's a perfect example of when a woman writes her question out and reads it and it really works. Yeah. I mean, it was a lot of women, but, but it's great. Like it just it, it's, it's, it's helpful when there's a whole story there. Okay, so what do you say?

Well, she said, How much emphasis should I be focusing on nutrition in pregnancy? But her question was really about weight gain, and they're different, so she should focus a lot on nutrition in pregnancy, because nutrition is very important weight gain is not so she should not worry about her weight gain if she knows that she is eating. Well, I think keeping a food log is a great idea because most of us aren't paying that much attention to what we're eating. So like, a three day food journal is helpful for just getting a sense of how much protein you're getting, how many calories you're getting if you're eating balanced, if you're eating carbs, fiber and fat together, because those are, you know, those are the healthiest things you can do for preventing blood sugar issues in pregnancy and having good, sustained energy throughout pregnancy. So if she does not have gestational diabetes and she knows she's eating well, then her midwife's comments about weight are just her midwives should keep her mouth shut. It's not a problem. What do you say? I'm just still processing that you just said another midwife should keep her mouth shut. I love that you're becoming increasingly bold. Well, I don't you just got. Year older this guy. So that's one of the things that comes with Asian wisdom boldness, I guess. But I mean, I think I would have said that before, midwife shouldn't be making those kind of comments if there's not a problem behind it. I mean, if this woman were gaining 50 pounds because she was going to McDonald's every day, then her midwife should say something.

What comes to mind for me when I heard that question is that there are many, many people who go about the world and go about their jobs very obtuse, in other words, very black and white. They see things in a very, in very black and white terms. And this midwife, at some point, learned something about weight gain, and she has these blinders on to everything else. She isn't able to take in the whole story and situation and differentiate, like you said, between weight and nutrition and and to look at a healthy mom and see a healthy mom in front of her. And there are so many people like this where they just they don't bend, they don't see things. They don't bend. They don't it's like the branches of a tree. Gosh, you know, it's like they, they can bend so much, and trees are so strong and tall and powerful, and they defy so many like, apparently, devise so many laws of physics. Where is the bending? Where is the saying? Oh, but let me read. Let me think about the whole picture here. She's just like, black and white. It's kind of like BMI, like, my huge opposition to BMI. BMI is useless. And this whole it's like the people who they see BMI, all the healthcare providers who look at BMI. I'm like, how, how do you not see the fault in applying BMI.

We're talking about body mass index, by the way. Yeah, yeah. It's just another example of when things become it's just another trend. It's like a black and white thing.

And it's not looking at the individual common sense. It's not looking at the individual. It's not looking at the holistic picture. It is looking at some CDC guideline like you said, that's just black and white, and that's not good healthcare.

I remember at a Tony Robbins event I went to Tony Robbins is six foot eight, and I remember he was talking about how there are many people like this, and I forgot what he called it, but there are people who go about their lives, they do their jobs like this, and they don't like It's like them. It's kind of like some minimum wage employees have a very managerial way about them, because they can fix a customer problem with without being like, Oh, but I can't do that. I'll get in trouble if I do that. They see the big picture of taking care of a problem that might have arisen for a customer. And Tony Robbins gave an example where he was at some kind of event or concert. He had an aisle seat, and everyone was seated. And he's six foot eight. He had almost no room for his body, and he had his legs a little bit, or one leg a little bit in the aisle to literally place it. He said that one of the people working there kept telling him, excuse me, sir, you have to put your leg inside. There was all this room in the aisle. But he said, like, please look at me. I'm six foot eight. I literally don't have room to put my leg. And every time he put his leg out a little bit, the man said, Sir, you have to get your leg back inside the aisle. And I just always think about that as an example. You know, everyone was seated. It's like, just see the flexibility in things. Look at the woman before you, she's healthy, and you're you're putting this all into a box, right? That's what it made me so to some people, the world is black and white, and to other people, the world is very gray. Yeah, yeah. This guy's, this guy's black and white. He's like, foot is not supposed to be in the aisle. End of story. That's it. It's either in or it's out. There's no in between, regardless of the circumstances, so, but the world really doesn't function that way. So okay, next, Hey, ladies, quick question. I am pregnant for the first time, and I'm very excited. I'm starting to interview local midwives, and I'm hoping to do a home birth, and unfortunately, there aren't that many midwives in my area who do provide home birth. I've only spoken to one so far, and I asked her what her hospital transfer rate is, and when I first asked, she didn't actually answer my question super directly. She just said that it was rare and that usually it's not for medical reason, and it's because the woman gets too tired or wants to pay meds, etc. So I pressed a little bit, and then she did say that her transfer rate is about 30% and this struck me as pretty high, but I don't actually know if it's high. I obviously want to do a home birth and not be transferred to the hospital, and I just don't know how worried I should be about that 30% any advice here would be very helpful, and thank you for the podcast. It has been totally life changing for me in how I think about birth, and I'm going into this experience with. So much confidence and excitement that I feel like I wouldn't have had otherwise. So thank you. Okay, bye.

Well, first of all, I think that this midwife should know her statistics a little more readily, especially something like transfer rate. This is not an uncommon statistic. She should know that right off the top of her head. So if she didn't know her transfer rate, and then had to go back and kind of figure it out that, to me, is a little bit of a orange flag, at least, and then a 30% transfer rate, that's high, that is high.

I was shocked by that.

That's definitely outside the norm, which is more like 10 to 12%

It makes me wonder if that midwife is transferring women because the labors are lasting long, and she's had it possibly, or she maybe it doesn't have a wide circle of safety, yeah, or maybe she's timid and and doesn't have a lot of experience and transfers at the first sign of anything feeling even slightly off, which, again, if You're a really experienced midwife, you have that wide circle of safety. You feel more confident staying home when things are just variations of normal and not true complications of pregnancy. So 30% transfer rate is high, or she's taking on very high risk women that probably shouldn't be having home births. I don't know, which is probably not the case, probably not.

So she should definitely inquire about why the why she transfers most commonly. She should definitely inquire about how many births this midwife has attended, where she got her education from. You know what would, what would be the most common reason that she would transfer her in labor? Just kind of like, try to get a feel for, if, you know, if she says, Well, I typically transfer women if they've been in labor for more than 15 hours, then, you know, you need to get out of there. Or I transfer women because they're if their water breaks for, you know, more than 24 hours, I would transfer them. Like, that's another major red flag.

Yeah, I think that's the big magic in the question. It's not just what percentage of women transfer. The real magic is, what are the reasons that you've had women transfer? And it's got to be because of normal things happening to have that high of a transfer rate.

It's kind of like I teach my clients, not only to ask everyone tells their prenatal clients, to ask their obstetrician their cesarean rate. And I'm like, you can ask them that hopefully they'll tell you the truth. There's, there's no way to know if they're telling you the truth. But when you get really educated, you can ask them a much more important question, which is, what are the top reasons that you give cesarean sections? And that tells you everything. So find out the reason for those transfers, and you'll know a lot more about that midwife, and then call us back and tell us why.

Hi, Cynthia and Trish. I was just calling because I'm coming out of my 36 week appointment, and there's confusion with my students, with my boss, my app, and the doctors themselves, and so they think that baby is birth restricted and want to induce me at 39 weeks. I'm just wondering, like, what happens if I just don't show up for an abduction and allow my body to birth naturally and physiologically.

Well, she has the right not to show up. And a lot of professionals like us would say, just don't show up for the induction. You hear it all the time. You have the right not to but where I get concerned is, what kind of stress is that going to bring you? It's not most women who can do that and feel totally at peace with it, and that's hoping that the provider basically forgets the whole thing and they don't mention it, rather than having them call you and get in say scary things to get you in there. So I think it's better to say, look, I don't plan on coming in, or calling them and saying, giving them a reason, giving them an excuse for why you're not coming in. But I just think again, I think that's a risk that could end up giving you more stress. So don't go be induced. By all means. Don't go be induced without a medical indication, but blowing it off, then I would just hope they don't make it worse and stress you out. I think you have to kind of take control of the situation a little better and tell them no, or have your partner or husband call and say, No, we're not coming in. Maybe tomorrow we'll let you know. I think you I think you stand your ground and just simply say, you know, I don't agree to be induced for non medical indications. And going past my unsure due date, when I have multiple due dates, is not a medical indication. Am I okay? Is the baby okay? Is there any pregnancy complication? No, okay. Then I choose to wait. I decline induction at this time, very simple. I agree with you. I would not just not show up, although you can, but it. Will probably be better for you in the long run, if you just have the conversation and make it clear what your position is. All right. Well, that concludes the first part of the September Q. A, if you are with us on Patreon or Apple subscriptions, you will be getting three more questions in the extended episode in which we are going to discuss two step delivery, the pelvic shape and a woman who has no urge to push and a ROM or artificial rupture of membranes. So we hope that you will join us in the extended episode. Or, if not, we will be moving on to quickies now. Quickie time, our favorite time. Okay, here we go. Why has my supply decreased? Using a nipple shield, I have flat nipples? Well, because a nipple shield prevents a baby from latching deeply, and if a baby doesn't latch deeply, they don't remove milk as effectively. And if you don't remove milk effectively, your supply will go down. That's the short answer. Um, heard an argument that eating a placenta equals cannibalism. Why is this incorrect? Interesting question, why is this incorrect? It is a temporary part of the body is a temporary organ. I can't come up with a reason why it doesn't fall into the umbrella.

I know. My only argument is that it's temporary. I'm trying to think of any other interesting she really stumped us. I don't know. I don't know. Okay, look here, here's the thing I've joked before that, even though I'm a proponent of women dehydrating and consuming their placentas, I think it's really cool, I have joked that I didn't do it because I'm vegetarian. So I've made a similar joke I would not actually have any opposition to consuming my own placenta. I didn't do it, but I don't know why I didn't do it. I really wouldn't have an opposition. And it doesn't. It doesn't. It's not cannibalism. It's just not, just I don't. It doesn't even matter what the definition. It's just not, is it like drinking breast milk? I mean, obviously drinking breast milk isn't cannibalism. Breast milk is a food almost consume their placentas, and that doesn't categorize them as cannibalistic when they do.

No, I I don't this. This is a really theoretical debate. We need to have a debate. We need to actually get some other why input on this, because why it isn't cannibalism, and then, in the end, who cares, right? What's the difference? If, who calls it what? What's the difference? Interesting question. Great question. Okay, it was fun. Wow. Really stumped us.

This is kind of a question, big baby concept, how does a five four woman push out a 10 pound baby vaginally, she just does. Her height Doesn't your height doesn't necessarily correlate with your pelvic size.

It doesn't at all and and five foot four is actually taller than most of the world, and it doesn't even matter. What matters when you're giving birth is the head position. The head is the effort. The head is the challenging part. It has multiple movable bones, but that is definitely the harder part. And then the shoulder comes out, and as I tell my my own couples in my hip and birthing class, once that head and shoulder is out, that baby is 100% coming out. Oh, yeah, it can be chubby. Doesn't matter. Super big. It can be 14 pounds. 15 pounds. Not that that's common, but it certainly happens. If the head is out and the shoulders out. It doesn't matter why, because fat is squishy, yes, exactly. And shoulders are actually squishy too. Um, my clean. I did not know that they're movable and squishable. Okay, my clingy baby is seven months, and everyone says, Put her down, let her cry. It feels wrong. What's your advice? Trust yourself if it feels wrong, don't do it. Forget what everybody else says, including us. True.

Yes. Hear everyone. Listen to yourself. Is it safe to fly at 35 weeks pregnant, as the first time mom, if you do not have any pregnancy complications, you can fly. Sure. I mean, the risk is that you could go into labor depends on how long you're flying, where you're flying to, if you're going to be in a foreign country, if you're on like an 18 hour flight to Japan, might not be the best idea. If you're flying two hours to Detroit, go for it. How long should the wait be to have a V back after a C section, we get this one so much.

Listen to our two episodes in july 2024 with Nancy Weiner, yeah, that very question was asked. Okay, great.

I have a two week old exclusive. Fed baby, and I love it, but I get resentful at my husband every night when he goes to sleep for eight straight hours. Fair, this is the phase in life where this is your job and it's, I mean, it's not unreasonable to be resentful, but if the choice is to breastfeed, this is just what comes with the territory. You can wake him up, but it doesn't help you.

It's easy to feel resentful over things like that, and we don't know why women are all powerful in pregnancy and breastfeeding and birth. We don't know why men can be there or not be there, and the baby is fully dependent on the mom. But I do think that you're going to find times in the longer years of your relationship where your partner is taking on things, and you're going to be like, who, I'm glad I don't have to do that. So the sleep is what, what gets people I think, I just think that if husbands can show a little more important and sympathy, yeah, a little more sensitivity, I think that's really where the resentment is. I think women understand women understand that it's their role. But if the husband's like, all right, I'm going to bed now, you know that's where she's going to feel resentful, rather than like, he rubs her feet, or he says, My gosh, you're doing so much work. I wish I could do more for you. Just, just let me know what I can do. Call me if you need anything. She's not going to feel resentment, because she's going to feel seen. And I think that's usually what women need well, and it's okay for it to be front loaded for the mom when the baby is an infant, because that's she's the only one who can do that. And then it's okay for it to be more heavy on the dad later, when they're older, and he might always do the math homework help or something. You know, it work. It works out. But it's normal to feel resentful. That's the point. But you will do yourself a service by by understanding where that resentful, those resentful feelings, come from, and working on them, because bearing that resentment over the long term isn't healthy for her, for the mother at all, or the relationship. Why do people not talk about prolapse issues after babies? I'm struggling with it. Yeah, people need to talk about it more. I mean, I do think it's being talked about a little bit more. There's a lot more. There's a lot more emphasis on pelvic floor therapy. It's very common, and it does need to be addressed. And a pelvic floor physical therapist is the answer. This is a bit of a silly question, but is there any way to make a twin pregnancy happen?

Supposedly it's more likely when you're breastfeeding.

It's much more likely if you're a dog. Okay, did you know dogs can carry the pups in utero from two different fathers? They can conceive. They can literally conceive again. Really? Yes, I had to look that up because I didn't believe that. Wow, that's crazy. Crazy. Okay, does eating high protein meals help with morning sickness and early pregnancy? Yes, yes, yes, yes, yes, yes, eating frequently and eating protein with your meals? Yes, absolutely. When should I be concerned if the baby hasn't returned to birth weight two weeks, I like to see them back to birth weight by 10 days. 12 days is great. Two weeks is the outer limit. If they're not back to birth weight by three weeks, we're definitely, definitely behind, way behind. It not that it can't be corrected. Of course it can. It has more to do with your milk supply than anything harmful to the baby. Last one, have you ever, okay, wow, it's an easy one is it. Have you ever had a terrible haircut, and if so, when and what was it?

Yes. I just told my daughter this story. Look at that. When I when I lived in the city in my 20s, I was very busy, because I worked full time, and I would then, after work a couple days a week, walk up to the upper west side and go to business school, where I was from six to 10pm at night, then had a long commute home after and in those days, Jennifer Aniston, her haircut. Everyone had that haircut, and it looked good on almost everyone, and it looks good on me. It worked with my hair, because my hair is wavy and not too unlike hers, when she doesn't like, you know, straighten her hair. And I love that haircut. And I would go anywhere I was, I was very busy. I was on a budget. I was and I would stop at, like, Supercuts, and I would get the haircut, and I would walk out. I'd feel great. My brother always went to this and my mom, they always went to this really expensive guy, because that's, that's how they roll, just not how I ever rolled. And they talked about it. My brother would talk about him, talk about him, and I said, you know, I want to treat myself. I'm just gonna go to him for a haircut one day. So I was all excited, and I went down, like, do whatever my hair. I let it grow a little long, and I said, Just do whatever. And it was the worst haircut of my life. It was just like it had, like it wasn't the Jennifer Aniston cut. I didn't ask for that. I said, just do anything. I'm. Really, it didn't have to be that cut. I was just kind of saying that, like, that was an easy cut. You didn't have to have a super special skill for people to look good with that haircut. You didn't have to pay a lot of money for people to look good with that haircut. But he, I said, Just do whatever. And he cut it, and it was just like, I don't know, he had, like, he it was almost, I don't know, like, bowl like, almost, like, it kind of like turned down on both sides. And I realized that there's some hairstylist that like, if they're cutting it on a wig, they can show their technique, and it's like, Ooh, cool. Look like, look at what I did with this hair. And I feel like that's what he did with me. But I think a really skilled one is able to look at the person and see their face and say, what hairstyle will look good on this face, right? And that's what I think he didn't do. So I just the irony of it was just incredible, because that guy had never paid more for a haircut at that point.

Well, how did you solve the problem?

Would he like? Did you get a recut? Well, it wasn't, no, it wasn't horrible, and it wasn't really a bowl cut. No, it wasn't horrible. It was kind of a stylish, funky look, but it didn't really suit me and my face and just, you know, it just wasn't a great cut a little bit above the shoulder. It was fine. I just it, just, was it really, well, it was my worst haircut.

What about you? Yes, I once had a really horrible haircut, and it was not fixable in any way, shape or form, because it what, because all of my hair was cut off. What do you mean? So that was in fourth grade. I had hair down to my butt my whole life. Lovely, long hair. Yeah, your mom, you said your mom likes you all to look like fairies. Yes, fairy hairs. We all had to have fairy hair. My mom always wants us to have stylish haircuts. She was still obsessed with fairy hair and but oddly, when she was in her 40s and I was in grade school, she has black hair and curly kind of kind of big black, curly hair. She got a buzz cut, and she looked so beautiful. And I remember as a child being like, I love her hair. It looked so good on her. And Sinead O'Connor was also buzz cut, and I really liked her music, and so I thought I should get a buzz cut.

Okay, wait a minute. You like sinead o'connor in fourth grade. Maybe that was a little Yeah, actually, yeah, Connor, and yeah, and you had short hair too. And, but I it was really my mother, my mother that inspired me. And so I said, Please cut my hair just like yours. And I and it was super short. I mean, it was practically buzzed. It was maybe a quarter of an issue. You liked it that way on your own. Mom, I loved it, little girl.

And what happened? I I cried hysterically. And I know your mom actually brought you somewhere, and your mom basically said, Are you sure? Are you sure? Are you sure? And I said, Yes, I'm sure. I'm sure. I'm sure. Please, I want my hair to look just like yours. And so she took me to get a cutter. She probably actually cut it herself, because she usually did that. She probably did. I think she might be correct.

So she buzzed off all your hair, and it looked horrible, and I had to go to school the next day, and everybody called me a boy, and I Yeah, buzz cut. I looked like a boy, and I at the time, I also had, you know, I grew into my ears. I had kind of big years when I was little, and so cutting all the hair off wasn't good for the years. And I got, yeah, I'm got made fun of plenty for that, and there was nothing I could do, because I couldn't go shorter. And I it took how many years to grow it out. I mean, years, we're not talking months. It took years to grow it out, really, years, yep, to get it back to like Bob length, oh yeah, three years story, yep, you have to send me a photo. I can't believe that you never told me that. Yep. So did your mom ever apologize? Or was your mom like you said it was like You asked for it. You asked for it. Oh, wow.

That's why we need parents to stop us from doing stupid things, not to grab the buzzer. I mean, you know, who knows? Maybe it made me tough. I'm sure it did. All right, everyone, thank you for the great questions.

All right, that's a wrap for September. Don't forget to please call in your questions to 802-438-3696. Write them down. Make sure you don't have a lot of background noise. It's really helpful for us, because we get so many questions, we want to listen to them all. But if they're too long or there's too much noise, it's really difficult for us to use them, and then we hate to not be able to use a great question.

All right, thanks everyone. See you next week. Adios.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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