Postpartum University® Podcast

The Problem with Obstetrics and How it's Failing Mothers with Dr. Stuart Fischbein EP 245

• Maranda Bower, Postpartum Nutrition Specialist

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Postpartum providers, the PPD and exhaustion your clients face are direct outcomes of the medicalized birth model. Renowned OB-turned-advocate Dr. Stu Fischbein joins us to expose why standard practices (like the "six-week checkup") create pervasive obstetrical trauma. This episode cuts through the noise to reveal the root cause of the postpartum crisis and shows you how to fight for the holistic care your clients deserve.

Check out this episode on the blog HERE

Key time stamps: 

  • 01:44: Dr. Stu's unique perspective: 28 years in hospital OB vs. 12+ years in home birth
  • 04:52: OB residency teaches providers to view pregnancy as an illness
  • 08:00: The hospital model is designed for efficiency and profit
  • 11:48: The "see you in six weeks" model is driven by financial reimbursement
  • 15:04: The medical system separates mother and baby as two entities
  • 20:50: The economic and societal benefit of paid parental leave
  • 23:44: subsidizing midwifery care for a year is an important social change
  • 26:40: Why women must not abdicate responsibility for their birth care
  • 29:44: Obstetrical abuse behaviors are similar to domestic abuse
  • 35:07: Obstetrical trauma makes postpartum recovery more difficult. 
  • 38:40: cognitive dissonance that prevents doctors from seeing the problem. 
  • 44:45: Why families cannot rely on the system for postpartum support. 
  • 46:00: The critical role of the husband in defending the mother
  • 48:38: Why medicine ignores what it can't quantify or bill for 
  • 50:40: The danger of licensing doulas and regulating quality. 
  • 54:17: Why midwifery schools are becoming medicalized 

Connect with Dr. Stu

Stuart James Fischbein MD is a published author of the book “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, A Midwife and A Mom” and peer-reviewed papers Homebirth with an Obstetrician, A Series of 135 Out of Hospital Births, Breech Birth at Home and Twin Home Birth. He spent 28 years assisting women with hospital birthing and, then for the next 12+ years, was a homebirth obstetrician who worked directly with midwives.  He now lectures globally, advocating for informed consent and reteaching breech & twin birth skills. Host of the weekly Birthing Instincts Podcast with Blyss Young. Website | IG 

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SPEAKER_01:

The postpartum care system is failing, leaving countless mothers struggling with depression, anxiety, and autoimmune conditions. I'm Miranda Bauer, and I've helped thousands of providers use holistic care practices to heal their clients at the root. Subscribe now and join us in addressing what modern medicine overlooks so that you can give your clients real lasting solutions for lifelong well-being. Hey, hey, everyone. Welcome to the podcast. Miranda Bauer here, and today I have Dr. Stuart Fishbein. Y'all know him as Dr. Stu. He is the published author of the book Fearless Pregnancy, Wisdom and Reassurance from a Doctor, a Midwife and a Mom, and a peer-reviewed papers, Home Birth with an obstetrician, and so many more. He spent 28 years assisting women with hospital birth. And then for the next 12 plus years, he was a home birth obstetrician who worked directly with midwives. And since retiring from attending home births, he has turned his focus into traveling around the world as a lecturer, an advocate for reteaching breach and twin birth skills, respect for the normalcy of birth, and honoring informed consent. He hosts the weekly Birthing Instincts podcast with co-host Bliss Young. And we are so thrilled to have him on the podcast. Welcome, Dr. Stew. So great to have you.

SPEAKER_00:

Thank you, Miranda, very much. It's always an a good opportunity for me to uh I'm honored just to be able to speak to an audience that might not normally get. Um when I retired from birthing, it it is hard, but the age did catch up to me. And the need for solid, even stolid slumber was was overwhelming me because I had been on call pretty much, you know, every day for almost 40 years. And even though you don't get called all the time at night, you are never going to bed not knowing you're going to be called. So it did wear on me. I got old. I miss being at birth. I don't miss the waiting around. I don't miss the being on call, but I certainly miss the moment when you know that that baby's coming out vaginally, whether it's crowning or rumping or whatever. And um so uh I'm honored that I still get to go around and teach this and be invited to come on podcasts like yours and share my experiences. And people can decide whether it's wisdom or not. I'll let them decide. But my experiences are real and I have this unique perspective because I spent, as you said, 28 years in the hospital setting and a little over 12 years at in the home setting, which is very rare. That you know, it's either one or the other. Um, rarely do OBs ever go to a home birth, and rarely do home birth midwives, I mean they have to transfer their patients, but they they don't have experience the pressures that doctors and nurses are under in the medicalized hospital system. So uh I have that perspective from both.

SPEAKER_01:

Which is, you're right, is extremely rare. And I actually back in the day when I got pregnant with my first my my son is almost 16 years old. I've got four kids, all home births. I was actually introduced to home birth by an OB who attended home births in the Chicago area. And it was absolutely fascinating. He was sharing with me, he said, Miranda, I don't know what you're gonna do for your birth, and it's all up to you. It's your complete decision. But I highly recommend that you look into home birth. And I was like, wow, that's that's really interesting. His name was Ben Lowe, Dr. Ben Lowe. And he had a practice working with three of uh two other two other male physicians. Uh and he has like eight plus kids, all born at home, like just absolutely amazing, wonderful man, just wonderful human being. And I was like, Oh, great, I I will look into that. And it was it was mind-blowing, and I and I did, and I had home birth with all, and I couldn't imagine anything different. And what I saw working with midwives was a completely different perspective as a doula. Now that I have that, you know, as a doula for many, many years, uh, and I don't do that work anymore because being on call, just as you had described, is awful. Um, but I, you know, I saw the difference between OB and midwifery care. And this this whole model of care was so fascinating and so different. And so for you who has this perspective, I'm wondering and curious how did working with midwives teach you about postpartum care or or birth care that your medical training never covered?

SPEAKER_00:

Wow. Okay. Uh well, just for your listeners, uh, I was conventionally trained in my residency program at Cedar Sine Medical Center in Los Angeles back in the early 1980s. And people have to understand that medicine and the practice of obstetrics was completely different in the early 80s than it is in 2025. In many, in many ways. Uh the whole system of medicine used to be private practice, you know, it was hospital-based, but the patients belonged to the doctors. And now we live in a world where doctors are just paid employees of a hospital working shifts, and the patients belong to the system. So when I finished my residency program, I was very medically trained. And I thought that pregnancy was a uh, you laugh, for lack of a better term, a high-risk condition that required management. This is what we were trained as residents. Everything uh had a protocol, everything had an algorithm. We had ways of dealing with all diabetics, ways of dealing with all twins. Um, very little individualization of care. It was very mechanized. Um, I did things that I now look back and I tend to think were pretty stupid and I mock a little bit, um, because that's all I knew. And that's the way doctors are trained now, is all they know is what they learn in their medical school and residency training. And then they come out, and even if they wanted to do something different like Dr. Lowe, um, it's very difficult for them to do that nowadays because they're not private practice, they're not independent. They're they're they're salaried employees. Um so what I learned was again that medicine, that pregnancy was an illness, and that almost all of them required some sort of intervention or treatment. And so every pregnant woman came into the hospital, she got an IV, she got blood drawn, she signed consent forms, uh, and then she got put on a monitor. Uh, you know, we had faith in the monitors back then, we had faith in Friedman's curve back then. Um, we had faith that Pitocin didn't, you know, wasn't a detriment or that Cytotech wasn't a detriment. We did, you know, we intervened a lot. When I was a medical student at the University of Minnesota, uh, every single woman, whether it was her first baby or fifth baby, got a medial lateral epesiotomy. We were dressed in full hazmat suits. The woman was on her back with her legs and stirrups. Uh, we were washing off her bottom with iodine called beta dine. Um, we were putting drapes on her legs. We were taking the baby, we were clamping the cord immediately. We were handing the baby to the warmer, to the nurse in the warmer, not the mother. Um, this was routine. This was how birth was done. This is what we all thought was normal. Until I when I came out of practice, I came out of residency and I started a private practice. And in those days, again, because you didn't get a you didn't get a salary, you didn't have it, you didn't, uh, you weren't working for anybody, you had to hustle to build your practice. So you covered emergency rooms, you covered other doctors when they were on call uh on vacation, or you assisted them in surgery. I I worked at free clinics. And one of the things that happened to me early in my career, which was life-changing, it's one of those sliding door moments, was I was approached by a couple local midwives, home birth midwives in in LA, and asked if I would take their home birth transports. And being open to these things, but also being very medicalized, I didn't think that home birth was a good idea. I'm pretty sure that I probably thought it was a bad idea, just like most doctors are indoctrinated to believe. Uh, I did it because it was revenue generating for me. Simple as that. So simple I was a simple mercenary uh trying to make money. Uh, but it changed my life because I got to spend time with the midwives. I found that their patients were not hippies. They were quite bright. They knew more about their bodies and birth than my patients did. Um, the they were not coming in with emergencies. They were coming in because they generally were exhausted, or maybe their blood pressure was up a little bit or something, and it wasn't something that was a disaster. Like those things tend to get uh amplified. You know, there was a meme I saw recently, Miranda, that said, when something goes wrong with a birth in the hospital, it's because of pregnant, it's because of birth. When something goes wrong with birth at home, it's because of home birth. Right. It's not that they never blame themselves for what goes on. And and so I began to hear from the midwives different ways of doing things. And they began to ask me questions like, why are you cutting the cord immediately? Why are you taking the baby to the warm or not handing it to the mother? And it's like I didn't have an answer. Well, the answer is like when I was a kid and my I was annoying to my mother, my mother would say, Do it because I said so. So this was like my answer to them was, well, this is our protocol. This is our policy. Like, well, that's not an answer. So they made me begin to think differently. And then after about 10 years in practice, I started a collaborative midwifery practice where I really got into the model of midwifery care and let the midwives do all the normal stuff, and I took care of the problem stuff. And that is probably the best model of care that I've I've dealt with. We are good at obstetricians are good at problems. But because we're good at problems, we see every birth as a potential problem. Midwives are experts in normal birthing, they're not a subset of uh obstetricians, they're not a lesser subset. You know, they're not a mid-level provider, they are a different profession altogether. But my colleagues don't appreciate that, and the system doesn't appreciate that. Um, and so I just I just found that that they had a better way of doing things, and most women are not, do not need medical attention when they're pregnant. So they taught me a lot. So you back to your question about postpartum. If you don't understand the whole process of understanding the midwifery model of care, then it may not be out of context when I say these things. So the midwifery model of care sees pregnancy as wellness, a normal function of the body that sometimes goes awry, and they accept uncertainty. Uh obstetricians see pregnancy as illness. They don't like uncertainty. And so they interject their own uh issues, which sometimes may cause more problems than nature itself, but it's their problems, they're comfortable with them. And they think that pregnancy uh needs intervention. That's the difference between the two models. The problem is, is course, of course, is the system isn't not set up to be human. The system is set up to be uh efficient for the system, to move women in and move women out. And doctors are trained in that system. We're almost trained as little, as little um worker bees to do what we're told to feed the system. And the system is to make money, and the system is to get uh babies in the bassinet, no matter how they get there, it doesn't really matter. And one of the things we were never taught was anything about postpartum care in their own.

SPEAKER_01:

And that's still to uh true for today. I mean, I know that your training was back then, but people who are being trained today as providers are not getting any sort of training in postpartum care whatsoever.

SPEAKER_00:

I agree with you. And I and how do I know that? Because the system still exists where they'll send you home on postpartum day two and they say to you, see you in six weeks. And that is still the system. Why is the system like that? Well, part of it is indoctrination, part of it is habit, and part of it is financial. The way insurance companies reimburse for pregnancy is that everything that happens within the first six weeks is part of your global fee. So if you come in, if you see a woman six times during the six-week period of postpartum or once, um, you get paid the same. And doctors are a business. They have to meet their quota, they have to pay their overhead, they have to do these things. So um there's no thought process or teaching uh that that this is not how it's supposed to be. There's no, we don't see other models of care. When you only work in the medical model, you don't see the kind of care that midwives provide for postpartum care, which is typically whether or not you deliver in the hospital or at home, midwives are gonna see you on the first or second day after you deliver. They're gonna come back maybe on day five. They may have come back on day 10 to 14, do another visit. There, you know who your midwife is in that model. So when you call with an issue at night, like baby's not latching well or something like that, you're not gonna get put through to a stranger. You're gonna be put through to the person who knows you. And I can't emphasize enough how important that is. Because I, as a physician who took call for all those years, I'm human. I'm going to give better attention to people that I know than people that I don't know. I'm gonna try to do my best, but we all, it's it's human nature, it's it's to give more attention to people who are directly in your line of sight. You care more about your family than you care about your neighbor. And you care more about your neighbor than you care about somebody who lives in a town 20 miles away. And you certainly care more about the person who lives in your state than maybe somebody who lives in a foreign country. This is just that's just how it works. There are those of us that are exceptional and they care about everybody and stuff. But that's not when there's an emergency, you're going to go back and you're going to pay attention to those people that you have a connection to, a relationship with, a communication with. And midwives know their clients. So another advantage to the midwifery model of care is postpartum. When there is an issue, you're going to get that person who knows you. And then they're going to see you again, maybe at a month, and then certainly at six weeks. And then, you know, midwives have a slogan on your it's your midwife for life. And so if you have a problem when your kid is three months old or six months old, you can call your midwife and they're going to be able to take care of you. Because midwives also look at mother-baby as a dyad, as connected, that there's a symphony that goes on between mother and baby. The medical model, one of the hugest, hugest, is that a word? No, that's not a good word.

SPEAKER_01:

It is today. It's a word today.

SPEAKER_00:

One of the biggest, one of the biggest flaws in the system is that they see uh mother and baby as two separate entities. And once that baby is born, that baby now belongs to the pediatric department. And the obstetrician doesn't deal with that. So the obstetrician deals with mom, the pediatrician deals with baby. Nobody's dealing with mother baby. Midwives do that. And some family practice doctors do that, and certainly some naturopaths do that, but obstetricians don't do that. Obstetricians are very reluctant to give advice about a newborn baby. I mean, they that that's not their field. Midwives know all about that. And mother baby is a diad. Breastfeeding is not something that you can farm off to a lactation consultant all the time. And the lactation consultants in the hospital, by the way, they work a shift also. So you may see one lactation consultant on day one who did give tells you something, and on day two, you see somebody else who tells you something different. So there's no there's very little continuity of care. And postpartum care in the midwifery model is designed for continuity. Now, what's happening with a lot of midwife practices these days, or they're getting larger or they're getting um taken over by medical systems, and they're becoming less personal or more impersonal, I should say, because they'll all the midwives are now working shifts as well. And I understand that working a shift is better for your lifestyle as a physician or a practitioner, but it's not better for the mom. It's not. So we don't we don't know much about postpartum care. We we don't know much about breastfeeding. I mean, listen, in my day, we discouraged breastfeeding. We encourage women to take a shot to dry up their milk so that they wouldn't get engorged while they bottle fed. While the pharmaceutical companies that came to our office and brought us really nice lunches and got us gift bags for our patients and took us to Laker Games. Um, this is this is what happened. They outlawed that. Uh, that we needed a law to be ethical is you know, that's just says a lot, a little bit about says a lot about the system. Um but uh yeah, we were influenced by what we were what we're taught. And again, if you only hear one thing, you only know that thing. I mean, if you lived your entire life in Greece and never heard someone speak another language, you'd think the whole world spoke Greek. But we know it doesn't. And they're not, and you have to be open to hearing those things. And I don't think that most OBs are. And it's not by their human nature, it's by the what happens to them uh uh working in a system that is not designed for nurturing.

SPEAKER_01:

So we have this system that's not designed for nurturing, and we know that it needs to be significantly improved. And I and I see so many providers who are standing up saying, hey, we need something different, but how do we integrate these principles back into this broken system? Is that even possible? Or are we gonna have to tear down the entire system and rebuild something different?

SPEAKER_00:

No, women are gonna have to have to ask for it. And and there are several things we can talk about. First of all, some of the things the midwife taught me was about the like the 40 days of lying in. That's not what we we used to tell women, okay, no sex for six weeks, no heavy lifting. I think that was pretty much the limit of our instructions.

SPEAKER_01:

So, what does that mean, right? Like, are you am I still able to carry my baby in that laundry basket or like up a number?

SPEAKER_00:

Oh, they'll make up a number, 20 pounds. Yeah, they just make it up. All right. And do they tell you how to pick up somebody if you have to pick up something off the floor? Do they tell you to squat, use your knees, don't? I don't know. Sometimes they do, sometimes they don't have the time to do that. But men wives would talk about the 40 days of lying in. And then you know, the the the old saying was it's like uh, what is it? Um postpartum, it's five days in the bed, five days, five days around the bed. Yeah, or is I'm not sure. I now I've I've forgotten. I there's so much in my head that's like. You got it.

SPEAKER_01:

Yep. Five days in bed, five days around the bed, five days.

SPEAKER_00:

Five days around the house.

SPEAKER_01:

Five days around the house. Yep.

SPEAKER_00:

That's only two weeks, though. But you're supposed to really stay around and do nothing and have that baby skin to skin for that entire time. You know, dad can take over for a little bit, but but there's no reason mom needs to be doing anything else. They should put their uh their phones away. You don't want to have the non-ionizing radiation nearby anyway. Uh, you should have this period of time where minimal visitors, you should be eating mostly warm food. That's a Chinese thing, I believe.

SPEAKER_01:

Um it's actually a cultural thing around the world. That's one thing that I teach. Around the world, every uh postpartum practice supports warm, digestive, easy to digest food. And it looks different, you know, it might be a different stew, it might be a different soup, but the practices are the exact same for any culture who supports postpartum.

SPEAKER_00:

Except ours.

SPEAKER_01:

Except ours.

SPEAKER_00:

And and do doctors know that? I don't think so. I don't I don't think they know that. Another thing that would really be helpful, and this gets into a a little bit more of the so our social and cultural system that we have, but we know that fertility rates are falling. We know that there are medical reasons for that, but putting that aside, um, we're not even at replacement value in our country anymore, and most countries are not. So when you want something, and we and we need we need to have more kids. I I the whole idea that the climate's gonna kill us all and and oh overpopulation. I mean, when I was in the 60s, they were talking about overpopulation. We we need to subsidize things that you want, and it's basic economics, and tax things that you don't want. Okay, if you subsidize something, you get more of it. If you tax it, you get less of it. So one of the things we don't have in our country is like substantial paid leave for both men and women. Women are given six weeks' disability. At least that's what they were in California. Maybe it's changed. But when I was there, you could say, and then you'd have to find a reason to extend it. So basically, you'd have to commit, say that the woman's back is hurting her or that she's not recovered yet, or you make up something. So essentially, you they force you to commit sort of fraud in order to give the woman more time. We could change that. A policy would change that where we could give women six months and we could give men six months of paid leave. So that would make it financially more viable for them to have more children, and it would make that period of time so much more therapeutic for both mother and baby and father to right. We don't do that. So that's one of the things that the system could change, which would help with uh with the postpartum issues, because families sometimes can't afford to take more than six weeks off. Dads are usually back at work when three, four days after the birth.

SPEAKER_01:

Absolutely, yeah. And moms too, they're they're back at work a week, two weeks later because the leave is unpaid, and they can't afford to be out an unpaid leave, which is insanely frustrating. I know here in Alaska, one of the laws that has just been enacted is that midwit midwives have the ability to work with women postpartum for an entire year. So that state Medicaid, I think it's Medicaid, right? Medicaid Medicare. I always get this confused.

SPEAKER_02:

Yeah, no, it's Medicaid.

SPEAKER_01:

It will it will be paid for completely. So if a mom has that insurance for an entire year, she can have that continuous care model, which you have described, so she can work with that same midwife that had helped her in in delivery and was with her during the birth of her baby through an entire year of care that it's paid for by insurance.

SPEAKER_00:

You know, I again listen, I'm not for socialism, but I think that social engineering is important. And and I know that everybody may have, not everybody, but there are many different ways of looking at a at an issue. Um, I just think that what we're doing, what we've done to the family in the past 50 to 70 years has not has not benefited our country. And we could change things by changing the way we subsidize things. And I'm not talking about socialized medicine. I'm talking, but I am talking about what you just said, where giving women support for a year and paying somebody to offer that support, especially a midwife, who certainly, by the way, is far more economical than a physician and shouldn't be, though, by the way. I mean, they're more uh they know more about this stuff than doctors do, yet doctors get paid more than they do. Again, another flaw in our system. But it's very, it's really important because we're not taught, the doctors are not taught anything about this stuff. There, there is no studies that really can break down the um the psychology that's happening to mothers afterwards, that the the trauma that's going on within them. They don't look at that stuff. That's not an outcome that's measurable in the medicalized model, which always wants to look at you know data. But they they it this is fuzzy data. They don't like that. They like data like morbidity and mortality and C-section rates and things like that. But they but none of the studies actually look at the at the downsides of what the medical model has really been doing to our mother-baby bonding and our family relationships and stuff like that. Midwifery does look at those things and how a society treats its women and its children, um, especially those the the weakest, is it it tells you, uh makes a statement about the society. And I don't think we're I don't think that we're doing well. There are countries that are doing far better than us when it comes to that. I mean, the world's in a mess, in a big mess right now, in so many ways.

SPEAKER_02:

Yeah.

SPEAKER_00:

But one of the things that we could do is we could help with this because the way we start out in life, our immune systems start out in the womb, uh, our our relationships, our connections, our stress levels, all those things. If if we experience those things when we're young, they're going to affect us when we're older. We can be kinder. I mean, what do women want more than kindness?

SPEAKER_01:

Connection.

SPEAKER_00:

Yeah. I mean, I would put that under the umbrella of kindness, right? Yeah.

unknown:

Yeah.

SPEAKER_00:

And the medical system doesn't do that. Midwifery model um is more supportive of that. Now, listen, there are midwives who are very medicalized. So it's not, it's a model of care. It's not just necessarily, oh, I hired a midwife, now I'm good. No, no, you have to do your due diligence. You have to check them out, you have to find out uh how do you how do they make you feel? How do you feel when you when you finish a visit with them? Do you feel better? Do you feel worse? Are you connected? We I mean we have abdicated our responsibility when it comes to pregnancy as if it's a part of our health care. We pay a fee every month for our insurance, and we and we go uh where they tell us to go, and they tell us how often to go. Oh, it's time to get your teeth cleaned, or it's time to get your mammogram, or it's time to get your paps, and you just go in and you just do it without any real thought process of it. You wouldn't do that with anything else in your life. Everything else in your life you plan ahead, but this one thing we tend to abdicate to somebody else. And when you abdicate responsibility, you get what, you know, you you you you get what you sort of deserve. And it and women who've I know this because I've seen both worlds. Women who go and do the work and find the right practitioner, whether it be an OB or a midwife, um, they're gonna have less emotional trauma, less physical trauma, they're going to recover better. Now, midwife, the midwife model itself, you're gonna see less physical trauma and therefore a less emotional trauma as well. We know for a fact that hospital births, you're far more likely to end up with interventions such as psiotomies, lacerations, C-sections, operative instrumental deliveries, um, mother-baby separation, not delayed cord clamping, uh, manual removal of the placenta, all these things with no real concern what that's doing to the baby or the mother long term, because nobody studies it. It's not quantifiable, therefore, we're not going to pay any attention to it. Plus, you can't bill for these things. And then our system is based on billing. I know I'm sort of going all over the place, and maybe listeners are starting to get a little nervous, anxious in their stomach, but that's because the system is chaotic. It's just chaotic. And that doesn't benefit anybody. The practitioners are not happy, the patients are not. Who's happy with the system? I mean, maybe the people that run it, the executives that run it, the administrators of hospitals that run, you know, they they do well. The risk managers, they do well. Yeah, but the individual patient, the individual doctor, the individual nurse, most of them are not very happy. I've said this many times before. How do I know that doctors aren't happy? Um, because everybody's heard of the fact that doctors often are they use coercion. They'll say things like, if you don't do this, your baby could die, or you know, um, you you have to have the hepatitis vaccine because you know, for whatever reason, and they'll use coercion, or you'll say, I don't really want to have an IV, and they'll roll their eyes, or they'll, or they'll stomp out of the room, or they'll laugh at your birth uh your birth plan, or they'll treat you badly, or they'll talk harshly to you. And I can just tell people uh it's common sense that happy people don't talk to people like that. Happy people don't do that.

SPEAKER_01:

That's so true.

SPEAKER_00:

And stories of these are legion in the hospital setting. Um that you were disempowered, you were uh you were uh embarrassed, your baby was used against you, your husband was used against you. There's a list of of uh behaviors that I that I when I teach my two-day seminar, I go through. It's a list of behaviors, and it sounds like things that are happening to women in labor and delivery about abusive things that happen to them. The list actually comes from a domestic abuse hotline. And the things that happen in domestic abuse um are what the hospital system is doing to women in labor. It's remarkable because I fool people. I say, you know, I think, you know, think about all these things in the hospital, and they we all we talk about all the things they're doing in labor. They say, by the way, this comes from a domestic abuse hotline.

SPEAKER_01:

You know, and and how that I'm sure plays out into postpartum mood disorders, for example, which we see are skyrocketing. None of that is shifting, none of that is changing, is actually getting worse and worse. And of course it's getting worse when we have all of these interventions and our the mother baby diet is uh you know separated or not even looked at as important. And then we have an abusive relationship with our provider. You know, sometimes it's it's not even just the OB, right? Sometimes we have even the medwife, for example, quote unquote, which I'm hearing become more and more popular. But we we're seeing that this isn't this isn't working, right? And I'm wondering what what mindset shifts are hardest for physicians to make? And and why are they so important into changing the way that we view birth and postpartum so that we can change the system?

SPEAKER_00:

Let me make sure I understand what you're asking me. How do we get doctors on board? Is that sort of what you're asking?

SPEAKER_01:

You know, you've you've worked with so many providers who come to you for these training uh for these trainings and the things that you do. Like what what mindset shifts are the parties for them?

SPEAKER_00:

Very few doctors come. Um I've had some. I mean I've even had a couple maternal fetal medicine people take it. But these are these are unicorns. Uh a lot of them take it, knowing full well that they'll go back and they won't be able to use the skills that they learn anyway, um regularly or plan, but they want to know what to do if they have an unplanned breach that shows up. Uh, which I think the fact that medical uh OB residency programs are no longer teaching this skill to doctors who are supposed to be professionals in all things pregnancy, and they don't know how to deal with one out of every 20 women that walk into the office with a breach or twin pregnancy who has a breach baby in it, um, is embarrassing that they don't know how to do that. So these people come, these doctors that come, these rare doctors that come, they do so because they haven't forgotten what their mission is, which is to provide the best care possible to their client, to take care of their client. Their fiduciary duty is to their client. Most doctors right now, their fiduciary duty is conflicted because as a salaried employee, you can't just you can't just be loyal to your client. You have to be loyal to your employer too. And if your employer says we don't let people go past 41 weeks, then you have to skew your counseling to tell a woman that she can't go past 41 weeks, even though in your heart you know that it's okay to go past 41 weeks. So you can see the dilemma that that that doctors have in that. Um, when I teach this, when I what I'd like to see happen is I'd like to see um them have a better understanding of their own psychology. If you if you don't understand the problem, if you don't see the problem, then you can't fix it. And there's a huge cognitive dissonance that goes on in the medicalized birth model to think that that their system is is doing good because the alternative is unthinkable. And yet, if you look at the data, the rising C-section rate, the rising induction rate, the rising rate of postpartum hemorrhage, the rising rate of NICU admissions, the more ultrasounds, the more color flow doppler, the more continuous monitoring, the more things that have they been done, and yet the outcomes are not getting better. So, how do they rationalize that? Well, they they use cognitive dissonance and techniques to solve that. They basically can't admit that they're that they're there those things are wrong. And how do you get people to change their mind? Is you have to get them first to see that there's a problem in the first place. And that's a very difficult thing to do because we don't really have access to the medical schools and the residency programs, they're very closed off. I mean, I teach breach and twin skills. Breach Without Borders teaches breach and twin skills. We're about it in the world. That's it. You'd think that residency, I could if I could have 10 residents for one day, I could teach them breach and twin skills. And I could teach them a lot of what's wrong with their model. But residency programs are not going to let me or even Breach Without Borders in very often. It's very rare. Is it ego? Is it or is it a cognitive dissonance saying, well, he's that crazy guy that does home breaches? Well, why would I let him come and talk to our residents?

SPEAKER_01:

Right, right.

SPEAKER_00:

When you do all these things, you make recovery, getting back to the postpartum thing, you make recovery more difficult for the mothers. And when you do all these interventions, you're setting them up for failure. There was a the um England and Australia a year or two ago had uh government hearings on obstetrical trauma. And around 40 to 45% of women reported obstetrical trauma at the time of birth. And I can tell you it's probably double that because some people don't consider being spoken to harshly as trauma. They don't understand the the probably the definition of trauma. They think trauma being injured or something like that, but that's not necessarily what's that that's physical trauma, but we have psychological trauma as well. And when a woman is psychologically traumatized or her husband is psychologically traumatized through fear and the manipulation that that can you that you can do from fear, then your recovery is going to be more difficult. I know women who who who love their children, their children are in their 20s, and they're still upset every time they think about the birth of that child and how it went and how they were treated and how they were ignored and how their their needs were not listened to. So that trauma goes on forever. And so that's got to affect the postpartum period of time. It has to affect the hormones you're secreting while you're caring for your baby, while you're feeding your baby. It's got to it may even affect the the production of milk. Um, is anybody looking? Maybe. I don't know. That I don't know that there's data on that. But it does, you don't necessarily need studies to tell you what common sense would tell you.

SPEAKER_01:

Yes. Yes, absolutely.

SPEAKER_00:

Yet they'll they'll always quote, by the way, they studies, first of all, sidelight. Um, research in obstetrics, research in all medicine now is is compromised. Uh, you know, you can only get things published if it's the narrative. It's very difficult uh to get things published against the narrative. One, the journals won't publish it if it goes against uh what Big Pharma is doing, because journals are sponsored by Big Pharma. Journals uh won't publish it if it goes against the ACOG narrative, um, because there, you know, there's a hierarchy there. So it's very difficult for me to get something like Home Breach and Home Twin articles published. I approached the Green Journal, that's the that's the American College of Wiggy Wen's journal, it's the premier journal in the United States on obstetrics about my two papers. They wouldn't have anything to do with me because ACOG doesn't believe home birth in uh for anybody, but let alone for breaching twins, they think it's it's outrageous. Um yet they don't offer breaching twins in the hospital, and they don't they don't get mad at hospitals that don't do that. They're not making an effort, they make far more effort to get women to get vaccinated while they're pregnant than they make it for women to have choices in how to catch how to deliver their baby.

SPEAKER_02:

Yeah.

SPEAKER_00:

Right. So their prior their priorities are different. So we have we have a problem with this thing about wanting data. And then by the way, if data comes out that's contrary to the narrative, it's ignored anyway. So why do they do that? And this is the part that makes it really hard to change, Miranda, because when people are invested in something, getting them to see that the error of their ways is really, really difficult to do. There's something, there's there's there's cognitivism, there's mass formation. Mass formation is a psychological term used for people that will give up their individuality, be part of a collective, be part of a group. There's fascinating, some fascinating studies on this sort of thing. But it's kind of why you're you know, neighbors that you that you used to have your kids play with and stuff like that during COVID, suddenly you couldn't play with their kids anymore. And if you had too many people in your backyard, they were calling the police. And how why do people suddenly do that? Why, why do they that and that's kind of defined by this thing called mass formation? I, you know, I don't know how you get through all that because it's extremely painful for people to realize after 20 years that, you know, I've been doing C-sections, you know, two-thirds of the C-sections I've been doing have been unnecessary. And I will tell you, how do I know that they're unnecessary? Because the C-section rate 50 years ago was 5%. It should be 10, 15% at the most. I don't know what it is in certain parts of Alaska, but it's I'm sure it's 30, 40%.

SPEAKER_02:

Correct.

SPEAKER_00:

Um, so that means that two out of every three C-sections being done are probably not necessary, yet no one admits to doing unnecessary C-section. How do you reach people like that? And and if we're getting back to the whole, again, the topic of the postpartum care, if they're not paid for it, if they're not taught this, if they think their system is working fine, why would they change it? So it's going to be up to the individual woman and a few of us outspoken people trying to get things to change. I've been to Washington a few times uh since this new administration took place with RFK Jr. as HHS secretary. Um, we've we've talked about maternity care, but it's very low on the radar right now. They're busy with doing other stuff. I can't stress to them enough how all the other stuff is related to how babies are developing in the womb and how they do it in the in the in the postpartum period.

SPEAKER_02:

Yeah.

SPEAKER_00:

Uh a lot of the things that happen downstream, that the things they're working on, like geoengineering and food and and vaccines and stuff, that they're all very important. But if we don't fix the way babies are being born and the way women are treated in pregnancy and postpartum, then we're we're not gonna make much of a dent in the in the problems.

SPEAKER_01:

Yeah. One of the sayings that I have at postpartum university is you heal the mother, you heal the world. So when we really care for her and we hold her up and give her what she needs, kind of woman is going to emerge from that. She's going to be strong, she's going to be confident, she's going to raise a family that's going to feel good. She's going to make great decisions for her family, not out of fear, but out of feeling empowered.

SPEAKER_00:

You and I are both witnesses to that.

SPEAKER_01:

Yes.

SPEAKER_00:

Yeah. Um, why why they don't believe it? Again, partly because doctors no longer are captains of the ship. They're again the the way they're treated in the system is not good for them either. They're put in a tough position. They're told to enforce rules that they have to know somewhere deep down inside are not right or certainly not the only option. And yet, if they go outside those boundaries, they themselves are going to put their careers at risk. Look what happened to doctors who said, don't get the vaccine, try ivermectin or hydroxychloroquine.

SPEAKER_02:

Oh, yeah. Yeah.

SPEAKER_00:

They got, they lost their license, they lost their board certification, uh, they were fired from their job. Um, they were, you know, they were they were ostracized for having a different opinion. And maybe people say, well, that's really an extreme example. No, that's actually what exists in a hospital setting. If you work for a big hospital system, like the Alaska Native Health System or a Kaiser in Southern California or some other place, you can't go color out of the lines. You're not allowed. You'll get in trouble. Not only will you get in trouble with administration, but if you do something, and then by the way, that person goes into labor when you're not on call, and some other doctor has to take care of the fact that you let a woman go past 41 weeks, or you uh let a woman who had two previous cesarean sections choose to have a vaginal delivery, but you're not the doctor on call, then those other doctors are gonna come down on you. They're gonna feel like they got uh um ambushed.

SPEAKER_01:

We've actually seen quite a bit of that. We've had a provider get completely ostracized and lose his license because a bunch of doctors ganged up on him when he was supporting home birth here. We've had another provider who gave her her patient a uh vaccine exemption pre-COVID for having an anaphylactic reaction. And within a couple years, she gave another uh uh exemption to another child who had an anaphylactic reaction. And she got a letter from the government demanding all of her papers, everything that she she was under complete review. They told her she was gonna lose her license, and she was just following exactly what they had told her to do.

SPEAKER_00:

So how does a how does yeah, so how does a midwife or a doctor go outside the lines? Yeah, how do they do that? I mean, I know midwives that do that, they risk everything to give women the choices that they deserve. And what's really odd about it all is that if you look at all these organizations, like American College of Obi-Juana, the American Medical Association, American Academy of Pediatrics, they all have statements on ethics and they all say the same things that a decisionally capable woman should have the right to choose whatever she wants, that use of coercion of any kind, including uh child protective services or anything like that, is strictly forbidden. Um, that sort of thing. They all say it and then they completely ignore it. But then if you ask doctors, do they follow ACOG guidelines, they'll all say, Yeah, we follow ACOG guidelines. Well, you don't follow this one. People should look up ACOG guideline number 664. They should just look it up. You'll read it and you won't, you won't believe it.

SPEAKER_02:

And what is that?

SPEAKER_00:

It's the opposite of what what you what's going on in hospitals and doctors' offices every day. Um, and they ignore that one. So I know we're we've kind of gone off the topic of really sticking with how do we get postpartum care to be um better respected. And I think that one thing is that that families need to understand that the system isn't there to support them. Two, that how you're cared for afterwards has to be your responsibility. Three, don't rely on your insurance card or your Medicaid card to be the only way that you get your care afterwards. Don't wait till the last minute to find out that you don't have, you only have six weeks postpartum, or you you they don't cover lactation consultants, or they don't, you know, find these things out ahead of time, check it out ahead of time. Know your community, know what your options are. And if you have to essentially maybe move to Ohio and live with grandma for your to have your baby and your recovery, then that's where you have to go or whatever. I'm not saying Ohio is a better place than in than Alaska or anything. I don't know. I just made that up. But um make put the effort in and find a way uh to give yourself that time, that special time with your baby uh that's best for you, it's best for your baby, it's best for your family. Um, make your husband an integral part of the process. Do not let him get alienated, do not let him get pushed to the side. Ask him what his concerns are. A husband who's included in this, who supports his wife. Listen, men just want respect from their woman. And most men, I mean, there's always exceptions, but uh a man who's involved in the in the pregnancy and birth of his child, who witnesses his the strength of his wife, who supports her when she's being told she can't do something. Excuse me, um, can we step outside? And I want to have a conversation with you. You can't talk to my wife like that. My wife doesn't want to hear those things. She doesn't want this intervention, she doesn't want a vaginal exam right now. Go away. And stands up for his wife, as opposed to just sits in a chair while his wife is being, I don't want to use the word abuse, it's a little bit strong, but be being disrespected. Her wishes are being disrespected. Uh, she's being traumatized. Um, she's not gonna look at her husband the same way as someone, husband who's defending her. And the man who helps catch his baby or is just bears witness to it, um, is going to be a better father, he's gonna be a better husband. I don't, again, don't there are studies that say that, but you don't need studies to say that. Um this is a time when you can really build that postpartum time, is when you can really build your relationship. Men, you need to know that the woman, you know, she may be quite capable of going out and chopping wood, but that's not what she's supposed to be doing. She's supposed to be nurturing her baby 24-7. Give that baby the best start in life, give that baby's immune system the best start in life, the best microbiome. Um beautiful, the happy, the happy hormones that she can be secreting when she's breastfeeding. And by the way, there are things that you and I don't even understand. There's probably electromagnetic things that are going on, there's auras. Um, we all know. I mean, a mother knows when something isn't right. How do you explain that?

SPEAKER_02:

Yeah.

SPEAKER_00:

You know, she's connected to, you know, the child's outside playing and suddenly she goes, hmm. And she runs outside, and yeah, he fell down and skinned his knee or something like that. And she she knew. So there's more to it than we even understand. But since again, like I said earlier, we since doc since medicine can't quantify that, it doesn't matter. And by the way, if they can't get an RVS code for it and bill for it, then it really doesn't matter.

SPEAKER_01:

That's so true.

SPEAKER_00:

It is true.

SPEAKER_01:

Yeah.

SPEAKER_00:

It's not cynical, it's true. It's it sounds awful. But I'm telling you, as somebody who spent all these years in both systems, there's there's just such a difference in the in the ideal midwifery model of care. Now, the problem with a midwifery model of care is you can't do volume with it. So there aren't enough midwives to go around, there aren't enough do lists to go around. And by the way, licensing, I'm going to go off on a tangent here. Licensing is not something that makes you better at what you're doing.

SPEAKER_01:

Amen.

unknown:

Yes.

SPEAKER_00:

Licensing is a way for the government to control you and take money from you every year to pay for your license.

SPEAKER_01:

Yeah.

SPEAKER_00:

Um, how do I know that? Well, because some of the dumbest things ever done, some of the most vicious things ever done, have been done by licensed, board-certified fellows of the American College of OBGYN. So it doesn't having those credentials does not make you a good practitioner. It does not mean that you are wise. It does not mean anything. That's true. They have the same degree as the person who graduated first in medical school. I was board certified by the American Board of Obi Juan for 20 years. And then it just doesn't work out for me to do it anymore. So I gave it up. And did I suddenly become a worse doctor the day after I gave it up? No. But there are people who will say, well, he's not board certified anymore, therefore he's not qualified. I would challenge pretty much any obstetrician on my narrow, I stay in my narrow lane of um of breaching twins to challenge any obstetrician, whether or not I'm I'm qualified or not to do those things. Yeah, they'll put the they'll they'll label, they'll throw these things on credentials. So licensing, and now states like some states want to start licensing doulas.

SPEAKER_01:

I was just gonna bring that up. This is a whole thing now with uh with licensing and doulas and insurance coverage, and and I'm watching the doula completely fall apart because they're like, Well, I'm licensed and you're not. And it's like now you're turning each other you're turning against each other. You you don't even understand what this is doing to the entire field of doula care.

SPEAKER_00:

And your participants know history are doomed to repeat it. The the idea that that doulas would that some doulas, there's always just like midwives, some midwives will want to be licensed, so want to be regulated. Some doulas, if you start to regulate them, if you start to take insurance, you're excuse the word, well, I don't want to say it, you're F. Okay. Because what's going to happen is that they're going to start to regulate what you can and cannot do, what clients you can and cannot take, and what you're worth. So if you if, and again, if they if insurance starts covering doulas, then people don't know the difference. So if you normally charge$2,000 as a doula, but insurance is paying$800, they're going to find a doula that takes their insurance, because therefore it's going to cost them nothing as opposed to$2,000. Without any real thought about why this woman is charging$2,000. Maybe she's better than the one that's. And so that's going to lead to conflict. It's going to lead to decreasing quality. And by the way, here's a good question for anybody listening. Doula's do a lot of things, but one of the things they do better than anything else is nurturing. How do you regulate nurturing? You're going to have like a checklist. I mean, some people are good at it, other people are not good at it. So, how how how are they going to do it? So they'll always use safety, by the way, as the canard for why they do something. They'll use fear to get you to worry about something. And then they'll say, we'll come in and we'll we'll license these people so that it's safe. In my old state of California, they licensed hairdressers. Now, why do they need to do that? So they could collect fees. They're saying, oh, because we want to regulate, we want to make sure that they're they're hygiene, they're safe. Can I do that as a consumer? Can I walk in? How do I mean the idea that that that licensing of hairdressers, improved hairdressing, I can't. I mean, we really are stupid. We really do deserve to be extinct, I think.

SPEAKER_01:

You know, so it's it's so funny this conversation, because what we're seeing in the doula world is that we are we're telling them what trainings that they must have. So we're we're telling them you can't have these trainings, they don't count. So these organizations over here, they don't pay us anything. So they they don't matter. And we'll only certify you if you have these specific trainings. And then what we've witnessed in the midwifery world over and over again is when we have these licensing fees. Now, you know, oh, it's legal and you can you can be a licensed midwife. You know, they did this in the state of Alaska. And then they there were a lot of people who didn't particularly like the fact that midwife midwives were now licensed and doing their thing. And so what do they do? They increased those fees significantly, so it became almost unobtainable to have. Because a midwife can't they get paid thousands and thousands and thousands of dollars per year to stay in business. They don't make that much.

SPEAKER_00:

No, they don't make that much. And by the way, midwifery school, midwifery schools are becoming medicalized because the uh the uh organizations that run midwifery have been taken over by academics. Um and the same thing will, you know, the same thing will happen to do's.

SPEAKER_01:

It's already happening. We're seeing it repeat.

SPEAKER_00:

Right. So this gets back to the whole thing of people taking responsibility and understanding that this is not something you should delegate to your insurance card. This is not like having your appendix taken out. All right. People spend a lot of money for plastic surgery. Okay. Can you imagine? By the way, it's a really interesting thing. If insurance started to cover breast augmentation, um I can tell you that the the quality of there are most plastic surgeons wouldn't be stupid enough to take insurance. And would you want to go to the lowest bidder? I remember a period of time, um, I had LASIK surgery on my eyes, I don't know, 10, 15 years ago. I don't remember how long ago it was. And it used to, I think it was$2,000 an eye or$2,500 an eye in those days. I don't remember what it was, but it was expensive. But then you started seeing billboards around Southern California, you know, LASIK surgery,$399 per eye. Oh, yeah, I'm gonna go there. Propaganda, advertising, gaslighting. This is this is the this is the nature of a of not just medicine, it's the nature of everything. But you have to be the discerning consumer. And you and I both want the same thing. We want women to enjoy their pregnancies. We want women, whether they end up with a cesarean or not, we want them to understand why they're the path that they they went on and not be gaslit. We want them not to be traumatized. We want them to have the postpartum care that they deserve, which they're not going to get from their insurance company and their obstetric model. You're not gonna get that. So, you know, sometimes it's just it's it's if you have a uh family members, you know, around in the old days, it was the family that took care of you. You gave birth in the home and the family stayed around and they took care of you. Other women, there were wise women. Now, now these wise women, they can't use the term midwife anymore. Some states and some countries have have captured the word, so they have to call themselves things like traditional birth companion or traditional birth attendant. And these are just wise women. It was the neighbor woman who came and helped you have your baby and then went back to be you know taking care of her chickens. That's how it was done. And by the way, other than the whole idea of germ theory and infection and stuff like that, the outcomes weren't a whole lot worse. We've sterilized birth, we've taken it out of the home. We've sterilized death, by the way, too. Most people live their entire life never watching someone take their last breath, and they never watch a baby coming into the world. They've never seen it except on video.

SPEAKER_01:

They they haven't, which is grossly, you know, not even realistic.

SPEAKER_00:

So anyways. It's not human, it's not human.

SPEAKER_01:

Yeah.

SPEAKER_00:

And that's one of the things that happened during COVID when you saw Granny had to die alone in the nursing home because she wasn't allowed to have visitors, uh, or people who are so fearful that they wouldn't let people come within, you know, a hundred feet of their newborn baby. Yeah. I mean, the mind is very easy to manipulate.

SPEAKER_02:

It is.

SPEAKER_00:

And you know, people will say that you and I are trying to manipulate minds now. No, I'm trying to get people to think. Don't believe anything I say. Go look it up. But be careful when you're searching, because I can tell you that searching on the internet is also skewed now. It's been skewed for a while. How do I know that? Because I've tested it. I'll put in like a specific article that I'm looking for and it won't show up on the first page. Or I'll put something in about hydroxychloroquine and COVID. And the first two pages are all about how it's it's uh or Ivermectin, it's it's horsepaced. It's you know, it's it's the dead the negatives of it as opposed to the the positives of it.

SPEAKER_01:

Yeah. Or it won't come up at all. It's just even there.

SPEAKER_00:

Be careful with Chat GPT or AI because AI will tell you what it's programmed to tell you. So whenever you whenever you ask AI a question, um, I've learned that what you need to do is ask the ask AI, is this data based on good science? Or is this the only uh is this the only answer there is? And then and then suddenly they become truthful and they'll go, well, actually, no, it's not. There are there's good evidence to show that the the alternative is also true. But if you just rely on the initial answer or the how many people go to page two or three on a on a search? Almost nobody. Sometimes I do it just to see what's on page three or four or five. I have time to do these things now. I tell you, I mean, this is nothing to do with our topic, but what has anything to do with it? When the Hunter Biden laptop story came out, there's a conservative news outlet called Breitbart. Some of you may have heard of it. I don't know if you have. I put in Breitbart, Hunter Biden laptop. And the first two pages were all New York Times, USA Today, Yahoo News, NBC, MSNBC. I didn't find Breitbart story on the Hunter Biden laptop, which was, and all those stories said the Hunter Biden laptop was Russian disinformation. I didn't find one that talked about what I wanted to find out, which was like, we know it's true, let's let's read about it, to like page five or six. And yet I put Breitbart as the first word and it didn't come up. So we live in a really, really weird time where it's really hard to know who to trust. And you can't abdicate your responsibility.

SPEAKER_01:

Amen.

SPEAKER_00:

And you can't assume that the obstetrical model of care has your best interest at heart. And they don't. And how do I know they don't? All you have to do is look at outcomes. They may be the nicest people in the world, but it's not about their intentions, it's about outcomes. And our outcomes are getting worse.

unknown:

Yeah.

SPEAKER_00:

So why would you trust them? And they've lied to you over and over again. Uh, I have found that most midwives don't have a financial interest in what they're doing. They do it because they believe in it and they're not compromised. And therefore, that's why I believe in their model of care far more than I believe in the model that I trained and used in the first several years of my practice.

unknown:

Right.

SPEAKER_01:

Stu, this has been absolutely incredible. I think you and I can go forever and ever on this conversation. Where can people find more of your work and and your deep dives into things that you have to share with everyone?

SPEAKER_00:

Everything is birthing instincts. So uh my website is birthing instincts.com, and from there there are links to the some of the papers I published on home birth and home breach and twin birthing, um, as well as some case reports and other things. Um Birthing Instincts Podcast has its own website called the Birthing Instincts Podcast.com, and you can find that. On your uh podcast apps, uh iTunes, um Apple, Spotify, it's all there. Uh Instagram, surprisingly, it's at birthing instincts. And uh if you are interested in having me come and do a two-day seminar with that, you can find that on the Birthing Instincts website. Uh, you can send in a request and my my sister Raquel will get out to you. Um, I would love to come back to Alaska. I taught one in Alaska um several years ago at the birth center where the doctor is no longer licensed, I believe.

SPEAKER_01:

Yeah.

SPEAKER_00:

In in Wasilla, I think.

SPEAKER_01:

And um I actually remember you coming. It was not something that I was aware of at the time, but it uh yeah.

SPEAKER_00:

Yeah, and I my the highlight of that for me was one see seeing a moose in my backyard, and two, um going on one of those uh excursions where you go up to see the northern lights. You leave at like eight o'clock at night, you get there around one in the morning, you stay for a few hours and you come back home. It's like a four-hour drive. I I can't imagine why in Alaska you have to drive four hours to see the northern lights, but you don't, especially if you are in Wasilla.

SPEAKER_01:

So I'm in Palmer, which is like maybe 20, 30 minutes to where you were.

SPEAKER_00:

Uh yeah, it took us four hours, it was a four-hour uh van ride.

SPEAKER_01:

You see it all the time. Like I'm on 40 acres in the middle of nowhere. We we don't have a lot of light from the cities or anything like that. So we get to see a lot more than and we got a really good show.

SPEAKER_00:

So I mean I remember that. But that's that's how people can essentially reach me. My passion right now is to advocate for choices and to teach the skills of breach and twin delivery and keep it alive. Uh, the the torchbearers of that skill right now are midwives. Obstetricians have become obtuse. Um, they're not interested in it. I think the individual obstetrician probably would love to learn it, but there's they're either cowed, um, or even if they were to learn it, they would be we'd be told that they can't use it anyway. But every now and then a woman's gonna walk in to labor and delivery and with a butt or a foot sticking out of the vagina, and they're gonna end up doing an emergency C-section on that woman 20 minutes later under general anesthesia. She's gonna have no memory of her birth. The baby's gonna probably end up in the NICU. Whereas if if she was completely dilated at that time, they could have the baby out in about 20 seconds, maybe 30 seconds, vaginally, knowing it knowing what to do, and yet they don't know what to do and they don't want to learn what to do. And I just I just find that um unacceptable. It's just unacceptable as the kindest word I can come up with uh for that kind of behavior. So I was lucky because I trained in an era where this was just considered to be normal. Um my residency program, I I worked at a very busy hospital uh and I got to see a lot of these things and they became very normal. As a matter of fact, we used to argue um between us, the residents, who gets the lady in room six with the breach baby or the twin baby, twin babies, because we wanted to do them. And everything then was hands-on. It's kind of the pendulum swung a little too far and went to hands-off the breach, which isn't a good idea either. Uh, you need to, there are certain skills you need, probably about a third of breaches need help. Uh, very simple maneuvers. I when I teach my two-day course, I can tell you the feedback is that nobody leaves my course as an expert in breach delivery, but everyone leaves my course knowing what to do if a breach were to walk in. If they were to go into the uh supermarket tomorrow and a lady was laying on the floor having a breach baby, they would they would know what to do. Okay. Um more so than than 99% of obstetricians. And that's embarrassing.

SPEAKER_01:

Yeah, yeah. That absolutely is.

SPEAKER_00:

And they should be embarrassed. And the leaders of my profession, those that run ACOG, those that run the residency programs, you should be ashamed of yourselves. Um, I'm not shy about saying that anymore.

SPEAKER_01:

I don't really have any well, I've said it on this podcast many times. So the things that you're you're saying is just, you know, almost validating everything that I've been saying for the last several years. And so they're this is not new information for them, but it's it's so beautifully spoken in a in a different way. And I'm just very grateful for you and your work and everything here that you've shared with us. So thank you from the bottom of my heart for doing everything that you are doing. And of course, we're gonna have all the links to find you and your work. I highly recommend if you don't know Dr. Stew, you need to know Dr. Stew. So please go take a look at all of that. Is there anything that you wish I would have asked you that I didn't get to today?

SPEAKER_00:

Oh, probably so many things, but I I I I don't know how to stop, so we should probably just stop here. I'm honored to be a guest on your show. And I hope our paths cross next time I'm up up north.

SPEAKER_01:

Yeah, absolutely. Give me a call. I'll be here.

SPEAKER_00:

Done.

SPEAKER_01:

Thanks so much for being a part of this crucial conversation. I know you're dedicated to advancing postpartum care. And if you're ready to dig deeper, come join us on our newsletter where I share exclusive insights, resources, and the latest tools to help you make a lasting impact on postpartum health. Sign up at postpartum you the letter you.com, which is in the show notes. And if you found today's episode valuable, please leave a review to help us reach more providers like you. Together, we're building a future where mothers are fully supported and thriving.

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Maranda Bower

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