Carrie

Katie and Carrie discuss how a love of nature can lead to a love of midwifery and how an active life outside of work can help prevent burnout. Other topics include teamwork and mentorship. 

Transcript

Katie: 0:00

Hello and welcome to my podcast. Mindful Midwifery presents the Labor behind Labor. My name is Katie O'Brien, and I've been a nurse midwife since 2007. Midwifery is both one of the most rewarding professions and also simultaneously one of the most demanding. The goal of my podcast is to give listeners an insider's view on what it feels like to be a midwife. Because this is an insider's guide to midwifery. It is not glossed. It's not all joyful. Some topics might be sad or controversial, but I think there is value in talking about hard things in order to convince my midwife guests to agree to be on my podcast. In many cases, I've gone to their house to record their episode, and while I have good software and good editing, please know that there might be some guests along for the ride in these episodes such as small children, babies, or dogs. For this episode, I'm with Carrie recording at her house in southern Delaware. Carrie's house is filled with nature. The first time I went to her house I realized two things. One, you can have plants everywhere in your house and it not look like you are a crazy plant lady. Two. I wanted plants everywhere in my house. I have since added several large plants throughout my house. Her rescue dog, Bertha, the French Bulldog, makes her appearance in this episode. Carrie recently bought a dog carrier, which makes both of them very happy. Now that I have set the scene, let's begin with Carrie's episode. So I wanted to start out your podcast. I've been thinking about this for so long. About, one of the first times I met you, like early on, when we started working together. I remember you saying to me that you wanted midwifery to be the least interesting thing about you. And at the time it really shook me. Like it was just such an amazing thing to say and I'd never heard another midwife say that before and it resonated with me because I think that's what I needed to hear at the time, And this was a while ago. So since then, do you like, elaborate on that statement?

Carrie: 2:06

At work when I am being a midwife, that means that I am not the star of the show. I am with the woman next to the woman adjacent and as a witness to her experience, but I am not in any way. The marionette of her experience. So I don't even feel like while I'm being a midwife that it's the most important thing I'm doing. I'm just happen to be there.

Katie: 2:37

Mm-hmm. I feel like

Carrie: 2:38

it is just something I happen to be dropped down into. And so outside of work It's super important for me to have all kinds of extracurriculars and extra hobbies outside of being a midwife, because that's when I'm not with women. I'm with myself and with my people that I love and adore. And it's so important to spend time with yourself and with people that you love and to separate work from fun and family and friendships. And it is frankly, a job, but it's also a calling, But after years and years and years of doing it, you really have to separate the work part of it from your rest of your life, otherwise it becomes you. Okay.

Katie: 3:23

Do you feel that, that you've grown into that over the course of your career, or do you feel like you came into midwifery and it was something that wasn't all consuming even then? I know that you did some interesting things before you became a midwife,

Carrie: 3:38

Yeah, certainly it evolved into that because when you're studying to be a midwife, it's very consuming and everything is about study and about learning the trade, and then the clinical experiences to develop your skills. So you're really all in. But then over time, whenever you're on call, sometimes. That means you're off call sometimes too, and you really have to be off when you're off and value your time off. So yes, it's evolved. And still I'm very much a midwife all the time, but I'm not always working. Sometimes I'm just traveling, cooking, doing my hobbies. Yes. Living.

Katie: 4:21

Yes. And you do have a, a lot of hobbies and, I think you're a great example of walking both worlds really well. I, I certainly look to you as, a way to. To be present when you're working, but then to be present elsewhere when you're not working.

Carrie: 4:37

Yeah, absolutely. And I don't think you can be really good at your job unless you fill your cup and if you can't fill other people's cups unless yours is full. And of course. That's kind of a cliche, but I believe in it. Plus there's so many more interesting things. And the thing that most fascinates me about midwifery and about being with women during their birth is the biology of it. And that's because I'm crazy for biology. I'm crazy for nature, and my whole entire life is trying to be as entrenched in nature as I can be. And that includes midwifery, which is why I'm not a doctor, which practices medicine. I practice midwifery or I try to because I believe in. Human nature. And I think that just like all nature, man cannot tame it. And we have to let things just kind of grow. Um, and birth is the same way for me. So that's why I think my whole life is midwifery. But really that's just because my whole life is really nature. Nature.

Katie: 5:45

That's such a great way of putting it, that I wouldn't have been able to say that eloquently, but when put that way, I can really relate to that. I would say that a big piece of how I feel like I'm filling my cup or gaining back mental sanity is nature involved and I've never quite put it together that yeah, birth is definitely nature for mo most midwives, I think that is. How most of us view it without being able to say it as well as you just did.

Carrie: 6:16

Yeah, and I think that's probably why I don't find it to be getting old or tiresome it. I still find it completely miraculous and beautiful and it's like, it's like watching a flower on Furl in real time. There's this time-lapse element to it that you as much medicine as we use to try to control birth, really it's out of our control always. And It's kind of like storms and tides.

Katie: 6:49

Well, things look the same, but then it always also in the same way looks different. Right? It's like, yeah. Get surprised, right?

Carrie: 6:58

all the time. There's interferences, lightning and, and, storms and floods in birth. It's the same way. You can't. Predict it. It's completely Yes. It's amazing. It's always different every single time, even from person to person. I mean, uh, the same person from birth to birth, it's completely always going to be different. No one can ever say that they're an expert in it, even if they've had 14 kids. I know

Katie: 7:24

I know.

Carrie: 7:24

it's never gonna be the same. It's like

Katie: 7:26

Right. It's like then you get thrown,

Carrie: 7:28

Which is why changing the topic as a midwife with no children, I don't feel like. I can't help people have children because I've never done it my own self doesn't mean I haven't been through things. Laborers Of sorts. But also because I don't think anybody's even one experience makes them an expert in the next experience. So if I had had one baby, I could have some empathy about the pain or about the process, but it doesn't make me an expert in it.

Katie: 8:06

It's true. I had very long labors and so when I have somebody that has a long labor, they're really disappointed that they didn't go natural, which ended up being my experience. Well, natural meaning no epidural. I can feel their pain in that moment, but I don't know that it has really altered how I have given care directly. Sure. And I think that, I give care, like I'd want my sister to have care. That's how I give care. Mm-hmm. You don't have to have babies to wanna give care the way you'd want your people to be cared for.

Carrie: 8:40

Right. It's like one time I had a midwife colleague say, well, just because you've never been pregnant or had a baby doesn't mean you can't help people through a process. She herself had scheduled C-sections and she said, I've never given birth through my vagina, but that doesn't mean that I can't help people. And just like an orthopedic can fix your knee, even if they've never broken theirs, it's. Just like you said, being the person to help them through it, not nobody can live through other people's experiences anyway.

Katie: 9:19

And we can't possibly relate to everything. I never had trouble with infertility, for example.

Carrie: 9:23

but yet you can certainly counsel people

Katie: 9:26

can counsel

Carrie: 9:27

Mm-hmm. You know,

Katie: 9:28

I'll never know what that feels like directly. But you can still, you can pull something from your own life experience that. Is that right? So infertility is, is a struggle and it's, it's a lack of control and it's your dream that is not being realized and all these things. And we have other experiences that might not be that, that you can still pull those emotions from.

Carrie: 9:50

Yeah. Same with miscarriage. If you've never had a miscarriage, doesn't mean you can't

Katie: 9:55

relate to

Carrie: 9:56

relate to that. Relate to that. Or cancer. Or infidelity or sexually transmitted infections. All midwifery is not just birth and it's not just pregnancy, it's all women's health all the time across a lifespan. And I don't even think you have to be a woman. of

Katie: 10:17

favorite mentors, it was pretty early in my career, but he was a male midwife and he was, he's one of the most gentle people I've ever met and. He was excellent. Like I would've felt so comfortable with him, if I was pregnant and going through the process. And, he can't directly experience a whole lot of what he did, but he was amazing. And people loved him.

Carrie: 10:40

I've never really worked with a male midwife,

Katie: 10:43

There's not many,

Carrie: 10:43

I'm sure things I could learn, there's a lot of things I could learn.

Katie: 10:46

We each bring different things to the table and each have things that you bring specifically, your own self. But then that can also, be negative sometimes because sometimes it's too close to home. So sometimes those people that actually have experienced those exact things aren't even able to, really care for, for that. I can think of a therapist, for example, who, Had a lot of infertility and she won't take clients with infertility because it's just too close to home, too close to her own feelings. We can't exactly escape it, which I think is one of the pieces of burnout for us. If we don't wanna touch an area, it can be hard to completely escape that. Yeah. And so you have to like relive it. But

Carrie: 11:30

burnout is an interesting topic. And here lately I found a realization that the thing I am most burnt out by, there's two things. One, the person who over researches and.

Katie: 11:47

the patient, like a, a patient that's over researching. Yes.

Carrie: 11:50

who's over researching and overthinking, and over critical overanalyzing, over demanding, over questioning. That patient bothers me because I feel like sometimes you can't ever help them. You can't ever get to what they're asking for. But then the opposite too, which is the person who doesn't do any research, doesn't do any questioning, doesn't ask any, uh, soul searching advice, doesn't. Even read a book or a paragraph is also a burnout for me. So it's so interesting that the two ends of the spectrum I have found have been hardest for me to deal with.

Katie: 12:32

I have been in practices, maybe I, I don't know the practices you've. Been in as a whole, if they've been that far on the spectrum. But I was in one practice that was the one spectrum and another practice that was the other spectrum. And both are equally burning. Yeah. Burning you out. Capable. Certainly I do better. Probably most of us do better when there's a mix. That's good. I think

Carrie: 12:54

for me would be is, is the ideal thing about where I'm working right now that there is no particular type and you never know what's gonna walk in the door, what's gonna come in, whether it's gonna emergency or a risk factor, or a race, or a country or an age. There's just a lot of diversity and there's no type. There's no type. Dover is a very strange place in terms of, identity. And I don't know if that's because. It has a military base, so people are coming from all over and some end up staying, but it really doesn't feel like there's a, I'm from Dover style.

Katie: 13:37

Maybe

Carrie: 13:37

that's what keeps me from getting too burnt out because I wouldn't be able to hang with all one size.

Katie: 13:45

Yeah. It's, it's challenging. My first practice was, the over researching and I came in as a new grad and that was really tough because they don't trust you. They certainly don't trust someone that's newer. And then I went to the total opposite spectrum and it, at, at the beginning, it felt a little bit like a, a breath of fresh air because I wasn't dealing with that. I was dealing with people that were just happy. To just say yes, didn't matter what the heck my plan was. Just yes. And then eventually that burns you out because you're like, come on now. You have to have some input here. You know? And I don't always do well with patients when I go in to counsel them about things. And their answer is just, whatever you, whatever you

Carrie: 14:29

Right. Whatever

Katie: 14:30

you want, I'll do whatever you want. And I'm like, that patient I struggle with, you know that that's hard

Carrie: 14:35

for me. Me too. Keeps you on your toes. Yes. that's the other part of burnout I'd say we were talking about before we started recording. We is the physicality of the job, keeping our keeping on your as I've gotten older. Aging has become an issue with physicality of this kind of work. Pushing for two hours, holding legs, standing on your feet, running from room to room, having 14 hour shifts has become more and more difficult and it makes you start to wonder whether or not there is a time where you should retire because you just can't do the work anymore. But then there are people older than us doing it and doing just fine. And people younger than us that can't keep up. But there are very few people that I went to school with 20 plus years ago who are still working full-time, full scope midwifery on our feet, doing the like front lines work. Most are doing some administrative or teaching or clinical, um, public health, but. Most, I think there's only two of us in my class who are full scope because of the physicality of it.

Katie: 15:54

I, I think that's definitely true when I have, looked at the midwives around me in general, I think when they're hitting that like 40-year-old range, you see less working full scope. I think a lot of them get burned out before that. And then, Physically they might just be challenged. I mean, you and I both had knee injuries just months apart from each other. It was crazy. And, your knee injury was a, an accident, uh, skiing accident, much cooler story than mine where I just stepped back and just stepped on my foot and got hurt. But we had very kinda similar trajectories on how that all went and how, what that meant for, trying to do full scope when you can't walk. Right.

Carrie: 16:40

That was crazy because it happened suddenly you can't plan for it and then all of a sudden you're outta

Katie: 16:47

Mm-hmm.

Carrie: 16:47

So suddenly you have to get people to cover for you because somebody has to be there. You can't have no care providers, you have to have somebody on call,

Katie: 17:00

but

Carrie: 17:00

not being able to do your work is really mentally taxing. You cannot do anything when you cannot walk. it made me like, I read the, read a book by Oliver Sacks at that time called, with a, called a leg to stand on and it. Talks about the psychology of suddenly having the, like limitations of your physical self and how it's literally like you're getting cut off at the knee in a way because you can't do your job or you can't function. And with midwifery, that's scary because this is an, you cannot possibly do the work if you can't use your arms and legs. And, uh, breaking my leg was a awful experience'cause I was seven months on crutches. On the other hand, I felt like it was teaching me to stop because I'd been doing too much. I was working too hard and stressing myself, stressing my body. And I always felt like I didn't break my leg skiing, I broke my leg working. Yeah, and then I went skiing and it just didn't hold me up. I,

Katie: 18:16

I can relate to that completely. I was fine and then I stepped back and I wasn't, and it really caused me to look at my life too, in so many ways that you probably did as well of, what have I been doing that is not serving my body and with that knowledge of what I've been doing that's not serving my body, how do I change that? Can I change that? What does my career look like in five years? I'm young. How do I still be doing this for 20 plus years? It makes you think a lot about where you're at.

Carrie: 18:47

It made me think about how I had become a martyr to my

Katie: 18:51

work. Mm-hmm.

Carrie: 18:52

and how I had sort of done this to myself. Nobody else forced me to work as many hours and for as hard and as long as I was. But I did that to myself'cause I felt like I was needed. But then guess what? When I broke my leg, other people stepped up and I really wasn't needed. I'm not as necessary as I had made myself believe and. While, you know, certainly I'm sure I was missed. Life went on just fine. And that's something I had to remind myself and still have to remind myself. Like, if I say no and I can't do it, somebody else will. It'll be okay.

Katie: 19:31

I think that's something we have to learn as midwives in general to, and I've said this on other podcast episodes, but to let yourself be vulnerable with. Saying, I can't continue doing this because I do think there's a culture of push, right? There's a culture of you can like push harder, push harder, push harder, do all of the things. Um, and it's easy to feel pressure, but also not wanna be vulnerable. You don't wanna be the one that looks weak. You don't wanna be the one that says, this is enough, that you don't wanna be the one that says, you know what? We can't handle this, or

Carrie: 20:11

Or I can't handle

Katie: 20:12

this. And so then you just keep going Until your body literally tells you no.

Carrie: 20:18

Right? Well, we have a tendency to view ourselves as heroes of the mm-hmm. Situation or heroines when really we're not, we're just witnesses. We're just there to be the narrator of somebody else's story. We are not in any way, saving anybody's day because frankly, if, for example, we're not a good match for a patient or her family, somebody el, it's okay to say, I am not the person for this person. I'd like somebody else to take it for the team. I can't. We're not jiving, we're not clicking. Maybe give it up, give it over to somebody else because there are other people who can do it. So even when you are. Pushing and pushing and pushing. Sometimes it's a really good idea to stop and let somebody else take over.

Katie: 21:13

It's tough. It's tough to do that sometimes. Or a lot of times, I'm sure you've had this, you're on a shift, and the wonderful li and delivery nurses that you're on with have decided that you are the provider they wanna deal with for that day. Mm-hmm. They do not trust the other provider. They don't want anything to do with the other provider. And as a team, they have, like, without talking about it, unanimously decided this. Mm-hmm. And so then you're killing yourself on this shift because they're, they're wanting you to be, the person that they're coming to and. but it's a, it is not great because it's also encouraging that, right. It's, and it, and you're like, oh, but I need to do this. I, I need to do this for the patient, or I need to do this for the nurses, or I need to do this for whatever. Mm-hmm. And so you oblige, but ultimately. that's, creating this system that continues to be like that. Right. That continues to demand it, that we don't correct things because we are accommodating.

Carrie: 22:16

Right? And you don't necessarily ask for help because you feel like you should be the one to, you should be able to do it all. Some of that, what you just mentioned about the nurses is it's very interesting'cause it's kind of like they're making us feel like we are the the best person to do all the work but you have to wonder if that's only for their own gain.'cause they know that sometimes we're easier to deal with than the other physicians or the other midwives or the other nurses.

Katie: 22:49

I do think that happens. It's tough to be a labor and delivery nurse. They're, they're in the middle of things too. And when you have a provider that's easy to deal with, um, easy to conversate with and, and you felt heard by, I think it's easy to just gravitate towards that person. Um, but so many of the dynamics actually that we're in all the time are creating this constant support of that ineffective. Method, it is ineffective to continuously have a provider practicing that the staff doesn't get along with. And so we're enabling it, on a level. We're enabling the system to allow this person to not change because we just pick up the slack. We just try to make things peaceful on the unit. And so we do things that are not good for us, possibly not even good for the patient. Because if you are running back and forth between rooms and you've got a provider that's doing nothing, that's

Carrie: 23:51

Well, right. And that's not providing the best version of ourself ever. When you're running between patients and you're busting your butt, you cannot give the very best care.

Katie: 24:00

Mm-hmm. Absolutely

Carrie: 24:01

Because you are literally being distracted by the phone ringing or screaming in another room. It you, when it is absolutely senseless, because there are other people who can be called, that's my point. Like you, you break your leg and you can't go to work. Somebody else is going to be able to do it

Katie: 24:21

for you. Mm-hmm. You just

Carrie: 24:21

have to get help. You just have to ask and you're, you're not providing the best version of yourself if you're doing a half-ass job And I find I'm, that is a lot of times the way it rolls on a shift job. You are. You're, every patient is your patient. There's not just a number that, there's not a number of patients that are yours. Everybody is yours. And so I think that everybody gets a, a very small version of me when I'm like that in a shift position because they don't really, we don't get to know each other. We don't know who, we don't spend prenatal care together. It's just, I happen to be on call when they walk in the door in labor for triage and there's 10 other patients in there that day. In labor, and so nobody really gets to know each other Even the nursing now is getting, pieced up because the nurse is now in front of the computer for most of the day, not in front of her patient, and so they're not getting to know each other the way they used to. Even 20 years ago when I started, things were different. We wrote on paper, we didn't have computers. so I think it's really evolved and there's a million different ways to practice, but this is when. To your point, when the nurses are asking me as the midwife to do everything, and I don't ask for help, I realize that people are not getting a very good version of my help.

Katie: 25:50

I think it's a, a field wide problem. I think that there are many midwives that would listen to this and relate to it, relate to this constant battle of, trying to provide the best care you can and feeling like you're in a system that is not allowing that,

Carrie: 26:11

Yeah. But we've only kind of done this to ourselves in many ways. By legislating more authority for ourselves as midwives, by demanding that we have privileges that we didn't use to have. We've taken on more responsibilities, which means that, we're just fracturing up ourselves a lot, bit by bit. And I think everybody. Can relate to it. I don't necessarily see it changing and I don't necessarily wanna give up any of the things we fought for, but I just think it makes, it pulls us, it pulls us really thin and it keeps the lifespan of a midwife reduced, which is, like I was saying before, there aren't many people who are still doing it full scope for 20 plus years or more. Almost everybody has to take a version of midwifery and whittle it away because of the burnout and because of the culture of it.

Katie: 27:12

For me personally, I look at the future and I don't necessarily see working full scope full time ever again.

Carrie: 27:23

Right. I don't blame you. I don't think most people do. And maybe that's because it's a stage like labor. There's a stage when you do

Katie: 27:33

Mm-hmm.

Carrie: 27:34

But then there's also the de NOIs, and then there's the postpartum. And you have in your career, these phases. These stages that you just have to gestate through and, and listen. Listen to your body, and listen to your soul, and it'll tell you what you're supposed to be doing. I don't know why. I'm still doing it. I don't know why I am still doing it full time. I don't know what the future of my career looks like, but I'm in it right now and I feel very much like right now I'm in it to collect stories and I don't know what the ending is of my book yet, so I'm just still doing chapters. This is the work and we'll find out whatever that ending is when it happens. I think, I think

Katie: 28:21

I think you, there's two different approaches. Some people will continue in something that feels right for this time and then address it when it feels not right anymore. Right. I am more of a long-term thinker in the sense of the knee injury for me, really was a point where I was like, I know I can't do this physically for 20 years plus, so what do, how can I start making a transition where, what I am doing, I can do for a long time? That's just how I function. And so, I've been exploring other versions of midwifery during this

Carrie: 29:00

a lot of ways to help women.'cause it's not just labor, it's not just birth. It's like I said, all phases of womanhood and there's different ways to help people

Katie: 29:10

right now I feel that working, PRN or part-time on labor and delivery feels good. It feels like I'm still connected. And,, and then, exploring other aspects. And who knows, maybe someday I'll go back to full-time. I don't know if I'll go back to office work, but I do know that, those are options.

Carrie: 29:32

Mm-hmm. Once

Katie: 29:32

you've been there, you can always go back. you've been working on a book that is kind of a tell-all in its own way Yeah. About midwifery. Which I think, or I should say, it sounds like from you that that has been part of your way to deal with the burnout, to write about it and to put it down on paper and then maybe tuck it away on a shelf. Um, so you're. Essentially reliving it all the time.

Carrie: 30:00

Yeah. I think that's been a processing method for me, So I've been processing and processing and processing it through writing. Now I'm at a point where I think it's time to start sharing it because people are interested and they can learn from the stories I've heard over the years. There's a lot that you learn when you're in people's most intimate moments about sociology and humanity, relationships and sexuality, but all of that is, is private. And somehow or another, as a midwife, you're dropped down into these people's most private, most intimate moments, and you're a stranger, completely a total stranger. So you are in a way responsible for taking what you're learning. From people's private moments and then making a through line to share with everybody else to teach it and not to give away people's secrets, but to sort of tell the stories, the narratives, because it tells us history through these little stories, the history of America. the history of obstetrics, the history of poverty and cultural, um, conditioning. There's so much to learn and at this point, it's enough processing and now I have to jump into the pro to the sharing part of it. But if I did that, I'm afraid it would be the end of my career as a midwife, because they're not happy stories all the time. It's not Pink Bowes and Blue Bowes and stuffed animals and happy stories always. It's a lot of really negative and really terrible stories. And I'm not just talking about like death and dying, I'm talking about just like

Katie: 31:42

system problems,

Carrie: 31:43

system problems. there's.

Katie: 31:45

Inappropriate behaviors, problems,

Carrie: 31:47

bad behaviors. There's relationship problems, poverty, hunger, so many things. And this is a first world country, but we see third world issues here. And the, the tell all part of it is that there will be a lot of people who think it's negative and a lot of people who think it's a sellout. Um, so I do think that the story when it comes out, like when I do eventually release this book, I've been writing for 10 years, I think it would be the end of my work in women's health. But the beginning of a whole new kind of work, well, it would

Katie: 32:29

it would in fact be a transition of your work in women's health, not the ending. Right. The transition. Whole different story. Yes. Um, that gave me a lot of pause about starting a podcast, actually was walking the line of how do I reach an audience and talk about things that are helpful without being so negative or, um, hopeless that I can't continue or revealing too much about a specific place or a specific, you know,

Carrie: 33:05

Yeah, sure.

Katie: 33:06

you can't walk back from it, you know?

Carrie: 33:08

there will be critiques everywhere.

Katie: 33:10

and how do you handle that? How do you handle the criticisms that are gonna come, even if you're right. Right. You could, you could say something that is definitely true and somebody is gonna put on some social media thing that, you know, this is horrific in whatever way. Yeah. Um, so being able to handle that, I personally find a lot of hope in what could be deemed a pessimistic view on things

Carrie: 33:41

sugarcoated,

Katie: 33:42

sugarcoated, I feel like I can't trust the version and it, it feels like we're not, it always feels that we're closer to fixing a problem if we've actually said what the problem is, as opposed to dancing around it and saying Everything is wonderful when it's not. And so, while. Some people might look at that and think it's negative because you're, you know, addressing what is not pretty. Yeah. To me it is actually very hopeful that okay, we, we might be able to, to move forward

Carrie: 34:19

with. Right. Which is why I think for me, writing with a sense of humor is very vital because you have to kind of laugh at these things. They're not always pleasant things, but it can be hilarious. It can be really hilarious.

Katie: 34:33

Some of what we do is actually quite hilarious. Yes. And it, it's interesting, I don't know if you've had this experience, but as I've gotten further into my career, less surprises me, so I sometimes am not able to see the. The humor quite as well as I did before, or, how outlandish it is because it almost becomes normalized. Yeah. And so I would, talk to my parents quite a bit, especially in this one practice I was in where it was just, I mean, a whole show could have been, it was just antics all the time at this practice. And I'll forget stories, and my parents will be like, Hey, remember that time? And then I'll be like, oh my God, that did happen. And yes, that was

Carrie: 35:15

And every day that some crazy thing happens. Every single day. It's what's fun about the work is it's never the same twice, ever.

Katie: 35:23

No. You get all the emotions and you can have all the emotions in an hour, right? Yes.

Carrie: 35:29

Yes. Okay.

Katie: 35:30

But I do think that's one of the places people get burned out, you get emotional fatigue because you're just not able to sit there and pause for a minute after some of these heavier emotions. Right. And just take time to own that. You just witnessed Something That is traumatic, you

Carrie: 35:49

know? Right. And that becomes very clear when you have a student or a resident midwife or nurse or physician who's witnessing something for the first time. And you realize like. What they just saw was in incredibly intense, and I, for me it's just another five minutes. Yep. Just another Tuesday. And, uh, we forget that all the time, but you can see it in their faces. It's good to kind of ground yourself in that sometimes, but it's, for me, I think one of the most fun part of the jobs is the sign out in the beginning and at the end of the shift because that's when we all bounce these things off of each other and we can laugh or, get upset or even angry at management or, you know, physicality or lab work. We can really get like, really worked up in that. A think tank of five or six of us going over one patient at a time. But I think part of it is the fun. That's funny. Like we kind of, you know, not that we're making fun of people, but that's where we get to all kind of laugh and talk about it and mm-hmm. Also get upset about it.

Katie: 37:08

Yeah. I had said that I wouldn't come back to a job that didn't have 24 7 midwife coverage because I didn't wanna give a report. I wanted to give report to another midwife. Yeah. Like, to me that was important on so many levels. One, just that patient care wouldn't change, but also just the, the decompressing that happens. Yes. When you give report to another midwife, the handoff. The handoff,

Carrie: 37:36

It's passing of a baton for sure. And, and then the follow up afterwards too. Maybe coming back the next day and hearing how it played out.

Katie: 37:45

Right. And you also, trust that the patient's in good hands. Yes. And I think that's was a big piece for me, having faith in what I was turning the patient over to.

Carrie: 37:59

sure. And not that the doctor. Taking the patient over isn't putting them in good hands. It's just different. It really is

Katie: 38:07

different, I guess the better explanation is different hands

Carrie: 38:10

Mm-hmm.

Katie: 38:12

you know, of uh, just the natural tendency of the physician birth process and what that looks like versus the midwife guided birth process and what that looks like. I mean, we absolutely need our physician counterparts. You need both of those care perspectives,

Carrie: 38:28

we have many different philosophies, but we all have the same goal,

Katie: 38:33

is there anything that you started your career thinking you would be doing at this point? Career-wise or feeling career wise that is different or the same than you were thinking back then? Like did you predict where you'd be?

Carrie: 38:51

No, I absolutely thought I would have probably four to six kids. My own self, I thought that I would be working at home birth practices. I had a notion of midwifery that I had gotten from spiritual midwifery by Ida Ma Gaskin, and that was kind of where I wanted to be. I wanted to be like a home birth hippie midwife, and my mom was a nurse and She told me I should never work in a hospital if I wanted to do home birth because I wouldn't be able to erase the fear that came from hospital birth. And I felt I needed to work in hospitals to get experience if I wanted to be a home birth midwife. But my mom turned out to be right. I think I got way too medicalized and I would've had a really hard time going not backwards side, sideways into the home birth world and into that realm. But that's what I thought I would do. And as it turns out, the patients that I wanted to take care of were people like me who thought like I did, but the people I have ended up taking care of are very, very different from me. Completely different from me, They didn't even necessarily know they were getting midwifery. This is just what they got. And now I feel like I'm more helpful to those people who didn't even know that they were being helped or they didn't even seek it. Um, they may still not know that they've been helped in any way. but those are the, that's my career completely went in a different direction.'cause I really thought I was there to, to be friends with my patients, not to be sort of an, a role model or a mentor to them.

Katie: 40:44

The start of my career, I. Was, in the kind of holistic midwifery practice. And we knew our patients really well, and I thought that's what I'd always want. The, and the interesting piece is as I've gotten older and gotten pulled in different directions with, family, I don't necessarily want that anymore. I find it wonderful to just go in and give the best care I can in that moment, but then not have any of that attachment lingering. I also thought that in order to do home birth, I actually never really wanted to do home birth. I mean, I didn't, I wasn't against home birth. I just wasn't necessarily like going into midwifery to be a home birth midwife. I came in not knowing where I felt I was gonna be on the spectrum. Um, but in my training realized I was much more on the holistic side, but. I actually didn't feel that I would have been comfortable with home birth until about year 10 maybe. And then I felt like I had seen everything that I needed to see to be a super good home birth midwife, but I didn't want the lifestyle.

Carrie: 41:57

Right. That's the other thing. A whole different thing. Yeah. But yeah, the call time, the. The fact that there's no time off. Yeah. Is the part that would be impossible for

Katie: 42:08

me's. The, yeah. The piece that really, and you do a lot of traveling and you know, it's really hard to do that, that kind of stuff. Being a home birth midwife and like, I love the idea of witnessing birth at home and supporting birth at home, and I feel that I could do that safely. I'm not willing to have my life kind of be 24 7 by it.

Carrie: 42:31

exactly.'cause this isn't the only thing you are,

Katie: 42:35

Mm-hmm.

Carrie: 42:35

a mother and you're also a wife and you have hobbies and friendships and family things and obligations. Yeah. I couldn't do it either. I couldn't do the full-time.

Katie: 42:44

But what's so interesting to me is I've had partners, you know, that on paper we'd look pretty similar, that have no problem being on call at all. One of my partners, um, that will be on an episode, she's, uh, done home birth ever since I stopped working with her, basically. And she has no problem being on call and she has kids and a family and all the things. And I, I, I was just not built that way, I

Carrie: 43:07

guess. Yeah, yeah. Me neither.

Katie: 43:10

But I have liked that midwifery is diverse enough now in how we practice that. It's okay. It's okay if you don't fit. One particular mold or if you change where, where you're

Carrie: 43:26

yeah.'cause you can go in a million directions. You could do whatever you want. Like, you know, for the time that I had broken my leg and I couldn't work in the hospital, I was just doing phone calls and phone triage and boy, that that took up a lot of time, that was full time because people want questions answered and they want them answered right now, and they don't necessarily want to go into a visit for. The answers. And so phone triage, if that could, that could, there's a place for that.

Katie: 43:56

Absolutely.

Carrie: 43:56

Yeah. And some people don't want you in their home and some people don't even wanna come into the office. So there's all kinds of ways to practice this. There's so many different roles to have. That's the beauty of the career.

Katie: 44:09

It is, especially if you're willing to move to different locations to do. Whatever kind of midwifery you wanna do. I think that's one of the limiting pieces is there's states that are not as easy to practice in certain capacities. Right? And, you know, you could, or maybe it's not even in your state, maybe it's your county, that's influencing how you're able to practice and, um, that that's something that I would like to see midwifery continue to work on. Being less state dependent on what that can look like practice-wise.

Carrie: 44:45

Well, that's just the thing. Uh, Delaware, when I first started practicing here 20 plus years ago, home birth was illegal. So we worked really hard in legislative hall to make home birth legislation happen. But you're absolutely right. The problem with not having a universality to our profession is that people have no idea what we

Katie: 45:07

Mm-hmm.

Carrie: 45:08

And that's because it's different everywhere. It's different state to state and it's different provider to provider. And that's okay. Except there are a lot of people who are missing out on our services'cause they don't know we exist. They think that we are just home birth. Of course we're not. They think that we just do birth, we just do pregnancy and we don't. Um, but that's. That's an image problem, which is a whole nother problem. Yeah. And one of the reasons why I have to get the book out, because it really talks about how diverse of a career this is, and that we're just way broader than

Katie: 45:48

mm-hmm.

Carrie: 45:50

what most people think of as a midwife, which is what they see on tv doing home birth.

Katie: 45:55

But, if you're burned out, Currently, really thinking outside the box can, can be helpful and, and really researching your state where, what you're able to do and what you're not able to do. Because I think, it's not always obvious actually, there, I, I still come up with questions sometimes that I'm like, oh, is this a state thing that we can or can't do something? Is this a county thing? Is this a hospital thing? Is it a scope problem? Like what aspect is creating

Carrie: 46:25

Yeah. In Pennsylvania, when I first started practicing, it was illegal to prescribe.

Katie: 46:29

Hmm, yes, yes.

Carrie: 46:31

ago. They

Katie: 46:31

wasn't, yeah, I remember that. Yeah.

Carrie: 46:33

People. have no idea that we prescribe medications. People do not understand that that's part of the job.

Katie: 46:40

I think now what a midwife looks like, what they're capable of doing, both in the hospital and out of the hospital still needs work. And certainly some states, for example, you can be back at home and then other states you can't. Sure. And states

Carrie: 46:55

right next to the other vary.

Katie: 46:57

Yeah. I know, in Maryland it's been the case where you could. Do VBACs at home if you were a certified nurse midwife, and then Delaware, it's neighbor, that was not, that has not been the case.

Carrie: 47:11

Right. But in Delaware, you've, you've brought this up before. Many times it's different county to county, hospital to hospital, what you can and can't do, including admitting privileges. And Delaware, some hospitals require you to have notes co-signed and other hospitals you do not

Katie: 47:27

policy, that's not a state policy. And um,

Carrie: 47:30

that

Katie: 47:31

definitely contributes to provider burnout as well, to feel like you're being held to something that is not the same in one place versus. The other place. And if you had practiced somewhere else and not experiencing that, then coming to a place that you are unable to do something or being treated differently to do something can feel really frustrating. What's an ideal shift look like for you these days when you get on and at the end of the day you're like, this was a great shift. What does that look like? And does that differ from what you would've said, 15 years

Carrie: 48:09

Okay. I think about this question a lot and I love having. Midwife students or midwife, orientees or midwife, newbies. I love the teaching and the witnessing of people coming up in the field, and I think my ideal shift is being sort of on the sidelines to somebody who's, I learned everything they really need to learn clinically and by textbooks, but still needs a little bit of support. So I love having, right now we have a new midwife, right outta school. Right before that we had another new midwife right outta school. And I think my ideal shifts are being a mentor to new midwives and having a full plate with maybe lots happening. I really like a busy shift. With help. Does that make sense?

Katie: 49:05

Oh, it makes perfect sense. Like

Carrie: 49:06

being a mentor to a midwife when we have a lot on the plate because I like to see how we can juggle it together and distribute the work. And it makes me realize that it isn't ever a one person job. It's too, you really, really work better when you have two midwives.

Katie: 49:24

Mm-hmm.

Carrie: 49:25

Because you can bounce things off of each other, bounce ideas. The students are teaching me things constantly that I wouldn't have thought of or are new. and I find that it just really is my ideal shift to have. Another person with me to help me, but also for me to help them.

Katie: 49:43

I also like those shifts.

Carrie: 49:45

I'm talking about the student that's like, well on her path and you're now

Katie: 49:49

a new

Carrie: 49:50

or a new grad. Yeah. I'm really digging that.

Katie: 49:52

Yeah. But when it's slow with a new grad and they're seeing everybody, oh my God, that's like the worst.

Carrie: 49:58

Yes. I, I

Katie: 50:00

I, I get so bored. But I also have, have loved mentoring. I find that to be really wonderful.

Carrie: 50:07

Yeah. And I do like, I hate to say this, but I think I do like a busy day. I don't like it when there's bad thing that hap bad things that happen, but I do like a kind of a faster pace. it just makes the day go by much quicker. But I really, I only like that whenever the team is working well together, where everybody's doing their part and it's like a well-oiled machine. I cannot stand it whenever I'm the only one doing all of the work as somebody else is sleeping I cannot, I, that's really impossible to deal with. And then I often wonder how much of that is my own fault when that happens? Am I not delegating enough? Am I not asking for help or have I. overinflated my confidence, am I becoming again, a martyr to the work? I really cannot stand being out in the field all by myself with no other players. That is the thing that I realize I dislike most about the sport. You need a team. You need other midwives. You need other cohorts. You need doctors who believe in midwifery and aren't just using it. You need patients who are accepting of our help, and you need to have fresh. Thinkers who come in without the burnout and the rage that a lot of us have over time. And without the physical limitations, you definitely need great nursing support, but without a full team, it's an impossible game.

Katie: 51:40

I have overtime realized that there are team players and then there are not team players, and there are some providers that I genuinely feel don't understand. Team

Carrie: 51:53

players. Sure. The micromanagers for example, or the,

Katie: 51:56

Or the ones that aren't there at all passer offers. Yeah. And that, that's very challenging. I, I don't know that you can actually completely teach team play. Mm-hmm. Like, to some extent, I think people either get it or they don't get

Carrie: 52:10

it. Mm-hmm. And

Katie: 52:11

everybody has be days. So maybe you have a provider that you normally work with that is a team player, and then just one shift for whatever reason they're distracted, whatever. Sure. That's, you know, um, but in general, I would say that. People either get it or they don't.

Carrie: 52:28

Right. And

Katie: 52:29

I know we can both attest to having some providers that initially look really difficult to work with. And then when you start working with them and they trust you, you realize that they are like the best team players. Yeah. And, and they become, and those shifts become really easy, even if your philosophies are different, like vastly different. But if they are willing to be a team player and really believe in that teamwork mm-hmm. You can accomplish a lot and feel really good about your mutual plan of care because you know you're both on the team. Right. we

Carrie: 53:03

about the collaborative model all the time and we as a group frequently will talk about this idea of whether we should do something. Or can do something and that sometimes you can do something, but it doesn't mean you should. We've been told just call when you need help. But sometimes there do, do need to be definite parameters'cause we are not the same exact thing. Just that we are not doctors, we are midwives. We are different than you. But that doesn't mean you tell us what to do or we say we won't do that. There's just this dance that happens and it doesn't happen easily. It does take trust and sometimes it just never happens with certain people. Certain midwives for sure. And certain doctors. Absolutely.

Katie: 53:54

Mm-hmm. Yeah. Team plate

Carrie: 53:56

works ways. Mm-hmm. Mm-hmm.

Katie: 53:57

And, I would say my least favorite shifts generally have nothing to do with the busyness. It has everything to do with, do I have a team player?

Carrie: 54:08

Yes. It's exactly what I'm saying. Who am I working with? And that includes the nurses too.

Katie: 54:12

Oh yeah. It's the whole, it's the whole group. Yeah. If, because if you're not dealing with team players, it, oh, it can be the worst. It just, it's just such a bad shift. And it doesn't matter. You could have two patients on the floor. You could have one patient on the floor and you were like ready to pull your hair out. Yeah.

Carrie: 54:32

Yeah.

Katie: 54:32

And I wish that there was a little bit more weight given to. People's teamwork skills, meaning there's,, I don't think that that gets really heavily paid attention to in, in like your yearly surveys or whatever, are you just generally a team player, like period, not just to your other physicians or to your other midwives or your other nurses, but like, are you a team player and not just do you think you're a team player, but actually do other people think you're a team player? And if you have those providers that are truly, I mean, I would say it's probably the same with nursing. I'm not trying to just single out providers, but truly, truly not a team player. They better be freaking amazing at something else, you know, to, to keep them there. Why do we keep, why do we keep people that can't handle the team approach in a place that requires

Carrie: 55:27

it. Sometimes it's because there's, you just need a body to fill. Yeah. The whole, Unfortunately that's a lot of times what happens in places where you're underserved, you don't have enough providers, so you take whatever you can get. And that's really unfair to the patients who show up Knowing what they're gonna end up with, not knowing who their doctor is going to be. They get sometimes they don't always get the best.

Katie: 55:54

No. And I think it leads to burnout among the people that are there and, it's really hard to generate and keep a team going when there are players in that team that are not mm-hmm. Contributing in the teamwork sense.

Carrie: 56:08

Sure. It's difficult when you disagree with the care provided by people that are on your side because it can end up legally. You can't ever throw them under the bus if they do something wrong necessarily. Like in the,

Katie: 56:25

Well you shouldn't, and a team player would understand that, but I have seen people that don't understand that team play that will undermine that. Yeah. To patients Exactly. Or to other providers. Right. Um,

Carrie: 56:36

absolutely. I used to work with a physician that would check after my checks. I would do a cervical exam, say, oh, you're three centimeters and 50% he faced, and then he would do the exam and be like, she's two centimeters and only 60% he faced, you know, really like over everything I did. Had to like negate it in his own way and undermine me and nothing destroys confidences in my care. More than that.

Katie: 57:09

That's true. And we're just in a field where you, it is not a wise decision to undermine your other care. Right, exactly. Absolutely. One of the phrases that makes me most insane, actually, and you can always tell a team player if they say this as a provider, is that like, I am carrying all the lawsuit risk in

Carrie: 57:31

in this. Oh, yes.

Katie: 57:32

And it's just so bogus. I don't care if you are a midwife or you're a physician or if you're a nurse, as both of us know, if you're

Carrie: 57:42

there's a shared liability.

Katie: 57:44

is a shared liability. And while I think a lot of times, particularly for physicians, they feel that. They have the most to lose in a practice like we're in now, it's actually the hospital that has the most to lose. If you're a hospitalist practice, the hospital is likely getting sued as a name. And in that, especially in those cases, you're all on equal footing, So to me that's like the ultimate non-team player statement, like, of, this is my license, it's all of our licenses.

Carrie: 58:18

Yeah, that's a very good point. And I have heard it a lot. I mean, and I guess that they're talking about their personal assets, but I don't see how it'll only affect them and not. Everybody's personal assets. If assets are coming, being come, if somebody's coming for personal assets, it's not gonna be

Katie: 58:38

gonna be, I think a lot of times they mean like their ability to get sued and then to continue practicing, because you can get dropped from insurances, if you have too many lawsuits, but the same holds, for, midwives or whoever it follows you, it follows you as a job. And definitely as midwives are expanding our scope and being involved more frequently with high acuity,

Carrie: 59:00

Mm-hmm. By

Katie: 59:01

we are certainly being brought into lawsuits. Yes. More and more. you know, at the start of my career, it was kind of unheard of for midwives to be getting sued. And now I would say that a lot of midwives I know have been involved in lawsuits, whether they're named or the hospital's named, and they're just part of, the, the group that was on the chart.

Carrie: 59:23

Mm-hmm.

Katie: 59:25

I, I think at this point, the majority of midwives I know have been involved in some. Absolutely.

Carrie: 59:31

Absolutely. Yeah. Absolutely.

Katie: 59:34

And so it feels really, I don't know, unprofessional to, to throw that back at us, Yeah. Like this, this is my license.

Carrie: 59:44

Yeah. everybody's kind of responsible for participating in risky business, taking chances. It's hypocritical to say that, and then to prescribe medication off label, for example. But yet we do it. We all do it. Mm-hmm.

Katie: 1:00:01

Mm-hmm.

Carrie: 1:00:02

Or to. Schedule an induction when it's not an indicated induction according to the standards of acog, for example, but everybody does it. So it's really messy to have a set of rules that you don't always play by, and then to throw somebody under the bus when they don't pay, play by the

Katie: 1:00:24

Mm-hmm.

Carrie: 1:00:24

Mm-hmm. I mean, I think everyone, everyone does it. Everyone takes chances. everything is subjective

Katie: 1:00:32

in mean, absolutely

Carrie: 1:00:33

of midwifery, the art of medicine, it is not entirely a science. And there's variations. In the way that we read things, the way that we see things, there's definitely instinct at play that cause us to break roles sometimes. Like there's no hard fast for saying, for example, you've had a category two tracing for X amount of time. It's absolutely time for a c-section right now. Like we have varying thresholds for when to say.

Katie: 1:01:05

I stop, I say to patients all the time, I'm like, babies don't tell us, Hey, I've got three more minutes left. You know, they,

Carrie: 1:01:12

it so you can't throw anybody under the bus because you, you can't say what you would have done in the exact same situation, in the exact same time. You can't, nobody would ever do the same thing twice. There's so many factors. So you can't throw people under the bus. You can be like, Hmm, I don't know if I would've done that. But you also don't know if you would've done

Katie: 1:01:34

Right. I, and I think that is a hallmark of, uh, teamwork is having that dance in conversation with whoever it is, whether it's the patient or the nurse

Carrie: 1:01:44

mm-hmm.

Katie: 1:01:44

a physician or another midwife. The dance of well, yes, empathetically. Yes. That sounds challenging. I can understand why that would concern you without being like, that person was wrong.

Carrie: 1:01:56

There's certainly the people who wanna go through all of the worst case scenarios and Sure. Any of those times, any of those things can happen. But do you do that every time you walk out the door? Like go through the worst case scenarios? It's just,

Katie: 1:02:10

Yeah. It's this whole other side piece of the job that feels overwhelming, Which is why I think it's important to be around other midwives,

Carrie: 1:02:16

Absolutely. And especially, like I said, it's important to have young people who are new to the field teaching us that things that we say and do are not necessarily right anymore. I'm constantly learning about passe language, for example. I didn't ever in school learn one time about trauma-informed consent or trauma-informed care. We never even heard of those things. There was sort of an allusion to it, but now it's something I have to be so careful about because I didn't get, brought up in

Katie: 1:02:48

mm-hmm.

Carrie: 1:02:49

Mindset of

Katie: 1:02:51

Mm-hmm.

Carrie: 1:02:52

I was in school at a time when people were still practicing on anesthetized patients. Yes. How to do gynecological

Katie: 1:02:59

I was just talking a about this to a resident recently, and I was like, same. I, I, I remember that being something that people were doing. Yeah. You had a GYN patient and they were anesthetized and, everybody's going in. The midwives weren't, the medical students and residents were going in and doing checks on them so that they were learning their skills. And when I was a midwife

Carrie: 1:03:21

school, we practiced on one another. Yes. Our classmates. That even seems now completely crazy. Mm-hmm.

Katie: 1:03:29

Mm-hmm.

Carrie: 1:03:30

At the time it was a given, it was just how it was done. But now when I look back on that, I realize that's wrong too, even with consent, because you can't consent to something you feel pressured to do. And it didn't bother me. But that's because I didn't come from a place of, say, abuse or sexuality. I sexual identity question marks. Um, at that time it was weird. I felt it was uncomfortable, but I didn't feel unsafe about it. But now, all these years later when I've had body changes that I'm not necessarily Uh, proud of or I feel shame around, I wouldn't wanna do that. I wouldn't want a, anybody, especially my friends, to check my breasts

Katie: 1:04:21

now. Mm-hmm. Yeah. But back

Carrie: 1:04:22

then we did it because we were told we That was just how it was.

Katie: 1:04:27

Yeah. Well, there's that culture, you don't even recognize it's a culture. It's just, it just exists. And then until it changes, you don't think a whole lot about it. So coming full circle on all of this, what, what is giving you hope right now in, in the field? What are you hopeful for? What makes you feel like you can keep doing this?

Carrie: 1:04:52

I think without any preparation to this question, I would say that. Right now, the political world in the United States is talking about women's health. They're talking about population, talking about giving tax credits for childbearing. They're talking about abortion laws, we are talking about racism and how it affects lives in obstetrics, and I don't necessarily think we're going forward. I don't necessarily think it's good. Some of the laws are very regressive, but it's being talked about. It's really coming to the forefront, and it's angering people on both sides in such a way that I feel like it's hopeful because. In my mother's day, it didn't even get talked about at all. People suffered in silence, had no choices at all, and the laws weren't even on the table even so much as in contraception and in, certainly in abortion there is at least fire under the topic and maybe it's all gonna literally explode. But I am impressed by how many people I see on social media freely. Discussing it. And I think that's where I feel hopeful, because as a midwife, I can affect change. I can make a difference, I can help people, and I am absolutely willing to do whatever it takes to get people to see that they have a choice. And whatever choice means to you, it means to me that it's not my choice to make

Katie: 1:06:57

Mm-hmm.

Carrie: 1:06:58

that. If I am going to call myself pro-choice, that means that I have to support you in whatever it is. That is your choice. Whether that's for or against what I'm for or against.

Katie: 1:07:12

That's a good way of looking at it. I think that's one of the things that midwives feel really strongly about is that we're supporting the patient, but. That often means that it's not necessarily what you would do.

Carrie: 1:07:24

Mm-hmm. Right. For example, we had a patient the other day who said, I don't wanna do this. I just want an elective C-section. I've had five babies vaginally. I want to schedule a C-section and have my tubes tied at the same time. No reason, no indication, no. Absolutely no medical rationale. I disagreed with her, but it was her choice, not mine. And that was one of those things that kind of shook up my, My thought process, because again, I can't judge you if I believe in choice.

Katie: 1:07:56

Mm-hmm.

Carrie: 1:07:57

When you make a choice that I disagree with.

Katie: 1:08:00

Hopefully that's where we're headed. And I guess I would find that hopeful, that we're headed to a place where people can understand that there's not a universal one way that. That we're not all the same cookie cutter

Carrie: 1:08:12

Yeah. And that's the other thing, like I also have conflict with what I'm saying because I also in a way believe that sometimes we don't really actually have a choice. Like we don't always have it. And sometimes, like for example, in infertility, in my own fertility, I didn't have a choice in the matter. It just is what it is. So sometimes it can be frustrating when people throw the word choice around.'cause you don't have a choice if your baby is born dead. You, you may not have had any choice in that. If you can't push out the baby'cause it doesn't fit through your pelvis and you actually need to have a C-section, that's not a choice. It's just the reality. Yeah. So it's conflict, you know, but it's hopeful. It's hopeful in the sense that there are alternatives. There's no single side to the coin. And if you can at least. Open your heart to the fact that there's gray areas and that nothing is black and white and that it isn't ours. To make that somehow we're just the sort of, I keep using the word narrator or witness. We're just sort of the conduit to get people where they're going. I have absolutely no power. I'm nothing except for a helper. And that's hopeful is, but it took a a long career to come to that. Like I'm just here to help. Mentality and not that I'm here to be the heroine.

Katie: 1:09:45

that's an evolved thought process that hopefully we can all get to. Yes. Because I think that actually helps you with burnout. It's not so much pressure.

Carrie: 1:09:53

That being said, I'm staunchly opposed to a circumcision.

Katie: 1:09:58

Yes. Well, we all have our things.

Carrie: 1:10:00

I won't help you with that choice, but she'll

Katie: 1:10:04

will direct the person in the right

Carrie: 1:10:05

tell the mood to call, but

Katie: 1:10:07

I won't do it.

Carrie: 1:10:08

it.

Katie: 1:10:09

But that's really important as providers to still be able to maintain what we are willing and not willing to do, and that we have the option to say yay or nay. Yeah. You know, and feel good about that. And then have other people that are willing to do that service, that do feel comfortable with, with that service.

Carrie: 1:10:29

Mm-hmm.

Katie: 1:10:30

Which I think speaks to the hope that you're saying, it's hopeful to me if we get to a place where there's an understanding that we might not all be comfortable with

Carrie: 1:10:38

same decisions. Right. Exactly. That we can talk about it, we can have discourse and that it can be, It can be. Something we all educate ourselves towards. A whole entire societies have been told what to do, and that's where it becomes problematic whenever you. Have no, no decision in the process. You don't get to choose. Yeah. I do want. To put it on the record that I'm gonna write my book and finish it and publish it. And that there is humor in not just negativity behind the stories.

Katie: 1:11:16

I am sure the listeners of this podcast will be very excited when you're finished with that. And you can come back on and talk about the book specifically at that point. When it comes out. When it comes out. Yes. Alright.

Carrie: 1:11:28

For the record

Katie: 1:11:29

Next time. Okay.

1:11:31

I hope you have enjoyed this episode of Mindful Midwifery Presents, the Labor Behind Labor with my guest. Carrie, I just love Carrie's view of midwifery as being a part of her love of nature. I hope you enjoyed that as well., The next episode you'll hear in two weeks is Lindsay's. Lindsay was going through a transitional time in her career during our recording together. I look forward to sharing her episode with you.