Doulas Unhinged

Episode 16: How Care Providers Can Empower or Traumatize- A client's Birth story

• Lacey Morgan and Alex Shaw

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0:00 | 1:01:41

This week on Doulas Unhinged, Lacey and Alex dive into a powerful topic- Empowerment or Trauma surrounding birth. This is one of the biggest differentiators in how someone remembers their birth for the rest of their life. The same situation can feel empowering or traumatic depending on how care is delivered. Tune in to hear and explore our thoughts!

How Providers Can Empower a Birth Experience

1. Informed Consent (not just “permission”)
•Explaining risks, benefits, and alternatives (BRAIN in action)
•Using language like: “Here are your options” instead of “This is what we’re doing”
•Respecting a “no” without pressure

👉 Impact: Builds trust, autonomy, and safety


2. Respecting Bodily Autonomy
•Asking before every touch (especially cervical exams)
•Honoring position changes, movement, and pushing preferences
•Supporting refusal of interventions

👉 Impact: Prevents feelings of violation or loss of control


3. Calm, Regulated Presence
•Grounded tone, slow movements, non-chaotic energy
•Confidence without urgency when things are still safe

👉 Impact: Keeps laboring person’s nervous system out of fight-or-flight


4. Language That Supports, Not Scares
•“Your baby is tolerating labor well” vs “We’re concerned”
•Avoiding worst-case framing unless truly necessary

👉 Impact: Reduces fear → supports physiological labor


How Providers Can Traumatize a Birth Experience

1. Coercion or Pressure
•“If you don’t do this, your baby could die” (without context)
•Repeatedly pushing interventions after refusal
•Using fear as a tool

👉 Impact: Loss of autonomy, panic, long-term mistrust


2. Non-Consented Touch
•Performing cervical checks or procedures without clear permission
•Ignoring verbal or physical resistance

👉 Impact: Can mirror sexual trauma → deeply triggering

3. Creating Urgency Without Explanation
•Sudden tone shift: “We need to move NOW”
•Rushing into interventions without context

👉 Impact: Triggers fear response—even if outcome is medically fine


4. Violation of Birth Preferences Without Discussion
•Ignoring birth plan completely
•Performing routine interventions without checking in

👉 Impact: Leaves people feeling powerless and unheard


5. Chaotic Environment
•Multiple people entering/exiting
•Loud conversations unrelated to patient care
•Lack of privacy

👉 Impact: Disrupts safety → stalls labor + increases stress


6. Postpartum Silence or Avoidance
•No explanation after emergency or unexpected outcome
•Brushing off questions

👉 Impact: Unprocessed experience → birth trauma, PTSD symptoms



SPEAKER_00

Welcome to Duel Let's Unhedged, the podcast where we tell the unfiltered truths and disrupt the accepted view of modern art and parenting.

SPEAKER_03

We're your hosts, Alex Shaw, and Lazy Morgan here to cut through the points, share the stories no one else will, and empower you with real talk that's equal to parts honest, funny, and unapologetic. Let's get unhedged. Ways to make life a little bit easier on us. Yeah, we need it.

SPEAKER_01

We do need it, especially coming off of that birth, Alex. Oh my god. I don't I'm still trying to wrap my head around it.

SPEAKER_03

Oh my gosh, right? Like there are times where I attend a birth that leaves me questioning everything that I know as a defense. Yes. Correct. This was one of them. This was absolutely one of our. This was one of them. Uh I had decided maybe two weeks ago that I was going to have a party for my kids just for fun because I don't know, sometimes it's nice to do that. And um the party, everyone was invited to sleep over, and nobody was able to. And that thank God. That was the universe protecting me, I think, so much, or protecting Andrew, maybe, because he would have been home alone with like 12 little girls.

SPEAKER_01

Oh my god.

SPEAKER_03

Yeah. So um the family reaches out at like eight or nine o'clock at night. Nine nine o'clock, and uh they say, Hey, you know, we've been having contractions for like an hour. And I was like, Oh, that's great. You know, and I excuse myself from the party chaos, and you know, I'm like, okay, guys, like just, you know, ignore, ignore, ignore. The same thing we tell everybody, hydrate and ignore. Yep. Um, and let's check in a little bit later. I said, I, you know, I have this little party with all these little chicks at my house, and um after they all leave, I'll check in and see how you're doing. And and so uh you know, they did exactly what they were supposed to do. They tried to ignore it, they um really just stayed positive and followed their bedtime routine. Um they sent dad to bed. He said uh he was so sweet, he said to her, I need half an hour to an hour nap. And then I'll be okay. Um yeah, and so a little after midnight she called me. He was sleeping, and I think she was just nervous to be alone. And so, um you know, we talked for four hours. Oh my god on the phone. Oh my god. But it was it was fine, you know. Like I I'm happy to do that as part of phone support, you know, just like keeping her calm, reassuring her that things were okay, and she was kind of like describing the contractions as uh intense, but when I was listening to them, I couldn't quite discern when she was having a contraction. Uh spoiler alert when she was fully dilated, pushing the baby out, experiencing the ring of fire. You also could not tell.

SPEAKER_01

I you know, I was gonna say that uh even when I was there, it was hard to tell what what she was doing. And some mom, like I have a few that that are on the top of my list where it's like some are really very internal, they go inward, some are external, and you know, but she was one that was I was very uh Yeah, it was hard to read. It was hard to read, yeah.

SPEAKER_03

Well, so between 12 a.m. and 4 a.m. her labor progressed like a multi, so like someone who had already had a baby, right? She went from like inaudible, couldn't tell that she was having contractions, maybe a slight change in her breathing was really the only cue for me that maybe she was having a contraction, and then um then she started to have these more like regular contractions that were getting closer together, more like four minutes apart. She was starting to make noise through them, and she had one or two really big ones, and then dad woke up. Like he could sense that he was needed, and he came into the bathroom, and um and so you know, I'm like giving them all the suggestions, right? Like maybe you should elephant walk, because I'm thinking like this is progressing too quickly for a first-time mom. And so I'm thinking, like, oh, it's gotta be baby's position, like there's something going on. So I suggest that she does elephant walking. Um told her to do five contractions on the toilet, then do five contractions in a different position, like just trying to facilitate baby shifting in the hopes that maybe things will spread out and normalize and um but they just kept intensifying, and you know, she was saying that she um she felt more pressure when she was sitting than when she was standing, right? Which is I think a little unusual. Like it sometimes they experience more pressure when they're sitting like on something when it's compressing their having that tactile feedback, right? Um, but typically being upright really brings baby down. So I was I was racking my brain trying to think of like what could be going on, but labor kept progressing, and it went from ten minutes apart to five minutes apart to three, four minutes apart, and then we were two and a half minutes apart, lasting 90 seconds, which for a multip is is normal typical, yeah.

SPEAKER_01

It's a normal quote unquote normal within the range of normal labor pattern. Yeah, yeah, and so I'm like, maybe she's just one of these moms who progresses fast, even though she's a first-time mom. Yeah, yeah. And they they do exist, they are they are unicorns, they do exist.

SPEAKER_03

Yep, yep. Um, you know, and and then communicating with the dad on the side, and I'm saying to him, like, you know, can you send me a video of what she looks like in labor? And she looks like she's in transition, you know, and I say to him, uh, keep an eye out to see if she's like popping up on her toes. Uh, you know, if you see anything that looks like the rhombus of Michaelis, which is where the tailbone pops up.

SPEAKER_01

I love it so much. I don't get to see it often. No. Like home birth, yes, maybe, but certain bodies don't do it, even though they could be in trick, you know, like well, I think you have to be in that forward-leaning position.

SPEAKER_03

Yeah. And not hands and knees forward leaning, but I feel like that angle sitting in a chair leaning over. Yeah, it's like a 45-degree angle between the ribs and the thighs really makes that more prominent. And I don't think we see women labor in that position too much. Which yeah. But so you beautiful. All the telltale signs, right? So, and and I can I can just feel sense this shift in energy, and you know, she's like telling me that she's having the pressure to poop. She's telling me that it is consistent between contractions, right? So as Adula, I am certain, and I think certainty is the fault here. I am certain that she is about to have this baby, and I'm starting to get worried that she's going to have this baby unaccompanied at home, right? And so I say to her, um, you know, where's your head space? Like, are you feeling like you need to be in your birthing location or are you still really comfortable at home? Yeah. And she said, She said, No, these these last couple contractions have really made me think like I need to be at the hospital. And I was like, Okay, all right, then it's time to go in. Because we always tell them, if you're asking, yeah. Go ahead. If you're asking, it is not time to go. Right? But if you're saying it's time to I need to go, get my shoes and in the car, we're going. Yeah, then it's time to go. Yeah, right. And so I'm like, okay, I'm gonna call Alex and I'll call you guys back.

SPEAKER_01

And I call you and I wake you up. Thank God I didn't know. I have FOMO. I have I won't sleep if I know someone's in labor, even if I'm not the one doing phone support. Like, I should be sleeping. I won't. I'm the worst. The worst. Anyway, thank God I didn't know. I was too tired. Yeah, it was so good. So it was so good because I did get some I got some sleep. Was up at what 3 a.m. you think I called you at 3.

SPEAKER_03

Um because she had gotten in the bath for like a half an hour and she loved the water. Yeah, but like that was it. She was like, this I she's like, I'm all done. I, you know, she started asking uh her partner for to do the hip squeeze at 3.10. I know. I'm still sore. We joke me too. I'm my body is wrecked from this bird. Yeah, we tell partners jokingly but lovingly. Yeah.

SPEAKER_01

But also slightly serious. Serious, totally serious. Because it is you should not be doing labor lasts, especially for first-time moms. The majority, I'll get closer to the mic to say this. The majority of first-time moms, labor lasts days. Days. Days and days and days. And so when partners start hip squeeze or counterpressure, that it and especially for a mom like this one who was determined to go on medicated, it is one of the tools that is so helpful. Yes. They absolutely love it. It is so helpful for them. But it is extremely hard as a support person to do it for days and days and days. And this is a this is why I mean, go back and listen to the episode of doulas are for partners, right? Like, thank God people hire doulas because we can all tap in and it's not just one person doing the physical support. Right. If you haven't checked that episode out, go check it out. For real, though.

SPEAKER_03

Yeah. And so, but I she was asking for it, right? Like sometimes partners start doing it because they want to be helpful and they don't know how. And but hands-on, yeah, specifically asked for him to start. And so I was like, dude, like she's gonna get to the hospital, she's gonna be complete, like checks all the boxes, right? Like we are golden. Good, right. Good idea. I was like, 2026 is just a winning year for beautiful, precipitous birds. And so I call you and send you in, and you're on the way to the hospital to meet them. They get there, the they won't let them in the front doors. They send them to go to the ER. I went through the front doors.

SPEAKER_01

I always go through the front door. Like I've never been through the ER at that hospital. Uh-uh. I always go through the front.

SPEAKER_03

Right, never.

SPEAKER_01

It's never an issue. And so I don't know if they walked to the ER, drove to the ER. I mean either. Lots of questions were happening, right?

SPEAKER_03

And so then they're talking to her in the ER, asking her a ridiculous dumb question.

SPEAKER_01

Dumb questions. Ridiculous. Like your last name isn't what's in our system. Like, that's not my problem. Like, you know what I like as the birthing mother, I would have been like, that's it sounds like a you problem. I'm going up. How about this? They had in the system that she was 42 and 3. Oh my god. And the person at the front door, the security person at the front, like was like, what? Your how many weeks? Like, why don't you get someone? I'm gonna be real mean right now. So you want to hear some unhinged stuff. Like, why don't you get someone that actually knows how like gestational like what to do with the person in labor? Oh yeah, or just like he uh it was he was like your how many weeks? You could hear him wrapping his brain around like the and I'm like, you know nothing.

SPEAKER_03

And then you're not gonna catch her baby, and whether she's 42 weeks or 22 weeks, it doesn't matter. Get somebody down here from labor and delivery. Stop asking her dumb questions. Oh, oh God. Anyway, and so then she gets up to labor and delivery, and it is taking forever. They're asking her dozens and dozens and dozens of questions, and I it was so bizarre to me. And I'm like, tell them that you're pushing.

SPEAKER_01

Oh yeah, I heard that. I heard that come out of your mouth. I was like, But she was.

SPEAKER_03

She was grunting, yeah, she was grunting during her contractions. Again, confirmation from me that she is ready to have this baby. And so they do the vaginal check, and she is three centimeters dilated, and I die. Yeah.

SPEAKER_01

Oh my god. And now, also though, my first thought was maybe that's just like her the cervix can close, right? You could be, let's say, completely dilated at home or close to it, right? Giving us all of the usual signs that we see. You get in the car, you get asked a million questions, you go in for that cervical exam, and your cervix like closes up. Okay, but not seven-seven. I agree. I agree. But that was my I was being hopeful in my thought process there. I was like, well, maybe it'll change real quick. Well, and she didn't have any vaginal exams during her pregnancy. Correct. We didn't even have like a baseline.

SPEAKER_03

Well, but I was kind of thinking, like, you know, it could just be like a I don't want to say a trauma response, but like that's kind of what it could feel like, you know, when your brain is being forced to activate and answer all these questions, and now you're in the ER with sick people and this guy questioning you, and this idiot right, right? Like all the things, and then you go up to labor and delivery, and they're asking you more questions, and it's slowing, and labor's already slowing down, right? She's in the car, labor slowing down, which is normal.

SPEAKER_01

Yeah, people don't want to be in the car for labor, right?

SPEAKER_03

Yeah, you know, and and the ER is not safe, and and there were multiple transitions out of her house, into the car, out of the car, into the front door, out of the front door, into the ER, yeah. Like, and so I'm like, okay, each time, yeah, each time could be bringing her clothes more and more closed, correct? But I'm I don't think three centimeters is a reasonable thing to think. So at that point, I'm like we just accept it. I'm like, I just woke up early this morning, hosted a party with a bunch of teens and pre-teens been on the phone with for four hours. Until 4 a.m. Yeah. And I'm like, I have to go to bed.

SPEAKER_01

Yeah.

SPEAKER_03

So you take over, and then I have no idea what happened.

SPEAKER_01

So then I took over. Should I bring out my notes? I took over, stopped, got them, uh, got her some watermelon. She housed that watermelon the entire time. Um, she was very intentional with like her cervical exams through the entire thing. She stayed dedicated to an unmedicated birth. Uh, she was just slow to to progress. She was throwing up, right? Like, so I was like, oh man, cool. Maybe we're like, maybe we're nearing transition, especially after hours and hours. And I had been there, I think, almost 17 hours. It was like 16 something. Uh, and as those hours and hours and hours passed, she would throw up, and I'm like, maybe we're getting closer to transition. We were doing all the things, you name it. There is one position that we did not do, which was Walters, which I did not think was appropriate at any given point during that almost 17 hours that I was with her.

SPEAKER_03

Yeah. Because she was making progress. She was making progress. She was getting about one centimeter, 10% effaced, and baby was moving maybe a station every four hours.

SPEAKER_00

Yeah, yeah.

SPEAKER_01

Which uh, but then when I her contraction pattern ended up spa by the end of my time with her, her can like her contraction pattern was really spacing out. And for someone, let's say, like at eight centimeters, they were like six minutes apart. I'm like, what the heck is going on? And every labor is different, right? Like there, and this is what we tell moms all the time. There is like yes, there's a a typical labor pattern that we see, but sometimes we see things that are still normal, but just hair outside of it, and so that that was clearly her normal. And that's what her body and her maybe and her body but her body still progressed to eight centimeters.

SPEAKER_03

I stand by the fact that I think that that baby had a nuclear hand because when he came out, the whole I think it was the left side of his face was all like red, looked like it was going to bruise, and it looked like there were fingerprints on his cheekbone. Interesting. No one declared a nuclear hand when he was born. Okay. Um, but there there was something funky, and the the nurse that was there, oh my gosh, it was amazing. Amazing. Amazing.

SPEAKER_01

I enjoyed all of the nurses that that were that was with me. They were all wonderful. Um the one, the first one that was there, she said something like, It was so great to work with you. Like, we love, you know, working with you guys, like it's so great. Like, and I was like, girl, we're all on the same team. Like, I love this too, you know. It's so important, like, because I think people, you know, are like, How is it? How like how is that dynamic and whatever? And and it was really nice to to to get that, yeah, that feedback.

SPEAKER_03

Well, I she had three different rounds of nurses, right? Because she had the nurse that she got when she went in that mor. So what was that Sunday morning? Yeah, she was at the hospital, so she had that nurse until 7 a.m. Then she had a daytime nurse, then she had the evening nurse, and then she had another daytime nurse. So really she probably had four nurses. Yeah. Um everybody every single nurse was incredible, but we had one who uh was a doula, was a labor and delivery nurse, and was in training to become a midwife.

SPEAKER_01

Yeah, midwife free school, which was fantastic. And I remember uh at one point during our swapping, right? I had to leave 15, 16, 17 hours later, like I'm done. I can only give so much, right? Lacey came in to relieve me.

SPEAKER_03

Um right at shift change too, which was terrible. It was, but whatever.

SPEAKER_01

It worked out like whatever. And so I was like, I like to be consistent. I don't know about you. I like to be consistent if if a mom is asking for cervical exams, I like to be consistent with it. The provider, the doctor that was that had been doing it was still there. And so I remember you're in the room, I'm in the room, mom's in the bathroom, mom's like, yeah, I want a cervical exam. Nurse comes in. I'm like, do you want do you want the doctor to do a cervical exam? And the nurse who we love was like, I've been doing this for a really long time. She said, I've done more cervical exams than that than the doctor. I know. And who was the baby doctor? She was, but she was fantastic. I loved her so much. They did, they did not.

SPEAKER_03

They felt neutral about her. About her? Okay. Yeah. I liked her. I liked her, I liked her a fuck ton better than the doctor who came in and caught the baby. I'll tell you how much she was a hair hole. We will get there. Ooh, can't wait. Yeah, but uh, no, so the nurse ended up doing the the job.

SPEAKER_01

Just yeah, and it was just so funny. She's like, I've been doing this a lot longer.

SPEAKER_03

Like, we were both like, all right, yes, hell yeah. But throughout her care, that nurse was like, here are the options, here's the recommendation, um, here are the pros and cons. She said, I don't care what you do. Yeah, my job is to inform you, and your job is to make the decision.

SPEAKER_02

And I said, Oh my god, I love you.

SPEAKER_03

Yes, right. She said, We tell people all the time that the providers, the nurses, they're all medical advisors, right? Their job is to give you advice, and then your job is to make the decision. And she said, My job is to make sure that we don't have a traumatized mother leaving this birthing room.

SPEAKER_01

Right, like amazing, right? Amazing. We love you. Should we like give her a shower?

SPEAKER_03

Yes, we love you, Ginger.

SPEAKER_01

Ginger, should we name the hot now?

SPEAKER_03

Absolutely incredible. Just absolutely wonderful. And I hope that she stays local. She will be an amazing midwife. She's from out west. Is she? Yeah, I think Arizona maybe. That makes sense. She has a I like that. Yeah, and she came here to to train as a midwife, and I I hope that we are so lucky to have a midwife in the area, as wonderful as she is. Because she truly believes in patient autonomy and um informing the patient. Well, like just informing, not even consent, right? Information, sharing information. Informing, right? And her role as educator and advisor. Yeah. I hope that we are lucky enough to keep her in this region because she was unbelievable.

SPEAKER_04

Yeah.

SPEAKER_03

Um, so yeah, so I took I took over at 7 p.m. Sunday night. And I was like, oh, I'm gonna be home before the Super Bowl.

SPEAKER_01

Yep. This mom was eight centimeters. I was like, not much more to go. Like the at that point too, like transition typically 30 minutes to three hours. Like it's not a full 10 or 12. Like, and also that mom was fully dilated for a long time before that baby came.

SPEAKER_03

So Was she fully dilated before you left?

SPEAKER_01

No. She was eight. She was eight when you left. When I left. No, no, no. She the there was uh an anterior lip. And I was and she was nine. Yeah, and I was like, what's an an like what's your definition of an anterior lip? I remember asking her. And sh the position that she got checked in, it was hard to say. So we didn't really get a good good answer to that. Um But anyway, she was past eight. And at that point, in even in a first-time mom, it typically and an unmedicated birth, it typically does not last another 15 plus hours. Right.

SPEAKER_03

So she she got checked uh just before midnight, and uh the who I can't remember who it was who did the check, but they said she was zero at that point and baby was plus one station. And I'm like, this is great, right? This is awesome. So uh we were albeit moving into the you know Monday morning now.

SPEAKER_04

Yeah.

SPEAKER_03

Uh but um yeah, everybody was kind of managing well. She the mom was unbelievable. Unbelievable. They're starting to suggest that she consider Pitocin. And um I guess that was around midnight because her contraction pattern never came back together. Baby had a couple of dips that were kind of long between uh 11 and 12 or 11 and 1. Um, but you know, he recovered okay, and I think it was really just positional because as soon as we changed her position, they went away. Um one, she was on her side, we were doing some maneuvers to try and get baby to engage in the pelvis. Um and then the other time she was on the toilet, but you know, it was kind of like she was staying in these positions for a longer period of time because at this point she is exhausted, right? Exhausted. Um and so I think it was just his response to the position, he totally bounced back and was completely fine. So no one's concerned about the baby. Everyone is concerned about her and her stamina for this, right? Um, but she is managing so beautifully. When I got there, at probably about eight o'clock at night, I did some CST on her. She was sitting on the ball with the squat bar in front of her, and I was doing some CST and her whole body just completely relaxed and she like was falling asleep. Like I'm holding her head up while doing the CST because she is like conking out completely. I I actually stood in front of her and like pulled her head to my chest and just held her in place.

SPEAKER_01

Yeah.

SPEAKER_03

Um but anyway, and you know, like it was she was just exhausted, and so around 2 a.m. they start discuss discussing the idea that maybe they should do some Pitocin. And you know, this mom wanted a completely unmedicated birth. Yeah, and you know, the idea of this was oh, she was just so I just disappointed, I guess, yeah that nothing, you know, nothing had progressed. And and I would argue that for most births, I think that they rush Pitocin, right? Because like a a funky labor pattern is often an indication of a funky labor, like a funky position of baby. Right. And I would say that a lot of the times the administration of Pitocin can force a baby deeper into the pelvis in an unideal position, correct. Right? And but this mom had done every single position imaginable to you, except Walters, and but it wasn't appropriate, so it was not needed. No, like that wasn't that wasn't what was needed, right? He was moving down, right? Like Walters is great when a baby just is not changing station at all. Yes, exactly. Right? Exactly. And this baby was doing the things just very, very slowly, very, very slowly. Um good old Pisces. Is that a Pisces? I don't know. Uh yeah, right, I think so. I think a water sign. Yeah. Um anyway, so he, you know, he was doing the things just really slow. Um, you know, and so we started talking about Pitt at 2 a.m. and she really, really didn't want to do it. And I said, listen, if you don't want to do it, then I want you to do lift and tuck against the door um and hold it during the contractions, right? Like don't like not coming out of it during the contractions, like you're uncomfortable. The really, really uncomfortable thing to do. And she tried so hard, she really she gave it all she could, but she kept dropping to her knees at the peak of the contractions. Um, you know, and and her her contractions came closer together, yeah, yeah, right? But then as soon as we stopped doing it, they'd spread out again. And so I was like, listen, girl, you have done so much work. And I said, you could keep doing this exactly the way that you for three more days, and and it probably would have it would have been at least two, it probably would have been. And I was like, or you can get a little bit of Pitocin, yeah, and it'll bring the contractions closer together so that you can have this baby. And I told her about I had this one client who refused monitoring through her entire labor. She did the 20 minutes at the beginning and then would not get on the monitor again. And I said, if they had seen her labor pattern, they would have insisted that it was ineffective for birthing a baby. Yes, right? So is it possible that you can do this with uh an atypical labor pattern? Absolutely, right? But it is going to take a really, really long time.

SPEAKER_00

Really long time.

SPEAKER_03

Right. And I support you, whatever you want to do, like you do what feels best and right for you, but a a little bit of pit does not mean that you're going to get an epidural or any of that, right? And so And she never did. Well, and I there were two times that she talked about it, considered it, and I I suggested that she wait and try some different things and you know, whatever, and and both times she like kind of moved past that idea. Yeah. So she got the Pitocin. And just like we tell people all the time, right? A little bit of Pitocin is completely manageable if your mindset is to have an otherwise unmedicated birth, right? Because I think sometimes people fear like they can't get Pitocin and continue to not have an epidural. And she was proof again that you absolutely can have low-dose pit and not get an epidural.

SPEAKER_04

Yeah.

SPEAKER_03

And so she she got the pitocin, and I I love this so much about ginger. She had come in to increase it. She said, We're going to increase it every 30 minutes because uh we want to see what your body can do at this particular dose. And I was like, look at you being up on your research. I said, Do you know how many people come in and like say that that's complete BS? And here you are, like demonstrating that there are people who know what's up.

SPEAKER_01

Yeah, yeah. She said, Listen in a hospital setting.

SPEAKER_03

She said, I've been doing this for 20 years. She said, Uh this is absolutely what I know to be true from my experience is that you should not increase it any faster than every 30 minutes. Uh and she came in and she increased it by one.

SPEAKER_01

Love it.

SPEAKER_03

So from two to three, and then she came back in a few minutes later and she was like, Oh, uh, I have to follow the doctor's orders that were put in to the computer, and she wants it increased by two. And so she bumps it up to to four units. And so I follow her out into the hallway and I go, doctor's orders say two, but if the patient doesn't want it, can the patient follow your protocol? Yeah, yeah. Right? And she was like, I can do whatever the patient wants. There we go.

SPEAKER_02

Yes, I love it.

SPEAKER_03

Right? And and so they did because she mom was concerned about increasing it significantly fast. Right. And I said, listen, the the difference between two and four, or two and three, yeah, it is so like that one extra unit is such a small amount that it's nearly indiscernible for you, most likely. Yeah. Uh, but the difference between two and eight and and increasing it in half the amount of time, yeah, that could be, you know, a a difference for you. Um and so she was like, you know, I don't she said, I don't feel like it's necessary. I'd rather do it with the least amount possible. And so we only increased it to three, and then we increased it to four, you know, an hour later or something, and and then at some point, I don't know when, but we we ended up getting up to six. Um and then her labor pattern was still not like it would come together to every three minutes, and then it would space out a lot. Yeah. A lot. And so she was complete, what did I say? At uh you have those notes. Yeah, in the middle of the night, right? Um so midnight. Uh and she labored for hours until 6:37 o'clock when the nurse came in and you know, it was just kind of like so. She's like bearing down a little bit. She's like grunty with them, she's fully dilated. So the doctor was like, You're totally good to like listen to your body, and you know, if you want to push, push, right? Whatever. Um but she was like, you know, when a mom starts pushing, typically things kind of progress pretty quickly. Like they go from being grunty to like really bearing down and like that feeling, right? Like, but that wasn't happening. She was just kind of grunty with every contraction, and and I was like, Okay, I knew that shift change was coming, and I knew that you know the whole energy was going to shift, and so I said to the nurse, um, what is coming down the pike? Like, what are the conversations happening in the hallway? And she said, Well, they're either going to recommend an epidural and bumping the pit a lot. Yeah. Uh, you know, I mean, they wouldn't do it all in one jump, but bumping it more aggressively, um just bumping the pit more aggressively or coached pushing.

SPEAKER_01

Yeah.

SPEAKER_03

And so that's when mom was like, maybe I'll just get the epidural and like do more Pitocin. And I was like, Cool, like that's fine, you know, you can definitely do that. But I was like, you know, this pressure that you're feeling doesn't go away with an epidural.

SPEAKER_02

Yeah.

SPEAKER_03

Right? Like some of the hip pain that she was experiencing. And she's like, but but the she was having she was having like the SI tightness and the uh hip flexors and and she was like glute too. Yeah, she was like, Well because right, because we had been doing the hip squeeze from the time she got to the hospital through your entire time with her, my entire time. Your entire time, yeah, with her hands on, not so much. She wanted a little bit of the like hip hip squeeze, like that glute press during the contraction, but she actually wanted a hip squeeze on the end of it, yeah. At the end of every contraction. Oh, yeah.

SPEAKER_01

So you're in like it ended up being like a minute and a half of squeezing.

SPEAKER_03

Yes, yep. Like dad was doing it, I was doing it, we were doing it together. You guys did the same thing.

SPEAKER_01

We did it, yep. We dad and I were doing it together. Dad was doing it, I was doing it.

SPEAKER_03

I actually got a sheet and did like the rebozo technique because I was like, she's gotta be able to like do some of this herself too, right? And like just have that counter pressure constant for her, um, which helped some. I didn't I am going to put a wooden spoon in my labor bag.

SPEAKER_01

You say this every time.

SPEAKER_03

Every time, every time, because they had nothing for us. I ended up using the pump from my um like my hand pump for the ball uh as a a tool for kind of like creating the torque. Um, but it became annoying to her because it was pressing into her legs, so we ended up just like twisting it real tight. Um but God almighty, and so you know, she's like, Will will the epidural help with that pain? And I said, Maybe, but you're still going to feel the pressure. And I said, Why don't you why would you consider trying some coached pushing and maybe like have somebody put some fingers in their own?

SPEAKER_01

Oh, yeah, that tactile feedback is is wonderful for moms to to figure out where they're supposed to be pushing. I I encourage that a lot.

SPEAKER_03

Especially first-time moms, because you've never used these muscles in this way, and having somebody be like push here, it's like, oh, right there, okay, okay. And then they get they get it much faster. Yeah, but also like we have no idea where she is. So it's been six hours since she's been checked. We have no idea where she is. I feel like it's a bad idea to get an epidural at that point without at least knowing because baby could be right there, and like all you have to do is like push like you're gonna poop, and and you could have a baby instead of an epidural. Yeah. So anyway, and I said, and we have ginger who is amazing, and who is not going to pressure you to do anything you don't want to do, and isn't going to be like shouting at you while you're pushing, and right, like, so I'm like, I think this is the best case scenario to to try. Um, and so we start we start trying that coach pushing. Yeah. And it is working. Yeah. It's working, and and she's doing a fabulous job. She's moving the baby, and and he's tolerating it well, and you know, we tried a a variety of positions. Um, you know, and once she kind of like got the hang of it, she got you know, like she really got moving then. But unfortunately, we had shift change right kind of through this. I was so hopeful that Ginger would catch that baby. Yeah. Oh, I was so hopeful. Um But she didn't, and um New nurse comes in, new doctor. Yeah, new doctor was the problem. The nurse was fine, but the doctor was garbage. Ugh. And um That's the worst. Yeah. You know, like they they asked, um, can dad catch the baby? And she goes, no. Like, not a you know, it's not really what we do here, or you know, like not for first-time moms, like not nice at all. Just like I'm the boss, we're not doing it, no. Yeah, end of discussion. And uh they said, Well, can she said, well, can he hand me the baby? And she said, We'll see. And so uh I'm shaking my head. Yeah. So she delivers the baby. Uh I'll leave out some of the details about how she was nasty to the nurse that was there too. Uh she delivers the nurse called the doctor and the NICU team at the same time because there was meconium at this point. Um, you know, and I explained to the clients that this is what happens when we have meconium, and you know, and and it's fine as long as he does well. They won't like they'll literally like listen to him and and be on their way. They won't even interfere at all if they're not needed.

SPEAKER_04

Yeah.

SPEAKER_03

And so the doctor is like nasty because the baby's head is not sticking out when she comes, right? But like mom pushed so well that like we had that like real like separation of the labia. You can see baby's head, like she moved the baby so well that the nurse was like, shit, if she pushes again, this baby's gonna be born, right? And so she calls everybody, and then the doctor comes in, and I swear to god, that baby was like back up, right? Like hide from this energy that was so palpable in the room, and and so now I have been awake for what feels like forever, right? Like 20 at this point, it had been 24 hours that I was awake, and you know, I have a brain injury, um, and so sleep is really important for my functioning, and and I I felt like I was almost like watching a movie and reacting to the movie, right? And so, like, I'm in this kind of like thought cycle of like this doctor and her influence on everyone in the room and her energy and her communication style, and and all like all of these things are kind of playing in my head about how this woman is interacting with everybody, right? Yeah, um, silently judging, yeah. But my brain is kind of like stuck in this thought loop, right? And now baby is getting ready to come out, and I say to them, they want to wait for white, and she goes, That's standard here. I said, No, like they want to wait until the cord is completely white.

SPEAKER_00

And that can take a while, right?

SPEAKER_03

And so, but now the baby is born, and doctor was great, where the baby comes out, like basically to his pelvis, and she says to dad, give me your bring your hands over here. Okay, and he like reaches one hand, she goes, No, both hands, right? And he doesn't know what's gonna be she's not explained what's happening, yeah, right? Like she doesn't say, Come catch your baby, right? So a little bit of bumbling there, but so she um she has dad reach down and he grabs baby that's wonderful, right, and brings baby up to mom, which was beautiful. And I may or may not have captured that moment for them with some of our recent endeavors with David pictures, right? We'll save that. Uh so he gets to bring baby up to mom, which was so precious for all his hard work during that labor. What a deserved moment for him. It could make me cry.

SPEAKER_01

He was truly, I know you are. She's got tears. Oh my god. He was he was the most supportive partner and with it and with her, with her the entire time. And he was exhausted physically from those hips. He did not look it, he looked good. I mean, he he was well fed. He was well fed and I was like, you need food, you're gonna I'm getting you food, blah blah blah. But he was he was with her. I have the most beautiful pictures of them.

SPEAKER_03

They don't know I took they would do now, but it was just incredible to see such com like a committed partnership, and he was verbally encouraging her and like gently and quietly in the moments she needed and loud and forcefully in the moments that she needed.

SPEAKER_01

He was so attuned to her, to her, it was so beautiful, didn't complain once, did not complain some day, like yeah, some partners whine about their own experience and like the back, my arm, I'm hungry, I'm tired, I'm you know, like all the things. Yeah, meaning. She didn't falter at all. And like, and he knew how committed she was to an unmedicated birth. And some partners are like, uh this I'm uncomfortable with watching you. Why don't we get an epidural? You know, get it for me. Yeah, and he like the most amaz I I wish every woman had that. Yeah. I wish I could bottle that up and give that to everyone because it like what a difference a partner makes.

SPEAKER_03

What a huge difference, right? He was such a huge part of her success in that labor. She 100%. Like when she was doing the the lift and tuck against the bathroom door, and you She hated me for it. Oh god, yeah. Right. And hated the experience. I said, look into his eyes. Look into his eyes and take his strength. And he just powered her through an amazing, wonderful partner. Um, so it was well deserved that he got that special moment to give her the baby. Yeah, that is. Um, bravo. But then all the people kind of swarmed her bedside, and I was holding a leg um while she was pushing and using my device to capture memories.

SPEAKER_00

Well, well, well.

SPEAKER_03

And uh and the the staff had swarmed, so I was kind of pushed back and I couldn't see what was going on. And uh they're telling her that the cord is white, and she was like, it happened that fast, and they're like, Oh yeah, yeah, it happens fast. It doesn't. Sometimes it does, sometimes it does.

SPEAKER_01

Most of the time it doesn't.

SPEAKER_03

It starts to compress fairly quickly. It does. But the transfer of the full amount of blood generally takes a substantial amount of time. Correct. The only way to know for sure that the baby has gotten all of their blood is to wait to clamp the cord after the placenta is delivered. That is the only way to know for sure. And so I think for families and and for next, like we will tell them for next time uh that if they don't want because they feel duped. I I'm gonna say right now they feel duped by the medical system. Okay. Um the only way to ensure that you're waiting for white is to wait until the placenta is out. Because once the placenta is out and detached from the uterus, it is no longer transferring anything to the baby, right? So they tell her that it's white. I can't she looks to me for confirmation. As they do, as they do. And I said, I cannot see what's happening, I do not know. Yeah, but at that point, but the doctor's holding up this portion that she clearly milked, yeah, right? Uh so it looks white. From what I can see, it looks white. Milking.

SPEAKER_01

Do you want to explain what milking is? Milking is when the when somebody literally takes the cord and runs their fingers in a certain direction to get all of the blood out of that area of the cord.

SPEAKER_03

Yeah, and so it looks like the cord is ready. Yeah. Uh, but between her legs connected to the placenta, you can tell that the the it is not done. It was still fat and purple, and um, and I I have a picture of it because I think that that is proof positive that they were uh poorly informed, right? That they were missed misled.

SPEAKER_01

And rushing, like being rushed in that process.

SPEAKER_03

Right. And so um then I see the doctor grab hold of the cord, right, in preparation for well, so they do they do have dad cut the cord and all that. Um then I see the doctor preparing for you know the supported third stage of delivery, pulling the placenta out. And I said, they do not want any traction on the cord. And the mom goes, yeah, no, I I want I can't remember her exact words, but I think she said that she wanted physiological delivery of the placenta. And the doctor goes, Why? And she said, Well, because that's you know, that that's what I want to do. And the doctor's like, why? Like, what are the benefits? And she goes, Well, uh, she's like looking at me and she just delivered a baby.

SPEAKER_01

Oh my god. And I'm gonna say this right now for all of our listeners on here who are pregnant, first time mom, anyone, right? You do not need um, you don't need anything to back up what you want, right? Providers, they need research to back up whatever they're recommending or advising you to do. We as doulas, right, should have research behind what we're recommending, you know, like from what we see, right? Mothers don't need anything, and so for her to question why was inappropriate, totally inappropriate, in that, and especially in that moment, yeah.

SPEAKER_03

Well, and that's what I said to you, right? So, uh, so they're like, you know, she says to the doctor, I respect you, but this is what I want to do. And the doctor goes, You respect me, but you don't respect my medical advice or expertise. And she goes to the nurse, get an AMA. Get an AMA for her to sign, and I want you to put on there hemorrhage and maternal death as loud as she could. Right?

SPEAKER_01

So inappropriate.

SPEAKER_03

So incredibly inappropriate.

SPEAKER_01

What's another word that could be used there?

SPEAKER_03

Uh whatever, it doesn't matter. If maternal death is what you're concerned about. Oh, what what was happening there? Yeah, it was abuse. It was absolutely abuse. Because and I texted you this morning because what what do we do? We replay these over and over and over and over. And I beat myself up so much for the things that I don't do in the moment. Like when my client was looking at me with eyes wide for like help me explain why I want to do this. And I can't ex I can't explain why you want to do this because this is your decision. Do I support it fully? A hundred percent. Yeah, but I can't I can't be your words in that moment because it's not my opinion and it's it's not my research, and it's not right, it's not for me. But I I also like again like being kind of like on a delay, felt like I was slow to react because I'm like trying to come up with like how to diffuse the situation, how to ensure her voice is magnified, how to make her feel safe, how to not provide medical advice all in this moment. Yeah, and uh the husband was so good. He goes so amazing. He's like, uh, you don't need to talk to her like that. Yeah, right? She is so amazing. And that gave me that like, okay, like get your shit together. What's right? And I said, Um So what I'd said to you was in hindsight, she had plenty of time to review these people's birth plan to see that they wanted a physiological third stage, to come in and counsel them and have them sign the AMA when the mom had not just birthed the baby.

SPEAKER_01

Exactly. And what time was baby born? 8 44. Yeah, and so this provider came on at 7 a.m.

SPEAKER_03

Yep, had almost two full hours to review and cons consult the consent the client for care or get a decline of care and have her fill out the form not in distress. Yeah, right? And so, anyway, so dad says that and I say, um, how much blood has she lost? Right? And the doctor says Normal question. The doctor says 300 CCs, and I look at her and I go, which is normal or not? And she goes, It's normal right now, but we don't know how much she's going to bleed. And I look at the client and I'm like, so it's normal, right? And I said, What she's worried about is sometimes the placenta can detach and then blood can pool behind, and we don't know how much bleeding there is, right? We don't know how much you're going to bleed afterwards. And I asked the doctor, what do we consider a hemorrhage here? Is it 500, 750?

SPEAKER_01

It's definitely not a thousand anymore, right?

SPEAKER_03

Well, so she says one liter. And I'm like, hmm, one liter. Wow. Okay. So because a lot of our hospitals locally consider 500 or 750 a hemorrhage. But we're talking about a thousand CCs.

SPEAKER_00

Interesting.

SPEAKER_03

But I love that she said a liter instead of a thousand CC's, right? Uh-huh. Because that makes it more difficult for these people who've been up for two. They've been up for three days, right? To comprehend. Figure out what how close are we to that. Yeah. Uh, she makes them sign the AMA, um, but then terrorizes them through the rest of it, right? Because then the mom is like, you know, as she's losing more blood, now she has a gush of blood. Right? And and I'm bearing witness to it because now the doctor is not communicating with them at all. She is standing between her legs in a huff. Her ego is like just bruised, bruised, right? She's angry that she doesn't get to do it the way that she wants. And and I understand that, you know, she's like, I just want to save your life, right? I want to keep you alive. This for this family, you know, she like the doctor is maybe reasonably concerned because she's post-dates, she's been in labor for a long time, she's been on Pitocin. She's had a tremendously long second stage of pushing, right?

SPEAKER_02

Yeah, yeah.

SPEAKER_03

So these are all risk factors that increase the risk of hemorrhage, right? And I understand no doctor ever wants to be in a position where they lose a patient when it could have been prevented. Correct. I understand. But it is not the responsibility of a doctor to keep someone alive, right? It is the responsibility of the doctor to advise you on the risks, on their experience, and then to support you in your choice. Yeah. Right? And and yes, it it is traumatizing to see somebody go through a hemorrhage. Yeah. Right. So I understand the human piece of it to want to avoid it if possible. But this family, this situation was not emergent, right? Like it was she lost a reasonable amount of blood from my experience, right? So then she gushes blood and it is pouring out of her and um and it's not stopping. You know how when the placenta detaches, there's a gush of blood, but then it kind of stops.

SPEAKER_04

Yeah.

SPEAKER_03

And so the doctor is not doing her job at this point, right? Because she is completely shut down. And I say to them, Well, I'm seeing a gush of blood, and it's kind of a lot, uh, and it's not stopping. And I said, How much are how much blood has she lost now? And the doctor goes, 500cc. And I look at my client and I go, you know, it could be the release of the placenta. Are you okay? If she feels to see, I said, you know, there there's a difference between cord traction and just feeling if there's like a loosening of the cord. And if the placenta is sitting in the vagina. Right. And and so she says, Yes, that that would be okay. Um, you know, and there's some back and forth where the doctor's like, well, I can't do anything now because you've, you know, signed the AMA. Signed the AMA. Um, you know, you have to tell me what you want me to do, right? Because when is it appropriate for me to intervene now? Right? Because the mom was like, if I start to hemorrhage, can you manage the hemorrhage? Yeah. And she's like, Well, at what point would that be okay with you? Right? Like, complete, just unnecessary aggression towards the family. And I understand there's like this difficulty of like, how do I do my job if you don't trust me to do my job? Right? Like, I I understand, but there's also a shift happening in society where people are no longer interested in being treated like run-of-the-mill, correct, like a number in the system. This is why people hire Nulas. And it's not like the person doesn't have an issue with the doctor, they have an issue with the system that the doctor is part of and trained within. And so, like, a a midwife at home would look at the amount of blood, they would look at your coloring, they would look at your lips, they would look at are you coaching? Right? Yes, like are there signs that your body is losing more blood than it should? And one woman's blood loss to another woman's blood loss is not the same. You could lose 750cc and I could lose 500cc and be in exactly the same bad spot, or you could lose 750 cc's and be totally fine, and I could lose 500 and not be fine. Yeah, right? Like so many factors go into play with that, and her hemoglobin was good when she came in, right? So she was she was in an okay place. Anyway, so it just it was it was so aggressive and so unnecessary, and and when she tugged on the cord there, like it was not loose, so she's like, This is you bleeding, right? And it's like, okay, but it's obviously not her bleeding out, right? Like anyway, and so eventually, and she was on a Pitocin drip, yeah, right, and they consented to the postpartum, they they shift the amount of postpartum, uh, Pitocin after the placenta's delivered, and they had consented to that as a you know measure, yeah, like as a compromise. Yep. It was just there was this beautiful experience that was taken from them from this physician who wanted to be right and in charge and does not get questioned by anybody. Like you I know she rules that hospital when she's there, everybody steers clear of her I can just tell the dynamics of what happens in that facility with that particular person. Yeah, and she's not accustomed to being told no and she didn't like it, and she was going to make sure that they knew how much she didn't like it. That's a shame. It is it is a shame because it's unnecessary, and it was abuse. Like we're gonna call it what it is. Like I I felt abused berating her in that moment. Yeah, yeah, it was it was something, I'll tell you that crazy. Yeah. All in all, I would say that I think it was the long it was so long. It was not the longest bird we've ever been at. Uh it was long. It was long was not the longest. No, but she was so powerful and she stuck to her plan. Yes, she did. You know, and she feels like she betrayed her plan, but I every decision that she made was made with intention. Right? It was made She was a beast. Not uh outside of the placenta issue, not under duress. Yeah. Like she was supported and nurtured and held in her very atypical experience. Uh she did an amazing job. And he did an amazing job. The two of them together are going to be incredible parents.

SPEAKER_01

Yeah, they are. So in tune. They're going, yeah, so in tune with each other, which means good parents.

SPEAKER_03

Yeah. They're they're gonna be just fine. And and I hope for her that her next labor is quicker. She she completed two labors worth of labor. She deserves a nice easy one when she does this again.

SPEAKER_01

I tell all the first-time moms, these first babies they pave the way for the next to come if you choose to have more. Yeah, they really, really do. Yeah.

SPEAKER_02

Yeah. Anyway, so happy birthday, little buddy. You are so cute, so adorable. And you have the best parents in the whole wide world. The most badass parents.

SPEAKER_01

Truly. So loving, so loving the support.

SPEAKER_03

Yeah, everybody deserves a partner like him.

SPEAKER_01

I know. Seriously, go check out that that other episode. Duelists are for partners. Oh my god. Yep. Like, incredible. He was incredible. He was incredible. It was amazing. It was beautiful to watch, watch, witness, be part of all of it. Mm-hmm.

SPEAKER_03

Thanks for getting unhinged with us today. We hope this conversation challenged you, validated you, or made you laugh out loud. Birth and parenting aren't meant to be perfect or polished, and neither are we.

SPEAKER_01

If you love this episode, share it with someone who needs real and raw truths. Leave us a review and make sure you're subscribed so you don't miss what we're unraveling next. We're Alex Schoff and Lacey Morgan reminding you that your voice matters and your experience is valid, and you're allowed to do this your own way.

SPEAKER_03

Until next time, stay on edge.