Ep 26: The Scrubbed-In Truth: An L&D Nurse Gets Real

This week we share a conversation with Ginger, an L&D nurse who blew Alex and Lacey away with her compassionate, patient centered care. They wanted to learn why she is the way she is, get tips on how patients can have the best experience possible and what patients should know before going to the hospital. 

Transcript

SPEAKER_00 0:30

That's always fun where I'm like, where is this conversation? Can I like make it sound like the beginning? So today we have the honor and pleasure to introduce all of our listeners to Ginger, who is a labor and delivery nurse in the area. She really caught our hearts and spoke to the fact that the system is broken, but the people within it are not. And we asked her to join us to share her story and talk a little bit about the incredible care that patients are getting at her hospital when she's in the room. So, Ginger, thank you for being here.

SPEAKER_02 1:16

Yeah, no problem. That was the best compliment I've ever seen in a really long time.

SPEAKER_00 1:20

Thank you. Yeah, well, you know, it's every time we go into the hospital, you know, there are some hospitals around here that Alex and I absolutely love going to, right? Like we kind of like let our guard down, right? Like you don't feel like you have to be a bulldog when you walk into the hospital and you work at one of those places. Uh, but even the best of the best has really, really amazing support and really good support, right? Like, but you stood out so much in the way that you took care of our client who had a very unusual, very long um birth experience. And you just were so loving, like you you clearly love your job. Like it's yeah. Oh yeah, 100%.

SPEAKER_02 2:11

Um, yeah. I mean, that's a I mean, you're right on it. I've been um I'll I can give you like I'll give you my little background because I don't think we really got to really talk about it when you guys were there. Um, I have been a labor nurse for I think I think it's 20 years now. Um, and I started in a really small community hospital. Even before that, though, I had my kids when I was young, you guys. Like I had my oldest biological child when I was 17, and I had my youngest by the time I was 21. Um, and yeah, and so and and that's in a time, you know, this is like early 2000s. My daughter was born in 2001. And at that point in time, you know, information wasn't as readily available on the internet like it is now. And so even then, I was like, okay, I already know what I want to do. Like, I know what an epidural is. I've looked at this. I don't know what a pudendal is, but I read about it, and that sounds weird, but okay, whatever. I'd like to do this, like, leave my body alone. I don't really want to do this. Like, I don't want you guys to mess with it at the very, very young, and you know, you think you know everything, age of 17. And I can remember very distinctly, I had a very, very old physician, Dr. London. God bless his sweet soul. Um, he was so patient with me, but also he was like somebody's grandpa, he was ancient, and he was no nonsense. Uh, but it was a different time. And I went to my like 38, 37, 38 week appointment, and he checked my cervix, and he was like, Well, you're not even dilating. So we either need to induce or you're gonna go two weeks over your due date and you're gonna put a C-section.

unknown 3:46

Wow.

SPEAKER_00 3:47

We're first time moms, you shouldn't be dilating at 38 weeks. Yeah.

SPEAKER_02 3:50

Right, right, right, right. At a time I didn't know enough, right? I didn't know, but I knew that I didn't want either of those options. And I can remember sitting in my appointment with my mom just bawling. And my mom, who is also very like straight to the point, suck it up buttercup kind of lady, she was like, Well, what do you want more, ginger? Do you like what do you want less? Like, what is more important to you? Do you not want a C-section or do you not want to be induced? And I was like, Well, I don't want to see that. And she was like, Then we're gonna get induced ginger. And I was like, Oh, okay. It ended up working out just fine. I mean, it was a rough delivery, but it was also all kinds of things. Um, and I had a terrible nurse, she was so mean, so mean because I really didn't want an epidural and I really wanted to do it unmedicated, and um, that didn't happen, you know, the change plans change, and I really tried to prepare myself, but it's hard to prepare yourself. And I remember my day shift nurse was amazing. My night shift nurse came in and just saw two very young 17-year-olds being dramatic and um kind of really bullied me into accepting an epidural and jokes on her. I went from three to complete in 45 minutes. My gosh. I know it was very intense, it was a terrible 45 minutes, one of the worst 45 minutes of my life. Um, I called that poor woman every nasty name I could think of. I was convinced that she was withholding this epidural as punishment to me. Um, my I can remember very distinctly like going off the rails. And then she came in and I was like, I'm so sorry. And I was like, I need to put and then I had a baby an hour later. Yeah, so haha. So that's what I wanted. But that woman really shaped like my my goal. Like I knew what I wanted to do at that point. I knew I wanted to be a nurse. Um, but I can remember thinking, like, I don't want to be this nurse, she's terrible still. Um, and then fast forward, I had another baby very close together. They were like 14 months apart, they're very close interval, um, and a friend of mine from high school. So at this point, I'm just barely 19. She also was pregnant at the same time. And I got the luxury of being her labor support person. And um it was the first time I'd not been in, I'd been in a delivery that wasn't my own. And I remember just coming out of it sobbing. Uh and I was like, oh my God, like this is this is this is it, this is the plan right here. So at the very young age of 19, I knew I would be where I'm at right now. And so I got lucky. I found something I loved and made a career out of it, which was the advice that was given by um by an adult friend of my mom's who was like, find something you love and make a career out of it. And that's what I did. Um, and then it just kind of progressed. I went into nursing school, and while I was in nursing school, I actually trained um through Kappa as a dual. I didn't get certified, but I went and got the training because I mistakenly thought that that was something that the labor world really, really supported. And they did not. Um, it was I did not realize I was so naive, you guys. I did not know that there was so much drama and like just aggressive opinions around labor and delivery at the time. Um, and then I fast-forwarded to, you know, I got my license and I was practicing in a really small community hospital in my small town in Arizona, um, which was a whole other level of drama and opinions because we are no sick and we're better than everybody. And that was like the attitude of the staff. And as you guys have experienced, that is not me.

SPEAKER_00 7:26

I bet that was really hard for you because you're not like a there's one way, right way to do this kind of thing. Right, 100%.

SPEAKER_02 7:35

Yeah. I'm also like in core of court, I've never been that person who like looks at somebody else and like I'm so much better than you, and I'm so much smarter than you. I have never been that person. I do not come from a background where that is even taught. And when people would speak to me like that, even as a young child, I hated it. Um, and so it's just never something that is carried forward in my life. Like even now in my 40s, I could not imagine. I will treat the Queen of England the same way I will treat a drug addict from the street. You're gonna get maybe a different kind of support, but you're still gonna get the same respect and a different, maybe like way to talk to each other. But yeah. Um, and that just kind of threw me into like it was really hard, like you said, it was really hard. It threw me into like almost like a like a life crisis as a nurse because how do I be myself but be what these women are asking me? And then um, a couple years into my career, I was gonna quit because I was I was like I made a bad decision. This was the wrong career path. And I got to a larger facility in Las Vegas and everything changed. And there was more equal roles between physicians and nurses, the nurses were real supportive of each other. They were like, it was kind of like what you guys thought like it's your decision. Like we're gonna chart that you don't want to do it, and it's cool. It's we're just charting that you said you want to do it. If somebody ever asked why we didn't do X, Y, and Z. And um, it really started to change how I became a nurse. So um, that kind of led me down this whole path. It led me to be better and it led me to really kind of evaluate. And then somewhere along the lines, I stumbled across, I don't think it's called improving birth anymore, but I stumbled across improving birth. Um, I don't know if you guys are familiar with that. No, I think I think it's I think it transitioned into evidence-based birth. I think I think it used, I think evidence-based birth used to be improving birth. And um, I still follow one of the original ladies that like founded improving birth, but they were running this camp, I'd call it a campaign, and I don't have a better way to describe it than a like a birth rape campaign because that's what it very much felt like. Somebody online had posted their home birth video, and I very naively commented as a very hospital-based nurse promptly got schooled, like schooled in the comments, and doulas and out-of-hospital birth workers were like, and this is why people don't like the hospital. Um it was it was it was definitely eye-opening, and they that's what led me to the improving birth page, and what they were doing is like it was like people like doulas and moms and dads and midwives and physicians and students posting things that they had seen providers and nurses and midwives all do without permission to their patients.

SPEAKER_00 10:38

Yes, I was just showed up at a birth. I missed the birth because everybody's done moxabustion, like we tell them to now, and so all the babies are flying out. Um, but anyway, and uh I got there and the mom was like, I did it and I didn't have Pitocin. And I look at her IV poll and I'm like, but but you have postpartum pit. And she goes, Wait, I what? Like no one even told her that they hung the postpartum pit.

SPEAKER_02 11:04

And I was like, Yeah, it's just it's like it that's what I mean. Like, it's like it's our job to make sure they know. Like, we know what they don't want. If they say they don't want pit in labor, they probably don't want bit after. Like, we have to clarify that. Like, it's not hard. What who is it offending? Nobody, it's like gonna hurt anybody, and you tell them, talk to them and tell them like these are the places that we would need to do this in this situation because we like it when you live, right? That is fun. Like, we like that part of this, but like that doesn't take, I don't understand why people are weird about it.

SPEAKER_05 11:34

Like it's I like what you just said, it's not offending anybody. Who is it offending by declining, right?

SPEAKER_02 11:41

Right, let them decline.

SPEAKER_05 11:45

You are a very humble, like you are not the norm, you are the unicorn, and I don't know about unicorn.

SPEAKER_01 11:53

A goat with a really good horn, maybe. Yeah, there you go.

SPEAKER_05 11:57

Take it.

SPEAKER_01 11:57

A unigoat.

SPEAKER_00 12:00

A unigat. You are you are the goat. You are the youngest of all time.

SPEAKER_02 12:06

Oh my god, I love it so much. I love sparkly unigoat hard.

SPEAKER_05 12:10

Yes, a unigoat. We need to make a meme like ginger the unigoat.

SPEAKER_00 12:18

I love this so much. You have to send me a selfie because I'm 100% doing that.

SPEAKER_05 12:22

Yes, we're absolutely doing it. Like, guys, listen to this podcast. We had Ginger the Unigoat on.

SPEAKER_00 12:30

You said something, and I don't remember exactly what your words are, uh, what they were at that birth, but you said something akin to I'm not in the business of traumatized moms.

SPEAKER_02 12:45

Yes. Oh my god, yes. Um, I definitely do not, and I speak from experience. I am not here to traumatize you. Like I've had a traumatic birth. My middle son came out, he didn't work. Like he just was like, Yeah, I don't want to do this life thing, you know? And as a young 19-year-old mom who didn't know Jack about Jack, that was scary. But also, like, it was scary because they didn't really tell me, well, at least they did tell me, but they didn't, I didn't really understand like why they were flipping me side to side like a pancake and why I needed to push. And all I know is when he finally came out, he wasn't working. Like that was scary for me. That was so scary for me. And and I didn't my experience with those two deliveries is that I didn't have a lot of power and I didn't have a lot of say in what was going on. So when I had my youngest son, I went in kind of almost like ready to fight the system. And I had a provider who wasn't that. She was like, Cool, do what you want. And I was like, Okay.

SPEAKER_00 13:52

You're like ready for fisticuffs, and she was like, Yeah, girl, like, why are you mad?

SPEAKER_02 13:56

Yeah, basically, that's exactly what what she was. Like, I can remember, oh my god, I love this. I can remember very distinctly. Um, I was pushing, and I was like, I'm completely unmedicated. And this is my first, like, fully unmedicated delivery. And I'm like pushing, pushing, pushing, and I was like, I have got to poop. And they were like, no, no, it's baby. And I was like, no, you guys, I really have to go poop. And they were like, no, ginger, it's baby. And I was like, no, no, it's not. And my doc goes, okay, okay, okay, okay. Everybody just stop ginger. Just go poop. And I went, okay. And then I very promptly did exactly that and then looked at them and was like, okay, now we can push this baby out.

unknown 14:40

Okay.

SPEAKER_02 14:41

Because I absolutely had to poop. They're like, I know the difference. It was different. And I can remember the nurse was like, Well, I guess she just got a really love and unmedicated laboring person. It was I had to poop, and then that's what I did. Yeah, it was one of the first times I had really had some like like some semblance of like respectful care and labor, like and in pregnancy. So it was really nice. That doctor was really refreshing for me. She was also younger than my previous physician and you know, was being chained by by the people who were changing things early in the game before we really saw much changes we're getting now. So it was really helpful. Um, but yeah, I all of it, like I'm not here to traumatize. Like, my I don't want you to walk away from this and have PTSD. There's enough PTSD involved in birth of by itself without me feeling like I'm doing inappropriate things to you. Like, ew, I don't want to do that. And I've seen things like that, and that's why like the more I saw it, the less I was like, I don't want to be a part of that at all.

SPEAKER_00 15:41

And I'm so the standard model of care is just not something that you subscribe to. And I want to know how, like, can you give us insight into why do sometimes we get ginger and then other times we get the people who like use the prescriptive uh language where it's like presumptive medicine, right? Where I'm gonna say it as if you've already complied. Like, what do you think is the the difference? Is it personality training? Like, where is it coming from?

SPEAKER_02 16:21

Uh a little of all of that. I actually have really good insight into that because I also teach you guys. I have taught pre-licensure nursing school for like 10 years. So I was the lead at my um nursing program, the OB lead at my nursing program where I moved from before I moved to Pennsylvania. Um, and I was also a graduate of this program. So it starts there, and that's what we need to recognize. And this isn't just early burn delivery, this is across the board. I can remember very distinctly in like my first or second semester of nursing school, keep in mind this is like early 2000s, being told, listen, patients don't want to comply. So we need to word things that we need them to do like they decided to do it, like it was their idea. And it quite literally was a skill I was taught. Like it's like in the world of OB, it's thinking when we come in, we're going, I'm gonna check your cervix now, okay? I'm not asking, I'm framing it like it's a question. So when later you'd be like, Well, I asked if I could check your cervix, but I didn't really ask.

SPEAKER_01 17:26

Do you know what I mean?

SPEAKER_02 17:27

Like it's like a very passive way to ask compared to is it okay if I check your cervix? Yeah, right. Like one is that presumptive, like, this is what we're gonna do, and you're cool with it, right? Compared to, hey, is it okay if I do this really super invasive thing where I'm putting what feels like my entire hand into your vagina? Like, is this okay? And it's something we're taught as nurses at the root of how to speak to patients so that they want to be more compliant and don't, like, I guess for lack of a better way to say it, like push back as much. And then you exit nursing school and you go into nursing. And part of the problem with nursing, especially today, we have a lot of nurses who are aging out, which is not a bad thing, but it's also not a good thing. So we're losing a lot of experience, right? But we're also losing with that that old school thought where that you're expected to just comply because that's what it used to be. Medicine was like, you just did what you were told. I mean, think back to like twilight sleep deliveries, is where the word put under and they didn't even know they'd given birth and they had no say in it. You know, Outlander does a great episode on that when Claire gives birth to Brie and they knock her out, and she's like, You will not knock me out, and they knocked her out anyway. Those times have changed drastically, right? But a lot of the older nurses, that's what they were like raised in as a nurse. And um, and then the flip side of it is if these new grads are being trained by younger nurses, so sure they technically have experience, they're doing what they're supposed to, but they're like maybe like three-ish years into their career. We know that like year one to year like three or four is a real pivotal time in a graduate undergraduate's life. They have to learn how to quickly think in the first year, they have to learn how to manage expectations, how to fit in this new environment. There's a whole theory around like new graduate training and nursing. Um, but the problem is in that they tend to burn out really quickly. And though those that don't burn out, I have noticed just from years of experience, kind of go through this period of like just jaded hate of their role. Like we're taught in a nursing school, we're gonna come out and we're gonna change the world, and we're gonna be the reason somebody's life is changed. And then we get there and it's not that right. Our patients, yeah, charting our patients are not as sweet and lovy as we think they are. Our doctors are kind of wrapped around the edges. The nurses tend to eat their young. We are terrible, at least we used to be terrible, about really like being hard on our new grads and like almost like a like a professional hazing is what it felt like for a long time. Um, and that's dependent on like facility, right? Like the culture in that facility can change. Um, and then they like they're like, okay, I've made it through the rough of it, and now I hate what I'm doing, I hate this. Like, why don't these people just listen? Why are they fighting it? And there's almost like this mindset that like they're just fighting everything. And I think it takes a little bit of time for those nurses to grow out of that. Like, there's like a hump they have to get over. I mean, I'm guilty of the same thing on the same, like the same time frame. And once they get over that hump, they tend to lose some of that. But you tend to see that more in your nurses who've been nurses for a long time, especially if they're in a space where patients are not deemed compliant, you know, by medical standards. So they tend to really lose a lot of that once they get into it and realize, like, okay, hey, I mean, I can't do anything, I've done everything I can, then it gets a little bit better after that. So I think it's a multi-factorial issue, honestly. I think it's we're taught to be like that. We are raised once we're a nurse to be like that, and then we we kind of have to learn on our own, unfortunately, unless you just get a really great reset.

SPEAKER_03 20:29

Yeah.

SPEAKER_02 20:31

I'm holding out myself, you guys. You know, I'm also very humble, you guys can tell. Yes, you are though. You are, yeah. You lack ego, right?

SPEAKER_00 20:38

You lack ego, which makes it easier to do your job. Because like this idea of a patient not being compliant is so incredibly absurd to me. And why, where else in our lives do we expect adults to comply, right? Without what I said, yeah, and so to expect patients to be compliant instead of being taught that your patients have agency in autonomy and are intelligent, for the most part, intelligent, capable, functioning human beings who make decisions every single day in every other facet of their life. Why on earth would a medical system think that they should have the authority to dictate what happens to somebody? And I know there are moments in healthcare where this conversation could be the difference between saving your life or not, right? Acting will save your life and chatting will cost you your life. I know that that's true. But in birth, that is such an incredibly unlikely rare scenario. And if we had conversations with the patient throughout the 27 hours that they were in labor and let them feel heard and built trust, I think that in those moments they would just consent, right? Like they trust you because you've talked to them for hours throughout their labor and they know that now that look in your face, it actually means that there's something wrong you need to act.

SPEAKER_02 21:54

Yeah, and I'll counter that a little bit honestly, Lake C, because even if I haven't, um you can still do that in the moment. And I have done that. So the place I From in Las Vegas, it's a big tertiary facility, it's a designated children's heart center. Like we're getting the sick kids, our patient population does not have a lot of health literacy. Um, and they're primarily a group of people who are used to not being treated well in the system. I served primarily black and non-English speaking Hispanic families there, and um, most of my patients didn't look like me. For those who can't see me, I am a pale lady. Um, and I recognize what that power imbalance is, but many times what ended up happening in because I did have a high risk population, lots of gestational diabetes that was not controlled, hypertension, moms with just health issues in general, kidney issues, all these things, right? We would, or like somebody like an extensive like uterine history in some sort, like some some woman one time had some like like the only way I can think of is like a kangaroo couch off of her uterus on like an obscure spot that would put her like a really high risk or uterine rupture. It was wild. Um, and like those people like know their high risk, but they still are like, I'm gonna try for like a low risk delivery. And when that goes south, I may not have met you, but you better believe when I walk in that room, I don't care whose patient she is, hey, here's what's going on, and this is why it is. Everybody's doing something else around them and getting them ready and going, hey, get the OR ready and the docs are here, and hey, we're gonna check you. Okay, here's what's happening. And I'm over here going, Hey, listen, my name's Ginger, here's what's happening. They are very concerned about this. Is the baby okay? We don't know right now, but what they're saying is that we don't intervene and do an emergency C session right now, that we're not gonna have a good outcome for here. Like, we need to we need to expedite this. And I know that that's not what you wanted. It generally, that's all they need to hear. Like, tell me what's going on. And they're like, Okay, like why are we waiting? Let's go. And I mean, it just takes one person in the room to do that because you don't have to even have that time with them. You give them the down and dirty of it in an honest way, in a way they're gonna understand, and they're still going to get on board usually with that plan. I can count on one hand in 20 years, where somebody has been like, yeah, I hear you that you're telling me worst case scenario of my baby not making out of this is happening, I don't consent to the C session. One hand in 20 years, like right. I mean, most people when you start giving them the real truth of it and not just using it as a manipulation tool, because that's really what I feel like happens is we use it as a manipulation tool before the emergency has happened. There's a lot of like, but the baby could.

SPEAKER_00 23:49

And it erodes trust because then when you're in the situation where now it's for real, people are like, Yeah, but like you told me about my pregnancy, you told me that you know my 20 hours ago.

SPEAKER_02 23:59

Right, right. And everything's been fine since then. And then especially if like we go, oh, but the baby could insert worst case scenario or terrible thing here, and then you have a vaginal delivery where they're perfectly healthy. Yeah, nothing wrong with his baby. Yeah, like now what? Now what? Like, what does it look like? A really good example of that, if you guys have not seen it, is the uh Kimberly Turbin video. Um, oh my gosh, again, something improving birth uh did. They got her um counsel for it, but she has her delivery videoed. It's like honestly, like maybe like 14 minutes. Um and she is on video declining enough force the physioutomy. Um, and the doctor's rationale is your vagina's only this big and your baby is this big, your baby is too big. Her baby was six pounds. Six pounds on normal size many. Like this, it was wild, like it is wild, like that right there, that's where our trauma comes from, and that's what I'm trying to do. I'm not about that at all. Like, who wants to do that? Who wants to drive by the hospital where the greatest thing in their life happened and have a panic attack? That's terrible. Like, no, we tell moms all the time.

SPEAKER_00 24:53

It is not the interventions that are employed in your delivery, it's how they happen, right? Like you can have every single intervention, including a cesarean delivery, and still feel blissful about your birth if you felt like you were the one who made the decision, you felt like they presented options, that it wasn't rhetoric, it wasn't fear-based, right? It wasn't rushed, right?

SPEAKER_02 25:12

And where you come into play ginger, you talking, you know, to your patients, you know, who don't want to spend 12 hours with the client that we share 12 hours of uh what just what complete fighting for 12 hours, right?

SPEAKER_04 25:21

Yeah, like yeah, and we just yeah. But you like in those scenarios, like you give them time. Hey, I'm ginger, this is what's going on. That's you creating time, which is something that we don't see. Don't see, yeah. I think you're being clear, direct and time.

SPEAKER_02 25:32

Yeah, and part of that stems from I do well with direct communication. So I just kind of assume everybody's well with direct communication. Um but part of that also it comes back to my educational background. I really love teaching you guys ideal. Like I love teaching nursing students, I love teaching people, I love to talk, so it's beneficial on everybody's side. Um, but um, I also tend to because I I struggle a little bit with like grasping and processing, and like why are we why do we say apesiotomy? What does that even mean? Can you just say it's cut on the perineum, like and don't even use perineum, please use the words that we all use, right? Like because we don't have special words for that area. Just call it what it is, like the space between your vagina and your butthole and like use normal people terms, and I think that really plays into it as well. It factors in because um you go in and you call somebody's vagina their vagina. If that word to them is a dirty word, that's like cursing in front of them. They're not, they're just they're not listening to you anymore. They're like, oh my god, you know, and so I think some of that comes back to that. Like I like the educational part of it, and I want to make sure they understand because the last thing I want to do is in 10 years get a lawsuit on my lap, also, and then go, well, all these things happened and nobody explained it. Like, absolutely not. Like, I don't want to be involved in that. Are you kidding me? And knock on wood, I've never been involved in a lawsuit from a patient I directly took care of. Like, that is to me, that's probably one of the best accomplishments I had in my career, is that I feel like I have provided care well enough to my patients that they were well informed, well educated. They made decisions based on their own. And even if the outcome wasn't necessarily what they want, like you said, they felt respected in their care and they made this decision. And they're not immediately going to, oh my God, I should sue those people, because that's what comes, you know, what it comes down to. And unfortunately, that's a lot of OB health care is it's a lot of um like fear prevention and like lawsuit prevention. Um, and a lot of providers especially function from that that place of like, well, we could we could get sued if we don't, so we should guide from there. But that's not what's best with a patient. So if you're documenting and you're talking to them, then they're adults, they can make their own choices. Yeah, like come on.

SPEAKER_00 27:06

But that that again is a systemic issue because they're taught that in school, right? Like if you don't do this, if they don't comply, you fail to do your job, right? Instead of your job is to educate, advise, counsel, support, right, but never to make the decision for your patient. Right, 100%, 100%.

SPEAKER_02 27:21

And I think part of that is due like systemically, they don't give enough time to do it, like right at all. Like they 15 minutes. I mean, so you know, because I graduated my mid-with rate program, and um I had not practiced in my clinics, like my clinical rotations had not been really city-based where care moves a little bit quicker until I came to the greater Philadelphia area. And I don't know how these physicians, these MPs, these midwives get anything done in 15 minutes. It's a 15-minute appointment. Like, and then they're seeing like 20 plus, 30 plus patients a day. How are you doing any education? That makes not even enough time to get vitals weight and say hello. Like, you have got to be joking me. And I think that really factors into it as well. So they're used to like really like cutting out the fluff, and but I think we lose a lot of the education in cutting out the fluff, and it just ends up kind of sideways, unfortunately. I don't I try to do my part on floor to combat that because a lot of times they don't understand. I saw patients we can. I was like, okay, so do you understand your diagnosis, like what this is? She goes, Well, like Googled it. Awesome. It's actually a big diagnosis buddy. We we need to really understand it. Yeah. But so let's have a conversation, please. Like, let's talk about what this means for you. Like, and they just don't get that in the office, I feel like, and it just stained. It's one of the things I'm most worried about transitioning from a foreign nurse to a midwife is how much of that I'm gonna lose in the office because I don't want to lose that. Like, I I wanna I wanna dig into that. So what I know, what what prompted you to for midwifery going down a midwifery path? Yeah, um, you know, I went through my my dual training when I was, I think like a second semester nursing student, and we had all this required reading, and one of them was Anime's Guide to Childbirth. Um and I kind of like knew what in mid-wife was, but I didn't like know. I was young. That book literally like that was the start of it, you guys. That's where my my opinions changed. And I can remember like driving around my little small town, and I was like, ooh, this is really close to the hospital. I could put a birth center right there, it'd be really easy to transfer. I didn't know anything, but in my head I was already planning it. And so it was always kind of just the thought, right? Like the goal and kind of come back to it. Like I went back to school to be an educator and learned in the process that I really loved the education component. And then um so in school I'm with the intention of being a nurse practitioner. And then I realized that I actually really hated office. I didn't want to do office at all. Um, and I really loved the education component, but there's no money in education, so I just did that kind of like as a sidekick. And um, because we still have bills to pay, unfortunately. And um eventually I just kind of kept coming back to it. Like I would see more and more things on the floor. Not that my residents that I worked with um were not amazing, my residents were amazing, and the physicians I worked with in Las Vegas were amazing, and even giving our patient population, they were respectful and direct and gave the patients as much autonomy as they could given the system constraints of you know, of just medicine in general. Um, but they were it it wasn't as like terrible as some places are, right? It's like kind of like a middle ground, I'd say. But I still was like, I I think I could do this, and then I started getting residents on the floor in these new residents, and you know, seeing how they were learning and we got new attendings and just kind of threw it all. I was like, I really just want to come back. This and I ended up circling back to during COVID, interviewed um with a program, really liked what they saw or what they told me and like what it was. But like I said, my partner at the time was not really supportive, and then um we went through a pretty aggressive divorce. And he said in the divorce that the um that I the only reason I got where I was in life to that point was because of him. And as much as I hate to say it, that was my driving force to actually go back to school. I was like, oh you don't I don't think you know who you married, sir. That's okay, sir. Watch this. And then got into realistically one of the more competitive programs in the country. Um, and I was very excited about that. So I'm very proud of it now. I get to say I graduated from that program. So congratulations. I can't wait to send him a passive aggressive note in the mail and tell them. Probably will just be aggressive, not passive. Yeah, just straight up the breath. Yeah, just gonna be like, uh, yeah, but that's really I mean it was always kind of there. It was always kind of there. And um it was I've always liked been fascinating. I remember the first baby I delivered, one of the nurses on the floor was undergrad. She was like, you know, you really should ask one of the physicians if they would let you deliver with them. And her rationale for was was that every nurse should know how to deliver a baby because it happens, right? They come when they come. Um and my patient that day let me, and literally the next week I had my first starting delivery, and it was, I know I was scary, I was scared. It was like, it was, I was like yelling at this woman in Spanish to just breathe, just breathe. And just kidding, the baby was out. I need to breathe, not her. Yeah, yeah. And um, and so and that's just even further cemented, right? I was like, this is just amazing. Like, why would anybody not want to do this for their entire life? So um midwifery talk took me back to it, and um it was, yeah. I had a doc that when I said I was leaving my facility in Vegas, he was like, Wait, what why are you moving? And I was like, Well, listen, I can't get a preceptor here, I have to go where the preceptors are. And he was like, You know, I don't understand. Why didn't you just go to med school? And I was like, you, I am 40. And you have to take organic chemistry. No, I'm the oldest resident. Also, could you imagine me as a resident? I'm mouthy. Oh my god, I'm gonna get kicked out of my residency. And he was like, I got strings in the men program, gender's not as strict as it used to be. And I was like, I love you so much, and that is literally the best compliment I could ever get from a physician that you would want me to be one of your colleagues. But I am 90% from the crack program, I'm okay. I also don't want to do surgery. Oh, that's creepy. So yeah, it was um, it was just always kind of there, and then I just needed that last little like mental push to do it and and get into it. And um, yeah, it's been quite the adventure for sure, getting to this point. I've learned a lot. So what's at least it looks like she just asked a question, what's what's next? Um, boards, which gives me deep-seated anxiety. Um, but uh we're gonna actually probably head back home. We're gonna head closer to home. We moved here with no support, so it's just me, my guy, and our dog. Um, and we've intended to stay. Um, my experience thus far with the medical community in the greater Philadelphia area is not necessarily the most positive. Um, I really struggled with the differences here. Um, some of it is, you know, just socially it's different, but also there's an idea of professionalism in this area that I don't subscribe to. Um I don't think we should be talking at our patients. I have always had really easy conversations with patients, even in the office. Like I worked with one midwife in my small hometown, um, and she's the same way. Like, we're rural community. And when I say rural, you guys have to understand the difference. Rural in Arizona means the next town over, like I'm in Ardmore. It's not like Haverford, like it's just like two blocks away. The next town over is 60 miles of open desert. It is, it takes us an hour to get there. It will be a rural. The closest large city to us is Las Vegas. It's two and a half hours of desert. So we are not, we don't have quick access, we're very remote. Um, and coming here to a space where the expectation is to be very professional, like the old school definition of professional. I have taken 20 years of nursing honing my professionalism in and talking to my patients like people. Not like a provider talking to a patient, like me and you, the way I'm talking to you is the same way I talk to my patients. It does not change. And I think that's really helpful. That was not well received at all in any capacity. Um, and I also come from a space where big topics um like racial disparities in healthcare and um diversity in healthcare is a more comfortable conversation than it is in this area. And all of that kind of led me to I don't think that if I planted some roots here, I would be setting myself up for success. Um, I think I would, I think I would end up hating what I was doing and I would be like I was when I was in a graduate. I don't think it's a good fit for me. And so we're gonna go back to Las Vegas is where we're we're gonna end up at, and um which is okay. All right, thank you, midwives. The midwife, the midwife uh community is growing, which is really good. Um, because when I left even a year ago, there was only I think one or two offices in the greater Las Vegas area that had midwives in it, and one of those offices the midwives disorder.

unknown 33:57

Wow.

SPEAKER_02 33:57

They were just office. Yeah, we like a glorious identity.

SPEAKER_03 33:59

So um, I know.

SPEAKER_02 34:00

And I got I've interviewed with the physician group that um worked at my old hospital. They've got an office, uh, and I've met with the lead physician there, and she's like, I'm about it, like we're gonna do the things. I've got midwives with experience on staff already, um, and we're we need to build this. Like, we need she's very midwife friendly, which is awesome. And the lead at my old hospital is the same thing. Um, she her plan is to build a midwife run practice. So it's gonna be, she's like, the office is gonna be what you guys want. You guys want to do centering? We'll do centering. You want to have longer visits, we'll have longer visits. Like, we are gonna build this program so it is a true midwifery model, and that's something I don't think Vegas has. And I really like that because here it's not like that. Even the midwives that are in hospital, it's still very like medical-based model. So I think it'll be a good fit. Yeah, I think it'll be a good fit.

SPEAKER_00 34:35

Sometimes we uh we call them midwives. Yes, midwives when you subscribe. Sure, sure. There's there's a time and a place for each position, right? Um, and I would say that like you, even if you were a hospital-based midwife, would never be a midwife, right? Like you don't just don't subscribe to the planet. I want to share a quick story with you that happened um about two weeks ago and uh get your overall response to it being on the opposite end. Is that okay with you? Okay, okay. So different hospital has no affiliation with you at all. We had a client who had originally planned a birth center birth, but the birth center closed. And so she transferred to a hospital that we recommended. Yeah. And uh the plan was to go unmedicated. Well, you know, first baby, and she decides she's going to get out of all. But she doesn't want Alex to leave the room.

SPEAKER_02 35:23

Or did they make you leave the room or her husband or your partner? She wanted both of them leave.

SPEAKER_00 35:27

She wanted one of them to stay.

SPEAKER_02 35:28

Yes.

SPEAKER_00 35:29

Did they have to leave?

SPEAKER_04 35:30

They tried to make both of us leave. My job is to, you know, share my experiences, you know. Like, um, you are allowed one support person. Like, I'm happy to step out. I've seen many epidurals. I don't really give a flying shit. Like, I don't care about this at all. You do, you girl. Um, what else would you want to say, Lacey, about it?

SPEAKER_00 35:47

So uh in this particular hospital, they don't allow support people to stay in the room during an epidural. I know I love the face you're making because that's how we all feel.

SPEAKER_04 35:52

Um because we've been in many epidurals at all of the hospitals.

SPEAKER_02 35:55

But even if you haven't, who cares? Who cares? Whatever. It's not like it's not like you're back there doing the epidural or talking or doing it or distracting.

SPEAKER_05 36:02

Yeah.

SPEAKER_00 36:04

And so um I happened to be on the phone because this this client needed reassurance that this was an okay thing to do. And I told her, um, you absolutely can have a support person there, right? Hospital policy is not law. Well wait, it's worse because I said sometimes you have to act like an asshole to get what you want. Okay, well, the nurse went and called the nurse manager, who then called me and said that I eroded the trust in the relationship by telling the patient that she had rights that superseded hospital policy and that I should be telling the patient as her doula that if I trust the nurse, that she can trust the nurse.

SPEAKER_01 36:37

Oh, good.

SPEAKER_00 36:40

She said she's been with that nurse all day.

SPEAKER_03 36:42

You've been with her for nine months.

SPEAKER_02 36:44

Like she's like, come on, that's like asking somebody not to listen to their mom. Like they like I could spend all the time in the world at bedside building a relationship, goofing off, cracking jokes, having a good old time. We can have a rager in my patient's room. But if her mom comes in and is like, epidurals are terrible and you should not have one, even though she wants one, she's probably gonna listen to her mom over me because the trust is there. I'm just the new girl in the room. Like, yeah, that's really frustrating, and that's so frustrating. Did you guys end up having somebody stay in a room or did they make you believe? So the nurse manager came in and um the anesthesiologist was super cool.

SPEAKER_04 37:12

I like I enjoyed the banter, like, oh well, we're gonna put it on anesthesia. And if anesthesia says if anesthesia says it's cool, then it's cool. Like, oh, okay, well, that's not what you just said at all. But okay, anesthesia was totally fine. Of course it was. Most of the time anesthesia don't care. They don't care, but I do like the back and forth of like, oh, I'm gonna throw it in their court. And if they okay, like no one wants to take responsibility.

SPEAKER_02 37:28

I would have asked to see that policy. Oh my god, the mom, like the poor mom. Oh, you're right. I would have to see policy. Can I see policy? Right. Where would someone find this? Where is what what kind of policy is that? You know, what is the where is the evidence behind that policy?

SPEAKER_04 37:39

For a mother to be left alone, getting a per getting a massive procedure done like without I don't care, like, but it was the fact that she wanted someone in the room and they would not quote unquote allow it.

SPEAKER_02 37:48

Like, yeah, that's so weird.

SPEAKER_04 37:50

This mother, and she was young, and my vibe like this, we had a couple, and my heart was very open. This mother, she kept saying, help me, help me, help me right through her contractions. That was something that was getting her through. But as a mother myself, it would, I was it was like I was her mom, right? Yeah, like you got this, you know, like providing whatever emotional and and verbal affirmations that I could, but it was it was like there is no way in hell this mother is getting left alone with people she doesn't know for a procedure that she's never done. If it were a second-time mom with a second epidural, sure, and she's like, guys, I got this. See, yeah. She did not.

SPEAKER_02 38:18

No, but she does that's not what she wanted, yeah. Even then, though, I mean, even then though, it's I mean second, I mean, I was a labor nurse for a long time, yeah. I don't know if I told you before, I was a surrogate twice, and my surrogaces were the only ones that I got epidurals with. Um, not that I didn't ask with my other ones because you know, labor is rough times, it just went too fast to get it. Um, but they were the only ones where I actually had it. I knew what they were. I had been a labor nurse a hot minute. I knew what they were, and I still can't throw it. I knew everybody in the room, I trusted all these people. If I work with them, I know what kind of people and providers and nurses they are, and I still absolutely, for lack of a better way to say it, lost my ever-loving shit through both of those epidermals. Like, and I knew what it was. I've seen a pajillion on my scary, it's scary, it's lost that control, and it's like that's so silly. I um absolutely to like ask somebody who's never done it before. I mean, I see that all the time as a labor nerd. So I mean it's it's expected because what do we hear? Oh my god, you spit this massive needle into my spinal column, right? And like people are like, oh, I had terrible back pain afterwards and it messed my whole back up and I it didn't work, and they have all of these things, and a lot of that is very valid and very true, and it does happen. But that's scary to hear that. Nobody's very rarely do you hear about the good things, right? It's like a plane crash. Only time you hear about it, only the time you're about planes when they go down. I mean, people aren't people aren't going, oh hey, look at it I have the best apigal ever and I didn't feel anything, and everything was glorious and sunshine and roses. People are like, eh, my girl is terrible. So it's scary for people. I don't understand the don't have anybody in the room thing.

SPEAKER_00 39:25

I mean, I saw that a long, long, long time ago, but well, who cares?

SPEAKER_02 39:28

They're sitting at the city.

SPEAKER_00 39:29

They still claim the the dads, you know. Every hospital, it's it's just mind-blowing. Every single hospital has had a dad pass out and crack his head and end up in the ER. So he's like, you know what?

SPEAKER_03 39:40

Who can we do?

SPEAKER_02 39:44

I mean, I had a dad do exactly, exactly that. He was and I thought he was okay. Usually we um we made them sit down for it and just standing there, and he was like, and he's like at the foot of the bed. And Dr. Henry, amazing man, does the fastest epidural I've ever seen in life. He's like, he's like, You good? And he's like, Yeah, I'm fine. And he's standing there, he's watching. And the guy like very calmly and passively like moved away from the bed. And I come, you know, your nerve senses go off, and I watched them, and I was like, okay, he's still on his feet. He's all right, no blow. And I was like, oh crap, man. And Dr. Henry is a very large man, and he turned and he was like, Man, he's fine, and he finished what he was doing. Yeah. And the guy was like, like, sometimes when people pass out, they kind of like do this like shaky thing, and I'm like, oh god, is did he is he did he do exactly that? Like, did he hit his head when he slumped down and now he's seizing? And Dr. Henry's like, no, he's fine, it's just because he freaked out. And he came too, he was fine. We said the ER, but he was fine. It came back like an hour later. He's like, They gave me some juice. I was like, I understand.

SPEAKER_00 40:33

It's like I better now. I'm embarrassed, a little hurt. Yeah. Like, put put the support people in a chair, but a woman who is in the most vulnerable state that she's ever going to be in in her entire adult life, and saying, No, the people that you trust can't be here, right? To protect us from online.

SPEAKER_02 40:48

So you're wrong. That's exactly what it is. Let's say that's exactly what it is. It's the same reason they don't want people to record. I'm a firm believer in this. The only reason I want people to record is because it is a video proof that you did something wrong and they don't want that liability. Um, and that's why a lot of facilities have recording rules around it, and they'll use it as like, oh, you don't have to miss your comparison. I could care less if you record me. Because you know what? If I'm doing something wrong, then and I need you to stop recording, then I'm the problem, period. Like I and I tell my patients that I'm like, I am confident in what I'm doing is the right thing and the best care and the most evidence-based that I have access to, I could care less, but not everybody feels that way. So you have to just check. Like, yeah, you're right, it's all liability based, 100%.

SPEAKER_00 41:20

But I think most of the hospital policies, and I want to come back to this question. I think most of the hospital policies are rooted in protecting the business for the patient, right? Like obviously, there are things that are in place. I talk about this all the time. Like your nurse was trained to do A, then B, then C, then D, then H. And if B does the exact same thing every single time, she's not going to miss step C, which already a high risk, create a high risk situation, right? Right. And so there is a protocol that is intended to keep people safe, but that doesn't mean that they can't explain step A and then step three, right? Right. They can have a conversation with you. And if step C is really scary to you and you've decided that it's not right for your path, that's okay for you to choose to decline. But let them do their job of explaining it to you.

SPEAKER_02 42:00

Right. And I think that's where a lot of nurses get frustrated because I feel like I know and I will say I'm guilty of this as well. Like I see the birth plans all the time. There's these things that, like, for especially at the facility I'm at right now. The facility I'm at right now is like an anomaly, I think, because I've not worked in a place where everybody is, it's just duh. Like, of course we have a birth plan, and uh, of course they're dual as and and especially for a facility that literally got its first midwife on staff like four months ago. Like these physicians function like midwife, it's wild to me. Um, but like seeing um like they like things that for me, like, well, no, we are gonna do delayed cord clapping. Okay. We all okay, that's best practice, so cool. Or like people who like feel like they have to fight for skin for skin. Like, why do you know? Like, are there really places that don't do skin and skin? I worked with a physician in Vegas, God bless her, I love her. She we would take baby, we would take baby out, but baby would come out and she would put baby here, and she would do her delay cord climb.

SPEAKER_03 42:43

She'd be like, Okay, my friends are just gonna take the baby over to the warmer now, and our girl, no, the baby's okay.

SPEAKER_02 42:48

That was it. Okay, well the baby isn't going for them, just get checked up. No, the baby's fine. She just she just didn't come from a generation where that's what was done, and she just didn't like the baby in her way. I don't care. Sorry. It's a little higher on her chat, so that's fine. But like sometimes some of the things that they come in with are just like misinformed and they didn't get the education, you know, they did their own education, which is very valid education. But sometimes when you're doing education on the internet, it comes from places that are not the best sources of information. Or yeah, it's fear, or if it's like an influencer who had a terrible delivery and in their mind they have correlated, you know, correlation, not causation. To them, the cause of this terrible thing was this specific moment in time, and so then they build their whole opinion around that intervention. Right. And then, you know, sometimes that like internal bias comes into reading the information and it just breeds misinformation and fear, and then we have to like redirect, and those conversations can be really hard when we get those um on like birth plans and whatnot. And like it's it's not the the best way to approach it, and it can be frustrating from a risking standpoint because we don't want to do terrible things, like most of us, I feel like in my experience, really just want to be respectful of you and give you good care. But sometimes it's really hard to fight that, fight that system and um and that like misinformation that's out there, you know.

SPEAKER_00 43:54

Yeah, I mean, I think that you bring up a good point, right? Like there's a difference between educating yourself and TikTok education, right? Like There's a big difference. And because I think that anything you see on the internet should be taken with a grain of salt, including PubMed, right? Like everything you see on the internet should be taken with a grain of salt. But when you're hearing people's personal stories, I think it's really important to remember that so many people experience trauma, don't know how to process it, right? And so then they spew it all over the internet and anybody who's pregnant. And it does, it creates the cycle of fear. Alex and I talk all the time about hypotosin is not the devil. It can literally be the difference between a vaginal birth and a cesarean. We we experience that ourselves.

SPEAKER_02 44:27

Same with an epidural, yeah, with an epidural too. Like, yeah. Sometimes the epidural is not their place. Sometimes a woman is an epidural. I can tell you, can't tell you how many times women were going unmedicated and they are that. I don't know if you guys know that like the fear-pain cycle, right? But they'll just triad of it hurts. So I have fear of that pain. And because I have fear of that pain, my perception of the pain gets worse. Because I perceive that pain as higher, even though it's not, then now I'm more fearful. And because I'm more fearful, my perception goes up and it just feeds off each other. And they'll think, oh, you don't want an epidural, but also you're not making any change because there's a pea in you know the peas of labor called psychological. And it's no different than a gymnast who puts a mental block on doing a skill. You can literally mentally block your thing. I think it's like sometimes an epidural is the part we need to overcome that pea of labor. Yeah. My opinion, the psychological component is one of the most important, if not the most important. Because if you're fearful of it, you're not gonna do it. Yes, that's what we tell our like our mums all the time.

SPEAKER_04 45:15

Your brain, your body can do this. It's your brain. And if your brain doesn't win, your body will not do it. Like it's that simple.

SPEAKER_02 45:19

100%. Um, ages ago when I was training as a doula, um, the lady who was teaching like the in-person session, she'd been a doula forever and ever. I think she was someone like maybe Colorado. She left California to teach a course, and she was telling us exactly that. That was my first experience with the psychological component of labor. Um, and she said that she had a client who had wanted unmedicated and she had to be induced. They were trying to do the things, but the providers came in and remember, excuse me, this was you know 20 years ago, um, where it wasn't as common and people are still more pushy than they are now. Um, and she was like, they wanted to add in photosin, my patient really wants that. Water was broken, and they were like, you know, can we just go for one more walk? Like, let us go take one more walk around the unit, let's see if anything changes. She'd been persistently three, persistently three, like whatever the circumstances were. And she said she stopped the patient in the hallway, like halfway through the walk, and she was like, Why won't you let your baby come out? Like just put it to her like that. Like, what is keeping you from letting your child enter this world? What is what is it? And she said the patient got really open with her and was like, I am scared to death of being my mom. She had a really terrible childhood and her mom was abusive. She had really negative examples of parents, and she was scared she was gonna be that. She had her moment, she cried it out, and they went back to her room. She was like, Selling years, oh my god. I know it was like I was like, There's no way, there's no way. And she was like, Yeah, she goes, It's probably the best example I can give of a psyche really interfering with the labor process. And I was like, I really took to heart. So I really like, I don't know if you cut you guys probably noticed it that day we were together. Like, okay, so tell me what's your worst case. What's your what's what are you afraid of happening right here? We're gonna start, I think we're talking about the toastin. So we're gonna start the toastin'. What are you afraid of? No, what do we do? How do we what let's just put words to it? Sometimes that's all we need. They just need a minute to really just let's be real direct with it and have it. Let it go to your body. Yeah, let it go, man.

SPEAKER_00 46:47

Sometimes sometimes when we label things, when we uh really like call it to the forefront of our mind and put words to it, it strips it of its fear, right? Like if you give it a name, it's like, okay, like now it doesn't have the same power in my body. Right. I I'd like to to ask you about another important P in labor. Um, you mentioned like ask for the policy. Yeah, which could become an adversarial situation. And a lot of people really are non-confrontational. So can a can a patient request hospital policies in advance of delivery? Is that a I couldn't answer that well.

SPEAKER_02 47:18

I would imagine so. I don't know. I think it's gonna depend on the facility. Um, I know some facilities' policies are not available to patients um and it state specifically not to be distributed. Um, but they could I they could try. I mean, what's the worst they're gonna hear is no, right? Like, I mean, what is your policy on it? Can I see that policy? Like, let me see the policy. I want to make sure that I'm following your policy and if this is the right fit for me. I mean, what's the worst they're gonna do? So I know. I mean, I would start with your provider, whoever your provider is, because they're gonna be better versed in it. They're not always well versed because they usually go to a lot of facilities, um, but they might be able to be helpful. I had something like that actually happen. Um, a friend of mine is a placenta person who does placenta things, and um the facility she was at was a sister facility, so the one I was at, and they were giving her slack about taking this placenta, and I was like, I'll send you the policy. I was not supposed to, but then she was like, That is actually really helpful, Ginger. Thank you. And I was like, I can't but it fixed her problem right up. She's like, I actually know what your policies are, I've seen it, so you can give me what was done now. Like, yeah, um, yeah, and but she was asking for the policies that had been. She's also a doula as well. So she was like, well, educating on it. And so she was asking for the policy in advance and not getting any response from them. So um, she was just kind of getting, you know, what the nurses were saying or what the doctor was saying, kind of thing. So I was going to ask, what's the first thing it's gonna do? Or say no.

SPEAKER_00 48:23

That's really difficult as a patient coming into a facility when people are hiding behind rhetoric and policy, right? Right, as like, oh, well, this is our policy. We'll prove it, right? Like, let's start there with like, are you being honest? Because sometimes it's a little bit like mom and dad being like, oh, swimming, you know, you can't swim after you eat because the sharks will get you, right? Because mom doesn't want to swim after she eats, right? Like sometimes it feels like they hide behind it because they don't want to say, like, I actually don't want to come in and adjust the monitor 17,000 times during your labor. So I'm gonna tell you that's policy, but really it's just because it's my preference.

SPEAKER_02 48:52

It's because I'm lazy. It's because they're lazy. Yeah, no, I know exactly what you mean. Exactly. And some of it too is like that's the old school, right? They haven't wanted the old school, they didn't move with the times. It's like uh getting out of bed after your water is broken. Um, there's still a whole lot of nurses in this world where like your watercore can have the same bed. Why? Why? Well, because the cord can prolapse. If well, sitting in bed isn't gonna make it prolapse less. No, it's gonna quite the opposite, in my mind, it's gonna let the head come down, so let the head cork it up, and then guess what? We don't want to prolapse. Yeah, I know it's um, it's like it in some of it, it's just like so many like factors to it and like individual factors, and it's just rough. But I mean, I owe astro policy. So it's okay, I'll I'll look up a policy policy, I'll look up a policy for a while. I don't care. Where are they housed? Um, usually on the internet. Like most facilities, if they have computer-based charting, which they should, um, should be not the internet, the intranet, so the internal web system. They usually have access to that policy event side if there's a computer charting system at that side. Um, because like for me, I can just go to my hospital's main page, and this is similar for every facility I've been at, go to the main web page for my intranet, and there's a policies and procedures button, and then I can just look it up straight from there. So they can quite literally look it up at that side.

SPEAKER_03 49:49

Yeah, that's really interesting.

SPEAKER_02 49:53

I liked that breakdown of like the intranet in there. Like that was, I think people find it interesting. Yeah, because we do they have their own like little internal like internet servers for the space. Like hospital hospital, even hospitals when we're not a safe healthcare system, each one has their own internal internet, which we call intranet. Um, and uh those are specific. Like it has like links, most of it is like links to like employee resources and like pay stuff and all that stuff, but our policies and procedures are there as well. But it's helpful. I mean, I've done that in our facility in Vegas, printed them out game with the physician, so the physician could could review it. Like, what does our policy say? Is this something our policy says I am allowed to do in my scope? And that way they at least are coming from a face of like, okay, I actually know where I stand here. Now I can move forward from there. So it's um they're not meant to be punitive, they're meant to be helpful. And then if you don't agree with that policy, like you said, you won't have to agree with it. It's not a you know, a prisoner and this is not jail, and you can do what you want, you know. We're gonna chart. I always like to tell people talking about things like that is I'm going to chart that you have declined this or you have refused this option, it is not meant to be punitive, it's not meant to be like, well, she's literally, yeah, it's literally because I know patients, like especially now that patients have such better access to their charts, like Epic and all of these things, your chart is a like, man, it is transparent. And it didn't used to be like used to be a process to get your medical records. Right. And um, having that transparency means that honestly we have to kind of pay attention to how we chart because using words like patient is non-compliant, the patient is compliant, she just doesn't want to do what you want with informed consent and conversations, and that is okay. She's so compliant, she's just choosing her own path. And so rewording how we chart, but still can be a little jarring scene, like patient decline X, Y, Z, or patient stated in quotations this and quotations. And I always tell people it's not meant to be punitive. This is just documentation of our conversation, so that there is a conversation that we had charted and that you have made the decision that's bad for you. Right.

SPEAKER_00 51:22

And I I think you know, if people understood more, like there was a mass exodus of obstetricians in Pennsylvania about 20 years ago. They all just either retired or left the state. Like it there was this huge leap and it came from the liability insurance skyrocketing because Pennsylvania in particular is so litigious. And providers are very, very nervous about their care. And so people understood, like I go to work every single day, terrified that I'm going to do something that's going to get me sued. And even if I did not know that, even if I didn't do something wrong, it's still going to cost me tens of thousands of dollars, it's going to cost me weeks of time or months or years of stress, right? And it's dependent on the loss of knowledge that it's not quick. And the stress that it creates for you to live in the background of your life is enormous. And so people can understand that their physicians don't work every day just under stuff, right? And it takes that one person who says, oh, that's a really critical dangerous thing. But in their mind, they've been trying to create dangerous, whatever it actually is, right? It turns out it's good for them. And so as a patient, I tell my clients all the time for our clients. If you are feeling like this doesn't feel right for me, and you say, can you go through the benefits? Can you go through the risks? Can you go through the alternatives? I really appreciate the information that you've provided me. I'd like some time to think and decide what's right for me. Right. It's not confrontational. It shows their respect by allowing them the opportunity to do their actual job, right? And then reminds them that you are a person with agent same autonomy and deserve the opportunity to be a sovereign citizen who makes decisions for themselves.

SPEAKER_02 52:48

Correct. And that I think that's important to point out like have the conversation, let them tell you worst case, best case about everything in between. And then you need to make the choice that's okay with you. Because the flip side of it is this providers also have autonomy, right? And I think we forget that. I think that in medicine in general, as patients, because I mean again, I'm guilty of this as well. Um, we forget that yes, they are there to quote unquote serve you as their client, but like you said, they are always kind of in that little simmer point because they also are protective. This is still their job, and they're still the best how they get their bills. Like if you're working at a restaurant and you are a server, you have a similar experience. You may not like the person sitting at that table and they are calling you terrible names, but you still have a like a decorum that you have to uphold, right? And the thing is, is I think people forget that it's okay, you know, physicians middle that also have a comfort level, and it's okay to not match. We just gotta find just somebody who you do match with because maybe that provider's not trained in breach birth. Most providers aren't, right? But let's find just somebody who is trained in breach birth, right? Maybe that provider is not comfortable with toilet deliveries, right? And delivering standing like that because they weren't exposed to it. Like, I mean, that's why we don't see forceps used hardly anymore because people don't know how to do it because there's no way to train them, you know, and that's why we don't see breach because the people who were delivering breach babies don't train our physicians any longer, right? Um, I think that one of the so like maybe in Lancaster has a breach program. Reading Reading, there it is. Yeah, and it's like it's like well known across the country. Like people come from all over to learn from these bias based positions. Um, but I think we need to like it's a flip thing, it's meant to be a conversation so both of you can find out where you are. And if you guys don't agree, that's okay. Ultimately we're gonna do what the patient wants, right? We can't force it, that's assault. Um, and we have to just kind of meet wherever we meet and go from there. And that's okay, we're laptoo. Nothing wrong with that, it's just what it is, man.

SPEAKER_00 54:16

Well, and I I think that that is, you know, that really highlights such an important thing that Alex and I talk to clients about all the time, right? Like these are just people who have the training where they don't, right? Like that you can't ask somebody to do something that they've never been trained to do and expect them to be super comfortable doing it, right? Especially when you're asking them to do it without any kind of like uh heads up.

SPEAKER_02 54:35

Yeah, right. Would you want the the the 18-year-old who wants to get an electrician when they're training wiring your house? No. Yeah, it's the same thing. Like some people have it, some people don't. I I think about it in the capacity of like my role. I have only had hospital-based training, even as a midwife. I've not got to any, I've not attended any out-of-hospital deliveries. Um, and I know that about myself, one, um, that I would not be a good fit for an out-of-hospital role. I know that about myself. Um, which I know because it is interesting. I know. And here's why, because even like that night, I think Lacey, you were with me that night. Um we had switched. Yeah. Yes, right when I came on. I was emotionally exhausted after that shift, which I tell people all the time. I'm like, I want to be a crunchy, crunchy, crunchy hardcore midwife, but I I am not a crunchy, crunchy hardcore midwife. I'm gonna be respectful, I'm gonna support you in every way, but I'm also gonna be like, hey, where's your doula? Where's your doula? We need to get her here. You're two centimeters and you hate this, call her now because I know myself well enough that my emotional battery, I don't, I I'm eventually I'm gonna exhaust out and I'm gonna just not be the best. Yeah, I am if and some of it's like self-recognition, but I would be a terrible out hospital provider. Like, I would be like, where is the the midwife's bedroom so I can now?

SPEAKER_00 55:38

Call me the pushy. You need to attend a whole. I know I do.

SPEAKER_02 55:42

I know I do. I really did lots of work and like it was like a logistical thing on my end. They have a and they really pushed me to do it. And I was like, I can't be on call 24-7, you guys. I just at this moment in my life I couldn't. If if there is an opportunity when I get back to Vegas to attend some, I will definitely go attend some, but it's just not something I have a chance to do. But yeah.

SPEAKER_00 55:57

Because midwives in our experience, and I don't know around around the country, but in our experience, midwives encourage people to hire doulas because they fulfill the role of doctor and nurse in the hospital, right? So it takes a load off. They're listening to baby, they're checking blood pressures, they're nearby, but they're on the you guys do that in our hospital or no? We don't rob us. Okay, yes, yes, yes, yes, yes, yes, right. But like they're they're sitting on the couch knitting or napping, napping and listening to music, like they're not in it until the very end. Yeah, with their momentary training. Yeah, yeah.

SPEAKER_02 56:28

That's because it is, yeah, it is like even like the little bit of Jula work I did. Um, like I had a couple of people who were like, Oh, you trained for the Jula, please come. And I was like, All right, cool, but I was like just like a few, right? But even then, like people in here, I was like, I am freaking exhausted. And this is when I was in my 20s, and all the energy in the world, but it's it is, I mean, just having patience, having a patient in general is exhausting. And then somebody who needs like extra emotional support can be just so so tiring. And I love go ahead, go ahead. It's like I loved, I love having like that patient had just great, it was fine. But at the end of that, I was definitely, I was like, You guys, I'm exhausted. And then the next week I had another patient similar, and I'm like, I need you guys to please. I know I'm like the resident student midwife here, but I need you guys to please, please give me one week of break because I am exhausted. Like, I couldn't imagine doing that. Like, I don't know how you guys do it, really truthfully. It's I I tell everybody all the time, I'm like, God bless them. I love my out-hospital people, I want to build a relationship with them. But there's a place for everybody among us at the bedside in a hospital, unfortunately. Yeah, it's but I can also give that role that care at the bedside. Like you can do that, and we need it, we need it there. We still need the rose at the bedside. Yeah.

SPEAKER_04 57:25

I think it's it's the the 24-7 excess. Lacey and I talk about this all the time. And we've gotten right because we have we make ourselves available 24-7. And over the years we've honed in on like, okay, guys, nine to five, unless you're in labor. Like, come on, right? Like because it is so emotional. We emotion we invest so much emotionally. Yeah.

SPEAKER_02 57:41

Yeah. It's all right. The the midwife I was training with in Arizona, she was intended to carry me through Michael Scope. She has a first center, so it was going to be a really well-rounded because she also had uh hospital privileges. Um it just didn't work that way. But she, her patients 24-7 have access to her. And she even says she's like, like, like it's all the time I never get a break. And she was an independent provider in a single provider practice. And I told her, I was like, You need a Google number so that they still call your personal phone at two o'clock in the morning and also boundaries, my friend, because some people are very anxious and they need that extra support, but we also need to recognize that your person needs sleep. Yeah. And we shouldn't be calling them for a yeast infection at two o'clock in the morning. We all know how it works, right?

SPEAKER_00 58:16

And it takes telling people that, like, because they don't they don't think, right? Like, we all have to remember that they have pregnancy brain, and you know, I mean, we've all been there, like your brain doesn't quite work the same way.

SPEAKER_02 58:25

I mean, there's science behind that. Like there's science behind pregnancy brain, um, that you actually lose brain cells in pregnancy, quite literally. Like, I read the article a couple years ago. Like there's some, I mean, enough change in like brain cell reproduction that they could log it. That's why we get pregnancy brain. So real thing. Wow.

SPEAKER_04 58:40

Do we grow them back after?

SPEAKER_02 58:41

Yeah, I think it takes time though, but like pregnancy brain is rough.

SPEAKER_04 58:44

Like, like like minerals depleting from your body, right? If you don't like restore them and you're just in a state of deposition, yeah, your brain cells back, or you're just like now an idiot.

SPEAKER_02 58:51

Right? Oh, I think let me find it. Okay, so yeah, NIH, brain changes observed during pregnancy. Hang on, I'm pull up. Um, this was in October of 24. It says that over the course of pregnancy the body experiences major increase in hormone production, and this triggers profound changes throughout the body, including the brain. Scans of the brain before and after pregnancy have shown a reduction in gray matter volume. Gray matter contains the bodies of neurons, synapses, and glial cells. I can't say that. And it's found mainly in the brain's surface layer called the cortex. Um, and so a study on women pregnant with their second child noted that while similar brain remodeling occurs, the changes are less pronounced the first time on. So it's like less over the course of the pregnancies, but it's there. Like the brain changes. Like pregnancy is wild, man. It is wild. Wild. Like, yeah, I like it. It's an interesting thing that our body does.

SPEAKER_00 59:33

Yeah, it's it's incredible, right? Like when you think about all the things that have to go right in order for you to get pregnant and produce an offspring, it is mind-boggling. Like, I it's remarkable that the entire planet is populated, in my opinion.

SPEAKER_02 59:44

I know I completely agree. Like if like a 24-hour widow, so sometimes only four.

SPEAKER_04 59:48

I've read research, some some eggs are only viable for four hours. Right. Not even the full 24. Four. I'm like, well, yeah, how? How does it happen then?

SPEAKER_02 59:55

Right. After 24 at the max, if it's not fertilized, then it's like your universe is like, well, you can go to hell.

SPEAKER_03 1:00:01

Yeah, here's a good yeah.

SPEAKER_02 1:00:02

It's like, okay, we're gonna implant you then implant. Well, all right, fine. Here's your week of terribleness.

SPEAKER_00 1:00:08

Ginger is if you could get a hold of patients. So as an LD nurse, if you could get a hold of patients before they come to the hospital, what would you want them to know or what would you want them to learn about?

SPEAKER_02 1:00:20

Um, I think that answer would depend on where I was, honestly. Um, at the facility I'm at currently, I have to say, the vast majority of these patients, they come in pretty well prepared. Like they're well educated, not like if they're health literacy education, like they're well educated on what to expect, what's going on, they know they have autonomy. Um in my previous facility in Las Vegas, a lot of it would be what is normal, like what is normal. And I think that's probably across the board, but it is here. Like I said, the the health literacy is better, but um, I think people don't realize what normal is. Most women are not exposed to labor and delivery until they're in it, which I think is a disservice in our country, but that's just the culture of America. If you go to Mexico or even like UK, a lot of these people have a medic adverse, they're having babies at home, and the young females in the family grow up watching their women have babies, and so they see labor in real time. I think that's probably the one thing that most people are unprepared for, even if they prepped, is the absolute intensity that is a contraction, and not the early contractions, because those early contractions that feel like the world's worst period cramps, oh my god, this is the worst period I've ever had in my leg. Those are baby contractions.

SPEAKER_04 1:01:19

We tell the same thing to our mamas. We're like, oh honey, you think this is bad? It's only gonna get way more like this. Is not intense. You got this is nothing compared to what you're about to experience. And you better damn well really want an unmedicated birth if that's what you're going for. Otherwise, you're like, you're gonna get the epidural. Like, and then that's okay.

SPEAKER_02 1:01:33

Yeah, yeah. I have that conversation with a lot of people who come in. Like my old facility, like everybody was like, Yeah, I'm gonna go as long as I can. I don't want anything, but we'll see, right? But they're like, it's gonna be fine. We 99% of those patients ended up in an epidural because they weren't prepared, and so then they would get in there and they would be off the rails at like two or three centimeters, which is very valid and it hurts. You're not wrong, but let's manage some expectations. Yeah, because if we're rating this at a 10 now, this is gonna be a two later. Yeah, it is it intensifies. And I tell people the way I explain it to them, like if these contractions feel the same as when you jammed your toe on the door jam, and the only noise you can make is like and just like exist in the moment, that's that's what it's gonna get to. I said that to a patient this week, and she was like, Are you serious? And I was like, Yeah, she was it gets that bad. I go, it gets worse, bad. And she's like, Oh my god, okay. All right, get me out of this bed. I gotta move. He's like, perfect, you do need to move. And it needs you to ignore these period grams.

SPEAKER_00 1:02:24

Yeah, because we tell them that the first thing you should do is deny that's happening. Like, this isn't like yeah, right, yeah, and ignore the area where and then ignore it, right? So, okay, I'm actually in labor, probably, but I'm going to ignore it and distract myself with anything else, and then gaslight, right? Like you have to gaslight yourself because I'm like, you're gonna call up three, four hours into labor and you're gonna be like, things are getting intense, and it is not this is not intense. And your language about this process matters because of your thought process matters more than anything else. And so if you're telling yourself, yeah, if you're telling yourself that this is intense, honey, you don't even know. Like you have to be like, nope, this is not intense. Yeah, this is not intense because we're gonna be over here being like, oh God, like if you're using that word already, right? Like, let's just go get the epidural, right? Like, yeah. So reframing your expectations and your thoughts, I think is so, so critical.

SPEAKER_02 1:03:09

Yeah. Um, I did exactly that. So only one of my labors out of the five were not induced. Um, and it was my first surrogate vape. I was due like two days after Christmas, and I was really adamant, I do not want to be induced. Like, just leave it alone. Like I was very much manipulated with my phone deliveries. I don't have doubt that my body knows how to do this. We know it knows how to do this. Like, can we just leave it alone? And he was like, All right, cool, but you're two and a half hours from the hospital, ginger, so let's have a backup plan, please. And I was like, all right, so we scheduled an induction for 40 weeks. I think it was like 40 and one. I got myself on the books. Um, so Christmas morning, well, Christmas Eve, I did not cook dinner. My partner cooked dinner, and we, you know, you always eat really early on Christmas, right? And um, I wake up at like two in the morning and I'm like, oh, my stomach really hurts. And I literally, I was like, You're just hungry. Go back to sleep. And then I made myself go back to sleep, and I woke up probably like five or six more times. I was like, You are such a cow. Look, I was like, I've said this to myself. You are just a cow. Stop. You're just hungry because it's been 12 hours since you ate fatty, knock it off. Oh my god. Woke up that morning sitting on the couch, opening Christmas presents, and my mom was there, and she wasn't meant to be, it was just kind of like a happy accent that she had been there. And um, I'm sitting on the couch cross-legged, and I was like this, uh, and then my face crunched up and I had a really strong breast and hicks contraction, and my mom was like, Her mama's senses went off. She went, You good? And I was like, Yeah, I'm fine, it's just a breast and hicks. And she goes, You sure? And I went, Yeah, oh my god. And my water broke all over the couch. Just oh my god, like the Hoover Dam came out of my body. I had gaslighted myself all night into thinking I was just a fatty who was hungry. Oh my god. I made myself sleep through late. Oh my god. But everybody should do that. It was crazy. I love to tell people that because I really did. I was just like, Man, I am just so hungry. Just kidding, I'm not. I'm glad I got to sleep through it, though. I would have done things very much. I I'm glad I did it though, because it very much would have been exactly what you said. I would have been like, these are getting terrible, and we need to go now. And then I almost didn't make it. That's the one where I almost didn't make it. I'm almost a baby on the road. Wow. I know I went and got there with six centimeters, and then 30 minutes later I was nine, and then 15 minutes later I was completely. And now that's part, of course, that's all my labors have been are just super, super fast. Like yeah. That's amazing.

unknown 1:05:02

Yeah.

SPEAKER_02 1:05:03

So it's funny what happens when you leave the body alone. Mm-hmm. Mm-hmm. So I think that's I I think that's a good point. Yeah, like you gotta gaslight yourself into it because it's not, it's gonna get worse. And I think that's the biggest problem, really truthfully, like circling back to what you asked is I think that's the biggest thing people don't realize is you have to see it to like really understand it, because there's a definitive shift in labor where it goes from, well, this is terrible and I don't like this, to literally you're only just trying to exist. Like, and even between between contractions. Even when I taught, there was a part of our textbook that talked about like use behavior change as a marker and like an evaluation tool for labor. Um, because if a patient isn't early laborer, generally they're gonna be like, Oh my gosh, these are so bad. Honey, hang on, mom, oh my god, no mom, I'm having one right now. This, oh my god, this is the worst crunch of my life. And like they're like telling you while they're having it that it's bad. And then it changes, and that change can be so quick. Like one contraction, you're like, oh, worst every crunch of my life. And the next one, you're like, I'm gonna die.

SPEAKER_03 1:05:50

I'm gonna die.

SPEAKER_02 1:05:51

Death is coming, let me die. And it changes from like, hey, I'm telling you while I'm having this contraction to all of a sudden we're not talking through that contraction any longer. And in between contractions, We're no longer chitter-chattering, we're resting, and we're more quiet and introverted. And they there's actually like information in the textbooks that we used with my nursing program teaching students that out the gate. Like we can't use behavior as a sign of pain, but we can use it as an assessment tool for whether or not we're progressing, right? Like because pain and progression are not always, they don't always coincide in labor. They can be very painful and not have any progression, right? So I think that's I think that's probably the biggest thing is understanding, like, yeah, early labor sucks. It is uncomfortable, we don't love it, but we gotta ignore it, we gotta gaslight ourselves, and then you'll know. You always want those things, you'll know. Very few women don't know.

SPEAKER_00 1:06:34

People think that they're gonna miss it, right? And we tell them all the time like you're not gonna miss labor. And if you are the one in a million moms who wake up with a baby in your bed, that's not the worst case scenario.

SPEAKER_02 1:06:47

Not the rest of us, you're making us look bad. I tell people I can count on like two hands how many times in 20 years a woman walked in and be like, I think I'm craping a little bit. And I'm like, Well, there's a baby on your vernium, so you should be yeah, like and like very few women can talk at that point in labor. Like, you generally are gonna know.

SPEAKER_00 1:07:02

Yeah, right.

SPEAKER_01 1:07:02

Yeah.

SPEAKER_00 1:07:03

Ginger, we're so glad that you came on and you shared your story and your wisdom. And I I feel devastated to know that you're going to move out of Pennsylvania. Uh the plan. Listen, and who knows what the future holds, right? Like you say it's the plan, but you you don't know. Um, we might actually barricade your exit. Um I'll tell you an apartment. You're going to do it with me in Pennsylvania.

SPEAKER_02 1:07:24

I'll bring them to you. Sit down. No, I think you know, I think I know I wasn't planning on it. We really, actually, really like Pennsylvania. It's just really, I think a family is our probably biggest precursor to going, but family matters, right?

SPEAKER_00 1:07:34

Your happiness matters and being in a community of people that you feel aligned with. That is it's so important.

SPEAKER_02 1:07:39

Yeah.

SPEAKER_00 1:07:40

We wish you the very best, no matter where you are. And just knowing that you are out there in the world providing good care to women. You, Ginger, are changing the birth in America. You're changing your experience for every mom that you touch.

SPEAKER_02 1:07:53

And the good part about it is I really intend to keep on teaching. So I will continue to pass that down because I absolutely intend to stay on the education side of things as well. So eventually, when I've got a little more time under my belt, I will be teaching it to the next set of midwives, hopefully, and making them more competent providers.

SPEAKER_00 1:08:06

Yeah. Thank you for that. Thank you for believing in you know patient rights and agency and autonomy and for showing up and speaking up and telling people that they have choices. Thank you. You're very welcome.

SPEAKER_02 1:08:16

I hope I see you guys. I'll be here for we'll be here for a little bit longer, but I hope I see you guys again. I just had somebody the other night, and I'm like, they were like, is Jules we know? I was like, is the KLP Julas? And they were like, no, but somebody else we've seen a few times. I was like, dang it. And I walk in and I knew who she was. She was from somewhere in Jersey, but yeah, I was and I get excited when I see people. I do every time I can't recommend you guys too. I was like, they're fantastic because all Jewas are fantastic. But I tell I tell nurses, a good jewel is worth your weight and goal because man oh man, you guys make my job so much easier. And I am down for whatever makes my job easier. It's kind of job sometimes. So no, I think it's great. I think you guys are doing good. I actually really just like it's fine. I really appreciate that Pennsylvania is open to it. It's a different space. I'm not used to a space that does not necessarily judge quite as heavily on those alternative roles in the birth world, where duolas and out-of-hospital providers and midwives is just very welcome in the area, which is I think fantastic. And so you guys are in a unique position to keep educating and keep like changing the stigma around those roles because it I mean the doulas I had in Las Vegas, um, unless you were really familiar with them, a lot of the nurses were just like, ugh, doolas, and then they, of course, were the ones who are like coming in and like, okay, this is kind of a rough place to be. So um, I think seeing it more that it is accepted in this well-rounded in this area is helpful because yeah, people take down the voices. You guys also, you should know I have physicians in Las Vegas who train in this area, and so they all of that stuff matters because that's changing positions, like it's changing how they practice because they're used to having those roles at bedside. So you've got providers coming out of this area for use to you and used to midwives and used to all of those options who are also doing the work that they're supposed, you know, they're doing.

SPEAKER_00 1:09:31

So yeah, it's what all of us are doing is going to have a lasting impact. I I've been Adula for uh what, 13 years, 12 years, something like that. And it wasn't, we weren't always well received, you know. It wasn't always something where nurses were like, yay, right? They were like, yeah, and but it is changing. And I'm seeing women take responsibility for their birth and take ownership, and it's making the medical system very uncomfortable. But I think that it is for the best. I think it is, it is going, we are going to learn how to coexist where people have rights and they have intelligence and they make the decision with the support of their medical team. And I think birth will be better for everyone 100%. The more the better.

SPEAKER_02 1:10:05

Completely agree. Yeah, I think we're in the right direction. We're kind of limited to like, okay, it doesn't need intervention, so it's nice. Yeah.

SPEAKER_00 1:10:12

Well, thank you. Thank you again for taking the time with us. We appreciate you so very much. Yeah, and yeah, hopefully we get to we have a couple of births in your hospital coming up. So hopefully we'll get to be like, can we please have ginger? I know she's in another group, but can you reassign, please?

SPEAKER_02 1:10:23

Oh man, sometimes they just I think they just automatically give me patients who are like doula patients and like natural patients. And I'm like, look, I don't mind. You guys make me you guys make my life easier. I'm telling you over it. Like, yeah, I don't know why anybody would complain at having a doula athletic. Because seriously, like I don't I mean, there's some deals like you guys simple things like do you want to change your pad? That's one as much as I can say I'm gonna sound like just a terrible little person, but that's one less thing I have to do. Like and it's keeping my patient comfortable, and nobody should have to sit in around cookie stuff, right? So that's one less time she has to push the button, one less time she feels like she's bothering me, and one less time of her basically asking permission if she can be clean. Why would I not want that? Like, come on, you know?

SPEAKER_00 1:10:56

Well, because they don't want us to say you don't have to do postpartum photocin if your bleeding isn't excessive, right? You have the right to ask what's my bleeding, right? Like we we support them in questioning the authority of the system and and not every nurse's soaking. So thank you for being open-minded. We're we're lucky.

SPEAKER_03 1:11:13

Oh, thanks for talking to me, ladies. Yeah, thanks for your time.

SPEAKER_04 1:11:16

Yeah, that was amazing. I love you so much.

SPEAKER_00 1:11:18

Incredible. I wish that like what I heard her say is that she still feels like a unicorn in this area, right? Oh, absolutely. She's not she's not seeing that there's more like her than not like her. Correct. Right. And and I think that if more people could let their ego go, right? Like remove the crown of anointment, right? Like get out of your ivory tower and and sit with the human being in your room and talk to them. Because so often it is a case of like tell me why this is making you nervous. Well, because I heard that it causes earthquake labor and and and that's gonna lead to my baby being in distress and I'm gonna have a C-section. Well, yes, sometimes that does happen with Pytosin, but the way that we do it, it doesn't generally turn out that way. And we can always turn it off, right? Like having a conversation can assuage so much of the fear that your patients have. But if you come in and you think that you can dictate their birth and just tell them what to do, right? Like you're making your job harder.

unknown 1:12:10

Right.

SPEAKER_00 1:12:10

And so I wish more people were like her. I'm glad that she's teaching. I am too.

SPEAKER_04 1:12:13

I'm glad that she's I mean, that sounds like she's had a wonderful career and she's you know taking the steps to get to where she is and continuing.

SPEAKER_00 1:12:20

On to the next thing. And love she's in her 40s becoming a midwife. Uh I know we always toy with the idea, but uh-huh.

SPEAKER_04 1:12:25

Oh, I know I had to just lit a spark in you.

SPEAKER_00 1:12:27

Yeah, I don't know. I'm like, I don't know. Maybe I'll just go get a desk job. I told Andrew that I think that he should talk to his boss and see if there's like an HR position at his company that I could just do like nine to five. Like I'll still attend births periodically, but you know, if I didn't have to be on call all of the time, it it doesn't feel so terrible. Uh but then I'm like, yeah, right, like as if he would stuck on a birth. That's true.

SPEAKER_01 1:12:48

It's true.

SPEAKER_00 1:12:49

But she's right, it's exhausting. Right? Like this this work is exhausting, and here we are.

SPEAKER_04 1:12:53

All right, well, that was great. If you liked this episode or you want to hear one of your nurses that you loved on our podcast, we would be happy to have them on. Um you have someone that you didn't like, we'd be happy to have them on. So true. Please leave us a review, send it to someone, like, subscribe, all the things. Um, and we are wishing Ginger the best of luck in all her endeavors, and we hope to stay connected to her um to hear how her life is going. And if we know anyone that's going out her way, we will send them to her for birth and babies. So she she will do well and the people under her care will do well. So yeah, catch you guys later.

SPEAKER_00 1:13:27

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_06 1:13:38

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 Stroff and Lacey Morgan reminding you that your voice matters, your experience is valid, and you're allowed to do this your own way.

SPEAKER_00 1:13:53

Until next time, stay unhinged.