Culture Apothecary with Alex Clark - “The Ultimate Home Birth Episode: Breech, VBAC, Twins & More!” - Dr. Stu Fischbein, MD

Episode Date: November 10, 2023

An OBGYN sounds the alarm on what he believes to be a corrupt medicalized system in America when it comes to labor and delivery. Dr. Stu Fischbein left the traditional hospital setting to assist midwives in the home in order to put power back into the hands of mothers. Dr. Stu answers listener submitted questions on everything from VBACS, breech, hemorrhaging, twin birth, and more. It’s the ULTIMATE home birth episode. “With Women, Not the System” long sleeve available for purchase.Follo...

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As always, find the link and code to everything I talk about this show in the show notes. You find out you're pregnant. The OBGYN recommends a C-section. You're not really given a reason why, except it's easier and we can plan when baby is coming. Fast forward to labor. You get to the hospital

and things are happening to you and your baby that you don't understand. Baby is being taken away. Baby is given this shot. You don't get to do skin to skin. It's chaos. This isn't what you expected. Here's another scenario. You give birth at home.

You get to eat when you're hungry. Relax and warm water. Walk when you want. Sleep when you want. You are in total control of who gets to come in and who doesn't. You can sleep in your own bed. The embellical cord stays attached. You get skin to skin.

and your baby isn't taken away to be wiped down and poked and prodded with things out of your control. Here's the next scenario. You do the homebirth, but things don't go as planned. Something is wrong. Something happened that wasn't supposed to and you're scared, but you live an hour away from the hospital. So now what? Every birth is different. Some people have amazing hospital births and terrible home births.

Some people have the opposite. What are the pros and cons of hospital versus home birth and birthing centers? Do you have questions about the safety of home birth, V-back, why C-section rates are so high, the pros and cons of an epidural, breach birth, or if having twins is as high risk as we're told? Today's guest specialty is everything I just mentioned. He's been a practicing OBGYN for 24 years, and after completing his residency at Cedar Sinai Medical Center in Los Angeles, his eyes were opened to how problematic the hospital model of birth really was. He became a staunch advocate and believer in the midwifery model of care,

and for the last 13 years has become a home birth obstetrician who works directly with midwives. He's an advocate for reteaching breach and twin birth skills, has respect for the normalcy of birth and honoring informed consent. And not only does he co-host one of the biggest podcast on all things birth, birthing instincts with midwife Bliss Young. You've also seen him on tons of documentaries, including more business of being born. I know many of you are already huge fans of his.

So the first portion of this interview is me diving into what exactly has gone so wrong with the hospital model of birth in America. And the second half is submitted questions from you. on everything from proclampsia to vitamin K if a woman is ever too small or a baby ever too big to give birth vaginally and lots more. We're still experiencing a record number of people listening, so I'm so glad that you're here if you're new. But people are not leaving five-star reviews. A lot of people listen and very, very few leave reviews. Reviews help our show look not only more credible to potential guests, but it helps move the show up in the podcast charts when a whole

bunch of people leave them at the same time so that new listeners can discover the spillover. The show is free. This is the one thing that I ask every week that you please take a minute to support us and do. You can pause the show right now and we'll be right here. Look, I'll wait. If you want to watch me with my guest this week, subscribe to Real Alex Clarke on YouTube. Thumbs up the video there. The sweatshirt, by the way, that you'll see that I'm wearing with the guest in the actual

interview is merch from a midwife named Callie. The sweatshirt says with women, not the system, and the back of it is super sick. It says birth belongs to women. This is not an ad, by the way. I just saw this merch, and I thought it was so amazing, and I bought it. I was not sent it for free. I just love the idea and the message behind what this midwife is doing. You can find all of her merch at birth belongs to women.com. Now, for the biggest homebirth episode ever, please welcome. Dr. Stu, fish vine to the spillover. Pregnancy is a normal function of the human body, so why do we treat it like a disease in America? That's the whole podcast.

Okay. Well, thanks for asking that, Alex, because we treat it like a disease for, because we have to go back to understanding how mammals give birth and where we deviated from that. So mammals give birth, if you've ever had, lived on a farm or, had a pet, you know that a mammal will give birth by going off quietly to a place where it feels safe and undisturbed and unobserved. Really important terminology. Sarah Buckley from Australia is the one that sort of codified those terms, safe, quiet, and unobserved. And if they're hungry, they eat, amazing. If they're thirsty, they drink. If they're uncomfortable, they move. They roll, they get up,

they pace, they lie down, they do all these things. And that's how. they give birth. And when they're ready to give birth, the baby comes out in the dirt or the straw or the litter or the carpet or the grass or wherever they are. It's not a sterile procedure. Nobody rushes in to cut the cord. Nobody ever separates the mother from the baby. And this way nature ensures the best chance of survival. Because if labor is disturbed by a predator approaching or a forest fire or little kids running into the room when your cat is in labor. Labor, the mammal will put out adrenaline, adrenaline will stop labor. The mammal will get up, flee, the fight or flight response, but they're not going to fight.

They're going to flee. And only when it's quiet will they go back into labor again. And everybody knows this, because if you have your dog or cat in labor and little kids are making loud noises, what do you say to little kids? Leave the dog alone. That's what you say. Okay. So that's how nature designed it. And that's how human mammals did it for eons. Eons. Somewhere in the last few centuries, it started to become medicalized.

And I don't believe, I'd like to give them the credit that they thought they were doing good. But the more I look back into history, the more I realize it probably wasn't that. It was probably about control. Was it control or money? I don't think it was money way back, you know, 100, 200 years ago. It was about controlling things because midwives had always been the torchbearers of the profession. And then suddenly doctors came in and said midwives are bad, midwives are witches. Are they actually saying midwives were witches? Oh sure. Midwives were burned.

What? Yeah. Like Salem Witch trials burned? Yes. I've never heard that. Yes. Why? Because they were a threat to the establishment.

So what happened was that men. started to take over the birthing world. And they began by first vilifying midwives and then by secondly subjugating women. This was an all, you know, I'm not an expert in the psychology of why this went on, but, you know, think back in history of how women were sort of dehumanized. They were, lester's couldn't vote. They had to wear crazy clothes. They didn't, their voices didn't matter. They were, they were subjugated. And so, this was a process that men wanted to take over and control. And gradually over time, it went from being something that was potentially a suggestion

to being something that started to be made into laws and guidelines and rules. And then the hospitals came in and they took it in from the hospital. In 1920 in the United States, about 100% of, 99% of women were born at home. By 1950, 99% of women were born in the hospital. So during that 30-year period of time, there was an active campaign to take women's health care into the medicalized world and make it their domain. And it was the 50s where we were also really promoting formula and stuff, right? Yeah. I mean, just everything was done.

It was, they had twilight sleep. I was born with my mother, put to sleep with ether. and I was pulled out with forceps. And that was considered the normal thing to do in the 1950s. And it's become more and more medicalized since that time. So we've lost the ability or we've lost the way to think about birth like our dog does or our horse does or a deer does. And we think it's a medical problem.

And we've had now three or four generations of American women who have been indoctrinated to believe that birth is, something to be feared. And fear is the greatest controller of your emotions and your actions. We've all seen that recently as well. And to take a line from the Batman Begins movie, you always fear what you don't understand. And my colleagues, current obstetricians, do not understand birth. And I don't say that with hatred or, you know, demeaning this. I'm just telling it's the truth. They don't understand it.

They think of birth as a medical problem because they're taught that way. And when you're taught that way, it takes a very independent thinker to survive four years of medical school and four years of residency and then come out and generally now getting a job working for a corporation that tells you how to practice medicine, what you can prescribe, how many minutes you have for an obstetrical visit, what's in the formulary, what surgeries you can do. so the doctor has very little power anymore.

And so that doctor, if he speaks up, if he says, no, I'm not going to induce this woman at 39 weeks because I don't think it's necessary. He may get yelled at. And if he says, no, I'm not going to give this woman these three vaccines at 28 weeks. He may get yelled at and he may lose his Christmas bonus. So we ended up now with a system of tyrannical rules that make no sense. And the reason I say they make no sense is because look at the outcomes. Look where we're at now.

Well, this is what's crazy is so this is where you're at now. But you're a board certified OBGYN. You worked at Cedar Sinai for many years. At first, you actually thought home birth was stupid. Yes. Why? Well, because I went through that system. You know, it's interesting.

I go back to when I was a little kid and I used to be that little annoying kid that would say, my mom would say do this and I would say, why? And then she would say because this and I would say, well, why? That doesn't make sense. Why? And eventually she'd get to the point where she's exasperated and she says what all parents say. Because I said so. You've heard me say this before, right.

Because I said so. Well, because I said so doesn't sit well with me then and it doesn't sit with me well now. And that's the problem is that I came through residency thinking that, you know, I was a great, you know, Cedar Sinai is probably one of the best programs in West Coast. I mean, that's where like every Hollywood celebrity has their baby. That doesn't make any. Yeah. But that's not why they were good. They have a good reputation and they deserve it for many, many things.

But they also have fallen into the trap of medicalizing birth beyond belief. But the idea that the people who go through that program can come out and then try to do something different, and it's very difficult these days. However, I began to see things even when I was a resident that made no sense to me. Like what? Well, for instance, immediate cord clamping, why are we doing that?

Why am I walking the baby over to the warmer? Why am I taking the baby? I mean, I'm doing everything antithetical to what I just decided, just to describe to you was what mammals do. A simple thing that I remember very clearly was when I was chief resident, And every single woman had a postpartum order for a CBC, which is a complete blood count on the first postpartum day.

Every single mom got that. When I became chief, I stopped doing that. And the first time that that happened, the attending was doing rounds with us and was asking my intern what her hemacolum was. And the intern goes, I don't know. And the attending taken aback is, why don't you know? And then he says, well, because we didn't check it. And then he goes, why didn't you check it? And by this point, the entrance is looking at me because I'm the chief.

And I said, because she doesn't need it. Why are we drawing a CBC? It's an invasive test. It hurts. You know, the hospital makes $87 on it. I understand that. But she's ambulatory. She's making urine.

She's not dizzy. So whether her hemoglobin is 7, 8, 9, 10, 11, or 12, it doesn't really matter. We're not going to transfuse her. We're not going to change our management. I had a very wise lab medicine teacher in medical school who said, only order a lab test if the result will possibly change your management. And there was no reason to do that. But the hospital wanted to do it because it was something they've always done.

It's like the long habit of not thinking something wrong gives it the superficial appearance of being right. And so what happened was, is that, and they also made $87 from doing it. Yeah. And if you notice that everything that's done at the hospital, from the moment you walk in the door, to the moment you put your baby in the car seat to drive home, not only is the antithetical to nature's design. They charge you? They charge you for it.

Everything has a charge for it. You don't get paid for doing nothing. So the hospital almost never does nothing. It could be as simple as peeing in a cup and sending a urine down when you walk into the hospital. Why? I'm not complaining of urinary tract symptoms. Why are you sending a UA to the lab? So what were your assumptions on homebirth when you first became an OBGAN?

And like, were you thinking this is unsafe? I don't remember thinking that it was unsafe because I trusted the midwives that I was dealing with. But I just, again, I was trained in that idea that, well, God, I have an anesthesiologist in the, you know, I have a NICU team that if I need them and stuff like that. So again, if you only see one way of doing things. Is it like looking at it through a lens of fear? Of course it is. That's what you're trained. I was talking to one of your guys beforehand who's thinking maybe you'll have a baby in here or two.

And he's something, what happens if something goes wrong? and the idea is that that's the model that has to be changed. That's the thought process that has to be changed. Labor and delivering, growing a baby, laboring, delivering a baby is a normal function of a woman's body. It's designed to do that. And if left alone, it does it right most of the time. And I'll get to what happens when it doesn't.

But it's very similar to breathing or digestion. These are primitive brain functions. You don't think about breathing. You don't think about digestion. you don't think about the growing a baby inside other than loving it, but it grows whether you think about it or not. If you're worried the entire time, and if you're fearful the entire time,

not only are you less likely to have a smooth pregnancy and a smooth labor, you're more likely to have a dysfunctional labor, but you're also bathing your baby in all these negative, fearful hormones, the entire pregnancy, adrenaline, cortisol. You should be bathing your baby in oxygen. and endorphins and laughter and love. And the way the medical model indoctrinates women and keeps them subservient

is to make them scared from the very first day they walk in. Yeah. This took a period of years to go from supporting midwives, taking their transports from home, which I did only because I wanted to make money. I didn't do it because I thought homebirth was a good idea. Oh, and I forgot to mention, by the way, that when I was a resident at Cedars, I also got very well trained because it was a different era then.

And that's where I learned my skills in breach and twin delivery was at L.A. County, USC, which was in those days the busiest hospital in the country doing about 22,000 births a year there, which is 65 babies a day. So we got a lot of training. And that went on. But when Midwai started to bring their patients to me, I would have plenty of time to sit and chat with them. And I began to hear a different way of doing things.

And it made a lot of sense to my why brain, you know, that, that, well, why? And then they gave me an answer. They said, because if you leave birth alone, things rarely go wrong suddenly. And since midwives are really experts in normal birthing and doctors are experts in problems and surgical birth. And since about 85% of women, don't have any problems, the actual experts for pregnant women are not obstetricians. They're midwives. And since midwives, as I said, are experts in normal, they're very quick to recognize abnormal.

It's like if you live in the same house all the time and you come home from dinner one night and you open the front door in the chair in the front hall has moved three inches from where it normally is, you know that just like that. You may not know why, but you know something isn't right. Yeah. It's the same thing with a midwife and a normal labor. They sense that. And they want the best for their clients. They're not going to do stupid stuff. Are there bad practitioners in all fields? Yeah, of course there are.

What are current OBGYNs being trained in a medical school that you think is wrong? They don't like nature's chaos. So they'll substitute their own interventions to prevent nature's chaos causing all kinds of chaos. But they're okay with that because it's their chaos. Should women start learning about birth before or after they find out they're pregnant? Oh, before. That's a no-brainer. They should be teaching that in junior high school and high school.

If you could teach them, but the problem is, Alex is who's teaching them? Yeah. If you're being taught by somebody who's scared about birth, then you're going to be scared about birth. And if you teach them that birth is a normal process that occasionally goes wrong. and when it goes wrong, again, as I said, it doesn't usually go suddenly wrong. I mean, think about this. 50 years ago, 1970, the C-section rate in the United States was 5%. All right.

Now it's 32% or around there. So that's about a 500% increase in the rate of Cesarian section. If we could say, okay, there's a bit of commensurate decrease in the rate of cerebral palsy or the rate of hypoxic ischemic encephalopathy or the rate of neonatal death, we could say, okay, so it's a trade-off. We're trading off this interventions and all these higher C-section rates,

but we're getting better outcomes. But we're not getting better outcomes. And this is where it gets really screwy. Because we've doubled the induction rate in the last 20 years. We've quintupled the C-section rate in the last 50 years, and our outcomes are no better.

So what are we doing? why are, why are doctors still supporting a system that has failed? Okay. For those of us who have absolutely never been around anybody who's given birth, let's just pretend somebody's listening to this and they're 19, they're like, I don't know anything about pregnancy or whatever. Can you explain like they're five? What is Adula?

What is a midwife? What is an OBGYN? Sure. The differences. Okay. Adula is a non-medical support person. they are vital when your support system is shaky at best because they are well versed in your options and so they help guide you to choices because if you go to a midwife or if you go to an

OBGYN you may be given skewed informed consent you may be given information to funnel you down a path that that practitioner wants you to take and a doula's job is not only just loving and nurturing and supporting when you're in labor, but also to help you find the right information so that you can then ask the proper questions. And you can find whether there's some red flags with your practitioner that say, hey, this is not the right practitioner for you. A midwife is a person who's trained either in the apprentice model or through academic models, depending on there's different types of midwives. There's licensed midwives, there's certified nurse midwives, certified professional midwives. There's no such thing as a lay midwife, but there's traditional midwives who are taught in

in different manners. And every state has its laws which allow certain midwives to practice, other midwives not to practice. So everybody's going to have to listen and it's going to have to figure out what's going on in their own state. But a midwife is trained in traditional model

of birth as wellness. Midwives respect the birth process. They accept uncertainty. And they do their best to support a woman's natural bodily functions. only interjecting when they feel that it's necessary because they love the informed consent model. They love giving people information

and letting families decide which way they want to go. And so they're very supportive of that. Plus, the model allows them a lot of time at each prenatal visit to inform them, to nurture them, to ask them questions about nutrition, ask them questions about stress reduction, how's your relationship, how are your family members basing your decision, who are you, you know, who's involved in your birth, how does your birth look to you? These are questions that an obstetrician just doesn't have the

time to deal with because the model by which obstetricians practice is much more business-like. Like how many patients you can see in a day? Right, because the reimbursement is so poor, they're involved with insurance and they've got overhead that's massive to run an office, and they've got hospitals that restrict what they're allowed to do. And so they've got a lot of masters. Midwives have lesser masters. Doolers have even fewer masters. And so the difference between a midwife, as I just described,

and an obstetrician, an obstetrician sees birth as a medical problem. I'll give you an example of, I've said this before. People have heard me say this, but it's a great example of how indoctrinated you become. So I've been practicing home birthing for over 10 years, and I've been in medicine for over 35 years when this happened to me. A woman comes in for a first prenatal visit with me. In the midwifery model, we've got an hour visit. She's sitting on the couch.

I'm sitting in my chair, just like here. And we're talking. And the way you take a history is you ask them about their current reason they're there, and you go through that information. And then you ask them about medications and allergies, past medical history, past surgical history, reviewist systems, family history. and that's sort of how history taking is done. So when I got to pass medical history,

just rolled off my tongue, I said, so do you have any other medical problems? And she looked at me and she goes, what's the first one? And then I realized that I'd been considering pregnancy to be the first medical problem, even after 30-some years of practicing a different style of medicine

because it was so indoctrinated to me. And I've not made that mistake before. It still slips out once in a while, but I try not to make that mistake. I try to be aware of the fact that pregnancy is not a medical problem. Yet doctors see it as such. And doctors want to control you because they don't like things going wrong. There's shame in it.

There's ego. There's liability. There's fear. So doctors have, fear has crept into the obstetric model of care far more so than the midwifery model of care and the Dula model and the Dula assistant model. that you asked about. So fear drives everything. Yeah. And when and and and and so obstetricians want to intervene, they they plant seeds of doubt from the very beginning. Oh, you're over 35. We're going to have to do this later on. Oh, your stomach isn't growing as well. Oh, your husband is six foot five.

You're only five foot two. There's no way that baby's going to fit out. And you're telling these women this at 10 weeks pregnant. So I liken it to the scene in, um, uh, inception where they were trying to figure out how to plant an idea in somebody's head. And you said, you can't just say it, you know, because I'll tell you, don't think about elephants. And of course, what do you think about elephants? Yeah. So don't worry about the fact that your husband's six foot five and your five foot two, or don't worry about the fact you're over 35, you know, but it's a problem.

So what's she thinking about? Or a woman gets an ultrasound at 20 weeks and they find that the baby looks perfect. But they find a little calcification in the heart that doesn't mean absolutely, it means absolutely nothing. And everyone knows it means absolutely nothing. doctor says to her, this doesn't mean anything in the face of everything else being normal and your genetic screening being normal, but I want to see you back in six weeks just to check it out. So what's the woman thinking about for six weeks?

That there's something wrong with the baby's heart. Yeah. Right. It doesn't matter that they said it isn't. So this is how they, this is the medical model. It just talks differently. It walks differently. It sees pregnancy through a prism of fear.

The midwifery model sees it through a prism of normal. I didn't know any of this when I came out because we're not taught this in residency. There's very little collaboration. And again, I'm not speaking about all programs, but there's very little collaboration between the midwifery model and the obstetric model in training. And if you don't learn something in training

and you come out of your residency and you get a job working for Kaiser in Southern California and you're getting paid a salary, you're working a shift, you're never going to pick up any new job. anything new. You are, you are stuck in that hamster wheel for the rest of your life. So many things, doctors that have a god complex and think that mothers do not know best, our intuition is worthless, and also sick of being diligent about using the same skin care routine

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go to Nemeyskine-Skincare.com to learn more and get 10% off with code Alex Clark. That's N-I-M-I-Skincare.com with code Alex Clark for 10% off or find a link in the show notes. Okay, so let's talk about the pros and cons of these three models of places to give birth, a hospital, a birthing center, and a home birth. Pros and cons of each. Okay. Which one do you want me to start with? Let's start with pros and cons of a birthing center. Okay. A birthing center is essentially like having a home birth in someone else's home. So it's a good intermediary between home and hospital birth for those people who don't

think their home is conducive to a home birth. What is a home that's not conducive to a home birth? You may be living with your in-laws. Oh, okay. In a two-bedroom apartment. Yeah, yeah. bedroom apartment or you may have you know five other kids or or whatever there may be thin walls or you may be in a location that is far from emergency help that sort of thing so you may say you know

I live like in where I where I was practicing there are people that lived in what we call deep Topanga canyon okay like 45 minutes to an hour up in up windy roads at night and and maybe that wasn't the best place for them to give birth although a lot of women did so they chose to so you come down into town and give birth at a birth center. Okay, so that was actually a question I was going to ask later, but it just fits right here. So I'll just ask it here then. So where's the cutoff for when somebody should be disqualified

from choosing home birth because of how far they are from a hospital? There is no cutoff for that. It's ultimately the decision that the family has to make and the practitioner has to be comfortable with. Okay. So in some cases, there will be a practitioner who will be comfortable. I drove all over Southern California because I was the only, when offering the kind of things that I was offering.

But some midwives don't want to travel more than 30 minutes or 45 minutes. Other midwives are going to travel a lot longer. So you need to find the right fit for you. And then if you don't have the option and you still think that home birth is what you want, then the other choice that you didn't really get into was like, well, free birth. Okay. When I think free birth, I'm like giving birth in my yard by a tree, crazy, no midwife, just it's you. It doesn't have to be in your yard.

by a tree. But yeah, it's in your, it's by you and your partner or your mother or your family members. I mean, that is the most radical to me. Yeah, but sometimes it's the only choice women are women are given because of the way laws are in certain states and the restrictions that are put on on midwives or doctors to do to help you. Home birthing is where you're in your own home, properly selected, and that's again, having midwifery care, midwife's going to let you know what she thinks about your medical situation, if you have one, and whether that is a contraindication. Most of the time it's not.

And things that were standardly thought as contraindications really are not, and it gets back to rethinking how we look at birth. You know, if somebody is hypothyroid, if somebody is diabetic, if somebody's hyper-tent, oh, my God, they're high risk, they're high risk, the high risk. You know what? Higher risk does not mean high risk. And not every diabetic is the same. Not every hypertensive is the same. The beauty of the Midwifery model is that they can individualize your care. Some diabetics definitely need to be born in a hospital setting where they have IVs and NICUs and stuff like that around. Other diabetics who are really well controlled, who have implants, you look at their phone and tell you what their blood sugar is in real time.

And they don't necessarily need to, why does their labor need to? to be induced and why do they have to be medicalized and why does their baby have to go to the NICU because there's a standard policy at the hospital that every baby that's born to that's called an infant of a diabetic mother needs to be observed in the NICU for several hours. The worst thing that you can do to a newborn baby born from a diabetic mother is separate that baby from the mother. Because the mother's skin to skin will often regulate their temperature, their breathing, their blood sugar, among other things.

And so that's one of the other dumb things that hospitals do is they immediately separate the baby from the mother, even in the standard delivery room. They take them over to the warmer instead of skin to skin. That's changing. I was preparing for this episode, I've never asked my mom details about my birth story before, but preparing for this episode, I was curious.

So I asked her, you know, what would you change if you could go back? What did you not like? And I was a C-section baby, born in hospital, obviously. And she said that they took me away and she had no idea for three to four hours before she got to hold me. Like, they just took me. And then she said, I don't know. You were just gone. And then it took a really long time for you to come back.

And they never told me why they did that. And if you asked them why they did that, the answer would be, well, that's how we do it. Yeah. They don't even know. They don't even know. They do it because they've been doing it that way for a really long time. They will, that's what the nurse will say is they'll say, well, I have to dry the baby off. Well, why?

Well, I have to check the baby. out. Well, check the baby out here. Well, we have to give the baby it's eye goop. No, we don't want the baby to have eye go. Yeah, that's a good point. When I look at videos of people that are doing home births, after the baby is born, mom is immediately holding the baby and the midwife is doing like checks on the baby as the baby is on the mother. And the checks are very soft and very subtle. It might be a stethoscope. It might be just putting a warm blanket over the top of them. But it's never wrapping the baby up like a burrito and handing the baby to the mother. I mean, that's one of the, another thing that everybody thinks is so cute. Oh, look at the baby with a burrito and a hat on. It's stupid. Wait, is it bad to do?

Yes. Why? Because babies, babies need to move. Babies need to feel their mother. They need to be skin to skin. They need to be getting colonized by their mother or their father's microbiome, the bacteria that live on their mother and father. What your first colonized with sets you up, possibly for life in your gut and your respiratory tract, bacteria flora. I mean, this is well-known stuff now. The microbiome is not a secret anymore. This is a weird question that I just thought of as you said that. When a woman is giving birth, is it good for her to not have any, like,

scented body wash or things that are on her skin then for anticipating the baby being on her for the first time? Like, should she be completely all-natural? Ideally, yeah, she should not have be totally showered with soap and water and stuff like that. She should be in the same condition that she's been in laboring in. She can be in the shower, but you don't really need soap and if you're sweaty or you've got a little bit of bucconium on you or a little bit of blood on you. That's great. Is makeup good or bad?

That I don't know. Okay. It's just a preference thing, but nothing crazy that you know. Yeah, I mean, I haven't seen too many women who've done homebursts who are bothered by whether they have. makeup. I have seen it for for C-section moms though. Right. Okay. So we did pros and cons of birthing center. Pros and cons of homebirth. More or less we've done the, oh well and again, beauty of homebirth really is that you never have to get in your car. You're in your own home where you feel most comfortable. Own bed. Yeah, it's just it's where you feel safe. Who doesn't feel

safe in their own house? Your own rules. Your own rules. You invite the people that you want there and only the people that you want there. There's not people walking in the strangers and other people. You can each, yeah, as you said, you have your own food. You have your own shower. You have your own bed. It's just a comfortable place to be. And then after it's all over, you just, whether you delivered in the tub or on the floor or in the bed, you just curl up in bed. You don't have to get in the car. You don't put your baby in the car seat. What about pros of hospital birth? Pros of hospital birth. Well, okay. So if you need, if you have a condition that we requires medical attention.

Which, in your opinion, what are the only conditions that you need to give birth in a hospital for? Well, prior to labor, things like placenta previa would be one where you can't deliver that baby outside. The mother and baby could both potentially die. And then obviously severe preeclampsia, diabetes out of control, prematurity, significant prematurity. like 28, 29, 30 weeks. If you're, again, if you're 35, 36 weeks, you could give birth at home,

except the laws make it very difficult for midwives to help. But there's no reason that that baby can't be born at home because that baby, the mom should be able to get the birth she wants and spend some time with her baby. And if that baby ends up having a little bit of respiratory difficulty, because it's born a little bit prematurely, that's rarely something that requires immediate attention with intubation from a NICU team.

It's something where, you know, an hour after birth, the baby's still breathing a little fast, and maybe it's desaturating. It's O2, it's oxygen a little bit. So, okay, at that point, you say, you know, I think we need to take the baby the hospital. But the baby got colonized with mom's bacteria. The mom got the beautiful birth in her home, beautiful memory. She got to have the people around her that supported. So that's home birth.

So hospital birth has its place. And certainly for a woman that is in labor that develops a fever, that develops a need for pain relief, that develops high blood pressure or has some medical problem like a seizure or something. Yeah, then being in the hospital or transporting to the hospital makes a lot of sense. But there are very few things that happen at home

when you're not meddling with mother nature, when you're not immobilizing a woman, starving a woman, hyper-stimulating her with pitocin, interrupting her all the time. Those sort of things don't happen at home. So you rarely see that sudden deterioration of fetal status that you often see in the hospital

where they say, thank God you were in the hospital. They do an emergency C-section on you and then they say, thank God you were here because what would have happened if this had happened at home, not realizing because they don't understand home birth that these things almost never happen at home to the frequency that they happen in the hospital. there are so many babies in the hospital that are delivered by cesarean section.

Probably half of all cesarean sections, if not more, are unnecessary. They're atrogenically induced. Then why are we doing that? Money, fear. It's all they know. So that's what they do. I mean, how can anybody think with an open mind that three out of every 10 women can't deliver their baby as nature design? So the C-section rate in the United States is about 30-plus.

percent. Let's just say 30 percent for easy math. The World Health Organization, which is not an organization that I have much respect for, but in numbers like this, they say in Western countries, the C-section rate should be no more than 10 to 15 percent. So let's say 15 percent, because you can see where I'm going with the math here. So it should be 15 percent, it's 30 percent. So that means that half of all C-sections being done are probably unnecessary. In the United States every year, there's about 1.2 million Cessarian sections being done. It's by far the most common operation being performed in the United States, if you trust what the World Health Organization is telling you,

and I do because I know the C-section rate 50 years ago was 5%. So let's say it should be 15%. That means that 600,000 unnecessary C-sections are being done every year in the United States. If there were 600,000 unnecessary knee surgeries or mastectomies or tonsillectomies, not only would people be outraged, but insurance companies would be outraged

because they're paying for this sort of thing. But not a peep about 600,000 unnecessary cesarean sections. Why? What's it going to take? It's going to take women waking up and asking. But let me make the final point of this is here's where cognitive dissonance comes in. Because ask yourself if there's this many unnecessary cesarean sections, who's doing them? Because no doctor goes home at night and says to their spouse, hey, honey, guess what? I did two unnecessary c-sections.

Every C-section a doctor does, he or she thinks is necessary, yet half are unnecessary. So this is the classic definition of cognitive dissonance. they have to blame it on the other guy. But what's the other guy doing? He's blaming on him. They're all passing the blame, yet 600,000 women a year in the United States, are having unnecessary surgery, which puts them at risk, their baby at risk, and all their future babies at risk.

If the majority of women stood up and say, I'm not doing this anymore, I want to give birth at home or a birthing center, but I want to go to the midwifery model. Would hospitals have to face the music and be like, all right, we got to fix the C-section thing because women don't want to give birth here anymore. In my opinion, the hospital model is not fixable. It's not like something we can revamp. It needs to be discarded and thrown out. Kind of like the FBI or the thing.

Here's the question that my audience wants me to ask you. Okay. Is it possible to give birth in a hospital and be able to give birth in any position you want, if you want to have zero interventions? Yes. Okay. Any hospital you can do that in. People don't know it, though, because the hospital doesn't tell you that you can do those things.

The hospital makes it difficult to do those things. But this gets back to informed consent and the right of informed refusal. And the right of the fact that you have huge amount of rights that you don't know about because your doctor or your hospital don't tell you about them. And every organization, none of which I have much respect for anymore, the American Medical Association, the American College of OBGYN, the American Academy, Pediatrics. They all have their codes of ethics. And if you search them, I have them on my website,

but if you search them, you'll find that they all, they imply so many things like the use of coercion is never acceptable. That includes the threat of child protective services, never acceptable. That given the same information, it's an ethical tenant that says two people given the same information, it should not be assumed that both will come to the same conclusion. But yet, in counseling people, they want everyone to go down the path that they're telling them. But that's not ethical.

They violate ethics every single day in every doctor's office, in every hospital. It's done not necessarily with malice, but it's done purposely to get you to do, to become a good patient, to do what they want you to do, to follow the path. and the reasons are, again, fear, legalities, money. That's it. That system is completely broken. But you have the right in the hospital to say no. No, I do not want to be monitored continuously.

No, I'm going to eat my food. If all you're offering me is a popsicle, honey, can you open up the cooler and, you know, take out the yogurt, take out the honey? Let me tell you. I wouldn't be eating hospital food anyway. I'd be bringing my own. Right. And we tell people that.

Yeah. Oh, good. Okay, do you agree or disagree with certain laws in different states stating that the midwife can't be the exclusive attendant for a twin or breach birth? Do I agree with that? Yeah. No. So you think she can be the exclusive attendant in those situations sometimes? Yes.

It doesn't require somebody with an MD degree to be a good twin practitioner. It requires somebody with skill. and midwives are probably in some ways more skilled in things vaginal than obstetricians are. I keep hearing this statistic that half of home births end up in the hospital, so we should just give birth in a hospital. No, the transport rate for most midwives in first-time mothers, which we call primips, is probably somewhere between 10 and 20 percent. and almost none of those are emergent.

They're almost all get in the car, drive to the hospital because you're exhausted or your labor's petered out or... Okay, good. I have a lot of questions about the exhaustion component of homebirth. Before we get that. And with multips, which are women that have had at least one vaginal delivery before, the transfer rate from home is probably about 1 or 2%. The success rate with multiparous women, women having their second and fourth baby, in home birth with a trained midwife properly selected is extremely high.

And if you took the same cohort of those women and had them birth in the hospital, their success rates would be much lower. How do you know if a study is a real or fake study when it comes to birth? This is a good one. First of all, to look at a study, you cannot just read the abstract and the conclusions. You have to look at the material and method section, which is the dry, boring part of a page. that no one really wants to read, but that's the meat. And that tells you whether the study is underpowered or is well done or whatever.

Also, you have to look at who's publishing the study and who is paid for the study. You have to look at those things. I might get in trouble for this, but if I see a study that's paid for by the Gates Foundation, I automatically assume that that study is false. Yeah. Okay. So if I see a study that's paid for by Big Pharma, I'm very skeptical. And most journals are beholden to Big Pharma because their main advertiser is Big Pharma in any journal. So that's one of the things I know from trying to publish articles myself is that if you're not mainstream, if you're

publishing something that's outside of what traditional medicine, I mean, I could use that term, but because that's a mixture of term, but medicalized medicine wants, the likelihood of you getting something published or even something through peer review is almost impossible. I look at some papers that got... They're gatekeeping information from us.

And I look at some papers that have been put out, like the arrived trial or like the term breach trial, and you wonder, you know, they're so flawed, they, you know, they're... People look at them critically after they're out and they've done the damage. And they find there's so many flaws in there. and you ask, you scratch your head and said,

how did that get through peer review? And the reason it got through peer review is because it was published by people who wanted that result out there. The people that in the medical model wanted the arrived trial out there. So it got published, whereas there were many studies that showed

that inducing everyone at 39 weeks, which is what the arrived trial was all about, that didn't have good results or better results. And even the results in the arrived trial weren't anything to shout about. But those were just ignored. It's the same thing with the term breach trial, which is the one trial that said C-section

should be done for all breaches when all kinds of papers were coming out before and certainly large ones after that have shown that it's the opposite, that breach birth vaginally really no different for the outcomes for the babies and better for the mothers vaginally, and those are ignored.

So when I determine, and the one thing that I also use to determine whether a good paper is someone making money off the paper. If I write a paper that says do less, I would trust that paper than a paper that comes out and says, do more. Right. And that's just my bias over all the years of taking deep dives. And because of the podcast that I do, Bliss makes me take deep dives into all kinds of topics.

And I've done some dives into vaccines and I've done some dives into recommendations that ACOG has and looked at them very in depth. and ACOG freely admits that two-thirds of their clinical guidelines that are put out that become adopted by hospital risk managers and all that stuff are based on consensus opinion. They're not based on any science. It's called Level C evidence. And level C evidence is based on the opinion of a bunch of academicians.

Well, what do you think? Well, they're against home birth. Well, duh, you got five or six guys, or I don't know how many guys. You got them sitting in a room and they all think like maternal fetal medicine specialists do, and they say, let's put out a guideline against home birth. And they go, yeah, that's a good idea. Nobody, there's no dissenters in there.

Were there any people like me or midwives or anybody that they talk to? No. Does the way a baby is born vaginally versus C-section, for example, have any impact on how a baby will turn out? Of course. How so? Well, we're learning more and more about that, but I think it's been known for a long time and just not really publicized very well.

but a baby that is born by cesarean section without labor. So what we call the pre-labor scheduled cesarean section, those babies are more likely to have problems later in life. Things like childhood asthma, autoimmune disorders, adult onset diabetes. Now, again, I'm not talking about very large increases, like a 21% increase or a 23% increase. But that, and that's where to get into the, numbers game where you can use numbers to make something seem really impressive or not impressive

depending how you do it. But nonetheless, there's increased risks of those things. We know it affects the microbiome. We know that the microbiome and what you're colonized with affects your immune system. It affects you for for years, if not your entire life, getting corrected. We have we have 54% if I've got the number correct of now children having a chronic illness. Whereas in 1990 it was about, it was single digits. So in the last 30 years, we've seen a rise, a five-fold rise in the rate of chronic diseases in children. Now, what's happened in those last 30 years? Well, there's a lot of things that have happened. The C-section rate has risen dramatically. Industrialized food. Industrialized food. Food die. 5G. The vaccine schedule has exploded. All those things are happening, but it should be

really concerning to us that we have more than half of all children have some sort of chronic disease. Now, what does that mean chronic disease? Well, it means anything from like maybe mild eczema all the way to autism or, you know, some diabetes or some other major problem. But nonetheless, 50 plus percent of children with a problem like that, where's the research looking into it? I mean, sometimes I wonder about research because a research is funded by the people that have the money.

And if there's no reason, if they don't want to find an answer, they're not going to do the research. But research, you don't need research to dictate you. Or they're going to. make the research prove whatever answer they want. Exactly. And so here's a good tenant that I got from listening to Dennis Prager for all those years, but research either confirms what common sense would tell you or the research is wrong. Now people can laugh at that or whatever else, but think about it for a second. Do I need a study to tell me it's safer to cross the street when the light is green?

No. And if you got a study that said it's just as safe to cross when the light is red, would you believe it? No. So, because it defies common sense. Common sense is, you know, you're safer when the light is green. So basically you're saying, if you are a mom and you are trying to figure out your birth plan or where you want to give birth or whatever, if something immediately pulls you and it bumps for you and you're like, well, wait a minute, I don't know, something about this doesn't seem right. Even though a study is telling you otherwise, go, your instinct. Definitely go with your instinct. Trust your gut. You know, the most important thing that a woman can have, I think, during her pregnancy is trust in the people around her. Trust in your caregiver. One of the very important red flags that your listeners can can easily assess is when you get

pregnant and you're going to the doctor's office, you know, you're normally anxious. It's normal to be a little bit excited but anxious and scared, and you've got questions and stuff like that. So the question to ask yourself is, how did you feel when you leave the doctor's office? Do you feel better? Are you happy or do you feel worse? Do you feel like you were ignored

that your questions weren't answered? If that's the latter part, then run from that office. That's not the office for you. Just because that person you like that person, she's been doing your pap smear for 10 years, she's giving you birth control, now you're pregnant, you're going to go to her.

But you go in with pregnancy issues. You saw her for six minutes, and you felt like none of your questions were answered, and you felt more concerned because she said, you know, there's this ditzel on your blood test or there's dizzle on your ultrasound, and now we've got to look into that and stuff like that. And you start to feel more nervous about things, and you're leaving the office more nervous. Take that as a sign.

Don't accept that. Okay. Two quick questions before I get into audience sending questions, which are going to be the fun ones. Okay. What's the cost difference between home birth and a hospital? Not much. Okay.

It depends what part of the country you're in. Most midwives charge between $3,500 and $8,000 for globally for their home birth. It's money well spent. It's usually not covered by insurance. Most midwives will not take insurance because insurance doesn't pay for it. And if they did, they'd pay lousy for it. So, you know, you don't want to have third party. Middlemen are a problem.

Middlemen always make money for the middlemen and everybody else loses. Okay, well, perfect. That was my second question was, does insurance cover midwife care? Generally not. There are some, like the Christian ministries and stuff, that do, and they do it really well. So they're great. So if you're looking to get into insurance before you're pregnant and you can switch to health-sharing ministries, they're really good about covering home birth.

The cost of a hospital birth, even if you have insurance or if you have Medicaid, it's still going to cost you some stuff. And you're not going to save a lot of money because there's co-pays and deductibles and things like that. but also there's a there's a opportunity cost of missing out on the type of home birth you have and there's no money you can put on that and if you spend $6,000 out of pocket that you don't have and you put it on a credit card or instead of having a baby shower you ask your friends to donate money that's money that will be really well spent because two three years later you'll have the memory of the best possible memory of the birth that you could have even if you ended up having to be transferred to the hospital and you ended up with the cesarean section you know that you at least needed it and you'll and you'll have that confidence that you did it. And that will be with you for the rest of your life. Whereas the $6,000 a few years from now is like, it's gone. It's gone. Yeah. Okay. Are you ready for the fun part? This whole thing has been fun. I mean, I'm having, I'm enjoying this immensely, Alex. Oh, thank you. It's a comfort, you have a comfortable studio and you've got great people. And it's just a thrill for me to be able to

reach, you know, wide audience. So I'm really grateful for the opportunity to be invited here today. Well, my mom friends were more excited for me to tell them I was having you on than if I were to say Taylor Swift was coming on, I think. So they were ecstatic. I got some great questions. Some stuff I've never heard before. So we'll get into it. Yeah, yeah. You have smart mom friends. Have you heard the phrase everything in moderation before? Dumbest thing I've ever heard. Some things in moderation, sure. But other ingredients or chemicals should just be never, ever. We are totally overloading our bodies. with toxic sledge. If you eat one yellow food dye pickle, you spray one squirt of perfume, you light the candle, you use the dish soap, you wipe with forever chemical toilet paper, you drink the Coke, use one chlorine soap tampon every day. See, you see what I'm saying here, it all adds up very quickly. This isn't doing everything in moderation. These are chemicals that our bodies were never meant to handle. We've got to eliminate a lot more than we are. One of the

easiest areas to improve your health directly and our water supply, plus the health of others, is to switch out your toxic toilet paper with bum roll. I love that bum roll is premium echo-friendly toilet paper, 100% recycled, free of chlorine, free of perfumes, free of BPA, and free of plastic wrap. Bum roll toilet paper is made in the USA with U.S. and North American materials, and that's not all. For every box they sell, they also donate to plant a native tree in the USA. And as you know, Trees are the life source for us to breathe clean air since they absorb all the carbon in the air and release precious oxygen that we need every second of the day. Use coupon code Alex to get $3 off your first shipment by going to join bumroll.com.

That's coupon code Alex to get $3 off your first shipment by going to join bumroll. Switch out the toxic chemical laced toilet paper with bumroll. Find the link in the show notes. How much money does a hospital make off of a C-section versus vaginal birth? About two and a half times as much. Of a C-section? For a C-section. So if they make $8,000 off a vaginal birth, and again, what they bill and what they make are different because they're contracted,

then they're probably getting about $20,000 for a cesarean birth. So I would just say about two and a half times if I had to get a short answer. What can you tell us about potocin versus oxytocin and the issues with bonding with the baby because of potocin? I'm a believer that potocin is, even though it's a synthetic form of oxytocin, is not obviously the same as oxytocin. The potocin's only function really does two things. It causes the uterus to contract and may cause you to retain a little bit of water, which is part of what oxytocin does. However, I mean, pitocin, excuse me, oxytocin, however, does, makes the ears contract, helps milk let down. It is your love hormone.

It crosses the placenta and it probably gives the baby the same stimulus that it would give you. Your baby's connected to you. It knows there's mom. Mom's there. Which is why it bothers me terribly when a woman gets an epidural. her contraction space out, they start her on pitocin, and then now mom's acytocin is pretty much gone along with some of her other hormones that she signals to the baby,

and the baby is left alone. Now, does that happen every time you take an epidural or only at a certain time? I think it happens every time you take an epidural. Because, well, this is not going to be a short answer. This is going to be a little bit longer answer, but I'll try to shorten it. That's all right.

I think they know by now when I have a doctor, or something like that. You guys love to, you guys have longer answers, and that's all right. They want the knowledge. It gets back to, it gets back to,

I think of Karen's talk with you on her, Karen Welton on the pain free birth podcast you did with her. Why are, why is Labor have discomfort? I don't want to use the word pain, but it has discomfort. Why is that? You'd think if,

if it wasn't beneficial over eons, it would have evolved away because it certainly doesn't serve a mammal in the wild. the benefit of being in pain because they would cry out or they'd make noises, which would probably attract a predator, which would then natural selection would say mammals that have lots of pain would get eaten, and then there would be natural selection toward mammals with less pain. Over time, you'd think that labor pain would go away, but it doesn't.

It's still there. So maybe if we think in the natural way of thinking things, maybe it serves a function. And what would that function be? well, every time that you have discomfort, your body puts out a chorus of hormones, things like adrenaline, which slows down your labor. You put out cortisol, which helps you deal with stress. You put out endorphins, which are your body's own opiates. You put out oxytocin, which is making you contract. They help you cope with that contraction until the next one comes. But those hormones all cross the placenta because when you're contracting, the baby's world is suddenly changing.

The baby has been living inside of you for nine months. They don't see light yet, but they've been living inside of you nine months and suddenly their world is starting to squish a little bit. And then ope the water breaks and now my head is getting squished. But every three minutes, they're getting a waft of mom's oxytocin, mom's adrenaline, mom's endorphins, mom's cortisol. So they're communicating. There's this beautiful symphony going on between baby and mom from the moment of conception. They're passing things back and forth. When a woman gets an epidural, pain is gone.

All of those things are cut off. The baby is left to deal with contractions now without mom. Ooh. And it's not uncommon to see after you get a woman gets an epidural, it's not uncommon to see the baby's heart rate change a little bit to go down. And then over time, eventually the heart rate starts to rise. and you start to see maybe some decels. And then they say, oh, gosh, your baby isn't tolerating labor.

Well, we better do a C-section. And they do a C-section. And they get a baby that comes out that's actually perfectly fine. It comes out with Apgars of 9 and 9. Okay, so wait, let me clarify with you. So what you're saying is when a woman gets an epidural, until the epidural is there, baby feels mom. And it's like, mom's here, mom's here.

As soon as she takes that epidural, they're like, where'd mom go? Yes. It's a theory. I don't know how you prove it. You can't survey babies when they come out and ask the question. Oh, the microphone. Excuse me, sir. It'd be cute to do that. But it makes, if you trust nature's design, every time you mess with nature's design,

you cause ripple effects. And a tenant, a real tenant of health care and medicine is that anytime you mess with something that nature has designed, the burden of proof is on the intervention that it is safe and effective, hey, those terms of. But that's not what happens. They come out with things. Let's try this. Like GMOs.

Yeah. Or fetal monitoring. I mean, whatever. They'll try something that without any proof of benefit and they'll do it anyway. And then if the outcomes don't come out right, they don't ever look back at themselves and say, boy, that was pretty stupid. I mean, one of the main reasons we have this rise in C-section rate has been fetal monitoring. It's never been proven to do anything that it said it was supposed to do. It was never tested.

It was immediately accepted in the late 60s, I believe. it was. And that's about the time that the C-section rate began to rise. It was because now they're seeing these things on the monitor and nobody really knew how to interpret them, but they're making the doctors nervous because the doctors and nurses live in a fear-based world, and they don't want to get sued. And so they're seeing these little things and make them uncomfortable. Let's just get the baby in the bassinet. Because once the baby's in the bassinet, it's not our problem anymore. If you've had a C-section but you want to have a home birth for your next child, how much time needs to have passed? Well, looking at the data critically, if you have a C-section, I mean, if you get

pregnant again within six months of the delivery date of your first baby, then there's an increased risk of the scar separating, but that risk isn't as great as people think it is. It's still about less, about 1%, maybe 2%, which is not 20%, 30%, 40%, which is what you'll be told. But it's a higher risk. And again, higher risk does not mean high risk. You need to know what the numbers are. And so you have to do a deep dive. Other people say you need to wait 18 months or 24 months. The data doesn't support that.

The data supports that in first six months, there's a slightly increased risk. But after six months, the risk is so small, it's greater, but it's so small that is probably not relevant. And, of course, not everybody who has a C-section heals the same. So some people may along, and it's hard to know, which is why I think reasonably waiting six months makes good sense. But if you get pregnant at eight or nine months and your doctor says, well, you have to have a C-section because the pregnancy interval is too short, find another doctor. That doctor's not right for you. What are the negative outcomes that can happen if the placenta is covering the cervix? Well, if the placenta is truly covering the cervix at term, that is a potential emergency.

I mean, that isn't going to be an emergency. Because in order for the baby to get out, the placenta is going to have to be torn through, and that's going to cause bleeding, which the baby can lose blood, mom can lose blood. So that's truly what's called a placenta previa. But most placentas that are found to be low-lying or marginal previas at 20-week ultrasounds will not be so by 36 weeks. And you don't have to keep following it. You can just wait.

Unless you have an episode of bleeding where you need to come in and find out why, Why? If you have a 20-week ultrasound that shows that you have a marginal posterior placenta previa or a low-lying placenta, don't even pay attention to that. Because if you don't have any bleeding during the pregnancy, maybe get another scan just, you know, at 36 weeks just to confirm. But you'll find that it's actually nowhere near the cervix. 90 to 100% of those placentas are going to move. And they don't just crawl. They just recede and it's, and they grow toward the area of the fundal portion of the uterus, which has better blood supply. So if at term it's covering these cervix, that is a reason to have a cesarean section.

But you want to make sure that that's actually the diagnosis. And not just a low-lying placenta, not something that's two centimeters from the os. In those cases, those women should be allowed to be to labor. And again, that word allowed is something that comes out of my mouth. Sometimes I hate that. The woman should have labor. But maybe in a setting where they can do something if bleeding becomes heavy, and they can intervene.

But to schedule a C-section for a low-lying placenta is unnecessary. Okay. If a lot of time is passed and a woman is still in labor but she's barely dilated, what's your recommendation? It depends. Is she exhausted? If she's not exhausted, and she's at home. Is she at home or she's in the hospital?

I don't know. This is just the question of just like long labor where like nothing's happening. You've just been laboring for hours. I guess, yeah, like how do you speed it up or do you just wait or like what do you say to do? Well, in the home world, we would try to tell you to go back to go to sleep. We would try to give you something to help you sleep and just take some rest. We wouldn't want you to try to walk your baby out. You get exhausted doing that sort of thing.

At some point, if the labor's been going on for a couple of days, then there are certain things you could try to do at home. You could try to do a cervical sweep. You could try to give castor oil if the labor is petered out a little bit to try to speed things up. If the woman's exhausted and she's ready to throw in the towel, give up or if she's already at the hospital and it's been a really long time. Yeah, getting an epidural to give you some peace and rest, even though we just talked about downsides of epidural. Epidurals have good sides. Giving you an epidural, getting you some rest and then maybe starting

some augmentation with, if your contraction space out entirely with prostate gland and vaginally or possibly just potocin to get things to pick up again and give yourself more time. Yeah, so that's what happened with my mom and why I was a C-section. baby is that she was in labor for like 31 hours and was only two centimeters. So she was like, we have to do this action. I can't do this anymore. Yeah. And again, people get talked into that sort of thing. If she would have had a supportive team around her, they might have said, here, let's try this. Let's, you know, here you have a glass of wine. Go crawl in bed with your husband. Go to bed. Try to rest. If you can't rest, we'll try this. But if, and then that's the case.

31 hours is not necessarily, I mean, it sounds horrible, but it's not necessarily a really long time. Right. Is someone ever too old to have a home birth? No. Why do they say that? Because they have a fear-based model. The whole thing about age 35 is made up. What's the age of the oldest woman you've done a home birth with?

51, I think. No way. Oh, yeah. I didn't even know that was possible. Over 50? Yeah. Wait. Yeah.

This is like literally used to me. Yeah. She might have been IVF client, but once she got pregnant and she got to term, then her uterus worked just fine. And if it hadn't, then we, you know, if she labored and labor stalled out, then she would have gone in. I've never heard of any woman. But there's no reason to make this magical number of 35, which came from an era long

before ultrasound was even invented where the age 35 came into play. And it's been propagated. It's kind of like just somebody. saying something stupid and then people keep repeating it and repeating it and it becomes part of the language, even though it makes absolutely no sense. Are you telling me that someone who's 34 is fine, but someone who turns 35 is now not fine? Does that make any sense to anybody listening? No. And 36 and 3730. There are some things about as you get older, there's a slightly greater risk of genetic abnormalities, but those things nowadays are easily screened with the early blood test that you can do

at 10, 11, 12 weeks called NIPT testing, non-invasive prenatal testing. So if you rule out the genetic stuff, is there a slightly greater risk of preeclampsia? Yeah, is there a slightly greater risk of diabetes? Yeah. All right. But if it doesn't, you know, if it happens,

then you'll deal with it. But if it doesn't happen, why does that woman need to be frightened the whole time? And why does she need to be told, oh, she's over 35, your placenta's going to give out, your placenta will get old. You need to be induced at 39 weeks

or your baby will die. It's like, that is just, coercion of the worst type, as we talked about with the ethics issue, never acceptable. That's coming from a doctor who's fearful about pregnancy, and they're projecting their own anxieties onto the woman they care for, and that is something that we as professional should never do. We can go home and we can b-ch and moan, or we can go into the doctor's lounge and scream into a pillow, but we should not be vomiting our fear onto the women we care for. have a home birth if you go into labor before 37 weeks?

Depends what state you're in. Okay. And you can have a free birth at home and you could have a home birth with somebody like me because the laws don't apply to physicians, which is another dumb thing. You know, if I can do a home birth at 36 weeks, why can't a midwife do a home birth at 36 weeks? The rules that they made for midwives were made by doctors. How do we change these laws?

It's hard. It's hard. But again, it's a paternal. By way, when I say paternalistic, I don't necessarily mean male OBGYNs. Female OBGYNs can be just as paternalistic as male OBGYNs. But it's very paternalistic to think that OBGYN should be making rules for midwives because they believe that midwifery is a lesser subset of obstetrics. When midwifery is its own unique profession of taking care of normal, healthy women,

midwives should decide with the informed consent of the woman, whether she wants to stay home or not. The idea that some group of people in Sacramento or whatever state capital you're in are deciding what a licensed person can do is ridiculous. We go through all this training to come out and then to be told by people with business degrees how we're supposed to practice. What is the mortality rate for births at home versus hospitals? Both of them are very, very low.

I mean, again, you're comparing apples to oranges here. Hospitals obviously take care of a lot of sicker people. But the neonatal mortality rate in homebirth is extremely. I don't even know what the number is. It's below one-tenth of one percent. Okay. But it's, you know, it's going to be higher in hospitals, but that's not fair because, as I said,

hospitals are taking care of some of the real problems. if you if you compare equal cohorts of women, outcomes for women are better at home birth than hospital birth for women with the same demographics. This was an interesting question. The CDC says that black women are three times more likely to die during childbirth than white women. Are our hospitals racist?

Yes. What's going on there? It's not like somebody comes in and goes, oh, there's a black woman. Let's treat her badly. It is partly the culture where the black population lives, the kind of hospitals that are there. It's the lack of access to prenatal care. Some of it is socioeconomic and financial.

And some of it is racism. And some of it is that the minute that somebody comes in with dreads or tats, they're already labeled as somebody who's got a potential problem. and we might have to call Child Protective Services. We'll have to do drug screen on the ma or drug screen on. This is what's thought in general. Again, I can't speak. I can only speak for the things that people have written me about,

stuff like that. I've been out of the hospital world for quite some time. Is that kind of stuff only happening, though, when the doctors are white? Or does that kind of stuff happen to African American women, even if the doctors are also black? It has nothing to do with the race of the physician. It, you know, it is sort of a,

I'm not a big, fan of the term systemic racism, but I think that the system has its problems. And the idea that we have a threefold increased death rate in black women, these are not black women having home births, by the way. So this rise in death rate is a hospital problem that I'm hoping is being addressed. Again, I'm sort of out of that loop, but it's very real. Can a woman give a breach birth vaginally? Well, now you know who you're talking to, right? I know. Of course they can.

Of course they can. Breach birth is pretty much as safe as head-down birth at term with a skilled practitioner. The problem is finding a willing and skilled practitioner these days because they've, the medical model has stopped teaching breach delivery. Some small programs are starting to bring it back again, but it should never have gone away. It was always just a variation of normal. The outcomes were always very similar to head-down vaginal delivery.

I have numbers on that where the risks are, the risk of neonatal death, which is, of course, the risk in pretty much every paper that everybody's worried about. There's lots of other risk, but certainly that's a big one. With a vaginal breach birth, that term is about one in a thousand greater than a head-down birth. So you might have two in a thousand breach bursts that would die. Whereas you have one in a thousand head down bursts would die. But nobody's concerned about, nobody's saying we shouldn't do head down vatchel deluxe.

Right. I don't understand why doctors aren't taught how to give, deliver, breach babies vaginally. Fear, liability, expediency, economics. There's many reasons why they're not taught, but it's wrong. Because doing a breach delivery

is a service that anybody who calls themselves an obstetrician should be able to do because it's part of what we do. if you don't do a breach delivery, if you won't do vaginal twin deliveries, if you don't know how to use forceps properly, what is it that you do as an obstetrician that makes your specialty unique from any other sub-specialty or family practice doctor or a midwife? There's nothing.

A C-section can be done by any general surgeon, even a family practice doctor trained as a training in surgery can do C-sections. Papsmere's, you don't need an OB-GYN to do a pap smear. So what OBGYNs do are the things that make it really unique are things like breach delivery. And I was lucky, as I said earlier, that I train in an era where breach delivery was part of my normal training when I was at L.A. County USC. We saw 65 babies a day, so we saw at least two to three breaches every day because term breach is about 3 to 4% of the population.

Term twins is about 1 in 3. I mean, excuse me, 1 in 33. So 3 out of 100. So about seven out of every hundred babies that came in with your breach or twins. That's pretty common. That's like one, seven, one out of, what, 15? Yeah. Can you imagine being an expert in something, but not to being able to be an expert in one

out of every 15 women that walk in your office? No, it's just like the more I learn, the less anything makes sense. Right. So breach delivery is something that should be taught, and women with a breach baby need to do the work, especially if it's your first baby, and especially if you want more babies. Because if you do a C-section for your first baby because it's breach, to save that one in a thousand chance that I just talked about, then what you've done is you've now put all your future babies at greater risk

because now you have the scarred, C-section scarred uterus V-back thing to deal with. And you may find a hospital that won't let you do that either. So you need to cross state lines. You need to travel. you need to pay out of pocket, whatever you need to do, if you have a baby that's a tournament breach and for whatever reason isn't going to turn, then find a skilled breach practitioner wherever you have to go

because those of us that do breach, we love it. It's actually, you know, all bursts, there's a little bit of anxiety when you're there. As a practitioner, you keep it inside. But they're fun. How many babies do you think you've delivered? You know, I don't know because, because doctors and residents, we never kept track of that thing. I know that I've done

somewhere over about 420 in the home setting and over 100 sets of twins, over 100 sets of breaches. It's interesting. I mean, about 50% of my practice has been breach or twins when it should be, what, 7%. Yeah, because they're all going to you. Because they don't have choice. That's the thing. They don't have choices. Okay, what is an ECV and how safe are they? It's called an external cephalic version. They're relatively safe. They're uncomfortable. And they're done in many different ways.

You could be done in a hospital setting, again, a fear-based world, hospital setting, OR crew standing by, woman has an epidural in place with an IV, given medicine culture, buterline to try to relax the uterus to turn the baby. Or it could be done in your, in your office or in your home. It's where you try to use the baby's physiology, whatever position is in. use your hands on the abdomen to try to make the baby do either a forward or a backward somersault to change it from breach to head down. There's a reason for doing that in a world where there's very few breach providers because if your only option for a breach as a cesarean, then I'd

suggest trying to find a good ECV practitioner. However, if you have the option of a vaginal breach birth, then there's probably no reason to do an ECV. There's very little risk with do, but they do it in the OR because they assume that they could cause fetal distress, but in all my career, I've not seen that happen. That doesn't mean it doesn't happen, but it's pretty rare. What is the evidence regarding an epidural labor progression and breastfeeding? Like, does an epidural tie into different outcomes? I believe so. I don't know if they're, you know, I don't, I can't quote a study on that, which gets me back to my whole thing. Does it make sense that it would interfere? Yeah,

it makes sense that it interferes with everything because once again, every time. you interfere with nature's design, there are going to be downstream consequences. We may see them immediately, like problems with breastfeeding, or we may not see them for 20 years. We don't really know, and no one studies it. That's why when you look at a drug or a vaccine where they said, like, I'm just going to digress for one second, if you'll let me, the HPV vaccine. It was tested, I believe, for about, if I'm correct, about four months. So they did a study on women for four months with the HPV vaccine. One of the worst vaccines you can possibly have.

There's a book called HPV vaccine on trial by Mary Holland. It's strongly recommended. What's the street name for this? When you go to the doctor, they say HPV or is it called something else? Orts, human papillomavirus virus. Is that Gardasil? Yeah, Gardasil is the vaccine. Okay.

So that is the same thing? Yes. Okay, okay. Yeah. So, but they tested it. Gartersil was the main one. So you can keep that in if you want. The Gardasil was the main one.

But here's the thing. They tested it for, I think, about four months. And then they came out with an advertising campaign saying that gartersill prevents cervical cancer. Yep. Cervical cancer is a disease that if you're exposed to HPV may take 10 to 20 years to show itself. So how can a test that's been done for four months? How can they come out with a byline that says we prevent cervical cancer? You can't say that until it's been 20 years.

Yeah, I believe Candice Owens was vaccine injured from the Gardasil shot. I loved her series, by the way. Oh, shot in the dark? Shot in the dark. Thank you. Yeah. Yeah. I listened to it.

It was great. What interventions are actually necessary for a baby being born? In most cases, none. In most cases, none. Interventions. Again, the term intervention implies that something that would happen if you didn't leave nature alone. I mean, right? But you know what I mean, right?

an intervention is something that would not have happened if you left it to nature. So Bliss, my co-host, likes to say even when a woman is laboring and you walk in the room to see how she's doing, that's an intervention because you're bringing her out of her primitive brain back into your cortical brain, which we talked about earlier, how that affects your labor. You start to use your higher functioning brain. it shuts down your primitive brain. So the answer is nothing is the ideal situation. Everything that you do other than that is an intervention. Okay, so what about sugar, water for a baby immediately after birth? No. Doctors say a single vitamin K shot at birth protects your baby from

developing dangerous bleeding, which can lead to brain damage and even death. Is that true? Yes, It's true. The question is, how true is it? All right. And so this one needs an explanation. So let me just say that we used to call it hemorrhagic disease of the newborn. They changed the name to vitamin K deficiency bleeding. I'm not sure why they did that other than maybe to make it seem like vitamin K was a really good idea. But the incidence of hemorrhagic disease of the newborn is about six per hundred thousand term babies. Right? That's about one in 13,000. Excuse me, one in 16,000. It's about one in 16,000. So we're going to give vitamin K injectable, which has a black box warning against intramuscular injection. We're going to give it to a baby intramuscularly in the first couple hours of life to prevent something

that has an incidence of one in 16,000. Now, can it be serious like you just described? Yes, that's why I said it's true. It can cause bleeding and death, intercranial bleeding, inter-emdominal bleeding, and death, but the incidence is 1 in 16,000. So the question is, do you want to give a artificial product

that has other things in it to a newborn baby to prevent something that's 1 in 16,000? What is the downside of giving it? And this is something that no one in the medical world ever thinks about, but if vitamin K is so important, for a baby to prevent this rare thing from happening,

why are human babies born vitamin K deficient? Wouldn't nature have found a reason or a way to give us vitamin K if they thought it was necessary? So maybe babies are supposed to be born vitamin K deficient, and one out of every 16,000 has a problem with that, but the other 15,999, maybe aren't supposed to have their blood clot so readily when they're first born, because maybe they are having little capillaries or little arterials

and their brain and their liver and stuff that need to stay open. And if you give them a vitamin K too early, they're not prepared to deal with the hypercoagulability that that might cause, and it might cause problems down the road. Again, the intervention needs to prove its value before you change what Mother Nature is designed. They don't do that. No one looked at that. Okay, so what about the eye ointment that they give babies at the hospital? How do you feel about that?

It's stupid unless the mother's got active gonorrhea or chlamydia. Now, if you don't know because the woman has no prenatal care or something, yeah, it makes perfect sense because it's probably harmless for the most part. It's not a systemic antibiotic and stuff. But to put that in every baby's eye when the two parents are living in a, you know, a normal home, monogamous relationship, well, the doctors will, how do you know she's monogamous? Oh, please. Yeah, this is what they say.

This is why they talk about giving them hepatitis vaccine, too. Don't do it. Let's talk about spontaneous versus coached pushing. I used to be a big fan of coach pushing because that's what I learned. But it's not right for most women. Some women benefit strongly from coach pushing. They're just not really good at it. Or they've got an epidural and they're so numb.

They can't feel anything, which is probably a mistake. They should probably let the epidural wear off and let the baby, what we call labor down. Laboring down means that the baby go, labor and labor progress as nature would have done by itself until the woman has what's called a fetal ejection reflex, which, as we all know, is where you feel like you have to poop.

And once you feel like you have to poop, there's no stopping it. So. The poop or the baby? Both. Okay. But by that time, most women don't have much left in them because labor has helped clean you out as well. Again, nature designs is pretty smart. but some women push and they're pooping at the same time and yeah it's that it's embarrassing for some women

but at that point like we talked about the very ending with the makeup and stuff it's not something that they they really care about at that point and we're very easy about just picking it up and throwing it up and throwing the garbage and that's fine so it makes much more sense to wait for spontaneous desire to push than coach pushing, but some women need coach pushing. So it should be, both should be in your bag of tricks that you have. As a provider. As a practitioner.

Again, I don't like the word provider. And I'll tell you why. Provider was a word that was created by insurance companies to get rid of the term doctor. Got it. Because doctor-patient relationship was something that was, that had been through time. and because insurance companies wanted to distance their subscribers from the idea that they have their own doctor, they change the book, so it's a book of providers.

It's just a name that is a diminishment to those people who went to medical school and nursing school and chiropractic school. Everybody that's in the book is a, we're all labeled the same as a provider. Is a baby ever too big or a woman ever too small for natural birth? Yes, but it's not known ahead of time. For someone to tell a woman that is wrong, except in very rare occasions, if you've got a baby that might be 14 pounds or something,

some ridiculous number. But nature is very smart. Again, it designs babies to fit out of women's pelvices, and babies' heads mold and women's pelvices are not fixed. They have hinges and joints and ligaments and stuff, and they move. And the worst position a woman can push in for space in her pelvis is on her back. And how do most women in the hospital push?

On their backs. And why are they on their backs? Better and easier for a doctor to see what's going on. And probably because they have an epidural and they can't support themselves because their legs are too weak or numb. What's actually the best position for pushing? For breaches is an upright position where they're sort of on your knees leaning forward like on a ball or on the end of the bed or standing on your feet and pushing

that way. birth stool is also really good. I like letting women push early on on the toilet. Because on the toilet, you are in a great position and you're used to opening up your bottom when you're on the toilet. Bursts stool is I'm not a big fan of, but that's because I'm a physician

and I didn't really train well with them. A lot of midwives love them. But usually on all fours or upright is the best position to be in. You have much more space in your pelvis when you're upright, 20 to 30 percent, more space. I think it helps to be in water. And so water birth is a big thing in the home birthing world.

Most women, I think, in home birth, will give birth in the water. Not everybody's designed to get birth in the water. Not everybody wants to be in the water. Sometimes there's reasons to get them out of the water. But the water is, it's not a natural thing because we're land mammals. We're not supposed to be giving birth in water. But it's a comfort thing. And it's a nice, easy transition for the baby to come out in the water and then be pulled up.

And we've all seen the videos on Instagram. They're just beautiful. It's a thrill. It's a thrill and an honor to have been assisting women and bear witness to the job that midwives and people like me have is one of the best on the planet. It's also one of the most stressful the planet. And it really doesn't necessarily pay real well. But it's, it, nothing can be more important, Alex, than how we start out in the world and how we give birth. And we've done such a poor job.

the medical model has really just put it on an assembly line of destruction. It's just awful. What is the best way to avoid tearing while pushing? Water and all force positioning tends to have less perineal trauma and letting, you know, not necessarily doing a lot of perineal fingering with your fingers. A lot of tearing has to do with the tissue and the genetic makeup of the woman. I mean, some people have much more collagen and much more elastin than other people. V-back is a vaginal birth after C-section.

How successful are V-backs at home? About 93% if I wanted to give you a number that I got not only from my own work, but from other people's work. Well, that's certainly not what they're telling us. Yes, over 90%. The same cohort of women in a hospital setting will have a success rate of V-back of somewhere around 55 to 60% at most. And how many C-sections can you have before a V-back is no longer considered safe? In our world, there is no limit.

We uniform consent. We talk about numbers. The risks are fairly well known for one C-section and two C-sections. They're not really known for three or four or more because no one really allows women to do that. And so there haven't been a lot of studies on that. But a lot of it depends on their history. and why they had a C-section in the first place. Most women will have had a C-section in the first place

for a wrong reason. There'll be one of those 15 or 20% we talked about that had unnecessary C-sections or 50% of sections. Who's a person where it's like, okay, you are not considered safe to have a V-back? If you've had, like, say, a classical, a true classical cesarean section,

say your first baby was born in breach at 26 weeks and they went in and they did a vertical incision that went right up into the muscle of the uterus, the fat part of the uterus, the top part, there's a risk of rupture of three, four, five percent, potentially in a subsequent pregnancy. Now, again, people will say, well, three, four, five percent. That means 95 percent chance not going to happen. That's true. So someone would say, well, I'm going to try to have a vaginal labor.

Most hospitals and doctors will not let you. Now, again, they can't stop you, but they can make it so difficult for you that trying to be in labor at a time when you're fighting for your rights is not a good place to be. These things all need to be settled ahead of time. What about past medication or past medical history? Does that impact a doctor's decision on whether or not to recommend a V-back? Past medical history of depending what. I mean, it's hard for me to say that. I mean, there are doctors who will support V-back no matter what, and there are most doctors who will do what they can to funnel you down the path toward repeat C-section. and if they can find a medical problem, even if it has no bearing on how you healed from your C-section.

Like you broke your leg in fourth grade. Yeah. Oh, you got to have a C-section. No, seriously. I mean, they do come up with crazy things. And that's why, again, for women who really want to have a hospital birth with an obstetrician, I would strongly suggest that they consider having concurrent care with a midwife just for prenatally, just for the experience of what you can get from a midwife prenatal visit

and a second opinion, but also nutrition, you're less likely to develop preeclampsia or gestational diabetes in the midwifery model of care because the midwives are paying attention to you and doing preventative work where a doctor who would love to do that may give you a handout on what to eat, but doesn't have time in the six or seven minute or eight-minute office visit to sit down with you and do diet recall

and talk about me, you really shouldn't be eating that. That sort of thing. They don't have time. How do I know that? Because I was, I have a unique perspective. I really can come at this because I lived in both worlds. The first time I ever saw someone from England eating pork and beans on their toast for breakfast in a movie, I gagged. Then I realized, you know, we do some really disgusting things for breakfast too here in America, like drinking soda.

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Go to shop. Squeezejuice.com with code Alex for 25% off. That's shop. Dot squeezejuice.com with code Alex for 25% off or click the link in the description. My best friend had a C-section with her twins. So as her first children were twins. Necessary or unnecessary? Well, I don't know. I mean, I don't know, I guess.

And that's a legitimate question. I think she was just told it's twins, it's high risk. I don't know. See, now she's going to act, but I don't know that. But, okay, so she told me to ask you this question. So she said, say this. My best friend had a C-section with her twins. Then she had another C-section with her third baby or her second pregnancy.

Because, oh, because she was on blood thinners. If she gets pregnant again, would a V-back be completely out of the question, she wants to know? Well, first, the question of why she had a C-section for the second one, because she's on blood thinners makes no sense to me at all. Why couldn't she just have a vaginal delivery on blood? You know, we do that all the time. Okay. So again, these are, these are tough questions because you don't know the full history. This is the kind of direct messaging I get on Instagram all day long every day. You're like, I don't know you. It's really hard for me to answer this. I do offer consult services, but, you know, it's difficult to be somebody who hasn't looked at your records and

doesn't know that. But would she be a candidate for a V-back after two C-section? Absolutely, 100% with somebody who's willing. That's why, again, finding a trusted care practitioner is the most important, well, not the most, but it's up there in the top five of the most important things you can do to prepare for your pregnancy. And you need to find someone who is supportive, not sort of supportive, not lukewarm supportive, but is enthusiastically supportive by giving you, honest numbers and saying, here's the risk of this, here's the risk of this, here's the chance of this, here's the success of rates of this, what would you like to do? And also, you know, and then supporting you, there are three, four, there are three parts of informed consent. There's a subjective

where you, you know, you give your opinion, there's objective where you give facts, and then there's support where you, no matter what you say as a practitioner, our job is to support the decision of the informed woman. And that's where responsibility lies. And that's where the thing breaks down because doctors will skew the first two to get a woman to make the choice that they want them to make.

It's really dastardly. Does maternal age have anything to do with Canada C for VBACs? No. What do we need to know about VBACs and uterine rupture? It's rare. Most uterine, first of all, rupture is a very bad word.

It conjures up the image of a tire sort of blowing out on a semi-truck on the freeway. not generally what happens. What generally happens is the scar separates. It just slowly separates. And there are symptoms and signs of that sometimes, not always. When the scar separates, about 5 to 16% of the time

will have a very devastating outcome with the baby, which by devastating, I mean brain damage or death. So if a scar separates about one in every 200 Vbacks after one single low transfer of Cessarian section, and about one out of every six of those, if we take the worst number, 16%, end up with a really bad baby, then the actual risk of a ruptured uterus causing a bad outcome is one in six times one in 200 or one in 1,200. That's how statistics work. So it's not this terrible, oh, you have a 5%, 10%, 20% chance.

No, you have about a 1 in 1,000 chance of having a really bad outcome with a V back after a single low transfer of Sarin section. these are the numbers that are often not given to people, or my colleagues don't know them. They, you know, if you've been doing something a certain way for a really long time, Alex, it's very hard to change that way. And when, and if you were to find out that what you've been doing has been wrong. Do you think there's some pride? Yes, that's a very difficult thing to say.

Peter McCullough was asked about this when he was in Europe last week, and he said, how is it that thousands and thousands of doctors could inject something into their patients and their family members and find out everything we found out now and still support giving the new to their patients and family members. And the reason he says is because the idea that they've done something wrong

is too hard to face. And this is true of my, I think it's really true in obstetric, in my obstetric colleagues. It's easier to call somebody like me crazy than it is to take the numbers that I'm talking about and actually do a deep dive and look and see, but is he true? Does shoulder dystocha really require a C-section?

You mean having a shoulder-stosia and a C-section in a subsequent baby? Because it's too late to do a C-section when you have a shoulder-distocial. So I think they're asking in a subsequent pregnancy, and the answer to this, absolutely not. Absolutely not. Having a shoulder distosia in general, sometimes things are called shoulder distosias that aren't even shoulder distosias by definition. Listen, I did a podcast on that. can look that up on the Burthing Instincts podcast.

But the idea that you should do a C-section because you had a shoulder distortion in the first pregnancy is foolish. It's foolish. It's a doctor who's scared. Doctor doesn't know anything. We're trained to deal with shoulder distosias. Right.

Now, a woman who has a really bad shoulder distosia where a baby suffers a brachial plexus injury, a nerve injury, something may request a C-section in a subsequent pregnancy. And that's certainly her reason, Once she's given information, if that's what she chooses, then I'll support that. But to recommend that to her is not evidence-based. What pain relief medication can you have in a natural childbirth?

Medication? There are some midwives who carry nitrous oxide. I don't, and the midwives I worked with never did. Because I think that's, again, that's an intervention that we don't want to use. The whole point of being in home is to, and if you listen to, your friend Karen Welton, is you can, you don't even call it pain. You can deal with it by other ways. And the beauty of the home model is that you have something where you can move,

you can get into water, you can get into shower. There's something that's called the gate theory of pain. Most people don't know about it. But the gate theory of pain is what happens what you do when you say burn your finger or bump your elbow. If you bump your elbow, what's the first thing that you do when you bump your elbow besides say you rub your elbow? Oh, okay, yeah.

Yeah, and if you burn your finger, you blow on it, you run it under cold water, you suck on it. That doesn't make the burn less, and this doesn't make the banging less. How does it work? Well, when you bang your elbow on the opposite side of your brain, there's a little mapping of your body, and there's a little area in the brain that's going, ouch, out, out, it's firing, it's going, out, ouch, ouch, ouch, out, out, out. The minute you start to rub your elbow, all the little nerve endings around that will start to fire, and your brain starts to get drained of neurotransmitters and can no longer pick out the specific spot,

hurts. That's called the gate theory of pain. So when you're at home and you're having a surge, if you can have the shower beating on your back or your husband rubbing your, squeezing your hips, or rubbing your back, or using a ribozo, which is like a traditional scarf or a thing, you can do all kinds of things with it to rub the woman's belly or back or shake her, you can do those things. Then you don't, then you can deal with the discomfort in a way that you can't when you're stuck in the hospital laying on your side because you have belts on for a continuous fetal monitor that's completely unnecessary. And then one cascade leads to that whole cascade of interventions where it happens at home. But we don't particularly use pain medicine in the home

birth because you don't need it. Water works really well. And if you need it and nothing's working, then a transport to the hospital is a reasonable choice. Yeah, I think they're asking that question because I think they're just scared of the pain for going all natural is why I think they ask. that. They need to listen to Karen Welton's podcast with you. They do. Thank you for the plug. Why are women told that they can't have a home birth with twins? Well, because doctors consider anything high risks to not be something you should have at home. But again, that term high risk is really overused and we should get rid of it. All right? Because something that's that has higher risk doesn't mean it's high risk. Can you have more than twin? Like can you have like a really crazy multiple

birth at home? Have there been triplets done at home? Yes, there have. Have I ever done them? No. Would I do them? I have done triplets vaginally in the hospital. But again, because of the world we live in right now and the idea that I want to continue to be able to advocate for what I'm doing and stuff like that, there are certain things that I would probably maybe do in my senior years that I wouldn't have done when I was still really active. Yeah. But because I don't want to risk my career doing that. However, doing twins at home is certainly a reasonable choice with a skilled practitioner,

but you're not going to hear that in the medical model. They're going to think that that's absolutely crazy. Ricksafreeze, who is the head of a organization called Breach Without Borders and I, we've co-authored a couple papers. We have a paper on twins that's at the publisher now. we're going through the peer review process and we're adding some edits and stuff to it. So hopefully that'll be out.

It'll be on 100 sets of twins born at home. Awesome. Why the fear mongering about going past 40 weeks? Is it really a threat to mom or baby? No. So why do they say, like, we got to have birth now? Because remember, they like to control everything. They do not like nature's chaos.

And because the risk of stillbirth, which is their biggest fear, and everybody's biggest fear, actually, does rise beyond 36 to 37 weeks in all pregnancies. All right. That's not an issue, but that's the issue they'll use. What issue is not that it rises, but how much does it actually rise?

Maybe the baby just likes it in there. It's like a little hot tub. And 40 weeks, by the way, is the middle of a bell-shaped curve. I heard you. So you got me on like answering, you know, rapid fire thinking mode, and I'm missing the humor. No, sorry. But I appreciate, yeah, it is.

They're very comfortable. Well, that's true. They're very comfortable in there. There's no reason that they'll decide when they want to come out. On rare occasions, they need to be told to come out because there's a problem. But 40 weeks is the average to stational age. That means 50% of women, if left of their own accord, will go beyond 40 weeks. And yet we won't let them do it. Again, it's another thing, like, what are we doing? Why do we hate Mother Nature so much? And I said, if our outcomes were really, really good, that'd be one thing. But the outcomes suck in the medical model. Worldwide, in many countries, 70% of women are having C-sections.

50% are being induced. What happened to us in two, three generations that we've forgotten, have women forgotten how to give birth? No. Might we forget how to give birth in several generations because of epigenetics and stuff? Maybe. Maybe all this intervention is really going to screw up. our daughters and our granddaughters and our great-granddaughters. Who knows? But we've

to, that's why it has to stop. And that's why this current system isn't fixable. And women have to take back birth. What should women know about hemorrhaging during a home birth? It can happen. And your midwife is fully equipped to deal with it, except on rare occasions where a transport would be necessary. But they carry things to stop bleeding. They carry IVs. They carry fluids. They carry medicines. And also, they're not. You'll see less postpartum hemorrhaging in the home, I think, than in the hospital, because there's less interventions. There's less rushing.

There's less pulling. There's less, you know, tugging on the placenta. Should you let the doctor tug on the cord to get the placenta out? No, not generally. Every question you ask, by the way, always has like a little caveat. And people understand that. You got to go to Dr. Stu's podcast, and then he will spend an entire episode basically on, like, one of these questions.

So that's the good thing about this is like a snapshot of his expertise. and then you go to his podcast and then, you know, if you're like, wait, I want to hear more. Like, you have an episode almost certainly on one of these things. I do. Okay. What is really causing preclampsia? Oh, nobody really knows. But we know what, you know, risk factors are.

And risk factors are funny thing. If you look at the risk factors, it's young pregnant women are a risk factor. Old pregnant women are a risk factor, you know. there is no way to predict that sort of thing. It's probably nutritional and some genetic makeup, but nobody has really discovered yet what causes preeclampsia. There's all kinds of theories out there. Preeclampsia for those people listening is a thing that happens in pregnancy,

usually in the third trimester where your blood pressure begins to creep up, your kidneys start to leak protein because you're leaking protein you start to get uh your body can't keep fluid in the veins and arteries so you start to get swelling in your feet and then it goes to your hands and your face and then sometimes it can become severe where the baby's not growing well or your liver's malfunctioning or your clotting studies are going awry and that ultimately can lead to eclampsia which is having a seizure so uh it's it's rare in the homebirth population maybe it's because of the clientele and the way they cherry pick home birth, or maybe it's because the way midwives care for these women that keep them from developing the nutritional issues that might lead

to preeclampsia. What are the range of treatments available for an ectopic pregnancy? If you have an ectopic pregnancy, that's a pregnancy that's not in the uterus. So it could be in the corneal portion of the tube. It could be in the tube itself. It could be somewhere else in the body. those pregnancies obviously will never survive, except on rare occasions you might hear about an abdominal pregnancy that goes to term, but they're extremely rare. So a true ectopic pregnancy is one that's going to eventually rupture the tube and cause severe damage to the tube and also bleeding internally and stuff like that.

So how can you treat that? If you catch it early enough, you can treat it medically. There's medicines that you can give. Methatresate is one of them. and if that's not working, then usually surgery, and the surgery will either be where they will either go in and do a salp-injostomy where they go open the tube up, take the pregnancy or what we call products of conception,

tissue out, and let the tube heal by itself. Or more commonly these days with the successive IVF is if you have an ectopic, they'll often recommend taking the tube that's affected by that if your other tube looks good. So taking what's called a salp-injectum. me. What's the most important thing in a birth plan? Trust. Having people on board, having your partner on board. The location is less important than having the right mindset, trusting your body,

trusting your caregiver, not bringing people into your circle who are doubters. You know, if your in-laws or your grandma, I don't want you to do a home birth, then don't tell them you're having a home birth. Well, what are you supposed to say? Somebody asked that question. They said, well, what should I tell a friend or a family member who's trying to convince me that I shouldn't do a homebirth? It's too dangerous.

It's a terrible idea. You know what I say to people like that? I say, I just say this. You might be right. You might be right. And just, you know, don't try to argue with them. Don't try to convince them that you can't. And again, people,

that interject this stuff, they're missing a social cue that says that, you know, I'm not interested in what you have to say. Why do you keep telling me this stuff? And they just, they just keep doing, they think it's caring. Right. But it's not helping. So those, and don't tell people your due date ever. Don't tell anyone your due date. For home birth or just anything? For any birth. Why? Any birth. Because everybody will write it down. And the minute you go to 40 weeks in one minute, you'll start getting texts and messages from people saying, what's happening? How come the baby's not here? My doctor said, if you go past 40 weeks, it's a problem. Blah, blah, blah. And everybody's getting on. So just tell people you have a due month.

Like, I'm due in the fall. I'm due in September. I like this idea. Oh, it's really, it's well known in the birthing world to don't tell people your due date. Okay. Are there any benefits to not cutting the cord for a while? Totally. Really? How long should you wait? You should never cut the cord. Wait. How long should you go? Until the placenta comes out and and leave. the baby alone on its mom for a while and then eventually you'll cut the cord just because it's getting in the way. But there's no reason in normal birthing to cut the cord. And if a baby is not doing well, then really the last thing you want to do is cut the cord because if there's a pulse in the cord,

the baby's still exchanging oxygen and other nutrients with its mother. And when a baby is coming out and it's floppy and it needs oxygen, the last thing you want to do is cut off its oxygen supply. But that's the first thing that the hospitals will generally do is immediately clamp the core and then take the baby over to the warmer and then give it oxygen in the warmer. If the baby needs resuscitation, whether it's at home or in the hospital, you should be done next to the mother or on the mother's chest. What are your favorite resources on what juices, if any, you should give your baby? First of all, I wouldn't give the baby any juice whatsoever. Juice. In almost any circumstance, it's never indicated.

Okay. Best books on that would be dissolving illusions by Suzanne Humphreys, Turtles All the Way Down by Anonymous. A new book that's just come out, which I've read the chapter on pregnancy is chapter 11. It's called, you can say it, Vax unvax by Robert F. Kennedy Jr. and Brian Hooker. And it's, it looks at the very obvious thing that the CDC and no one wants you to look at? And that would be how are children who never got any juice doing compared to children who got all the juices that were offered to them? Oh, I thought

nobody had done this. Nope. Well, there's been over 100 studies in the world, but the, but the CDC and the FDA have never done one. Yet they keep approving these things. So they took these studies, and they looked at them. And one of the, in the, in chapter two, which is on children, they looked at 19 different areas of health in the children. And the children who never had any juice were healthier in every category, all 19 categories, than children who are, sorry for me to say this, children who are fully juiced. It's a medical term. So, yes, look very carefully.

I'm not saying to each individual family, depending on your circumstances, but realize that none of these juices have ever been tested against the randomized placebo-controlled saline trial for safety. And yet they are injecting them into children. And now they're offering four different juices to pregnant women, none of which have ever been tested in pregnancy for safety alone, let alone giving three, which is actually five different juices at the same time at 28 weeks. And then one maybe a couple months later that's come out now that just recently got

approved that I've done, I did a reel on that that's on my Instagram thing about the new RSV juice. How can somebody find the best midwife or doula that is going to be on board with everything you talked about today? Interview them. The only thing you can do, word of mouth. you know, you live in a community. There are people, if you know somebody that has a home,

but if you don't, you just, you know, do a search, and then you make an appointment to interview them and go and interview them, just like you would a new doctor, you know, or a new pediatrician, you want to interview them, and you see how you click. Does it matter for your midwife to have the same political views as you? To me, it would. Okay.

I'm just curious. To me it would. Yeah, we had that issue in our office. We had, you know, I have different political views. And during the lockdowns and stuff like that, they, they got mad at me and my clients because I refused to make my clients wear masks. And their clients were wearing masks and were vaccinated and they were upset that we weren't wearing masks. So here you have the vaccinated masked people upset that somebody else. If the masks work and the vaccines work, then why are you upset? But it didn't, logic does not compute when. these emotional things come into place. So yeah, I mean, it's kind of like finding a spouse. I mean, can you, you know, because your midwife is your midwife for life. They don't just disappear. They don't say after you go home after, you know, from the home birth and they say, by that day, they say, I'll see you in six weeks like they do at the hospital.

They don't do that. They'll be back the next day and probably a few days after that. And then the two weeks and then, you know, they'll be available for you 24-7 on the phone. and it will be the midwife that generally you have signed up with as opposed to the way medicine works now, which I never did, but most doctors are in a large group now. So when you call to speak to a doctor, you have a very small chance of actually getting the doctor that you know. You get whoever's on call and it could be a perfect stranger who doesn't know you and doesn't, you know, and it's harder to treat somebody without knowing their backstory.

You just can't do the same job. You can give the, you can write the same prescription and all that stuff. You just can't reassure them as much as having that relationship. So that's really the biggest thing is having a relationship with somebody. And finding it that way, the best way to do that is, you know, word of mouth or interviewing them. How do we change the gaslighting around birth in America? We've gotten to the point now where pretty much anything the medical model tells you, you shouldn't believe. And that's really sad that we've reached a point where how can you trust the

If someone lies to you once, you can forgive them. But if someone lies to you consistently or they're wrong consistently, why do we keep going back to them as a source? And my internist of 30 years is a devotee of the CDC. Whatever the CDC says, he follows. So he's no longer my internist. Part of it is lucky because I moved away, so I didn't really have to break that relationship

because it would have been really hard for me to do that. We've lost the trust of the populace, and women especially should be really skeptical about the obstetrical model of care because it doesn't have your best interest in it. Everything that pretty much is done to you when you go to the hospital is not for your benefit. It's for the benefit of the institution.

And you just need to know that. And it's very difficult for people who grown up with, like, Marcus, Wellby and Dr. Kildare and, you know, what's the doctor from the cute doctor that was on, not ER, he was on Gray's Anatomy or whatever. Yeah. Yeah. All those guys, Dr. Dreamy or whatever they call them.

McDreamy. Yeah, McDreamy. Okay. Yeah, I mean, these are trusted people who just always had your best interest at heart. That's just not the way it works anymore. These doctors right now are just cogs in a machine. They're employees. Okay.

What is the name of your podcast remind everybody? where can they listen? And then how often do you release new episodes? Burthing Instincts podcasts. We're on everything, essentially Spotify, Apple, iTunes, with me and Bliss Young. And we release every Wednesday morning. And we've got 330-some episodes, I think. Dr. Stu, thank you for coming on the spillover. Alex, it's been a real pleasure. I'm just honored. It's been a great two hours. Thanks. If you can, you should ask your mom what your birth story is. Did she feel coerced into anything?

Did she feel like she had informed consent? What was her plan? And if anything deviated, what deviated? If she could do anything differently, what would it be? Here's what I found out after asking my mom about my birth story. I was born in Terre Ha, Indiana, and was a C-section baby. My mom felt like it was the right decision because she was only two centimeters dilated after 31 hours. and she was not allowed to hold me for over three hours after she gave birth to me and has no idea why till this day.

I was over nine pounds, little baby Alex. I was nine pounds. Over nine pounds when I was born. Had a head full of so much black hair that gave me a pink bow. If you're watching on YouTube, we'll put up a picture. And then my mom spank me on the butt took me home to do worm things. If you're new here, welcome to Alexisms. No, but seriously, two other birthing episodes I've done on the spillover.

You want more. We're in season two. One was called the dark side of the birthing business with Allie Beth Stucky. And then the other was called I coach women on how to have a pain-free birth with Dula Karen Welton. That's the one that Dr. Stu loved that he kept referencing throughout this interview. Just scroll back in the podcast and you'll see them pop up. Or you can just type any of those names and then the spillover into any search engine and the

episode will pop up that way. Next week is another true crime episode. I am talking to one of the most. iconic and well-known forensic psychologist and authors in the country who have spent time building relationships with serial killers in prison to understand why they do what they do. Every week is a completely new guest on the spillover. Topic has a different expert. You will never be bored.

New episodes of the spillover drop every Thursday at 9 p.m. Pacific, midnight Eastern, wherever you listen to podcasts. And you have the option to watch the episode by subscribing to Real Alex Clark on YouTube and you'll find tons of other videos and content from me there too. I'm Alex Clark and this is the spillover. Love you mean it, bye. Can a woman? Yes.

If she's a woman she can do anything.