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Why So Many Women End Up With C-Sections: Birth Interventions Explained | Dr. Stuart Fischbein
01:33:14
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- [00:00]
A
If anybody thinks that health care is about getting you well and it's not about money, they're being naive. If you look back at how a mammal gives birth, whether it's your dog or a deer or horse, the mammal goes off to a quiet place. They go off by themselves. They want to feel safe, quiet and undisturbed in their environment. You don't interrupt them. You don't restrict their movement. You don't anesthetize them. You don't bother them. The other dogs or deer don't come around and ask how they're doing. Nobody's doing a vaginal exam on a tiger at 7 cm. The system is designed very poorly for good outcomes. It's designed very well to maximize profit. And so we have this whole system where everything that the hospital does to you when you come in, make you go bathroom and pee in a cup, draw your blood, start an iv. They bill for all those things. If anyone's ever been to a home birth, we don't make women pee in a cup, draw blood, or start an iv, and somehow they still have babies. If doctors had the ability and the freedom to treat women as independent people, we probably would improve our outcomes. But then somebody's going to lose control and profit. That's the problem.
- [00:59]
B
Doctor Stu, welcome to the Real Foodology podcast. I'm so excited to have you on. I have had so many people in my life tell me that I need to get you on the podcast, including my own midwife. So she was very excited when she found out that you were coming on my podcast because she's a big fan of yours and listens to your podcast. And then I actually realized yesterday when I was looking you up that you were on my friend Alex Clark's podcast, like, two years ago, I think.
- [01:22]
A
Yeah, it was an honor to be. That's when she was. I think she's still in Phoenix, but it was called the Spillover in those days. Now she's got culture apothecary. But. But, yeah, it's one of my biggest downloads for being on that. And again, that long format that you and I wanted to have, but we couldn't quite arrange the scheduling for me to get to Austin in time. And you have a deadline coming up, so.
- [01:46]
B
I do, yeah. Just for my listeners, because they're going to be like, why are you doing this virtual? I don't normally do virtual, but because my due date is rapidly approaching and I really wanted to get you on before I gave birth to my sweet little baby boy. We did what we had to do so. I'm so honored to have you on to give you a little context, because I don't know you. I don't know if you know a lot about me and my story, but I'm 41. I got. We got pregnant on the first try. I, unfortunately, am just one of those women that it took me a lot longer to find my person. So I'm having my first baby at 41. And one thing that I was really shocked by going into all of this was hearing everyone call pregnancy geriatric after 35. Is pregnancy after 35 actually geriatric, or is that label outdated and fear based?
- [02:38]
A
Exactly. Let me, let me explain something again. I don't think many of your listeners probably know who I am, so they probably haven't heard much of what I said, because when you go on podcasts like this, you kind of tend to repeat yourself and you think you're telling the same story over and over again, but you got to realize you're speaking to a different audience. I have something that I call my exact number rule. And this is how medicine in general and other things in life put these things together where they come up with these numbers and then somehow they become rules or tenants or benchmarks for quality. And 35 is one of those numbers. You're not old when you're 35, and, and the risks don't suddenly change when you're 34 years old in 11 months to suddenly now you're 35. There are certain things that. Chances of things happening that rise as you get older, but the amount of the rise is very small. So what happens is when doctors and medicalized birth models want to manipulate you, they'll start using things like relative risk or high risk or whatever to. To convince you that there's something wrong. And that when you are convinced there's something wrong, you're easier to manage. So when you're over 35, you're just at a slightly greater risk of having a baby with a chromosomal abnormality, which is easy to rule out these days. You are not at significantly greater risk of hypertension or diabetes or stillbirth or anything else. Yet they came up with this number. It's very much like other numbers in pregnancy, like 42 weeks or 39 weeks, for that matter, or 24 hours of ruptured membranes or one minute of delayed cord clamping or six feet apart. These are all made up numbers. And it's one of those things that really bothers me because the first thing you said to me today was I'm 41, so I know that that's something that's on your mind. And how did it get on your mind? The culture. And I'm pretty sure your midwife didn't dump that on you, but the culture dumps that on you, that sort of thing. So what is it about age 35? Well, people need to understand where that number came from. And if you understand the history, you'll understand how ridiculous it is. But my understanding where 35 came from was prior to the era of ultrasound. So we're talking the 1940s and 50s. The risk of doing an amniocentesis without ultrasound guidance, the risk of miscarriage was 1 in 200. Now it's like 1 in 700, 1 in 800 because of the ultrasound guidance. But you used to just find a soft spot and take the needle and you used to stick the needle in, and you were 1 in 200. Risk of miscarrying from that procedure.
- [05:28]
B
My mom actually had a miscarriage at 20 weeks from an amnio. How do you say that again? Amniosa.
- [05:33]
A
Amniocentesis. I mean, it does happen. Everything carries benefits and risks, and so you have to. Every individual woman needs to weigh those herself, because it's one of the tenets of medical ethics, is that given the same information, it's not reasonable to expect two people to come to the same conclusion. Yet the medical system would want all women over 35 to come to the same conclusion. So why that 1 in 200 is significant is because that's the risk at age 35 of a woman having a baby with down syndrome. So there are apples and oranges, but it's where actuaries that work for insurance companies decided, we'll pay for amniocentesis beyond age 35. So 35 became a number. And then it just. It was like the blob of Cleveland. It just kept growing and growing in importance. It doesn't mean anything significant because everything that can happen when you're over 35 can happen when you're under 35. And if it happens with a slightly greater frequency when you're over 35, slightly greater frequency doesn't mean common. But because most of my colleagues in obstetrics fear birth, and they use that fearful language when they talk. It's a bit coercive, actually. I'm not sure they even know they're doing it because they're just repeating what they learned. But your body works perfectly well. At age 41, you conceived on your own. Your body knew exactly what to do. You're growing this baby on your own. There isn't a sell by date. You don't need to be induced at 38 or 39 weeks because you're over 35. It's just a number that somebody came up with and it's now sort of become, you know, a benchmark that's used by everybody, but it doesn't really mean anything.
- [07:19]
B
Yeah, that was a great explanation. And to your point, this is something I also really wanted to talk to you about, Dr. Stu, because I, I went into this with a completely different mindset than I think a lot of women do, where I came in knowing I've been prepping my body for years. I've been an integrative nutritionist for the last 15 years. I know how to take care of my health. I know how to eat really well. I focus on eating whole real foods. And so I've really been. I knew that I was going to meet my partner later. As it started creeping up, I was like, okay, like I still want to be able to get pregnant, so I'm going to really dial in my nutrition and take care of my health. So I never approached this from a place of fear. I always felt like, you know what, this is going to work out. My body's really healthy. And to your point, what you said is that just because you're 35 and over doesn't mean that you're going to have all these issues. You could be 27 and dealing, you know, with health issues and have a really hard pregnancy. And for me, I'm happy to report that I've actually had a really great pregnancy and I've been completely free of fear. I haven't had a lot of crazy symptoms. It's been pretty easy, honestly, symptom wise. And one of the reasons that I sought out a midwife and why I'm only going with a midwife and why I didn't do an ob GYN was because I didn't want somebody telling me my whole pregnancy that I needed to be fearful because of my age.
- [08:36]
A
Again, we have to go back to basics and we have to think about how do mammals give birth and what has the medicalized birth model done to that? If you look back at how a mammal gives birth, whether it's your dog or a deer or horse, the mammal goes off to a quiet place. They go off by themselves and they want to be undisturbed. They want to feel safe, quiet and undisturbed in their environment. And when they're hungry or thirsty, they eat and they drink, which is nobody restricts their food. You would never take your dog's food and water off the floor when they're in labor. You don't interrupt them, you don't restrict their movement, you don't anesthetize them, you don't bother them. The other dogs or deer don't come around and ask how they're doing. Nobody's doing a vaginal exam on a tiger at 7cm. And when a mammal is approached by a predator, or there's a forest fire, or little kids run into the room where the mammal is laboring, the mammal stops, puts out adrenaline for the most part and other things too, and stops contracting, gets up and runs away and will go back into labor only when it feels safe. This way nature ensures the best chance of survival. We are no different. We may be a higher intellectual species, but this is not a higher intellectual process. This is a primitive brain function. Women in a coma, they can grow a baby and they can go into labor without thinking about it. Thinking about it actually gets in the way. So when we have a system that treats women differently from the very start of the pregnancy, all the way till the time when you go into labor, you get in the car to drive to the hospital, until the moment you put your baby in the car seat to drive home, pretty much everything that you can think of, you could rattle off all the things that are done at the hospital. And I'll tell you, they're anti mammalian design. You would never do that to any mammal. You would never ask them a bunch of questions when they come to treat. It would never make them change places anyway, move. You would never ask them a bunch of questions. You'd never make them go in the bathroom and pee in a cup, put on a hospital gown, have blood drawn, start an iv, have belts put on you, immobilize you, interrupt you with taking your blood pressure and asking a whole series of questions that don't mean anything.
- [10:52]
B
Why do we do that to humans? Why do we treat pregnancy and labor like a medical emergency?
- [10:57]
A
Well, you can control people better when you have a fear based system. Everything that they do, and this is not cynical, it's true, is there's billing codes for that. And if anybody thinks that healthcare is about getting you well and it's not about money, they're being naive. The system is designed very poorly for good outcomes. It's designed very well to maximize profit. And so we have this whole system where everything that the hospital does to you when you come in, make you go in the bathroom and pee in A cup, draw your blood, start an iv. They bill for all those things. If anyone's ever been to a home birth. We don't make women pee in a cup, draw blood or start an iv, and somehow they still have babies. They say it's for safety. They say, well, we want to know what your hemoglobin is. Or we want to have a blood clot and a blood bank just in case. But that's silly. What do you do if a woman comes in from a car accident or a gunshot wound? You. If they really are bleeding that badly, you give them O negative blood until you can type and cross them. You don't have to do that. But there's no money in not drawing labs. If hospitals got paid more for not doing stuff, they do less stuff. But they don't. And then there's the fear built in and the way the system is designed and the way doctors are taught. Doctors are taught mostly these days. Obstetricians are taught by maternal fetal medicine specialists. When it comes to obstetrics, they are the high risk specialists. And they obviously, as a high risk specialist, you see everything as high risk. That's kind of what you do. And so if everything's high risk, then things can go wrong at any minute, and they live in that world. And then, of course, we have the fear of liability, which is real, because we have people that want to sue and we have trial lawyers that can't wait to do it. And it's a whole industry and nobody wants to get sued. And you're more likely to get sued if you do something that's outside of the way the hospital does it, even if it's better for your client, the mother, or it's better even medically, like for instance. I mean, I love giving examples because I think it makes it. It helps a lot. Which is RISKIER? Being over 35, Courtney, or being induced because you're over 35?
- [13:24]
B
I would think being induced.
- [13:25]
A
Correct.
- [13:26]
B
Because it's not natural.
- [13:27]
A
But which one's labeled high risk?
- [13:30]
B
Being over 35.
- [13:31]
A
Correct. How about this one?
- [13:33]
B
Crazy.
- [13:33]
A
Having a breech baby and being told you have to have a C section, but nobody asking you, do you want a second baby or do you want a third baby? Or having a breech baby and delivering it vaginally? Which one carries more risk? I'll make it easy for you. The C section carries more risk for that mom, not that baby. That baby has a slightly less risk, but that mom has much more risk. And then all you've done is you've Taken the slightly gain risk diminishment in that first pregnancy and now she wants a second or third or fourth baby. You've increased the risk to all those babies because you have the scarred uterus. So the C section for breach will be labeled standard of care. The vaginal delivery will be labeled high risk, but it's actually the opposite. So it's a way of thinking. And when you're, you know, it's a way of brainwashing. And ultimately, whether the doctor or the hospital system thinks that this is safer is really not what matters. What matters is what does the woman think? And how can a woman make an honest decision if she's not been given honest information? They talk about evidence based medicine and standard of care and stuff like that. Those are all terms that sound good, but they really don't mean anything. Because of the standard of care in your community is to not allow a woman to have a vbac. And I allow you to have a vbac. I'm outside the standard of care, but what I'm doing is actually better care. And it's supported by the evidence.
- [15:09]
B
But they're going to label you as dangerous.
- [15:10]
A
They're going to label me? Yeah, they're going to label you as crazy and me as an outsider. And they'll pick up. And then they tend to go after the outsiders. They tend to go after the people that make waves. They just do. I mean, midwives across the country right now are getting picked on. And I'll ask anybody this question. We have a system now where about 98 plus percent of babies are born in the hospital, about 1 1/2% are born at home. Some states are doing pretty well, like Idaho, I think I heard, has about an 8% home birth rate, which is great, but it's about 98% in the hospital. We have rising rates of cesarean section, rising rates of induction, rising rates of postpartum hemorrhage, rising rates of nicu, rising rates of epidurals, all these things. And our outcomes are getting worse or certainly not getting better. So when I see the state legislatures going after midwifery, we don't have a horrible outcome in pregnancy because 1% of women are giving birth at home. It's the 99% that are giving birth in the hospital that are causing the problem. And yet that's too big a thing to take after. And that's where the money is. And so is kind of like in California, we don't deal with infrastructure, but we'll ban plastic straws. So that's the kind of thing that happens. And you see this in states right now, because who has the lobbying power? Organized medicine does. Big pharma does. The American Hospital association does. What do they want? They don't want any competition. They don't want women giving birth at home.
- [16:46]
B
Well, they make a lot of money off the C sections, too, don't they?
- [16:49]
A
They make a lot of money off of everything that goes on in the hospital. And they especially make a lot of money when a woman has a problem like needs a C section or a baby needs to go to the intensive care unit. What I can't understand if the system is so good, is over the last 20 years, Courtney, the rate of NICU admissions, newborn intensive care unit admissions, has nearly doubled. It's gone from a little over 5% to about 9.8%. So one out of every 10 babies is going to the NICU. Now, if the system is so good, then how come it's not so good? You know, there's a guy that I listen to on the podcast sometimes, and he calls it the Moneyball theory. And I don't know if you ever saw the movie Moneyball. There's a scene where Brad Pitt plays this bass, Billy Bean, the general manager, and he's talking to the scouts, and the scouts are telling him about this great hitter in the Miners, and he just says something real fast. He says, if he's such a great hitter, how come he doesn't hit good? And it just goes on to the next scene. And I think about that sometimes when it comes to our obstetrical world, the people that are running the system are singing the praises of the hospital, and they're cursing the idea of home birth. Yet if your system is so praiseworthy and so good, how come it's not so good?
- [18:04]
B
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- [21:06]
A
Okay. I got so much to say about that. Are all your friends over 35? Just out of curiosity?
- [21:13]
B
You know what? It's a range. Actually. A couple of them are in their early 30s, but yes, two of them were over 35.
- [21:19]
A
I imagine that many of some of them were probably induced. And they were probably induced for no reason. You're absolutely right that it can't be possible. It would be statistically almost impossible that all seven of them ended up with this emergency C section because they needed one. There's a word called iatrogenic, which means medically induced or whatever else, or a medical cause for the problem. And I can tell you that that's the case. And how do I know that's the case? Because it's simple math. It's simple math. Fifty years ago, the C section rate coordinate in the United States was 5%.
- [21:56]
B
Oh my gosh, what is it now?
- [21:58]
A
It's about 35%. I'm using even numbers because it's just easier math. Okay, it's about 35% now. What's happened in the last 50 years? Well, we've got more inductions, we've got more high risk specialists, we've got more, you know, we've got all these things. We got continuous fetal monitoring, we've got labor curves. I could go off on tangents on every one of these things and give you 10 minutes on how stupid they are. I do a segment on our podcast every now and then called Dumb doctor Dogma. And most of these things, if you really look at them, you wonder, how do these things ever get through peer review? How do they ever get accepted as normal? Because they make no sense. For instance, continuous fetal monitoring is where you wear the belts. And they've been using it now for over 50 years. And the idea was if we monitor babies in labor, we're going to find the babies that would have ended up maybe having cerebral palsy or an interpartum death. And we're going to save them. But after 50 years of use and hundreds of thousands of unnecessary cesarean sections, not only has there been no evidence of benefit from continuous fetal monitoring, there's been evidence of non benefit. And yet it's still standard of care in almost every hospital because it's a labor saver. And they Think it's a liability preventer. They don't care that the outcomes end up with cesarean section. Again, the system is set up that the hospital actually makes more money if you have a cesarean section. So how did all these women end up with cesarean sections? And I'll get to your question about true indications in a second. They ended up because doctors meddled in their pregnancy. They coerced them into doing something that they didn't need to have done or they didn't allow them to labor as nature designed. They brought them into the hospital too early. They made them stay in bed wearing the belts. They couldn't move. They gave them a Popsicle or some ice chips, didn't let them eat. They got uncomfortable because they couldn't move and deal with labor as any other mammal would do it. They finally got an epidural. An epidural slows down labor. Then they started Pitocin. An epidural disconnects the mother from the baby hormonally, maybe even psychologically, not feeling anything anymore. Yet the baby still is feeling things and doesn't have mom to rely on anymore because mom stops sending signals that she's contracting because mom doesn't feel anything and the baby then doesn't. They don't like the way the baby's heart rate tracing is. And so they do a C section. They get a baby that comes out most of the time crying and doing well. And everybody says, God, we got that baby out just in time. And it's like, yeah, I mean, it's silly. If you look at the C section rate, what it should be, and I'm not a big fan of the World Health Organization, and I don't think many of your listeners probably are either. But 40 years ago, they said the C section rate above 10% probably had no benefit and probably had detriment, and they even went 10 to 15%. So let's just say it's. The C section rate should be 15%, which, by the way, was three times higher than it was in 1970, and we don't have better outcomes now than we did in 1970. So let's just say it should be 15%. And let's just give the benefit of the doubt to hospitals and say that the C section rate in the United States is 30%, because you can see where I'm going with the math here. Well, that means that if you believe that, then that means half of all C sections being done are unnecessary.
- [25:33]
B
Oh, my God, that is crazy. And then afterwards, they will tell you thank God you were here in the hospital, because if you were at home, then what would you have done? Maybe could have harmed your baby? And I'm thinking, well, you may have never had to have any of these interventions if you had been in the hospital in the first place.
- [25:49]
A
But here's the scary part, because there's about 1.2 million cesarean sections being done every year in the United States. A little less than 4 million babies every year. So if we take 30% of that, it's 1.2 million. Now, just assume that half of those are unnecessary. That's 600,000 unnecessary major abdominal surgeries every year. If there were 600,000 unnecessary knee surgeries or gallbladders or mastectomies or something, not only would people be upset, but insurance companies would be upset because they're paying for that. Yet Here we have 600,000 unnecessary surgeries every year. No one's upset about it. That's absurd. If half of all C sections being done are unnecessary, who's doing them? Because no doctor goes home at night and says to their spouse, hey, honey, I did two unnecessary C sections today. Every C section a doctor does, he or she thinks is necessary, yet half are unnecessary. So this is where something that happens.
- [26:50]
B
What's the disconnect happening there? I'm sorry to interrupt you.
- [26:53]
A
There's a disconnect. It's cognitive dissonance. It has to be because no doctor wants to believe they're doing something wrong. I don't believe that doctors are evil by nature, but the idea that that one third of all women in this country, and in some countries it's 2/3 of all women, can't have their baby as nature designed. And that's considered normal now. That's considered standard of care. You can see where I'm going with this. Standard of care doesn't mean what people think it means. It's a tool to get you, to manipulate you. And I know this is upsetting for a lot of people who are listening right now. They're probably saying, God, I wish that guy would shut up. But because he's making my stomach all upset, because I don't want to not trust my doctor, I don't want to not trust my hospital. Well, you need to do your research. You need to look into that.
- [27:37]
B
Yeah. And I was going to ask you, so I kind of have a two part question. Well, first of all, what you were talking about is actually another question I wanted to ask you, which is essentially the cascade of interventions that happens, which is you Know, you go in. Everything you kind of just explained, which is you go in, you get the epidural, and then they put you on the Pitocin, and then the baby's heart rate goes down, and then they have to rush you into a C section. It's like, you know, just a cascade of interventions that happens that ultimately leads to the C section. That if you were at home, none of this would have ever happened because you would have just been able to labor as nature designed. There's also the aspect that we didn't even mention yet, which is what I'm hearing a lot, and this makes me so mad. I see red is that doctors and nurses are wanting to get out in time because they want to, you know, go home for dinner or whatever it is, which I understand, but I'm also like, this is a. A woman's life and her baby in your hands. And then they're trying to get the baby out sooner with the C section. So there's the cascade of interventions. There's also that notion of the hospitals don't want to pay for the mom to be there for multiple days in a row. Whereas, you know, think about me, if I'm laboring for two days, like I'm at home, you know, for my home birth, if I don't end up in the hospital. And then my other question I just don't want to forget to ask you is what is how does somebody navigate this and find someone that they actually trust and know that they're in good hands?
- [28:56]
A
I wrote this all down because there's four questions here that I want to get to. First, I want to get back to your original question, which is, what's a true emergency? I still had that. We didn't finish that one. This is what I do, though, Courtney, is that I tend to go off on tangents. And so I told you this before we started that I can monologue on something because I'm so passionate about this, because we're doing it so wrong. And I've seen both sides. I spent 28 years working in the hospital and 12 and a half years working in the home. So I have a unique perspective on this. Most doctors who work in a hospital have never been to a home birth. They don't really know what goes on. They only see the home birth transports, most of which, by the way, are not emergent. They're just a woman that's exhausted, just wants pain relief or you need Pitocin or something, or a vacuum or something to help deliver the baby. Very rare. When a home birth goes awry. But those are the ones that make the news, which is fascinating, by the way, because bad things happen in hospital every day. Those things don't make the news.
- [29:56]
B
They never make the news.
- [29:57]
A
Yeah, they don't make the news. Okay. True emergencies, things like a placenta previa.
- [30:02]
B
And what is that?
- [30:03]
A
That's where the placenta covers the cervix so the baby can't get out without tearing through its own placenta. That's a true emergency. Some babies will have a bradycardia where their heart rate goes down. And it's not caused by, you know, starving her, immobilizing her, numbing her, hyperstimulating her. It just happens. Sometimes, occasionally, rarely. About one in every 500 pregnancies, you'll have something called a prolapse cord, where the cord comes out before the head. It's a little more common in twins and breeches, but it's about 1 in 500 head down babies. We'll have that happen. You can have something called a placental abruption where the placenta separates. Usually no fault of anybody. Sometimes it can occur after a sudden deceleration injury, like a car accident or falling down. But most of the time, when you have an abruption, there isn't an obvious cause. That's a reason for, you know, if she's not about to deliver. That's a reason for cesarean section. Certain anomalies in babies that probably would be better off coming out gently through the abdomen as opposed to more traumatized. I don't mean that in a bad way, because nature designed babies to come out vaginally. There's a lot of benefits to babies having to navigate the birth canal and use their reflexes and be exposed to your microbiome and the stresses of labor and the delayed cord clamping and all that goes with a nice vaginal delivery. But sometimes some babies with spina bifida or maybe an abdominal wall defect, but we're not talking about, you know, a failed induction at 39 weeks because you have. Woman happened to be 36 years old and they brought her in and the baby didn't like labor after mom had been laboring for 20 hours with no food, and she took an epidural and she was on pitocin. And we're not talking about those. We're talking about those true emergencies that that can happen. But when you are working with women at home and you don't meddle with mother Nature. I learned this. I didn't know this. I learned this from My experiences with midwives, they taught me pretty much everything I know about normal birth. I learned a lot about problem birth in residency, but not much about normal birth. We treated them all the same. Every woman came in, had the same protocols, and that's wrong. But at home, we don't see this rapid deterioration of a maternal or fetal status. When you're not meddling with mother Nature, if something is going wrong, you can generally see it coming from hours away. You start to get a feeling like this labor's not progressing normal. And the longer a midwife has been in practice, the more familiar she is with what's normal. A good example of that, because I like these examples, is if you live in the Same House for 30 years and you go out for dinner and you come home and you open the front door and the chair in the front hall is moved three inches from where it normally is, you immediately, Courtney will know something is wrong. I might not know because I'd never been in your house before, but you'll know something is wrong. Now. Could it be an earthquake? Could have been a burglar, could have been the dog hit it. Who knows? Could it, you know, could your partner have pushed it when he picked up your purse or whatever? Who knows? But you know that something is wrong. And now you're going to try to figure out what's wrong because you're so familiar with what's normal. And that's where midwives are good, because midwives are experts at normal birthing. And really, about 80% of women who are pregnant should be taken care of by a midwife who practices like a midwife, not a midwife who's being forced to become what they call midwives, where they basically are mini obs. They're just practicing the policies that the obs set for them in the hospital setting, which we see a lot of that. So those are the true emergencies. Then you asked about cascades of intervention and why we don't see them at home. And I kind of just. I sort of did summarize that, because we don't mess with nature's design. I know that a racehorse is a valuable animal, but how many horses need C sections?
- [34:06]
B
Probably none.
- [34:06]
A
Well, every now and then, if you have a million dollar horse, you might and you know, that kind of thing. But I'm just saying, for the most part, none dogs, none. Unless you're French bulldogs, which is kind of silly. They bred dog. French bulldogs would be too big to come out. I mean, talk about silliness.
- [34:24]
B
All right, which is actually something I want to ask you about humans in a second, but yeah, okay.
- [34:30]
A
So yeah, cascade of interventions is as I said, you brought into the hospital, either you come in in labor, probably too early, or you come in because your bag of water's broke and you're not contracting. And in midwifery world we would ask you a couple questions like baby moving? Yep. Fluid clear? Yep. Any contractions? Nope. Any blood? Nope. Okay, go back to bed. In the medical world, if you break your bag of water suddenly they start looking at their watch and they say, you know, well, we only have 18 hours or 24 hours before all hell breaks loose, so you should come in. So you come into the hospital, you're not really in labor and so you're not in labor, but you're in the hospital. So what are they going to do for you? They're going to do a vaginal exam and they're going to probably say your Cervix is only 2cm. We probably should start augmentation with pitocin and then that starts that whole cascade because now you have to be in bed and be monitored because your membranes are ruptured so you can't move, so you're uncomfortable, so you ask for an epidural and then your contraction space out, then they give you more pitocin. The baby doesn't like it and you know the story and that's the way it works. Whereas at home we don't do those things. So you don't see that cascade of interventions except on rare circumstances where it's actually necessary. If a woman is having a home birth with a good midwife and we'll talk about you asked, how do you pick that person if she ends up with a C section for that pregnancy, she's going to be one of those five, 10% of women who probably needed it, not one of those 35% who, you know, the other balance who didn't.
- [36:05]
B
Inflammation is an important part of the body's natural healing process. But unfortunately, our modern lifestyle diets, high in sugar, unhealthy fats, stress, allergies, poor sleep, environmental toxins can trigger chronic inflammation. Inflammation which can become the foundation of modern day disease. If you're looking for a delicious drink that will improve energy focus and support healthy inflammation levels, you need to try Paleo Valley's superfood Golden Milk. It combines the profound, well demonstrated health benefits of turmeric with other nourishing certified organic superfoods such as lion's mane reishi, cordyceps, shiitake, Ceylon cinnamon ginger and more. Plus they've added organic coconut milk for its brain supportive MCTS black pepper, Himalayan Pink salt and organic monk fruit for an amazing taste and maximal absorption. To try the Superfood Golden Milk Today, go to paleovalley.com Real Foodology and you will save 15 off when you use code Real Foodology. Again, that's paleovalley.com Real Foodiology okay, let's talk about dogs and allergies. I noticed something with my dog's turkey and butters like paw licking, ear scratching. Those can be signs of allergies. A lot of these allergy symptoms in dogs can start in the gut. When their gut is out of balance, it can show up in their skin, ears, digestion, energy levels. As someone who's really intentional about my own health, I need to be thinking about my dogs the same way too. They need good bacteria to support their gut and keep their immune system balanced. That's what led me to Better Wild Allergy Relief Soft Chews. They're designed to support your dog's allergy defenses by strengthening digestion and helping restore balance. They use natural ingredients and include probiotics plus ingredients that support gut, immune and skin health. So you're not just covering things up, you're supporting your dog at the source. I've been giving them to turkey and butters daily and they think they're treats. I've especially been more consistent now that we're heading into spring because that's when allergies tend to flare up and it gives me peace of mind knowing that I'm doing something proactive for their health and not reactive. Right now, Better Wild is offering my listeners up to 40% off your order@betterwild.com Real Foodology well, that's exactly what my to your point when my midwife told me and my husband very early on because you know, we're first time parents, we're admittedly a little bit nervous about a home birth. But what I told you earlier, before we started recording, I'm actually more scared of a hospital birth than I am a home birth, which is why I'm doing a home birth. But my midwife told us very early on she said, look, I know when there's going to be an issue and we will be headed to the hospital long before there's actually an emergency because I know what to look for. And you gotta think about it. I mean, this woman doesn't want to have a liability on her hands. So if she really knows and she sees something serious happening, she's going to get us to the hospital before it's even an issue.
- [38:51]
A
Midwives don't do this because they want to get rich. And midwives don't do volume because they can't, because they have this continuity of care model, which is the best model of care. And sadly, what's happened is that you asked about why doctors want to, you know, they want to get home for dinner or they want to get to their kids baseball game or whatever else. They've changed that a little bit because now what's happened is doctors used to be the captains of the ship. They used to own the patients. They used to bring the patients to the hospital, and the hospital will then take care of the patients. And if the hospital wasn't nice to the doctor, the doctor could say, you know, I think I'm going to take my practice and move it over to that other hospital over there. Well, hospital businessmen didn't like that. They didn't like the fact that they didn't have control. So what did they do? In the late 80s and early 90s, they brought in something called managed care, and they began to take over the patients, and then they began to hire the doctors. And this was one of the biggest downfalls, I think, in why care has gotten worse, because doctors were less invested in the individual patients since they didn't really know them very well, and there was less continuity of care. They may take care of a patient at almost every prenatal visit, but there's only a 1 in 7 chance that they're going to be on call when they're in labor. So that woman is hoping that her doctor's the one on call, and she's not. So now she's taken care of by a stranger. And a stranger has no connection to you, doesn't know you. And that's human nature. We care more about people in our direct line of sight, like our family, than we do about the neighbor down the block. And we care more about the neighbor down the block than we care about somebody living in the town 20 miles away or somebody living in another country or whatever. So that's just the way we are. So they broke that up because they wanted to destroy the doctor patient relationship. They being people that run healthcare, that run the obstetrical world. And I mean, this is more than just obstetrics, but that's what we're talking about. And they even changed the word doctor. To what? Provider.
- [40:55]
B
Practitioner. Oh, yeah. Provider.
- [40:56]
A
Provider. It's like, interesting. Provider of life. And by the way, midwives, unfortunately, midwives are only mid level Providers. So they've demeaned everybody and they demean midwives even more by calling them mid level providers. No, she went to school, she went to training. She had, she did an apprenticeship. She did. She became a nurse and then a certified nurse midwife. She's not a provider. And I, as a physician, am not a provider. But it is another way to demean us. And what they've done by taking doctors who used to be independent and now making them salaried employees working a shift is they divided their loyalty and their fiduciary duty. My fiduciary duty as a solo practitioner was always to my client. Now my fiduciary duty is supposed to be to my client. But if my client wants to go past 41 weeks and my employer says we don't let people go past 41 weeks, now I have to change my language and stuff and subtly coerce my client into having an induction because otherwise my employer will be pissed off at me. You can see the inherent conflict.
- [42:07]
B
So you were just talking about how they're basically demeaning midwives and saying that they're mid level. Did you say mid level? I think provider.
- [42:15]
A
Mid level provider. Right.
- [42:17]
B
So I want to tell you something because I also really want my listeners to hear this. So I, I, you know, I've had a very different experience than a lot of people I know have had throughout this entire pregnancy, because I've never stepped foot in an ob GYN office since I got pregnant. And that was on purpose. Every single appointment that I have with my midwife is anywhere between an hour to two hours and we go over everything. Perfect example. Which is another thing I wanted to ask you about. My husband and I are different blood types, so I'm a negative and my husband's a positive. So there was a concern for the blood. Right. We got really lucky. My baby is the same blood type as me, so he's a negative as well. So we didn't even have to explore the idea of doing the RHOGAM shot. But before we found out what my baby's blood type was, she spent 30 minutes going into full detail with me about the ins and outs of the RHOGAM shot. And when I shared a little bit about this on my Instagram, I have never been flooded with so many messages in my life from pregnant women that were going, wait, wait, wait. My doctor just basically told me I had to take it. They said nothing about testing the baby's blood. They just said, out the gates. You just take the Rhoam shot. There were no questions. They. They gave me no explanations about it. And my point about this tangent is that we have never gotten more like we got. So we've gotten so much information every step of the way. Same thing with gbs. Another thing I want to talk about the vitamin K drops, all of this stuff. She, every time we sit down and talk with her for over an hour about the ins and outs, the pros and cons. Why would we do this? Why wouldn't we do this? What would happen if we didn't do it? What would happen if we did? People going to a regular OB GYN are not getting this type of information explained to them at all. They're just being told, you have to do this.
- [44:05]
A
That's correct. They may be getting a handout, but they, you know, because the way the medicine system is set up, doctors have to do volume. They can't, because first of all, their overhead to run their office or to run an office setting is extremely high. And even if they're an employee of a large system like Kaiser Permanente in Southern California, I don't know what you have in Texas, but you know, one of the big health systems there's. The overhead is immense, so they have to do volume. And the doctors, again, it's of their own making because they never stood up and said no. But their schedules are not made by them. Their schedules are made by schedulers. And if they're told they get six minutes for a prenatal visit, that's what they get. If they get eight minutes for an annual exam with a woman for her pap and whatever else, that's what they get. And if they don't do their volume every day and they get behind all day long, eventually one of their managers is going to come to them and saying, you know, you're moving too slowly. You have to speed things up. That's how it works. It's not the same. It's when you're cared for by somebody you know, don't you feel good about going to your visits with your midwife because you know her? And by the way, when you call at night, who's going to answer the phone?
- [45:16]
B
My midwife.
- [45:17]
A
That's right. If you're in the doctor system, who's going to answer the phone? You have no effing idea. You just don't know. And the idea that you said that, you know, you. You feel safer not going to the hospital, that's important because ultimately where a woman feels safest is where she should labor. But how do you Make a decision on safety. If you're, if you're given skewed information. Now, if you're given full information and you think that you feel better in the hospital, that's where you should be. But you have to go in with eyes wide open and understand that the likelihood of you having an unmedicated birth and having a vaginal birth and having delayed cord clamping and skin to skin and not being harassed a little bit about hepatitis vaccine or vitamin K or other things like that is going to be something you're going to have to deal with. You need to know that. And so people should check out. I always say this. When you move to a new community, you check out the schools, you check out the parks, you check out. You know, the crime rate in your community. You might check out, where's the Costco? Where's the grocery store? Is there a movie theater? What people don't ever check out is the hospital.
- [46:20]
B
It's a great point.
- [46:21]
A
They should check out the hospital. They should ask, you know, what's your VBAC rate? What's your C section rate? Do you do breach delivery? What happens if I break my bag of waters and I'm not in labor? You know, who's on call? Is it? You know, how does it work? And check it out so that you can find out that maybe, just maybe, this isn't the hospital for you. Might be the best town for you, but you might decide that you're going to give birth at the hospital and next town over. But if you don't check it out, you get what you don't have any say in it, and it's too late when you find out you're in labor, that suddenly they say, no, you can't eat. No, you can't do this. Yes, you have to be augmented. And ultimately they should never talk to you like that because that's coercive language. And you know, the funny thing is, Courtney, they say they follow ACOG guidelines, and ACOG guidelines should not be what midwives, the standards that midwives are held to, because midwives aren't obstetricians. But they lie to you when they say they follow ACOG guidelines. What they actually mean is, we follow the ACOG guidelines that we like and we ignore the ones we don't like, because there are very strict ACOG guidelines against the use of coercion and coercive language and threats of Child Protective Services and all those other things that they will do to you if you refuse to do what they want you to Do.
- [47:43]
B
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- [48:54]
A
Right.
- [48:54]
B
I was like, what they will call CPS on you if you don't stay in the hospital.
- [48:59]
A
And they think they're being virtuous. These people that are calling, they think they're protecting the baby because obviously they care more about that baby than the parents do.
- [49:05]
B
And the parents. It's crazy.
- [49:07]
A
It is, it is. It's, it's, it's crazy. But it's a, it's a paternalistic system that is. And they're fearful about liability. So they think that they're protecting the baby is going to protect them from being sued when we really need to rede. That's not the right word. Redesign the, the entire system. Because the system we have right now is not fixable. It's not going to change. They're not going to suddenly say, you know, we've been doing all these things for decades, they're not working. So we're sorry, we're leaving and we'll let Dr. Stu and the midwives figure it out. No, they're not going to do that. Right? I wish they would, but they aren't.
- [49:44]
B
I wish they would too. So what's the solution? More people just opt for home births or maybe the middle ground is birthing centers. What are your thoughts on birthing centers?
- [49:53]
A
Well, because of time. Let's talk about Sol. Because a lot of times we sit there and complain and complain and complain and we don't have solutions. I got a lot of them. All right. The first one, I think starts with how reimbursement and payment is. It's basic economics. Remember basic economics 101. If you want more of something, you subsidize it. If you want less of something, you tax it. So if they pay more for C sections, what are you going to get?
- [50:18]
B
More of them?
- [50:19]
A
More of them. If they pay more for babies in the nicu, what are you going to get? More babies in the nicu. If they pay more for ultrasound than not doing an ultrasound, what are you going to do? Going to do more ultrasounds. So change the incentives. How about if they pay more for vaginal birth, pay less for cesarean? How about if they pay more per birth to a hospital that has a C section rate under 20% and a little bit more if it's under 30% and a lot less if it's over 30% or whatever number you want? You know, I'm just making up these numbers. But how about changing the way we incentivize people? People will say, well, that's coercion. Well, of course it is.
- [50:58]
B
But what's happening right now is coercion.
- [51:00]
A
That's how we decide. We decide we don't want to go 85 miles an hour in a 45 zone because we're going to get a ticket. We don't want a ticket. There's a consequence to it.
- [51:11]
B
So yes, and we might as well be encouraging things that are actually better for baby and mother's outcome.
- [51:17]
A
Right. That's one is changing the way insurance companies and insurance companies could lower the C section rate tomorrow simply by lowering the amount they pay for C section and raising the amount they pay for vaginal birth. Suddenly breach delivery would come back, VBAC would come back. And along with that has to be tort reform. Tort reform is something we talked about a lot in the 80s and 90s because there were a lot of states that were going crazy on malpractice premiums, and Florida was one of them. California was another one. We passed laws that helped protect. I put a cap on pain and suffering and stuff like that so we could cap the insurance premiums because doctors were just basically being forced out of business because they couldn't afford the malpractice insurance. So have a system of either loser pays, like they do in England and Canada, where if you're going to sue somebody, you better have a damn good case, because if you have a damn good case, they're going to settle right away. And if they don't have a damn good case and the defendant wins, then you have to pay the defendant's attorney. You might think twice about a frivolous lawsuit. So tort reform can't. You can't have one without the other. Start with youth education. I think it would be really important to get into middle schools and high schools. And there's an organization that, that Bliss and I and my co host of my podcast, we support without. We don't take any money from them, but we, we advertise for them. It's called Girls who Know. And I encourage your, your listeners to look them up and what they're trying to do is educate young women about their bodies, about their menstrual periods, about pregnancy. And eventually we need to get our young boys educated as well. But if we can educate these women, these young girls, young in life, then it's going to be hard for them to be gaslit when they're older. And they go to the doctor and the doctor says this and says, no, well, actually, that's not true, doctor. You know, I'm, I'm not at high risk because I'm 35 or 41 or whatever. You know, if you educate, start early because once you can, once you instill fear into the birthing world, you can't get rid of it. There's a scene in the movie Inception where they're talking about how they're going to implant this idea into Cillian Murphy's character's brain. And one of the people, they're sitting on the roof and one of the person says, why can't we just tell him to break up his company? He says, because then he'll know where it came from. And he goes, what do you mean? And the guy says, don't think about elephants. Okay? So if you start to plant seeds of fear early on, like your hips are too small, your husband's too large, your, you know, your mom had C sections, you know, all these things. And, and doctors do this kind of stuff. Remember that when you go in to see the ob, they have, it's all electronic now, but the electronic records have what's called a problem list. That's how doctors do things. And when you're pregnant, what's the number one thing on the problem list that you're pregnant? And the American College of Ob GYN has a statement in one of their guidelines that says pregnancy itself is a high risk condition. And I'm not taking that out of context, that's what they say. So if that's the prism by which doctors and medical students and residents are learning about obstetrics, you can understand why they're all scared. Because pregnancy is itself is a high risk. Is pregnancy itself a high risk condition? No. High risk is not a number. High risk is something that makes doctors uncomfortable.
- [54:43]
B
I'm seeing this incredibly concerning trend happening online right now in the comments in the DMS that I'm getting. And also I see videos about it where women have been told not everybody, but there's a trend happening online where I'm seeing women are making these comments and saying, well, it's incredibly dangerous for a woman to be pregnant. And it's the most dangerous, high risk thing that a woman can do is to get pregnant and have a baby. And they're being told that it's, it's risky and dangerous to be pregnant. And not only that, but they're also being told too to just immediately opt for the epidural. Because why would a woman ever put herself through unnecessary trauma and pain? And I think all of that is so concerning. And where are they getting this from? Probably from the doctors and from the medical system.
- [55:32]
A
Some of it's from the medical system, there's no doubt. And some of it's propagated through mom's groups where mom has had a bad experience and therefore she's finding solace in a way or redemption in a way of trying to prevent that from happening to other women. They're not doing you a favor. Pregnancy is a normal function of a woman's body and most of the time it goes really well. Occasionally it can go wrong, but that's not the norm. And the idea of going into it and being fearful the whole time, it's very short sighted. Because what does fear do to the mammal? And what is the mammal secreting when the bamboo is scared? And what is that doing to the developing fetus when a woman is worrying all the time versus a woman that's joyous all the time secreting their baby in dopamine and oxytocin as opposed to cortisol and adrenaline when those little neuron pathways are forming, I mean they're mini me's, these things inside of us and they carry a lot of it, but a lot of it isn't set. We think that genetics is set, but a lot of it isn't. Things can epig. There's a thing called epigenetics, which, which can change how genes are expressed and when. So this fear is not beneficial, but sometimes it's psychologically a way that people can cope with something that happened to them that's bad, or justifying rationalizing their decision to, to have an induction at 39 weeks ending in a C section by saying that this is really, it's really scary. See what happened to me? And blah, blah, blah. And there's a need to do that. And then the doctors, of course, propagate that partly because they themselves fear birth, partly because they profit from that fear, and partly, I think, they just don't know anything else. They learned something 20 years ago in medical school or residency. They've never bothered to look deeper at it anymore. And now, since they're just an employee, a cog in somebody's system, why would they. Why would you do extra homework? You know, I could, I could really go off on a tangent here. And the, the American Board of Medical Specialties and the American Board of Ob GYN used to be when you were board certified, you were board certified for life. Then it was every 10 years, then it was every six years, but you had to take every year modules that were put out by the American Board of obgyn. Then it became you need to do that every year.
- [58:07]
B
So do they do that every year?
- [58:09]
A
Now they have to take this certain number of modules every year to keep their board certification. Now, these things are not free. You have to pay for them. So if you, if you need a certain amount of continuing medical education credits are called CMEs as a doctor for a midwife, they're called CEUs. And you can get them from taking your board modules. Then you're going to just take your board modules because you have to take them anyway. Why would you take something on breach delivery? Why would you take something on midwifery care or whatever? You just focus on that. But I just want to make it very clear, and I'm not saying this because I'm bitter, because I'm not. I was board certified for the first 20 years of my practice, and then I wasn't. And then I decided it was a kind of a decision that I was kind of forced into to either do something that I didn't want to do or to keep my board certification or just let it go. And I just let it go. And did I suddenly become a worse doctor the day after I let my board certification go? No, as a matter of fact, I think I became a better doctor, but I certainly didn't become a worse doctor. So doctors, just because they have md, F, A C, O, G, which is Fellow of the American College of obgyn, Board Certified, does not make them necessarily wise. How do I know that? Because all the stupid things we've been talking about for the last 45 minutes or so have been put into place by board certified fellows of the American College of obgyn.
- [59:45]
B
We saw this during COVID It was a great way to get doctors to coerce them to do exactly what they wanted them to do, to have them all get in line and push out this narrative that was not necessarily, oh, it was not better, for it was honestly putting a lot of the public in danger.
- [60:02]
A
Don't we know that? And we knew that then and we know that now. They suppressed it back then. The American College of WGN is still to this very day that we're talking. What is it? April 30th of 2026, still pushing Covid vaccines, DTAP vaccines, flu vaccines, and RSV vaccines on all pregnant women. And they tell you to use something called motivational interviewing. Motivational interviewing is a, is a euphemism for coercion. Basically, you want to. If a woman, if you counsel a woman and you tell her she should have a COVID vaccine and she chooses not to do it, then ACOG actually tells you that you haven't counseled them well, and next time they come in, you should try again. As opposed to honoring their ethical right to decline a treatment and saying, given information, you decline the treatment. I respect that. It's not maybe what I would do, but I respect it. I honor that. I'm not going to keep bothering you. Nope. Got to do motivational interviewing again. They're compromised by Big Pharma. They make a lot of their money from Big Pharma. Big Pharma controls the journals. Big Pharma controls the medical schools. Big Pharma controls the organizations. The American Academy of Pediatrics is one of the most corrupt organizations. And, you know, right now, at least, they're facing a racketeering lawsuit in federal court. So we'll see what happens with that. But I don't put a lot of faith in these processes. They take too long. And I'm. I can't wait that long. But. And then you also, the other thing you mentioned about. I think there was something about why would you get an epidural? And there's an old thing about. I wrote a paper. I wrote a. Not a paper, a blog. Once called labor is not a toothache. Because you hear people say, well, you would never have your teeth drilled without lidocaine. Why would you, you know, or novocaine. Why would you have a baby without an epidural? And that I, I've said this many times that that's just very. So short sighted. And again, no respect for nature's design. In the medical, in the medical world, they, they don't, they don't have any, they think that they, they, that they intervene on stuff, they're going to make it better, but they often will intervene without proving that their intervention is safe first. They'll just do it, probably because of a profit motive like continuous fetal monitoring. There was a lot of money in that. People had to buy these devices. They have to buy the paper, they had to buy the software and the hardware. And, and when they, when it became introduced in the 1960s, you know, every hospital bought one, bought, you know, one for every labor room they had. Every doctor's office started buying them. It's a huge industry. They brought it in place without ever proving that it was going to do what they said it was going to do, which was lower the rate of intrapartum death or cerebral palsy, which it didn't do. So epidurals interfere with nature's design. And I don't know if you've heard this story, you probably have, but I'll just briefly, if I might, When a woman, you know, you ask yourself the question that is universal question, why is labor painful? What's the point of labor being painful? All right, well, putting the biblical reason aside, you know, eating of the fruit of the tree of knowledge without their permission, whatever. Putting that aside, labor is painful in all mammals. We know that because they've studied that. They actually looked at catecholamine secretion and sheep, and they're in labor. It's like, I mean, I, I could think of better things to do with my life, but that's what somebody did. And they found that there's surges. Every time they have a contraction, they're putting out more catecholamine. So we know it's painful. But, but painful labor in nature, how does that benefit the mammal? Because if the mammal is crying out or moaning, it's more likely to attract a predator. So it's not beneficial in that way. So maybe it's beneficial in this way. And this is a theory, but there's a connection between mom and baby. Baby has been living the life of Riley inside your belly for nine months and now suddenly Uterus starts to contract and every time it contracts, there's more pressure on the baby and there's diminished blood flow through the placenta for that 30 or 40 seconds. And that's affecting the baby sensing something that it's never sensed before. But because mom is uncomfortable, mom is secreting hormones like endorphins, which are her natural opiates, and adrenaline, which helps to space out contractions, and cortisol, which deals with stress, and of course oxytocin, which everybody knows is your bonding love making hormone. And so baby gets a waft of mom's hormones. Now there is question. Some people don't believe that the hormones cross in great enough amount to make a difference, but I don't believe that. I believe that these things cross the placenta and the baby gets a sense of there's mom. And this is what I talk about with Alex. If you remember the interview with Alex, I did that. And her and her reel about that, where, you know, that without mom was, was very, very well put together on Alex's podcast. So they're getting a waft of mom and a reassurance that mom, who they've been communicating with for nine months, hormonally, electromagnetically, through sound, through other things, hearing voices, they've been communicating with their mom. They know their mom. It's very familiar to them. And so suddenly the contractions get so intense that their mom decides to get an epidural. So now mom is numb and now, but she's still contracting, but the baby's no longer getting any connection from mom. And sometimes the contractions space out. Courtney. And so they say, well, the contractions are spaced out. Let's add Pitocin. So now Pitocin is saturating the oxytocin receptors. You're not even getting any oxytocin from mom. And you're not getting endorphins, adrenaline, cortisol, or other things that I'm not talking about. You're not getting those things from mom because mom is actually probably snoring because she's taking a nap. She's so exhausted. She got her epidural. Now she can rest. But the uterus is still contracting. Now the baby's without mom. And so eventually the baby's heart rate begins to show signs of changing. Like maybe it's accelerating a little bit, maybe there's a decrease in the variability, maybe there's some decelerations. And now we have the monitor on and God, that's making the doctors and the nurses uncomfortable because the baby's showing signs of not tolerating labor. And so they end up deciding to do a C section for the fake diagnosis of fetal intolerance to labor. When it's really fetal intolerance to induce and augmented and intervened upon labor. It really is, and the baby comes out generally fine.
- [66:55]
B
Is this why baby sometimes has a hard time latching first after breastfeeding? I also heard it might be because baby is a little doped up from the fentanyl that's in the epidural.
- [67:04]
A
I don't know if that's the case or not. I don't know that the fentanyl does that. I just know that C section interferes with bonding and breastfeeding, but not always. So again, I don't want to be accused of being hyperbolic. The relative risk might be slightly higher, but the actual risks are still relatively small. But the baby is deprived of using its reflexes to come down the vaginal canal. And we did a podcast with somebody who talks about fetal reflexes and being integrated into your childhood reflexes and those babies that are missing that may have some other problems like attention deficit disorder and bedwetting and other things like that that you may see. Really interesting to look at a study of bedwetters and find out how they were delivered. I know for me, I, I didn't wet my bed, but I, I, my mom has no memory of my birth because my mom got twilight sleep and I got pulled out with forceps, which is what they did in the 50s. Oh, wow.
- [68:02]
B
What's twilight sleep? Where they just put you out? They put you under?
- [68:05]
A
Yeah, they gave, it was ether or some general anesthetic in those days. They just put you out with gas and then they pulled the baby out. So we have these babies that aren't getting, getting delayed cord clamping. They're not getting exposed to mom's microbiome. They, they will have problems chronically. Labor, there's higher rates of asthma. There's higher rates of autoimmune disorder in babies born by cesarean section.
- [68:27]
B
And is that because they're missing out on the bacteria coming through the canal?
- [68:31]
A
We think so. Okay. Yeah. Nature designed a system over eons for man to come in in the last hundred years and think that we can do better just tells you something about mankind that, that yes, there are times where nature does goes awry and a baby has a problem that medicine can solve, but that doesn't justify meddling in every fricking labor.
- [69:03]
B
Yeah, it doesn't justify out the gates acting like pregnancy is just A medical emergency in of itself. And labor is a medical emergency. If there is an actual emergency, it would be different.
- [69:14]
A
But. And that's why those Facebook posts you're talking about, where people are doing that, they're doing women a disservice. They think they're not, but they should present both sides. It would be really. What would really be great is to have debates between people. They used to have something on TV called Point Counterpoint. I don't know if you remember it. You might be too young. Yeah. Where they had. They had like, a conservative and a liberal, and they. And they had a moderator. I forgot his name. William Buckley, I think, was the name. And he did this thing. And it was. It was brilliant because you got to see both sides of an argument. It was when things weren't so polarized as they are now. But wouldn't it have been great during COVID the very beginning, whether if President Trump or President Biden had said to Anthony Fauci, you know, Anthony, there's a lot of questions out there about masking and six feet apart and locking down and about ivermectin and hydroxychloroquine. So what I've done is I've gotten two hours of primetime television on cnn, and we're going to have a moderator, and you're going to be on stage
- [70:25]
B
with Jay Bhattachara or Peter McCullough would be awesome.
- [70:30]
A
Or Peter McCullough. Yeah. But Jay is with the author of the Great Barrington Decoration, one of the three authors, and it would have been great. Or have Peter and Jay there with Fauci and Deborah Birx or Francis Collins or somebody who are all pro it or Peter Daschik or any of these other people that are so proud of the lockdowns and everything else and have it on national television, but they won't ever do that. And I would love to be on a podcast with a moderator where 2. If I was on with a very rigid maternal fetal medicine doctor who thinks that all they're doing is great, I would think we'd probably find a way to agree on 70% of stuff. And the other 30% we could have a conversation about, and they could hear my side of the view, and I would hear their side of the view, and then the listener could. But they just never. You can't ever do that. I mean, I've tried to get people to come on podcast. They won't come on.
- [71:24]
B
I know I've tried to get people that disagree with me to come on my podcast. Some have, but it's very rare. And it's hard to get them because they feel like they're just being trapped, which I'm like. I'm. I'm a very reasonable person. I just want to hear the other side.
- [71:36]
A
And the thing is, a confident person is willing to admit they don't know something. Yes, it's the insecure person. It's the insecure person that feels like they're going to be trapped. I mean, you need to be wary. When I speak to a reporter, I'll talk to them for 30 minutes, and then I'll see that they quoted me one sentence.
- [71:57]
B
Same.
- [71:58]
A
So you got to be careful about that sort of thing. And I would tell anybody who's being interviewed by somebody, if you're being videoed, you should video it yourself, too, and keep a copy, because they do edit those things. But you can't be afraid. If you. If you believe that you're right, you should be able to come out and defend it, and you shouldn't be afraid to defend it against people who think you're wrong. But dialogue has gotten to be. It's disappeared in this generation. There's too much screaming, and everybody can anonymously attack you. You've probably been attacked, Courtney. I know that I have a lot.
- [72:35]
B
I have been attacked a lot. Yeah.
- [72:38]
A
I mean, look at you. Why would anyone want to attack you?
- [72:41]
B
Thank you. That's very nice. Well, I've been in the, you know, it sounds like similar to you. I've been in the alternative, holistic, if you will world for a long time, health world. And people don't love that. When you. When you swim upstream and you go against the status quo, people do not like it and they attack you for it. I get it from all angles. I get it from just people. I also get it from doctors. I get it from nutritionists. And, you know, it's fine. We don't need to. We don't need to go into it. But, yeah, it's just when you go against the status quo, you're going to get a lot of hate for it. But I think eventually, everything that we've been talking about in this episode, hopefully things are going to change. And I love that you brought up earlier so many of your ideas and solutions that you have, because there's so many people that are waking up now going, okay, what we're doing is not working. We need to do something differently because we're having horrible outcomes for baby and mom. And just in general, when you look at the medical system as a Whole, we are having terrible outcomes, we are getting unhealthier as a population. What we're doing is not working and we need to fix it.
- [73:46]
A
Ideally getting, getting back to practitioners being independent and not being employees. I don't know that that's ever going to happen. But these, again, this would, would help because then they'd have more stake in the game. They'd have more commitment to the individual client. Instead of legislatures increasing regulation, they need to deregulate. Let women choose. Yes, if a woman wants to be delivered by her granny, she can do that.
- [74:12]
B
Let her do it.
- [74:12]
A
But if a woman wants to be delivered by her granny, who happens to be a midwife, she can't do that. I mean, just think about how stupid that is. I mean a taxi driver can deliver your baby, but a certified nurse midwife in Nebraska can't, you know, so it's a felony if they, if they do that. Look at the midwifery model of care. Again, it's not a for profit, volume driven model. So you'd have to get a lot more midwives out there. We don't have anything close to the number of midwives you would need to get 80% of pregnant women being seen by a midwife. Primarily we need hospitals. We cannot say we get rid of the hospitals because we need the hospitals. But the hospitals in turn can't make money if they're only doing with 20% of the pregnant women. So they need the normal pregnant women to bring them in. But then they over test them and they over intervene upon them and that causes all the problem. Let families decide who supports them. The family wants a midwife, let them have a midwife. If a family wants to free birth, let them free birth. If a family wants a maternal fetal medicine doctor or an ob, fine. That's what they should have. And we should have paid family leave that's longer. So that, I mean there's nothing more important than how we raise our children and how our children are born into this world. And we put so little emphasis on that. How we come into this world really affects us for the rest of our lives. And maybe part of the reason we have so much chaos in the world right now is because we've really excuse the word up. Birth.
- [75:51]
B
I worry and I wonder about that a lot too because I think about. Yeah, though, just the medical emergency that, that babies come into in this world, in the hospital. And you know, we haven't said this at all and I think it's implied, but I'll just say this anyways. Obviously thank God for modern medicine. Thank God for these interventions for when there are true emergencies and those babies and maybe mom would have otherwise died. Thank God. But we've just taken it to a place now where we're acting like birth is unnatural and that laboring is unnatural, and we're just intervening before we even need to. Before there's even an emergency in the first place.
- [76:27]
A
Yeah. Courtney, There's a number that's used in statistics called the number needed to treat and the number needed to treat to prevent one death in breach delivery runs around 1 in 500. So in other words, you have to do 500 C sections to save one baby. Now, some people say, well, that's great, we saved a baby. Yeah, but you might lose one mother from surgery and what are you doing downstream to all her future babies? So it isn't just about. I mean, medicine can do miracles. That's true. But they need to be able to. They need to look at the whole picture. What is this family's values? What are the desires in the future individualizing your care? The problem with a big system like that is they don't individualize their care. Everyone gets the same protocol. If you have a certain type of twins, then you get this kind of testing and you get this and you're induced at this week and the babies need to go to do babies have to do this certain thing. And that's not true for some women. It is true for some women. It isn't true. If doctors had the ability and the freedom to do the. To treat women as independent people, we probably would improve our outcomes. But then somebody's going to lose control and profit.
- [77:51]
B
Okay, so I'm really curious because I saw a post about this the other day that a woman was told that her baby was too big for her to birth and so she had to have a C section. Is, does this happen where babies are too big for you to birth them naturally?
- [78:07]
A
Well, when you ask the question that way, can it happen? Yes. Does even. The American College of OBGYN doesn't really support induction or C section for suspected large baby unless it's, you know, unless it's a diabetic and it's over like 10 pounds, that kind of thing. But even then, the prognostic uncertainty of ultrasound makes it not really a reliable thing to do. Any doctor that tells you your baby is too big for you is a doctor. You shouldn't be going to simply unless they give you a really good explanation. Because first of all, the estimating fetal weight is not very accurate. Second of all, the pelvis is a dynamic organization. It, it's not fixed, so it moves. And by the way, when you deliver in an upright positioning, when you're on all fours and upright, there's 20 to 30% more space in your pelvis than when you're laying flat on your back. And for, for generations, how have women giving birth flat on their back? Okay. Because that's the way we're taught. And there's many doctors who, when a woman says, I want to do, I want to deliver squatting, they don't know what to do because they've never seen a woman deliver in any position other than lithotomy.
- [79:22]
B
Well, then there's the issue too. If they're, they have an epidural, they can't move or they can't stand or
- [79:26]
A
sit that way, Right? So again, that's why the C section rate is higher in women who have epidurals. I mean, that's one of the reasons. And the other thing is, and the baby itself is not fixed. Baby's head is designed to mold. So the idea that baby's too big to fit out. And again, they're going to say this to you when you have a nine pound baby, a nine pound baby is a normal baby. I mean, these are the kind of things you need to find out about your practitioner long before you're 39 or 40 weeks. So this is why you need to interview them. I always tell women, remember I talked about checking out the local hospital. But I also, first visit you have with your object should not be a medical visit. You should not be going in there, letting them take your blood pressure and drawing your blood and doing that. It should be an interview. You should go in there. Remember, you're the consumer. They're the salesperson. You can decide whether or not you want to buy that car. You want to go to a different dealer, you can decide that with your OB and by how do they answer the questions? Do they give you the time of day? Do they look you in the eye? Are they busy with typing in their computer? Or do they have one foot out the door? What do they do when you break your bag of waters at term and you're not in labor? What do they do? Do they do breach delivery? Oh, you don't? Why not?
- [80:44]
B
Will they let you go to 41 or 42 weeks?
- [80:47]
A
Ask these questions as an interview. Just say, you know, I'm not here to have you check on me today. I'm here to interview you. I'm happy to pay you for your time, pay you your consult fee, whatever it is. But I'm not here to be your patient yet. I'm here to see if we click. And everybody knows when you feel good about somebody, you walk out of there feeling better. Then if you walk out of that office feeling, like, worse than you walked in, and you were already nervous when you came in anyway, because you're always sort of nervous when you're pregnant, going to the doctor. But did you walk out feeling safe and secure, or did you walk out feeling more agitated? And if you walk out feeling more agitated, why the hell are you going back?
- [81:26]
B
I totally agree. Wait, so I have a question about. What are your thoughts on inducing at 41 or 42 weeks versus just letting a woman let her baby come when he comes?
- [81:40]
A
I believe in nature's design, so I would tend to let women go as long as they want. But I do believe in checking on the baby. So if you get to about 41, I wouldn't. There's no reason to be doing antenatal testing on a woman who has no problems. No hypertension, no diabetes, no growth restrictions. True growth restriction. We didn't even get into that whole issue with maternal fetal medicine doctors. But if they don't have any problems, then about 41, 41 and a half weeks, I'd start testing the baby with what's called a biophysical profile. And that's just looking at the baby on the monitor and also checking the fluid around the baby, because fluid is a good indicator of fetal urine output, and urine output's a good indication of placental perfusion and blah, blah, blah. So if those things are fine, then there's nothing magic about going beyond 42 weeks. Does the stillbirth rate rise? Yes, it rises in all pregnancies beyond 36 weeks. So that it rises is not what's important. What's important is how much does it actually rise? And that is a very small number. But you'll be often be told relative risk. You'll say, well, it's twice as risky if we wait another week. Well, if the risk was one in two thousand this week, so next week it's one in a thousand. That may be. You know, some people may say, well, I don't want to take that risk. Okay, fine. Other people will say, well, that's a 99.9% chance it's not going to happen. And I think that there's benefits to my baby going into labor spontaneously picking its own birthday. I don't know what it is, but I know nature Designed it this way. So I'm going to wait. And you should be able to have that choice. You should never be in a situation where you're feeling coerced. You should always be able to get an explanation from it. And if the explanation seems reasonable to you, then that's fine. But if it's not plausible, then understand that your doctor is just trying to get you down the path that makes them the most comfortable.
- [83:32]
B
I. Yeah, I completely agree. This was one of the many reasons why my husband and I didn't want to have an OB gyn because we were told that since I am quote, unquote geriatric, that most OB GYNs would not allow me to give birth after 40 weeks. They would be forcing me into an
- [83:46]
A
induction, and they would have started testing your baby. 36 weeks. You had to go in twice weekly, by the way. No concern how, Courtney, you're a busy woman. How that affects your schedule. Schedule that you have to drop everything twice a week to go and sit in the waiting room for an hour and then be on the monitors for a long time. And again, no concern about the fact that the monitors are a form of ultrasound, which is a form of emr, non ionizing radiation. And no one's ever tested those things for safety. We live in worlds where we're bombarded by everything between microplastics and 5G and glyphosate and geoengineering. We don't really know all, you know, differentiate, but we do know that ultrasound is a form of radiation. It's not like X rays, but it can cause potentially cause problems. And because they've never really done any real good studies on that since the late 8, 1980s, we don't really know what that's doing to our babies. We know that we have children right now who are more chronically ill than any generation ever before. Now, we can blame that on many different things, as I just said, or even the vaccines or whatever else you want to blame it on, that's fine. But maybe it's also what's happening in the womb, and maybe we need to take consideration about that and just go back to trusting nature's design. And for some women who I'm talking about these things and say, well, listen, I have medical or Medicaid, I can't afford to do some of the things that you're saying, can't afford to go to a different hospital, make this a priority. Start as a young woman, start saving money, get a health savings account going so that you're not limited in your choices by financial constraint, because this is the most important thing that you will do in your life. And I always say, like, winning a gold medal is a great thing, or graduating law school is a great thing. But the thing you'll remember when you're very old and nearing. Sorry, I get emotional when you're nearing the end is you remember the birth of your children. And too many women love their children, but do not love the birth story of their children. And what have we done as a medical community to change that, to make that story something that women are upset about, that they. They can never really get over? And I've talked to women my entire professional career, and a lot of them come to me in a second pregnancy or third pregnancy because they had a bad experience in their first pregnancy, and they may have a nice birth in their second pregnancy. But you talk to them years later, and they're still upset about the fact that they got coerced into doing something and ended up with a C section for their first pregnancy that they didn't need. And they always wonder if they could have done it differently. And that doubt shouldn't have to be something that hangs over this most monumental event that you're about to embark upon. So it's really kind of cool.
- [86:40]
B
I love everything that you just said, and I feel like that's a great place to end. And I will say it's. It's very tragic and sad that we've taken that away from so many women. And I want to say one other thing. So my husband and I actually joined a crowdsourcing. It's not technically insurance, but we just call it insurance. There's a company called Crowd Health, and they pay for the entirety of our home birth after a little deductible, which is very manageable.
- [87:05]
A
They're great. We have the CEO on our podcast, and you should, too, if you haven't had him on. He's great.
- [87:09]
B
I did. Oh, yeah, he's amazing.
- [87:11]
A
Yeah, no, he's great.
- [87:11]
B
We're huge fans of. Of Crowd Health, so anyone listening that feels like it's not attainable for them? My husband and I, for both of us, for our plan, I think we pay like 180amonth or something. I mean, it's wild. So it's a great resource for people, especially if you're wanting to do a home birth or paying for the entirety of my home birth after a little deductible, which I think is cheaper than what we pay in the hospital, so.
- [87:33]
A
And you could pay a fortune in Insurance premiums and they won't pay for a home birth. And you know, insurance companies are, you know, we all need it because the, the idea was, was actually designed by farmers. It was a co op so if somebody's crops failed, they didn't lose their farm because they all banded together. And then the idea then was morphed into something that was, that was not ever meant to be, which is where insurance companies, they have the nicest buildings, they have the private jets, they sponsor the, the bowl games, they, they, you know, have to sponsor the golf tournaments. Clearly they have enough money to blow on all kinds of things.
- [88:11]
B
And then they deny life saving care.
- [88:13]
A
And then they deny life saving care. They make it hard for you to get, you know, you don't pay your premium on time, you're canceled. But try to get payment for something that, a service that you had and it might take, you know, nine months of fighting only to get a diminished reimbursement or nothing at all. Right. It's again that, that them, along with pharma, along with big medicine, have not made our country a healthier country.
- [88:38]
B
Well, my next guest is here, so I'm gonna have to go. I hate cutting you off because I want, I could talk to you for hours. I'm definitely gonna have to have you come back on. In fact, if you would like to come back on, I would love to have you on after I've had my baby and we can talk more. Maybe we can talk about my birth story.
- [88:53]
A
I would, no matter how it goes, I would love to do that. And I would love to talk to your listeners a little bit about breach and twins.
- [89:00]
B
Yes, well, that was on my list of questions.
- [89:02]
A
Yeah, we didn't get to it.
- [89:03]
B
I know, but let's do that.
- [89:05]
A
Okay.
- [89:05]
B
I'll have you come back.
- [89:06]
A
I'll come to, I'll come to Austin next time. Right.
- [89:09]
B
I was going to say this time, come here and we can do it in person and we can share my birth story and maybe I'll even bring my baby with me. We'll see.
- [89:16]
A
Yeah. I'm sending you blessings to you and Hector and just hope it goes as smooth as you, as, as you desire and you get everything that you desire. It's going to be the heart, one of the hardest things you've ever done, and it's going to be one of the most valuable things that you've ever done. And, and odds are it's going to go great. It just is. And you have a trusted midwife who knows what she's doing. So you're in really good hands. So we at the very beginning, you said you're a little nervous about it. Don't be. Just go into it and surrender. Surrender to nature's design and trust that your body knows exactly what to do.
- [89:51]
B
That's why I just keep reminding myself over and over again. I'm like, so many women have gone before me. My body knows exactly what to do. God designed my body to do this. I was meant to do this. Just keep reminding myself all of that.
- [90:02]
A
Many blessings, Courtney. Thanks for having me on.
- [90:04]
B
Thank you. Also, please share with everyone where they can find you, your podcast, your Instagram, anything.
- [90:08]
A
Oh, sure. Well, everything is Birthing Instincts. All one word. So it's birthing. Well, no, it's Birthing Instincts Podcast website is birthing instincts.com and the Instagram is at Birthing Instincts. And I my mission in life right now, I've sort of retired from clinical practice simply because I got old and I didn't want to be on call anymore, but is to I go around the world and I teach breach and twin delivery skills along with along with the podcast with Bliss, which we've been doing now. I've been doing the podcast since 2013, so it's been a long time. But Bliss has been with me for 10 years and we have fun doing it. And I advocate for women's choices and informed consent. And not skewed informed consent, but honest informed consent. So that's my mission in life. It's a good mission. I am very happy. I moved out of California three years ago. I live in a small town in Southern Utah. So if anybody's listening who happens to be traveling near Zion or Bryce or whatever and wants to stop and say hello, I. I'm more than happy to see you.
- [91:12]
B
Thank you so much, Dr. Stu. This was an amazing episode and I'm so excited to release it and I'll be in touch after I've given birth.
- [91:18]
A
Thanks, Courtney.
- [91:20]
B
Thank you so much for listening to the Real Foodology podcast. This is a Wellness Loud production produced by Drake Peterson. Theme song is by Georgie. You can watch the full video version of this podcast inside the Spotify app or on YouTube. As always, you can leave us a voicemail by clicking the link in our bio. And if you like this episode, please rate and review on your podcast app. For more shows by my team, go to wellnessloud.com see you next time. The content of this show is for educational and informational purposes only. It is not a substitute for individual medical and mental health advice and doesn't constitute a provider patient relationship. I am a nutritionist, but I am not your nutritionist. As always, talk to your doctor or your health team first. Are you overwhelmed by the shoulds? Do you want to simplify your life to better align with your values? Do you want to create space in your schedule so you have room for the good stuff, play, joy, relationships, creativity, and more? Check out Edit yout Life, a podcast to help you edit the unnecessary from your life so you have more room to enjoy the awesome. Through episodes with me, Christine Koh, and a range of smart, compassionate guests, you will come away with insights and tactics to help you simplify and declutter your home time, mental space, and more.