Jamie Hinton (20:52)

You make you don't know anybody until.

Tiffany Reese (21:08)

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Gina Thompson (23:45)

My name is Jamie Hinton. I am a licensed midwife in the State of Texas in the Dallas Fort Worth area. I was a CPM as well as lm. I am no longer a cpm. I came into this profession in a very natural way of my own pregnancy and birth of my first baby and then teaching childbirth classes, becoming a doula and then moving on to becoming a Licensed midwife. Gina and Caitlin and I were friends before any of us were midwives. Gina was a doula, I was a doula, and Caitlin eventually became a doula as well. We did have a friendship and we worked together. I would teach childbirth classes and refer people to Caitlin as the doula, or Gina would refer people to my classes from her doula clients. Gina was the first of us to decide that she wanted to become a midwife and become licensed. I was the next and then Caitlin was the third to start. Gina, when she was almost through her apprenticeship, knew that I was about to start an apprenticeship as well and that I was wanting to do an academic program. She said, let's go to Starbucks and talk. She laid out a plan for how to fast track the route to becoming a licensed midwife. She basically said, I know that you want to train with this particular midwife that you used as your own midwife, but that would be really difficult. If you come over to this location and work with these two midwives, it will be much faster. You can come in to births towards the end. You catch a baby, it counts for your numbers. A lot less time, a lot less stress. If you want to just buy the first module for the academic program, you could do that, but you don't actually need to finish it or buy the rest of the modules. You can say that you're enrolled in the program without finishing it and no one will really know. As long as you get your skills signed off on and put a past doula birth as your apprenticeship start date, then you can get done as fast as you can get your 50 births in. That was her outline of how to become a midwife quickly. The minimum requirement is supposed to be two years of an apprenticeship. Some do longer than that. A three year apprenticeship is pretty common if you're doing academics and a true apprenticeship. My view of that was we are not painting walls where I can go back if I use the wrong color and redo that or touch up the corners because I didn't do it well enough. These are people's lives and this is a very serious thing. You're holding lives in your hands. I have a bachelor's degree and I taught for several years before entering the birth world. And so education is very important to me. And I told her that and I said, I understand that this looks like a good plan, but again, like, these are people's lives and so I don't have respect for you in doing this and I'm not going to do that. And you know, she was Gina, she was very loving and friendly and like, I just wanted to let you know that this was an option. I mean, it's going to be really hard if you work with the other midwife. We left with it feeling like we were on good terms, but I did not feel good about her and who she was anymore. Within the next day or two, I talked to Caitlin about it and said, I can't believe this, why would you even want to do this? And she agreed with me. And then two weeks later, Caitlin was then following her track and going to birth with Gina and Gina's preceptor. So it was a pretty natural separation. That was pretty much the end of the a friendship with both of them. A view of watching Caitlyn at that point go through an apprenticeship very quickly, use a start date on her student midwife forms of a doula birth that she went to with me to shadow me as a doula. That was the very first birth she'd ever attended. So I knew the date and I called Narm and asked about that and they said, oh, that's no problem, she can put that date. I said, even if I know it was a doula birth? And they said, yes, that's fine. Even if she gets done in nine months, they said yes, that's fine. So I sat back and went through a three year apprenticeship and finished academics and it was very difficult. She went through that so quickly and is making all this money in the successful birth center. That was difficult on a personal level for me, but also on the professional level of knowing there are going to be people who suffer from this. I just thought, how long will it take before this can be stopped? And that's really when I started figuring out there were not many places to go to or people to go to. So that was a really hard thing to go through knowing I was becoming a part of that community.

Tiffany Reese (29:09)

So essentially, because you chose to go with a longer three year program with a different preceptor, by the time you're getting licensed, they already own the birth center, I believe.

Gina Thompson (29:24)

So they were in business together.

Tiffany Reese (29:27)

I'm curious what it was like for you having your unique experience of having this sort of inside information about ways that they were potentially cutting corners and then simultaneously, given the smallness of this community, seeing these negative outcomes over the years. I imagine as somebody who's passionate about this work and the importance of midwifery, it's especially hard to see.

Gina Thompson (29:56)

Yes, very, very hard to see. Became harder as time went on and their birth centers grew and their Clientele grew because this seemingly perfect portrayal of births and the herbal baths and the pictures and the videos, very hard knowing that underneath that if you look behind the pretty was just a whole undercurrent of not good for anyone. I do believe that part of Gina's philosophy, the shortcut method that she presented to me on here's how you could become a midwife so quickly. It just from the get go was a lot of you can make a lot of money. While I appreciate that everyone has to make a living and I am my family's only income, you have to value people's lives over the money. I think that a lot of the argument that people have about hospitals being a business, the overwhelming drive for hospitals is to get people in and out, in and out, because that's more money. It can also apply to out of hospital birth. With birth centers such as Origins, you have owners that now are wanting to not practice and just run a business, and you have multiple locations that you can't be at. But a huge part of midwifery care is the relationship that you have with the client. That's what makes it valuable to the client and to the midwife, is you're investing a lot of time and care. The money becomes more important when you are removed from that. I think we see that in a lot of businesses, a lot of things in the world, that money will take over when you lose the personal connection. I think that's a lot of what has happened here that has led to poor outcomes. Some of it not being the people directly involved with the care of those clients, but from the owners themselves and the way that they ran the business.

Tiffany Reese (32:06)

Obviously, you can't speak specifically to the transfers that we've covered this season, but I'm wondering if, in general, you could speak to why some of these birth centers that are not following proper protocol might be avoiding transfer.

Gina Thompson (32:26)

Some of that does come from the monetary aspect. With my practice, I don't bill insurance. People pay a fee and that's it. And then I break it down if they need it, prorated, et cetera. I think when you function as it sounds like Origins functioned with billing insurance and needing clients to continue their growth. With more midwives working there, more birth centers, it leads to, we need to make clients happy. And if a client is unhappy because they transfer, then they're going to want a refund. And I have heard that Origins had a contract where they did not refund past 34 weeks. Most midwives at that time, back when Origins first started, were saying once you hit 36 or 37 weeks, no refund, because it's difficult at that point to replace on your calendar a due date that you've already been on call for and done work for. So they had theirs on the earlier side of 34 weeks. I think it may have originated from A, we're trying to keep people happy and so we don't want to do a lot of transfers. B, we're so busy that we need to use students to care for clients when licensed midwives aren't around. Students haven't yet seen a whole wide range of when you need to transfer a client out. And so I think there's a lack of knowledge there as well that led to a lot of the not transferring until it was a shit show.

Tiffany Reese (34:06)

We've come to hear from many that it's alleged that origins by their protocol was essentially if you are a graduate midwife student, meaning you've done everything except pass your exams and gained a license, you could essentially practice without your preceptor in the room. I'm curious if you could speak to if you've heard about similar circumstances elsewhere.

Gina Thompson (34:35)

Yes. Back when all of this first started being an issue, there were discussions within the community of well, what is a graduate midwife like? What qualifies as that? This is not a term that's used by narm. This is not a term that's used by the state of Texas with licensed midwives. But it overall is a large problem. I think it goes back to we don't have a standard for every CPM lm. We know that they do this educational route and so we know that they know this information. Even if we did have a defined. Here's what a graduate midwife is or they've met all their numbers and completed everything and they're just waiting on their paperwork to be processed, we still don't have the assurance that they've completed these things on their educational route. You could have me in the office with you as a student where I haven't done any didactic work. I've just learned by situations that came into the office over the last three years versus you could go to somebody else's office and have somebody that completed an outlined academic program with markers throughout of tests and skills reviews and that has been in their apprenticeship for two or three years. Their education level may be different than mine was. She may know how to run the labs, what labs to run to diagnose preeclampsia versus if I never saw that come through the office in my apprenticeship and hadn't decided to pick up the right textbook to read to figure out that, then I may not know that there's new information that comes out, new research, new standards. As someone who's taking care of moms, babies, families, you need to constantly be educating yourself, researching, finding out what the newest recommendations are from reputable evidence based sources. There's some controversy surrounding what's called the PEP process route to becoming a cpm. You would not have to complete an academic program. If you're going through the PEP process, if you are able to get your skills signed off on by preceptors saying that you are competent and you are skilled in those and you are can be a competent test taker and you can pass narm, then you will become a cpn. And in Texas that means then you also become a licensed midwife and lm. So I think that that really needs revisited. There are not many professions where you don't have to complete some sort of coursework outline, especially when you're dealing with healthcare and people's lives. It seems like there are too many loopholes to being able to get through quickly, to being able to lie on paperwork, and too many loopholes for not actually having the skills that you say you have.

Tiffany Reese (37:48)

I've gotten so many different opinions on this. What is the appropriate amount of time that someone can be pushing? That is a safe amount of time before transport is needed.

Gina Thompson (38:03)

So there's actually some guidelines on that and they differ whether it's a first time mom or whether it's someone who's already had vaginal bursts before the average time. Like if you have someone who has had vaginal bursts before. If we're getting to two hours of pushing, that's pretty abnormal. For someone who's called a maltip that's had these bursts before. For someone who is a primip. If we're getting to the three to four hour mark of not making progress with pushing, we're not having a baby here very soon using those guidelines. That would be an appropriate time to transport for sure.

Tiffany Reese (38:46)

Some of the survivors we spoke with mentioned getting to a place in their labor where they are crawling and walking and having to like scoot on the ground to make it to the car to get to the emergency room. Is that typical?

Gina Thompson (39:03)

I would not say that's typical. Most out of hospital midwives don't want it to get to that point. When people plan out of hospital births or even just a natural birth without pain medication in a hospital, there is a difference between normal labor pain, normal labor, progress and suffering. Whether that suffering is from a problem during the labor with a malpositioned baby or exhaustion, or whether it's the mental part of labor, if we've turned our corner into this is not just normal. You're not able to cope with this anymore. Most of us want to transport for that, not get to the point where you're unable to walk and unable to communicate anymore. It goes back to we're not just birthing out of hospital to birth out of hospital. If this seems like you're going to have a more positive experience with an epidural, then that's what we're going to do. I don't want suffering to enter the equation.

Tiffany Reese (40:14)

It would just be so helpful to hear for listeners what are the things that they should be asking any potential practitioners that they're considering for their care.

Gina Thompson (40:27)

I think that a really good place to start is asking them what their apprenticeship was like. What experiences did they have throughout that apprenticeship? How long was the apprenticeship? Did you complete an academic program or do self study or do no didactic work? How many births have you attended and was your attendance at those births for most of the labor and birth or just towards the end? I think it's also good to ask any midwife, no matter how long she has been practicing licensed, tell me the complications that you've seen and how you managed those. Tell me about a time that you had an emergency transport, what was that for? How did that go? Do you have clients who have been in that situation that I can speak to so that I know their perspective on how your care was and how the transport was and how their postpartum was? Those are great questions to ask any provider. The normal questions that I get a lot when people are interviewing me to see if they want to hire me as their midwife, is what's your transfer rate? A lot of midwives will say, well, it's 7%, but most of the time it's a first time mom who's exhausted and she just needs an epidural. After we've tried everything there is to try at home, we go in, she gets an epidural, sometimes pitocin, and everything still goes great. But is that true? Because over the last nine years of being licensed, I can say that that's not my most common reason for transporting someone in. Digging further to get to the truth of some of those things, of why people are transferred is important. Ask more than just what my transport rate is. Ask what I transport for, where I go, what relationships do you have at those places. Can I talk to anyone who's been through this? Either someone that takes, transports or transfers from you, or clients who have been through that. Those things all matter.

Tiffany Reese (42:46)

Thank you so much. I'd love to hear how midwifery can benefit clients.

Gina Thompson (42:52)

There are a lot of benefits to midwifery care, the relationship that you can develop with your provider and them hearing you and listening to you. Providing care based on you as an individual instead of you as one of hundreds can be life changing. The entrance into motherhood, whether it's your first baby or your 10th baby, really changes you. Having a provider, whether it's your doctor or your midwife or your nurse who provides respectful, safe care, offers you options, explains things to you, and sometimes when there aren't any options, as in an emergent situation, still cares for you through that can be life changing and affect you as a mother and how you parent your baby.

Tiffany Reese (43:45)

Thank you so much. I appreciate greatly your opinion and your time and willingness to speak with me, especially on the record and in support of the survivors. I think we need more bridges and I think those bridges of communication are so essential. If we want to be fully inclusive, then we need to be collaborative as well.

Gina Thompson (44:07)

Yes, I 1000% agree and I very much enjoyed speaking with you.

Tiffany Reese (44:20)

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Gina Thompson (45:03)

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Tiffany Reese (45:58)

As I mentioned at the top of today's finale, since our investigation into Origins, Birth and wellness began 10 months ago, we've had other survivors come forward to share their experiences with us. Some who have delivered after the podcast began airing their stories, which we have fact checked. Like all of the other survivors, stories through medical records, testimony and public record are concerning and heartbreaking and they underscore the issues highlighted this season. Like Survivor Rose, who felt more comfortable having me read her statement about her experience, Rose became pregnant and first sought care at Origins Dallas in November of 2021 at a friend's recommendation. Rose reports that while under Jennifer Crawford's care during her time at Origins, Jennifer never told Rose that she was an unlicensed midwife who should be directly supervised by a preceptor. Rose also saw licensed midwife Elizabeth Fluell, who was licensed on July 2, 2021. Rose's impression was actually that Jennifer seemed to be fully in charge of the birth center because all the midwives and staff always consulted her end quote. When starting her care, Rose shared with her Origins team that she struggled with anorexia. Doctors had previously told Rose that a higher than average weight gain was anticipated and desired with her pregnancy. Yet Rose states that while at Origins, they, quote, continually commented on the amount of weight I was gaining end quote. As her care with Jennifer and Elizabeth continued, Rose shared with her caregivers that she was a survivor of sexual assault and was worried about becoming triggered during her labor and delivery. Rose alleges her midwives assured her that they were well versed in trauma informed care. However, when Rose went into labor, she said she felt Origins offered very little comfort or direction aside from telling her to reach out to their on call texting line. By the time she got to Orygen's birth and wellness in Dallas, Rose was already 7cm dilated and in transition. At the time of Rose's delivery, Elizabeth Fluwell was a certified professional midwife and licensed midwife serving as the primary provider. Jennifer Crawford, unlicensed with the state of Texas at the time, acted as the assistant. Rose shared that there was also a student and licensed midwife there in an observational capacity. Rose shared that Elizabeth Llewell then took her blood pressure, which she recalled as reading 165 90. Rose alleges Elizabeth seemed concerned about the reading, but then left her alone in the room with her husband because they were busy with another mom. She shared that she felt disregarded and that this was very triggering and upsetting for her as she felt her feelings and pain weren't being taken seriously. She also shared that she looked at her birth notes in Maternity neighborhood after her labor and delivery and noticed her medical chart listed her blood pressure reading as 140 92, not 16590 as she recalls it originally being read aloud. Eventually, once Rose began pushing, she stated that she would eventually face such high pain levels that she had to stop. She states that the midwives encouraged her to push through her pain despite her pleas that her pain levels were excruciating. After her child was delivered, Rose shared that she was bleeding heavily and at that point she felt like she had to urinate. She says the midwives directed her to go to the bathroom, but because Rose couldn't walk, the midwives told her to urinate on her bed, which Rose felt was degrading. However, she found that she couldn't relieve herself at all. Rose alleges Jennifer Crawford then used an alcohol wipe to clean Rose's vagina, which caused her to scream in pain. And because Rose continued to bleed post delivery, her care team called 911 to emergency transport Rose from Origins to a nearby hospital. Rose estimates that after about 30 minutes of waiting for the ambulance, paramedics were finally able to arrive. She said she was then placed on a stretcher and a robe was simply thrown over her naked body. She now describes this moment as humiliating. To make matters worse, because Rose's birth suite was on the second story of Origins, Dallas, and there was no elevator, paramedics had trouble getting Rose down the stairs, which took additional time and discomfort. When finally arriving at the hospital, Rose was informed that she had experienced horrific labial tearing. According to Rose, the OB said her injuries were easily avoidable if she had been allowed to slow down during pushing, which she'd instinctively tried to do. But Rose claims Jennifer and Elizabeth shouted at her to push through the horrific pain and that she literally felt every second of her labia tearing into multiple pieces. As a result, Rose alleges she's since had to go through two subsequent surgeries to repair the damage, and she still deals with daily pain and scarring even two years later. Rose claims Jennifer and Elizabeth never apologized, never offered to talk to her about her birth, and she never got the notorious herbal bath they'd promised she'd get at a later date. Thank you rose for sharing your experience with us. We wish you continued healing on your journey. Marie is another incredible survivor we've had the opportunity to connect with. Ironically, a medical provider at her hospital told her about the season of Something was wrong as she was checking out of the hospital March of 2025 after being a client of Jennifer Crawford and Elizabeth Flewell at both Origins Dallas and DFW Community Birth and Wellness, Marie alleges she also experienced birth trauma that has had lasting physical and emotional effects. Early in her care, Marie states that she shared with Jennifer Crawford, who was a licensed midwife in the state of Texas by this time, about her intense fear of needles. According to Marie, she felt validated and supported by Jennifer's response. After this appointment with Jennifer, Marie felt seen and heard which made her more confident in the decision to continue care with her. After Origins Dallas closed, she followed her midwives Crawford and Flewell to their new birth center and midwifery school, DFW Community Birth and Wellness. Marie saw no initial red flags except for some minor kinks here and there which she felt was natural for a new company to work through. Marie shared with us that Jennifer Crawford actually brought up to her negative reviews that led to the closure of Origins Birth and Wellness center and that the allegations were false. Marie shared that Crawford rationalized the negative reviews by saying something along the lines of that there were people out there who had bad experiences and were out to get them. Marie recounted that Crawford had also told her that there was a mom that had falsely accused her of killing her baby and that at the time Crawford was so convincing she believed Jennifer Crawford when she said all of these women were making stuff up as a witch hunt. After transferring to dfw, Marie reports that her urine samples were no longer collected at her visits leading up to her birth. Marie was diagnosed during her pregnancy with gestational diabetes. Because of this, Marie states that she went to see a doctor that had an ongoing relationship with the midwives to assess if she was still considered low risk and able to remain in her midwives care. Marie shared that the OB GYN allowed her to continue in the midwives care, but by mid January 2025 Marie was nearing the end of her pregnancy and was becoming more concerned about the possibility of an in hospital birth. Marie says her midwives assured her that she was still low risk and eligible to remain in their care in the week leading up to her due date. Marie alleges that her licensed midwife Jennifer Crawford instructed her to insert castor oil soaked tampons into her vagina Marie provided a message sent by Jennifer Crawford via DFW Community Birth and Wellness Online Maternity neighborhood portal on February 3, 2025. It reads Recipe for Castor Oil Tampon Fresh castor oil tampon Smell it. It goes rancid quickly Unbleached applicator free tampon. The smaller size the better. Soak the tampon in oil for 10 minutes and then insert near cervix for 40 minutes daily. In communications provided to us by Marie, Elizabeth Fluell also sent a recipe for a castor oil burrito and was instructed to eat the dish to help induce labor. The message from Elizabeth reads, hi Marie, here's the recipe. You can make the burrito or you can make it a bowl tonight and take it around 6am Then try to go back to sleep. Contractions usually begin within a few hours. If you're not having consistent contractions, you'll take another dose in four hours. The recipe listed after the directions calls for 4 tablespoons of castor oil per burrito. While Marie did use the castor oil soaked tampons throughout her 39th week of pregnancy at Jennifer Crawford's direction, she didn't feel comfortable eating the castor oil burrito. Marie says during this week when she was instructed to use the castor oil soaked tampons, she was simultaneously visiting the midwives to have her membrane stripped, which can increase the risk of infection. On February 10, Marie says she visited DFW Community Birth and Wellness for the last time. She recalled her midwives noticing pitting edema on her right leg below her knee and on her left leg to ankle and on her abdomen below her belly button. Edema is caused by fluid buildup and can be a symptom of preeclampsia. Marie also received a high blood pressure reading of 139 over 87 that day. She had gone all 40 weeks receiving regular readings and assumed that the elevated reading on the 10th was because she was so stressed out about having to go to the hospital. Marie states that Jennifer Crawford then wrote on her chart that Marie was still appropriate for midwifery care at this time, and in that day's chart notes, Jennifer also wrote declined taking castor oil. This amazing end quote. Due to her increasing concerns, Marie had promised herself that February 10th would be her personal cutoff. If she didn't go into labor naturally by then, she would transfer to the hospital for care in hopes to be induced there. When she told her midwives this, she says they labeled her decision as an elective induction. According to Marie, she does not believe it was elective, especially considering what she would learn upon her arrival at the hospital. Marie then headed to Baylor Medical center and was admitted later in the day, February 10, 2025. Upon being admitted, Marie alleges the hospital determined that she was diagnosed with preeclampsia with severe features. She says her white blood cell count was elevated and continued to rise despite intervention. Marie's water broke the following day, February 11, as it leaked, she says the smell was foul. Marie's OBGYN was worried about potential infections and meconium in her waters, so they recommended Marie have a cesarean delivery. Marie states that her child did not cry after delivery because they were born with meconium in their eyes, ears and nose. Her baby was intubated and transferred to the nicu. Marie was unable to hold her for days, which was heartbreaking for her as a new mother. Recovery would prove to be difficult for them Both because by February 20th, Marie's OBGYN believed there was a hematoma caused by her cesarean section forming near Marie's incision site. A hematoma is a localized collection of blood outside of the blood vessels. It occurs when a blood vessel is damaged, causing blood to leak into the surrounding tissues. It was decided that Marie would have to have a second surgery to open her back up to determine if any further damage needed to be addressed. Marie shared that during her second surgery it was discovered that she didn't have a hematoma but that she had necrotizing fasciitis in her uterus, which is a life threatening bacterial infection that devours the soft tissue beneath the skin. She says it was eating her from the inside out. Making matters worse, the infection had caused Marie to become septic and she began experiencing respiratory failure. Because Marie was under general anesthesia, Marie's husband was called by surgeons who had to ask for his approval to save his wife by allowing her care team to remove her uterus, tubes and cervix in an effort to save her life. She says she was strapped to a hospital bed and intubated. Marie says later her primary surgeon had told her that had they not removed her uterus swiftly, she likely would have died. She also later found out that she had been suffering from E. Coli and Strep B infections. Marie shared that after her second surgery, she then needed to have three further surgeries to repair what she describes as damage and disfigurement. She remained in the hospital for weeks and was finally discharged on March 7, 2025. The same day, a member of her care team told her there was a podcast out called Something was Wrong and that it was about her midwives. Marie reports that because of her birthing experience and subsequent surgeries that she is disfigured. She says her scar goes from hip to hip, up past her belly button and up past her waist on the left side of her body. Her thigh muscles are still atrophied. She says she experiences lower back pain and also reports experiencing difficulty mentally and emotionally as a result of these traumas. The first time I spoke with Marie, she tried logging into her maternity neighborhood portal while we were on the phone, and she then realized that her access had been cut off, similar to accounts we heard from other survivors this season. Thankfully, Marie had previously captured her maternity neighborhood information and notes prior to her access being shut off. Marie shared with us that she reported her concerns about her care to the Texas Department of License and Regulation, whom she hopes will continue to investigate problematic midwives. Thank you for sharing your experience with us, Marie. We wish you all the best in your healing. Next, a survivor whom we're calling Grace shares her experiences at a different birth center in Texas. Grace is a health actuary. Her job is to analyze claims and forecast risks in the healthcare industry. She sought a freestanding birth center in 2018 for her second birth after having an emergency C section with her first child. Grace wanted to attempt what is often referred to as a vbac, or vaginal birth after cesarean. She was drawn to the birth center she ultimately selected because it was covered by her insurance policy, according to her birth center charts. Her care team included midwives with varying licenses as well as a birth assistant. Grace shared that her team did consult with her about potential risks of having a vaginal birth after C section, but they also assured her she would be about five minutes away from the hospital in the event of an emergency. She says she decided to continue on with care and didn't see any major red flags before her labor began. Here's Grace.

Jamie Hinton (63:25)

They had given me wormwood to try to encourage labor because I had been about a week past my due date. I learned after the fact that if you had a prior C section, that can increase the chances of your uterus tearing. The night I started going into labor, my contractions were very strong and getting close together. I had called the midwife a few times. She was trying to convince me not to come in and I told her I don't feel comfortable not coming in, my contractions are too strong and too close together and she told me I can't come in because I'm not falling on the floor and not able to talk due to the pain. I went in, and she was annoyed that I came in. She was saying some pretty rude things to me. She was trying to convince me to go home. She would say things like, well, when you're in my house, you're gonna follow my rules. You do not want someone talking like that to you while you're giving birth. She was also attending another birth, which is not okay. When you have a VBAC going on, you need continuous monitoring. She would pop in every once in a while. And I was starting to have some pretty horrible warning signs. I was bleeding, I was puking. I was experiencing excruciating pain in between contractions, not just during contractions. Those are all uterine rupture warning signs. At some point, I'm on the floor, kneeling, and I feel this distinct large and painful movement in my uterus. Nothing that a baby could do than just excruciatingly painful. More painful than the contractions. She was like, oh, your baby's just turning around. I'm like, no, a baby can't move that way. And it was all very downhill from there. It turns out that was the pop of my previous scar starting to open. She said, oh, don't worry. This is all part of rapid labor. And she was telling that to my husband. At that point, not too soon after, I couldn't speak. I couldn't hold up my own body weight. My baby's heart rate kept dropping. It was dropping to the 60s, which is very, very low for a baby. Very dangerous. I guess she didn't know because she didn't have much medical training. And when you're doing a vbac, they're supposed to have continuous electronic monitoring. Every once in a while, she would take the baby's heart rate with a handheld Doppler, and it was not very frequent. When she did take it, the baby's heart rate was low. She noticed that the heart rate was not quite as low if I was on my hands and knees, but I just can't because my organ's tearing apart. She wasn't calling the ambulance. And I was afraid that if I went into another position, like if I laid down or on my side or anything, I don't know. I just had this feeling my baby would die. I was doing everything I could to avoid that. It took superhuman strength. And to this day, I don't know how I did it. I think my husband was just in mental shock, thinking, maybe you're watching your wife and baby be in danger. And you trust whoever is attending the birth to do what they need to do. At some point in the morning, maybe an hour later, the nurse midwife came in, saw the low heart rate, freaked out, and she told me after the fact, that's never something you want to see when you get to work. She called the ambulance. She gave me terbutaline to try to stop the contractions. She put an oxygen mask on me. And then the ambulance takes a while to get somewhere. They had to load me in the ambulance. That was a very painful process. And I'm going to the hospital. The midwives did not come to the hospital with me or give my medical records to the hospital. The midwife didn't know I was having a U rupture. The nurse midwife didn't come in until an hour after my rupture started. The tear is getting larger and larger as time goes on, and it was two hours until I got the C section in the operating room. They gave me the epidural. Then they lost my baby's heart rate completely. So they couldn't wait for the epidural to kick in. They gave me ketamine and I had a cross C section, which was a very unpleasant experience. I wouldn't recommend high dose ketamine or a cross C section if you can avoid it, but the surgeon was amazing. When he opened me up, my baby's head and hand were in my abdomen, not my uterus. So his entire head and hand had gone through the opening of my uterus. So pretty large tear. It's called a catastrophic uterine rupture. His head and hands were blue. And the surgeon, he told me afterwards, he took out all my organs, checked them, put them back in, and he was just so quick. I mean, he really, really saved our lives. Ketamine takes effect very quickly, and epidural takes a few minutes to kick in. Ketamine, it's a very strong hallucinogen, so it's not the mindset you want to have when you're welcoming your baby into the world. I had a very bad trip. I had bad hallucinations. And I remember after those bad hallucinations, hearing my baby cry for the first time. You know, they cry. That's a healthy sound. And it was just like nightmarish because of the ketamine. I'm in this little recovery room just wondering what the heck happened. Freaked out, holding my baby as tight as I can. And he was just so perfect. Like he actually did recover. And it's really a miracle. I'VE talked to so many OBGYNs and midwives after the fact and done research on that topic. Babies can die or have brain damage and somehow it was two hours and me and my baby both survived. A lot of the times when a mother has a uterine rupture outside of the hospital, she's at great risk of bleeding out. And neither of those things happened. So I think somehow my baby was positioned in just the right way. Only the OBGYN who delivered me and my medical records can attest to it. But I'm here, I'm alive, and I want to do something about it because not everyone had that same outcome. But I proactively reached out to them to try to educate and convince them that what they're doing is not safe, it's not medically sound, it's very dangerous, they can kill someone, that VBACs are not safe outside of the hospital, that they need to hire people who have more training. They would not listen at all. The medical director said that they are doing everything according to standard midwifery practices. And that's true, sadly. The week after the birth, I was in a very dark place. I was having flashbacks. I had my one week follow up with the obgyn. He explained to me that I could have died, my baby could have died. We got really lucky. And he explained to me that what I experienced was medical negligence from the birthing center and the midwife. He encouraged me to report them to the state of Texas. He told me he was going to report them, but it really helps if the patient reports them too. So he kind of told me how to do that.

Tiffany Reese (70:39)

What's confusing to me is if insurance is covering both, shouldn't they be held to the same standard?

Jamie Hinton (70:47)

Yeah, that was my million dollar question. Why is insurance covering this? In fact, insurance companies these days, it seems like they want to deny even the care you need. I knew that insurance companies would not be covering this if they knew it was happening. So I did a few things. I did a deep dive claims analysis since I had access to a massive amount of claims data so I could see the results of hospital births versus birthing center births, including the diagnostic codes that the birthing centers were using. This is claims data throughout the entire country. Since I'm a health actuary, I had access to that data. I'm lucky that I can actually look into things like this through my line of work. And we did find that costs can be a lot higher at the birthing center. It looks like it can be a lower cost, but if you have to transfer from a birthing center to a hospital. You're paying for the birthing center. You're paying for the ambulance. You're paying for all the costs that happen due to delayed emergency care. You're paying a lot more than if you would have just started birth in the hospital. If nothing happens and you're lucky, then the birthing center is less expensive. We looked at the costs and we looked at the health outcomes and what we found was really startling. For example, we have these diagnostic codes. You are only supposed to take a patient at a birthing center if they're low risk. But we kept seeing this pattern of the midwife or the birthing center coding the patient as low risk when they're clearly high risk. For example, a mom is having their prenatal care at the birthing center. They might also see another provider outside of the birthing center for whatever reason. And the urgent care or the ER or the other provider codes them as a high risk pregnancy. And the birthing center keeps coding them as a low risk pregnancy. So that's concerning. It either highlights lack of training. Don't know what the heck you're doing if you can't even identify a high risk pregnancy or a level of deception. And I can't speak to why people do what they do, but it's possible that both could be happening in different situations. What I found through looking into it a lot is insurance companies don't know that they're covering this. So the volume of people at birthing centers is still very low compared to at hospitals. And insurance companies are going to focus their time on the highest volume things, the things they know about. You don't know what you don't know. I started advocating for insurance companies to look at their coverage policies. Most providers go through a rigorous credentialing process in order to be covered by insurance, but the midwives don't because only the birthing center is going through this credentialing process. So that responsibility does fall under them. But as I started highlighting what was happening, I got a lot of different reactions. A lot of people didn't believe me that it was happening because they figured if this was happening, someone would be fixing it. Trust me, I did not want to share my personal story with a lot of older men who were much higher up in the company than I was. But I kind of had to, to at least get something done. You know, I didn't do it for me. I did it to try to help other families not go through what I went through. So I kept pressing until eventually I ended up presenting to a chief medical officer at a large insurance company. He thanked me for bringing the issue to his attention. He directed me to the right person at the company who can make sure they're not paying for high risk births outside of the hospital. And I've tried to highlight this issue to a few insurance companies since then. I will always remember what that chief medical officer told me. He said, keep doing what you're doing. If you get pushback, keep doing it. I didn't tell him what an uphill battle it had been to get this issue addressed or to get time on his calendar to present to him. But when someone says something to you like that, they know how hard it is to fight for patient safety because they've seen it before. And that's just one of the sad aspects of healthcare in the United States. But what I did, it's probably the most important thing I've ever done in my career and that I ever will do. And I won't get a thank you for it because you can't thank the person who avoided something happening to you. I just feel really compassionate towards people who've been through this or who are considering a birthing center.

Tiffany Reese (75:23)

Thank you so, so much.

Jamie Hinton (75:32)

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Gina Thompson (76:15)

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Tiffany Reese (76:46)

Next Lee Franzen, a former midwife, shares the troubling realities behind questionable and dangerous practices she says she witnessed during her time as a student and midwife Lee shared that during the early 2000s, she received her midwifery education through the now closed International School of Midwifery in Miami, Florida. Lee alleges that as her studies progressed, so did her concerns. Here's Lee.

Lee Franzen (77:14)

I learned very early on that we were doing things we were not supposed to be doing. We were using the vacuum, for example, to assist deliveries. And we did not write it down, it did not go in the chart, and we didn't talk about it openly. So if you wanted to tell another student what happened, you might say something like, well, she had to eat some fruit. Some people have heard me talk about this and have said, well, why didn't you get out of there? All I can say is that it felt like we were doing something good. It felt like we were breaking the law for all the right reasons. I learned how to make placenta pills. Placenta pills are where you take a woman's placenta and you cut pieces off of it, put it into a dehydrator, and then you grind it up into a powder. And then you take that powder, you put it into capsules, and you give them these capsules and tell them to swallow them. We made placenta pills for everybody who wanted them. It was extremely popular. This was in the early to mid 2000s. Probably 80% or more of our clients took their placenta pills. There was actually a bust where they came in and they took all of the placenta pill making equipment. And when I say they, I don't remember exactly which government agency it was, but it was a government agency that showed up and took all the placenta pillow making stuff.

Tiffany Reese (78:50)

Reports from WCTV and the Miami Herald about this incident have since been removed. But In January of 2009, other online reports shared details from the now removed articles published by the aforementioned sources, which read, on Christmas Eve, a joint investigation by government agencies led to a search warrant. At the Miami Maternity center. Staff was accused of commingling placentas while dehydrating and encapsulating them. Midwife Sherry Daniels denies the claims, suggesting the raid was fueled by anger from local obstetricians, who charge more for deliveries.

Lee Franzen (79:31)

It came to light at that point that the hygiene practices at this birth center were pretty abysmal. The fact that we used to have multiple different women's placentas drying in the same dehydrator at the same time. The fact that sometimes you would mix up whose placenta was whose. I remember that one time I was cleaning out the grinder and I was really trying to get it clean. Because I was going from one person's placenta to the next person's placenta. And the senior student saw me, and she was like, what are you doing? And I said, well, I'm cleaning out the grinder between placentas. And she kind of laughed and rolled her eyes, and she was like, we don't do that. You go straight from one placenta to the next. It was one of those things. I was just part of the culture. I thought to myself, well, what's the point of me being so fastidious if no one else is? I found out that was not the only thing that was happening at that birth center. That was not legal. We were allowed to start IVs, but there were things going into those IVs that shouldn't have been going in there, according to the law. Sometimes we would give someone an herbal supplement. And I'm putting herbal supplements in quotes because it wasn't actually an herbal supplement. It was Cytotec, which is a medication that's used to induce labor. But she was not being informed that.

Tiffany Reese (81:06)

She was given Cytotec Misoprostol. Often marketed under the brand name, Cytotec, is a drug primarily used to prevent and treat stomach ulcers. However, in obstetrics and gynecology, it can be used for various purposes, including medical management of miscarriage, induction of labor, and cervical ripening before surgical procedures, and treatment of postpartum hemorrhage.

Lee Franzen (81:33)

There were women that were being told that evening primrose oil was being inserted vaginally when in fact, the midwife was inserting Cytotec. The midwives would crush up Cytotec and put it in their tea and say, I'm giving you some herbal tea to help you get some more energy. I don't know how often it happened, but it happened. I witnessed it a few times myself, and I know it happened other times as well. I wasn't happy about that. I remember I had to get myself to calm down and tell myself, you're so close to graduating. You're almost done here. Just put your head down, keep doing what you need to do to graduate. And when you leave here, you can do things better. You can make sure that people have informed consent. I just kind of hung onto that, and I did what I had to do to graduate and get out of there. I was in the school for three years. In that time, I managed 50 births, and I attended 75 more. When I say managed, I had caught 50 babies, as we say, and it felt like an impressive number. Everyone I told seemed to think, oh, wow, that's a lot. So I felt pretty well prepared to get out there and start being a midwife.

Tiffany Reese (82:59)

After leaving the now closed International School of Midwifery, Lee went on to open a birth center in South Carolina alongside two direct entry midwives and and a nurse who was in the middle of seeking her midwifery licensure. Lee reported the birth center was highly successful within its first year of operation and that they began making a lot of money. Their birth center was conveniently close to the border of North Carolina, which she stated helped residents of North Carolina who didn't want to receive care from a more expensive state mandated certified nurse midwife. Their clients could cross state lines to access their birth center instead, which she says helped build their client base quickly.

Lee Franzen (83:43)

Insurance was paying us well. People were paying us a lot of cash. There was never an issue.

Tiffany Reese (83:50)

Were you required to carry malpractice insurance?

Lee Franzen (83:54)

There was no requirement for malpractice insurance for a licensed midwife. As a birth center, we were required to have what was called professional liability insurance. I remember that we were concerned that this would be really expensive. It was not very expensive. It was definitely not cost prohibitive.

Tiffany Reese (84:19)

What do you recall your transport rates being like, where your clients are needing to go to the hospital due to whatever complication they're experiencing during birth?

Lee Franzen (84:28)

I don't know the exact transport rate for our facility and honestly I don't even know the transport rate for the other midwives. What I can tell you is that my transport rate for first time moms was about 25%. And at the time I thought that that was way too high. I thought that it was a sign that I was doing something wrong. Now when I look back and I think about how I transported 25% of my first time moms, I'm actually so glad that I did because when you're being compassionate and taking someone to the hospital for pain relief because they're having a long, difficult labor, that should not be seen as a flaw. In Florida, our transport rate was like 5%. It was very low. You would expect it to be higher. But we were kind of cheating. We were using Pitocin and we were using kiwi vacuums and we were getting those babies out one way or the other instead of transporting. I mean, there's no real accountability. Nobody is checking to see if the rate I'm advertising or telling people is accurate. So you're completely taking my word for it. I remember this one birth. It was another midwife's client and this young woman had been in labor for a very, very long time, and she was really suffering. I was in the break room, and I could hear her just crying and begging to go to the hospital. I could overhear the midwives talking her out of it, saying, if you go to the hospital, they're not even going to do anything for you. It's going to be hours of just waiting, telling her all the reasons she doesn't want to go to the hospital and what a bad experience she'll have if she goes to the hospital. And I'm overhearing this, thinking they're lying to her. And it made me so angry. I remember when the other midwives came into the break room, I snapped at them, like, she's begging to go. Why aren't you taking her? And they were shocked that I would speak to them this way. And one of them says to me, why are you even here? Meaning, like, why was I at the birth center? Why was I a midwife at all? And I remember just saying, I'm here because it's the woman's choice to be here and to do this. And she's telling you this isn't her choice anymore. I think that was the beginning of the end for me. I did not get along well with the other midwives, and we had a lot of disagreements. Some of them were about issues of safety, and we butted heads enough time, and at some point, they decided to get rid of me. And so the three of them voted me out. I felt like I should be upset about being voted out, and yet I mostly felt relief. The only part that I hated was that I had numerous clients that were due to give birth at the birth center. When I was forced out of the birth center that I had founded with three partners, the first thing I did was figure out how to go finish my bachelor's degree. I had attended a couple years of community college, and then I had gone to midwifery school and gotten my associates in midwifery. I went back to school, and once I was out of that world, I was able to be a little bit more honest with myself about how I felt and thought about my experiences. The more I thought about it, the more I was just really, really glad that I was out of there and doing something else. So I stopped attending births right away and never really looked back.

Tiffany Reese (89:13)

I'd love to hear what led you to start your blog, the Honest Midwife, and share the devastating realities behind some of what you saw in midwifery.

Lee Franzen (89:21)

When I graduated from midwifery, School. I knew that I wanted to open my own birth center. I was researching and trying to put together a solid plan. I ran across a blog on the Internet that was critical of home birth midwifery. It talked a lot about the dangers of giving birth at home. And I had never seen this kind of information before. I had just graduated, I had big plans, and yet this information was not something that I felt I could ignore. So I started reading it and I decided that I was going to use it to make me a safer practitioner. I do think it made me a safer practitioner, but it wasn't enough to make me want to quit. It was enough to make me want to be better. When I was forced out, I already had a lot of knowledge about what was going on in school. I decided to do a deeper dive. I was studying psychology and I was very interested in how people evaluate evidence and make decisions for themselves and their health care. So I used that as inspiration for my honors thesis. I wrote what basically amounted to is a short book about my experiences and about my developing understanding of why people choose to have their babies at home with midwives and why midwives do what they do. Once I had written all of that, I tried to connect with other like minded people and I was able to find people online that were supportive and were able to guide me and suggested that I turn that project into a blog. When I left the birth center in 2013, within several months of my leaving, there were three babies that died at that birth center. And I did find out after the fact that there was at least one more death associated with that birth center. But it had occurred at a home birth where the woman had received her prenatal care at the birth center that was not really shared and didn't make the news. So there was actually a minimum of four babies whose deaths are associated with that birth center. This had a big impact on me because even though I wasn't there, I knew that I had had a huge hand in starting that birth center. And that was really disturbing and heavy for me. I knew at that point that I had an obligation to share what I knew about what had most likely led to the death of those babies, which was that we were offering substandard care.

Tiffany Reese (93:01)

Do you know if they faced any sort of legal or civil action because of those deaths?

Lee Franzen (93:07)

I don't know of any civil repercussions and I know there was never any criminal repercussions. One of the births where the baby died led to a coroner's inquest, which I attended. The Coroner's inquest was 2015. The finding from that coroner's inquest would determine whether the death was natural, accidental or homicide and it was ruled a homicide. So yes, the death was a homicide, but no, the midwife was not prosecuted in any way and as far as I know continues to practice with no repercussion. I was not required to be there. I attended because it happened at the birth center that I started and I wanted to be able to document what had happened. I did post a three part series on my blog about that coroner's inquest. It goes into great detail as to what occurred at that birth and I put my commentary along the way, talks about what was testified and then gives my reaction to it. The sad thing is that everything that happened at that birth sounded so familiar to me and there were several major missteps that were made that I've seen made over and over and over again. They just don't usually result in the death of a baby. Usually with birth, everything works out despite mistakes, despite carelessness. But in this case, it all caught up with them.

Tiffany Reese (95:10)

As reported by the Charlotte Observer In June 2015, a York County, South Carolina jury ruled the death of a newborn at Carolina Community Maternity center in Fort Mill as a homicide. The baby who died from meconium aspiration shortly after birth on January 20, 2015, showed no signs of trauma. Despite the inquest's verdict, investigators found no evidence of criminal negligence and no charges were filed. The freestanding birth center, Carolina Community Maternity center closed around February 2015 and returned its license to the state.

Kristin (95:57)

Here's Amanda when you listen to podcasts or you have influencers on Instagram or what have you, keep in mind that those people are in different states and regulations in different states are different. There's different types of midwives who have different types of education. And I didn't know that going in, even all the research I did, I thought all midwives were nurses and that is not the case. I'm not saying that all CPMs are bad and I'm not saying that all CNMs are good, but I think that that should definitely be taken into consideration. When somebody is looking at into using a midwife and you can look up how long someone has been a midwife through the TDLR website or CNM through the Board of Nursing website, I didn't know that you could do that. It never crossed my mind because I've never gone into a doctor's office or a hospital and asked for anybody's licensing and how long they've been licensed you go into a place for health care, expecting those people to be trustworthy and knowledgeable, and sometimes that's just not the case. So I would say do your research, search for those midwives names or those birth center names and see what people have said about those midwives and those birth centers. That's where you're going to get the most accurate information. There's a lot of misinformation out there, and I wish I had known what I know now then, because I don't think that I would have chosen Origins. When I had that conversation with Caitlin one week postpartum, I told her that I was gonna be the voice for the moms that didn't feel like they could stand up for themselves. When me and Kristen and Markita started talking about all of this, we just wanted to save one mom and one baby. And I think we've saved tons of moms and tons of babies already. We're not against midwifery. We all chose that route. We want midwives to hold themselves to a higher standard so that everybody can have these options. I don't know anybody who would be against that.

Tiffany Reese (98:11)

I think that it's very inspiring what you've all accomplished collectively. Community coming together can feel rare in these times. And when people come together to help one another and to make their community safer, I think that's very inspiring and very just encouraging.

Kristin (98:34)

We appreciate you for letting us tell our stories. I think a lot of us felt alone in all of this. We don't want anyone to feel alone in this.

Tiffany Reese (98:45)

Here's Markita.

Markita (98:48)

It's supposed to be one of your most beautiful experiences, but for me, it's one of the most traumatic ones that I've ever experienced. It has completely altered my mind frame around me personally giving birth with a midwife and at a birthing center outside of a hospital. I don't think that I will ever be able to bring myself to do that again. My next pregnancy will be in hospital. It just changed my perspective on the holistic aspect of labor and delivery. Now, I think that it's still possible for some mothers, but I do highly suggest that you be very diligent whenever you're searching for a birth center or a midwife and to always have maybe a secondary provider for the medical professionals. Whenever we receive our license, we are to follow the Nurses Practice Act, I believe is what it's called. We're supposed to provide unbiased, professional, competent, compassionate care. And that applies to everyone, regardless of of skin, regardless of financial status. I just think that we have to really make sure that as health care providers that we are providing the best, competent care for everyone. And think about if it was your mother, your sister, your daughter or wife, how would you want them to be treated by their health care professional? If we are going to go the route of out of hospital births, these midwives definitely need to have a standard of care and they need to be upheld to that standard of care. And they need to be held accountable just as other medical providers would be held accountable.

Tiffany Reese (100:55)

What do you hope that listeners consider when hearing all of your stories this season and taking in this information?

Markita (101:03)

I hope that whenever they are looking into whatever care that they decide to go with, that they just really, really do their due diligence and they really research who they're going to allow be in such a precious moment. If you are a religious person, pray that you have the discernment to make the right decisions whenever you're choosing a provider. If you're listening and something tragic like this has happened to you, sorry doesn't even cover it. I love you. I'm praying for you. Whoever has experienced this time helps heal the pain. I don't think it will ever go away, but it gets just a little bit easier as time goes on. And don't lose hope on your dream birth because it still can happen. For us to come together and help other mothers who has experienced this or prevent mothers from experiencing this or help mothers have amazing experiences, it's just been really great to be there for one another because it's not easy.

Tiffany Reese (102:24)

Thank you so much for your willingness to be so vulnerable and to share with all of us. It's truly an honor to be able to hold space for Malik. You're incredibly inspiring. I too will be praying for you and holding all of you and your loved ones in my heart as well.

Markita (102:47)

Thank you so much. I appreciate y' all for taking the time to allow our voices to be heard and allowing us to hopefully help other mothers.

Tiffany Reese (102:58)

Here's Kristin's husband, Thomas.

Thomas (103:01)

This still affects me to this day. I'm not a normal dad. I know the tendency or some parents would be helicopter parents and hover over their kid and be concerned for their safety. But I really live a good part of my life now. Feeling like doom is just right around the corner that tomorrow something is gonna happen. It'll just all be ripped away. The biggest thing that I want to say is that that is the product of this. Luckily we have a beautiful baby boy and he's as healthy as can be. I don't know how long I can enjoy it as fully as I can without being scared that something's gonna take that away. Jennifer, the quote unquote midwife to take care of us, wasn't licensed at the time that she was seeing us. You know, her license started May of 2022. Our son was born in February of 2022. Jennifer recently admitted that she was unlicensed at the time. She comes right out and says it. Regardless of what your bosses or employers are telling you, if you know that you're not licensed and you are treating people, seeing people on your own, you're part of that negligence. I don't drive a car without a license. I don't need somebody to tell me it's okay or not. It is concerning that that is allowed to go on in the heart of a major city across from one of the biggest hospitals in the state. If this is happening here, like, imagine what's happening in rural communities throughout Texas. The sickening thing is these people are using that movement of women empowerment and women discovering their autonomy, and they're using that to make money. These owners prey upon someone's desire to take their autonomy and their body back from this patriarchal system that we live in and then use that against them. Where are we going to stand up for women in this way? I would love to see the laws and the regulation around midwifery and women's care in general change. I would also love to see birth trauma be taken seriously and sharing my story with people, whether on social media or in real life. I've had so many people, especially women, tell me about their own birth trauma, who even had men tell me about their partner's birth trauma. You don't hear people talking about birth trauma survivors. I would love for that to change. I would love that to be something that as a society, we talk about and really validate and support survivors. And of course, I would like some justice for this. I don't want a lawsuit and things like that. I would much rather see licenses be taken away and people being criminally punished for this.

Tiffany Reese (105:32)

Thank you so much for taking the time and for everything you shared.

Thomas (105:37)

Absolutely. And I just want to say, too, this was my idea. I hope you know this. I'm actually a big fan of the show. I said you should hit up. Something was wrong, so here we are.

Tiffany Reese (105:47)

It's all because of you, Thomas. All of my male listeners impress me so much.

Gina Thompson (105:51)

Shout out to them.

Tiffany Reese (105:52)

More rare, but we love you guys all the same. Here's Kristen.

Grace (105:58)

This has never been about getting rid of Midwifery or abolishing midwifery or insert X thing that people like to say.

Tiffany Reese (106:07)

About us and our organization.

Grace (106:10)

We see on Instagram and on social media these perfect, beautiful births that are happening in out of hospital settings. But we don't talk about what happens when things go wrong. I've had someone say to me before, I can never do what you're doing. You absolutely can. Let me tell you, before all this, I definitely was not like a confrontational person. I kept mostly to myself. I wasn't a leader of a movement. I didn't feel like I had that in me. But when the only other option is to do it yourself and your reason why is meaningful enough, important enough, you will do the damn thing regardless of how scared you are, regardless of how confident or not confident you are. When I started this, I had no confidence. I was like, I have no idea what I'm doing and everyone's gonna be able to see it the moment I walk into a room. Even now, sometimes I feel that way. I have imposter syndrome. I'm no expert in what I'm doing, but I know that if I do it right that this could potentially save lives. That propels me to figure it out. And that's what all of us are doing. Anybody who has ever started a movement or a non profit or became a lobbyist or whatever, they started from ground zero, which meant I know nothing about this, but I have a reason and so I'm going to figure it out. And that is how you do things like this. I would like to think that most people could take up arms and do this. I'm extremely grateful. It was not by my own fruition that has gotten us this far. It is by everyone who's entrusted me with a story, everyone who has reached out to me to give me information to help me along my way, anybody who's reached out with the power to help, the ability to help, that is what's helped us get this far. And I'm so grateful to all of those individuals. In Frozen 2, Anna sings the song the Next Right Thing. Even though internally she's feeling awful, she's in despair, and she chooses to do the next right thing. And that led her to all the things that led to the solution and the happy ending that you see in Frozen. The quote from that song, the Next Right Thing repeats in my head often. Just keep walking, keep moving, doing the next right thing. And I think I'll eventually get to where I want to go.

Tiffany Reese (108:40)

Thank you so much. It's truly an honor and shout out to Dallas, Texas, one of Something Was Wrong's largest listenership cities since the beginning. We're not only able to make that direct impact and reach people who live there who need to know about this information, but also hopefully educate other people who are considering childbirth and give people a more educated understanding of like, the things to look out for, the red flags to look out for the ways that we need to understand how we can advocate for ourselves in medical situations. So I just appreciate y' all so, so much.

Grace (109:17)

I just appreciate what you do so much. I truly do. I admired your podcast before and I'm so honored to be here to be able to tell my story. And if this changes one person's mind or makes one person ask questions about safe practices in their state, we've made the dream come true. So thank you so much for giving us the opportunity to speak here. I really appreciate you, Tiffany.

Tiffany Reese (109:45)

Thank you again to everyone who contributed this season. Our hope is that in the future, regardless of where people plan to seek care, we can all work together to help solve the maternal health care crisis. Something Was Wrong is a Broken Cycle Media Production created and produced by Executive Producer Tiffany Reese Associate producers Amy B. Chesler and Lily Rowe with audio editing and music design by Becca High. Thank you to our extended team, Lauren Barkman, our Social Media Marketing Manager and Sarah Stewart, our graphic artist. Thank you to Marissa Travis and our team at WME Wondry, Jason and Jennifer, our cybersecurity team, Darkbox Security and my lawyer Alan. Thank you endlessly to every Survivor who has ever trusted us with their stories. And thank you each and every listener for making a our show possible with your support and listenership. Special Shout out to Emily Wolfe for covering gladrag's original song you Think youk for us this season. For more music by Emily Wolf, check out the Episode Notes or your favorite music streaming app. Speaking of Episode Notes, there every week you'll find episode specific content, warnings, sources and resources. Until next time, stay safe friends. If you like something was wrong, you can listen early and ad free right now by joining Wondery plus in the Wondery app or on Apple Podcasts. Prime members can listen ad free on Amazon Music. Before you go, tell us about yourself by filling out a short survey@wondery.com survey.