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Birthing A Bad Dream

The Dream

Thu Jan 15 2026

Summary

The Dream — “Birthing A Bad Dream”

Host: Jane Marie
Guests: Alicia (Jane’s friend), Dr. Sarah Toogood (OB-GYN at Cedars Sinai, LA)
Air Date: January 15, 2026

Episode Overview

In this reimagined episode of The Dream, host Jane Marie returns with a deeply personal and incisive look at the “cult of wellness” as it infiltrates the most intimate and anxiety-ridden experience: pregnancy and birth. Shifting the show’s format toward candid, wide-ranging interviews, Jane Marie explores how expectations, cultural pressure, and an abundance of conflicting advice converge to create what can only be described as a “bad dream” for many women at their most vulnerable.

Through honest storytelling (her own and her friend Alicia's), Jane dissects the roles of science, wellness culture, healthcare providers, and personal agency in shaping experiences of pregnancy and birth. OB-GYN Dr. Sarah Toogood joins the conversation, shining a light on the chasm between medical outcomes and emotional journeys, and why no amount of information can ever guarantee control or peace of mind in the birthing process.

Key Discussion Points & Insights

The Cult of Wellness Targets Pregnant Women

Jane Marie opens with a critical observation: while wellness culture is usually easy to avoid, pregnancy makes women lightning rods for unsolicited advice, judgment, and “the right way” messaging from every direction.
- “Once a woman becomes pregnant, her body is no longer her own... the whole world suddenly feels ownership. This comes at us with unwanted questions and unwanted touching, unsolicited advice about the right way and the righteous way to be pregnant, to give birth and to mother.” (04:59)

Medical Uncertainty & the Myth of Control

Jane shares a deeply personal moment: a scary pap smear result at five weeks and a doctor’s advice that vaginal birth might “flush out” potential cancer.
- “I'd never related to friends on the hippier end... but here I was, unwillingly thrust into their world... spending 35 weeks thinking, maybe you're growing a cancerous tumor right next to a baby is... well, it was fucked up.” (05:36)
Her approach: “I basically just wanted the baby to come out however it needed to... But then reality intervened.” (05:44)

Comparing Approaches: Jane vs. Alicia

Alicia, a close friend, shares her high-information, Type-A approach to pregnancy, shaped by both medical necessity (Ehlers-Danlos made hers high-risk) and personality. She attends natural birth classes mostly to learn, not to eschew medicine.
- “I have like a joint disorder called Ehlers Danlos syndrome. So I was told I had a high-risk pregnancy... So I was constantly asked, six or seven times a day: What kind of birth are you going to have? Are you going to do delayed cord clamping?...I remember getting into a thing about delayed cord clamping...” (07:00–09:03)
She hoards information out of fear, not fascination.
- “It was not that I am so interested in birth actually...it was that I was completely terrified that I was going to make the wrong decision and something bad was going to happen. In fact, I was sure that something bad was going to happen.” (10:21)

The Information Deluge & Decision Fatigue

“Because all these decisions are available... I want to be responsible and have answers to these questions and really think it through.” — Alicia, on the overwhelming array of “choices” offered to pregnant women (09:16)
Jane’s coping mechanism was the opposite: “A point at which information overload convinced me that there wasn’t an answer. I shut down.” (10:08)

The Reality of Birth: When Agency Meets Biology

Alicia’s labor story — induction at 41 weeks, expectations shaped by documentaries and doulas.
- “Every drug I got, I had the most painful, least productive possible reaction... I was having a panic attack. I think, like, I can't breathe and I can't stop crying.” (19:38)
- The hospital process was lengthy, confusing, and emotionally exhausting, ultimately making her feel like any pain or unexpected outcome was her own fault:
- “This pain is my fault. And the baby's going to die for sure. And that's definitely going to be my fault.” (22:35)

The Medical Perspective: Dr. Sarah Toogood

Dr. Toogood highlights the divide between “complementary” and “alternative” medicine and how a well-resourced patient population leans heavily on additional “wellness” information.
- “I like the word wellness. It implies you're trying to be well, and that means something different for different people...I like it when patients use it as a compliment to our treatment, not as an alternative.” (28:07)
She acknowledges the “small stuff” women obsess over (coffee, wine, beauty products), but confirms it's rational to care:
- “Pregnancy is not a disease state... There are things that are safe that you did before pregnancy that you can continue... but in certain amounts, caffeine can be dangerous.” (30:33)
She warns against confirmation bias and apophenia – finding patterns and causation where none exists:
- “We seek out info to confirm stuff we believed before... It's not scientific... But it feels good to distill reality down like this.” — Jane (31:34)
- “Apophenia is the tendency to make connections between things that have nothing to do with each other and then to instill meaning where there is none... like thinking you landed a dream job because you started drinking moon juice.” — Jane (32:16)

The Myth of the “Right” Birth Experience

Dr. Toogood on the conflict between outcome and experience:
- “As your doctor, I want a good outcome for you and your baby. Just because you're having a good experience does not mean you're going to have a good outcome. Everyone wants a good experience and outcome. For some women, they can have that, for others, they can’t...” (38:47–39:21)
Empowerment messaging in birth classes can backfire:
- “For women who have that mindset going into labor and have a vaginal delivery... of course they feel empowered because everything they told themselves was correct. When those women have to come to the hospital... they're disempowered... they feel like they did something wrong... but statistically that's just not true.” (42:15)

The Elusive Nature of Certainty

“No amount of information—or virtue—can guarantee a smooth or natural birth. So much is out of your hands, and taking on the burden of every decision is a sure path to self-blame.” (Paraphrased throughout)

Notable Quotes & Memorable Moments

On the Uncertainty of Advice:
- “There are the decisions that we make based in feelings. Some people choose home births because they feel more comfortable there... who are we to judge?” (22:49)
On Self-Blame and Birth Experience:
- “It was like my job to try to stay on the cliff... This pain is my fault. And the baby's going to die for sure. And that's definitely going to be my fault.” — Alicia (22:35)
On Confirmation Bias:
- “Like, I think if I don't get induced, I'll have a vaginal birth. Oh, look, I didn't get induced and I had a vaginal birth. So I was right. It's not scientific.” — Jane (31:34)
On Medical vs. Experiential Values:
- “If you want to trump your experience at the expense of your outcome, that's really difficult for a doctor to help guide you through... I, as your doctor, want a good outcome.” — Dr. Toogood (39:00)
On Blame and Trauma:
- “...they dissect every minute of every day for the weeks leading up to their birth and think if they had done one thing differently, it would have changed the outcome. And it's just not. Statistically, that's just not true.” — Dr. Toogood (42:15)

Important Segment Timestamps

[04:59] — Jane introduces the episode’s core theme: the “cult of wellness” during pregnancy
[06:44–10:51] — Alicia describes her hyper-preparedness and anxiety in childbirth classes and decision-making
[16:03–19:38] — Alicia and Jane recount their birth stories with frank confusion, fear, and systemic critique
[27:35–30:33] — Dr. Sarah Toogood joins, reframing the patient-provider relationship and wellness questions
[31:34–32:16] — Jane covers psychological phenomena: confirmation bias & apophenia
[36:03–37:46] — Discussion on clean beauty, phthalates, and the limits of risk avoidance
[38:43–43:50] — Deep dive on outcome vs. experience, empowerment, and the emotional aftermath of difficult labors

Takeaways

Pregnancy and birth are inherently chaotic and uncertain. The modern wellness industry, consumer culture, and even the medical establishment offer both overwhelming choice and little actual control.
Self-blame and “perfect outcomes” are dangerous myths. No matter the preparation or the information, many aspects of birth are out of moms' hands; self-flagellation for imperfect experiences is both unnecessary and common.
Medical evidence and empowerment narratives can clash. Having “the right mindset” or “trusting your body” does not guarantee a desired result; outcomes often depend on unpredictable biology, not planning.
The wellness industry’s promise of control is seductive but illusory. The best anyone can do is make informed decisions, accept uncertainty, and avoid internalizing blame for the uncontrollable.

Conclusion

Birthing a Bad Dream is a refreshingly honest, relatable, and deeply thoughtful deconstruction of what it means to navigate the choices, judgments, and uncertainties of pregnancy and birth. Jane Marie’s frank storytelling, Alicia’s vivid anxiety, and Dr. Toogood’s medical candor combine to create a powerful meditation on control, empowerment, and self-compassion during life’s most vulnerable moments.

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Transcript

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Jane Marie (1:44)

Love y'. All. I'm Jane Marie, and this is the Dream. Today we're bringing you one of our favorite episodes from season two. Enjoy. Most of the time, unless you opt in to thinking about wellness, you can pretty much avoid it. But there are a few moments in life where, try as you might to avoid it, you're inundated by the messaging of the cult of wellness. And one of those is during pregnancy and birth. It's well known that once a woman becomes pregnant, her body is no longer her own and I'm not just talking about the body being taken over by the new, more important, more precious being inside of it, but the whole world suddenly feels ownership. This comes at us with unwanted questions and unwanted touching, unsolicited advice about the right way and the righteous way to be pregnant, to give birth and to mother. And a lot of that has to do with wellness, eating well, exercising well, sleeping well, taking the right pills and tinctures, and choosing the correct caregivers for this special time. Often on this show we're talking about the people and businesses that take advantage of these vulnerable moments to profit from our uncertainty or our attempts to be healthier. But it's hard to say that there's a specific villain in the birthing industry. Sure, there are a slew of teas and supplements and crystals that promise to support fertility and pregnancy, but it's not like there's widespread policies or cases of evil doing healthcare providers hell bent on screwing women over at this time. It's more the culture around birth is broken and often the damage comes from inside our own heads. So today we're just going to talk about what it feels like to be in one of those vulnerable moments, to be overwhelmed with advice and information, and to be forced to question everything you're hearing. Because when it's just you alone, you have a right to pick and choose how well you'd like to be. But introduce a new human, whose existence you are completely responsible for, into the mix, one who cannot yet voice their opinion on the subject, and things get complicated. I grew up being told that birth was easy by a mother who'd had three successful natural births and who also claimed, until she saw me in labor, that mothers who had epidurals experienced less pain, and that pain was necessary to create the maximum amount of love women like her had for their children. Basically, until a few years ago, her thinking was that you had to pay a great price, sacrifice as much as humanly possible to earn true love. She was also, I might add, 20 years old when she had me, so her bones and joints were supremely bendy and she had super short labors. But enough about my mom. I love you, mom. Despite this attempt to indoctrinate me, when I found out I was pregnant at 34 years old, I didn't have super strong feelings about the type of pregnancy or birth I wanted. I basically just wanted the baby to come out however it needed to from pretty much the day it went in. But then I got a bad pap smear at five weeks. Something showed up called atypical glandular cells. And my doctor called me. She said it could maybe be cancer, maybe not, but that A, they couldn't do any more tests on me while I was pregnant, so, B, our best bet was to try for a vaginal birth because that process has the potential to flush out whatever was creating those cells. That's what she said. Spoiler alert. I'm fine. I just had HPV like half the planet. But spending 35 weeks thinking, maybe you're growing a cancerous tumor right next to a baby is. Well, it was fucked up. I'd never related to friends on the hippier end of the spectrum who, like my mom, had really strong feelings about natural birth. But here I was, unwillingly thrust into their world in la, of all places. And I found myself having many conversations with women like my friend Alicia, who had a baby a few years after I did and who couldn't have been more different than me in terms of how she looked at her pregnancy. Did you always want a baby?

Jane Marie (10:57)

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Yeah. My doula had texted me, just so you know, as you go into this. Induction can be kind of a mind fuck because it can take a lot longer than you think. And I had kind of absorbed that and thought like, okay, whatever. It was 55 hours from the second it started, and every, Every drug I got, I had the most painful, least productive possible reaction. So they gave me cervidil and they were like, you'll sleep through this. And about an hour later, I was having like one continuous level 10 contraction that lasted for 12 hours and nothing happened. I wasn't dilated. And because I was so scared of getting a C section, I asked for laughing gas, which also confused them because they were like, I guess they had to go find this machine. They offered it, which did absolutely nothing. My whole body was like shaking uncontrollably. I was in so much pain. And the nurse came in at one point in the middle of the night in the first night, and she was like, how are you doing? And tears were just streaming down my face, but I was trying to be quiet because my husband was finally asleep. And I was like, I'm having a panic attack. I think, like, I can't breathe and I can't stop crying. And she was like, okay, well, okay, that's burst. Baby looks fine. Yeah, I mean. So then the doula came and she said, you look like someone who is at about. You look like you're in the kind of pain that someone who's about to give birth is in. And you're not dilated at all. So this isn't doing anything. I think you should get the epidural. So my doula went home because I wasn't in labor. Every next thing that happened, when they were going to break my bag of water, when they were going to give me a different drug, when they were talking about a C section, the doctor would come in and say, It. And I would say, give me a minute. And I would call the doula and she would tell me different and new information. Okay, they want to break your bag of water. Just so you know, once you start that you're on a 12 hour clock, they're not going to let you labor more than 12 hours because your bag of water has been broken and it's a chance for infection. So if you do not deliver in 12 hours, you will have a C section a day later or whatever. When they're like, I'm going to break your bag of water, I was like, stop. No. If you do that, I can't go home. I'd been there for 48 hours in labor. I'm not going anywhere. I can't even. I can't walk. I can't barely talk. Like, I'm mumbling. And it's like, you think you're gonna leave, but it's because I had all these ideas in my head. Like, oh, I was so afraid. Like, well, then I can't go home and then I'm gonna lose my. I was just so, like, it was like clawing. It felt like I was like being pulled off of a cliff. And it was like my job to try to stay on the cliff. What was in my head was I decided to do this and this is my fault. So every single thing, I was so mad that I had been surprised at all. Like, you should have told me I couldn't move around. You should have. Why didn't you tell me that this could take so long? The doula had to tell me. So I don't trust you because you told me this was going to be 12 hours and I don't trust the doula because, like, she said something about cherries, but, like, this is all my fault. This pain is my fault. And the baby's going to die for sure. And that's definitely going to be my fault.

Dr. Sarah Toogood (40:22)

Yeah, I talk about this a lot because we worked so closely with one of the birthing centers who I loved working with, and I trusted the midwives, and I thought they took excellent care of patients, and we would be their doctors if the patient disqualified for a birth at the birthing center because she developed some complication or, you know, an induction was indicated or if something happened during labor. And by the time they come to the hospital, I mean, they're. They have a 50% chance of having a C section because they've already veered off of a normal labor course. And that's why the women who were already in labor being transferred, that's why they had to come to the hospital as they veered off course. All of their kind of education and childbirth classes were geared towards giving birth unmedicated in a birthing center with limited interventions and really no options for pain control except for nitrous oxide. All of their birthing classes were centered around empowerment and empowering themselves. And if you feel empowered, you will have a better outcome, and you're in control. Your body's made to do this. And so for women who have that mindset going into their labor and delivery, and they have a vaginal delivery in a birthing center, as expected, of course, they feel so empowered because everything that they told themselves was correct, that they trusted their body and their body could do this, and they did it. When those women have to come to the hospital because their labor course is not going the way that they thought. They're disempowered, and more so than women who are expecting to give birth in a hospital, but they feel like they did something wrong, that it was on them, that they, you know, they surrounded themselves with the wrong person or they weren't in the right mindset, or they what. Whatever it is they could think of, they. They go through and dissect every minute of every day for the weeks leading up to their birth and think if they had done one thing differently, it would have changed the outcome. And it's just not. Statistically, that's just not true. A lot of them feel devastated, and the outcome was good, right? But their experience was not good for them. And it's partly because they blame themselves for it, because they were always told, this is how you empower yourself. So then if you fail that you've disempowered yourself. I had a patient stuck with me who had a C section for arrest of descent, which means that you're 100% dilated and you've pushed, and the baby is not going to come out of the vagina. So this woman had a C section. And the next day, she was still questioning the decision to have the C section. And she asked me, well, what would have happened 100 years ago if I was in this situation? And I looked at her and I said, you and the baby both would have died. And I 100% believe that. And she said, oh, well, that's dramatic.