#31 Unpopular Opinions

We had a plan originally, but I have a new plan and I thought it would be fun.

Okay.

Because to be totally frank, I don’t want to go to work tonight, and I need some uplifting laughter. Hopefully this helps some other people.

Oh, no pressure.

But I think it would be fun to talk about our unpopular opinions, and I think they’re going to be very different. I’m going to give you a second-

I need a second.

… to write three unpopular opinions down, and then we’re going to share.

OB-related, or like life-related, too?

No, it was OB-related, but-

Oh, bummer.

…. OB-related, but then we’ll do… You can do two regular ones that people probably also agree with you, and then one, like, that you think… I have one on my list. There is a definite drast difference between the nurses that care about this.

Oh boy.

I know.

Okay, I need a second.

I’m going to get some haters. Take a second.

Okay. Bring it.

Okay. You want me to go first, or you want to go first?

I think you should go first.

Okay.

This was your idea.

So one unpopular opinion is I think it’s really fun to ask if the support person wants to feel the head when the baby’s pushing.

Oh.

I’ve told other nurses this and they’re like, “That is so gross.” And I was like-

What?

… Why? They get to be the first person to touch the head. So that’s an unpopular opinion I have. Maybe it’s more popular than I thought.

Huh. I don’t think that’s gross at all. They’re about to touch their slimy baby when it comes out anyway.

It’s true, right? And I don’t know, maybe because if it’s like-

What’s the difference-

… going through vagina-

… when it’s at the perineum or not. Yeah.

Yeah. And it’s motivated… I love when the patient does it, don’t get me wrong.

Oh, yeah. Same.

And then it’s funny, too, if you think about it, we ask the patients if they want to do it, they do it with their finger, and then we’re so concerned about our sterile gloves when we’re pushing and it’s like all non-sterile.

And you’re trying to get your sterile gloves on, shaking.

Like, it’s not that big of a deal.

Unpopular opinion. I think… I don’t know how to totally word this, but I think that if you need to call the doctor in the middle of the night, you should never feel bad about that.

Oh.

Because they chose this profession.

It’s so true.

What, you’re going to be upset, and they’re yell at you. And literally in my head, I think to myself, I got there at the end of my bedside time, where I’d be precepting and talk about this. I’m like, what if they yell at… I’m like, no, that’s their issue. They chose this job. They knew what it was about. This is a part of the role.

That’s so true. I have to tell you about a story of a nurse I started with, and I work with her still, and we are making fun of her in a loving way on nights because she works on days now, of how she doesn’t give two Fs about anything. And the doctor was mad at her for calling about something, and she straight up told him, “You’re on call, right, for 24 hours?”

Right.

Okay. Why are you getting mad? She literally said, “Why are you getting mad?” And he didn’t know how to respond.

Yeah. I mean, that’s really what we need to start doing.

You’re on call.

Not like in a respectful… Exactly. You’re doing a job, and you get to sleep while you are on call. I don’t get to sleep.

And I chose-

I’m actually the one laboring with them.

Right, and you choose, Sarah, to be on call for your clients?

Yes.

I chose to not be a midwife because I didn’t want to be on call. Those are the things we choose in our lives.

Exactly.

You chose this, person. Sorry.

Yes. And don’t make my life miserable because you chose something that you don’t love. That’s your issue, not mine.

So true. Okay. My unpopular opinion, too. I don’t mind when my patient and their person cuddle in bed.

Oh, that’s a good one. That’s a really good one. I don’t either. He can pop out of bed, or she can pop out of bed so fast.

Yeah, and we were talking a little bit, like, this is good for physiologic birth. This is good for hormone.

Oh, yeah.

This is just, they want to do that, they want to do that. Let the oxytocin get going.

Get in there.

And then nurse will be like, “Well, what about when they’re ruptured and there’s fluid?” I’m like, “They’re deciding to do that. If they don’t care, why do I care?”

And there’s experienced some fluid, probably, in the past.

There has been fluid. Yeah, that’s so true. So that is an unpopular opinion I have. I let them cuddle and I think-

That’s a good one.

Yeah, whatever. We just-

Who cares? It’s not a big deal.

Who cares? It’s not a big deal.

We make so many things such a big deal where it’s like, okay. Gosh, I feel like you have such good ones. And I’m like, really? I don’t care… I don’t know if I don’t care because I know it’s easier, but if you have a really uneducated patient, where literally they know nothing about it, I’m like, “Oh, challenge accepted.” Or they’re super overeducated. I think you can go on either front and not like either one. You want them to do their childbirth classes, but don’t tell me what to do. And I sort of like the challenge-

So true.

… of, “Oh, you know so much? Okay, great. So let’s figure out what you know and then let’s build off of that and support what you know,” and even if they’re… Very unpopular opinion, even if what they’ve heard is not necessarily true, they’ve heard some real bad TikToks, or they heard a story that, oh, it’ll kill your baby, I’m like, hmm, okay. How do I sneak this in in a way that’s non-threatening and doesn’t make them feel judged for the education they have, but I supplement in little ways to help just sort of shift perspective. I think that’s a fun game.

I like that. That’s good. I would say I don’t mind at all when there’s no education, just because that’s kind of what I feel like it’s a baseline for everything nowadays. But I guess I would probably be, I don’t necessarily like if they know everything.

Know-it-all.

Yeah, but I want them to know things. So I don’t know where my opinion lies there.

Well, I think we’re quick to judge the ones that are like, “You don’t know anything? You haven’t done anything? How? This is a big deal,” kind of thing, which I do. And we know that it’s better for them to know. You need to be sending them to childbirth classes. They need to have a frame of reference. That will only support their experience if it’s coming from the right source. But even if that happens, what are you going to do then? If they show up, well, all right, let’s sit down, do a little crash course. And so-

Go ahead.

Dull it down in a way that they can get the important nuggets in the moment.

That’s so true. I mean, we talked about this. I don’t know if it was on a podcast or just with us, so we get so irritated when they don’t know anything, but then when they know even a little bit and have opinions, we’re like, “Excuse me. That’s not my opinion. You want to delay for 90 seconds and not 60? We don’t do that.”

And my unpopular opinion is, free for all. I don’t care. And I like, sort of, the adaptation and the sneaky challenge of which camp are we in?

Yeah.

And then, how do I help level the playing field in a way that they can down-regulate their nervous system, they can understand what’s happening, we can do the shared decision-making thing, and yet they’re receiving accurate information along the way and replacing some of the poor information they’ve heard. I think that’s fun.

Yeah, that is fun.

It’s a challenge, though. I’ll say that.

It’s a lot of work. We have an education guide in our store. Makes it a lot easier.

We do. I dreamt that up in my head-

And you drew it.

… years ago, and then eventually I drew it. Yeah. Turned into something.

Okay. I think we’re going to disagree on this one.

Ooh, yeah.

That’s okay. We can lovingly disagree. My unpopular opinion is I don’t mind how many visitors are in the room. I’ve had 15 before.

Oh, yeah. You think we’d disagree on that?

Yeah. I thought you were more like no visitors. Not no visitors, but you have a more, like, what if an emergency happens? What are you going to do?

Eh, it depends. No, I don’t really care.

Yeah? I mean, I think where I care is if the visitors are causing shifts in energy that then, especially I would say almost less as a nurse and more as a birth coach, that I’m having to navigate the million different energies and the anxiety and then the passive-aggressive and then the over-opinionated-

Very true.

… and then all of that just plays into their birth memory. So that’s more what I care about. But, I mean, more the merrier in general. And it depends on what the patient wants, too, because a lot of times I feel like the patient doesn’t actually want their people in there. They would prefer to not have a big group, but they don’t know how to speak up for themselves in that way. And so then, I get a little feisty on that one. And I also… See, I have so much to say.

I also have a mother complex. And this is not, I love, hear me loud and clear, that if your parent has done the work and they’re self-reflective enough that they can make it about you, and/or your relationship with your mom is significant, it’s safe, it’s all the things that we dream of having in a mother, then all the more power to you.

But too often I see, and probably a lot of you see, that that relationship, there is so many layers of dynamic. And then they show up to the room, and they have strong opinions or they’re talking about their birth story the whole time, or la-di-da-di-da. It just is way too much drama, and it’s always a thing. And this is where, especially in the last five years of knowing the parents ahead of time before we get in the room and having these conversations about the concerns and me voicing those of like, “Okay, this is definitely something to consider and it will affect your experience.” And they still choose to have them there. And then I’m the one navigating all the awkward and trying to reframe and trying to pull them back when it could just be avoided. So-

That’s so true.

… that’s my nuance to that.

It instills the importance of getting your patient alone to see what they want because we don’t know them ahead of time. And so, we had a meeting yesterday, actually, and we’re trying to figure out, we want partners to go back to triage with our patients. We don’t have that right now. Ever since COVID, like they stopped and now we’re like, “Okay, we need to bring them back.” But I will tell you, and people that are listening to us that work with me, sorry. I will tell you, a lot of our nurses use the excuse of, “Well, I have to ask the safety question so they can’t come back,” because they don’t want them back there. They just don’t want more people. And it’s the small space. There could be three patients with their support people. And it’s cramped, don’t get me wrong, but I would want my person there.

Everyone wants their person there.

Yeah.

No one wants… I have… Oh, finish your thought.

So we all we know and the leadership team is like, “Well, so what’s the solution to that?” We were all nurses. We know what the excuse is. So I think we’re going to have our secretary. Our secretary weighs the patient and walks them back to triage. And so our secretary can ask, “Are there any questions you don’t want the nurse to ask you in front of your support person?” And then, “Is there any part of your living situation where you don’t feel safe?” And then they’ll just let the nurse know that. If the nurse knows that, they won’t bring the support person back right away. Added on-

And the secretary asked those questions without being a clinical person?

So we asked that. We were talking about that. They’re not going to chart it. They’re just going to say, “Is there anything you don’t want to be asked in front of your support person?” And then, “Do you feel safe at home?” And say they said, “No, I don’t feel safe at home,” be like, “Okay, we’re going to make sure you’re safe here.” And then that will be relayed to the nurse, and we won’t get the partner. If they’re like, “Yeah, I feel safe at home,” and there’s no questions, we can bring the partner back with them.

But another question I’m thinking we can add on is if there’s anyone you don’t want in your room that’s here, that we need to let them know ahead of time. Because it is hard once the secretary or whoever gets them all in the room together and they’re all there, it’s like, oh, well, now it’s hard to kick them out. You just can’t let them in the first place. So someone for me, because you were saying you’re a little feisty, you can kick them out. Someone with my personality, I’m like, that’s a lot harder for me to kick them out.

Oh, I as a birth coach wouldn’t kick them out.

No, I know. But as a nurse-

Oh, as a nurse, I would. Yeah, fore sure.

Even now as a supervisor, I could be like, oh, I could be called into the room and, “Just so you know, we’re only going to have one…” Or I don’t know. But then they already were in there, so why were they already in there? It’s always really awkward for me. This is one skill I do not have, to get them out.

I think we’re going to… Things are progressing and now that things have progressed in labor, we’re going to request that for the safety of the family, that there’s only one person present.

Yeah.

Is that a lie? I don’t know. Is that a lie?

I mean, it’s kind of a lie.

I mean, you could call it a safety thing. You could just say, “We can’t move around,” and, “Per patient request.” Just kidding.

Right, we can’t throw-

The patient in front of the patient.

Right. And then again, you could easily do the nine to nine, the visiting hours are over, it’s 9:00 PM, for the night shift part. But-

But then they come back in the morning, and they want to come in.

That’s true.

And then you’re dealing with the same issue.

That’s true.

I don’t have a solution for that. But I do have an unpopular opinion about this because I do 1,000,000% believe that your patients should have their support people present, and it should be two. And a doula shouldn’t count. And I will say this because I literally did a birth last night. She was the most pro-epidural human I’ve ever met in my life. She’s like, “Just get me the epidural. Just get me the epidural.” Second baby. And she goes into triage by herself, and they were waiting to get her in a room to get her husband even in there. Husband was allowed, but her husband’s overwhelmed, and she’s unblocked, second baby, and progressing very quickly. I’m in my car. I know I can help them, and they’re depending on me to be that sort of rock for the two of them when things are moving so quickly.

And she’s texting me the whole time, “I wish you were here. I wish you were here.” And I’m like, “Me, too. That’s what I’m here for.” I’m literally sitting in my car. And I would be helpful to everybody there, hopefully. And sure enough, they checked her, her water broke in triage. They texted me that. I’m like, “Oh, shoot.” And I’m thinking to myself, “I’m going to have to really coach this person through it because she’s moving.” She had contractions for two hours and was already moaning. And so, sure enough, I just went and I went to the front and was like, I’ll see if they’ll let me in because she’s going to give birth. And sure enough, I got in the room, we went to the next room, and she delivered without an epidural. And it was wild and crazy and fun and whatnot.

But we talked about it afterwards. And she’s like, “I felt so alone.” And I think it’s easy to think as a nurse that “Well, but we’re there.” But you’re not. I’m sorry. When you’re getting them admitted, she’s a multip that’s progressing quickly. She just dropped. You’re not. It’s not the same. Or even, what I hear a lot, and actually I have a prenatal visit tomorrow with this client whom this was an issue. She’s like, “The one thing that is traumatizing for me is doing the spinal for my C-section without my partner there. It’s awful. It’s awful.” She’s like, “When I think about my birth, that’s what I think about. And it’s just horrific for me to consider.” And I’m like-

I’m really tearing up because it was such an awful time for me, too. And I knew what was going on.

Right. But these are the things that, I mean, I’m on this humanity kick yesterday and I got talking about this with my client. I’m like, “Something has happened in the medical system where we forget that they’re human.” It’s my patient in room eight, or my multip. And I know there’s a patient confidentiality thing there, that is you’re trying to protect them and you’re not going to call them necessarily by name at the nurse’s station. Fine. But we forget that this is their experience.

And easily, it becomes this robotic thing of like, “No, we won’t do that. No.” It’s whether this is how we do it, or it’s that’s not as comfortable for me. And what if all of this fear-based decision-making, what if the partner passes out, how often is that actually going to happen? They stay for an epidural. It’s the same thing. And then you lay them down, and then you put them on a stool in the corner and have them sit back and be able to talk to their partner. That may actually make such an incredible difference to their experience. And I will say right now that this particular client, she won’t let it go. And I’m like, “Oh.” She’s a virtual. And I’m like, “Well, you can talk to your care team,” but I just don’t see it happening. That is so silly to me. Definitely an unpopular opinion.

And I’m thinking, too, of all the excuses of why. Well, HIPAA, because they’re going to hear us talking about information because there’s only curtains. And I’m like, “Well, the patient’s hearing you talk about the other patient, so that’s already HIPAA if you’re worried about that.”

Yeah, you’re still doing your intake then behind a curtain the whole time. Everyone knows everything happening in curtain rooms.

Right. I had a little dream the other day. I was daydreaming about triage, and I was thinking if I had three patients that were in early labor, it would be so fun to just open all the curtains and be like, “You guys are all the same right now. You’re all primes. You’re all two to three centimeters. Let’s just labor together.”

Cute. Put on some music and jam.

It would be fun like that.

I want to do that with all my friends. Let’s have a labor party. That’s fun.

That’s funny.

That was a good one.

Yeah. Well, I guess that was your third one.

I want more.

You’re having a hard time making a third, right?

No, I have more.

Okay. Say one. Say more than one.

Do you have more?

I think I have a lot of popular opinions. I don’t want to float. I don’t want to count MBUs.

Oh, yeah. I don’t want to chart.

We just take it away. I don’t want to do it.

This is none of it.

Oh, I don’t… Okay. This is a mildly unpopular opinion. I do not like circulating, but a lot of people do.

Really?

Yeah. When I’m in there, I want to be good at it. But I would say I’ve circulated once in the last year, so…

What?

Yeah. I don’t… Because with nights, crashes, we don’t do that often. So-

I don’t like all that. I need variety.

I don’t like triage either.

Oh, love triage.

And I know you do, but in our triage is a lonely island back there. It’s so lonely. You’re all alone. I know you have the patients, but you’re just, like itching to talk to your friends.

Yeah. Well, and the last triage I was in, there was two of us always.

Yeah, that makes it way more fun. We hope to do that.

But it also depends on who you’re with. Because if you hate the person that you got, that you’re in triage with, then it’s like a horrible night.

Then you’re really trying to change your brain on how you feel about them.

Right.

What about one of yours?

So I wrote this down, and this is a new one. It’s developing for me, and it’s a shift in my brain that I would never tell clients. So if you’re a client, don’t listen to this because really, I am so flexible to people. Whatever you want, I’m totally down. But personally, the more I learn about physiologic coping and physiologic birth, the more I’m like, strangely, don’t do the medical intervention thing. I know we like-

And you’re all about interventions.

It’s funny that you would say that because I feel like publicly people would think that I’m physiologic birth ladies.

Which we are.

We are, yes.

Yeah.

And I totally believe it. Nothing has shifted in that. And I’m like, if you want to be induced, hallelujah. Let’s do it. We can make the most of it. Or you get an epidural, great. And I was thinking last night, because she went without, and I stepped in as, “Look in my eyes, right now,” and had to really coach her hardcore as she’s gripping my hand and screaming. And I’m like-

Which you haven’t had to do in a minute.

No. That’s what I’m saying. I haven’t not had an epidural for a while. And it’s interesting timing because I’m in the Cancun land of physiologic coping prep. The more I learn about the physiology of the body and all of the insane intricacies of what’s happening to not only create a baby, but birth a baby, even just with hormones, that it does mess with your systems.

And this is an unpopular opinion that I’m even saying out loud to my internal self because I don’t want to believe it because it’s so much easier. Especially if the patient chooses it, fine. That’s their choice. But also, how much are they really understanding and how much of a chance are we actually giving them to avoid medical interventions when it’s just so quick to… Even with my clients, they need some pit, I’m like, “Well, it’s been a few hours. How do you feel about it?” And they’re like, “Well, what do you think? And I’m like, “Ah, whatever.” But in turn, now I see the research and I’m like, “Oh my God. It really does affect it.” And we think it’s like, oh, it might affect the labor portion, but the hormonal cascade that takes place in the postpartum period for bonding, for attachment, for mental health, for breastfeeding is such a beautiful process that now I’m coming to appreciate even more than ever. And I’m like, oh, how much of this are we really truly messing up?

So question, you have a patient, she’s nine and a half, zero station, and they do an AROM. Someone asked me the other day, would you have done one? Obviously if I was a provider or whatever, and I was like, my staffing brain is multip of nine and a half, zero station. I’d be like, yeah, I get her delivered. We need some nurses. My nursing brain would be like, I don’t know what I would think if she had an epidural or not. If she didn’t, probably do an AROM. Let’s get this baby delivered, get her out of pain. If she did, can we wait? Blah, blah, blah. There’s multiple factors. But would that interrupt the hormone cascade, like an AROM?

An AROM? I don’t think, not from what I’m reading because the water breaks, however it breaks. Whether it’s artificially broken or not, it’s still is broken. And honestly, an AROM is going to initiate more of a natural hormone cascade than pit. But it’s like, in a lot of circumstances, I think we’d rather start pit than we would AROM.

That’s true.

We’re worried about infection, whatever.

I’m going to say an unpopular opinion that I just decided.

Okay.

Just decided it. AROM. Why do we say SROM when we say AROMs?

It’s SROM. This, I disagree.

Saying it, I get why people get mad at us Californians-

Because you can’t say AROM, AROM, SHROM.

But I could say SROM, when I say PPROM.

AROM. I’m just going to start saying AROM. People are going to be like, “What is this-”

This is your real unpopular opinion.

No, it’s nothing. Right. It’s SROM.

That’s really funny.

AROM. That’s true.

Yeah. All right. Well, this is fun.

I think you should also be able to video in the room.

Oh, absolutely.

And I understand liability, shmi-ability, but if it happened, it happened. And we all need to be accountable to how we got this.

Someone just got mad at me and called me out on Instagram about that.

What do you mean?

They made me anonymous, but they posted my story that I wrote, of how I’ll just be, “Pretend that you’re taking pictures, but I don’t care.” And they were like, well, they were talking to providers like doctors and saying, “Well, do you think patients should be able to secretly record you?” And I was like, “Well, that’s taken out of context.” But I think they should be able to record the birth of their baby, not your face.

Right, and that’s the thing-

But I do think it’s important to take… Don’t get the providers in the room and…

People, if they’re going to be on camera, they need to consent to that. Or this particular client is the public person and they’ll blur out people’s faces, even if there were videos that I took.

I will say-

I mean, as I’ve said, I want a whole film crew for my birth. Everyone’s going to see it. And I don’t care. I say that now, but flex and flow. But in general, I want to watch that over and over and over again. This is what I do. And for somebody to… I would choose a provider based on the fact that they would let me record or not. It’s that important to me and that devastating to me to think about not having any memory of it.

Why wouldn’t people want that? I guess they could choose not to want it. People don’t do wedding videos and stuff like that, but-

Yeah, but no, there are people that don’t.

Yeah.

Or they’re like, “I don’t need to see my vagina like that.”

Yeah, totally.

I totally get that. Or I’ll ask, when I’m taking photos, “Do you care?” Because normally I’ll get the whole full monty. Most of the time, people are really grateful for that and they want to see everything and whoa.

Right. Well, and I’ve shared with you that I used to, we had this big bucket of pictures as a kid, and my mom had vagina pictures is what we called them. Because one of the birds, they took photos, and every time we’d reach them and be like, “Oh, gross,” and throw it away, the picture of her vagina. But now, I’m like, “Where are those photos?” I went and looked for them.

Yeah.

I was like, “I want to see your birth photos.”

Yeah. Let me see your vagina.

Yeah. Love it. Let me see it.

My mom has both of our births on video and I’ve seen them a hundred times.

That’s awesome.

I know exactly what’s happening with mine. Mine, I had a prolonged decel. It’s the running joke that, think of how smart I’d be if I wouldn’t have had the 25-minute decel that I thought… It’s stressful to watch my own birth. You’ve seen it.

I don’t think I have.

Oh my God. We have to watch it.

Yeah.

My mom will be mortified because so many people have seen her now births, but it’s like every labor and delivery nurse I watch with, they’re like, “Wait, wait, wait, wait. Get it.” I think that. I’m like, “I’m not going to be okay.” And maybe that’s why. It was the decel.

That’s funny.

But I was fine. Clearly, I made it. Maybe a few less brain cells, but whatever.

Babies are resilient.

They are. And they actually are. Like, and that is also what I’m learning through the physiologic birth stuff, is the fetus has such an important adaptive hormone. I can’t even get into that in Cancun because it would be a whole nother world. I’ve had to focus on the labor portion.

I have to get into it for my breakout, I realized.

Oh, well, I have lots of research for you.

I know. I need you to shoot me some of your resources.

I mean, my resource list right now, you’re going to have to peel through. It’s over 200. So, sorry.

But yeah. Okay. That was fun. That’s helpful.

Oh, that was fun.

My drive to want to go to work.

Oh, good. I’m so glad. You can do it.

Share with us… Thank you. Share with us your unpopular opinions. Email us, or I wish they could comment. You can comment on YouTube, but share on our DMs. I want to hear your unpopular opinions, or if you agree, let us know.

Or we should do like a carousel post.

Yeah, that’s fun. Send me-

Our unpopular opinions, and then you can comment on them on Instagram.

Yeah, I will do that. Thanks for spending your time with us here today on Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us both if you subscribe. Great. Leave a raving review and share this episode with a friend. If you want more from us, head to bundlebirthnurses.com, or follow us on Instagram or TikTok. Now it’s your turn and take what you learn today, apply it to your life, and be okay if your opinions don’t match when you take care of your patients. We’ll see you next time.