#25 What People Want in their Birth

So, part of me wishes that we recorded ourselves on video with these podcasts. I absolutely don’t wish we did that because I would not want to get ready every day, but just so you can see what Sarah looks like right now under a blanket trying to make this sound work out.

We are real high-tech over here with this podcast.

Yes, so high-tech.

I don’t know where my phone went, I lost it, and if I move, the blanket moves, so I have a blanket over my head, over my computer. Oh, I found my phone. We will take a photo for you.

While sitting on the ground. And I am currently traveling. I’m in Oregon, and so my mic and headphones are not working currently. So, if my sound is a little off, that’s why. We’ll be back to normal next week, but we want to make sure we get these out on time because people are really liking them, Sarah. I’m really excited. We get a lot of emails about these podcasts and DMs-

I know, it’s fun.

So I’m so thankful for everyone listening and having us in your car, or in your house with you. That’s awesome.

Oh, I wanted to say, so Heidi, if you listen to this, I did a class with Heidi from Oregon on intermittent fetal monitoring this week, and I met her husband and I guess afterwards her husband was like, “Is that that girl from Instagram?” And she was like, “Oh yeah, that’s Justine.” And he was like, “I recognized her voice.” And she started laughing, because she listens to me in bed. I was thinking how many family members recognize our voice now, based on just the podcast alone too? So, anyway, thanks everyone for listening. We have a fun episode that I’m excited to learn from Sarah, and she has a personal experience she wants to share, and I think it’s going to be really good.

I’m going to rope you in, of course.

That’s fine. Yeah.

I want to know your opinion because I’m sure you have a lot of opinions about this. So, in the last episode, we talked about, oh, help me, experiential evidence of the world that helps contribute to, I’m so sorry.

Your lived experience.

Lived experience.

Okay, so I found it. It’s lived experience, informed practice.

I need to memorize that so bad.

Thank you paula by the way. If Paula’s listening.

Yeah, thank you, Paula. But honestly, we all know this. I’m going to rant again really quickly here because it’s so challenging when you are seeing something regularly and you turn to your nurses at the nurse’s station and everyone’s like, “Yeah, we know. Yeah, that’s what it is, yeah.” And yet you go to your hospital administration, we get emails about this a lot actually, and they’re like, “Oh, well, where’s the evidence? Where’s the article?” And actually when I was pulling articles for today, so many of the “research articles” were like, “In a cohort of 12 laboring people in the Congo…” Actually, one of the really interesting ones was in the Congo. But just because it’s in research now for 12 people is more validating than the hundreds of births I’ve seen it actually in my practice. And when I turn to my colleagues who are doing this day in and day out that we’re actually seeing it, that might actually be more unbiased than designing a study that has perfect variables, and et cetera.

And so I really love that term for that reason because it validates our lived experience. And so often I feel like in the medical world, unless there’s a clinical study that was done in the last five years, then we don’t have much to say about it. Like I said, I did pull some research from today just to add to the way that we learn and the way that validates what we learn. But I wanted to share a story. I did a one-on-one call with a pregnant person. This was her second baby, and she wrote me, she’s due in five seconds, actually, she’s overdue now. And the call was last week. And she was like, “Can I just get in and talk to Sarah? Can I just talk to Sarah for an hour? I just have some questions.”

So, it was this last minute thing. Basically, the story was she’s a G2 P1. She had a previous myomectomy, they’re calling it a myomectomy, but from outside the uterus. They didn’t take any uterine tissue, they didn’t cut into the uterus. So, she had abdominal surgery for fibroids and calling it a myomectomy, but she technically ruled in for a vaginal birth for the first time around. But it constantly came up in her story when she was in the hospital. “Well, you’ve had previous uterine surgery.” No, it wasn’t uterine surgery. But how frustrating when you’re in labor and you’re trying to just read the medical chart and now you’re stressing me out and making me think, “What am I missing?” So, anyway, she’d done all of the research for herself on myomectomies and vaginal births and really wanted a vaginal birth and just felt like she got to the hospital with her first birth and she wasn’t prepared for navigating the hospital system, the politics, the potential for bias.

This was a woman of color and was ready to fight with the data and thought that would work. And unfortunately, she had an extremely traumatic birth experience. She did end up having a C-section. She felt coaxed into it. She didn’t understand what was going on. And looking back, she’s like, “I failed myself because I didn’t prepare for the fact that I’d have to navigate human dynamics, not just the research. I thought the research would speak for itself.” And so I thought that was really interesting. And so going into this one, she was going for a VBAC, really wanted VBAC, but not at all costs, I’ll be clear. And so she was like, “I’m wondering if you can give me some tips for how to navigate the hospital system, what I’m up against, et cetera, because I want to be ready this time around. I’ve done X, Y, Z, but I want to be ready to be able to advocate for myself.”

And as I listened to her story, I saw her in so many other one-on-ones that I do and so many other clients and patients that I’ve had, in patients that I’ve heard speaking on TikTok or Instagram, and in your stories for mentorship, et cetera. And I just couldn’t help but summarize that every laboring person wants the same thing. And that’s not complicated. And I think as I was listening to her previous story and then as I was talking about her future birth and anticipating different things, and she actually pulled up her birth preferences, which was one page, the most simple birth preferences of all time. I read through it and I thought to myself, “There are three things in this birth preferences that are going to be triggering to your nurses and/or your providers, so let’s reword them so they’re not triggering.” Even though the meaning of it is entirely the same.

And so that’s what we did, but this is where I think it’s important for us, I thought of you nurses, especially as we say the gatekeepers of the experience, and I want to be very clear of what I’m hearing from not only this person, lived experience, but also I think generalized. What do people want? And I think if we understand what people want, we can also realize that this isn’t that complicated. And so often we over-complicate like the issues in the medical system and Well, what about this and what about that? When really regardless what happens in their labor experience, they all want the same thing. The first one I will note is they want a calm experience. And any prenatal visit I have ever done, I actually taught doulas this weekend. I ended up last minute going into a DONA training and teaching the end of their training on comfort measures and whatnot, and they were asking all these really sweet, awesome questions, and we were talking about interviews for doulas, and they were like, what’s your tips for landing the interview?

And I’m honestly, the best interview is when you share who you are in an honest, authentic way, the worst case scenario is you walk away being like, “Oh, that wasn’t a really good representation of who I am,” because if they hire you, you want them hiring you for who you are. And so I was giving them this tip that honestly at the end, I’ll ask them what they want and what’s your dream for your birth? I do this with every interview, every client, and I’ll hear all these little things and la di da da and all like, “Oh, I’m thinking maybe the candles or like, I really want my partner to be there and I’m really hoping that the hospital transfer goes good and blah, blah, blah, blah, blah, blah.” Ultimately, I will listen to it all, and then it comes down to the exact same thing and I’ll say, “So what I’m hearing you say here is that you really want a calm environment.”

And they’ll look at me, I told this to the doulas. They’ll look at me and be like, “Oh my gosh, she gets me. Yes, that’s exactly what I want. That’s the summary.” And for us as nurses, that is not that hard. You know? And I think if we understand, let’s dull it down so much to know that they want it to be calm, and this is why you were blue in the face at this point in saying the same ish over and over and over again, but presented in a different way, hopefully lands in a different way for all of us, that if we can stay calm, if the words we choose are calm, if we keep the lights low, if we listen to or ask them, “What kind of experience do you want? I’m hearing it be calm. What would feel more calm in this moment?” That means silencing alarms when they’re beeping or offering tea. Even that can help.

That this idea of calm and carrying that in as a theme, regardless the circumstance, or even in an emergency that you come over and you take a deep breath prior to getting within their eyesight and say, “Look, we are here for you. We are doing everything possible to take the best care of you and your baby” in that way. Even if you’re dying inside because you’re so stressed, that element of calm makes a difference to their birth experience.

I hear that and I’m like, it feels so easy. What do you think the barrier is of why it’s not happening?

Because I think there’s lack of intention. Honestly, it’s like the stand at the door post, and I’m going to give my best to my patient today. It’s like, let me just carry my energy in a different way of, like let me… And I know you’re getting report and you’re running around and oh my gosh, and this patient’s having a decel and da da da, and decel is like, you do what you got to do emergencies. You do what you got to do. But for the majority of the time, you’re not dealing with decels and emergencies, right? There’s like that day-to-day sort of consistent, how you carry yourself in, the energy when you’re cleaning the room, the energy when you’re asking questions, da da da versus la da da da da da. I just think we don’t think about it. And I think if we did, we would be able to impact the birth room in such a significant way, without changing literally anything of our workflow.

You’re so right, and I’m reminded of our stand at the door. We need to do an episode just on that, I think.

Sure. That’s what we say every time.

I know, but I’m going to write it down.

Great.

I’m currently writing it down because that’s a whole nother team underwear idea. It’s a whole campaign

Or stand at the door, pause at the door, pause at the door campaign. Let’s do it.

Pause at the door campaign. We’re Going to do it.

And send us a picture of you pausing at the door and we’ll start the campaign. So, calm is the first one, but I want to move actually into her story because what I heard was that she wanted to be listened to. She wanted to be included in her plan of care, and she wanted to understand what was happening. Have we heard this before? And once again, it’s the same thing over and over again. This is the starfish analogy. It was almost laughable. And that sounds mocking of her experience, and I don’t mean that in any type of way, but I just sat there being shaking my head, being like, “why is this so hard?” And I think easily because she was so well-educated and because she came across, I actually know the stats probably better than you do. She knew more stats than I did on myomectomies in pregnancy, and on VBACs and on all these different things.

She’s getting her PhD in public health or something like that. So, she’s smart, and I think she could easily be disregarded and we write their story of the know-it-all. When I wet it down, I’m thinking this is the most compassionate, loving mother, who just wants to do the right thing for her family and wants to be included in her birth experience, which is what they all deserve. It was so simple to me. And so one of the things I want to give you as an example of her birth plan, I wish I had it totally written down. I could ask her for it, but basically the original on the birth plan, she was like, “Will, you just look at it and make sure that it’s not going to annoy anyone?” And I was like, “Okay, sure.” I’m, and regardless whether it annoys anyone, the fact that families have to even think about that is really sad to me, but I digress.

And so she said, please leave the vernix on the baby after baby’s born. And I’m looking at that and I’m like, is that a reasonable expectation? Totally. Is that a reasonable expectation in a resuscitation? Yes. Leaving the vernix is no big deal, but I could hear the nurses, what are the nurses saying? “Well, we have to dry the baby after the baby’s born, so we can’t leave all the vernix and some of the vernix will come off and we need to stimulate the baby. And so if we stimulate the baby, then that might take up the baby. And if you see us drying the baby, don’t be upset.” Because, and I’m being aggressive to prove a point, but don’t be upset because we’re actually trying to keep your baby safe because your baby might get cold, and if your baby gets cold, then your baby could become hypoglycemic and hypothermic, and then they could die. I’m exaggerating.

Well, I just want to say I appreciate your systems mind in cases like this because I would’ve seen that on the birth plan and been like, “Yeah, okay, we’ll leave the vernix on.” But you’re right. There’s so many things that people will think through when they see that. So, I just wanted to say, I appreciate that. Your brain.

Well, and I think it’s like that’s the perfect example of how not everybody’s going to see it that way, but as I sort of feel like I’ve developed this skill of where my power comes as a birth coach, is understanding the hospital system and being able to anticipate and prevent those kind of silly disruptions in the process. The lady just wanted the vernix, because she read that it was good for the skin and it is, that’s all it has to be. It truly doesn’t have to be anything else. And then when I explained the rationale of drying and stimulation, she’s like, “Of course you can do that. Totally, no problem.” There was no issue even to the point of please explain things to me. And then we talked about emergency scenarios or in the case of a uterine rupture, et cetera, and I’m like, “There may not be time.”

She’s like, “I get it totally. That completely makes sense to me. But in the regular day-to-day, like I just want to be included. I just want to understand and I really want help understanding,” because they don’t know what they don’t know. I actually just read, oh Lord, of course it comes to my brain, but I don’t have the reference in front of me, but it was about obstetric violence and racism in healthcare. I was reading this article a couple days ago, and basically it was that the families want to be free from the question of all the information being given, basically. And so the idea that, and we know this is true, we know this is true, that you can “give informed consent” and not give all the information and it be a form of coercion. And as nurses, we are that in between that if we’re hearing something be explained, oh, well, an AROM, oh yeah, well, what are the risks?

Well, increased risk of infection, but that really is the same whether your water broke right now or not, and a cord prolapse. Well, what’s a cord prolapse? Even that, there’s like, there’s lack of information. How often does that happen? What would that look like? A cord prolapse means nothing to a laboring person unless they’ve read way more than we would anticipate them having read, and they don’t need to prep for that. Actually on this call, what I did was, I gave her two examples of a shared decision making model and just literally just used the brain analogy, which is a childbirth ed strategy comes from the childbirth ed world. I did not make it up, but that’s benefits, risks, alternatives, and I stick there, I do BRA, but BRAIN is intuition, and then nothing. That that intuition, we actually had already talked about that prior to BRAIN, but if you just keep it as simple as benefits, risks, or alternatives, I did that and I modeled that for her for a position change.

And then I also modeled that for her for an AROM and those being very different things, but ultimately she has control, she has autonomy. So, if I’m the nurse and I’m going to give a benefits risk alternatives, “Hey, I have a suggestion for this position change. You’ve been in this position for a little bit. The benefit I would see is it helps your baby navigate the pelvis a little bit easier, helps soften out all of your pelvic structures, make room for the baby. Also, as you’re laying in the same position with, let’s say she does have an epidural with an epidural, that there’s decreased blood flow to that area, and we normally shift our weight regularly. So, I’d like to turn you to your left side. How does that sound? Now, the risks of this are really that you could be uncomfortable, and if you are, we can shift your weight or it could be that maybe the baby doesn’t tolerate that side, and we would know that by the fetal monitors. In that case, we would turn you again, I got nothing else for a position change. They’re like one of the most low risk interventions in the world. And the alternative is we could stay here or we could try a different position. Well, how does that sound to you? What questions do you have?”

And then you open a discussion. Versus an AROM is going to look very different, which I sort of just modeled enough. You guys know benefits, risks, alternatives, of an AROM. That’s a different episode. So, either way, when I went through the position change, she was like, “Oh, okay. Yeah.” And then I went through the AAM M. This is somebody who from birth preferences, you would assume she doesn’t want an epidural. And her preferences were she doesn’t want an epidural. She really wants a VBAC. She had a traumatic birth in the past. She has a doula this time. She wants the vernix left on. She doesn’t want to bathe her baby. She’s taking her placenta home to encapsulate.

What stereotypes have you put in your head about this client?

Super crunchy.

Yeah. And anti-intervention.

Yeah,

Yeah, yeah. We’ve pegged that client very quickly. It’s funny, I’ll come in with clients and the nurse will be like, “Wait, they want an epidural?” I’m like, “Yeah, they do.” And they’ll look at me like, “Why are you here?” There’s so much more that I do once my client gets an epidural, if that’s their choice, whether they get one or not, I don’t really care, but I mean, I work just as hard if not harder. That’s again, a whole nother episode. We’ll write it down this time we’ll start a list. So, moral of the story is we pegged the patient, and easily I could just see the stereotypes coming in.

She also, she knew a lot and could speak to those stats and all of a sudden she becomes the know-it-all patient. And what I think for me, I had an aha moment when I was on this call, which sort of led me to the podcast, which was right here when I was explaining the AROM risks, benefits, alternatives, before I even got to the benefits, I was just explaining the risks and barely got into the benefits. She was like, “Oh, okay.” And then I said something about speeding up her labor and the cushion around the baby, and then the pressure on the cervix and blah, blah, blah. And she’s like, “Oh, yeah, yeah,” on the call. She was like, “I’m fine with that.” And I looked at her and I thought to myself, this is why we don’t write people stories. Because easily you see the birth plan with the vernix and you think that they’re anti-hospital, anti-intervention.

And not to say that maybe we do avoid AROM, that’s not the episode, but if she’s open to it and it’s appropriate for her plan of care, I will say from my experience, most families are going to be comfortable with those interventions if they’re used appropriately. This is why physiologic birth information is so important and having the tools to help educate and whatnot. And so I think at the end of it all, I heard, to summarize, that she wanted a calm environment. She wanted to be acknowledged as the human being, that this is her birth experience, that her preferences are respected and that she was listened to along the process, and included in her plan of care, giving her an element of control. You’ve heard these themes before, but to summarize once again, that if we are doing that from a lived experience perspective, and I will say, this is what I offer my clients. They walk away having a more positive birth experience.

And that is entirely regardless who the provider is, where they give birth, what happened in their labor progress, whether it was a vaginal birth or not, epidural or not, complications or not. I’ve had NICU stays go and be like, “This went so well. Thank you so much for everything you’ve done. I felt like I had control,” and they’re not traumatized from the experience.

So, I want to pull just a little bit of data, just share some little pieces of information here, in relation to what families want for their birth, because there are lots of clinical studies on this. And when I went through and did a Cochrane review and then I went into the medical library, and then I just Google scholared it real quick, there was just never ending. And it’s control. All the same themes I just talked about are there. But one of the things in California, if you’re in California, regardless if you’re in California or not people are people, regardless what state they’re in, but there’s this survey that goes out every so often. It’s like maybe every three to five years-ish, called Listening to Mothers. Have you heard your hospitals talk about this, Justine? Interesting.

No, I’m excited though.

Oh, okay. So, it’s basically, it comes from the National Partnership for Women and Families, and the last data that they did was from… They have a published something from 2018, so it’s older. They studied from 2002 to 2016, listening to mothers and say, “What do we actually want?” So, it was just a 30 minute questionnaire, but they looked at 2,500 self-identified women in the study, and basically they looked at these different areas that came out and what they actually want.

So, as far as maternity care practices, the ultimate statement was that birth is a process that should not be interfered with unless medically necessary. About half agreed strongly, and another quarter agreed somewhat, versus fewer than one in 10 who disagreed. And I think that as a basis for why our physiologic birth class came about was sort of the whole point. It’s not that we’re… We’re not using medical interventions entirely, right? We’re very pro-hospital birth around here ,that’s what we specialize in. But it’s like just know how to support it in a way that it could be successful without, rather than going first, to medical interventions.

Ideally, they did want vaginal births if possible, which again, I would say physiologic birth is a way to do that. But then it started talking about respectful versus disrespectful treatment. So, under this, the summary says most women reported that they had been granted autonomy and decisions about how their birth would proceed, and had been well-supported and had experienced good communication during the hospital stay for giving birth. And that was based on the positive experiences. So, it would be autonomy over their decisions, well-supported, and good communication. Do you hear a theme? And then there’s stuff on postpartum experiences and maternal mental health. We’ll link it in the show notes down below. So, whether you’re in California or not, I think people are people, and what they prefer is across the board. It’s the same thing. It’s so simple.

There was a systematic qualitative review done by Down, Finlayson, et al. I’m going to read you the results of this study. They put together 35 studies. What mattered to most women was a positive experience that fulfilled or exceeded their prior personal and sociocultural beliefs and expectations. This included giving birth to a healthy baby in a clinically and psychologically safe environment with practical and emotional support from birth companions and competent, reassuring, kind, clinical staff. Most wanted a physiological labor and birth while acknowledging that birth can be unpredictable and frightening, and that they may need to go with the flow. I wish they would’ve said flex and flow there, but we’ll take it.

If intervention was needed or wanted. Women wanted to retain a sense of personal achievement and control through active decision making. These values and expectations were mediated through women’s embodied physical and psychosocial experience of pregnancy and birth, local, familial and sociocultural norms, and encounters with local maternity services and staff. That literally just summarized everything that I’m seeing in practice. Therefore, I will say our lived experience does matter in alignment with what they’re finding in the data.

We also know that in our medical system in the United States in particular, there are disparities with women of color and people of color giving birth. That black women in particular die four times more likely. You’ve heard these stats. It’s that we have a racism issue in this country. And so we will also link this one down below because I think that it’s easy to talk about people’s experience of birth and not acknowledge that there is a divide between races, in terms of what they’re experiencing and how they’re coming out, whether it be psychologically whole and listened to and well, or that could also be physically well. And so this comes from a article from 2019 from Altman, Oseguera and McLemore, and the title of it is Information and Power, Women of Color’s Experiences Interacting with Healthcare Providers in Pregnancy and Birth.

And basically the conclusions were that women of color’s experiences during pregnancy and birth were influenced by how they were treated by providers, particularly in the information that was shared and withheld. Ooh, this totally goes along with the other article I was reading. The provider’s control over information led to a power dynamic that diminished women’s ability to maintain autonomy and make healthcare decisions for themselves and their children. This study provides insight and impetus for change in how providers share information, utilize informed consent, and provide respectful care to women of color during pregnancy and birth care. So, again, it all comes down to shared decision making. This is hashtag team underwear. This is how we treat our patients. This is our job as nurses, to assure no… First of all, we have to know what the risks, benefits, alternatives are of everything that we do. And if you don’t, we have an entire mentorship program for that.

There are books available. There are… and we’ll actually, let’s link the AWHONN Perinatal book. Again, I’m so bad with titles, but basically- perinatal nursing book, and that is a good textbook of an example of literally just explaining the risks, benefits, alternatives, why they do it, what’s the process from a nursing perspective for everything that we do, especially if you’re new, that would be a good one to have in your library. So, we have to know what those risks, benefits, alternatives are. And then in the efforts of advocacy, regardless who the patient is, setting our own bias aside, which again simplifies the whole issue, but that your job is regardless to listen to the shared decision making that’s happening from the provider. It is the provider’s job. And we parse that out. We brought in an attorney and an MD from Yale and Harvard to teach you a piece of this for our shared decision making module in mentorship.

And so honestly, it was like so eye-opening to me to learn from her, that I know it will be also for you, but basically it’s their job to give the initial information. And once they do, then it’s your job to fill in the gaps and you can now give nursing education to help the client make sure that they’re getting all the information possible. And so if you’re noticing that things are being omitted, that’s also something to pay attention to because it is not shared decision making unless all of the information is being shared in an unbiased way. And I know, we’re human, we are biased. We have our preference and bias, not even talking about for weight or gender or socioeconomic or education level. I’m literally talking about birth bias. And so we need to know what our biases are, what do we believe is right?

And I mean will say right now I have a bias towards physiologic birth, but that comes from a place of love and understanding of knowing what families want. And so even with that, there may be somebody that’s like, “I want a scheduled C-section” and can I care for them in the same way with the same love, and kindness, and care, and calm, and shared decision making process that I will somebody who comes in that wants the physiologic birth, I hope so, but I’m going to have to enter that space being really intentional with how I carry myself into the room. That was a whole rant.

That was that good rant though. And I’m trying to think through someone listening to this, “Okay, but what about all of the pushback I get from my charge nurses or my providers or my leadership?” And I think that’s a whole nother episode, but I’m thinking like, “Okay, what’s step one?” And you said it right? It’s knowing RBA like the back of your hand, being able to teach to that, and then taking your mentorship. But the art of labor and birth and what it could be, is very muddied, if that’s the word. And we don’t see it as a non-emergency a lot of times. Many of us see it as an emergency. And so it’s hard to step back and being like, “When do we need to intervene and when is low intervention okay?” And does that make sense? That’s kind of what I’ve been trying to think through as you’ve been talking, of how to make it so that this is a new norm for all these new nurses listening. Because I think it’s hard for you.

I don’t even think it matters of low intervention, like scrap the physiologic birth perspective that we bring, but it’s truly, it’s how you speak, it’s how you approach a circumstance. It’s even starting with benefits, or starting with the risks, choosing which one you start with potentially has impact on how they make that decision. And being mindful to present information in a way that knowing that this is not your decision, and you are not responsible for their decision if you do this process right. And I think that for me has been so freeing, especially as a birth coach where they’re looking to me and I’ll be in interviews and they’ll be like, “I need you to advocate for me.” And I’m like, “Whoa, whoa, whoa, whoa, whoa. Nope. That’s not how it works. I can advocate for you to advocate for yourself, and I can help script things out. I can help you reword things. I can help you understand what’s going on, but the job is for the family to get to a place of full understanding.”

And honestly, this is where childbirth education, and we should do an episode on that too. Will you write that one down? Because we all know that, and actually we’re seeing this in the studies of, and it was the very first one that I read of their own knowledge coming in, of setting realistic expectations. I will say that TikTok right now, when I’m on pregnancy TikTok, it is terrifying what they’re seeing. And if that is their only source of childbirth ed, which is why I’m trying to get on TikTok, I literally just hired someone, guys be so excited, I’m going back to the birth side and I’m going to help contribute. That’s my mission statement because we all need a mission statement to help us do hard things, and social media is challenging for me right now.

So, but if that’s all they’re getting, they’re going to walk in with a frame of reference that may not be a realistic expectation setting for their experience. So, when you catch them in triage, when you’re out and about, when you’re on social media, when you’re talking to pregnant people, a lot of you have influence in your worlds on that is that we have to be encouraging childbirth education. By the way, I do have classes on the bundle birth side. If you don’t know where to go, I do have a free YouTube channel for that so that we have resources, but there’s also other resources. We’re not the end all be all, although I will say that the class that we just recorded is pretty freaking awesome. So, when it comes, we’ll be telling you about it so that you can recommend it to your clients because it will only set you up and them up for success.

I digress, again. Moral of the story is they need to come in and they’re responsible for their decisions. Ultimately it is. But if they’re not given the chance to be responsible with their decisions, they’re only being set up for regret. Because when they hear the story of, “Oh, I asked for four more hours to wait before my C-section,” “Wait, I didn’t know that I could do that.” And then it becomes something that I hear about years later in birth debriefs that I’m doing prior to their next baby, where I’m like, if only, and a lot of times I’m looking at the scenario and I’m like, “Four hours wouldn’t be appropriate. I literally review medical charts sometimes and I’m like, there’s no way there would’ve been a four hour mark.” But somebody needs to tell them that in the moment. We need to give them the full picture. And if we’re doing that, it will make a difference on their birth experiences.

Drop the mic. Everything’s changed now. Go ahead.

Yeah, but it’s so simple.

It is really simple.

I think this is not like… That’s what I want people to take away from this episode is when we’re asking you to level up your care, I’m literally asking you to just be calm inside or at least act calm inside. You don’t have to be calm inside.

The masks help that.

For sure, for sure.

I think if I would’ve started as a new nurse with a mask, so much of my emotion would’ve been hidden in a good way.

That’s funny. I mean true. Use whatever resources and tools you have to help maintain a level of calm in the room, advocate for autonomy, include them in the decision, give them choices, respect their birth preferences and celebrate them. Help them set up clear expectations of what’s realistic based on their clinical scenario and not. Like we’ve said this before, but once again, especially for this season two situation of podcasts, it’s always good to have that reminder to hear it again and to be reminded that our jobs are truly, it’s not that complicated. Mind you, these are soft skills. And these are soft skills that we teach throughout and we continue to reinforce, and I hope that we can help model. And I hope you’re seeing modeled around you. Pay attention to when somebody does the shared decision making process well. Ask them where they learned. But this is also where we all need to be continuing to level up ourselves in our own knowledge, and understanding, and clinical knowledge so that we can help to advocate for these families.

Thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us if you subscribe, rate, 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. Now. It’s your turn to take what you learned today and apply it to your life. Giving calm, patient-centered and therapeutic care to every single patient you care for. We’ll see you next time.