July 30, 2024 • 35 mins
Hey there! Today, we're diving into the ever-changing world of hospital births in 2024. With over 10 years of experience as birth photographers and doulas, we've seen it all! From the hustle and bustle of Denver to the calm vibes of Ann Arbor, we're here to share the latest trends, improvements, and areas that still need some love in the hospital birth scene.
We've noticed some incredible changes, like the rise of trauma-informed care and true informed consent. Nurses are stepping up their game, learning new techniques, and advocating fiercely for their patients. But let's be real—there are still some outdated policies that need a major overhaul.
Join us as we chat about everything from the pros and cons of inductions to the joy of seeing more diverse birthing positions. Whether you're a birth professional or just curious about the latest in the birthing world, we've got you covered. Let's celebrate the wins and brainstorm ways to make hospital births even better!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Hi, Jen. Hi, Monet. How are you?
Good. I know you've been at a birth all night long, so thanks for being here.
I'm sure you're exhausted.
So tired, but that's birth work for you. I know.
This has been our biggest struggle with starting the podcast was trying to figure
out how we were going to make it work with our schedule.
(00:21):
And so we're just going to push through and record even on days when we're tired
because between the two of us,
I feel like one of us is always been to a birth or is going to a birth.
So yeah, but I'm glad that we're here and we're going to go ahead and jump right in.
Hi, it's Monet and Jen, and we are the co-founders of Birth Becomes You.
(00:43):
We are birth photographers and doulas with over 10 years of experience.
We've attended over 1000 births collectively.
We started Birth Becomes You to create a safe space for new and experienced
birth photographers to share and grow.
We aim to equip and empower We empower birth workers to feel confident in the
birth space and take beautiful, world-changing images.
(01:04):
We believe in a world where birth is visible, where shame is absent,
where fear is translated to power, and where each individual's experience is
honored as valid and valued.
We are so glad you're here, and we can't wait to learn and connect with you.
So today we thought it would be interesting to talk about hospital birth in 2024. 24.
(01:27):
Jen and I have been doing this work for 10 years, and we've been parents for well over 10 years now.
And so much has changed, I think, in the hospital birth space over the last decade.
And specifically, even since COVID ended, I think a lot has changed,
a lot of positive changes, honestly.
So we're going to just kind of go through things that we've observed in birth
(01:51):
and talk about the things that we feel like are working really well in the hospital
system. and some things that we feel like could be improved upon.
Jen, how many hospital births, like what percentage of births that you attend are hospital births?
I actually attend more home births than hospital. I would say I probably attend,
probably 40% hospital births and the rest are at home right now.
(02:14):
Yeah. I feel like my stat's probably pretty similar.
I would say maybe a little bit more hospital birth than you,
Jen, but I would say at least 40, maybe 50% of the birth that I attend are hospital births.
And for those of you who don't remember or don't know, I am located in Denver
and Jen is in right outside of Ann Arbor in Michigan.
(02:37):
So I think that's important because as leaders in Birth Becomes You,
we talk to people all over the country and world and some of the experiences
that we hear from other birth photographers is very different than what we experience.
So, you know, this is not a like picture of birth in America.
This is going to to be pretty specific to our local birth cultures.
(03:01):
But I think especially for Denver, and I also, from Jen talking to you in Ann
Arbor, I think that both of those communities are really kind of leading the
way in a good way in terms of providing really competent.
Trauma-informed hospital-based care.
So I think it's a good thing to highlight for sure. Yeah, absolutely.
(03:22):
And coming from Denver to here, I felt like in Denver, the hospitals were a
lot farther along in, you know, just allowing more things to happen,
allowing more things to happen.
Whereas here, I felt like I was kind of taking a step back when I moved.
But the University of Michigan Hospital is really great here.
(03:42):
And we see a lot of steps forward in hospital birth.
Absolutely. All the time. Yeah, there are great things happening for sure in
Ann Arbor and here in Denver.
And the first thing that we want to talk about, I think it's probably the most
important thing that we have seen and we continue to advocate for is just informed consent.
(04:03):
I think a lot of people have realized how a lot of health care providers have
realized how important informed consent is and how it's not just about telling
people like the risks and benefits.
It's telling them the risks and benefits and then also giving them the choice
and truly respecting that choice, even if it's not the choice they would make
(04:26):
for themselves. selves.
I have, you know, I have clients who are planning a hospital birth and that
is different in a lot of ways than the clients who are planning home births
and end up going to the hospital.
And in those situations, I really get to see informed consent modeled in really
cool ways because those home birth transfers, obviously they wanted a very different birth experience.
(04:51):
They chose a very different health care provider and they're at the hospital
because they need some sort of help or assistance.
And I think it would be easy. And in the past, I saw a lot of providers,
a lot of nurses talking down to these patients, not really giving them options or choices.
(05:11):
It's like, if you come to the hospital, then you're playing by our rules,
and this is how it's going to be.
And I've seen that change, like 180 in the last several years.
And now when I go to the hospital with my home birth clients,
the nurses, the OBs, they They treat these families with such respect and they give them time.
(05:33):
You know, if they're like, I really think Pitocin is what you need,
they'll explain why, but they will give them time and space.
And if they end up saying no, that's okay. I just attended a birth the other
day where my client did not want Pitocin, even though her contractions had really
spaced out and they recommended it. She said no.
(05:53):
And they said, okay, well, do you want to do the breast pump instead?
That. And so she did the breast pump for several hours.
And we ended up on Pitocin eventually, because I really do think that clinically
that's what needed to happen.
But they gave her ample time. They allowed her to make a different choice.
They didn't judge her. They just provided information.
(06:14):
And then they let her and her partner decide what they wanted for themselves and their baby.
And it was a really powerful thing to witness.
And my clients kept on looking at me and being like, this hospital is amazing.
Like I had no, I thought that hospitals were not like this.
And it's really cool to see that changing because they really are,
(06:34):
I think, making huge strides to providing true informed consent to their patients.
Now, are you seeing all of this at one hospital or are you seeing this at every
hospital? Because it's different here.
Yeah, I know. I mean, I would say too, we definitely have some like stellar
hospitals here in Denver, right?
(06:55):
And so there are some, the hospital that I was just talking about was Denver
Health, where you actually had Clem, Jen.
So, and, but even from the time that you had Clem to now, oh my gosh,
like it is just, it continues to improve.
So they were good then, I thought. I mean, like I knew what I was getting into. Clem is eight.
So this was a while ago and when I had to transfer, but I did feel respected
(07:21):
and listened to, and I didn't feel...
Like I was looked down upon at all. Yeah, no, I would say, so,
you know, there's some leaders that are really like just the top of the list,
but I really see this at almost every hospital that I'm going to now.
Really? That's so good to hear. Yeah. I mean, I really, of course,
(07:42):
there's always situations, there's always providers, there's always nurses where
sometimes Sometimes I'm like, oh, but I would say by and large,
we have really moved towards a lot of of shared decision making and informed
consent, which I love, but not not the case as much.
Right. For you in Michigan, it's a little bit. It's different here.
The University of Michigan, which is the hospital that I will like sing their praises constantly,
(08:08):
has been really great at home birth transfers and facilitating like community
events for the home birth midwives and even for doulas.
So that when a transfer is happening,
at least they've met the staff before, they've met the midwives before,
(08:30):
the midwives, the home birth midwives understand the process and the hospital
staff understands where the home birth midwives are coming from.
But the midwives here will drive an hour if it's safe for their home birth transfer
to go to U of M. If they have to go to a local hospital because of an emergency, it's very different.
(08:55):
And I think that's probably what we're hearing from a lot of folks right in
our community is that some of the larger city hospitals,
university hospitals are doing a much better job than maybe some of the smaller
hospitals or hospitals,
I guess, maybe necessarily even smaller because we hear these stories in big areas as well.
(09:17):
But you can tell that there's like culture changes happening,
right, at certain hospitals where they've decided like as a community of providers,
we are going to do things different. We're going to do things better.
You know, even when it comes to like cervical exams, like I've loved watching
nurses and providers truly practicing informed consent with cervical exams.
(09:41):
And then also trauma-informed care, you know, not coming in and saying,
I would like to do a cervical check right now. Is that okay?
Using the kind of language where they say, hey, a cervical check might give
us some more information.
Are you okay with me doing this now? Or would you rather us not giving them
both options so they're not having to fight back?
(10:03):
They can choose one of the two options in front of them using language.
That choice is so important.
It is. And I can see the staff, the hospital that does it well here does it well.
But the other hospitals are working on informed consent.
But you can see that shift in their mindset when they're even like asking a question like that.
(10:23):
Absolutely. And they are giving
a lot of options rather than just like saying, you know, half of it.
Like, well, I'd like to do a cervical exam now. We would like this information.
Right. Right. Exactly. Yeah. Yeah.
You have to give people the opportunity. Well, not only the opportunity to say
no, but the option, like what would it look like if I said no,
(10:44):
if you said no, we might, you know, need to do X, Y, or Z.
We might need to give it a couple of hours, but giving people two choices,
I think is one of the most important things you can do in terms of informed consent.
Like this is, if we do this choice, if we use Pitocin, if we,
you know, if you get an epidural, If we go back for a cesarean,
(11:04):
these are the reasons why these are the risks and benefits.
And then these are the risks and benefits if we don't do anything at all.
And then giving them the space to, to think about that, of course, as long as there is time.
And that's the thing about obstetrics is that in most situations,
there is time, there's time, you know, of course, there's always emergencies,
(11:25):
cord prolapses, you know, that we know all of those really rare emergencies
that happen, a shoulder dystocia, you can't really have minutes to think about what you want to do.
We're not talking about those situations. We're talking about the vast majority
of the care that does happen during labor and delivery, where there is time for people to...
(11:47):
Think and discuss and hear their options.
Now, Jen, you were telling me, was it that not one of your clients,
but somebody else had an episiotomy done without consent, right?
Yeah. One of my doula friends here had a birth at a different hospital on the
other side of the state for me.
And she, the person giving birth said, I do not want to be cut.
(12:10):
And the doctor or did it anyway. And it wasn't an emergency situation.
Of course, that doula is filing a complaint. She's talked to the hospital.
But the mom is very traumatized, rightfully so, by the terrible situation.
I mean, when she shared the full story with me, I was shocked.
(12:34):
And you can't believe that sometimes this stuff still happens.
Like, while we don't see it all the time, and I've probably only seen three
or four episiotomies in my whole 10 plus years doing this,
and they were all with consent and all very emergent, but they were with consent.
Yeah. So you can consent somebody before you do something like that.
(12:57):
And this was not that situation at all. Yeah, that's really sad.
And you know, Jen, that makes me think about, and I try to remember this quite
often, is that I am, as a birth photographer,
as a well-known birth photographer here in Denver, Colorado,
I'm working with a very specific population of birthing families, right?
(13:20):
A lot of my families are financially well-off.
They are very educated. They're very informed.
They know their options. They know how to advocate for themselves.
And so I want to put a caveat on this whole episode, as we talk about hospital
births, is that we see a lot of births. Jen and I go to a lot of births,
(13:41):
but we also are working with a very specific, small demographic of people.
And so this cannot be all of these talks about how wonderful and informed consent
and all the great things are happening.
Yes, they're happening, but I don't know how far reaching this is, right?
And so I want to just make sure that we acknowledge that privilege.
A lot of our clients are privileged, And so they have perhaps different relationships
(14:06):
with providers and hospital systems and other folks.
And I think that's important to just say. Yes, absolutely.
Yeah. So I think that there are definitely...
Areas and communities in our
country where we know this kind of stuff is not happening on the regular right
we also are photographers we're in there with a camera we're in there documenting
(14:28):
the birth and i do think that that sometimes changes the way that providers
act and in a good way and i hate to say that because i don't think that anybody
wants to think that your care changes,
but i know that if someone was like like for example when i have like family
photos done at my house with my photographer, she's taking pictures of me with my kids.
(14:50):
I'm trying to be the very best parent version of myself that I can be, right?
Like I will have hard moments. I will have hard times in my day-to-day weeks.
I might, I might like have a, you know, a mom meltdown, but when I have someone
watching and taking pictures, I'm really trying my best.
And so sometimes I think that might be happening at some of the births we attend.
(15:11):
And it's not a bad thing. It's just, I think, a natural human thing.
But it's another caveat for us to mention as we discuss all of this is that
it's a special circumstance for sure.
Another thing that I think that Jen and I have talked about and have seen is
I feel like the nurses are just, they are amazing.
(15:31):
That's all I can say. I am seeing such positive things.
Change within the nursing community. I'm seeing nurses who are working really
hard to help their clients and their patients have safe vaginal births.
I see nurses who are advocating for their clients, who are stepping up and saying
(15:53):
things to providers when things need to be said,
who are learning spinning babies on their own time so they can help their patients
get those baby's in a better position and have a vaginal birth.
All of that, I think, is really making a huge positive impact on hospital births
right now in our country. Yeah, absolutely.
And I can say that even U of M has great nurses, but a lot of the hospitals
(16:17):
around here have great nurses. And that does make a big difference.
If you have a wonderful nurse that is working with you and the the family that
you're serving, their birth is 10 times better. Absolutely.
The nurse has the ability to sway things so much. And a lot of that has been swayed positively.
(16:38):
And it's really great to see. I had a nurse recently, she advocated really hard
for my client to have me come back for her cesarean birth.
And they have never had anybody back in the OR ever, ever before at this hospital besides a partner.
And while I had to switch out with the dad for a few minutes after the baby
(16:59):
was born, it was a big step for the hospital.
It was great for the mom because she got the pictures that she wanted.
And it was really like it all happened because of her nurse.
Absolutely. The nurse happened to be because we were there. It was a long induction.
We were there for two or three days. I don't even know.
But the nurse came back the second night, you know, And I was still there.
(17:22):
I mean, you've been in that situation where you're like, yep, I'm still here.
And you went home and had a whole day in the life.
But she really saw what we were trying to achieve and.
When we had to go back for the cesarean, she really made sure to keep my client's
wishes like as close as she could.
And it was, I mean, it was literally the first time that anybody had been back.
(17:43):
So that was, that was a big deal. And I praise that nurse for it.
Absolutely. I always tell my clients that, you know, you may have a wonderful
relationship with your OB, but your labor and delivery nurse is going to be
the person that's with you from the beginning of your labor to the end.
They are right there. where they are really wanting, and at least here in Denver,
(18:04):
they want to know who you are.
They want to know what's important to you and they want to help communicate
that to your provider and to the birth team.
And so I just, yeah, just, I want to give a lot of love to all the labor and
delivery nurses because you are often unsung heroes and you're doing really important work.
And I can see the difference you're making in my clients' lives and in the births that they're having.
(18:27):
So thank you for putting all the energy into your work and your crafts.
You know, it really is, I think working in birth is an art, right?
It's being able to, of course, assess what's going on medically,
but also to read, you know, read emotions, figure out like, hey,
like, there seems to be some anxiety here, there seems to be some fear.
(18:48):
And I mean, you've loved seeing I know that, like, there are so many,
like great Facebook groups and nurse labor and delivery influencers who are,
I think, leading the charge.
And that's helped a lot. I think that's been great, honestly.
It's been great to see the other side of nurses and sitting in their car,
talking about what they experienced today. Right.
(19:10):
And I think that's really humanized that. Yes. A lot.
Absolutely. So thanks. And thanks to people like Jen Hamilton and all the amazing
nurses that are doing all of
the good, important, hard work for our families. Yes. Because it's hard.
It's hard to put that out there on social media and talk about it and be real
and get some of that criticism back because, you know, it's not going on in
(19:35):
a vacuum. Right. Exactly. Yeah.
And then going back to what you talked about, Jen, with your nurse who really
advocated for you going back into the OR, that's another huge positive change.
And we talked about that in our
cesarean episode, but we are seeing that happen more and more and more.
I was at a birth over the weekend where, again, things didn't go as planned.
(19:56):
My client's birth plans, original birth plans, ended up being very different
than the reality of what was happening.
And the decision to have a cesarean was agreed upon by everybody.
They asked if I could go back. The OB was kind of like, well,
you know, I don't know. I got to check. I got to make sure.
And the nurse midwife just kind of put her hand up and said,
(20:19):
you know what? Actually, I'm going to make an executive call here. She's going back.
Like this is one thing we can do to make, to match her original birth plan. Let's do it.
And I was able to go back and be with the family.
The birth was a little scary. Like the baby didn't come out.
And that's one thing that I think is important for hospital providers to know
(20:39):
is that we know what to do when things happen emergently or urgently.
Absolutely. It didn't cause me to panic. I wasn't running around the room.
If anything, I just was able to sit with mom and tell her what was happening,
put my hand on her shoulder, say it's going to be okay, go over and hug dad,
reassure him, go with dad to the NICU. I was able to be a support.
(21:03):
And I know that that family, you know, their birth did go so differently.
But I think being able to have those images is going to be important for them
as they process postpartum.
Absolutely. It's not like we're going to see something happening and not get out of the way.
Like, I just I feel like that just needs to be said. Like, honestly,
(21:25):
like it's one of those things where you're just like.
We're here in the birth space all the time. I know the OR is a little bit different,
but it's still a birth space and we can still read the room and understand when
something is happening and we can support the family.
Yes. Because usually all hands on deck for whatever emergency is happening there.
(21:46):
So there's not too many people that are there like telling the mom or the dad,
everything's going to be okay.
It's nice to have, you know, it really is. It's only helpful.
And I had the same kind of situation.
It was actually a nurse that said, well, the anesthesiologist didn't want me
to go back right away into the C-section with the family.
(22:08):
They wanted me to wait with dad.
And the nurse said, no, she's not waiting.
She's a part of the care team. And I went in with the patient.
I was able to be there for her epidural and laying down on the table and all
of that. And it was because of a nurse. So that's really cool. I love that.
Yeah, I think that kind of brings up this is a big pet peeve of mine.
(22:28):
This has happened at a birth a few weeks ago.
But you know, as we've seen a lot of positive changes, we've seen,
you know, routine allowing doulas and birth photographers back in the OR, which is wonderful.
But then there are still some very like weird and inconsistent policies that
I feel like have not been upgraded to 2024.
(22:49):
Right. And one of those would be, you know, this is just a small example,
but epidural placements.
I'm allowed to go back into cesareans. Like I said, I go back to one or two every single month.
In a lot of places, they still ask me to leave the room when they are doing the epidural.
(23:09):
So that's weird to me because arguably, you know, a cesarean birth is a lot
more, you know, there's a lot more risk there in terms of the sterile field than an epidural.
And what happened a couple weeks ago, I had a patient, she was a multi,
her water had broken, third baby, very fast births. We all got to the hospital
(23:32):
and it was very evident that she was close to having a baby.
Her sister was there who was her labor support.
I was there and the anesthesiologist came in and said, okay,
we're going to place the epidural.
You guys need to leave. And not only leave, but we were asked to go to the waiting room.
And I looked at the nurse and I said, you know, I think she's about to have her baby.
(23:55):
It's really important that we're here with her and for her.
Please come and get me if she starts
pushing because i knew from enough right births that
we she was not she was going to have the baby so we
go out to the waiting room and the sister was like
pacing the halls you know we were anxious and sure
enough in a few minutes the the door flies open the nurse is like come back
(24:19):
now she's having the baby we have to run back into the room she has the baby
we don't miss it but i can't help but think how stressful that was for my client
as she was going through transition to be totally alone.
We could have been in the room. We could have been holding her hands.
We could have been offering her encouragement. She didn't speak.
(24:40):
English wasn't her mother tongue. She was Portuguese, like Portuguese was her mother tongue.
And her sister could have been there communicating to her and her language.
And instead we were in the waiting room. So it's things like that where I'm
just like, okay, you know, we've made so much progress.
Why are we still doing certain things this way?
(25:00):
And so I would, sorry, I had a really similar situation and it actually was
even more infuriating. And I want to share it because I just you're so right.
Like these inconsistent policies are just not always great for the birthing person.
And you can do so much to like move things forward. And then you're like taking
(25:20):
steps back here. But I was with a family during a loss.
And it was very evident that the baby was coming very soon.
And the patient wanted an epidural and they asked me to go out and the anesthesiologist
asked me to leave. And the mom said, please, like, she's my doula.
This is really hard. And he was like, no, you got to go out.
(25:42):
And I mean, did not have any compassion in that moment.
And so I stepped out. I knew that the baby was going to come very soon.
I don't, he never got the epidural in. I could hear her screaming,
eventually came out and was like, is there a doula out here?
And then I went into the room to support.
But it was their worst day of their life.
(26:04):
And to have their support person taken away in that moment was just, it was awful.
And it was the wrong choice all around.
And everybody in that room, nobody spoke up. There was a midwife,
there was a nurse, and the anesthesiologist.
And of course, mom and dad cannot speak up in that moment. So So it was just
one of those times where you're like, this really isn't the best thing here.
(26:26):
We could do better. It's an epidural. Yeah.
And I think that's a lot of the hospital. And I tell my clients this sometimes is that.
There are a lot of policies that have just, that's just the way that they've
done things for a really long time.
And there's not really evidence to support that, but that's just the policy of the hospital.
(26:46):
And so you have to ask questions and really determine, is this really for the
betterment of myself and my baby, or is this just hospital policy?
And if it's hospital policy, like you can push back. You can say,
actually, no, it's really important.
I would like to have my doula in here. what is the
reason you know we can put a surgical
(27:09):
cap on we can sit on the other side just like dad
we're not going to pass out from an epidural needle so
i understand why certain policies are in place but there
are a lot of policies that i feel like are are out of date and need to need
some pushback so that's what we're talking about them here um i think the best
thing we can do is communicate and share information and talk about it as a
(27:31):
community another thing that we're seeing a lot of, which I guess this isn't new,
but we're seeing a lot of inductions.
Even at the best hospitals we're seeing.
I had a nurse actually tell me that 80% of the patients at the hospital under
midwifery care even were getting induced, were scheduled for an induction date.
(27:55):
And the anxiety that that causes patients is really big.
Like every single patient that has a 41 week induction date, every one of my clients.
Is not looking forward to that date. They're not happy about that date.
They're doing things to try to get their baby to come out before the date.
(28:18):
And it's just this arbitrary, well, you're 41 weeks. We're going to just put it on the calendar.
And I really would love to see that stop.
It's just not evidence-based. It's not great for families. It's not great for morale.
And we know how inductions can go. They can be very long and trying and difficult.
And most of my cesarean births that I have start from an induction. Right.
(28:42):
And I know that if there's OBs listening and other providers,
I know that, again, data can be interpreted in different ways.
It can be. Arrived trial and all of this stuff that has come out.
I know that you're taking care of large populations and you're trying to figure
(29:03):
out how do I interpret this and what does this mean for my client?
And I understand all of that, but I also think that there's a lot we don't understand
still about the induction process.
We don't understand fully the effects that Pitocin has on moms,
birthing people, babies.
It is a serious medication, right? There's a reason that they haven't,
(29:25):
at least at the hospitals here in Denver, it's a high alert medication.
There has There has to be two nurses that come in to start Pitocin.
So it's not farmless for sure.
And so I think we have to figure out why are we doing these inductions?
Is it because this is just, again, like hospital policy?
(29:48):
Or does this person really need an induction? Can we wait a little bit longer?
What are some ways that we can encourage someone to go into labor on their own?
And sometimes threatening an induction actually makes people get so anxious,
like you mentioned, that it's hard for them to go into labor. Yeah.
I mean, I only really work at two hospitals and almost every single one of my
(30:13):
clients has that induction date.
Every single one. Ones that don't want an induction date.
While inductions can go well, and like you said, a big hospital is trying to
manage a lot of patients and trying to do it in the best way that they can,
but we do need to individualize some things. Right.
And having an induction date for every person is not that. Right, right.
(30:38):
Again, like we could probably spend a whole episode talking about inductions,
not only what we think about inductions.
Again, they're sometimes totally necessary and we've supported many wonderful inductions.
But I do think it's something that we're definitely seeing a lot of in 2024.
So it's hard to talk about hospital birth without bringing up inductions.
And I feel like it's what we've been seeing for 10 years and,
(31:01):
you know, like it's not changing. It's actually getting higher.
Right. Absolutely. Yeah.
And then I think we could end on a positive note because I don't want to end
on anything negative because I do think that there has been a lot of really
positive change in the hospital systems.
One thing that I love seeing is people pushing and giving birth in a lot of different positions.
(31:25):
I am seeing, and again, the nurses have kind of led the way on this,
but people with epidurals are getting up and squatting with a squat bar.
They're pushing on their side. They're pushing on all fours.
They're delivering babies on all fours.
I have seen OBs come in and being very comfortable with delivering a baby in
all different sorts of positions.
(31:46):
And that's something that I love to see. And I'm so happy that that change is
making its way across the country.
Again, I know it's not at every hospital, and I'm sure there are plenty of hospitals
where when that OB comes in, you're on your back.
But at least here in Denver, I'm seeing providers offering and doing something
different, which is really encouraging.
(32:07):
Yeah. And we're able to see hospital water births here at University of Michigan.
I don't believe there's any other hospital in our state that allows for delivery in the tub.
Most of the hospitals allow you to labor in the tub, but U of M allows water birth delivery.
And I think that's a huge change and like a step forward for all hospitals, really.
(32:31):
University of Colorado, when I lived in Denver, like water birth was kind of
new then at the hospital.
And I remember that being a big change and being really excited that hospitals
were just going to let that happen.
And they were blowing up pools and putting them in hospital rooms.
Now, you have actual pools, right?
(32:52):
Well, we have tubs. Tubs that are permanent. Yeah, the permanent corner tubs.
That's the one gripe I have about the University of Colorado is that while they
do allow water births, they have to have the tub.
The blow-up tub. And that's really, especially if a multip is coming in who's
about to have a baby, it can be really hard to get that tub blown up,
(33:12):
filled up, all the things.
I was at actually Pudra Valley Hospital in Fort Collins, and they just redid
their labor and delivery rooms, Jen.
And I walk in, and then I don't know if it was all the room,
maybe it was just a couple of rooms.
But you walk in and there's this huge white porcelain tub in the middle of the room.
(33:33):
It's like not in the bathroom. It's like in the middle of the room.
And they're going to start offering water births there. That's so great. That is so amazing.
Like they didn't have to do that.
Certainly there's only a, I think they're only the second hospital that I know
of in the front range that offers water births. But to like put these like big,
beautiful cubs, that's awesome.
(33:54):
And again, I think that there are a lot of people that are choosing like free
birth or they don't want to go to the hospital because of all the horror stories they've heard.
And so it's really cool to see the hospital working hard in a lot of ways to
make changes so that families that need to have that extra care still feel comfortable
(34:15):
and that they can have the birth experience that they want.
Absolutely. Because not everybody can give birth at home. Not everybody.
It's not safe for those people.
Some people don't want to give birth at home. And so even though I love home birth,
big proponent of home birth, I know you do too, we want there to be great and
(34:36):
positive change in the hospital system too, because that's what most people, at least in our country,
are going to access when they have their babies.
And so we want change to ripple into every area of birth in America.
Well, thanks, everybody.
We are so glad that you're here. here jen thank
(34:56):
you especially for great sorry i'm just just trying to like stay awake over
here yeah we are really grateful looking at my bagel like i can't wait to eat
it we're grateful that you were able to do this and we can't wait to talk and
share more next week bye everybody thank you bye.
Hi, Jen. Hi, Monet. How are you?
Good. I know you've been at a birth all night long, so thanks for being here.
I'm sure you're exhausted.
So tired, but that's birth work for you. I know.
This has been our biggest struggle with starting the podcast was trying to figure
out how we were going to make it work with our schedule.
(00:21):
And so we're just going to push through and record even on days when we're tired
because between the two of us,
I feel like one of us is always been to a birth or is going to a birth.
So yeah, but I'm glad that we're here and we're going to go ahead and jump right in.
Hi, it's Monet and Jen, and we are the co-founders of Birth Becomes You.
(00:43):
We are birth photographers and doulas with over 10 years of experience.
We've attended over 1000 births collectively.
We started Birth Becomes You to create a safe space for new and experienced
birth photographers to share and grow.
We aim to equip and empower We empower birth workers to feel confident in the
birth space and take beautiful, world-changing images.
(01:04):
We believe in a world where birth is visible, where shame is absent,
where fear is translated to power, and where each individual's experience is
honored as valid and valued.
We are so glad you're here, and we can't wait to learn and connect with you.
So today we thought it would be interesting to talk about hospital birth in 2024. 24.
(01:27):
Jen and I have been doing this work for 10 years, and we've been parents for well over 10 years now.
And so much has changed, I think, in the hospital birth space over the last decade.
And specifically, even since COVID ended, I think a lot has changed,
a lot of positive changes, honestly.
So we're going to just kind of go through things that we've observed in birth
(01:51):
and talk about the things that we feel like are working really well in the hospital
system. and some things that we feel like could be improved upon.
Jen, how many hospital births, like what percentage of births that you attend are hospital births?
I actually attend more home births than hospital. I would say I probably attend,
probably 40% hospital births and the rest are at home right now.
(02:14):
Yeah. I feel like my stat's probably pretty similar.
I would say maybe a little bit more hospital birth than you,
Jen, but I would say at least 40, maybe 50% of the birth that I attend are hospital births.
And for those of you who don't remember or don't know, I am located in Denver
and Jen is in right outside of Ann Arbor in Michigan.
(02:37):
So I think that's important because as leaders in Birth Becomes You,
we talk to people all over the country and world and some of the experiences
that we hear from other birth photographers is very different than what we experience.
So, you know, this is not a like picture of birth in America.
This is going to to be pretty specific to our local birth cultures.
(03:01):
But I think especially for Denver, and I also, from Jen talking to you in Ann
Arbor, I think that both of those communities are really kind of leading the
way in a good way in terms of providing really competent.
Trauma-informed hospital-based care.
So I think it's a good thing to highlight for sure. Yeah, absolutely.
(03:22):
And coming from Denver to here, I felt like in Denver, the hospitals were a
lot farther along in, you know, just allowing more things to happen,
allowing more things to happen.
Whereas here, I felt like I was kind of taking a step back when I moved.
But the University of Michigan Hospital is really great here.
(03:42):
And we see a lot of steps forward in hospital birth.
Absolutely. All the time. Yeah, there are great things happening for sure in
Ann Arbor and here in Denver.
And the first thing that we want to talk about, I think it's probably the most
important thing that we have seen and we continue to advocate for is just informed consent.
(04:03):
I think a lot of people have realized how a lot of health care providers have
realized how important informed consent is and how it's not just about telling
people like the risks and benefits.
It's telling them the risks and benefits and then also giving them the choice
and truly respecting that choice, even if it's not the choice they would make
(04:26):
for themselves. selves.
I have, you know, I have clients who are planning a hospital birth and that
is different in a lot of ways than the clients who are planning home births
and end up going to the hospital.
And in those situations, I really get to see informed consent modeled in really
cool ways because those home birth transfers, obviously they wanted a very different birth experience.
(04:51):
They chose a very different health care provider and they're at the hospital
because they need some sort of help or assistance.
And I think it would be easy. And in the past, I saw a lot of providers,
a lot of nurses talking down to these patients, not really giving them options or choices.
(05:11):
It's like, if you come to the hospital, then you're playing by our rules,
and this is how it's going to be.
And I've seen that change, like 180 in the last several years.
And now when I go to the hospital with my home birth clients,
the nurses, the OBs, they They treat these families with such respect and they give them time.
(05:33):
You know, if they're like, I really think Pitocin is what you need,
they'll explain why, but they will give them time and space.
And if they end up saying no, that's okay. I just attended a birth the other
day where my client did not want Pitocin, even though her contractions had really
spaced out and they recommended it. She said no.
(05:53):
And they said, okay, well, do you want to do the breast pump instead?
That. And so she did the breast pump for several hours.
And we ended up on Pitocin eventually, because I really do think that clinically
that's what needed to happen.
But they gave her ample time. They allowed her to make a different choice.
They didn't judge her. They just provided information.
(06:14):
And then they let her and her partner decide what they wanted for themselves and their baby.
And it was a really powerful thing to witness.
And my clients kept on looking at me and being like, this hospital is amazing.
Like I had no, I thought that hospitals were not like this.
And it's really cool to see that changing because they really are,
(06:34):
I think, making huge strides to providing true informed consent to their patients.
Now, are you seeing all of this at one hospital or are you seeing this at every
hospital? Because it's different here.
Yeah, I know. I mean, I would say too, we definitely have some like stellar
hospitals here in Denver, right?
(06:55):
And so there are some, the hospital that I was just talking about was Denver
Health, where you actually had Clem, Jen.
So, and, but even from the time that you had Clem to now, oh my gosh,
like it is just, it continues to improve.
So they were good then, I thought. I mean, like I knew what I was getting into. Clem is eight.
So this was a while ago and when I had to transfer, but I did feel respected
(07:21):
and listened to, and I didn't feel...
Like I was looked down upon at all. Yeah, no, I would say, so,
you know, there's some leaders that are really like just the top of the list,
but I really see this at almost every hospital that I'm going to now.
Really? That's so good to hear. Yeah. I mean, I really, of course,
(07:42):
there's always situations, there's always providers, there's always nurses where
sometimes Sometimes I'm like, oh, but I would say by and large,
we have really moved towards a lot of of shared decision making and informed
consent, which I love, but not not the case as much.
Right. For you in Michigan, it's a little bit. It's different here.
The University of Michigan, which is the hospital that I will like sing their praises constantly,
(08:08):
has been really great at home birth transfers and facilitating like community
events for the home birth midwives and even for doulas.
So that when a transfer is happening,
at least they've met the staff before, they've met the midwives before,
(08:30):
the midwives, the home birth midwives understand the process and the hospital
staff understands where the home birth midwives are coming from.
But the midwives here will drive an hour if it's safe for their home birth transfer
to go to U of M. If they have to go to a local hospital because of an emergency, it's very different.
(08:55):
And I think that's probably what we're hearing from a lot of folks right in
our community is that some of the larger city hospitals,
university hospitals are doing a much better job than maybe some of the smaller
hospitals or hospitals,
I guess, maybe necessarily even smaller because we hear these stories in big areas as well.
(09:17):
But you can tell that there's like culture changes happening,
right, at certain hospitals where they've decided like as a community of providers,
we are going to do things different. We're going to do things better.
You know, even when it comes to like cervical exams, like I've loved watching
nurses and providers truly practicing informed consent with cervical exams.
(09:41):
And then also trauma-informed care, you know, not coming in and saying,
I would like to do a cervical check right now. Is that okay?
Using the kind of language where they say, hey, a cervical check might give
us some more information.
Are you okay with me doing this now? Or would you rather us not giving them
both options so they're not having to fight back?
(10:03):
They can choose one of the two options in front of them using language.
That choice is so important.
It is. And I can see the staff, the hospital that does it well here does it well.
But the other hospitals are working on informed consent.
But you can see that shift in their mindset when they're even like asking a question like that.
(10:23):
Absolutely. And they are giving
a lot of options rather than just like saying, you know, half of it.
Like, well, I'd like to do a cervical exam now. We would like this information.
Right. Right. Exactly. Yeah. Yeah.
You have to give people the opportunity. Well, not only the opportunity to say
no, but the option, like what would it look like if I said no,
(10:44):
if you said no, we might, you know, need to do X, Y, or Z.
We might need to give it a couple of hours, but giving people two choices,
I think is one of the most important things you can do in terms of informed consent.
Like this is, if we do this choice, if we use Pitocin, if we,
you know, if you get an epidural, If we go back for a cesarean,
(11:04):
these are the reasons why these are the risks and benefits.
And then these are the risks and benefits if we don't do anything at all.
And then giving them the space to, to think about that, of course, as long as there is time.
And that's the thing about obstetrics is that in most situations,
there is time, there's time, you know, of course, there's always emergencies,
(11:25):
cord prolapses, you know, that we know all of those really rare emergencies
that happen, a shoulder dystocia, you can't really have minutes to think about what you want to do.
We're not talking about those situations. We're talking about the vast majority
of the care that does happen during labor and delivery, where there is time for people to...
(11:47):
Think and discuss and hear their options.
Now, Jen, you were telling me, was it that not one of your clients,
but somebody else had an episiotomy done without consent, right?
Yeah. One of my doula friends here had a birth at a different hospital on the
other side of the state for me.
And she, the person giving birth said, I do not want to be cut.
(12:10):
And the doctor or did it anyway. And it wasn't an emergency situation.
Of course, that doula is filing a complaint. She's talked to the hospital.
But the mom is very traumatized, rightfully so, by the terrible situation.
I mean, when she shared the full story with me, I was shocked.
(12:34):
And you can't believe that sometimes this stuff still happens.
Like, while we don't see it all the time, and I've probably only seen three
or four episiotomies in my whole 10 plus years doing this,
and they were all with consent and all very emergent, but they were with consent.
Yeah. So you can consent somebody before you do something like that.
(12:57):
And this was not that situation at all. Yeah, that's really sad.
And you know, Jen, that makes me think about, and I try to remember this quite
often, is that I am, as a birth photographer,
as a well-known birth photographer here in Denver, Colorado,
I'm working with a very specific population of birthing families, right?
(13:20):
A lot of my families are financially well-off.
They are very educated. They're very informed.
They know their options. They know how to advocate for themselves.
And so I want to put a caveat on this whole episode, as we talk about hospital
births, is that we see a lot of births. Jen and I go to a lot of births,
(13:41):
but we also are working with a very specific, small demographic of people.
And so this cannot be all of these talks about how wonderful and informed consent
and all the great things are happening.
Yes, they're happening, but I don't know how far reaching this is, right?
And so I want to just make sure that we acknowledge that privilege.
A lot of our clients are privileged, And so they have perhaps different relationships
(14:06):
with providers and hospital systems and other folks.
And I think that's important to just say. Yes, absolutely.
Yeah. So I think that there are definitely...
Areas and communities in our
country where we know this kind of stuff is not happening on the regular right
we also are photographers we're in there with a camera we're in there documenting
(14:28):
the birth and i do think that that sometimes changes the way that providers
act and in a good way and i hate to say that because i don't think that anybody
wants to think that your care changes,
but i know that if someone was like like for example when i have like family
photos done at my house with my photographer, she's taking pictures of me with my kids.
(14:50):
I'm trying to be the very best parent version of myself that I can be, right?
Like I will have hard moments. I will have hard times in my day-to-day weeks.
I might, I might like have a, you know, a mom meltdown, but when I have someone
watching and taking pictures, I'm really trying my best.
And so sometimes I think that might be happening at some of the births we attend.
(15:11):
And it's not a bad thing. It's just, I think, a natural human thing.
But it's another caveat for us to mention as we discuss all of this is that
it's a special circumstance for sure.
Another thing that I think that Jen and I have talked about and have seen is
I feel like the nurses are just, they are amazing.
(15:31):
That's all I can say. I am seeing such positive things.
Change within the nursing community. I'm seeing nurses who are working really
hard to help their clients and their patients have safe vaginal births.
I see nurses who are advocating for their clients, who are stepping up and saying
(15:53):
things to providers when things need to be said,
who are learning spinning babies on their own time so they can help their patients
get those baby's in a better position and have a vaginal birth.
All of that, I think, is really making a huge positive impact on hospital births
right now in our country. Yeah, absolutely.
And I can say that even U of M has great nurses, but a lot of the hospitals
(16:17):
around here have great nurses. And that does make a big difference.
If you have a wonderful nurse that is working with you and the the family that
you're serving, their birth is 10 times better. Absolutely.
The nurse has the ability to sway things so much. And a lot of that has been swayed positively.
(16:38):
And it's really great to see. I had a nurse recently, she advocated really hard
for my client to have me come back for her cesarean birth.
And they have never had anybody back in the OR ever, ever before at this hospital besides a partner.
And while I had to switch out with the dad for a few minutes after the baby
(16:59):
was born, it was a big step for the hospital.
It was great for the mom because she got the pictures that she wanted.
And it was really like it all happened because of her nurse.
Absolutely. The nurse happened to be because we were there. It was a long induction.
We were there for two or three days. I don't even know.
But the nurse came back the second night, you know, And I was still there.
(17:22):
I mean, you've been in that situation where you're like, yep, I'm still here.
And you went home and had a whole day in the life.
But she really saw what we were trying to achieve and.
When we had to go back for the cesarean, she really made sure to keep my client's
wishes like as close as she could.
And it was, I mean, it was literally the first time that anybody had been back.
(17:43):
So that was, that was a big deal. And I praise that nurse for it.
Absolutely. I always tell my clients that, you know, you may have a wonderful
relationship with your OB, but your labor and delivery nurse is going to be
the person that's with you from the beginning of your labor to the end.
They are right there. where they are really wanting, and at least here in Denver,
(18:04):
they want to know who you are.
They want to know what's important to you and they want to help communicate
that to your provider and to the birth team.
And so I just, yeah, just, I want to give a lot of love to all the labor and
delivery nurses because you are often unsung heroes and you're doing really important work.
And I can see the difference you're making in my clients' lives and in the births that they're having.
(18:27):
So thank you for putting all the energy into your work and your crafts.
You know, it really is, I think working in birth is an art, right?
It's being able to, of course, assess what's going on medically,
but also to read, you know, read emotions, figure out like, hey,
like, there seems to be some anxiety here, there seems to be some fear.
(18:48):
And I mean, you've loved seeing I know that, like, there are so many,
like great Facebook groups and nurse labor and delivery influencers who are,
I think, leading the charge.
And that's helped a lot. I think that's been great, honestly.
It's been great to see the other side of nurses and sitting in their car,
talking about what they experienced today. Right.
(19:10):
And I think that's really humanized that. Yes. A lot.
Absolutely. So thanks. And thanks to people like Jen Hamilton and all the amazing
nurses that are doing all of
the good, important, hard work for our families. Yes. Because it's hard.
It's hard to put that out there on social media and talk about it and be real
and get some of that criticism back because, you know, it's not going on in
(19:35):
a vacuum. Right. Exactly. Yeah.
And then going back to what you talked about, Jen, with your nurse who really
advocated for you going back into the OR, that's another huge positive change.
And we talked about that in our
cesarean episode, but we are seeing that happen more and more and more.
I was at a birth over the weekend where, again, things didn't go as planned.
(19:56):
My client's birth plans, original birth plans, ended up being very different
than the reality of what was happening.
And the decision to have a cesarean was agreed upon by everybody.
They asked if I could go back. The OB was kind of like, well,
you know, I don't know. I got to check. I got to make sure.
And the nurse midwife just kind of put her hand up and said,
(20:19):
you know what? Actually, I'm going to make an executive call here. She's going back.
Like this is one thing we can do to make, to match her original birth plan. Let's do it.
And I was able to go back and be with the family.
The birth was a little scary. Like the baby didn't come out.
And that's one thing that I think is important for hospital providers to know
(20:39):
is that we know what to do when things happen emergently or urgently.
Absolutely. It didn't cause me to panic. I wasn't running around the room.
If anything, I just was able to sit with mom and tell her what was happening,
put my hand on her shoulder, say it's going to be okay, go over and hug dad,
reassure him, go with dad to the NICU. I was able to be a support.
(21:03):
And I know that that family, you know, their birth did go so differently.
But I think being able to have those images is going to be important for them
as they process postpartum.
Absolutely. It's not like we're going to see something happening and not get out of the way.
Like, I just I feel like that just needs to be said. Like, honestly,
(21:25):
like it's one of those things where you're just like.
We're here in the birth space all the time. I know the OR is a little bit different,
but it's still a birth space and we can still read the room and understand when
something is happening and we can support the family.
Yes. Because usually all hands on deck for whatever emergency is happening there.
(21:46):
So there's not too many people that are there like telling the mom or the dad,
everything's going to be okay.
It's nice to have, you know, it really is. It's only helpful.
And I had the same kind of situation.
It was actually a nurse that said, well, the anesthesiologist didn't want me
to go back right away into the C-section with the family.
(22:08):
They wanted me to wait with dad.
And the nurse said, no, she's not waiting.
She's a part of the care team. And I went in with the patient.
I was able to be there for her epidural and laying down on the table and all
of that. And it was because of a nurse. So that's really cool. I love that.
Yeah, I think that kind of brings up this is a big pet peeve of mine.
(22:28):
This has happened at a birth a few weeks ago.
But you know, as we've seen a lot of positive changes, we've seen,
you know, routine allowing doulas and birth photographers back in the OR, which is wonderful.
But then there are still some very like weird and inconsistent policies that
I feel like have not been upgraded to 2024.
(22:49):
Right. And one of those would be, you know, this is just a small example,
but epidural placements.
I'm allowed to go back into cesareans. Like I said, I go back to one or two every single month.
In a lot of places, they still ask me to leave the room when they are doing the epidural.
(23:09):
So that's weird to me because arguably, you know, a cesarean birth is a lot
more, you know, there's a lot more risk there in terms of the sterile field than an epidural.
And what happened a couple weeks ago, I had a patient, she was a multi,
her water had broken, third baby, very fast births. We all got to the hospital
(23:32):
and it was very evident that she was close to having a baby.
Her sister was there who was her labor support.
I was there and the anesthesiologist came in and said, okay,
we're going to place the epidural.
You guys need to leave. And not only leave, but we were asked to go to the waiting room.
And I looked at the nurse and I said, you know, I think she's about to have her baby.
(23:55):
It's really important that we're here with her and for her.
Please come and get me if she starts
pushing because i knew from enough right births that
we she was not she was going to have the baby so we
go out to the waiting room and the sister was like
pacing the halls you know we were anxious and sure
enough in a few minutes the the door flies open the nurse is like come back
(24:19):
now she's having the baby we have to run back into the room she has the baby
we don't miss it but i can't help but think how stressful that was for my client
as she was going through transition to be totally alone.
We could have been in the room. We could have been holding her hands.
We could have been offering her encouragement. She didn't speak.
(24:40):
English wasn't her mother tongue. She was Portuguese, like Portuguese was her mother tongue.
And her sister could have been there communicating to her and her language.
And instead we were in the waiting room. So it's things like that where I'm
just like, okay, you know, we've made so much progress.
Why are we still doing certain things this way?
(25:00):
And so I would, sorry, I had a really similar situation and it actually was
even more infuriating. And I want to share it because I just you're so right.
Like these inconsistent policies are just not always great for the birthing person.
And you can do so much to like move things forward. And then you're like taking
(25:20):
steps back here. But I was with a family during a loss.
And it was very evident that the baby was coming very soon.
And the patient wanted an epidural and they asked me to go out and the anesthesiologist
asked me to leave. And the mom said, please, like, she's my doula.
This is really hard. And he was like, no, you got to go out.
(25:42):
And I mean, did not have any compassion in that moment.
And so I stepped out. I knew that the baby was going to come very soon.
I don't, he never got the epidural in. I could hear her screaming,
eventually came out and was like, is there a doula out here?
And then I went into the room to support.
But it was their worst day of their life.
(26:04):
And to have their support person taken away in that moment was just, it was awful.
And it was the wrong choice all around.
And everybody in that room, nobody spoke up. There was a midwife,
there was a nurse, and the anesthesiologist.
And of course, mom and dad cannot speak up in that moment. So So it was just
one of those times where you're like, this really isn't the best thing here.
(26:26):
We could do better. It's an epidural. Yeah.
And I think that's a lot of the hospital. And I tell my clients this sometimes is that.
There are a lot of policies that have just, that's just the way that they've
done things for a really long time.
And there's not really evidence to support that, but that's just the policy of the hospital.
(26:46):
And so you have to ask questions and really determine, is this really for the
betterment of myself and my baby, or is this just hospital policy?
And if it's hospital policy, like you can push back. You can say,
actually, no, it's really important.
I would like to have my doula in here. what is the
reason you know we can put a surgical
(27:09):
cap on we can sit on the other side just like dad
we're not going to pass out from an epidural needle so
i understand why certain policies are in place but there
are a lot of policies that i feel like are are out of date and need to need
some pushback so that's what we're talking about them here um i think the best
thing we can do is communicate and share information and talk about it as a
(27:31):
community another thing that we're seeing a lot of, which I guess this isn't new,
but we're seeing a lot of inductions.
Even at the best hospitals we're seeing.
I had a nurse actually tell me that 80% of the patients at the hospital under
midwifery care even were getting induced, were scheduled for an induction date.
(27:55):
And the anxiety that that causes patients is really big.
Like every single patient that has a 41 week induction date, every one of my clients.
Is not looking forward to that date. They're not happy about that date.
They're doing things to try to get their baby to come out before the date.
(28:18):
And it's just this arbitrary, well, you're 41 weeks. We're going to just put it on the calendar.
And I really would love to see that stop.
It's just not evidence-based. It's not great for families. It's not great for morale.
And we know how inductions can go. They can be very long and trying and difficult.
And most of my cesarean births that I have start from an induction. Right.
(28:42):
And I know that if there's OBs listening and other providers,
I know that, again, data can be interpreted in different ways.
It can be. Arrived trial and all of this stuff that has come out.
I know that you're taking care of large populations and you're trying to figure
(29:03):
out how do I interpret this and what does this mean for my client?
And I understand all of that, but I also think that there's a lot we don't understand
still about the induction process.
We don't understand fully the effects that Pitocin has on moms,
birthing people, babies.
It is a serious medication, right? There's a reason that they haven't,
(29:25):
at least at the hospitals here in Denver, it's a high alert medication.
There has There has to be two nurses that come in to start Pitocin.
So it's not farmless for sure.
And so I think we have to figure out why are we doing these inductions?
Is it because this is just, again, like hospital policy?
(29:48):
Or does this person really need an induction? Can we wait a little bit longer?
What are some ways that we can encourage someone to go into labor on their own?
And sometimes threatening an induction actually makes people get so anxious,
like you mentioned, that it's hard for them to go into labor. Yeah.
I mean, I only really work at two hospitals and almost every single one of my
(30:13):
clients has that induction date.
Every single one. Ones that don't want an induction date.
While inductions can go well, and like you said, a big hospital is trying to
manage a lot of patients and trying to do it in the best way that they can,
but we do need to individualize some things. Right.
And having an induction date for every person is not that. Right, right.
(30:38):
Again, like we could probably spend a whole episode talking about inductions,
not only what we think about inductions.
Again, they're sometimes totally necessary and we've supported many wonderful inductions.
But I do think it's something that we're definitely seeing a lot of in 2024.
So it's hard to talk about hospital birth without bringing up inductions.
And I feel like it's what we've been seeing for 10 years and,
(31:01):
you know, like it's not changing. It's actually getting higher.
Right. Absolutely. Yeah.
And then I think we could end on a positive note because I don't want to end
on anything negative because I do think that there has been a lot of really
positive change in the hospital systems.
One thing that I love seeing is people pushing and giving birth in a lot of different positions.
(31:25):
I am seeing, and again, the nurses have kind of led the way on this,
but people with epidurals are getting up and squatting with a squat bar.
They're pushing on their side. They're pushing on all fours.
They're delivering babies on all fours.
I have seen OBs come in and being very comfortable with delivering a baby in
all different sorts of positions.
(31:46):
And that's something that I love to see. And I'm so happy that that change is
making its way across the country.
Again, I know it's not at every hospital, and I'm sure there are plenty of hospitals
where when that OB comes in, you're on your back.
But at least here in Denver, I'm seeing providers offering and doing something
different, which is really encouraging.
(32:07):
Yeah. And we're able to see hospital water births here at University of Michigan.
I don't believe there's any other hospital in our state that allows for delivery in the tub.
Most of the hospitals allow you to labor in the tub, but U of M allows water birth delivery.
And I think that's a huge change and like a step forward for all hospitals, really.
(32:31):
University of Colorado, when I lived in Denver, like water birth was kind of
new then at the hospital.
And I remember that being a big change and being really excited that hospitals
were just going to let that happen.
And they were blowing up pools and putting them in hospital rooms.
Now, you have actual pools, right?
(32:52):
Well, we have tubs. Tubs that are permanent. Yeah, the permanent corner tubs.
That's the one gripe I have about the University of Colorado is that while they
do allow water births, they have to have the tub.
The blow-up tub. And that's really, especially if a multip is coming in who's
about to have a baby, it can be really hard to get that tub blown up,
(33:12):
filled up, all the things.
I was at actually Pudra Valley Hospital in Fort Collins, and they just redid
their labor and delivery rooms, Jen.
And I walk in, and then I don't know if it was all the room,
maybe it was just a couple of rooms.
But you walk in and there's this huge white porcelain tub in the middle of the room.
(33:33):
It's like not in the bathroom. It's like in the middle of the room.
And they're going to start offering water births there. That's so great. That is so amazing.
Like they didn't have to do that.
Certainly there's only a, I think they're only the second hospital that I know
of in the front range that offers water births. But to like put these like big,
beautiful cubs, that's awesome.
(33:54):
And again, I think that there are a lot of people that are choosing like free
birth or they don't want to go to the hospital because of all the horror stories they've heard.
And so it's really cool to see the hospital working hard in a lot of ways to
make changes so that families that need to have that extra care still feel comfortable
(34:15):
and that they can have the birth experience that they want.
Absolutely. Because not everybody can give birth at home. Not everybody.
It's not safe for those people.
Some people don't want to give birth at home. And so even though I love home birth,
big proponent of home birth, I know you do too, we want there to be great and
(34:36):
positive change in the hospital system too, because that's what most people, at least in our country,
are going to access when they have their babies.
And so we want change to ripple into every area of birth in America.
Well, thanks, everybody.
We are so glad that you're here. here jen thank
(34:56):
you especially for great sorry i'm just just trying to like stay awake over
here yeah we are really grateful looking at my bagel like i can't wait to eat
it we're grateful that you were able to do this and we can't wait to talk and
share more next week bye everybody thank you bye.
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