August 31, 2024 • 46 mins
Katrina Bolduc, a certified professional midwife, shares her journey to becoming a doula and midwife and the importance of supporting families throughout the birth process. She emphasizes the need for comprehensive, family-centered care and the benefits of having a birth team that aligns with your goals. Katrina also discusses the importance of creating a birth plan, starting small and adjusting as needed, and preparing for postpartum. She highlights the significance of informed decision-making and the role of a doula in advocating for the mother's wishes during labor. The conversation with Katrina Bolduc focuses on the importance of person-centered care during pregnancy and childbirth. She encourages families to advocate for their preferences and make informed decisions. Bolduc discusses the significance of creating a birth plan that is concise and focuses on the most important aspects. She also highlights the importance of self-care during pregnancy and postpartum, including rest, nutrition, and emotional well-being. The conversation touches on the global shift toward comprehensive care and the increasing demand for midwifery and doula support. Bolduc recommended resources such as Evidence-Based Birth and the book 'The Mama Natural' by Genevieve Holland.
CHAPTERS 00:00 Introduction and Background 01:39 The Journey to Becoming a Doula and Midwife 08:29 Creating Your Dream Birth Team 14:21 Preparing for Birth and Postpartum 29:19 The Importance of Planning and Preparation 32:12 Prioritizing Self-Care 39:02 Preparing for Pregnancy 42:30 The Global Shift Towards Comprehensive Care
RESOURCES Birth Without Fear - January Harshe "That’s the thing about birth, we don’t get an itinerary. We have to surrender and let go and it’s in that vulnerability we find the courage and strength we forgot we’ve had since our own birth. The power is already in you." The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth by Genevieve Howland Rebecca Dekker of Evidence Based Birth Baby Bath Frida Baby Basics Kit Happy baby organic puffs - all flavors Huggies Diapers
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:05):
It's the Best Birth Podcast, wherewe interview experts that elevate
you as you prepare your heartand mind to have the best birth.
Each episode will interviewprofessionals so you are prepared
for pregnancy, birth, and postpartum.
Our experts will build your confidenceand empower you to trust your
intuition throughout your pregnancy.
This audio is takenfrom videos on YouTube.
(00:27):
Watch the entire episodes onYouTube at Birth Made Mindful.
The Best Birth [00:02]
You're listening toThe Best Birth Podcast.
We are so excited for our guest today,Katrina Bolduc and she is a certified
professional midwife, a licensedmidwife and the owner of GEA Midwifery.
We're excited for our conversation today.
Katrina Bolduc is a firm believerthat a person's pregnancy, labor and
(00:50):
birth are one of the most powerfullypivotal moments in their life.
She honors family units and embracesindividualized family center care.
Katrina holds an Associate of Sciencedegree in Psychology, Bachelor's of
Science in Psychology, and graduated fromNational Midwifery Institute in 2021.
Katrina is a certified professionalmidwife and licensed midwife and
(01:12):
practices in the state of California.
She has proudly been attending births andsupporting families since 2016, entering
the birth field through prenatal yoga,doula services, and childbirth education.
With a passion for helping others,Katrina fell in love with the aspect
of supporting, encouraging, and helpingothers grow with compassion, respect,
understanding, and a commitment tomeet each individual where they are at.
(01:36):
Katrina is a wife, mother of threeincredible children, an Ironman
triathlete, lover of nature,animals, and everything birth.
With a heart for helping and a passionfor pregnancy, birth and beyond, she
is dedicated to the field of midwiferyand enjoys teaching and supporting
healthcare workers and families alike.
Welcome Katrina.
Katrina Bolduc [01:27]
Thank you so much for having me.
(01:57):
The Best Birth [01:29]
We were talking right beforethis conversation and Katrina has
assisted in almost 230 births.
That is incredible.
Thank you for your service.
Katrina Bolduc [01:37]
Yes, of course, my pleasure.
The Best Birth [01:39]
We would love to know justfrom your personal experience,
what led you to become a doulaand then eventually a midwife.
Katrina Bolduc [01:47]
Ooh, that's a good question.
(02:17):
So I have stage three endometriosisand I've had multiple surgeries for it.
So when I finally did get pregnantafter being told I could never have
children of my own, I initiallywent to see an OB, one of the OBs
that had done one of my surgeries.
And as a first time mom,I had lots of questions.
I was excited.
(02:38):
I was nervous, you know, all the things.
And my first interactionwas very disappointing.
The doctor was literally closing the dooras I was trying to answer or ask questions
and didn't answer my questions, spentless than like six minutes in my room.
And I just felt like for my first visit,for my first pregnancy, I wanted more.
(03:01):
So I left feeling really defeatedand I really didn't know what to do.
And I knew that that wasn'tthe experience that I wanted.
So I started to educate myself and that'swhen I learned more about midwives, about
doulas, and I was like, my goodness,yes, this is exactly what I want.
And then I scheduled an interview witha midwife and she spent an entire hour
(03:22):
sitting and talking to me and answeringmy questions and asking me questions.
And that just feltcomfortable and felt real.
And I was like, thisis exactly what I need.
I hired a doula for myfirst birth as well.
And kind of after that experience,it really opened up my eyes
to kind of what was available.
So prior to that, I did havesome experience in the prenatal,
(03:44):
postnatal realm with teaching yoga.
But this was sort of a biggerkind of door swinging wide open.
And that's where I really foundthat calling to birth work.
And throughout that process, and thenimmediately after I had friends getting
pregnant and other people watching yogastudents going through pregnancies.
And I felt like a lot of them had alot of unanswered questions and were
(04:07):
left feeling like, well, this is it.
And not really realizing that there'sother choices in terms of finding a
new OB, finding a midwife, hiring adual, like all of these things, they
just simply didn't know about them.
And so that's when it kind of becamemy mission to get that information
out to people of like, you know,birth is not one size fits all, not
all births belong in the hospital,but not all births belong at home.
(04:30):
Right, so really finding that placewhere you feel most safe and most
supported and then building that teamto support the vision that you have.
So kind of once that ball gotrolling, it literally never stopped.
So I've done so many different types oftrainings and exercises and continuing
to build this wealth of knowledge thatI have, I'm simply to support families.
(04:52):
So that's kind of where it all began.
The Best Birth [04:26]
I love your mission in supportingfamilies and just supporting the mother.
Like your work as a doula.
You were my doula for my second birth.
And I just felt so much empowerment,so much love and genuine concern for
how I was doing, how my baby was doing.
It was such a miraculous experience.
(05:13):
I look back on that day withsuch fondness and appreciation
for the work that you're doing.
I want to ask you aboutsupporting families.
Katrina Bolduc [04:33]
Mm -hmm.
small.
The Best Birth [04:54]
Why do you feel that supportingthe family, the entire family,
is so important in birth?
Katrina Bolduc [05:01]
Yeah, that's a great question.
I think birth is a family event, right?
(05:33):
We are growing families to simply focuson just the maternal aspect or the
parent that's carrying that pregnancy.
I think we leave a lot behind.
And I think as a family unit thatis growing and is expanding, when
we include everyone into thatconcept and into prenatal care, we
really get into comprehensive care.
(05:56):
And I think that's one of thereally big differences between
obstetrical care and midwifery care.
And first, I would definitely liketo preface this conversation with,
I think all providers are needed.
I think we need OBs.
I think we need midwives.
We need duals.
We need everybody.
We need hospital births.
We need availability for a cesareansections and interventions when needed.
(06:16):
And we need ability for home birth.
So all of those things are important.
That being said, I do think there aresome restrictions in terms of obstetrical
care in our general health care model.
Simply
you know, in the fact that theydon't have time to spend enough
time with each individual person.
You know, visits are rushed.
You sit in the waiting roomfor 45 minutes, not being seen.
(06:39):
You see a differentprovider every time, right?
That continuity of care is not there.
And the availability to trulyhave family -centered care is also
not there due to the lack of timethat you have with your provider.
And there's no relationshipif you're seeing a different
provider every single time.
So when we look at prenatalcare as family -centered care,
It truly is comprehensive and that'sone of the most beautiful aspects about
(07:03):
pregnancy is when we have comprehensivecare, we have healthier moms and babies.
We have healthier family units.
We have families that thrive better.
So we're talking about things like,you know, mental stress load and
what are you doing to, you know,support yourself and have self care?
What are you eating?
What is your family eating?
(07:23):
What are you drinking?
Right.
How are you feeling about birth?
How are you planning for birth?
How are you planning for postpartum?
Will the children be involved?
What does that look like?
Who's gonna be helping with them?
So we really unpack a lot of informationand a lot of ideas and further education,
because families will often say, wow,gosh, I never really thought about what
(07:44):
I want my older children to be involvedwith and what if they're sleeping
or what if it's too much for them?
So it really gets that ball rollingso they can decide, do I want
my children present at birth?
In what capacity?
who will be there to support them in theevent that they don't feel comfortable
being there, and how do we make them feelincluded because sometimes we have older
(08:05):
siblings that feel like, my gosh, allthe attention was on me and now we have
this new baby and I'm totally left out.
So with family -centered care, we'relooking at each individual person
of that family and building themup and supporting them together.
I mean, oftentimes you'll have dads thatcome in and they're stressed and they have
so many things emotionally that they wantto discuss, but no one's ever asked them.
(08:26):
You know, and it's so beautiful tosit and ask, okay, hey, dad, like,
how are you feeling about this?
Or, you know, to the differentpartners that come in or grandmas
that come in, they have questions too.
And oftentimes they're great questionsor they're great things to discuss.
So really having that family there,that birth team there, who's ever
going to be there during thatbirth, it's great to include them
(08:46):
because they are the family, right?
The family is not just theparent that's having the baby.
So family centered care is very important.
The Best Birth [08:29]
What do you recommend forcreating our dream birth team?
So right from the start, I think alot of times an individual kind of
goes to their insurance maybe to seewho is in network that they could see
(09:10):
for their delivery, for their care.
What do you recommend asfar as creating the team?
Katrina Bolduc [08:49]
Yeah, it's a good question.
So I think there's a lot of differentaspects that we need to consider here.
The first being, you know, your provider.
What type of provider do you want?
Is
(09:30):
that an OB?
Is that a CNM?
Is that an LM or a CPM?
Right, kind of figuring out andthen what are those things, right?
I'm sure a lot of people listeningare like, okay, none of those
things mean anything to me.
So, you know, we have our obstetriciansthat practice in the hospital.
There are a few that practice outsideof the hospital, which is pretty...
unique and really amazing.
We have certified midwives, certifiednurse midwives who work predominantly
(09:53):
in the hospital, but some of themalso work out of the hospital setting.
And then we have CPN, certifiedprofessional midwives or licensed
midwives, depending on the state.
And then also in your states, right?
So some states in the United States,we have illegal midwives where
they're not legal to practice.
So they're practicing under thelaw because women deserve the right
(10:14):
to choose how they want to birth.
And we also have illegal stateswhere there aren't laws that say,
yes, this is legal or no, it's not.
So kind of figuring out what makes senseto you and then interviewing providers.
And oftentimes people go, they meet adoctor, they're like, awesome, I met
this doctor, they were so fantastic.
They're gonna be at mybirth the whole time, right?
(10:35):
As a doula, these were some of thethings that I would often hear from my
families and I'd be like, they did notexactly explain everything to you, right?
So if you find that doctor youlove, it's important to see
how many doctors or howmany providers rotate call.
So we have some massive practices wherethere's eight to 20 providers that rotate.
(10:56):
And so yes, you might love this oneparticular doctor and maybe you see
them one or two times for prenatalcare and then it's some random
stranger that shows up at your birth.
And so asking those questions too oflike, what does labor support look like?
When do you join the in labor?
Because oftentimes with obstetrical care,doctors don't come in until you're pushing
or until certain interventions are needed.
(11:16):
They pop in and then they leave andthen they come back to literally
catch the baby, cut the cordand bye and they leave again.
So it's important to kind of getthose answers and then from there
you can build what else you need.
So having that additional supportperson, a doula who's going to
be there from the very beginning.
throughout until the very end soyou have that continuity of care and
(11:36):
someone who's there with you that entiretime supporting you, your partner,
your family, whoever else is there.
And then seeing what yourpartner feels like they need.
And oftentimes I feel like sometimespartners get a little bit nervous
of, we don't need extra people.
I'm all the support that you need.
And yes, it's really fantastic thatpartners wanna be a part of birth.
(11:57):
And yes, they probably do a fantastic job.
But doulas are also for partners.
Right?
So sometimes we have labors.
I mean, my first labor was 44 hours.
That's a really long labor to expect oneperson to be awake and totally attentive.
So having a doula is also foryour partner and for your family.
If they want to go outside and have,you know, some fresh air or go get a
(12:18):
sandwich or make something or take a 45minute nap knowing, okay, their partner
is provided for, they have continuoussupport so they can step out too.
Also, you build a relationshipwith that person, whether it's your
provider or it's your doula throughout.
They know your birth preferences.
They're gonna make sure thatyou have everything that you
need and desire during labor.
And they sort of safeguardthat space for you.
(12:40):
So that, in a way, also takes away fromthe partner so the partner can focus
on you instead of focusing on you andthen, no, no, wait, she didn't want that.
Or, wait, she wanted this but not that.
But wait, did you want that?
hold on, she's having a contraction.
Right, it's a lot of workto put on one person.
So having that team that's there tosupport you can really be fantastic.
And then figuring out if you haveany other family member or friends or
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anyone else that you want a part ofyour birth, children, and then doing a
lot of preparation and work for them interms of what it looks like, watching
videos, reading books, talking about it.
And then knowing that at anypoint you can change providers.
So just because you signed up with onedoesn't mean you need to stay with them.
And this goes for anyone,doctors, CNM, CPMs, doulas, right?
(13:24):
If you get to that point where you'relike, this is really not the right
fit and this isn't feeling good to meanymore, or it was some type of bait
and switch, they promised me this,they said this, now they're saying
this, you can change at any point.
You do not owe those people anything.
And I think sometimes as humans,especially as pregnant women, we were
in such a vulnerable state that we'relike, well, they've been there since
(13:46):
the beginning and I don't wanna hurttheir feelings and maybe this is best.
And I'm here to say it probably isn't.
Your intuition is suchan incredible thing.
And if you start to have those red flagsor those concerns, go interview other
people, go talk to people that havehad different births with different
providers or different doulas and switch.
It is literally never too late to switch.
(14:08):
I mean, we've taken onclients 41 and plus before.
We've taken on clients one time inlabor during the pandemic because crazy,
crazy things were happening, right?
And families were not being supportedand they were sort of pushed through.
these really horrible times, theirchoices were stripped from them, their
birth support was stripped from them,and it should be a fundamental right for
(14:32):
humans to have the birth team that theydesire no matter where they're birthing.
And so I think it's really important tomake sure you build that support ahead
of time so those people are truly inyour corner and everybody is replaceable.
So if they're no longer aligningwith your vision, then it's
time to find someone new.
The Best Birth [14:21]
These are such great fundamentalquestions to ask ourselves when
(14:53):
we are creating the best birth.
You know, the premise of our podcastis to educate yourself, to find the
professionals, the experts, the resourcesthat you need so you can create, a really
great experience for you and your family.
I love that you talked alittle bit about, interviewing
practitioners because we don't haveto just go with the first person
(15:14):
that we sign up with or the firstappointment that's available.
We can go in, we can, layout some of our goals.
Maybe we're asking them what some oftheir goals are, what they recommend.
If you're a first time mom andyou've never done this before, you
probably don't know what you want.
You don't know how to get there.
And there are people along thepath to help you and to support
you every inch of the way.
(15:37):
When you talked about transferringcare, tell us a little bit more so.
Katrina Bolduc [14:54]
Okay.
The Best Birth [15:14]
In different states, there'sgoing to be different options.
But does your practitioner havelegal obligations to support you?
Do you feel like it's more justlike a preference when you know
that you're not aligned with themanymore and you need to transfer?
How can we make thisexperience more positive?
(15:59):
Katrina Bolduc [15:31]
Sure, yeah.
And I think a lot of that's trulygonna be provider dependent, right?
And also birthing location dependent.
And so that's why creating your birthplan is so important to review with
your provider and not only get yourprovider's feedback, but also discuss
what that birth plan looks like in thefacility that you're birthing in, right?
(16:24):
So.
without a hospital birth, it's going tobe very different than in hospital birth.
And oftentimes I talk to moms thatare, you know, coming and seeking
a different form of care with theirsecond, third, fourth pregnancy
because they've done hospital birthsall the other times and their wishes
weren't valued and they weren't taken.
And part of that reason is, well, mydoctor said all these things were fine.
(16:46):
And then I got to the hospitaland my doctor wasn't there.
And the nurse said it's hospitalpolicy to do X, Y, and Z.
Or they could only do delayedcord clamping for 60 seconds,
but they clamped it at 30.
But I was too busy looking at mybrand new baby and my partner that
I didn't know that these things werehappening to me without my consent.
Right?
So I think it's important to talk toyour provider about what their feedback
(17:10):
is, what they're comfortable with,what they're not comfortable with.
And then that's going tosort of be that first step.
So if they come back and say, thesethings I'm not comfortable with.
and you've already done your researchand they're evidence -based and
you know they're safe and they'rebeneficial and you want to do
them, that's your first red flag.
So if they're already giving you pushbackon things that you know for sure are
(17:31):
safe and are effective and are yourwishes and you're not in labor, right?
So when we're in labor, we'rein a much more vulnerable state.
And oftentimes,
they'll ask us questions at the worstpossible time at the top of a contraction.
Okay, well Sarah, I see thatyou wanted this, but we're
gonna go ahead and do this.
And you're in a contract and you'relike, okay, whatever, like stop talking
(17:52):
to me, I'm trying to focus here.
And then we sort of let things gothat were really important to us.
So I think talking to your provider,figuring out the facility that
you're birthing in and what you'redoing it, but really those initial
conversations with your provider.
throughout your pregnancy.
So at the beginning, as soonas you have a rough draft of a
birth plan or birth wishes ordesires, talk to them about that.
(18:14):
And then as you get closer,talk to them again about it.
And you'll start to see ifred flags are coming up.
And I will say, if in prenatal care,you're having a lot of red flags,
if you bring information in and yousay, hey, here's all this information
that I did, I did the research,I looked at the evidence, here's
what's safe, here's what I wanna do.
And they're still like, yeah,no, we don't do that or.
(18:35):
No, hospital policy is X, Y, and Z.
Hospital policy is not law.
This is your birth.
You can do whatever you wantand it sounds like your provider
is not truly supportive.
but they're a nice person.
I'm sure they are.
I'm sure they are.
I'm sure they're a great personand that's why you're seeing them.
But if that's not being aligned whenyou're not in labor, you're cool, calm,
and collected, you're talking abouta labor and delivery that's months
(18:58):
away or weeks away, and you're havingissues, that's the time to switch.
The Best Birth [18:34]
So if you're looking at a physiologicalbirth or an unmedicated labor, is that
possible to achieve in a hospital settingor do you recommend seeking a midwife?
Katrina Bolduc [18:45]
Yeah, so that's another great question.
And I think one of the important questionsthat we should be asking obstetricians
(19:21):
is, number one, have you ever seena physiologic birth in the hospital?
Because you will be surprised to hearthat some go through all of their
schooling, all of their clinicalrotations, they become an OB and they've
never seen a physiologic birth, right?
So it's that those questions thatwe're asking initially our providers.
(19:42):
You know and as a midwife I get askedso many different questions and I would
love to like ask people sometimes likeare these the same questions you you
ask your OB because I guarantee youthey are not but they're important
questions to ask So depending on thetype of birth that you're wanting to have
we have to ask our providers the samething Do you support physiologic birth?
What does physiologic birth meanto you because it's gonna be
(20:05):
different for everyone, right?
And some people are like, well avaginal birth is a physiologic birth
No, not necessarily.
Right.
So there's lots ofquestions to kind of ask.
And I think that's part of thatinterview process and that initial
information and kind of that honingin and education of yourself to
figure out what exactly do I want?
(20:26):
What exactly does that look likeand who does it look best with?
But I would say if you are planninga physiologic birth in the hospital,
I definitely recommend a doula100 % every time hands down.
The Best Birth [20:11]
In your presentation, merging the gaptrue between true bodily sovereignty
and physical physiological birth, youspeak of three steps, creating a plan,
(20:48):
starting small, adjusting and adapting.
Could these steps also helpin preparing for birth?
Katrina Bolduc [20:25]
Absolutely.
Yeah, they definitely will.
And one of the key components too Iwould just like to point out is as
we're preparing for birth, we alsoneed to be preparing for postpartum.
And that's one of the biggestaspects that I see missed, right?
It's like we plan so much for the bigday and then the baby's here and we're
(21:12):
like, my gosh, the baby's here and Ihave all these other kids and I have
a house and I have all these things.
And so as we're preparing forour birth, we should also be
preparing for our postpartum.
because that's part of it, right?
That fourth trimester is so important.
And I think it's importantto make sure that that stays
a part of the conversation.
But yes, I do.
I think, you know, from the moment thatwe find out we're pregnant, I think we
(21:34):
have so many ideas and visions and wishesand, my gosh, I wonder if it could be like
this or I wonder this or I wonder that.
That's the time to startdoing your research.
And so in the beginning, build a birthplan, start just writing everything down.
What does it look like?
What does it feel like?
what things are happening or nothappening, if this, then that, right?
(21:55):
And that's one of the things I liketo talk to my clients and my care
about is, you know, we stay on thephysiologic plan for as long as possible.
We try all the things to have abirth at home as long as we have a
healthy mom and a healthy baby, right?
So for me, a goal of home birthis not home birth overall.
That's not the case.
(22:15):
It's home birth with a healthymom and a healthy baby.
And as soon as we start to deviatefrom that low risk status and that
healthy mom and that healthy baby,then we start having conversations.
And so those are really important to haveahead of time as well for hospital birth
center or home birth of if everything'sgoing great, here's my ideal plan, right?
If we get to this intersection,what are my options?
(22:39):
So let's see.
you went to the hospital too early,they admitted you too early, or
your water broke and you went to thehospital and you aren't in labor.
And this could be birthcenter or home birth as well.
It's going to vary from place to place.
But when you're looking at it from ahospital standpoint, when your water
breaks, you go in, if your labor plateaus,they're like, let's get things going.
(22:59):
Right.
And so often that first line of defenseis like, well, labor stalled, it's
not really moving like we should,you're not progressing like we want
you to, we're going to start pitocin.
And that was not true informeddecision making, right?
And the way that that was presented,most people are like, okay.
Because number one, itwasn't explained to me.
What is it?
(23:20):
What are the risks and the benefits?
Why are we doing it?
And then secondly, no one said,or here's your other options.
Here's some things thatwe can try instead.
So having that extra supportperson, that doula there is really
beneficial because they're goingto sort of merge that gap, right?
So when your provider comes inand is like, this is too slow,
we're going to start Pitocin.
they can kind of speak up and say, hey,remember when we were talking about
(23:43):
interventions prenatally and we haveall these other options, you said that
you wanted to do X, Y, and Z instead,would that be an appropriate option here?
Is that something that we can consider?
And oftentimes it sort of makes OBs ornurses or hospital staff kind of step
back because they have a checklist, right?
Like your number and in a hospitalsetting, your number, your, you know,
(24:05):
how many babies were born today?
How many babies were born this week?
And so it's sort of like,
They're so used to doing it.
It's not person -centeredfor the most part.
You can have beautiful, wonderful hospitalbirths, but for the majority of people,
it's not family -centered comprehensivecare in the way that I would define it.
And so they sort of havethese checklists, right?
Well, it's like, okay, well, didthat, did that, did that, did that.
(24:26):
labor's taking a long time.
Start the pit so we canmove on to the next step.
And so when we're asking thesequestions, what are my other options?
Can we wait two more hours and readjust?
They kind of step back out ofthat, like check, check, check.
yeah, that's interesting.
We could definitely try that.
There's no rush.
You're doing fine.
Baby's doing fine.
I see no reason to rush this.
(24:47):
Right?
So it sort of takes them out and forcesthem to have that person -centered
care and relationship that we all want.
Right?
Even if it's just for those two secondsfor them to sort of get pulled out of
that, like, I've got my blinders on.
Here's the things that we do to belike, wow, yes, you're a real person.
This is your first babyor your third baby.
Like, this is your experience.
And I just work here.
(25:07):
So it's kind of nice to kindof have them kind of step out.
So yes, going back to that,creating your plans, starting small
and then adapting and adjusting.
And that's the thing.
So we can have those ifthis, then that clause.
And so starting with a birth planthat's big, write down everything.
And then as you get further andfurther along in your care, start
reducing and defining and pullingout a lot of, you know, your fluffy
(25:30):
language and everything like that.
So by the end, when we get to term, wehave a birth plan that's a single page.
I like to break it down into severalcategories including labor, birth,
immediate postpartum and newborn.
So those are sort of the fourcategories that I like seeing on them.
And then very distinct bullet point,short and to the point things.
(25:53):
So when we have, I've seen them before.
I had a family once with like a 26page birth plan and it is wonderful.
And I wish your providerwould sit down and read that.
They won't, okay.
So that's why it's so important to havethe short and concise bullet point because
if it takes them longer than, you know, 10seconds to, yep, yep, yep, yep, yep, and
(26:13):
put it away, they're not gonna read it.
Okay.
So that's why we pull out all thepleases and thank yous and all the
background because in reality, theydon't have time to read it and it's not
important or pertinent to their job.
So we're gonna have short things on there.
No pitocin unless medically necessary.
Bam, that's it.
You don't need to explain why.
You don't need to say anything else.
Delayed cord clamping.
(26:34):
Put in that timeframe that youwant, you know, X amount of time.
No episiotomy unless medically necessary,which in most cases it's not, right?
Or no episiotomy withoutdiscussing it with me first, right?
And that's something too, thathaving a Dua can be really amazing.
There's been one time in my career whereI saw a doctor reach for episiotomy
scissors as a Dua in the hospital.
(26:55):
And what I said was, you know,mom, doctor so -and -so just
picked up the episiotomy scissors.
How do you feel about that?
and the doctor looked over at me shocked.
And I'm like, you were aboutto cut that woman without even
telling her what you were doing.
And then she was like, no, no, no.
The doctor got really upset.
And then seven minutes later,she pushed her baby out.
(27:17):
There wasn't a reason for it.
So having that extra supportcan be really helpful.
And again, eyes, right?
When you're pushing, yourpartner's probably close by.
They're not watching whatyour provider's doing.
So having that kind of extraset can be really helpful.
And then again, so you know you haveall those sweet little bullet points
and then make several copies that wayyou can give them to your nurse they can
scan it to the chart and oftentimes Youknow your new nurse comes on and there
(27:40):
we say yeah We gave the birth plan tothe nurse before you just like I can't
find it Not sure where they put it.
They didn't scan it and you'relike, great You know what?
I have another copy and you canpull it out and give it to them
then that way everybody has it andthen as you get close to actual
Delivery then just reminding them.
Okay, you know, we're gettingready to the delivery.
My baby's coming really soon
These are the things thatare really important to me.
(28:02):
And talking to your nurse, really,tend and befriend that person.
They're gonna be your BFF in labor.
If you are not getting along withyour nurse, if you are not seeing
eye to eye, ask for a new one.
You can do that.
So this is your birth.
If you have, let's say for instance,you're planning a physiologic
birth and you have a nurse thatevery three minutes is like, honey,
please let me get you an epidural.
(28:22):
you're in so much pain.
Please let me give you this.
Let me give you this.
And you've told her multipletimes that you don't want that.
ask the charge nurse for a new nurse.
It's fine, you can say, you know,we're just, we don't have the
same views and values on birth.
She's asked me repeatedly for an epidural.
I'm planning a physiologic medication-free birth and I would like
someone else that is better suited.
(28:42):
And you know what?
They'll find that nurse on the floorthat's like, woo hoo, like physiologic
birth and she's gonna grab the peanut balland she's gonna come do all the things.
And now you have a better experienceinstead of just being like, my gosh, this
nurse is awful and then dealing with it.
you don't have to deal with itand you don't have to settle.
So being able to speak up and havingyour preferences laid out initially
(29:03):
with your birth team, with yoursupport team is really gonna help
you so you're not fighting and you'renot settling on actual Labor Day.
The Best Birth [28:44]
Yeah, once you get in there and, and it'stime for baby to come, the moments of like
planning and preparing for what sort ofbirth you want, that kind of has passed.
And for a lot of us, I think theexperience of birth is not something
(29:26):
that we feel in control over.
And so we don't plan asif we have the control.
And that's one of the, the biggest,regrets that some people can have
is not feeling like they planned theexperience that it was just done to them.
Katrina Bolduc [28:54]
Mm -hmm.
The Best Birth [29:11]
You know, so taking ownership,being the driver of this vehicle
and knowing your options, knowingwhat hospital policies might be.
(29:48):
You can go and ask a hospital for a tour.
You can ask them, whattype of tools they have.
The peanut balls are amazing.
You can labor in the shower.
You can use that hot water therapy.
You know, there's so many differentresources that you have, even when you
are laboring and delivering in a hospitalthat I think everybody should deserve.
Katrina Bolduc [29:11]
Mm -hmm.
The Best Birth [29:39]
the birth that they want.
(30:11):
What are some ways we can prepare ourbody, mind, and soul for pregnancy?
Katrina Bolduc [29:48]
Yes, so many things.
So I think when we're talking aboutprenatal care and postnatal care,
it's really important to recognizethe fact that we take the best care
of ourselves when we're pregnant.
And we're not taking care ofourselves to take care of ourselves,
(30:34):
we're taking care of ourselves totake care of our babies, right?
And so kind of that hasbeen like a whole mindset.
Warp that I've really beenkind of focusing on because I
myself am just as guilty, right?
I have to make sure I'm doingthis and make sure I'm doing that
but I'm not doing it for myself.
I'm doing it for my babies.
(30:54):
And so when we're talking about prenatalagain making sure we're not skipping
out on that postpartum period but thenalso realizing that this is an ongoing
lifetime goal and it shouldn't befocused just on prenatal and postnatal.
But really on motherhood in general.
So we have resilience on one sideand we have burnout on the other.
(31:17):
Right.
So we have this sort of spectrumof where we can be for everything.
Prenatal, labor, birth,postpartum, motherhood.
And, you know, sometimes we're likeso resilient and we're so amazing.
We're a super mom andwe're doing all the things.
And then sometimes we're like,
you know, this close to burnoutwhere we're like, my gosh,
these kids, this house, thesedishes, my body, I'm exhausted.
(31:40):
And we go back and forth and that'sjust the human experience, right?
We go one way, we correct, we getbetter, we swing back the other
way, we're really good for a while.
And I sort of like the comparison.
It's a graft and it basicallyshows like progression is not
like a straight staircase, right?
So from here to here, it'snot a straight line going up.
(32:03):
progression really looks like threegood days and a really bad day.
A mediocre day, a good day, a bad day.
A mediocre day, a goodday, a bad day, right?
So it's constantly fluctuating.
And I think we give our children so muchmore grace than we give ourselves, right?
Like once we're moms, like ourkids have bad days and we're
like, my gosh, like that's hard.
(32:23):
I'm so sorry that that happened.
But then it happens to usand we're hard on ourselves.
We're our own worst critics.
my gosh, why can Sally Lu aroundthe corner manage all these kids and
keep a perfect home and her laundry?
And like, I can't even make breakfastwithout my house exploding with chaos
and fighting and anger and you know, andI didn't do this and I didn't do that.
(32:44):
And we just have these like mental,you know, caseloads and tally loads
of things that we need to check off.
So that's a really longwinded introduction to the
question that you asked.
But I think it's really importantto look at the big picture first.
and then hone in.
So things like rest and recoveryduring pregnancy, during the
postpartum are important andthey're imperative and we need them.
(33:07):
Self care, we need them.
And this doesn't mean going outand getting a luxurious, expensive
two hour prenatal massage andsoak and mani -pedi, whatever.
It could be anything.
It could be waiting till yourpartner comes home or getting a
babysitter and being like, I wantto take a shower by myself without
kids banging on the door like.
and I want it to be longerthan two and a half minutes.
(33:28):
Okay, like that is self care.
And basic needs are not self care.
So let's rewind it a little bit.
Just showering is not self care.
Okay.
But showering for a longer extendedperiod of time using your foot
scrub or your loofah, usingessential oils, that is self care.
Basic human needs are not.
Eating is not self care.
(33:49):
It can be, but it mostly is not.
Okay.
So really focusing on
adequate nutrition and hydrationfor our body in the stage that
we're at prenatally, postpartum,mom, breastfeeding, right?
All these different things, eating allthe colors of the rainbow in terms of
your veggies and fruits, high protein.
Protein is one of the best thingsthat you can do for your body.
(34:11):
When in doubt, eat more protein, right?
It's not gonna hurt you.
And then really thinking about youremotional, your physical, your mental,
your spiritual needs and desires.
And again, thinking aboutcreating a list like
What are my actual needs?
What fills up my cup?
What depletes me?
And how can I create a way or a systemor support circle or tribe, whatever
(34:34):
you want to call it, to ensure thatI'm getting my needs met so I can
be on this resilient end of thespectrum and not so close to burnout?
Thinking about thingslike education as well.
So.
What are the next steps?
What am I going to need?
What are my choices movinginto the postpartum?
What is going to be askedof me, expected of me?
(34:56):
What is my baby going toneed at their wellness visit?
And I think that's one of the things too.
We're so focused on thatprenatal experience and
birth that postpartum comes.
We go to that initialwellness visit for baby.
And depending on, you know, where youare on, you know, your vaccine choices,
they come in, they're like, Hey, we wantto start baby on all these vaccines.
(35:17):
And a lot of the times we'relike, I didn't even know
that was gonna happen today.
I didn't think about it.
I don't even know what you'replanning on giving my baby.
I didn't have time to research it.
And again, we're sort of in thatplace where we feel like that
provider is an authority figure andthey're saying we need to do it.
And so sometimes we kind of liketurn inward into our shell of like,
(35:37):
okay, if this authority figure istelling me I need to do these things
today, I need to do them today.
But you don't.
you can say, you know what, I wouldlike some more time to think about this.
I'd like to go home and do my research.
If I want to come back and schedulethat you can do a vaccine only
visit, so you don't need to see thedoctor, you can go back and do that.
Or you can say, you know what,I'm not comfortable making
(35:58):
that decision right now.
I want to do some more research,see where I feel, and let's revisit
this at our next appointment.
If I have questions, I'd loveto review them with you then.
And you know what they're going to say?
Okay.
Right?
It's your body.
It's your baby.
It's your decision.
It's your choice.
So again, you are thecaptain of your ship, right?
You are the driver of yourvehicle that Sarah said.
(36:19):
This is your life.
This is your baby.
This is your family.
This is your decision.
I truly believe that my families knowwhat's best for them and their babies.
They live in their bodies.
I don't.
Okay.
So you and your intuition when youreducation and your experience will tell
you what's right and what's not right.
(36:39):
And if you're unsure, then you're goingto go to those trusted places where
you can get education or support orunbiased information so you can make the
best decision for you and your family.
So that way in five years, 10 years,20 years down the road, you don't
look back and say, I hate thatmy doctor made me do X, Y, and Z.
I hate that my midwife said this iswhat I needed to do and didn't offer
(37:01):
me other choices or more education ortime to make that decision for myself.
Right, and so that's one of thosebiggest pieces is I never tell
people what they should do, right?
If everything's going along great,we're low risk, we have a healthy mom,
we have a healthy baby, we're cruising.
And people say, well, whatwould you do in my situation?
(37:22):
Well, here's all the different things youcould do, what feels best to you, right?
Because you need to make thosedecisions, not me, not your provider.
So the family unit should have timeto sort of discuss those things
and figure it out themselves.
The Best Birth [37:08]
You have shared so muchgreat knowledge with us.
I know that you have done so much study.
You're just a lifelong learner.
(37:44):
Do you have any favorite resourcesor books that you'd like to
share with our listeners today?
Katrina Bolduc [37:20]
Ooh, I love Evidence -based Birth.
That is definitely one of my favoriteplaces because not only do they give you
evidence -based information, but theyalso provide all the resources and all the
studies where they got their information.
So you don't have to gohunt everything yourself.
(38:05):
You can just go and find it and then youcan find these other studies and do that.
So I'd say that's probablyone of my favorite books.
And I also like, I know a lot ofpeople like sort of week by week.
pregnancy books, what's going on withmom, what's going on with baby, and
probably my favorite one would be Mamaand Natural, so Genevieve Howland's book.
Hers is probably my favorite.
(38:26):
I feel like it's really comprehensive,it goes over everything, so that's
probably another one of my favorites.
The Best Birth [38:04]
that's so amazing.
I'm a big reader and I can see in allof the, I keep track of all of my books.
And so I can see throughout my life,when I was dating, I had a lot of
books about dating and then I hada lot of books about, cultivating
and creating a great marriage.
(38:46):
And then like my baby book stageand now my mothering stage of like
just trying to soak up all of thegreat resources that are out there
in the book, Birth Without Fear.
Katrina Bolduc [38:11]
huh.
Yeah.
The Best Birth [38:28]
January shares such a great quote thatreally went along with what you were
saying with like our timeline in birth.
But she says, that'sthe thing about birth.
We don't get an itinerary.
We have to surrender and let go.
(39:09):
And in its that vulnerability that wefind the courage and strength we forgot
that we've had since our own birth.
The power is already in you.
Katrina Bolduc [38:29]
Mm.
Mm -hmm.
Yep.
Yep.
And it's just so important to rememberthat it's not one size fits all.
Even if it worked great for yourfirst birth and child, guess what?
It might not work great for your second.
(39:29):
So kind of finding that unique wayto try all of the things, be open
-minded, see what works for thattime in space for that child for
that pregnancy, and then do that.
There's no wrong way to do it.
The Best Birth [39:15]
And speaking of education andexperience, I did just want to ask, how
has your maternal care understandingchanged as you've traveled the globe?
(39:54):
Katrina Bolduc [39:26]
Yeah, that's a good one.
So it was definitely humbling someof my experiences traveling and
spending time in developing countries.
But, you know, I think overallglobally, there's still that need for
focus on safety and accessibility.
But then also what's really neat andbeautiful is we're seeing this push
for mental health support, which wasnever really included before, right?
(40:17):
We treat the body, wedon't treat the mind.
And now we're starting tosee people fighting for it.
comprehensive care.
I'm like, no, you can'thave one without the other.
So I think it's really neat to see there'sa strong desire for comprehensive care.
There's a strong desire for amidwifery care and doula care.
And with the global pandemic, we'veseen this time and time again, where
(40:41):
people, the pandemic had some reallybeautiful things come out of it.
One being a lot of people wereexposed to out of hospital birth
that never would have considered it.
We had a lot of families transferlate to care that we're planning
epidural births, we're planning
repeat C -sections.
I'm just going to go in anddo whatever the doctor said.
(41:02):
I would never have a natural birth.
I would never birth out of the hospital.
Right?
And then it was, you know, youcan't have your photographer, your
doula, your mom, your best friend.
In Utah, there was even somedads that missed their birth
because of the pandemic.
They weren't allowed inside.
So it was this horrific time.
but we also had beauty come out of itwhere we had these late minute transfers
(41:27):
that were like, I need my birth team.
I'm not birthing inthe hospital by myself.
And they had these amazing births.
And then afterwards they said like,wow, I never would have considered this.
I never would have agreed to thisif it weren't for the pandemic.
Now that I've done it,there's no way I'm going back.
So we saw these really awesomeshifts where more people were
(41:50):
exposed to midwifery careand to doula support, right?
And so we've seen globally an increasein midwifery care and doula care.
I think I wrote it down somewhere.
The CDC had a 22 % increase in outof hospital births from 2019 to 2020.
So that first year in the pandemic, wesaw a huge increase and that first year
(42:14):
was the worst for birthing families.
So we saw this increase and guess what?
It's still trending that way.
And if you look at a lot of otherEuropean countries that have better
maternal and neonatal outcomes than wedo here in the United States, guess what?
It's midwifery led care for the majorityof the population, except for those that
are high risk that truly need an OB.
(42:35):
So it's really neat to kind of seethese things come out or the new
studies that just came out saying itdoesn't matter where you give birth.
If you give birth in a birth centerat your house or the hospital.
with a skilled provider, you're just assafe wherever you want to birth, right?
So it's sort of combat some of theseold ideas and these old ideologies
where doctors or, you know, grandmasor sister, well, that's not safe.
(42:58):
You can't do that.
That's not safe.
And so we have this mentalityof safety and what safety means.
But now we're seeing all thisinformation come out of like,
see, we are safe at home.
See, we are safe at birth centers, right?
So it's really neat to justhave that additional information
and see people trending.
towards it because peopleare demanding better care.
And we're seeing that globally whereit's unacceptable for you to see
(43:21):
your provider for three minutes.
I'm sorry, but it is.
There's no way that they can trulydo risk management and evaluation of
you and your baby in three minutes.
Right.
And again, it's not their fault.
Right.
We have a lack of providers.
We have OBs that are leavingthe profession for a multitude
of different reasons.
We have not enough midwives.
(43:42):
We have not enough health care providers.
in general in the United States and thatis dwindling and we need better providers
and families are demanding better care.
They want comprehensive care.
They don't want these five minutevisits of, my blood pressure was fine
and they said see me in four weeks.
Right?
So we're demanding better care,which I think is going to shift
(44:03):
this paradigm in healthcaretowards more comprehensive care.
And while I don't see it going, youknow, completely towards midwifery
care where everybody gets a fullhour because that just is impossible.
We don't have enough providers, butI do see a bigger push on providers
recommending doulas, recommendingmental health counseling, right?
Meant offering chiropracticcare and acupuncture.
(44:26):
So we have all of the facets ofbody and mind truly taken care of
instead of, I'm just going to checkon you and baby and you're fine
and we'll see you in four weeks.
So we do have some neat thingsthat are coming out and globally
we're seeing that as well.
In India, some of my friendsand fellow colleagues there are
building an amazing birthinghospital where it's midwifery run.
(44:49):
They're putting in an operating theaterwhere they will have OBs on call and
on staff if the midwives need them.
Right?
So we have this completely shiftin paradigm of like, no, the
midwives are calling the shots.
Cause guess what?
They have really excellent outcomes.
They have better satisfaction.
Right?
We're looking at family centered care.
(45:10):
where the parent is informed and they'remaking informed decisions, they're running
the ship as it should be for everyone.
So it's really neat to see thechanges that are happening here,
stateside and in other countries.
And I'm really excited to go to thePhilippines next year and kind of see how
they're managing and running and trainingand doing everything over there because
(45:32):
they're making incredible changes aswell in terms of maternal and neonatal.
Outcomes are improving, peopleare healthier, people are happier.
So it's a pretty amazing shift and I'mjust thrilled to be a small part of it.
The Best Birth [45:19]
thank you so much for this conversation.
Erin has our mom squadsecret for the week.
She says, if you're thinkingabout breastfeeding, get support
(45:55):
before your baby is born.
Talk with friends who have hada good nursing experience, ask
your baby's pediatrician or meetwith a lactation consultant.
And that goes right along with whatwe were talking about in preparing
and looking forward to it insteadof worrying about it when it comes,
or if there's not time to figureout your desires or your intentions.
(46:16):
Katrina, thank you so much forbeing on the podcast today.
Katrina Bolduc [45:51]
Thanks for having me.
Thanks for joining us on today's episode.
We hope you've been elevated andinspired by this week's expert.
Subscribe today so you never missan episode and please share our
podcast or post on your socialmedia so that other moms and dads
to be can also have the best birth.
(46:38):
Please note that the informationprovided is based on the expert's
insights and personal experience.
It is not intended as medical guidance.
Please seek the advice of yourmedical provider as it applies
to your specific condition.
It's the Best Birth Podcast, wherewe interview experts that elevate
you as you prepare your heartand mind to have the best birth.
Each episode will interviewprofessionals so you are prepared
for pregnancy, birth, and postpartum.
Our experts will build your confidenceand empower you to trust your
intuition throughout your pregnancy.
This audio is takenfrom videos on YouTube.
(00:27):
Watch the entire episodes onYouTube at Birth Made Mindful.
The Best Birth [00:02]
You're listening toThe Best Birth Podcast.
We are so excited for our guest today,Katrina Bolduc and she is a certified
professional midwife, a licensedmidwife and the owner of GEA Midwifery.
We're excited for our conversation today.
Katrina Bolduc is a firm believerthat a person's pregnancy, labor and
(00:50):
birth are one of the most powerfullypivotal moments in their life.
She honors family units and embracesindividualized family center care.
Katrina holds an Associate of Sciencedegree in Psychology, Bachelor's of
Science in Psychology, and graduated fromNational Midwifery Institute in 2021.
Katrina is a certified professionalmidwife and licensed midwife and
(01:12):
practices in the state of California.
She has proudly been attending births andsupporting families since 2016, entering
the birth field through prenatal yoga,doula services, and childbirth education.
With a passion for helping others,Katrina fell in love with the aspect
of supporting, encouraging, and helpingothers grow with compassion, respect,
understanding, and a commitment tomeet each individual where they are at.
(01:36):
Katrina is a wife, mother of threeincredible children, an Ironman
triathlete, lover of nature,animals, and everything birth.
With a heart for helping and a passionfor pregnancy, birth and beyond, she
is dedicated to the field of midwiferyand enjoys teaching and supporting
healthcare workers and families alike.
Welcome Katrina.
Katrina Bolduc [01:27]
Thank you so much for having me.
(01:57):
The Best Birth [01:29]
We were talking right beforethis conversation and Katrina has
assisted in almost 230 births.
That is incredible.
Thank you for your service.
Katrina Bolduc [01:37]
Yes, of course, my pleasure.
The Best Birth [01:39]
We would love to know justfrom your personal experience,
what led you to become a doulaand then eventually a midwife.
Katrina Bolduc [01:47]
Ooh, that's a good question.
(02:17):
So I have stage three endometriosisand I've had multiple surgeries for it.
So when I finally did get pregnantafter being told I could never have
children of my own, I initiallywent to see an OB, one of the OBs
that had done one of my surgeries.
And as a first time mom,I had lots of questions.
I was excited.
(02:38):
I was nervous, you know, all the things.
And my first interactionwas very disappointing.
The doctor was literally closing the dooras I was trying to answer or ask questions
and didn't answer my questions, spentless than like six minutes in my room.
And I just felt like for my first visit,for my first pregnancy, I wanted more.
(03:01):
So I left feeling really defeatedand I really didn't know what to do.
And I knew that that wasn'tthe experience that I wanted.
So I started to educate myself and that'swhen I learned more about midwives, about
doulas, and I was like, my goodness,yes, this is exactly what I want.
And then I scheduled an interview witha midwife and she spent an entire hour
(03:22):
sitting and talking to me and answeringmy questions and asking me questions.
And that just feltcomfortable and felt real.
And I was like, thisis exactly what I need.
I hired a doula for myfirst birth as well.
And kind of after that experience,it really opened up my eyes
to kind of what was available.
So prior to that, I did havesome experience in the prenatal,
(03:44):
postnatal realm with teaching yoga.
But this was sort of a biggerkind of door swinging wide open.
And that's where I really foundthat calling to birth work.
And throughout that process, and thenimmediately after I had friends getting
pregnant and other people watching yogastudents going through pregnancies.
And I felt like a lot of them had alot of unanswered questions and were
(04:07):
left feeling like, well, this is it.
And not really realizing that there'sother choices in terms of finding a
new OB, finding a midwife, hiring adual, like all of these things, they
just simply didn't know about them.
And so that's when it kind of becamemy mission to get that information
out to people of like, you know,birth is not one size fits all, not
all births belong in the hospital,but not all births belong at home.
(04:30):
Right, so really finding that placewhere you feel most safe and most
supported and then building that teamto support the vision that you have.
So kind of once that ball gotrolling, it literally never stopped.
So I've done so many different types oftrainings and exercises and continuing
to build this wealth of knowledge thatI have, I'm simply to support families.
(04:52):
So that's kind of where it all began.
The Best Birth [04:26]
I love your mission in supportingfamilies and just supporting the mother.
Like your work as a doula.
You were my doula for my second birth.
And I just felt so much empowerment,so much love and genuine concern for
how I was doing, how my baby was doing.
It was such a miraculous experience.
(05:13):
I look back on that day withsuch fondness and appreciation
for the work that you're doing.
I want to ask you aboutsupporting families.
Katrina Bolduc [04:33]
Mm -hmm.
small.
The Best Birth [04:54]
Why do you feel that supportingthe family, the entire family,
is so important in birth?
Katrina Bolduc [05:01]
Yeah, that's a great question.
I think birth is a family event, right?
(05:33):
We are growing families to simply focuson just the maternal aspect or the
parent that's carrying that pregnancy.
I think we leave a lot behind.
And I think as a family unit thatis growing and is expanding, when
we include everyone into thatconcept and into prenatal care, we
really get into comprehensive care.
(05:56):
And I think that's one of thereally big differences between
obstetrical care and midwifery care.
And first, I would definitely liketo preface this conversation with,
I think all providers are needed.
I think we need OBs.
I think we need midwives.
We need duals.
We need everybody.
We need hospital births.
We need availability for a cesareansections and interventions when needed.
(06:16):
And we need ability for home birth.
So all of those things are important.
That being said, I do think there aresome restrictions in terms of obstetrical
care in our general health care model.
Simply
you know, in the fact that theydon't have time to spend enough
time with each individual person.
You know, visits are rushed.
You sit in the waiting roomfor 45 minutes, not being seen.
(06:39):
You see a differentprovider every time, right?
That continuity of care is not there.
And the availability to trulyhave family -centered care is also
not there due to the lack of timethat you have with your provider.
And there's no relationshipif you're seeing a different
provider every single time.
So when we look at prenatalcare as family -centered care,
It truly is comprehensive and that'sone of the most beautiful aspects about
(07:03):
pregnancy is when we have comprehensivecare, we have healthier moms and babies.
We have healthier family units.
We have families that thrive better.
So we're talking about things like,you know, mental stress load and
what are you doing to, you know,support yourself and have self care?
What are you eating?
What is your family eating?
(07:23):
What are you drinking?
Right.
How are you feeling about birth?
How are you planning for birth?
How are you planning for postpartum?
Will the children be involved?
What does that look like?
Who's gonna be helping with them?
So we really unpack a lot of informationand a lot of ideas and further education,
because families will often say, wow,gosh, I never really thought about what
(07:44):
I want my older children to be involvedwith and what if they're sleeping
or what if it's too much for them?
So it really gets that ball rollingso they can decide, do I want
my children present at birth?
In what capacity?
who will be there to support them in theevent that they don't feel comfortable
being there, and how do we make them feelincluded because sometimes we have older
(08:05):
siblings that feel like, my gosh, allthe attention was on me and now we have
this new baby and I'm totally left out.
So with family -centered care, we'relooking at each individual person
of that family and building themup and supporting them together.
I mean, oftentimes you'll have dads thatcome in and they're stressed and they have
so many things emotionally that they wantto discuss, but no one's ever asked them.
(08:26):
You know, and it's so beautiful tosit and ask, okay, hey, dad, like,
how are you feeling about this?
Or, you know, to the differentpartners that come in or grandmas
that come in, they have questions too.
And oftentimes they're great questionsor they're great things to discuss.
So really having that family there,that birth team there, who's ever
going to be there during thatbirth, it's great to include them
(08:46):
because they are the family, right?
The family is not just theparent that's having the baby.
So family centered care is very important.
The Best Birth [08:29]
What do you recommend forcreating our dream birth team?
So right from the start, I think alot of times an individual kind of
goes to their insurance maybe to seewho is in network that they could see
(09:10):
for their delivery, for their care.
What do you recommend asfar as creating the team?
Katrina Bolduc [08:49]
Yeah, it's a good question.
So I think there's a lot of differentaspects that we need to consider here.
The first being, you know, your provider.
What type of provider do you want?
Is
(09:30):
that an OB?
Is that a CNM?
Is that an LM or a CPM?
Right, kind of figuring out andthen what are those things, right?
I'm sure a lot of people listeningare like, okay, none of those
things mean anything to me.
So, you know, we have our obstetriciansthat practice in the hospital.
There are a few that practice outsideof the hospital, which is pretty...
unique and really amazing.
We have certified midwives, certifiednurse midwives who work predominantly
(09:53):
in the hospital, but some of themalso work out of the hospital setting.
And then we have CPN, certifiedprofessional midwives or licensed
midwives, depending on the state.
And then also in your states, right?
So some states in the United States,we have illegal midwives where
they're not legal to practice.
So they're practicing under thelaw because women deserve the right
(10:14):
to choose how they want to birth.
And we also have illegal stateswhere there aren't laws that say,
yes, this is legal or no, it's not.
So kind of figuring out what makes senseto you and then interviewing providers.
And oftentimes people go, they meet adoctor, they're like, awesome, I met
this doctor, they were so fantastic.
They're gonna be at mybirth the whole time, right?
(10:35):
As a doula, these were some of thethings that I would often hear from my
families and I'd be like, they did notexactly explain everything to you, right?
So if you find that doctor youlove, it's important to see
how many doctors or howmany providers rotate call.
So we have some massive practices wherethere's eight to 20 providers that rotate.
(10:56):
And so yes, you might love this oneparticular doctor and maybe you see
them one or two times for prenatalcare and then it's some random
stranger that shows up at your birth.
And so asking those questions too oflike, what does labor support look like?
When do you join the in labor?
Because oftentimes with obstetrical care,doctors don't come in until you're pushing
or until certain interventions are needed.
(11:16):
They pop in and then they leave andthen they come back to literally
catch the baby, cut the cordand bye and they leave again.
So it's important to kind of getthose answers and then from there
you can build what else you need.
So having that additional supportperson, a doula who's going to
be there from the very beginning.
throughout until the very end soyou have that continuity of care and
(11:36):
someone who's there with you that entiretime supporting you, your partner,
your family, whoever else is there.
And then seeing what yourpartner feels like they need.
And oftentimes I feel like sometimespartners get a little bit nervous
of, we don't need extra people.
I'm all the support that you need.
And yes, it's really fantastic thatpartners wanna be a part of birth.
(11:57):
And yes, they probably do a fantastic job.
But doulas are also for partners.
Right?
So sometimes we have labors.
I mean, my first labor was 44 hours.
That's a really long labor to expect oneperson to be awake and totally attentive.
So having a doula is also foryour partner and for your family.
If they want to go outside and have,you know, some fresh air or go get a
(12:18):
sandwich or make something or take a 45minute nap knowing, okay, their partner
is provided for, they have continuoussupport so they can step out too.
Also, you build a relationshipwith that person, whether it's your
provider or it's your doula throughout.
They know your birth preferences.
They're gonna make sure thatyou have everything that you
need and desire during labor.
And they sort of safeguardthat space for you.
(12:40):
So that, in a way, also takes away fromthe partner so the partner can focus
on you instead of focusing on you andthen, no, no, wait, she didn't want that.
Or, wait, she wanted this but not that.
But wait, did you want that?
hold on, she's having a contraction.
Right, it's a lot of workto put on one person.
So having that team that's there tosupport you can really be fantastic.
And then figuring out if you haveany other family member or friends or
(13:02):
anyone else that you want a part ofyour birth, children, and then doing a
lot of preparation and work for them interms of what it looks like, watching
videos, reading books, talking about it.
And then knowing that at anypoint you can change providers.
So just because you signed up with onedoesn't mean you need to stay with them.
And this goes for anyone,doctors, CNM, CPMs, doulas, right?
(13:24):
If you get to that point where you'relike, this is really not the right
fit and this isn't feeling good to meanymore, or it was some type of bait
and switch, they promised me this,they said this, now they're saying
this, you can change at any point.
You do not owe those people anything.
And I think sometimes as humans,especially as pregnant women, we were
in such a vulnerable state that we'relike, well, they've been there since
(13:46):
the beginning and I don't wanna hurttheir feelings and maybe this is best.
And I'm here to say it probably isn't.
Your intuition is suchan incredible thing.
And if you start to have those red flagsor those concerns, go interview other
people, go talk to people that havehad different births with different
providers or different doulas and switch.
It is literally never too late to switch.
(14:08):
I mean, we've taken onclients 41 and plus before.
We've taken on clients one time inlabor during the pandemic because crazy,
crazy things were happening, right?
And families were not being supportedand they were sort of pushed through.
these really horrible times, theirchoices were stripped from them, their
birth support was stripped from them,and it should be a fundamental right for
(14:32):
humans to have the birth team that theydesire no matter where they're birthing.
And so I think it's really important tomake sure you build that support ahead
of time so those people are truly inyour corner and everybody is replaceable.
So if they're no longer aligningwith your vision, then it's
time to find someone new.
The Best Birth [14:21]
These are such great fundamentalquestions to ask ourselves when
(14:53):
we are creating the best birth.
You know, the premise of our podcastis to educate yourself, to find the
professionals, the experts, the resourcesthat you need so you can create, a really
great experience for you and your family.
I love that you talked alittle bit about, interviewing
practitioners because we don't haveto just go with the first person
(15:14):
that we sign up with or the firstappointment that's available.
We can go in, we can, layout some of our goals.
Maybe we're asking them what some oftheir goals are, what they recommend.
If you're a first time mom andyou've never done this before, you
probably don't know what you want.
You don't know how to get there.
And there are people along thepath to help you and to support
you every inch of the way.
(15:37):
When you talked about transferringcare, tell us a little bit more so.
Katrina Bolduc [14:54]
Okay.
The Best Birth [15:14]
In different states, there'sgoing to be different options.
But does your practitioner havelegal obligations to support you?
Do you feel like it's more justlike a preference when you know
that you're not aligned with themanymore and you need to transfer?
How can we make thisexperience more positive?
(15:59):
Katrina Bolduc [15:31]
Sure, yeah.
And I think a lot of that's trulygonna be provider dependent, right?
And also birthing location dependent.
And so that's why creating your birthplan is so important to review with
your provider and not only get yourprovider's feedback, but also discuss
what that birth plan looks like in thefacility that you're birthing in, right?
(16:24):
So.
without a hospital birth, it's going tobe very different than in hospital birth.
And oftentimes I talk to moms thatare, you know, coming and seeking
a different form of care with theirsecond, third, fourth pregnancy
because they've done hospital birthsall the other times and their wishes
weren't valued and they weren't taken.
And part of that reason is, well, mydoctor said all these things were fine.
(16:46):
And then I got to the hospitaland my doctor wasn't there.
And the nurse said it's hospitalpolicy to do X, Y, and Z.
Or they could only do delayedcord clamping for 60 seconds,
but they clamped it at 30.
But I was too busy looking at mybrand new baby and my partner that
I didn't know that these things werehappening to me without my consent.
Right?
So I think it's important to talk toyour provider about what their feedback
(17:10):
is, what they're comfortable with,what they're not comfortable with.
And then that's going tosort of be that first step.
So if they come back and say, thesethings I'm not comfortable with.
and you've already done your researchand they're evidence -based and
you know they're safe and they'rebeneficial and you want to do
them, that's your first red flag.
So if they're already giving you pushbackon things that you know for sure are
(17:31):
safe and are effective and are yourwishes and you're not in labor, right?
So when we're in labor, we'rein a much more vulnerable state.
And oftentimes,
they'll ask us questions at the worstpossible time at the top of a contraction.
Okay, well Sarah, I see thatyou wanted this, but we're
gonna go ahead and do this.
And you're in a contract and you'relike, okay, whatever, like stop talking
(17:52):
to me, I'm trying to focus here.
And then we sort of let things gothat were really important to us.
So I think talking to your provider,figuring out the facility that
you're birthing in and what you'redoing it, but really those initial
conversations with your provider.
throughout your pregnancy.
So at the beginning, as soonas you have a rough draft of a
birth plan or birth wishes ordesires, talk to them about that.
(18:14):
And then as you get closer,talk to them again about it.
And you'll start to see ifred flags are coming up.
And I will say, if in prenatal care,you're having a lot of red flags,
if you bring information in and yousay, hey, here's all this information
that I did, I did the research,I looked at the evidence, here's
what's safe, here's what I wanna do.
And they're still like, yeah,no, we don't do that or.
(18:35):
No, hospital policy is X, Y, and Z.
Hospital policy is not law.
This is your birth.
You can do whatever you wantand it sounds like your provider
is not truly supportive.
but they're a nice person.
I'm sure they are.
I'm sure they are.
I'm sure they're a great personand that's why you're seeing them.
But if that's not being aligned whenyou're not in labor, you're cool, calm,
and collected, you're talking abouta labor and delivery that's months
(18:58):
away or weeks away, and you're havingissues, that's the time to switch.
The Best Birth [18:34]
So if you're looking at a physiologicalbirth or an unmedicated labor, is that
possible to achieve in a hospital settingor do you recommend seeking a midwife?
Katrina Bolduc [18:45]
Yeah, so that's another great question.
And I think one of the important questionsthat we should be asking obstetricians
(19:21):
is, number one, have you ever seena physiologic birth in the hospital?
Because you will be surprised to hearthat some go through all of their
schooling, all of their clinicalrotations, they become an OB and they've
never seen a physiologic birth, right?
So it's that those questions thatwe're asking initially our providers.
(19:42):
You know and as a midwife I get askedso many different questions and I would
love to like ask people sometimes likeare these the same questions you you
ask your OB because I guarantee youthey are not but they're important
questions to ask So depending on thetype of birth that you're wanting to have
we have to ask our providers the samething Do you support physiologic birth?
What does physiologic birth meanto you because it's gonna be
(20:05):
different for everyone, right?
And some people are like, well avaginal birth is a physiologic birth
No, not necessarily.
Right.
So there's lots ofquestions to kind of ask.
And I think that's part of thatinterview process and that initial
information and kind of that honingin and education of yourself to
figure out what exactly do I want?
(20:26):
What exactly does that look likeand who does it look best with?
But I would say if you are planninga physiologic birth in the hospital,
I definitely recommend a doula100 % every time hands down.
The Best Birth [20:11]
In your presentation, merging the gaptrue between true bodily sovereignty
and physical physiological birth, youspeak of three steps, creating a plan,
(20:48):
starting small, adjusting and adapting.
Could these steps also helpin preparing for birth?
Katrina Bolduc [20:25]
Absolutely.
Yeah, they definitely will.
And one of the key components too Iwould just like to point out is as
we're preparing for birth, we alsoneed to be preparing for postpartum.
And that's one of the biggestaspects that I see missed, right?
It's like we plan so much for the bigday and then the baby's here and we're
(21:12):
like, my gosh, the baby's here and Ihave all these other kids and I have
a house and I have all these things.
And so as we're preparing forour birth, we should also be
preparing for our postpartum.
because that's part of it, right?
That fourth trimester is so important.
And I think it's importantto make sure that that stays
a part of the conversation.
But yes, I do.
I think, you know, from the moment thatwe find out we're pregnant, I think we
(21:34):
have so many ideas and visions and wishesand, my gosh, I wonder if it could be like
this or I wonder this or I wonder that.
That's the time to startdoing your research.
And so in the beginning, build a birthplan, start just writing everything down.
What does it look like?
What does it feel like?
what things are happening or nothappening, if this, then that, right?
(21:55):
And that's one of the things I liketo talk to my clients and my care
about is, you know, we stay on thephysiologic plan for as long as possible.
We try all the things to have abirth at home as long as we have a
healthy mom and a healthy baby, right?
So for me, a goal of home birthis not home birth overall.
That's not the case.
(22:15):
It's home birth with a healthymom and a healthy baby.
And as soon as we start to deviatefrom that low risk status and that
healthy mom and that healthy baby,then we start having conversations.
And so those are really important to haveahead of time as well for hospital birth
center or home birth of if everything'sgoing great, here's my ideal plan, right?
If we get to this intersection,what are my options?
(22:39):
So let's see.
you went to the hospital too early,they admitted you too early, or
your water broke and you went to thehospital and you aren't in labor.
And this could be birthcenter or home birth as well.
It's going to vary from place to place.
But when you're looking at it from ahospital standpoint, when your water
breaks, you go in, if your labor plateaus,they're like, let's get things going.
(22:59):
Right.
And so often that first line of defenseis like, well, labor stalled, it's
not really moving like we should,you're not progressing like we want
you to, we're going to start pitocin.
And that was not true informeddecision making, right?
And the way that that was presented,most people are like, okay.
Because number one, itwasn't explained to me.
What is it?
(23:20):
What are the risks and the benefits?
Why are we doing it?
And then secondly, no one said,or here's your other options.
Here's some things thatwe can try instead.
So having that extra supportperson, that doula there is really
beneficial because they're goingto sort of merge that gap, right?
So when your provider comes inand is like, this is too slow,
we're going to start Pitocin.
they can kind of speak up and say, hey,remember when we were talking about
(23:43):
interventions prenatally and we haveall these other options, you said that
you wanted to do X, Y, and Z instead,would that be an appropriate option here?
Is that something that we can consider?
And oftentimes it sort of makes OBs ornurses or hospital staff kind of step
back because they have a checklist, right?
Like your number and in a hospitalsetting, your number, your, you know,
(24:05):
how many babies were born today?
How many babies were born this week?
And so it's sort of like,
They're so used to doing it.
It's not person -centeredfor the most part.
You can have beautiful, wonderful hospitalbirths, but for the majority of people,
it's not family -centered comprehensivecare in the way that I would define it.
And so they sort of havethese checklists, right?
Well, it's like, okay, well, didthat, did that, did that, did that.
(24:26):
labor's taking a long time.
Start the pit so we canmove on to the next step.
And so when we're asking thesequestions, what are my other options?
Can we wait two more hours and readjust?
They kind of step back out ofthat, like check, check, check.
yeah, that's interesting.
We could definitely try that.
There's no rush.
You're doing fine.
Baby's doing fine.
I see no reason to rush this.
(24:47):
Right?
So it sort of takes them out and forcesthem to have that person -centered
care and relationship that we all want.
Right?
Even if it's just for those two secondsfor them to sort of get pulled out of
that, like, I've got my blinders on.
Here's the things that we do to belike, wow, yes, you're a real person.
This is your first babyor your third baby.
Like, this is your experience.
And I just work here.
(25:07):
So it's kind of nice to kindof have them kind of step out.
So yes, going back to that,creating your plans, starting small
and then adapting and adjusting.
And that's the thing.
So we can have those ifthis, then that clause.
And so starting with a birth planthat's big, write down everything.
And then as you get further andfurther along in your care, start
reducing and defining and pullingout a lot of, you know, your fluffy
(25:30):
language and everything like that.
So by the end, when we get to term, wehave a birth plan that's a single page.
I like to break it down into severalcategories including labor, birth,
immediate postpartum and newborn.
So those are sort of the fourcategories that I like seeing on them.
And then very distinct bullet point,short and to the point things.
(25:53):
So when we have, I've seen them before.
I had a family once with like a 26page birth plan and it is wonderful.
And I wish your providerwould sit down and read that.
They won't, okay.
So that's why it's so important to havethe short and concise bullet point because
if it takes them longer than, you know, 10seconds to, yep, yep, yep, yep, yep, and
(26:13):
put it away, they're not gonna read it.
Okay.
So that's why we pull out all thepleases and thank yous and all the
background because in reality, theydon't have time to read it and it's not
important or pertinent to their job.
So we're gonna have short things on there.
No pitocin unless medically necessary.
Bam, that's it.
You don't need to explain why.
You don't need to say anything else.
Delayed cord clamping.
(26:34):
Put in that timeframe that youwant, you know, X amount of time.
No episiotomy unless medically necessary,which in most cases it's not, right?
Or no episiotomy withoutdiscussing it with me first, right?
And that's something too, thathaving a Dua can be really amazing.
There's been one time in my career whereI saw a doctor reach for episiotomy
scissors as a Dua in the hospital.
(26:55):
And what I said was, you know,mom, doctor so -and -so just
picked up the episiotomy scissors.
How do you feel about that?
and the doctor looked over at me shocked.
And I'm like, you were aboutto cut that woman without even
telling her what you were doing.
And then she was like, no, no, no.
The doctor got really upset.
And then seven minutes later,she pushed her baby out.
(27:17):
There wasn't a reason for it.
So having that extra supportcan be really helpful.
And again, eyes, right?
When you're pushing, yourpartner's probably close by.
They're not watching whatyour provider's doing.
So having that kind of extraset can be really helpful.
And then again, so you know you haveall those sweet little bullet points
and then make several copies that wayyou can give them to your nurse they can
scan it to the chart and oftentimes Youknow your new nurse comes on and there
(27:40):
we say yeah We gave the birth plan tothe nurse before you just like I can't
find it Not sure where they put it.
They didn't scan it and you'relike, great You know what?
I have another copy and you canpull it out and give it to them
then that way everybody has it andthen as you get close to actual
Delivery then just reminding them.
Okay, you know, we're gettingready to the delivery.
My baby's coming really soon
These are the things thatare really important to me.
(28:02):
And talking to your nurse, really,tend and befriend that person.
They're gonna be your BFF in labor.
If you are not getting along withyour nurse, if you are not seeing
eye to eye, ask for a new one.
You can do that.
So this is your birth.
If you have, let's say for instance,you're planning a physiologic
birth and you have a nurse thatevery three minutes is like, honey,
please let me get you an epidural.
(28:22):
you're in so much pain.
Please let me give you this.
Let me give you this.
And you've told her multipletimes that you don't want that.
ask the charge nurse for a new nurse.
It's fine, you can say, you know,we're just, we don't have the
same views and values on birth.
She's asked me repeatedly for an epidural.
I'm planning a physiologic medication-free birth and I would like
someone else that is better suited.
(28:42):
And you know what?
They'll find that nurse on the floorthat's like, woo hoo, like physiologic
birth and she's gonna grab the peanut balland she's gonna come do all the things.
And now you have a better experienceinstead of just being like, my gosh, this
nurse is awful and then dealing with it.
you don't have to deal with itand you don't have to settle.
So being able to speak up and havingyour preferences laid out initially
(29:03):
with your birth team, with yoursupport team is really gonna help
you so you're not fighting and you'renot settling on actual Labor Day.
The Best Birth [28:44]
Yeah, once you get in there and, and it'stime for baby to come, the moments of like
planning and preparing for what sort ofbirth you want, that kind of has passed.
And for a lot of us, I think theexperience of birth is not something
(29:26):
that we feel in control over.
And so we don't plan asif we have the control.
And that's one of the, the biggest,regrets that some people can have
is not feeling like they planned theexperience that it was just done to them.
Katrina Bolduc [28:54]
Mm -hmm.
The Best Birth [29:11]
You know, so taking ownership,being the driver of this vehicle
and knowing your options, knowingwhat hospital policies might be.
(29:48):
You can go and ask a hospital for a tour.
You can ask them, whattype of tools they have.
The peanut balls are amazing.
You can labor in the shower.
You can use that hot water therapy.
You know, there's so many differentresources that you have, even when you
are laboring and delivering in a hospitalthat I think everybody should deserve.
Katrina Bolduc [29:11]
Mm -hmm.
The Best Birth [29:39]
the birth that they want.
(30:11):
What are some ways we can prepare ourbody, mind, and soul for pregnancy?
Katrina Bolduc [29:48]
Yes, so many things.
So I think when we're talking aboutprenatal care and postnatal care,
it's really important to recognizethe fact that we take the best care
of ourselves when we're pregnant.
And we're not taking care ofourselves to take care of ourselves,
(30:34):
we're taking care of ourselves totake care of our babies, right?
And so kind of that hasbeen like a whole mindset.
Warp that I've really beenkind of focusing on because I
myself am just as guilty, right?
I have to make sure I'm doingthis and make sure I'm doing that
but I'm not doing it for myself.
I'm doing it for my babies.
(30:54):
And so when we're talking about prenatalagain making sure we're not skipping
out on that postpartum period but thenalso realizing that this is an ongoing
lifetime goal and it shouldn't befocused just on prenatal and postnatal.
But really on motherhood in general.
So we have resilience on one sideand we have burnout on the other.
(31:17):
Right.
So we have this sort of spectrumof where we can be for everything.
Prenatal, labor, birth,postpartum, motherhood.
And, you know, sometimes we're likeso resilient and we're so amazing.
We're a super mom andwe're doing all the things.
And then sometimes we're like,
you know, this close to burnoutwhere we're like, my gosh,
these kids, this house, thesedishes, my body, I'm exhausted.
(31:40):
And we go back and forth and that'sjust the human experience, right?
We go one way, we correct, we getbetter, we swing back the other
way, we're really good for a while.
And I sort of like the comparison.
It's a graft and it basicallyshows like progression is not
like a straight staircase, right?
So from here to here, it'snot a straight line going up.
(32:03):
progression really looks like threegood days and a really bad day.
A mediocre day, a good day, a bad day.
A mediocre day, a goodday, a bad day, right?
So it's constantly fluctuating.
And I think we give our children so muchmore grace than we give ourselves, right?
Like once we're moms, like ourkids have bad days and we're
like, my gosh, like that's hard.
(32:23):
I'm so sorry that that happened.
But then it happens to usand we're hard on ourselves.
We're our own worst critics.
my gosh, why can Sally Lu aroundthe corner manage all these kids and
keep a perfect home and her laundry?
And like, I can't even make breakfastwithout my house exploding with chaos
and fighting and anger and you know, andI didn't do this and I didn't do that.
(32:44):
And we just have these like mental,you know, caseloads and tally loads
of things that we need to check off.
So that's a really longwinded introduction to the
question that you asked.
But I think it's really importantto look at the big picture first.
and then hone in.
So things like rest and recoveryduring pregnancy, during the
postpartum are important andthey're imperative and we need them.
(33:07):
Self care, we need them.
And this doesn't mean going outand getting a luxurious, expensive
two hour prenatal massage andsoak and mani -pedi, whatever.
It could be anything.
It could be waiting till yourpartner comes home or getting a
babysitter and being like, I wantto take a shower by myself without
kids banging on the door like.
and I want it to be longerthan two and a half minutes.
(33:28):
Okay, like that is self care.
And basic needs are not self care.
So let's rewind it a little bit.
Just showering is not self care.
Okay.
But showering for a longer extendedperiod of time using your foot
scrub or your loofah, usingessential oils, that is self care.
Basic human needs are not.
Eating is not self care.
(33:49):
It can be, but it mostly is not.
Okay.
So really focusing on
adequate nutrition and hydrationfor our body in the stage that
we're at prenatally, postpartum,mom, breastfeeding, right?
All these different things, eating allthe colors of the rainbow in terms of
your veggies and fruits, high protein.
Protein is one of the best thingsthat you can do for your body.
(34:11):
When in doubt, eat more protein, right?
It's not gonna hurt you.
And then really thinking about youremotional, your physical, your mental,
your spiritual needs and desires.
And again, thinking aboutcreating a list like
What are my actual needs?
What fills up my cup?
What depletes me?
And how can I create a way or a systemor support circle or tribe, whatever
(34:34):
you want to call it, to ensure thatI'm getting my needs met so I can
be on this resilient end of thespectrum and not so close to burnout?
Thinking about thingslike education as well.
So.
What are the next steps?
What am I going to need?
What are my choices movinginto the postpartum?
What is going to be askedof me, expected of me?
(34:56):
What is my baby going toneed at their wellness visit?
And I think that's one of the things too.
We're so focused on thatprenatal experience and
birth that postpartum comes.
We go to that initialwellness visit for baby.
And depending on, you know, where youare on, you know, your vaccine choices,
they come in, they're like, Hey, we wantto start baby on all these vaccines.
(35:17):
And a lot of the times we'relike, I didn't even know
that was gonna happen today.
I didn't think about it.
I don't even know what you'replanning on giving my baby.
I didn't have time to research it.
And again, we're sort of in thatplace where we feel like that
provider is an authority figure andthey're saying we need to do it.
And so sometimes we kind of liketurn inward into our shell of like,
(35:37):
okay, if this authority figure istelling me I need to do these things
today, I need to do them today.
But you don't.
you can say, you know what, I wouldlike some more time to think about this.
I'd like to go home and do my research.
If I want to come back and schedulethat you can do a vaccine only
visit, so you don't need to see thedoctor, you can go back and do that.
Or you can say, you know what,I'm not comfortable making
(35:58):
that decision right now.
I want to do some more research,see where I feel, and let's revisit
this at our next appointment.
If I have questions, I'd loveto review them with you then.
And you know what they're going to say?
Okay.
Right?
It's your body.
It's your baby.
It's your decision.
It's your choice.
So again, you are thecaptain of your ship, right?
You are the driver of yourvehicle that Sarah said.
(36:19):
This is your life.
This is your baby.
This is your family.
This is your decision.
I truly believe that my families knowwhat's best for them and their babies.
They live in their bodies.
I don't.
Okay.
So you and your intuition when youreducation and your experience will tell
you what's right and what's not right.
(36:39):
And if you're unsure, then you're goingto go to those trusted places where
you can get education or support orunbiased information so you can make the
best decision for you and your family.
So that way in five years, 10 years,20 years down the road, you don't
look back and say, I hate thatmy doctor made me do X, Y, and Z.
I hate that my midwife said this iswhat I needed to do and didn't offer
(37:01):
me other choices or more education ortime to make that decision for myself.
Right, and so that's one of thosebiggest pieces is I never tell
people what they should do, right?
If everything's going along great,we're low risk, we have a healthy mom,
we have a healthy baby, we're cruising.
And people say, well, whatwould you do in my situation?
(37:22):
Well, here's all the different things youcould do, what feels best to you, right?
Because you need to make thosedecisions, not me, not your provider.
So the family unit should have timeto sort of discuss those things
and figure it out themselves.
The Best Birth [37:08]
You have shared so muchgreat knowledge with us.
I know that you have done so much study.
You're just a lifelong learner.
(37:44):
Do you have any favorite resourcesor books that you'd like to
share with our listeners today?
Katrina Bolduc [37:20]
Ooh, I love Evidence -based Birth.
That is definitely one of my favoriteplaces because not only do they give you
evidence -based information, but theyalso provide all the resources and all the
studies where they got their information.
So you don't have to gohunt everything yourself.
(38:05):
You can just go and find it and then youcan find these other studies and do that.
So I'd say that's probablyone of my favorite books.
And I also like, I know a lot ofpeople like sort of week by week.
pregnancy books, what's going on withmom, what's going on with baby, and
probably my favorite one would be Mamaand Natural, so Genevieve Howland's book.
Hers is probably my favorite.
(38:26):
I feel like it's really comprehensive,it goes over everything, so that's
probably another one of my favorites.
The Best Birth [38:04]
that's so amazing.
I'm a big reader and I can see in allof the, I keep track of all of my books.
And so I can see throughout my life,when I was dating, I had a lot of
books about dating and then I hada lot of books about, cultivating
and creating a great marriage.
(38:46):
And then like my baby book stageand now my mothering stage of like
just trying to soak up all of thegreat resources that are out there
in the book, Birth Without Fear.
Katrina Bolduc [38:11]
huh.
Yeah.
The Best Birth [38:28]
January shares such a great quote thatreally went along with what you were
saying with like our timeline in birth.
But she says, that'sthe thing about birth.
We don't get an itinerary.
We have to surrender and let go.
(39:09):
And in its that vulnerability that wefind the courage and strength we forgot
that we've had since our own birth.
The power is already in you.
Katrina Bolduc [38:29]
Mm.
Mm -hmm.
Yep.
Yep.
And it's just so important to rememberthat it's not one size fits all.
Even if it worked great for yourfirst birth and child, guess what?
It might not work great for your second.
(39:29):
So kind of finding that unique wayto try all of the things, be open
-minded, see what works for thattime in space for that child for
that pregnancy, and then do that.
There's no wrong way to do it.
The Best Birth [39:15]
And speaking of education andexperience, I did just want to ask, how
has your maternal care understandingchanged as you've traveled the globe?
(39:54):
Katrina Bolduc [39:26]
Yeah, that's a good one.
So it was definitely humbling someof my experiences traveling and
spending time in developing countries.
But, you know, I think overallglobally, there's still that need for
focus on safety and accessibility.
But then also what's really neat andbeautiful is we're seeing this push
for mental health support, which wasnever really included before, right?
(40:17):
We treat the body, wedon't treat the mind.
And now we're starting tosee people fighting for it.
comprehensive care.
I'm like, no, you can'thave one without the other.
So I think it's really neat to see there'sa strong desire for comprehensive care.
There's a strong desire for amidwifery care and doula care.
And with the global pandemic, we'veseen this time and time again, where
(40:41):
people, the pandemic had some reallybeautiful things come out of it.
One being a lot of people wereexposed to out of hospital birth
that never would have considered it.
We had a lot of families transferlate to care that we're planning
epidural births, we're planning
repeat C -sections.
I'm just going to go in anddo whatever the doctor said.
(41:02):
I would never have a natural birth.
I would never birth out of the hospital.
Right?
And then it was, you know, youcan't have your photographer, your
doula, your mom, your best friend.
In Utah, there was even somedads that missed their birth
because of the pandemic.
They weren't allowed inside.
So it was this horrific time.
but we also had beauty come out of itwhere we had these late minute transfers
(41:27):
that were like, I need my birth team.
I'm not birthing inthe hospital by myself.
And they had these amazing births.
And then afterwards they said like,wow, I never would have considered this.
I never would have agreed to thisif it weren't for the pandemic.
Now that I've done it,there's no way I'm going back.
So we saw these really awesomeshifts where more people were
(41:50):
exposed to midwifery careand to doula support, right?
And so we've seen globally an increasein midwifery care and doula care.
I think I wrote it down somewhere.
The CDC had a 22 % increase in outof hospital births from 2019 to 2020.
So that first year in the pandemic, wesaw a huge increase and that first year
(42:14):
was the worst for birthing families.
So we saw this increase and guess what?
It's still trending that way.
And if you look at a lot of otherEuropean countries that have better
maternal and neonatal outcomes than wedo here in the United States, guess what?
It's midwifery led care for the majorityof the population, except for those that
are high risk that truly need an OB.
(42:35):
So it's really neat to kind of seethese things come out or the new
studies that just came out saying itdoesn't matter where you give birth.
If you give birth in a birth centerat your house or the hospital.
with a skilled provider, you're just assafe wherever you want to birth, right?
So it's sort of combat some of theseold ideas and these old ideologies
where doctors or, you know, grandmasor sister, well, that's not safe.
(42:58):
You can't do that.
That's not safe.
And so we have this mentalityof safety and what safety means.
But now we're seeing all thisinformation come out of like,
see, we are safe at home.
See, we are safe at birth centers, right?
So it's really neat to justhave that additional information
and see people trending.
towards it because peopleare demanding better care.
And we're seeing that globally whereit's unacceptable for you to see
(43:21):
your provider for three minutes.
I'm sorry, but it is.
There's no way that they can trulydo risk management and evaluation of
you and your baby in three minutes.
Right.
And again, it's not their fault.
Right.
We have a lack of providers.
We have OBs that are leavingthe profession for a multitude
of different reasons.
We have not enough midwives.
(43:42):
We have not enough health care providers.
in general in the United States and thatis dwindling and we need better providers
and families are demanding better care.
They want comprehensive care.
They don't want these five minutevisits of, my blood pressure was fine
and they said see me in four weeks.
Right?
So we're demanding better care,which I think is going to shift
(44:03):
this paradigm in healthcaretowards more comprehensive care.
And while I don't see it going, youknow, completely towards midwifery
care where everybody gets a fullhour because that just is impossible.
We don't have enough providers, butI do see a bigger push on providers
recommending doulas, recommendingmental health counseling, right?
Meant offering chiropracticcare and acupuncture.
(44:26):
So we have all of the facets ofbody and mind truly taken care of
instead of, I'm just going to checkon you and baby and you're fine
and we'll see you in four weeks.
So we do have some neat thingsthat are coming out and globally
we're seeing that as well.
In India, some of my friendsand fellow colleagues there are
building an amazing birthinghospital where it's midwifery run.
(44:49):
They're putting in an operating theaterwhere they will have OBs on call and
on staff if the midwives need them.
Right?
So we have this completely shiftin paradigm of like, no, the
midwives are calling the shots.
Cause guess what?
They have really excellent outcomes.
They have better satisfaction.
Right?
We're looking at family centered care.
(45:10):
where the parent is informed and they'remaking informed decisions, they're running
the ship as it should be for everyone.
So it's really neat to see thechanges that are happening here,
stateside and in other countries.
And I'm really excited to go to thePhilippines next year and kind of see how
they're managing and running and trainingand doing everything over there because
(45:32):
they're making incredible changes aswell in terms of maternal and neonatal.
Outcomes are improving, peopleare healthier, people are happier.
So it's a pretty amazing shift and I'mjust thrilled to be a small part of it.
The Best Birth [45:19]
thank you so much for this conversation.
Erin has our mom squadsecret for the week.
She says, if you're thinkingabout breastfeeding, get support
(45:55):
before your baby is born.
Talk with friends who have hada good nursing experience, ask
your baby's pediatrician or meetwith a lactation consultant.
And that goes right along with whatwe were talking about in preparing
and looking forward to it insteadof worrying about it when it comes,
or if there's not time to figureout your desires or your intentions.
(46:16):
Katrina, thank you so much forbeing on the podcast today.
Katrina Bolduc [45:51]
Thanks for having me.
Thanks for joining us on today's episode.
We hope you've been elevated andinspired by this week's expert.
Subscribe today so you never missan episode and please share our
podcast or post on your socialmedia so that other moms and dads
to be can also have the best birth.
(46:38):
Please note that the informationprovided is based on the expert's
insights and personal experience.
It is not intended as medical guidance.
Please seek the advice of yourmedical provider as it applies
to your specific condition.
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