November 8, 2024 • 15 mins
Discover the pivotal elements that can unexpectedly turn a birth experience from joyful to challenging. On this episode of The Ordinary Doula Podcast, we draw on a wealth of insights from my 20 years as a seasoned doula and the compelling data from a comprehensive 15-year retrospective survey. We unravel the mystery behind why 60% of surveyed clients found lengthy labor to be a major hurdle, often catching expectant parents off guard. With labor sometimes stretching on for days, even the most prepared individuals might find their birth plans shifting dramatically as time progresses and fatigue sets in.
But what about the unseen dynamics in the delivery room? Forty percent of respondents pointed to their interactions with nurses as another significant influencer of their birth experiences. As a doula, I've witnessed firsthand how nurses tread the complex line between hospital policies and patient advocacy, which can sometimes lead to tension. I share strategies for expectant parents to navigate these interactions, potentially transforming what could be a stressful situation into a more empowering and supportive one. Join me as we explore these crucial topics, offering fresh perspectives and practical advice to help you and your partner prepare for a more positive birth journey.
Visit our website, here: https://birthlearning.com/
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Follow us on Instagram at @birthlearning
Show Credits
Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helping thousands of
people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:47):
Hello and welcome to the Ordinary Yule podcast.
This is Angie Rozier and if youheard our recent episode just
before, this kind of a companionepisode we talked about factors
that most led to positiveaspects of a birth experience.
So, as promised on this episodewe're going to flip that coin
(01:10):
and we're going to look atfactors that most led to
negative aspects of the birthexperience.
So again, this was research Idid when I was getting my
master's degree and I pulleddata from about 15 years worth
of clients, hundreds andhundreds of clients, and kind of
pooled through the data combedthrough it.
It's a fascinating, grueling,tedious experience but pulled a
(01:32):
lot of really interesting thingsfrom 15 years of doula work and
looking at that.
And this particular piece wasdone in a retrospective survey
that was sent to hundreds ofclients and this was so.
This is people looking backright and answering questions
(01:54):
about their birth experience.
So some of them were lookingback just a few months.
Some of them were looking backup to 15 years or more.
So you know there's a lot offactors going on here and I gave
them some, some components toconsider when they were thinking
about what led to negativeparts of their birth experience.
(02:16):
So not that they had a negativeexperience, but just the the
parts that maybe weren't theirfavorite.
Why?
Why was that?
So the factors they got tochoose from?
Again same thing with thepositive aspects of a birth
experience.
Same factors communication,partner participation,
childbirth, education,birthplace, midwife, doctor,
(02:36):
nurses, doula, length of labor,meeting your goals and initial
contact with your baby.
So not everyone answered this.
I had better, a higher responserate to the positive parts,
which is awesome.
I was glad about that.
I had about an 83% responserate to this and much higher
(02:56):
response rate to the other, tothe positive aspects, specs,
which is cool.
So the most common componentmaybe you could guess that led
to any negative aspects of thebirth experience was long labor.
So 60% of folks said the lengthof labor.
(03:19):
Well, actually it just sayslength.
I am assuming and I happen toknow because I was there.
But long labors, you know, whenwe're looking at two, three,
four days, you know even, youknow even one day, 24 hours of
labor in a lot of cases can belong, super normal, but it's
long.
A lot of times people aren'trealistically prepared for how
(03:49):
long labor can be.
But 60% said the length oflabor was the top most
contributing factor to anythingnegative about their birth
experience.
Now that is outside of people'scontrol, right To a large
extent.
We can look at the nuances oflike are we inducing?
When are we inducing?
How are we inducing?
Why are we inducing?
Are we augmenting?
There's a lot of reasons.
What's the baby's position?
There's a lot of reasons.
Labor could be long, but it can.
It can be long and that is hard, super hard.
(04:10):
When I have someone who hascertain birth goals and then
we're looking at you know we'regoing on hour 30 of labor.
That's hard, but things mightshift, preferences might change
as labor draws itself out andbecomes fatiguing and tiring.
So, other than that, the nextmost common thing that
(04:31):
contributed to negative aspectsof the labor was nurses.
So 40% of the folks that.
Well, that was our next mostcommon answer, 60% for length of
labor, and then 40% was nurses.
So I thought that was reallyinteresting that we jumped from
length of labor to nurses.
(04:52):
That's what people didn't like.
So whether that was how nursestreated them and I call nurses
are kind of referees like nurseshave to be referees on a labor
and delivery floor.
They have to meet you where youare and they also have to meet
the rules, the policies of theplace that they are, wherever
(05:12):
they work, right, that's whothey work for, that's who pays
them, that's how they have a job.
They have to uphold policy andthey have to be a patient
advocate.
Sometimes that puts them in atough spot.
Sometimes nurses aren't comingoff super compassionate, kind
and caring.
Sometimes you know we hit themafter a super long shift.
They might be tainted.
(05:34):
They've seen a lot.
Maybe they haven't seen anyonevery well prepared for labor.
I see that a lot where nursesmight not be super supportive.
So interesting, I thought thatwas a little shout out to like
hey, nurses, let's like see whatwe can do to become a positive
aspect.
Because from these people inthis survey, that was the after
(05:56):
a long labor, that was the nextmost negative thing about their
birth experience was theirinteraction with nurses.
Following close behind, we gotoh sorry, that was 39%.
39%.
So almost 40% was nurses andthen a 34 percent was doctors.
So doctors weren't far behind.
Um, whether that was, you knowhow the doctor came across the
(06:19):
interactions, but I will tellyou from working with thousands
and thousands of people that thebirthing person and her partner
want to be treated with respect.
They don't want to be mocked,they don't want to be nothing
condescending, they don't wantto be chastised, they want to be
respected, they want to besupported.
(06:40):
And sometimes nurses anddoctors are not the best at
supporting and showing respect,kindness and compassion.
A lot of times they do work onthe efficiency of the process,
kind of cranking through theprocess, forgetting the human
component.
That's why doulas have a job isbecause we are all about the
human component being there forthat.
(07:01):
Taking the time we have thetime to take, we can devote time
to one patient be a continuitypoint.
We can be in the room the wholetime.
Where nurses can't, doctorscan't.
They have a lot of other rolesto to fulfill.
So that's part of it, just theway the system is set up.
But please, doctors, nurses,approach with kindness,
compassion and respect.
(07:21):
It's very important.
Um, after doctors came thebirthplace at 25%.
So whether and generally, youknow 93% of these births were
taking place in hospitals.
So that's probably the one I'mgoing to select is probably just
self-select, is probably themost common.
This could be something aboutthe place, the hospital policies
(07:46):
that were there.
Sometimes people get frustratedwith that.
Different rules.
Hospitals abound with policiesand rules.
The next most common after thatwas meeting your goals.
So this came in at 19%.
So they felt like they didn'tmeet their goals and that led to
(08:06):
negative aspects of their birthexperience.
Whether they wanted to not beinduced, they ended up being
induced.
Whether they wanted a VBAC hada repeat C-section.
Really common one is theywanted to go unmedicated.
They ended up using narcoticsor getting an epidural.
And that's tough like havingyour goals met, meeting your
goals, your expectations,largely in childbirth, so many
(08:31):
things, so many variables areoutside of our control, so that
can be difficult in just meetingour goals.
The next most common one, at 15%, was communication.
So whether it was poorcommunication not being able to
get your point across or desires, or feeling like you weren't
heard, that your communicationwas bad, there was a barrier to
(08:53):
communication somewhere led tonegative aspects of that.
Next it was partnerparticipation, which kind of
surprised and didn't surprise me.
Some partners are gung ho,super supportive, some go
overboard, some get bored.
I heard today of a story afriend of mine had to go support
her sister in a different statebecause after 72 hours well, in
(09:16):
the middle of a 72-hour laborthe partner said I can't take
this anymore.
This is taking too long.
And he left.
He just left.
So she drove up to Virginia andhelped her sister in the labor
process.
So partner participationwhether it wasn't what you
thought wasn't as much as youthought but sometimes that can
contribute to negative aspectsand hopefully, you know partners
(09:39):
are prepared.
I think partners mostly want tohelp.
You know if they have the righttools and are supported in the
right way, they're going tohopefully be pretty supportive,
and doulas can help facilitatethat, of course.
And then we also the next afterthat kind of interesting was
doulas.
So that at 5.7%, so almost 6%,like doulas led to a negative
(10:03):
component of the experience andI think this is a little
reminder to doulas that we're wewe, you know do our best but we
are not a guarantee that thingsare going to go beautifully,
positively.
We're not going to have aperfect, empowering birth just
because there's a doula thereand we might do or say some
wrong things that didn't go well.
For this client too of oursthat definitely can be a case.
(10:24):
And doing this research wasactually really humbling to me
as I got these survey responsesand dug into a lot of different
data points.
Um, it was really eye-openingto me that uh and and kind of
informed how I moved my practiceforward, um, and learned new
things that doulas aren't aguarantee to anything and
(10:44):
sometimes sometimes we makemissteps and misspeaks,
sometimes as well.
Other ones that were super low,at less than 4%, were childbirth
education.
So childbirth education hadvery little to do with negative
aspects and if you remember, inour other podcast it was pretty
high on positive aspects of thechildbirth.
(11:05):
So get some childbirtheducation, do some preparation.
It does not contribute tonegative and it was really
impactful and positive.
Midwives Midwives did betterthan doulas when we're looking
at what led to negative aspectsof the birth experience.
So go midwives.
I'm a huge proponent ofmidwives, I think everyone
(11:26):
should have a midwife in theirlife.
And then initial contact withbaby was also low.
So childbirth education,midwives and initial contact
with baby were all 3.8%, so thesmallest things that contributed
to any negative aspects of thebirth experience.
So again, as I said in theother podcast about positive
(11:47):
aspects of the birth experience,once you consider aspects of
the birth experience which, ifthey came in, if they were
negative, what would they be toyou?
And that's going to bedifferent for everyone.
Maybe having a long labor wouldbe a negative component.
Maybe not having thecommunication you need and want,
or having too muchcommunication, maybe having
overboard support or not havingenough support.
(12:07):
Everyone's different.
We can't write anyone else'sstory, but consider what would
make my birth negative andconsider, even more than that,
what would make my birthpositive and prepare towards
that.
These are some components toconsider that we've talked about
.
Come up with these and justcome up with more.
Come up with your own.
What parts would make yourbirth experience positive?
(12:29):
How do you want yourinteractions with your nurse to
be and how can you facilitatethose with your nurse?
You can use a birth plan tofacilitate that.
Um, create connection with yournurse.
Nurses can be a very impactfultool but, as we saw here, they
can also be one of the mostnegative parts of the birth
experience.
Partner participation,communication, the place you're
(12:51):
at the length of labor Gosh, Iwish we could hit a sweet spot
for everybody on that.
But people tend to really likethe initial contact with their
baby.
That's a highlight, for sureand they tend to really like
midwifery care, which is awesome, and they never have regretted
childbirth.
Education is what this datatells us.
So go forth as you consideraspects of your preparation for
(13:14):
your best birth experience.
Kind of consider what that isfor you and how can you get
there.
What questions can you ask?
What people can you involve orincorporate?
What shifts and changes mightyou want to make to ensure that
you start out in a great place,that you're in a comfortable
spot physically, emotionally,mentally, psychologically, that
(13:40):
you like what you're gettinginto Because it's a ride.
I tell you what it is quite aride and we want it to be
thrilling, exhilarating,positive, empowering as we go
through this journey ofchildbirth, labor and delivery
and into parenthood.
Thank you so much for being withme here today on the Ordinary
Doula podcast.
This is Angie Rozier, your host, signing off today.
(14:00):
Come again next time as we diveinto more components of
childbirth, labor, delivery,breastfeeding and the postpartum
period.
It's quite a journey.
Go out and do something youenjoy today.
See something that inspires you, seek for the goodness in the
postpartum period.
It's quite a journey.
Go out and do something youenjoy today.
See something that inspires you, seek for the goodness in the
world and I promise you willfind it.
We will see you again next time.
Speaker 1 (14:35):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth.
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helping thousands of
people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:47):
Hello and welcome to the Ordinary Yule podcast.
This is Angie Rozier and if youheard our recent episode just
before, this kind of a companionepisode we talked about factors
that most led to positiveaspects of a birth experience.
So, as promised on this episodewe're going to flip that coin
(01:10):
and we're going to look atfactors that most led to
negative aspects of the birthexperience.
So again, this was research Idid when I was getting my
master's degree and I pulleddata from about 15 years worth
of clients, hundreds andhundreds of clients, and kind of
pooled through the data combedthrough it.
It's a fascinating, grueling,tedious experience but pulled a
(01:32):
lot of really interesting thingsfrom 15 years of doula work and
looking at that.
And this particular piece wasdone in a retrospective survey
that was sent to hundreds ofclients and this was so.
This is people looking backright and answering questions
(01:54):
about their birth experience.
So some of them were lookingback just a few months.
Some of them were looking backup to 15 years or more.
So you know there's a lot offactors going on here and I gave
them some, some components toconsider when they were thinking
about what led to negativeparts of their birth experience.
(02:16):
So not that they had a negativeexperience, but just the the
parts that maybe weren't theirfavorite.
Why?
Why was that?
So the factors they got tochoose from?
Again same thing with thepositive aspects of a birth
experience.
Same factors communication,partner participation,
childbirth, education,birthplace, midwife, doctor,
(02:36):
nurses, doula, length of labor,meeting your goals and initial
contact with your baby.
So not everyone answered this.
I had better, a higher responserate to the positive parts,
which is awesome.
I was glad about that.
I had about an 83% responserate to this and much higher
(02:56):
response rate to the other, tothe positive aspects, specs,
which is cool.
So the most common componentmaybe you could guess that led
to any negative aspects of thebirth experience was long labor.
So 60% of folks said the lengthof labor.
(03:19):
Well, actually it just sayslength.
I am assuming and I happen toknow because I was there.
But long labors, you know, whenwe're looking at two, three,
four days, you know even, youknow even one day, 24 hours of
labor in a lot of cases can belong, super normal, but it's
long.
A lot of times people aren'trealistically prepared for how
(03:49):
long labor can be.
But 60% said the length oflabor was the top most
contributing factor to anythingnegative about their birth
experience.
Now that is outside of people'scontrol, right To a large
extent.
We can look at the nuances oflike are we inducing?
When are we inducing?
How are we inducing?
Why are we inducing?
Are we augmenting?
There's a lot of reasons.
What's the baby's position?
There's a lot of reasons.
Labor could be long, but it can.
It can be long and that is hard, super hard.
(04:10):
When I have someone who hascertain birth goals and then
we're looking at you know we'regoing on hour 30 of labor.
That's hard, but things mightshift, preferences might change
as labor draws itself out andbecomes fatiguing and tiring.
So, other than that, the nextmost common thing that
(04:31):
contributed to negative aspectsof the labor was nurses.
So 40% of the folks that.
Well, that was our next mostcommon answer, 60% for length of
labor, and then 40% was nurses.
So I thought that was reallyinteresting that we jumped from
length of labor to nurses.
(04:52):
That's what people didn't like.
So whether that was how nursestreated them and I call nurses
are kind of referees like nurseshave to be referees on a labor
and delivery floor.
They have to meet you where youare and they also have to meet
the rules, the policies of theplace that they are, wherever
(05:12):
they work, right, that's whothey work for, that's who pays
them, that's how they have a job.
They have to uphold policy andthey have to be a patient
advocate.
Sometimes that puts them in atough spot.
Sometimes nurses aren't comingoff super compassionate, kind
and caring.
Sometimes you know we hit themafter a super long shift.
They might be tainted.
(05:34):
They've seen a lot.
Maybe they haven't seen anyonevery well prepared for labor.
I see that a lot where nursesmight not be super supportive.
So interesting, I thought thatwas a little shout out to like
hey, nurses, let's like see whatwe can do to become a positive
aspect.
Because from these people inthis survey, that was the after
(05:56):
a long labor, that was the nextmost negative thing about their
birth experience was theirinteraction with nurses.
Following close behind, we gotoh sorry, that was 39%.
39%.
So almost 40% was nurses andthen a 34 percent was doctors.
So doctors weren't far behind.
Um, whether that was, you knowhow the doctor came across the
(06:19):
interactions, but I will tellyou from working with thousands
and thousands of people that thebirthing person and her partner
want to be treated with respect.
They don't want to be mocked,they don't want to be nothing
condescending, they don't wantto be chastised, they want to be
respected, they want to besupported.
(06:40):
And sometimes nurses anddoctors are not the best at
supporting and showing respect,kindness and compassion.
A lot of times they do work onthe efficiency of the process,
kind of cranking through theprocess, forgetting the human
component.
That's why doulas have a job isbecause we are all about the
human component being there forthat.
(07:01):
Taking the time we have thetime to take, we can devote time
to one patient be a continuitypoint.
We can be in the room the wholetime.
Where nurses can't, doctorscan't.
They have a lot of other rolesto to fulfill.
So that's part of it, just theway the system is set up.
But please, doctors, nurses,approach with kindness,
compassion and respect.
(07:21):
It's very important.
Um, after doctors came thebirthplace at 25%.
So whether and generally, youknow 93% of these births were
taking place in hospitals.
So that's probably the one I'mgoing to select is probably just
self-select, is probably themost common.
This could be something aboutthe place, the hospital policies
(07:46):
that were there.
Sometimes people get frustratedwith that.
Different rules.
Hospitals abound with policiesand rules.
The next most common after thatwas meeting your goals.
So this came in at 19%.
So they felt like they didn'tmeet their goals and that led to
(08:06):
negative aspects of their birthexperience.
Whether they wanted to not beinduced, they ended up being
induced.
Whether they wanted a VBAC hada repeat C-section.
Really common one is theywanted to go unmedicated.
They ended up using narcoticsor getting an epidural.
And that's tough like havingyour goals met, meeting your
goals, your expectations,largely in childbirth, so many
(08:31):
things, so many variables areoutside of our control, so that
can be difficult in just meetingour goals.
The next most common one, at 15%, was communication.
So whether it was poorcommunication not being able to
get your point across or desires, or feeling like you weren't
heard, that your communicationwas bad, there was a barrier to
(08:53):
communication somewhere led tonegative aspects of that.
Next it was partnerparticipation, which kind of
surprised and didn't surprise me.
Some partners are gung ho,super supportive, some go
overboard, some get bored.
I heard today of a story afriend of mine had to go support
her sister in a different statebecause after 72 hours well, in
(09:16):
the middle of a 72-hour laborthe partner said I can't take
this anymore.
This is taking too long.
And he left.
He just left.
So she drove up to Virginia andhelped her sister in the labor
process.
So partner participationwhether it wasn't what you
thought wasn't as much as youthought but sometimes that can
contribute to negative aspectsand hopefully, you know partners
(09:39):
are prepared.
I think partners mostly want tohelp.
You know if they have the righttools and are supported in the
right way, they're going tohopefully be pretty supportive,
and doulas can help facilitatethat, of course.
And then we also the next afterthat kind of interesting was
doulas.
So that at 5.7%, so almost 6%,like doulas led to a negative
(10:03):
component of the experience andI think this is a little
reminder to doulas that we're wewe, you know do our best but we
are not a guarantee that thingsare going to go beautifully,
positively.
We're not going to have aperfect, empowering birth just
because there's a doula thereand we might do or say some
wrong things that didn't go well.
For this client too of oursthat definitely can be a case.
(10:24):
And doing this research wasactually really humbling to me
as I got these survey responsesand dug into a lot of different
data points.
Um, it was really eye-openingto me that uh and and kind of
informed how I moved my practiceforward, um, and learned new
things that doulas aren't aguarantee to anything and
(10:44):
sometimes sometimes we makemissteps and misspeaks,
sometimes as well.
Other ones that were super low,at less than 4%, were childbirth
education.
So childbirth education hadvery little to do with negative
aspects and if you remember, inour other podcast it was pretty
high on positive aspects of thechildbirth.
(11:05):
So get some childbirtheducation, do some preparation.
It does not contribute tonegative and it was really
impactful and positive.
Midwives Midwives did betterthan doulas when we're looking
at what led to negative aspectsof the birth experience.
So go midwives.
I'm a huge proponent ofmidwives, I think everyone
(11:26):
should have a midwife in theirlife.
And then initial contact withbaby was also low.
So childbirth education,midwives and initial contact
with baby were all 3.8%, so thesmallest things that contributed
to any negative aspects of thebirth experience.
So again, as I said in theother podcast about positive
(11:47):
aspects of the birth experience,once you consider aspects of
the birth experience which, ifthey came in, if they were
negative, what would they be toyou?
And that's going to bedifferent for everyone.
Maybe having a long labor wouldbe a negative component.
Maybe not having thecommunication you need and want,
or having too muchcommunication, maybe having
overboard support or not havingenough support.
(12:07):
Everyone's different.
We can't write anyone else'sstory, but consider what would
make my birth negative andconsider, even more than that,
what would make my birthpositive and prepare towards
that.
These are some components toconsider that we've talked about
.
Come up with these and justcome up with more.
Come up with your own.
What parts would make yourbirth experience positive?
(12:29):
How do you want yourinteractions with your nurse to
be and how can you facilitatethose with your nurse?
You can use a birth plan tofacilitate that.
Um, create connection with yournurse.
Nurses can be a very impactfultool but, as we saw here, they
can also be one of the mostnegative parts of the birth
experience.
Partner participation,communication, the place you're
(12:51):
at the length of labor Gosh, Iwish we could hit a sweet spot
for everybody on that.
But people tend to really likethe initial contact with their
baby.
That's a highlight, for sureand they tend to really like
midwifery care, which is awesome, and they never have regretted
childbirth.
Education is what this datatells us.
So go forth as you consideraspects of your preparation for
(13:14):
your best birth experience.
Kind of consider what that isfor you and how can you get
there.
What questions can you ask?
What people can you involve orincorporate?
What shifts and changes mightyou want to make to ensure that
you start out in a great place,that you're in a comfortable
spot physically, emotionally,mentally, psychologically, that
(13:40):
you like what you're gettinginto Because it's a ride.
I tell you what it is quite aride and we want it to be
thrilling, exhilarating,positive, empowering as we go
through this journey ofchildbirth, labor and delivery
and into parenthood.
Thank you so much for being withme here today on the Ordinary
Doula podcast.
This is Angie Rozier, your host, signing off today.
(14:00):
Come again next time as we diveinto more components of
childbirth, labor, delivery,breastfeeding and the postpartum
period.
It's quite a journey.
Go out and do something youenjoy today.
See something that inspires you, seek for the goodness in the
postpartum period.
It's quite a journey.
Go out and do something youenjoy today.
See something that inspires you, seek for the goodness in the
world and I promise you willfind it.
We will see you again next time.
Speaker 1 (14:35):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth.
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