March 25, 2025 • 55 mins
What if everything we've been taught about childbirth is fundamentally flawed? Dr. Stuart Fischbein (Dr. Stu) takes us on a profound journey from conventional obstetrics into the world of home birth, challenging the very foundations of modern maternity care.
After decades as a hospital-based OB, Dr. Stu noticed something troubling: the medical model was creating problems rather than solving them. "I thought I was the sharpest tack in the box," he admits, "but I began to see that much of what I knew was wrong." His awakening led him to recognize that standard hospital procedures—from IVs to continuous monitoring to laboring flat on your back—directly contradict what mammals need during birth: quiet, safety, and freedom of movement.
The statistics tell a compelling story. When Dr. Stu shifted to a midwifery-collaborative model, his C-section rates plummeted to 7% compared to the national average of 30-32%. This wasn't because he took more risks, but because he stopped creating unnecessary ones. "I was an expert at about 15% of pregnant women and I was taking care of 100%," he explains. "What they need is midwifery care."
Perhaps most troubling is how fear permeates obstetrics today. From breech babies to vitamin K shots, medical professionals routinely use vague terms like "risky" without providing context or actual numbers. When pressed for specifics, they often can't answer. As Dr. Stu puts it, "All that matters to the medical model is a live baby in the bassinet, and how it gets there is not their concern."
Whether you're planning a pregnancy, recovering from birth trauma, or simply curious about our maternity care system, this eye-opening conversation offers a radical reimagining of what birth could be. Listen now and discover why your body might know more about birth than our medical system does.
Ready to reclaim the wisdom of natural birth? Subscribe, share your birth story in the comments, or follow us for more conversations that challenge conventional thinking.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:32):
Hello and welcome to the Radiant Mission podcast.
My name is Rebecca Toomey andwe are on a mission to encourage
and inspire you as you'renavigating through your life and
with your relationship withChrist.
We are doing something specialtoday.
We are recasting one, twoactually not just one two of our
(00:54):
most popular episodes ever.
Those are the episodes that wedid with Dr Stu.
It has now been two years sincethose episodes were released
and they continue to be our mostlistened to, most downloaded
episodes.
So here we are today recastingthem.
(01:15):
Now, if you hear a little bitof a funny noise right now, I
have my little newborn on my lapand she's just making all of
the baby sounds here today, butthis is the birth episode to
(01:35):
listen to for anyone that ispregnant or planning to get
pregnant.
If you know someone that willbe pregnant one day, dr Stu's
episodes are the ones to listento.
So we're recasting, let's go.
(01:55):
Hello and welcome to the RadiantMission podcast.
My name is Rebecca Toomey and Iam here with my amazing co-host
and sister, rachel Smith.
Hey guys, we are on a missionto encourage and inspire others
as they're navigating throughthis crazy life and with their
relationship with Christ.
Today, we have a very specialguest with us today.
(02:18):
His name is Stuart Fleshbein Ihope I pronounced that, okay MD
but he's also known as Dr Stu,so I'm going to go with that.
He is a community-basedpracticing obstetrician and an
associate of the AmericanCollege of Obstetrics and
Gynecology.
He is a published author of thebook Fearless Pregnancy Wisdom
(02:42):
and Reassurance from a Doctor, aMidwife and a Mom, and
peer-reviewed papers Home Birthwith an Obstetrician, a series
of 135 out-of-hospital birthsand breach-at-home outcomes of
60 breach and 109 cephalicplanned home births and birth
(03:03):
center births.
So Dr Stu has spent 24 yearsassisting women with hospital
birthing and for the last 12, hehas been a home birth
obstetrician who works directlywith midwives.
If you want to check out moreabout Dr Stu, his website is
birthinginstinctscom and rightnow Dr Stu travels around the
(03:25):
world as a lecturer and anadvocate for reteaching, breach
and twin birth, respect for thenormalcy of birth and honoring
informed consent.
You can follow him on Instagramat birthinginstincts and at the
birthinginstincts podcast withmidwife Bliss Young on your
smartphone app, and he offershope, reassurance and safe
(03:47):
evidence support choices reallyfor women who understand
pregnancy is a normal bodilyfunction not to be feared,
simply desire common sense andwho cannot find a supportive
practitioner for VBAC, twin orbreach deliveries.
So, dr Stu, thank you so muchfor being here with us today.
Speaker 2 (04:10):
Thank both of you for having me on.
It's like I said earlier it'san opportunity for me to reach
an audience that I might notnormally get to.
So I'm on a mission, like youguys are, to sort of normalize
this beautiful thing that we'veall been through, because all of
us were, at one point, born.
Speaker 1 (04:31):
Yeah, that is true, we were, and we all have to be
born.
You know, everybody else that'scoming.
Speaker 2 (04:39):
And we don't do it very well.
So, there's such a better wayto do things.
And so again like I said, I'mjust happy to be here.
I'll just leave it at that,thank you, thank you, we love
your story.
Speaker 1 (04:52):
You know, rachel and I both have been following you
on Instagram for a while andtuned into your podcast, and
that was really what sparked usto say, hey, I wonder if Dr Stu
would come talk to us.
We love talking birth.
I sent you way too muchinformation about what I went
through and what she wentthrough, so we're passionate
(05:12):
about it.
I had my first home birth thisyear after having a C-section
for my first, and my sister hashad two C-sections and now she's
having a well, what do we callthat?
A birthing center, home birthwith a midwife, and so we're all
about birth.
You know that and we love ithere.
But we love your story and howyou were practicing as an
(05:34):
in-hospital OB, but then youshifted to home birth.
What really prompted thatchange for you?
Speaker 2 (05:42):
Well, there was no epiphany, it wasn't something
that just occurred.
Okay, it was a process of beingan inquisitive, curious person
who always had a little problemwith authority.
You know, I respect honest andyou know trustworthy authority,
(06:03):
but I don't respect stupidauthority, sure.
So I would always questionthings.
I mean, even as a kid orgrowing up through high school
and college and medical school,I would always sort of be the
person that's asking well, whyare we doing that?
And what happens in residencyand medical school?
You get beat down and you stopasking because you just try to
(06:25):
get through your days.
So when I came out, I was verymedicalized.
I thought that the obstetricalmodel was the only way to do
things, that I thought that Iwas the sharpest tack in the box
and that anybody who did thingsdifferently was crazy.
Anybody who did thingsdifferently was crazy.
You know I did all the thingsthat now I look back on and I
(06:47):
say, jesus, I can't believe thatI did all those things.
And you know simple things likeimmediate cord clamping or
taking the baby over to thewarmer, away from the mother, or
giving the mother an injectionof something to dry up her
supply of breast milk, orwearing a hazmat suit to catch a
baby or making all womendeliver in lithotomy position
flat on their back and notthinking there's anything wrong
(07:09):
with inductions and epiduralsand pitocin and C-sections.
That's what you're trained with.
If all you know is Greek, thenyou only speak Greek.
And so I came out speaking onlyGreek, out speaking only Greek,
and as part of my building of apractice.
It was a different era Back inthe early 80s.
(07:34):
You didn't just come out andget a job working for a big HMO
like Kaiser or something likethat.
You built your own practice andnow doctors essentially just
come out and get a job.
They're just a cog in the wheel, they're employees.
But in those days you weren't.
So I hustled to build practiceand one of the things I did
besides cover emergency roomsand assist other guys in surgery
and all that stuff was and workat free clinics.
I was a medical director ofthree free clinics in Los
(07:54):
Angeles.
I hustled a lot.
I was approached by some localmidwives and asked to take their
transports from home and I waslooking for revenue stream and I
didn't think that midwifery wasa good idea.
I didn't know anything about it.
I've never been to a home birth, so I of course I judged it,
like like many of our colleaguesdo.
(08:14):
You know it must be bad, causeI've never been to one, so I
don't know anything about it.
So let's just judge it.
But I did it because I couldmake revenue off of that.
But when the women would comein and they would get put in a
bed and they get their epiduraland they get their Pitocin and
we're trying to make the laborat stalled out at home.
These were generallynon-emergent transports, which
(08:35):
are what most transports are.
I'd have time to sit in alounge with the midwife and we'd
be sitting there talking and Ihave a composite memory.
I don't have any specificmemories of any of those events,
but I began to hear differentways of doing things and I began
to see that the clients theywere bringing in were not
ill-informed.
They were actually far betterinformed than anybody in my own
(08:55):
practice and a lot of them werehighly professional.
They were intelligent people.
They weren't just hippies orpeople who are counterculture.
They were mainstream culture,lawyers, hollywood people,
medicalized medical people.
They had all chosen a differentpath and so I was curious.
(09:15):
I was having intellectualcuriosity and I'm a bit OCD, so
I, you know, I started to lookinto things and I began to see
that much of what I knew waswrong to things.
And I began to see that much ofwhat I knew was wrong and did
not apply to women who don'thave a problem.
I mean, I was like most doctorscoming out of residency, we're
pretty well trained to take careof somebody with a problem.
But what we do is we start tosee everybody has a problem.
(09:37):
We start to make problems wherethere aren't problems because
that's our model.
So I was an expert at about 15%of pregnant women and I was
taking care of a hundred percent.
So 85% of the women I'm takingcare of I'm really not an expert
in, because what they need ismidwifery care.
What they need is somebodywho's going to give them time
and keep their hands off of themand not over-test them and not
(09:59):
project fear upon them, to helpthem realize that this is a
normal function of your body,like breathing, like digestion.
It does it.
Whether you want it to or not.
You're going to grow that babyinside of you and at some point
you're going to go into laborand there's not a damn thing you
can do about it.
It's going to happen.
(10:19):
So that's how I got in.
So after about 10 years inprivate practice I I started a
collaborative midwifery practicewith two certified nurse
midwives in a hospital settingstill, and for 15 years or so we
had a really great practice.
We had low intervention rates.
We had a C-section rate overallof about 7%.
(10:40):
The next group that took careof the similar cohort of women.
Their C-section rate was in themid 20% at that hospital.
So we were three to four timesless likely to have a C-section
in our practice than theirpractice, and it was simply
because I followed the midwiferymodel of care, where anything
that was normal I never reallyeven took care of, unless I was
filling in or covering for amidwife on vacation.
(11:01):
But the midwives took care ofall the normal stuff.
The midwives did the well womenexams, they did the pap smears,
they did all that sort of stuffthat you would do, prescribe
the birth control, and I wouldcome in when, say, a woman had
an abnormal pap smear or a womanhad a cyst on her ovary or a
woman came in with an ectopicpregnancy or she ended up with a
breech baby or twins orpreeclampsia or some other
(11:25):
problem, then I would step inand so it was the best of both
worlds, because midwives areactually better at taking care
of pregnant women than doctorsare, because they're trained to
take care of normal pregnantwomen and we're not.
Speaker 3 (11:41):
We think we are, but we're not, was this in Southern
California, where you had yourpractice?
Speaker 2 (11:45):
Yeah, oh yeah.
I did my residency atCedars-Sinai in Los Angeles and
I had the good fortune of thoseyears.
Cedars had a collaborativerelationship with LA County USC,
which at that point in time wasthe busiest hospital in the
country.
It's not that anymore.
They were doing about 22,000births a year there, which is
about 65 babies a day.
So if you break that down 65babies a day and I'm there for
(12:12):
three to four months every otherday, so that's like 60 days I'm
there you can see how manybirths are coming through across
our plate.
Speaker 1 (12:18):
And if you have 65 babies a day, you're probably
having at least two breeches andtwo sets of twins every day
because, Because it's about 3%breach and 3% twin and you were
delivering breach the whole time, or not, until you got involved
with the midwives.
Speaker 2 (12:35):
Oh no, I learned to do breach in residency.
It was just considered a normalvariation, so you learned.
Speaker 1 (12:40):
In fact in the 80s they were teaching it because
it's not something that reallyis taught to in medical school
today.
Speaker 2 (12:47):
It was already fading in the 80s.
It was already fading in the80s and 90s.
There were papers coming out.
You know what I would callconfirmation bias papers.
They basically said we need apaper so that we can do
C-sections.
And suddenly there were paperscoming out saying that C-section
is safer for breach than not,were papers coming out saying
that c-section is safer forbreach than not?
(13:07):
And there was a sentinel paperthat came out in 2020, 2000
excuse me called the turnbridgetrial, which got so much
publicity and it was really abad paper and had a lot of flaws
in it and within two years itwas sort of mostly retracted and
yet the damage that it did wasalready there to stop all
training of breach deliveryaround the world.
(13:27):
Because they just jumped on it?
Because, again, of confirmationbias.
Because since that time therehave been numerous papers much
larger, with much better controlfor their study come out saying
that there's really not a lotof difference between properly
selected breach at term,vaginally or by cesarean, and
(13:48):
it's better for the baby andbetter for the mother and for
the mother's future babies todeliver vaginally.
But it doesn't matter, becauseif they're not, if you don't
learn how to do it when you'rein training, you're never going
to come out and do it.
You can take a course like mycourse or Rick's and David's
breach without borders course,and that's fine.
You'll know, maybe, what to do.
(14:09):
But if your partners don't wantyou doing it, if your employer
doesn't want you doing it, ifthe hospital doesn't want it,
doesn't matter, you're not goingto do it.
So if your malpracticeinsurance is going to say, yeah,
you can do it, but we're goingto charge you more on your
premium, there's no incentive.
All the incentives are to notdo what's necessarily right for
the women that we're supposed tobe taking care of.
Speaker 3 (14:31):
Yeah, I wish I knew about you and your practice and
your work with my first twopregnancies, because my first I
delivered in Los Angeles.
He was breech automaticC-section, although I did
attempt a version with him thatwas unsuccessful.
My second was in Orange County.
(14:51):
He was breached and that was ata teaching hospital and that
was a really traumatic C-sectionfor me because no one told me
that residents and med studentswere going to be in my birth and
so I'm just in an OR with a tonof people that I don't even
(15:12):
know.
My doctor didn't even show upfor it.
The whole experience was what Iwalked away from that with not
only birth trauma from thatC-section but also very
disturbed to actually experiencehow doctors are being trained
in birth today, because theyliterally treated me like I was
(15:34):
not a human, like I was theirtheir lesson for that day, that
I was like a test subject, thatI was like a test subject and
and it was.
This is actually like why Ilike I have so much respect for
you and not only like what youdid in your, in your practice,
(15:54):
but what you're doing incontinuing education today,
because you're you're impactingwomen like me who were affected
negatively by the medical systemin this way and who are seeking
out something else, you know,seeking out a better, a better
birth experience.
You know that is our right.
It's our right to have that.
Speaker 2 (16:16):
So, yeah, the educated the educated pregnant
woman is is the bane of theexistence of the current medical
model, Because they don't wantpeople to ask questions.
And again, when I say thesethings, we're talking about the
nebulous they.
Okay, your individual doctor isprobably a really good person
(16:39):
and he or she probably loves herkids and is a good family
person and all that stuff andwants to do good, but they're in
a system that is not designedto allow them the individuality.
Everything is done on analgorithm.
And when you come in and yousay you know, I don't think I
(16:59):
want the genetic screening, youknow I don't think I want
vitamin K.
You know I don't think I want a20-week ultrasound.
You know I don't want to beinduced at 39 weeks or 40 weeks
or 41 weeks, and no, my babyisn't too big.
Or no, I don't think I want anIV, or no, I don't think I'm
going to lay flat on my back.
(17:23):
You cause them so much turmoilinside because they're on a
hamster wheel and they don'tknow what to do and what you
experienced, Rachel, beingtreated as sort of, you know,
almost like veterinary medicine,where you're not really talking
to the dog.
Speaker 1 (17:44):
Yeah, that is what it was like.
Speaker 2 (17:46):
Yeah.
Speaker 1 (17:47):
On the other side of that.
Speaker 3 (17:49):
I was not an awake human being.
I was like a lab rat.
Speaker 2 (17:54):
Yeah, it violates every tenet of medical ethics,
but we can get to that maybefurther down the conversation.
But when they do that, theydon't know what to do with you
if you step out of line on thelines that they've drawn and the
lines that they've drawn havenothing to do necessarily with
reality or evidence-based.
You know, I always hate theterm evidence-based medicine
(18:16):
because it makes it sound likeit's good evidence.
But evidence-based medicine isonly as good as the evidence
you're using to claim that youhave evidence-based.
And the same thing goes forstandard of care.
You know what's the standard ofcare?
Our hospital doesn't do breachdeliveries.
Therefore, if you come in hereand do a breach delivery, you're
breaching the standard of care.
Well, yeah, but that's not whatthe standard of care is.
(18:38):
It's defined by whoever has thepower, defines what the
standard of care is, defineswhat the standard of care is.
So these terms are thrown outthere and the use of language is
something to really get us totoe the line.
And so what happens is thatthey do these things and they
don't know what to do with you.
And there's an analogy that Ilove, because everybody's seen
(19:00):
the movie, I think, A Bug's Life.
I hope everybody's seen A Bug'sLife.
That's a the movie.
Speaker 3 (19:04):
I think A Bug's Life.
Speaker 2 (19:05):
I hope everybody's seen A Bug's Life.
That's a great movie.
Yeah, pixar used to make reallygreat movies that didn't have
any agendas in them.
Oh, yeah, yeah, there's a sceneat the beginning where they're
bringing an offering to the bigpile for the grasshoppers and
the ants are all in a row.
And you know how ants followeach other.
They always follow each other.
If you've ants in your kitchen,you know what I'm talking about
.
Um, and this leaf falls off thetree and it falls in front of
(19:28):
the ants in the line and theants behind the leaf they're in
panic, they're in full-blownpanic.
We do, what do we do?
What do we do in the one antgets up on a rock and I'm
paraphrasing every sayssomething like calm down, we'll
go around the leaf, and theyfigure it out.
Okay, yet in the hospital, ifyou, if you say, listen, I don't
(19:50):
want you to cut the cord, butwe have to take the baby to the
warmer.
Well, why do you have to takethe baby to the warmer?
We have to check the baby out.
Well, the baby's on my chestand he's just fine.
But but then we, you know, Imean we have to dry it off.
Well, why do you have to dry it.
I mean, I'm just saying, and Iand I'm, and again, these are
good people, these nurses thatdo this, but if they don't do it
(20:12):
, somebody on monday morning isgoing to yell at them if they
don't check every box and ifthey don't document that they
took.
They said I, we, that theyoffered you this and they
offered you that.
Speaker 1 (20:25):
That's a very good point.
I work in business and inbusiness it's all about process.
You create the process.
It's a good process.
You follow it.
When you deviate from theprocess and things go wrong, you
got to go back to the process.
You can edit the process.
But that's what I'm hearingfrom you is, people are so used
(20:45):
to being inside that processthat when you go out of it or
when you question it, it's likeno, no, no, this is the process,
this is what's working, butunfortunately it's not working.
It might be working for thehospital but it's not working
for the mothers that are givingbirth, it's not working for the
families.
(21:05):
I mean the amount of birthtrauma that comes out of the
traditional system.
I mean there's entire podcastsabout this.
I was on one and it's just.
It's something that has becomevery interesting to me because I
see a huge awakening happeningright now that women are saying
(21:25):
wait a second, this isn't right,and that's when they're
starting to pursue and look intohome birth.
But then we're so programmedabout going to the hospital with
an emergency and we've been soprogrammed that birth is one of
those emergencies.
That then that's the bigquestion that I get.
It's actually one of thequestions I have for you on my
(21:46):
list, because I have a number offriends right now that are
pregnant and they're consideringhaving a home birth.
But that's their one questionthat they always ask me is well,
what if there's an emergency?
What if something goes wrong?
And of course, my question iswhat's going to go wrong?
What do you think is going togo wrong?
(22:08):
But I'd love to hear from youhow you respond to that question
when people say well, if I havea home birth, what happens if
something goes wrong?
Speaker 2 (22:20):
Well, a couple of things.
First of all, there's adocumentary coming out that I
just watched today becausesomebody sent it to me called
Birth Time.
It's from Australia and in thatthing they say one third of all
the women in Australia thatwere surveyed complain of birth
trauma.
And I'm surprised it's that low.
Speaker 1 (22:41):
Yeah, a third is even still.
Speaker 2 (22:42):
I would have thought it would have been higher, but
anyway, we can talk a little bitabout the topic that you just
brought up, which is what ifsomething goes wrong?
I had another point to make,but my brain gets 10 feet in
front of my mouth.
It was my Greek example.
There's so much fear involvedin birth in the United States
(23:05):
and other Western countriesbecause women fear birth, and
the reason that women fear birthis because the medical model
has projected their fear ontothe women of our country.
Speaker 3 (23:14):
Amen and they fear birth.
Speaker 2 (23:15):
So when people ask that question, it's a reasonable
question to ask, but it showsthey really have no idea what
normal mammalian birth is like.
So before I answer the whathappens if something goes wrong
question, I just want to digressa little bit to the mammalian
birth issue and talk about howother mammals give birth.
And the human female is amammal with the same innate
(23:41):
natural processes that go on thesame hormones, the same natural
processes that go on the samehormones, the same needs for
birth.
And, as Sarah Buckley likes tosay, birth should be quiet, safe
and unobserved.
And if you ever watch any othermammal when they're in labor,
where do they go?
They go off to a place wherethey feel safe and quiet.
They don't go to a noisy streetcorner.
They don't go to the middle ofyour living room with the Super
(24:03):
Bowl on TV.
They go off someplace quiet.
And who goes with them?
No one, absolutely nobody,right.
And if they're hungry they dosomething really amazing they
actually eat.
And if they're thirsty, theydrink.
And if your dog was in labor,you would never, ever think of
taking the food and the wateroff the floor and putting it up
on the shelf.
You would never do that.
Yet we do that to human femaleswhen they come in and labor.
(24:26):
You would never have your dogsit still in one place.
You would never duct tape yourdog to the floor so it couldn't
move.
You would never do that.
And if the little kids wererunning around the house and
they happened to run into theroom where the cat or the dog is
in labor, what do you say tothe little kids?
Leave the dog alone, okay.
(24:49):
And when the babies come out,nobody rushes in to cut the cord
and nobody ever separates thebaby from its mother.
Speaker 1 (24:57):
You're not putting your hands in there.
That dog had just had puppies,no way.
Speaker 2 (25:00):
It's never done Like as my co-host likes to say.
You know, no one ever does avat exam on a tiger at seven
centimeters.
Speaker 1 (25:10):
That's a good one, I like that.
Speaker 2 (25:11):
Yeah Well, you try it see what happens.
So so, but what we do to thehuman female is pretty much
everything that's done.
When you go to the hospital isantithetical to nature's design.
You have to come in and youhave to sign paperwork Talks
about death and consent formsabout surgery and then you have
(25:34):
to go in the bathroom and youhave to change into a hospital
gown.
Why are you changing into ahospital gown?
What does that make you feellike?
Speaker 3 (25:42):
A patient.
Speaker 2 (25:44):
A patient right, and why can't you wear your own
jammies?
Speaker 3 (25:47):
or nothing.
Speaker 2 (25:50):
And you have to pee in a cup.
And I always ask the questionwhy do you pee in a cup?
You're not complaining ofurinary tract infection symptoms
, you're not doing anything.
My assessment is that somebodywill say, well, we want to check
for protein or whatever else.
It's like no, no, you want todo it because it's a billable
charge and you can bill for theurinalysis.
(26:13):
There's no reason to pee in acup.
And then you stick an IV in themand then you draw blood on them
.
Why are we drawing blood onsomebody coming in the hospital?
We don't do it at home.
Don't do it to your dog or yourhorse when it's in labor.
Why do we do it?
Oh, we have to have a clot inthe lab in case you bleed.
We can type and cross yourblood faster.
It's like well, what happens ifI came in with a gunshot wound
or a car accident, you'll findme some blood.
(26:35):
If I need it that fast, you'llfind it for me.
And then we strap you down andput monitors on, which have been
shown to have really no effectother than raising the c-section
rate.
We don't let you eat anything.
If you're lucky, you can have apopsicle, and you're constantly
being interrupted.
Uh, you're interrupted for yourblood pressure cuff machine
going off like if you'reblushing.
(26:56):
If you come in with a normalblood pressure, what are the
odds that during labor, ifyou're left unfettered, that the
blood pressure is going tosignificantly drop or rise?
And yet hospitals have aprotocol that nurses must take
your blood pressure every hour,every two hours.
So anytime you do that you'reinterrupting.
So in nature, what happens whena mammal is interrupted?
(27:16):
What happens when there's aforest fire?
What happens when the littlekids run in the room?
What happens when there's apredator approaching the mammal,
puts out adrenaline.
Adrenaline stops thecontractions.
The mammal gets up and runsaway, and only when it feels
safe does labor ensue, and thatway nature ensures the best
chance of survival.
So the same thing.
So when we take a woman fromher home and we make them get in
(27:40):
a car and drive to the hospitaland go through all that I just
described, it's no surprise thatshe was contracting every three
minutes at home and now she'scontracting every eight minutes
because she's nervous.
Now she's put out adrenalineand she's being interrupted.
And sometimes, you know, thelabor continues, because nature
is amazing, but a lot of timesit doesn't.
And so now they check yourcervix with an unnecessary
(28:01):
vascular exam and say you'rethree centimeters.
Oh, you're three centimeters,you're 40 weeks.
We might as well keep you.
You know why don't we just goahead and break your bag of
waters and then you start thatwhole cascade of interventions.
And during that cascade ofinterventions I'm getting to
your answer to that otherquestion.
Speaker 1 (28:16):
You're right on, I'm following.
Speaker 2 (28:19):
You can see where I'm going with this.
So then they rupture yourmembranes, but nothing happens.
So then they say, let's startsome Pitocin.
So then they start Pitocin,which then shuts off your own
oxytocin production and thecontractions get pretty intense.
And you say, can I have anepidural?
Because you're told thatepidurals are candy and there's
nothing wrong with getting anepidural, because why would
(28:41):
anybody want to have their toothpulled without Novocaine?
That's the analogy they'll use,as if a tooth and labor are the
same thing.
Labor is a complex hormonalsymphony going on between you
and your baby and the epiduralshuts it off immediately because
now you're not communicating,because you're not in discomfort
anymore, you're not sendingyour baby signals to help your
baby through its labor.
(29:02):
So then the baby now you'renumb and you're hyperstimulated
because your contractions aretoo common, too frequent and the
baby's heart rate doesn't likeit anymore.
And suddenly the baby's got afetal tachycardia, which is
where the heart rate goes up, orit has a D cells where it goes
down.
And doctor comes in and checksyou and you're only six
centimeters and they say, hmm,baby's not tolerating labor, I
(29:22):
think we need to do a C-section.
Thank God you're in thehospital, because what would you
have done if you'd been at home?
Not realizing what they justsaid is one of the stupidest
things that they can say.
Yes, things can go wrong athome.
Things go wrong in the hospitalall the time, but things can go
wrong at home.
But if you leave nature to itsown accord, rarely does it go
(29:43):
wrong suddenly and awell-trained midwife and
educated parents can often seeit coming way ahead of time,
when there's plenty of time tosay you know, your labor's
stolen out or your baby's heartrate's rising a little bit.
Oh, you spiked a fever, maybeit's time to go to the hospital.
Those are not emergencies.
Those are not 911 ambulancecalls.
(30:04):
Those are pack your bag, get inthe car, drive to the, put a
check on the seat before you getin the car so you don't make a
mess and you drive to thehospital and you go in through
triage and then you go throughall those questions too.
It's obviously not an emergency.
Rarely when something reallybad happens at home, yeah, there
can be a problem with that, butthe likelihood of a cesarean
(30:25):
section, the likelihood of a badoutcome, the likelihood of a
newborn intensive care unitadmission is actually much
higher in the hospital, and whateverybody needs to understand,
including occasional trolls thatfollow me on Instagram, is that
no one guarantees a perfectoutcome.
(30:46):
There's no guarantee of aperfect outcome.
Once the sperm hits the egg,you know what.
There's no guarantee.
Speaker 1 (30:52):
There's no guarantees in life, dr Stu.
I mean I must get out of thisthing alive.
Speaker 2 (30:56):
Well, death and taxes .
Death and taxes, oh yeah,you're right.
So that's why you know whenpeople say that and then they
say, well, how can you do abreech at home?
Or how can you do twins at home?
Well, in all honesty, when Ifirst started doing that at home
I actually was we made adocumentary called Heads Up the
Disappearing Art of BreechDelivery, and in there I say you
(31:17):
know, all things being equal,it would be safer for women to
have a breech baby in thehospital because you have all
the emergency things immediatelyavailable.
And that was early on in myhome birth career.
I wouldn't say the same thingnow.
I wouldn't say it's safer tohave your breech baby in the
hospital because you're going toend up in the hospital, they're
going to have a protocol forbreech and every woman's going
(31:39):
to have to follow the algorithmand you're going to have to be.
You're probably going to haveto have an epidural.
They may not activate it, butthey'll want you to have it just
in case and then you'll have tobe in the operating room to
deliver your baby just in case.
And all these things aredisruptive.
It's like get back to the thinkof how a mammal labors and
think of all the things we do todisrupt it, it's still amazing,
that's.
(32:00):
You know, 68% of women in theUnited States can still have a
vaginal delivery.
Yeah, 30,.
You know the C-section rate'sabout 30, 31% and 32%.
And, and you know, one or 2% ofwomen are having their babies
at home.
And if, if, we can all agreethat the maternity system United
States is broken and in theWestern countries, australia,
(32:22):
you know, europe is broken, it'snot because 1% or 2% of women
are having babies at home.
Speaker 1 (32:28):
No.
Speaker 2 (32:29):
It's broken because 99% of women are having babies
in a hospital system that isn'tdesigned to individualize care,
to respect autonomy anddecision-making, to give
informed consent.
You're a cog in a wheel of amachine that has to make money
to survive and the fiduciaryduty of the hospital is not to
(32:50):
you.
We need to understand that theydon't care about you Individual
people that work there.
Maybe they do, and of coursethe risk managers don't want
anything bad to happen, but theindividual person is lost there.
It's a system-wide thing and itneeds to be thrown out.
(33:11):
There was a great analogy inthat documentary I watched today
.
They talked about thefoundation being shaky and you
keep putting more scaffolding onthe foundation and if the
foundation is shaky, thescaffolding is just going to
collapse and we see it theydon't want to deliver breaches
(33:42):
as another opportunity to justc-section somebody, which is
another way for them to makequick money and not have to deal
with in all fairness, doctorsdon't make more money doing a
c-section, but they save timethey don't make more money.
The hospital makes more money,don't they hospitals do?
Speaker 1 (34:03):
but the doctor themselves.
Speaker 2 (34:04):
Here's a simple solution to that problem if the
insurance companies, thehospital makes more money don't
know, hospitals do, sure, butthe doctor themselves?
Yeah, here's a simple solutionto that problem If the insurance
companies you know I know thatthis sounds a little snarky, but
if insurance companies weren'tin cahoots with the hospitals,
the two lobbies getting togethersometime figuring how we can
manipulate things in Washingtonor Sacramento or wherever we are
they could lower the C-sectionrate immediately tomorrow by
(34:27):
simply just offering to pay moremoney for a vaginal delivery
and less money for a cesareansection.
Speaker 3 (34:33):
Interesting.
Yeah, it blows my mind.
After my second birth, the onethat I mentioned before, that
was in a teaching hospital, whenI got the bill that was charged
for my insurance it was $78,000.
And I'm like and that was morethan my first C-section that was
not at a teaching hospital, butI was like this is crazy, like
(34:55):
there, like this was like aeducational experience for all
these med students in there andthere was no you know like
financial incentive for me or myinsurance.
It was.
It's just insane how much theycharge for that surgery.
Speaker 2 (35:11):
Well, it's a game.
Billing is a game and anybodywho runs a medical practice
knows it's a game.
It's all about coding andeverything has to have a coding.
If it doesn't have a code, thenyou didn't do it.
So you fake, you make up codes,you make up things that you
didn't do and then what happensis the hospital knows that
they're contracted with theinsurance company and the
(35:31):
insurance company's got a cap onwhat they're going to pay them.
So they inflate the bill asmuch as possible to try to get
the maximum they can under theircontract with the insurance
company.
That's why an aspirin is $5 anda box of Kleenex is $12.
And I mean nobody.
We all know that that'sridiculous, but that is true.
(35:53):
And if people were to pay morescrutiny?
Now see, and the problem withthird-party pay?
We're going to go off on atangent here.
The problem with third-partypayers is they take away the
direct relationship and everytime you add a middleman to
something, you decrease quality,you make it more impersonal,
(36:16):
because you're not making thattransaction with the person
sitting across from you and theperson in the middle is
generally making the most money.
The people actually providingthe service make less.
In California they always talkabout oh, those greedy oil
companies are making so much ona gallon of gas.
Well, I read an article,several articles, and the oil
(36:37):
companies make maybe a nickel toa dime on a gallon of gas.
The state of California makes64 cents on every gallon of gas.
Right, because they put the taxon there.
The state of California ismaking six to 10 times as much
money per gallon of gas.
And then on the press theybadmouth those greedy oil
companies.
It's the same thing here.
When you have insurancecompanies that get in the middle
(36:59):
, then you're not negotiatingwith me and I'm at the mercy of
an insurance company who says ifI'm doing things that they
don't like, they can kick me offthe panel.
Speaker 3 (37:11):
Yeah.
Speaker 2 (37:11):
And if I have a practice that's got 30% Aetna
and 50% Blue Cross, I can'tafford to be kicked off Aetna or
Blue Cross because my marginsare really thin running a
practice, or running a hospitalfor that matter.
So, again, the individualpeople want to do the best that
(37:35):
they can, but the system doesn'treally allow it and in the end
run what happens is that thepatients suffer and the bigger
it gets.
And you know, and then thebigger it gets, there's no one
to complain to.
Yeah, tried to.
You know, when I, my Instagramaccount got hacked a couple
months ago, a month ago orwhatever, and I was at the mercy
.
There's nothing I could do.
(37:57):
The only way I got it back wassomebody I know, knows somebody
that works for Meta, and theygot it back for me.
That's helpful.
I emailed them every daythrough their service, every day
complaining about this, goteither an automated response or
no response whatsoever.
I had lots of my followers sendin.
(38:21):
This account got hacked, blah,blah, blah, nothing, nothing.
I found somebody who knewsomebody who knew somebody who
knew somebody.
Speaker 3 (38:30):
Yeah, to help you out .
I'm glad you got it back.
Speaker 2 (38:33):
Right, but if it was a small company, you know, if I
have an electrician come to myhouse and he screws up, it's
between me and him.
Speaker 3 (38:40):
Yeah.
Speaker 2 (38:41):
Okay.
So it's the same sort of thingin medicine.
If you go to a small,individual practitioner, you're
going to get better care.
I truly believe that, notnecessarily for something that's
really complicated.
Obviously, if you want to go tothe Mayo Clinic or Cedars-Sinai
or the Cleveland Clinic, yeah,when you've got something that's
really wrong with you, you wantto go to a big specialist.
But for individual healthcare,your daily needs and stuff like
(39:05):
that, you want to find a privateguy.
And what's happening, of course, is that governments and big
medicine are trying to squashthe private guy.
They're making it impossiblefor us to call in prescriptions,
they're making it impossiblefor us to run certain tests.
They say you have to have thissoftware in your office.
Well, if you have a hundredphysicians in your office, you
(39:26):
can afford that software it'sdivided between a hundred people
.
But if you're a solopractitioner and you have to
have this software, you can'tafford it, sure.
Speaker 1 (39:34):
Hey, speaking of money, this is something that I
read a lot about in.
I joined some home birth,assisted and unassisted type of
groups on Facebook when I wasplanning my home birth and there
would be a lot of moms thatwould come and say I really want
to have a home birth but Ican't afford it.
(39:57):
And what I can't afford it theymeant five, six, $7,000 for to
pay a midwife out of pocket wastoo much money for them.
But it was hard for me to evenlike know how to respond to this
, because in my mind I'mthinking don't pay for your
health insurance.
You know, just put the moneythat you would have put into a
health insurance policy that'sgoing to send you to this
hospital and use it towards yourmidwife, or you know, this is
(40:20):
worth it.
It's worth it at the end of theday five grand to have somebody
that is going to be supportiveof you at home and you're not
going to go through all thoseinterventions at the hospital.
They're going to cost you$78,000 to your insurance policy
.
I don't know it's aninteresting conversation that's
often had in these communitiesis we're so used to being in the
(40:45):
system, in the health insurancesystem, that we don't know how
to step back and say, instead ofputting money into this, I'll
put money into an account that Ican use to pay a midwife.
Speaker 2 (41:00):
Yeah, it's the culture we live in.
We have this third-party payersystem, this insurance, or it's
the culture we live in.
We have this third-party payersystem, this insurance, or
Medicare or Medicaid, and so wethink, well, if I'm sick, I
should be able to use myinsurance and we don't put a
value on the individual healthcare like that, and that's
(41:20):
something that people will haveto break out of if they can't,
because I'll tell you that the$6,000 that you spend on a
midwife might be a big burdenfor you.
So you put it on a credit cardor you borrow it from your
parents or, you know, you put a,have a ghost, a give, send go
account and raise the money orhave people who are going to
give you a baby shower.
Stop buying you stupid stuffthat you'll never use anyway and
just donate towards your homebirth fund, because two, three
(41:43):
years from now, that $6,000won't even mean anything, but
the memory of how you gave birthwill be with you your entire
life, exactly.
But it's a cultural thing.
It's hard to break out of that.
It's kind of like a lot of mycolleagues who are in internal
medicine and one of my bestfriends.
He's an internist, he's anintensivist.
(42:04):
He takes care of really sickpeople in the ICU.
He's semi-retired now but hedid that for 35, 40 years.
We talk sometimes about medicalstuff and he knows more about
it than I do.
But I follow Del Bigtree, Ifollow the highway or I follow,
I look into things all the timeand he thinks that every person
(42:25):
over 40 should probably be on astat.
You know what a statin is.
Speaker 1 (42:32):
Tell me more.
Speaker 2 (42:34):
Oh, it's a cholesterol-lowering drug.
Speaker 3 (42:35):
Okay, okay, oh wow.
Yeah, everyone should be on whothinks this Because it's the
greatest thing ever.
Speaker 2 (42:42):
But there's a lot of data that says it isn't true.
But that's the culture inmedicine is to immediately give
a prescription for somethingrather than say you know what.
You need to change your diet.
You need to lose 30 diet.
You need to lose 30 pounds.
You need to start exercising.
Then come back.
We'll recheck everything, butno, because we have a
(43:04):
pharmaceutical culture as well.
Speaker 1 (43:06):
Right, absolutely, absolutely.
And there's another money pitthat we could.
Speaker 2 (43:10):
And it's much easier.
Doctors don't make more moneywriting you a prescription but
they can get you in and out ofthe office faster.
And they're taught and they'retold by the drug reps who come
to our office that this is thebest thing since sliced bread
and I'm just picking on statins.
There's a lot of parallelsright now out there that we
(43:33):
could think about that, getinjected into your arm, but we
won't even talk, we won't gothere.
That we could think about that,get injected into your arm, but
we won't even talk.
We don't want to get censoredor anything like that, but, um,
but that's what they do and it'syou know.
It's the same thing inobstetrics.
A woman walks in at 10 weeksfor her first prenatal visit.
Why does the doctor say to heryou know, honey, you're over 35.
Um, you know, likelihood thatwe'll probably have to start
(43:55):
testing your baby later onbecause your placenta might get
old.
Or you know, you're only fivefoot six and your husband's six
foot five.
There's no way that baby'sgoing to fit through your pelvis
.
And they plant these seeds ofdoubt and all they're doing is
they're projecting their ownanxieties and own fears.
It must be, you know.
Quite frankly, I don't thinkthey're aware of it because of
cognitive dissonance, but Ithink it must be awful yeah To
(44:19):
go to work every day.
Speaker 1 (44:21):
To be nervous yeah.
Speaker 2 (44:22):
To be scared, you have to live that way, I would
totally agree with that.
Speaker 1 (44:27):
My midwife sent me to have my scar checked when I was
35 weeks to see you know, justto make sure my C-section scar
had healed from my previousbirth, and the doctor that I
spoke to after, by the way, myscar was healed, everything was
good.
She had so much fear inside ofher because she experienced she
(44:48):
saw someone's uterus rupture.
Now I don't know if this personwas on Pitocin or whatever.
I don't know the scenariosurrounding this.
Speaker 2 (44:56):
It happens, it can happen.
It's something that can justhappen.
Speaker 1 (45:00):
Sure, I don't know what the circumstance was, but
this happened to her one time,one time.
She's been a doctor for 20years.
This happened to her once andshe was using that scenario that
happened to her to try to scareme and I thought this is crazy,
like this happened to you once.
You've seen thousands of womenand but, like you're saying, it
(45:25):
must be very hard to live inthat that you're projecting your
own fears from an experiencethat you went through.
You know it'd be like if I gotinto a really bad car accident
and then I was like don't drive,you could get in a really bad
accident.
Speaker 2 (45:41):
Well, there are some people that have PTSD and don't
drive again.
That's true, but they shouldn'tbecome taxi drivers.
Speaker 1 (45:48):
They probably won't.
Speaker 2 (45:51):
So you know, if an OB is that traumatized by
something like that, they maybeshould consider giving up ob,
doing just kind of I mean youcan't really quit, you've got so
much invested in yourprofession and I mean I totally
empathize with that.
Speaker 3 (46:05):
But maybe you should be not doing ob anymore, sure,
maybe you should just dogynecology, gynecologic surgery,
sub-specialized in somethingwhere you don't have to deliver
babies yeah it kind of seemslike it's all I I guess I
shouldn't generalize, but a lotof it is fear based because I
know that's what I experiencedas well of, oh, your baby's
(46:26):
breach, so we need to schedule ac-section.
And it's like, oh well, likewhat would?
Well, you'll put your baby atrisk if, if you, if we don't do
this, and it's like okay, wellthen, I didn't ask these
questions at the time, but now Ihave what are the risks?
What is the percentage?
(46:46):
What is the ratio of riskingthe baby from a vaginal breach
delivery versus a C-section?
And this is what's so greatabout organizations like Breach
Without Borders that are puttingthese statistics out there and
putting their research forwardthat it's not as risky as the
(47:07):
doctor that's sitting in frontof you in your OBGYN office is
making it seem.
And maybe that's all becausethat's all they know.
They only read that one study.
Speaker 2 (47:20):
So I have a story for Dr.
They probably didn't even readthe study.
Go ahead.
Speaker 1 (47:24):
I have a story for you, dr Stu, that relates to
this, and then I think you canreact to both of us.
So when I was having my first,I put together a birth plan
because I thought that a birthplan meant that they would
actually follow it.
Little did I know it doesn'tmean anything, but I go to the
OB's office with the birth planprior to the birth, you know,
(47:46):
just to go over it and she readsthrough it and she goes okay,
yeah, this looks okay, butthere's one thing that you
really need to reconsider.
I had on there that I did notwant them to administer vitamin
K and she said you need tochange this.
You really need to get thevitamin K.
(48:08):
And I said why?
And she said, well, becauseyour baby could die.
And I said, well, why would mybaby die?
She said, well, if there wassome sort of trauma, like if you
got into a car accident whenyou were pregnant, or if there
was a trauma when the baby wasborn.
The blood is too thin and ifthey don't have it, then they
(48:32):
could die.
And I said how many babies havedied in your practice from not
getting vitamin K?
And she goes, uh, and was soflustered and then got the heck
out of there and it just kind ofcircles back to this whole, you
(48:53):
know fear-based type ofconversation and when you ask
the questions, she didn't knowhow to answer that question.
All she knew is she's supposedto do this.
This is a box that they check.
She didn't know how tothoroughly communicate about
this particular area.
Speaker 2 (49:09):
Anyway, they're just regurgitating information that
they were once told they don'tagain.
This is well, maybe it is meantto be insulting in some way.
They don't know anything.
When they say something isrisky to everybody listening,
(49:29):
that doesn't mean anything.
The word risky doesn't meananything unless you know what
the denominator is, unless youknow well what the alternatives
are and what the risks of thosealternatives are.
And they don't know.
They say words like risky, oryou know lowish fluid, or you
(49:51):
know large baby.
They say these things to getyou to do, to funnel you down
the path, to get you to do whatthey want you to do.
And I'll give you an example ofthe vitamin K thing that you
brought up just a second ago.
The instance of late-onsetvitamin K-dependent bleeding,
which is what they're worriedabout, has nothing to do with
the baby in utero in a caraccident or anything like that.
I don't know what that even hasanything to do with it.
(50:20):
Right, wasn't that a fun story.
You don't give it until thebaby is out, but the risk of
vitamin K-dependent bleeding isabout six per 100,000, which, if
you do it now, is about one in16,500.
So what you should tell a womanis if you don't get vitamin K,
your baby has about a 1 in16,500 chance of having this
very serious problem ofinternally bleeding.
Now, 1 in 16,000 is essentiallyzero.
(50:43):
If you divide it out andmultiply it by 100, you're going
to find it's like 0, 0, 1% orsomething like that.
So it's a very small number.
But yet if you give vitamin K,it drops to about one or two in
100,000, which is also a verysmall number.
So you're scaring people.
(51:05):
You're scaring 15,999 peopleinto getting vitamin K to save
one person.
That may be your decision ofwhat your risk benefit
evaluation is.
Your assessment is, but it'snot your assessment that matters
.
Sure, it's the woman'sassessment and the family's
assessment that matters.
Speaker 1 (51:26):
It is, and not for nothing.
They don't share those insertson the risks of getting vitamin
K, the risks associated withhaving that.
Speaker 2 (51:40):
No, they don't.
They don't talk about in thecase of C-section for breech.
I'm sure they didn't tell youabout the risks of C-section.
Speaker 1 (51:47):
Oh, of course not.
And they don't tell you therisks of repeat C-section either
.
Speaker 2 (51:51):
No, yeah, or the risks to your future babies or
the possibility of abnormalplacentation in future
pregnancies.
No, it's the default positionand this is a problem.
And again, it comes from fear,as you said, rachel, but it also
comes from an idea that whatwe're taught in residency
program is we want to controleverything.
(52:11):
And, by the way, when you wantto control everything in a world
that's full of entropy andchaos, it only makes it worse
because you can't.
And so all these things thatthe medical model does is purely
to try to control the outcome,because again and I'm not going
(52:34):
to wax religiously orphilosophical here, I'm not an
expert in those things, but youknow, it's that thing that says
that there's more to the thanjust the destination, it's the
journey too, and they don't careabout the journey.
One of my sayings that peoplecome to my seminar knows all
that matters to the medicalmodel is a live baby in the
(52:54):
bassinet and how it gets thereis not their concern.
And what happens to that babyand that mother and that
mother's future babies is nottheir concern.
It sounds harsh, but think ofit like that.
When you go to the hospital,that is their concern.
Now you may have a greatrelationship with your doctor
(53:14):
and that's great, but there arevery few doctors who take call
for themselves all the time.
So if you're a doctor's in acall group of five other people
and you go into labor, you onlyhave a one in five chance that
the person that you maderelationship with is actually
coming, sure.
So the system again is it?
It's run on a on a shiftmentality, but this is one thing
(53:36):
where it's not like an er.
This is.
This is a very personable thingand it's not.
You know it's.
It's the medical model treatsit as a medical issue.
It's not a medical issue untilit becomes one.
Yeah, definitely most of thetime it doesn't become one, so
don't we gotta stop treating itlike this is a medical problem?
(53:59):
Your body is designed to thatto deliver a baby, to grow a
baby and deliver a baby.
Speaker 1 (54:04):
As you've been hearing, we have been having a
fantastic time talking to Dr Stu, so much, in fact, that we
continued this conversation.
So be sure to tune in next weekfor the continuation of our
interview with Dr Stu.
Thank you so much for listeningand tuning in and for being on
(54:25):
this journey with us.
If you'd like to follow alongoutside the podcast, be sure to
join the mission on Instagramand Facebook at the Radiant
Mission.
You can also find Dr Stu atBirthing Instincts and, of
course, you can find thispodcast in video format on
YouTube as well.
And today we will be closingwith Ecclesiastes 11.5.
(54:47):
As you do not know the path ofthe wind or how the body is
formed in a mother's womb, soyou cannot understand the work
of God, the maker of all things.
Wishing you a radiant week andwe'll see you next time.
Hello and welcome to the Radiant Mission podcast.
My name is Rebecca Toomey andwe are on a mission to encourage
and inspire you as you'renavigating through your life and
with your relationship withChrist.
We are doing something specialtoday.
We are recasting one, twoactually not just one two of our
(00:54):
most popular episodes ever.
Those are the episodes that wedid with Dr Stu.
It has now been two years sincethose episodes were released
and they continue to be our mostlistened to, most downloaded
episodes.
So here we are today recastingthem.
(01:15):
Now, if you hear a little bitof a funny noise right now, I
have my little newborn on my lapand she's just making all of
the baby sounds here today, butthis is the birth episode to
(01:35):
listen to for anyone that ispregnant or planning to get
pregnant.
If you know someone that willbe pregnant one day, dr Stu's
episodes are the ones to listento.
So we're recasting, let's go.
(01:55):
Hello and welcome to the RadiantMission podcast.
My name is Rebecca Toomey and Iam here with my amazing co-host
and sister, rachel Smith.
Hey guys, we are on a missionto encourage and inspire others
as they're navigating throughthis crazy life and with their
relationship with Christ.
Today, we have a very specialguest with us today.
(02:18):
His name is Stuart Fleshbein Ihope I pronounced that, okay MD
but he's also known as Dr Stu,so I'm going to go with that.
He is a community-basedpracticing obstetrician and an
associate of the AmericanCollege of Obstetrics and
Gynecology.
He is a published author of thebook Fearless Pregnancy Wisdom
(02:42):
and Reassurance from a Doctor, aMidwife and a Mom, and
peer-reviewed papers Home Birthwith an Obstetrician, a series
of 135 out-of-hospital birthsand breach-at-home outcomes of
60 breach and 109 cephalicplanned home births and birth
(03:03):
center births.
So Dr Stu has spent 24 yearsassisting women with hospital
birthing and for the last 12, hehas been a home birth
obstetrician who works directlywith midwives.
If you want to check out moreabout Dr Stu, his website is
birthinginstinctscom and rightnow Dr Stu travels around the
(03:25):
world as a lecturer and anadvocate for reteaching, breach
and twin birth, respect for thenormalcy of birth and honoring
informed consent.
You can follow him on Instagramat birthinginstincts and at the
birthinginstincts podcast withmidwife Bliss Young on your
smartphone app, and he offershope, reassurance and safe
(03:47):
evidence support choices reallyfor women who understand
pregnancy is a normal bodilyfunction not to be feared,
simply desire common sense andwho cannot find a supportive
practitioner for VBAC, twin orbreach deliveries.
So, dr Stu, thank you so muchfor being here with us today.
Speaker 2 (04:10):
Thank both of you for having me on.
It's like I said earlier it'san opportunity for me to reach
an audience that I might notnormally get to.
So I'm on a mission, like youguys are, to sort of normalize
this beautiful thing that we'veall been through, because all of
us were, at one point, born.
Speaker 1 (04:31):
Yeah, that is true, we were, and we all have to be
born.
You know, everybody else that'scoming.
Speaker 2 (04:39):
And we don't do it very well.
So, there's such a better wayto do things.
And so again like I said, I'mjust happy to be here.
I'll just leave it at that,thank you, thank you, we love
your story.
Speaker 1 (04:52):
You know, rachel and I both have been following you
on Instagram for a while andtuned into your podcast, and
that was really what sparked usto say, hey, I wonder if Dr Stu
would come talk to us.
We love talking birth.
I sent you way too muchinformation about what I went
through and what she wentthrough, so we're passionate
(05:12):
about it.
I had my first home birth thisyear after having a C-section
for my first, and my sister hashad two C-sections and now she's
having a well, what do we callthat?
A birthing center, home birthwith a midwife, and so we're all
about birth.
You know that and we love ithere.
But we love your story and howyou were practicing as an
(05:34):
in-hospital OB, but then youshifted to home birth.
What really prompted thatchange for you?
Speaker 2 (05:42):
Well, there was no epiphany, it wasn't something
that just occurred.
Okay, it was a process of beingan inquisitive, curious person
who always had a little problemwith authority.
You know, I respect honest andyou know trustworthy authority,
(06:03):
but I don't respect stupidauthority, sure.
So I would always questionthings.
I mean, even as a kid orgrowing up through high school
and college and medical school,I would always sort of be the
person that's asking well, whyare we doing that?
And what happens in residencyand medical school?
You get beat down and you stopasking because you just try to
(06:25):
get through your days.
So when I came out, I was verymedicalized.
I thought that the obstetricalmodel was the only way to do
things, that I thought that Iwas the sharpest tack in the box
and that anybody who did thingsdifferently was crazy.
Anybody who did thingsdifferently was crazy.
You know I did all the thingsthat now I look back on and I
(06:47):
say, jesus, I can't believe thatI did all those things.
And you know simple things likeimmediate cord clamping or
taking the baby over to thewarmer, away from the mother, or
giving the mother an injectionof something to dry up her
supply of breast milk, orwearing a hazmat suit to catch a
baby or making all womendeliver in lithotomy position
flat on their back and notthinking there's anything wrong
(07:09):
with inductions and epiduralsand pitocin and C-sections.
That's what you're trained with.
If all you know is Greek, thenyou only speak Greek.
And so I came out speaking onlyGreek, out speaking only Greek,
and as part of my building of apractice.
It was a different era Back inthe early 80s.
(07:34):
You didn't just come out andget a job working for a big HMO
like Kaiser or something likethat.
You built your own practice andnow doctors essentially just
come out and get a job.
They're just a cog in the wheel, they're employees.
But in those days you weren't.
So I hustled to build practiceand one of the things I did
besides cover emergency roomsand assist other guys in surgery
and all that stuff was and workat free clinics.
I was a medical director ofthree free clinics in Los
(07:54):
Angeles.
I hustled a lot.
I was approached by some localmidwives and asked to take their
transports from home and I waslooking for revenue stream and I
didn't think that midwifery wasa good idea.
I didn't know anything about it.
I've never been to a home birth, so I of course I judged it,
like like many of our colleaguesdo.
(08:14):
You know it must be bad, causeI've never been to one, so I
don't know anything about it.
So let's just judge it.
But I did it because I couldmake revenue off of that.
But when the women would comein and they would get put in a
bed and they get their epiduraland they get their Pitocin and
we're trying to make the laborat stalled out at home.
These were generallynon-emergent transports, which
(08:35):
are what most transports are.
I'd have time to sit in alounge with the midwife and we'd
be sitting there talking and Ihave a composite memory.
I don't have any specificmemories of any of those events,
but I began to hear differentways of doing things and I began
to see that the clients theywere bringing in were not
ill-informed.
They were actually far betterinformed than anybody in my own
(08:55):
practice and a lot of them werehighly professional.
They were intelligent people.
They weren't just hippies orpeople who are counterculture.
They were mainstream culture,lawyers, hollywood people,
medicalized medical people.
They had all chosen a differentpath and so I was curious.
(09:15):
I was having intellectualcuriosity and I'm a bit OCD, so
I, you know, I started to lookinto things and I began to see
that much of what I knew waswrong to things.
And I began to see that much ofwhat I knew was wrong and did
not apply to women who don'thave a problem.
I mean, I was like most doctorscoming out of residency, we're
pretty well trained to take careof somebody with a problem.
But what we do is we start tosee everybody has a problem.
(09:37):
We start to make problems wherethere aren't problems because
that's our model.
So I was an expert at about 15%of pregnant women and I was
taking care of a hundred percent.
So 85% of the women I'm takingcare of I'm really not an expert
in, because what they need ismidwifery care.
What they need is somebodywho's going to give them time
and keep their hands off of themand not over-test them and not
(09:59):
project fear upon them, to helpthem realize that this is a
normal function of your body,like breathing, like digestion.
It does it.
Whether you want it to or not.
You're going to grow that babyinside of you and at some point
you're going to go into laborand there's not a damn thing you
can do about it.
It's going to happen.
(10:19):
So that's how I got in.
So after about 10 years inprivate practice I I started a
collaborative midwifery practicewith two certified nurse
midwives in a hospital settingstill, and for 15 years or so we
had a really great practice.
We had low intervention rates.
We had a C-section rate overallof about 7%.
(10:40):
The next group that took careof the similar cohort of women.
Their C-section rate was in themid 20% at that hospital.
So we were three to four timesless likely to have a C-section
in our practice than theirpractice, and it was simply
because I followed the midwiferymodel of care, where anything
that was normal I never reallyeven took care of, unless I was
filling in or covering for amidwife on vacation.
(11:01):
But the midwives took care ofall the normal stuff.
The midwives did the well womenexams, they did the pap smears,
they did all that sort of stuffthat you would do, prescribe
the birth control, and I wouldcome in when, say, a woman had
an abnormal pap smear or a womanhad a cyst on her ovary or a
woman came in with an ectopicpregnancy or she ended up with a
breech baby or twins orpreeclampsia or some other
(11:25):
problem, then I would step inand so it was the best of both
worlds, because midwives areactually better at taking care
of pregnant women than doctorsare, because they're trained to
take care of normal pregnantwomen and we're not.
Speaker 3 (11:41):
We think we are, but we're not, was this in Southern
California, where you had yourpractice?
Speaker 2 (11:45):
Yeah, oh yeah.
I did my residency atCedars-Sinai in Los Angeles and
I had the good fortune of thoseyears.
Cedars had a collaborativerelationship with LA County USC,
which at that point in time wasthe busiest hospital in the
country.
It's not that anymore.
They were doing about 22,000births a year there, which is
about 65 babies a day.
So if you break that down 65babies a day and I'm there for
(12:12):
three to four months every otherday, so that's like 60 days I'm
there you can see how manybirths are coming through across
our plate.
Speaker 1 (12:18):
And if you have 65 babies a day, you're probably
having at least two breeches andtwo sets of twins every day
because, Because it's about 3%breach and 3% twin and you were
delivering breach the whole time, or not, until you got involved
with the midwives.
Speaker 2 (12:35):
Oh no, I learned to do breach in residency.
It was just considered a normalvariation, so you learned.
Speaker 1 (12:40):
In fact in the 80s they were teaching it because
it's not something that reallyis taught to in medical school
today.
Speaker 2 (12:47):
It was already fading in the 80s.
It was already fading in the80s and 90s.
There were papers coming out.
You know what I would callconfirmation bias papers.
They basically said we need apaper so that we can do
C-sections.
And suddenly there were paperscoming out saying that C-section
is safer for breach than not,were papers coming out saying
that c-section is safer forbreach than not?
(13:07):
And there was a sentinel paperthat came out in 2020, 2000
excuse me called the turnbridgetrial, which got so much
publicity and it was really abad paper and had a lot of flaws
in it and within two years itwas sort of mostly retracted and
yet the damage that it did wasalready there to stop all
training of breach deliveryaround the world.
(13:27):
Because they just jumped on it?
Because, again, of confirmationbias.
Because since that time therehave been numerous papers much
larger, with much better controlfor their study come out saying
that there's really not a lotof difference between properly
selected breach at term,vaginally or by cesarean, and
(13:48):
it's better for the baby andbetter for the mother and for
the mother's future babies todeliver vaginally.
But it doesn't matter, becauseif they're not, if you don't
learn how to do it when you'rein training, you're never going
to come out and do it.
You can take a course like mycourse or Rick's and David's
breach without borders course,and that's fine.
You'll know, maybe, what to do.
(14:09):
But if your partners don't wantyou doing it, if your employer
doesn't want you doing it, ifthe hospital doesn't want it,
doesn't matter, you're not goingto do it.
So if your malpracticeinsurance is going to say, yeah,
you can do it, but we're goingto charge you more on your
premium, there's no incentive.
All the incentives are to notdo what's necessarily right for
the women that we're supposed tobe taking care of.
Speaker 3 (14:31):
Yeah, I wish I knew about you and your practice and
your work with my first twopregnancies, because my first I
delivered in Los Angeles.
He was breech automaticC-section, although I did
attempt a version with him thatwas unsuccessful.
My second was in Orange County.
(14:51):
He was breached and that was ata teaching hospital and that
was a really traumatic C-sectionfor me because no one told me
that residents and med studentswere going to be in my birth and
so I'm just in an OR with a tonof people that I don't even
(15:12):
know.
My doctor didn't even show upfor it.
The whole experience was what Iwalked away from that with not
only birth trauma from thatC-section but also very
disturbed to actually experiencehow doctors are being trained
in birth today, because theyliterally treated me like I was
(15:34):
not a human, like I was theirtheir lesson for that day, that
I was like a test subject, thatI was like a test subject and
and it was.
This is actually like why Ilike I have so much respect for
you and not only like what youdid in your, in your practice,
(15:54):
but what you're doing incontinuing education today,
because you're you're impactingwomen like me who were affected
negatively by the medical systemin this way and who are seeking
out something else, you know,seeking out a better, a better
birth experience.
You know that is our right.
It's our right to have that.
Speaker 2 (16:16):
So, yeah, the educated the educated pregnant
woman is is the bane of theexistence of the current medical
model, Because they don't wantpeople to ask questions.
And again, when I say thesethings, we're talking about the
nebulous they.
Okay, your individual doctor isprobably a really good person
(16:39):
and he or she probably loves herkids and is a good family
person and all that stuff andwants to do good, but they're in
a system that is not designedto allow them the individuality.
Everything is done on analgorithm.
And when you come in and yousay you know, I don't think I
(16:59):
want the genetic screening, youknow I don't think I want
vitamin K.
You know I don't think I want a20-week ultrasound.
You know I don't want to beinduced at 39 weeks or 40 weeks
or 41 weeks, and no, my babyisn't too big.
Or no, I don't think I want anIV, or no, I don't think I'm
going to lay flat on my back.
(17:23):
You cause them so much turmoilinside because they're on a
hamster wheel and they don'tknow what to do and what you
experienced, Rachel, beingtreated as sort of, you know,
almost like veterinary medicine,where you're not really talking
to the dog.
Speaker 1 (17:44):
Yeah, that is what it was like.
Speaker 2 (17:46):
Yeah.
Speaker 1 (17:47):
On the other side of that.
Speaker 3 (17:49):
I was not an awake human being.
I was like a lab rat.
Speaker 2 (17:54):
Yeah, it violates every tenet of medical ethics,
but we can get to that maybefurther down the conversation.
But when they do that, theydon't know what to do with you
if you step out of line on thelines that they've drawn and the
lines that they've drawn havenothing to do necessarily with
reality or evidence-based.
You know, I always hate theterm evidence-based medicine
(18:16):
because it makes it sound likeit's good evidence.
But evidence-based medicine isonly as good as the evidence
you're using to claim that youhave evidence-based.
And the same thing goes forstandard of care.
You know what's the standard ofcare?
Our hospital doesn't do breachdeliveries.
Therefore, if you come in hereand do a breach delivery, you're
breaching the standard of care.
Well, yeah, but that's not whatthe standard of care is.
(18:38):
It's defined by whoever has thepower, defines what the
standard of care is, defineswhat the standard of care is.
So these terms are thrown outthere and the use of language is
something to really get us totoe the line.
And so what happens is thatthey do these things and they
don't know what to do with you.
And there's an analogy that Ilove, because everybody's seen
(19:00):
the movie, I think, A Bug's Life.
I hope everybody's seen A Bug'sLife.
That's a the movie.
Speaker 3 (19:04):
I think A Bug's Life.
Speaker 2 (19:05):
I hope everybody's seen A Bug's Life.
That's a great movie.
Yeah, pixar used to make reallygreat movies that didn't have
any agendas in them.
Oh, yeah, yeah, there's a sceneat the beginning where they're
bringing an offering to the bigpile for the grasshoppers and
the ants are all in a row.
And you know how ants followeach other.
They always follow each other.
If you've ants in your kitchen,you know what I'm talking about
.
Um, and this leaf falls off thetree and it falls in front of
(19:28):
the ants in the line and theants behind the leaf they're in
panic, they're in full-blownpanic.
We do, what do we do?
What do we do in the one antgets up on a rock and I'm
paraphrasing every sayssomething like calm down, we'll
go around the leaf, and theyfigure it out.
Okay, yet in the hospital, ifyou, if you say, listen, I don't
(19:50):
want you to cut the cord, butwe have to take the baby to the
warmer.
Well, why do you have to takethe baby to the warmer?
We have to check the baby out.
Well, the baby's on my chestand he's just fine.
But but then we, you know, Imean we have to dry it off.
Well, why do you have to dry it.
I mean, I'm just saying, and Iand I'm, and again, these are
good people, these nurses thatdo this, but if they don't do it
(20:12):
, somebody on monday morning isgoing to yell at them if they
don't check every box and ifthey don't document that they
took.
They said I, we, that theyoffered you this and they
offered you that.
Speaker 1 (20:25):
That's a very good point.
I work in business and inbusiness it's all about process.
You create the process.
It's a good process.
You follow it.
When you deviate from theprocess and things go wrong, you
got to go back to the process.
You can edit the process.
But that's what I'm hearingfrom you is, people are so used
(20:45):
to being inside that processthat when you go out of it or
when you question it, it's likeno, no, no, this is the process,
this is what's working, butunfortunately it's not working.
It might be working for thehospital but it's not working
for the mothers that are givingbirth, it's not working for the
families.
(21:05):
I mean the amount of birthtrauma that comes out of the
traditional system.
I mean there's entire podcastsabout this.
I was on one and it's just.
It's something that has becomevery interesting to me because I
see a huge awakening happeningright now that women are saying
(21:25):
wait a second, this isn't right,and that's when they're
starting to pursue and look intohome birth.
But then we're so programmedabout going to the hospital with
an emergency and we've been soprogrammed that birth is one of
those emergencies.
That then that's the bigquestion that I get.
It's actually one of thequestions I have for you on my
(21:46):
list, because I have a number offriends right now that are
pregnant and they're consideringhaving a home birth.
But that's their one questionthat they always ask me is well,
what if there's an emergency?
What if something goes wrong?
And of course, my question iswhat's going to go wrong?
What do you think is going togo wrong?
(22:08):
But I'd love to hear from youhow you respond to that question
when people say well, if I havea home birth, what happens if
something goes wrong?
Speaker 2 (22:20):
Well, a couple of things.
First of all, there's adocumentary coming out that I
just watched today becausesomebody sent it to me called
Birth Time.
It's from Australia and in thatthing they say one third of all
the women in Australia thatwere surveyed complain of birth
trauma.
And I'm surprised it's that low.
Speaker 1 (22:41):
Yeah, a third is even still.
Speaker 2 (22:42):
I would have thought it would have been higher, but
anyway, we can talk a little bitabout the topic that you just
brought up, which is what ifsomething goes wrong?
I had another point to make,but my brain gets 10 feet in
front of my mouth.
It was my Greek example.
There's so much fear involvedin birth in the United States
(23:05):
and other Western countriesbecause women fear birth, and
the reason that women fear birthis because the medical model
has projected their fear ontothe women of our country.
Speaker 3 (23:14):
Amen and they fear birth.
Speaker 2 (23:15):
So when people ask that question, it's a reasonable
question to ask, but it showsthey really have no idea what
normal mammalian birth is like.
So before I answer the whathappens if something goes wrong
question, I just want to digressa little bit to the mammalian
birth issue and talk about howother mammals give birth.
And the human female is amammal with the same innate
(23:41):
natural processes that go on thesame hormones, the same natural
processes that go on the samehormones, the same needs for
birth.
And, as Sarah Buckley likes tosay, birth should be quiet, safe
and unobserved.
And if you ever watch any othermammal when they're in labor,
where do they go?
They go off to a place wherethey feel safe and quiet.
They don't go to a noisy streetcorner.
They don't go to the middle ofyour living room with the Super
(24:03):
Bowl on TV.
They go off someplace quiet.
And who goes with them?
No one, absolutely nobody,right.
And if they're hungry they dosomething really amazing they
actually eat.
And if they're thirsty, theydrink.
And if your dog was in labor,you would never, ever think of
taking the food and the wateroff the floor and putting it up
on the shelf.
You would never do that.
Yet we do that to human femaleswhen they come in and labor.
(24:26):
You would never have your dogsit still in one place.
You would never duct tape yourdog to the floor so it couldn't
move.
You would never do that.
And if the little kids wererunning around the house and
they happened to run into theroom where the cat or the dog is
in labor, what do you say tothe little kids?
Leave the dog alone, okay.
(24:49):
And when the babies come out,nobody rushes in to cut the cord
and nobody ever separates thebaby from its mother.
Speaker 1 (24:57):
You're not putting your hands in there.
That dog had just had puppies,no way.
Speaker 2 (25:00):
It's never done Like as my co-host likes to say.
You know, no one ever does avat exam on a tiger at seven
centimeters.
Speaker 1 (25:10):
That's a good one, I like that.
Speaker 2 (25:11):
Yeah Well, you try it see what happens.
So so, but what we do to thehuman female is pretty much
everything that's done.
When you go to the hospital isantithetical to nature's design.
You have to come in and youhave to sign paperwork Talks
about death and consent formsabout surgery and then you have
(25:34):
to go in the bathroom and youhave to change into a hospital
gown.
Why are you changing into ahospital gown?
What does that make you feellike?
Speaker 3 (25:42):
A patient.
Speaker 2 (25:44):
A patient right, and why can't you wear your own
jammies?
Speaker 3 (25:47):
or nothing.
Speaker 2 (25:50):
And you have to pee in a cup.
And I always ask the questionwhy do you pee in a cup?
You're not complaining ofurinary tract infection symptoms
, you're not doing anything.
My assessment is that somebodywill say, well, we want to check
for protein or whatever else.
It's like no, no, you want todo it because it's a billable
charge and you can bill for theurinalysis.
(26:13):
There's no reason to pee in acup.
And then you stick an IV in themand then you draw blood on them
.
Why are we drawing blood onsomebody coming in the hospital?
We don't do it at home.
Don't do it to your dog or yourhorse when it's in labor.
Why do we do it?
Oh, we have to have a clot inthe lab in case you bleed.
We can type and cross yourblood faster.
It's like well, what happens ifI came in with a gunshot wound
or a car accident, you'll findme some blood.
(26:35):
If I need it that fast, you'llfind it for me.
And then we strap you down andput monitors on, which have been
shown to have really no effectother than raising the c-section
rate.
We don't let you eat anything.
If you're lucky, you can have apopsicle, and you're constantly
being interrupted.
Uh, you're interrupted for yourblood pressure cuff machine
going off like if you'reblushing.
(26:56):
If you come in with a normalblood pressure, what are the
odds that during labor, ifyou're left unfettered, that the
blood pressure is going tosignificantly drop or rise?
And yet hospitals have aprotocol that nurses must take
your blood pressure every hour,every two hours.
So anytime you do that you'reinterrupting.
So in nature, what happens whena mammal is interrupted?
(27:16):
What happens when there's aforest fire?
What happens when the littlekids run in the room?
What happens when there's apredator approaching the mammal,
puts out adrenaline.
Adrenaline stops thecontractions.
The mammal gets up and runsaway, and only when it feels
safe does labor ensue, and thatway nature ensures the best
chance of survival.
So the same thing.
So when we take a woman fromher home and we make them get in
(27:40):
a car and drive to the hospitaland go through all that I just
described, it's no surprise thatshe was contracting every three
minutes at home and now she'scontracting every eight minutes
because she's nervous.
Now she's put out adrenalineand she's being interrupted.
And sometimes, you know, thelabor continues, because nature
is amazing, but a lot of timesit doesn't.
And so now they check yourcervix with an unnecessary
(28:01):
vascular exam and say you'rethree centimeters.
Oh, you're three centimeters,you're 40 weeks.
We might as well keep you.
You know why don't we just goahead and break your bag of
waters and then you start thatwhole cascade of interventions.
And during that cascade ofinterventions I'm getting to
your answer to that otherquestion.
Speaker 1 (28:16):
You're right on, I'm following.
Speaker 2 (28:19):
You can see where I'm going with this.
So then they rupture yourmembranes, but nothing happens.
So then they say, let's startsome Pitocin.
So then they start Pitocin,which then shuts off your own
oxytocin production and thecontractions get pretty intense.
And you say, can I have anepidural?
Because you're told thatepidurals are candy and there's
nothing wrong with getting anepidural, because why would
(28:41):
anybody want to have their toothpulled without Novocaine?
That's the analogy they'll use,as if a tooth and labor are the
same thing.
Labor is a complex hormonalsymphony going on between you
and your baby and the epiduralshuts it off immediately because
now you're not communicating,because you're not in discomfort
anymore, you're not sendingyour baby signals to help your
baby through its labor.
(29:02):
So then the baby now you'renumb and you're hyperstimulated
because your contractions aretoo common, too frequent and the
baby's heart rate doesn't likeit anymore.
And suddenly the baby's got afetal tachycardia, which is
where the heart rate goes up, orit has a D cells where it goes
down.
And doctor comes in and checksyou and you're only six
centimeters and they say, hmm,baby's not tolerating labor, I
(29:22):
think we need to do a C-section.
Thank God you're in thehospital, because what would you
have done if you'd been at home?
Not realizing what they justsaid is one of the stupidest
things that they can say.
Yes, things can go wrong athome.
Things go wrong in the hospitalall the time, but things can go
wrong at home.
But if you leave nature to itsown accord, rarely does it go
(29:43):
wrong suddenly and awell-trained midwife and
educated parents can often seeit coming way ahead of time,
when there's plenty of time tosay you know, your labor's
stolen out or your baby's heartrate's rising a little bit.
Oh, you spiked a fever, maybeit's time to go to the hospital.
Those are not emergencies.
Those are not 911 ambulancecalls.
(30:04):
Those are pack your bag, get inthe car, drive to the, put a
check on the seat before you getin the car so you don't make a
mess and you drive to thehospital and you go in through
triage and then you go throughall those questions too.
It's obviously not an emergency.
Rarely when something reallybad happens at home, yeah, there
can be a problem with that, butthe likelihood of a cesarean
(30:25):
section, the likelihood of a badoutcome, the likelihood of a
newborn intensive care unitadmission is actually much
higher in the hospital, and whateverybody needs to understand,
including occasional trolls thatfollow me on Instagram, is that
no one guarantees a perfectoutcome.
(30:46):
There's no guarantee of aperfect outcome.
Once the sperm hits the egg,you know what.
There's no guarantee.
Speaker 1 (30:52):
There's no guarantees in life, dr Stu.
I mean I must get out of thisthing alive.
Speaker 2 (30:56):
Well, death and taxes .
Death and taxes, oh yeah,you're right.
So that's why you know whenpeople say that and then they
say, well, how can you do abreech at home?
Or how can you do twins at home?
Well, in all honesty, when Ifirst started doing that at home
I actually was we made adocumentary called Heads Up the
Disappearing Art of BreechDelivery, and in there I say you
(31:17):
know, all things being equal,it would be safer for women to
have a breech baby in thehospital because you have all
the emergency things immediatelyavailable.
And that was early on in myhome birth career.
I wouldn't say the same thingnow.
I wouldn't say it's safer tohave your breech baby in the
hospital because you're going toend up in the hospital, they're
going to have a protocol forbreech and every woman's going
(31:39):
to have to follow the algorithmand you're going to have to be.
You're probably going to haveto have an epidural.
They may not activate it, butthey'll want you to have it just
in case and then you'll have tobe in the operating room to
deliver your baby just in case.
And all these things aredisruptive.
It's like get back to the thinkof how a mammal labors and
think of all the things we do todisrupt it, it's still amazing,
that's.
(32:00):
You know, 68% of women in theUnited States can still have a
vaginal delivery.
Yeah, 30,.
You know the C-section rate'sabout 30, 31% and 32%.
And, and you know, one or 2% ofwomen are having their babies
at home.
And if, if, we can all agreethat the maternity system United
States is broken and in theWestern countries, australia,
(32:22):
you know, europe is broken, it'snot because 1% or 2% of women
are having babies at home.
Speaker 1 (32:28):
No.
Speaker 2 (32:29):
It's broken because 99% of women are having babies
in a hospital system that isn'tdesigned to individualize care,
to respect autonomy anddecision-making, to give
informed consent.
You're a cog in a wheel of amachine that has to make money
to survive and the fiduciaryduty of the hospital is not to
(32:50):
you.
We need to understand that theydon't care about you Individual
people that work there.
Maybe they do, and of coursethe risk managers don't want
anything bad to happen, but theindividual person is lost there.
It's a system-wide thing and itneeds to be thrown out.
(33:11):
There was a great analogy inthat documentary I watched today
.
They talked about thefoundation being shaky and you
keep putting more scaffolding onthe foundation and if the
foundation is shaky, thescaffolding is just going to
collapse and we see it theydon't want to deliver breaches
(33:42):
as another opportunity to justc-section somebody, which is
another way for them to makequick money and not have to deal
with in all fairness, doctorsdon't make more money doing a
c-section, but they save timethey don't make more money.
The hospital makes more money,don't they hospitals do?
Speaker 1 (34:03):
but the doctor themselves.
Speaker 2 (34:04):
Here's a simple solution to that problem if the
insurance companies, thehospital makes more money don't
know, hospitals do, sure, butthe doctor themselves?
Yeah, here's a simple solutionto that problem If the insurance
companies you know I know thatthis sounds a little snarky, but
if insurance companies weren'tin cahoots with the hospitals,
the two lobbies getting togethersometime figuring how we can
manipulate things in Washingtonor Sacramento or wherever we are
they could lower the C-sectionrate immediately tomorrow by
(34:27):
simply just offering to pay moremoney for a vaginal delivery
and less money for a cesareansection.
Speaker 3 (34:33):
Interesting.
Yeah, it blows my mind.
After my second birth, the onethat I mentioned before, that
was in a teaching hospital, whenI got the bill that was charged
for my insurance it was $78,000.
And I'm like and that was morethan my first C-section that was
not at a teaching hospital, butI was like this is crazy, like
(34:55):
there, like this was like aeducational experience for all
these med students in there andthere was no you know like
financial incentive for me or myinsurance.
It was.
It's just insane how much theycharge for that surgery.
Speaker 2 (35:11):
Well, it's a game.
Billing is a game and anybodywho runs a medical practice
knows it's a game.
It's all about coding andeverything has to have a coding.
If it doesn't have a code, thenyou didn't do it.
So you fake, you make up codes,you make up things that you
didn't do and then what happensis the hospital knows that
they're contracted with theinsurance company and the
(35:31):
insurance company's got a cap onwhat they're going to pay them.
So they inflate the bill asmuch as possible to try to get
the maximum they can under theircontract with the insurance
company.
That's why an aspirin is $5 anda box of Kleenex is $12.
And I mean nobody.
We all know that that'sridiculous, but that is true.
(35:53):
And if people were to pay morescrutiny?
Now see, and the problem withthird-party pay?
We're going to go off on atangent here.
The problem with third-partypayers is they take away the
direct relationship and everytime you add a middleman to
something, you decrease quality,you make it more impersonal,
(36:16):
because you're not making thattransaction with the person
sitting across from you and theperson in the middle is
generally making the most money.
The people actually providingthe service make less.
In California they always talkabout oh, those greedy oil
companies are making so much ona gallon of gas.
Well, I read an article,several articles, and the oil
(36:37):
companies make maybe a nickel toa dime on a gallon of gas.
The state of California makes64 cents on every gallon of gas.
Right, because they put the taxon there.
The state of California ismaking six to 10 times as much
money per gallon of gas.
And then on the press theybadmouth those greedy oil
companies.
It's the same thing here.
When you have insurancecompanies that get in the middle
(36:59):
, then you're not negotiatingwith me and I'm at the mercy of
an insurance company who says ifI'm doing things that they
don't like, they can kick me offthe panel.
Speaker 3 (37:11):
Yeah.
Speaker 2 (37:11):
And if I have a practice that's got 30% Aetna
and 50% Blue Cross, I can'tafford to be kicked off Aetna or
Blue Cross because my marginsare really thin running a
practice, or running a hospitalfor that matter.
So, again, the individualpeople want to do the best that
(37:35):
they can, but the system doesn'treally allow it and in the end
run what happens is that thepatients suffer and the bigger
it gets.
And you know, and then thebigger it gets, there's no one
to complain to.
Yeah, tried to.
You know, when I, my Instagramaccount got hacked a couple
months ago, a month ago orwhatever, and I was at the mercy
.
There's nothing I could do.
(37:57):
The only way I got it back wassomebody I know, knows somebody
that works for Meta, and theygot it back for me.
That's helpful.
I emailed them every daythrough their service, every day
complaining about this, goteither an automated response or
no response whatsoever.
I had lots of my followers sendin.
(38:21):
This account got hacked, blah,blah, blah, nothing, nothing.
I found somebody who knewsomebody who knew somebody who
knew somebody.
Speaker 3 (38:30):
Yeah, to help you out .
I'm glad you got it back.
Speaker 2 (38:33):
Right, but if it was a small company, you know, if I
have an electrician come to myhouse and he screws up, it's
between me and him.
Speaker 3 (38:40):
Yeah.
Speaker 2 (38:41):
Okay.
So it's the same sort of thingin medicine.
If you go to a small,individual practitioner, you're
going to get better care.
I truly believe that, notnecessarily for something that's
really complicated.
Obviously, if you want to go tothe Mayo Clinic or Cedars-Sinai
or the Cleveland Clinic, yeah,when you've got something that's
really wrong with you, you wantto go to a big specialist.
But for individual healthcare,your daily needs and stuff like
(39:05):
that, you want to find a privateguy.
And what's happening, of course, is that governments and big
medicine are trying to squashthe private guy.
They're making it impossiblefor us to call in prescriptions,
they're making it impossiblefor us to run certain tests.
They say you have to have thissoftware in your office.
Well, if you have a hundredphysicians in your office, you
(39:26):
can afford that software it'sdivided between a hundred people
.
But if you're a solopractitioner and you have to
have this software, you can'tafford it, sure.
Speaker 1 (39:34):
Hey, speaking of money, this is something that I
read a lot about in.
I joined some home birth,assisted and unassisted type of
groups on Facebook when I wasplanning my home birth and there
would be a lot of moms thatwould come and say I really want
to have a home birth but Ican't afford it.
(39:57):
And what I can't afford it theymeant five, six, $7,000 for to
pay a midwife out of pocket wastoo much money for them.
But it was hard for me to evenlike know how to respond to this
, because in my mind I'mthinking don't pay for your
health insurance.
You know, just put the moneythat you would have put into a
health insurance policy that'sgoing to send you to this
hospital and use it towards yourmidwife, or you know, this is
(40:20):
worth it.
It's worth it at the end of theday five grand to have somebody
that is going to be supportiveof you at home and you're not
going to go through all thoseinterventions at the hospital.
They're going to cost you$78,000 to your insurance policy
.
I don't know it's aninteresting conversation that's
often had in these communitiesis we're so used to being in the
(40:45):
system, in the health insurancesystem, that we don't know how
to step back and say, instead ofputting money into this, I'll
put money into an account that Ican use to pay a midwife.
Speaker 2 (41:00):
Yeah, it's the culture we live in.
We have this third-party payersystem, this insurance, or it's
the culture we live in.
We have this third-party payersystem, this insurance, or
Medicare or Medicaid, and so wethink, well, if I'm sick, I
should be able to use myinsurance and we don't put a
value on the individual healthcare like that, and that's
(41:20):
something that people will haveto break out of if they can't,
because I'll tell you that the$6,000 that you spend on a
midwife might be a big burdenfor you.
So you put it on a credit cardor you borrow it from your
parents or, you know, you put a,have a ghost, a give, send go
account and raise the money orhave people who are going to
give you a baby shower.
Stop buying you stupid stuffthat you'll never use anyway and
just donate towards your homebirth fund, because two, three
(41:43):
years from now, that $6,000won't even mean anything, but
the memory of how you gave birthwill be with you your entire
life, exactly.
But it's a cultural thing.
It's hard to break out of that.
It's kind of like a lot of mycolleagues who are in internal
medicine and one of my bestfriends.
He's an internist, he's anintensivist.
(42:04):
He takes care of really sickpeople in the ICU.
He's semi-retired now but hedid that for 35, 40 years.
We talk sometimes about medicalstuff and he knows more about
it than I do.
But I follow Del Bigtree, Ifollow the highway or I follow,
I look into things all the timeand he thinks that every person
(42:25):
over 40 should probably be on astat.
You know what a statin is.
Speaker 1 (42:32):
Tell me more.
Speaker 2 (42:34):
Oh, it's a cholesterol-lowering drug.
Speaker 3 (42:35):
Okay, okay, oh wow.
Yeah, everyone should be on whothinks this Because it's the
greatest thing ever.
Speaker 2 (42:42):
But there's a lot of data that says it isn't true.
But that's the culture inmedicine is to immediately give
a prescription for somethingrather than say you know what.
You need to change your diet.
You need to lose 30 diet.
You need to lose 30 pounds.
You need to start exercising.
Then come back.
We'll recheck everything, butno, because we have a
(43:04):
pharmaceutical culture as well.
Speaker 1 (43:06):
Right, absolutely, absolutely.
And there's another money pitthat we could.
Speaker 2 (43:10):
And it's much easier.
Doctors don't make more moneywriting you a prescription but
they can get you in and out ofthe office faster.
And they're taught and they'retold by the drug reps who come
to our office that this is thebest thing since sliced bread
and I'm just picking on statins.
There's a lot of parallelsright now out there that we
(43:33):
could think about that, getinjected into your arm, but we
won't even talk, we won't gothere.
That we could think about that,get injected into your arm, but
we won't even talk.
We don't want to get censoredor anything like that, but, um,
but that's what they do and it'syou know.
It's the same thing inobstetrics.
A woman walks in at 10 weeksfor her first prenatal visit.
Why does the doctor say to heryou know, honey, you're over 35.
Um, you know, likelihood thatwe'll probably have to start
(43:55):
testing your baby later onbecause your placenta might get
old.
Or you know, you're only fivefoot six and your husband's six
foot five.
There's no way that baby'sgoing to fit through your pelvis
.
And they plant these seeds ofdoubt and all they're doing is
they're projecting their ownanxieties and own fears.
It must be, you know.
Quite frankly, I don't thinkthey're aware of it because of
cognitive dissonance, but Ithink it must be awful yeah To
(44:19):
go to work every day.
Speaker 1 (44:21):
To be nervous yeah.
Speaker 2 (44:22):
To be scared, you have to live that way, I would
totally agree with that.
Speaker 1 (44:27):
My midwife sent me to have my scar checked when I was
35 weeks to see you know, justto make sure my C-section scar
had healed from my previousbirth, and the doctor that I
spoke to after, by the way, myscar was healed, everything was
good.
She had so much fear inside ofher because she experienced she
(44:48):
saw someone's uterus rupture.
Now I don't know if this personwas on Pitocin or whatever.
I don't know the scenariosurrounding this.
Speaker 2 (44:56):
It happens, it can happen.
It's something that can justhappen.
Speaker 1 (45:00):
Sure, I don't know what the circumstance was, but
this happened to her one time,one time.
She's been a doctor for 20years.
This happened to her once andshe was using that scenario that
happened to her to try to scareme and I thought this is crazy,
like this happened to you once.
You've seen thousands of womenand but, like you're saying, it
(45:25):
must be very hard to live inthat that you're projecting your
own fears from an experiencethat you went through.
You know it'd be like if I gotinto a really bad car accident
and then I was like don't drive,you could get in a really bad
accident.
Speaker 2 (45:41):
Well, there are some people that have PTSD and don't
drive again.
That's true, but they shouldn'tbecome taxi drivers.
Speaker 1 (45:48):
They probably won't.
Speaker 2 (45:51):
So you know, if an OB is that traumatized by
something like that, they maybeshould consider giving up ob,
doing just kind of I mean youcan't really quit, you've got so
much invested in yourprofession and I mean I totally
empathize with that.
Speaker 3 (46:05):
But maybe you should be not doing ob anymore, sure,
maybe you should just dogynecology, gynecologic surgery,
sub-specialized in somethingwhere you don't have to deliver
babies yeah it kind of seemslike it's all I I guess I
shouldn't generalize, but a lotof it is fear based because I
know that's what I experiencedas well of, oh, your baby's
(46:26):
breach, so we need to schedule ac-section.
And it's like, oh well, likewhat would?
Well, you'll put your baby atrisk if, if you, if we don't do
this, and it's like okay, wellthen, I didn't ask these
questions at the time, but now Ihave what are the risks?
What is the percentage?
(46:46):
What is the ratio of riskingthe baby from a vaginal breach
delivery versus a C-section?
And this is what's so greatabout organizations like Breach
Without Borders that are puttingthese statistics out there and
putting their research forwardthat it's not as risky as the
(47:07):
doctor that's sitting in frontof you in your OBGYN office is
making it seem.
And maybe that's all becausethat's all they know.
They only read that one study.
Speaker 2 (47:20):
So I have a story for Dr.
They probably didn't even readthe study.
Go ahead.
Speaker 1 (47:24):
I have a story for you, dr Stu, that relates to
this, and then I think you canreact to both of us.
So when I was having my first,I put together a birth plan
because I thought that a birthplan meant that they would
actually follow it.
Little did I know it doesn'tmean anything, but I go to the
OB's office with the birth planprior to the birth, you know,
(47:46):
just to go over it and she readsthrough it and she goes okay,
yeah, this looks okay, butthere's one thing that you
really need to reconsider.
I had on there that I did notwant them to administer vitamin
K and she said you need tochange this.
You really need to get thevitamin K.
(48:08):
And I said why?
And she said, well, becauseyour baby could die.
And I said, well, why would mybaby die?
She said, well, if there wassome sort of trauma, like if you
got into a car accident whenyou were pregnant, or if there
was a trauma when the baby wasborn.
The blood is too thin and ifthey don't have it, then they
(48:32):
could die.
And I said how many babies havedied in your practice from not
getting vitamin K?
And she goes, uh, and was soflustered and then got the heck
out of there and it just kind ofcircles back to this whole, you
(48:53):
know fear-based type ofconversation and when you ask
the questions, she didn't knowhow to answer that question.
All she knew is she's supposedto do this.
This is a box that they check.
She didn't know how tothoroughly communicate about
this particular area.
Speaker 2 (49:09):
Anyway, they're just regurgitating information that
they were once told they don'tagain.
This is well, maybe it is meantto be insulting in some way.
They don't know anything.
When they say something isrisky to everybody listening,
(49:29):
that doesn't mean anything.
The word risky doesn't meananything unless you know what
the denominator is, unless youknow well what the alternatives
are and what the risks of thosealternatives are.
And they don't know.
They say words like risky, oryou know lowish fluid, or you
(49:51):
know large baby.
They say these things to getyou to do, to funnel you down
the path, to get you to do whatthey want you to do.
And I'll give you an example ofthe vitamin K thing that you
brought up just a second ago.
The instance of late-onsetvitamin K-dependent bleeding,
which is what they're worriedabout, has nothing to do with
the baby in utero in a caraccident or anything like that.
I don't know what that even hasanything to do with it.
(50:20):
Right, wasn't that a fun story.
You don't give it until thebaby is out, but the risk of
vitamin K-dependent bleeding isabout six per 100,000, which, if
you do it now, is about one in16,500.
So what you should tell a womanis if you don't get vitamin K,
your baby has about a 1 in16,500 chance of having this
very serious problem ofinternally bleeding.
Now, 1 in 16,000 is essentiallyzero.
(50:43):
If you divide it out andmultiply it by 100, you're going
to find it's like 0, 0, 1% orsomething like that.
So it's a very small number.
But yet if you give vitamin K,it drops to about one or two in
100,000, which is also a verysmall number.
So you're scaring people.
(51:05):
You're scaring 15,999 peopleinto getting vitamin K to save
one person.
That may be your decision ofwhat your risk benefit
evaluation is.
Your assessment is, but it'snot your assessment that matters
.
Sure, it's the woman'sassessment and the family's
assessment that matters.
Speaker 1 (51:26):
It is, and not for nothing.
They don't share those insertson the risks of getting vitamin
K, the risks associated withhaving that.
Speaker 2 (51:40):
No, they don't.
They don't talk about in thecase of C-section for breech.
I'm sure they didn't tell youabout the risks of C-section.
Speaker 1 (51:47):
Oh, of course not.
And they don't tell you therisks of repeat C-section either
.
Speaker 2 (51:51):
No, yeah, or the risks to your future babies or
the possibility of abnormalplacentation in future
pregnancies.
No, it's the default positionand this is a problem.
And again, it comes from fear,as you said, rachel, but it also
comes from an idea that whatwe're taught in residency
program is we want to controleverything.
(52:11):
And, by the way, when you wantto control everything in a world
that's full of entropy andchaos, it only makes it worse
because you can't.
And so all these things thatthe medical model does is purely
to try to control the outcome,because again and I'm not going
(52:34):
to wax religiously orphilosophical here, I'm not an
expert in those things, but youknow, it's that thing that says
that there's more to the thanjust the destination, it's the
journey too, and they don't careabout the journey.
One of my sayings that peoplecome to my seminar knows all
that matters to the medicalmodel is a live baby in the
(52:54):
bassinet and how it gets thereis not their concern.
And what happens to that babyand that mother and that
mother's future babies is nottheir concern.
It sounds harsh, but think ofit like that.
When you go to the hospital,that is their concern.
Now you may have a greatrelationship with your doctor
(53:14):
and that's great, but there arevery few doctors who take call
for themselves all the time.
So if you're a doctor's in acall group of five other people
and you go into labor, you onlyhave a one in five chance that
the person that you maderelationship with is actually
coming, sure.
So the system again is it?
It's run on a on a shiftmentality, but this is one thing
(53:36):
where it's not like an er.
This is.
This is a very personable thingand it's not.
You know it's.
It's the medical model treatsit as a medical issue.
It's not a medical issue untilit becomes one.
Yeah, definitely most of thetime it doesn't become one, so
don't we gotta stop treating itlike this is a medical problem?
(53:59):
Your body is designed to thatto deliver a baby, to grow a
baby and deliver a baby.
Speaker 1 (54:04):
As you've been hearing, we have been having a
fantastic time talking to Dr Stu, so much, in fact, that we
continued this conversation.
So be sure to tune in next weekfor the continuation of our
interview with Dr Stu.
Thank you so much for listeningand tuning in and for being on
(54:25):
this journey with us.
If you'd like to follow alongoutside the podcast, be sure to
join the mission on Instagramand Facebook at the Radiant
Mission.
You can also find Dr Stu atBirthing Instincts and, of
course, you can find thispodcast in video format on
YouTube as well.
And today we will be closingwith Ecclesiastes 11.5.
(54:47):
As you do not know the path ofthe wind or how the body is
formed in a mother's womb, soyou cannot understand the work
of God, the maker of all things.
Wishing you a radiant week andwe'll see you next time.
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Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.
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