33. Dr. Stu Talks Breech, VBAC, Twin Home Birth, and More!

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Natalie (00:00):
On today's podcast, I chat with Dr.
Stu about twin birth breachvaginal birth, and what the
difference is in the care youreceive at a hospital versus a
midwifery setting.
He provides insight from over 40years in the birth world.
This discussion is such animportant one, so grab your
favorite drink and enjoylistening.
Welcome to the Resource Doulapodcast.

(00:21):
I'm Natalie, your host, and mygoal is to equip you with the
tools and information you needto make informed healthcare
decisions while having some funalong the way.
Through engaging interviews withexperts, personal stories, and
insightful commentary.
I'll save you the time andeffort of sifting through
countless sources on theinternet.

(00:41):
Consider me your personalresource dealer because if I
don't know the answer, I canconnect you with someone who
probably does.
So whether you're a seasonedhealth guru or just starting
your journey, I hope this showinspires and encourages you
every step of the way.
I have the pleasure ofintroducing Dr.
Stu for today's episode.
Dr.
Stewart Fishbein has been apracticing obstetrician for over

(01:03):
40 years.
He is co-author of the book,fearless Pregnancy Wisdom and
Reassurance from a Doctor, aMidwife, and a Mom, and Peer
Reviewed papers on Home Birth,Andre Birth.
Dr.
Stu as he is known by, spent 24years assisting women with
hospital birthing, and for thelast 13 years has been a home
birth obstetrician who worksdirectly with midwives.

(01:25):
He travels around the world as alecturer and advocate for
reteaching, breach and twinbirth skills, respect for the
normalcy of birth, and honoringinformed consent.
You can follow him on Instagramat birthing instincts and listen
to the Birthing InstinctsPodcast Midwife Bliss Young as
he offers hope, reassurance, andsafe, honest evidence supported

(01:46):
choices.
For those women who understandpregnancy is a normal bodily
function not to be feared, hiswebsite is birthing
instincts.com.

(02:06):
dr.
Stu, welcome to the ResourceDoula podcast.
Thanks so much for being heretoday.
I feel

Dr. Stu (02:11):
like I've been here before.
This might be take three.
Yes, take three.
Uh, Natalie, thank you forhaving me, uh, in your studio
and the opportunity to speak toyour, uh, listeners because, uh,
I always love the opportunity todo what I think is spreading
truth and spreading wisdom, uh,on the idea that birth is

(02:31):
something that, that.
It, it's so, it needs to be somuch different than the way we
treat it now.
So, uh, we're working on it.
We're working on it.
You're helping.
Yeah.
Yeah.
I appreciate that.
Right.

Natalie (02:41):
I, I would also be remiss if I didn't say, just use
this platform to say thank youfor everything that you're doing
too, because it's, it can beeasy to just not say anything
and stay in your own bubble.
Right.
But it's really, you're doing,you're doing massive work around
the world.
So I appreciate it and I, I knowthat I speak on behalf of my
listeners as well to say thankyou.

(03:02):
So, um, I wanted to start outjust asking you what led you to
women's health in general in thebeginning and then how you
transitioned from that hospitalsetting?
The conventional setting to themore the midwifery model of care

Dr. Stu (03:17):
in home birth.
Okay.
Um, unlike a lot of fellowtravelers that we, you and I
both have, Who may have had anepiphany, it may have been they
saw their sister give birth ormaybe they, they had a bad
experience at the hospital orwhatever that inspired them to
do something.
That wasn't the case for me.
It was, it was a gradualprocess, um, with a lot of
evolution that required exposureto the right things at the right

(03:41):
time and having an open mind.
Um, I have very strong opinions,but I'm also open-minded enough
to know that, you know, a lot ofmy thoughts and opinions and
things I thought were true ornot.
So I started out, um, I went tocollege and in the seventies,
everybody that goes to, well,everyone who graduates high

(04:02):
school went to college.
That's just what you did.
And, um, at least in our, mycircle of friends and stuff like
that.
So, um, and then, uh, my thirdyear as a junior in college, I
decided that I would go pre-med.
Because a bunch of my friendswere doing it, and I was sort of
aimless.
I was a biology major.
I wanted to be a forest rangeror marine biologist, but I don't

(04:23):
know, there wasn't a whole lotof feeling about anything then.
It was a different time anddifferent era.
People have to really understandthat the seventies were a
completely different era than weare in 2023.
Uh, things were, world was acompletely different place.
And so I, I went pre-med.
I got into medical school at theUniversity of Minnesota, and

(04:45):
then in the first two years ofmedical school, it's pretty much
all didactic.
You're spending a lot of time inthe classroom and in the lab.
And the second two years, uh,you're do a lot of rotations on
different specialties to try tofigure out what you want to do.
And unfortunately you have tomake this decision, you know,
three years into medicaltraining and really not knowing

(05:05):
anything, being very naiveabout.
Options and, and where thingsare gonna go.
And ob obviously beingidealistic.
And I had just come off ahematology oncology rotation
where I'd spent time dealingwith very sick kids, uh, with
cancer and fungal infections.
And was, it was, it wasdepressing for me.

(05:26):
And then my next rotation was OBg y n, where I was up at three
in the morning, uh, catching ababy instead of up dealing with
a seizure and a child.
So I really liked it.
And then I took a deeper diveinto it and I realized that I
really liked longitudinal care,which is taking care of people
over time.
And in the, in obstetrics inthose days, that's what you did.
It was, there was no shiftmentality.

(05:47):
There was no being on at seven,off at seven type thing.
You took care of somebody andthey were your client and you
took care of them.
Of course, we didn't call'emclients then.
They called them patients, ofcourse.
Mm-hmm.
Um, And so, uh, and then you getto do a little psychiatry, a
little surgery, a littleinternal medicine, a little
endocrinology.
So you get a lot of differentthings in one specialty.
And I really liked that.

(06:08):
And of course, you don't thinkabout hours and liability and
being on call and being up inthe middle of the night when
you're young and naive.
So I matched at Cedar Sinai inLos Angeles, where I did my
residency for four years in theearly eighties.
And I was affiliated with, uh,LA County U S C at the time,
which was, that's the Universityof Southern California, um, the

(06:29):
busiest hospital in the countryin the early eighties doing
about 22,000 births a year.
Wow.
Which is about 65 babies a day.
So you're gonna see a lot ofstuff when you're there for
three or four months.
Mm-hmm.
And so that's where I got mytraining, Andre in twins.
And it was all considered normalforceps.
We, we got really good training.
That kind of training isn'tavailable anymore.
And I finished my residencyprogram and I came out very

(06:51):
medicalized thinking that I kneweverything about women's health
because.
I, that's what I was trained todo.
Mm-hmm.
And as part of building apractice, in those days you
didn't come out and get a jobworking for somebody and get
paid a salary, you hustled tobuild a practice.
So I covered emergency rooms, Icovered free clinics, I assisted

(07:14):
other people in surgery.
I took call for other guys whowanted to take less call and I
was approached by a couplemidwives and asked if I would
take their home birthtransports.
And I said, sure.
But unlike I would say now, backthen I thought home birth was
stupid and I had no, nothingabout midwifery.
I just said yes because it wasrevenue.

(07:34):
For me, it was, I was amercenary and I was looking to
make money.
Uh, fortunate that that happenedbecause when a woman would be
transferred from home, it wouldwas almost never for an
emergency.
There were a few that were realemergencies, but most of'em was,
were just the kind of thingsthat we all know about where the
woman is exhausted or labor hasstalled out or.

(07:54):
Whatever.
Mm-hmm.
And it's non-emergent.
They come in by car and theyjust need an epidural and
Pitocin.
And so there'd be a lot of timedowntime once they got settled
in the hospital.
And I'd be sitting in the loungewith a midwife and, um, we would
just be talking and I wouldbegin to hear a different way of
doing things.
And the, the, the women theybrought in were actually quite

(08:14):
intelligent and they wereactually more well-informed
about their bodies than aboutpregnancy than my patients by
far.
And I realized that there was a,I was doing something wrong and
it was a slow process.
Over 10 years, I think about 10years later, I started a
collaborative mid midwifemidwifery practice with two
midwives in Ventura County.
Cedars wouldn't allow midwivesto have privileges in those
days, and so we started acollaborative practice and I

(08:37):
thought that this was going tobe great because.
Midwives could take care of allthe normal stuff, the well-woman
exams, the normal pregnancies,the, all that stuff.
And I could do the colposcopiesand the biopsies and the
surgeries and the forceps andthe twins and the breaches.
And, uh, so it was really a nicecollaboration.
We had really good results.
We had a 7% C-section rate.
We took all comers, um, but wewere never accepted in the

(09:00):
community.
Mm-hmm.
The, uh, ob, other obs, thepediatricians and the
anesthesiologists were allpicking on us, uh, doing what's
called SHA peer review and gunnysacking, and you can look these
terms up and, and, uh, they madeit very difficult for us.
But we survived for about 15years there.
And finally it came to a pointwhere, um, they said that they

(09:23):
were not gonna renew myprivileges.
They had canceled, they had, uh,canceled the midwives
privileges.
They had canceled vbac, they hadbanned breach.
Uh, no bad outcomes, just.
Made the anesthesiologist andthe pediatricians nervous.
Yeah.
And the nurse and the nurseswere nervous because they were
getting all their informationfrom the old, old bees who just

(09:44):
didn't wanna do any of thatstuff.
When I first came to thatcommunity, no one was doing
laparoscopic surgery.
If you had an ectopic pregnancy,you had a laparotomy.
Wow.
Um, I was the first one to dolaparoscopic surgery cuz I was
trained in that.
Um, and that caused us a, aminor stir because they didn't,
you know, they weren't used toit.
Mm-hmm.
Now standard of care is thisweird, uh, phrase, which is

(10:09):
really open to interpretation ofwho sets the standards.
And if people who don't knowanything are setting the
standards, then you have lousystandards of care.
So, right.
That was what's going on.
So they weren't gonna renew myprivileges, so I had a choice of
fighting them legally, which isa pain.
Mm-hmm.
And you're probably gonna losebecause of the way the system
works or leaving.
And I was approached by somemidwives that I had known for

(10:31):
years and they said, Stu, cometo some home births.
You know, and I, and after 25years in practice, Natalie, I'd
still never been to a homebirth.
Wow.
Wow.
Right.
And, uh, I said, okay.
Unfortunately, I went, uh, I hadseveral, several women I had in
my practice who were pregnant atthat time, who were due after

(10:51):
the date that my privileges werenot gonna be renewed.
Um, they said to me, we'll,we'll go, we'll just stay home.
You come to our house.
So between the, between thewomen and the midwives in the
community, I, I went andfortunately those births were
just smooth and beautiful.
And, and then the rest is sortof history.
So I got into it sort of by afluke of the way my rotations

(11:15):
were in medical school, uh, in,um, in medical school.
And then I ended up in midwiferysimply because, and home
birthing, simply because I wasopen to the fact that everything
that I, almost everything that Ilearned in residency program
only applied to about 10% ofwomen.
And I knew nothing about other,the 90% of women that I was

(11:35):
still taking care of andtreating them as if medi as, as
if pregnancy was a, a problem.
Mm.
And not a natural, normalfunction of their body.
And the midwives have taught meso much more, and then I've
taken it to the next level.
And I've started to do breachesat home and twins at home, and
diabetics at home, andhypertensives at home.
All just thinking a little bitoutside the box and saying,

(11:58):
well, you know, if she'sdiabetic and she has a, a meter
inside her body and a pump, andshe can just look at her phone
and know what her blood sugaris, and if it starts to go outta
whack, we can drive to thehospital.
But why should she have to bereduced at 38 or 39 weeks in a
medicalized system, which isgoing to give her IVs and no

(12:18):
food and immobilize her and havepeople around her, she, and then
take the baby to the nicu?
Because the hospital has aprotocol that says all infants
of diabetic mothers need to beobserved.
Not observed on the mother'schest, but observed in the nicu.
I mean, separately.
Yeah.
Right.
So we could spend the whole hourtalking about the absurdities
that go on in prenatal care and,and labor and delivery, and that

(12:42):
would be the whole podcast, butI don't think that's where you
wanna go.
So I answered the best I can sopeople can understand sort of
how I evolved.
And fortunately I was just openenough to, um, to hear what
these other people were saying.
I didn't shut myself off as somany of my colleagues do.

Natalie (12:58):
Yeah.
Yeah.
Wow.
Well, thank you for going intothat.
I know that a lot of mylisteners are kind of lean
towards more of the holistic,like crunchy side of things
anyways.
Um, but there were somequestions on like, what would
you say is the biggest predictorof a successful home birth now
that you've seen it, you've gonethrough with all of the Yeah.

(13:19):
More complicated deliveries.

Dr. Stu (13:21):
Well, if I had to sum it into one thing, I'd say there
are two things.
What is having the rightmindset?
And surrounding yourself withsupportive people.
Mm.
That's it.
Yep.
It's a physiologic thing.
It's like, it's like, how do Idigest my dinner?
What's the best way to digest mydinner?

(13:43):
Is to leave it alone.
Mm-hmm.
And not worry about it.
Not think about it.
It's the same thing here.
Yeah.
It's a primitive brain function.
And when your cognitive brain,or your higher brain or your
neocortex gets involved, um, itcan only really screw it up.
So you wanna, you wanna besurrounded by people that keep

(14:03):
you safe and that you trust.
Yeah.
That's it.
And then everything else willfall into place.
If you end up having a problemthat's medical that really
requires hospital care, yourteam is gonna know that.
Mm-hmm.
And it's very rare for somethingto suddenly happen in labor when
you're not meddling with labor.

(14:26):
The reason we see so manyemergency, I love that term,
C-sections in the hospitalsetting is because of the way
the hospital manages labor.
It just is.
And, and people say, well, howcan you say that?
And I say, because I lived inthat world for 20, I don't know,
28 years.

(14:46):
Mm-hmm.
Count my residency 28 years Iwas in the hospital setting.
And then I've, for the last 13years I've been out of the
hospital.
And so I, I have that uniqueperspective of having lived in
both places.
And so I can speak to both,whereas most people live in one
or the other and really, reallydon't know.
There's no, there's no breakingof the silos.

(15:06):
Right.
Ob ob residents don't come andspend a rotation for a month
with a home birth midwife.
Wouldn't that

Natalie (15:12):
be amazing if they did?
Oh

Dr. Stu (15:13):
man.
Wouldn't it be amazing if theyhad to spend a month as a labor
and delivery nurse too?
Yeah.
Right.
Yeah.
And then having home birthmidwives come in and, and spend
a month in the hospital setting.
To see what goes on in thehospital so that they can better
deal with it.
I can't even imagine being adoula right now, or even a labor
and delivery nurse and watchingevery day some of the stuff that

(15:34):
goes on.
I, we've talked about this onour podcast and, and with so
many people that I've talked toabout how it's, they, they,
they, they quit.
They can't take it anymorebecause they're watching
malfeasance go on every singleday.
Mm-hmm.
Yeah.

Natalie (15:48):
Yeah.
No, it's, it's rough out there.
It's surprising that it'scontinued this long.
I think, I feel like there's abreaking point coming.
I don't know, that's just my,maybe wishful thinking, but I
feel like the word is spreadingthat physiologic birth is normal
and pe more people are pursuinghome birth.

(16:09):
Um, so we'll see.
I dunno, it's, it's

Dr. Stu (16:12):
climbing, it's certainly not climbing fast
enough for your liking or myliking, but, but it is, the, the
problem of course is the, the,is the value that we put on it.
We still, as long as we continueto think of pregnancy as a
medical condition, then we'regonna expect our insurance to
take care of it.
Our insurance is not gonna paywell for it.
Uh, they're gonna mandate thatyou go to this doctor or this

(16:33):
hospital and you can have thismedicine or this procedure, or
you can, and, and when we, whenwe give, when we surrender that
to a third party, the thirdparty's ethical and fiduciary
responsibility is not to me,it's to their company or their,
or their business.
Right.
And so the, the people need tochange the way they value, they

(16:55):
need to put money into it andeffort into it.
Like they would, as we use theanalogy as you would your
wedding.
Mm-hmm.
You would never let some thirdparty decide what you can have
at your wedding and who you caninvite and where you can have
it.
You would just wouldn't do that.
Mm-hmm.
And so, uh, but we do it.
And so until we change themindset of people that it has

(17:15):
value, Then people will begin toinvest in it more and will make
more demands on the system.
And the system will either breakor which, uh, it, it is already
broken, but, or, or they'll haveto adapt.
Mm-hmm.
Um, or a new system will rise upand that's what will happen to
the people who are looking.
But they'll have to find a, youknow, the, it's, it's, it's a

(17:36):
long process because the oldsystem is not gonna just say,
you know, we, we suck, we'regoing away.
Right.
They're not gonna do that.
Right, right.

Natalie (17:44):
Yeah.
Uh, okay.
Let's transition to twins cuz wehad some twin questions.
So could you give us kind ofsome definitions of like the ti
the different types of twins andmaybe some considerations for
each type and how that birth,that birth might play out or
what you might watch for with,with each

Dr. Stu (18:03):
type?
Yeah.
Well there are, there are.
Essentially three types of twinsif we, unless we get into real
rare things, which we won't getinto, and that would be based on
the ity.
The ity is the number ofmembranes around the twins.
So, um, there's diamnioticdichotic, twins, which would,

(18:23):
would everybody would callnon-identical twins or fraternal
twins, where they're twoseparate eggs that the woman
ovulated that both getfertilized and they both
implant, um, on rare.
Again, I don't want to get intothe weeds, so I'm not even gonna
go off to the rare occasionwhere they're identical, but in
two separate sac.
So they each have their ownamnio, their own corion, their
placenta are separate.

(18:45):
They never, they can be fused,but they never communicate with
each other.
You don't have to worry aboutthis rarer condition called
twin, twin transfusion syndrome,or again, a weed thing called
taps or traps or all kinds ofdifferent things.
But, um, and then there's monodytwins where the twins are iden.
We call'em identical twins.
They're in the same corion, butthey each have their own amnio.

(19:07):
So those are monochorionicdiamniotic twins.
And there's about a 15 to 17%chance that those twins will end
up with a problem with theirblood flow between the two of
them, which can, which can bequite serious.
Um, if that doesn't occur,however, then, then there's
really no significant increasedrisk for monody twins than there
is for die, die twins as far asallowing them to go to term and

(19:29):
go into labor.
And then there's the rare casewhere you have what's called
mono mono twins, which are twotwins in the same sack.
Okay.
And that has the high morbidityrate because of, of the
placental, uh, perfusion issueas well as cord entanglement
because the Quin, the Quinns,tie themselves into knots when

(19:49):
they're little.
So, um, that's very, that'ssomething that you wouldn't be
do thinking about doing outsideof the hospital, and that's
something that would need to bedealt with earlier.
So we're really dealing with d ddye twins and mono die twins
outside of the ho.
Uh, if we're talking about twinsin general, and, and I'm
assuming that because that'swhat I do is, is doing them at
home.
Right.

(20:10):
Um, mono die twins are probably15 to 20% of twins, and dai dye
twins are probably 80, 75 to 80%of twins.
Oh, wow.
Okay.

Natalie (20:19):
Okay.
Yeah, that's higher than Ithought.

Dr. Stu (20:21):
At least, at least, at least that's in my practice.
Okay.
And then I may, I may have aselection bias and my numbers
aren't big enough to reachstatistical significance, so,
but it really doesn't matter.
I mean, when we talkpercentages, percentages are,
are, are population based.
Yeah.
It's either you have mono die,or you have die die.
You don't have a 80% d you know,it doesn't work like that.

(20:42):
So statistics are often used,uh, and misconstrued, so.
Mm-hmm.
We talk about actual risk,relative risk a lot, and we'll
talk, maybe we'll even have anexample of that later on today.
Cool.

Natalie (20:53):
Okay.
So when twins, like you got babyba, baby A and baby B, right?
And they position themselves inorder to be born, um, oftentimes
people worry about thetransverse lie or a breach
presentation or all of, can youjust go into that a little bit
more and, um, how you approachthose kinds of

Dr. Stu (21:13):
births?
Yeah.
Early in the pregnancy, almostalways, there's a small
percentage where a and B don'tactually declare themselves, but
usually early on a will become aand a will stay a the whole
time, and a's the one that'scloser to the exit of the
uterus, which is called the, uh,internal Os of the uterus.
And that almost always stays thesame.

(21:34):
And then they could be inmultiple positions.
The most common is Vertex.
Vertex, all right.
Which is about 44.
About 44% of twins will beVertex.
Vertex.
Okay.
About 27% will be Vertex breach,and about 13% will be breach
vertex or breach.
Breach.

(21:55):
And that leaves about two or 3%for things like transverse lie
or, or the cord presenting firstor placenta previa or some other
weird thing which we're notgonna talk about today.
So if you add that up, itactually turns out that over 50%
of twins have at least one twinthat is breach.
Hmm.
Whether it's the first twin, thesecond twin, or both twins.

(22:18):
So this is something that I'vetalked about recently a lot, and
I'll just mention it herebecause it's so powerful for me,
is that if you have apractitioner who's uncomfortable
with a breach baby and you havetwins, and you know that more
than half the time you're gonnahave at least one twin that's
breach, then that practitionershould not be the one taking

(22:39):
care of you.
Mm-hmm.
You should find someone who'scomfortable with breach.
They will tell you that breachis dangerous, that breaches need
c-section that brought can'tdeliver a breach for his twin.
That's all not true.
They may have been trained thatway, or they may be stuck in
their box and they may not wannalook outside their box to see
that that's not true because noone likes to admit that they

(22:59):
don't know so something, or thatthey've been doing something
wrong for their entire career.
Right.
That's, there's cognitivedissonance there and it's very
difficult to do that, and Iunderstand it, but the confident
person is not afraid to say theydon't know something.
Mm-hmm.
And the insecure person is theone that tells you, you know,
that talks in certainty.

(23:20):
So there's old saying that says,it's not my skepticism that
should bother you, it's yourcertainty that should, so yes,
it's their c it's theircertainty.
So, um, yeah.
So, um, breach is a very commonpresentation.
It breaches a very normalpresentation up until the late.
Eighties, early nineties breachwas just considered a variation
of normal.
And then it, for whateverreason, the medical people

(23:41):
running the programs, theydecided that they didn't really
wanna do it anymore.
And they, they said, let's get apaper that shows that we can
don't have to do it anymore.
And they, and that's what theydid.
It's almost as if they said, wedon't want to do breach.
Or the same thing too.
We, we think all women should beinduced at 39 weeks.
Let's get a paper that saysthat.
And so out comes the Arrivetrial, right?

(24:03):
It's the, it's the same sort ofthing.
Even though lots of papers sayit's not a good idea, they
choose to glom onto the onepaper that says it's a good
idea.
And with Breach First Twins inthe same year that the term
breach trial came out, whichkind of killed breach in most
training programs in mosthospitals.
There was a paper that came outthat actually had the same

(24:25):
numbers of, of, of women in it.
That said that, uh, breach firsttwins weighing more than 1500
grams.
There's no increased morbiditywith those twins, and there's no
reason to section them.
And that paper was completelyignored.
Wow.
And there's a, there's a,there's a many places in the
history of medicine whereconflicting papers came out, and

(24:47):
confirmation bias may causepeople to choose the paper that
supported their position andignore the paper that didn't
support their position.
That's problematic.
That's, that's the, that's thehuman condition.
That's, that's we're all humanin the, and we tend to want to
kind of gravitate toward thingsthat make us feel good and avoid

(25:07):
those things that make us feellike we're doing something
that's not okay.
Right.
Or just

Natalie (25:11):
nervous in general.
I think a lot of providers arejust nervous about it.

Dr. Stu (25:15):
Well, they're trained in a fear-based world.
I mean, everything aboutobstetrics that's taught to, to
medical students and residentsis taught by people who look at
pregnancy as, as danger andfear.
Um, Maternal fetal medicine.
Doctors.
Doctors or the doctors that areteaching.
Most residents, they run theprograms, they're the directors
of the programs, almost always.
And maternal fetal medicinedoctors are specialists in what

(25:37):
problems?
Very rare things.
Yeah.
Yeah.
High risk problems.
Yeah.
So they look at every woman as apotential problem.
I don't know that there's anywoman who goes through the
obstetric model of, of pregnancyand comes out without at least
one diagnosis of somethingthat's wrong with them.
And having that seed of fearplanted in them early on turns

(26:01):
out to be nothing.
Your hips are too small.
Your baby's too big.
Your baby's too small.
You know, your're too old.
Uh, your placenta looks old.
Um, you know, uh, your, yourthyroid's outta whack, whatever.
All these things are just theanalogy that I use all the time.
If people, a lot of your.
People who are listeningprobably saw the movie Inception

(26:22):
and they're sitting around onetime early in the movie and they
say something like, well, can'twe just tell them?
Can't we just put the idea intheir head and no, cuz they'll
know where it came from.
And they give an example, theysay, okay, don't think about
elephants.

Natalie (26:34):
Right?

Dr. Stu (26:36):
So the rest, the only thing you think about the rest
of the pregnancy, a woman'sthinking about elephants.
If they're, if they're told at10 weeks that, you know, you're
35, that means your placenta is,we're gonna have to watch you a
little closer, maybe talk aboutinduction later on.
Then for 30 weeks you've got,you've just planted seeds into a
woman that, that is completelyunnecessary.
Yeah.
But that's the model by whichthey're trained.

(26:56):
They think they're doing theright thing because that's all
they see.
They've never seen anybody do itdifferently and they don't know
it and they don't wanna know it.

Natalie (27:07):
Yeah, it's like the, if you have a hammer in your hand,
everything looks like a nailkind of illustration.
Yeah.

Dr. Stu (27:14):
Um, you wanna hear a really funny side story?
Can I just tell you a reallyfunny story?
Yes, of course.
Okay.
So, um, my sister married a mannamed Bruce Hammer and my wi my
former wife's maiden name wasNail.
Oh my gosh.
So my sister married a hammerand I married a nail.
Is that funny or

Natalie (27:34):
what?
That's hilarious.
Yeah.
How did you guys, I'm sure itwasn't planned, but that's, it
didn't even,

Dr. Stu (27:39):
you know, it didn't even occur to me until years
later that, that was, that,that, that was funny cuz she
doesn't go by that name.
Right.
When I married her, she hadanother, another last name, but,
okay.
Her, her ma, her maiden name, ifwe still use that term Yeah.
Is, uh, is was Neil.
So that was pretty funny.
Anyway, when you.
I couldn't resist.
Sorry.

Natalie (27:58):
No, that's a good story.
Um, someone did ask, like, canyou talk about the risk of a,
just a cesarean versus a, abreach vaginal birth, and it
could be singleton or twins,whichever.
That's like a relative versusabsolute risk.
Okay.
Conversation.
Well,

Dr. Stu (28:15):
if you take one pregnancy and you look at the
risk, right, and you only lookat the risk that the medical
model uses as their goldstandard, which is neonatal
death.
All right?
Then you have then the royalcollege of ob g gyn has the best
numbers and the risk of aneonatal death if you do a
C-section at term for breach isabout one in 2000.

(28:38):
Okay?
And the risk for vaginaldelivery is about one in 500.
So the relative risk is fourtimes greater with a vaginal
birth for that one baby.
Okay?
But the chance of it nothappening to that baby, Is
99.95% with a cesarean and 99.8%with a vaginal delivery.

(29:00):
And before I go on to talk aboutlong-term risks, the risk of a
neonatal death with a head downbaby is one in a thousand or
just twice.
So the breach birth is onlytwice as risky as a head down
baby.
Okay?
So it's 99.8 versus 99.9 versus99.95.
If you ask the person what's, isthere a significant difference

(29:20):
between those numbers?
Most people are gonna say no,right?
They're almo, they're all, allof them are very small risks,
okay?
So if you wanna convincesomebody, you use relative risk.
You say, oh, it's four timesriskier and blah, blah, blah.
But if you do a C-section forthat baby, then there's problems
with that baby.
Potentially more likely to havean altered microbiome, which can

(29:43):
affect the baby for its entirelife and cause chronic illnesses
and things like adult onsetdiabetes and childhood asthma,
and that sort of thing.
You could have more bondingissues.
More breastfeeding issues cuzthe baby's separated from the
mother.
Um, I, I, I mentioned themicrobiome.
You have more, more risk to themother, um, in this pregnancy.

(30:05):
And then what you've done in, ifthe mother wants more children
is then you, everything thatyou've saved and risked to this
one baby, that little four timesrisk that we talked about.
Right?
You've now transferred to allher future babies cuz now she
has the VBA issue and thescarred uterus.
So people that say it's safer todo a c-section for breach,

(30:27):
they're, they're, they're,they're talking with blinders
on.
And I can tell you why I knowthis, because when I see a
consult for breach and it sayit's their first pregnancy and
they're 37 weeks and they'recoming in for the first time to
see me and they say, my doctorsays I need to c-section to
schedule it, I'm gonna scheduleit in a week or two and blah,
blah, blah.
And the, I I will ask the woman,And her husband.

(30:49):
Did the doctor ever ask you ifyou want more children?
And the answer is universallyno.
Hmm.
Because all that matters to thatobstetrician is that one baby
being live in the bassinet.
Right.
And what happens to that motherand that mother's future babies
and even that baby that theydelivered by cesarean and
electively scheduled rather thanwaiting for labor?

(31:10):
Um, because it's inconvenient.
Um, that doesn't matter to thembecause we have a crying baby in
a bassinet.
Right.
And we're happy about that.
And so again, it's stage onethinking.
We're not thinking long term.
We're not thinking down the roadwhat's, what's, what's the
overall greater risk?

(31:31):
And cesarean section is notbenign.
It's a major operation.
Right.
And there are complications withthat, including like simple,
like I'd say simple things likewound infection, but.
Future.
You could have adhesions, youcould have pain, you could have
bowel obstruction, you couldhave injury to your bladder.
You could have all kinds ofthings down the future.
And you could have the risk ofruptured uterus.
Again, small risk, but if you'regonna emphasize small risk to a

(31:54):
vaginal breach birth, then weshould be equally, we should
treat the risks of, uh, future,um, deliveries after a cesarean
section with the same, um,respect.
Right.
Or disrespect never.

Natalie (32:09):
Right.
Yeah.
Yeah.
Okay.
Well, this, this goes right intoanother question that somebody
had.
Um, somebody was asking, whatwould you look for with an hvac,
so home birth after cesarean,um, in order to have a
successful deli vaginal deliveryand maybe signs to look out for
for things going

Dr. Stu (32:27):
south?
Well, there are no signs really.
What, um, if you wanna have asuccessful vaginal birth after
cesarean, you're better offdoing it at home.
Mm-hmm.
By far.
Yep.
By far it's well known that thesuccess rate for VBAC at home is
over 90%.
The success rate for VBAC in thehospital is somewhere between 60
and 70%.
And that's simply by the,because of the model by which

(32:49):
you're cared for.
And that's true with a woman whojust walks in the hospital, um,
a first time mom who walks inthe hospital, to have a baby has
a 25% chance of having aC-section.
So high in the midwifery world,it's somewhere between two and
7% depending on the, whichpractice.
Yeah.
And it's only because of themodel by which you're cared for.

(33:11):
So there's, you know, yourmidwife in your home birth
situation is trained to watchfor certain things.
Now, ruptured uterus, which issomething we all fear, is a
scary term.
And it implies, it, it gives youthe image of a tire sort of
exploding on the freeway orsomething that's not normally
what happens.
Usually the scar begins toseparate and there are most

(33:31):
often there will be somesymptoms and it'll fetal heart
rate or mothers.
Uh, subjective feelings ofdiscomfort or whatever, not
always, but only a smallpercentage of scars that
separate lead to a really badoutcome.
And so when you're giving peopleinformation, you have to give
them honest, informed consentwith, um, actual risk, not

(33:51):
relative risk, that sort ofthing.
So your midwife knows what towatch for, but it's really,
really rare to have a problemwith a VBAC where you're not
immobilized, anesthetized, andon Pitocin.
Right?
If you're just laboring at home,you're not going to generally
see those same types ofproblems.

(34:14):
Are you gonna have a perfectoutcome?
No, of course not.
No matter what venue you're in,you're not gonna have a perfect
outcome, and you're gonna have atragedy every now and then.
Mm-hmm.
That's the human condition.
Right.
And that's just the way it worksin life and death.

Natalie (34:28):
Yeah.
Yeah.
No, that's, it's good to feelthat.
And,

Dr. Stu (34:31):
and, and, and by the way, Natalie midwives accept
that they're trusting of theprocess, and they're accepting
the fact that they can't controleverything.
Doctors don't accept that, sothey want to control everything.
And in the process ofcontrolling everything, they,
they screwed up.
They do.
Mm-hmm.
They create their own chaos, butit's chaos that they feel

(34:54):
comfortable with because it'stheir chaos.
They don't want random chaos.
Right, right, right.

Natalie (35:00):
Controlled chaos, I suppose

Dr. Stu (35:01):
they want controlled chaos.
Huh?
I mean, look at the model.
Look at what they've done.
They've taken a c-section rateof 5% 50 years ago and made it
over 30% now.
Right.
Overall, and, and that's a 500%increase with no decrease in the
rate of cerebral palsy or theoutcomes that you, that you want
to try to prevent has notdecreased at all, but your

(35:23):
morbidity and mortality to yourmother's has gone up.
And they're the ones in controlof the profession.
They're the ones telling us homebirth people.
We home birth people telling us,no, US home birth people, us my
mother was an English teacher,so I gotta get this right.
Um, that we're the ones that aredoing things wrong and they

(35:43):
don't take a look at their ownoutcomes.
Yeah.
You know, we have, we have arising chronic illness rate in
children now that'smultifactorial.
It could be nutrition, it couldbe vaccines, but it could be the
microbiome exposure at birth.
It could be lots of things.
Yeah.
Um, but we're not looking at it,you know, the problems we have
with birth in America are notbecause 1% of women are giving

(36:06):
birth at home.
Yeah.

Natalie (36:09):
Is it really only 1%

Dr. Stu (36:11):
overall?
About 1.6%.
Some states are higher, but somestates are lower.
Yeah.
But it went from about 1.2% toabout 1.6% in during the covid
years.
Which sounds like nothing.
I mean, it is like a 35%increase.
Yeah.
It's, it's not, it's certainlynot satisfying to me.
I'd like to see it rise muchfaster.

(36:34):
Yeah.
Right.
Yeah.
What we need is more midwives,though.
We can't, we can't handle themore home births right now
because we don't have enoughmidwives out there practicing.
And then when we do try to getmore midwives, what happens is
the state legislatures, afterbeing lobbied by medical
societies, will make it moredifficult for midwives to
practice.
And as my co-host, bliss likesto say, we end up, um,

(36:56):
medicalizing midwifery.
Right.
And we're gonna end up withbecoming in midwifery what we
really didn't want to become,because everybody wants to be
legislated and licensed.
Uh, well, not everybody wantsit, but that's where we're
headed.
Yeah.
And even the organizations likeMeac and Nam, they, they,
apparently, there's a new thingnow.

(37:17):
They want you to take N R P,which is.
Neo, the Neo Neal Resuscitationprogram that we all take, but
they, they're gonna adopt the,now that you have to take the
American Academy of Pediatricsmodel of N R P, which includes
all the hospital based stuff,not home birth intubation and
about using drugs and all thatstuff.

(37:39):
That's not something that wewould do.
And so they're gonna make itmore and more difficult for the
average midwife to practice likea traditional midwife practice
because they want to control.
It gets back to that whole thingabout the medical model does not
like individuals makingdecisions.
It does not like individualchaos.
It wants to put everybody on analgorithm, not realizing how

(38:02):
stupid that is, that we're notthe same, that we all don't
dilate at 1.5 centimeters anhour.

Natalie (38:10):
Okay.
Really?
Uh, do you feel like the, was itcorrelated where the breach
births went down and c-sectionswent up?
Like was that kind of theturning point for the c-section
rate in America is breach?
Oh, no, it started,

Dr. Stu (38:26):
started long before that.
The turning point, I believe,was in the seventies when they
came up with an, uh, continuousfetal monitoring.
Okay.
And when and when, uh, ManuelFriedman came out with his
Friedman labor curve, I thinkthose were the two biggest
things to see arise because itwas 5% in the seventies.
By 1990 it was 20 some percent.

(38:48):
Um, and by, and, and the, uh, soI don't, I don't think it was
anything other than those twothings.
And then cuz the banning ofbreach and stuff like that
didn't occur till 2000.
And we're talking three, we'retalking 3% of term pregnancies.
So 3% of term pregnancies can'tmake your C-section rate go up.

(39:09):
That's 20 or 30%.
Right.
It doesn't work like that.
So same thing with twins.
Yeah.
Okay.
Twins are about 3% of thepopulation too.
Okay.
Used to be one in 80.
Now it's about one in 32 orsomething like that.
I

Natalie (39:23):
feel like it's going up.
I don't know, this is just likecircumstantial data up.
It's, but it's

Dr. Stu (39:27):
going up mainly cuz of I v F, but also possibly because
of, uh, older women, um, givingbirth.
And there's slightly greaterrisk of, of, I guess I wouldn't
call it a risk of twinning.
That's a terrible term.
Right.
Possibility of twinning.
Okay.
Yeah.
I hate, I I, the language we useis really important.
Mm-hmm.

(39:47):
And a lot of times we use wordsthat like mal presentation for
breach.
Okay.
Sounds terrible.
Terrible.
Does ma what does mal mean inLatin?
Bad.
Bad.
Yeah.
Right.
I hate that.
Mm-hmm.
But we just, with these thingsroll off our tongue all the
time.
We, we say things likeincompetent cervix.

(40:09):
Yeah.
That

Natalie (40:10):
one gets me.
Or the geriatric pregnancy.
That also gets me.
Yeah.
Yeah, yeah.
Right.
I don't know, it seems like allof my friends are having twins
right now, so I know so manypeople having twins.
Maybe it's,

Dr. Stu (40:23):
are they spontaneous?
Are your friends spontaneoustwining?

Natalie (40:25):
Yeah.
Yep.
All of them.

Dr. Stu (40:28):
So, yeah.
Mm-hmm.
Well, maybe the world know,maybe the world knows that the
pop, we need more babies.
Yeah.
So they're saying less women aregetting pregnant, so we better
get, we better have more womenhave twins.

Natalie (40:40):
Oh, man.
I don't know

Dr. Stu (40:41):
that that makes No, that makes no sense.
But it's as good as a goodexplanation as anything else.
I, I

Natalie (40:46):
agree.
Yeah.
Okay.
So when you're re-teaching BREand you're training midwives and
obstetricians, hopefully, um,what does that look like?
You're doing workshops and thenlike if hospitals, if, if
providers are still in hospitalsthat are saying no to breach,
like how does, how does thatwork?

Dr. Stu (41:04):
Um,

Natalie (41:05):
Well, it doesn't,

Dr. Stu (41:07):
yeah, it doesn't work.
Uh, yeah, I have a reteachbreach seminar that I go around
and teach, and then my friends,rre, David Hayes and Christine
Loria, um, have the, uh, breachWithout Borders group.
And they, they go around, they,they go more locally and
worldwide, and they have anonline course.
I, I am a old fashioned doc.
I like face-to-face.

(41:28):
I like interaction.
I like having those, that's thatstyle.
They do all their didacticteaching online and then the,
and then David or Christina goesaround and does the seminars
with it.
Whatever it is, it's great.
But almost all the seminarsattended mostly by midwives and
other birth workers.
We rarely get obs to come.
Yeah.
Um, this year I've had a coupleof obs and I had one MFM in

(41:52):
Kansas City, much to her credit.
Wow.
But other than that, um, doctorsdon't come.
Uh, RZA is an academician, soshe's working harder to get in
her foot in the door of academictraining programs.
We're gonna be in Chicago thefirst week in August teaching
at, uh, I can't remember if it'sNorthwestern or some place.
So we're gonna get a chance tospeak to some residents, which

(42:14):
I'm really excited about becauseI really like to reach them.
Um, unfortunately there's aproprietary ego thing that goes
on with people that run trainingprograms of residents, and they
don't want people like DavidHayes or me, you know, coming in
and doing that.
I just, I, you know, that's myperception of it.
Maybe I'm wrong.
Maybe there's another reason,but I, I have yet to find one

(42:37):
that they, they wouldn't wantthe residents and I think that
residents, like I said earlier,were, were young and and
enthusiastic.
They wanna know these skills.
Yeah.
If I finished my OB residencyprogram, not knowing how to do a
breach delivery or put onforceps, I'd be pissed at my
residency program.
Because I may not be practicingin an institution where
c-section is readily available,nor may I wanna be doing

(42:57):
C-sections and ev all thesewomen.
I may decide I wanna go to arural community, or I wanna do
something.
I need the skills that make myprofession unique and you're not
training me.
And you are the porch bearers ofmy profession.
Yeah.
And you're not training me to bemy, uh, uh, professional
obstetrician, you know, any, anywell-trained chimpanzee can do a
c-section.

(43:18):
I know.
Not literally.
Not literally.
Oh, take me literally.
Alright.
Okay.
But, but they can, I mean, it's,it's a general surgeon can do
it.
A family practice doctor can doit.
You know, they don't, you don'tneed to be an obstetrician to do
a C-section.
It's a turf battle.
And, uh, surgeons don't wannatouch it because during their
training they're taught that,oh, we don't want a too with

(43:39):
pregnant women.
You know, that's why we stillhave dentists and other people,
you know, asking the woman whoneeds dental work to get a note
from their obstetrician thatit's okay to give you
antibiotics.
Mm-hmm.
I mean, you went to dental,dental school for god's sakes.
You didn't learn about how totake care of teeth of pregnant
women.
Right.
Of course you did.

(43:59):
You just want someone to coveryour ass.
Yeah.
That's what we have going onthroughout.
Yeah.
I don't know how I went off onthat tangent,

Natalie (44:07):
but that's okay.
I see that also in the fitnessworld, like I specialize in pre
and postnatal exercise and a lotof other trainers or exercise
physiologists kind of like, ugh.
They, they worry and they don'twanna touch them, and they just
do, you know, the quote unquotesafe exercises, which, if we're
not loading pregnant women, likethey need to lift heavy, they,
their lives are like strengthworkouts, essentially.

(44:30):
The car seat and the diaper bagand the baby's growing.
Like, there's a lot of thingsthat they need to train for, and
we're underdosing themchronically for exercise-wise.
So, I mean, yeah.

Dr. Stu (44:42):
Yeah.
There's just a, there's just alot of, again, it's the fear
that permeates everything aboutpregnancy and our culture.
And what's really interesting,if you look at other cultures
where maybe even their outcomes,they may even have more maternal
deaths than we do, um, like sayCentral America or, or even the
Amish population where they'renot, where they're not based in

(45:04):
fear, where pregnancy is a lifeevent.
Um, they, they enjoy theirpregnancies much more than
American women do.

Natalie (45:11):
Yeah.
Yeah.
I believe it.
Hmm.
Yeah.
Yeah.
Wow.
Okay.
Um, I have a, a good questionfrom one of my audience members.
Um, what's your, all,

Dr. Stu (45:22):
all the questions have been good, by the

Natalie (45:24):
way.
Oh, good.
I'm glad.
This one is a, this one's apivotal one.
What is your opinion on

Dr. Stu (45:30):
free birth?
Okay.
Um, you know, as a, as a medicalprofessional, even though I'm
No, no, I'm certainly not likemost obstetricians, it's not,
it's not great for me to su tosay that I com completely
support free birth.
But I completely support freebirth.
Hmm.
Yeah.
Okay.

(45:50):
Depending on what your choicesare, I mean, I think it's
smarter to have somebody that'strained on your team, even if
they're sitting downstairs whileyou're upstairs with your
partner just laboring and havingthe baby, just in case.
Um, certainly having someprenatal care that's valuable.
Not the kind of prenatal carethat you get in an
obstetrician's office, but kindof prenatal care that you get in

(46:13):
a midwifery model where youlearn about certain things.
Uh, but ultimately, and I thinkMichelle Odont would agree with
me that free birthing isprobably the way we're designed.
Um, and we should be preparedfor things to go wrong.
And that's why having a skilledperson there, and that's why
it's hard for me as a medicalprofessional to really endorse

(46:35):
it.
Right.
But I'm endorsing it.
Mm-hmm.
Um, if you have no other choicesand the, and the, and I would
strongly take free birth over,over hospital birthing.
For, for women that are properlyselected.
Again, I'm not talking aboutsomebody with preeclampsia
Right.
Or something like that.
I'm talking about perfectlyhealthy women with generally
singleton pregnancies.
I've, you know, I know thatthere are some that birth twins

(46:56):
at home and they do fine.
Mm-hmm.
But there are potential, morepotential problems and that's
why having access to a trainedprofessional with their, with
their birth bag, with them, withall their potential meds and
stuff that they may need, or,you know, giving birth in a, in
a location where you're closeenough, where 9 1 1 is close.

(47:17):
That makes perfect sense.
But other than that, um, youknow, I really, the more I watch
what goes on in the hospital andthe more I've been around
midwifery care, I think that,that women are capable of doing
this.
Mm-hmm.
And we've just lost faith inthat because we've been so
indoctrinated to believe thatthat birth is a medical

(47:39):
condition.
Yeah.
And it's not.
And

Natalie (47:42):
we outsource.
Yeah, we outsource our health alot of times.
Not even just in pregnancy, butin the rest of life as well.
We worry about whatever it maybe.
Like, oh, I got sick, call thedoctor.
I got whatever, call the doctor.
And it's kind of like anautomatic response rather than,
let me see if I can like, waitthis out.

(48:03):
Trust my body to heal itself.
Right.
As long as there's no, you know,no like immediate concerns.
I think just, yeah.
We tend

Dr. Stu (48:10):
to, yeah.
I've learned a lot.
I've learned a lot in the lastdecade or so from, from midwives
and from smart people readingabout like fever.
Mm-hmm.
You know, when you have a fever,unless it's like really high,
you shouldn't be trying to breakthe fever.
Right.
The fever is your bodyresponding properly.
Um, and you know, this is, thisis controversial in, not in our

(48:33):
circles, but you know, when youhave well children, why do they
go to the pediatrician at all?
Mm-hmm.
If they're, well, why are theygoing?
That's a great question.
They're going because there's avaccine schedule.
Mm-hmm.
And if you are not on thevaccine schedule, if you choose
to not follow that, many peopleshould.

(48:56):
Um, then why are you going infor well, child exams?
Um, you know, you could have amidwife, a naturopathic person.
If you just, somebody you know,or you, you as a parent, you can
sort of tell if your kid'sthriving or not.
Mm-hmm.
The whole, the whole idea thatwe have these well, uh, person

(49:17):
exams, you know, in, in myprofession, we had the annual
pap smear mm-hmm.
And the annual mammogram.
And I just went along with that.
And then I started to realizelike, like what are we, why are
we, what's the, what's theadvantage of doing all this
screening?
Is it, is it leading to, tobetter outcomes, worse outcomes,
more unnecessary, and worryingmore unnecessary biopsies and

(49:40):
interventions?
And the answer is in my, myresearch is, yeah.
Yeah.
Unless you have high riskbehavior, um, getting an annual
pap smear for a woman in amonogamous relationship after
she's, you know, Dr.
She, she reaches when she, whenshe's married, something like
that.
It, it, that, that'sunnecessary.
Mm.

(50:00):
And yet, and yet the, in theindustrial lobbies that are
called acog or, or the AmericanRadiology Association, or
whatever they call themselves,um, you know, they would go,
they'd go nuts because that'sthe revenue generation, right?
It's people in the door.
We always have to look at no.
One of the ways, one of the waysthat I, people say, well, how do

(50:21):
you decide which evidence totrust and which evidence not to
trust?
It's very difficult though,because science is totally
corrupted.
Totally corrupted by money.
Yeah.
And by big pharma.
Which is the same thing.
And so one of my, one of thethings I use is, is reliable
sources.
But the thing that I'm talkingabout here is if some paper

(50:42):
recommends you do less, thatmakes sense to me.
Mm-hmm.
Probably true because there's nomoney in doing less.
Right?
Exactly.
Exactly.
There's no money in not taking amedication for the rest of your
life.
Mm-hmm.
A statin, an S S R I, uh, youknow, a blood thinner, whatever,

(51:02):
you know, once you're on thosemedications, thyroid birth
control, you know, we're nottrying to fix the underlying
problem.
We're just treating the problemwith a medicine that you will
take for the rest of your lifeand you'll have to refill it
every 90 days.
And it's an annuity for thepharmaceutical companies.
And we, we, you know, have theydone great things?
Sure.
They have created some greatmedicines that have saved lots

(51:23):
of lives, but the idea that,that they, uh, have your best
interest at heart is so naive.
Yeah.
We've seen that now, we've, nowit's now been exposed.
The, you know, they used Covidto their advantage to, to take
more control over the world.
But it also gave us a real good,clear insight into, into how

(51:45):
that all works.
And if people are payingattention, then they know that,
and that's been going on inobstetrics, you know, for a
hundred years.
The gaslighting of people.
Yeah.
And tell them they need to do itthis way and they need to do
that.
And this is safer.
Well, safer is what, what doessafety mean?
Safety doesn't mean the same,it's not like, it's like the
Friedman curve.
Everybody's safety is exactlythe same.

(52:05):
No, it's not the case.
Not true.

Natalie (52:07):
Yeah.
Right.
Yeah.
I feel like I could have a lotof other questions off of that,
but I'm gonna stick on track.
Um, somebody else, I think thisis probably the last one of our
Instagram submitted questions.
Somebody else was asking, um,couple people actually.
What would be your idea of asafe time safe?
I guess it segues in safety ofbetween twins.

(52:30):
So how long would you wait, um,after, you know, first baby's
born, before like, I don't know,transfer or getting worried
Sure.
Or something like

Dr. Stu (52:39):
that.
Yeah.
Yeah.
Ricks and I have a paper comingout, um, probably next month I'm
hoping, or maybe oh, yay, reallysoon.
I keep, I've been saying thisfor about a year now, so it's,
hopefully it's coming out soon.
Um, the twin to twin interval iswhat we call that.
What's the difference?
The difference in time or the didistance in time between twins
in the hospital, twin pregnancyvaginally delivered.

(52:59):
They're usually like fiveminutes or less because the
first twin comes out.
They immediately go up andrupture the membranes of the
second twin, and they have thewoman push the baby out, whether
she can feel it or not.
Wow.
Um, that's the way we were alltrained.
Okay?
We all thought that that was theway it should be, but I realize
now, the reason that they do itthat way is mainly because
they've got 10 people waiting inthe, in the delivery room.

(53:20):
They've got the, the pediatricteams there, they got the
anesthesiologists there.
You got a bunch of nurses there.
They can't have people standingaround for an hour and a half,
um, doing nothing.
Waiting.
Yeah, waiting.
So that's wrong right now thequestion is how long is too
long?
And that's an interestingquestion.
And there is some worldliterature that talks about the

(53:40):
longer the twin to twin intervalgoes, the more likely you are to
get an acidotic.
Baby B an acidotic baby Btranslates into a baby B that's
probably got lower Apgar scoresand may or may not need more
respiratory assistance.
Okay?
So they don't give any timelimit.
They're just saying that thelonger you go, the more the pH
of that baby's gonna be droppingmore.

(54:03):
All right?
And I have found.
Again, not statisticallysignificant cuz my numbers don't
reach that.
That the longer you go, the morelikely you are to have a
postpartum hemorrhage.
Hmm.
Now you could go two hours andhave no postpartum hemorrhage
and you could have a postpartumhemorrhage with a five minute
twin to twin interval.
So it isn't a directcorrelation, but it is a, a

(54:24):
correlation nonetheless.
Okay.
So I have, since thatinformation has been collated by
myself and Rx, I have decidedthat I think that about 30 to 45
minutes is a reasonable time todo absolutely nothing except L
you know, let, as long as baby Bis fine inside with a heartbeat.
Yeah.

(54:45):
So baby A, if you get the cordslong enough, you can leave the,
pull the baby up to mom and Momcan bond with baby A and you can
have skin to skin time and thenyou can, if the contractions are
still spaced out a little bit,you can get baby A to latch and
that may help bring downoxytocin, which then will make
your uterus contract more andget things going with baby B.
But if after 30, 45 minutes it'snot, and I have this discussion

(55:07):
with my twin moms, um, in theprenatal period, it's not, we're
not talking about it right thenand there.
We'll talk about it and somewill say, no, I don't want you
to intervene.
And others will say, fine, youcan go ahead and rupture
membranes.
And so then normally that's whatwe would do is rupture membranes
at that point.
And that usually jumpstartsthings pretty quickly.
Mm-hmm.
And then, and then you get thatbaby out and then, um, uh,

(55:31):
you're less likely to have ababy with a low, low Apgar
score.
So, um, there is no, I don'tlike to have algorithms and I
don't like to tell people whatthey should do, but I think, uh,
a reasonable and nature, most ofthe time will, will solve the
problem without me having tointervene because it will be
less than four 30 minutes or sobefore the things start to heat
up again.

(55:51):
Okay.
But sometimes it can be a longtime, and we've had people go
four hours, six hours in betweentwins.
I, I know part, part of me isalso the person that can't sit
there and wait that long.
Yeah.
Right.
I I, I go nuts.
Mm-hmm.
I mean, you can, you can takethe doctor outta the hospital,
but you can't take all of thedoctor outta the doctor.

(56:12):
And I, you know, I can't sitaround for that long.
I know that I hear stories fromsome of my saintly midwife
colleagues who say, yeah, we hadone baby born 12 hours after the
other one or something, and wedidn't have a postpartum
hemorrhage.
And that's great.
Yeah.
But I'm just saying that, thatultimately I think a reasonable
time period of 30 to 45 minutesbetween twins is between

(56:32):
starting up and trying to get,be moving.
Makes sense.
Okay.
And that is purely subjective onmy part.
And is

Natalie (56:39):
that primarily with die, die twins then?
No.

Dr. Stu (56:43):
Okay.
It doesn't matter.
No.
There the, if you reach termwith mono die twins, there's no
reason that you can't delay cordclamping.
They're not all of a suddengonna develop a shunt that
wasn't there for nine months.
Right.
So if, if, if die, die, if monodie twins make determine in
labor.
I try.
I don't treat them anydifferently at all.
Okay.

Natalie (57:01):
Right.
So with Die Die twins, thismight be a dumb question from me
personally.
So Baby A comes out, does theplacenta stay or does it also
come out and then the whole nextbirth happens?

Dr. Stu (57:14):
Well, that's a funny story too, because I always
thought they all came out aftertwin B until it happened to me
once where after Twin A cameout, there was a gush of blood
and I wasn't thinking because itwas so routine for me.
Yeah.
So I'm worried a little bit.
So I, I examined, all I can feelis placenta at the in, in the
opening and I'm thinking, well,she can't have a placenta Previa

(57:36):
Baby A just came out of thereand then I realized, oh, it's
baby.
A's placenta was just sitting atthe, you know, the internal
loss.
And so Right.
Just, you know, just a small.
Gentle tug on the cord and outcame baby's place.
But then baby B actually therewas more bleeding than I liked
and so we expedited baby B byrupturing membranes and getting
baby B out.
But that's only happened onetime to me in 40 years.

(57:59):
Wow.
To practice where the aceplacenta came out before B,
right?
Almost always.
Both because ultimately theuterus has to contract generally
enough for the placenta to shearoff Right.
And right.
Even though one twin comes out,it's very rare that the uterus
contracts enough cuz there'sstill another 5, 6, 7, 8 pound
baby in there.
Mm-hmm.
For the uterus to contractenough to cause the placenta to

(58:20):
shear off.
Okay.
So that's an oddity.
Most of the time they bothplacenta will come out after
baby B comes out.
Okay.

Natalie (58:27):
And then, um, in call birth for twins, is that like
somewhat common if you're, or Iguess for baby a potentially

Dr. Stu (58:36):
no more common or less common for me than, than in call
singletons.
Okay.
Nothing I've seen.
You know that, that way, I mean,baby B maybe even more likely
with baby B to be on call.
Okay.
Um, but again, I don't, youknow, I know on-call is cool,
but I'm not sure that it has, Imean, maybe I'll get yelled at

(58:57):
for this, but you maybe can tellme what, what, what's the
significance of a baby being oncall versus rupturing and then
coming out like 30 seconds lateror five minutes later or
whatever?
I, I'm not sure.
I think it's one of thosemagical, mystical cauldron
things that midwives love, sothat might be it.
Yeah.
I mean, we never had oncallbursts in the hospital when I

(59:18):
was training because everybodygot a Right.

Natalie (59:21):
Right.
Yeah.
Hmm.
It's one of those things, Iguess you probably see more in
home birth, obviously.

Dr. Stu (59:27):
Oh, ob you absolutely, you absolutely see more in home
birth and you know what?
It's obviously very nice.
It's if, if it comes out thatway, then nature designed it to
come out that way.
But, but nature also designedRUP membranes to rupture before
labor even starts, and thenYeah, that happens too.
So it, it, it's, it's a randomthing, but I think it's one of
those things like a, like ablood moon or a, you know, or a
lunar eclipse.
It's kind of a cool thing thathappens once in a while.

(59:49):
And so we give it a little moreemphasis maybe than it needs.
Yeah.

Natalie (59:53):
Yeah.
That's fair.
So I wanna ask you what yourfavorite resources are, and you
can totally push your ownpodcast as well.
I want people to listen to it,but like, books, any Instagram
accounts, films, all of that.
What, what would you recommend

Dr. Stu (01:00:08):
for people?
You're gonna get me in troublehere.
I don't know that I can reallyanswer this question very well.
Ok.
Cause because there are so manygood resources for women who are
looking for.
Information, not indoctrination,but information to give them
insight.
Mm-hmm.
And, you know, I mean, there aresome great podcasts, but if I

(01:00:28):
name a couple, then I'm gonnaleave out a bunch and I don't
really want to do that samething with books.
Okay.
Um, you know, on my, on mywebsite I have a resource page,
but, you know, I haven't updatedthat thing in like five years.
So, um, because, because I, youknow, I just, I, it's not
important to me at this point.
I think, um, what's important todo is, is to read about things

(01:00:52):
about your children.
And that's why I think bookslike the Vaccine Friendly Plan
and reading, um, dissolvingIllusions or turtles all the way
down about vaccines because youknow, you're gonna give birth
and it's gonna be, you know,however you want it.
I mean, I would tell you betterthan any book would be to, to,

(01:01:13):
for every woman, whether shewants a hospital birth or not,
to have prenatal care with amidwife.
Um, because the midwives willthen be their resource and then
they can refer them to the booksand the podcasts and the, and
the blogs and things that theythink are, are most valuable.
Mm-hmm.
Um, rather than putting me onthe spot

(01:01:34):
like

Natalie (01:01:34):
that, that's okay.
Right.
No, that's, I think

Dr. Stu (01:01:36):
that's a great answer.
Look, there are so many good.
I have, you know, I've, I on my,um, my podcast feed from iTunes,
uh, apple Podcasts, uh, I can'tkeep up with them all.
There's so many good podcastsout there.
And not every topic is somethingthat people wanna listen to,
which is why they should gothrough and they should pick out
the topics that seem to beinteresting to them.

(01:01:58):
Listen, and I try to do topics.
She likes to do topics.
I like to just talk

Natalie (01:02:04):
and, you know, you guys are a good team that

Dr. Stu (01:02:06):
way.
I think.
I think we are.
I, I do think we are.
I think that we bring eachother, bring Audi, each other
our best.
Um, uh, but we do topics like werecently did, so.
The umbilical cord, or we didlow lying placenta, which I
think is a real good onebecause, um, people are freaked
out about low lying placenta.

(01:02:26):
You know, when you have your 20week scan, doctors will
sometimes find a low lyingplacenta, and I found research
that showed that when you have alow lying placenta at 20 weeks
and it's anterior 100% of thoseresolve.
Hmm.
Yet for the next eight weeks orso, you're gonna be worried.
Yeah.

(01:02:47):
Because they found a low linepresent.
They're not gonna tell you thatit's gonna resolve.
They're gonna tell you they wantyou to come back in four to six
weeks to take a look at it.
Of course.
That, that's the cha-ching,cha-ching, uh, thing that
maternal fetal medicine doctorsdo.
Mm-hmm.
Again, they don't make money bynot seeing you.
It's a great point.
And I know there's an, I knowthere's an supposed to be an
ethical wall there, but thatethical wall is long.

(01:03:10):
It's got, it's like Swisscheese.
Mm.
We, we, we, it's very, verydifficult.
Every one of us.
Skews our counseling, you know,every, every midwife.
We don't have the time, most ofus, to give full informed
consent on everything.
It's really interesting.
At the last seminar I did justup in, um, post Falls Idaho a

(01:03:32):
couple weeks ago, uh, we weretalking about informed consent,
and I talked about full infortrue informed consent, and I
said, you can't possibly giveit.
And then, and then when the WiMidwife said, well, I do, and I
go, oh, okay.
Do you give lidocaine when yourepair a thing?
Yes.
Do you tell a woman that she candie from that?
Yes.

(01:03:52):
And I look at her and I go, youdo, right?
I mean, like, would you read thepackage insert to her?
I mean, I mean, do youunderstand that every medicine,
everything that we do has alaundry list of things that are
so rare, right.
That you can't possibly give a,but sh she says she does.
So I, well far be it from me.
So she may be right that she cando that.

(01:04:12):
But no more normal people can'tgive.
True informed consent.
So they, we skew it, but the thesystem skews it terribly.
They funnel you to funnel youdown the path they want you to
take.
Right?

Natalie (01:04:24):
Yeah.
Yeah.
No, that's a, a whole notherreason why it's really crucial
to see a midwife and to readthings yourself and do a lot of
research prior to the

Dr. Stu (01:04:35):
whole process.
Right?
No, and, and, and not everybodylistening to your podcast, well,
probably everybody listening toyour podcast is gonna feel like
we do, but, but not everybody isgonna agree with everything that
I'm saying.
I wouldn't expect them to.
Yeah, but I wouldn't, I wouldn'texpect them to just outright
dismiss what I'm saying either.
But that's what will happenbecause what I'm saying makes a

(01:04:56):
lot of people uncomfortable.
Yeah.
It makes a lot of myprofessional colleagues
uncomfortable.
It makes a lot of women whofollow the medical advice,
uncomfortable women who have thecascade of interventions.
This is not to diminishanybody's birth experience, but.
Birth should be this wonderfullife event.

(01:05:17):
It shouldn't be this, itshouldn't go into it with this
fearful process.
Sometimes it goes wrong.
Yeah.
And then you need medicalattention, but most of the time
the medical attention isactually detrimental Yeah.
To the process and the havingthe life experience.
Right?

Natalie (01:05:31):
Mm-hmm.
Yeah.
And I, I like to say that too,like there's no guilt or shame
in past experiences when youweren't as informed as you could
have been.
Like, and as you know, you know

Dr. Stu (01:05:42):
better.
You No, not for the individual.
Yes.
There's guilt.
I, I, I'm, I'm guilting andshaming my colleagues.
Mm-hmm.
Yeah.
Because they should wake up.
But the individual woman whoends up falling into that trap,
it's not their fault.
Right.
How are you supposed to know?
Yeah.
I mean, I, I was part, I waspart of that trap.

(01:06:02):
Mm-hmm.
I was the guy wearing the hazmatsuit with the immediate cord
clamping who showed you yourbaby, and then walked it across
the room and put it down in thewarmer.
That was me.
Oh

Natalie (01:06:11):
man.
That's so like foreign to thinkabout.

Dr. Stu (01:06:16):
But yeah, it still goes on in a lot of places.
But that's how, if you know, ifthat's how you're trained and
that's all you know, that's allyou know.
And that's all you know.
I mean, if you only, if you livein a box and you never look
outside the box, you only knowwhat's in the box.
Yeah, agreed.
Like my cat has never beenoutside except when I carry her
from, you know, house to houseor whatever, but Yeah.

(01:06:38):
But you know, I, she doesn'tknow what it's like outside and
it's a good thing because sheprobably wouldn't last a day
where I live now.
Yeah.
And my colleagues live in, theylive in the box that they're
trained and they, some, some ofthem never get out of it.
And in order for them to feelgood about what they're doing,
they either have to ignore whatpeople like me say, or they have
to ridicule what people like mesay.

(01:06:58):
Yeah.
That's how it works.
Hmm.
That's the solution forcognitive dissonance.
That's how we all deal with it.
Oh man.
Yeah.
You know, I wish I, I will, Iwill tell you right off the bat,
I really do wish that there wasa way I could speak about these
things with total glee andpositivity, but yeah, no, I

(01:07:18):
don't blame you at all.
I can't.
Yeah.
I mean, when you, if you read myinbox every day from what people
write to me and tell me theirstory about how they just had a
glorious VBAC after twoC-section home birth, because
they listen to the podcast andthen they go on and tell me
about their first c-section wasfor no reason whatsoever, and

(01:07:38):
their second one was just aschedule or, or whatever, or, or
they've had two vaginaldeliveries and then they had a
third baby that was a C-sectionfor macros, somia.
Oh, yeah.
And, and, and these doctors.
You know, I didn't get into itand I don't want to, but have
you heard my thing about theC-section rate and about
cognitive dissonance?
Cuz it's, it's a great littleanalogy.

(01:08:00):
Think maybe, but yeah.
The C-section rate in the UnitedStates is 30%, let's just say
it's 30%.
And say the World HealthOrganization says it should be
10 to 15%.
So let's say 15% and say everyyear in the United States
there's about 1.4 millionC-sections being done.
Maybe less, but let's just say1.4.
It's by far the biggestoperation being performed
anywhere.
The most common operation.

(01:08:22):
Wow.
But according to the WorldHealth Organization, half of all
C-sections are necessary.
So that means there's about700,000 unnecessary surgeries
being done on women every yearin the United States.
And no one says a peep about it.
Right.
Not even the insurance companieswho are paying for it.
Which is odd because if you had700,000 unnecessary knee
surgeries or gallbladdersurgeries, the people would, the
insurance companies be up inarms about it, right?

(01:08:44):
Yeah.
But here's the really scary partis if you have 700,000
unnecessary C-sections, who'sdoing them?
No doctor goes home at night andsays to their spouse, Hey honey,
guess what?
I did two unnecessary C-sectionstoday.
Right?
Every C-section a doctor does isnecessary, yet half are
unnecessary.

(01:09:06):
So how do you live with that?
And that's where cognitivedissonance comes in.
Cuz they'll have to say, well,it's the other guy that's doing
the unnecessary ones, but theother guy's saying it's you
that's doing the unnecessaryone.
Yeah.
And nobody takes responsibilityfor it.
They're just ignoring it.
Yet, 700,000 women are what?

Natalie (01:09:21):
What?
They're just ignoring it.
They're ignoring the fact thatthey're doing the unnecessary
and

Dr. Stu (01:09:24):
700,000 women are having unnecessary surgeries
affecting them.
Their current baby and all theirfuture babies.
Yeah.
And no one says anything.
Oh yeah.

Natalie (01:09:36):
No, I don't,

Dr. Stu (01:09:37):
I don't quite understand the silence about
that and the acceptance of thatas being the norm.
I think it

Natalie (01:09:48):
probably, well, somewhat has to do with just
people worrying about like, Imean, it's fear-based,
obviously, but it's a baby and,and they don't touch pregnant
women or they don't do studieson babies or pregnant women as
much as they should or couldbecause it's a ethical
liability.
And in their eyes it's like,well, if it was unnecessary but

(01:10:09):
the baby still lived, then Iguess it was still fine and
good.
Right?
Like,

Dr. Stu (01:10:13):
I don't know.
Yeah.
Well they all, well, you whatyou got, like you said, all that
matters is live baby and theBestNet.
But here's the interestingthing.
If, if insurance companies wouldsuddenly say to a hospital,
we're gonna pay you half as muchfor a cesarean as we do for
vaginal delivery, they would goway down.
The C-section rate would drop by10 15 by, by by 50%.

(01:10:36):
Yeah.
Um, in a matter of months.
Yeah.
Because they'd put in newpolicies that say, you know,
breach delivery, vbac.
Um, you know, stop theseinductions that are leading to
these pri c-sections.
Stop.
We not, you're not allowed tointroduce somebody for or do a
c-section for suspected macrosomia.

(01:10:58):
You're not allowed would, theywould, it's so stupid.
They would find reasons to, toget rid of cesarean section, but
as long as the system isdesigned to reward you for bad
behavior, you'll get more badbehavior.
That's just standard economics 10 1.
Right, right.
Yeah, because again, it's not a,it's not a lighthearted subject.

(01:11:19):
It's one of my, another heavysubject, but it, it, it just
shows you how crazy the currentsystem is.
Mm-hmm.
That nobody's speaking up aboutthis, and that those people that
run this system are criticizingmidwives for how they practice.
Jesus.

Natalie (01:11:39):
It doesn't make sense.

Dr. Stu (01:11:40):
No.
And then the, the, and then the,and then them wanting to you to
be grateful for how they savedyour baby.
Right.

Natalie (01:11:47):
All that matters is a healthy mom, healthy baby.

Dr. Stu (01:11:50):
Right?
They, they, they hold this wholecascade of interventions leads
to a cesarean section and theysay, thank God you were here.
Not realizing how stupid thatis.
Right.
It's like a fireman starting afire and then you calling them
to come put it out, and thenexpecting you to say, thank you
for putting out the fire thatyou started.
I mean, no one would do that.
Yeah.
But for this, they do.
Mm-hmm.

(01:12:11):
Yeah.

Natalie (01:12:11):
Yeah.
I, I mean, I think it has to beheavy, like it can't be
lighthearted because if it'slighthearted, then we're not
putting enough emphasis or, youknow, like, well, there, I mean,

Dr. Stu (01:12:21):
but it, no, but it, it is.
It's a beautiful moment in aperson's, in a woman's in a
family's life.
And when I see these videos ofwomen having home water births
with their little kids around,and then little kids climb in
the pool afterwards and stufflike, those children will never
look at birth with the samefears.
Yeah.
That most children, we'vesterilized birth.

(01:12:42):
Mm-hmm.
And we've sterilized death.
Most people lived their entirelife.
Never seeing a person born,never seeing a person die.
Yeah.
I was, so, a hundred years ago,a hundred years ago, no one
lived their life without seeinga person born and without seeing
a person die.
Yeah.
We've
turned

Natalie (01:12:59):
it over.
Usually it was in the same room.
Right.
Like they had a birthing room.
A dying

Dr. Stu (01:13:03):
room.
Yeah.
No, no.
Grandma died in bed and, and,and mom gave birth in the same
room.

Natalie (01:13:09):
Yeah.
Right.
Yeah.
Okay.
I'm taking it a little bit lessheavy.
I want to know what, first ofall, what your number one piece
of advice for our listeners is.
What do you want every singleperson

Dr. Stu (01:13:22):
to know?
You mean who's pregnant?
Yes.
Or in life in general.
I mean,

Natalie (01:13:27):
I guess you could do either, you could do two if you
want one for

Dr. Stu (01:13:30):
pregnancy.
No, I'm not.
I can't tell people in life, in,in pregnancy.
Uh, I would tell everyone tohire a midwife and a doula, but,
but, but look at the midwiferymodel of care before you settle
on the, uh, medical model ofcare.
Nice.
Just look at it.
Yeah.
And if you're gonna, and if youare somebody that really wants a
hospital birth because you feelsafer there, that's 100% fine.

(01:13:56):
But your prenatal care is stillsomething that you should
consider getting with a midwife.
What we call concurrent care or,or collaborative care.
Mm-hmm.
Um, at the same time, eventhough you're gonna go with your
OB and you're gonna do it in thehospital, and you may want an
epidural as a life-saving bridgebecause the, the idea of pain
and labor is just too much foryou.

(01:14:16):
That is absolutely fine as longas you're informed.
But, but you can't really getinformed in the obstetric model.
You get groomed Yeah.
Not informed.
So that would, I mean, I mean,number one advice for a pregnant
person is realize that you'renot sick and that midwifery
model looks at your pregnancy aspart of a, just a natural

(01:14:38):
function.
And so look at it that way.
And if you can find a greatcollaborative situation, that's
great too.
That's, that's it.
I mean, all the other stuff is,you know, is, is too specific
for each individual thing.
But the whole idea is thephilosophy of not worrying,
bathe your baby in oxytocin anddopamine during your pregnancy,

(01:14:59):
not.
Adrenaline and cortisol not beworried all the time.
Yeah.
Trust that your body got you,your body got you pregnant.
It can do that.
It's growing a baby, it knowswhat to do if you just trust it.
And of course you wanna batheyour baby in whatever you can to
make your baby's epigeneticsbetter.

(01:15:21):
Yep.
We don't really understand thatwhat, what fear can do to a
developing brain in our, in ourwomb.
Hmm.
But it can't be good.
Yeah.
It can't be, it can't be good.
Maybe it's neutral, but it's notgood.
Yeah.

Natalie (01:15:38):
Right.
I love that.
Okay.
My next question I ask everybodyis, what is your favorite
wellness habit that you'reincorporating into your daily

Dr. Stu (01:15:47):
life right now?
Me?
Right now?
Yeah.
Oh, I, I, I, I drink green stuffin the morning.
Nice.
Nice.
That's new, that's new for me.
I used to be like bagels orcereal and bananas or
strawberries, you know, thatkind of a breakfast.
Um, now I think that, um, I takemore supplements.

(01:16:12):
I take a lot of things that I'velearned.
You know, I take a probiotic, Itake choline, I take zinc, I
take vitamin D, vitamin C, youknow, all the protect yourself
against covid stuff.
Yeah.
And, um, and then I starteddrinking.
You know, we have a, um, coupleof sponsors that help sponsor us

(01:16:34):
and, um, uh, well, they don'tsponsor us, but they're, you
know, they like Athletic Greensis one.
And then there's this othercompany that I, you know, I, I,
you know, we get ads in ourInstagram all the time and we
ignore them completely.
Sometimes they hit the, hit youon the right day at the right
time and, oh yeah, go on.
And you spend, you spend$200 on,on.

(01:16:54):
Supplements.
So that I think has been helpfulfor me to keep.
Cause as we get older, you know,our bodies do give out and we,
you know, men tend to get a gutand women tend to get a butt.
And that's just the way itworks.
And you know, if you can stayphysically active and physically
fit.
And I think that, so that's onething that I do.

(01:17:16):
And I, and I also try to stay asactive as I can.
I've got some orthopedicproblems and as you know, I had
the eye issue.
I'm still recovering from that,so I'm not really doing as much
as I normally do.
But I have a, a electric bike,which has been a godsend for me.
Awesome.
Uh, I can explore places I couldnever have gone before, cuz I've
had two knee operations and Ihave a bad knee and I just don't

(01:17:37):
have the strength to pedaluphill that much anymore.
But now it's like, you know,when you have pedal assist, it's
great.
Yeah.
And being outside.
And now that I have a homesteadin southern Utah, I can walk in
the grass and I can, I canconnect and I have a garden.
And I'm gardening of growingvegetables and flowers and I am,

(01:17:58):
uh, I think that these are thethings that are keep gonna keep
me healthy and happy till the,the day I don't wake up.
Yeah.
And that, and that will happenat some point, hopefully not for
about another 30 years.
Yeah.
We want

Natalie (01:18:11):
you around for longer.

Dr. Stu (01:18:13):
Yeah.
Well, yeah.
But that's, that's the, the keyis to, is to not, I know.
I don't watch the news anymore.
I get enough crappy news onInstagram and stuff.
They can't help it.
Yeah.
So I I, I, you can't becauseyou, this last hour with me,
you've heard me, you said getheavy.
It's gets heavy.

(01:18:34):
Mm-hmm.
Because, because I'm sopassionate about trying to point
out the flaws in what, what weconsider to be our traditional
medical system as it comes toobstetrics.
And it can be, it can be, it canwear on you and, you know, and
I, and I read incessantly and soI, you know, I have to have a
way to get rid of that.
Aggravation Yeah.

(01:18:54):
That I get from reading myjournals that just, you know,
they just won't, they won't,they won't, they don't see the
light and they just continue totry to find new ways to
intervene in, in nature'sdesign.
Yeah.
So exercise, you know, drinkinggreen stuff.

(01:19:15):
Sorry.
Um, uh, I don't, it doesn't haveto be green.
Just, you know, it's a healthiermixture of, of things that I
think are good for your body.
Do I feel any different?
No, not really.
I don't know.
Maybe I feel worse if I didn't,but mentally I feel better.
That's, that's

Natalie (01:19:33):
valid.

Dr. Stu (01:19:33):
That's worth it there.
Well, that's what we talkedabout at the very beginning.
I think the very first questionwas tru having, you know, trust
your body mm-hmm.
And allow your body to do whatyour body's designed to do and
stop messing with it all thetime.
Yeah.
You know, don't take regularmedications if you, you know,
unless you.
Clearly have to, but try tosolve the under underlying

(01:19:55):
problem.
I mean, I, I had, um,cholesterol that was slightly
high, and my internist, who I'dbeen with for 30 years wanted to
put me on a statin.
And I said, how about if I justchange my diet and then lose a
little bit of weight?
And I did.
And, and you know, if I tired oftaking a statin, I'd be on that
drug for the rest of my life.
Yep.
With all the costs and the sideeffects from that.

(01:20:15):
Mm-hmm.
And we're finding out, and wewill find out more and more that
statins are horrible.
There are so many side effects.
I have a lot of, a lot of doctorfriends who, who swear by them,
but they, you know what we sworeby a lot of medications and,
and, you know, thalidomide and de s and Vioxx and, and r i
vaccines, we swore by those too,and they turned out to be
horrible.
So, uh, so yeah.

(01:20:38):
You, you know, let your body dowhat it's designed to do.
Yeah.
Um, no, there's certain things Ican't help, like, like my
orthopedic issues.
I mean, I, I, I'm resistinggetting an artificial.
Joined.
Don't really want one.
Yeah.
But at some point I'm, I'll,I'll probably do it and then
I'll kick myself for not havedone it 10 years earlier.

(01:20:58):
That's what everybody, everybodywho gets one says, I wish I
would've done this earlier, andyet I'm just still don't wanna
do that.
Yeah.

Natalie (01:21:06):
Yeah.
I've had a lot of clients echothat same, same thing.
It's, it can be very beneficial.
It can get you back to where youwant to be as far as movement

Dr. Stu (01:21:14):
wise.
You know what, like artificialhips and knees.
Exactly.

Natalie (01:21:17):
Yeah, yeah, yeah.
Not the shoulder.
Right.
I wouldn't recommend theshoulder.

Dr. Stu (01:21:23):
Yeah.
Well, we're getting outside.
I think I'm getting reallyoutside my expertise.
You just asked for what, youknow, some things that I do.
Yeah.
And I tell you that, thatfinding a homestead finally and
getting out of Los Angeles washuge for me.
Um, the last few years, eventhough, I mean, my kids are all
grown, but the last few yearsliving in LA I just, I watched
my city go downhill and I just,I watched, um, me fighting some

(01:21:47):
losing battles and I justdecided that, That, you know, I
can't, I can't continue.
I did it for 40 years.
I can't, I can't continue to, todo that.
Yeah.
And so I needed, I needed achange and now I'm re-energized
to do other things like teachadvocate, consult with people.
I have a consulting service, um,bliss and I are working on

(01:22:11):
probably doing some sort ofPatreon type thing coming up
where people can then havedirect contact with us.
Subscription type thing.
Yeah.
Something cuz I obviously I needto make an income.
Yeah.
Um, so that, we'll figure thatout.
But I want to do, uh, thingsthat are not as physically and

(01:22:35):
emotionally stressful and beingon call to all my midwife
colleagues out there and all mybirth worker colleagues out
there, doulas, lactation,consult, being on call.
It takes its toll.
Mm-hmm.
And you need to take breaks.
You need to do this in a, in atime of your life where you're,
where you're, you're not boundby dealing with your babies and
your toddlers and your childrenand you need to take breaks.

(01:22:57):
So, so work for six months andthen take three months where you
take no clients and rejuvenateyour body.
Cuz being on call will wear youout.
Yeah.
Um, and you'd never wanna losethat spark of enthusiasm that we
all have for birth.
I mean, we are birth geeks.
Yep.
Hundred percent.
Um, yeah, but what's better?

(01:23:19):
Hockey maybe?

Natalie (01:23:23):
Can't think of anything that's better.
Oh, so that.
Subscription hopefully soon.
But otherwise, services youhave, um, a way that people can
get in contact with you throughyour website, right?
Birthing instincts.com and yourpodcast, birth Birthing
Instincts podcast

Dr. Stu (01:23:42):
and Instagram is birthing and Instagram perfect.
Right.
And my, my website has, um, hastestimonials in it.
It has guidelines in it, it hasblogs, things I've written.
I just was reading some stuffthat I wrote back in 20 13, 20
14, and stuff like that.
I, I was like pretty, I waspretty on it right then.
And unfortunately nothing hasreally changed in the last seven

(01:24:02):
or eight, nine years.
But, but, um, it's reallyinteresting to read that stuff.
And then I have a link at thevery top.
I'd like it to be in a biggerbanner, but it's a tiny little
banner that says, become amember.
People can sign up formembership or they can sign up
to have a consult virtual, justlike this.
Okay.
Um, one-on-one, that sort ofthing.
Um, and I, uh, and look, I, Ithink.

(01:24:25):
First thing that people need todo is have decide to put, like
we said at the beginning, putvalue on this process.
Mm-hmm.
If you don't value giving birth,if you don't think it has value,
you won't wanna spend any moneyon it or any time on it.
And, uh, that's so true.
True.
Then you get what you pay for.
Yeah.
It, it, the way we give birth toour children has immense value

(01:24:46):
because it will be with you therest of your life.
You'll remember it more thanyou'll remember just about
anything else.
And we like to give you, um,happy memories.
Yeah.
Um, and the medical model isn'tdoing that for the most part.
Yeah.
Right.

Natalie (01:25:04):
Yeah.
Well said.
Well said.
Well, Dr.
Stu, thank you.
Thank you.
Thank you for everything thatyou do and for being here today.
I, I truly appreciate

Dr. Stu (01:25:13):
it, Natalie.
Thank again, thanks for havingme on, and thanks for the
patience of the technicalglitches at the beginning.
Oh, we're, we're good.
Yeah, we're all good.
Awesome.

Natalie (01:25:21):
I really enjoyed my conversation with Dr.
Stu about birth and hisperspectives on all the things.
I hope this really piqued yourinterest.
To learn more about physiologicbirth and to do some research of
your own, you'll find all thelinks for the resources he
mentioned as well as his siteand social pages for you to
follow in the show notes forthis episode.
Please remember that what youhear on this podcast is not

(01:25:44):
medical advice, but remember toalways be an active participant
in your care and talk to yourhealthcare team before making
important decisions.
If you found this podcasthelpful, please consider leaving
a five star rating on Spotify orwriting a review on Apple
Podcasts as this really helpsother people find the show.
Thanks so much for listening.
I'll catch you next time.

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