March 31, 2025 • 39 mins
Ep 178: Ned Johnson joins Dr Jessica Hochman on "Your Child is Normal" and they explore the complexities of parenting, emphasizing the importance of connection, understanding, and enjoying the journey with children. Ned shares insights from his new book, "Seven principles for raising self-driven children", highlighting practical strategies for building lasting relationships with their children.
To purchase Ned's new book The Seven Principles for Raising a Self-Driven Child: A Workbook click here
Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner.
For more content from Dr Jessica Hochman:
Instagram: @AskDrJessica
YouTube channel: Ask Dr Jessica
Website: www.askdrjessicamd.com
-For a plant-based, USDA Organic certified vitamin supplement, check out : Llama Naturals Vitamin and use discount code: DRJESSICA20
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Tiny Health using code: DRJESSICA
Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.
The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Unknown (00:00):
Sometimes life brings unexpected silver linings. I met
(00:03):
today's guest, Carson Meyer inthe middle of the Los Angeles
fires While both of us wereevacuated from our homes. When
we started talking, I learnedthat Carson is a doula, a
passionate advocate for maternalwellness, and now an author. Her
new book growing together, doulawisdom and holistic practices
for pregnancy, birth and earlymotherhood just came out this
week. It's a beautiful week byweek, companion for expectant
(00:25):
parents, filled with guidance,reassurance and practical
wisdom. What I love aboutCarson's approach is how she
honors the natural process,helps women trust their bodies
and reminds them that theirexperience, whatever it looks
like, is valid, normal andworthy of support. It was truly
a privilege to reconnect withher for this conversation, and I
think you'll take so much fromher insight and warmth. And
(00:46):
before we get started, if youdon't mind taking a moment to
leave a five star review,wherever it is you listen to
podcasts, I greatly appreciateit. Your reviews helps other
people find your child asnormal, and that helps us
continue reaching more parentswho need a little less worry and
a little more reassurance. Nowon to the podcast. I am so
excited to have here. CarsonMeyer, thank you so much for
(01:07):
coming on the podcast. Thanksfor having me. Carson is a very
special human being. She's amother, a doula, a child birth
educator, and now she's anauthor of a fantastic,
wonderful, wonderful book. I'mso proud of you for writing it.
Thankyou so much. I'm so excited. I
have always dreamed of writing abook, and I had just had no idea
that the opportunity would comethe week I was due to give
(01:30):
birth, or, like, right around mydue range. I got a call from
Chronicle about it, and I waslike, Oh my gosh, this is a
dream. I'm so excited. And ifyou read my book, you know, I'm
really big on that sacredwindow, taking time and space
to, yeah, just to be present inthose early weeks and months and
even years when you don't get itback. And so I spent the first
(01:51):
two years of motherhood writinga book, which I'd say are
probably like two of the biggestfeats you can do at the same
time, but the book is soreflective of my journey, and I
don't think I would have beenable to recall and chronicle the
feelings had it been later, likeI would have in real time. So
I'm so grateful that it came atthat time, because I got to just
(02:14):
like, be in it and write aboutit.
I can see that the memories aremuch more fresh as you're going
through it. So I'm sure thatadded a lot of authenticity to
the book. It actually soundslike perfect timing, as hard as
it sounds to have done both. I'mso glad that you were able to
put it together. Thank you. Youtoo. So tell me first, so the
audience is aware you're adoula. What is a doula Exactly?
(02:38):
Can you just describe what adoula means to you?
Yeah, and that's a good way ofphrasing it, because doulas have
so many different definitionsand ways of approaching this
work. But to me, it's alwaysjust been in service to the
woman and the family through thetransformation of birth, of
pregnancy, even preconceptionbirth and the initial postpartum
(03:01):
period. And so this looksdifferent, like I said,
depending on what the doulaoffers for me, education is a
big part of it. And more andmore, I realized that the best
way that I could set myself myclients up for success was by
helping to prepare them inpregnancy, more so, even than
being at the present at thebirth, which is obviously such a
wonderful and beautiful part ofit, and so I'm a certified
(03:23):
nutrition consultant, so Iincorporate that in my prenatal
education. I teach communitycircles that are childbirth
education circles for moms, andthen during the birth, doulas
attend the birth whether it'shome, hospital, birth center,
provide hands on comfortmeasures and help facilitate
conversations between theirprovider and hospital staff to
(03:45):
help them advocate forthemselves. What
I think sounds so beautifulabout your description of doulas
is that really you're just thereto support a mother and her
partner. And what's sofascinating to me is myself
being part of the medicalcommunity, I can see that what
we offer to mothers throughoutpregnancy isn't enough, that you
really need more support. And Ido find that a lot of people
(04:08):
nowadays, we are not alwaysliving by our families. We need
more of a village. And so what abeautiful concept that a doula
can be, that support can offerthat support for families. Thank
you. Yeah, it's interesting. Iwas asked this on a podcast
yesterday, like, how providersand doulas can work together,
and, you know, it barely variesand depends, like, who that
(04:29):
provider is and theirwillingness. But I said, I was
like, you know, you have a gooddoctor if they're gung ho on you
having a doula. Because not onlydoes the evidence show that
birth outcomes are better acrossthe board for mom and baby in
the present, when a doula ispresent, but also it's a
provider that recognizes youremotional needs and wants you to
(04:52):
have what you need to feel good,whatever that is. And so that's
why I immediately we hit it off,because I saw that you. You
recognize thatI agree with that. I have to
say, I do notice there's thisfunny cultural aspect in
medicine, where, when a familyshows up to the hospital with a
birth plan, I notice that someOBS, some pediatricians, don't
really look at it too fondly.
(05:16):
You know, they'll sort of say,Oh, the bigger the birth plan,
the more trouble the patient'sgoing to be, and I don't like
that we have that attitudethat's prevailing, because it's
the opposite of what we all wantto accomplish, which is we want
to work together. We want tosupport the parents together.
And so I'm so glad that we'rebringing this up, because I do
think it's really important thatwe do support the families in
(05:37):
their entirety. So now tell me,I'm just so everybody knows. And
here's your beautiful story.
What inspires you to become adoula?
So in the book, I talk a littlebit about my own, like my
mother's birth with me, how Ibelieve that we have an
imprinting that takes placeprior to birth that really helps
define who we are and who webecome and what we're passionate
(05:58):
about. And so that's one part ofit. I think it was a calling
that was always there, butcertainly was not one that I was
cognizant of simply because ofthe culture that we're in. I,
like so many young women inAmerica, was terrified of the
thought of birth so close to mymom, my sisters were moms like
(06:20):
when I was young, and so I justhad this deep reverence and
appreciation and admiration fromothers. But I was like, and
that's crazy, and I'm neverdoing that scary and just
overwhelming and all of it. Andit wasn't until I saw the
business of being born, which isthe documentary about birth in
America, that Ricky Lake andAbby Epstein made my gosh over
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15 years ago, but that film waslike, my aha moment. I was in
college, and I'll never forgetthe emotional response I had,
and I remember my older sisterbeing like, I don't know if it's
normal that you like, have beencrying for three days over a
Ricky Lake documentary, like,are you okay? And I was like,
this is like waking something upinside of me that is, like a
(07:04):
deep calling. And I was so blownaway to see for the first time
ever, footage of birth that wasunscripted, so like, not the
Hollywood depiction of birth andand just seeing it be this
empowering and sensual and,like, just ecstatic experience
for women was was so inspiringto me. And I felt like I was
(07:26):
like, when, when was anyonegonna come back into my adult
life and let me in on this?
Because I had had all theingrained fear, but no one came
back to tell me, actually, itcan be wonderful, and here's
how. And I realized it's becausea lot of a lot of people don't
have that informationthemselves. So
true. First, I think howwonderful that you found your
calling. It sounds like it'sdefinitely your true calling.
(07:47):
And I agree with you. I do feellike actually the theme of my
podcast is I'm trying to lessenthe fears of the parenting
experience, and I feel like areally helpful way to do that is
to feel empowered, to feeladvocated for to gain knowledge,
because I feel like the more youknow, the more you can feel
calmer, and the more you canactually enjoy what's happening
(08:08):
around you. And it seems likethat's your theme as well. Yeah,
I do, and it's in my the 11 weeksessions that I offer called
growing together, which is whatthe book is named after. It's
always my favorite one to talkabout the physiology of birth
and like, what happens in thebody the hormones. Because when
you understand and see themechanisms at play, it's like
(08:32):
you can't help but be lessscared, because it's such a
brilliant system as all systemsin our bodies are. You
know, during residency, you seehundreds and hundreds of births.
So I don't go to I don't go tobirth so much anymore. But every
single time I saw a delivery, itwas fascinating to me. It never
got old. Yeah,no. And it never makes complete
logical sense, too, no matterhow, like, sciency, or, you
(08:55):
know, into the Yeah, the like,the mechanism of the body you
get, I say to my clients too,like we have to also leave room
for the mystery and like,whatever this means to you, the
spiritual aspect of birth.
Because no matter you know howmany years in med school, how
many years you've studied this,how many years of a doula, how
(09:16):
many births you've seen or givenbirth yourself, it does not
exist in the realm of anythingthat makes sense, a human is
coming out of you, and it's adivine, wild experience. It's
true. It is a complete miracle,nothing short of a complete
miracle. I also think it'sinteresting how you know, once
you have a baby, that day thatyou've delivered, you never
(09:37):
forget that day. So many days inyour life, they blend together.
You can forget, but it'sdefinitely a day that will
forever be imprinted in yourmind. Yeah, it's so special that
you get to be part of it. Sosomething that I think about a
lot when it comes to givingbirth and preparing for birth is
I do feel like in the US, we'veover medicalized something that
(09:58):
should feel more natural.
Natural. And I really like thatdoulas can help remind us of
that. They can help ground us,that it is a normal process.
Yeah, so how do you feel likeyou've helped parents prepare
for pregnancy? Sokind of again, going back to
this understanding of the body,there's so many different ways,
but I always like to start withwith that, because we don't
(10:22):
really learn that ever as womenagain, we we're lucky. We get
sex ed, we get a little bit oflike the birds and the bees that
way. But we're not reallyunderstanding, you know, how
oxytocin plays a role, right?
How? Which, for those who aren'tfamiliar with oxytocin, it's a
love hormone that is released inour bodies when we're when we're
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laughing, when we're with peoplewe love, when we're in intimate
situations, when we're havingsex, when we're with our
children, when we're cuddlingwith our pets, right? And so
it's literally that's why it'scalled the love hormone. It is
the highest surge of oxytocinyou ever get, is in labor and
birth and immediately after. AndI like this for my more like
science minded or medical mindedclients, which I have a lot of
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to be like, this is that proofthat feeling good, right, and
feeling safe is actually goingto benefit the process? And so
knowing things like this,learning about those hormones,
learning how we can supportthem, learning how you know our
body knows how to show up for usis, I think, the first steps
exactly what you said thateducation, also what I offer a
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lot in my book and in my workwith clients, is that
introspection, journaling,writing, every week of the book
has a prompt, and one of thoseprompts is working through your
fears and then seeing wherethey're coming from, because
sometimes they are not ours,right? Like these are fears that
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have been passed down throughgenerations. We have generations
of women who have been verydisconnected from this process,
most of our grandmothersprobably gave birth under
Twilight sleep right for manyyears, babies were whisked away
right away and taken to thenursery, and mom and baby maybe
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didn't really have any time toconnect right after birth. And
so the last century, there aresome really horrifying birth
practices that give us goodreason to be afraid, and so just
looking at that, I think, canhelp people contextualize some
of the fear that feels like theywere born with this fear, but in
fact, it's a fear that maybewe're born with, right? But it
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doesn't mean that it'snecessarily a primal fear, but
one that we can work through inour understanding of our mothers
and grandmothers relationship tobirth. So that's one.
So I know you mentioned that youwere scared when you were
pregnant. Do you think that fearwithin you came from the story
that you heard about yourselfand your mom?
Yeah, so I think I mean, I had atremendous amount of fear, as I
(13:00):
mentioned in the beginningaround birth, prior to becoming
a doula, prior to having thisunderstanding of birth and the
way that it could be. And so Ido feel like the nearly decade
of work and experience as adoula before leading up to my
own birth helped chisel away atso much fear. And I think that
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everybody, no matter howexperienced you are, we we
because of its gravity andmagnitude. Like, there's a
reverence that we walk into itwith. There's also a grief too,
of knowing, like, how much isgoing to change in your life.
And so, yeah, I remember, like,those last few days of just
being like, I want to get itover with, like, any big jump
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off a cliff, you're like, can Ijust go? Because I don't want to
stand here and look, and I don'tknow if that was so much my fear
of birth, but just myunderstanding of, like,
something big is about tohappen, and it's eminent, and I
can't turn back and, like, let'sjust let me do it already. And
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that's why I think that lastweek or month, especially for
those who go past their duedate, for those listening, I'm
doing air quotes, it just canfeel like torture, because you
have to sit with that discomfortof what you know you're about to
be facing and is the mostincredible thing on the other
side, but it's big work.
(14:24):
I remember I always felt nervousduring my pregnancy. I'm pretty
sure a lot of it had to do withmy mom would always tell us
stories about how difficultlabor was. She had a hard
experience delivering me. Shehad a fourth degree laceration,
so she was she always said itwas so worth it. But I had been
raised hearing stories about howtraumatic her birth experience
was. But I remember I kepttelling myself when I was
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pregnant, everybody that existson the universe, their mother
went through the same thing, andthey got through it, and they're
here to tell the tale. And so Isaid, for everybody that's
existing today on this earth,which is. 8 billion people and
all their mothers havesuccessfully delivered a baby. I
know I can do it too, and I canmake it to the other end. So I
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don't know why statistics havealways comforted me, but that
definitely gave me reassuranceas I went through my pregnancy.
Totallyalso another one that I think is
so cool to think about, but inany given moment when you're
laboring, there's a couple100,000 women across the world
laboring at the same time as youand so that, I think, is a
feeling that's really special,like you're not, yes, it's a
journey you have to go on byyourself with your baby. But
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you're really never alone.
You're never alone, especiallyif you have a doula. So I was so
curious about the statistic thatyou talked about in your book.
I'd love for you to talk aboutthis, how common is it in the
United States to actually use adoula? It's
only about 6% of women utilizedoula support. And I'd say it's
(15:56):
becoming, I think it's becomingmore popular or common, but
obviously, based on thatstatistic, is not a significant
amount of people. And you hadmentioned that there's evidence
based data showing that there'sbenefits to using a doula. What
is that evidence?
Yeah, so it really is across theboard. So for babies, the Apgar
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scores tend to be higher.
There's less use of medicationreported when someone has a
doula, lower induction rates,higher maternal satisfaction,
which I think is just the mostimportant overall. So along with
the Cesarean rates and all ofthat dropping, the fact that
moms report higher satisfaction,I think is the most important to
look at. Iwould agree with you when I was
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reading that paragraph in yourbook about what the evidence
showed to support benefits fromusing a doula perceived parental
satisfaction. I agree with you.
I think that's the mostimportant. Why should why
shouldn't pregnancy be a timethat we enjoy and revel in and
and have a good experience? Sothat's that's beautiful.
And I think too, when we talklike people who are listening
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like, why would that be moremost important, wouldn't like
the baby's health and all that.
Like, of course, those areimportant. But when we we think
of birth, and we talk aboutbirth, not everybody, for some,
avoiding cesarean is like themost important part, right? Or
for some, not having painmanagement is most important
part. But for everyone acrossboard, no matter what they
choose and how they choose theywant to have a positive
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experience. And so it's less soabout like, what that birth
looks like, but what they willremember is how they were
treated, how they crossed thatthreshold, and the support they
had. And so that comes back toit. You know, I love that you're
acknowledging that too as adoctor, because we often hear
healthy mom, healthy baby,that's all that matters. And
it's not right, becausethroughout whatever we're going
through in life, how theexperience sits with us because
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of those who are around us issuch a big part of it.
I'm curious your thoughts on Csection rates. When I look at
pregnancy and delivery and howour current medical system is
set up, I think we're so focusedon healthy mom, healthy
delivery, that we're seeing anincrease in C sections, and in
my mind, we're probably doingmore than we need to. And I'm
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curious, from your perspectiveas a doula, what do you wish
doctors knew more or familiesknew more, so that potentially
we would see fewer C sections?
Yeah, so a lot of theintervention that is routine in
obstetrics, is treatingeverybody like they're high
risk. And we actually, we have,we spend the most money in
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obstetrics. We have all thetechnology, but we have the
worst outcomes of the developedworld right, which is showing
us, and we have the highestcesarean
rates. Share with everybody whatthose rates are. So the World
Health Organization says weshould be at a 12%
in terms of a cesarean rate toreflect its necessary use as a
life saving procedure for mom orbaby. We're at 30. And some
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states, like Texas, I believe,is around 50, right? So it is a
lot, a lot higher than what thestandard is. I believe there's
so many different factors thatplay into this, but things like
induction or the overuse andmisuse of ultrasound and fetal
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monitoring, right? Can all beassociated with a higher
unnecessary use of cesarean it'salso
interesting to me, because whenyou look at the data on fetal
monitoring, or especially ontheir heart rate, I don't think
there's any evidence to showthat it's improved outcomes with
deliveries, but we use them allthe time, and they're so
annoying to listen to as you'repregnant and delivering, I
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mean, and that's a perfectexample of how our fear of
liability, which is anotherreally big part of why our
cesarean rates are so high, thisis where the heart rate monitor
comes in, because it's not aboutit improving outcomes, it's
about the hospital needs thatheart rate on record in case
they get sued, or in casethere's a malpractice suit, and
they need to be able to utilizethe heart rate as evidence.
(19:59):
Okay. Iagree with you. I actually
think, you know, I'm not lookingat any statistics here when I
talk right now, but in my view,if I were to guess, I think that
most unnecessary C sections, orI should say C sections that
could have been avoided, areprobably driven by a concern for
potential liability. Yeah,because I think, as a doctor,
you don't get in trouble fordoing an extra C section, you
would get in trouble for notdoing enough. Yeah,
(20:23):
yeah. It holds up a lot betterin court to say I did everything
I could. C section, this, thisintervention, this versus I
watched and waited. Iagree. Unfortunately, when I was
pregnant for the first time thatthe heart rate monitor showed
her heart rate dropping. This ismy first born, her heart rate
was dropping for a while, andthey were concerned about it,
and they actually sent me to theoperating room to have a C
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section. I got prepared for a Csection. They said, We have to
make this happen. Her heart ratehas been too low for too long,
and so, of course, you want ahealthy baby, healthy mom. So I
went along with it. And then I'mso grateful because the OB that
came in to do this. Azarian, shelooked at me, and she noticed
that when I turned on my side,the heart rate went up to
normal. And she said, Hmm, theheart rate went up to normal as
(21:09):
you're on your side, why don'twe watch this mom for a little
bit, and I'm so grateful becauseshe had the patience and the
confidence to know thatpotentially, I could avoid a C
section if I stayed on my side.
And she looked at me and shesaid, Do you want to have more
kids? And I said, I would liketo. And she said, let's see what
we can do here. And she observedme in the operating room for an
hour, and we found that if Istayed in a certain position,
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the heart rate was acceptable,and I was actually able to avoid
a cesarean section.
What a story. Wow. I'm sograteful to this OBGYN. It
turned out she had had a lot ofexperience working in other
countries. She'd had years ofexperience doing deliveries
outside of the hospital, and youcould tell that that confidence
within her really saved me fromhaving a C section. And I'm so
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grateful, because without her, Iprobably would have had 3c
sections. So that's incredible.
All all of this is to say thatthe people that are there to
support you throughout yourlabor and your delivery boy,
what a tremendous differencethey make. And
once you get in the or I wouldsay to my clients too, you're
never a prisoner there. So youcan, if you know, you can change
your mind, you can be in the or,actually, I don't want to do
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this, you know it's like, but tobe at that stage, to be already
in the OR, and to have a doctorat that point, which is like
you're very committed that thatstage, to being on your path to
cesarean, to say that, and tohave that patience and that
trust is such a what a beautifulstory.
Thank you. Yes, I remember itwas a little bit scary because
(22:35):
my husband wasn't with me. Theysent him outside to drape me and
get me ready. You feel verypowerless when you're in the
delivery situation and you're onyour own. So it would have been
nice to have a doula there too.
Yeah. So, and then I'm curious,when you think about it, what
are some of the biggestmisconceptions that people have
about pregnancy and labor, like,is there anything that you wish
that expecting parents knew wassomething that's normal, that
(22:56):
they're made to believe is notnormal?
Yeah? Great question. So Ialways say, you know, through
those nine months of pregnancy,you're really trusted like every
moment, whether you're awake orasleep, your body is growing
your baby. You don't have tothink about it. It's happening
without any thought. The secondwe go into labor, there's this
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assumption that you need all ofthe instruction, right, all of
these external things, becauseit would be just terrible if we
let this process unfold like wehave the last nine months,
right? And so that doesn't meanI'm saying, like, oh, free birth
is the way for everyone. I'msaying, look at that and let
(23:38):
that nine months of growing ababy, help bring the confidence
into the nine hours, or, youknow, 40 hours, or whatever your
labor is, and being like, Wow, Idid all of that right, and I was
trusted to let my body doexactly what I knew how to do.
Think of labor the same approachlabor in that same way, with
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this trust and this patiencethat it's going to happen. So
that's one, I think, that alsothere's this misconception that
you know around the time of howlong it should take, right? And
there's so much pressure onwomen a when they're supposed to
give birth, like they're whenthey're due date, and then how
(24:19):
long the birth is supposed tobe, and we're still utilizing
archaic frameworks from like the50s, with studies that are so
flawed that don't even actuallylook at true physiological birth
to try and dictate how longsomebody's labor should be and
how quickly they should beprogressing. And so I talk about
(24:41):
this in my book, that I didn'tdo any vaginal exams in my
labor, so I never knew howdilated I was. I thought it was
really, really important todetach from the numbers or this
idea that, like, I was going todilate a certain amount. I also
know that I have a tendency toget in my own head about.
Progress in life and things, andI'm very, you know, type a in
(25:03):
that way. And I was like, if Isomeone tells me a number, I'm
gonna feel like a failure, thatI'm not this next number. And so
really trying to remove thoseexternal expectations, these
arbitrary numbers and times anddates around this process is
going to bring so much moreease, and making sure that you
have a provider that's alignedwith that is gonna give you that
(25:26):
patience that this processrequires.
I agree with you so muchbecause, of course, some data is
helpful. Some data gives youinformation that could
potentially be helpful for thebaby, for their health, but I do
think we're living in an agewhere it's just too much. And,
for example, my OB, thankfully,he gave me the option of having
my cervix checked. He said, Youknow, the truth is, I'll tell
(25:46):
you a number, it's going to beuncomfortable to check you, and
it's not going to change myadvice, the baby's still going
to come when the baby's going tocome. And so I was so thankful
that he allowed me to say no.
Thank you. The same thing Ithink about when they tell you
the statistics of the baby whenyou're pregnant, when they give
you the weight of the baby,because I have a lot of moms
that are nervous to deliver,because maybe they're on the
(26:07):
petite side, and the OB toldthem that their baby is on the
larger side, and they'rethinking already, they're
doubtful already, that they'regoing to be able to have a
successful vaginal birth. Butthe numbers can be very off,
right? There's a lot of babiesthat they think are going to be
on the bigger side, and they'renot on the bigger side because
it's hard to you don't have anactual scale in utero, and the
numbers can sway 20% on eitherdirection, exactly, and then it
(26:30):
puts a seed of doubt in yourmind that you can, that you can
do it. And I think that's theworst thing for a mom before she
before she gives birth.
I often say that what's moredangerous than a big baby is the
fear of the big baby, becausewhen we look at the stats, the
interventions that they imposebecause of the fear of a big
baby that has very unreliablemeasurements, right? The
(26:51):
ultrasound is not a reliable wayof measuring a baby's weight in
the third trimester. It's justnot and so to impose those
interventions create a greaterrisk, because we know that
cesarean comes with risk,induction comes with risk. And
so I break down the data alittle bit in my book and talk
about exactly that, how we'vecreated more problems with this
(27:15):
fear of a problem, yes,and my feeling is it never hurts
to try if the OB suspects arehaving a baby on the larger side
and they're nervous about havinga vaginal birth, why not just
attempt,yeah, and we don't know, right?
Like that baby and that pelvishas never done the journey
before. I've had clients withsix pound babies have a hard
time. You know? It doesn't. Itdoesn't necessarily, again, come
(27:37):
down to a number. I have a Iwrote about a dear friend and
client who's about to give birthto her fourth and she makes huge
babies, like she just knowsthis, and she births beautifully
every time, and she likes tohave unmedicated births in
hospitals, and they always freakout, and she's always like,
guys, I know this about myself,look at how it's worked out
(28:00):
every time. Ido think that too much data, too
much knowledge, can get intoyour head and be less helpful
and more fear mongering.
Yeah, and you probably have abetter answer to this being a
doctor yourself, but in termsof, like, where it's coming from
and why, I'm always curious, butI think it's, of course, yes,
liability. It's the way we'retrained. Sometimes it is
(28:22):
financial incentive, and I thinkit's also just reflective of our
modern culture. It's not justthe medical system, and it's not
always this malicious or rarelyis it a malicious thing. It's
it's more of like we live in atime that yearned for numbers
and answers, and we just want sobadly to have this perceived
(28:44):
feeling of control. Youwant to know the due date. You
want to know the sex of thebaby. You want to know
everything. And sometimes, ifyou can just relinquish a little
bit and throw your hands up andsay, You know what? There are
some things. I'm just going tohave to have a little faith that
it's going to work out. It'sgoing to work out the way it's
meant to be. I think that makesthe experience so much better,
yeah,but it's also, I think it's
that's a spiritual choice,right? Like, that's something
(29:05):
that is, again, it's not just inmedicine, like we all have to
return to and I know kind of funfact, but Jessica and I met
while we were both evacuatedfrom the fires, and it was like,
this moment of the universethrows these things at sometimes
we're just all plans are up inthe air. All of what I thought
was going to be is different, somuch change, so much surrender,
(29:26):
and it's so effinguncomfortable, right? Like to
just be faced with uncertainty.
And that's what this process,apparently, is doing to us on a
spiritual level, I think, islike trying to expand our
capacity for thatabsolutely. And I have to say,
what I noticed about you whenyou were with your daughter was
(29:49):
that you were just it felt veryspiritual. It felt like you were
just enjoying her, enjoying themoment. You didn't have your
phone out, which I'm soimpressed, because not many moms
can say that these days.
Yes, thank you. I'm very guiltyof that a lot, so I'm glad you
caught me in a moment, but it'snot all the time. I wish I was
better.
No, I did. I did notice that soi i could just sense that you
(30:13):
were somebody who is trying tomake the most of life's moments.
Thank you. So going back tobeing a doula, can you explain
what doulas can't do, like,what? What can they do and what
can't they do? In other words,how are they different from a
midwife or an OB? GYN? Totally.
So doulas do no clinical medicaltests. We don't draw blood. We
(30:33):
don't, you know, listen to thebaby's heartbeat. We we don't.
We're not catching the baby.
We're not diagnosing or anythinglike that. So none of none of
our role is medical or clinical.
It's all an emotional andphysical support and education.
But doulas have always existed,similar to what traditionally
(30:53):
midwives were, beyond anygoverning body, right? And so
the idea is that I'm there forthe mother, hired by the mother
just to serve her, which is aluxury that obviously, when you
there's good reason for certaincertifications and licensure and
(31:14):
all that, but we don't have toabide by that. And so that means
we do get to create, again, notwithin practicing medicine, but
we get to kind of create andbuild this relationship based
off of our client and how wewant to show up to support them,
and how they want to receivethat support.
So beautiful, so amazing. I'm sohappy to highlight what doulas
(31:36):
do, because I think a lot ofpeople have heard the term, but
they don't actually know andwhat way they can be served. So
wonderful, because you can helpwhile pregnant, during delivery
and also postpartum, correct,yeah,
and postpartum doulas, whichsometimes you'll find a doula
who does both, and then somewill do birth, and some will do
just postpartum. But apostpartum doula is a very
(31:59):
different hat, again, with thatsame underlying intention of
being of service to the family.
But it's a wonderful thing toexplore, because what that can
look like, and again, looksdifferent based on the doula,
but it is maybe a few days aweek, or even daily, a doula
coming into the home after birthto help cook, help with some
laundry, and help take care ofthe mother, and really giving
(32:21):
space and allowing andunderstanding that that time is
really important for the mom andbaby to be together, to be skin
to skin, for, you know, mom tobe breastfeeding. And so instead
of somebody else coming in tofeed baby and to care for baby
and to do all the things withthe baby, it's I'm going to take
care of all the things that theparents need to be taken care of
(32:42):
so they can be present in theparenting role in the sacred
time. I'm going to provide bodywork or massage for the mom so
she can be rested and have, youknow, a healthy nervous system
in this big transition. And sohaving a postpartum doula, I
think, is really wonderful,because most will recognize that
(33:02):
the mom knows how to mother. Shejust needs to be mother too.
You know, as a pediatrician, Imeet a lot of moms who
definitely have a hard timeafter delivery. Yeah, they've
just had a baby, their body'shealing, their emotions all are
all over the place, even if,even with the nicest husbands,
sometimes, you know, it's stillhard, because the breastfeeding
(33:24):
falls on the mother, so thatmeans a lot of the waking up at
night falls on the mother. Andso to have that extra support is
a tremendous gift. I'm sure wesee lower postpartum depression
rates with when you havesupport, postpartum
depression is correlated withlack of support, right? And so
absolutely, and I see this allthe time with the families I
(33:48):
work with, which is like thesweetest, most well intended and
supportive fathers who are like,I'm gonna do it, I'm gonna cook,
I'm gonna take our other childto school, and I'll walk the
dog, and I will do all thethings so she can rest. And I'm
like, Oh, I love that, thatethos and that intention, and
(34:11):
for you to be doing all thosethings takes you away from the
presence too, which is equallyimportant. And sometimes what a
new mom just needs is to be seenand held and talk to and
acknowledge and so to put it allinto the other parent isn't the
solution, right? Because thatother parent is often also
really tired and going throughtheir own huge identity shift,
(34:32):
navigating what work is going tolook like. And so that was even
though, of course, like therewere so many things My husband
was doing to help out afterbirth. He is one of those people
who will kind of go to thatservice mode, oh, I'll just,
I'll do this. I'll do that. AndI knew I was like, you already
do a lot, and kind of feeloverwhelmed by it. We throw a
(34:53):
baby into it, it's not gonna begood. And so looking back, he's
like, I'm so glad you made meslow down with you. Yeah,
because there was no way I couldhave integrated all of these new
rules, all of this, these newfeelings, in this period of
time, and been able to enjoy it.
Yes,and also, I'm thinking about
breastfeeding. That is somethingthat I think a lot of moms think
(35:15):
should be a more innateexperience than it is. Right?
You have a mom with a new baby,and all you want to do is just
feed your baby. And we're told,or I was told I was under the
misconception, thatbreastfeeding would be really
easy, it would be painless, thatI would make milk within two,
three days, and it would be avery seamless process. And then
I learned that it's normal to beuncomfortable for a couple of
(35:37):
weeks. And I think, had I hadsome external support, you know,
thankfully, I had a goodlactation consultant, but
someone like a doula, lactationconsultant, someone who or an
experienced friend, anexperienced mother, if they tell
you that boy that can really, Ithink, I think that can make the
experience a lot easier. Becauseyou relax, you go, okay, having
(35:59):
a little discomfort is normallybeginning. It's gonna come. I
just have to hang in there. Sowhat I'm trying to say is I feel
like in every step of the waywith pregnancy, labor and
delivery and that fourthtrimester, that first month or
so after having a baby, I thinkhaving quality support makes the
world a difference.
(36:19):
It really does. Soif people are listening and they
want to find a doula, do youhave any resources that you can
recommend?
Yeah, so there's,you know, I say there's a lot of
different ways you can find adoula asking around word of
mouth. That's where most of myclients come from. So this is
(36:39):
easier in some communities thanothers. But, you know, finding
out from other friends, familymembers, and then going to, you
know, your local yoga studio,acupuncture clinic, like some of
the more, maybe holistic, evenyour pediatrician. If you're
lucky enough to have apediatrician, like Doctor
Jessica, right, you may be ableto recommend doulas, even your
(36:59):
OB, your gynecologist, who mightbe somebody who likes to
collaborate with doula. Soasking around is really useful.
Also, social media can be agreat tool. You know, there's
not like one big database, butthere's, of course, collectives
and certain online resources toour matching with a doula. On my
website, I have my directory ofrecommendations for not just
(37:22):
doulas, but pediatricians andjust everything. You name it.
There's obviously not every cityand state, but I'm working on
it. And thentell us about your beautiful
book. Where can we find it? Howcan I send people to read your
book? Yeah,it's going to be available March
25 on the shelves. I'm not surewhen this is airing, but it
might be around then, and Iremember what the other question
(37:44):
was, I guess, where to orderAmazon, anywhere in the
bookstore. Yeah, I'llmake sure and link it too in the
description below, where you canjust easily click and get this
book. Great. Well, thank you somuch. I think it's very clear,
after talking to you afterreading your book, how important
support makes a difference inenriching the experience of
pregnancy, and so I'm so happyto have your book now to
(38:07):
recommend to people that theycan feel an extra resource to
get to get support. Thank you somuch. Thank you for listening,
and I hope you enjoyed thisweek's episode of your child is
normal. Also, if you could takea moment and leave a five star
review, wherever it is youlisten to podcasts, I would
greatly appreciate it. It reallymakes a difference to help this
podcast grow. You can alsofollow me on Instagram at ask Dr
(38:28):
Jessica. See you next Monday.
You.
Sometimes life brings unexpected silver linings. I met
(00:03):
today's guest, Carson Meyer inthe middle of the Los Angeles
fires While both of us wereevacuated from our homes. When
we started talking, I learnedthat Carson is a doula, a
passionate advocate for maternalwellness, and now an author. Her
new book growing together, doulawisdom and holistic practices
for pregnancy, birth and earlymotherhood just came out this
week. It's a beautiful week byweek, companion for expectant
(00:25):
parents, filled with guidance,reassurance and practical
wisdom. What I love aboutCarson's approach is how she
honors the natural process,helps women trust their bodies
and reminds them that theirexperience, whatever it looks
like, is valid, normal andworthy of support. It was truly
a privilege to reconnect withher for this conversation, and I
think you'll take so much fromher insight and warmth. And
(00:46):
before we get started, if youdon't mind taking a moment to
leave a five star review,wherever it is you listen to
podcasts, I greatly appreciateit. Your reviews helps other
people find your child asnormal, and that helps us
continue reaching more parentswho need a little less worry and
a little more reassurance. Nowon to the podcast. I am so
excited to have here. CarsonMeyer, thank you so much for
(01:07):
coming on the podcast. Thanksfor having me. Carson is a very
special human being. She's amother, a doula, a child birth
educator, and now she's anauthor of a fantastic,
wonderful, wonderful book. I'mso proud of you for writing it.
Thankyou so much. I'm so excited. I
have always dreamed of writing abook, and I had just had no idea
that the opportunity would comethe week I was due to give
(01:30):
birth, or, like, right around mydue range. I got a call from
Chronicle about it, and I waslike, Oh my gosh, this is a
dream. I'm so excited. And ifyou read my book, you know, I'm
really big on that sacredwindow, taking time and space
to, yeah, just to be present inthose early weeks and months and
even years when you don't get itback. And so I spent the first
(01:51):
two years of motherhood writinga book, which I'd say are
probably like two of the biggestfeats you can do at the same
time, but the book is soreflective of my journey, and I
don't think I would have beenable to recall and chronicle the
feelings had it been later, likeI would have in real time. So
I'm so grateful that it came atthat time, because I got to just
(02:14):
like, be in it and write aboutit.
I can see that the memories aremuch more fresh as you're going
through it. So I'm sure thatadded a lot of authenticity to
the book. It actually soundslike perfect timing, as hard as
it sounds to have done both. I'mso glad that you were able to
put it together. Thank you. Youtoo. So tell me first, so the
audience is aware you're adoula. What is a doula Exactly?
(02:38):
Can you just describe what adoula means to you?
Yeah, and that's a good way ofphrasing it, because doulas have
so many different definitionsand ways of approaching this
work. But to me, it's alwaysjust been in service to the
woman and the family through thetransformation of birth, of
pregnancy, even preconceptionbirth and the initial postpartum
(03:01):
period. And so this looksdifferent, like I said,
depending on what the doulaoffers for me, education is a
big part of it. And more andmore, I realized that the best
way that I could set myself myclients up for success was by
helping to prepare them inpregnancy, more so, even than
being at the present at thebirth, which is obviously such a
wonderful and beautiful part ofit, and so I'm a certified
(03:23):
nutrition consultant, so Iincorporate that in my prenatal
education. I teach communitycircles that are childbirth
education circles for moms, andthen during the birth, doulas
attend the birth whether it'shome, hospital, birth center,
provide hands on comfortmeasures and help facilitate
conversations between theirprovider and hospital staff to
(03:45):
help them advocate forthemselves. What
I think sounds so beautifulabout your description of doulas
is that really you're just thereto support a mother and her
partner. And what's sofascinating to me is myself
being part of the medicalcommunity, I can see that what
we offer to mothers throughoutpregnancy isn't enough, that you
really need more support. And Ido find that a lot of people
(04:08):
nowadays, we are not alwaysliving by our families. We need
more of a village. And so what abeautiful concept that a doula
can be, that support can offerthat support for families. Thank
you. Yeah, it's interesting. Iwas asked this on a podcast
yesterday, like, how providersand doulas can work together,
and, you know, it barely variesand depends, like, who that
(04:29):
provider is and theirwillingness. But I said, I was
like, you know, you have a gooddoctor if they're gung ho on you
having a doula. Because not onlydoes the evidence show that
birth outcomes are better acrossthe board for mom and baby in
the present, when a doula ispresent, but also it's a
provider that recognizes youremotional needs and wants you to
(04:52):
have what you need to feel good,whatever that is. And so that's
why I immediately we hit it off,because I saw that you. You
recognize thatI agree with that. I have to
say, I do notice there's thisfunny cultural aspect in
medicine, where, when a familyshows up to the hospital with a
birth plan, I notice that someOBS, some pediatricians, don't
really look at it too fondly.
(05:16):
You know, they'll sort of say,Oh, the bigger the birth plan,
the more trouble the patient'sgoing to be, and I don't like
that we have that attitudethat's prevailing, because it's
the opposite of what we all wantto accomplish, which is we want
to work together. We want tosupport the parents together.
And so I'm so glad that we'rebringing this up, because I do
think it's really important thatwe do support the families in
(05:37):
their entirety. So now tell me,I'm just so everybody knows. And
here's your beautiful story.
What inspires you to become adoula?
So in the book, I talk a littlebit about my own, like my
mother's birth with me, how Ibelieve that we have an
imprinting that takes placeprior to birth that really helps
define who we are and who webecome and what we're passionate
(05:58):
about. And so that's one part ofit. I think it was a calling
that was always there, butcertainly was not one that I was
cognizant of simply because ofthe culture that we're in. I,
like so many young women inAmerica, was terrified of the
thought of birth so close to mymom, my sisters were moms like
(06:20):
when I was young, and so I justhad this deep reverence and
appreciation and admiration fromothers. But I was like, and
that's crazy, and I'm neverdoing that scary and just
overwhelming and all of it. Andit wasn't until I saw the
business of being born, which isthe documentary about birth in
America, that Ricky Lake andAbby Epstein made my gosh over
(06:41):
15 years ago, but that film waslike, my aha moment. I was in
college, and I'll never forgetthe emotional response I had,
and I remember my older sisterbeing like, I don't know if it's
normal that you like, have beencrying for three days over a
Ricky Lake documentary, like,are you okay? And I was like,
this is like waking something upinside of me that is, like a
(07:04):
deep calling. And I was so blownaway to see for the first time
ever, footage of birth that wasunscripted, so like, not the
Hollywood depiction of birth andand just seeing it be this
empowering and sensual and,like, just ecstatic experience
for women was was so inspiringto me. And I felt like I was
(07:26):
like, when, when was anyonegonna come back into my adult
life and let me in on this?
Because I had had all theingrained fear, but no one came
back to tell me, actually, itcan be wonderful, and here's
how. And I realized it's becausea lot of a lot of people don't
have that informationthemselves. So
true. First, I think howwonderful that you found your
calling. It sounds like it'sdefinitely your true calling.
(07:47):
And I agree with you. I do feellike actually the theme of my
podcast is I'm trying to lessenthe fears of the parenting
experience, and I feel like areally helpful way to do that is
to feel empowered, to feeladvocated for to gain knowledge,
because I feel like the more youknow, the more you can feel
calmer, and the more you canactually enjoy what's happening
(08:08):
around you. And it seems likethat's your theme as well. Yeah,
I do, and it's in my the 11 weeksessions that I offer called
growing together, which is whatthe book is named after. It's
always my favorite one to talkabout the physiology of birth
and like, what happens in thebody the hormones. Because when
you understand and see themechanisms at play, it's like
(08:32):
you can't help but be lessscared, because it's such a
brilliant system as all systemsin our bodies are. You
know, during residency, you seehundreds and hundreds of births.
So I don't go to I don't go tobirth so much anymore. But every
single time I saw a delivery, itwas fascinating to me. It never
got old. Yeah,no. And it never makes complete
logical sense, too, no matterhow, like, sciency, or, you
(08:55):
know, into the Yeah, the like,the mechanism of the body you
get, I say to my clients too,like we have to also leave room
for the mystery and like,whatever this means to you, the
spiritual aspect of birth.
Because no matter you know howmany years in med school, how
many years you've studied this,how many years of a doula, how
(09:16):
many births you've seen or givenbirth yourself, it does not
exist in the realm of anythingthat makes sense, a human is
coming out of you, and it's adivine, wild experience. It's
true. It is a complete miracle,nothing short of a complete
miracle. I also think it'sinteresting how you know, once
you have a baby, that day thatyou've delivered, you never
(09:37):
forget that day. So many days inyour life, they blend together.
You can forget, but it'sdefinitely a day that will
forever be imprinted in yourmind. Yeah, it's so special that
you get to be part of it. Sosomething that I think about a
lot when it comes to givingbirth and preparing for birth is
I do feel like in the US, we'veover medicalized something that
(09:58):
should feel more natural.
Natural. And I really like thatdoulas can help remind us of
that. They can help ground us,that it is a normal process.
Yeah, so how do you feel likeyou've helped parents prepare
for pregnancy? Sokind of again, going back to
this understanding of the body,there's so many different ways,
but I always like to start withwith that, because we don't
(10:22):
really learn that ever as womenagain, we we're lucky. We get
sex ed, we get a little bit oflike the birds and the bees that
way. But we're not reallyunderstanding, you know, how
oxytocin plays a role, right?
How? Which, for those who aren'tfamiliar with oxytocin, it's a
love hormone that is released inour bodies when we're when we're
(10:44):
laughing, when we're with peoplewe love, when we're in intimate
situations, when we're havingsex, when we're with our
children, when we're cuddlingwith our pets, right? And so
it's literally that's why it'scalled the love hormone. It is
the highest surge of oxytocinyou ever get, is in labor and
birth and immediately after. AndI like this for my more like
science minded or medical mindedclients, which I have a lot of
(11:08):
to be like, this is that proofthat feeling good, right, and
feeling safe is actually goingto benefit the process? And so
knowing things like this,learning about those hormones,
learning how we can supportthem, learning how you know our
body knows how to show up for usis, I think, the first steps
exactly what you said thateducation, also what I offer a
(11:33):
lot in my book and in my workwith clients, is that
introspection, journaling,writing, every week of the book
has a prompt, and one of thoseprompts is working through your
fears and then seeing wherethey're coming from, because
sometimes they are not ours,right? Like these are fears that
(11:54):
have been passed down throughgenerations. We have generations
of women who have been verydisconnected from this process,
most of our grandmothersprobably gave birth under
Twilight sleep right for manyyears, babies were whisked away
right away and taken to thenursery, and mom and baby maybe
(12:16):
didn't really have any time toconnect right after birth. And
so the last century, there aresome really horrifying birth
practices that give us goodreason to be afraid, and so just
looking at that, I think, canhelp people contextualize some
of the fear that feels like theywere born with this fear, but in
fact, it's a fear that maybewe're born with, right? But it
(12:37):
doesn't mean that it'snecessarily a primal fear, but
one that we can work through inour understanding of our mothers
and grandmothers relationship tobirth. So that's one.
So I know you mentioned that youwere scared when you were
pregnant. Do you think that fearwithin you came from the story
that you heard about yourselfand your mom?
Yeah, so I think I mean, I had atremendous amount of fear, as I
(13:00):
mentioned in the beginningaround birth, prior to becoming
a doula, prior to having thisunderstanding of birth and the
way that it could be. And so Ido feel like the nearly decade
of work and experience as adoula before leading up to my
own birth helped chisel away atso much fear. And I think that
(13:21):
everybody, no matter howexperienced you are, we we
because of its gravity andmagnitude. Like, there's a
reverence that we walk into itwith. There's also a grief too,
of knowing, like, how much isgoing to change in your life.
And so, yeah, I remember, like,those last few days of just
being like, I want to get itover with, like, any big jump
(13:42):
off a cliff, you're like, can Ijust go? Because I don't want to
stand here and look, and I don'tknow if that was so much my fear
of birth, but just myunderstanding of, like,
something big is about tohappen, and it's eminent, and I
can't turn back and, like, let'sjust let me do it already. And
(14:02):
that's why I think that lastweek or month, especially for
those who go past their duedate, for those listening, I'm
doing air quotes, it just canfeel like torture, because you
have to sit with that discomfortof what you know you're about to
be facing and is the mostincredible thing on the other
side, but it's big work.
(14:24):
I remember I always felt nervousduring my pregnancy. I'm pretty
sure a lot of it had to do withmy mom would always tell us
stories about how difficultlabor was. She had a hard
experience delivering me. Shehad a fourth degree laceration,
so she was she always said itwas so worth it. But I had been
raised hearing stories about howtraumatic her birth experience
was. But I remember I kepttelling myself when I was
(14:46):
pregnant, everybody that existson the universe, their mother
went through the same thing, andthey got through it, and they're
here to tell the tale. And so Isaid, for everybody that's
existing today on this earth,which is. 8 billion people and
all their mothers havesuccessfully delivered a baby. I
know I can do it too, and I canmake it to the other end. So I
(15:08):
don't know why statistics havealways comforted me, but that
definitely gave me reassuranceas I went through my pregnancy.
Totallyalso another one that I think is
so cool to think about, but inany given moment when you're
laboring, there's a couple100,000 women across the world
laboring at the same time as youand so that, I think, is a
feeling that's really special,like you're not, yes, it's a
journey you have to go on byyourself with your baby. But
(15:33):
you're really never alone.
You're never alone, especiallyif you have a doula. So I was so
curious about the statistic thatyou talked about in your book.
I'd love for you to talk aboutthis, how common is it in the
United States to actually use adoula? It's
only about 6% of women utilizedoula support. And I'd say it's
(15:56):
becoming, I think it's becomingmore popular or common, but
obviously, based on thatstatistic, is not a significant
amount of people. And you hadmentioned that there's evidence
based data showing that there'sbenefits to using a doula. What
is that evidence?
Yeah, so it really is across theboard. So for babies, the Apgar
(16:17):
scores tend to be higher.
There's less use of medicationreported when someone has a
doula, lower induction rates,higher maternal satisfaction,
which I think is just the mostimportant overall. So along with
the Cesarean rates and all ofthat dropping, the fact that
moms report higher satisfaction,I think is the most important to
look at. Iwould agree with you when I was
(16:38):
reading that paragraph in yourbook about what the evidence
showed to support benefits fromusing a doula perceived parental
satisfaction. I agree with you.
I think that's the mostimportant. Why should why
shouldn't pregnancy be a timethat we enjoy and revel in and
and have a good experience? Sothat's that's beautiful.
And I think too, when we talklike people who are listening
(16:59):
like, why would that be moremost important, wouldn't like
the baby's health and all that.
Like, of course, those areimportant. But when we we think
of birth, and we talk aboutbirth, not everybody, for some,
avoiding cesarean is like themost important part, right? Or
for some, not having painmanagement is most important
part. But for everyone acrossboard, no matter what they
choose and how they choose theywant to have a positive
(17:21):
experience. And so it's less soabout like, what that birth
looks like, but what they willremember is how they were
treated, how they crossed thatthreshold, and the support they
had. And so that comes back toit. You know, I love that you're
acknowledging that too as adoctor, because we often hear
healthy mom, healthy baby,that's all that matters. And
it's not right, becausethroughout whatever we're going
through in life, how theexperience sits with us because
(17:44):
of those who are around us issuch a big part of it.
I'm curious your thoughts on Csection rates. When I look at
pregnancy and delivery and howour current medical system is
set up, I think we're so focusedon healthy mom, healthy
delivery, that we're seeing anincrease in C sections, and in
my mind, we're probably doingmore than we need to. And I'm
(18:07):
curious, from your perspectiveas a doula, what do you wish
doctors knew more or familiesknew more, so that potentially
we would see fewer C sections?
Yeah, so a lot of theintervention that is routine in
obstetrics, is treatingeverybody like they're high
risk. And we actually, we have,we spend the most money in
(18:29):
obstetrics. We have all thetechnology, but we have the
worst outcomes of the developedworld right, which is showing
us, and we have the highestcesarean
rates. Share with everybody whatthose rates are. So the World
Health Organization says weshould be at a 12%
in terms of a cesarean rate toreflect its necessary use as a
life saving procedure for mom orbaby. We're at 30. And some
(18:54):
states, like Texas, I believe,is around 50, right? So it is a
lot, a lot higher than what thestandard is. I believe there's
so many different factors thatplay into this, but things like
induction or the overuse andmisuse of ultrasound and fetal
(19:14):
monitoring, right? Can all beassociated with a higher
unnecessary use of cesarean it'salso
interesting to me, because whenyou look at the data on fetal
monitoring, or especially ontheir heart rate, I don't think
there's any evidence to showthat it's improved outcomes with
deliveries, but we use them allthe time, and they're so
annoying to listen to as you'repregnant and delivering, I
(19:36):
mean, and that's a perfectexample of how our fear of
liability, which is anotherreally big part of why our
cesarean rates are so high, thisis where the heart rate monitor
comes in, because it's not aboutit improving outcomes, it's
about the hospital needs thatheart rate on record in case
they get sued, or in casethere's a malpractice suit, and
they need to be able to utilizethe heart rate as evidence.
(19:59):
Okay. Iagree with you. I actually
think, you know, I'm not lookingat any statistics here when I
talk right now, but in my view,if I were to guess, I think that
most unnecessary C sections, orI should say C sections that
could have been avoided, areprobably driven by a concern for
potential liability. Yeah,because I think, as a doctor,
you don't get in trouble fordoing an extra C section, you
would get in trouble for notdoing enough. Yeah,
(20:23):
yeah. It holds up a lot betterin court to say I did everything
I could. C section, this, thisintervention, this versus I
watched and waited. Iagree. Unfortunately, when I was
pregnant for the first time thatthe heart rate monitor showed
her heart rate dropping. This ismy first born, her heart rate
was dropping for a while, andthey were concerned about it,
and they actually sent me to theoperating room to have a C
(20:46):
section. I got prepared for a Csection. They said, We have to
make this happen. Her heart ratehas been too low for too long,
and so, of course, you want ahealthy baby, healthy mom. So I
went along with it. And then I'mso grateful because the OB that
came in to do this. Azarian, shelooked at me, and she noticed
that when I turned on my side,the heart rate went up to
normal. And she said, Hmm, theheart rate went up to normal as
(21:09):
you're on your side, why don'twe watch this mom for a little
bit, and I'm so grateful becauseshe had the patience and the
confidence to know thatpotentially, I could avoid a C
section if I stayed on my side.
And she looked at me and shesaid, Do you want to have more
kids? And I said, I would liketo. And she said, let's see what
we can do here. And she observedme in the operating room for an
hour, and we found that if Istayed in a certain position,
(21:31):
the heart rate was acceptable,and I was actually able to avoid
a cesarean section.
What a story. Wow. I'm sograteful to this OBGYN. It
turned out she had had a lot ofexperience working in other
countries. She'd had years ofexperience doing deliveries
outside of the hospital, and youcould tell that that confidence
within her really saved me fromhaving a C section. And I'm so
(21:54):
grateful, because without her, Iprobably would have had 3c
sections. So that's incredible.
All all of this is to say thatthe people that are there to
support you throughout yourlabor and your delivery boy,
what a tremendous differencethey make. And
once you get in the or I wouldsay to my clients too, you're
never a prisoner there. So youcan, if you know, you can change
your mind, you can be in the or,actually, I don't want to do
(22:15):
this, you know it's like, but tobe at that stage, to be already
in the OR, and to have a doctorat that point, which is like
you're very committed that thatstage, to being on your path to
cesarean, to say that, and tohave that patience and that
trust is such a what a beautifulstory.
Thank you. Yes, I remember itwas a little bit scary because
(22:35):
my husband wasn't with me. Theysent him outside to drape me and
get me ready. You feel verypowerless when you're in the
delivery situation and you're onyour own. So it would have been
nice to have a doula there too.
Yeah. So, and then I'm curious,when you think about it, what
are some of the biggestmisconceptions that people have
about pregnancy and labor, like,is there anything that you wish
that expecting parents knew wassomething that's normal, that
(22:56):
they're made to believe is notnormal?
Yeah? Great question. So Ialways say, you know, through
those nine months of pregnancy,you're really trusted like every
moment, whether you're awake orasleep, your body is growing
your baby. You don't have tothink about it. It's happening
without any thought. The secondwe go into labor, there's this
(23:17):
assumption that you need all ofthe instruction, right, all of
these external things, becauseit would be just terrible if we
let this process unfold like wehave the last nine months,
right? And so that doesn't meanI'm saying, like, oh, free birth
is the way for everyone. I'msaying, look at that and let
(23:38):
that nine months of growing ababy, help bring the confidence
into the nine hours, or, youknow, 40 hours, or whatever your
labor is, and being like, Wow, Idid all of that right, and I was
trusted to let my body doexactly what I knew how to do.
Think of labor the same approachlabor in that same way, with
(23:59):
this trust and this patiencethat it's going to happen. So
that's one, I think, that alsothere's this misconception that
you know around the time of howlong it should take, right? And
there's so much pressure onwomen a when they're supposed to
give birth, like they're whenthey're due date, and then how
(24:19):
long the birth is supposed tobe, and we're still utilizing
archaic frameworks from like the50s, with studies that are so
flawed that don't even actuallylook at true physiological birth
to try and dictate how longsomebody's labor should be and
how quickly they should beprogressing. And so I talk about
(24:41):
this in my book, that I didn'tdo any vaginal exams in my
labor, so I never knew howdilated I was. I thought it was
really, really important todetach from the numbers or this
idea that, like, I was going todilate a certain amount. I also
know that I have a tendency toget in my own head about.
Progress in life and things, andI'm very, you know, type a in
(25:03):
that way. And I was like, if Isomeone tells me a number, I'm
gonna feel like a failure, thatI'm not this next number. And so
really trying to remove thoseexternal expectations, these
arbitrary numbers and times anddates around this process is
going to bring so much moreease, and making sure that you
have a provider that's alignedwith that is gonna give you that
(25:26):
patience that this processrequires.
I agree with you so muchbecause, of course, some data is
helpful. Some data gives youinformation that could
potentially be helpful for thebaby, for their health, but I do
think we're living in an agewhere it's just too much. And,
for example, my OB, thankfully,he gave me the option of having
my cervix checked. He said, Youknow, the truth is, I'll tell
(25:46):
you a number, it's going to beuncomfortable to check you, and
it's not going to change myadvice, the baby's still going
to come when the baby's going tocome. And so I was so thankful
that he allowed me to say no.
Thank you. The same thing Ithink about when they tell you
the statistics of the baby whenyou're pregnant, when they give
you the weight of the baby,because I have a lot of moms
that are nervous to deliver,because maybe they're on the
(26:07):
petite side, and the OB toldthem that their baby is on the
larger side, and they'rethinking already, they're
doubtful already, that they'regoing to be able to have a
successful vaginal birth. Butthe numbers can be very off,
right? There's a lot of babiesthat they think are going to be
on the bigger side, and they'renot on the bigger side because
it's hard to you don't have anactual scale in utero, and the
numbers can sway 20% on eitherdirection, exactly, and then it
(26:30):
puts a seed of doubt in yourmind that you can, that you can
do it. And I think that's theworst thing for a mom before she
before she gives birth.
I often say that what's moredangerous than a big baby is the
fear of the big baby, becausewhen we look at the stats, the
interventions that they imposebecause of the fear of a big
baby that has very unreliablemeasurements, right? The
(26:51):
ultrasound is not a reliable wayof measuring a baby's weight in
the third trimester. It's justnot and so to impose those
interventions create a greaterrisk, because we know that
cesarean comes with risk,induction comes with risk. And
so I break down the data alittle bit in my book and talk
about exactly that, how we'vecreated more problems with this
(27:15):
fear of a problem, yes,and my feeling is it never hurts
to try if the OB suspects arehaving a baby on the larger side
and they're nervous about havinga vaginal birth, why not just
attempt,yeah, and we don't know, right?
Like that baby and that pelvishas never done the journey
before. I've had clients withsix pound babies have a hard
time. You know? It doesn't. Itdoesn't necessarily, again, come
(27:37):
down to a number. I have a Iwrote about a dear friend and
client who's about to give birthto her fourth and she makes huge
babies, like she just knowsthis, and she births beautifully
every time, and she likes tohave unmedicated births in
hospitals, and they always freakout, and she's always like,
guys, I know this about myself,look at how it's worked out
(28:00):
every time. Ido think that too much data, too
much knowledge, can get intoyour head and be less helpful
and more fear mongering.
Yeah, and you probably have abetter answer to this being a
doctor yourself, but in termsof, like, where it's coming from
and why, I'm always curious, butI think it's, of course, yes,
liability. It's the way we'retrained. Sometimes it is
(28:22):
financial incentive, and I thinkit's also just reflective of our
modern culture. It's not justthe medical system, and it's not
always this malicious or rarelyis it a malicious thing. It's
it's more of like we live in atime that yearned for numbers
and answers, and we just want sobadly to have this perceived
(28:44):
feeling of control. Youwant to know the due date. You
want to know the sex of thebaby. You want to know
everything. And sometimes, ifyou can just relinquish a little
bit and throw your hands up andsay, You know what? There are
some things. I'm just going tohave to have a little faith that
it's going to work out. It'sgoing to work out the way it's
meant to be. I think that makesthe experience so much better,
yeah,but it's also, I think it's
that's a spiritual choice,right? Like, that's something
(29:05):
that is, again, it's not just inmedicine, like we all have to
return to and I know kind of funfact, but Jessica and I met
while we were both evacuatedfrom the fires, and it was like,
this moment of the universethrows these things at sometimes
we're just all plans are up inthe air. All of what I thought
was going to be is different, somuch change, so much surrender,
(29:26):
and it's so effinguncomfortable, right? Like to
just be faced with uncertainty.
And that's what this process,apparently, is doing to us on a
spiritual level, I think, islike trying to expand our
capacity for thatabsolutely. And I have to say,
what I noticed about you whenyou were with your daughter was
(29:49):
that you were just it felt veryspiritual. It felt like you were
just enjoying her, enjoying themoment. You didn't have your
phone out, which I'm soimpressed, because not many moms
can say that these days.
Yes, thank you. I'm very guiltyof that a lot, so I'm glad you
caught me in a moment, but it'snot all the time. I wish I was
better.
No, I did. I did notice that soi i could just sense that you
(30:13):
were somebody who is trying tomake the most of life's moments.
Thank you. So going back tobeing a doula, can you explain
what doulas can't do, like,what? What can they do and what
can't they do? In other words,how are they different from a
midwife or an OB? GYN? Totally.
So doulas do no clinical medicaltests. We don't draw blood. We
(30:33):
don't, you know, listen to thebaby's heartbeat. We we don't.
We're not catching the baby.
We're not diagnosing or anythinglike that. So none of none of
our role is medical or clinical.
It's all an emotional andphysical support and education.
But doulas have always existed,similar to what traditionally
(30:53):
midwives were, beyond anygoverning body, right? And so
the idea is that I'm there forthe mother, hired by the mother
just to serve her, which is aluxury that obviously, when you
there's good reason for certaincertifications and licensure and
(31:14):
all that, but we don't have toabide by that. And so that means
we do get to create, again, notwithin practicing medicine, but
we get to kind of create andbuild this relationship based
off of our client and how wewant to show up to support them,
and how they want to receivethat support.
So beautiful, so amazing. I'm sohappy to highlight what doulas
(31:36):
do, because I think a lot ofpeople have heard the term, but
they don't actually know andwhat way they can be served. So
wonderful, because you can helpwhile pregnant, during delivery
and also postpartum, correct,yeah,
and postpartum doulas, whichsometimes you'll find a doula
who does both, and then somewill do birth, and some will do
just postpartum. But apostpartum doula is a very
(31:59):
different hat, again, with thatsame underlying intention of
being of service to the family.
But it's a wonderful thing toexplore, because what that can
look like, and again, looksdifferent based on the doula,
but it is maybe a few days aweek, or even daily, a doula
coming into the home after birthto help cook, help with some
laundry, and help take care ofthe mother, and really giving
(32:21):
space and allowing andunderstanding that that time is
really important for the mom andbaby to be together, to be skin
to skin, for, you know, mom tobe breastfeeding. And so instead
of somebody else coming in tofeed baby and to care for baby
and to do all the things withthe baby, it's I'm going to take
care of all the things that theparents need to be taken care of
(32:42):
so they can be present in theparenting role in the sacred
time. I'm going to provide bodywork or massage for the mom so
she can be rested and have, youknow, a healthy nervous system
in this big transition. And sohaving a postpartum doula, I
think, is really wonderful,because most will recognize that
(33:02):
the mom knows how to mother. Shejust needs to be mother too.
You know, as a pediatrician, Imeet a lot of moms who
definitely have a hard timeafter delivery. Yeah, they've
just had a baby, their body'shealing, their emotions all are
all over the place, even if,even with the nicest husbands,
sometimes, you know, it's stillhard, because the breastfeeding
(33:24):
falls on the mother, so thatmeans a lot of the waking up at
night falls on the mother. Andso to have that extra support is
a tremendous gift. I'm sure wesee lower postpartum depression
rates with when you havesupport, postpartum
depression is correlated withlack of support, right? And so
absolutely, and I see this allthe time with the families I
(33:48):
work with, which is like thesweetest, most well intended and
supportive fathers who are like,I'm gonna do it, I'm gonna cook,
I'm gonna take our other childto school, and I'll walk the
dog, and I will do all thethings so she can rest. And I'm
like, Oh, I love that, thatethos and that intention, and
(34:11):
for you to be doing all thosethings takes you away from the
presence too, which is equallyimportant. And sometimes what a
new mom just needs is to be seenand held and talk to and
acknowledge and so to put it allinto the other parent isn't the
solution, right? Because thatother parent is often also
really tired and going throughtheir own huge identity shift,
(34:32):
navigating what work is going tolook like. And so that was even
though, of course, like therewere so many things My husband
was doing to help out afterbirth. He is one of those people
who will kind of go to thatservice mode, oh, I'll just,
I'll do this. I'll do that. AndI knew I was like, you already
do a lot, and kind of feeloverwhelmed by it. We throw a
(34:53):
baby into it, it's not gonna begood. And so looking back, he's
like, I'm so glad you made meslow down with you. Yeah,
because there was no way I couldhave integrated all of these new
rules, all of this, these newfeelings, in this period of
time, and been able to enjoy it.
Yes,and also, I'm thinking about
breastfeeding. That is somethingthat I think a lot of moms think
(35:15):
should be a more innateexperience than it is. Right?
You have a mom with a new baby,and all you want to do is just
feed your baby. And we're told,or I was told I was under the
misconception, thatbreastfeeding would be really
easy, it would be painless, thatI would make milk within two,
three days, and it would be avery seamless process. And then
I learned that it's normal to beuncomfortable for a couple of
(35:37):
weeks. And I think, had I hadsome external support, you know,
thankfully, I had a goodlactation consultant, but
someone like a doula, lactationconsultant, someone who or an
experienced friend, anexperienced mother, if they tell
you that boy that can really, Ithink, I think that can make the
experience a lot easier. Becauseyou relax, you go, okay, having
(35:59):
a little discomfort is normallybeginning. It's gonna come. I
just have to hang in there. Sowhat I'm trying to say is I feel
like in every step of the waywith pregnancy, labor and
delivery and that fourthtrimester, that first month or
so after having a baby, I thinkhaving quality support makes the
world a difference.
(36:19):
It really does. Soif people are listening and they
want to find a doula, do youhave any resources that you can
recommend?
Yeah, so there's,you know, I say there's a lot of
different ways you can find adoula asking around word of
mouth. That's where most of myclients come from. So this is
(36:39):
easier in some communities thanothers. But, you know, finding
out from other friends, familymembers, and then going to, you
know, your local yoga studio,acupuncture clinic, like some of
the more, maybe holistic, evenyour pediatrician. If you're
lucky enough to have apediatrician, like Doctor
Jessica, right, you may be ableto recommend doulas, even your
(36:59):
OB, your gynecologist, who mightbe somebody who likes to
collaborate with doula. Soasking around is really useful.
Also, social media can be agreat tool. You know, there's
not like one big database, butthere's, of course, collectives
and certain online resources toour matching with a doula. On my
website, I have my directory ofrecommendations for not just
(37:22):
doulas, but pediatricians andjust everything. You name it.
There's obviously not every cityand state, but I'm working on
it. And thentell us about your beautiful
book. Where can we find it? Howcan I send people to read your
book? Yeah,it's going to be available March
25 on the shelves. I'm not surewhen this is airing, but it
might be around then, and Iremember what the other question
(37:44):
was, I guess, where to orderAmazon, anywhere in the
bookstore. Yeah, I'llmake sure and link it too in the
description below, where you canjust easily click and get this
book. Great. Well, thank you somuch. I think it's very clear,
after talking to you afterreading your book, how important
support makes a difference inenriching the experience of
pregnancy, and so I'm so happyto have your book now to
(38:07):
recommend to people that theycan feel an extra resource to
get to get support. Thank you somuch. Thank you for listening,
and I hope you enjoyed thisweek's episode of your child is
normal. Also, if you could takea moment and leave a five star
review, wherever it is youlisten to podcasts, I would
greatly appreciate it. It reallymakes a difference to help this
podcast grow. You can alsofollow me on Instagram at ask Dr
(38:28):
Jessica. See you next Monday.
You.
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