Find it here on Apple or Spotify Podcasts

Watch the original video:
Check out the full discussion and visuals on our YouTube channel.

Disclaimer:
This podcast provides general information and entertainment only. It’s not a substitute for medical advice. Please consult your healthcare provider about any health concerns or questions specific to your pregnancy and personal situation.

About Hilary, The Pregnancy Nurse®
Hilary is a registered nurse with over 20 years of labor and delivery experience. Since 1997, she’s helped thousands of pregnant patients navigate the ups and downs of pregnancy, including common concerns like ligament pain. Her mission is to empower families with clear, expert information for a smoother pregnancy journey.

Timestamps:

00:00 Understanding unexpected pain experiences

03:46 Understanding pregnancy ligament pain

07:08 Identifying pain and when to visit

The post From Sharp Stabs to Relief: Navigating Ligament Pain in Pregnancy with a Pro Nurse – 266 appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Disclaimer: This episode is meant for entertainment and general medical information purposes only. It is not medical advice. Please consult your own provider for guidance specific to your pregnancy.

Watch the original video:
Find the original episode on Youtube https://youtu.be/aqHSHhcyrvQ?list=PLtc_SbtL2LYHwTOyMArKTWoxAQD0G2lsq

Why Hilary is an expert:
Hilary Erickson has been a nurse since 1997 and brings over 20 years of labor and delivery expertise to the podcast. Having helped thousands of people push out their babies, she knows firsthand how every birth is different and what really works in the delivery room.

 00:00 Pushing and Parenting: No Rules

05:12 “Pushing Techniques in Childbirth”

06:07 “Flexibility in Birthing Methods”

10:07 Optimal Positions for Pushing Birth

13:38 “Preparing for Pushing at Delivery”

The post How to Push Out Your Baby: Options, Expert Advice, and Personal Choice 265 appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Big thanks to our sponsor Laborie — LifeBubble® Umbilical Catheter Securement System

LifeBubble is made of a Soft Medical Grade Silicone to minimize skin irritation, Reduces the Risk of Catheter Migration and Early Discontinuation, and Protects the Insertion Site of our most vulnerable patients. Find them on Instagram @laborie_ob

Today’s guest is Janene Fuerch, MD.

She is a Clinical Associate Professor of Pediatrics, Division of Neonatal and Developmental Medicine, Associate Director of the Biodesign Innovation Fellowship Program at Stanford University, and Co-Director of Impact1 where she mentors and advises entrepreneurs in the pediatric and maternal space through all aspects of medical device development, from identifying clinical needs to commercialization. Her specific areas of investigational interest include the development and commercialization process of neonatal, pediatric and maternal health medical devices. She is a national leader in neonatal resuscitation, ECMO, device development and has been an AHRQ, FDA and NSF funded investigator. But her work extends outside of the academic realm to industry having co-founded EMME (acquired by Simple Health 2022) an award-winning reproductive health company, medical director for Novonate (acquired by Laborie 2023) a neonatal umbilical catheter securement company and notable consultant for Vitara (EXTEND – artificial environment to decrease complications of prematurity), Laborie, Ceribell, Novocuff and Avanos. Janene is passionate about improving the health of children and newborns through medical device innovation and research.

Links for you:

Previous Laborie Episode on Forceps (260)

Timestamps:

00:00 NICU Challenges: Bonding & Separation

06:55 Choosing the Right Hospital Level

09:47 Bonding with Baby After Separation

14:06 NICU Innovation: Challenges and Opportunities

15:14 Umbilical Catheter Infection Solution

18:17 NICU Bonding and Communication Tips

21:59 Premature Baby Care Innovations

25:04 Prioritizing Investment in Children’s Future

Keypoints:

• Many families are surprised when their baby needs to go to the NICU, so it’s important for all pregnant families to know some basics about what to expect.
• The NICU can range from having just a couple of extra staff in the delivery room to having 15 people if a baby needs help, making the birth experience much more intense and involved.
• Planning ahead with your partner about who will go with the baby in case of separation can help make a stressful situation a little easier.
• About 10% of babies need some help breathing at birth, but most recover quickly; only a small percentage require NICU care beyond the basic interventions.
• NICUs are graded by levels (I-IV), and knowing what level your hospital offers can help families prepare—higher-level NICUs can treat more complex issues but aren’t always necessary for uncomplicated births.
• If your hospital isn’t a level III or IV, babies needing higher-level care may need to be transferred, which could mean temporary separation from parents; hospitals always work to reunite families as quickly as possible.
• NICU nurses are passionate, skilled, and deeply care about the babies and their families, creating a loving and safe environment even during stressful times.
• Parents can support their recovery and milk production by getting rest and using NICU technologies (like webcams) to stay connected—it’s okay to take breaks and trust the NICU staff.
• Emerging technologies like Labry’s Life Bubble are making NICU stays safer and more comfortable, allowing parents to hold their babies even when special catheters are in place.
• Skin-to-skin contact in the NICU is highly beneficial for both babies and parents, helping with bonding, milk production, and even neurodevelopment; parents are encouraged to ask staff about timing and any concerns about wires or tubes.

Producer: Drew Erickson

PUT TRANSCRIPT HERE:

Keywords:

NICU, neonatal intensive care unit, premature babies, neonatologist, types of NICU levels, level 1 NICU, level 2 NICU, level 3 NICU, level 4 NICU, hospital delivery, separation from baby, bonding with baby, skin-to-skin contact, umbilical catheters, infection prevention, NICU innovations, Labry, Life Bubble, technology in NICU, neonatal health, maternal health, NICU nurses, milk production, pumping breast milk, trauma of NICU stays, baby monitoring, necrotizing enterocolitis, artificial womb therapy, premature birth complications, hospital transfer, parental tips for NICU, emotional impact of NICU

The post What Every Pregnant Family Should Know About the NICU appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Big thanks to our sponsor The Online Prenatal Class for Couples — if you’re looking to get prepared with your partner, it’s your best option!

Today’s guest is Dani Morin child safety advocate and CPST on TikTok. Helping parents make informed parenting decisions and providing product research to help moms make the perfect baby registry.

Find her on: Tiktok (@danimorin13) or Instagram (@danimorin_)

Links for you:

Baby Proofing 101: Dani Morin’s Mission for Baby Safety Awareness (her previous episode)

Timestamps:

00:00 “Life-Altering Realization of Parenthood”

05:58 Overcoming Grief and Rediscovery

15:20 “Embracing Parenthood Despite Loss”

20:26 Navigating Fertility Challenges Alone

23:06 “Sperm Donation Normality Perception”

29:51 IVF Expenses and Fertility Misconceptions

33:07 Vanishing Twin Syndrome Explained

40:15 Struggles Changing High-Risk Doctor

43:24 Alone for Life-Changing Ultrasound

50:10 Plane Safety and Medical Workaround

56:11 Birth Center Inequality

01:01:18 Three Key Takeaways from Episode

Keypoints:

• Dani Morin shares her experiences with three very different paths to pregnancy, from an unplanned pregnancy in her 20s to home insemination as a single mom, and eventually a natural conception after getting married.
• The episode highlights the emotional aftermath of Dani’s first pregnancy, including the life-changing impact of her son’s tragic loss and her journey through grief, sobriety, and rediscovering her sense of purpose as a mother.
• Dani describes how early parenting trends and online information influenced her choices—she candidly discusses how she embraced “all-natural” parenting, even using products later shown to be unsafe, and how she has since shifted to an evidence-based approach.
• Hilary and Dani emphasize that unplanned pregnancies are far more common than most people believe, and that being surprised by pregnancy doesn’t make anyone less of a mom.
• Dani details her experience with home insemination using donor sperm as a cost-effective and empowering option for single women or couples with fertility challenges, demystifying and normalizing this choice.
• The conversation explores the stigma, criticism, and unsolicited advice Dani encountered online and in real life regarding her non-traditional paths to motherhood.
• Dani shares practical tips for others considering home insemination, including financial readiness, emotional support, and building a “village” before taking that step.
• The difficulties of navigating healthcare, especially when you’re high risk or dissatisfied with your provider, are explored—Dani discusses real challenges in switching OBs, accessing support, and advocating for yourself during pregnancy.
• Dani and Hilary discuss the limitations—and some dangerous pitfalls—of using AI and online sources for pregnancy advice, and stress the value of trustworthy, evidence-based resources.
• Throughout the episode, the importance of compassion from healthcare providers, honest conversations, and finding the right support network for your unique pregnancy and parenting journey shines through.

Producer: Drew Erickson

names removed 262 Dani Morin — getting pregnant

[00:00:00] Hilary Erickson | The Pregnancy Nurse®: Hey guys. Welcome back to the Pulling Curls podcast. Today, on this episode, we are talking about three different things. So the first one is gonna be different ways to get pregnant and how that affects your pregnancy. Stay tuned. This is gonna be a good one. Also, managing your provider when you don’t really like them, and it’s gonna be real difficult to switch. And then finally, is AI okay to ask pregnancy questions to? So let’s untangle it.

[00:00:21] Hi, I’m Hilary, a Serial over Complicator. I’m also a nurse mom to three and the curly head behind pulling curls and the pregnancy nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with pregnancy and parenting untangled the Pulling Curls podcast.

[00:00:51] This episode of the Pulling Curls podcast is sponsored by the online prenatal class for couples. If you are looking to get prepared for your upcoming birth, please join me. It truly is the easy way to get prepared.

[00:01:01] Today’s guest is a child safety advocate and CPST on TikTok. She loves to provide informed research on product safety for parents who are getting their registry together. I wanna introduce today’s guest, Dani Morin.

[00:01:13] Hey Dani. Welcome back to the Pulling Curls podcast.

[00:01:16] Dani Morin: I’m so excited to be back. I feel like this time you and I have gotten to know each other so well that it’s just really friends talking to friends. So things may just may get intimate here because we are talking about conception in every different way that you could think.

[00:01:36] Hilary Erickson | The Pregnancy Nurse®: not every, I mean you didn’t, so she never did IVF, like full on IVF, right?

[00:01:41] Dani Morin: I never did IVF people get that so confused, which we’ll get into

[00:01:47] Hilary Erickson | The Pregnancy Nurse®: Yeah. Okay, so Dani has been pregnant three times in all three very different ways. So most off, I want people to understand that there are different options for people to get pregnant. And your second option, I think is a viable one that a lot of people don’t even consider because they just think it’s too out there. Right? Like, I told your story to my mom and she was like aghast at it. And I was like, why? What is the difference between her going into the office and having it done and doing it at home? But anyway, the just like, a spoiler for everybody. Okay, pregnancy number one, got pregnant.

[00:02:20] Dani Morin: So pregnancy number 1, 24 years old, I was working at a wine company. I was, you know, living the lavish lifestyle of a 24-year-old, kind of like an Alex Earl, right? I was on yachts, I was living in Newport Beach very much up into the party scene. And it was one of those situations where I fell pregnant, having some fun, having fun.

[00:02:45] So the great thing about that pregnancy though is I never, thought I wanted to be a mom and I found out I was pregnant. I was like well into my second trimester, by the way. And I knew, because, you know, I was a big partier, but I could not put down even a glass of wine. I was like vomiting. I’m like, what is going on?

[00:03:05] So I had gone like a month or so without like even having like a sip of alcohol. It was making me so sick. I should have known right then. But I had had a doctor, and so this is for all the girls listening. I had a doctor tell me like, well you have PCOS and a tilted Ute. Not maybe is it a tilted uterus or a tilted?

[00:03:26] A tilted something. So, you know, ’cause.

[00:03:28] Hilary Erickson | The Pregnancy Nurse®: cervix.

[00:03:29] Dani Morin: A tilted cervix, it was a tilted something. And so I was probably gonna have a tough time ever conceiving. I probably wouldn’t. And I’m like, oh fine by me because you know I’m gonna live in a high rise someday and just be like single and successful. Like that’s just the vibe that I was like putting out 24-year-old me.

[00:03:45] And it’s so crazy because the second I found out I was pregnant with that baby, you know, I go in and like I knew the gender that day. I go in and I know the gender and everything that day. And I had had this like crazy emotion come over me. I cannot even explain it. I have not had this with my other pregnancies, but this crazy emotional connection to this child. And again, we’ve gone into loss and stuff, so I think my other pregnancies, I haven’t had this immediate connection because of my fear of loss. But I had this emotional, crazy connection of just wanting to do everything to make sure that this baby was safe and taken care of.

[00:04:30] And, in the womb and just like the best baby products and all this stuff. And like, I became like, mom 5,000 overnight. Like it was, it was this crazy thing. And I realized at that point I was like, my purpose on this earth is to be a mom. And 10 days prior it was completely opposite. Like, oh, I’m totally fine never having kids. So sometimes things happen that give you a different perspective on life and getting pregnant with my son, Deacon, was just that. Like what I thought my purpose was, was completely different than when I found out I was pregnant. And I’m like, this is my sole purpose and I will do everything to be like the best mom I can.

[00:05:13] Now we’re not gonna dive too much into the grief, but when he was 18 months old, he was strangled by a Baltic amber teething necklace at a negligent daycare. That’s a whole thing. If you guys go on my social media, you could dive more into that. So I lost him around almost 19 months old. And that ruined me, completely shattered me, ruined me. Again, I had just found my purpose and that was like in motherhood and being this boy’s mom. And I was a single mom and I thought I was doing so well with that. And this tragic thing happened and it ruined me. To the point where I, you know, was making really bad choices. I did not know how to grieve. I was medicating with alcohol and other things.

[00:06:01] And I just was like, hoping not to wake up. Like I just, that was just not something I wanted to do anymore, was like live on this earth without being a mother and being that boy’s mom. I did end up getting help for that a couple years into my grief. I just was like, if I’m gonna keep waking up, I don’t want to keep waking up like this.

[00:06:24] Like, there’s has to be more to life than, than this grief and like this pain. And I got my life back together and I just kind of saw things skyrocket. Some of which was sharing my story and opening up about my truth and my story on social media. Believe it or not, I think it was a huge part.

[00:06:42] I mean that and the rehab. But, I think it was a huge part to kind of just living my truth and these are the things that happened and this is how I got pregnant. This is how he passed away. This is the guilt that I’m dealing with. These are the struggles that I have. And now I’m sober going through all of this again.

[00:07:05] But like just in a few years, I literally saw my life skyrocket and it has not stopped. So, I guess now’s the point. We could get into the very controversial subject of my next birth. And you can stop and ask all the questions because I want people to understand that when I am telling you about how I got pregnant with my second child. Who’s now almost five, by the way. All I knew.

[00:07:33] Hilary Erickson | The Pregnancy Nurse®: really quick. I wanna stop

[00:07:34] Dani Morin: Yeah.

[00:07:35] Hilary Erickson | The Pregnancy Nurse®: I was thinking it was

[00:07:36] Dani Morin: Okay.

[00:07:36] Hilary Erickson | The Pregnancy Nurse®: too, how you were talking about how you like turned into mama bear and you wanted to do like everything natural with your first one, right? It turned on

[00:07:46] Dani Morin: Yes,

[00:07:46] Hilary Erickson | The Pregnancy Nurse®: natural cloth diapering all feet on the ground, like in

[00:07:51] Dani Morin: yes. Okay. I’m so glad that you brought that up because there was, and I had gotten vulnerable with you on this topic at that table actually. And that’s just the gems of Mom 2.0. You just start, you know, word vomiting, your vulnerability. But so when I found out I was pregnant, I thought like, all these people are gonna look down on me for how I became pregnant, right?

[00:08:17] And so I’m gonna prove everyone wrong and I’m gonna be the top mama dog out there. Like, I’m gonna have the best rated car seat at the time. I’m gonna, you know, and then in 2015, it was very much the all natural mama, right? So you breastfeed until your kid goes to kindergarten and like you do not put a regular diaper on your kid.

[00:08:41] You cloth diaper. You do not use regular wipes. You make your own wipes, which is like grape seed oil. And at the time, lavender, which we know is like, you never put lavender on like a boy’s genitals. Like I don’t, it was just the crazy thing, the teething, the baltic amber teething necklaces, which were part of the, how he died. Those were like your badge of honor. Like if you were taking your kid out to Target and he had on a baltic amber teething necklace, like those mamas knew you were all natural mama. And it was just this, you know, this whole thing of, everything’s natural. And I really fell into that and I held a lot of guilt about the baltic amber teething necklace for the longest.

[00:09:23] I still do, to be honest. But I have come to terms with the fact that I was doing the best that I could with the information put in front of me and the information that I was consuming. So at the time, and you are an OG blogger, so you know this, but like at the time in 2014- 15, so I was like pregnant in 2014, 2014, 15, 16.

[00:09:49] The blogger life was like a real big thing. We didn’t have really Instagram or we had Facebook, but we didn’t really have all these things going on that we do now. We didn’t have pediatricians making videos. We didn’t have the experts out there like yourself, like making videos and stuff like that. I didn’t even know what the AAP was like. Don’t even ask me what those acronyms stand for. And so we had these mama bloggers and so when we would Google, you know, all natural remedies or safety or whatever, this is what was popping up on our Googles right, was these mom blogs, which are not reputable at all. I could Google right now, like, “can I do meth while pregnant?” And I’ll find something that supports that. Like, it’s out there. Like people anywhere could write anything that they want online. And so I fell into these like all natural trends. And I was not, not that I wasn’t open to the evidence based. It just was not what was being populated in front of me at the time.

[00:10:51] Now I think people definitely know that they can find the evidence or they can find the topics that, that are gonna support their narrative or how they wanna parent and they’re gonna choose the latter. So it’s a little bit different now and we are seeing kind of a similar thing happening in 2025 with the all natural, the anti-vax, anti evidence, anti pediatrician, anti doctor.

[00:11:21] We’re seeing that again now in 2025. But it was pretty heavy in like 2015. And I definitely fell into that trap. And it took me a while to climb out of this crunchy, crunchy, holistic, homeopathic life. It took me even, I was still lingering a little bit when I had my second child. I’m like, come on, you know better.

[00:11:46] Like, you know better. Like, that sounds good, but that is not safe. So, yeah. So I was sucked into that. But, I have come to, I guess, realization and I guess a little bit of peace. I’ll say I’ve come to a little bit of peace with the fact that there wasn’t anything out there saying that the baltic amber teeth necklaces were bad.

[00:12:07] Now it’s all you’re gonna find. But at the time, thousands of kids were wearing ’em. This was the information put in front of me that instead of giving your kids Tylenol, this is going to help. We know it’s a hoax now and it’s a whole thing, but, i, I do feel that even at that time.

[00:12:23] Hilary Erickson | The Pregnancy Nurse®: at uh, mom two.

[00:12:24] Dani Morin: I know. And, I do feel like, and we could get into that too. But I do feel like at, at this point, I was the best mom that I could be for that baby with the information that I had.

[00:12:37] And so I’ve actually changed my tone online to how I talk to parents when I see moms using things, and then I’m like, Hey, just so you know, like those aren’t recommended. Here’s some evidence to prove it. And then they’re on the defense and I’m like, you know what? They’re on the defense because they’re doing the best with the information that they got. And that’s an ad for a teething necklace, you know?

[00:12:59] Hilary Erickson | The Pregnancy Nurse®: Yeah.

[00:13:00] Dani Morin: Or whatever it might be that’s, a mommy blog about, you know, bed sharing or whatever. So it’s whatever they find. It’s just that like they’re, so, my tone has changed a little bit. But yeah, with the teething necklace at Mom 2.0, I had a ton of people coming up to me saying, you should go tell that mom your story because her baby’s wearing a teeth necklace.

[00:13:21] And I’m like, you should go tell that mom my story and just point to me and say that mom doesn’t have a son anymore because of that necklace and you’re wearing it. I was like, there’s a time and place and I’ll never go up to a mom like at a Starbucks in front of a bunch of people and be like, like in line in front of people, and being like, oh, that necklace is what killed my kid.

[00:13:40] I would never do that. I used to. Now I’ll wait and see like, Hey, can I get that mom alone privately and say something. Mom 2.0 and there’s thousands of moms there and everybody’s feeling judged. Sorry, I have a little acid reflex from the pregnancy.

[00:13:55] Hilary Erickson | The Pregnancy Nurse®: Shocking.

[00:13:56] Dani Morin: so bad. .

[00:13:58] Hilary Erickson | The Pregnancy Nurse®: So many people have unplanned pregnancies and I think they all feel like no one else has an unplanned pregnancy. But as a nurse, when you’re going through prenatals, ’cause your doctor asked you at your first appointment, was this planned, unexpected, unwanted. So many people say unplanned and so I never want people to think just because they weren’t planning on this, that somehow they’re a worse mom. And, just in case people are listening who are like, yeah, that’s me, like I’m pregnant and wasn’t expecting it, you’re still an amazing mom. That doesn’t, that doesn’t mean anything about you going forward. Hopefully, I wish somebody had told Dani of 2015 that.

[00:14:33] Dani Morin: You know what’s so funny is, is how I look back at it, is that people were very upset with how I got pregnant, right? But when that baby was here, like that all seemed to go away. And I remember at his funeral, like seeing people show up there and like I was able to pull comments that they left on my pregnancy announcement.

[00:14:54] And I’m like, oh, it’s funny that like you cared about him now that he is alive and now dead. But like when I was pregnant, I was this, this, this, and these names that you left in the comments. But like my whole thing is that, once the babies are here, it does not matter how they came to be.

[00:15:10] Like they are so loved on and, it does not matter. And people have unplanned pregnancies while married. Like it’s, you know what I mean? Like, they happen all the time. These are things that happen. And for me it was the best thing that happened.

[00:15:24] I actually get asked a lot, and I’ve never done a video on this, but I get asked quite a bit, like in one-on-one conversations. Like if you knew that you were going to have a child that was gonna die at 18 months. Like, would you have, you know, because I, I got pregnant in this weird way. Like, would you have done it again?

[00:15:44] And my answer is always 100,000 times over. Like the lessons learned, the value of becoming a mom, learning my purpose, of having this love that I’ve never, ever, ever known or experienced before is a love like that of a child. To be able to do that again, I would 100% sign up for it. Even though it would come with the grief and the alcohol and the rehab and the recovery and all of these other things, I would still choose to do that again.

[00:16:15] So, and that’s just like my story, but it’s something that gets asked. I sat on it for the first time and I’m like, and it was too close to the death, you know what I mean? But now I could sit back almost 10 years later and I’m like, I would do it 100 million times over.

[00:16:31] Hilary Erickson | The Pregnancy Nurse®: That’s amazing.

[00:16:32] ,

[00:16:32] Then you decided you wanted another one.

[00:16:34] Dani Morin: yeah, so I was a couple years into my sobriety life was going really good.

[00:16:39] I had, at my corporate job gotten rep of the year, a couple years in a row. I was starting to do social media by accident. I was just sharing my story to honestly just help. I have a big thing, like sometimes when you share your truth, you’re helping others, and in turn, I felt like I was doing good in my son’s name and doing the safety advocacy and stuff like that, like.

[00:17:01] I felt like I was making him proud and I was making myself proud and it felt really good. And I just really wanted to be a mom. Now, I had started dating, I was going on numerous dates every single week. It was very weird. I just was, this is just not what I want. And I was like finding myself, like, on these dates, being like, could I settle for this?

[00:17:26] Like, and I’m like, why would you wanna just settle to have. Like, my goal was to be a mom again, and I just don’t know if I was wanting to date and wanting a boyfriend or a husband. And I wasn’t finding like that match. And so I started, I had gone to HRC Fertility. They had a fertility night where they were going over IVF options and, they had this fertility night. So I was like, I’m gonna walk up there. The hospital’s like walking distance to my house. I was like, I’m gonna walk up there and sit in on this and hear about IVF. I really just wanted to know what it would cost to do IVF. So I go in there and it was definitely like a salesy thing.

[00:18:06] Like, this is like a money maker, like I realized. But they went into sperm donors. A lot of people that were there actually were married couples where the guy was sterile. And I had never heard of something like that before. So a lot of people there were trying to figure out. So they had like the sperm donation, I think like California cryo might have been there, like some of the sperm donation.

[00:18:29] There was like, it was a salesy thing, like use our services and stuff. So, I never even knew that that was even a thing. So I did do a consultation with them. I remember the doctor in our meeting, like had, like fallen asleep. Anyways, it was like a weird situation. I was like asking what the steps were gonna be and, I had ordered some sperm from a sperm bank, and I was planning on doing IUI. So I, so there’s IVF, and this is, okay, I’m gonna break this down because this is, everyone’s like, did you choose the gender? I’m like, oh my God, they have no idea what I did. Okay, so IVF is where they take the sperm, they put it into the egg and they insert that into the uterus.

[00:19:15] And you could tell me if I’m using these terms wrong. Okay.

[00:19:18] Hilary Erickson | The Pregnancy Nurse®: All these

[00:19:18] Dani Morin: IUI. Okay. So IUI is where they kind of take like a catheter and they place the sperm directly as close to the egg as possible. So some men have issues with mobility of sperm to where they got the sperm count, the sperms good and clean and all this stuff.

[00:19:38] But for some reason it’s not swimming as it should to the egg. So IUI sometimes like gives the egg, gives the sperm a better chance to penetrate the egg. So to speak. So they used kind of like a catheter. So that was gonna be the option I did because I’m like, I’ve gotten pregnant before. I don’t think I need IVF.

[00:19:57] Well, we were doing this whole thing and because I had, you know, tilted cervix or tilted uterus and PCOS because I’d been diagnosed with that before I was using that and to get IUI covered by insurance. Well, you cannot get IUI covered by insurance until you’re 35 years old, which I did not know.

[00:20:16] So what I thought was gonna cost me like $2,500 was gonna cost me close to 12,000. And I was like, that’s gonna be a negative. I’m crying in the office and I’m like, my whole plan, you know, I was supposed to start the medications, which are on their own like $2,000. So, this nurse kind of like pulls me aside and she’s like, ” you should go on Facebook and join the lesbian communities and they’ll tell you the ways to have a baby on your own at home.” And I’m like, “psychotic? No.” So I had gotten in the car with my mom and I was like, “yeah, I had this idea of you know, getting pregnant on my own, but it’s not gonna work out.”

[00:21:00] And my mom had kind of said something like in a joking fashion where she was like, “what if though you like found somebody and like, you know, friendly or something and you could like get pregnant that way.” So I was like thinking, I’m like, and she’s like, I mean, don’t do that, but like, she’s like, I know, it’s just, this is like what you want this so bad?

[00:21:25] And I went home and like I slept on it and I’m like. No, but for real, like how are the lesbians, like how are they having babies? Are they all going through IVF-IUI? So I find a lesbian group and they’re like, join this group, which is, home insemination is what it’s called. And shout out to the lesbian community for opening your arms wide open and teaching me the ways of how this works.

[00:21:53] There’s a science to, I mean, they taught me the way. So I was on the home insemination group. I ended up finding single mom by choice group. Now I’ve not been on Facebook since probably five years. But I found, single mom by choice group. I found home insemination group. And the home insemination is where, now some people find like live partners that will produce sperm into a cup and then they inseminate it more like in a live situation. I had ordered sperm already, so I just had that then shipped to my house instead of to the IUI place and or to the fertility clinic. And I did it myself. So there was a whole science behind it. You know, you let it thaw for 20 minutes and then it’s basically like a syringe, so smaller than a tampon and you just put it up there and you wait 30 minutes.

[00:22:46] And I got pregnant on the first try. First vile, first try. But these women walked me through it, exactly what to do. And then I thought it would be a good idea to, after I was like nine months pregnant, to make a video of how I did it. And the internet had some things to say. And it’s so funny because I had been researching how I was gonna do this for about seven months before I pulled the trigger.

[00:23:14] So all I thought in my mind, so I had gone to the fertility clinic where I met, there was all these like couples there where the husbands were sterile. So everything was about sperm donation stuff. So in my mind, I had gotten so wrapped up in this that in my mind the only way people were conceiving these days was sperm donation in my, in my mind.

[00:23:36] Like, so when people were like, “oh my God, this is shocking.” I’m like, is it like, this is pretty normal? Because what I’d been going through and like what I was like presented with and the groups that I was in, like this was the most normal thing. So I had to take a step back and be like, people are shocked about this. You know, and I made it very clear in this video, the first thing I said was, I am reviewing my finances because mind you, I got knocked up with my first child, young, in my twenties. And although at the time I thought I was making a lot of money. Oh, you do not equate for your $1,500 of daycare every month and $500 of groceries, clothes, and diapers, or whatever you need.

[00:24:19] And you are not equating for all this other money of this other human that you have to raise. When I had my son, Deacon, I did have to move home. There was no way I was gonna be able to pay rent and then also put him in daycare and work and pay for all these things. Like, so the first thing I ever did in that video was I was like, you have to look at your finances first and foremost.

[00:24:41] Like the last thing you want is now. I figured it out with my son, Deacon. I moved in with my mom and it was great and I love that she was a huge part of his life and my sister was living at there at the time and she like, I love that it worked out that way, but I want people to know. A lot of people just account for how much it costs to get pregnant. They’re not thinking of childcare, groceries, clothing, school. They’re not thinking of all this other stuff. So I’m like, you need to think about this and make sure if you are going to purposely do this, that you do it with intent and that you are set up to the best of your ability? What? Like financially, emotionally.

[00:25:19] I also talked about, I had a lot of help. Like I had my mom, like I knew I was gonna have a village of support already. So I just gave people, I was like, before I dive into how I did this, like these are things that you really need to think about. But everyone’s biggest thing was like, my son was gonna end up in jail because statistics without a father, you know, all this stuff.

[00:25:43] And I’m like, well, those are statistics, so some people don’t end up in jail. You know what I mean? Like, but there was a lot of that. Now my son, I did make sure had a father figure from the day he was born, which was my brother, who is a huge part of my son’s life and has been since that day. And so, I did make sure that I had thought all of these things through, and I think when I made the video, it was at the time, you can, tiktoks are only a minute.

[00:26:12] So my video was 58 seconds. So it’s like, how do you explain all this in 58 seconds? And a lot of people in the comments were like, you should have just, you know, gotten drunk and like hooked up with someone. I’m like, no, I’ve done that before. Like, this is the better option for me at this point.

[00:26:28] So, in the comments I was like, really catty and funny about it, which is what I think made the video go more viral because people are like, oh, these comments are not even phasing this girl. Like, these people are writing vulgar, vulgar, vulgar things. But what I realized, I’m like, they don’t understand also.

[00:26:46] So I had not told people that I lost a child before I was gonna take that to the grave actually, when I had first posted this like video on TikTok. I had very much opened up on the Facebook and some of the other apps. But TikTok is its own thing. So, people were confused like, what just makes?

[00:27:03] And I’m like, I was a mother before. Like, I know what I was getting into. So that’s how I was able to plan for this. Which gave me another leg up, just kind of on motherhood on what to expect. So I had to kind of come on the TikTok and tell people like, “Hey, this is kind of what happened and why I made this choice. And everybody’s choice is different.” So since I’ve posted that video, I’ve had a lot of moms and women reach out to me. One mom reached out, I wanna say she lived maybe Atlanta or something. She’s a lawyer, she’s 40. She got out of a relationship for seven years. It was not going anywhere. She realized this was not her person.

[00:27:42] She had no idea that she could get pregnant this way. She was planning on doing $40,000 for IVF. And like, she’s onto her second baby, single mom by choice. She’s successful. She has these two kids now. And her life is very fulfilled in that way. There is another mom, I think she’s onto her second baby.

[00:28:00] She’s from Florida. She had reached out. I had kind of taught her the ways. And, you know, she had all this support from her dad and her family. And I think she’s now on her second baby too. But like, already successful in her mid thirties. And was feeling like that pull to motherhood. But was like, “oh, I thought I was gonna have to save up 40, $45,000 for IVF. Like, I had no idea that this was an option.” A lot of girls were like, “thank you so much. Like I’ve been with my boyfriend, he’s about to propose and I hate him, but I just like really wanna be a mom.” And I’m like, okay, don’t bring me into this. But like, I gave women another option to take life into your own hands, essentially responsibly, I hope.

[00:28:43] Now there would be 20 year olds reaching out to me and I’m like, live your life. No, I’m not even gonna entertain you. Live your life. You know,

[00:28:53] Hilary Erickson | The Pregnancy Nurse®: Yeah.

[00:28:53] Dani Morin: wanna be a, I’m like, you have no idea what you’re getting yourself into. I’m like, live your life. Hit me up when you’re 30. You know?

[00:28:59] Hilary Erickson | The Pregnancy Nurse®: Right.

[00:29:00] Dani Morin: So, ,

[00:29:00] Hilary Erickson | The Pregnancy Nurse®: it’s such a viable option

[00:29:01] Dani Morin: yeah.

[00:29:02] Hilary Erickson | The Pregnancy Nurse®: ‘ cause there’s plenty of people who out there find out their partner sperm can’t make it up there or they’re sterile and could try this and save so much money. Right. There’s, there’s a lot of people

[00:29:13] Dani Morin: Yes. Well, and I think a lot of people just don’t know it as an option or they think it’s an unsafe option. Now, I did have a fertility clinic stitch my video. And, they’re like, this is not a safe option. Like you definitely should, you know, come in and do IVF and IUI. It’s the safer option. So like I had on my other account, my Zippy Mom account, I was like, “oh, can you explain like why, what’s unsafe about, about it seems just like sex essentially.”

[00:29:48] And They could not come up with really a way except I realized, I was like, okay, so you’re just like hoping that the moms will spend. You don’t want moms that know that they’re fertile to not spend the 12,000 or $45,000 on IVF. Like, so I think people get in their minds, like going to a doctor’s office is just probably safer.

[00:30:06] But sex and this, it’s the same thing. And so they could not, so what their video back to my comment was, ” well you’ll have a better chance.” And I’m like, if you’re fertile, you’re fertile. You know? So, I got pregnant on the first try, you know, and I’ve clearly that doctor that told me tilted cervix, PCOS thing, you can’t get pregnant. That was a lie. So if, if doctors are telling you guys that just, don’t rely on that as truth. And now I’m pre,

[00:30:34] Hilary Erickson | The Pregnancy Nurse®: either. Breastfeeding, A lot of

[00:30:35] Dani Morin: yeah.

[00:30:36] Hilary Erickson | The Pregnancy Nurse®: you can’t get pregnant while you’re breastfeeding. Wrong.

[00:30:38] Dani Morin: Yeah, wrong. So many, that’s probably the robot, saying that. But yeah, so now I’m pregnant with twins, which I also got pregnant pretty quickly. I did have one cycle that I was like tracking ahead of time, but it was the cycle I took out the IUD, so I’m like, maybe that counts, maybe that doesn’t.

[00:30:56] There’s, you know, six week period that you gotta let that rest. But, and then I, I’m pregnant now, twins, so there’s that.

[00:31:05] Hilary Erickson | The Pregnancy Nurse®: clo or

[00:31:05] Dani Morin: But

[00:31:06] Hilary Erickson | The Pregnancy Nurse®: right? No. No egg dropping

[00:31:08] Dani Morin: no, so, even when I got pregnant via home insemination, I didn’t take any medication. I took, well, I will tell you what I took. I did vitamin D, I was taking a prenatal vitamin DI was taking something called avocitil, which was for PCOS, which I’d been taking for a while.

[00:31:30] And I was taking something called Vitex. All of these things you could get at Sprouts. Okay, that’s just your regular supplements. Now, Vitex. So my second pregnancy with my son Rett, who’s now almost five. that was actually a twin pregnancy, believe it or not. Vitex I found does the same thing, similar to Clomid.

[00:31:52] You should not be taking Vitex if you don’t need it. So Vitex is for people that are not getting a lengthy enough luteal phase. So this is where I was still kind of dipping into that crunchy stuff. So, Vitex supposedly will help supposedly, and I don’t know how much truth there is to this.

[00:32:12] If your luteal phase is not long enough, it could lengthen your luteal phase and get you more regular period. I did notice it was giving me more of a regular period. I will say that apparently if you do not need it, so if your period’s already regular, you already have a lengthy enough luteal phase that it could cause you to ovulate multiple times.

[00:32:33] So it could do something similar to Clomid. So I did not know that and I must have ovulated twice. Now it was Covid at the time, so you did not have your first doctor’s appointment until 10 weeks. So when I had gone in for my, ultrasound, they thought it was like a sub chronic hematoma, A SCH. And then they looked further into it and they’re like, oh my gosh, it was another baby.

[00:33:01] Just, it had, it looked like it stopped growing around seven weeks. So I was like, well, what happens? What, so what does it do? And they’re like, well, it’s called a vanishing twin syndrome. Which statistically, accounts for, I think it was like 42% of twin pregnancies equate for I could be off on that number, vanishing twin syndrome.

[00:33:22] So it’s very common. And a lot of times moms when they get to their appointment, don’t even know that there had been two babies in there. So, as you can imagine, I get pregnant now and I find out very early on I’m having twins. And I’m just like, I’m not gonna believe that because I know the statistics and I’ve researched this before, ’cause I’ve gone through this before.

[00:33:43] So, finally at like, I think I was like 13 or 14 weeks, and she’s like, have you like told your family and and your friends? And I was like, no. She’s like, well, you’re past vanishing twin syndrome. So I guess now is the point I tell you like, you’re having twins. Like, unless something happens, which like, you know, something like this is, these are twins now.

[00:34:05] Like you could tell people if you want that you’re having twins. But still in my mind I’m like thinking, well, I’ve gone through that. I didn’t go through that. Like I found out at my ultrasound like, here’s one baby that at there was another one, you know?

[00:34:20] Hilary Erickson | The Pregnancy Nurse®: Yeah.

[00:34:20] Dani Morin: So, and then when I got pregnant this time with twins, I was doing my research again and it was just like the perfect storm.

[00:34:28] So if you’ve been pregnant with twins before and you’re over the age of 35. You’re like three times more likely for that to happen again. So it was just kind of like a perfect storm situation, I guess. I mean, I just don’t know. We look at it honestly like a crazy miracle. You know, they can’t really explain it.

[00:34:50] Ours was a split embryo, so it’s just a crazy situation. And we’re so excited. I fight the paranoia. Me and you talk about this. I have called for those of you guys listening, Hilary in hysterics, just over my

[00:35:09] Hilary Erickson | The Pregnancy Nurse®: That wasn’t hysterics. Does that make you feel any better? That

[00:35:13] Dani Morin: was.

[00:35:13] Hilary Erickson | The Pregnancy Nurse®: I don’t even call that hysterical.

[00:35:15] Dani Morin: When I was leaving you the voice messages and I’m like, hold on a second. I’m just like, I didn’t even get it together.

[00:35:24] It’s just like, I think the fear, I’m not vibing with the, and we could get into that with my doctor. And I just like,

[00:35:33] Hilary Erickson | The Pregnancy Nurse®: should mention you

[00:35:34] Dani Morin: yeah, you got

[00:35:35] Hilary Erickson | The Pregnancy Nurse®: between,

[00:35:36] Dani Morin: married

[00:35:36] Hilary Erickson | The Pregnancy Nurse®: re

[00:35:36] Dani Morin: in between. Oh yeah, yeah, yeah. Okay. So this pregnancy now, so I did meet somebody. Yeah, this pregnancy now natural with my husband. So 19 months ago I met a boy and I was set up with a guy that’s, we have mutual friends, we are set up. He lived across the country at the time. And so I thought it would be a good idea to fly out there and that we would have this 10 day road trip back to California where he would live in his friend’s back house until I let him move into the house. And a month after that, we were engaged.

[00:36:12] And eight months after that we were married. And a month after that we became pregnant. So this guy was just this single man bachelor in Boston, living his life. And now he’s essentially a married father of three.

[00:36:26] Hilary Erickson | The Pregnancy Nurse®: Two years later, right

[00:36:28] Dani Morin: And he loves every minute of it. He’s such a good dad and he is. I had something a scare, I guess. A scare. It’s, I could talk to you if we could talk about that also, but, the other day, and he’s just like immediately hitting up the doctor, looking things up and like he’s so into the pregnancy and so into being Rhett’s dad. And reading the books on discipline and, you know, things like in the baby books. And he has like, just accepted this whole thing and he loves it. And so I, it’s been really fun. It’s been really fun doing this with a partner. So, now I will say the funniest part about this, and this may be TMI. The funniest part about this, so I got knocked up, so I was single. And then I did home insemination single. I’ve never been in a position where you are intimate during pregnancy. And I’m like, can you hurt the baby? Like, how does it, and he is like, well, what? And I’m like, no, I’ve never had to do this in pregnancy before. I’ve always been single. I’ve never, like, you know, and so I have, some of this stuff is also brand new to me.

[00:37:37] Like I’m looking up like, does it, can you. Like pop your amniotic fluid sack. Like, I’m like, I don’t all these. I know it sounds so crazy, but these are things that now as a third time mom, I’m having to look up for the first time, which is just hilarious.

[00:37:54] Hilary Erickson | The Pregnancy Nurse®: Well, I think that happens on every baby. All of a sudden you have new concerns ’cause you’re older or your other one did something. Also not an unknown concerns. Many people have asked me that question, so I don’t think I have a post,

[00:38:04] Dani Morin: Yeah.

[00:38:05] Hilary Erickson | The Pregnancy Nurse®: about that on my site, but pretty close.

[00:38:08] Dani Morin: I’m shocked you don’t have a post. I’m shocked you don’t have a post specific to that because when I reached out to you at, was I 14 weeks pregnant and I go, why am I lactating? Am I going into labor?

[00:38:23] Hilary Erickson | The Pregnancy Nurse®: like, girl, I totally have a post on that.

[00:38:26] Dani Morin: And you sent me a post so fast, like you were faster than the robot at that point. Like you were like, this is actually completely normal.

[00:38:34] Go to Walmart and get some nursing pads because this is your life now. So, yeah, so I’m currently wearing the nursing pads. It was the craziest thing and it wasn’t anything that triggered it. I just, like, my breast had been very tender. And I was like, looked down and I’m like, why are my nipples like I had on a gray t-shirt and I’m like, what is going on?

[00:38:58] To me? I was like, this has to be a sign. I’m going into preterm labor. You know, which is like my biggest fear and a common fear with twins. So I guess it’s normal. And so it’s just like what I’m gonna have to be like dealing with. I’m not collecting milks. So some people I’ve told, they’re like, oh girl, put that in the freezer.

[00:39:15] And I’m like.

[00:39:16] Hilary Erickson | The Pregnancy Nurse®: first

[00:39:16] Dani Morin: Hilary gave me the, Hilary gave me the advice to chill for a little bit, and we will consider doing that later in pregnancy.

[00:39:23] Hilary Erickson | The Pregnancy Nurse®: in your third

[00:39:23] Dani Morin: So,

[00:39:24] Hilary Erickson | The Pregnancy Nurse®: we start doing that.

[00:39:25] Dani Morin: yeah. So, yeah, so that’s where we’re at now, but, so far so good. I think with my pregnancy, I’m not having the O-B-G-Y-N experience that I have had in the past, nor that I thought that I was gonna have.

[00:39:41] So that’s kind of been difficult. But thank God for you and for some other people that I could like, rely on for questions and concerns, so, yeah.

[00:39:49] Hilary Erickson | The Pregnancy Nurse®: a lot of people online will just say, if you don’t like your provider, just switch. And every time I see that, I’m like, it’s so much more complicated than that. For some people, they live rural.

[00:39:58] Dani Morin: Yeah.

[00:39:59] Hilary Erickson | The Pregnancy Nurse®: There is one OB in that town and they have to go several hours to a new ob. So that’s not fair to those people.

[00:40:05] And if you’re high risk, you kind of get egged

[00:40:07] Dani Morin: Mm.

[00:40:07] Hilary Erickson | The Pregnancy Nurse®: into one, one practice. ’cause you need a referral or your insurance only covers one, you know, fetal medicine group. It’s tricky.

[00:40:15] Dani Morin: Well, so kind of what I had learned, and so I had learned a couple things, going through this process of trying to change doctors and just so everybody knows I have yet to be successful. I have one workaround that I have to wait till 18 weeks to try to get out of this situation that I’m in. But I am high risk.

[00:40:37] So I am gestational hypertension, I’m geriatric and I have twins. So kind of how it was explained to me, was that, you know, these doctors, they don’t. They wouldn’t wanna take a risky transfer. Now, if you go to their office and you’re risky, you know, you’re already their patient, they don’t wanna take a risky transfer because for every baby that does not make it, they kind of get a mark on their name a little bit. So they’re like, you’re someone’s already dealing with you. Don’t bring that over here. You know, you already have an MFM and, and a doctor team over there. Like, don’t be bringing that over. Like, we don’t want that. So, it would have been different. So one doctor told me, like, yeah, it would be different if you were, yeah, third successful pregnancy, you had two, you know, positive vaginal birth and this is your third pregnancy and everything is going good.

[00:41:28] Singleton, like, no risks associated with this. Like, yeah, come on over. This is a different situation. And so the transfers are not happening now. I was a little spoiled. I had two doctors in Orange County. I went to St. Jude with my son, Deacon. Phenomenal experience. Great office. Traumatic birth, but that’s because I was trying to be the all natural mom, and I should have listened to the doctor and made different decisions.

[00:41:55] That’s all on me. I’m not gonna look back on that. But my second birth, I was at Hoag, which is just, it’s the mastros of all birthing places, hospitals. Like the way they treat you, the way the doctors treat you. So how it works there is, if you have any concern whatsoever, any concern like.

[00:42:18] A twinge of, and now you’re, and you have gotten it in your mind that your baby has passed in your 10 weeks. Like if you have anything, you just walk right on in there. So you have your own provider and you walk into the doctor’s office, but there is 12 other OBGYNs there. Someone will check you out real quick.

[00:42:36] The high-end ultrasound is right there. The LabCorp is right there that does your blood. Your pelvic floor therapy is in the same office and, the hospital’s across the street, if you needed to waltz over there for something. The NS STS are in there and you have your own private room and a tv ’cause you know you’re in there for hours or two.

[00:42:55] It is a premium experience. This situation, I found out I was having twins. I was so sick with morning sickness, she sent me to that imaging center to get, your ultrasound. So you go to the hospital to get your ultrasounds done. And, I was in there and it was an ultrasound tech who was giving me information out of her scope of practice that she shouldn’t have been.

[00:43:17] And two students all taking turns trans badging me, ultrasound wise. And guess who was not in that room? My husband, because it’s against their policy. And I found out one of the biggest pieces of news of my life alone, while two 20-year-old students trans vaged me. In a ultrasound room for 45 minutes.

[00:43:42] And it was one of those things, again, I did not know that this was not normal because I posted a video and people were like, oh, how did your husband take finding out you’re having twins? And I was like, oh, I have a video of it. ’cause I had walked out in the waiting room and I showed my husband the, the ultrasound and people are like, “Jeremy ultrasounds aren’t scary. You could go in there with her.” And I’m like, “oh no, he’s not allowed to come in.”

[00:44:02] And people are like, dude, that’s basic standard of care is for him to be in there with you during this news. Like, what if he found out bad news? Then I had all these girls riding me and being like, oh my gosh. The ultrasound center, I found out I was having a still birth there alone while my husband was in the waiting room and I had to do the, where I walk out and shake my head at 28 weeks that we lost our baby alone.

[00:44:24] And I’m like, oh my God. Like this is insane. And they’re like, well that’s just our policy, like go to another hospital. And I’m like, no. See, that’s the thing. I would love to, I can’t. And then I’ve just had some issues. So with the gestational hypertension of it all, it’s something very scary ’cause it could turn into preeclampsia.

[00:44:45] Now I have never had preeclampsia, but I’ve had gestational hypertension in both of my pregnancies. Could it be stress? And I have the high blood pressure, who knows what it’s from. But, it’s something that my previous doctor took extremely seriously. Starting at like, I think maybe even 24 weeks, I was having two nst every, every week.

[00:45:05] She took it extremely seriously. I slept overnight in the hospital twice during that pregnancy just because they’re like, “Hey, we’re gonna just do some further monitor.” Like they take it extremely seriously. And I was talking to you ’cause I’m like, usually I start this gestational hypertension protocol around like 10 or 12 weeks from what I can remember.

[00:45:26] Like, I’m shocked. My doctor is like not having me start this, knowing my history. Well, I had, had, I tracked my blood pressure. So I had, tracked my blood pressure for five days and I was on five days of it being high. And I put in the little, ’cause you can’t just go to the office, you have to do it in the health record.

[00:45:43] So I put in the health record like, Hey, I’m concerned about my blood pressure. And they’re like, well, when you were here four weeks ago, it was fine. So that’s what we’re going off of. And I’m like, that’s great. Now we’re here and I’m having five days of high blood, consistent high blood pressure. I’m worried about it.

[00:45:58] I’m also concerned that I haven’t been starting the high blood pressure protocol. Which if you guys don’t know, it’s, it’s essentially baby aspirin. Now, my other doctor, the baby aspirin, I went to the pharmacy, I gave a prescription and they handed it to me. You could buy it over the counter, but that’s just how it worked in the past.

[00:46:15] So she’s like, well, if you feel that strongly about starting it, go ahead and get some. And I’m like, get some what? And she said, and this is via chat. She said, get some LDA. And I’m like, what’s LDA? She’s like, low dose aspirin. And I’m like, milligrams. Like, I’m like having like Why am I having to ask this?

[00:46:33] Like, she’s like, yeah, if that’s what you want. I’m like, okay. So I go and get it. I start that and I felt confident in starting it. ’cause you and I had talked and also because in my previous pregnancies, that’s when I started at 10 weeks. So finally like I’m just getting to a point where I’m like, I feel a little bit in the dark with this pregnancy. I want a meeting with the doctor.

[00:46:57] And so we call a meeting with the doctor. And from what I had heard from people who are kind of in like hospital administration, is that, which is my sister. She’s like, I am certain your doctor’s gonna be very much on your side. I am certain your doctor also doesn’t like the imaging center’s situation of not letting your husband come in.

[00:47:16] She was like, sometimes it’s not the doctors that you should be mad at. It’s just the procedures and like what’s in place. And the protocols in place. And like, I guarantee my sister’s like, you’re gonna go in there and she’s gonna be very empathetic to how you’re feeling and maybe probably agree with you on some things.

[00:47:34] And she’s like, these doctors are overwhelmed. They’re, you know, the hospitals don’t always listen to the doctors and so I think she’s really gonna have your back. So I went in thinking like, I’m gonna be met with some compassion here. That’s what I’m thinking. So I go in and I’m very nice. I’m like, I did the shit sandwich. So, I went in and I was like, I wanna start off by saying that your office has been phenomenal. Like, I love the women that work here. I really appreciate the chat feature, even though I’m used to being able to just go in and see a doctor, but like, okay, I like the chat feature. I’m like, I do have some concerns where I’m not sure if I’m getting the level of care that I deserve.

[00:48:11] And she immediately goes into the defense and she’s like, she’s like, I’ve been doing this for 23 years. I answer you back in the chat. Like, if you need something, you have to ask. Like, if you don’t ask, I’m like, I don’t think that I should be asking, about low dose aspirin for high blood pressure considering I’ve had it in all of my pregnancies. And it’s definitely recorded. And you know about that. She’s like, you’re having twins. You should be taking two. And I was like, so that’s my husband steps in and he’s like, okay, so this right here is the first we’re hearing of this. And at this point I’m like, 15 weeks. So this right here is the first we’re hearing of, she should be taking two.

[00:48:48] I’m like, do I take two prenatals? Do I take 2D HA? Like what else should I be taking? Like, and I’m starting to write stuff down. I’m like, this is the first time you’ve spent more than five minutes with me. So I honestly don’t, is there anything else I should know? And she’s like, well, just ask, what do you want to know?

[00:49:01] And I’m like, I want you to treat me like this is my first pregnancy. I’m like, I also have concerns with my husband not being there in my ultrasounds. She’s like, that’s not on me. Take that up with the hospital. I’m like, it is on you. You sent me there, you sent me to a place that doesn’t allow my husband, so no, it is on you.

[00:49:21] And so we never met, and she’s like, well, if you wanna transfer, you know, good luck with that. Go to the front and I’ll try to do it. And I’m like, okay, well you and I both know I’ve already been trying to transfer and I’m not having luck. So at this point. I’m gonna see the nurse practitioner until my birth.

[00:49:39] You unfortunately are gonna be the one to slice and dice me open. Just land that plane with all souls on board, including my own please. Like that’s, at this point, just land that plane. I don’t care if there’s turbulence. I don’t care if, if, you know, an engine goes out, okay. All souls must be safe when we land and just land that plane.

[00:50:02] And that’s kind of where we have left it. So I did my research with my robot that there is a little bit of a workaround. So, when I start seeing the MFM, if the MFM sees something. In my ultrasound with twin pregnancies, like the MFMs, they go through everything with a fine tooth comb and almost 100% of the time they find something, a shadow, a spot or whatever.

[00:50:28] I can request a second opinion and I can request that second opinion at the hospital in which I would want to go to. And when they take me in to do that second opinion, I’m kind of registered as a patient. So I’m going to, try to do that workaround, possibly. So that’s kind of where we’re at, at from here.

[00:50:49] Again, that’s what my robot’s saying.

[00:50:51] Hilary Erickson | The Pregnancy Nurse®: should not be having, we’re getting to the robot. Don’t you worry. You should not have to ask your doctor about aspirin. That should be one of the first things that providers are getting on that first appointment is going through all the questions about aspirin, because there’s a lot, like some of it’s if your mom or your sister had high blood pressure, which wouldn’t be related to your health history at all.

[00:51:11] So they have to go through a list of a few questions, which, by the way, you were having twins. They, they don’t even have to go through the questions because that’s one of the ones. But people, I get frustrated when the doctor’s like, well, you should just ask. And I’m like, well, how on earth are people gonna know to ask? Like, that doesn’t make any sense to me, but God bless.

[00:51:29] Dani Morin: Yeah, so I mean, I was kind of being catty towards the end of the situation at this meeting, and I was like, should I ask you now for like maybe an anesthesiologist at my C-section? Like, what else do I need to ask for? Like, I was like, I just asked. Had, and I feel like there is a way, and if providers are listening to this, I just want, and I made a video coming out of this meeting and I will post it after I have my birth.

[00:51:57] There was a way she could have addressed the situation and never admitted that she was wrong or that any of this is bad. There was a way she could have done that, and that’s with a single ounce of compassion. If she could have mustered up the courage to even have a single ounce of compassion. I’m gonna go to a ob GYN, this is on my list. I’m gonna pitch the OB GYN conferences, and I’m gonna go up there as a patient and be like, here’s a way that you can address the concerns of your patient without ever saying that you’re wrong. Had I walked in there and said, I have some concerns. I feel like I’m not being heard. I’m not giving enough time.

[00:52:42] Had you been up there and just said, “I am so sorry that you are feeling this way. I would never want one of my patients who’s pregnant to have to feel this way. Let’s discuss some ways that I could better help you and we could better help each other in communicating so you get the best care possible.”

[00:53:03] Do you see how I just talked right there where I never said like, I am so sorry that I did that. I should have done better. That is totally on me and like, I should, you know, I should be sending you to a different ultrasound. Never she had, she just gone in there and been like, I’m so sorry you are feeling this way.

[00:53:20] I never want my patients to feel this way. Let’s discuss some things together and be a team here. Do you see how a tiny bit of compassion could have changed the entire directory of the situation

[00:53:34] Hilary Erickson | The Pregnancy Nurse®: Yeah,

[00:53:35] Dani Morin: it, and,

[00:53:35] Hilary Erickson | The Pregnancy Nurse®: so

[00:53:36] Dani Morin: it, it was just not there.

[00:53:38] Hilary Erickson | The Pregnancy Nurse®: or any customer service business. Obviously she don’t care about the customer service. Have you watched The PIT yet?

[00:53:44] Dani Morin: I haven’t Is that on Paramount?

[00:53:47] Hilary Erickson | The Pregnancy Nurse®: It’s on Max,

[00:53:49] Dani Morin: think it’s on paramount.

[00:53:49] Hilary Erickson | The Pregnancy Nurse®: talking about patient satisfaction scores, which can be frustrating as a healthcare provider because you’re like, you’re not giving us enough staff. That is literally why our patient satisfaction scores suck. So anyway,

[00:54:00] Dani Morin: And that’s what I think my sister was trying to get at was like they’re, the doctors are dealing with a lot too, and they’re very much like on the team of the patient. So I went in there thinking she’s gonna be on the team of the patient and just be like, Hey, there’s some stuff going around. We are fighting for changes right now.

[00:54:15] And like, you know, you got caught up anything. Except she was like, I’ve been doing this 23 years. No one has ever had a problem with me. This is a you thing. Like, and I was like, oh my God. So I’m just hoping that when she sews up my C-section scar that it’s like somewhat in a line. Like, I just hope it’s not like a squiggly mark, like she’s all, I’m gonna show her.

[00:54:38] Like I just, you know, and she’s a professional and I just, one of my good friends just had twins, same doctor, same c-section, super successful babies. Didn’t spend one day in the nicu. She had the best care there. It was the best team of people. She felt very confident. And so therefore, I’m kind of like holding onto that right now.

[00:54:58] Hilary Erickson | The Pregnancy Nurse®: Yeah.

[00:54:59] Dani Morin: I was sent to this doctor by everybody in my community. Everyone, and I’m not gonna say the doctor’s name, but everybody was like. Like this person, she’s the best. Oh my God, there’s no better doctor. And what I realized is that I have been eating at Mastros with my pregnancies

[00:55:17] Hilary Erickson | The Pregnancy Nurse®: Yeah.

[00:55:18] Dani Morin: the, and some of these girls, they don’t know anything better than McDonald’s.

[00:55:22] And so to them it’s been a great experience. But I think for me, when I’ve had this high standard of care, and now I’m at a situation where I’m like, but this seems different. You know, not that it’s bad, it’s probably just normal. But I don’t think I’m asking for a lot to just tell me the medications I should be on for something that could cause preeclampsia.

[00:55:44] You know what I mean?

[00:55:45] Hilary Erickson | The Pregnancy Nurse®: That’s a real push in the United States right now. It’s not like this is something weird. I wanna,

[00:55:50] Dani Morin: Yeah. So we’ll see when this comes out.

[00:55:53] Hilary Erickson | The Pregnancy Nurse®: It’s hard to watch videos of people like at birth centers that are like lighting and a tub in the room and, you know, special music you can play. Whereas I’ve worked at birth centers that, we were lucky if the, the tile was like intact, right?

[00:56:06] Like, you know,

[00:56:08] Dani Morin: Yeah.

[00:56:09] Hilary Erickson | The Pregnancy Nurse®: Or that there weren’t roaches falling out of the ceiling, which has happened at some of the hospitals that I worked at. And so sometimes when I watch these, it’s really hard to compare like situations just because it varies so much. And I know even in the south it’s even worse than where I am at. So,

[00:56:25] Dani Morin: Yeah.

[00:56:25] Hilary Erickson | The Pregnancy Nurse®: It’s always tricky when you compare doctors and stuff like that. But Dani, I have also been talking about how she uses her, AI robot to answer her pregnancy questions. And I’ve always been like. Stop! I am your AI robot. Just text me. And you’re like, no, I have my AI robot trained on the right sites or whatever. what are some things you’re, you’ve

[00:56:44] Dani Morin: What are some things.

[00:56:45] Hilary Erickson | The Pregnancy Nurse®: robot, and I’m gonna tell you if that’s safe to ask Orate. know what aspirin would’ve been safe to ask? I’ll give it that probably.

[00:56:53] Dani Morin: Okay, so one thing that I asked my robot last night is, is it okay to get Botox and laminate? Not that I’m going to, but I’m seeing pregnant girls and their faces look near perfect, and I know that ain’t natural. And I put that on my stories and people were like, yeah, no, it’s totally fine now. And I’m like, Hmm.

[00:57:14] So you’re saying, no,

[00:57:16] Hilary Erickson | The Pregnancy Nurse®: I think it’s a no, as far as I know, Botox is a no, just because they don’t know if that could get into your bloodstream or something like that. I don’t understand brow lamination, so I don’t know how, how that could accumulate in your body. The internet told me to write a post on that, but I was so out of my, have

[00:57:33] Dani Morin: it’s too new.

[00:57:34] Hilary Erickson | The Pregnancy Nurse®: I don’t know. I don’t know.

[00:57:36] Dani Morin: It’s too, it’s too new.

[00:57:38] Hilary Erickson | The Pregnancy Nurse®: for a long time they didn’t even massage pregnant women because they were worried that they could hurt the baby, which now I’m like, come on. Like we gotta,

[00:57:45] Dani Morin: What about, how do you tell your twins apart?

[00:57:49] Hilary Erickson | The Pregnancy Nurse®: I’ve seen parents put a little sharpie on one of the toenails, like the big

[00:57:54] Dani Morin: You said that and I feel like that’s a good, okay.

[00:57:58] Hilary Erickson | The Pregnancy Nurse®: Yeah,

[00:57:59] Dani Morin: so I,

[00:58:00] Hilary Erickson | The Pregnancy Nurse®: polish

[00:58:00] Dani Morin: so,

[00:58:00] Hilary Erickson | The Pregnancy Nurse®: off harder. Like it comes off easier. Fingernail polish,

[00:58:05] Dani Morin: okay, so this is another one that I, freaked out over was what’s the difference between discharge or my water breaking? My robot told me like, the,

[00:58:17] Hilary Erickson | The Pregnancy Nurse®: I have 16 articles about that.

[00:58:17] Dani Morin: can you send those to me? Because I had a scare this weekend. I like sat down and I felt like, what was like a gush or something and I immediately called the doctor and was like, I think my water broke.

[00:58:28] It turned out it was a more of a milky texture and that’s what my robot said. It would be more of a milky texture in which it, in which it was,

[00:58:36] Hilary Erickson | The Pregnancy Nurse®: Yeah. I have

[00:58:36] Dani Morin: um.

[00:58:37] Hilary Erickson | The Pregnancy Nurse®: is it pee? What, what does it feel like when my water breaks? Because most people will feel a pop. I would say 70% of the people I say they feel a pop when their water breaks. So that sometimes can help people reassure. But the big one is that your water just

[00:58:51] Dani Morin: Is that

[00:58:52] Hilary Erickson | The Pregnancy Nurse®: out. If it’s

[00:58:54] Dani Morin: Yes.

[00:58:55] Hilary Erickson | The Pregnancy Nurse®: not. It.

[00:58:55] Dani Morin: So that’s what I have.

[00:58:57] Hilary Erickson | The Pregnancy Nurse®: Yeah. So I

[00:58:58] Dani Morin: Yeah.

[00:58:59] Hilary Erickson | The Pregnancy Nurse®: just, when I was writing articles based on Google searches, I would just do AI for fun. Like, I was like, can you drink wine during pregnancy? And AI was like, absolutely. The antioxidants in wine, I would suggest two to three glasses a day. And I was like, strong work ai, really, really good work.

[00:59:14] And then I wrote one is sour cream safe during pregnancy? And it was like, absolutely not. Your risk of listeria goes up with sour cream. And I was like, pasteurized

[00:59:23] Dani Morin: Oh my gosh. I feel like pasteurization is okay

[00:59:27] Hilary Erickson | The Pregnancy Nurse®: no

[00:59:28] Dani Morin: anyways.

[00:59:29] Hilary Erickson | The Pregnancy Nurse®: cream? Totally fine. Yeah. Also, you

[00:59:31] Dani Morin: Okay. Okay.

[00:59:31] Hilary Erickson | The Pregnancy Nurse®: you get listeria. Maybe you can get listeria from unpasteurized cheese products like brie, you’re not supposed to be eating, unpasteurized cheese

[00:59:40] Dani Morin: Yeah, I don’t, I don’t mess with that. I don’t mess with that. Anyways.

[00:59:43] Hilary Erickson | The Pregnancy Nurse®: the time for brie. Right.

[00:59:45] Dani Morin: Yeah.

[00:59:46] Hilary Erickson | The Pregnancy Nurse®: Let’s get some brie in me.

[00:59:48] Dani Morin: Well you’ve just been like the best thing for me during this pregnancy and I so appreciate you and I hope that people use you as a resource. You just put out so much good stuff and you’re someone I trust and your stuff is easily digestible and I just really, really appreciate it and our friendship, so thank you.

[01:00:04] Hilary Erickson | The Pregnancy Nurse®: you. We gotta get Jeremy in the birth class though ’cause he obviously is ripe and ready to go. So we’re gonna get Dani

[01:00:11] Dani Morin: we will.

[01:00:11] Hilary Erickson | The Pregnancy Nurse®: the birth class ’cause

[01:00:13] Dani Morin: We will.

[01:00:14] Hilary Erickson | The Pregnancy Nurse®: that’ll answer a lot of everyone’s questions too, probably. Thank you for coming on. This has been so much fun. I

[01:00:19] Dani Morin: Thank you.

[01:00:20] Hilary Erickson | The Pregnancy Nurse®: I hate that that doctor was like, this is unsafe.

[01:00:23] Because when doctors do stuff like that, it doesn’t open up the door for like collaboration or the fact that it really is not unsafe. Especially compared to regular sex where you could pass chlamydia or gonorrhea, like a syringe is a lot safer from like a medical perspective.

[01:00:37] Dani Morin: Yeah,

[01:00:38] Hilary Erickson | The Pregnancy Nurse®: So anyway,

[01:00:40] Dani Morin: they wanna make money. But yeah.

[01:00:42] Hilary Erickson | The Pregnancy Nurse®: And,

[01:00:43] Dani Morin: Thank you for letting me. You

[01:00:44] Hilary Erickson | The Pregnancy Nurse®: Make sure you follow Dani. She has so many good tips on car seats, child safety. It’s gonna also be fun to watch Dani head into life with three kids, versus just one ’cause I’m sure there’s gonna be a lot of fun, chaos to, enjoy

[01:00:56] Dani Morin: love you.

[01:00:57] Hilary Erickson | The Pregnancy Nurse®: all. All right, we’ll talk to you later.

[01:00:59] Dani Morin: Bye.

[01:01:00] Hilary Erickson | The Pregnancy Nurse®: I hope you guys enjoyed this episode. It was fun to like bounce around a different topic. Dani and I are obviously friends, but I think three things that I learned. First off, you know, the money is important. And I really love that she tried something that worked for her instead of just doing something that kind of was the standard for getting pregnant.

[01:01:17] Second of all, if you’re in a position where you can’t switch providers, sometimes you have to make do. She’s definitely looked around like we’ve talked a lot about it. But I just want people to know that sometimes you don’t get the provider of your dreams, but can still have a really great outcome.

[01:01:30] And third watch ai, those robots will get you. thank you for coming on Dani. I hope you guys will join us on our next episode.

[01:01:36] Thanks for joining us on the Pulling Curls podcast today. If you like today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.

Keywords:

getting pregnant, home insemination, sperm donor, unplanned pregnancy, single mom by choice, IVF, IUI, PCOS, tilted cervix, prenatal care, child loss, grief, parenting guilt, Baltic amber teething necklace, child safety, product safety, natural parenting, evidence-based parenting, social media advocacy, birth plan, switching OB providers, high risk pregnancy, gestational hypertension, low dose aspirin in pregnancy, twin pregnancy, pregnancy anxiety, provider communication, hospital policies, AI for pregnancy questions, financial planning for parenthood, support systems

The post Unconventional Conception Stories and Advocacy in Motherhood with Dani Morin appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Big thanks to our sponsor The Online Prenatal Class for Couples — if you want to learn to communicate better, it is the class for you!

Today’s guest is Today’s guest is Juli Pyle (she/her) a certified nurse midwife who practices at a community hospital in rural Pennsylvania. Juli was a stay at mom for many years to five children before deciding to return to school to pursue a degree in nursing. She graduated from Colorado Mesa University with a bachelors of science in nursing degree in 2016 and then began her nursing career as a labor and delivery nurse. She quickly discovered that this was her true passion (as she had suspected since having her own children) and quickly gained a reputation for professionalism, compassion and expertise among colleagues and patients. She then returned to Frontier Nursing University to complete a Master’s degree in Nursing with an emphasis in midwifery. In 2020, she graduated and began as a certified nurse-midwife at a small community hospital in central Pennsylvania where she has been since that time. Her focus as a CNM is to provide evidence-based education to all birthing families, give true autonomy and informed consent throughout their time with her and to share love, understanding, empathy and true shared-decision making. When not immersed in the birthing world, she enjoys spending time refinishing furniture, gardening, raising and breeding different types of chickens, hiking and vacationing with her family.

Links for you:

Julie’s previous Episodes:

The Best Providers for Your Baby’s Arrival: A Deep Dive with CNM Juli Pyle — Episode 204

What Your Providers Think When You’re in Labor with CNM Juli Pyle – Episode 189

Timestamps:

00:00 “Informed Consent Importance in Medicine”

04:20 Balancing Patient Communication and Time

09:24 Respectful Informed Consent Dynamic

10:29 Patient Choice in Labor Induction

14:06 Informed Consent for Episiotomy Decisions

18:17 Informed Consent for Induction

22:31 Labor Induction and Position Choices

25:56 Documenting Risk in Patient Decisions

29:16 Holistic Prenatal Care Approach

32:33 Nurses’ Role in Informed Consent

35:45 Patient Communication with Providers

37:21 Importance of Informed Consent

Keypoints:

• Informed consent in labor and delivery is a crucial and often misunderstood part of medical care, emphasizing the patient’s right to understand and make decisions about what happens to their body.
• There are five main components of informed consent: patient understanding, absence of coercion, full disclosure of risks/benefits/alternatives, the right to decline, and documentation of the discussion.
• Time pressure, provider biases, and regional/cultural differences often affect how effectively informed consent is communicated in hospitals.
• Patients are encouraged to ask, at any point, for the risks, benefits, and alternatives to a procedure—it’s their right, even for routine interventions.
• Some medical staff may overwhelm patients with information, while others may inadvertently minimize discussion; finding the right balance to suit each patient is key.
• Regional culture, age, language, and personal preference play huge roles in how much information patients want or are comfortable with during labor and delivery.
• Informed consent isn’t just for major decisions like C-sections or epidurals—it can and should apply to things like cervical exams and labor positions, even in less formal, conversational ways.
• Declining a recommended intervention (e.g., breaking water, episiotomy, induction) is absolutely an option for patients, and the birth experience should support their decision, barring emergency situations.
• The benefits of midwifery care are highlighted, including a more holistic and consistent approach to informed consent and labor support, but ultimately provider style matters more than title.
• Good communication and shared decision-making between providers and patients help prevent birth trauma and litigation, reinforcing the importance of patients feeling informed and respected during their birth experience.

Producer: Drew Erickson

Transcript

(

[00:00:00] Hilary Erickson | The Pregnancy Nurse®: Hey guys. Welcome back to the Pulling Curls Podcast. Today we are talking about informed consent in labor and delivery, so let’s untangle it.

[00:00:06] Hi, I’m Hilary, a Serial overcomplicator. I’m also a nurse mom to three and the curly head behind pulling curls and the pregnancy nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with pregnancy and parenting untangled the Pulling Curls Podcast.

[00:00:36] Today’s guest is a certified nurse midwife in Pennsylvania. She actually had five kids of her own, then went back to school, became a labor and delivery nurse, and then became a midwife. I wanna introduce today’s guest, Juli Pyle.

[00:00:48] Hey Juli, welcome back to the Pulling Curls Podcast. I’m so excited to have you here.

[00:00:52] Juli Pyle CNM: Hi Hilary. It’s good to be back today.

[00:00:54] Hilary Erickson | The Pregnancy Nurse®: Yeah, so we’re on this longer form content, and when I was thinking about who I wanted to have a guest, Juli definitely came to mind because I think you have a lot of great information as someone who’s had multiple babies, someone who’s been a labor nurse, somebody who’s a midwife of things that people are actually thinking about as they deliver their baby.

[00:01:12] And of course it’s, it’s sort of different like locationally. ’cause I’ve delivered in the west, you’re in the east. So I’m just excited that you’re here, and today we’re gonna talk about informed consent. So let’s first define. What is informed consent?

[00:01:24] Juli Pyle CNM: Yeah, I think informed consent is really a hot topic right now in the medical world, and especially in labor and birth, because really once we define it, you’ll understand why, but it’s super important for us to have a grasp of what is going on with our bodies in any sort of medical scenario.

[00:01:41] So informed consent really has five components. The first one, which seems pretty obvious, but does the patient or do you understand the information? That doesn’t seem like something we’d have to define, but sometimes as medical providers we get talking and talking and we don’t have the right words so that the person understands what we’re talking about. So patient has to understand the information.

[00:02:04] The second part of that is it needs to be without any sort of coercion or undue influence. So you have to be really objective in the information you’re giving and not try and sway somebody because of what you think should happen as the provider.

[00:02:18] Really, all the information should be disclosed about the risks, the benefits, the alternatives. The right to decline whatever treatment we’re talking about and knowing what the potential complications are either way. That’s not always a simple conversation, but a really important one when we’re talking about informed consent and the right to refusal is really the fourth point.

[00:02:39] And then the last piece of all that is documentation that it’s happened some way, shape, or form. Sometimes that’s an already like pre-printed form that people just fill out and sign. Sometimes it can just be documented in the medical notes. Somehow there needs to be something written that informed consent was discussed and what the outcome was.

[00:02:58] Hilary Erickson | The Pregnancy Nurse®: That’s actually one of the first things I learned as a nurse. Back when we had paper charting, we had a little stamp about informed consent, and then the provider would sign it before a C-section, and I think they did it before an epidural. Now people. It is tricky because they’re like, well, we wanna informed consent on everything and let, let me just remind you, like if we did an informed consent in our lives, like I don’t know if our car would ever get going.

[00:03:20] Right. If it gave us like all the things that could happen to us in the car. So we as providers tend to like keep informed consent to the important things. But you’re always welcome to ask for informed consent, right?

[00:03:32] Juli Pyle CNM: Absolutely. If I think that’s a big piece of, as the patient or as the person receiving care.

[00:03:37] You know, anytime you feel unsure about what’s happening, just a simple question of can you explain the risks, the benefits, and the alternatives to doing this to me, because then that should give the provider the clue that like, okay, this person needs to understand more.

[00:03:52] Hilary Erickson | The Pregnancy Nurse®: Yeah. Why? Why do you think we’re not good at giving it in the hospital?

[00:03:55] ’cause I’ll say, Juli, my mom was just in the hospital having ankle surgery, not having a baby, thank goodness. And it’s surprising, like it’s just they people aren’t great at it. I think they think this is obvious, right? For her, it’s been a long plan of care. Several, several things. And so they’re just like, this is obviously the best option for you.

[00:04:15] But it, it is annoying that they aren’t like, this is why.

[00:04:19] Juli Pyle CNM: Yeah, I think we are in a hurry. Always. Our lives are busy, right? And so to think about taking. Five to 10 minutes with every single patient to explain Every single procedure can feel overwhelming from the provider side, but that, that doesn’t mean it’s not important to do so.

[00:04:33] But I think that, I think busyness and time is a huge part of it. I think there’s a, there’s a component that if we explain too well that people may not choose to do the treatment or may not choose to have the surgery if we’re really honest about what could happen. And of course as a provider, we sort of obviously count on people doing these, these things as part of our jobs.

[00:04:53] Not counting on it like they have to do it so that we make money, but just, just like, obviously if our schedule doesn’t have procedures on it, then we wouldn’t have a job. Right. And I do think it comes down to. We don’t do a good job of like really explaining things in a way that doesn’t include our values and preferences, you know?

[00:05:13] Like, oh, I would do that, so you should do it. And we just leave it at that. But that’s my perspective on, on what’s going on.

[00:05:19] Hilary Erickson | The Pregnancy Nurse®: Yeah. Two thoughts. Oh, so we used to have an anesthesiologist who, they come and they give informed consent. Nobody seems to remember, which, I can’t blame you because you’re in pain when you get the epidural informed consent.

[00:05:29] But they always come in the room and they say, there’s a risk of a really bad headache. There’s always a risk of infection, or blah, blah, blah. And then he always ended it, or you could die. I would see the patient’s eyes get really, really big, and so I started to like cut, like before he came in, I said, just so you know, his informed consent will end or you could die.

[00:05:48] I’ve never seen anybody die from an epidural, but he’s just giving you like all the things. Not every anesthesiologist… do you ever hear that?

[00:05:56] Juli Pyle CNM: We, we have a couple that go so in depth with their informed consent, which again, should not be considered a bad thing that even the patients are like, yes, whatever.

[00:06:03] I’m just, I’m ready. Like give me the epidural. Like, I don’t care what you’re telling me right now. So I think there’s both ways, like. You can do too much and people stop listening, you know?

[00:06:12] Hilary Erickson | The Pregnancy Nurse®: Yeah. And you have to remember that if your oven or your car gave you informed consent, the full informed consent it would end with, or you could die.

[00:06:19] Because obviously ovens could be very unsafe, especially in the hands of me or my car with my teaching. My 15-year-old how to drive it should yell that at me, right when we get in the car. So sometimes patients are overwhelmed and some patients do not want it at all. They do not want to hear all the risks and the benefits.

[00:06:36] They don’t wanna make a choice. They literally just wanna hear whatever the provider thinks is best. That’s what they wanna do, and I think that’s valid and I think you could even stop them and be like. Whatever you think is best I’m on board with, if it’s really starting to freak you out. Because a lot of patients will be like, maybe I don’t want an epidural.

[00:06:52] And I’d be like, are you sure? Like the risk was always there. You knew that there was a risk of dying with anything we are doing today. And then they’re like, I guess, and then they’re just freaked out, right?

[00:07:01] Juli Pyle CNM: Yeah. You know, it’s funny you mentioned that I did a small little couple of months in the South as a nurse and there was very much a mentality regionally like.

[00:07:11] If the provider comes in and says, this is what should happen, I’m gonna do it. Like they didn’t ask questions, they really didn’t care about informed consent. The provider knew best and I’m gonna follow it, which has risks in and of itself. Right. So it was very interesting that just regionally, that can vary quite a bit of how much information people even want to know.

[00:07:30] Hilary Erickson | The Pregnancy Nurse®: Yeah, and overgeneralizing a whole bunch. It definitely varies depending on your age. Sometimes your nationality, I feel real bad when we’re trying to give informed consent and we’re giving it through the translator line, and I’m never sure that the people are really, truly understanding what the informed consent is.

[00:07:46] You know, they’re trained interpreters like, it’s like that’s all we can do, but sometimes those language barriers just not interested in maybe learning about their own care because they have so much going on in their own life at home. Things like that can really affect it.

[00:07:58] Juli Pyle CNM: Interestingly, when you look at acog, which is the governing body for obstetricians and also A CNM, which is the governing body for certified nurse midwives, they have very clear statements and very clear information on what informed consent is and that it should be happening in every instance humanly possible. That we should be providing that education. And that it’s really being much more recognized and taught in the coursework for these up and coming physicians and midwives as well. And, and that should tell us that it’s an important topic.

[00:08:29] Hilary Erickson | The Pregnancy Nurse®: And some people call it different things. I noticed, like when I was at the AWHONN convention, they have a different word that they use. And I cannot remember what it is, but it’s basically the same thing.

[00:08:38] Juli Pyle CNM: I know we talk about shared decision making. I don’t know if that’s what you’re talking Yes. Shared about shared decision making. Yeah. Um, and really that’s the process of the informed consent and making the future plan. Is that shared decision making.

[00:08:49] I do feel like they are used synonymously sometimes, but both are components for sure.

[00:08:55] Hilary Erickson | The Pregnancy Nurse®: Okay, so what should people be looking for informed consent on? Because I know a lot of people are like, well, you should give informed consent before you get the iv. You should be giving informed consent before you take a blood pressure.

[00:09:05] And I was like, okay. I don’t know that I can do it for a blood pressure. Also, if I was giving it for every single little thing, sometimes they might skip the like really important things. Right. I think we should be giving it briefly for maybe an exam, like an ex, a cervical check, just to be like, you know. ‘Cause a lot of times the alternative is that we wait.

[00:09:23] Juli Pyle CNM: There’s this weird. I think dynamic because like some of that. I think for us that do it well, it’s, it’s respect. Like I am respecting this person I’m taking care of and I’m gonna let them know I’m gonna put the blood pressure cuff on. You know, just telling them that like is a type of informed consent.

[00:09:40] Right? Because they may not know that that was your next step, you know? So you don’t wanna freak somebody out or like with a cervical exam, you know, giving a little bit of warning and a little bit of. Notice about what’s going on. I think that’s just respect. But it also can fall into the category of type of informed consent.

[00:09:54] Hilary Erickson | The Pregnancy Nurse®: Yeah, and you know, like she said, it’s not always gonna be like, today I am gonna assess the risks, the benefits, and the alternatives of this circle exam. It could just be like, Hey, you know, your provider was wanting us to check you every couple hours. What do you think about doing it now? If you wanna wait, we could do that too.

[00:10:11] We just kind of wanna see what your cervix is doing. We’re inducing you. We, we wanna make sure we’re doing our job. You know, that is an informed consent. It just didn’t be like, I’m gonna go through the risks and the benefits. Yeah. Because it’s awkward. Like we wanna just have a conversation with people.

[00:10:25] We don’t wanna be like checking boxes all the time through our care.

[00:10:29] Juli Pyle CNM: Yeah. And I think, like, I had a good example. In the last couple weeks of an induction that I was managing. And we know as labor nurses and providers, like if we get to the point that breaking the water is a good option, like it’s gonna make labor faster for somebody, especially that’s had a baby, right?

[00:10:44] But I gave that informed consent and that patient did not want water broke. And I said, great, you let me know when you’re ready for that. I’ll ask again at some point, you know? And instead of a baby, probably in one to two hours from that point, it was like seven hours from that point. Is there anything wrong with that? Probably not, you know, and she can fully say that she was in charge of that decision and, and was able to make the plan for herself that way. Looking back, I think she would’ve probably liked me to break the water earlier, you know? And we would’ve known that she could have had a baby sooner, you know?

[00:11:15] And that’s a good example of like, she chose to decline. And it, that was okay.

[00:11:19] Hilary Erickson | The Pregnancy Nurse®: Yeah. I did that same thing with my last baby. I didn’t wanna have my water broken ’cause I was sure I would end up with a c-section if they broke my water and then they broke my water finally at like six centimeters and I had the baby like half hour later, you know?

[00:11:30] Yeah. But I had made the choice, I had driven the car and I had drove the car very, very slowly up until that point. Uh, yeah.

[00:11:37] Juli Pyle CNM: And on the flip side, if you had been forced into a decision, you know, of like, or this patient, if she had said. I don’t want that. And I said, uh, we’re gonna do it anyway. You know then that her whole experience is different and then it becomes birth trauma or it becomes like.

[00:11:53] You know, a potential lawsuit potentially, right? Like, those are things that can happen if, if that doesn’t go correctly.

[00:11:59] Hilary Erickson | The Pregnancy Nurse®: Or my favorite, the doctor doesn’t even say anything, he just goes hand me the Amni hook. And I go, oh, did you wanna have your water broken Jane? And he glares at me and I’m like, don’t you think we should ask her?

[00:12:11] Juli Pyle CNM: Yep. Absolutely. And that, that still happens. Yeah, I think, I think it’s happening less, but it still happens.

[00:12:17] Hilary Erickson | The Pregnancy Nurse®: And I… Pro tip for everybody out there who’s gonna have a baby. When they go to do a cervical exam or a doctor or a midwife, because labor nurses officially are not allowed to break water. You can always ask, are you thinking about breaking my water while you’re in there?

[00:12:29] Especially for the hospital. They’re not gonna do it in their office, hopefully. But yeah, I think sneak it in. We don’t like to sneak things.

[00:12:35] Juli Pyle CNM: I think that for labor and birth specifically, a really classic example, and one again I hope is happening less, but it still occurs, is the episiotomy. Right. That becomes like a big topic of debate and like if a doctor or provider or midwife says, oh, we’re just gonna make a little extra room to help baby get out faster.

[00:12:56] That’s not informed consent, right? That’s not explaining what’s happening. That’s not giving the patient a true option to decline or accept, but that still happens, you know, versus like, Hey, this is what I’m seeing. I can do this procedure. These are the risks, these are the benefits. Would you like this?

[00:13:12] You know, to to be part of your care. That’s a really classic one that we’re gonna continue to see. But I think as labor nurses, you really have seen that a lot more. And it makes you nervous when that’s happening.

[00:13:22] Hilary Erickson | The Pregnancy Nurse®: So that is tricky because there are points in time where they’re like, I need to give you a cut when the crap is really hitting the fan or whatever.

[00:13:29] And hopefully providers have talked to you while you’re in the office about it. I don’t do, do people do this anymore. When I had my first baby, they went over like probably 30 weeks. They went over, are you okay with blood products? We might need to do an app episiotomy. We might need to do an emergency C-section and we might need to take your uterus.

[00:13:45] Like they went through all three of all like four of those things. Just to kind of let you air your thoughts on all those different kinds of things. Right. Do do any providers do that anymore?

[00:13:54] Juli Pyle CNM: I think it’s really like provider and facility dependent. ‘Cause I have seen that still happening and then other places that like literally nothing’s talked about ever.

[00:14:03] So varies quite a bit, unfortunately.

[00:14:06] Hilary Erickson | The Pregnancy Nurse®: Yeah. And if you’re having that discussion with your provider, I think it’s akay to say, you know what, if me or my baby’s life is obviously in jeopardy, we’re akay with a, an episiotomy. But everything up until that point, I would really like you to stop and say, do you want me to do this?

[00:14:20] And that? I’m just here to say that that does happen. Sometimes they’re like, you know, you could keep pushing for another half an hour, or I could give you a little cut and we, and we could have this baby sooner. And I think that’s valid. I mean, I think that’s true in form consent. ’cause maybe the woman really values just getting that baby out.

[00:14:36] She’s so tired and miserable and if that provider, experienced provider knows that a cut will help get the baby there sooner, she’s like, do it. I’m over this. Right. Or Yeah. She’s like, no, I really love my perineum. I wanna try and keep it as intact as possible. I wanna push until my eyeballs fall out before you cut me.

[00:14:53] Juli Pyle CNM: Right. Everybody, there’s two different people. Truly, I think that’s the part of informed consent we don’t often talk about is that somebody may want the more invasive thing, you know, and they may really feel like that’s better for them. And sometimes we don’t even talk about it, you know? So then we really haven’t given them all of the information.

[00:15:11] To make a decision. We’ve talked about this previously on induction podcast that we did. Right? That like, yeah, somebody may have a lot of really valid options for desiring that higher intervention induction at 39 weeks as soon as humanly possible, even though that might not be what the majority of the people would choose.

[00:15:28] Hilary Erickson | The Pregnancy Nurse®: Yeah. And I actually have a super conservative friend who home births, and she was like, I don’t even understand why they give women the option. And I was really taken aback by that because that just makes me feel like, okay, it has been proven to be safe, at least. For the most part, it may increase C-section rates, whatever we wanna talk about.

[00:15:44] The arrive trial, it has been proven that it really doesn’t ultimately hurt mom or baby to have an elective induction at 39 weeks. And we as sentient people who get to make choices for our own bodies really should be able to make that choice, not just the provider doesn’t make that choice. Now, of course, if the hospital’s too busy or things like that, then then we don’t get to make that choice.

[00:16:05] I have people all the time that are like, no, they will not induce selectively before 41 weeks, which I’m like, whoa. It’s crazy how different some hospitals are, but what do you think on that? About like 41 weeks? Well, no. Oh. What do you think about, uh, the 39 week induction? Like, don’t you think we should all be?

[00:16:22] Sometimes I’m like, well, if somebody really wants to be induced at 37 weeks, it is kind of weird that we don’t even give them the option. Of course, we’re having to balance the pro, the thing of. Prior to 39 weeks, it has been proven that maybe your baby could have a NICU state or have ultimately bigger problems.

[00:16:37] And so we’re really trying to push that off. But it does sort of bother me that if people are begging for an induction at 37 weeks, we’re just like, nope, nope, nope, nope.

[00:16:45] Juli Pyle CNM: Yeah, I think that 39 week discussion again gets really heated. And if you have 10 different providers, labor nurses are gonna get all 10 different perspectives.

[00:16:54] And again, this is part of my informed consent when somebody’s asking about it, it’s like. There are things that start to increase your risk by not having a baby after 39 weeks. You know? So we know that definitely after 41 weeks, right, placental function declines, other things start happening that will not help a baby on the outside.

[00:17:12] But even after 39 weeks, that risk of stillbirth, the risk of preeclampsia, the risk of fluid around baby going down, like all of those start to get more risky, not significantly. So we’re not talking about 50% between 39 and 39 and two days, you know, but it is start to go up. And so some people even use the term risk reduction as far as like what happens after a 39 week induction.

[00:17:37] You know that, that you’re reducing the risk of somebody by inducing. So there’s certainly a lot of discussion that happens, but we just have to respect that somebody can understand that information and then make the decision of yes or no for themselves.

[00:17:50] Hilary Erickson | The Pregnancy Nurse®: Yeah, it’s tricky and everybody’s like, oh, I’m gonna make that decision when I’m like 30 weeks pregnant.

[00:17:55] I’m like, no, you make that decision based on, you know what? What’s your cervical exam at that point? If you’re six centimeters and contracting every evening. You know, that’s a big difference between I’m close, thick and high, I’ve never had a baby before. These are very different situations that we’re looking at.

[00:18:11] Juli Pyle CNM: Absolutely. Yeah. And And that’s what makes it so tricky. ’cause there’s so many variables.

[00:18:16] Hilary Erickson | The Pregnancy Nurse®: Yeah. So what do you think, I think this is a big one that people maybe don’t get enough of an informed consent on because they’re just thinking. I want this baby out, right? Because I’m so tired of being pregnant. So what do you think are things that people should be talking with a provider so that they feel like they get a full informed consent?

[00:18:34] Because I so often hear online, my provider forced me to have an induction and I didn’t wanna have it. Or he scared me and said I should have an induction and then I ended up having a C-section or whatever like that. What do you think people should be going through before. For an induction so that they really feel like they have a handle on what’s gonna be happening to them.

[00:18:52] Juli Pyle CNM: I think you have to specifically ask what the induction protocols and like what the plan usually is at the facility and the provider you’re using, because the way I manage an induction may be completely different from somebody else, and that can make your whole experience very different. You know, evidence has proven that nurse midwives as.

[00:19:11] Providers, you’re gonna have more successful labor progress in general, and that includes induction. Part of that is because we’re, we are not, and this is a very general statement, but generally speaking, you know, we’re not as tied to really specific timeframes and milestones throughout. We’re gonna individualize that to exactly what your body’s doing, you know, so for example, you know…

[00:19:34] Hilary Erickson | The Pregnancy Nurse®: And a shout out for midwives because they’re there.

[00:19:37] So that’s how they can tailor it, right? Yes. Whereas an OB calls in maybe every four to six hours. They’re not there. They aren’t kind of watching everything every step of the way. Shout out for midwives,

[00:19:46] Juli Pyle CNM: guys.

[00:19:47] Yeah. Historically and generally speaking, we’re gonna be a little bit more present in the care and be able to kind of doing informed consent all along the way instead of like just this one discussion, you know, at 39 weeks right before your induction.

[00:20:00] And again, I think that’s a big conversation for people who desire that is like, okay, what happens if my cervix is staying the same for four hours? What are you gonna do? You know? And then getting that answer. And if you’re not happy with that, then you have to start, start making decisions along the way.

[00:20:16] Hilary Erickson | The Pregnancy Nurse®: Yeah, it is true. A lot of people are really upset with their Foley bulb inductions lately because it can be really painful. Some people that that. That’s the tricky thing, right? Some people get a fully bowl placed and they, they could care less. It doesn’t bother them at all. And then some people get a fully bowl placed and it is literally the worst thing in their whole lives.

[00:20:33] They want the epidural just for that fully bulb. And I think sometimes people forget that this is, it’s such a huge range. Just like IUD placements, like I got my IUD placed. I was like, when are you gonna be done? Right? And she was like, oh, it’s already in. I was like, oh. I don’t have any feelings down there apparently.

[00:20:49] And so there is a huge range of how people feel different things. And the best part of informed consent is knowing that you can, you know, you get that fully well placed and it’s absolutely miserable. You’re like, I wanna go home. This is, I want it out. I wanna go home. And that, that’s always an option.

[00:21:03] Juli Pyle CNM: Yep.

[00:21:04] I think that’s important. Like especially for fully bulbs, I tell people, I’m like, what? I think this is a good option if you absolutely hate it. It can come out. That’s the great thing about that process. You know, now water breaking, like we talked about earlier, can’t take that back. Right? So that’s one that you have to be pretty sure about.

[00:21:20] I’m all about giving people all of their options and allowing them to make a decision. And there are times when they will tell me, I have no idea, what do you think we should do next? And then that’s when my professional experience and opinion becomes, you know, probably likely to what’s gonna happen because they’re asking me that for that.

[00:21:37] Right. And that’s part of their informed consent is that they’re like, I don’t know. This is a lot of information. What do you think?

[00:21:43] Hilary Erickson | The Pregnancy Nurse®: Yeah, because it can feel like a deluge of information in labor and delivery, and it’s okay to be like, I’m not sure what I should do. What do you think? Or if this was your choice or your daughter or whatever like that, what would you be encouraging them to do at this point or something?

[00:21:58] I think that really helps is, you know, I really value. Aiming for a vaginal delivery, right? Like that is one of my highest priorities in this delivery. This fully bulb is hurting like a son of a gun. What do you think my best option is to try and not die with a fully bulb, but also get a vaginal delivery and then see what your provider has to say,

[00:22:17] Juli Pyle CNM: right?

[00:22:17] Absolutely. Yep. You should always be open for things to change throughout the process, especially when we’re talking about babies being born.

[00:22:26] Hilary Erickson | The Pregnancy Nurse®: Yeah. What other things do you think people should be looking for in informed consent on?

[00:22:30] Juli Pyle CNM: Well, induction, like we said, that’s a huge one throughout the labor process.

[00:22:34] Breaking water, that’s a big one. As well as, uh, a big topic right now is delayed versus immediate pushing. So, and then also positions in labor I think is always gonna be a big thing because there’s a lot of facilities and a lot of people that. That don’t want laboring people to move around because it makes our jobs harder.

[00:22:53] And so positions, I think throughout labor, I don’t know that that’s truly like informed consent, but like if, if you have a provider that says you have to stay in bed, the patient, you can ask like, why do I have to be in bed? What are my other options? What are my other alternatives? And, and why are we doing it this way?

[00:23:07] Hilary Erickson | The Pregnancy Nurse®: Yeah, I think that’s a great one. And also sometimes as a nurse, I would go in and be like, okay, let’s, let’s roll you to the other side, or whatever, when they had an epidural and they’re like, oh, I’m just so comfortable right here. And so sometimes I would go into informed consent, not again. We’re not gonna be like, well, these are the risks of you staying on your left side.

[00:23:23] Right? Just saying, Hey, I have noticed that patients who move more during labor tend to progress a little bit better, and I would love to help you move, but if you wanna stay on your left hand side, then you can totally do that. What do you wanna do? Right. And that is an informed consent where I’m just saying, I think you might be better off turning, but if you wanna stay where you are, go for it.

[00:23:42] Juli Pyle CNM: Yeah. I think one that I hear a lot is people say, oh, I don’t wanna give birth on my back. Right? I don’t wanna have the baby come out in my back, but I often find that laboring people prefer that position. So I’m open to like any position, like if you feel like you can do a handstand and you wanna try pushing like that, I’ll try for you.

[00:24:00] You know, like, let’s go for it. But a lot of times people are trying to figure out what to do and I said, let’s try that position. A lot of people prefer it, and then they’re like, oh. I don’t wanna change outta this position, like I like this position and it’s the one that they thought that they absolutely didn’t want.

[00:24:15] Hilary Erickson | The Pregnancy Nurse®: Yeah, there are a lot of benefits to being on your back, most of them being that between contractions, you can chill out a little bit. And the other thing with informed consent is it’s okay if your provider says, you know, I feel. I think this is the best way I deliver. If your tile man came and you were like, well, I want you to tile the ceiling, wouldn’t you want ’em to say, I am not great at tiling the ceiling.

[00:24:37] You know, that’s not my skillset. And the same thing goes for your provider. They can say, you know, I’ve delivered 99% of my patients on their back. That’s delivery. That doesn’t mean you have to push the whole time on your back, and I’m best at that, but if you wanna try doing it squatting, we. I’m happy to try that.

[00:24:53] I just want you to know my A game comes when you’re on your back and I think people get mad that they’re like, well, why don’t you have a B game for squatting? But the reality is, I think it’s great when a provider says, this is what I’m best at. What do you want me to do?

[00:25:06] Juli Pyle CNM: Yeah. And I think that’s where you should be evaluating that relationship between provider and yourself before labor.

[00:25:14] Asking questions along the way so that you’re not blindsided by something, but also so that it’s a good fit and hopefully a good experience.

[00:25:20] Hilary Erickson | The Pregnancy Nurse®: I think it can be really tricky. And the other thing that I don’t think people understand is that in the hospital we can give you informed consent and you can still end up suing us it.

[00:25:29] So that ends up feeling really tricky for us because, you know, if we have a patient that we’ve seen is in trouble and they definitely don’t want a C-section, we are hands off and we’re like, okay. Baby ends up having a bad outcome and we’re like, well, we just informed consent the heck out of that lady.

[00:25:44] You know, nurse, doctor, second doctor have all come in and said, we see a bad outcome and yet they still come back and sue us. And so that is really tricky for us as providers. Do you have any thoughts on that?

[00:25:54] Juli Pyle CNM: Yeah, that gets really in the weeds of documentation and being able to show that there was real good conversations and if that can happen and the outcome was still not as expected or not great.

[00:26:07] That unfortunately gives us a little bit more clout on our side to say like, and I will make documentation, like if somebody’s declining something and their risk of stillbirth is really high, you know, for various reasons I will put in my note like discussion held about whatever it was, and that her risk of stillbirth is higher.

[00:26:25] If we do not do this thing, you know, because none of us can know if that would happen, that would be the worst outcome, obviously. But it has to be really clear, you know, on the provider side. And hopefully if we’re documenting that it was really clear. We really give the information clearly to the patients so that they’re getting the information that they really need.

[00:26:43] But that’s so hard because we can’t predict the future, especially in labor and delivery. It gets very, very gray in many situations.

[00:26:50] Hilary Erickson | The Pregnancy Nurse®: I just like people to understand that sometimes when we’re like going over things, maybe excessively, that’s part of the reason why is we’re all real worried about liability and I wish we didn’t have to be so worried about it.

[00:27:02] Obviously, I wish we could just give informed consent and that would be enough, and you get to make the choice that you want. But liability is a tricky part in labor and delivery especially.

[00:27:10] Juli Pyle CNM: And the other part that I’ll mention is that, you know, I’m talking about litigation because. We work in ob so we’re, we’re gonna have to have to talk about litigation ’cause it’s a high litigation area.

[00:27:20] But again, the research has beared out that one midwives are less likely to have litigation on them. And two, that a good relationship with the patient. So somebody who feels like they can trust you. You’ve given them information that you’ve respected them as a person are much less likely to even think about or pursue litigation even when there’s been really horrible outcomes.

[00:27:43] If the process along the way has been compassionate and respectful, it’s less likely that that’s gonna come to that.

[00:27:49] Hilary Erickson | The Pregnancy Nurse®: So Juli, you are a certified nurse midwife, and we have an episode that I’ll link in the show notes that we talked about, like the different people that can deliver your baby. And it is so confusing for people because some people think of a midwife as just like Joan down the street who delivers babies, like on Little House in the Prairie where Caroline would go sit with them, right?

[00:28:07] Versus somebody who, do you have a doctorate? Juli? We have to have a doctorate in, um, Arizona.

[00:28:12] Juli Pyle CNM: I don’t, I have a MA master’s degree, but yes, some states require a doctorate, but. It’s the equivalent of a nurse practitioner. Yeah.

[00:28:19] Hilary Erickson | The Pregnancy Nurse®: Yeah. Where you’ve had like a residency plus you were a labor and delivery nurse before you were a midwife.

[00:28:24] Like it’s an extensive training. And the beauty about a midwife that I think a lot of people don’t understand is you always have an OB where you’re kind of like, you know, we’re starting to get in the weeds here a little bit. I’d like a consult with a little higher up. Right. I’d like to move this up. So what’s the best part of having a midwife deliver your baby Juli versus an open?

[00:28:44] Juli Pyle CNM: Yeah. The first part of that, I think is that. The understanding that, yeah, we’re not obstetricians, we don’t have a physician training. We can’t do surgeries. Right? Yeah. But we actually manage, not all of us. It depends on our training and our experience, but most of us manage high risk conditions throughout as well.

[00:29:01] It’s not just like the most low risk person is the only one that can have a midwife as a provider. So you know. I, I will manage people with hypertension, people with regular diabetes or gestational diabetes, like those are things that I can help manage. So we’re not just like the lowest risk people that can have a baby in a teepee, and that’s all.

[00:29:20] So we’re not exclusively keeping people that have high risk conditions out of our care. We can do that. Again, there’s much more of a holistic approach. So we’re looking at the whole person and like, you have five other children, how are we gonna get you to twice a week? Fetal testing appointments, right.

[00:29:36] How is this gonna work for you? Instead of just saying. If you need twice a week visits, figure it out. Like we’re gonna try and work through, you know, the whole scenario as well as looking past those points. You know, like maybe a C-section is recommended again, you have five other children. How’s your recovery gonna be?

[00:29:52] What are you gonna have in place for that? I just think we do a better job of being able to see, especially because we’ve been a nurse before, so our perspective is not as medical, it’s nurse and holistic person perspective. So I think that’s really valuable. And then depending on where you’re practicing, it’s not always this way, but hopefully a midwife can be a little bit more hands-on throughout the labor process and be able to give a little bit more support than the obs who are busy with surgeries, busy with a million other things that we don’t have to do.

[00:30:22] Hilary Erickson | The Pregnancy Nurse®: Yeah. Now, of course, I wanna caveat this, that there are obs who practice very similarly to midwives, I find, and there are midwives who practice very similarly to ob. Yeah. So I’m not saying that you just be like, oh, she’s an ob, or she’s this midwife.

[00:30:36] She’s gonna be amazing. ’cause some midwives I’ve worked with and I’m like, oh my gosh, we’re all gonna die today. Or, I’ve worked with obs and I’m like, oh my gosh. Like they wanna be here from six centimeters on. They clear their schedule and they just make it, and they really wanna be there for the patient.

[00:30:49] They love that part of it. So obviously you wanna find the provider that’s right for you, but I get so many people in my groups that are like, well, I didn’t wanna have a midwife because she, you know, what if something went wrong, I got diabetes or preeclampsia or something. And I’m like, no. Like, that’s not gonna preclude you.

[00:31:05] From using them. You know, maybe you go see an o, an OB for one appointment and then you go back to your midwives rights. I think a lot of people don’t understand that there’s like midwives, there’s obs, and then there’s perinatologists, right? Like there are always these different levels of care that we’re kind of like, you know, we’re kind of in the weeds here.

[00:31:22] Let’s get somebody higher. Is there anybody above perinatologists? I think that’s it. Or maternal fetal medicine is their new name. Similar?

[00:31:28] Juli Pyle CNM: Yeah. Yeah. Yeah. And that’s the thing is like a lot of these things I can just make a phone call and be like, Hey. Maternal fetal medicine, what’s our plan? But I can still implement that plan and be the primary person throughout the pregnancy journey, and that’s really, really helpful, I think.

[00:31:44] And that’s what it should be. We should try and keep ourselves connected with the people that we know and have our relationship with if we can.

[00:31:51] Hilary Erickson | The Pregnancy Nurse®: Yeah. And I see midwives doing informed consent. It tend to be, again, tend to be overgeneralizing all along the way. Right? Like they’ll, at 36 weeks they’ll be like, Hey, I am seeing that you might, you know, your blood pressure’s trending up a little bit.

[00:32:05] There is gonna maybe be a possibility of an induction. I just wanna put a little seed in your head so you can start to think about what’s important to you and how we’re gonna balance that with an induction. We’re gonna see you next week. Right? Absolutely. That’s exactly what I do. Yeah, because whereas an OB, all of a sudden your blood pressure’s high and you’re like, we’re gonna induce you tomorrow, and they’re just totally taken off guard.

[00:32:24] Juli Pyle CNM: Or they show up in labor and delivery. They’re like, I don’t know why I’m here. And nobody’s told them anything, you know? So yes, I agree with that completely.

[00:32:32] Hilary Erickson | The Pregnancy Nurse®: I should say that one of the trickiest things is officially your labor nurse is not the one to give informed consent for the big stuff.

[00:32:39] Obviously a cervical exam or putting your blood pressure cuff on, we can do stuff like that. Definitely not for a c-section. We shouldn’t be the ones really doing it for an induction. That should be a, a conversation that you have in the office or over the phone or something, but. A lot of people are like, oh, the nurses didn’t give me informed consent, but officially, that’s not really our job.

[00:32:55] We should be the ones who catch it. Where the we’re like, this girl doesn’t even know how or why she’s getting induced. I feel like maybe we should have a conversation today.

[00:33:03] Juli Pyle CNM: Yep, absolutely. I feel like the labor nurses are there to help facilitate, to make sure it’s happening. You have a little bit more time usually to, to give more of the background information that maybe the provider doesn’t spend as much time on.

[00:33:15] And I think that that’s really valuable. And you have the perspective of, again, that whole person that you’ve been taking care of, you know, and you’ve been able to say, I don’t think that this is what they really have been telling me they want, you know, and you can communicate that to the provider a little better sometimes.

[00:33:29] Hilary Erickson | The Pregnancy Nurse®: Yeah. That part’s super rewarding for me. And also just because you give informed consent to be induced, like we talked with about, with a Foley bulb. If you get into it and it’s just miserable and you’re starting to be like, I just wanna have a C-section, my cervix isn’t even opening. You can make another choice.

[00:33:44] It’s not like informed consent. And then you are on that train forever. You can be like, I wanna get off this train. This train isn’t taking me where I wanna go. I can make a new choice. Obviously once your water breaks, there’s certain things we do that we can’t roll back, but there’s a lot of choices in labor and delivery where you can say, this is not working for me anymore.

[00:34:01] What can we do to change? And that’s a, that’s an opportunity for a new informed consent. Absolutely. It’s tricky because a lot of people are like, I do not wanna go home under any circumstances, but I, it’s hard for us because we’re like, two days at home could be a big difference for you.

[00:34:15] Juli Pyle CNM: I had a patient who we were sort of preemptively discussing like the need for induction, and she asked me that.

[00:34:21] She said, well, did people ever go home? And I said, great question. I said, most of the time that’s the patient that doesn’t wanna go home. Honestly. Yeah, they’re ready to, they’re ready for the baby to be on the outside. I understand that. But it can be an option of like, this hasn’t worked for 24 hours. Like literally nothing’s helping.

[00:34:35] Can I go home for a couple days? And there are scenarios that that is not a good option, but there are many scenarios that it could be.

[00:34:41] Hilary Erickson | The Pregnancy Nurse®: You know, Juli, I think one of the hardest parts of being a labor nurse is that it is, I give birth all the time. Right. As a labor and delivery nurse. So it ultimately, it doesn’t end up as big of a deal, but when you are coming in, you’re new, what do you do you have thoughts on that?

[00:34:54] Juli Pyle CNM: I just think as providers and nurses, you know, we do this. Every single day, multiple times a day. So, you know, an informed consent on induction, right? We might be like, oh my gosh, I’ve said this seven times today. And that might change, you know, the words we’re saying. But if we keep the perspective of like, for this person, this is their first baby, maybe first induction for this person, they have not experienced maybe ever being on the monitor.

[00:35:19] You know? And so explaining some of the things that we’re doing is important for me. I keep that perspective. I try to, that like. This is the most important day for them, even though I’ve maybe already caught five other babies today as a midwife. Like this is their time. And so that perspective helps me, uh, be able to like refocus and be like, okay, I, I need to explain all of this exactly the same way again. And that’s okay.

[00:35:44] Hilary Erickson | The Pregnancy Nurse®: Yeah. And as a patient, if you feel like your provider’s sort of running through it, think of your job and something you tell people constantly all the time. And how sometimes it’s more clear than other times, right? If you work at McDonald’s talking about this, the fry sizes or whatever, if you can always say to your provider, Hey, can we just slow down and have a quick conversation about this?

[00:36:02] Sometimes, you know, it’s been a long day. They’re kind of quickly going through it when, but if you say something like that, that triggers in them that. That you need a little bit more information. And I would say 98% of us are human. And when they hear something like that, they’re like, okay, she really wants more help with this decision and we are gonna slow down and really help you.

[00:36:19] But sometimes because we’re human and you’re human, we need that reminder that you would like a little bit more information and to slow things down. And that’s A-okay to say as a patient? A hundred percent.

[00:36:29] Juli Pyle CNM: Absolutely. Yep. We are, we are humans after all. We’re people just living the experience and getting through the journey, especially labor and delivery.

[00:36:36] That’s a whole separate life changing day, you know? Yes. So I agree with you. Absolutely.

[00:36:41] Hilary Erickson | The Pregnancy Nurse®: Yeah. Guys, informed consent is so important. I really want you to take it serious. I think providers are taking it seriously way more seriously than they used to because it really used to just be for a C-section and that’s it.

[00:36:54] Well, an epidural, but we really are doing a better job at it. But when you communicate what kind of information you want or things like that, I think it just helps everybody. End up having a better experience and can prevent a lot of birth trauma when you understand that you are really in the driver’s seat of this car.

[00:37:09] Thanks for coming on, Juli. Thank you so much. I know you’re a busy midwife. You gotta go catch some babies probably now. Or deliver. We catch, we don’t deliver. Yeah.

[00:37:17] Juli Pyle CNM: Yes. Thank you for having me today. It’s always great to see you.

[00:37:20] Hilary Erickson | The Pregnancy Nurse®: I hope you guys enjoyed that episode. I don’t think we stress how important informed consent is, and I think a lot of times when you’re in labor, you’re just overwhelmed and you don’t wanna hear about it. So I think this is a good one to have your partner listened to and to just think about how you’re gonna implement when you’re in labor, even when you’re tired and you don’t wanna hear about it.

[00:37:36] Because I think it can be really helpful in making the choices that you want when you’re in labor and helping you feel like you are in charge of what’s going on.

[00:37:43] Thanks for joining us on the Pulling Curls Podcast today. If you like today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.

Keywords:

informed consent, labor and delivery, childbirth, induction, epidural, c-section, certified nurse midwife, obstetrician, patient rights, shared decision making, medical risks, medical benefits, alternatives to treatment, refusal of treatment, documentation, birth trauma, labor nurse, pregnancy, patient-provider communication, cervical exam, water breaking, episiotomy, pain management, delivery positions, hospital protocols, regional differences in care, language barriers, birth plan, stillbirth risk, maternal fetal medicine

The post Informed Consent During Pregnancy: Knowing Your Rights appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Or, watch the video version:

Big thanks to our sponsor Laborie, makes of the Kiwi® Complete Vacuum Delivery System: https://www.laborie.com/product/kiwi/

Today’s guest is Dr. Tori O’Daniel. She is a Board-Certified OB/GYN whom has been practicing for 14 years. For the past 11 years she has been an OB/GYN Hospitalist in OKC, Oklahoma. Dr. O’Daniel is the Medical Director for the OB Hospitalist and women’s services. She also is the Medical Director for Women’s Health Services at Mercy Hospital. She instructs educational classes and facilitates the OB Emergency Simulations for the nurses and physicians within her department. As an Adjunct Faculty at Oklahoma State University, she is the Director of the Medical Student Clinical rotations at her institution.

She has been actively involved in the Society of OB/GYN Hospitalists (SOGH) for the past several years. She co-chaired the Simulation committee in 2020 & 2021 and Co-Chaired the ACM 2022 & 2023. She currently serves on the Board of Directors.

Dr. O’Daniel is passionate about education and advocating for women’s safety in health care. Thus, she actively teaches across the country about vacuum assisted deliveries, treating post partum hemorrhage and other OBGYN Emergencies.

Links for you:

Previous episode sponsored by Laborie (#246) about plus size moms in labor: https://www.pullingcurls.com/246-plus-size/

Timestamps:

00:00 Assisted Delivery and Labor Mechanics

03:22 Assisted Vaginal Delivery Options

06:26 Decline of Forceps in Deliveries

10:38 Vacuum-Assisted Delivery Explained

13:54 Vacuum Procedure Timing Guidelines

16:10 Assessing Delivery Options and Pelvic Adequacy

19:26 Challenges in C-section Deliveries

23:15 Forcep Use in Obstetrics

25:50 “Consent Challenges in Childbirth Decisions”

31:43 Forceps vs. Vacuum Delivery Risks

33:16 Birthing Risks: Maternal and Fetal

37:24 Considerations for Assisted Vaginal Delivery

39:56 Navigating Birth Plan Conversations

44:07 Normalize Asking for Help

46:57 Flexible Tubing Revolutionizes Vacuum Use

49:15 Flexible Neck Vacuum for Childbirth

Keypoints:

• Assisted deliveries involve using tools like vacuums or forceps to help a baby out during vaginal birth, usually when there’s exhaustion, fetal distress, or a tricky position.
• The difference between forceps (which look like fancy salad tongs) and vacuum devices (like the KiwiVac) was explained—with forceps generally having a higher risk for maternal tearing, while vacuums can be safer for the mother but have their own set of risks for baby.
• Forceps use is becoming rare in the US, and many younger doctors are not trained in both tools; most providers specialize in one over the other.
• The vacuum method, such as the KiwiVac, doesn’t just involve pulling—the device helps rotate and flex the baby’s head to ease passage through the pelvis, working in tandem with the mother’s pushing effort.
• Not every provider can use both vacuums and forceps, and midwives in the US generally use vacuums regionally; outside the US, like in Europe, midwives may use vacuums more routinely.
• Assisted deliveries make up less than 5% of births, so most people will not need them, but knowing about the process can reduce fear if the situation arises.
• Before offering assisted delivery, doctors must ensure the baby is low enough, the mother’s pelvis is adequate, and water is broken—these tools can’t compensate for a truly “stuck” baby or incomplete dilation.
• Vacuums and sometimes forceps can even be used during C-sections if the baby is deeply engaged or in an awkward position, to help bring the baby up through the uterine incision.
• Consent and clear communication are vital—sometimes decisions have to be made quickly, so it helps when patients have discussed these possibilities in advance with their providers.
• The episode emphasized not to fear assisted deliveries—they’re tools to reduce C-sections and make births safer when used by skilled, well-trained professionals, and advances like the KiwiVac improve outcomes for both moms and babies.

Producer: Drew Erickson

[00:00:00] Hilary Erickson | The Pregnancy Nurse®: Hey guys. Welcome back to the Pulling Curls Podcast. Today on episode 260, we are talking about assisted deliveries. We’re gonna talk about what those are. We’ve got a doctor coming on, so let’s untangle it.

[00:00:08] Hi, I’m Hilary, a Serial over Complicator. I’m also a nurse mom to three and the curly head behind pulling curls and the pregnancy nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with pregnancy and parenting untangled the Pulling Curls podcast.​

[00:00:44] I wanna introduce today’s guest. She, this is actually her second time on the podcast. She is a board certified OBGYN for 14, maybe 15 now years in Oklahoma. She’s passionate about education and she actually teaches other doctors how to use the vacuum. I wanna introduce today’s guest, Dr. Tori O’Daniel.

[00:01:02] Hey Tori, welcome back to the Pulling Curls podcast.

[00:01:04] Dr Tori O’Daniel MD: Thank you. I’m excited.

[00:01:06] Hilary Erickson | The Pregnancy Nurse®: Yeah, guys, this is a thing I get a lot. People don’t really understand like how assisted deliveries work. And so I’m excited to have a real doctor here today because the nurses do not, we, we just hand things. We just hand things to the provider and then they do all the work.

[00:01:21] So I think this is gonna be really helpful you for you guys to understand them. Tori actually works for Laborie and this podcast is actually sponsored by Laborie. And the Kiwi complete vacuum system delivery. It is used globally. In fact, I’ve used it myself, well as the nurse, and it’s designed to give control back to the physician. Whatever your preference or needs are, the Kiwi family of products offers a vacuum to meet them. And I would agree. I was a nurse when Kiwi started, like being a thing. Like I remember, before, when I used to pump up the vacuum, I wasn’t a fan of that part. So it is so nice that we are advancing technology. ’cause I gotta say, as a labor and delivery nurse, there’s a lot of things that are exactly the same as when Hilary started day one in 2001.

[00:02:01] Dr Tori O’Daniel MD: Absolutely. I could not agree more with that. So it’s always fun to see an evolution of product that is providing better healthcare for our patients. So I couldn’t agree more, and I was right at the beginning of my training when I saw somebody, pump the vacuum from behind me and that, that was a bit much for me. So I’m glad that we switched over.

[00:02:16] Hilary Erickson | The Pregnancy Nurse®: Yes. So first off, we’ll talk more about like how these different vacuum systems work, but what is an assisted delivery? A lot of people are like, well, aren’t we like everyone? Unless you’re free birthing at home, which I’m not a fan of. If you’re a free birther, this isn’t the podcast for you.

[00:02:30] Dr Tori O’Daniel MD: Yeah.

[00:02:30] Hilary Erickson | The Pregnancy Nurse®: An assisted delivery means that we’re helping you through what, Tori?

[00:02:33] Dr Tori O’Daniel MD: Yeah, so I mean, you could look at this a couple of different ways. Honestly, an assisted delivery is trying to get this baby to do what we would love it to do naturally. And the baby is, um, known to go through what we call the cardinal movements of labor, which essentially tries to get the baby to flex or put its head straight down and to get in this position, which we call oa.

[00:02:54] So the back of the head is facing the mom’s interior body and trying to get the smallest diameter to come the pelvis. The thing about that is that some babies are stubborn and they don’t want to do that. And patients have all different shapes and sizes of pelvic boney structure and so sometimes we don’t have the best position of the baby.

[00:03:12] So assisted can be a lot of different options. We move patients around to try to get this baby to do what it needs to do. As obstetricians or midwives, we can put our hand inside and try to get the baby to maneuver or rotate, as we like to call it, or we have two options for an assisted vaginal delivery with either a vacuum system or Forceps. And really the concept with those two things is that you’re trying to get this baby to rotate, to get the smallest diameter to come through the pelvis while the patient is pushing, and then you provide traction with either forceps or with a vacuum to be able to assist in that rotation and pull while they push.

[00:03:51] Hilary Erickson | The Pregnancy Nurse®: Okay. First off, can a midwife use vacuums or forceps most across the board in general?

[00:03:56] Dr Tori O’Daniel MD: So I would say that really depends on the region. In Europe, midwives are routinely using vacuums. I don’t know about

[00:04:03] Hilary Erickson | The Pregnancy Nurse®: Oh.

[00:04:03] Dr Tori O’Daniel MD: forceps but I know they are routinely using vacuums. and as long as they’re well-trained, really we’re encouraging any provider to be able to use, a vacuum assisted vaginal delivery option in the United States.

[00:04:14] That is also very, very regional, but there are. Much fewer regions that are allowing midwives to do a vacuum assisted vaginal delivery. Some of the areas that we previously talked on our, other podcast about, deserts where you don’t have access to obstetricians, the midwives are trained in, kinda outlet vacuum deliveries to be able to have options to provide safe care for their patients.

[00:04:36] Hilary Erickson | The Pregnancy Nurse®: Yeah. and also family practice, like some of our family practice doctors when I worked with them, were able to use vacuums or forceps or sometimes they had to call in an OB to come do those things. Just so you guys know, sometimes that’s an advanced level of care that they’re just not trained to do. So I think that’s important to know. Midwives always have like an upgrade of care. The uncertified nurse midwife always has an OB that they can call in to come back them up for that type of a delivery.

[00:04:58] Dr Tori O’Daniel MD: Yep, exactly.

[00:04:59] Hilary Erickson | The Pregnancy Nurse®: Okay. What would you call the difference between like, okay, so forceps look like salad tongs. If you’re listening just with your ears.

[00:05:06] If you’re not listening with your ears or you’re listening with your eyeballs, then I will put, a picture of what forceps look like, but they basically look like very fancy, very expensive. I’m sure. Salad tongs.

[00:05:16] Dr Tori O’Daniel MD: Yes,

[00:05:17] Hilary Erickson | The Pregnancy Nurse®: Yeah.

[00:05:17] Dr Tori O’Daniel MD: And there are a lot of different shapes and sizes of forceps because depending on what your patient is presenting to you with, you want different sizes, and so there are some, that are smaller for, smaller infants. There’s also some that are a little bit more elongated for those heads that have had a lot of molding for an unmolded head that kind of came down quickly, but still needing some assistance. we would have one that’s a little bit, more rounded. So the obstetrician, midwife and or, a family practice doc that if they’re trained to know how to do this, and again, midwives are typically trained in vacuum over forcep, but you would know which one that you would prefer. There’s actually also, forceps for a breach delivery if in fact you are, Trained to do breach delivery with something called Piper Forceps. And they’re shaped differently ’cause the baby’s coming out, in a totally different direction. And so the, the those little salad tongs that you described have to go on the head in a different way, in a safe method.

[00:06:07] Hilary Erickson | The Pregnancy Nurse®: Yeah. and are most doctors trained in both? Like, I’ve probably seen two doctors in my life that were good with vacuum and forceps. I feel like either they do one or the other. What do you think?

[00:06:17] Dr Tori O’Daniel MD: Yeah, so if you look statistically what’s happening with assisted vaginal delivery across the United States, they’re both less than 5% and about three and a half to 4% vacuum assisted vaginal deliveries. And then forceps, unfortunately, are almost extinct. It’s like in some in some places, not at all, and in others 0.5 to 1%. And that’s unfortunate because if you’re not getting trained in both options, then you have less opportunity to provide people who could be appropriate candidates for assisted vaginal delivery. So back to your original question. No, unfortunately, I find that it’s very rare that people are trained in both.

[00:06:53] I was really fortunate to have, attendings in my residency that knew how to do forceps and some that did vacuum, and so I just hounded my, my attendings that knew how to do forceps and I was taught how to do both. So I, I do both and I think that it actually taught me so much more about why assisted vaginal deliveries work and how they physiologically rotate the baby and what kind of additional force that you need to be able to provide that traction. and it’s important to know both skillset. There’s a huge misnomer that forceps have kind of gone out of practice ’cause they’re so much more difficult to learn. And I, I really couldn’t think that that’s farther from the truth. You have to know how to use them both well. To use either of those devices, but no, most people are either trained in forceps and think the vacuum is not something they want to do, or they’re trained in vacuum and never have even seen a forcep, let alone watched a, a forcep assisted vaginal delivery.

[00:07:46] Hilary Erickson | The Pregnancy Nurse®: Yeah, I a lot of times have people say, oh, which should I ask for? And I am always like, whichever one your doctor is good at using. Because if they’re, again, not trained in how to do a forceps, you definitely don’t want them sticking the salad tongs in you.

[00:07:57] Dr Tori O’Daniel MD: absolutely, I don’t want people to be using instruments and devices that they are not well-trained, to use. But I love being able to offer a patient either option and I may, Choose one over the other based on what I’m being presented with. When I first started using vacuum, I did not completely understand the beauty of the rotation that the vacuum provides.

[00:08:18] And then I learned really well how the vacuum works, and I know that it helps reinstitute those cardinal movements of labor and help rotate the baby. And so I know I can rotate a baby with delivery, with vacuum or forceps, and if a patient provides me, um, an opportunity as a candidate. For either one, then I have the opportunity to use either, and so I’m extremely grateful for knowing how to use both.

[00:08:41] Hilary Erickson | The Pregnancy Nurse®: Yeah, you are a woodland fairy. Okay, Tori.

[00:08:43] Dr Tori O’Daniel MD: Yeah, I honestly think as I’m stubborn, I knew I was gonna go practice in a really rural area, in Oklahoma, and I just wanted to have all of the tools that I could in my tool belt. and so I, I’m grateful, but I think that whenever we go train, ’cause we train, I train, to teach, vacuum assisted vaginal delivery, I will not stop advocating for making sure people get the opportunity to learn both if they can.

[00:09:03] Hilary Erickson | The Pregnancy Nurse®: That’s amazing. I was just thinking that we wanna emphasize what a vacuum can do. We talked about it a little bit at the beginning. I think a lot of people think it’s just like us just yanking down on that baby,

[00:09:12] Dr Tori O’Daniel MD: Yep.

[00:09:13] Hilary Erickson | The Pregnancy Nurse®: it can be used to turn the baby, which is not something you really need to know.

[00:09:17] Babies, a lot of times they’ll do it on themselves, but a lot of times they don’t because babies are the worst. And sometimes it is pulling and, and helping a mom. So, a lot of times the doctors will give the mom like a choice. Like at the end where they’re just not pushing very well. You know, you’re in your fourth hour of pushing, as you can imagine, as somebody who does YouTube workout videos, at the very end, I am done.

[00:09:37] I am not gonna be doing burpees on those last 10 minutes of the workout. Right. And that’s how it is. When you push, sometimes you’re like, I am done. I can’t help push anymore. And of course, we also need you to be pushing. A lot of times we’re like, oh, the doctor’s just doing all the work. Absolutely not.

[00:09:52] You are still doing your work as well.

[00:09:53] Dr Tori O’Daniel MD: Absolutely. so I think you hit the nail on the head about. The point or the purpose and the mechanism of a vacuum is to reinstitute the cardinal movements of labor that occur with traction. Right. So traction helps that because, and I have actually a fetal head, so don’t, don’t be shocked that there’s no baby, there’s just a, a fetal head. and then there’s the vacuum. So for those of you looking, obviously this is the front of the head. This is the back of the head, and this is that

[00:10:20] Hilary Erickson | The Pregnancy Nurse®: So This is a podcast you’re gonna wanna watch on YouTube. So the podcast will be on YouTube also. Tori is showing us a baby head, just so you’re aware if you’re just got me in your ear holes. Hello.

[00:10:29] Dr Tori O’Daniel MD: Thank you for clarifying. I forgot that people are sometimes just listening, but this is really a good visual that I think that people often miss when learning. And I also go through this with nurses at my facility and where we train to walk them through understanding. ’cause as Hilary mentioned, you’re not the one using the vacuum, but I genuinely want you to understand how this vacuum works. Because if a baby is not coming down directly OA with this fontanel or that posterior fontanel, that posterior soft box coming down this way and then out, and it might be turned to one side or it might be transverse or it might be what we call sunny side up or op. We really need that baby to flex and then rotate, right? So the vacuum goes right along that sagal suture just anterior to that posterior fontella or that soft spot. And when you pull through the vagina, so this right here is that vaginal canal, and when I pull down it gets this baby because of the spot. Like the physics guys, we gotta go back to what we learned in undergrad and in grad school.

[00:11:31] If you went there, I hated physics, but you have to know this and understand this flexes. And then if your baby is not positioned as you’re pulling down, it flexes and rotates the baby to get the smallest diameter to come through the pelvis. Now the key to this is that pulling down with this system actually flexes and auto rotates that baby with the pulling down mechanism ’cause it uses the vaginal canal like a pulley system. So we don’t pull up, we don’t do a ton of different movements. With the vacuum, you pull down and then towards yourself, and then that gets that baby to get flexed and then come underneath that pubic bone like it would have done without assistance. And so it is traction, but it’s assisted traction.

[00:12:14] So I still need maternal effort. This system is allowing that rotation to get the smallest diameter. So I should have. The least amount of effort that I should need with traction and Mom to get the baby delivered. It’s not just about traction or pulling it out. I’ve heard that sort of like tow truck mentality.

[00:12:30] I’ve had patients cannot, can you just do this for me? And whether I’m using forceps or vacuum, I say, no, I’m gonna help you. I’m gonna assist, but I really need you to give me your effort. So this is a combined effort that I’m providing traction while rotating and you’re pushing for me.

[00:12:46] Hilary Erickson | The Pregnancy Nurse®: Yeah, you know, I just realized we didn’t really talk about how the vacuum works. Like people are thinking we’re like throwing up our Dyson in there. That is not the case. So it is just a real gentle type suction cup. It looks like if you’re not watching, it looks like a little bagel

[00:13:00] Dr Tori O’Daniel MD: yep.

[00:13:01] Hilary Erickson | The Pregnancy Nurse®: on that has a little bit of gentle suction, that they put on the baby’s head.

[00:13:04] Dr Tori O’Daniel MD: Yep, it goes right here on that baby’s head, and then you’re, the afterward you’re gonna see what I call a little hickey. The formal word for that is a chinon, and that’s because you’re pulling or creating, um, suction on the baby’s head. So it creates a little edema. It pulls some of that fluid into the scalp, and that usually will go away.

[00:13:22] That’s like a hickey slash bruise that goes away within a day or so.

[00:13:25] Hilary Erickson | The Pregnancy Nurse®: Yeah, and the doctors have like a little hand pump. They’re not, again, turning on their Dyson. They have a little hand pump that they squeeze that gets it to the right, like there’s a green spot that you’re like in the clear that this is when you can pull, and then they release it between pushes to just like minimal suction.

[00:13:40] So it’ll stay on. Right. Because we don’t wanna have to find the spot.

[00:13:43] Dr Tori O’Daniel MD: Nope,

[00:13:44] Hilary Erickson | The Pregnancy Nurse®: don’t?

[00:13:44] Dr Tori O’Daniel MD: No, I love that you said that. because we don’t, so we were originally trained several years ago, decade and a half ago or so, to release the vacuum in between. But the recommended time for a vacuum is about 15 to 20 minutes in length of your procedure.

[00:13:58] And so even when she’s not. Pushing. You do not release vacuum. You just don’t provide traction. So you leave that on so that it

[00:14:04] Hilary Erickson | The Pregnancy Nurse®: Okay.

[00:14:04] Dr Tori O’Daniel MD: slip off of your spot. Because this placement, which is why we teach this method, is that this placement and getting accurately placed over the spot is super important to get that flexion and then rotation into that smallest diameter plane in your pelvis, and you don’t wanna release the suction in between those pushes.

[00:14:23] So Let’s say the patient is pushed, three different times in one contraction. Contraction goes away. The patient feels the contraction goes away, or we can see the contraction goes away, and then we just sit. Everybody takes a deep breath and the contraction builds. Patient goes to push again, and then we provide the traction. The other thing is that I put my hand, just my finger and my thumb inside the vagina so that I can put my finger on the baby’s scalp and then my thumb is on the center of that cup so I can feel this flexion. And then I can also feel descent of the baby. And then my thumb provides counter pressure.

[00:14:55] ’cause you talked about that cup releasing or or letting go, which is called a pop off. And we don’t. Want to get a pop-off, that’s not our preference. It’s not a safety feature of the device, and so we wanna make sure we can decrease that chance of having a pop-off when the patient is pushing.

[00:15:09] Hilary Erickson | The Pregnancy Nurse®: Yeah. And one of the most important things that we’re all watching for when we’re using a vacuum is that the baby is actually descending because of course we don’t wanna try and bring a baby through a birth canal that will not fit.

[00:15:20] Dr Tori O’Daniel MD: Mm-hmm.

[00:15:21] Hilary Erickson | The Pregnancy Nurse®: so we wanna make sure that the baby is descending. The nurse and the provider are both watching for that, and we have to chart it like there is a lot of charting that the nurse somehow, I don’t know why. Even though I don’t touch the vacuum at all, that we still have to chart as we’re watching the doctor do the vacuum.

[00:15:35] Dr Tori O’Daniel MD: Absolutely. And you actually brought up a great point, you know, when you were offering, a patient the option of an assisted vaginal delivery. There are some prerequisites for me to go through and I’m kind of always assessing whether or not that’s gonna be needed. I like to go worst case scenario in my head, and then I tell the patient, Hey.

[00:15:53] This is how we plan to go through the delivery process. I get them to ask me questions. We kind of go through their birth plan with me to tell me what their options and suggestions are, and then I say, you know, if this is gonna happen, if X, y, Z happens, then I will offer you. These two options and I’d like to do that before we really get into the thick of labor so it’s not crisis moment. And then I can just ward off evil juju like I call it. And I go through what the possibilities are. And one of the prerequisites is that I need to assume that your pelvis is adequate for this baby. I either have a recent ultrasound that gives me a weight that I think it is, or I can Leopold and feel how big the baby is.

[00:16:29] I can assess the patient’s. Pelvis and make sure that I feel like we’ve got an adequate pelvis to deliver so that I know that I feel comfortable that a baby is gonna come out. I cannot predict all shoulder dystocia. That’s not the way that this works. Although I would love if we could do that, but I have to assume that the baby’s gonna be able to come out and that I’m not doing exactly what you said, like pulling a too big baby to come through the pelvis.

[00:16:50] Hilary Erickson | The Pregnancy Nurse®: Super smart, and I love that you go over it in advance. Sometimes I wonder if providers are doing that in the office because they never go over it in advance in general that I’ve ever seen because Tori is a woodland fairy.

[00:17:01] Dr Tori O’Daniel MD: Well, I’m also a hospitalist, so I don’t get the .

[00:17:03] benefit of doing this in the clinic. I think a lot of my colleagues go over these things through the prenatal process, just to kind of say closer towards the end of third trimester, Hey, this, this might be an option. And I don’t always get the benefit either, because sometimes as a hospitalist, I get called into an emergency and I.

[00:17:18] Literally have just met the patient and the baby’s heart tone are down, you know, so indications for assisted vaginal delivery are maternal exhaustion, like you mentioned. The patient is exhausted. We’ve been pushing, for quite some time, and we’re just not getting a delivery, fetal indications where if my heart tone go down and I need to expedite that process. That expedites the conversation. And so I consent a patient for this option, and then once it’s all said and done, I stay and then I just reiterate what just happened, right? Because if that happens really, really fast for them and then all of a sudden they’re like. I don’t even know what just happened to me in all of that. I stay afterward and say, Hey, everything’s good. Your baby’s good. You’re good. Let me just review what we, what we just did, and then if I get the chance, I’ll go back the next day too and just say, do you have any questions about any of that? Because this is, you know, sort of black out patient blacks out for a second with all of that crisis, and so I wanna make sure that they don’t start thinking about it afterward and then have questions they didn’t get a chance to ask.

[00:18:18] Hilary Erickson | The Pregnancy Nurse®: Yeah, and if your doctor is not the woodland fairy that Tori is, you can always ask those questions. Especially even if you think of them in postpartum and postpartum. Nurses don’t know a whole lot about vacuums and forceps, but they can always call up a labor nurse to address your concerns. Who can just basically say why it was used?

[00:18:34] You know, maybe your labor nurse is still there, maybe she’s not, but we have a basic idea of why it’s used, what to watch for, things like that. I did wanna mention that we sometimes use the vacuum in c-sections, and a lot of people are shocked by that one. Some providers use ’em more often than others I find. But if the baby is really like low in the pelvis or the head’s sort of wonky, which is a very technical term, baby’s head was wonky,

[00:18:54] Dr Tori O’Daniel MD: Uhhuh.

[00:18:55] Hilary Erickson | The Pregnancy Nurse®: a lot of times they’ll use the vacuum to kind of pull baby up out of the pelvis.

[00:18:59] Dr Tori O’Daniel MD: Yes, and wonky. I love that word. I also like, kitty wampus. I use kitty wampus in cat corner and all kinds of weird things, but yes. Okay. So you can use forceps or a vacuum in, a c-section. And again, depending on what you’re trained and what your comfort level is. You know, there are two issues with babies coming out in a c-section.

[00:19:17] one is that it’s been, they’ve been pushing for a while and the baby is really, really impacted or or engaged into that pelvis. And then the other one is a is a patient that may have had a scheduled section, unlabored, and those babies’ heads are not molded. It wasn’t attempting to come down into the pelvis.

[00:19:36] And so it’s just beautifully round head, which some would assume would be easier to deliver. But sometimes those stinkers just love hanging out in the uterus and they’re round and they’re floating. There’s a lot of amniotic fluid and it’s hard to get the baby to come. So you have an incision, and again, I’m just showing for those of you that are listening, I’m showing this baby’s head.

[00:19:54] But if you have a baby coming through the incision, I’m doing the same thing where I’m putting my hand underneath and lifting it so that the smallest diameter is coming up through the incision while my assistant is giving some gentle pressure on the top of the uterus to help get that baby to come out. If the baby’s head is really round and molded, and I cannot get it to come up into the, the incision or, I’m sorry, not molded, or if it’s really molded in the pelvis and I have to get it to come up to come into the incision, occasionally an assisted c-section delivery occurs because the vacuum, I can put the vacuum, on the baby and pull straight up and it gets that smallest diameter to come through.

[00:20:31] Or I could, if it’s like this and just not popping up, I could slide a forcep blade and a forcep blade and pull up to come out. Sometimes, when they’re really engaged, I have to get my hand deep into the pelvis to pull or disengage that suction, and then I can’t get it to flex to come up. So the assisted c-section deliveries occur, but for different reasons.

[00:20:51] I’m not asking the patient to give me that maternal effort, right? ’cause they’re, they have a spinal or an epidural, that this really helps get the smallest diameter to come through that incision.

[00:20:59] Hilary Erickson | The Pregnancy Nurse®: Yes. And a lot of times where people are like, well, just enlarge the incision, but your uterus is actually only a certain amount, so it’s not like a regular surgery where we could just cut you open like a magician. We only have so much room that we can cut, which is confusing when you see on the skin where they could have made it larger, but your uterus only has so much room for us to get into, so that’s why we sometimes use it.

[00:21:18] Dr Tori O’Daniel MD: it’s actually, it’s not. I mean, sometimes, sometimes it’s about the incision size, but it really is more about trying to get the baby into a position that creates the best delivery because babies know, they intuitively know that they’re trying to get the smallest diameter.

[00:21:37] I have no idea how that works. That’s way bigger than than me. It’s lovely, but they know to do this. And when I’m trying to get it and I just can’t get it to flex, for whatever reason, the assisted delivery, whichever device I’m using, gets the smallest diameter up there that maybe my hand can’t do for whatever reason in that scenario.

[00:21:56] Hilary Erickson | The Pregnancy Nurse®: Yeah. By the way, I extra love the Kiwi vac for C-section assisted deliveries because when I was trying to like not get in the field, but also use the pump and, and listen to the doctor, it was miserable. So I’m so glad we have new things.

[00:22:07] Dr Tori O’Daniel MD: That’s awesome. I love that.

[00:22:08] Hilary Erickson | The Pregnancy Nurse®: I also wanted to mention there might be people listening to this podcast who have already had their baby that are like, well, I couldn’t get, you know, failure to progress. Like they can’t push the baby low enough. And they’re wondering in their minds, maybe the doctor could have just used a vacuum and I could have avoided a C-section.

[00:22:22] And I don’t want you to feel like that is usually ever a, a thing. If you are pushing, a baby’s not descending and we’re just thinking maybe your pelvis is too small. We, that is not a point that we would use a vacuum or a forceps. Because we could get into trouble.

[00:22:34] Dr Tori O’Daniel MD: Absolutely. You have to have some prerequisites, so your water has to be broken. We like to have your bladder emptied. we need to make sure that your baby is engaged in your pelvis and we describe engagement in your pelvis in like, increments, centimeter increments. And if you are past this bony process in the patient’s pelvis, the baby is past that and it’s plus two.

[00:22:56] The way do we describe how far down the baby is in your pelvis and it’s plus two or greater than you’re a candidate for us to use this vacuum assisted vaginal delivery. Now, if you go back and read historically, if you have nothing better to do with your time and read about forcep evaluation and sort of evolution. They did do some high and what we call mid forceps, where that station could have been a little bit higher. That’s not typically performed now for lots of reasons, but partially because we’re trying to provide the best care with the least amount of harm. And so exactly what you just said, Hilary, we wanna make sure the baby is showing us signs that it can come down and out.

[00:23:32] It’s just some combination isn’t working. And if I can get the baby to rotate and give a little effort while the patient is pushing. I want to do that. So bladder emptied, your cervix has to be completely dilated. So if your failure to progress because you’ve got stuck at seven centimeters, neither one of these instruments are offered for you. I have to have an engaged baby down in that pelvis, and I have to assume that the pelvis is thick enough for this baby to come out. And I do that by either knowing the estimated fetal weight or I have done Leopolds and I know that.

[00:24:03] Hilary Erickson | The Pregnancy Nurse®: And Leopolds is where they just like manhandle you on your belly in case people are like, oh, that’s like a special thing.

[00:24:08] Dr Tori O’Daniel MD: Yeah, it’s like a guesstimation where I do this little trickery, this little trickery to, to make sure I can guess how much I think, that your baby is. And again, I think we talked about this before, but I can’t predict shoulder dystocia any better than anybody else can. And sometimes small babies have shoulder dystocia.

[00:24:25] And just to reiterate, shoulder dystocia is where that shoulders of the baby. So this diameter I’m just showing from one shoulder to the next is bigger or gets stuck in that pelvis. And so my. Top shoulder, my anterior shoulder gets stuck on the mom’s pubic bone and it won’t come out. And so sometimes small, babies, have this issue if the pelvis is shaped in a certain way or if the, the maternal pelvis is just smaller, that happens.

[00:24:49] So we cannot predict that all the time. But you clearly don’t want that to be an assumption that you’ve got a really large baby. For example, patients who have diabetes, and I know that their babies are going to be big, they also have extra fatty deposits, in that fatty tissue of those babies.

[00:25:04] And so those babies tend to have more dystocias even at the same size of, patients who do not have maternal diabetes.

[00:25:09] Hilary Erickson | The Pregnancy Nurse®: Yeah. So there’s a lot of things we’re considering before we use the vacuum. I don’t wanna ever want you to be like, oh, they should have used a vacuum. I could have avoided a c-section. That, that’s not usually the case.

[00:25:18] Dr Tori O’Daniel MD: Absolutely.

[00:25:19] Hilary Erickson | The Pregnancy Nurse®: And the way we’re talking, we’re like every delivery gets a vacuum or forceps, but I wanna remind you guys, you said at the beginning, this is about 5% of deliveries, but it’s enough that it’s awesome to know about so that you’re not caught off guard when your doctor’s like, Hey, I, what do you think about forceps?

[00:25:33] I don’t know if you would know this, Tori, ’cause you probably don’t see a lot of providers asking, but do you think they give informed consent really well with vacuums or forceps?

[00:25:41] Dr Tori O’Daniel MD: I think that, that’s a loaded question, right?? I think that, I think people intend to consent people, and meet them where they’re at. And so you wanna inform somebody as much as they can be informed to allow them to make an educated decision with you. But. You don’t wanna scare them and make them feel like a c-section is just the better option ’cause there are risks with an assisted delivery. And let’s be frank, right? a delivery, a vaginal delivery is risky regardless of how we look at it. Whether it happens without any assistant with plus or minus an epidural, plus or minus medication, it’s still a very risky thing that we go through.

[00:26:16] And so that’s a complicated question for me because I feel like people consent. But maybe not consent and go through all of the details because that seems so scary. And I try to make sure that what I’m using, the verbiage that I’m using, the words that I’m trying to say to explain what can happen is meeting a patient where they’re at.

[00:26:39] So I’m not using these words that are like, sure. Yeah. Okay. And they have no idea what I’m actually saying could happen. And so I don’t sugarcoat it. I mean, I say a C-section is an option, and these are the risks that come with that. And a vacuum. These are the risks that come with that. And the forcep, these are the risks that come with that.

[00:26:55] And then I also tell them if I have a preference based on how they’re presenting to me, and I say I would, I would prefer to use a forcep on you. And this is why I still say you’re still a candidate for a vacuum if you prefer one over the other. So.

[00:27:07] Hilary Erickson | The Pregnancy Nurse®: That’s awesome. and hopefully your provider’s going over this in the office, they should do things like, you might end up getting blood, you might need forceps or a vacuum. Like there are some very things that we do kind of just like in the moment, because a lot of times we don’t have 30 minutes to talk about should we use a vacuum.

[00:27:22] You know, it’s something that’s being done. Sometimes very quickly, if baby’s heart rate’s going down, sometimes it’s like, we need the vacuum, we need it now. We need to go. and in those cases, you, hopefully you’ve had that discussion in the provider’s office and you, and you trust your provider. I mean, hope everybody trusts their provider, although it can be tricky. I get it.

[00:27:37] Dr Tori O’Daniel MD: Yeah.

[00:27:38] Hilary Erickson | The Pregnancy Nurse®: Yeah.

[00:27:38] Dr Tori O’Daniel MD: Yeah. and so yeah, I think people intend to consent well. I think making sure that you consent and then discuss and then debrief and have conversations when it’s not in the heat of the moment. when it’s the heat of the moment, I. I really dial down to what I feel like is the most important conversation.

[00:27:55] Your baby is at risk because of X, Y, Z. Heart tones are down. I have two options. These are my options. These are my risk with these options, and I need you to tell me right now what you’d like to do, which is so hard for me to say because somebody’s trying. They’re like. I don’t know. What do you think that I should do? And if I have a preference either way, of course I say that if they’re not a candidate, I say, I’m so sorry. I do not feel comfortable offering you this because X, Y, z my recommendation is a C-section. You know, I mean, I just feel like everybody provides different, clinical scenarios to you, which is what makes obstetricians as fun and as, fear-based as we are.

[00:28:30] Because we, there’s a lot of educated fear that comes with, we know, right? You know. You know, as a labor and delivery nurse, it is good when it’s good and it is not good when it’s not good.

[00:28:38] Hilary Erickson | The Pregnancy Nurse®: Yeah, and I think a lot of people learn about forceps or vacuums and they’re like, well, those sound really barbaric. But I want you guys to realize that the reason we have these is to prevent a C-section. And most people that come into labor and delivery wanna do a large variety of things to try and prevent a C-section, including the staff, because we ultimately feel

[00:28:55] Dr Tori O’Daniel MD: Absolutely.

[00:28:56] Hilary Erickson | The Pregnancy Nurse®: that either a vacuum or a forceps when used appropriately by trained staff is less risky than having a C-section.

[00:29:03] Dr Tori O’Daniel MD: Mm-hmm. and again, if you go back and look at what we offer in the United States, a lot of places don’t even offer a trial of labor after a C-section. So if I can safely avoid that first C-section and offer people who are candidates for an assisted vaginal delivery safely, absolutely. I mean, this is going to help prevent long term possibility or risks. If I can avoid that first C-section. I am not gonna do that at all costs, though. I’m a very, very like, practical person If you have to have a C-section, because that is what has been presented to us, that doesn’t mean you’re damned for life. Right? And I don’t mean to say that harshly.

[00:29:41] I just, c-sections are not a bad word. It’s just. I would love to be able to allow us to get through a vaginal delivery, if you’re an appropriate candidate, your baby is cooperating. All of those things that I say, and if I have to do a c-section, we can work through that too. You know, I love how you empower people to know and to ask questions.

[00:30:00] Just ask questions like, if anybody is getting defensive with you, that should be a little bit of a red flag. if they’re comfortable with what they’re doing, they should be able to converse and have a conversation with you about it. For sure.

[00:30:09] Hilary Erickson | The Pregnancy Nurse®: Yes. Okay. So fun fact, Hilary had a forceps delivery on my first baby. So my first baby was born in 2000.

[00:30:15] Dr Tori O’Daniel MD: okay.

[00:30:16] Hilary Erickson | The Pregnancy Nurse®: I knew what forceps were ’cause I went to nursing school and I had done labor and delivery as a capstone. Didn’t work labor and delivery though at that point in time. I was with the old people.

[00:30:23] Literally thought, I mean. When you’re, you’re kind of like sugarcoating it. Like we just apply a little pressure. I thought he was gonna hurl me across the room. It was a point in time where my baby’s heart rate was down. I could tell that we were having decels. I knew what decels were. And he, old guy, by the way, I think he also delivered, me.

[00:30:40] So not a young fella,

[00:30:41] Dr Tori O’Daniel MD: Okay.

[00:30:42] Hilary Erickson | The Pregnancy Nurse®: came in, you know, and it was one of those situations where they couldn’t get the heart rate to come up. He said, we need, this is to avoid a C-section. And just like pulled the heck outta that baby. And side note, you can still feel the forcep mark on his head, but he is graduated college.

[00:30:56] He has a degree in computer science. You know, at the time I was kind of like, well, this, this could be a problem. And totally functioning human being. He is a boy that’s 25. So not fully functioning, but pretty darn functioning. So that was my, um, that was my. Thing with forceps. I believe he did go through the risks and the benefits, although I literally have no idea because it was very quickly and he had him out.

[00:31:18] He was one of those doctors who was super trained in forceps, um, and had him out very quickly. So that’s what happened with Hilary. But I do wanna talk a little bit about the risks and the benefits. Well, we’ve talked about the benefits, but what are the, some of the risks with, forceps or vacuum? ’cause I think they’re pretty well, a little bit different.

[00:31:33] Dr Tori O’Daniel MD: Yeah. there are some similarities and then there are some differences. And I think the first difference that people associate between risks for forceps with vacuum is that the forcep needs to go, like you just said, those little salad tongs, it goes around the baby’s head. So if I were a forcep, I’m showing. Sort of where my, my hands, are coming around the baby’s head to sort of sit right on here and be able to get the baby to come through. That in inadvertently widens the diameter of what is having to come through the pelvis because I now not only have the baby’s head, but I also have those blades.

[00:32:08] And those blades are thin, they still widen the diameter of what’s coming through. And so you have maternal risks with the, forceps that can cause, vaginal lacerations or what we call sulcus tears. You can also have, um, a tear on the posterior side, like right where we think of where we have an episiotomy, it can tear. And that tear then can go into, um, near your rectum, that’s called a fourth degree tear. That can have longer term sequelae or long-term Side effects.

[00:32:37] That’s your girl right here. Right here. Fourth degree, still functioning. Lot of para, a lot of, pelvic floor.

[00:32:43] doing pelvic

[00:32:44] Hilary Erickson | The Pregnancy Nurse®: gotta do your pelvic floor physical therapy. When you get one of those,

[00:32:46] Dr Tori O’Daniel MD: those, those, pelvic floor physical therapists. ’cause man, they are really like, they’re in the trenches with us, making sure the patients are doing well. But that’s a risk. And you could still have a fourth degree having a regular without assisted vaginal delivery, having a vacuum assisted vaginal delivery. But your risk with forceps is higher because it’s increasing the diameter. When you put a vacuum on a baby. You can see that this is not increasing the diameter of what’s coming out of the vagina, and so this device does not widen that.

[00:33:15] So you don’t have what I consider those maternal risks. And I just say that, that my maternal risk with forcep is more sulcus, vaginal. Up into the urethra and then posterior or rectal, tears, those fourth degree tears. You still can have risks, to the baby, with forceps and vacuum. And that is a skull fracture or tearing or shearing of the blood vessels that are in, those like in between the, the scalp and the skull, and that’s called a cephalic hematoma or a subgaleal hemorrhage. You do have a slightly higher risk with a vacuum for those fetal scalp, vessel lacerations. And then you can have, you can have a scalp laceration if this. Kind of shears off of the scalp.

[00:33:54] And that’s more of like a skin abrasion or a cut in the skin. Those vessel tears that cause that bleeding, those can be more significant. The ceal hematoma, it’s underneath the skin in a way that it can stop because of the suture lines of the baby. And a subgaleal hemorrhage is something that you can have more bleeding ’cause it can kind of extend over the scalp.

[00:34:16] And so those are risks with either one, but the fetal risks are slightly more with, a vacuum. And I counsel people that. Can people have a scalp, I mean a, cephalohematoma or a subgaleal hemorrhage without assisted vaginal delivery? The answer is yes. It’s just not as frequent. So if you look across, the United States, the subgaleal hemorrhage risk for vacuum assisted vaginal delivery is about 4.2, 4.3%.

[00:34:44] So there is some risk with that.

[00:34:45] Hilary Erickson | The Pregnancy Nurse®: Yes. And even, even if you don’t see, a lot of times there is just a little bruising, like you said, a hickey. but whatever you’re seeing on your baby, if you have any questions after an assisted delivery, please ask because we as nurses see it enough that we’re not like, oh my gosh, I don’t know what that is.

[00:35:00] No, we know what it is and we know when it’s a problem and we need to call like a provider.

[00:35:04] Dr Tori O’Daniel MD: Absolutely. And forceps can get that bruising, like right where the blades are sort of lying on the bony process of your cheek. You can have a little forcep bruise from that. You can have that chinon or hickey. And we, at our institution and what we counsel and, tell people is that you should let pediatrics know.

[00:35:18] If you use an assisted vaginal delivery, let them know. You assess. They always look if they’re concerned about anything, then baby would get imaging and things like that.

[00:35:25] Hilary Erickson | The Pregnancy Nurse®: Yes. And before, when you mentioned the blades of the forceps, that’s just a fun word we use for the salad tongs. There’s nothing sharp on the forceps. It’s all rounded. Nobody could get cut by the actual forcep blade. We just, we just use fun words at the hospital.

[00:35:38] Dr Tori O’Daniel MD: Thank you for clarifying. There is nothing sharp going in your vagina. It’s this nice rounded smooth, salad tong as she described it. And that’s really what it looks like. ’cause a big salad tong.

[00:35:48] Hilary Erickson | The Pregnancy Nurse®: Yeah, so Tori, what would you say to people who are pregnant and are like, sort of freaking out maybe a little bit with this conversation. Again. First off, only 5% of deliveries and I it does it happen more on your first baby? ’cause mine, it was my first baby. Second baby’s third baby. Easier.

[00:36:02] Dr Tori O’Daniel MD: and I don’t have the exact stats on that, but certainly anecdotally it does. And part of that is because, you’ve never had something that large come through your pelvis, right? So you’re trying to figure out how to push a baby out and, your pelvis has been new to that. and the other ones are, you know, a multip or somebody who’s had babies before still can have an assisted vaginal delivery, and that may just be either because of that fetal distress that we talked about, if something occurred. And or if the baby is malpositioned and just not coming down in the pelvis in the right way.

[00:36:28] Hilary Erickson | The Pregnancy Nurse®: Yeah, babies can get wonky at any stage

[00:36:30] Dr Tori O’Daniel MD: love,

[00:36:31] Hilary Erickson | The Pregnancy Nurse®: children can get wonky.

[00:36:32] Dr Tori O’Daniel MD: your, I love your, adjectives. Wonky is exactly what I say to people. I’m like, it’s just coming down their kitty wampus. I don’t know what’s, you know, I’ve tried to rotate, maneuver the nurse. We’ve tried to use the peanut ball and switch. It’s just not coming down. So

[00:36:43] Hilary Erickson | The Pregnancy Nurse®: Yeah, sometimes I’ve sat down to chart, you know, in your nurse’s notes and you’re like, fetal head feels real wonky. I’m like, I don’t know how to say that. Malposition, I guess

[00:36:53] not as fun.

[00:36:53] Dr Tori O’Daniel MD: for sure.

[00:36:54] Hilary Erickson | The Pregnancy Nurse®: Okay, so if you’re freaking out, first off, they don’t happen very often.

[00:36:57] Second of all, talk with your provider in your office.

[00:37:00] This isn’t something that like is taboo topic to talk. I mean, I probably wouldn’t talk to ’em about your 12 week appointment about forceps and vacuum, but if you’re in your third trimester, I think it’s, you know, it’s good to say, Hey, which do you usually use? Because again, most providers only use one. And, do you have anything you wanna tell me about it?

[00:37:15] Right?

[00:37:15] Dr Tori O’Daniel MD: And I think that asking is there anything that would encourage you to use one or the other if they know how to use both? And is there anything that would prevent me from being a candidate for this? So again, if my patient is, a type one, type two diabetic, and the baby is huge, I would say to them in their prenatal period. Hey, we, uh, you know, we’re gonna go through this delivery and there are options if I have any concerns towards the end of your delivery. One of them is assisted vaginal delivery. Unfortunately, in your case, I would not feel comfortable offering you that because we’re already a little concerned about the size of your baby, and I don’t wanna make that worse.

[00:37:48] And then the other thing is that talking with your physician about, you know. When would you choose to try it? And then you stop doing it if it’s not working? You have to get a physician who is really, really comfortable knowing when it is not working, and part of that assisting hand with a vacuum.

[00:38:04] And part of that feel with forceps is knowing I have placed this, I have attempted, and I’m not feeling a budge. If I put a vacuum on and I don’t feel any descent or flexion, I say to the patient, I stop. I take the vacuum off and I say. is not working. I gave it a valid effort. I don’t wanna make things more difficult in your C-section, and this is why.

[00:38:25] And then the second part of that is make sure that they’re capable of handling that abandonment swiftly, right? So I need to have an OR team ready for me to be able to go back to do a C-section if either of those options have not worked.

[00:38:36] Hilary Erickson | The Pregnancy Nurse®: Yes. the other thing, they’re probably like, oh, I wanna put on my birth plan that I do not want an assisted delivery, and I do not put assisted delivery on birth plans because A, nobody wants an assisted delivery. Right?

[00:38:47] And B, it’s such, it’s like made in the moment choice. It’s not like, are you planning to breastfeed?

[00:38:53] Yes or no? Like, it is such a, like this is what’s happening. We’re in the moment. I guess you could, if you’re like getting tired and do you want the assist with a vacuum or are you okay doing it on your own? Like that’s a choice. But, most often it’s, it’s a thing that’s made in the moment, which is a lot of birth.

[00:39:08] I think it’s great to be educated and you’re like, you know, if I, if I still have that effort in me, I wanna push it on my own instead of getting the vacuum. ’cause I prefer not to tear. But that in general is not most of the vacuums that I’ve seen placed.

[00:39:20] Dr Tori O’Daniel MD: Absolutely. And I think, you know, we laughed last time you and I spoke about the infamous birth plan. And people love or hate them, I think, and there’s very little gray in the love. They either love or hate. I am a little gray in that zone because I don’t feel like it’s fair to have, patients get so specific in something that they think that they have. A lot of control over. ’cause sometimes I don’t have control over it, right? And so your body does what it wants to do. Your baby presents how it wants to present. The clinical scenario is different with every single patient. So I just sit down and just have a little heart, heart and say, let’s go through this birth plan.

[00:39:55] And then we walk through it and say, okay, you said you want X, but what if? What if this happens? You know, that may change your mind. And so we just have that conversation more organically about what the options are. And I say, I would love for you to be able to deliver this baby without any assistance from me and or a C-section.

[00:40:11] However, let’s go through worst case scenario so we can ward off evil juju and then we can get that outta the conversation. And then, you know, and I know where we stand in case something like that presents and that seems to sort of, you know when somebody comes in and they’re feeling heightened, ’cause they’re like, I don’t want you to talk to me about it because it’s not gonna happen for me.

[00:40:26] I feel like it just sort of drops some of their guard and armor when I’m like, yeah, let’s just word it off. We’ll just talk about it that way we don’t have to worry about it later. And so, you know, we can go from there and that usually helps people.

[00:40:35] Hilary Erickson | The Pregnancy Nurse®: Yeah, I love that war. It’s like the bad juju.

[00:40:38] Dr Tori O’Daniel MD: Yeah, Yeah, I have, I have a little bit of a black cloud, which is probably why I talk about all these things. ’cause I like to just make sure that people are prepared. and a black cloud is not to freak anybody out, but a black cloud, like meaning, I have all kinds of strange things happen to me. So I have to anticipate them and I want you to know that I know how to handle them and that my team knows how to handle them.

[00:40:56] And I say, if I’m not talking to you. Really quickly in that moment, it’s because I’m trying to make sure I’m taking care of all the steps that need to be taken care of, but I promise you, I’ll talk to you about it as soon as I can, and I just say that to them.

[00:41:08] Hilary Erickson | The Pregnancy Nurse®: I love that. Okay. The other thing I would recommend is learning to take care of your bottom, like

[00:41:12] Dr Tori O’Daniel MD: Hmm.

[00:41:12] Hilary Erickson | The Pregnancy Nurse®: we sort of ignore, like I took a birth class and they were just like sunshine and rainbows. Once that baby’s come out, you won’t have a single problem for the rest of your life because it was so easy to parent this baby, right?

[00:41:21] Dr Tori O’Daniel MD: right?

[00:41:21] Hilary Erickson | The Pregnancy Nurse®: And that was a lie. So I didn’t know how to like take care of my bottom. So I think that’s a really important thing to learn. We’re not gonna go into that a ton in this podcast,

[00:41:29] But understanding that you might tear and your bum might hurt more than you thought it was going to. Because I swear with my fourth degree, my bum hurt.

[00:41:37] My other friend had a C-section like a week later and me getting in and outta the bed and her getting into bed was like, I was like, it’s worse for me.

[00:41:45] Dr Tori O’Daniel MD: Yeah.

[00:41:46] Hilary Erickson | The Pregnancy Nurse®: so that’s always a choice that we’re having to make. You know, he’s fine. So it, and then I ended up having vaginal deliveries with the rest of mine.

[00:41:52] So there were pros and cons, but learning to take care of your bottom, learning that it could be an issue. Learning that it even is gonna happen because a lot of people are really caught off guard by how much their bum hurts after they have a baby.

[00:42:01] Dr Tori O’Daniel MD: Abso, oh my gosh. I feel like this is one of those things we just don’t talk about enough. And Absolutely. Before you leave the hospital, you should ask about, pericare. And we call it pericare. So like your perineum, which is where your labia are, all the way into your rectum. You need to ask, and if you have a third or a fourth degree, you need to be asking, okay, what are my goals?

[00:42:21] How do I manage this? What are the things that I can do to help prevent any other side effects and they should be talking to you about stool softeners. They should be talking to you about these little donuts that you sit on to help provide some comfort. They should be talking about, a spray that helps numb stuff, ice pack, like all of these things.

[00:42:39] Are crucial to help you provide yourself the best environment to heal, but absolutely. And then sometimes you may not even had a third or fourth degree and it still stink and just hurts. Like it hurts. Like your vagina went through a huge transition and you have to talk about that to know what to expect, and then look for signs and symptoms of things that may be outside of what’s normal and know when to call and come in for sure.

[00:43:01] Hilary Erickson | The Pregnancy Nurse®: Yeah. let me just give an amen to a stool softener.

[00:43:04] Let me just give an amen to the, I wish I had a bidet.

[00:43:06] Dr Tori O’Daniel MD: Oh,

[00:43:07] Hilary Erickson | The Pregnancy Nurse®: If anybody’s thinking about getting a bidet, install it before your postpartum,

[00:43:10] Dr Tori O’Daniel MD: I

[00:43:10] Hilary Erickson | The Pregnancy Nurse®: because I would’ve just sat there.

[00:43:12] Dr Tori O’Daniel MD: should get bidets. Everybody.

[00:43:13] Hilary Erickson | The Pregnancy Nurse®: It’s shocking. They’re so cheap at like Home Depot. Like I was like, oh, this is gonna be thousands of dollars to add to my toilet wrong.

[00:43:20] But if I could have just sat there and ran the cold bidet water on my lady bits, that would’ve been, I probably wouldn’t have never left. I probably would’ve just breastfed from the toilet until it overflowed. I don’t know. But I’m just saying bidets are amazing. And also, I kept my tucks in my fridge. I had a sister-in-law who told me that one, and that felt really good.

[00:43:37] I mean, a lot of people make padcicles but sometimes padcicles, like melt. It can be hard, but just keeping my tucks in my fridge was something that I could do, and I wish I had put ice on actually longer once I got home. But I was like, I literally just thought I was weak,

[00:43:50] Dr Tori O’Daniel MD: Right.

[00:43:51] Hilary Erickson | The Pregnancy Nurse®: you know?

[00:43:51] Dr Tori O’Daniel MD: It’s

[00:43:52] Hilary Erickson | The Pregnancy Nurse®: I was like, it’s a third degree, but I can just still muscle through it.

[00:43:54] No, I couldn’t just muscle through it. It was miserable and that’s fine.

[00:43:57] Dr Tori O’Daniel MD: why we do that. I think we do that to ourselves and we do that collectively as a a whole, we just don’t talk about it enough to sort of normalize asking for help, and you shouldn’t have to be painfully recovering in a way that you don’t get things to help you with the pain.

[00:44:13] I don’t know why we do this, but Amen. I, I, unfortunately, or fortunately, however you look at it, had, a c-section, and then a repeat c-section. My first C-section, I had no idea what to expect even though I was an obstetrician at the time. I was a resident and I was still trying to figure it out, and I was just trying to be a hard ass, you know?

[00:44:28] My husband’s like, what are you doing? Why don’t you ask for help? I’m like, I can do this. He’s like, why do you have to do this, like, let me help you. And so I don’t know why we feel like we have to be, she rock going through all of, all of these of recovery and pregnancy and all of the things, but the tucks pad in the fridge, that’s like a golden nugget, guys.

[00:44:44] So if, if you take one thing out of here, that tux pad in the fridge is where it’s at.

[00:44:47] Hilary Erickson | The Pregnancy Nurse®: Yeah, well, especially, I lived in a very tiny apartment, so the fridge, the fridge was just a few walks away. Now I would be like, I’d have to go down the stairs. I would’ve put a fridge in my room. I literally would put a fridge in my room if I had to go back and do it again, and lived in a larger home.

[00:45:00] Just so you guys know.

[00:45:01] Dr Tori O’Daniel MD: we should also put on the the baby registry bidet. I mean, that should be your first number one baby registry bidet. Done?

[00:45:09] Hilary Erickson | The Pregnancy Nurse®: Yeah, It’s so helpful. Laborie, I hope you start building a bidet.

[00:45:13] Dr Tori O’Daniel MD: Yes.

[00:45:13] Hilary Erickson | The Pregnancy Nurse®: our next podcast with them. Alright, so I think, let’s sum it up. I think we’ve learned that these can be super, super helpful and This isn’t something to be afraid of. It’s another tool in our tool belt. Don’t come in afraid of this.

[00:45:24] And that providers are gonna use, which works best for them. And that’s okay. I think I see a lot of people online mad that a provider doesn’t know how to do absolutely everything in the whole wide world. And that’s that’s just not the way it is. Hopefully, you know, maybe you’re in a group where there’s like a lot of different people who are different at good, good at different things, but sometimes you’re also in the middle of nowhere and you’ve got the one provider and you’re gonna wanna cater to what they do best, which is how we do things. Like when my tile guy comes, I want him to do the best tile job he can do in the best way he knows how to do it, not me. Like, why don’t we do the ceiling, you know?

[00:45:59] Dr Tori O’Daniel MD: Absolutely. that’s such a huge thing, is just talk with them. Know what they’re capable of doing, know what, what instruments and devices they’re comfortable using, and then don’t steer from that. Don’t ask them to do something that they’re not proficient in doing. ’cause that’s just risky for you, which I know you don’t want. You want it to be the least risky option for you and your baby.

[00:46:18] So a hundred percent.

[00:46:19] Hilary Erickson | The Pregnancy Nurse®: Yeah. And also the third thing is I’m so glad that we have advances like the Kiwi vac so that we, we are able to do things better than maybe we were doing before or have another option because I’m not saying that the vacuum’s right for everything, and I think you’ve said that too, but this one is better than the one The nurse would like pump up and they’d be like, come on. And we’d be like all stressed out and freaking out at delivery. It’s so much nicer to have something that one person is controlling and then I’m able to do my other things, and

[00:46:44] Dr Tori O’Daniel MD: Yeah.

[00:46:44] Hilary Erickson | The Pregnancy Nurse®: think it’s just. I love that we’re having some advances in care.

[00:46:48] Tori O’Daniel, MD: one other thing that I, remembered about the vacuum when you were talking sort of like you had said previously where you have a squirrel moment and the idea is fleeting is that this vacuum, this particular evolution, this part of this vacuum that is so crucial is the fact that this tubing is flexible. So it makes this ability of the vacuum to be able to get to these really mal positioned babies who are op, that sunny side up baby or a baby that is transverse. And if it’s wonky, the term that we use is asynclitic. So it’s just in the pelvis wrong. And let’s say your physician has tried, your midwife has tried to rotate and it’s just not rotating. The thing about these flexible neck vacuum, so this kiwi vacuum gives me ability to offer candidates a vacuum who are mal presented like that. Previously when you had a vacuum that just had a rigid neck, I could not get a baby that it was OP to get a vacuum on appropriately to get it to flex and rotate. And I did not understand that part when I was trained. And that’s partially because I don’t think that my attendings that were training really understood that, which is why I became really passionate about teaching other physicians how a vacuum works. Like what is the actual process behind how a vacuum works and why a flexible neck gives you more options for candidates.

[00:48:04] So if my patient is op or sunnyside up, I can use a vacuum. I don’t just have to use forceps. And those docs that just use vacuums. They don’t even, they didn’t even think that they could have the option ’cause they weren’t using forceps. And if I can teach you and train you that you can show how this will rotate, then that opens up so many more people, which are usually the people that can’t deliver vaginally because those op babies don’t want to deliver vaginally because they’re de flexing and increasing that diameter.

[00:48:32] So to kind of like encompass this, you are so right. The evolution of the vacuum and how it’s evolved to really provide better care is huge over the last 15, 20 years.

[00:48:42] Hilary Erickson | The Pregnancy Nurse®: Yeah, in case you guys are like, well what did the other one look like? So this one looks like a bagel in case you’re not on the video. And the old one looked like the Liberty Bell. So it was like a cone shape. It didn’t have that big thing that a hang on the church, but it was a cone shape, very rigid.

[00:48:54] And so you couldn’t slide it. You were, and more likely to tear people. I felt like, I felt like we had less tears with the new vacuum than with the other one. ’cause they were like trying to slide it in and I was like, the Liberty Bell, not the Liberty Bell.

[00:49:06] Tori O’Daniel, MD: and they still make that, and it’s now what the evolution of that one is that that material is softer, and people use it and it’s still totally okay and appropriate to use it, but it’s only for those babies who are oA where that posterior fontanel is on the anterior part, like this, this, or this, you can still use them, perfectly safe to use them.

[00:49:25] And now they’re soft so you can squeeze ’em. So you can avoid like what she was describing. You can actually squeeze it to go into the vagina, but it cannot get to these positions. So that OP OT positions where you need to get deeper in the pelvis, you need a flexible neck vacuum, which is what this one is.

[00:49:41] And that’s, that’s such a huge thing to teach people that we say. All the time when we teach, you can open up the opportunity for people who are candidates to do that, and babies who are now op.

[00:49:52] Hilary Erickson | The Pregnancy Nurse®: Yes. And so thank goodness for companies like Laborie. I’ll put the other episode, in the comments or in the show link, whatever we call it. but we had another one about, Overweight moms or people with an apron belly and, and you guys have other things that can make those type of things better too.

[00:50:07] So I’m so grateful that there are companies out there who are looking to make a difference to better OB care because I feel like a lot of people are just like not doing that because they don’t want the, I don’t know, they think Mother Nature’s gonna do her job, but she doesn’t always do her job. So I’m grateful that we have things that can help us.

[00:50:22] Tori O’Daniel, MD: Yeah, absolutely.

[00:50:23] Hilary Erickson | The Pregnancy Nurse®: Yeah, which is why we love this video and this podcast sponsored by Laborie. They make, a lot of things that we can use to help prevent C-sections or make C-sections safer, when, if we have to do them. So big thanks to them for sponsoring this podcast. Big thanks to Tori for coming on. I hope you guys understand them a little bit better.

[00:50:38] That they’re not something to be afraid of. There’s something to learn about and just be prepared if they end up happening to you. And also just be prepared for all the things, including postpartum, because we want you guys to have safe, happy deliveries.

[00:50:49] Tori O’Daniel, MD: Thank you so much Hilary, for letting me come on and talk, about all of this stuff. I think it’s important to make sure that you’re as educated, as you can be when you’re going through this process because it certainly is a lot of unknown and a little bit scary if you don’t

[00:51:01] Hilary Erickson | The Pregnancy Nurse®: Yes. All right. Thanks, Tori.

[00:51:03] Tori O’Daniel, MD: Thank you so much.

[00:51:04] Hilary Erickson | The Pregnancy Nurse®: okay. I hope you guys enjoyed this episode. I think it’s something that’ll, there’s a lot of fearmongering that goes on, and I of course am never here for the fearmongering. I think it’s important to be educated on it, but again, it doesn’t happen that frequently, and hopefully you just have like a regular vaginal delivery.

[00:51:17] But in case this ends up happening to you, at least you’re educated. I hope you guys will join me for more episodes in the future.

[00:51:23] Thanks for joining us on the Pulling Curls podcast today. If you like today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.

[00:51:42]

Keywords:

assisted delivery, vacuum-assisted delivery, forceps delivery, Kiwi Complete Vacuum Delivery System, OB GYN, labor and delivery, childbirth, maternal exhaustion, fetal distress, vacuum system, assisted vaginal delivery, shoulder dystocia, c section, birth canal, perineal care, vaginal lacerations, episiotomy, pelvic floor therapy, chignon, subgaleal hemorrhage, cephalohematoma, labor nurse, midwife, family practice doctor, maternal risks, neonatal risks, delivery complications, birth plan, postpartum recovery, Laborie

The post Vacuums, Forceps and Birth: What Every Parent Should Know About Assisted Deliveries appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Big thanks to our sponsor The Count the Kicks App — It is free and available in 20+ languages. Start using daily at 28 weeks or 26 weeks if high-risk or pregnant with multiples. It makes doing a daily kick count easy. 77% of app users report that using the app helped decrease their anxiety about the well-being of their baby. 84% said it helped to increase their feelings of bonding. The app can be a great way to involve your partner or your baby’s older siblings.

Download the app here: https://countthekicks.org/download-app/

Today’s guest is Kimberly Isburg. She is the Communications Director for Healthy Birth Day, Inc., the nonprofit that created the Count the Kicks stillbirth prevention program. She is a mom of two boys and a firm believer in the power of Count the Kicks. She’s on a mission to make sure all expectant parents know about kick counting in the third trimester of pregnancy.

Links for you:

When to start kick counts: https://www.pullingcurls.com/when-start-kick-counts/

The importance of kick counts: https://www.pullingcurls.com/podcast-bonus-kick-counts/

Timestamps:

00:00 “Pregnancy & Parenting Insights Podcast”

05:38 Pregnancy App Tracks Baby Movement

09:24 Mindful Baby Movement Tracking

10:14 Importance of Monitoring Fetal Movement

14:01 Pregnancy Health Concerns

18:50 Assessing Fetal Movement with Anterior Placenta

20:30 Baby Movement Tracking Eases Anxiety

23:16 Monitor Fetal Movement with Anterior Placenta

25:59 Kick Counts Start at 27 Weeks

31:01 Labor Nurses’ Challenges and Solutions

33:03 Third Trimester: Key Time for Testing

35:48 “Daily Kit Counts Benefit Health”

Keypoints:

• The episode features Hilary Erickson, RN, and guest Kimberly from Count the Kicks, diving into frequently asked questions about fetal kick counts during pregnancy.
• The Count the Kicks app is highlighted as a free, easy-to-use tool available in over 20 languages, designed to help expectant moms track their baby’s movement and identify normal patterns.
• Kick counting involves tracking any fetal movement (kicks, rolls, pokes, jabs, swishes) except hiccups, focusing on pattern consistency over time rather than comparing to a fixed standard like “10 kicks in 2 hours.”
• It’s recommended to begin daily kick counts at the start of the third trimester (around 26–28 weeks), which is when babies typically establish a recognizable movement pattern.
• Every baby—and pregnancy—is different; the key is to learn what’s normal for your individual baby instead of comparing to others or strict timeframes.
• Count the Kicks app allows for note-taking, monitoring movement strength, and creating a graph for clear visualization of your baby’s movement history—helpful for discussing with healthcare providers.
• Changes in a baby’s movement pattern (either slower or faster) should always be reported to a healthcare provider, as they can indicate potential problems with either baby or mom’s health.
• Kick counts are proven to help reduce stillbirth rates, with research cited showing a 32% drop in Iowa after the practice was widely encouraged with Count the Kicks.
• Hilary and Kimberly address common concerns such as anxiety related to kick counts, babies described as “lazy,” and complications like an anterior placenta, encouraging open communication with providers.
• Both emphasize kick counting as an empowering, bonding daily ritual—useful not only for peace of mind but as a practical safeguard for mom and baby, and encourage listeners to download the app and make daily tracking part of their routine.

Producer: Drew Erickson

Transcript:

[00:00:00] Hilary Erickson | The Pregnancy Nurse®: Hey guys. Welcome back to the Pulling Curls Podcast. Today on episode 259, we are talking about frequently asked questions about counting your baby’s kicks, so let’s untangle it.

[00:00:09] Hi, I’m Hilary, a Serial over Complicator. I’m also a nurse mom to three and the curly head behind pulling curls and the pregnancy nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with pregnancy and parenting untangled, the Pulling Curls podcast.

[00:00:39] This episode of the Pulling Curls podcast is sponsored by the Count the Kicks app. Guys, I’m a firm believer in this and fan girling over the fact that they wanted to sponsor my podcast because it is the app that is going to make kick counts easier and more attainable for you to do at home. I know a lot of you have excuses as to why you don’t do kick counts, and I really think that this app can make a big difference for you.

[00:01:00] So download it in your app store right now.

[00:01:03] Today’s guest is the Communications Director for Healthy Birth Day, which is the nonprofit that created the Count the Kicks app. She is a mom to four and a firm believer in the importance of kick counts. I wanna introduce today’s guest, Kimberly Isburg.

[00:01:15] Hey Kimberly. Welcome to the Pulling Curls podcast.

[00:01:18] Kimberly Isburg: Hi Hilary. Thanks so much for having me here.

[00:01:20] Hilary Erickson | The Pregnancy Nurse®: Yes, this is a very requested episode. People are always interested in how kick counts and it’s huge soapbox for me, so I’m so excited that you guys are here. First off, let’s talk a little bit about the Count the Kicks app.

[00:01:34] Kimberly Isburg: So we have a free pregnancy app. It’s available in the iOS or Android stores. it is available in more than 20 languages, so, hopefully anyone can count kicks, regardless of what language you speak. And it looks a little bit like this. Bright, yellow and red. We do have a dark mode in the app, but really, starting at the beginning of the third trimester, you can use this app every day, to get familiar with your baby’s normal movement pattern.

[00:02:00] So, it’s really easy. You just click the start counting button and then you tap. The little foot put on the screen every time you feel your baby move. so you’re not only looking for kicks, you’re looking for things like pokes, jabs, rolls, wishes, pushes, any type of movement counts as a movement except for hiccups.

[00:02:19] Those are involuntary or babies aren’t choosing to hiccups. So those don’t count. But any other types of movement count. It’s gonna run a timer on the screen Until you reach 10 movements, and then it’s gonna ask you to rate the strength of your baby’s movements, because research shows that the strength of movements is also an important sign of your baby’s wellbeing.

[00:02:38] So rate those on a scale of one to five, and then you can finish up by taking any notes that you want. So maybe it’s a question you wanna ask your doctor. Maybe it’s, something you ate that day and it really made your baby move and groove, during your kick counting session. so you can take notes and then finish your session.

[00:02:53] And if you do this every day around the same time. You are gonna begin to see a pattern. It’s gonna create, a really cool graph that’s gonna show you kind of what’s normal for your baby. again, that average amount of time that you’re taking, for your baby to reach 10 movement. So this is just a test one that I’ve done, but what you’re.

[00:03:10] Looking for the screen is not working very well. but anyway, you’re kind of looking for a, a pretty level, line across time. If you see that that line starts to go up or significantly down, that’s a change in your baby’s normal movement, and that’s a sign that you wanna call your provider and go in and get checked.

[00:03:27] Hilary Erickson | The Pregnancy Nurse®: Okay. Do you guys alert them in the app? Like is there an alert where it’s like, this is taking a lot longer, or anything like that, or it’s kind of up to

[00:03:34] Kimberly Isburg: No, it’s kind of up to each person. and really that’s why it’s important for you to do it every day around the same time, really get to know what’s normal for your baby. because every baby and every pregnancy are different. And so a change for you might be different than a change for somebody else.

[00:03:48] Hilary Erickson | The Pregnancy Nurse®: Yeah, and I always recommend that first week is a lot of just learning your pattern.

[00:03:52] Kimberly Isburg: Yeah.

[00:03:52] Hilary Erickson | The Pregnancy Nurse®: will be like, oh, it was 10 minutes yesterday and it was 20 minutes today. I am like, right. So your average is probably around 15. So yeah, learning the pattern is so important. And comparing just your baby to your baby not anyone else.

[00:04:05] Kimberly Isburg: absolutely, absolutely. It’s, yeah, my baby might move, you know, within five minutes and it may take your baby 15 or 20 or 30. So, again, every baby and every pregnancy are different. And the other thing that’s great about the app and that I wanna mention is that, if you create an account.

[00:04:21] Pregnancy profile is what we call it. You’re gonna be able to see that history over a long period of time. So if you start counting at the beginning of the third trimester, 26 to 28 weeks, you’re gonna be able to see 12 weeks of kick counting history, you know, if you go all the way to your due date. So by creating that account, you’re really getting that long term data.

[00:04:40] Otherwise you’ll still be able to see like the last five sessions in the app. but really the key is being able to see that history over time.

[00:04:47] Hilary Erickson | The Pregnancy Nurse®: Yes. Okay, so let’s talk about, I get so many questions. I just had a recently a viral video on kick counts, and so I wanted to go through the questions that I saw most frequently on there, and we can just discuss ’em so that people can really understand how to integrate kick counts in your own life.

[00:05:03] Because I gotta tell you, there were nights I skipped, things I forgot. I was a working mom, and so sometimes it just didn’t happen. Is that the best? Absolutely not. But you would just pick up the next day, or you pick up when you remember, and you try and do your kick count then,

[00:05:16] Kimberly Isburg: Yes, absolutely. It’s again, just being consistent over time and getting to know. The more often you do it, the more consistently you do it, the more you’re gonna know what’s normal for your baby. Like if it is that 15 minute average and one day it’s taking way longer than that, you’re like, okay, this is, this is not normal and I need to call my doctor.

[00:05:36] Hilary Erickson | The Pregnancy Nurse®: Yes. Okay. The first one that everybody says is, my doctor says 10 movements in two hours. I think when I started, so I started in labor and delivery in 2001. I think that’s what we said for

[00:05:46] Kimberly Isburg: Mm-hmm.

[00:05:46] Hilary Erickson | The Pregnancy Nurse®: kick counts. but as that is comparing your baby to everyone else’s baby, which you don’t wanna do when they’re in elementary school either.

[00:05:53] Kimberly Isburg: Yes, yes. Every baby is unique. Just like every person is unique, they’re gonna have their own, unique movement patterns, and so the research has really moved away from the idea that you should expect to get a certain amount of movements in a specific amount of time. So the 10 movements in two hours is not really best practice anymore.

[00:06:11] Again, it’s just doing that daily kick count and learning what’s normal for your baby timing, how long it takes to reach 10 movements. And then paying attention to the strength of those movements as well.

[00:06:21] Hilary Erickson | The Pregnancy Nurse®: And because I had crazy babies, if I had waited two hours to get 10 movements, something would, would, would’ve been seriously

[00:06:27] Kimberly Isburg: Right.

[00:06:27] Hilary Erickson | The Pregnancy Nurse®: wrong. Whereas some people with an anterior placenta, they may just feel 10 movements like all day. And if that’s you talk with your provider, there are specific people that this is really difficult for.

[00:06:37] So that’s when you’re talking with your provider and maybe getting further testing during your pregnancy. But you gotta compare your baby to run your own baby’s race.

[00:06:45] Kimberly Isburg: Yes, absolutely. And even every pregnancy, you know, my first son moved way differently than my second son. And, if I had been comparing them, I would’ve felt like something was wrong with my second baby. But that was just what was normal for him.

[00:06:59] Hilary Erickson | The Pregnancy Nurse®: Yeah, ’cause I just wanna remind you guys, it really depends where in your uterus your, placenta is. And so if your uterus, if your placenta is right here where your baby is kicking, then that is gonna be different than if your placenta is like in the back.

[00:07:11] And so you feel everything on the front. So sometimes that visual helps. People understand how different placenta can change how you feel your baby’s movements,

[00:07:19] Kimberly Isburg: Yeah, and that’s an important thing, you know, to ask your doctor too. If you don’t know where your placenta is located and you’re getting ready to start kick counts, that can be a really helpful piece of information.

[00:07:29] Hilary Erickson | The Pregnancy Nurse®: and it is on every ultrasound. If you guys are like, well, what if my doctor doesn’t know? It’s just part of every single ultrasound that we get, they share where the placenta is on the uterine wall.

[00:07:38] Kimberly Isburg: Awesome.

[00:07:38] Hilary Erickson | The Pregnancy Nurse®: Okay. The next thing is when people say, my doctor said not to worry about kick counts. So just make sure that the baby’s moving during the day. What are your thoughts on that? And then I’ll share mine. ’cause I’m, I’m the cynic in this room.

[00:07:51] Kimberly Isburg: So, I mean, I think. That’s kind of practicing mindfulness, just being aware of movements, and I think that’s really important too. Your baby, the beginning of the third trimester is going to get into kind of a recognizable pattern, times of day where they’re more active, times of day where they’re resting.

[00:08:06] but again, the key is. Picking a time of day when you know that they’re active and counting during that time. we are busy during pregnancy. We have a lot going on. You may have other kids. It is easy to get just wrapped up in your day and kind of forget about when was the last time I felt my baby move.

[00:08:24] And so having this daily practice where you take time to sit down, lay down. Really focus on your baby’s movement. It really gives you that peace of mind to know like, okay, today my baby is moving at the time they normally do in the way they normally do, and I can go back to making dinner or playing with my kids.

[00:08:41] Hilary Erickson | The Pregnancy Nurse®: Yeah, so first off, I think it’s really important to not turn off your brain like when you’re doing kick counts, you’re still monitoring for fetal movement all during the day. Some people are like, well, if you only, monitor it after dinner, that’s not good either, which I agree should always be making, you know, that should always be reassuring when you’re feeling baby move. Second of all. Some of these doctors, I feel like do not wanna be notified when your baby is moving less because they wanna sleep. and that’s the cynic in me coming out. But I just wanted you guys to understand that that could be a red flag if your provider’s like, oh, fetal movement doesn’t really matter. Might wanna look for a different ob. That’s just me. That’s just Hilary. because I think some of them like to ignore it because they don’t wanna see you or take those phone calls.

[00:09:22] Kimberly Isburg: Yeah, and I agree like just because your doctor isn’t talking to you about it or isn’t recommending it, doesn’t mean it isn’t important. Like this kick counting is for every mom in every pregnancy. It’s important practice, even if it isn’t something that your doctor is specifically asking you to do.

[00:09:39] Hilary Erickson | The Pregnancy Nurse®: Yeah, and I would bring it up at appointments. If they haven’t brought it up,

[00:09:42] Kimberly Isburg: Yeah.

[00:09:42] Hilary Erickson | The Pregnancy Nurse®: and you’re close to your third trimester, they’re not gonna bring it up when you’re 12 weeks. But if you’re getting 25, 26, 27 weeks and they’re still not bringing it up, bring it up in the office and just see what they say. It’s always a good, communication thing to be kind of like, you know, do they care?

[00:09:54] Kimberly Isburg: Yeah, and I think that’s where the Count the Kicks app is a great, it’s a great tool. It’s a great conversation piece, and you can bring it with you to appointments and you can. show, you know, your chart on the app, or you can even text or email your data from your kick sessions directly to your provider.

[00:10:09] And so it can kind of help you have that conversation about your baby’s movement patterns during your appointments.

[00:10:15] Hilary Erickson | The Pregnancy Nurse®: Yes. Then I hear a lot. “I should just figure out their schedule. My doctor told me to just figure out my baby’s schedule and make sure that they stay on it.” And again, you wanna be monitoring baby’s movements, but I, that is tricky. A lot of these are so vague that me as a person who really likes boundaries And spreadsheets and stuff. I really like the kick counts because it gives me more of a concrete thing to aim for rather than, “well, is your baby on their schedule?” Whereas if I’m not on my schedule, I decide to go to the mall instead of like work at home that day, then I have no idea what’s going on.

[00:10:48] Kimberly Isburg: Yeah, absolutely. Yeah. Your schedule changes every day, so that can impact your baby schedule as well. we like to say that this app, kick counting is like having a data download for your intuition. You’re still aware of the baby’s schedule, but you’ve got data there to show you like, yep. Today it took 20 minutes just like it did all week.

[00:11:07] and so again, yeah, be aware of your baby schedule if you know that they’re always moving and grooving when you lay down to go to bed at night and there’s a night where they’re not doing that, that’s, you know, a red flag. That’s something that you might want to call your doctor about or go in and get checked.

[00:11:22] But, still important to do that daily practice of kick counts.

[00:11:25] Hilary Erickson | The Pregnancy Nurse®: Yeah. Okay. And the final one I hear a lot from providers is that later on in pregnancy, baby will just move less. And I can see where these people are coming from because the characteristic of the movement does change. It’s no longer karate and cheerleader kicks because your baby just doesn’t have the room to pull back and really sock you.

[00:11:46] Kimberly Isburg: right.

[00:11:47] Hilary Erickson | The Pregnancy Nurse®: They’re shifting a lot. They’re just, I always was like, my baby is gonna come out and be a full on cheerleader, right? There’s, they’re gonna be like doing the spread eagle, whereas, and then you see ’em and they’re just like this and you’re like, is that all you were doing in there? I thought you were really going at it.

[00:12:00] Kimberly Isburg: Yeah. Yeah, absolutely. The types of movements that you’re gonna feel towards the end are, are different and more nudges, fewer big roll and kicks more, you know, kind of elbows, jabs. But they should still continue to follow that same pattern, have the same times of day when they’re active, and take about the same amount of time to reach 10 movements.

[00:12:19] They do not slow down. They do not run out of room. They do not kick less at the end of pregnancy. They should still be moving up to and during labor.

[00:12:28] Hilary Erickson | The Pregnancy Nurse®: And if they are running out of room, which could mean that you have less fluid or baby is extra large, you know, this is more than just learning like that something’s really wrong with baby. Some of it is you just aren’t producing enough fluid. I. Right, and you need further testing ’cause that can be detrimental to baby or you have preeclampsia.

[00:12:47] I can’t tell me how many people in the comments were like, I actually went in and found out my blood pressure was high, which could make your fluid lower or things like that. you’re learning about your pregnancy health along with these kick counts. Not always just baby’s health.

[00:13:00] Kimberly Isburg: Correct. Like your baby’s movements are not only a sign of their wellbeing, but a sign of the health of the pregnancy. And we do see a connection between, a change in movements and some pregnancy complication that’s going on with mom. Things like preeclampsia, things like placental issues. it can be an indication, not just that something is happening with your baby, but that there’s something going on in the pregnancy.

[00:13:22] And so that’s why it’s so important to pay attention to those movements and to speak up every time that you have a concern, you know that your baby’s not moving like normal. Something feels off.

[00:13:32] Hilary Erickson | The Pregnancy Nurse®: Yeah. Now we’re shifting to a segment that I called, I’m doing this instead because everyone was like, “I don’t think kick counts really work. I, I’m doing this instead.” So the one I hear a lot is “I’m just mindful of baby’s movements, and that’s the same.”

[00:13:47] Kimberly Isburg: again, it’s great. Being mindful of movements is awesome. again, you don’t have that like data knowing, okay, I, my baby was moving, but like, how much did they move? how long did it take them to reach 10 movements? That’s what Count The Kicks is really helping you get, it’s a kind of. taking that mindfulness of movements and quantifying it and saying, okay, my baby moved 10 times in 15 minutes today, and the strength was a three, pretty average.

[00:14:14] so I think mindfulness is great, but kick counting, doing the practice of the app is like, again, that data download for your intuition and what you’re feeling.

[00:14:23] Hilary Erickson | The Pregnancy Nurse®: Yeah. And beyond that, you guys have a study, so, we’ve always said be mindful of baby’s movements, but you guys have a study that you linked to on your site when they integrated kick counts into prenatal care, really pushed it in the state of Ohio,

[00:14:37] Kimberly Isburg: Iowa. Yeah,

[00:14:39] Hilary Erickson | The Pregnancy Nurse®: Yeah.

[00:14:39] Kimberly Isburg: that’s okay.

[00:14:40] Hilary Erickson | The Pregnancy Nurse®: that when they started talking about doing the count, still dropped by 33%.

[00:14:47] Kimberly Isburg: in the first 10 years of Count the Kicks in the state of Iowa, which is where our organization was founded.

[00:14:54] Hilary Erickson | The Pregnancy Nurse®: So, you know, we’ve always talked about mindfulness. Of course. That’s like one of the first questions I get when I, when you come into labor and delivery, how are you feeling, baby move because it’s really important. Your OB probably goes over it at your prenatal appointments. We’ve always said that, right?

[00:15:08] But when they integrated these, the data of count the kicks, which is actually what, Got me going like in the first place. My manager went to a conference, saw you guys and brought the information back to me. And then I was like, oh my gosh, I totally need to write an article on this because this is crazy good data.

[00:15:24] And this was probably like 10 years ago, maybe more than that. it really saves stillborn babies. So if you’re telling yourself that, you’re just gonna be mindful. The data shows that. You know, one in three still births can be saved by doing kick counts. That doesn’t mean one in three pregnancies.

[00:15:39] Kimberly Isburg: right.

[00:15:40] Hilary Erickson | The Pregnancy Nurse®: That means one in three still births.

[00:15:42] Kimberly Isburg: Yeah. And stillbirths, there’s about 21,000 in the US every year, and that’s roughly one in every 177 pregnancies nationwide. So it’s not uncommon, but it’s not super common either. But again, the risk is higher than I think most of us realize, and that’s why we’re trying to talk about it and raise awareness that it is an outcome that can be prevented.

[00:16:02] Hilary Erickson | The Pregnancy Nurse®: When you guys say the one in 177, does that mean after a certain number of weeks? ’cause that doesn’t include miscarriages,

[00:16:08] Kimberly Isburg: One in 1 77 means it’s 20 weeks and none is what’s classified as the silver. So that includes, babies that are lost in that late second trimester as well.

[00:16:19] Hilary Erickson | The Pregnancy Nurse®: Yes. The other thing I hear a lot is “my baby is lazy.” by the way, my teenager is lazy, so I understand that. but my, she’s not, she does the transcriptions, but sometimes she is, we’re all lazy sometimes,

[00:16:31] Kimberly Isburg: Yeah.

[00:16:31] Hilary Erickson | The Pregnancy Nurse®: my baby is lazy. I can’t do these. what are your thoughts on that?

[00:16:34] Kimberly Isburg: I, again, every baby is different. I had one baby that just kicked me like crazy and my other baby was much more chill. your baby may be kind of chill. They may be lazy, I guess as you described them. Still important to do it. It’s still important to know that your baby, Is, is taking 30 minutes a day to get their kick counts or whatever it is that’s normal for your baby.

[00:16:59] Again, don’t compare it to your friend’s baby. Don’t compare it to your last pregnancy. Know what’s normal for your baby. And if they are just not quite as much of an active kicker, that’s okay. But again, by doing that daily kick count, picking the time that your baby is normally moving around, you are gonna be able to quantify what their movement pattern is.

[00:17:17] Hilary Erickson | The Pregnancy Nurse®: Yes. And I think some of those people are thinking the 10 in two hours, they’re like, my baby’s not gonna hit that. Maybe they have an anterior placenta or whatever. If you literally, I know Dr. Fran has done some, some things on her page where she has anterior placenta on every baby, and she really only felt a few kicks every hour.

[00:17:35] Or every day. And so if that is you, that’s definitely something you wanna bring to your provider. I would say that if that’s the case, you probably are looking for maybe NSTs during the week or they should be upgrading you to a, a higher risk care plan if that’s really all the baby movement that you’re feeling.

[00:17:50] So I would talk with your provider if you’re feeling like kick counts are taking more than two hours every day, just to kind of get an idea because we obviously can’t stop our lives and

[00:17:59] Kimberly Isburg: Okay.

[00:17:59] Hilary Erickson | The Pregnancy Nurse®: just wait for baby to move. For hours and hours and hours. Yeah.

[00:18:03] Kimberly Isburg: Yes.

[00:18:03] Hilary Erickson | The Pregnancy Nurse®: And, but I, when I did them at work, because I tried to do them after dinner, I would try and sit down and, and just use my fingers.

[00:18:10] ’cause we didn’t have apps back in the day. Um, fine too, you don’t have to use the app or if you get, you’re like, you’re at a concert and you’re like, I don’t wanna open the app. Just use your fingers and, you know, just feel for baby to move, while you’re there.

[00:18:22] Kimberly Isburg: Yeah, absolutely.

[00:18:23] And we do have other resources available for kick counting. So we’ve got, wristbands that have like a slider that moves from one to 10. so we’ve got some of those available on our website in certain states. And then we’ve also got paper charts that you can print out, and those are available in a lot of different languages on our website, and anybody can download and print those out.

[00:18:42] So if an app is not your thing, there’s still other ways to count. You can just set a timer on your phone or set a, an old school timer as well.

[00:18:49] Hilary Erickson | The Pregnancy Nurse®: Yes. okay. The other one I get is “Kick Counts will make, they’ll make me so anxious and crazy. I am not able to do it.” So how do you guys respond to that?

[00:18:57] Kimberly Isburg: We hear that a lot and what our app users tell us is more than 77% of them say that it actually helps reduce their anxiety about the wellbeing of their baby. So again. Knowledge is power. And by doing this every day, you’re quantifying that movement. You’re getting familiar with your baby’s patterns, and that’s gonna give you a lot of peace of mind so that once you do it, you know, okay, today my baby is moving just like they always do.

[00:19:22] I can go on and finish my work or, make dinner, whatever you need to do next. And by the same token, if you have a day where your baby, you’re just feeling off, something’s not right, you do your kick count, it’s taking longer than normal. Again, you’ve got that data to back up how you’re feeling and you know, okay, this is a concern.

[00:19:41] I need to call my provider and get checked.

[00:19:43] Hilary Erickson | The Pregnancy Nurse®: Yes. I will say that also, if you’re just sitting there living in your anxiety, that’s probably not helpful. So I always encourage people, that’s your time to get to know your baby, to dream about this baby, how perfect they’re gonna be. How they’re never gonna have a problem, that you will never have to put ’em in timeout or whatever.

[00:20:01] Like they’re just gonna be. The perfect baby. I dream about like all the good things you have going, like the first time they open a Christmas gift and like they get what’s going on. The first time you put ’em in a Halloween costume when they’re two. It’s like there are so many good moments for you guys coming if you dream about those rather than like. It’s been oh, oh, oh. Like if you spend the whole time just freaking out, then yes, that’s gonna cause you anxiety. But if you take the time to like work on some meditation, just dream about the excitement, then it hopefully will decrease your anxiety. And if you think you’re one of those people who think anxiety’s gonna be like a real problem, just start. Do it for a week. See where you’re at after a week.

[00:20:38] Kimberly Isburg: Yeah. And

[00:20:39] that’s great advice. And yeah, just try it and see how it goes. You’re gonna learn something in the process and that’s also, thank you so much for, for bringing that up. It is a fantastic time to bond with your baby to get to know their personality. It is an opportunity to involve your spouse or your partner or your baby’s older siblings.

[00:20:59] Like anybody can help you do this kick count and spend time bonding with your baby before they arrive. So There are many benefits to it, in addition to just checking on your baby’s wellbeing.

[00:21:09] Hilary Erickson | The Pregnancy Nurse®: Oh, I love the idea of a sibling or a partner helping you out with it. That’s a good one. Yeah. Okay. Now we’re gonna talk about some complications. We’ve already talked about this a little bit. So the first one is an anterior placenta, which means your placenta is on the front of your uterus. If it’s behind, then that is a posterior placenta. And early on in pregnancy, if you found that you had an anterior placenta, it actually can move to a posterior placenta as your uterus grows. Just so everybody knows. So your most recent ultrasound, usually if you get your 20 week, it’ll tell you which side your placenta is on. but if people with an anterior placenta can’t get 10 movements in two hours, what is your guys’ recommendation?

[00:21:43] Kimberly Isburg: I mean, like you said, definitely talking to your provider and getting advice from them about how you can monitor movement with your anterior placenta. but really, and same like. It may be that you need to be a little bit more mindful of kick counting. You need to sit down, you need to lie down on your side.

[00:22:01] Really take that time to be a hundred percent focused on that so you can kind of, fine tune and like zero in on those movements in a way that you might not have to if you didn’t have an anterior placenta. But really the research does show that fetal movement counting times are similar to other placental locations from 24 weeks and on.

[00:22:21] So it may delay kind of feeling those early movements. But what the research shows is that it’s still possible to kick count and that you should see similar movements from 24 weeks and on.

[00:22:32] Hilary Erickson | The Pregnancy Nurse®: Okay. That’s super interesting because sometimes I’ll have people in the comments who are like, I have a anterior placenta and I, you know, my kick counts 20 minutes. And so I agree that sometimes you have to sit down and actually feel for baby to move, which is a bummer because we’re busy. Right. But personally, I did it after dinner, so my husband would have to clean up dinner.

[00:22:51] I was like, oh no. I need to sit down and do my kick count, honey. there were so many benefits to a kick count at my house.

[00:22:58] Okay. The next complication, well just question is why do we not start until 27 weeks? Because then I get people who are like, well, I’m 12 weeks and I’ve already felt my baby move, and it seems like it’s less today.

[00:23:08] And I’m like, that’s so complicated. But what do you guys say to that?

[00:23:12] Kimberly Isburg: Yeah, so the reason that doctors recommend, the beginning of the third trimester, which is around the 28 week mark, or 26 weeks if you’re high risk or expecting multiples. But the reason for that is because the beginning of the third trimester is when babies start to get into a recognizable pattern of movement.

[00:23:29] So it’ll be a little, you’ll still feel movements before that, of course. But they aren’t gonna be as, patterned. And so again, at that 28 week, 26 weeks, you’re gonna begin to see like those active times of day, the things that you do that are, sparking your baby to move. And it just makes it easier to kind of monitor that pattern and those normal movements.

[00:23:51] Hilary Erickson | The Pregnancy Nurse®: Yes. just a reminder that your placenta is so much bigger than your baby early on. And so it can really blunt a lot of those movements and depending on where baby is in the womb against the placenta or where they’re kicking. ’cause if they’re kicking the front, you know, you have muscles and stuff that are feeling that, but it whereas if they’re kicking to the side, you know, it might just be buggin’ your liver, I don’t know. And so you just might not feel it as much because baby’s so small compared to the rest of your body until you reach that third trimester. So I think that’s important to think about. And also as a healthcare provider, there really isn’t all that much we could do prior to 27 weeks, if you came in and said baby’s moving less. That’s something to think about. That’s part of why we do it. We don’t want you to be stressing out at something that movements change and patterns change because we aren’t looking to increase your stress, even though people seem to think that we are online with kick counts. That’s why we don’t start ’em until 27 weeks.

[00:24:42] If you think you’re high risk, though, definitely talk with your provider. A lot of moms are saying they start at 25 weeks and again, those first week or two where you’re mostly just learning the pattern, of what your baby’s gonna do.

[00:24:51] Kimberly Isburg: Yeah, that’s great advice.

[00:24:52] Hilary Erickson | The Pregnancy Nurse®: Okay. Now our kick counts are slower or way faster.

[00:24:56] A lot of people, are like, it’s any change in fetal movement. So if baby’s kicking a whole lot more, you wanna go in. Or if baby’s kicking a whole lot less, you wanna go in. True?

[00:25:06] Kimberly Isburg: True, true. Any change in, in what’s normal for your baby is a reason to go in and get checked.

[00:25:12] Hilary Erickson | The Pregnancy Nurse®: Yeah, out of their normal pattern,

[00:25:13] Kimberly Isburg: Right.

[00:25:14] Hilary Erickson | The Pregnancy Nurse®: right? So just because it only took eight minutes where it usually takes 10, that’s not a change in your pattern.

[00:25:19] Right?

[00:25:20] so you go into the hospital and the thing I hear all the time is my baby kicked the monitor as soon as we got in.

[00:25:26] Kimberly Isburg: Yeah. And I say, great, like you went in, you listened to your instincts, you listened to what your baby was telling you, you got in there and everything is fine. that’s best case scenario. And you know. Doctors and nurses are there to help you and to support you and to check, um, to make sure that you and your baby are doing okay.

[00:25:44] And so they really would rather do that than find that you, you delayed and didn’t come in until um, something really was wrong. So.

[00:25:53] Hilary Erickson | The Pregnancy Nurse®: Yeah, and with kick counts, I wanna encourage you guys that it’s not an absence of fetal movement. I mean, I, as a nurse, I’ve had so many patients come in and say, oh, I haven’t felt my baby all day. Total fear and dread into every labor nurse’s heart. We want that monitor on immediately so that we can reassure both you and ourselves at that point in time. But decreased kick counts mean baby is still moving. You’re still feeling baby move, which means they could kick the monitor. ’cause babies love to kick our monitors. We love it. But why is it decreased? Again, that could show, an issue with the health of your pregnancy, an issue with the amniotic fluid, things like that where baby’s movements are decreased, but you’re still gonna feel the baby kick the monitor or things like that.

[00:26:34] Kimberly Isburg: Yeah, I mean, research shows that a change in movement is really one of the earliest signs that there may be an issue with the pregnancy. So it’s one of those early warning signs. and also, you know, babies are like us. Their movement is a sign of their wellbeing. So think about what happens if you have the flu or if you have a cold, you don’t have as much energy.

[00:26:53] You don’t wanna be running around your house doing chores. You want to lay down in your bed or lay down on the couch. Your movement changes. And so your baby is much the same if they’re not. Getting what they need. If they’re experiencing something that’s causing them to not feel like themselves, their movement is gonna change.

[00:27:10] And so that’s a really important sign that you wanna pay attention to and go in as soon as you can. Call your provider as soon as you can so that they can check and make sure that you know there isn’t something wrong.

[00:27:22] Hilary Erickson | The Pregnancy Nurse®: Yes. Um, I just don’t want people, everyone, you know, when you take your kid into the pediatrician, this is a hundred percent gonna happen.

[00:27:28] They’re like miserable at home, not like getting off the couch, dying tears coming outta their eyes. You take ’em to the pediatrician, suddenly they see the fish tank and they’re like a hundred percent better. So. That’s gonna happen for the rest of your life. But don’t think that just because you went in and the baby kicked a little, doesn’t mean that we shouldn’t still be monitoring you and baby.

[00:27:48] Kimberly Isburg: Yeah. Yeah. And if, again, if you go in one day and everything is fine and two days later you’re feeling things are feeling off again, your baby’s not moving like normal again. Go in and get checked. Call your provider every time that you feel like something is different than usual. It’s important to go in and get checked.

[00:28:06] Hilary Erickson | The Pregnancy Nurse®: Okay. The last thing is “I went into my provider, they listened on the Doppler, baby’s heart rate was fine, and they wanna send me home, like if they go into just their doctor’s office. What do you guys recommend? If that’s the case,

[00:28:20] Kimberly Isburg: I mean, trust your instincts. really if you really feel like you don’t feel reassured, you don’t feel like your baby is moving like normal, trust your instincts and continue to ask.

[00:28:32] Ask for additional testing. Ask to be monitored longer. Ask for a non-stressed or test or a biophysical profile. Ask to check your fluid levels. The other thing is you can show your data from Count the Kicks, that’s the other thing. Pull up your app, show them the chart and say like, look, it normally takes 15 minutes for my baby to move 10 times, and today it’s been an hour.

[00:28:56] And I didn’t get there yet. Like show them the data, so that you can help advocate for yourself and for your baby. You can ask to see a different nurse, the head nurse, you can ask to talk to the doctor. There are lots of things you can do, to help advocate. And again, just the key is trust your instincts.

[00:29:12] Hilary Erickson | The Pregnancy Nurse®: Two thoughts on that. The first one is we frequently get people who come into labor and delivery and who are like, I haven’t felt my baby move all day. And I’m like, okay, let’s get the baby on the monitor. That’s obviously our first thing. And then we start going through like, when did you last eat? And they’re like, oh, like six o’clock last night.

[00:29:27] And it’s like 1:00 PM And I’m like, why did you not eat this morning? And so that kind of thing is a little bit frustrating for us because you know that you should be eating and those kind of things or you know, Just as a, as a labor nurse, it’s kind of hard to know exactly what they mean when they’re like, baby’s moving less today.

[00:29:43] Or you know, have you been busy? is it Christmas? Like a lot of times at Christmas people will come in and they’re just like, well, I’m just not feeling baby move, but they’re doing like all these family things and stuff like that. And so it’s kind of hard as a labor nurse to know exactly what they mean.

[00:29:55] But if somebody comes in saying, my kick count usually takes 10 minutes, and now I’m to 40 minutes,, and I still haven’t gotten to 10 kicks. I know that A, you’re monitoring it and B, we have data behind it that we really need to upgrade this, care to something a little bit more. As a labor nurse, that’s just what you’re thinking.

[00:30:11] We’ve got data, right? So that’s why I love you guys’ app to help people out. And then the second thing is a lot of people don’t know. ‘Cause you go into your doctor’s office, they just doppler, right? But in the hospital, we’re required to do an NST on every single patient that comes in that’s past their third trimester, which is when you would start doing kick counts.

[00:30:28] And Even if the NST is okay, there are more things you can order, like you talked about. We can do A BPP, which is an ultrasound that measures how baby’s moving in the womb, how they’re, they breathe amniotic fluid when they’re in the womb, like how, like tight their muscles are and all these different things.

[00:30:41] It’s just like a, a mini test to see how baby’s doing. And so we can order that further testing. It’s not just either just a Doppler in the doctor’s office or just an NST. We can upgrade it. but sometimes I think you do have to ask. It just depends. ’cause sometimes the unit is so busy, we’re just like, yeah, baby’s fine.

[00:30:56] You’re good to go. Whereas if you said, I’m really concerned, then I think we’re gonna really take that seriously.

[00:31:02] Kimberly Isburg: Yeah, absolutely. And I would say, if you’re looking for advice for, you know, feeling empowered or, wanting to make sure that you are able to speak up if you need to, read the baby save stories on our website.

[00:31:15] Like almost every single mom in every single story says something about trusting your instincts, advocating for yourself and for your baby, the importance of continuing to speak up until you feel like your concerns have been addressed and heard.

[00:31:30] Hilary Erickson | The Pregnancy Nurse®: Yeah. I would totally agree. And as a labor nurse, I want to know that if your concerns aren’t addressed and you still feel anxious about it, I want to know and then we’ll go from there.

[00:31:40] Right. It might be further testing, it might be talking a little bit more. Again, I see a lot of people who are like, well, I went in at, you know, 23 weeks with decreased fetal movement. They pretty much are just gonna doppler you maybe an NST if they can get the baby on the monitor. But that’s really all we can do.

[00:31:55] Which is why you know, it’s so important to start this in your third trimester. ‘Cause there really is more testing we can do and more we can do. It might just be like serial blood pressures. Let’s check this mom blood pressure and see how things are going. Let’s check her glucose. You know, there are little things that we can do to just kind of see how your pregnancy health is going.

[00:32:10] Do you guys recommend that you go straight into labor and delivery, or do you recommend going to your provider? What do you guys recommend?

[00:32:16] Kimberly Isburg: Definitely call your provider, and check with them. But again, if it’s after hours, if you’re not hearing back right away, like it’s always okay to go straight to labor and delivery and to get checked.

[00:32:27] You can call and let your doctor know that you’re on your way. But, really again, just trust your instincts and if you’re concerned, get yourself checked as soon as you can.

[00:32:35] Hilary Erickson | The Pregnancy Nurse®: Yes. And I will tell you from a labor and delivery nurse, we have people who come in for this all the time.

[00:32:39] I think people think that you only come into labor and delivery when you’re gonna have the baby, and that’s not the case at all. You come in for bladder infections, you come in for baby not moving, you come in for, extreme ligament pain that you think is labor, but really ends up being ligament pain.

[00:32:50] We have a nurse who’s dedicated to just seeing patients who come in like a mini emergency room for pregnant people.

[00:32:56] Kimberly Isburg: Right. Yeah. So yeah, you can go straight to labor and delivery and they know what to do and to check when you get there.

[00:33:04] Hilary Erickson | The Pregnancy Nurse®: Yes. And they’re open 24 7, 365 days a year. You don’t have to be like, is labor and delivery open?

[00:33:09] I can tell you that it is. Of course you wanna make sure that the hospital you’re going to has labor and delivery, and I think that’s important for every patient to know because there are labor and delivery units closing. So you could show up to a hospital that really isn’t prepared. So talk with your provider about where you’re gonna be delivering so that you know that that’s probably the hospital that you should head to if you’re having an issue.

[00:33:28] Kimberly Isburg: And also think about for those moms that live in rural areas or farther away from their birthing center, I think that’s another consideration. If you know that you’re an hour away from the nearest labor and delivery unit, that’s another thing to think about in just making sure that. Maybe you call your provider, but you go ahead and get in the car and start heading that direction so that you can get evaluated as soon as possible.

[00:33:49] ’cause hours and minutes really do matter when there is an issue in pregnancy, and so the sooner you can get checked, the sooner you’re gonna have a chance to address anything that’s going on.

[00:33:59] Hilary Erickson | The Pregnancy Nurse®: Yes. And I absolutely hate the fact that we have so many post or pregnancy deserts out there. So many people are driving long distances to their labor and delivery.

[00:34:08] And I’m not talking about the people who pass like five hospitals on the way ’cause they’re picky. Right. And they want a specific one. I’m talking about people who that is their option. Yep. So we gotta work on that too. We have so much to work on. But kick counts is something that you can do for you and your baby’s health every single day, and I think it’s really gonna reassure you if you think you’re gonna be anxious or you think your baby isn’t gonna do it.

[00:34:28] My tip is to give it a try. Commit to try for a week, see how you’re feeling after the week, because that week is really just learning about your baby’s pattern. And then see where you’re at after the week.

[00:34:39] Kimberly Isburg: I love that advice.

[00:34:40] Hilary Erickson | The Pregnancy Nurse®: Yeah. Because I’m an anxious person. I get it. I would sit there and be like, it’s been 12 minutes and we’re only to eight counts.

[00:34:46] And yesterday we were at 10 minutes. I get that. But again, you’re looking for a pattern.

[00:34:50] Kimberly Isburg: Yes. And the more, again, the more data you have, the easier it’s gonna be to see that pattern. So

[00:34:55] Hilary Erickson | The Pregnancy Nurse®: yes. Alright. Thank you so much for coming on Kimberly. Do you have anything else to tell the pregnant mamas out there?

[00:35:00] Kimberly Isburg: I just wanted to share our app now has a contraction timer as well. So, another tool and feature that’s on the Count the Kicks app that you can use, once you get close to, the end of your pregnancy and it’s time for labor to start. You can use that to time your contractions and help inform you on when it’s time to head to the hospital or call your midwife or doctor.

[00:35:20] Hilary Erickson | The Pregnancy Nurse®: Yeah, it’s a great app that you’re gonna be able to find lots of use for. it’s not something that is just one thing. You can get lots of information from it. So the other thing I gotta say is. Download the app, get in your phone, download the app, especially if you’re like 25 weeks and it’s already on your phone, you’re ready and set up to do your kick counts once the big day comes in your 27 weeks.

[00:35:38] Kimberly Isburg: Yep. And you can set reminders right in the app. So, it’ll send you a notification every day when it’s time to count. So, really easy to use.

[00:35:46] Hilary Erickson | The Pregnancy Nurse®: Yes, please do your kick counts, guys. It’s a huge soapbox for me because the less still births the better in my mind. And I have found still births and I’ve definitely taken care of still births moms and we wanna decrease them as much as possible.

[00:35:59] And this is something we can do has been proven to decrease still births. Yes. Alright. Download the app. Do your kick counts. Let’s go team.

[00:36:07] Kimberly Isburg: Thanks Hilary. I totally agree.

[00:36:09] Hilary Erickson | The Pregnancy Nurse®: Thanks for joining us on the Pulling Curls podcast today. If you like today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.

Keywords:

kick counts, fetal movement, Count the Kicks app, anterior placenta, pregnancy monitoring, stillbirth prevention, third trimester, baby movement patterns, contraction timer, prenatal care, high risk pregnancy, labor and delivery, amniotic fluid, monitoring baby kicks, placenta location, pregnancy complications, non-stress test (NST), biophysical profile (BPP), pregnancy anxiety, doctor/patient communication, pregnancy apps, Healthy Birthday nonprofit, kick count reminders, ultrasound, pregnancy health, mindful of baby’s movements, reduced fetal movement, fetal monitoring, pregnancy data tracking, pregnancy deserts

The post Kick Counts Made Simple: FAQs, Expert Tips, and Why It Can Save Babies’ Lives appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Big thanks to our sponsor The Online Prenatal Class for Couples — we have a whole section on postpartum as well as recognizing danger signs that can help ALL of you manage your entry into life with a new baby better.

Today’s guest is Kara Kushnir, psychotherapist and founder of A Work of Heart Counseling, author and current Chair of the Board for Postpartum Support International New Jersey. Kara specializes in supporting new parents and children navigating pregnancy, postpartum, anxiety, trauma and hard life transitions. Her new book, “Mama’s Thoughts” (a children’s book for parents in disguise) helps affirm new parents by considering how their baby views them despite the ups and downs many new moms experience. Through sharing her own lived experience and professional training in perinatal mental health, Kara aims to stop the stigma that keeps new moms suffering by training providers and helping new moms reclaim their confidence and trust in themselves.

• Her book: Mama’s Thoughts
• Find her on Instagram: https://www.instagram.com/aworkofheart_counseling/
• Her Website: https://www.aworkofheartcounseling.com/

Links for you:

PSI Helpline: https://www.postpartum.net/get-help/psi-helpline/

• Call 1-800-944-4773 (4PPD) #1 En Español or #2 English
• Text “Help” to 800-944-4773 (English)
• Text en Español 971-203-7773
• Contact HelpLine

Timestamps:

00:00 “Pregnancy & Parenting Insights”

05:49 Postpartum Anxiety Concerns

06:37 Postpartum Anxiety and Self-Doubt

10:18 Leaving NICU: Overcoming New Parent Anxiety

15:31 Embrace Presence in Parenting

16:40 Prioritizing Self-Care in Parenthood

20:22 Pregnancy Mental Health Support Tips

23:25 Distinguishing Postpartum OCD from Psychosis

26:41 Perinatal Mental Health Awareness

Keypoints:

• The episode covers postpartum anxiety in-depth, aiming to demystify it and provide practical advice for new parents.
• Hosts Hilary Erickson, RN, and guest Kara Kushnir, LCSW, discuss common symptoms of postpartum anxiety, such as feeling like “jumping out of your skin” and uncontrollable worries.
• Kara highlights the difference between normal anxiety and clinical anxiety, providing signs that indicate it’s time to seek professional help.
• The episode stresses the importance of addressing perinatal mental health even during pregnancy to prevent postpartum complications.
• Differentiate between postpartum OCD and postpartum psychosis, and the seriousness of thoughts that cause distress versus those that align with the person’s beliefs.
• Kara offers practical tools for managing anxiety at home, including the ACE technique (Acknowledge, Come back into your body, Engage).
• The significance of a strong support system and the dangers of facing motherhood alone are emphasized.
• The episode encourages engaging with trained perinatal mental health professionals and promotes resources like Postpartum Support International (PSI).
• They share the PSI hotline and text line, assuring listeners that seeking help is a sign of good parenting, not failure.
• The discussion aims to reduce stigma and normalize the experience of postpartum anxiety, offering empathy and understanding for struggling parents.

Producer: Drew Erickson

Transcript

[00:00:00.000] – Hilary Erickson

Hey, guys. Welcome back to the Pulling Curls Podcast. Today, we are talking about postpartum anxiety, so let’s untangle it.

[00:00:07.980] – Hilary Erickson

Hi, I’m Hilary, a serial overcomplicator. I’m also a nurse, mom to three, and the curly head behind Pulling Curls and the Pregnancy Nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with Pregnancy and Parenting Untangled, the Pulling Curls Podcast.

[00:00:30.220] – Hilary Erickson

Today’s episode of the Pulling Curls Podcast is sponsored by the Online Prenatal Class for Couples. If you want to get prepared for everything from your third trimester all the way till when baby’s home, come join me in the online prenatal class for couples where we discuss things, including postpartum anxiety. So come join us.

[00:00:52.090] – Hilary Erickson

Today’s guest is a psychotherapist and founder of A Work of Heart Counseling. She actually has a children’s book called Mama’s Thoughts that affirm new parents by considering how their baby views them despite the ups and downs of many new mom’s experiences. She is also the Chair of the Board for Postpartum Support International. I want to introduce today’s guest, Kara Kushnir. Hey, Kara. Welcome to the Pulling Curls Podcast.

[00:01:14.780] – Kara Kushnir

Thanks for having me. I’m excited to be here with you today.

[00:01:17.120] – Hilary Erickson

Yeah, excited to talk about anxiety. Those are two antithesis.

[00:01:21.420] – Kara Kushnir

Well, listen, I get it. It’s a weird thing to say, although excitement and anxiety can feel very similar in your body, so fair enough. But it’s so important, so I’m excited to be able to talk about it and demystify it, hopefully a little bit.

[00:01:33.200] – Hilary Erickson

Yeah, that is 100% what I tell myself on planes. I’m like, I’m just excited to be there. It’s fine. Yeah.

[00:01:39.500] – Hilary Erickson

Okay, so I had postpartum anxiety on my first baby. I remember I had a fourth degree tear. And I was up trying to do aerobics because I felt so anxious inside. Probably wasn’t a great thing for my old perineum at that point in time.

[00:01:56.110] – Hilary Erickson

Had no idea. I was like, Oh, it’s not depression. I just feel like I want to jump out of my skin and scream 95% of the day, including when I was asleep. I would have horrible dreams about losing receipts, those little weird things that would make you anxious, like receipts flying around, and I had to grab them.

[00:02:13.890] – Hilary Erickson

So I’m so excited that you’re coming on because I hear so often people don’t know that anxiety can be an issue, and then they find themselves having the anxiety, and they don’t know what to do because they’re not suicidal, but they also cannot get comfortable in any way, shape, or form.

[00:02:29.200] – Hilary Erickson

By the way, I totally talk about this in my birth class because I think postpartum is just left behind like a sad little sister to labor.

[00:02:37.200] – Kara Kushnir

100%. Yeah, I always say when you’re getting ready to have a baby, it’s like when you get ready to get married, you’re planning for the wedding and you forget about the marriage. It’s the same thing. Everybody is all about the birth plan, all about the nursery, all about the prep. We forget that actually this is the rest of your life. ‘You’re postpartum for life’ is something we like to say in our world. But yeah, the real meat and potatoes of what it is we really need to be planning for, actually. Yeah.

[00:03:03.750] – Hilary Erickson

So what do people… How do they describe it? So I said I wanted to jump out of my skin. I couldn’t be comfortable in any way. There were a lot of worries in my mind. A lot of like, don’t drop the baby. Constantly like, don’t drop the baby. When I had worked for a pediatrician, I had been a nurse, I had never dropped a baby before.

[00:03:22.150] – Kara Kushnir

Yeah. First of all, I still like to say to commonize it, over 90 % of new moms have scary or intrusive thoughts. It is just par for the course. It doesn’t necessarily mean you have postpartum anxiety. Certainly, there is, I would argue anecdotally, and I think the research is going to catch up, far more individuals who have postpartum anxiety than we realize because people do often default and assume it’s postpartum depression, and that’s what we talk about. That’s what the media talks about. But I think it’s just as if not more potentially rampant in our society than postpartum depression.

[00:03:53.500] – Kara Kushnir

Anxiety is something that we can all feel. It doesn’t mean it’s clinical. But what new moms will say is to your point of, I feel like I’m jumping out of my skin, they also say things like, I just don’t feel like myself. I can’t stop thinking about this. Or they don’t say anything because these are the thoughts they have in their head that they’re afraid to say out loud. If you’re having thoughts of, What if I do this? What if this happens? A lot of the what if, the maybe, this could, things like that.

[00:04:20.320] – Kara Kushnir

You either don’t want to tell somebody because you think they’re going to think I’m crazy or they’re going to be, What do you mean? It’s fine. That can be a potential sign, but I think if it’s coupled with, you can’t stop thinking about it, that rumination, it’s over and over, or it’s coupled with, I can’t sleep because of it. It’s affecting how I function in my day to day. I’m really starting to feel like not only, yes, my life turned upside down because I have this new person to take care of, but it’s beyond that. It’s “I feel so out of sorts and just so lost and scared”. That’s often a sign to me something’s going on.

[00:04:54.960] – Kara Kushnir

Most of the people that end up in my office or that I speak with will say that anxiety looks like that intense, constant or repetitive presence of those kinds of thoughts. They can vary in shape or form. It’s interesting, too, is it’s not just postpartum anxiety. That can also be postpartum OCD, which is a type of anxiety disorder. There’s a lot of overlap and nuance to this for sure.

[00:05:18.920] – Hilary Erickson

Yes. Okay. I agree that I think a lot of people have anxiety, mostly about doing something wrong with this baby, right? Or themselves. Some people are concerned they’re going to not catch a problem with themselves, and they could have a bigger deal. Thankfully, so many people have just ignored themselves for so long. So I’m glad that we’re actually thinking about ourselves after we have a baby. But what are some signs that this has progressed past normal anxiety for a new mom, because there is a certain threshold that is pretty normal. Yeah.

[00:05:49.360] – Kara Kushnir

So it’s very common and normal, to your point, to be anxious in those first few weeks. Just like we think about baby blues in the first two weeks and having that significant drop in hormones and shift in your life, you’re going to experience a change in mood and anxiety level.

[00:06:02.540] – Kara Kushnir

I would expect that, especially if you’re a first-time parent. It doesn’t just have to be for a first-time parent, but certainly, if it’s continuing on now for beyond that first few weeks or month, and it’s pretty present for that duration of time, we start to realize, Okay, this is more than just I’m adjusting and having a tough time and I’m nervous. This is something more.

[00:06:22.020] – Kara Kushnir

Again, going back to functioning, the sleep piece, being able to eat, and also a lot of avoidance. So you will see a lot of new moms with anxiety avoid anything from, I’m afraid to give the baby a bath because what if something happens? And you have to be home with me to do it. To, I can’t take them out because what if this happens? Or what if they get sick? And so a lot of fear of doing typical day-to-day things, getting out there, meeting other people.

[00:06:46.570] – Kara Kushnir

So they’ll cocoon. But there’s also a lot of mistrust of self. So a lot of self-doubt talk that persists beyond that first few weeks. And I think also, really, we know that postpartum anxiety can present any time in that first year after having a baby. So just because you were okay for the first few months and you were anxious, but you were navigating it, and then you start to feel a spike in intensity, maybe at the three or the six month mark, it doesn’t mean it’s not postpartum anxiety.

[00:07:12.110] – Kara Kushnir

There’s so much nuance to how the entry into motherhood could look, whether you had a pleasant birth experience to a traumatic birth experience to life circumstances, that it might catch up with you later. If you’re noticing that you feel this way for a longer period of time within that first year, it’s a sign that it’s time to go and ask somebody about it. I think often people will go to their OB as a first line, which is a great resource, but it’s okay to even bypass them and go straight to somebody who’s trained in paredatal mental health and say, Hey, I want to meet with you and see what’s going on here if you’re concerned.

[00:07:44.120] – Kara Kushnir

Certainly, if you’re having such anxious thoughts that you’re not sleeping at all or you’re avoiding taking care of your baby, we’re talking about a real intense need to be addressed as soon as possible.

[00:07:53.450] – Hilary Erickson

As you were talking, I was thinking about two things that happened to me, especially… Well, this first one on my first baby, I could not get our car seat to click in. So I would haul him down from our third apartment landing, and there was one day I could not get it to click. I was not well-versed in car seats. You got to remember this was back in the three-point harness days, and I felt really good that we had a five-point harness day.

[00:08:13.480] – Hilary Erickson

And after that, I was so anxious to even try and put him in the car because he started crying. I thought people would make fun of me in the parking lot. All these anxiety thoughts came back to me. And I think a lot of times we don’t think about those simple things, but the car seat started to revolve a lot of anxiety for me.

[00:08:29.330] – Hilary Erickson

The second one is, every single time my husband goes back to work, I cry. Even if I am mostly pretty much handling everything at home at that point, I burst into tears. I hear that so much in my groups. People are like, My husband’s going, or my mom’s leaving, or whatever, and I’m going to have to do this on my own.

[00:08:47.190] – Hilary Erickson

I know that I can do it on my own, but I’m so nervous about it. Those are things that people might be feeling, but I agree when it just continues and continues. Or if it’s getting worse, would you say? Because that’s always my thing. When you go home, your bleeding should be getting better. You’ll probably have a ramp up of anxiety when you get home because all of a sudden the nurse isn’t there, you feel alone. Maybe you go to your pediatrician and you find out there were a couple of things you weren’t doing at a level. I think it’s normal to have your anxiety go up, unlike bleeding. Anxiety is probably going to go up a little bit when you go home.

[00:09:21.770] – Hilary Erickson

But I would say that if it keeps going up or it’s not going down, that’s a time to seek help. I agree, OB’s are not super helpful on this.

[00:09:29.940] – Kara Kushnir

Yeah. Unfortunately, by and large, what I hear is people go to their OB, they offer them some medication, and then they sell them on their way. That’s just such a bandage to the issue, and it’s so problematic. To your point of those triggers of somebody’s going back to work, another transition, another level of responsibility that comes up that’s a trigger for that anxiety to possibly intensify.

[00:09:50.260] – Kara Kushnir

I think that that points to something that’s really critical, which is that we were never supposed to do this alone, and yet we live in a world that really puts that pressure on us to to be it all, do it all, and for moms to feel so capable of, Oh, yeah, I know what I’m doing, and I’m just going to navigate this, and it’s all going to be fine. It actually makes a lot of sense sociologically for people to be nervous and anxious when they start to do things on their own. I see this, especially in parents where… I work with NICU parents. It’s terrifying when you leave the NICU. It’s terrifying to leave the hospital, period. But then you have to take care of a baby who might have extra needs or did have extra needs at that time.

[00:10:27.080] – Kara Kushnir

You doubt your ability to do it. There is comfort despite the fear of the tubes, the wires, the nurses, the being checked at 4: 00 AM, it feels like somebody’s there to catch you. I think that that shift into doing it on your own or having just a partner or just a family member who’s there for a short while, it sets us up to then have to go through it again, that same transition in another way. And that can really start to ramp up those feelings of self-doubt that underpins a lot of that anxiety. Yes.

[00:10:56.430] – Hilary Erickson

And oddly enough, when I went back to work, so I went back to work at six weeks with all of my kids, that actually decreased my anxiety because all of a sudden, I was at work, which I knew how to handle. Nothing had changed at work. People were still having babies the same way.

[00:11:09.850] – Hilary Erickson

I was like, this is so much easier than dealing with a newborn and two other kids at home. So not every transition. Sometimes I feel like that was a part where all of a sudden it started to drain away. I was like, You’re capable. Get over it. I don’t know. It’s tricky, but I get a lot of parents who are like, I’m freaking out about work. I was like, You just never know how the situation going to hit you, you have to take it a little bit because that was really surprising to me that work. I was like, I’m popping it in one spot.

[00:11:37.930] – Kara Kushnir

Yeah, but you faced that fear of taking the leap. Once you’re in it, you usually start to realize the idea of it might have been actually much more worse than the reality of it. And that’s massive for people with anxiety, right? It’s the idea. It’s the fear that keeps you stuck, not the reality. The reality, by and large, is usually, Oh, I can do this, or, Oh, I do know how to do this. So when I go back to work, I’ve got this.

[00:11:59.450] – Kara Kushnir

I felt the same way when I went back to work and I got to have an adult conversation or work with a client, I was like, wow, this is actually really easy. I know how to do this. All the other stuff, I feel like a fish out of water. Absolutely, that can definitely be the case for people. And I think that it’s funny because by and large, I see that probably more often than I see people go back to work and they say, oh, my gosh, I feel like I’m miserable. There’s sometimes a lot more guilt that can come up with that of, Oh, my gosh, I am doing so great here.

[00:12:26.020] – Kara Kushnir

What does that mean about me? And then we start to question ourselves and the anxiety could take form somewhere else. But I think that’s the trickiness. It’s like whack-a-mole sometimes with anxiety. It’s like it pops up in different places. And getting to the root of what is it you doubt in yourself or about this experience can be a really critical part of alleviating it for a lot of people.

[00:12:44.620] – Hilary Erickson

Yeah. Okay, So you have your basic anxiety. What are some tools people can use just at home to manage the… Everybody’s worried that baby’s in their crib and they’re going to die during the middle of the night. I want to say that’s a worry for everyone. And honestly, that worry is never going to leave because you send them to school. You’re playing outside. You don’t know if they could fall.

[00:13:02.530] – Hilary Erickson

The worry is… You teach them how to drive, which we’re doing again at my house. The worry is always going to be something because everyone’s like, Oh, once they get past six months, I won’t have that worry about Sids anymore. I’m like, Yeah, but that worry is constant. So you have to make friends with it and just realize that that’s a part of being a mom for me.

[00:13:20.290] – Kara Kushnir

Yeah. So one of my favorite lines I tell people is the more you resist, the more it persists, meaning that the more you’re like, No, no, no, don’t think about it. It’s not true. You try to argue with anxiety. It can often get louder. Usually, the technique of acknowledging what you’re feeling, and I’m having the thought that this could happen. It’s bothering me. Putting it out there, I’m acknowledging it. It’s real. And I’m going to come back into my body and I’m going to realize I’m here, what’s actually in this present moment, what I can control, and then I’m going to keep doing whatever I need to do is the way through.

[00:13:52.250] – Kara Kushnir

A really helpful technique is ACE, right? That’s an acronym. I acknowledge the feeling, I come back into my body, and then I continue to engage in whatever it is that I am doing in that moment. If I should be sleeping, I’m going to notice my body in the bed. I’m going to notice how I feel. I’m going to pay attention to my breathing and just slow it down. Maybe I’ll do something else to help my brain settle. For some people, they need something to be a little bit more distracting.

[00:14:17.520] – Kara Kushnir

A really great technique for that could be some mental gymnastics technique around, okay, I’m going to pick, think of a word. It starts with the letter R. I’m going to come up with a bunch of other words that start with the letter R. So starting to let your brain take a break and deviate from what it was you were focusing on. Not resisting it, not outwardly saying, I can’t think about it, but choosing purposely, I’m allowed to and can think about other things. And then to that point, focusing on what you can control when you can.

[00:14:45.480] – Kara Kushnir

So going back to sleep, for example, I set up a safe sleep environment. I have the monitor. I’ve done everything I can do. Now I need to trust myself because the hard reality is that we face uncertainty all day, every day. We don’t know if we’re going to walk outside and we’re going to get struck by lightning, or if we’re going to win the lottery. We have no idea. And we do it anyway because it’s worth it. So actually learning how to face that with a baby is setting you up for success in parenthood, because as you go through, uncertainty continues to unfold in so many different ways, including all the way through to teaching your kid how to drive.

[00:15:17.190] – Kara Kushnir

That’s a whole level of uncertainty and anxiety that can emerge for folks. It’s just a nice way to remind yourself, I have faced every other hard thing I’ve had to up until this point. I’m still here. I want to enjoy as much as I can what is and be present in that.

[00:15:31.710] – Kara Kushnir

Another good way to think about the coming back into your body being present is when you are feeding baby, changing baby, you’re touching them, you’re seeing how soft their skin is, you’re really soaking them in, you’re talking to them, you’re just really allowing yourself to be present with your baby, it’s a really great way to slow it down and say, This is my life right now. I’m going to try to be present as much as I can in that, not so much getting sucked into the future or to the past and getting being immersed in this idea, this story of what could be.

[00:16:03.530] – Kara Kushnir

Because it is just a story. It’s not actually what your reality is. If you did have an adverse experience, there’s ways to address that therapeutically to alleviate the pressure that puts on you. But it doesn’t serve you to live anywhere else but the here and now.

[00:16:18.810] – Kara Kushnir

I think that way of trying to come back is really critical. I also will say, encouraging people to prioritize the things that do help them access that. If you are struggling with sleep because of anxiety, finding somebody who you do trust to be able to help you get that sleep is so critical.

[00:16:35.580] – Kara Kushnir

Protecting sleep is massive for protecting your mental health, and it’s not often sleep with a baby sleeps. It’s, I have my mom come over to be here, so if a baby wakes up, I get to have a 4: 00 to 5: 00 hour chunk of time uninterrupted to sleep. It might be hiring a doula or a night nurse.

[00:16:50.340] – Kara Kushnir

It might be, I’m noticing that I really am not eating so great. I need to prioritize that, especially for individuals who are having troubles with feeding. That’s a source of anxiety. How do I have access to lactation consultant and support? It’s really noticing, those are the places to put your energy to actually take care of you.

[00:17:08.260] – Kara Kushnir

When you are doing better, you can be in a better mental state to respond to the anxiety and also to be the best version of yourself in parenthood. It is coming back to what do I need right now, not what could happen. That’s a massive shift for people to try to make, though, and it takes practice.

[00:17:24.870] – Hilary Erickson

It’s funny when you were talking, you’re like, you could get hit by lightning or you could win the lottery. I’m like, oh, I never think about winning the lottery. And maybe that’s one of the things that you could think about to get your mind off of the negative things is how amazing this baby could end up being, right? Yes.

[00:17:39.190] – Kara Kushnir

I love that. And to that point, another technique that I will often ask people is to shift what if this happens to, I wonder what will happen. So what if something happens to my baby? I wonder what they’re going to be like when they’re three. I wonder who they’re going to be when they grow up.

[00:17:52.660] – Kara Kushnir

Giving yourself permission to wonder rather than worry is a really big shift. And it’s a gift, and it takes practice, but it’s allowing yourself, I’m allowed to feel good about this. And I think what’s really exciting about that, too, is that it gives you permission to see through your child’s eyes. That’s massive to me. I actually wrote a children’s book about motherhood for moms because of all the scary and mean thoughts we tell ourselves.

[00:18:17.150] – Kara Kushnir

And I wrote it intentionally reframing things through baby’s eyes because I wanted us to consider… Your child never looks at you and doubts you and thinks the scary things you think. They look at you and you are the sun, moon, and stars. So if you consider that you’re allowed to also take a little bit of that glimmer and that shift into the wonder that they have, that also can help you leave some of those anxious thoughts behind.

[00:18:40.790] – Hilary Erickson

Yes. What is it going to be like that first time when they’re three and they see the Christmas tree light up or they see Santa and they’re just like… There are so many magical parts of parenting that never crossed my mind with a newborn. It was like, what if we’re at the park and I can’t get the car seating the car and we literally have to live at the park and I need to find a tent?

[00:18:58.600] – Kara Kushnir

Yeah. Yeah, then you stop and you’re like, wow, what did I just say out loud? Yeah, that’s not realistic, but we buy it. We buy that story every time, even though if we took a step back to say, what do my five senses tell me right now that I can touch and see with my eyeballs? What is it that is actually realistic and possible? What does common sense say?

[00:19:19.050] – Kara Kushnir

You’re like, wait a second, hold on. This could actually be really good. It’s going to be okay. That is a really empowering place to shift to. I love that.

[00:19:26.660] – Hilary Erickson

Okay, so if people are there like, I’m not able to fix this on my own, and especially pregnant individuals, if you’re already noticing a lot of anxiety around something specific, like putting baby in their bed, maybe you have a niece or nephew or a previous loss of your own, there is absolutely no reason not to address that while you’re pregnant because it is going to be so much easier to get to your appointment while the baby is inside of you.

[00:19:49.250] – Hilary Erickson

What can people look for? I mean, I would hope OBs have someone to refer people out to, but I know that there just are not a lot of trains. So what can people look for? Who could they call? I know there’s a hotline for postpartum individuals.

[00:20:01.230] – Kara Kushnir

Yeah. So I love that you asked this. I think it’s so important. I wish I had learned about this well many, many years ago. I now actually am very involved with Postpartum Support International. And if you go to postpartum.net, there is a provider directory that you can filter and search for your state. You can filter by your insurance. You can look for specialization. And it’s a great resource to getting support.

[00:20:22.170] – Kara Kushnir

I 100 % recommend, to your point, if you’re already unsure, you have a history of anxiety, or you have a history of depression, or you’ve experienced something that was really adverse earlier in your life that you’re starting to notice might be creeping up in pregnancy. Being connected to a provider during pregnancy, we know, will by and large yield a positive and better result for you in postpartum because you already have access to a team.

[00:20:45.720] – Kara Kushnir

But more importantly, we can actually prevent some of what you might have experienced because you’ll have the tools earlier and you’ll feel more confident and safe in that transition to parenthood. It’s something that I think we wish more people would do. Some local OBs do have great connections to providers locally, and I do encourage folks to ask.

[00:21:03.640] – Kara Kushnir

I think the more we ask our providers and we put that responsibility on them to consider the need to have those connections, the better the outcomes will be, too.

[00:21:10.690] – Kara Kushnir

But certainly, for folks listening and for people who are unsure where to start, PSI at that website has a great list of resources, and there’s free virtual support groups, including one for pregnant individuals for peer support, because that’s also just as important as individual psychotherapy, medication, things that people need sometimes, whether they’re pregnant or postpartum.

[00:21:31.250] – Hilary Erickson

I remember just thinking I was completely alone. No one else felt this anxiety. Everyone else looked like they were handling parenthood like a dream. It was just Hilary in her own mind. I think understanding that other people, especially people love that because my kids are adults, well, some of them are adults now, they’re like, Oh, she made it through.

[00:21:49.680] – Hilary Erickson

Even though she had these crazy, anxious dreams, it’s really nice to know that somebody made it through that and their kids are functioning adults, right? Because you’re like, I’m a mess. I’m going to make this kid a mess if I don’t kill them, these are my two options.

[00:22:02.620] – Kara Kushnir

Yeah, no, totally. I think that’s so true. The lived experience piece is so vital. I even see it in my office. I have a preschool-age kid, and they’re like, Okay, you got through the thick of it. All right, you might know something.

[00:22:14.400] – Kara Kushnir

I think that that piece is really helpful for people to see that, yes, this too shall pass. You will get through this. You’re not alone. That’s so important. It’s destigmatizing. That’s a massive piece of this, too. We talk about speaking the secret. If more people talked about this, The reality is we probably would have far better outcomes and far greater access to care.

[00:22:35.450] – Kara Kushnir

I encourage people to find the folks who really are trained in this because it’s not just about seeing any therapist or talking to any mom. It’s like being in a community of people who intentionally choose to be there, as well as finding a provider who’s trained in perinatal mental health so that they really understand not just what this can look like, but how to get you access to the best resources and supports you might need and the most effective techniques and tools to get you where you want to be.

[00:23:01.240] – Hilary Erickson

Yeah, because I think as our going out note, we should say that this can be really scary. As I look at the moms who ended up really hurting their kids or having real serious issues, everyone’s like, Oh, it’s postpartum depression. But when you hear what they’re thinking in their mind, it’s really postpartum anxiety, right? Yeah, or psychosis. There are demons coming to attack my kids. That also sounds very anxious to me rather than I’m so sad.

[00:23:25.460] – Kara Kushnir

That’s so important. I’m really glad you brought that up. It’s so critical because sometimes people will have really scary intrusive thoughts like that, and that’s where it can be a border into the difference between postpartum OCD and postpartum psychosis. Psychosis, it’s egosyntonic thoughts. It’s I agree with my thoughts. If I think my child is a demon, I believe it, I truly believe it, and I want to hurt them, that’s usually somebody’s having a psychotic episode.

[00:23:49.350] – Kara Kushnir

Whereas postpartum anxiety or OCD, I have this thought, but it’s so distressing to me. I don’t agree with it. Why am I thinking this? What’s happening to me? And sometimes untreated, Sure. Sometimes untreated, it can lead to psychosis, and that’s really challenging for folks. It’s so important the earlier you get care, the better we can prevent these tragic outcomes from happening. It’s sad that it happens at all. I do think it reflects that people don’t know what to look for.

[00:24:17.860] – Hilary Erickson

Especially support people. I love that because if you’re… In my head, I was like, at some point, you’ll get the car seat to click in, you’re not going to live in a tent. But if you’re like, I’m going to live at the park, and a homeless man is going to come and kill both of us, and my husband’s hearing me say that, I agree with this, it’s just going to escalate, then they need to think, Okay, maybe this is time to get some help. She doesn’t even realize that she’s insane at this point, would be what we think.

[00:24:42.330] – Kara Kushnir

Yeah, when you’re in that episode, I think that’s so important because usually at that point, people don’t realize that it’s a crisis, and that’s a time in emergency psychiatric support. It’s unfortunate. It happens roughly in 1-3% of cases. It’s not super, super common, but it does happen enough that we need to acknowledge it.

[00:25:00.910] – Kara Kushnir

And I think that being able to recognize and also not demonize yourself, I see this a lot with my clients with OCD. Yes. So for example, I have a lot of new moms who will talk to me about harm thoughts. Why do I keep thinking about, I’m chopping vegetables. Oh, I could stab my baby. Oh, my gosh, why are you thinking that? I don’t want to do that. Because you don’t want to do that. It’s an intrusive thought. That’s an egodystonic thought.

[00:25:22.040] – Kara Kushnir

I don’t agree with it versus, Oh, yeah, I could do that. Yeah, because my child is a demon, I should hurt them. That is different. That is an emergency, and that’s something that we need to get that parent help. We need to make sure that child is safe. People hearing that and knowing to look for that is really important because it also helps to demystify anxiety, OCD, because they can overlap a lot.

[00:25:42.860] – Kara Kushnir

It doesn’t make you a bad person. And psychosis doesn’t make that person necessarily bad. It means they’re so sick. They need so much help. We have to do something about that before they do something that they regret and can’t take back. And it’s really, I think understanding that nuance helps people to actually come forward and say, I am having these really scary intrusive thoughts. I’m so anxious. I don’t want to do this. Please help me. So that they know that it’s okay to say that because people do fear if they speak up, something terrible is going to happen, their child is going to be taken away. And that should not be the case at all. Yeah.

[00:26:14.960] – Hilary Erickson

And I think a lot of people think of it as like, I am a failure. And you should look at it the same way as, I have a headache that won’t go away. I think I need to go to the ER. My bleeding has increased. I need to go to the ER. I have a red tender spot on my calf. I need to go to the ER. We have these problem signs. It’s just a problem sign. It’s not like you are a failure. If you look at the graphs of hormones after delivery, it’s insane. It’s amazing any of us make it out alive.

[00:26:40.630] – Kara Kushnir

You’re so right. I think that’s so important is the mental and physical health component being on that equal playing field for folks. Listen, perinatal mental health or postpartum mental health conditions are the number one complication of childbirth, which means that you’re more likely to experience this than you are a pulmonary embolism or hemorrhage or anything else, this is something that more people face.

[00:27:02.010] – Kara Kushnir

If you are aware of it, you can prepare for it. You can know what to do so you can get the help immediately, and in some cases, you can prevent it. I think that is a huge thing for people to take away and realize that you don’t have to feel like this. If you do, we can do something about it. So say something. That’s a huge thing I think that people need to really embrace more of.

[00:27:23.100] – Hilary Erickson

Do you know the PSA hotline number so we can give that to people right now?

[00:27:26.150] – Kara Kushnir

Yeah, it’s 1-800-944-4773, and you can speak to someone in English or Spanish. There’s also a text line. You can text “help” to 800-944-4773, as well to get connected to someone at the PSI Helpline to get support close to you as soon as you can.

[00:27:46.620] – Hilary Erickson

Yeah. And those people are amazing, so compassionate, really also passionate about helping people postpartum because they understand how important it is. So don’t be afraid to text them. They are not going to call social services on you. I know that’s the biggest concern that they are going to come take away your baby. That is not the same thing.

[00:28:03.620] – Kara Kushnir

Yeah, 100 %. I think that’s so critical is that asking for help from them and asking for help for yourself actually says what a good mom you are. Amen. It’s the opposite.

[00:28:12.250] – Hilary Erickson

Kara, thank you for coming on. I think I’m actually going to be a better teaching my kid how to drive. I’ll be like, imagine how much fun she’s having at prom rather than envisioning her with the sirens and everything in the ambulance.

[00:28:24.920] – Kara Kushnir

Yeah. No, it’s tough. Yeah. Give yourself permission. One day I won’t be a taxi driver. That’s the wonder.

[00:28:30.700] – Hilary Erickson

Amen. All right. Thanks, Kara.

[00:28:32.320] – Kara Kushnir

Thank you. Take care.

[00:28:33.530] – Hilary Erickson

Thank you guys so much for joining me on this episode. It’s not one that you’re like, Yay, let’s talk about anxiety, but it is so important. Important to know when to get help. That’s one of the key things I wanted to talk to her about, how to get help. And if you are feeling anxiety during your pregnancy, I cannot recommend any more finding someone to talk to, even just one appointment before baby’s born to give you a few tools in your toolbox.

[00:28:55.200] – Hilary Erickson

And then you already have somebody that you can reengage with after baby’s born if you’re having issues. Maybe you won’t. Hopefully, you won’t because you’ve already got those tools in the toolbox. I will say that I hear so many people saying, I can’t have a cervical exam or I can’t have an IV because I’m afraid of needles. If those kinds of fears are keeping you from enjoying your pregnancy or life, go have a chat with a therapist. I think it can only pay off a ton.

[00:29:18.710] – Hilary Erickson

Thanks for joining us on the Pulling Curls Podcast today. If you liked today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.

Keywords:

postpartum anxiety, postpartum advice, new mom anxiety, postpartum depression, perinatal mental health, mental health support, new parent fears, anxiety symptoms, birth plan, postpartum blues, psychotherapist, A Work of Heart Counseling, online prenatal class, intrusive thoughts, psychosis symptoms, postpartum OCD, sleep deprivation, postpartum support, parenting anxiety, Postpartum Support International, pregnancy nurse, childbirth complications, anxiety in motherhood, managing anxiety, infant safety, seeking therapy, support for new mothers, acceptance of anxiety, acknowledging anxiety, mental exercises for anxiety.

The post Understanding Postpartum Anxiety: Expert Tips from Kara Kushnir, LCSW appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Big thanks to our sponsor The Online Prenatal Class for Couples — a hospital class isn’t meant to take the place of a tour, but it is a great addition to a great class like that one!

Links for you:

Timestamps:

00:00 Hospital amenities vary; inquire during your tour.

04:28 Familiarize yourself with hospital layout and procedures.

08:43 Consider hospital and sibling tours post-25 weeks.

10:36 Your support significantly boosts our podcast growth.

Keypoints:

• Hospital tours are valuable for choosing the right hospital for delivery.
• Many hospitals offer virtual tours post-COVID, sometimes with a nurse answering questions.
• A hospital tour serves as a dry run for driving to the hospital, parking, and finding your way inside.
• Touring the hospital helps you understand the available amenities, such as room features and provided toiletries.
• It’s an opportunity to familiarize yourself with the layout and location of the maternity unit within the hospital.
• Knowing whether you’ll stay in the same room or move to a postpartum floor can lessen anxiety.
• Prepare a list of important questions tailored to your specific needs and concerns for the tour.
• Understanding nurse-to-patient ratios can help gauge the level of support you’ll receive.
• Hospital tours can offer insights into common practices and the birth culture within the unit.
• Sibling tours can help prepare older children, making them more comfortable with the hospital environment.

Producer: Drew Erickson

Transcript

[00:00:00.000] – Hilary Erickson

Hey, guys. Welcome back to the Pulling Curls Podcast. Today on Episode 255, we are talking about why you should take a hospital tour. So let’s untangle it.

[00:00:09.910] – Hilary Erickson

Hi, I’m Hilary, a serial overcomplicator. I’m also a nurse, mom to three, and the curly head behind Pulling Curls and the Pregnancy Nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with Pregnancy and Parenting Untangled, the Pulling Curls Podcast.

[00:00:30.270] – Hilary Erickson

This episode of the Pulling Curls Podcast is sponsored by the online prenatal class for couples. Beyond getting to know your hospital, there’s lots of things that you can learn on your own timeline at home. And I recommend the online prenatal class for couples. It is the easy way to get prepared for a reverse. Remember, it is taught by an expert. It only takes three hours, and it is available 24/7. So if you want to join me at 10:00 PM on a Sunday night. Let’s do it. Come join me.

[00:01:03.190] – Hilary Erickson

One of the biggest myths I hear is that people think they have to take the hospital birth class in order to take the hospital tour, and that is not true at all. The hospital uses these hospital tours as a marketing method to help you pick which hospital is right for you, hopefully their hospital, so they are available for anyone to take.

[00:01:20.650] – Hilary Erickson

Now, since COVID, a lot of hospitals have changed to just doing them virtually. Sometimes they have a nurse there that can answer questions after they show you a video, or sometimes it’s just a video. Whatever your hospital is going to do, try and do it.

[00:01:35.330] – Hilary Erickson

If it’s a video tour, if it’s just an online website that tells you some of their policies, do it. Hopefully, they have something. I know lots of hospitals are starting to do in-person tours, and I think it is worth your time. I know it is a pain to get to the hospital, find parking, do the tour, but I would recommend doing it. Okay, so what are the benefits of doing a hospital tour?

[00:01:56.210] – Hilary Erickson

First off, it is a dry run at driving to the hospital. Hopefully, you are taking this tour together, but your partner can understand how to get to the hospital, where to park, all those different kinds of things. It’s just nice to have that done if it’s not an area that you frequent often.

[00:02:11.340] – Hilary Erickson

I know a lot of people live a long way from their hospital, so that is an extra thing. Hopefully, you could schedule this tour maybe when you’re seeing a provider or something by the hospital. I will say that our hospital would even provide impromptu. If your provider knew you wanted a hospital tour, if they called the hospital and said, Hey, Heather would love a hospital tour, is there anyone that can give it to her in the next half an hour? Sometimes we would be able to accommodate that, and you could even get a private tour. So that’s something to think about as well.

[00:02:39.980] – Hilary Erickson

Okay, the other thing is to think about what amenities your hospital have. And when I say that, it sounds like I’m talking about a hotel, right? Is there a country club? No. But some hospitals have a fridge in the room that you can bring food and put food in. My hospital didn’t have that, so just FYI.

[00:02:56.460] – Hilary Erickson

Some have special lighting, some have a tub in every room, Some provide specific things for the mom, special hospital gowns or whatever. But knowing the amenities that are standard in your hospital can help you know what you should be bringing, right?

[00:03:10.420] – Hilary Erickson

If you want a specific lighting in your room and the hospital has fancy lighting, then you know that it’s something you don’t have to pack. Or if you want special lighting in the room and all of it is horrible fluorescent bulbs, you know that that’s a priority for you, right? And you can ask at the hospital tour if that’s even possible, because some hospitals are really reticent to allow you to plug things in that could be a fire hazard.

[00:03:30.400] – Hilary Erickson

So these are good things to ask. Every hospital is super different and weird about those things as well.

[00:03:36.410] – Hilary Erickson

Your hospital tour is a great time to find out what they recommend you bringing in from home. A lot of people think that the hospital provides toiletries, and we do. I mean, I don’t know why they label it as lotion, but we have a bottle of what is labeled as lotion, but it is like white water. It doesn’t even do anything.

[00:03:54.060] – Hilary Erickson

So I always recommend it, be sure if you want to be able to shampoo, conditioner, use lotion. We had a bar of soap for you, so as long as you’re not super picky about that, that would work. But I was really clear on what I would be willing to take from the hospital versus what you should bring. And at the same point in time, I would say, We have mesh panties. You don’t need to worry about bringing panties from home unless you think that’ll make you more comfortable.

[00:04:15.500] – Hilary Erickson

I should do a note that I did a ton of hospital tours because I really enjoyed talking with these patients. And so they always knew that I was willing to go give the tour when the provider would call and say, Can Heather have a hospital tour in 15 minutes? Not every nurse is up for this, but I love chitty chatting with patients, which is why I’m the pregnancy nurse.

[00:04:34.020] – Hilary Erickson

It also gives you a time to get a feel for the unit and where in the hospital you’ll be. You might look at the hospital and be like, Well, I’m going to give birth there. But hospitals, once you get inside, are really big. Is it on the top floor? Is it on the bottom floor? Is it in a separate area?

[00:04:47.410] – Hilary Erickson

The last hospital I worked for was actually not in the main hospital building. We had to walk across the street to take our labs to the hospital because we were a free-standing birth center, even though we were still affiliated with the hospital. If we called a code, those nurses came from the ICU, ran across the street to us.

[00:05:03.620] – Hilary Erickson

So it’s really important that you understand where in the hospital you’re going to be. And I think it just gives you peace of mind knowing, Okay, I’m going to have my baby on the third floor, right?

[00:05:11.740] – Hilary Erickson

Also, it’s going to give you an idea, do you stay in the same room after you have your baby, or do you transfer to a postpartum floor that’s on a completely different floor?

[00:05:19.290] – Hilary Erickson

And it gives your partner an idea of how that transition is going to work as well, because it can catch them off guard if they leave you after labor and delivery to go grab you a sandwich because hello, deli meat. And then they come and you’re not in the room. They’re like, Oh, my gosh, what happened to my wife? Oh, she got transferred to postpartum. But if they already know in advance she’s going to get transferred to postpartum, then they just know, and it decreases anxiety and things like that.

[00:05:42.700] – Hilary Erickson

I think it’s really important to have a list of questions that you can ask on your hospital tour about what’s important to you, and that’s going to vary person to person. You can’t ask things about your specific medical circumstances, but let me give you some that I thought of. One of them is, how many patients do nurses usually have? I will say that a lot of hospitals’ nurses have two patients, mostly up until the patient is pushing.

[00:06:05.900] – Hilary Erickson

Some hospitals, they only have one patient throughout. It really, really depends. And so I think that’s a valid and important question to ask so that you can understand how much support you’re probably going to get from your nurse while you’re in labor.

[00:06:16.520] – Hilary Erickson

Of course, these are not hard and fast rules. There are times that I’ve had four patients, one of them possibly delivering in the hallway because that’s how labor and delivery goes. And there’s times where we only have one patient on the unit and we all just don’t on her because we have nothing else to do. So it really just depends on who’s coming in, but it just gives you an idea of how busy the hospital is in general.

[00:06:36.190] – Hilary Erickson

I think it’s a great one to ask them, How often do you have births that fill in the blank? Go natural. Deliver on their back, ask for extra long cord clamping. Whatever is important to you? Do you ever deliver patients standing? Things like that.

[00:06:49.540] – Hilary Erickson

Now, a lot of those are really going to depend on your provider, usually your doctor. But it does give you an idea of the birth culture on the unit. If the nurse who’s giving the tour is like, No, we really don’t deliver too many patients’ standing. And if I was giving the tour on that, I would be like, That’s something I would talk with your provider about at your appointments.

[00:07:06.370] – Hilary Erickson

As nurses, we can always facilitate that because honestly, we’re not the ones on the floor delivering the baby, and we don’t hold any of the liability for that type of thing. So that is something you’d want to talk with your provider. But usually on the tour, they’re really good about saying that’s something you’re going to want to talk with your provider about.

[00:07:20.630] – Hilary Erickson

But again, these are good things to ask at the hospital tour because maybe they’re going to say, Yeah, we deliver people squatting all the time, and then you’ll know. Another good one that I think you can ask is, What’s something that surprises a lot of patients delivering here?

[00:07:32.640] – Hilary Erickson

If I was answering for my last hospital, I would have said, It is a hidden gem in the valley, so few people know that we even exist. We end up giving great care. But other ones, it would have been like, We ask you for money at the bedside to do your hospital binder. I probably wouldn’t have said that in the tour because I probably would have gotten in trouble. But just ask them just some questions like that so that you start to get a vibe or some idea of things that you might want to bring or expectations you can set for your delivery.

[00:08:00.880] – Hilary Erickson

As a reminder, as I just said, these are PR tours for the hospital. So we’re trying to bend over backwards, show you that you’re going to have a great delivery here, and they’re trying to spin things in a very positive way for the most part. I mean, we are nurses, so we’re probably going to be pretty honest.

[00:08:15.380] – Hilary Erickson

Although a lot of our tours were given by our unit secretary, the person that ordered pencils and pens for us. So she probably spun things nicer than the nurses did.

[00:08:24.970] – Hilary Erickson

And a lot of people are like, Oh, I should take this hospital tour at 35 weeks. I have people taking a hospital tour who are still trying to decide what doctor they were going to go to. So don’t feel like you have to do the hospital tour right before delivery. A lot of people are looking at a couple of different hospitals and they want to take the tour, and then they pick their provider based off of the hospital tour.

[00:08:44.040] – Hilary Erickson

So don’t feel like you can only do it once you’re close to your delivery date. However, if you know that you’re going to XYZ hospital because it’s the one you’re going to go to, I would recommend doing the hospital tour after about 25 weeks so that’s not too far in advance of when you’ll actually deliver.

[00:08:59.500] – Hilary Erickson

Because some hospitals have certain policies that kick in during cold and flu season, or if the parking lot is snowed in, they have specific areas where they want labor and delivery to park because the hospital parking lot gets smaller because of all the snow. So there’s things like that to think of that going a little closer to a due date is handy.

[00:09:18.970] – Hilary Erickson

One thing that I think a lot of people don’t think about is I actually did a sibling tour with my son when I had my second baby. If your hospital offers something like that, I think it can be really nice. It was nice for him to know where I was going to have the baby, and it wasn’t as surprising when he came to visit me because he had seen that unit before. There was a lot less catching him off guard when he came to see me after we had the baby. It also gave us a time to talk that the baby was going to come and all those different things. So if your hospital offers a sibling class, I would recommend it or at least call and find out what they talk about in there.

[00:09:53.080] – Hilary Erickson

My son got to wear a little hat and the little boot covers. It was really fun. We had a good time doing it together.

[00:09:58.640] – Hilary Erickson

So as you can see, I do recommend taking a hospital tour. If you guys have questions, come find me over on Instagram. I would love to chitty chat about what to expect at your hospital tour, or if they said something specific on your hospital tour that had you with a question mark over your head, tell me on Instagram, and I can interpret that and give you some ideas about what it might mean for your birth.

[00:10:18.590] – Hilary Erickson

Stay tuned. Next week, we are talking about smelly fridges and how to get rid of that smell at your house. And the week after that, we have a social worker coming on to talk about postpartum anxiety. So stay tuned.

[00:10:30.250] – Hilary Erickson

Thanks for joining us on the Pulling Curls Podcast today. If you liked today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.

Keywords:

hospital tour, hospital birth class, COVID hospital tours, virtual hospital tour, online prenatal class, prenatal class for couples, hospital amenities, hospital policies, driving to the hospital, hospital parking, labor and delivery tour, hospital toiletries, hospital mesh panties, hospital special lighting, hospital room fridge, pregnancy tips, parenting tips, childbirth preparation, childbirth questions, labor support, postpartum transition, sibling hospital tour, unusual childbirth requests, labor nurse support, birth culture, prenatal education, childbirth resources, hospital tour benefits, hospital room features, hospital preparedness

The post Hospital Tours 101: What Parents-to-Be Should Know appeared first on Pulling Curls.

Find it here on Apple or Spotify Podcasts

Big thanks to our sponsor The Online Prenatal Class for Couples — if you’re looking to get prepared it really is the easy way to do it!

Links for you:

Timestamps:

00:00 Birth trauma: deeply personal, varies between individuals.

04:45 Start communication early to prevent birth trauma.

07:36 Understand expectations, communicate effectively, learn from experts.

Keypoints:

• Introduction to the topic of preventing birth trauma.
• Emphasis on the dual responsibility of both providers and patients in preventing birth trauma.
• Explanation of birth trauma as a deeply distressing or disturbing experience.
• Importance of understanding the normal processes and procedures during labor and delivery.
• Advocacy for learning effective communication with healthcare teams early in pregnancy.
• Encouragement to lower and manage expectations about labor, delivery, and postpartum periods.
• The significance of having realistic and correct expectations for the birth process.
• Promotion of the online prenatal class for couples as a resource to prepare for birth.
• Discussion about the prevalence of misrepresented birth experiences on social media and TV.
• Upcoming episodes on baby safety and the benefits of taking a hospital tour.

Producer: Drew Erickson

Transcript

[00:00:00.000] – Hilary Erickson

Hey, guys. Welcome back to the Pulling Curls Podcast. Today on episode 253, we are talking about preventing birth trauma, so let’s untangle it.

[00:00:09.930] – Hilary Erickson

Hi, I’m Hilary, a serial overcomplicator. I’m also a nurse, mom to three, and the curly head behind Pulling Curls and the Pregnancy Nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with Pregnancy and Parenting Untangled, the Pulling Curls Podcast.

[00:00:30.290] – Hilary Erickson

Before we get started, I want to be sure that you understand that birth trauma has to be fought on both fronts, right?

[00:00:45.300] – Hilary Erickson

Providers 100% need to do better. But as patients, we can do better as well. And because my podcast is focused more on patients than providers, I’m going to tell you some things that you can do to help prevent birth trauma. So I’m not putting this all on your shoulders, but I’m saying you can help it, so why not give it a try?

[00:01:03.430] – Hilary Erickson

Today’s episode is sponsored by the online prenatal class for couples. We’re going to talk more about how it prevents birth trauma, but it is one of the best things you can do to have a great birth.

[00:01:12.780] – Hilary Erickson

Okay, before we get started, what is birth trauma? It is a trigger word a lot of times on social media. People are talking about trauma in lots of different ways, not just pregnancy.

[00:01:23.330] – Hilary Erickson

But trauma is a deeply distressing or disturbing experience. So something that you experience that was just really disturbing to you. And it really varies. That’s the tricky thing about trauma.

[00:01:34.500] – Hilary Erickson

One person can have an event and not find it traumatic, and one person can have the same event and find it very traumatic. So it’s always hard when people are saying, I had a birth where everyone came in to adjust the fetal heart rate monitoring, and that was extremely traumatic, whereas other people will be like, That wasn’t traumatic at all. I was so glad that they were there to save my baby, I don’t understand what your problem is.

[00:01:54.810] – Hilary Erickson

So we have to give the okay that everyone experiences things in their own way, and some people will find things traumatic that other people won’t find traumatic, and that’s okay.

[00:02:03.370] – Hilary Erickson

And as we do that, we realize that lots of different things can cause birth trauma, right? Things we did not plan. We all are like, Okay, you coded during your labor. That would be very traumatic to come back from the brink of death. We all can say that. Although sometimes I see parents who are just so grateful and don’t end up being traumatized by stuff like that. And I’m like, wow, either you’re shoving a lot deep down inside or you’re amazing that you do different things.

[00:02:29.080] – Hilary Erickson

So, lots of different things can cause birth trauma. And I’m always wildly surprised about the things that end up causing birth trauma. So what are four things that you can do to help prevent birth trauma in your upcoming birth? We’re going to talk about those things now.

[00:02:43.010] – Hilary Erickson

So the first one is to understand what’s going to happen. Honestly, I will say that some people are traumatized by the admitting process, the fact that you are in pain, and they’re like, What’s your name? What’s your social security number? Or however they’re going to identify you, they find that traumatic. They’re like, I just want to get to my room.

[00:03:00.550] – Hilary Erickson

Whereas if you understand it, you realize that they have to get you in the system. We have to be able to chart on you. We have to be able to pull up your prenatal records. If you understand why we’re doing that, it’s not just like, We’re trying to bill you, and I have a whole thing on that in the online prenatal class for couples.

[00:03:16.780] – Hilary Erickson

But understanding why they’re doing those specific things a lot of times can help. I’m just talking about the admission to labor and delivery. I’m not even talking about those five nurses that run in when we see the heart rate go down.

[00:03:27.540] – Hilary Erickson

And that can feel traumatic if you don’t understand that that is an everyday occasion to almost every patient in labor and delivery, right? Now, if I was on Med Surge and five nurses come running in my room, that is unusual.

[00:03:39.540] – Hilary Erickson

But it’s not in labor and delivery. So understanding what’s going to happen, what things are very normal, why things are happening that are very normal can really help. That’s why the online prenatal class for couples covers 95 to 99 % of very normal things that will happen in labor and delivery. So you just understand them and you know what’s going on. You feel very confident.

[00:03:59.400] – Hilary Erickson

I call it the scary stack because one thing happens, like the lady admitting wants her social security number and you can’t remember it. That’s the first book in your scary Stack. And then the next thing is you can’t understand how to put the hospital gown on, but you want to wear it. The third thing is they can’t find the baby on the monitor for 2 seconds, and you find that very distressing. And you start holding all these books, which are really very normal books and could go in your backpack, but you’re holding them. I call it the scary Stack. So you can put a lot of those things down when you understand that all this is very normal and it doesn’t need to be traumatizing.

[00:04:31.310] – Hilary Erickson

Okay, the second one is learning to communicate with your healthcare team. And wherever you’re at in your pregnancy, this is something that you start today. If you have any questions in your office, you’re asking your provider. When they say, It’s time to get a blood work for anemia, you go, Oh, really? Why?

[00:04:47.810] – Hilary Erickson

Even though it’s just a standard of care, you learning to say, Oh, why are we getting that? Is there something wrong with me? You can start having these conversations with your provider instead of just going like, Okay, and not really having a clue as to why we do it.

[00:05:01.900] – Hilary Erickson

You’re starting these communication things early. That’s why I recommend bringing a birth plan early, because a lot of times it just starts this communication in a really easy way, even if it doesn’t really affect what care you get during your birth. It’s starting those open communication pathways, because when you feel forced into something, that’s one of the biggest trauma triggers, right?

[00:05:22.280] – Hilary Erickson

If you feel like you don’t have any control over the situation and you can’t affect any change, that is a trauma trigger for a lot of people. But when you learn to communicate, when you learn how to say, I don’t understand what’s going on, when you learn how to ask, Is this a real emergency, or do we have a second to talk through things? It really can help with birth trauma. So understanding how to communicate early on at your next prenatal appointment is so important.

[00:05:46.280] – Hilary Erickson

And quick reminder, it’s not just about communicating with your provider. It’s everyone that you meet, the ultrasound tech, the nurse in the office, or the MA in the office, all these different things. You’re just learning to communicate with them because I don’t know if you know this or not, but when you’re in labor, you’re actually going to see your doctor for very little of the amount of time that you’re having your baby. You’re mostly going to see a labor and delivery nurse.

[00:06:07.150] – Hilary Erickson

So learning to talk with providers who aren’t your doctor or midwife is an important skill. Keep it up, ladies.

[00:06:13.540] – Hilary Erickson

Okay, the next one is to lower your expectations or to not have false expectations. A lot of us think you’re going to go into the hospital, you’ll probably have the baby within an hour because that’s always how it happens on TV. When you go in and you find out that you’ve got a long time waiting in pain in the hospital, and then it also takes two hours to push out the baby, that can be really disheartening.

[00:06:35.900] – Hilary Erickson

So lowering your expectations of yourself, the fact that you haven’t experienced this type of pain before, and although you’d like to avoid an epidural, it’s okay if you want to get an epidural, or you thought you didn’t want to have an induction throughout your pregnancy, and then all of a sudden you get to 39 weeks and you’re like, I’m done. I want this baby out. It seems safe to do it.

[00:06:55.150] – Hilary Erickson

Lowering your expectations is such a good thing to do throughout your life. That is like, I should rename the podcast, Lower your expectations, but it doesn’t have anything to do with Pulling Curls, so I can’t. But I feel like I talk about that so often on this podcast. Lower the expectations.

[00:07:11.610] – Hilary Erickson

And then finally, you need to have correct expectations. Understanding what’s going to happen at birth is going to help you modify your expectations.

[00:07:17.680] – Hilary Erickson

And I see this, especially in postpartum. We always see these adorable pictures with a mom looking like she has makeup on and her hair doesn’t look like Simba, and she’s loving her baby because that’s the picture people want. They don’t want the picture of them sleepless, no makeup on, hair looks like Simba, they’re yelling at their partner. Just understanding expectations for labor, pregnancy, birth is so important.

[00:07:41.190] – Hilary Erickson

Those are the four things that I recommend to decreasing your birth trauma. Let’s review them one more time. Lowering and having adequate expectations or correct expectations, I should say. Communicating with your healthcare team well and understanding what’s going to go on during this process. Don’t letting the three deliveries that you’ve seen on social media or on TV make you think that that’s what’s going to happen in the hospital because every birth is different and you need to learn from an expert.

[00:08:06.580] – Hilary Erickson

So come join me in the online prenatal class for couples. It is the easy way to get prepared for birth, and we really do prepare you from bump to bassinet so that you’re completely ready and it only takes three hours. It is completely virtual, and you can do it whenever you want. So I would love to see you guys in there.

[00:08:21.930] – Hilary Erickson

And of course, I hope that as OB providers, we are working on our end to make birth less traumatic in general. But I hope you guys want to do the things on your part that can help prevent it as well.

[00:08:33.330] – Hilary Erickson

Stay tuned. Next week, we are talking with one of my good friends about baby safety. And then the week after that, we’re going to talk about why take a hospital tour. So stay tuned.

[00:08:42.120] – Hilary Erickson

Thanks for joining us on the Pulling Curls Podcast today. If you liked today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.

Keywords:

Pulling Curls podcast, birth trauma prevention, Hilary Erickson, episode 253, preventing birth trauma, pregnancy nurse, birth trauma definition, patient empowerment, traumatic birth events, preparing for childbirth, online prenatal class, couples prenatal class, understanding labor, labor and delivery process, hospital admission process, fetal heart rate monitoring, communicating with healthcare team, birth plan, trauma triggers, managing childbirth pain, postpartum expectations, realistic birth expectations, labor expectations, childbirth education, healthcare communication, prenatal care, labor nurse interaction, birth trauma causes, hospital birth experience, pregnancy advice.

The post The Role of Preparation in Preventing Birth Trauma appeared first on Pulling Curls.