Premature Rupture of Membranes at Term

How do you know your main bag of water breaks? You feel a pop & fluid bursts out of your vagina like a river, making a large ~ 2 1/2 - 3 cup puddle on the floor, or it totally saturates your clothes or where you were sitting/lying. You keep leaking fluid throughout the day that’s not pee, saturating your maxi pad like the first morning baby diaper, or your poured at least a few cups in it. It looks clear, blood tinged with white specs of vernix, or it’s brown/green color of baby’s first poop meconium (let your provider know). It does not look or smell like pee or semen (no history of recent sex). Your provider sees it flowing out of your vagina, pooling in your vagina on sterile speculum exam or on microscope, or simply + Amnisure test.

And it’s not the few tablespoons of fluid between the two membranes that can release before labor making ~ pancake size stain on your underwear, seat, sheets. It is important to know that as main membranous bag is intact. When in doubt discuss with your provider. They can confirm or rule it out. The test strip that turns blue with amniotic fluid is not diagnostic by itself as it can also turn blue with other things, like blood and even the fluid in between the membranes. It is important to be certain of the diagnosis of PROM. You do not want to be falsely diagnosed as “ruptured membranes” with all the possible unnecessary potentially treatment that entails.

PROM - premature rupture of membranes means when the main amnion bag of amniotic fluid breaks at term, before labor. It happens 8-10% of the time. It’s important to know for sure it’s not just a crack in the inner chorion membranous bag, leaving the main bag intact, so you’re not on the “clock” unnecessarily. Babies are double wrapped with a few tablespoons of fluid in between the two membranes - enough to make a pancake sized stain on your underwear or whatever you’re sitting on if outer bag tears, but then no further leakage. If in doubt, I advise wearing a maxi pad & walking around a few hrs. If it becomes saturated like an overnight diaper that’s the main inner bag with lots more fluid just > 1/2 liter; if it remains dry PROM is unlikely.
But is this “clock” evidence based? No. Recommending to induce to avoid risk of infection & stillbirth is based on outdated low quality studies from 1959s-1960s. According to newer quality research, as long as mom & baby are doing well & meet certain criteria, induction is just as much an evidenced based option as waiting for mama to go into labor on her own up to 48-72 hours later, without increased risk newborn health problems or death. 77-95% will go into labor anyway by 24 hours.

Many leading professional organizations like ACNM, RCOG, NICE, AOM, & RANZCOG recommend offering both options as acceptable as long as certain criteria are met - like single term uncomplicated pregnancy, clear fluid, no fever, no GBS, & normal fetal heart rate. ACOG says induce immediately but that if mom declines, waiting for labor to start on its own (expectant management) is acceptable. Waiting for labor to start on its own has very good outcomes for moms & babies. Induction of labor has strong consequences like the cascade of interventions, cesarean & birth trauma, & many opine it can not be justified as standard of care for a normal physiological occurrence in healthy term pregnancy.
It’s important to know your rights to autonomy, & be educated to make an informed decision if this happens. Do avoid or minimize internal exams or anything internal as it increases risk of infection.

If you are interested in more gentle ways of bringing on labor naturally refer to my Natural Birth Secrets book second edition.
Be informed, empowered & educated with my online course Guide to Pregnancy, Birth & Postpartum - sold separately or in a bundle.

Induction of Labor: Invalid Reasons

According to the research, not many of the common reasons for induction are evidence based. People are feared into induction too often unnecessarily. For a surprising number of conditions, there has been no proof of the benefit or effectiveness of labor induction but actually have been shown to cause more harm - like suspected big baby, being labeled as high risk by your age alone, isolated ow amniotic fluid, and intrauterine growth restriction before term.

The benefits of imminent birth must outweigh risks of induction of labor and all that entails. That is when mama’s or baby’s life is in jeopardy and imminent birth is life saving as compared to possible dangers of continued pregnancy.

Thanksgiving, Christmas or any holiday are certainly not complications of pregnancy. Rates of induction continues to skyrocket, remarkably so in the days leading up to the holidays, with US rates in general, way above the rates from even 20 - 30 years ago, but our outcomes are continuing to get worse! A large amount of research demonstrates the risks far outweigh the benefits of induction especially when mom and baby are healthy. Elective induction without a well-supported medical reason clearly increases risks - for babies especially before 39 weeks. Induction before 41 weeks significantly increases chance of having a cesarean birth, major abdominal surgery with all its associated risks - especially for first time vaginal birthers and having a cervix that is unripe - not ready. Induction also greatly increases the chance of needing pain relief like epidurals which have their own risks for both mom and baby.

For example, induction of labor is absolutely appropriate in worsening gestational hypertension or preeclampsia, if mama or baby has a serious illness in which prompt treatment is needed after birth. But even in pregnancies that go beyond 41-42 weeks, there are pros and cons, potential risks and benefits to watchful waiting versus labor induction, which must take into account mama’s preferences, knowing that she has medical legal right to autonomy and declining induction of labor.

IUGR is not an evidenced based reason to induce labor. There are a variety of known causes of true IUGR (intrauterine growth restriction), like high blood pressure, heart/lung/kidney disease, diabetes, malnutrition, serious anemia, cigarette smoking, drug and alcohol abuse, certain infections, and fetal abnormalities. But do know that in well dated pregnancies, the majority (80-85%!) of babies identified as having IUGR are simply constitutionally small but healthy. They are just weighing below the tenth percentile. All of my four babies were off the growth charts diagnosed small for gestational age (SGA) but I and my husband are not tall and I simply make six pounders who consistently grew but stayed way below average in growth by height and weight even as kids.

Oligohydramnios - low amniotic fluid, by itself (not associated with other problems such as preeclampsia or birth defects) is also not a reason for induction as it is not associated with increased risk of poor outcomes, nor backed by the research. Actually, the main risk of low amniotic fluid at term in a healthy pregnancy is induction and cesarean as a result of the induction, and potentially the risk of lower birth weight of a baby born too early. There is no evidence that inducing labor for isolated oligohydramnios has any beneficial impact on mother or infant outcomes, but rather the risks of induction far outweigh the alleged benefits. A large body of research indicates that ultrasound measurement of low amniotic fluid is a poor predictor of actual amniotic fluid volume, so potentially inaccurate assessments dictate risky recommendations. Amniotic fluid in an otherwise healthy pregnancy lessens in the few weeks before birth, and post term related to decreased swallowing and urine output by baby. But it is often related to dehydration, seen more in summer months. If a mama drinks 2 - 2.5 liters of water daily she is likely to increase the amount of amniotic fluid volume, and she can up her amount if a low amount was detected on ultrasound.

Induction at 39 weeks of pregnancy is based on the Arrive study, which has flaws and goes against common sense as well as all the science & research up until now. The American College of Nurse Midwives does not support it and continues to advocate for spontaneous labor & healthy normal physiologic birth as well as a women’s right to self determination. For a thorough analysis of the the Arrive study on which these recommendations are based here are a few resources:

- evidencebasedbirth.com/arrive
- midwife.org/ACNM-responds-to-release-of-arrive-trial-study-results

- sarahbuckley.com/should-every-mother-be-induced-the-arrive-trial

- Lamaze.org/connecting-the-dots/parsing-the-arrive-trial-should-first-time-parents-be-routinely-induced-at-39-weeks.

Inducing labor or cesarean for suspected big baby in pregnancy isn't evidence based care and is potentially harmful. Estimated fetal weights based on ultrasound or abdominal assessment are notoriously inaccurate. They do not account for the ability of the pelvis to stretch, the power of mobility and gravity, baby's head’s ability to mould to navigate through the birth canal.

Especially because of the inaccuracy of estimated fetal weights, it is not evidence based care to induce labor or send you to the operating room for this alone. It is a fear based practice and has way more risks than benefits and again, not backed by the research. Time to stand firm. Don’t let them scare you. Fear increases your stress and negatively impacts your labor. You have the right to decline and even switch providers to those more calm, supportive of your choices and who practice evidence based care.

Even if baby is a good size, baby’s not yet fused skull bones can mould to fit through the pelvis which can stretch and increase capacity in asymmetrical upright and mobile positions, which also work with gravity. Plenty of mamas birth ‘big’ babies when given the opportunity and support. You have your provider there also as a lifeguard in case of need, like to relieve the uncommon but potentially serious complication of stuck shoulders called shoulder dystocia which can also happen in smaller babies. It’s certainly easier to push out smaller babies, and you can do your part by staying off sugar foods, refined carbohydrates, and juice. But no, don’t succumb to this routine practice of induction or scheduled cesarean for suspected big baby (macrosomia).

TRIGGER WARNING: With permission I share a tragic story of someone I knew who was having her first baby. She was told she needed to be induced before due date because they said baby’s weight was almost 10 pounds and she had a small frame. It was a top notch, highly esteemed medical center and hospital. Induction at 39 weeks no surprise didn't work, so birth was by cesarean. Baby weighed 7 1/2 pounds. Mom bled profusely during surgery. That is a risk of cesarean especially followed by medications for induction. She bled so much they removed her uterus. She ended up in a coma in the ICU and despite blood transfusions and intensive care she died. There is a patch for her in Ina May’s large Safe Motherhood patchwork quilt project, one patch devoted for every maternal death in the US.

For a more inspiring birth story of redemption, on a happier note, another mama came to my practice wanting a VBAC. Her first cesarean was done for suspected big baby over 9 pounds, but baby weighed only 7 pounds. She said her doctor told her no trial of labor as her pelvis was too small for her big baby and it would be too dangerous. She had a lot of trauma from her birth experience which propelled her to educate herself, prepare big time do things in a whole different way next baby. She took my online signature course Guide to Pregnancy, Birth & Postpartum & used my Natural Birth Secrets book 2nd edition as her “bible” she called it. She read lots of other books, took my prenatal yoga classes….and switched to midwifery care with me against her obstetrician’s warnings she and her baby might die. We worked closely together. She was so proud of her ability to have a beautiful VBAC at home (HBAC), and that a 9 pound baby slipped right through her birth canal without a tear. She actually wrote her obstetrician telling him that her pelvis grew.

Sometimes I have to get real with you to drive a point. Despite all the money and technology of modern US medical and hospital care, the United States ranks the worse among developed countries in terms of birth outcome statistics - our maternal mortality and morbidity rates are on the rise like no other country, and rates of neonatal morbidity and mortality and birth trauma are also horrendous. The countries who have best outcome stats are countries that have more midwifery care that services the low risk healthy population who benefits most by not disturbing physiologic birth when all is well, leaving the obstetricians to provide care to those who have higher risk conditions, complications and need lifesaving medical and surgical care. When high risk care is applied to healthy low risk people, we see more problems, we contribute to the horrid outcome stats of our country.

So let baby come when they are supposed to come and don't let anyone pressure you into an unnecessary induction. Even back in 2013, a listening to mothers survey showed that 4 out of 10 mothers (41%) said their care provider tried to induce their labor. You have the right to say no and switch providers to those who support the natural process of letting labor start on its own when all is well. Rates of routine unnecessary inductions are on the rise - from 9% of births in 1989 to 31.37% of births in 2020, which increases risks - including failed induction as the body is not ready, & unnecessary cesarean with all that entails.

Remember we are not in control or as wise as the greater intelligence that designed the process. Giving birth is such a lesson in surrendering to that greater power that transcends us all.

What can you do? Empower yourself with resources like my book & online course Guide to Pregnancy, Birth and Postpartum - bundled together or sold separately! Say No!! Prepare like a boss. Go to supportive providers. They are out there. We must be the change we want to see.

Interview with renowned author Henci Goer

It was such an honor to speak with renowned pregnancy and birth author Henci Goer…We talk all things out-of-hospital home and birth center birthing as well as hospital birth. What is the evidence saying about the safety of each option, and how can you best navigate the world of having a baby these days….to birth YOUR way, have safer outcomes and feel wonderful about your experience.

Starting out as a Lamaze teacher and doula, Henci Goer’s life’s work soon became analyzing and synthesizing the obstetric research in order to give pregnant women and birth professionals access to what constitutes optimal care in childbirth.

 She is the author of four books: Labor Pain: What’s Your Best Strategy?, Optimal Care in Childbirth: The Case for a Physiologic Approach (co-author Amy Romano MSN, CNM), The Thinking Woman’s Guide to a Better Birth, and Obstetric Myths Versus Research Realities. In addition, she has written numerous blog posts and articles and given lectures around the world. 

In recognition of her work, she has received, among others, the American College of Nurse-Midwives Best Book of the Year Award, Lamaze International’s President’s Award, DONA International’s Klaus & Kennell Research Award, a Lifetime Achievement Award from BOLD Atlanta, and the Media Award from the American Association of Birth Centers. 

The “Take Charge of Your Birth Series,” short books on single topics to help women make informed choices and obtain optimal care for themselves and their babies, is a continuation of her work. Labor Pain: What’s Your Best Strategy? is the first book in the new series. It delivers up-to-date access to the best medical research plus practical strategies for developing your plan and putting it into action. Also available in audiobook.

Website: hencigoer.com

Facebook: https://www.facebook.com/takechargeofyourbirth

Instagram: @takechargeofyourbirth

Her Latest Book: Labor Pain: What’s Your Best Strategy? is available on Amazon in paperback, ebook, hardback, and audiobook versions.

If you are planning a pregnancy, expecting, wanting to prepare as best you can for birth and postpartum, get yourself my online Guides!

I’ve taken everything I’ve learned from over 27 years in my private practice and I’ve poured all of my love, passion, knowledge, and experience into creating something truly special for you… my new Pregnancy, Birth & Postpartum Guides. My transfer rate from home to hospital is 7% which means 93% of mamas are having beautiful natural homebirths, and I have not once had to transfer a mama for an epidural because she could not handle the sensations of normal labor. Not once. A huge part of that is how I help them prepare. I want that for you!

As they say, knowledge is power, and my Guides/e-courses can be a great way to understand the pregnancy, birth and postpartum process, clear up any confusion and trepidation, find your confidence, inner calm and strength, bust through fears and misconceptions, get expert guidance on everything you need to know, learn coping tools and mindset shifts to last a lifetime, as well as boost your health and well-being, and absolutely love your experience no matter how challenging.

Whether you’re an experienced or new parent, there are over 24 hours of videos, workbooks, and PDFs to answer all of your questions. Everything in my Guide is searchable; so you can just type or talk and it’ll bring you right to the exact moment in the video where I answer your question. Try it! Say "Labor Positions" and it'll bring you right to the moment I start talking about positions ideal for labor. It’ll blow your mind!

The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Moms like you!

have created THREE Guides with hours of searchable videos, workbooks and pdfs to lead you to the birth of your dreams! They are easy to use, mobile friendly, and transliterated and translated in Spanish, French, and any language you need! AND THAT IS HUGE! TAKE ADVANTAGE NOW, AND YOU HAVE LIFETIME ACCESS.

Pregnancy

Childbirth & Labor

Postpartum

For more in depth discussion and holistic modalities for common ailments through the entire journey of having a baby, check out my Natural Birth Secrets book 2nd edition, available in print, kindle and ebook.

Natural Birth Secrets: An Insider's Guide...How to Give Birth Holistically, Healthfully and Safely, & Love the Experience! 2nd edition eBook

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Becoming The Creator Of Our Pregnancy, Birth and Life

As featured in the Best Holistic Life Magazine….

The biggest act of self-love is to become the creator of our lives, not the victim; to take charge of our thoughts, emotions, reactions, behavior and habits that do not serve us; to take responsibility for our own health and well-being, not depend on others to do that for us. As a holistic nurse-midwife of 27+ years, self-love includes taking back our pregnancies, births, and health of our babies. This takes lots of work. But the reward is divine, sacred , empowering and transformative. You want to shout from the roof tops how incredible your experience was, how it moved you and your partner to tears and opened your hearts, that you DID it, you found your strength in the challenge – in the mountain that you felt too big to climb, and you birthed your baby as YOU wanted to. Your body worked to birth as your heart knows how to beat and your lungs know how to breathe.  You can draw on this power forever as you face other mountains that seem too high.

In the westernized early 1900s, healthy birth was moved out of the homes and normal family life, and taken over by hospital institutions and their providers; it was treated as an illness and stripped of humanity; our ability to give birth and experience it in its intensity, its raw realness and wondrous beauty, surrounded by the support and wisdom of our loved ones was robbed from us. We surrendered our autonomy, and harmful things were done to us in our most intimate areas, at our most vulnerable moments; we trust technology and modern medicine rather than ourselves and our healthy bodies innately wise ability to grow, birth and breastfeed our babies, and our healthy babies’ ability to be born and breastfeed. This caused high rates of birth trauma and worsening health outcome stats for mom and baby as compared to developed countries, among other concerning long term effects.

There is HUGE hope. That depends on YOU. It involves lots of preparing like you are running your marathon, educating and empowering yourself with knowledge; mastering coping and life enhancing techniques to practice so they become habitual; shifting your mindset, getting your modern mind out of the way so you can let you body do its thing; remembering what you forgot; going against your conditioning, going against the grain, your culture, your family and friends who may not understand, and joining a new rapidly growing community who are doing this with you around the world; being very selective about the provider and setting you choose to give birth, and respectfully speaking up for your rights as an autonomous human being. This may involve paying more money, but it’s worth every penny. The outcome is not only a healthy mind, body , heart and spirit for you, but also for your baby and your family, you will all treasure forever. You will have the experience of pregnancy and giving birth beyond your wild dreams, supported as you deserve postpartum – as we have been for thousands of years before. You will LOVE the experience in spite of its intensity and challenges. You will be so darn proud of yourself with a heart bursting with joy and gratitude.

It is SO possible. But YOU must be the change. I recently received an email from a mama who lives in a remote rural area. She had no option for her birth setting and provider other than a small local hospital with an obstetrician with unacceptable, extremely high rates of risky interventions and cesarean. She was inspired by my social media pages, devoured my book. She wanted a natural birth, a special peak life, family-centered experience that is inherent in bringing the new life of your own baby into the world. He said he did not practice that way, never saw natural birth and did not believe in it. She empowered herself further by taking my online course, presented him with her evidence based decisions and choices, and kindly insisted that he honor her wishes, to be there in the background, just in case, to do nothing but let her body go through its natural physiologic process without disturbing it. He finally agreed. She had her beautiful healthy birth and not only was she in heaven, but also her obstetrician was humbled and moved beyond words. What a ripple effect that will have on how he cares for others in his practice. That is how we improve birth and make needed change.

My gift to you to get you started is my free guide to planning your own birth mini course - with video and PDF download. My advice is to prepare like a boss so you can rock you birth in all settings. It takes work, but it is beyond worth it. Here are more resources I have for you. Each are different, and they are meant to be used in adjunct to one another. Many blessings on your journey of a lifetime!

Love Your Birth Course

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NEW! and IMPROVED, including an extra 20+ BONUS Videos!

Love Your Birth is a holistic, holistic midwife created, doctor recommended, on-demand course to help you birth YOUR way at home, birth center or hospital. Prepare for the most blissful experience from pregnancy to postpartum.

I’ve taken everything I’ve learned, trained and supported women with locally for over twenty years in my private practice and I’ve poured all of my love, passion, knowledge and experience into creating something truly special for you ... LOVE YOUR BIRTH!

10 core video modules with 13+ downloadable resources and packed with over 20 new BONUS videos and resources:

• Health In Pregnancy

• Preparing The Mind

• Testing Procedures

• Anatomy and Physiology

• Labor Coping Techniques

• Birth Preferences

• Guidance For Dads And Partners

• Postpartum - the 4th trimester

• Breastfeeding and Newborn Care

• Meditation, Breathwork, Visualization and Relaxation

  NEW! Over 20 Newly-Added BONUS Videos Where I Answer the Most Common Questions I am Asked, and Discuss Hot Topics Relevant to Your Journey.

  Value — Priceless :)

  The videos include discussions about such topics as:

• What to do when family and friends not supportive of your choices.

• Supplements in pregnancy.

• Prenatal yoga.

• VBAC (Vaginal Birth after Cesarean).

• Kids at birth.

• Friends and family at birth.

• Ideal Candidates for homebirth.

• How to have a homebirth like experience in the hospital.

• More on the placenta.

• How to deal when things don’t go as planned, and so much more!

The key to a positive birth, is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take.

Photo Credit: Megan Hancock Photography

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A Walk With Anne - Tips & Insights on Holistic Pregnancy, Birth & Beyond Online Course

$77.00

Take a walk with me, Anne Margolis, where I talk on topics that matter to you on your journey of planning pregnancy, birth, postpartum and beyond.

Over 45 short, sharp video talks, covering:

Planning pregnancy

• What to do

• The preconception appointment

  Pregnancy

• How to find & choose a provider

• When to start prenatal care

• Elective testing

• Pep talk for first trimester feeling sick symptoms

• Group B Strep

• Internal exams

• Preventing late pregnancy panic & birth trauma

• Pep talk for going past due date

• What we can control & when we need to let go & flow

• What happens at the prenatal home visit when planning a homebirth

• How to know if your tub is good for water labor/birth

• Tub temperature, when to set up & get in

• Planning a homebirth & packing a hospital suitcase?

• Dealing with homebirth in apartments or with neighbors close by

• Postpartum prep

  Birth

• Fear of losing control

• Pep talk for second time mama birth fears

• How we can improve birth outcomes

• Why the name Home Sweet Homebirth for all settings

• Handling emergencies out of hospital - at home or birth center

• Need for advocacy in hospitals & why we must be the change

• Soothing nature and labor sounds

• Visual for birth

• Inspiration for your birth

• The huge gift in birth

• Dogs & cats at birth

• When to call your provider in labor - noticing stages & progression

• Early labor pep talk

• Pep talk for on and off or prolonged labor

• The post birth sacred pause

• Dealing with birth ‘mess’

• Planned unattended freebirth

• Some things we learn from animals

  Postpartum

• Preparation begins in pregnancy, what you need to do, what support is needed

• Dealing with emergencies - processing & healing afterwards

• Postpartum illness, depression/anxiety

• Gifts to give your midwife

  Holistic Health and Healing

• What is it?

• Importance of posture & improving it

• Pausing throughout the day

• Tools for hard days

• How to find your inner calm

• Transforming ‘what if’ thinking

• Meditation - why and how

• Self-care non-negotiables

Watch anywhere/anytime, on your PC, laptop, tablet or mobile.

Prenatal & Mindful Hatha Flow Yoga Class Series Online Course

$147.00

This course has 16 yoga classes plus bonus material:

• Seven ~ 60-80 minute Prenatal Yoga classes

• Seven ~ 60-80 minute Mindful Hatha Flow Yoga classes

• A soothing Gentle Slow Flow Yoga class

• A Restorative Yoga class for deep relaxation

• Bonus videos of an hour Live more advanced Vinyasa Class, shorter breaks of yoga anywhere anytime, use of props - like the wall, a chair, yoga blocks, yoga belts, yoga blankets and bolsters to enhance your practice, and practicing with your baby or pet.

The prenatal yoga 7 class series will invite you to grow, strengthen, focus, train and enhance your mind, body, heart and spirit. Discover for yourself the calming, healing and transformative power of yoga - intentional meditative movement with breath. Classes begin with meditation made simple using breathwork, gradual warm up, increasing difficulty as well as yoga play, gentle cool down, and end with restorative practices in deep relaxation. They are slow flowing, with space to explore specific poses but are meant to challenge you. Classes are different each session, with classical fundamental alignment based asana fused with modern postures and their many modifications and varied creative transitions. The classes are taught with modifications for pregnancy, incorporate positions for positively influencing baby’s position and active birthing as well as those to relieve common discomforts in pregnancy. They also are fused with meditative, breathwork and visualization techniques and tools for coping with and easing sensations of labor and birth, which will transform your childbirth experience with regular practice.

The seven classes are there for you to practice a different class each day of the week or according to your own frequency, then start over again from the beginning of the series. Each class ranges from on average 60 minutes to 80 minutes, and they build on each other; following the sequence from class 1 onward is advised if it is your first time taking the series or are a beginning practitioner. Classes are mindful, at a slow safe pace, gentle but challenging, so that you build strength, flexibility & agility. They start with the basics but are for all levels, and beginners too are welcome! If you are not pregnant, you can use the prenatal classes as beginner classes, just modify as needed and use any mention of pregnancy and labor as it pertains to any labor of your own life. The need to relax into intensity and the multiple benefits of yoga practice pertain to everyone. Or simply take the general Mindful Hatha Flow Yoga Class Series online course.

Once you hone your skills, you can take the Mindful Hatha Flow 7 Class Series that follows, doing your own modifications as needed - for pregnancy or wherever you are on your yoga journey, or simply start them after you are recovered postpartum. They also build on one another and can be practiced successively until you are ready to mix and match and create your own classes and practice schedule.

Additional videos are included to enhance your practice with use of the various props, as well as a soothing gentle slow flow class and a restorative yoga class for deep relaxation (great for evening!), shorter breaks of doing it anywhere and anytime, and a live bonus video of a more advanced class.

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Want a comprehensive holistic guide to the journey of getting pregnant, being pregnant, birth, breastfeeding, postpartum and beyond? Check out the second edition of my international and national best selling book Natural Birth Secrets.

Cesarean Birth and Prevention

Blog post featured image: Photo by Jonathan Borba on Unsplash

--- BEGIN TRANSCRIPT Instagram.com/homesweethomebirth ---

Hi. I wanted to come on and talk about cesarean and why I'm so passionate about preventing it. 

But what I want to mention first is that the rates in this country, in the United States, are going up and our outcomes are getting worse. Okay. The national average is 30%.

That's just unacceptable.

Some hospitals around where I live, the rate is 40 to 50%. Unbelievable. Why? There are so many reasons why, but I just want to share something with you.  

My rate is 5%. My rate of cesarean birth is 5%. I'm not bragging. This has nothing really to do with me. I, 

What's different. Why is that?

Why do you think the rates in my practice are 5%, and the rates in the national average of hospitals are 30% and climbing?

The families that come to my practice don't have different bodies. The people don't have different bodies. 

You know what's different. They're getting midwifery care.

They're getting midwifery care. They are low risk and healthy. And maybe someone even labeled them as high risk, but they're not really high risk. They're just healthy. They might have an issue or two, but you know what they're doing? They're taking responsibility. That's also what they're doing.

They're preparing as I recommend them to prepare, and they're taking responsibility for the birth, they're not just saying to me, do whatever, right. 

They are taking it upon themselves. 

Why do they need to prepare? I'll tell you why they need to prepare, because I know that women's bodies know exactly how to give birth. A healthy body knows how to give birth. Right? 

Why in the West do we need to prepare? Because we're in the West. We're in the Western culture.

I feel so strongly about this because I do hospital shifts. I do hospital shifts and I love to do hospitals shifts in hospitals that serve the immigrant populations.

I love that. And I can actually do prenatal care and help a mama in labor as much as possible with my heart and with my Spanish. Now I am not fluent, okay, but I love working with this community, the immigrant population that's coming up, because I'll tell you why. Not just, I love them, but the less Westernized they are, they don't need to take childbirth classes, they just come and birth just like that. 

And you know why? Because the newer they are to this country, the less westernized they are, they came from countries where they were surrounded by people having birth. And in a community. And the women in their community, the elders, the wiser ones would talk to them about it and they would see it. 

I mean, I just spoke with a grand-momma, an abuela, who had 11 babies in her casa - back in her country. 11 babies in her Casa. That's what everybody did.

She didn't need a childbirth course. She was surrounded by everybody doing that. So, she got that education, and she got that by osmosis, that “We know how to do this. This is what we know how to do". And you know what, it's hard, but we can do hard things. Like we don't need to numb ourselves from pain. They deal with pain. They just deal with it. The more westernized they are, the more we are in our brains, the more we are in fear. Not “we”. No, because I've healed myself, I've tried to de-Westernize myself when it comes to helping moms give birth.

And I feel strongly about this, because, we can't help the way of our culture. Okay. We get fear messages. Oh my gosh we get fear messages all over the media. You know, someone sees you're pregnant they're going to tell you a story. And we are addicted to Googling everything. We're just too much in our brains. It's just, it's just the way it is. We have to research this, we have to research that, and we have to numb. We're not comfortable with discomfort.

And that's why I love my yoga training. That taught me, that deep in yoga, to combine that with being a midwife is just an amazing combination. Yoga doesn't come from the West. It comes from the East. To be comfortable with uncomfortable. To be comfortable with discomfort. To be comfortable and relax into intensity. 

And I needed that to help me understand and how to help other people do that. But there are cultures around the world, here are countries around the world that never did any yoga. They just live in a community, and are surrounded by the elders and other women in the community. They just do it. You know, we do hard things. And we just give birth.

So, that’s why I think a huge part of the success of a lot in my practice, and a lot of my colleagues, is that we're really are, to the families that have a baby in the home, in our practice are Westernized. They might want to have a home birth, but it's their first time, they know nothing about birth. They haven't been around it. 

They tell me they don't know anybody that's had a home birth that I can connect them with. Well, I know tons of people that have had a home birth.

So, that's why I love connecting moms and their partners, so that they don't feel so isolated. But a lot of times the families that come to me, their parents gave birth in hospitals with all kinds of interventions and they just, they feel very isolated and unprepared. And, and just looking at videos and pictures, scrolling down, on Instagram is not the way to prepare. I'm sorry. It's not. And that's why I really think a lot of the success comes from myself and my colleagues really being insistent that the family who comes in to have a home birth is going to prepare like a boss, right? 

Get de-Westernized, get primal and get sensual, and learn how to relax into intensity and learn about birth because no one ever taught you. Right. And learn the techniques that you need to do to master your calm. And, and to just let your body do it. And, and I think that's a huge part of our success. 

I track my stats, and unfortunately the 7% of times that I have to go into the hospital, it's not because of an emergency. Emergencies are rare. We deal with them, or I can count them on my hand.

I'm the EMT. The midwife is the EMT at the birth. We prevent and we deal with any problems that come up. And if we need to go to the hospital, we need to go to the hospital.

But that's 7% of the time. That means 93% are having births at home.

But who is my 7% that needs to go to the hospital?
It tends to be, and I track my statistics. I've been tracking them for years. It's people with long, stuck labors, first time birthers, first time vaginal birthers, who did not prepare.

They just didn't want to take a course, they were preparing on Instagram or they, or they just weren't preparing at all before Instagram.

You can't prepare on Instagram. You have to take a class today. Yes. In the West. You have to take a class, unless your mom and your grandparents have given birth at home, and you're surrounded by, natural birth. Because natural birth in the West is very different. It's a very different experience if you've never done it before and you can't prepare on social media. Okay? 

Then, you have to think about who are you going to, who are you going to - let's say you want a natural birth. Well, if the hospital or the provider that you're going to is, let's say you're healthy and you want a natural birth, if the hospital and the provider that you're going to doesn't do natural birth. They're not into it. They weren't trained in it. They're into interventive birth, it's going to be very hard for you to have a natural birth, right? And one intervention leads to another intervention, leads to the other intervention, and unfortunately ends up in too much intervention and complications and cesarean births. 

I am so grateful for cesarean births for when it's necessary and that's why I post on it. And yes, we could have gentle cesareans for those mamas. Five percent - they're still human beings, and that's still a birth, and those mamas are rockstars because they need to have a compassionate, human, respectful family centered, gentle cesarean, and we can have as much as possible that home-sweet-home birth in the hospital or in the operating room, but we still have to prevent. 

So, you have to think about – even if you want a vaginal birth - let's say you want an epidural - if you want a vaginal birth, you have to know. Ask “What's the rate of cesareans in your hospital?”. Is it 30%? Is it 40%? Is it 50%? Then it's very unlikely - unless you prepare. Then have to prepare even more, right, to fight that system. Because, I don’t know, I talk about this all the time and I'm so passionate about it because I think that's how we make the change. 

How we be the change, how we make the change, is for you all to prepare yourselves and take back your birth and know what setting and what provider you're going to. 

And if you are blessed, if you're healthy, or you have a little issue or two, that doesn't risk you out of midwifery care. Find a midwife. 

That's the model of care in a lot of countries where the midwives who are trained. You know, I have seven years of training, it's not just a weekend course. I had to get my bachelor's, and I got my master's, and where I live, I need a master's degree. I have seven years of training and education, and it's specifically focused on supporting the low risk healthy.

Yes, we screen, we prevent, and we look. That's what prenatal care is all about, that relationship, and making sure that it is still safe and appropriate for that mama to have a home birth, or a birth with a midwife in the hospital. 

But midwifery, our specialty, is supporting normal. Keeping it normal. Lay low on intervention. No intervention. No interventions necessary when it's working well. 

What's an obstetrician? What's an OB/GYN. Do you know the difference? There’s a huge difference, and we need them, thank god, but an obstetrician and a gynecologist, OB/GYN, goes to medical school and does residency and extra training for high-risk pregnancies and surgery, to use very highly sophisticated technology to diagnose and treat high-risk situations, medically or surgically. But that kind of provider, I have doctors, I love the obstetricians that I work, but they always tell me they know nothing about natural birth. They're bored of it. They don't know what to do. They love the midwives. If someone's healthy, they say “you're going to get better care with a midwife”. 

So, it's very important for you to know the difference between a midwife and an obstetrician, their training and their background, because if you want a surgical birth, then no, you don't go to a midwife – go to a surgeon.

And that's what an obstetrician and gynecologist, OB/GYN is. And we need them. 

And that's why there are certain countries, that's why the United States ranks the lowest among all developed countries in the world, in terms of maternal and newborn outcomes. We're losing more babies and mamas, or having more serious complications with mamas and babies, than all the other developed countries in the world.

The countries that have the best outcomes are countries where, like Sweden, there's a lot of countries where everybody sees a midwife, if they're healthy. The doctor (obstetrician) is there for the high risk. High-risk and when surgery is needed. When medicine and surgery is needed. 

And that's how we serve the whole population of people having babies, and that's how we get excellent outcomes - live, happy, healthy mamas and babies. 

So last week I talked about a bleeding in pregnancy - this week I thought I'd talk about this.

If you found that helpful, comment, share. I'd love to hear what you have to say, but that's all for now. 

Have a wonderful weekend. Bye.

--- END TRANSCRIPT ---

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