Trish: [00:00:00] Welcome back to the birth experience where we're going to be diving into more things, birth. We're also going to be talking about advocacy and empowerment today. Today, I am so thrilled to have an incredible guest who has dedicated her life to helping parents reclaim their power in the birth room. Her journey started working with children on the autism spectrum, and she noticed a recurring theme that a lot of these parents were carrying the weight of birth trauma and anxiety.

And so fuel. By that she dove into becoming a doula and birth work and educating, and this is just gonna be an incredible conversation with he, he from the birth lounge.

Good morning Mamas. I am so excited. for you guys to be here with us today. I have [00:01:00] got HeHe who is from Tranquility by HeHe and she is a doula and an amazing birth advocate. And I am so excited. So go ahead and just kind of introduce yourself.

HeHe: Thanks so much for having me, Trish. Yeah, I'm HeHe. I'm the creator of the Birth Lounge and the host of the Birth Lounge podcast and I've been in childbirth education for the last 10 years being a doula at bedside, teaching childbirth education classes, helping dads understand what their role is and helping people bridge the connection between themselves and their birth goals and their medical team because I find a lot of times it can feel like us versus them, but at the end of the day, we're actually all in the on the same team.

And so that's what I teach people.

Trish: I love that. I love that so much because it should be a team feeling, but a lot of times it's not. And that's kind of what, kind of what I want to talk about today. So I had a very [00:02:00] interesting experience. Last May, one of my doulas on my team was having a baby, and she had asked me to come and be her doula, which I was like, uh, yeah, I actually screamed, right?

And so, I found out that I did not like being the doula. I am used to having more power in the room. Yeah, and so I that's kind of why I wanted to talk to you about that because I knew Oh, wait. No, this is not not the right thing now I am a 16 year labor and delivery nurse and heard labor nurse was very new So I was not about to see ashley go back to the or for some dumb ass reasons.

So I did Speak up, but I wanted to really ask you like what does that feel like when you're because we both know That a lot of stuff happens in the labor room that really shouldn't be happening So I want to kind of walk through that with you like And i'd love to hear how [00:03:00] you've evolved.

HeHe: Yeah

Trish: from when that happened in the beginning

HeHe: Yeah, absolutely.

Well You know, I think like anybody, when you first start out something new, you are really energetic and you just have this like greenness about you, this ripeness where you are kind of unscathed from the system and you just bring this light of like, oh my gosh, newness. I can definitely say that through the, the years, I've been doing this since 2016 and seeing that constant trauma has definitely made me, in some places in some regards, it has certainly I've had waves of bitterness that I've had to work through.

And so I think that anyone who's in the birth area, you're going to have these ups and downs because we see so much. I highly recommend therapy. I'm in therapy. I'm a big proponent of therapy. I think everyone should be in therapy. You just, you know, when you're, when you're in those really [00:04:00] vulnerable and transformational times of other humans lives.

Really sensitive places and places that things can actually go wrong really quickly and they can go wrong Just really really intensely. We need you need a support system and that includes therapy in terms of You know being in the bedside and what that feels like I mean For me, I think it comes down to knowing that everybody is responsible for themselves.

And so I'm really lucky in regards that when I'm in the birth room with someone, I have worked with that couple for upwards of six, seven, eight months. Most of our clients are getting signed up with us by about eight to 12 weeks pregnant. And so I've had the privilege of getting to know them and knowing their goals and knowing their whys and knowing what's important to them and understanding what they truly do desire out of their birth.

I can rest assured that they're not going to be taken advantage of because we've done that work. I can't say the same for [00:05:00] someone who is going in and they don't have dual support, right? Or they don't have a partner that has done the work and maybe they are having their baby with someone who they've never met before because their nurse is just assigned to them that day and that doctor is the on call doctor and they actually are a hospitalist so they don't even really Do clinic work.

You've never met this person. That's going to be a different experience now I've seen people i've worked with for months and months be taken advantage of in the birth room and it it Crushes me. I mean I typically Not in the birth room in the birth room. I'm always very Professional and I support them no matter what.

But when I get home, I cry a lot. It, it hurts to see the people that you love be taken advantage of, to see the people that you have watched do the work and see the people that you know. What they really want out of their birth, to see that be stripped away, and you not be able to, I don't know, almost help them pivot back, is really, [00:06:00] really hard.

Now, a lot of times you do walk away, and you go, Oh my god, thank God we talked about that in one of our prenatal classes, because they could have very easily said yes to that, or they could have very easily said no to that, and they really needed it. But sometimes, I don't know. Sometimes the hospital tactics are just better than you and, and you do watch people you love get taken advantage of by the system and that's tough.

That's really hard.

Trish: Yeah. And I, and I told you my story that I just got sick because my hands are tied bedside as your nurse, unless, unless the patient refuses, then I can go to bat for you. But the truth of the matter is, is that. And this is why I started doing what I'm doing is that when mom's in labor, her really only job is to labor.

She shouldn't have to deal with coercion and bulliness and BS. Right? So I guess my, like, how do you prepare your clients for a [00:07:00] situation? Maybe you didn't cover in the class, but. Do you have some kind of code? Like, hey, we need to talk a little more about this. Do you, like, how do you guys prepare for like an unexpected where you know she needs to talk to you a little bit more or have more time?

Do you have some kind of process for that?

HeHe: Yeah, absolutely. So what I teach people, so if they find themselves in a situation where they're like, oh my gosh, I didn't, I, we didn't, we didn't talk about this. This is a situation we weren't prepared for. First, first step always, take a deep breath. And remind yourself that this is not an emergency because if you are having the time to have a conversation like it's not, they're gently bringing things to you.

Yeah, exactly. Like then that means you have the time to take a deep breath and evaluate your options. And then you're going to ask questions, right? Maybe that question looks Can I have 10 minutes to just wrap my head around what you just told me and we'll be ready to have conversation Maybe you know the questions.

Well, what does this mean for my labor? Well, what are the risks to my baby? Well, are [00:08:00] there any risks to me? Is there anything individual to me that you think would make me at a higher risk for this? Do we know why this is happening? There's a million questions. You could ask you may know them already. You may not I think also relying on the people in the room with you, so You can clear the room and it be just you and your partner.

You can also clear the room and it be just you and your partner and you call just your nurse back in. You just want to hear what your nurse says. It doesn't have to be this big grandiose community event. Clear the room and then slowly let people in as you filter through them, you know? As far as a code, yes, obviously I'm a very expressive person with my face, so I think it's always probably very clear on my face.

If my clients need to ask stuff, I'm usually like, That's not right, or they might look at me and I might like give them some eyes of like, uh, you should dig a little bit more here. A code kind of phrase that I teach, and it's [00:09:00] not a code because we use it out in the open and it's not a secret, but Is there any questions I'm not asking?

Are there any questions that I'm not thinking of? Is there anything that I haven't asked that I still need to know to make this decision? If I'm in the room with you, it usually looks like you're saying like, He he, what should I be asking? And that's kind of code for like, he he, what's on your mind?

Tell us your opinion. And you know, I'm, I'm a very assertive doula. And so, If there's a conversation happening and no one has actually addressed me, I will actually speak up and if you were my client, I would say, Trish, I have a couple thoughts. Are you interested in hearing that? Or, hey Trish, I have something that hasn't been talked about.

Is that something you want to hear? I'm never going to just blurt it out. I'm always going to ask you if you want to hear my opinion. I might say something like, Trish, there's a couple things that haven't been asked yet. Are you interested in hearing what's What those are, what's on your mind, and you know, I want to, I want to [00:10:00] touch on now.

I'm kind of going off on a tangent, but I want to touch on tangents and this is, this is a good one. You know, you talked about nurses having their hands tied. Doulas in a sense have our hands tied as well. So it kind of depends on what kind of doula you want to be. But in my practice and what my team does is we're.

We are always very conscious of our relationship with that hospital and those doctors. Now, if we're ever backed into a corner, we have to choose. I want to make sure that we make it very clear. I will always choose my clients. So will my doulas. We will always choose them. We work for them. But that doesn't mean that we will choose them at the expense of my clients.

And again, we are not talking about the expense of a doctor or a hospital just because. We're always trying to find that middle ground. We're always trying to, and you shared this when you guest appeared on the birth launch podcast, but you said, we don't decline stuff just to decline it as well. You talked about two like baby baby compromises.

So what, how can we bridge this gap? How can we make this healthcare provider, this doctor [00:11:00] OBGYN midwife nurse, feel confident and safe. in what we are choosing, but not. compromise our goals as to go so far as to give us birth trauma, or to change our birth outcomes, or to, you know, agree to something that we don't want to agree to, your, your doula is navigating that with you.

And so a good doula will read the room. If this mom looks like she's holding back and she looks like she has something to say but she's not able to say it, a good doula will speak up and say, Trish, do you have something that's on your mind? Trish, you don't look like you're 100 percent confident in this choice.

Do you still have questions? Do you still have things you want to talk about? But, If that doctor is suggesting something and that mom is a hundred percent on board and she's totally good with it You definitely especially if it's a lie, you definitely have room to say Trish are you feeling good in this conversation?

Are you feeling good with this decision? And if she says yes In my opinion, [00:12:00] then she's good with that, right? I, it is not my job to push back on her and say, but Trish, he's lying to you. But Trish, this is dangerous, but Trish, no, you shouldn't be doing that. She just told you she was good with it. She just said that she felt confident and you checked in.

She seems respected. She seems like she has said everything. You asked her if she had more questions. She said, no, you asked if she wanted to hear what your opinion was. She said, no, she felt good. A good doula will let that be. Yeah, because that could cause trauma. Oh my god, it, it's not right. It almost always does cause trauma.

That mom almost always walks away saying, Well, I was confident until my doula really pushed me, and then she made me feel bad for the decisions I was making. And we never, ever want that. As a doula, that is not your job. Your job is to make sure that no matter what decision is being made, whether you agree or you don't agree.

Is one that she feels confident in and she feels informed and she feels like she's [00:13:00] making the decision and you personally You don't have to agree with that and that is such a pillar in my business And it's something that my duel is in my team and I uphold in every single birth room when we walk through that threshold We're taking off the me And we're putting on the you, this is not about me at all.

Well, he, he, what would you do? I always say it doesn't matter what I would do, but would you like to hear what some of the data suggest? Would you like to hear what the most, the most up to date research says that may help inform your decision. It doesn't matter what I would choose as he, he, but it does matter that you have all the information to make that decision confidently.

Trish: I love that so much. So on the flip side, do you think there are doulas who struggle with that?

HeHe: Yeah, absolutely and look I It's hard It sucks to be in a room to see someone making a decision that you Have seen be made a [00:14:00] million times before and you literally know where this is headed, you know where we're going And you're not trying to say this is a mistake, but you are trying to say are we sure are we sure?

We really want to do this. Are you a hundred thousand percent positive that this is what you want to choose? That's a really tough place to be you need therapy You need to work through your own stuff and I say that as somebody who as a new doula I had to navigate that I had to learn when is it appropriate to speak up?

I had to learn when do I hold my tongue? I had to learn how do I approach this health care provider this nurse this doctor this anesthesiologist? They're the scariest of them all they are so scary Anesthesiologists are you know, how do I approach? this healthcare professional who may or may not respect my role as a doula in a respectful way but also that, that approaches them and lets them know, hey, I'm on your team.

We [00:15:00] don't necessarily see eye to eye in this moment but I'm hoping to get there. I'm hoping to explain to you why I just started. I spoke up in the way that I did and I said what I did. And I want you to know it wasn't a challenge on you. It was just that there was a big gap in care. There was a big gap in information that wasn't being talked about.

And I wanted to make sure that we did speak about it before she made that decision. Because she deserves to have that information. But it also means that you don't go, well, Dr. Trish is lying. She's clearly a liar. She's obviously trying to cut you open. Her whole goal must be to get home at five o'clock so she can go to dinner.

That will, that will always taint that. And you don't want It'll taint your relationship with her too. You don't want to be that person in her birth memory that did that in her birth. So a better way might be to say. You know, one thing we didn't talk about was the risk of c section for you and your baby.

Are you interested in talking about that at all? Cool, and [00:16:00] now she has the opportunity to go, Oh, yeah, actually I didn't even think about that. Or she has the opportunity to go, No, it's a surgery. I mean, I kind of understand what the risks are great She seems so confident in that, you know Just because you as the doula want to have a conversation doesn't necessarily mean that it's the right conversation to have And that has to be left up to your client as the doula your job is not to 1000 percent facilitate that conversation.

It is just simply to bring space and to bring acknowledgement to that topic. Is this something we want to think about? Is this thing something we want to discuss? Is this something that we should talk about before you make this decision? And that for me is the fine line of being a good doula and a disruptive doula.

And I think that it's very easily. To conflate those two and to slip from one way to the other. And you, you really have to be in control of your own self and your own emotions in the birth room [00:17:00] in order to stay in that good doula area and avoid slipping into disruptive doula land.

Trish: Yeah. And I love, I love one thing you said is that if she is confident, if she has made that decision.

And we know it's wrong because I've been in the same position. My hands are really tied because I'm employed by these people. But if we start pushing our own agenda, because that's what it is at that point, then we're no better than them. Yeah, yeah, so, it really is about what she wants.

HeHe: Yeah, regardless of how you feel. And I think that's true for all medical professionals, right? And, and again, we all slip into this. This is not specific to doulas. Nurses can slip into this, midwives, doctors, anesthesiologists, uh, physicians. I mean, uh, All of us are subject to slip down this slippery [00:18:00] slope and sometimes it just takes you, go to the bathroom, step out of the room, any excuse to get out of the, I, I, I just need a breather and go check in with yourself.

Is this her agenda or is this my agenda? Is this what she wants for her birth or is this what I want for her birth? And those are very different things. What she wants. I promise you nobody will make a decision that will absolutely give them trauma if they feel informed. If they know all their options, they will make the choice that leaves them with least trauma.

You can never make that decision for someone because you just don't know what is going to be traumatic for them and what's not. And they will know every time.

Trish: Yeah, and it, and I love, I love because you and I had talked before, and I said like there was one specific birth that really, spurred me to start Labor Nurse Mama and I gave her as much information as [00:19:00] I could, but ultimately she felt more peace going to the OR instead of, because it really is like, when you have a lack of peace in your labor room, the effect is going to be the same, no matter where it's coming from, you know?

And so that was really hard for me as a labor nurse as well. But again, it's about what they want, period. You know, so I love that. I love that you said that because I think we all have the disruptive doctor, the peaceful doctor, disruptive nurse, the disruptive doula, and it really is about what you said, like ultimately what she wants.

And like I told you, my births were not picture perfect. So I always tell my students that I can't guarantee a perfect birth, but I can guarantee that you're going to know what's happening inside you, around you, and you will know how to ask the right questions. That I can guarantee. And that you can have a birth that on the [00:20:00] outside people are like, Oh my God, I can't believe that happened.

But you leave feeling really empowered. And that It was your birth and you loved it.

HeHe: Yeah, and you chose all the pieces to it, right? It really is about who is in control of that room and I think one of the things I love about you so much is that you talk about doctors love to be in control. The hospital system was designed to be in control and I think You know, what you and I really are just pushing people to do, women to do, is you be in control.

I want you making the decisions. Don't let the hospital make decisions for you. Don't decline stuff just because you can, but don't let them make decisions for you. You be the decision maker in your birth, and that is how you are gonna have your best birth. possible. And your best birth is different than her best birth, and it's different than mine, and it's different than theirs, and it's different than your neighbors, and your sisters, and your cousins, and your best friends.

Your birth is as individual as your fingerprint, and that's why the decisions that are made during that time also have to be individualized by [00:21:00] you and by your care team. It's very, very important.

Trish: And I always, I always joke around and say it's like a wedding, right? You would never let everyone else make all the decisions of your wedding.

You might end up in like, all the bridesmaids have like, purple and pink dresses and like, you know, like, and there's all these things and you would be seeing all the things that are wrong. However, if you make all the decisions, even if some things go wrong, you go with it, you, you pivot and that's it. You should be the one that is driving it, and that goes down to, like we talked about before, if there's someone in your room, I don't care who it is, if they are causing dissension, they need to be talked to, and you can fire your nurse, you can fire your doctor, you can fire your doula, your partner might not, It might be a little difficult with the partner situation, but I have seen that go south sometimes during a delivery But you definitely need to remember that this only happens once for you Even if you [00:22:00] have seven kids like me That birth with that baby.

It's one Time and it's a job for the rest of us. No matter how much we love it. It's still a job It is not going to affect the rest of our lives But it does affect yours and if it's that big of a deal for you, then you should be the one Don't wing it. Don't just be like, Oh, I'll show up. They'll do what I, you know, I'm going to get my epidural.

I don't, I always say like, no, do not just show up. Cause that will lead to trauma.

HeHe: Yeah. Winging it is tough. I've seen people, I've seen people go into birth. And actually wing it and have an amazing birth. One of my closest friends. I am a doula. I've been a doula for years This is her second baby and I am like, please don't wing this don't wing this and she's like I I winged it.

I won't get the first time I it turned out fine and i'm like, okay, that was luck Please don't play with fire now We're [00:23:00] asking like you already got you got away with it once don't do it again She did it again and she had another fabulous birth. So some people can do that I think it's Some people's personalities, that's not normal.

That's also, uh,

Trish: luck because if the, if the pieces are good, you have a good doctor, you have a good nurse and the units and the unit's not busy and everybody's doting on you. Yeah. You might be able to wing it because maybe your nurse has more time to show you some positions and do these different things with you or, you know, but even having a really fast birth can be traumatizing if you don't know what the heck's happening to you.

So. Do you really want to chance it that you'll be the one of how many who have birth trauma That just loved their birth that they were winging The majority of my parents who come to me who've already had a baby are coming to me because that wing it don't work It doesn't

HeHe: work. Oh true That is so true.

[00:24:00] Oh my god, so I would say she's rare No, definitely. She's a unicorn and I think you know, that's all that to say like Does it happen? Sure. It totally can. That's not the norm. So if you're banking on that I personally No offense would have a plan b. I would have a backup plan because that's your plan a What are you going to do if plan a doesn't work out?

I I really i'm encouraging you to have A little bit of education in your back pocket because we net you're right. It just it can work. It's a chance Yeah, it doesn't often. I have something that just like dropped into my head. Can I give some tips for how doulas can go into the hospital and, like, start to facilitate a good relationship?

Like, how can they put positively to the birth room and work together with the hospital staff? Yes, please. I love it. Something that I'm super super good at. So the first thing that I always do is introduce myself to the nurse. So, if, if this is a [00:25:00] nurse that comes and gets you from the waiting room, when they come and get you, you should say, are you our nurse?

And a lot of times it is. And you can say, Hey, I'm HeHe. I'm super excited to be here. I've been a doula for X amount of years. So just let them know. If you're new, they're not going to judge you. Just let them know. If you've been a doula for 50 years. They're not going to judge you. Just let them know who you are a little bit about what your goals are.

And this is all, this is quick. You guys, it's while you're walking from the lobby or the, the waiting area to the room where your clients are. By the time you get to that door, you're done with that conversation. It's not an ongoing conversation, but you've introduced yourself. You've told them that you're excited to be there and you're excited to work together.

And. This is one of my little, like secret weapons. Offer to be helpful and say. I am not here to get in the way. So if I'm ever in the way, please let me know. But also, you should know, I'm here to be extra hands for you. I know that you don't have enough hands to get [00:26:00] everything done. So if there's anything that I can do to help make your job easier, please don't hesitate to ask me.

Again, my name is HeHe, but you can really call me anything. I answer to a lot, okay? Now we've let that nurse know, hey, I'm safe. I'm on your team. We're working together. I'm not going to try and make this some sort of funky space where it's us versus you. I promise. Okay. Then you go into the room, wash your hands, set your stuff down, say hi to your clients, and then really just be, don't try to be making decisions for people.

Don't try to be interfering. Don't try to be reading the monitors. Don't try to be rearranging the room. Now I understand setting. Things like little candles out, keeping the lights dim. One of the things that you can do is if you're going to be changing things in the room, just let your medical staff know why you're doing it.

Hey Trish, I'm going to be turning down these lights because Megan really wants to birth in a dark place and she just told me that the lights are a little bright. [00:27:00] Is that okay with you? The nurse is never going to be like, no, keep the bright lights on. And I guess if they did, you could just be like, okay, well, Megan wants them off.

So we're going to turn them off for now. And maybe if we need them later, we can turn them on. You know, if we need them, it's okay. Or

Trish: the nurse might say, Hey, I'm getting ready to start her IV or do this. And I need the lights up, but as soon as we're done, that would be fine.

HeHe: Totally. Another compromise there is.

You know, would you mind if I turn these, these big overhead lights on and I actually just brought the flashlight on my phone over? Or I actually have this headlamp in my birth bag. Could I just like, hold that over? Like, there's so many compromises.

Trish: Do you really have a headlamp in your birth bag?

HeHe: Sometimes, yeah. So I've had clients who absolutely do not want any lights on. And so then that big, huge light that actually is a lot brighter. I mean, it is just like, it is like, Oh, I'm

Trish: about to turn the lights of God on your vagina. Just giving you a heads

HeHe: [00:28:00] up. Yeah. You know, that doesn't fit well with a lot of people.

I mean, sometimes people just find that super disruptive. You can have a headlamp and just hand it to the doctor and it will literally keep it contained right there to their vaginal area. It takes a really open doctor. Yeah, I've never seen this in 16

Trish: years. That's why I'm asking.

HeHe: I mean, look, at some point you're going to come across a, a client or a patient that just Is not flexible and they're not going to do it And so you will either compromise to what they want or you just will go without and so I have had clients who say I'm you will not turn that light on and so then I you know And more power to her

Trish: because birth can have here.

Here's something I want you guys to hear. This is really really shocking Cutting edge, but your baby can come out without that. You don't say It can happen. It can actually happen and I always am like [00:29:00] So, like, for those of you who haven't had a baby, you're pregnant, one of the most beautiful things in the world is when the doctor's out of the room and I'm able to dim the lights back and that baby's eyes just pop open.

They don't want those damn bright lights either. It's awful. And it's But remember what I told you, one of our mantras inside of my, my world is nothing out of convenience or curiosity. That light is convenient for someone. It is not your vagina or your baby or you. It's the doctor. So they can see the playing field.

But birth can happen without them being able to see every little nook and cranny. So I mean, even in that sense, they don't need that headlight either. Now, if, if something happens, that's emergent and that's different. And again, it goes back to, like, we talked about reading the room. If you're doc, you can tell if it's an emergency or it's a convenience.

HeHe: Yeah. I mean, [00:30:00] I think too, there's something to be said about just being in control of the environment, because we know what that does to our hormones. So if someone is constantly flicking on and off and on and off and on a light, it's going to disrupt your hormones. I mean, just think about it, you know, and then we wonder, well, why is her contractions slowed and, and why have her contractions spaced out and why are these not as intense?

Well, it's because the environment that she's trying to birth in, you know, and, and she's feeling this tug of war with her provider that they just, they have to have it their way. But then, you know, for a fact, that's not an evidence based decision or that mom knows for a fact that she doesn't want those lights on or better yet.

She knows for a fact she doesn't want to burrs on her back, and that doctor just will not give up, they're relentless. You gotta get on your back, you gotta get on your back, I can't do it this way, I can't see your baby, I definitely cannot deliver your baby this way. And it's like, of course that's gonna disrupt your labor.

It's, it's literally shutting off the chemicals in your brain that [00:31:00] you need to birth, you know? Okay, so introduce yourself, offer to make their job easier. And then my favorite way to actually kind of progress the room and get people on board is asking open ended questions. So You know, this may look like me saying, Hey Megan, so my client, do you have any questions for Trish about the IV she's gonna set?

Do you have any questions about the doctor that's on call? Do you have any questions about having your waters ruptured and what that may mean for your labor later down the road? Right? doulas are unsure how to speak up in the room. And for me, Questions are, are just a little secret weapon. It is just asking open ended questions.

They, they aren't suggestive of anything. So you're not, you know, be careful of your tone and be very mindful of the inflection. So you're not saying, Trish, do you have any [00:32:00] questions for your doctor about The risk of a amniotomy, you know, you're not it's not sassy. It's not inflammatory, it's just open ended questions Do you have any questions about what this procedure might look like?

You have any questions about what the fetal scalp electrode looks like or how it's placed on your baby's head There's nothing that you're not trying to rile up the room. Remember your job That, that was a heavy one though. Cause

Trish: most

of them don't know how it's placed on their head.

HeHe: And a lot of doctors are not up front about it.

It's a clip. It's a sticker. Oh, we just place it. No, it's a little baby tiny corkscrew. We screw that into your baby's head, which sometimes is needed. You don't want to demonize that either, right? We're not trying to demonize any option, but it It's very important that you understand what's happening.

It's needed when it's needed, not out of convenience or curiosity.

Oh my god. I [00:33:00] tell, I say this to my students too. Like at the, I do a free workshop where I go through a lot of this and When your baby, like you can say, I absolutely would never do an FSC or I'd never do a vacuum or any of those things. But if your baby is down in the forties and we cannot resuscitate that baby and we need to know what's going on so we can make a decision to save you in this baby.

You're going to say yes, like you should say yes, there is a reason, and thank God, thank God for technology, thank God we have FSCs, and we have C sections, and we have all those things, because there would be a lot of people who wouldn't be with us. But, on the flip side, it is not needed if maybe mom is fluffy and the nurse can't keep the monitor on her, they don't need to go and screw it into the baby's head.

Like, that just means the nurse needs to work harder. Maybe she needs to come in every 15 minutes to adjust the, the monitor. But, we should not be using something that's for a specific set of [00:34:00] circumstances just because someone is inconvenienced by it. And that's where I get really fired up.

I always remind people that, you know, the tools that we have were made out of necessity.

Most of the time, they were made because we saw a gap in care and we created a tool to make that better. However, what we have done, especially in the U. S., but birth in general, is we have overutilized almost everything. There is almost nothing in the birth world, right down to surgery. Cervical checks that we don't utilize properly.

I mean, it is like, or that we do utilize properly. Almost everything is over utilized and it is just inserted into birth in places where it's just not needed or appropriate.

Trish: Yeah, I love that you brought up the cervical checks because I, I was a guest on Evidence Based Birth and she, I had a team meeting right after that and My team and my students all know me, but one of the questions [00:35:00] was, what would you tell a student who is going to the hospital?

She's in labor and they tell her they won't admit her if she won't let them do a cervical exam. And I was like, what, how would you tell her to answer? Like, what would you say to tell her? I said, say no. No, I, they have to. And I was like, here's the truth. They have to admit her. And she said, you would just tell her to say no.

And I was like, yes, no is enough. Like you can say no. And again, just like the lights, birth can actually happen without a cervical exam. Now, if you're being induced, you've agreed to being induced. We do have to do them, not as much as, like some hospitals still do them every two hours. It's ridiculous. We don't have to do them that much, but to be able to titrate the medicine and change, like, decide your plan of care, we have to know what's happening, and a lot of times, it's not your body language, like, a good nurse can [00:36:00] diagnose how far dilated you are when you come through the doors, if you're in labor, but Induction's a little different, so we do need to know in that case, but other than that, one of my favorite stories with a student.

I had this student, Haley, so if Haley's listening, you're a badass. Haley came to me to my fearless birth experience, which is like a five day birth, challenge experience. And at the start of it, she came wanting a scheduled C section. I flipped her mindset. I have, like, I've very. set way of flipping mindsets and She decides not only did she not want a c section she wanted unmedicated She was never gonna have a cervical exam during pregnancy.

She was gonna wait for labor to start So her doctor was just blown away by her like a blown away by her because she kept refusing the cervical exams and she was Like no, they don't mean anything right? Like what does it matter if I'm dilated right now? And what does it matter if I'm not like it doesn't matter.

I'm waiting for labor to start. So her very first She, [00:37:00] she did end up going almost to 42 weeks and did get induced. So, she goes in and they do her very first cervical exam, and she's not dilated. Like, barely. And she's like, See? Like, what? You wanted to check me at 37 weeks. Why would it have mattered, you know?

And so she had a beautiful birth, and obviously, like, she, she ended up getting induced because she was, she was like 41 in 4 days or something, I believe. Something like that. I could be getting that a little bit. I do know her first cervical exam was in the hospital, and she looked at me, and she goes, That's why it didn't matter!

She could have every week had a cervical exam, and that would have led to more innuendos and suggestions. So I always tell them, unless they want it. If they want it. That's different. If they want the cervical exam, that's fine, but yeah, they're, they're not necessary, but okay, so we, what you recommend is polite communication [00:38:00] skills.

HeHe: Yeah, I mean, and just direct. Like, get to know her. Totally, you know, and I think.

Trish: Yeah.

HeHe: It can, it can definitely, depending on the culture of the hospital that you're walking into, it can feel like you're not welcome as a doula. I have attended births all over the nation. I do travel doula support. And so I've been really, really blessed at being able to see a lot of hospital cultures.

And sometimes we are welcomed with open arms and people love to have us there. And nurses are like, yes, a doula. I love it. And the physicians and the midwives are like, yes, a doula. I love it. And then there are. There are some hospitals that you walk into and they're like, and you are who? And why are you here?

Why, why does she need a doula? I've literally been looked in the eyeballs and asked, why does she need a doula? And the mom was sitting right there. And she was like, well, , because I wanted the extra support and I wanted to make sure that I had somebody with me to [00:39:00] help me make decisions. And the nurse just rolled her eyes.

Like she could not even believe that. You know, a doula was here. And so it's gonna, you are gonna walk into different scenarios. You have to be in control of you. You have to remember that no matter what that hospital culture is, doesn't have anything to do with you as a doula. Your job is to make sure that mom, that mom is respected.

She is heard and listened to and that she is the one making decisions, right? She's not being taken advantage of. People are not bullying her. She's not being coerced into it. decisions without a discussion or without information that she needs that's critical to that decision. That is your job. Your job is not to fight with hospital staff.

Your job is not to fix the hospital culture. Your job is not to insert yourself into anything. You are there as a, I almost think about it as like the Wharton's jelly. We are there to make sure that things are smooth and if there's a knot, [00:40:00] Fine. We will make sure that it never gets too tense and too tight that it causes some sort of compromise for that birth situation.

We are the jelly that keeps things moving and grooving whatever that looks like that. Do you want to explain what Wharton's jelly is for my

Trish: mamas who are listening? Absolutely. So on your

HeHe: umbilical cord, it is the coolest thing. Your body naturally lubricates it with Wharton's jelly and it keeps it moving.

It keeps the cord from being compressed, and it keeps the cord from, I'm like, drying out. It just keeps it really healthy so that the blood and oxygen can continue to flow through that. But sometimes the umbilical cord can get a knot in it, and it is where your baby has kind of flipped through. So it looks like a physical knot, as if you were to tie, like, a shoelace in a knot, except it's in your umbilical cord.

Now That can cause problems if it gets too tight, or if, um, you know, it starts to squeeze the umbilical cord too much. It may compromise your baby, but Wharton's Jelly, it's literal job is to keep that [00:41:00] knot sliding back and forth. And so if you look up videos online, you can see nurses and doctors holding the knot and sliding it.

You guys, it is the coolest thing ever. It is so neat. I think for me it just like I say it's just a really cool analogy to think about doulas as that jelly that there may be knots that were totally out of our control. We didn't cause them and we can't undo them but what we can do is make sure that they don't compromise that birth experience and we keep things moving and grooving and smooth.

But don't you think all of us should be that though? Yes but that goes back to like you can't control other people like I can't control you Yeah,

Trish: no, but I'm saying if the doctors were viewing it that way, if the nurses are viewing it the way, if the partners were viewing it that way, all of it, it would just be, we're all working together to have this beautiful birth experience.

Well, thank you so much for coming today. Can you tell everyone where they can find you?

HeHe: [00:42:00] Yeah, absolutely. Thanks for having me. This really was a joy. People can find me at thebirthlounge. com and you'll find all of my stuff there. You can download the Birth Lounge app. It's five dollars a month and it gives you all evidence based articles that you can help, that will help you have discussion with your providers.

There's questions to ask your providers Data and science and everything. And yeah, find me on Instagram. I'm tranquility by he, he, and the dot birth dot lounge. And we hang out and it's just a lot of fun birth, nerdy stuff, education, and talking about the what ifs and talking about, you know, how do I do this?

How do I say that? Where do I find this information? So. Yeah,

Trish: check it out. I love it. Oh, thank you. We, we turn what ifs into even ifs. That's our theory over here so that you can navigate it. All right. Well, thank you so much.

Wow. What a conversation. I loved this episode and I hope you guys are walking away. Whether you're a doula or a pregnant mama. I hope you're [00:43:00] walking away with a better understanding of the doula's role as an advocate and how creating a collaborative relationship with everyone inside of your birth team is so stinking important.

If you loved this episode, don't forget to share it with someone who might need the message. Check out HeHe at the Birth Lounge. Make sure you guys hit subscribe and leave a review. We're going to do a drawing at the end of the month. Thank you so much. I'll see you guys again next Friday. Okay, bye for now.