Trish: [00:00:00] My name is Trish Ware and I am obsessed with all things pregnancy and birth, and helping you to navigate with the practical and the magical seasons of this journey called motherhood. I'm an all day coffee sip and Mama of seven. I've had the amazing privilege of delivering mini babies. In my 15 plus year career as a labor and delivery nurse, and as a mama of seven, I'm here to help you take the guesswork out of childbirth so you can make the choices that are right for you and your baby.

Quick note, this podcast is for educational purposes only and does not replace your medical advice. Check out our full disclaimer at the bottom of the screen. of the show notes.

So let's get started. I've got my notes here because y'all know I will get off track if [00:01:00] I don't talk through the notes. So today we're going to talk into something that is so critical for every one of you guys to know about and that is medical interventions during your pregnancy and your birth.

Understanding these interventions can empower you to make the best informed decisions about your birth experience. And trust me, when I say that if you are laying in the bed in labor, when I say all the time, your only job during labor is to labor, and all of a sudden you hear about maybe an IUPC or an FEC, FEC for the, These dogs, for the very first time, you're going to be really confused as to is this the right choice for me?

Should I say yes? Should I say no? Should I ask to wait? And I want to help you guys with that. Now, obviously, I'm not going [00:02:00] to break down every kitten caboodle that happens during your birth. But I am going to talk about the importance of having an understanding of each type of intervention. Now, if you want to know all the things, if you want to be as prepared as a labor nurse, then you just need to jump into my classes.

And I will say that until I'm blue in the face. I don't care because I 100 percent know that I am the person to educate you for your birth and my students will tell you as well that not only will you get the knowledge, you're going to get your mindset and your courage and we're going to work on those fears and have you like a freaking birth queen that you are, but you're also going to get access to me and my team, which is invaluable.

Okay. So the very first thing we're going to talk about today. is the very first thing we tend to intervene and do when you land in triage or in the labor and delivery room, and that is movement [00:03:00] restriction. Movement restriction is one of the most damning things that we can do to you during labor. So if you're watching the video of this, which you can see it on YouTube later as well, You're going to see a mama who is strapped to the monitor.

You're going to see a mama who's laying flat in the bed. And those are not positions that are conducive to a natural flowing process. And we want to make sure that if your movement is being restricted, it's for an absolute necessary purpose. reason. So for some of you guys, if you have extremely volatile, blood pressures and you have preeclampsia or high blood pressures, then movement restriction might be appropriate, appropriate for you.

And there's other times that movement restriction is appropriate, but when is it not? Being able to walk, to sway, to use the positions that we Teach you inside of calm labor. Competent birth [00:04:00] is one of the most powerful things you can do during your birth. And I am not exaggerating. Movement is the most important tool you have, and it's needed.

So. You know, there are things we can ask for and we can add into your birth plan to allow you to be able to move and sway and change positions. And not only do the positions help the baby get in the right position, which a baby out of position is the worst, But the other thing is how well you'll be able to cope during your labor contractions is also really dependent on your ability to move.

So we want to make sure that you're able to move and sway and dance, get on your hands and knees and utilize all the positions that we're going to teach you inside the full birth classes. Okay, who's tracking with me? I hope you guys are like, yes, I need to know how to [00:05:00] move during labor and I need to know how to navigate movement restriction, which is one of the worst things that we do and we do it to just about everyone.

Okay, so the next intervention we're going to talk about is an IV. So this is another super common intervention that you get admitted, we strap you to the monitor, we put you in bed, we don't let you move, and we put an IV in, which can also make it really difficult to move during labor. And we want to know, is this something that's absolutely And yes, I do teach you the situations where it is beneficial and it is necessary.

You know, the worst thing you can do is get dehydrated during your labor. It can make it a hundred times worse. So, but, the question to ask is, Are fluids given routinely? necessary? Are they [00:06:00] always necessary? If you're offered an IV, there are times where you can talk to your provider and ask them, why is it being recommended?

Is this just routine? Or is this necessary in my personal situation? And we help our mamas navigate this all the time. Inside calmly were confident birth as well, because there's pros and cons to both sides and there's other options. There's ways to navigate that specific, intervention where you're happy and your doctor's happy.

So if you thought. Just because you're giving birth, you have to have an IV. I want you to really start questioning that. Okay, the next one we're going to chat about is fetal monitoring. So if you saw in that initial picture that all of the moms get the fetal monitor, right? We strap you into the bed, movement restriction.

We give you the IV, movement restriction. The [00:07:00] monitor is also a movement restriction, depending. But it is. one of, if not the top most common intervention during labor. And it is an intervention. Continuously monitoring can also lead to a cascade of interventions, unnecessary interventions, because it's going to detect some minor variations that may not be clinically significant.

But your doctor's going to see it and they're going to want to do something about it. But it doesn't always necessarily mean that you should have things done. And not all of you guys really need continuously monitoring. If you are a low risk delivery, If your baby looks good when we first get you to the hospital, yeah, we want to check on baby, see how baby's doing because the fetal monitor, the movement of the baby tells us how well baby's faring on the inside.

And we want to know that your little booger [00:08:00] is doing good. Right? But a safe alternative for low risk pregnancies is intermittent monitoring, which means that's going to give you more freedom to move. It's going to give you more freedom to feel like a normal person and not a hospital patient. And it allows us to also check on the baby.

The other option would be wireless monitoring, and we discuss that a little bit more when it's appropriate and when it's not inside the classes. You need to discuss with your provider the best monitoring method for your situation. Have that conversation. Have it now. Okay? Do this. Trust me on this. You want to make sure you are discussing all of these things.

Just because you're having a hospital birth does not mean you have to do all the things we tell you that we say you have to do. Okay. The next thing that we're going to chat about is cervical exams or sterile vaginal exams. And this is [00:09:00] another super common intervention. And here's the thing. Cervical exams are really for us to know the progress, to assess the progress of labor, but are they 100 percent necessary?

You know, and the other thing is, is that the more frequent we do them, the more it increased the risk of infection, especially after your water has broken. So I always tell my patients in person and my students, like, we only need to do them when they're necessary and they're absolute. And I will challenge that the majority of the time.

We say that they're necessary, they're not. A lot of hospitals still practice doing cervical exams every two hours when you're in the hospital. And I'm going to say, That is not necessary. That is overkill and it's ridiculous and it doesn't feel great. So when you're in labor, those, those nerve endings and your cervix is in pain, like that it's, it can be [00:10:00] painful and it's unnecessary and it's not going to change the course of your labor if we know how dilated you are.

It's not going to change your labor if you know how dilated you are. So have any of you guys seen I don't know if I want to have cervical exams, but do I have to have cervical exams? No, you don't. However, I will say a little caveat is that if you're being induced to be able to continue your plan of care, to be able to titrate the medication, the Pitocin, we do have to know what's happening with your cervix.

So that is an exception to the rule. But you have a right to decline. Cervical exam, examinations. You have a right to decline that, okay? And you have a right to ask questions. You have a right to say, Hey, you're telling me that I need a cervical exam, but can you tell me why? And will it change the course of your care?

If I agree or disagree [00:11:00] because it shouldn't so remember that it is an intervention and you have a right to say yes or no There are appropriate times that they're needed and there are times where it's literally one of the mantras I say to my students on the inside, which we've already said you need to reply Class and join the classes stop winging your birth One of the things we say is, is this out of convenience or curiosity?

If it is out of convenience or curiosity for anyone other than you, then we say no, period. Okay. The next thing that we're going to talk about is induction, augmentation of your labor. So induction and augmentation is when we either start your labor, which is induction, or we augment, which means we help it along.

And I can tell you 100 percent from working 16 years in labor and delivery, That a lot of times, either way, we want to [00:12:00] help it out, we want to get it started, we want to make it go faster, we want to do all those things, and it's not 100 percent necessary. So, when it, we're talking about induction or augmentation, we're going to start with amniotomy.

And on the left side of this picture, you can see this woman with the bun in her hair. It's a midwife and she has what looks like to be a crochet needle in her hands, but that is actually called an amni hook. And that is the hook that they will use to break your water. It has a little loop on the end. I meant to get mine out so I could show you, but I did not.

But it has a little loop on the end that will break your bag of water. And we do this during a cervical exam. Most states in the U. S., only a midwife or provider can do it. There are still some states that let a labor nurse do it. But we prefer that your doctor does, just in case there's any problems.

So, 100% [00:13:00] You want to talk to your provider and ask them questions like, when would you want to break my water? You don't have to break your water. We don't actually encourage our students to let them do it until they're in, until they're in active labor. However, there are times where it might be a good idea for you and you need to know when and why you need to know, is this appropriate?

Is this not? Should I say wait? Should I say go? What have you? I even had one of my students, it's really good. You should listen to the podcast. It was with Laura and, the name of the podcast I think is, birth tubs and fish scoops for poop or something like that. It's really funny. But she said that they wanted to break her water and she was like, nothing out of convenience or curiosity.

And her, her provider was like, okay. And then her water broke on its own. So why would she need to go through all of that when her body was already doing it and doing it so incredibly? You do not have to [00:14:00] agree to these things that everybody else says yes to. Be the rebel. Be the birth queen that you are.

This is why you need to join me, so I can encourage you and help you be that rebel birther. All right? right? The rebel birth. Okay. So the other thing that we do to almost everyone is give them Pitocin. So Pitocin is a synthetic form of oxytocin, which is used to induce or speed up your labor. Well, you know what?

You're allowed to labor at your own speed. You do not have to be sped up. And it can be necessary in some situations, but it often does lead to stronger, more, like, you get to that quicker, painful level of contractions, which is why it also increases the likelihood of you wanting an epidural Or other interventions are necessary, like, oxygen and more IV fluids and position changes and all the things.

So ask your provider, what, what is their stand on Pitocin? Do you try to give Pitocin to all of your patients? Are [00:15:00] there other things that you could do, like nipple stimulation for instance? But always weigh the benefits and the risks. Okay, the other pictures that I have on here are those pills. Those are Cytotec.

Well, they're not really, but it's a picture of pills. Cytotec is a pill that we do either orally, vaginally, or after birth. If you're having any hemorrhage symptoms, we might do it rectally. So, the pill is given, we break it up. We don't give you the whole pill. You get it by mouth or in your vagina to, Soften your cervix.

Pitocin actually strengthens your contractions and Cervidil and Cytotec, ripen your cervix. The beginning of labor all starts with that cervix being ripened, usually by the pressure of the baby's head. So what you see in the middle that looks like a snake, that is Cervidil. I actually like Cervidil better because we can remove it if there's any problems.

And again, those are all things we do to induce your Labor. Okay. The [00:16:00] next thing we're going to talk about, let's get to the next one. Okay. The next thing we're going to talk about is assisted birth. When I'm talking about assisted birth, these interventions look like forceps, vacuum, episiotomy, and also cesarean, which we'll talk about in just a moment.

So again, Let me just say, there are times where your, these are necessary. These assisted birth interventions are absolutely, thank you Jesus, that someone invented them because they have saved countless women, countless babies. But they may not be necessary all the time. Now, let's say your baby is in fetal distress, or maybe you've been pushing and you are freaking out.

You cannot do it for another minute, but baby is right there. Maybe it's necessary. Maybe it's convenient for you. I 100%, 100 percent [00:17:00] support my students if it's necessary for them. Now, if these interventions are convenient for your provider, no, I do not at all agree to that.

So before agreeing to your, to any of these, ask your providers about the risks, about the benefits, what are the alternatives. And that's something I teach you inside of the class, things you can do instead of a vacuum. Things you can do instead of forceps. Things you can do instead of a c section. And I also teach you how to read the room so that you know exactly what is appropriate in that moment.

Please, please, please. I'm being very dramatic today. Very dramatic. Please do not just agree because your doctor says to do it. That is not wisdom. You know, this is why inside of my birth classes, we have a three part framework. There's knowledge. I'm going to teach you every last stinking thing that [00:18:00] I know from 16 years of high risk labor and delivery nursing and from my own six births.

I'm going to teach you all of that. You're going to have all the knowledge. My students say all the time that their labor nurses are like, are you in this thing? field. How do you know so much? Because Trish told you everything, right? And they tell me all the time, I heard your voice in labor. I'm a rebel, y'all.

I am a labor and delivery nurse who is crunchy with a side of medical because I 100 percent believe that the medical interventions are very valuable. Thank you, God. Thank you for them. Thank you for them, but why do we need to use them on everybody? Is that really necessary? No, and you can join the classes by replying to this live with the word class and I will get in and have a conversation with you, not my bot.

My bot will answer you, but then I will jump in. They'll assign it to me. You can go to labor nurse mama. com forward slash the word calm to join [00:19:00] and we will join you on the inside and you're going to know as much as I know because yes, these interventions are incredible. Incredible. And Jenny just said yes, your voice was so loud in my, my head.

I hope that's a good thing. I love my students so much, you guys. But before you agree to any of this stuff, before you say, yeah, yeah, let's do it, you need to ask the right questions. You need to know how to discern. And if you don't understand when they're necessary, you're just going to say yes, Because you're going to think that you have to, but there are times we're changing positions.

There are time for giving labor more time. There are times when using something natural and like movement or position change is the answer. I, I'll never forget you guys. This morning. First started my birth classes and I was doing the VBAC lab, which I have two birth classes. I've got com labor competent birth, which is for [00:20:00] everyone.

I don't care if you're hospital birth or home birth and first baby or 10th baby. But then I have the VBAC lab, which is specifically for my moms who have had a C section who need to learn how to trust their body and trust their instincts and want to give birth vaginally after C section. That's the VBAC lab.

And I'll never forget my. My founding members, I had 15 founding members, and one of them, she was in labor. Her labor was doing great, but her doctor was rushing her. Her doctor comes in and says something like, we need to think about a c section. And her husband said, Please give us some time to talk and he leaned into her and he said we're doing this your way And I'll be darned if she didn't give birth like 30 minutes later when those that oxytocin was flowing and she felt safe and she Felt supported and she didn't feel pressured Understanding how to navigate the interventions will change everything for your birth.

So you have to join in in [00:21:00] the class. You have to get in the full classes and I see some of you saying that you did the fearless birth VIP. Girl, go ahead and join in the actual classes where I can work with you and be your birth coach. Okay, so the last thing we're going to talk about, well actually it's not the last, but the last big doodles is cesarean.

Don't you love my official terms? So when we're talking about a cesarean, it is an intervention. Is it necessary? Yes, there are times where it will save you. It will save your baby. But, if a c section is being suggested, especially before you give, before you're in labor, let's say you're pregnant. I think I saw one of you say it's your first baby and they're telling you you need to have a c section.

I would love to chat with you a little bit more, so see if Send me a DM and tell them you want to talk to Trish directly and that she said to assign it to her. [00:22:00] We're going to talk about, sometimes they are necessary, but it is a major abdominal surgery. It's not just another way to give birth. It is a major abdominal surgery and you should navigate that decision cautiously because there are significant risks.

And you're going to have a longer recovery time and guess what? The C section postpartum nurse does not come to your house and take care of your tiny human. That is you with a major abdominal surgery and that is hard as crap. So I want you to make sure you understand why it's being recommended and whether or not it's truly necessary.

And again, I teach you how to read the room so that you know, yes, this is, this is necessary or wait. Thank you. I call BS. So you need to discuss with your provider the possibility of waiting or trying other interventions, right? Okay. And this is the crux of all of it. [00:23:00] Now we're going to go over a couple other common interventions really quickly.

I'm not going into detail, obviously. I know you people and I know you don't like to stay on these lives very long. So we try to keep them short. We're also gonna put this on the podcast so you can come back and watch it on YouTube. You can watch it on, listen on the podcast or watch it on Instagram. Okay, so other interventions.

NPO, what does that mean? You can't eat. That is an intervention and it's stupid. Unless there is a true emergent situation, you should be able to fuel your precious body because it's working super hard. Another thing is they say you can only have clear liquids. No. Please fight them on this one, unless it's 100 percent necessary.

You need to know when it is and when it isn't. The other thing would be, administering oxygen on you. Sometimes that is necessary. There's been, there's not, you know, some studies say it's not that beneficial. Others say it [00:24:00] is, that it's more for us. But, there are times during your labor, maybe your baby has a fetal deceleration, a fetal heart deceleration.

We are going to do a couple things. We're going to administer IV fluids, we're going to give you oxygen, we're going to change your position. Those are all interventions, you guys. Got to have my coffee. Okay, another intervention we do is a Foley catheter. Now, here's something that you may not know, but a full bladder blocks your baby.

It's a roadblock. So we want to keep that bladder empty. So if you get an epidural, you can't empty your bladder. So you will have to have a Foley catheter. Lithotomy position, that is pushing with your legs up in the air and stirrups on the things. That is an intervention. Guess who it's convenient for?

Not you. Mm mm. It's convenient for your doctor, and it's not always necessary. Guided pushing. That's where your nurse is like, okay, you're gonna push your chin to your chest, you're [00:25:00] gonna hold your breath, and we're gonna count to ten, and you're gonna push down like you're pooping. That is guided pushing.

That is an intervention. It is not the natural way to push. Now, if you naturally hold your breath without us guiding you, then that's your body telling you how to do it for your body. Let your body tell you. This is why I teach you all the different push in positions and breathing techniques during pregnancy so that it comes to you instinctively during your birth.

And you have to know how These things. Now, other interventions would be things like your epidural, your nitrous oxide, IV narcotics, but we go over that in our medication module in the big course, the birth courses, or we've got some podcasts on those things. So. Let me just tell you that you have a choice in all areas of your birth.

You are the queen. I want you guys right now to [00:26:00] say out loud, message back to me, I am a birth queen, or just write birth queen, or send me a crown. Do something to show me that it is sinking in, that you're the boss of the birth room. You Not me, the labor nurse, not your provider, not your midwife, not your mama, not your mother in law, not your partner, not anyone else.

This is yours. You take ownership. Now, you would not just wing a big trip. You would not wing your wedding. Well, maybe you would. I don't know. But you wouldn't wing something big, right? So don't wing your birth. Be educated. Education is one of the most powerful things you can do to avoid the cascade of interventions.

You have to understand. I'm seeing these queens flopping through. I am taking a screenshot of that. I love y'all so much. And there's Vaughn, one of my students. I love her so much. She's been such a commodity to this community. We love you so much, Vaughn. Yes, Natalie and Amanda, and hello, and you, best [00:27:00] friend Rage, all of you guys.

I am so proud of you guys. Yes, look at the birth queens. Come and join us. You guys, stop waiting. There is nonsense in that. You do not want to wing your birth. You'll end up in the VBAC lab, or you're gonna end up with a trauma. Let us come alongside you. When you join my classes, you get access to me for reals.

You get access to my amazing community. You actually get a bonus. You get four bonuses when you join my birth classes. You get 30 days free in my membership, which is amazing. Unbelievably amazing. You'll never want to leave. After 30 days, it's 19 a month, which gives you access to doulas. It gives you access to a postpartum doula, birth doula, a labor and delivery nurse.

It gives you access to a mindset life coach who gives is helping my mom's the last Thursday of every month. She is working on releasing trauma, releasing, any of the things that you bring from your childhood and your own parents. And then we have experts who come in and do expert [00:28:00] workshops. You hang out with me on zoom, hang out with my doulas on zoom.

It's really unbelievable. Another option you have when you join my classes. Yes, Jenny, it is. Thank you. Jenny's been with me. She's on her second baby with me. When you join my classes, you also have the option of adding your labor bat signal. If you don't know what that is, I have some information in my highlights on Instagram, but the labor bat signal is literally unbelievable.

And I, everyone else in the, in the birth community thinks I'm insane for offering it, but for 49, you can add to your birth class. You do have to be a student. Because we become your virtual doulas, me and Allison, we create you your labor bat signal, which is a group text message with me and my doula, Allison.

And once you have the baby, we add in my postpartum doula, Ashley. And we are going to walk alongside you in the most intimate way possible. Intimate, hand holding way. So if you're sitting at your [00:29:00] doctor and they say some BS like you need to go to the hospital right now, we're going to help you navigate that.

Now, it's not guaranteed 24 7, but we're in there a lot. And for 49, you cannot find that anywhere else. Anybody else that does virtual doula is going to be thousands. So it's It's crazy. So jump in right now. Yes, Von just started hers. Jenny starts in three weeks. It's her second one with me. Oh my God. She did it with Melly.

She did not use it as much as she should though. Okay, you guys, you can see in the comments how much everyone loves our community. Stop waiting. Join the classes. Comment right now, class. If you're watching this on YouTube, go to labor nurse mama. com forward slash C A L M. Calm. Because you're going to be a calm, confident birth queen, and you are going to rock your freaking birth.

Okay, if you guys have any more questions, just shoot them to us. We'll be happy to answer them. I'll see you guys on the inside. Have an amazing Friday and an [00:30:00] incredible weekend. We love y'all so much. So, so much.

Hey mama, I hope you found this episode empowering and filling you with the knowledge and the confidence to make informed decisions during your birth experience. That's what it's about. If you found this discussion valuable, be sure to hit subscribe and leave us review. And if you're ready to take the next step.

You have a couple options. You can take my free mini birth class, go to labor nurse mama. com forward slash secrets. Or if you're ready to deep dive and go all in and be the queen of your birth experience, go to labor nurse mama. com forward slash calm and use the coupon code pod 50 to get 50 off. Okay, you guys, I will see you again next Friday.

Bye for [00:31:00] now.