[00:00:00] Dr Renee White: Knowledge is power, and we are all about empowering the mamas of the world. In each episode, we will unravel and interpret the latest research and evidence-based practices for pregnancy, postpartum, and motherhood. As mums and researchers ourselves, we have experienced firsthand the overwhelming complexity of information myths and those classic old wives tales.

[00:00:27] Dr Renee White: I'm Dr. Renee White, and this is the science of motherhood. Hello and welcome to episode 201. This is The Science of Motherhood, and I'm your host, Dr. Renee White. In today's episode, we're exploring birth after cesarean and the groundbreaking research that's changing how we support women's choices. Have you ever been told that once a cesarean, always a cesarean?

[00:00:54] Dr Renee White: Are you pregnant after a previous C-section? And feeling a little bit overwhelmed by all the conflicting advice about having a vbac? Some people trying to tell you it's too risky, others saying you should definitely try it. Or maybe you are caught between what you want and what the system says you are quote unquote, allowed to have.

[00:01:17] Dr Renee White: If you are trying to make sense of your options and no one seems to be giving you the full picture, this conversation is absolutely for you. Today, I'm joined by Dr. Hazel Keedle, a senior lecture of midwifery at the Western Sydney University. An author of two books now on birth after Cesarean. One for women, the first one, and now one for clinicians.

[00:01:43] Dr Renee White: She's the lead researcher on Australia's largest maternity experiences survey and has spent over two decades fighting for women's rights to respectful, supportive maternity care. And in today's conversation, Dr. Keedle reveals her revolutionary four factors. Framework that helps women cut through the noise and make decisions that are right for them.

[00:02:06] Dr Renee White: So you'll discover how doulas and birth workers can use this framework when families are drowning in conflicting advice and the biggest misconceptions clinicians have about what women actually fear. And stay with us for when Hazel talks about the changes she desperately wants to see in maternity care systems, because it's not just about individual choice, it's about systemic change.

[00:02:33] Dr Renee White: This episode is proudly supported by fill your Cup, Australia's first doula village. If you are pregnant or have a new baby, congratulations. We have some amazing doulas ready to nurture and nourish you across Melbourne, Geelong, Sydney, Newcastle, Brisbane, gold Coast, Hobart, and Perth. And our link is in the show notes to look at our do doula services.

[00:02:58] Dr Renee White: Alright, everyone, let's dive into today's episode with Dr. Hazel Keedle.

[00:03:04] Dr Renee White: Hello and welcome to the podcast, Dr. Hazel Keedle. How are you today?

[00:03:10] Dr Hazel Keedle: I'm great. I'm well. Thank you for having me on.

[00:03:12] Dr Renee White: Oh, my pleasure. Now, everyone would've heard from the introduction that you are back on the pod to talk about your second book now, which is very, very exciting. Congratulations.

[00:03:25] Dr Hazel Keedle: Thank you very much. I never thought I'd write one, let alone two.

[00:03:29] Dr Renee White: Amazing. Well, I kind of feel like this is your third, because I feel like the thesis is a book in and of itself, right? Like

[00:03:39] Dr Hazel Keedle: three thesis. So then I had a master's and then the PhD, so, yeah,

[00:03:43] Dr Renee White: exactly. So I tell you what, that was always something that I was quite hesitant about like, I actually didn't wanna do a PhD 'cause you had to write a thesis.

[00:03:53] Dr Renee White: I was like, oh no I don't. I don't wanna do it. My supervisor's like, yeah, yeah, yeah. You got, you got top of class for honors, you have to do a PhD. And I'm like, yeah, but I have to write a thesis. Like

[00:04:03] Dr Hazel Keedle: that's why you do my publication. 'cause then

[00:04:05] Dr Renee White: yes. Well that was my aim, Hazel. And then it didn't kind of pan out like that because Yeah anyways, that's a long story. Um, we are here to talk about you and we are here to talk about. The amazing book that you've written, which is complimentary to your first book. Now, the second book is called The Clinician's Guide to Better Birth After Cesarean, and your first one was Birth After Cesarean, your Journey to a Better Birth.

[00:04:32] Dr Renee White: What inspired you to, I guess, write this second book specifically for C clinicians this time, like after empowering all these women with your first one.

[00:04:45] Dr Hazel Keedle: So after the first one, I was invited to go and do some, you know, book launch stuff and it would go from, you know, a small thing to then a few hours. And from that I developed a workshop for clinicians.

[00:04:58] Dr Hazel Keedle: Mm-hmm. And so that was for midwives, doulas, doctors and students of those professions. Mm-hmm. And I started traveling around, so I developed it all by myself. I developed an e resource for an Etri resource for the College of Midwives, and I was going around doing, you know, all these workshops all over the country, plus then having the book with me as well.

[00:05:17] Dr Hazel Keedle: Mm-hmm. And I based it on the four factors, which is what came out of the PhD and is in the first book. And as I started doing it and hearing from clinicians as well. That's really where the seed came from because I just thought, well, not many people are come, well, I had a fair, fair few people come do my, my workshops, but I couldn't do them forever and I couldn't do them everywhere.

[00:05:37] Dr Hazel Keedle: I did one in the uk, one in America recently, but I can't get everywhere. Mm-hmm. And I was getting really great feedback from clinicians that were doing it, really enjoying it. I just thought I should dive deeper because, you know, one of those really important factors for women is that relationship with the healthcare provider and therefore we need to be, have clinicians that are better prepared to be able to be that person in the relationship for the woman.

[00:06:04] Dr Hazel Keedle: Mm-hmm. So this is where I thought, you know, I've, all the stuff that I've done in the workshops and all the stories that I've heard in the workshops, I think I could put this together in a book and um, and I did.

[00:06:18] Dr Renee White: Absolutely. And I'm so glad that you touched on that because I think in, in the blurb it actually says, you know, the book goes beyond the data, and you've kind of just touched on the fact that you are hearing all of these stories from clinicians as you're traveling around the world.

[00:06:34] Dr Renee White: Can you, I guess, explain, you know, why evidence alone isn't enough? You know, just, you know. Pulling numbers out of studies and things like that. Particularly now when we're supporting women considering VBAC versus, you know, repeat cesarean.

[00:06:52]

[00:06:52] Dr Hazel Keedle: Well, I think if the data was enough, then we would have very high rates of VBAC in Australia. Mm.

[00:06:58] Dr Hazel Keedle: And we don't, the norm is to have a repeat cesarean, whether that's planned or unplanned. So I know from the research that I've done that a massive part of that is the clinician. Mm-hmm. And that can either be a positive impact or a negative impact. And those negative impacts, you know, I just keep on.

[00:07:18] Dr Hazel Keedle: Hearing about and I thought, we know we need to change. We need to change that. And there's so much with it. You, you do need to understand the data because the data actually is very supportive of birth choices.

[00:07:29] Dr Hazel Keedle: Mm-hmm. But you also need to think of everything else that gets involved, because data alone does not change culture. Yeah. And does not change the attitudes of people. So that's where I wanted to bring in, you know, you need a, there's a lot more to this.

[00:07:43] Dr Renee White: Mm-hmm.

[00:07:43] Dr Hazel Keedle: As usual, I've gone down the whole, you know, interesting little, little diversions into trauma, ob, sexual violence, receptor for maternity care, trauma-informed care.

[00:07:55] Dr Hazel Keedle: But there's a lot that makes up how to really support women to plan that better birth after the cesarean. So that's kinda where I've, where I've gone into within those four factors. And so I think if we just have the data, the data's really favorable. So why is not? More women having access and the barrier, one of the biggest barriers for women to have access is the clinician.

[00:08:15] Dr Hazel Keedle: Mm-hmm. So I'm trying to come in from that angle now to go, you need the data, but you also need to know the why. And you need to know how to do it. And that's where this book comes in.

[00:08:25] Dr Renee White: Yeah, absolutely. And so I guess without, you know, doing too many spoilers, because we obviously want clinicians to get this book in their hands, can you kind of just walk us through what those four, the four factor framework is, and I guess you know what they are and, and how did you, how did you arrive at at those.

[00:08:48] Dr Hazel Keedle: So they, uh, they came through, um, my PhDs. Yes. So this is where I in, I had a mixed methods PhD and the first part of it was following women on their journey. And so they were all planning a vbac and I got them during their pregnancy. They had a purpose-built app where after every appointment they would share their story.

[00:09:09] Dr Hazel Keedle: So what the appointment had been like, what they had been told, what happened, how this impacts them. Um, there was very loose guidelines, but then they kind of didn't need it because we're just such good talkers. Yeah. I get all these installments. It was like the, the best soap opera ever because I was like, what are they gonna tell me today?

[00:09:26] Dr Hazel Keedle: Because I'm getting it in real time. Yeah. And then I interviewed them all afterwards as well. And so I think I had 12 women for that part of the study. Mm-hmm. And because I had their in-depth journeys, I didn't break it all up. I did something called a narrative analysis, which keeps their stories intact.

[00:09:41] Dr Hazel Keedle: Mm-hmm. And then you compare and contrast the stories for differences and similarities and what the real core of the messages are that are coming out of that.

[00:09:50] Dr Renee White: Mm-hmm.

[00:09:50] Dr Hazel Keedle: And that was an interesting process. It was a new methodology for me. I'm, I'm used to kind of putting everything in. Mixing it all up and then pulling stuff out.

[00:09:59] Dr Hazel Keedle: Mm-hmm. So this was really a lovely way to keep their stories intact. Mm-hmm. And I also had a lot of my reflections as well. So like, after I would go to an interview, I'd write down reflections. And so they kind of went in as something to analyze as well. And during that process of analysis, I did get a few aha moments.

[00:10:18] Dr Renee White: Okay.

[00:10:18] Dr Hazel Keedle: Because women would, so about half of em had a vbac and half of em had a, a repeat cesarean and one had a forceps in. Yeah, so that was like the, the makeup of it. And from that the experiences were so vast. Mm.

[00:10:34] Dr Hazel Keedle: And so for example, there were two stories, two women that had on paper, like if we were reading notes

[00:10:41] Dr Renee White: mm-hmm.

[00:10:42] Dr Hazel Keedle: Would be identical. Mm-hmm. They both got to fully dilated and they both had a repeat cesarean at full, at full dilation.

[00:10:48] Dr Renee White: Mm-hmm.

[00:10:48] Dr Hazel Keedle: But their account of their stories and how they felt about it. And I did these interviews back to back. Mm. And then I went, I wrote a reflection, then I went straight to the other one, wrote reflection, uh, on the same day.

[00:11:00] Dr Hazel Keedle: And you would think it was two ends of a spectrum. Like they just felt so different about their experience, but on paper it looked the same.

[00:11:10] Dr Renee White: Yeah.

[00:11:10] Dr Hazel Keedle: So that was like one of those aha moments to go, all right. Like, you know, we often think that. You know, we love to live, live in this dichotomous world of good versus bad and mm-hmm.

[00:11:22] Dr Hazel Keedle: You know, black and white and all these kind of things. And we think, you know, one birth choice is good, the other birth choice is bad and mm-hmm. And you come from different viewpoints on that. And then we also then think as clinicians, well if you planned something and you got it, good. If you planned something and you didn't get it, then bad.

[00:11:40] Dr Hazel Keedle: Yeah. And that was the thinking that, and to be fair, I'd come into my VBAC thinking it was all about the vagina. Mm-hmm. And vagina both have cesarean. So that was a good point for me to go, alright, there's more to it than this.

[00:11:53] Dr Renee White: Mm-hmm.

[00:11:53] Dr Hazel Keedle: And then looking at all these other stories and comparing them. And that's when I realized that you could have the birth that you were planning or the birth that you didn't plan the outcome, that you weren't planning.

[00:12:04] Dr Hazel Keedle: And you could still, you could feel really good about it or you could feel really bad about it. Mm-hmm. And it was about what those factors were. Mm-hmm. And those factors became the four factor framework. Mm-hmm. And so they are having control, having confidence, having a relationship, and having active labor.

[00:12:21] Dr Hazel Keedle: Mm-hmm. And that's then that was then put into, well I then tested that in a national survey. Um, and they certainly did stand and then, um, wrote that in the first book for women, it was a guide on how can you have good experiences of having control, having confidence, having relationship, and having active labor based on the evidence and what do, what, what does that even mean?

[00:12:44] Dr Hazel Keedle: Like what's involved in all of those?

[00:12:46] Dr Renee White: Mm-hmm.

[00:12:47] Dr Hazel Keedle: When I then write it for this book and what I was doing with the workshops is sometimes the, the things that we were in a factor from the woman's point of view was in a slightly different factor for the clinicians. Yeah.

[00:12:59] Dr Hazel Keedle: That, that was interesting for me. So some of the, some of the things are still the same order, control, confidence, relationship, and active labor.

[00:13:07] Dr Hazel Keedle: But some of the things are in different spots. So we talk about different things because it's from the clinician's point of view, or the clinicians need to know compared to a woman going through it herself. Mm.

[00:13:19] Dr Renee White: I I just wanna touch on that point. You said it has to go in an order, is that right?

[00:13:24] Dr Renee White: Well, it's just in the order, in the book, so that's not Oh, okay. I was like, oh, I'm very keen to know about this. Same,

[00:13:30] Dr Hazel Keedle: um, and I think there is some kind of order with that. Yeah. It moves around. So it's not a, it's not a timeline order.

[00:13:39] Dr Renee White: Gotcha. Okay.

[00:13:40] Dr Hazel Keedle: But it's the same. It's the same format that I put them. I always had them in that order.

[00:13:45] Dr Renee White: Yep, yep. No, no, no. That totally makes sense. And so when we're talking about clinicians, I mean, you know, I'm a doula. I'm not a birth doula, but I'm postpartum for sure. And obviously, you know, leading the charge here at Fill Your Cup. Uh, when we're talking about clinicians, is the book pitched specifically to, you know, midwives and obstetricians?

[00:14:05] Dr Renee White: Or like, how, how could doulas pull information and, you know, from this to use, I guess that framework practically when they're supporting families who are, you know. I don't know, feeling very overwhelmed about tackling a vbac.

[00:14:24] Dr Hazel Keedle: Absolutely. There, there's a lot of doula love in there.

[00:14:27] Dr Renee White: Yeah. And there's woo-hoo.

[00:14:28] Dr Hazel Keedle: Yeah. Doula the stories as well. Uh, the, you know, there's a couple of doula stories and they really blow my mind. So there's a lot, and there's actually even a lot in there that women can get from it as well. Mm-hmm.

[00:14:39] Dr Hazel Keedle: Because then they can kind of see in the, in the eyes of a clinician. Even ask those things of a clinician as well, you know, you could use it to prove that that person deserves to be on your team.

[00:14:49] Dr Hazel Keedle: Yeah. By talking about some of these things and, and it just, it has a, just a different lens on stuff so anyone could read it because a lot of midwives and doctors and doulas found a lot of benefit in the first one, even though it was to women. And so the same with this one, and it's just some of the evidence is updated because that was one of the, you know, fun parts was to go in and see what's, what's been done since the last book.

[00:15:11] Dr Hazel Keedle: Um, but then also there's different things that are talked about. That are not talked about in the first book. Also because I hadn't done research in it at that point. So now since then, when I wrote the second book, I've done a lot of work on birth trauma. There's been the inquiry.

[00:15:25] Dr Hazel Keedle: Mm. I've been part of that and I've published on obstetric violence. So there is that in there now. So there's a lot of stuff on birth experience study is now in there. But do those, there's a lot they can bring from it. I think it reinforces a lot of what they probably know.

[00:15:39] Dr Renee White: Mm-hmm.

[00:15:39] Dr Hazel Keedle: Um, and then also puts it in ways that they can use the evidence to support it as well. So you know, if you're having a conversation with a woman about models of care

[00:15:49] Dr Renee White: Yes.

[00:15:49] Dr Hazel Keedle: Then this will go through what, you know, more updated information on models of care, how that impacts women planning of vbac. Yeah. So each of those things, you know, it is not just an update. There's a lot, there's lots of different things in one book that's not in the other.

[00:16:01] Dr Renee White: Mm. Yeah. No, no, that's really good. I think that's definitely, you know, part of the conversations that I see when we're putting together people's, you know, birth maps or birth wishes, they are always craving evidence, you know? Particularly the people that work with us, like we are very evidence-based here. And so yeah, any opportunity to kind of go, yep, here it is.

[00:16:27] Dr Renee White: Like this is what we're talking about. And that's where I feel like, uh, to your point, like that's where they get their confidence from. They're like, okay, yep. I'm making decisions based on, you know, what, what's out there in, in the data, so, okay.

[00:16:41] Dr Hazel Keedle: Absolutely. And I don't write things, I just don't think I've got the capability to write things really complicated. So it's that, you know, I think the clinician on the floor could understand the clinician that. Is not doing research, is not, hasn't got time to do all that, just wants to make a difference to the everyday practice, then it's written in that way. Um, I'm, that's, I'd like to say it's just because I'm really good at translational research.

[00:17:03] Dr Hazel Keedle: I just don't think I can write a fancy, to be honest. So a journalist said to me once, oh, Hazel, I really enjoyed reading your article and thank you. Like, like a journal article, right? Yeah. Like journal article. Yeah. You really wrote it in a way that everyone can understand and I'm thinking, I don't think I know another way.

[00:17:21] Dr Hazel Keedle: I just look. It's really important that everyone can understand research shouldn't just be for those that can really understand the terminology, but in my head I'm thinking, I think that was my fancy language. Yeah.

[00:17:34] Dr Renee White: But that. I, I really appreciate that though, because you know, as someone who has read probably way too many journal articles, there are some that you kind of, you have to reread a paragraph like five times and, and then cross check to like figures and you're like, oh. What is the point that they're making here?

[00:17:53] Dr Hazel Keedle: Like what is the point of writing like that? Yeah, good. Just self inflate your ego.

[00:17:58] Dr Renee White: It does

[00:17:59] Dr Hazel Keedle: The other fancy pants people, like, if it's not gonna make a difference, I think it's, you know, if I was, if I was a pure scientist and doing lab rat experiments, then sure I need the other scientists to understand my research. Yeah.

[00:18:12] Dr Hazel Keedle: But I'm a midwife. I do midwifery research and my area is women's experiences. Yeah, it was feedback, but now it's generally women's experiences, so therefore the people I would want to make the changes or to understand it are the women. Yeah. And the consumers and the support teams and the clinicians.

[00:18:32] Dr Hazel Keedle: So there is a responsibility even in the frame, even in the. The theoretical framework that I've used my PhD, which is transformative emancipatory framework, is the responsibility is to give the research back to those that you've researched. Yeah. Such an extreme in writing in the way that I do, but also writing in the, in the books.

[00:18:53] Dr Renee White: Absolutely. I kind of wanna shift gears a little bit and talk about, you know, the current practices that we have. Like you've already said, you know, if we were relying straight on the data, why are we not having more VBACs in Australia? What do you think, I guess, are the biggest perhaps misconceptions you see clinicians having about women's motivations and fears regarding VBAC versus, you know, repeat cesareans?

[00:19:26] Dr Hazel Keedle: I think there's a few things. I think it's the. The fear-based language and the risk-based model.

[00:19:34] Dr Renee White: Mm-hmm.

[00:19:35] Dr Hazel Keedle: That we have in certainly in our hospital systems and with the professions that work in them. Yeah. And those professions that have the power in those in that area is that in Obste. And I love obstetricians I have a controversy.

[00:19:50] Dr Renee White: We we're not throwing anyone under the bus here people.

[00:19:52] Dr Hazel Keedle: I've never wanted to do cesarean, so I'm more than happy that you are the experts when it comes to that. Yeah. However, the, one of the issues is that they're kind of put a bit more on a pedestal and have more power. Mm-hmm. And they come from an illness model because that's what they do.

[00:20:07] Dr Hazel Keedle: Right. You get sick, you go see a doctor, doctor knows how to, how to understand your disease, and hopefully come up with some treatments. And in that model then by nature, the person who understands the body and knows what happens when it's sick, and then what needs treatment. The expert knowledge is held by that person in that profession.

[00:20:27] Dr Hazel Keedle: And so then the person who might be saying, well, actually I don't think it is that. I think it could be something else. Their knowledge is not as, as respected or taken into consideration. Mm-hmm. Things have changed a lot more, uh, recently with that, but that is kind of the model we have. Then those people, the doctors kind of got interested in women's healthcare, and particularly to do with maternity care systems, which had generally been in the domain of midwives and traditional midwives in that way where they know it's comes from midwifery, comes from this wellness model. Mm-hmm. You know, women are well and they're going through a life transition and we are there to support them and there may be times when we need to use like pre. Premodern midwifery, like we might need to use certain herbs or certain positions and stuff, but we've got that knowledge and we are there to assist, not to take over.

[00:21:15] Dr Hazel Keedle: Mm-hmm. And we'll just really listen to what the women are saying as well. But you, you move the women from that community into the hospitals with the risk-based, we've got the expert knowledge and we understand your, your body more than you do.

[00:21:27] Dr Renee White: Mm-hmm.

[00:21:28] Dr Hazel Keedle: And it's all to do with illness. Then suddenly pregnancy, labor, and birth and postnatal is dealt as an illness. Yeah. And that has stayed within the hospital system and, and the hospital system has to get all of that un expectation, all those, uh, all those different things that can happen within a system that has to try and manage that risk.

[00:21:50] Dr Renee White: Mm-hmm.

[00:21:51] Dr Hazel Keedle: And it's almost like maternity is kinda like in the wrong spot at that point. Yes. Because you've then gotta fit in there that women are generally treated as risk and risky. Yeah. They've got just make more risk. And therefore if you actually end up with a, with a vaginal birth and you went into labor spontaneously, then you are kind of lucky. Yes. Like it was something that your body was capable to do.

[00:22:13] Dr Hazel Keedle: It was 'cause you were lucky and none of the other risk bad things happened.

[00:22:17] Dr Renee White: Mm.

[00:22:17] Dr Hazel Keedle: Managed in that way. And then this is like, VBAC is the perfect barometer for that because the women's had a cesarean. We know that that's just there for whatever reason and her experiences of that or how she feels about that isn't really taken into consideration.

[00:22:33] Dr Hazel Keedle: But they're now thinking, okay, now, now you know, we could in our little. Ordered system of a hospital that we try and order with things as much as possible.

[00:22:42] Dr Renee White: Mm-hmm.

[00:22:42] Dr Hazel Keedle: We will encourage you to have a repeat cesarean because it's all planned and elective surgeries are much easier to be managed and less risky than an emergency.

[00:22:52] Dr Hazel Keedle: Yeah. And the unknown with VBAC is you are going back into labor, you dunno what's gonna happen. You could explode. You can't actually explode. There could be things that can happen to you. Yeah. That lead to an emergency and we don't like emergencies because we then, you know, there's slightly worse outcomes with that.

[00:23:09] Dr Hazel Keedle: Mm-hmm. And we can't control it. Mm-hmm. So it's like you can have this nice ordered repeat cesarean. Yeah. Even though women are then not told about the risks of the repeat Cesarean. And there are many Yes. Or feedback's really hard to control. Mm-hmm. And then if you're thinking about it from the viewpoint of the, I guess the dominant profession in that is risk, let's manage and maintain this risk.

[00:23:30] Dr Renee White: Mm-hmm.

[00:23:31] Dr Hazel Keedle: But also being aware that this isn't just a new issue like cesarean have been around for a very long time. Yes. And one of the things I enjoyed in, in this book. Which I didn't do in the first book as much. I really went into the history of cesareans. Ah. So I had to dive deep dive into what went on.

[00:23:49] Dr Hazel Keedle: And why is there this term once a cesarean, always a cesarean, which is well over a hundred years out of date?

[00:23:57] Dr Renee White: Yeah.

[00:23:58] Dr Hazel Keedle: Why is that still the common belief? Mm-hmm. Especially in our, in Australia and in America and in other places. Not every place has the same rates that we do, though. I went back and looked at that and I think really what happens is that although all the techniques and that have changed and cesareans very different now that it used to looked at, at that point when you would say once the Cesarean or Cesare, cesarean, the attitude hasn't kind of shifted along with it.

[00:24:28] Dr Hazel Keedle: The science has changed. Yeah. The outcomes have changed, but the attitude hasn't, and that attitude, not only did it get adopted within the medical community, but it actually got adopted in society too.

[00:24:39] Dr Renee White: Yes.

[00:24:40] Dr Hazel Keedle: So we call that, or or Bridget George Jordan used to call, call this authoritative knowledge. Mm-hmm.

[00:24:45] Dr Hazel Keedle: The knowledge is, has come from these experts, but it actually goes into community that, well, once you've had a cesarean, must always have it.

[00:24:53] Dr Renee White: Yeah.

[00:24:53] Dr Hazel Keedle: And if that's the most common thing as well. Then why would you not believe that?

[00:24:58] Dr Renee White: Yes, absolutely.

[00:25:00] Dr Hazel Keedle: It's what everyone is doing. So you are then getting women saying, well no one's had a cesarean in my, no one's had a vaginal birth in my family and therefore we can't. And once and, 'cause I've had a cesarean, I have to have another one.

[00:25:11] Dr Renee White: Yeah.

[00:25:11] Dr Hazel Keedle: If you go back in the family tree long enough, they must have had vaginal births. Otherwise your lineage would not exist. Yes. Say that because you know. Most cesareans back then were women weren't surviving them.

[00:25:24] Dr Renee White: Yeah, absolutely.

[00:25:25] Dr Hazel Keedle: You go back far enough, you'll find a vaginal births, don't you worry.

[00:25:27] Dr Renee White: Yeah.

[00:25:28] Dr Hazel Keedle: They come in with that belief because that's also then what they're, whoever they're relating to have also been told.

[00:25:34] Dr Renee White: Yes and And it just becomes the dogma, right? Like

[00:25:39] Dr Hazel Keedle: so when you've got this world of the society saying one thing and then the expert medical opinion saying another thing, and then in the middle is potentially midwives. Mm. And women wanting a vaginal birth of cesarean. Then were kind of the, the disruptors, but also potentially the difficult women and the ones who are, you know, then bucking the trend against both society and the medical system. Yeah, and then I think that's where all those hurtful comments come into, come in, all those, all that coercion, because you're just doing something a little bit differently.

[00:26:10] Dr Renee White: Yeah. So how do you, how do you broach that kind of tension between, I guess, those. That kind of institution that we're butting up against versus individual women's choice. Like I almost feel like, you know, the people that that we support, you know, they're really open with me from the beginning and they're just like, you know, I'd love to try for a vbac.

[00:26:34] Dr Renee White: And I'm like, fantastic, let's go for it. But it's almost like, they've got this giant mountain in front of them before they've even begun. You know, like how do we, if you had your magic wand Hazel, like how do we do this? Right? How do we shift? Like, it's huge. Like it probably won't happen in our lifetime.

[00:26:58] Dr Renee White: Like, let's be honest, I don't think,

[00:27:00] Dr Hazel Keedle: I think there's a lot of changes happening.

[00:27:01] Dr Renee White: You think,

[00:27:02] Dr Hazel Keedle: I think, uh, to the, the start of it is knowing that. Knowing why that it's there in the first place.

[00:27:08] Dr Renee White: Okay.

[00:27:09] Dr Hazel Keedle: So you know why I added that history bit in there? So that the clinicians who read it go, oh, I see where that came from now.

[00:27:15] Dr Hazel Keedle: Mm-hmm. And maybe I could challenge that and I give challenges. Like, come on, join me. And let's say we no longer need to have that belief anymore. Like

[00:27:24] Dr Renee White: Yeah.

[00:27:25] Dr Hazel Keedle: And then get to know the knowledge, get to increase your knowledge and understanding. About VBAC and, and birth out to cesarean options, what the evidence actually then says.

[00:27:36] Dr Hazel Keedle: Mm-hmm. Challenging that. Challenging the norms that you are being told on that.

[00:27:39] Dr Renee White: Yeah.

[00:27:40] Dr Hazel Keedle: And then going through, you know, really important part of under the confidence thing is actually knowing the why. Why is it yes. Who cares what women's experiences are. And that's what I've tried to bring in is, well, you should, because if you don't get out, like you actually should care.

[00:27:58] Dr Hazel Keedle: But if all you see is cesareans and repeat cesareans mm-hmm. And women happy with those experiences, then why would you care?

[00:28:06] Dr Renee White: Yeah.

[00:28:07] Dr Hazel Keedle: Why would you? And that's where I've tried to go, well, you should, and these are the reasons why.

[00:28:13] Dr Renee White: Yes.

[00:28:14] Dr Hazel Keedle: So it's even got some research in there that came from my PhD and we just never fitted in any of the five papers that I published from it.

[00:28:20] Dr Hazel Keedle: Um, which is where we asked women, why, why would you plan a VBAC, uh, in the national survey? And then I did a content analysis of listing, you know, what was the most important. Things that they said and I've, I've exposed that to try and share. I've shared it in the book for people to go, oh, okay. That's not what I was thinking.

[00:28:38] Dr Renee White: Yeah. Okay.

[00:28:38] Dr Hazel Keedle: So try and get them to become invested in it.

[00:28:42] Dr Renee White: Yeah.

[00:28:42] Dr Hazel Keedle: To realize that it's important and then to listen to women's experiences as well. And if they're never seeing it, then go listen to those podcasts that are out there. Yes. Like this and the other ones out there to actually hear why. Because the why is huge.

[00:28:58] Dr Hazel Keedle: Yes. Why it's important for women is huge, and so I think we can change it, but we've also got a lot of changes in our models of care, and I think we need to keep that going.

[00:29:07] Dr Renee White: Yeah.

[00:29:07] Dr Hazel Keedle: There's always gonna be, we've got a little bit of a backlash thing going on at the moment. Thankfully, professor Hannah Darwin has put some really good stuff out on that.

[00:29:16] Dr Hazel Keedle: God, she's one of my favorite people. And so I was like, yeah, yeah, you just deal with that bit.

[00:29:20] Dr Renee White: Yeah, you do. You do that one over there.

[00:29:24] Dr Hazel Keedle: And she's literally two offices down from me. So it works well in that way. And so yeah, there's always gonna, like, as something becomes, as something is rising, you always gonna get people fighting against it.

[00:29:34] Dr Hazel Keedle: And right now we have had a bit of a rise here in Australia. About medical continuity of care, and it's fantastic. It's, we should be doing it. It's what the evidence says, it's what women want as well. Yeah. And certainly from the birth experience study, we can prove that as well.

[00:29:45] Dr Renee White: Mm-hmm.

[00:29:46] Dr Hazel Keedle: So with that, we are building up that relationship factor.

[00:29:50] Dr Renee White: Mm-hmm.

[00:29:50] Dr Hazel Keedle: And so, again, in this book, I tell them more about that. Why is it so important? Why should you, if you are an obstetrician, should you be invested in this actually? How's it gonna make your job better by doing? What you should be focusing on. We need you for the emergencies. We don't need you to be sort of supporting women with a philosophy that doesn't fit VBAC.

[00:30:07] Dr Hazel Keedle: So I, I dunno. I mean, I've been a bit, I've been a bit cheeky in a lot of places too, and just kind of gone, you know, stop being a jerk and I dunno if those jerks are gonna read it.

[00:30:16] Dr Renee White: Yeah. That's the thing, right? Isn't it? It's kind of like, uh, may maybe, maybe they won't. Well, okay, so how about this though?

[00:30:25] Dr Renee White: Like, you know, we talk about it is. About the woman's choice. So let's say the scenario is, you know, a woman is meeting with her obstetrician and you know, they say, oh look, VBAC it's a bit too risky. You know, like that type of narrative. What would be your suggestion of how to navigate that conversation with them?

[00:30:54] Dr Hazel Keedle: What saying, first of all, throw the book at their head up on it. Were you, I say risky for who? Yeah. What is the risk? Tell me the risk. What are you talking about? Oh, the risk of you trying to up to tell me about that. What does that actually look like? How many women would do that? And what increases that risk?

[00:31:12] Dr Hazel Keedle: What lowers that risk? And then. All right. Well you've told me about that, but what about the risk of a repeat cesarean? Tell me about that risk. Mm-hmm. If you wanna use the word risk, then I want you to tell me about that risk in every single detail. You dunno those numbers, then you better go find that out.

[00:31:25] Dr Hazel Keedle: Like, don't come and tell me. It's just too risky if you actually don't have the data. Yeah. Like what does that risk mean? Risk for who? Risky for you? 'cause you don't like doing it.

[00:31:34] Dr Renee White: Yeah.

[00:31:34] Dr Hazel Keedle: Or is it me? And I really wish that, and something I brought in that first book for women is that. If there's choice available, and I know sometimes there isn't, especially in regional remote areas.

[00:31:46] Dr Hazel Keedle: Yeah. If there's choice available, then that person needs to earn a spot on your team.

[00:31:52] Dr Renee White: Mm.

[00:31:53] Dr Hazel Keedle: I just think, you know, you've gone to the best doctor because your friends said they're good and you get a nice TV in your room like, but do they deserve a spot on your team if your team is to get the best birth after cesarean?

[00:32:05] Dr Hazel Keedle: And your first choice is for vaginal birth. Then you pick that team, go find that team.

[00:32:11] Dr Renee White: Yeah.

[00:32:12] Dr Hazel Keedle: And then go question 'em and go, I don't really like your risk-based kind of thought. What do you mean about that? How are you actually gonna support me get thi to get this? Yes. If you're not, I don't wanna see you anymore.

[00:32:21] Dr Hazel Keedle: Yes. I think you are my team. You don't deserve a spot on my team.

[00:32:24] Dr Renee White: That's so true.

[00:32:26] Dr Hazel Keedle: Use our consumerism to a benefit and go, I can go somewhere else. And even in a fragmented system, you can say that person, I don't, I don't wanna have appointments with you.

[00:32:35] Dr Renee White: Mm-hmm.

[00:32:35] Dr Hazel Keedle: I, I wanna see somebody else. I don't, I don't think that I wanna go and see a midwife.

[00:32:38] Dr Renee White: Yeah. Yeah.

[00:32:40] Dr Hazel Keedle: And, and when women start demanding it, that

[00:32:43] Dr Renee White: Yes, that's so true. Because I have,

[00:32:46] Dr Hazel Keedle: I think they've gotta be, they need to be deserving on that team too.

[00:32:51] Dr Renee White: Yeah.

[00:32:52] Dr Hazel Keedle: And that might seem really foreign, but you know who, that's not foreign to private midwives. Yeah, so five midwives. I remember a time when I first started out in, uh, in the area I was living in, there was quite a few of us around.

[00:33:05] Dr Hazel Keedle: And so the woman would, would book a, uh, a meet and greet. And you never charge 'em for it either. Mm-hmm. Things have changed a lot. Okay. This is going back a few years. So, uh, a bunch of us would come up to this woman and we're trying to sell our services. You, you know, like Yeah. Mutual connection at the same time as you know everything else and say all the great things that you want to, and it's, and it is down to the woman to choose.

[00:33:29] Dr Hazel Keedle: Yeah. As each should be. And then as the, as the midwife, you're trying to be as authentic as you can be in that appointment. You are not promising bullshit, you're not promising things that. You know, and then gonna be a bait and switch scenario later on. You're just putting yourself forward. And does she then connect with you?

[00:33:44] Dr Renee White: Yeah.

[00:33:45] Dr Hazel Keedle: And you are, you are trying to prove to her that you deserve a spot on her team.

[00:33:48] Dr Renee White: Mm-hmm.

[00:33:49] Dr Hazel Keedle: And if we had that attitude that women then went along and went, I don't know if you deserve a spot on my team, um, I'll go somewhere else. Then maybe that would make the clinicians think too, that they need to build up their skills and their knowledge and think about their, the way that they're thinking.

[00:34:04] Dr Hazel Keedle: Yes. That person on the team, and there are some that are doing this. Yes. Like I chop out in Western Australia and there had these great people come along and one of them was an obstetrician and he shared that obstetrician shared. They were coming to the workshop because they were needing to get more confident about feedback.

[00:34:25] Dr Hazel Keedle: Okay. And women were asking him to support him and he was gonna have to deal with some stuff. Yeah. And to do that and came along for that. And really that person was just saying. How do I become the better person on that team? Like how do I become the person that deserves that spot?

[00:34:42] Dr Renee White: Yeah, yeah.

[00:34:43] Dr Hazel Keedle: I need to do some work. And they did and did a lot of that work in the workshop and it was really important and I hope in a way feeling more confident. The results of the Posts survey workshop generally told me they did. Yes. But that they went away more confident to go, yeah. I So with the woman now says, I will support them. I can now honestly say yes and this is how I'm gonna do it and this is what else I think you could be doing as well.

[00:35:04] Dr Renee White: Yeah, I, I absolutely bloody love that because I feel like, you know, I, eight years ago I was, I, I don't think I'd heard anyone specifically say anything about obstetricians. I was kind of like one of the first in my group to have a baby. So I had no, no background whatsoever. When I was reviewing, well, first of all, the context for me was I thought that you get what you pay for.

[00:35:29] Dr Renee White: So if you pay. Big money for an obstetrician, you're gonna get the best birth possible. And let's just say I did get the birth that I wanted, but it ended up being an elective cesarean because my brain completely. Capsized because I had no idea. Like, I was like, oh my God, I'm not prepared for this. I have no idea what's going on, and I needed to feel in control again.

[00:35:53] Dr Renee White: And so that's where it went. But to your point, like it, there is this phenomenon in your head and I, it's, um, it is good marketing because it's this scarcity model, right, of like an obstetrician is only gonna take x amount of people per month. And you see these people who are like scrambling to get, you know, some celebrities OB because they think, oh, that person had them.

[00:36:21] Dr Renee White: They must be amazing. Can I just tell you, I have a friend who went in with that mentality and she did not have a very good birth and she would not have gone with that person again, but she went with that person because she saw. Uh, you know, an A lister in Melbourne have their babies with that person. And she's like, that was the worst experience ever.

[00:36:45] Dr Renee White: And so it just doesn't pan out. And can you imagine if we flip the lid and we were like, actually, you know what? I'm going to interview you. Instead of going, calling up, going, oh, do you have any spots left? Uh, can I, can I get a spot? And to your point, like. You know, this usual model of, and I, I get why they do it because people are human, but this shared obstetrics kind of group where it's like you have your main person, but then you're seeing other people in the group because, and I didn't know this when I booked on the day.

[00:37:20] Dr Renee White: You could have whoever's on call and I, I can say hand on heart. That the, there was some people in that group that I was like, if I turn up and I'm in labor, I don't want that person. Because we did not mesh well in that 10 minute rush job of a check-in. And so I'm like, I don't want you holding my hand because I think you're gonna be a pushy shit with me and you're gonna be not, not my person.

[00:37:49] Dr Renee White: Right. And it just goes to your point,

[00:37:54] Dr Hazel Keedle: we know that the better outcomes is to do with relationship based care. Yes. And what people often see with the different models of care is they, they want will then think, well, with this obstetrician model, I'm gonna have the same person throughout. And, and they, they, they may or they may have other people in the team, but also who do you want to be there doing your labor and birth and actually holding your hand?

[00:38:18] Dr Hazel Keedle: Is that the kind of person that you want? Because they're kind of just gonna come in, manage the situation, and then leave. Yeah, come in and leave and then come back in and then leave and then be there and catch a baby and take all the glory. But or do your cesarean. That's very different really to midwifery continuity of care where you have that same person through labor and birth.

[00:38:36] Dr Hazel Keedle: Yeah. And then can happen. They might not be on call or you might have someone else in the team and know there is then the challenge of that and mm-hmm. Any of the work that we've done on models of care through birth experience study, we, we know that. Women, there can be a disconnect if it's not the same person during labour and birth.

[00:38:55] Dr Hazel Keedle: Yeah, but something it is that person isn't just gonna come and go like they're gonna be with you. During that time and your team can be bigger than just that.

[00:39:04] Dr Renee White: Mm-hmm.

[00:39:05] Dr Hazel Keedle: So we are about having a doula there who can be with you the whole time there.

[00:39:09] Dr Renee White: Yeah.

[00:39:09] Dr Hazel Keedle: And knowing that that team is going to be, and how do they get on?

[00:39:13] Dr Renee White: Mm-hmm.

[00:39:13] Dr Hazel Keedle: Like if you've got an individual or a healthcare provider, then says, I don't work with doulas, I don't want you to have a doula, but that should be a massive red flag and you should be

[00:39:22] Dr Renee White: Oh, absolutely.

[00:39:23] Dr Hazel Keedle: Like, you know what, I'm gonna go now and I'm not paying for my appointment. Thank you very much. Goodbye.

[00:39:26] Dr Renee White: Yeah. Yeah. Yeah. Do not pass. Go. Do not collect $200. Like

[00:39:31] Dr Hazel Keedle: I know you do. You don't go, oh, okay, well, I'll cancel the person. I've really developed a good relationship with

[00:39:35] Dr Renee White: exactly who's actually gonna be there to hold my hand and support my partner and all, and who's, you know, mapped out this amazing birth plan for me. Sure.

[00:39:44] Dr Hazel Keedle: And the evidence shows they're supportive. Yes. You know, you don't like it. Why is that? And that's the question we go, well, why, why? What don't you like about doulas? What's your problem with the doula? Do they threaten you?

[00:39:55] Dr Renee White: Mm.

[00:39:56] Dr Hazel Keedle: What is it? You don't like it all? Because they're strong women and they often say maybe they don't have to.

[00:40:01] Dr Hazel Keedle: The woman doesn't have to follow everything that you say. Oh yeah, I can understand that. You're not the person for me. Yeah, you don't deserve the spot on my team. Mm-hmm. And if just, if we could change that. If I could hope for anything. But actually I must say, since, um, you know, since the first book, I've seen language change even on the VBAC support pages, you know, on the, on the social media pages where women talk about their team.

[00:40:24] Dr Hazel Keedle: And I'm like, hell yeah, that's good. You've got it. Like you are using the language of the team. This is my team. I'm the person doing this, and I'm choosing the people to be with me. And so I kind of want this book for people to, for clinicians to go, oh, I just I need to prove that I deserve a spot.

[00:40:43] Dr Renee White: Yeah.

[00:40:44] Dr Hazel Keedle: I can be the best person for them in the profession that they're employing me for to, in, in, on that team so that I've got a worthy, I'm worthy of that spot.

[00:40:54] Dr Renee White: I bloody love that. Hazel, we're gonna jump into our rapid fire just to wrap up, but, and we'll talk about release date and everything for your book and all that kind of jam in a sec. Okay. First question that we always ask our guests, what is your top tip for mums? And I'm gonna nuance this and go, people who want a vbac, that's what I wanna know. Top tip for those women.

[00:41:17] Dr Hazel Keedle: Top tip, we're going on the theme we've been saying, choose your team. Find the best team for you.

[00:41:22] Dr Renee White: Yeah. Perfect. Go-to resource for those particular women.

[00:41:29] Dr Hazel Keedle: Ah, my book

[00:41:31] Dr Renee White: apart, apart from your book, like I know it's a great shameless plug and like Absolutely. But is there anything else that they can do? like

[00:41:38] Dr Hazel Keedle: there's, there's a lot that I kind of go through in there. So yeah, really knowing those four different factors and where you come with that, each one of those can explode into other research, other resources. Yeah. For example, connect with other women, and that can be through listening through podcasts, for example.

[00:41:54] Dr Hazel Keedle: Yeah. So, you know, have that peer support. Look at who's, who's that, who's gonna be there on that side for you. Yeah.

[00:42:00] Dr Renee White: Yeah. Absolutely. Final question, we borrow this one off, Brene Brown. What do you keep on your bedside table?

[00:42:12] Dr Hazel Keedle: I actually didn't read these questions beforehand, which I like. 'cause I like to be more,

[00:42:15] Dr Renee White: we, we don't give these questions to anyone. Oh. People like, ah, can you send some through? And I'm like, yep. I never send the rapid fire. I'm like, nah, I need spontaneous.

[00:42:23] Dr Hazel Keedle: I didn't we that email. Excellent. I take that guilt off. Um, well it's a bit weird because at the moment I've got a home with my family and then I come down and I've got an apartment. In a city where I, where I'm working. Mm-hmm. And we are looking at merging altogether. But right now that's our thing. So in one apartment. I don't have, in my apartment, I don't have too much on there because I'm more transient.

[00:42:45] Dr Hazel Keedle: So if I think about when I'm back home, which is a bit more messy mm-hmm. The things on there get knocked off continuously by my, by my pug. Mm-hmm. So I have to be very selective on there. And I have some lavender spray.

[00:42:57] Dr Renee White: Mm-hmm.

[00:42:57] Dr Hazel Keedle: For my bed, and from when I go to bed and to try and calm the pug down. What else do I have on there? I have some water, I have some medications and books come and go from there.

[00:43:09] Dr Renee White: Okay.

[00:43:10] Dr Hazel Keedle: Because I am, I've got ADHD so I struggle actually reading books, which is hilarious how I've written them. Yeah. Um, I'll have them sitting there and then my pile might just kind of move to my second bedside.

[00:43:21] Dr Renee White: I'm curious to know, do you find it easier to dictate rather than type or when you are doing your books?

[00:43:29] Dr Hazel Keedle: The quick thoughts? I, I can dictate, but I like typing. Okay. I might write some notes, but I, I'm okay with typing and I think, yeah. I've done so much of it that yeah, I'm a very digital person. Okay. So I don't print stuff off. I Yeah, do that. I'll just do everything on the, on the screen and yeah. I'm okay with typing.

[00:43:49] Dr Hazel Keedle: Okay. I might like do brainstorms and stuff and, yeah. Yeah. But even when I started the second book. I did the work on a Word document and I put headings in and then I started filling it out. Yeah, gotcha. Around. So, yeah.

[00:44:04] Dr Renee White: What about audio books? Like is that more your jam or,

[00:44:08] Dr Hazel Keedle: I like podcasts, but I can't concentrate long enough for an audio book.

[00:44:11] Dr Renee White: Yeah.

[00:44:11] Dr Hazel Keedle: Because before I've skipped an entire chapter.

[00:44:14] Dr Renee White: Yeah, yeah, yeah, yeah, yeah. Like what was going on then? And I have to go back. The only time I've done an audio book is. A long drive, like a four hour drive because I'm like,

[00:44:25] Dr Hazel Keedle: well, I do a lot of driving and then I will, my mind will go off, so, yeah. Okay. Like I, I dunno. Then I'm like thinking of something else because I've seen something out the window.

[00:44:34] Dr Renee White: Yeah. Like, oh, that was pretty tree.

[00:44:36] Dr Hazel Keedle: Yeah. It's the constant firing. Yeah. In my brain, that makes it very difficult to do. To do that, to sit and to listen to something. It just doesn't quite podcasts I like and then I like ones that've got short segments in them as well, so I can kind of, yeah.

[00:44:53] Dr Hazel Keedle: Or I've had some serious podcasts, but again, they're not kind of going past like. An hour max.

[00:44:58] Dr Renee White: Yeah, yeah, yeah.

[00:45:00] Dr Hazel Keedle: Of that. And there's usually like other stuff in the, in the middle of it. So that tends to get my attention, but even then I'll have to go back and re-listen. Yeah. There's a lot that goes on in the a d, adhd.

[00:45:11] Dr Renee White: Fair enough. Where can we find your book? Let the B listeners know, and then also your social media as well.

[00:45:17] Dr Hazel Keedle: Sure. So I've been working on a website where everything is Oh, so just go to hazel Keedle.com. Really simple. It's got, so this podcast interview will go on it. It's got a page with all the podcasts that I've been on.

[00:45:29] Dr Hazel Keedle: It's got a page with all the book launch events. So the first one is on Friday coming up, and then I've got some others coming up in conferences I'm going to as well. So I put them on there. I've got links to the books. Well, the new one isn't live until, until Friday. Yeah. Yeah. Um, which can be so, which can be bought on Amazon, but also some online bookstores in Australia.

[00:45:50] Dr Hazel Keedle: Mm-hmm. So they're all on there. All my journal articles are on there.

[00:45:53] Dr Renee White: Amazing.

[00:45:54] Dr Hazel Keedle: And everything is in one space. So, and then my social media, my biggest one that I like to engage on is, um, Instagram. So that's just hazel Keedle with a blue tick. Yeah. And, uh, you can find me on there.

[00:46:06] Dr Renee White: Amazing. Thank you so much for your time, and congratulations again on the second book, or rather the fourth book.

[00:46:13] Dr Renee White: I'm gonna say that you never thought you were gonna write, but you have.

[00:46:19] Dr Hazel Keedle: I have, I have. And I just look, I didn't, I, I was not brought up thinking that I was smart or that people thought that I was either, so it is, it is kind of fun to look at them and go, oh, okay. I, I did that. I got a PhD. I did all of that.

[00:46:35] Dr Hazel Keedle: I was told at school I'd never make it to university. So, yeah.

[00:46:39] Dr Renee White: Well, look at her now. Everyone, you've proved them wrong and you are making an absolutely amazing impact on this world, Hazel, I hope. I hope you know that because you know the people that I speak to in the profession and you know, the families that we support.

[00:46:59] Dr Renee White: It's interesting how you talk about, you know, the team and the fact that. There is this movement now of continuity care. And I'll tell you, I, I spoke to, I did a discovery call with a first time mum this week, and one of the first things she said to me, she said, I didn't get into the midwifery practice group at the hospital, but I know from the research that continuity of care is the gold standard.

[00:47:29] Dr Renee White: And that's exactly what I want. 'cause I want positive birth care outcomes. And I just thought. Wow, okay. Four years ago when I first started fill your cup, I was kind of having to educate people around this and now it's just, it's there like it's in the language, it's in the culture. We are seeing it, and you are a huge force in that.

[00:47:54] Dr Renee White: So thank you so much for all of that. I really do appreciate it.

[00:47:58] Dr Hazel Keedle: You are welcome. Thank you for having me on to talk about it. I love hearing from women when they tell me, you know, how the book impacted them. Like it is probably the biggest joy that I get and hearing from midwives and, and doctors too, how it impacts them.

[00:48:12] Dr Hazel Keedle: So yeah, I'm very lucky. I get to do what I love. Yeah. And, and, uh, yeah. And I've got the writing bug now.

[00:48:19] Dr Renee White: Yes. Alright, Hazel, everyone, uh, we will see you next week. See ya.

[00:48:26] Dr Renee White: If you loved this episode, please hit the subscribe button and leave a review. If you know someone out there who would also love to listen to this episode, please hit the share button so they can benefit from it as well.

[00:48:41] Dr Renee White: You've just listened to another episode of The Science of Motherhood proudly presented by Fill Your Cup, Australia's first doula village. Head to our website I fill your cup.com to learn more about our birth and postpartum doula offerings where every mother we pledge to be the steady hand that guides you back to yourself.

[00:49:02] Dr Renee White: Ensuring you feel nurtured, informed, and empowered so you can fully embrace the joy of motherhood with confidence. Until next time, bye.