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 sipping mama of seven. I've had the amazing privilege of delivering many 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 show notes. Hello, hello, you guys.

I'm so excited to be here with you. I haven't done a live for a couple of weeks because Grayson was so So sick [00:01:00] last week, like so sick, like a hundred and two hundred and three temperature. And I don't know about you guys, but my mama heart cannot handle that. It was so hard. And I'm a nurse, right? But it's different when it's your child, for sure.

33 weeks, second baby from Texas. Hi, I hope you've joined the birth classes. First child, 36 weeks. I love it. Oh my gosh. Oh my gosh. 25 weeks, first baby from Quebec. I love it. We have so many Canadian students. Hello, hi, 24 weeks, second baby, a VBAC, yes! I'm obsessed with VBACs, Laura. I love it from Minnesota. I did a travel job, a short one, it was like a two week assignment.

It was in Minnesota, and I'm trying to remember where, but I don't remember. Okay. So what we're going to talk about today, now that I've been recording for the podcast for 10 minutes, talking about nothing, we're going to be talking [00:02:00] about where you give birth and the choices each of those spaces have for you.

So we're going to talk about home birth. We're going to talk about birth centers, and we're going to talk about, hospital birth. If that sounds good. Oh, I love it. The Nerdy Mermaid is in the house. Hello. Hello. Make sure you guys, when you join, tell me how far along you are and tell me what number baby.

Okay, so we're going to break down the different birth spaces that you can deliver your baby. So, Now what I want you guys to do if you're watching this live or you're watching the recording or you're listening to the podcast, I want you to comment or write a review and tell me where you're delivering, whether it's a home birth, a hospital birth or a birth center.

Or maybe you're undecided and that's why you're here today. So let me move my notes over here because y'all know I won't stay on track if I [00:03:00] don't. Okay so let me break down where you should give birth depending on the type of birth experience you want to have. So if you want to have like no rules, do it my way.

I want to give birth on the floor. I want to give birth in the bed. I want to give birth in my back porch. That is definitely a home birth. Home birth give you way more control, way more options. And I mean, let's just face it. Like if I'm having a really bad day, I want to be at home. I always wanted to have a home birth you guys, and I was going to do it with grace and butt.

I ended up on blood thinners, and then I didn't feel confident having a baby at home on blood thinners. So, if you're choosing a home birth, the providers that deliver at home, there's a couple different ones. But most of it is going to be, now, and it also depends on your state. So I know in North Carolina, home births are [00:04:00] not legal.

However, you can go across the border and deliver in some of the border states of North Carolina. I only know this, you guys, because when I first married my husband, he was flipping houses in Asheville and I went to stay with him. And of course I did all the research on birth in case we ended up staying there.

Funny story. Asheville is such like a hippie community, but I found out that the hospital there rarely has unmedicated birth, which blew my mind. That's just a side note just for you guys. Okay, all right, so where should you give birth if you want to be in control? home birth, right? But I teach my students how to be in control, how to own their voice, how to be as powerful as they can be. Because you guys, I want you guys to hear me, let this land. No matter where you give birth, [00:05:00] you're a human and you have rights.

So, Do I want you just going willy nilly, refusing all the things and just being really, really stubborn? No. I want you to be educated. So one of the things that I tell my students inside of Calm Labor Confident Birth Course and the VBAC Lab is that you can refuse But should you? So let's talk about some of the options that are different from a home birth to a birth center to a hospital birth.

So we've already said home birth, you're going to have the most control. You don't have to have an IV. You don't have to lay down on your back. You don't have to lay down at all. You could walk around the house. You could crawl around the house. You could. Give birth standing in your tub. You can order an inflatable birth tub, which I highly recommend that you do no matter where you're delivering.

Cause I want your butt to stay at home as long as possible and you can order a birth tub and have it, you can even rent them and [00:06:00] have it set up so you can labor at home longer. The more you. Plan for pain coping the better you're going to do. Okay, so I got off track again you guys all right, so Home birth your space your rules and you know If you want to squat next to your couch, you can now I do recommend you order the supplies because birth is messy So there are actually sites that you can go to to order your home birth supplies.

A lot of times your home birth midwife who is going to deliver your baby at home will bring the supplies with her. You just have to chat with them and find out. Now most of the time insurance does not cover home birth. Now for my mama in Quebec, yours probably does, but I think you guys have to Choose at the beginning of your pregnancy.

If I had a choice in insurance paid, girl, you better believe if I were low risk, I would be delivering at home. And that's coming from a high risk labor [00:07:00] and delivery nurse for 16 years, right? I've seen it all. But birth is a natural process. I want you guys to let that land. Birth is a natural process. If you're just joining me, say hello.

Hi, Hibba. How are you? Look at Kadri is 38 weeks in Poland. How amazing. Oh my gosh, I'm so excited. Five months postpartum here, educating myself for the second baby. Yes, Sam. I love it. And she's extraordinary. You belong here. For sure. 31 weeks first in California. Cass, if you're new here, my name is Trish.

I'm a longtime labor and delivery nurse for over 16 years and the majority of my nursing career. I was a travel nurse in California. I love California. I love it. Just so expensive. Okay, let's see who else. Let me check in with you guys. And if you guys have any questions, I'll answer a few when I'm done.

[00:08:00] Oh, JFO is 32 weeks with her second. Congratulations. I'm going to have you guys so excited about your birth. That is my magic sauce. That is my magic spell. I promise. Okay, let's see anybody else before I go on.

Okay, so 28 weeks, Heba. I love it. Okay. 36 weeks today is Lady Breeze and Lady Breeze is one centimeter still. Girl, flip that script. You only have to get to 10. So instead of saying one centimeter still, I want you to be like, I am one centimeter.

Ready to go. One out of ten is amazing before labor starts. Dilation doesn't matter until labor starts. Okay, now that I've gotten completely off track answering your questions. Okay, so home birth. Your rules. You get to decide who delivers a home birth midwife. What are the things you have to do? Pretty much nothing.

Your home birth and midwife is going to have Pitocin on hand. [00:09:00] She's going to have the things in case there's an emergency. She'll have the things to do resuscitation or take care of the baby. And she will have an assistant that will be dedicated to the baby. Usually they should. You should definitely ask that.

You want to ask the right questions. Ask them if they have experience and even look at reviews or talk to past patients because this lady's going to be intimate with you in your home. So home birth, your rules, your way. You can give birth out back, you can give birth in your kitchen, whatever you want.

You can, uh, set the scene. Right? All right, so now let's move to a birth center. Most birth centers, if they are a, if they are a freestanding birth center, usually they have a lot less rules than the hospitals. So, Things like IV placement. You might, you more than likely don't have to have an IV. However, [00:10:00] they're capable of giving you an IV as is a home birth midwife usually.

You also have the option, a lot of home birth or birth centers are attached to the hospital and you can get transferred really quickly. If I were going to do a birth center, I would prefer one that has a quick transfer because God forbid baby needs to go to the hospital. If you're like Miles and miles away, you're going to have to stay until you're able to transfer.

So the good thing about delivering in a birth center is if there is an emergency with a baby, you'll be able to transfer to, you'll be able to go from the birth center because they usually let you get discharged really quick. I've had students who have given birth at birth centers and And they go home a few hours later.

So it really just depends on you and your risk. What I love about birth centers is that if you are the type of person who's like, I don't think I can give birth at home. I would be freaking out and really fearful. It's [00:11:00] a good step in between home birth and hospital. It's got that homey feeling, the ambiance.

A lot of times you'll have like a queen size bed that will be where you and baby and, and dad sleep in that room. You also can deliver in a normal bed instead of a hospital bed. So that means they're not going to break it down like a transformer. And then you also have like a really homey environment.

You're going to have rugs on the floor, like a house. You're going to have a nice bathroom, more than likely a really nice shower, a birth, a tub. And you'll have different options in the room. Sometimes they'll have birth stools. Sometimes they'll have like the inflatable thingy that I can't think of the name.

Can't think of the name right now. All right, so, The home or the birth center is going to have nurses and it's going to have certified nurse midwives and sometimes an OB.

What I like about birth [00:12:00] centers is it's a good in between so that you have like the best of both worlds somewhat, but of course you're not at home. And being at home It is amazing. Now no matter where you deliver, unless you're delivering at home, I want you to stay and labor at home as long as possible.

This is why I recommend you, if you join our birth classes, you add on your labor bat signal. The labor bat signal is going to be like the best thing in the world. That's where you have a direct text message. With me and my doulas on telegram, so you'll love that. All right. So you may even have at a birth center, they have birth stools, they have recliners, they have rockers, and just being able to change positions and utilize all of these things is like heaven.

You will love that because. Gravity and movement is your bestie when you're in [00:13:00] labor. Being able to, they have done studies that having a freedom of movement and using movement and gravity actually makes stronger contractions and produces more oxytocin than having pitocin. And I was telling my students yesterday on one of our, we do a weekly hangout that.

Is insane, right? Because doctors don't say, okay, I'm prescribing movement and gravity. They say, oh, put her on Pitocin. What level Pitocin? Up her Pitocin. Give her more Pitocin. Pitocin is not the answer to everything. And it actually is not the best thing for us. Being up, moving, utilizing our, our amazing bodies, knowing how to open your pelvis.

For those of you guys who are getting ready to deliver that are like, are like, Oh my God, Trish, it's too late to take your class. It's not. I have people join the night before. So if you need the class right now, comment class [00:14:00] and get in. Your insurance will reimburse you. We can help you with that. But we teach you how to open your pelvis, how to allow the baby to move through your pelvis.

So that is really, really important. One of the most powerful things that you guys can do to have the birth you envision is to empower yourself with knowledge, tools, and positioning. Okay. All right. So now the other thing about, Birth centers is you're not restricted to the bed. You're not even a lot of sometimes you're restricted to the room But some of the birth centers will have like areas you can walk to They might have an outside area that you know, like I don't know about you guys But when I get overwhelmed and stressed I take a walk outside changing your environment when you're in labor can be huge So that's why I want you guys to stay at home.

Go for a walk. You can go to Target. You can do whatever you want. Okay, but the magic that is so [00:15:00] amazing is that birth centers really are like a really magical in between and a balance. So like I said, for my girls who are too scared to deliver at home, a birth center will give you that home like feel.

But it's still a little bit medical and y'all know I'm crunchy with the side of medical. Okay, so a hospital birth, 90 percent of y'all are going to give birth in the hospital. Hi Whitney, how are you today? Tell me how far along you are, what number baby, all those things. Okay, so the majority of you guys are going to give birth in the hospital.

So I'm talking to you guys right now and I want you guys to really lean in and listen. You can have. an empowered, beautiful, peaceful, calm, medicated or unmedicated birth in the [00:16:00] hospital. Now, birth centers sometimes will have IV narcotics and nitrous oxide, but not epidurals. Okay, so a lot of my moms, most of my moms, we do have a subset of home birth and hospital center moms that join us.

Birth is birth no matter what. It's you that makes the difference, your voice and your preferences. But I want you guys to hear me, just because you're giving birth in a hospital does not mean that you can't have this magical, beautiful experience. I gave birth to all six of my babies unmedicated at the hospital.

I also want to tell you You can have a magical medicated birth too. So that's your choice. I don't want you guys to feel like I can't have the birth I want. You can have a beautiful, magical hospital birth, okay? You just have to be educated, empowered because you can't make decisions if you don't know what's being said.

I say this all the time and I know Jenny's on here. She's been with me for two [00:17:00] babies and I've seen some other students popping in here. If you don't know your options, you don't have any, so you have to know your options. You have to. Okay, so the truth is there are more limitations at the hospital.

Hospitals have policies, but the other truth is just because they have a policy, you still have a human right. to refuse. Again, we don't refuse just because we can. We refuse based on knowledge and appropriate, like, is this appropriate for me right now? Well, the only way you know that is if you're educated.

You do not want to give birth without education. That is the worst decision you can make. Okay, so hospital births, it is going to be more traditional, but here's some things that I want to tell you. First, we've talked about who delivers at a home birth. It's a home birth midwife. Sometimes there are some [00:18:00] OBs who do home births, but not many.

There are some states that it's illegal to give birth at home. There are, you can drive to another state. So don't let that deter you either. Then there's some places like Canada that pay for your home birth, which they are amazing. Thank you, Canada. Okay. Hospital births, you're going to have a certified nurse midwife.

That is different than a home birth midwife. A certified nurse midwife is more, she's medically trained. She cannot do high risk delivery. She cannot do C sections. She can assist during a C section. So if you have a nurse midwife, she can go into the OR with the provider, the obstetrician who's going to do your surgery if you for some reason have to have a C section.

So in a hospital, we have certified nurse midwives and we have obstetricians. Sometimes you have a family practitioner if it's a really small [00:19:00] hospital. It just depends. Okay, the hospital, you are going to be told that you can't do things because their policies like they're going to limit your movement, like you might not be able to walk in the hallway or they may want you to stay in the bed.

But girl, you have a right to get out of the bed. In the hospital, you're going to have much more intense fetal monitoring. A home birth, you're going to have, they're going to use a Doppler just like they use in your doctor's office. And they're going to listen to the baby periodically throughout your labor.

In a birth center, they're going to use a Doppler and maybe, maybe they'll use the traditional fetal monitoring machine and put you on for what we call intermittent monitoring. That is usually a. limited amount of time. Make sure baby's doing good. It's like an N. S. T. If you're in the hospital, you can have the choice of If you are low risk, you can have intermittent [00:20:00] monitoring. You can ask and you can insist. You guys hear me if you're low risk. You can also have wireless monitoring and you can have the traditional monitors where we put the bands on your belly. The monitor monitors baby and it monitors contractions. In a home birth and a birth center they might just use their hands to palpate your belly.

So I'm going to give you guys a little secret Ted bit, you can actually palpate your belly to feel what stage of labor you're in, but it takes some experience.

That's a little trick I'm going to teach you inside those classes. So there's a little dangling fruit to come hang out with me.

Okay. So at the hospital, you're going to have an OB, a midwife. Or a nurse practitioner, not usually a nurse practitioner, family practitioners, but small hospitals, maybe they're going to want to keep you in bed. They're going to want to have the delivery lights. I call them the lights of God, and they're going to want to [00:21:00] have an IV.

They're going to want you to push on your back with your feet and the stirrups. The reason I created my birth classes, the reason I took my 16 years of high risk labor and delivery experience and went all in online is because you have a right. To not do those things. You have a right to be at the hospital where you want to feel safe and protected and have the options, but also have a birth the way you want to have it.

Do you guys hear me? You have a right to give birth how you want. Even if you're in the hospital, we can't manhandle you. So if you're laboring away, you're on your hands and knees, and that's how you want to push. And then your doctor comes in and says, roll over, let's get your legs in the stirrups. Just ignore him.

You don't have to. We're not going to manhandle and flip you. Now, if your doctor comes running in, they're trying to put oxygen on you, and they're telling you, oh my gosh, but this is going on. Well, they won't say, oh my gosh, but if they're saying, [00:22:00] you know, we really need to get you on your back. We need to check the baby.

That is a different vibe, right? Do you guys feel that? Here's the two scenarios. And I want you guys to tell me which do you absolutely need to consider listening to and which is just his preference for convenience. So you're laboring away, you're on your hands and feet, hands and knees in bed, you're starting to push and the doctor comes in and says, Okay, let's see.

I'm going to pick one of your names. Okay, Tracy, let's get on your, your back. I'm going to put, break the bed apart. We're going to put your feet up in these stirrups, and we're going to have a baby. That is preference. That is convenience for your doctor, not for you. Now, if your doctor, and you can just ignore them, you don't even have to refuse, girl.

You just say, you can say no, Frank, one time. Be succinct or you don't have to say anything because I try. I'm going to tell you guys as a labor and delivery nurse for [00:23:00] over 16 years, I have never put my hands on a mom and forced her into position that is abuse and I could go to jail. Your doctor is not going to force you.

They might verbally force you or verbally coerce you or even bully you. You guys I dropped a thread over in threads If you're not following me in threads go over there because I get to be way more laid back and mouthy. I dropped a thread asking people some of the most ridiculous things that doctors have said to them During their birth, you guys, let me see if I can pull it up.

If I can, I might not be able to. Some of the things were insane, but I've seen some insanity too. And in fact, I created the birth, the VBAC lab because of something someone told me in my DMs that their doctor said during their VBAC birth. Okay, so if your doctor comes running in your room, you're on your hands and knees, you're pushing fine, [00:24:00] and they're like, baby's heart rate dropped.

I need to get you on your back. I need to see what's going on. That is a different scenario. That is not out of convenience. That is why we're there, right? So we can help you if there's an emergent situation. We are not there for you to give birth how we want. You guys let that land.

Okay. So you can say no. You can refuse. You do not have to do what your providers tell you to do if you don't want to.

But again, I'm not saying be a sassy little toddler. I'm saying be an educated woman who knows her rights. You guys hear me? Okay, so home birth, pretty much your way, whatever you want. Gonna have a home birth midwife. Birth centers, You get a lot more freedom, probably going to have a certified nurse midwife who's going to deliver you.

Hospital, you're going to have an OB or a midwife and your choices [00:25:00] are limited, but not completely gone. You guys hear me? So if you guys want more information, shoot me a DM. You can always ask me a question.