“All About Home Birth, Part 2” – with Midwives Lauren Abrams and Susanrachel Condon

We get more practical with today’s episode featuring Lauren and Susanrachel, two midwives with different experiences with home births. Home births represent less than 2% of all births in the US, but the rate is rapidly increasing despite its low percentage. There are some basic criteria that would rule out some people for having a home birth, such as needing consistent running water, electricity, and being generally healthy – no person who is high-risk should plan on having a home birth. They share how to find the best midwives for people interested in home births to ensure quality care, as well as what to expect differently during a hospital birth experience.

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Dr. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB-GYN and maternal-fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness.
Lauren, Bertie, thank you for coming on the podcast again. We had such a great talk about home birth. I really appreciate your perspectives on it and your experience with it and your thoughts about it. And I wanted to shift now and talk really practical, right? So let’s say someone’s out there and they’re listening and they’re like, “Hey, I’m interested in home birth. I’m pregnant or I’m going to be pregnant and something I’m really interested in.” So I think the first thing I want to ask is how would someone know if they are or are not a good candidate for a home birth? What should they be, like, thinking about? And they may not have to because they could just ask a midwife or a doctor, whoever CERT is in this world, and they can tell them, but just so people get an understanding themselves of the expectations, who qualifies as someone who’s low risk enough? So let’s say in your practice, Bertie, who is in and who’s not in?
Bertie: Well, it’s an interesting thing because a lot of the things, sometimes people will start and then will develop some kind of an issue down the road. So they might be just dandy for a home birth in the beginning and then something changes. It doesn’t happen too often, but it can. So people need to have a sense of agency. They need to have a sense of responsibility because it’s really, really different. You’re doing something that is not common, and take so little different kind of planning and organization. You should definitely have a licensed midwife if one is available to you depending on where you live. And I think that people have to understand that birth is not something that happens to you, it’s something you do. And when you are in the sort of hospital paradigm, it’s a little bit more passive. It’s more like something that happens to you unless you’re working with providers who are really, really encouraging you to take a class, and learn about your body, and read about things, and don’t come into the hospital until you really need to be here. Like, unless they have a lot of support and encouragement.
And when you’re having a home birth, you’re really in charge. So it’s a different paradigm. It’s a different way of envisioning the whole process. So they have to be generally healthy. They probably shouldn’t have diabetes or high blood pressure. Other things that could be issues would be something like anti-phospholipid syndrome or some kind of thrombophilia. Some kind of inherited disorder that affects how you clot when you bleed. Somebody who has had a lot of surgery on a uterus may choose a different plan, like working with midwives in a hospital. It’s not an absolute no for any of this thing. And multiple gestation is another thing. If you are having more than one baby, generally, home birth is probably not ideal. But unfortunately, we’re in a world right now where it’s just really hard to just have a normal birth of twins even if they’re both full term and head down. It’s really hard to get that.
Lauren: Unless you’re with Nathy’s practice.
Bertie: There you go. Thank you.
Dr. Fox: Lauren, thanks for being in my corner.
Bertie: Well, it’s true. I mean, [crosstalk 00:03:49.465].
Dr. Fox: It is true. You’re right. No, you’re 100% right.
Bertie: New diamonds out there but it’s hard to find you guys.
Dr. Fox: I’m more like the cubic zirconia but that’s fine.
Bertie: Who’s [inaudible 00:04:00]. So it’s a lot of that. You have to have plumbing, ideally, and electricity, and it’s the way [crosstalk 00:04:11]
Dr. Fox: You mean actual plumbing, you don’t mean a euphemism?
Bertie: Yes.
Dr. Fox: All right. All right. Plumbing is gotta work.
Bertie: You should live in a place with heat, lights, and running water. I’m telling you I work in really rural areas where people don’t…it’s not New York City, and we have a lot of religious people who have lots of babies and are very low-tech. It’s different out here in the sticks. So you have to have that kind of facility, and you probably shouldn’t be terribly far from a hospital. We don’t have a kind of hard and fast you must live within this line. But it’s rough when you have to transfer somebody who’s really far from any place or any place good. There’s a hospital up by us that’s pretty close, but it doesn’t have any maternity. There’s nothing. And I used to have hospital privileges at a hospital, which is in a small city in New York, but the OBs were not in the hospital unless we called them. So even though you’re in the hospital, the floor is run by midwives, and family practice physicians, and family practice residents. It’s a small community hospital in a little city. So if you need a stat section, it’s an issue. So a lot of it has to do with kind of the infrastructure around you as much as it has to do with your health and your mental status and capacity to do this thing.
Dr. Fox: Yeah, I wanted to ask you about… I mean, I think the health part most people sort of get, right? “Okay, like, maybe it’s not safe.” But I want to talk a little bit about the first part, which is sort of, like, almost whether it’s a personality trait, or whatever it is, how many people come to you and after you talk with them, you’re like, “No, thanks. Like, not for me?”
Lauren: Lately more. Lately more.
Bertie: I will say that, you know…I don’t know how aware you were of this, and you probably were, but in the early days of COVID, when people were…
Lauren: People were afraid to go to hospital.
Bertie: They were really afraid to go to hospital. So a lot of people who were not married to the home birth paradigm and did not really grasp what it would mean to have a home birth let their fear of hospitals overwhelm their, you know…
Dr. Fox: Their nature.
Bertie: …whatever it was.
Lauren: Yeah, they weren’t really choosing, right? It was, let [inaudible 00:06:37] the home birth but avoiding the hospital.
Dr. Fox: Geez, that’s a good point.
Bertie: Thank you, Lauren.
Lauren: That’s exactly right.
Dr. Fox: That’s why we have Lauren around, she just makes things easier.
Bertie: She knows everything [inaudible 00:06:47]. So we had people who were…we called them jumpers because they were jumping ship. So you would say, “Oh, we got a call from another jumper.” And a lot of them would look at me and say like, “I had a baby before and I don’t know how I’m gonna do this without an epidural.” And I would say, “Well, I believe that you can and I’m going to help you. But if you want an epidural, you can go to the hospital. It’s okay.”
Dr. Fox: They got them.
Bertie: “And we don’t have them here. I cannot give you one but I can take you someplace where you can get one. But I also believe that you can and that we’re going to do everything we can to help you wrap yourself around that.” So, there were people who kind of rose to the occasion. But there is a mindset. I will say that being afraid of hospitals or not liking hospitals, I’m making air quotes, is not a reason to have a home birth. Because really there’s nowhere to hide from yourself at home in labor. It’s all you. I will say, though, also that we have seen everybody from a rural bus driver to a physician to a teacher to somebody who works in the grocery store. Like, anybody can have a home birth. It’s not, like, there’s a personality, so to speak. But you do have to have the floor under you. You have to have a sense of yourself and your capacity to do something miraculous.
Dr. Fox: Yeah. I think that’s a really good point. And I’m curious, so someone…okay, so they feel that they’re that person and they’re generally pretty healthy, how would someone go about finding the right provider for them for a home birth? I’m curious what you both think about this. I talk about this all the time that it is nearly impossible to figure out if your doctor is any good or not. It’s one of the hardest things in medicine. Like, you sit across this person, “Oh, they’re wearing a nice tie, and that degree looks okay, and I guess she’s speaking in full sentences,” but how would you ever know? Like, it’s very, very difficult. Then you go online, and you get ratings, and we all know those are total bogus in both directions. So, okay, with that premise that it’s hard to find it everywhere, what are the types of either, let’s say, red flags that would be bad or green flags that are good when you’re speaking with a homebirth provider to know that this is someone who is quality, is safe, is going to do what’s in my best interest? And you mentioned all that trust that’s built over pregnancy, but to get in the door, you have to sort of make a choice. So how would they possibly know them, first of all, both of you think on this?
Lauren: Well, Bertie, I’m sure you have a lot more perspective. But I would say anyone who’s looking for any kind of midwifery care should really make sure that it’s a fully licensed midwife in their state who has gone through an accredited education program, and has passed the exams, and has done the clinical experience, and has experience, and has an actual license. So that’s the basic thing. There are midwives who haven’t got… There are different ways to become a midwife in this country. And there are some midwives who have gone through programs that may be good but aren’t regulated. And so you just don’t have the same standard. And so I would make sure that your provider is fully licensed. And I would ask the provider the hard questions, “What if something does go wrong, where will you take me? What has been your experience with women who have had hemorrhages or who have had emergencies in labor? What is your plan for this?” Those are the sort of the initial questions that I would ask.
Dr. Fox: Bertie, what do you think?
Lauren: Yeah, how many births have you attended?
Dr. Fox: Ooh, good. Yeah.
Bertie: That is the most common question that we get in an interview.
Dr. Fox: How many?
Bertie: I would say…
Lauren: Yeah, how many?
Bertie: …how many births have you attended is a really… And you can go on Google and you can get a list of questions to ask them before. And they always seem just like what you’re saying…
Lauren: Yeah, when people ask me how many births I’ve attended, I say, “I have no idea. I stopped counting when I realized it wasn’t about me anymore.”
Dr. Fox: So, like, what does that mean? Like six?
Lauren: It’s a long time. I literally have no idea. I mean, I could guess but it would be a guess. So I think, honestly, word of mouth is the big thing, is my friend or my sister or my niece or my whatever, my mother-in-law, “Somebody had a baby with you and recommended you.” It’s almost all word of mouth. And everybody has a website. And so you go on the website and you get a feeling like a vibe. “What do you like about it? What are you not so sure about? How do people present themselves in the world professionally?” That’s the reality of how people find midwives. And then there’s, “Who’s in my area?” There are a lot of areas where there’s nobody. You don’t have a choice. So, in the city, there are many, many, many homebirth midwives. When I started doing home births in New York City, there were two and then three. And that was it for all of New York City, and it’s certainly changed.
But where I live, a lot of us we’ll go to peer review, we’ll look at each other and think, “Oh, my God, we are too old to be doing this. Why are we still doing this?” We’re still doing it because nobody else is doing it. So it’s kind of rough. But there is a website called ny.homebirth.com. So for New Yorkers, both in the city and upstate and out west, everywhere, they can go on that website, and they can peruse. They can window shop without having to actually call anybody. And then they can see who’s in their area. And if there are three, if they’re lucky enough to have three who are within their radius or if you’re within their radius, then you can call those three and get a feel for it. I think almost everybody does a meeting at no charge just to kind of see if it feels like we’re going to be good dance partners. Because the other thing is, honestly, a lot of people are there and don’t have no practice. So they have to trust the clients too.
Dr. Fox: Right. That’s fair.
Lauren: It’s a two-way street. We have to trust you too. We have to trust that you’re going to be a grown-up and you’re going to take responsibility for your life and your choices.
Dr. Fox: How would someone know if the person…other than being licensed, is that really the best way of knowing that they’re a quality provider or that it’s…you know? Meaning, is there anything where they should be, you know, if they’re in the meeting and they learn of something, they should like get up and run the hell out of there?
Lauren: I can’t imagine that anybody would say this, but anybody who says, “I’ll get you home no matter what.”
Dr. Fox: Okay. No. I think people sometimes have that impression of their homebirth midwife. They may not be accurate impression, right? But some people will say, “Oh, yeah, my homebirth midwife says, ‘I never transfer people.’” And I’m like, “Really?”
Lauren: There is one midwife like that, she actually lives in Israel, so she’s not around New York. But she says that all the time, and we all look at her like, “What are you talking about? That doesn’t make sense. That’s statistically impossible.”
Dr. Fox: Right. Right. Okay. And I wanted to talk about a little bit, you know…so let’s say someone’s not quite ready for a home birth, like I’m not there, you know? But what are their alternatives? So obviously, there’s the hospital, which is where most births in the U.S. happen. Talk to me about freestanding birthing centers or not freestanding birthing centers. Lauren, you said you had experience in that realm. So what are those?
Lauren: Yeah, so they are sort of considered the alternative to home birth for people who don’t want to give birth in the hospital but also want a slightly more maybe formalized structure. Some place to go rather than their home. And it’s a wonderful alternative for people who are sort of in-between. Honestly, though, the criteria for women who want to give birth in and out of a hospital birth center are essentially the same as women who want a home birth. You really have to be a low-risk person to give birth out of the hospital.
That being said, out-of-hospital birth centers try to create a home-like atmosphere while providing all the equipment necessary in case of an emergency. So in the birthing center that I worked in, we had three beautiful birthing rooms. They all had king-sized beds so that the whole family could be in the bed together. We had tubs. We had adjoining bathrooms. But we also had all the resuscitation equipment that would be needed. We had IVs if they were necessary. We had antibiotics if they were necessary. They were all sort of tastily hidden away in cabinets but completely accessible if need be. We actually had…we were part of a community health center.
So if a woman did go past her due date, we could do fetal testing and non-stress testing in our own facility and didn’t have to refer her out. So that was a really wonderful thing. And the other great thing about being part of the community health center was that we had primary care and pediatric providers right across the street. So women would come to get their prenatal care with us in the birthing center and then continue with us for GYN care. It was truly a community center. And women would come to just hang out in our waiting room. It was a beautiful area. It had a huge skylight. Women would bring their families. We’d come. Everyone knew everybody. It was just an amazing experience working there. It really, really was.
Dr. Fox: And what would happen if someone needed to be transferred? Was there a formal process, like you were affiliated with the hospital and you had a med transport or whatever it is or something like that?
Lauren: Yes, exactly. We were affiliated with a hospital that was 10 minutes away by car. And we had a formal relationship with that hospital. So we could call the labor floor and tell them we were coming. And we would use 911, which didn’t…we would use an ambulance usually because that just felt safer. Although most of our transports, just like in Bertie’s experience, most of our transports were not emergencies. They were for prolonged labor. I do remember one time I called the ambulance to ask them to come and transport a woman to the hospital who needed Pitocin. And they asked me if she was crowning. And I said, “Well, if she…” I told you this morning, maybe, “If she was crowning I wouldn’t need you actually. The problem is she’s not.”
Dr. Fox: Right. If only. Yeah.
Lauren: I think the dispatch service, that wasn’t the best solution. But usually, the ambulance personnel were people from the community who knew the birthing center and understood the relationship.
Dr. Fox: And there are, around the country, places where there are birthing sort of centers that are not freestanding, meaning they are literally down the hall in a hospital where sort of a hospital carves out a unit that is intended to be a birthing center, intended to be a home birth but physically in the hospital, which is interesting.
Lauren: Exactly.
Dr. Fox: Yeah. Which is sort of another way. And it’s really interesting because, you know, what you’re mentioning is, like, literally what the home birth is supposed to be. So you were describing the birthing center exactly what Bertie is describing as a home birth. Like, we have the things we need to have, and we can always move if we need to move and that’s it. But I guess it’s just one of these things where if it’s not typical or common, people maybe just feel more comfortable that there’s a building they’re going to. I don’t know. Or maybe they just, like you said, they don’t have the right home for it potentially.
Lauren: Yeah, that [crosstalk 00:19:04.973].
Bertie: Yeah, certainly the case.
Lauren: Yeah. I will say the downside to the birthing center was that many of our patients’ families did not feel safe having them deliver with us in the birthing center. And so women would come to us for their prenatal care and then their families, when they went into labor, they would take them to the hospital. And that birthing center doesn’t exist anymore or the community health center does exist and they continue to provide prenatal care and GYN care, but there is no more birthing center mostly because the births weren’t enough to sustain it, which is really sad. And that’s part of the whole culture thing we were talking about last week in our podcast.
Dr. Fox: Yeah. I’m curious what your thoughts are about hospital births. And that’s where I practice, Lauren, that’s where you currently practice. I’m trying to get a sense of whether you feel that hospital births just, like Bertie you’re saying before, like why would the default be a hospital, it shouldn’t be a hospital. Like we shouldn’t have this conversation. Like hospital births should be for people who need to be in a hospital. Okay. But I’m just saying, do you think that maybe that we’ve done something in the hospital births that are driving people away or that we can make it an experience that is a little bit less aggressive, so to speak, so that people have an option for maybe not the entire experience of the home birth or birthing center birth, but maybe some of the elements of that that they were hoping for and wanting without maybe a full desire to do home birth, or if, for example, they’re not a good candidate for a home birth? I’m curious what your thoughts are on that. And if so, where have we gone wrong, like, we the hospitals? Let’s do it. All right.
Lauren: Yeah. I’ll start with where we’ve gone right.
Dr. Fox: Oh, that’s so nice, where we’ve gone right.
Lauren: Well, it’s not here in New York, unfortunately. So I have one of my classmates from midwifery school actually is from Portland, Oregon.
Dr. Fox: Oh, everyone has got to bring up Portland, Oregon. Oh, God. I’ll tell yah.
Lauren: And she works for Kaiser, which is a huge healthcare system out in the west. And she works in the hospital. Their labor floor is completely midwife-run. They have anesthesia available. They have obstetric attendings available, obviously, but their birthing rooms are huge and beautiful. Every single room has a tub. I think what Bertie was saying about the sense of agency, I think we tend to take that away from people in traditional hospitals. But when you have a hospital that is truly designed to support physiologic birth and to avoid interventions that aren’t necessary, it’s truly possible to create that atmosphere if you have hospital administrators who care enough and who are willing to put in that kind of effort.
And I saw that at Kaiser where, for example, they have an entire room devoted to centering pregnancy, which is this wonderful system for prenatal care that has not only been shown to decrease preterm birth rates but also to just provide an incredible community experience for pregnant women and improve outcomes. So the hospital is actually built to provide that experience. Here, it’s just not. There are not facilities for waterbirth. We barely even have showers in the bathroom. There’s a culture here where interventions are why you come to the hospital. So when you walk in, everyone expects an IV, a bed, anesthesia to be offered. And there are some people who prefer to want that kind of experience. But I think for people who might not want that, it’s just not available. And it could be. It truly could.
Dr. Fox: Interesting. Bertie, what are your thoughts?
Lauren: Does that makes sense?
Dr. Fox: Yes.
Lauren: Amen. Amen.
Bertie: Yeah. I also think that, taking that step further, it has to do with the…you know, going back to that concept of relationships, a lot of practices now are just these big giant practices where if you’re lucky, you meet all the providers during your prenatal care. So you don’t know who’s going to be your birth attendant. And I’m going to just say it, birth is something that is a profoundly transformational sexual experience. And so you are vulnerable, you are open, you’re in an altered state of consciousness if you’re not medicated, and if you are medicated, you’re in an altered state of consciousness because of medication. But, you know, the opioids that your brain makes to help you work with labor are really powerful, and people are talking to you like you’re there to get your gallbladder out and you can have a lucid conversation. So I think what happens a lot of times in the hospital is people actually forget that this is a really private, personal, sacred, sexual experience, and they’re just at work doing their jobs, which I can’t blame them because it’s a hard job. But what happens is it just takes something essential away.
When I was in grad school, I went back to school in my late 50s to do research on respectful care and obstetric violence. And I found that we do what we observe, we practice what we were taught, and a lot of times we’re not taught about giving really respectful care. We think we are. Everybody wants to think they’re being respectful. But do you ask for consent every time before you touch someone? And if they look hesitant…sometimes I’ve got a speculum in my hand and I’ll say, “Are you ready?” And they’ll say, “Yes.” And then their body says no. And I say, “I’m not sure, maybe you need another second.” So being tuned in to what you are actually doing when you’re engaging with somebody around their genitals and entering their body, that is not something that happens. So a lot of people come out of the experience of a hospital birth, even if it went well, from our point of view, good outcomes, that they’re a little traumatized.
Lauren: Yeah. And I feel also, Bertie, that being a midwife in a hospital setting, I, initially, when I first learned about midwifery, I imagined doing home birth. And I quickly learned…I ended up choosing to work in the hospital setting mostly because that’s where most of the women are. And that’s where…I wanted to be where the women needed me. And after 30 years, minus the 5 years in the birthing center, which was sort of like a magical experience for me, I am still struggling every day with the ability to provide gentle, respectful care in a setting that does not promote it. And it’s literally a struggle every day to try to teach residents not to just burst in the room and shove your hand in someone’s vagina. It’s not okay to do that. If you haven’t met someone, it is not okay to do that.
Dr. Fox: Hey, even if you have met them, it’s not okay. Just throwing that out there.
Lauren: Exactly.
Dr. Fox: Throwing that out there, Lauren.
Lauren: And maybe you’re trained here and you’re an amazing physician, but you know what I’m talking about. You know, physicians are not mild.
Dr. Fox: Yeah. And, listen, hospitals are very busy. Yeah. They’re very busy sort of heightened alert type of place.
Lauren: [crosstalk 00:26:58.414], right? I’ll be sitting there and someone will say, “Oh, go rupture room 32.” And so whoever the PA or the resident who’s never met this woman will just walk into the room and hopefully be polite and introduce themselves, but they don’t have a relationship with this person who is lying in a bed 100% passive. We have a 98%, pretty much [inaudible 00:27:21]. Midwifery practice is slightly lower. But the vast majority of women have epidurals, which is a woman’s choice. Obviously, if a woman doesn’t want to feel the pain of labor, I fully understand that. But it does set you up for being in that passive position when you’re in the bed and can’t move. You don’t feel that you have agency over yourself. And when you walk into the hospital, you’re essentially signing that away. And women who do try to assert some control over the process here are sometimes mocked. Women who have birth plans come in and there’s a lot of eye-rolling, “Oh, this is the woman who’s gonna get this section because she’s so determined to have a vaginal birth.” That’s the culture here.
And midwives in the hospital have to fight against that every day. And have to fight against the fact that, “I prefer not to intervene if it’s not needed.” But there is pressure every single time I have a patient to go in and rupture her membranes and do things to speed up her labor even if I don’t think it’s necessary. And so it’s wearing. The flip side is I feel that, actually, the midwives here at Mount Sinai can provide midwifery care in a setting that wouldn’t otherwise provide it. And so the women we care for have the opportunity to have an experience that is different than it would be if we weren’t here. And both prenatally and on the labor floor. But it’s not always possible, and it’s a really tough place to practice. Really, really tough place.
Dr. Fox: Some of it is logistics, obviously. Like you said, if the labor floor is a busy place and there’s people waiting for rooms, then yeah, you can see why people are like, “Listen, it’d be great if someone could have 48 hours in the room,” but just the next person is gonna be delivering in the elevator if that’s what happens. And, okay, like, there are logistical issues, but I think, you know… Listen, I’m an OB-GYN, I’m in a high-risk practice, I’m an MFM. So the people coming to me are not looking for home births, and most of them are not appropriate for home births. And even those that would be, they’re coming to me because they want what we offer. Fine. And I’m cool with what I do. That’s good.
But I’ve always felt that the biggest issues on the OB side of things, on the medical side of things is, number one, it’s really important to teach the doctors early on that we can learn a lot from the midwives. That’s just an attitude, that if you walk into medical school or into residency and someone says, “Hey, we’re going to be here with the birth experience, you should learn from the midwives.” Just that changes the entire tenor of the relationship versus, like, “Don’t listen to the midwives, just follow this doctor around.” And it’s a hit or a miss, maybe it’s good, maybe it’s not.
But I think that just that attitude…I’ve been fortunate, and I know we’ve spoken about this before, that I’ve always trained in a hospital that had midwives integrated into our system. And so I’ve always found that to be very helpful to my training. And I think, also, like what you said, Bertie, the other aspects of this is so much based on trust and relationships. And there’s been this push for laborists, people who just do deliveries. And I get why there’s a role for laborists to be sort of a backstop and safety and to help and if someone’s out there. But some have argued that the best systems have one person provide the prenatal care and a complete stranger come in and deliver you, specifically because there’s no emotional attachment. And I’ve always found that to be a little bit backwards. I was like, “Why would you try to remove that attachment at a very personal time?”
Bertie: I don’t think that’s why it’s safer. I don’t think that the purpose is to remove that emotional attachment.
Dr. Fox: No, people have argued that. Some have argued that, which is sort of, like, when you go into the emergency room, somehow you’re better off that the emergency room doctor doesn’t know you when they’re resuscitating you. Again, I don’t quite understand the logic of it but I do see…
Bertie: Birth is not a resuscitation.
Dr. Fox: Yeah, that’s what I’m saying, it’s a very…like you said, it’s a very charged, it’s a very personal, it’s a very intimate, and it’s a very vulnerable sort of experience for people. And having a relationship with the person or the people who are caring for you and sort of helping you through this, I think is critical to making it safe and having the experience not feel so medicalized so to speak.
Lauren: Yeah. What’s interesting though, the flip side of that, and I can’t put the exact study, but what I’ve heard, and there are studies to show this is that laborists have much lower C-section rates than private attendings who are on-call. And that has a lot to do, I think, with the lifestyle and the difficulties of being on-call, being awake for an entire weekend, being so tired and stressed that you are more likely to recommend a C-section, not consciously because you’re so tired, but you just can’t do it anymore. And the laborists are there. They have nowhere else to be. They are not rushing. They’re not in a rush to get the labor done. And so they are less likely to call the C-section on a prolonged labor. They’re more likely to be patient with long labors. So that’s, I think, the flip side of that.
Dr. Fox: Yeah. No, I’m not dumping on the laborists. I think that it’s…I actually know that the study and some of it is, like, what you’re saying that the study didn’t compare people who know the patients versus don’t know the patients. It was a model where people sort of cover shifts and they aren’t pressured for time, versus a model where they are pressured for time. And I agree that there’s definitely pressures that are conscious and subconscious there. But I do think that there is something that gets lost when the people in the room don’t know each other and don’t feel mutual trust and respect and care for one another. And it’s hard. I mean, it’s doable and it could be a good experience with a stranger too. But I don’t know, it’s just I’ve always been very…I put a lot of weight in that concept. I always have. And I know, Bertie, you were talking about that for you, I mean, this is like the most…you’re going to their home, right? I mean, that’s a real intimate situation.
Bertie: Yeah. And I’m a guest.
Dr. Fox: Yeah. Yeah. Wow.
Bertie: It’s really interesting.
Dr. Fox: Well, I think we all have a lot to learn from one another in the world, and certainly, in this world. And I’ve learned a lot from talking to you two. I really appreciate this conversation and taking all the time to educate me and our listeners just about home birth in general and just your wonderful, overarching attitudes about women’s health and about birth and about care for them. I just think it’s terrific. And I really appreciate it. Thank you both so much.
Lauren: Thank you, Nathy.
Bertie: Yeah. Thanks for having us. It was a great conversation.
Dr. Fox: Good stuff. Thank you for listening to the “Healthful Woman Podcast.” To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s healthfulwoman.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day.
The information discussed in “Healthful Woman” is intended for educational uses only. It does not replace medical care from your physician. “Healthful Woman” is meant to expand your knowledge of women’s health and does not replace ongoing care from your regular physician or gynecologist. We encourage you to speak with your doctor about specific diagnoses and treatment options for an effective treatment plan.