“(Everything I Do) I Doula For You” – with Stephanie King and Cortney Clegg
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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. I’m here with Stephanie King and Cortney Clegg who are the creators of My Essential Birth and the podcast, “Pregnancy and Birth Made Easy.” Thanks for coming on “Healthful Woman.” I’m so happy you guys are here.
Cortney: We’re happy to be here. Thanks for having us.
Dr. Fox: Just so our listeners understand, who are you guys? Where are you? Where are you from? What do you do? What’s your story? Just jump right into it.
Cortney: So, Stephanie and I are both professional doulas and childbirth educators. We both kind of felt called to birth work as a lot of people often do. We both had amazing childbirth experiences ourselves. And when you have an experience like that, that kind of changes who you are and changes how you see yourself and how you view bringing life into the world. You can’t help but kind of shout it from the rooftops. And I think that’s how a lot of people move into birth work. I know that was certainly true for me. I think Steph you’d say the same thing as well.
Dr. Fox: That’s awesome. So, I know that we’ve been circling the state for a while. I found your podcast and listened to it and I think it’s awesome. And I hope my listeners listen to it as well. And the interesting thing is Cortney and I had a conversation sort of to prep for this. And it’s so interesting that you guys are…you’re doulas and you’re coming at it from one angle, and I’m doing like high risk-obstetrics, the other angle. But there’s so much overlap in terms of, like, philosophy and how we think about these things, which is, I’m not surprised by it because I see that a lot, but it is fascinating that you have people from such different angles looking at the same thing in a similar way.
Stephanie: Yeah. And wouldn’t you kind of consider that gold standard of care? If you could have people from completely different viewpoints looking at what you want for the mom, that best possible outcome for mom, and coming at it with all that information, I mean, that would be that gold standard of care that we talked about.
Dr. Fox: I agree. And I think that it’s ideal. It doesn’t always happen that way, unfortunately. Yeah, we’ll talk about that. Occasionally, there is conflict. But usually, it shouldn’t be that way. It really… There’s no need for it to be that way is what I would say.
Stephanie: Yeah, I agree. I think, again, if you’re looking at this from the perspective of the woman and her best interest, then, really, anybody entering that birth space, and we see this, especially as doulas. Sometimes we’re invited and people feel happy for us to be there that are other than the parents being other professionals or family members. And sometimes we’re not. But our ultimate goal when we’re dealing with a mother is to make sure that her birth space is protected and that she feels empowered and has a joyful experience. And I think that does take a decent amount of skill. It takes some of that stepping back in certain situations or leaning in in others, but ultimately making sure that she has a good experience overall is really important.
Cortney: I think when any woman’s assembling her dream birth team, one of the things she should be looking for is cohesiveness amongst the group. “Are we all on the same page in terms of goals? This is what I want out of my birth experience. Does my provider want to support me in that? Does he or she want the same for me? And what about the rest of the people on my birth team?” When it’s a green light for all of them, I think that’s where a lot of amazing, powerful experience happen.
Stephanie: It’s where the magic happens.
Cortney: It’s the magic. Yeah.
Dr. Fox: That’s where the magic happens. So, how did you find each other?
Stephanie: When I looked at this, I was like, “Oh, Cort, like, we’re in love.” Right? You tell it this time.
Cortney: We met at a doula training donor. The organization was holding a workshop in Salt Lake City. And she and I both happened to be next to each other and kind of hit it off. We found out that we were teaching the same natural childbirth method that we had a lot of commonalities there. We were both homeschooling moms. I really admired Stephanie right from the start.
Dr. Fox: Well, that’s a… What a nice story. And so what is it that makes you two a good team?
Stephanie: We discuss this a lot because the thing is Cortney and I while we… The basics of what we do, the very base core of what we do, we have a lot of the same beliefs and values that we hold not only for ourselves but for the work that we do. But if you’ve listened to our podcast or you’re in the birth course with us, you’ll know that we come from very different spectrums on several issues. And I actually think that’s such a benefit to women at first. I mean, we went through our growing pains in our relationship, right, Cort?
Cortney: Everybody does. Yeah.
Stephanie: We argued, we hung up on each other, we, like, had to work through some things. But when it came down to it, we were able to take those differences and realize this is such a blessing for mothers everywhere because the truth is no two mothers are the same. You’re gonna see things differently. It’s the same with care providers. I’m sure you run into that all the time. And so what a blessing for women to be able to see that. You don’t have to be seeing things the same and you can still come together for that better good, that good purpose.
Cortney: I think I tend to approach things emotionally first and address the physical later. Stephanie is kind of the reverse of that. But I think that’s really a powerful combination to have because then when you’re talking about birth preparation, you can talk about it from all these different angles and not necessarily value one higher than the other. Like Steph said, I think that even with our differences, we’ve been able to put our mission of helping women have amazing birth experiences above personal egos. And I think that makes us such a great team.
Dr. Fox: Oh, that’s nice. Now, you didn’t mention this. And Stephanie, you may not know this, but Cortney told me that you’re the more granola of the two.
Stephanie: Am I?
Cortney: I think so.
Stephanie: I thought you were more granola.
Dr. Fox: Oh, here we go.
Cortney: Oh, no. It’s the granola off?
Dr. Fox: Is anyone out there a psychiatrist?
Stephanie: We did a crunchy podcast episode and I thought, “Did I score higher on that?”
Cortney: I thought you did. Maybe not.
Stephanie: Maybe I’m more granola. Let’s talk it up.
Dr. Fox: I’m kind of a granola MFM. I’m a little bit of a… I guess so. I’m into all that. I think it’s awesome.
Cortney: I feel, though, like, not everybody starts off this way. In my defense prior to having children when I was married, I’m never gonna homeschool my kids. Those kids are weird. I’m never gonna have an unmedicated birth. Those women are martyrs. I put my foot in my mouth several times and here I am having checked so many of the things I said I would never do.
Dr. Fox: It’s an evolution. And you guys were both originally doing Bradley method, correct?
Cortney: Yes. Yep. That’s what we taught.
Dr. Fox: Right. And so just so our listeners understand, what does it even mean, like, where you were? What is the Bradley method? And then… Briefly. And then what did you move into that’s maybe a little bit different from that?
Cortney: So, the Bradley method was developed in part by Dr. Robert Bradley. And he’s got a book that’s called “Husband Coach Childbirth.” It’s a great book. There’s really some amazing principles in there that hold true and stand the test of time for helping women to have really powerful, they call it natural birth experiences. We tend to prefer the term unmedicated simply because, you know, to me, all birth is natural, right? So, we say unmedicated, but it’s a natural birthing method that’s, I don’t wanna say hardcore, but it’s kind of you do it this way. This is the only way. That’s something Stephanie and I we both took and taught and we got a lot from it. But one of the things we had in common was there was more that we were wanting out of what we were teaching the women. There was more that we felt like should be offered to them. And that’s kind of what got us started on the path of creating our own course.
Stephanie: And Bradley method, like we said, we both took it. Part of, like, to become a teacher, you have to take the method and have a Bradley birth, you have to use the method and have your unmedicated birth experience.
Dr. Fox: You have to have a baby yourself to be a Bradley method to do this?
Cortney: And you have to have had an unmedicated Bradley birth to be able to teach it.
Dr. Fox: Oh, my God. You gotta do it. Oh, my God. So, I guess I can’t then.
Cortney: Which is encouraging…
Dr. Fox: All right. I’m out.
Cortney: Sorry, you’re out, man.
Stephanie: If you’re a mom and that’s your goal, then it sounds really exciting, but the problem is what happens when you get thrown those kinks or, you know, it just doesn’t go the exact way that you would plan for it to go, and then you have to come back and look all of those other members in the face and say, “Oh, you had your natural birth, this unmedicated experience and I had a cesarean. How does that make you feel?” The truth is, there’s a lot of different, we call it, like, when we do our birth planning within our birth course we call it a map because there’s an end destination, which is obviously that mom, baby and everyone involved is safe and healthy and well. But there’s a lot of ways to get there. And your path might look completely different from another mother’s path and how you feel about that experience will look different depending on how much say you have along the way. And that’s kind of our main point. The other part that we were seeing is that we had many people reaching out to us that we couldn’t accommodate. It’s a 12-week series, which is great because that’s a ton…
Cortney: In-person series.
Stephanie: In-person. It’s a ton of one-on-one time, but what about all the other mothers that were coming close to their due dates or that we didn’t have schedules that met their needs? We were leaving a lot of people out that deserved to have the information.
Dr. Fox: The first things, I also agree. I have a hard time with the term natural related to childbirth. And people use it. It’s fine, like, whatever. I’m not gonna, you know, argue with them. But natural means different things to different people. I mean, I’ve had women who say, “I want this pregnancy be as natural as possible.” And meanwhile, it was an IVF pregnancy with an egg donor and a sperm donor and it’s like, “Okay. That’s not natural.” But fine. If that’s how they view it, that’s how they view it. But for the women who have a different experience, you know, if they have an epidural and deliver vaginally, some women call that natural and others don’t. And if you have a cesarean and it’s all these things. It’s natural to have children and it’s natural to make decisions about how you wanna have children. I think it’s also natural to want to avoid pain. That’s natural. Right? So, it’s just an odd term to use. And I think it’s too loaded and it ends up being wonderful for people who sort of get what they thought they were gonna get and potentially very upsetting for women who don’t get it because it’s viewed as, like, they did something wrong.
Cortney: We couldn’t agree more. Yeah. Like Steph said, it was just hard to have, you know, a reunion of my birth class students. And we know that about 5% to 10% of women are going to need a cesarean birth for their health or for the baby’s health or both. And for those women to come to that little after party and feel any kind of shame or disappointment in their experience, my heart ached for those women. Nobody should have to feel that way about their birth experience, especially if they did everything right, so to speak, right? I’m doing air quotes. If they took the class, they did the information, they tried to implement and apply those principles, but, like Steph said, they got thrown some curveballs, you can’t always control that and you shouldn’t have to feel bad about that.
Stephanie: Yeah. And same with mothers that choose medication. There’s nothing wrong with choosing an epidural. In fact, there’s better times to get one and we talked about that. I think that should be an option.
Dr. Fox: Yeah. And I think that another issues sometimes it’s really not so much the events or the outcome, but it’s how women view their experience through it and what their journey was, like you said. So, for example, if…
Stephanie: You nailed it. That’s it exactly.
Dr. Fox: Yeah. You have two women who both, you know, went into this thinking, “I wanna have an unmedicated vaginal delivery. I really, really want this. This is my goal. I’m gonna work towards it.” And let’s say both of them ends up with an epidural or cesarean area, which is exactly what they… I mean, healthy baby, they wanted, but that wasn’t the experience they wanted. But the first one, it just sort of, like, you know, “It happened to her. She wasn’t a part of the conversation. Her provider just sort of told her, “This is what we’re doing. This what we’re doing,” and she feels like she was left out of that. She’s gonna be much more miserable than maybe the other one who understood what was happening going into it, have conversations with her provider, was part of the decision-making process and in the backend, okay, wasn’t what she thought she was gonna get, but, ultimately, it was her journey and not something that just happened to her.
Stephanie: That’s exactly it. It really makes me wonder, “Where did you learn that?” because that is not necessarily the verbiage or the viewpoint…
Cortney: Predominant viewpoint from us.
Stephanie: …that we see. And that’s from personal experience and it’s from watching women going through it time and time again. So, I’d love to know more about that.
Dr. Fox: I was raised right. I don’t know. I mean, like, I don’t think this is… I don’t…
Stephanie: Has this always been your approach, like, from medical school on? This has just been how you felt about it or did this develop and evolve?
Dr. Fox: I can’t say that when I was, you know, in eighth grade, I thought much about women’s birth experience and how I was gonna guide them through. It probably didn’t come up much until, yeah, at least high school? No, I don’t know. It’s… I don’t know. It’s hard to say. I think that, ultimately, it’s a combination of things. I think by nature, I tend to be a little bit more laid back and conversational and I like, you know, to clewd people and talk to people. And I think also I was fortunate to have good examples when I was training people that I gravitated towards who I thought were really good doctors and I also midwives. And when you’re training in medical school in obstetrics-gynecology, there should be and there frequently are midwives around and we’re encouraged to learn from them as well, obviously.
And, yeah, I think I was just fortunate to be…to have maybe an inclination towards that, and then be guided by the right people in that path. And I think there’s a lot of really good providers out there who do that. And I think that in my experience, it’s actually the majority, but I think there’s some people that just can’t pull it off, and it ends up being combative between the doctor and the patient. The doctor may not even have know it or it’s just the patient feels that way on the way out. Unless I’m sure those people feel that way about me and I just got it wrong. I thought it was in a certain way. But it’s not how we try to do it. I just think it’s unfortunate if it happens the other way. How did you come to this realization just because you went through it yourself?
Stephanie: For me personally, it was totally how I was treated. And at the end of the day, I think most of our… Right? Like, when you go to counseling or you’re talking to people about things, what you’re really expressing is the emotion behind it. It’s how you felt in any given experience that makes it good or bad or neutral. And so when you come up upon people who don’t respect your opinion or choices that you would like to make about your body or maybe don’t even give you the opportunity to voice them or at least that’s how you felt, as you said, when you leave the office, then it does make for a less than good experience. And it is… I will be honest, it is not easy to stand back as a doula because something that we have to do is respect that space. We have to respect the provider. And not only do they deserve that respect, but the mother deserves that cohesiveness that Cortney was talking about within that birth space.
But I have seen providers or outside influences, even family members or friends who say things to women or don’t allow them the opportunity to have their own experience walking through that birth space, and it does affect them for a very long time. Unfortunately, I think we get a lot of those second-time moms that are like, “I didn’t have this good experience and now I’m seeking for something better.” How wonderful would it be if we had people that worked from the beginning to give mothers their options and informed consent and said, “What do you want? This is the reality of the situation that’s in front of us. Here’s your options. How can we work through this together?” instead of, “This is the way it’s gonna be, so we hope you enjoy it.
Cortney: I would say at least 50% of the women who come into our course are women who have had babies before and they didn’t like how they felt about it, they didn’t like how they were treated. And I still view that as we have some work to do, here and all around the world, right? We wanna see that number go down. We want women to have positive birth experiences right from the start. But it’s a two-way street, right? There’s work that needs to be done on the part of the providers. But one of the things we’re trying to help women to recognize is that, but it’s also work that you have to do on your part as well. You have to put in the time to educate yourself on your options and what consent looks like and what’s reasonable to expect from your birth experience and things like that. So, it’s gotta be everybody.
Stephanie: And not to go in with your fists first. If you go in combative with your provider, like, “This is how I want it. Get out of my way.” how good is that gonna be too? So, yeah. It’s just a communication thing I think at the core. It really has to do with communication.
Dr. Fox: I agree. I think it really comes down to being a good communicator in both directions. Like you said, I think that the provider should be a good communicator. And so should the woman and the family going through this. And it’s communication, obviously, doesn’t mean “How well do I speak?” It’s mostly “How well do I listen?” Right? Which is really, you know, two ears, one mouth. Listen twice as much as you speak. One of the interesting things you said is your own experience, but I have not found in my own observations that either looking at, let’s say, women providers, that the ones who have children are better than the ones who don’t or that women, in general, are better than men providers at this meeting. I don’t know if the experience of birth will lead everybody to understanding more about it. I think people who maybe have that innately have it and people who don’t, don’t. And I think a lot of it is just the personality of the person and just what’s their disposition and how comfortable are they with conversation as opposed to rules. And different people are different with that?
Cortney: Yeah, that would be a blanket statement, I think, to say that if you’ve had a baby before, then you’re gonna be more relatable through that experience as a provider, whatever. I don’t think that’s true at all.
Dr. Fox: One of the other things you said about starting early is so important also, and, you know, talking here, it sounds like I’m okay with everything. I’m not. Listen, I’m a doctor, I’m an obstetrician, I’m Maternal Fetal Medicine Specialist. I’m not comfortable with everything that a woman might ask me for or what she wants to do. But the point is, I’m okay telling her that, meaning, if I’m meeting with someone and she says, “I really like it to be A, B, and C, I’m more than comfortable to say to her, “I’m totally fine with A. B, let’s figure out, but C is just on the other side of the line for me. I can’t do that for you.” And that’s okay. It’s polite. It’s pleasant. This is just… This is who I am. This is who you are. My brackets only goes so far, so wide. Either logistically, I can’t do that for you, like, you know, woman says, “I want to waterbirth.” I’m like, “Well, we don’t have water. We don’t have a pool. This is not an option.”
So, okay. Or there’s certain things that she wants that either I feel they’re not safe or it’s just not something that I’m comfortable doing and you don’t want your provider being in a position that he or she is uncomfortable because then they won’t perform well, but they won’t do what they’re supposed to do. But if you have the conversation early, she can make a decision like, “Well, I like this guy. I like his office. I like where it is. I can handle not having see and I’ll be fine. Or at the deal-breaker, I’m gonna go somewhere else.” And that’s great. If she needs to go somewhere else, that’s okay. She should have what she wants. And if I can’t provide it, I can’t provide it. But those conversations should not be happening three days before you’re gonna deliver because then there’s nowhere to go. And that’s happened.
I’ve had people who are talking to me about very specific things that they really, really need or want, I’m like, “We can’t do that.” And she’s like, “Well, where should I go?” “I have no idea. You’re due tomorrow. What are we supposed to do here?” And so it is something that has to happen early. And another thing which is… And this is why I’m a little bit discouraged, you know, as we move forward is so much of this is based on the relationship between the woman and our provider, that that personal relationship that there’s trust. They trust each other and that is becoming more and more difficult to build in our healthcare system. Visits are shorter, you see different people, they have someone taking care of you for pregnancy, someone else taking care of you for delivery. And there’s nothing better than trust in this situation. If I trust that, you know, she’s with me and she trusts that I’m with her, it’s all gonna work out. And if you can’t build that trust, it’s very hard.
Cortney: We have had women within our course who come to us, what I would consider fairly late in the game to start getting educated. We never turn anybody away. In fact, we’ve had women who are like, “I’m 39 weeks,” and we’re like, “Okay. Bust out the course in a day and you’ll be good to go.” So, I think that we… I’ve personally known women who have switched providers with a week left in their pregnancy or the middle, because sometimes they realize that the person that they’re with, they’re not saying eye to eye on things. But we totally agree with you. That conversation should happen as early in the pregnancy as possible so you can be with the right provider, you know, as early as you can and build that relationship I know, like, and trust you. And because of that, we’re gonna be able to understand one another and come to some agreement on best care for myself and my baby.
Stephanie: Yeah. In fact, that’s the number one thing that we stress. I don’t know how many podcasts we say it in, like, every single one maybe that aside from preparing yourself with education and knowledge and all that, that’s wonderful, but if you do not have a provider that you trust, and you can work with, and you can ask questions, and get informed consent, and have that strong relationship with. You could have the best birth plan and all the knowledge in the world and it’s not gonna work out probably the way that you want it, because when it comes down to it, that provider is going to be the one making very important decisions for you during your pregnancy and throughout the birth. And so you have to be able to have that communication early on, or it does make for a more difficult process, I guess.
Cortney: That was another big factor of why we created the podcast in the first place and why we created an online course is because we felt like the reach could be bigger. If we can find women sooner and let them know, all these awesome things that we’ve talked about like, “Make sure you’re with the right provider early on. Here’s some great questions to ask to see if you guys kind of align in terms of your goals and your approach to this.” We felt like we could find women sooner if we have these online resources.
Dr. Fox: Yeah, I think that’s great. And I have my own opinions on this, but I’m curious from your personal experiences and also your expertise, as you know, educators and doulas, how would you advise women? In what way could they figure out if their provider is someone they can trust? What is sort of the hints either in a good way or in a bad way? Because a lot of people are like, “I don’t know. He seems nice. She seems nice. How do I know if I can trust them?” What is it that they should be looking for in their provider?
Stephanie: So, the first thing that we tell them to do is to visualize their birth because different women are gonna have different ideas of what a good provider looks like for them based on what they want their experience to look like. So, we actually include like a meditation practice where it’s like, “Pause and be quiet, be still for a moment and take yourself through the entire pregnancy and birth process. What does a comfortable conversation look like with you and your provider?” If you are one of those women that’s like, “I want to go completely unmedicated and I wanna use waterbirth,” and you have all that stuff on your list, well, if you go to a provider that doesn’t offer any of those things, then it’s gonna be a little trickier.
So, if you can visualize the process first and write down your top things before you get into interviewing providers, that’s number one. Number two is interviewing providers. How often are we like? Who’s the closest and within my insurance? And that’s fine. There’s nothing wrong with that. That provider can still help you have a healthy, happy experience, but is that going to be the best provider for you? That’s a great question. So, once you have those things underway, I think it’s important to bring in that list of information. These are my top things. What are you… And bringing them up to the provider. What do you feel about these? Or what’s most important to you? Or what’s…
Cortney: What’s your experience level?
Stephanie: …your experience, your background? We have women ask a lot is, “What’s your cesarean rate?” Obviously, somebody who’s a high-risk doctor is going to have a higher rate, right? But it matters because a woman’s experience is very important. A woman’s experience matters through the process because she’s gonna take it with her for the rest of her time. We do talk about red flags. And that’s a different situation. And I would say those piece by piece, like, it depends on the woman and the situation as to what we would consider a red flag.
Dr. Fox: I’m curious what the red flags are and how many I’m holding right now.
Cortney: Well, I can give you an example of one. If we have a mother who’s had a cesarean birth, you know, is otherwise having a healthy pregnancy maybe the second time around. So, she really wants that VBAC, that vaginal birth after cesarean. And she’s meeting with her provider. And you can just tell from the language that he’s, you know, “Well, I really strongly recommend that my patients who have had prior cesarean continue to have repeat caesarean. This is what I’m afraid of.” If you keep pushing and you say, “But I really wanna try for this VBAC.” I think it’s important to pay attention to the language and the feeling, right? I’m kind of an emotional-based person, so I pick up on the vibes in the room, I guess you can say, but when… If a provider is saying something like, “I guess I’ll let you try a VBAC,” that might not be somebody who’s gonna be super supportive of what you’re trying to do.
And when push comes to shove and you’re in the middle of that experience, I don’t know what that’s gonna look like, right? I tell them that’s a question mark. But if you get somebody in there and you say, “I had a cesarean birth for the following reasons. I’m having a healthy pregnancy. This time around, I’d really like to try for a VBAC.” And you get a provider in there that’s like, “Awesome. Let’s do this. Let’s make it happen. I can be available during that time. I can be on call. I totally support you in this.” That’s a different attitude. That’s somebody you wanna partner with. So, that would be a red flag. What’s their attitude as you’re saying what your goals are for your experience?
Dr. Fox: Right. But it’s also, like you said, it’s reading sometimes the body language. It’s a lot of EQ possibly over IQ. And that’s why I’m not a big fan of the question about caesarean rates. The data isn’t nuanced enough. I mean, if someone is a real good data analyst, they can tease it out, but so much of that has to do with patient population, how many have had many babies before? How many are older? How many are twins? There’s a lot of things that sort of go into that, and so straight up rates are tough to compare. You have to sort of get into the nitty-gritty on that. We actually did a podcast on that exact question, how to ask it, how to get the data you want as opposed to just a number because it’s not gonna be all that helpful.
I’ve had that situation with patients where I’ll say to someone, I’ll say, “It’s obvious to me you don’t trust me. It’s just clear from our conversation that you don’t trust me. So, why are you here? Why do you come to me if you don’t trust what I’m…if you don’t trust me as a person?” And it’s very hard for them to answer and they don’t know why they’re here. I’m like, “Why don’t you find somebody else? I’m not kicking you out. I’m happy to take care of you, but you clearly don’t value anything I’m, you know, saying. And so it’s like… And you think I’m, like, not here for your best interest.” And I think that people don’t realize that they can look around and find the person that they do trust. And that’s gonna be different for different people based on what their needs are and what their personality is and just maybe how the stars align that day. Who knows?
Cortney: We tell women all the time, you’re the consumer. At the end of the day, it’s an exchange of service, right? You pay money, they provide a service. And because of that, you can shop around just like you can shop around for anything else. And knowing that you have that power, I think is helpful for women to understand.
Stephanie: It comes down to personality. And I know we’ll get into maybe doula work a little bit later. But when we’re interviewing other women, you know, and I tell them all the time, you know, “Feel free to interview more than just me.” I know I did that when I was coming up with doula’s stuff and it didn’t have to do with what certifications my doula had or how many births that she attended. What it came down to was personality. Is this somebody I can trust and feel comfortable with in my birth space? And so I think personality is a huge part of it when you’re selecting a provider.
Dr. Fox: Yeah, I 100% agree. And so let’s actually jump into that. Just what is a doula? What do you guys do?
Cortney: So, a doula is someone who provides emotional support, hands-on physical support for comfort measures during labor. They’re there to provide information to make sure that, you know, you’re getting informed consent. They’re there to support your goals and protect your birth space, we try to make it really clear that doulas do not perform any of the tasks of labor like, you know, vaginal exams or delivering the baby. That’s not what they’re trained to do. They’re there for emotional, physical, informational support throughout labor and pregnancy and even into postpartum. And that’s what they’re there for. They’re there for you to help. They don’t advocate for you. They should never be speaking for you to the provider or anybody else, but they can help you find your voice in doing that and they can support you in that.
Dr. Fox: And how do you become a doula? What is it? What’s the training to become it?
Stephanie: You can technically just be attending births. There’s no formal training that is necessary in order to become a doula. And so I think a lot of women get into it because they were at their sister’s birth, or they attended a friend’s birth, or they had this incredible experience themselves. So, there’s always that part of it. But if you are looking for the more technical side of things, which I found absolutely necessary, if I’m being honest, there are different trainings that you can take. And so I won’t go into all of them. But Cortney and I were trained through DONA, which is Doulas of North America. And they hold like a three-day workshop where they have somebody come in and train you on, not just… And I think this is where a lot of it we kind of knew because we taught childbirth education, but it’s not just the hands-on stuff. It’s teaching them about the process of birth. And I think that’s really important because there are different stages of birth that you’re helping a woman work through. And what that support looks like as it progresses is very different.
Dr. Fox: Something you Cortney told me before, which I really liked was that doulas are a bridge between women and their providers in terms of that part of the relationship, but then, as you said, it’s more than just that because it’s the entire educational piece.
Cortney: I mean, one of our motivations, again, for creating the My Essential Birth course, you guys both just head on two of the things. One of the things when I took this doula workshop and I started attending more births rather than just doing the birth education piece was that I realized that there’s a whole big wide world out there of other techniques for comfort measures and relaxation and fetal positioning and, you know, all that kind of stuff that I didn’t know about. And here I was a childbirth educator, right? We were very limited by the curriculum that we were given to teach. We couldn’t really teach anything outside of that.
And here I was learning all these new, you know, rebozo techniques and feeding babies and stuff like that that I really wanted my students to know and understand. So, that was a motivating factor. The other thing too is that just like you said, I felt like I was…again, because of curriculum restraints, I was training these women, these pregnant couples to kind of go in with their fist up into their birth space and to view their provider as somebody that they may have to fight against to get what they want. And I thought, “This isn’t how it’s supposed to be. I want to create a bridge between educators and doulas and women and their providers, again, where we can all come together and support women in the experience that they wanna have.”
Dr. Fox: Yeah. I think that’s such an important piece of it because the majority of doulas that we work with that I work with are fantastic, right? They have similar philosophy to what you’re describing to how I view birth, and it’s just an amazing person to have in the room to help, because I’m not in the room the entire time, obviously. I have to come in, I have to come out. There’s a lot of things I have to do. And for the woman in labor, it’s so helpful to have a person there who’s supporting our team. And this is in addition to her partner, but someone maybe with more experience and more knowledge and more understanding. And then when I come in, the conversations and the discussions about what’s going on and what we’re gonna do and what we’re not gonna do, all things are at such a higher level because everyone’s on the same plane, and that’s when it’s perfect, right? It’s just amazing.
But I found that the situation you’re describing when someone, whether it’s the woman in labor or the doula comes in, like, ready to brawl, you know, “Here we are. Let’s roll up our sleeves and wrestle,” like, that’s a very bad situation to be in. And it can get pretty ugly. It’s the exception, fortunately. But I’ve been in those scenarios where, you know, I’m trying to, you know, have a conversation with the woman in labor and the doula is just, “Argh.” like going at me or sometimes the doula and the woman herself are at odds with what should be going on and it’s just… That’s a bad triangle right there.
Cortney: We’ve been in those situations on the other end too where we have been, you know, maybe attending a birth as a doula, got a provider who, for whatever reasons, is following protocol. I was attending a birth at a teaching hospital and there was a med student that came in and was trying to insist upon some things that I knew from my background and training were probably not necessary, right? That’s a provider preference. That didn’t necessarily need to happen. And the whole energy and mood in that room shifted to where I felt like we were kind of at odds, that we weren’t wanting to go about the same goal in the same way. I had to pause for a minute because, above anything, is that fair to the birthing mother? Is that fair to bring that kind of energy and attitude into her birth space? Right? I don’t think that was good on either one of us.
So, again, I had to do my part and reiterate to this birth in coupling. I mean, mom was in active labor. She wasn’t really paying attention, right? So, it’s kind of more of a conversation between her partner and I and saying, “Look, this is the option that they’re presenting on. This is why you heard them talk about that. You could ask this follow-up question to determine if it’s really necessary and where you wanna go from here.” And from there, I had to kind of hold my peace. I had to do whatever the couple decided was best for them whether that’s what I felt would be the best way to go about things or whether they felt like they wanted to do what their doctor said, it really doesn’t matter. It’s not my decision, it’s theirs. And whatever they decide from that point on, I immediately jump on board even if it’s not the idea that I had.
Dr. Fox: And you’re totally right, that, obviously, the conflict can arise from the, you know, provider side, obviously, like, that could happen as well and I’m sure it does. When I’m on the labor floor and… Not all of our patients have doulas. Some do, some don’t. And you can tell that sometimes in labor floors, a doctor walk in and say, “My patient is here with her doula.” And a few of the people in the room will go, “Argh.” And then I’ll be like, “Oh, that.” And which is… Probably, because they’re, you know, reliving those bad experiences and always say, “Oh.” I’m always like, “Oh, that’s awesome.” I really… I mean, again, unless it happens to go bad. And when I walk in the room, I’m like, “Where is the doula?” I’ll make a beeline for her and I’m like, “All right. Who are you? Let’s talk. What’s the story? What’s going on?” because she’s gonna be there the whole time. It’s like she’s in the room the entire labor and she’s gonna be so helpful. That’s why she’s there, is to be helpful. Right? That’s it.
Cortney: To paraphrase the quote, if doulas were a drug, people would be crazy not to use them. Right?
Dr. Fox: Right.
Cortney: The incidence of induction in cesarean birth and utilization of pain medications goes down when you have a doula present. And that continuous support is just such an important thing. I laugh because I’m thinking of one thing you said during our phone call prior to this podcast recording, you were like, “Nine out of 10 doulas, I love them. Man, they’re great. I’m so happy they’re there.” You’re like, “Every once in a while you get one and you’re wrestling on the floor with them.” But then you and I came to the conclusion that, “Isn’t that true in all professions in all walks of life?” Right? Nine out of 10 people are gonna be amazing and awesome and good humans. And every once in a while you get some that kind of throw you for a loop, but it’s…
Dr. Fox: One out of 10 people. That’s the number. Yeah.
Stephanie: I would say as part of our doula training that we were told, like, you leave your ego and your baggage and just whatever you have…
Cortney: Your own opinions.
Stephanie: …for yourself out the door. And I do that with every single birth as I’m walking in. It’s a deep breath and I’m like, “Okay.” And I do a little prayer. I’m spiritual that way. But kind of a deep breath and, like, allow this to be her experience and keep me out of the way. And I think when you walk into a space that way, then it really does become about what’s best for her in whatever situation she’s facing. So, yeah, it’s important that she has all the information, but it’s also important to keep the peace in the space and to allow her the space to make her own decision.
Cortney: And like we’ve said here, I think most things can be resolved with just asking good communicative questions, right? Ask some more questions to find out, “Is this really necessary? If it’s not, what are my options and alternatives? If it is, you know, what’s the best way to move forward where everybody feels good?”
Dr. Fox: There must be times where you’re just, like, itching to just push the doctor out of the way. It’s like, “All right. I’m taking over. I’m driving the bus here. You’re out of here.” But yeah, I think that a very non-confrontational way to do that is just to say, “Let’s talk about that.” Just something very silly. “Hey, let’s talk about that. Your great idea, let’s talk about it.” And there’s no reason anyone shouldn’t talk about it. I mean, women in labor are awake, right? They’re alert. There’s no reason they can’t talk. And if there’s a doula there, you know, she’s awake and alert, the doctor is probably more tired than both of them, but maybe he’s awake and alert. And I think, yes, and it’s just a conversation. That’s really all it is. It’s remarkable.
Cortney: And one thing we tell women, you can tell if something is an emergency situation if there’s that space and time to talk about it. If the doctor is like, “I’m sorry, but we’ve got to wheel you back now. We can talk about it on the way, but we’ve got to go now.” That is an emergency situation when there’s not that time and space to talk about it.
Dr. Fox: Right. And that’s the exception. Usually, most decisions we make there isn’t enough time to discuss them, even the ones that are important. It happens, obviously, in labors that there’s urgent decisions, and people figure that out. It’s not too complicated to, you know, get that there’s an emergency going on. In terms of who would… I guess you said everyone would benefit from a doula, I guess, in your experience. Is there anyone who might not or just like, “Well, they’ve got this”? It’s only been their third or fourth baby or someone’s got an amazing partner already or someone just…they know they’re gonna have an epidural anyways and they’re not really worried about pain and labor. Have you found that you’re sometimes there and, like, “Why am I here? It’s not helpful”?
Stephanie: No. But you’re talking to somebody who has hired us, right? So, anytime that I’ve been at a birth, it’s because somebody has wanted to seek out that kind of extra support and care. So, even when a birth does… And I’ve actually made it to a birth after they’ve had their baby and the care has still been useful. But if you’re talking about specific to the actual labor process, I think most people would benefit from it unless they’re kind of the ignorance is bliss in which case, they’re probably not going to be seeking out a doula anyways. And sometimes it is blissful for them too, so let’s be real about that. Not everybody needs a doula. Cortney did not have a doula. I didn’t have one until my third. It doesn’t mean that everybody has to have one or it’s this perfect answer for everyone. But for those who are seeking that extra support, I would say 100% of the time, it makes sense to have an extra support person there.
Cortney: I felt like my husband was such an incredible extra support person. We always joke that, you know, he’d be a great man doula. Not that anybody would hire him, but he was really great. So I never felt the need to have that extra support there. But one of the big components to our course is training the partner. We wanna train you to be an amazing doula, you know, support your partner through birth. But as we sit there and we tell them what they’re gonna need to be focusing on, “Okay. You need to be paying attention to when her contractions are coming. Here’s the counter-pressure moves we want you to do. Here are the different positions you need to look for.” We tell them all these things to monitor, you know, “You wanna watch her breathing. You wanna watch how she’s acting emotionally. Pay attention to protect her space.” All these things and we let them know at a certain point, “If you’re feeling overwhelmed by this, you may want to consider even interviewing two or three doulas. You don’t have to hire them, but just interview and get a feel for if you think that having an extra set of hands would be helpful,” because if you have these marathon births, you know, over 24 hours or over 15 hours, your birth partner is gonna get tired. It can be nice to have somebody to sort of tap out with.
Dr. Fox: Right. I’m gonna let you in on a little secret that 50% of Earth knows, all the men in the world, we’re all overwhelmed with this. And when they say they’re not, they are. They just don’t wanna fess up to their wife or whoever that they’re not, but the men are all terrified, they have no idea what they’re doing. And they’re overwhelmed and they need you. So, whatever they say, that’s the truth. Here it is. I’m speaking for all of us.
Stephanie: Yes. And we appreciate it because, honestly… If you’ve ever taken a birth course with your wife or you know people who have, like, “Who was the deciding factor in that?” Was the dad like, “Hey, I got this great idea. Follow me”? No. That’s never the case. But the number one thing that we hear is from the men, “I didn’t know that I didn’t know.” And how grateful they are by the end of the time that now they have tools to support this person that they love and they’ve created this child with. So, there’s power in not knowing and there’s power in finally getting the education and understanding how to help.
Cortney: My husband was a little grumpy that he gave up Monday night football to attend a birth course with me. But by, I would say, halfway through the course, he was just as much of an advocate for, “Hey, we need to do our relaxation practice. Where are you at with your nutrition goals today? Can I fix you something to help you hit that protein goal?” He was just as much on board as I was and that made such a huge difference.
Dr. Fox: Right. He was lying to you. He just wanted to get back to the football. I do…
Cortney: He could be.
Dr. Fox: My wife did get me a shirt that says “World’s best doula.”
Stephanie: Love it.
Cortney: That’s awesome.
Dr. Fox: That’s one of my favorite labor shirts. So, it’s…
Cortney: You wear it to births?
Dr. Fox: Yeah, absolutely. I have to wear my scrubs over it, but it touches my heart.
Stephanie: Oh, that’s so cool. That’s awesome.
Dr. Fox: It’s closest to my heart. All right. So, someone decides they wanna do it. And by the way, what you’re saying about the benefits, they’re real. I mean, if you look at the studies on labor and outcomes, there’s this idea of one to one support. And many of the studies like in some of the European studies, that’s who we would call the labor nurse who is with them the entire time and labor. In the U.S., it’s very unusual that you’re gonna have one to one nurse to patient because a typical situation labor floor as a nurse will be covering two, maybe three patients in labor and going. And they give a lot of support, but it’s divided by two or three plus all the charting and stuff they have to do. And then when she’s pushing, it’ll be one to one. But during the whole labor, the only way really to get one to one support is either get really, really lucky and your nurse is there the whole time or have a doula with you, otherwise, you just don’t have that. If a woman is seeking a doula and you said she has to choose wisely and for her, what is it that she should look for in terms of the match? Obviously, there’s, you know, doulas who are great, but there’s gonna be, you know, someone who’s better for one person and better for a different person. How would a woman make that choice?
Stephanie: You interview several.
Dr. Fox: And what are they looking for?
Stephanie: It really comes down to personality. If they know what they want for their birth space before you interview just as you would a provider, then you’ll be asking questions like, “Well, how do you feel about, you know, supporting me at home for as long as possible before we go to the hospital?” or, “How do you feel supporting me just for the beginning part until I can get the epidural?” There’s different questions you can ask including, like, “How many births have you attended?” or, “Have you been in any emergency situations? And what does your response look like for those things?” or, “What kind of education do you have that you can share with me to make this a good experience?” Any training that a doula might have? Has she attended births that are in or out of the hospital or both? Does she have a good working relationship with any providers in the area? What about resources for prenatal or postpartum issues that might come up? One of the best things about being a doula is that you get to be there in the interim after a mother has had her baby and before she meets with her provider again. And you can catch a lot of those postpartum things that otherwise would go untreated or unseen or could develop…
Cortney: Or succeed.
Stephanie: …or a little worse for a couple of weeks after. And so having somebody who has that training and resources, that might be great, but as I mentioned, when I was researching and I interviewed my doulas, the doula that had all the training and had been to over 200 births and she would have been a fabulous, fabulous person to have in my birth space, I chose the woman that had not attended a training and had been at four births, ever, because that was the person for me. So, all of that said, I think it really does come down to who you’re comfortable having in your space.
Cortney: I remember being at a doula get-together, right? It’s nice to get together with people within your same line of work.
Dr. Fox: Also see wild-wild parties.
Cortney: Oh, yeah. Let me tell you.
Dr. Fox: You guys have great, great stories.
Cortney: Everybody’s to bed by 9:00. It’s awesome. Anyway, one girl was telling us about how… What is your interview process like? What have your interviews been like lately? And she’s like, “Well, immediately when I get there, I sit down next to the mom and I just start massaging her hands and I work my way to my shoulders.” I was uncomfortable just hearing. And so that’s not something I walk in to do, but she was a very popular doula and women picked her all the time. If I was the mother on the receiving end, I would be like, “Hey, you gotta buy me dinner first. Don’t just touch me.” So, again, different personalities, some women love that. They’re gonna wanna be touched. I was in an interview where, I’m going back to what Steph said, the first thing every pregnant woman should do is visualize their experience from pregnancy through to postpartum. What do you want that to look like? And I remember this one mom was like, “I wanna… I just picture myself being massaged the whole time through the whole birth.” And I’m sitting there thinking…
Dr. Fox: I’ve got a doula for you. I got the hands you want. There she is.
Cortney: Let me refer you to somebody else. And I am hands-on…
Dr. Fox: Yeah. That do the touchy touch.
Cortney: I’m hands-on, but it’s in a more technical way, like, we’re doing counter pressure for a reason, we’re doing a spinning babies technique for a reason. Sure, I’ll brush your hair, I’ll rub your feet, but it’s not gonna be for 10 hours at a time. So, anyway, yeah. So, it’s okay to just say, “You know what? I love that. I love that’s what you want. I think that’s wonderful. I’m not sure I’m gonna be the best fit for you, but let me give you some names of women who are gonna be great at that.”
Dr. Fox: When women ask me, you know, “Who should I use as a doula?” We work with some and, you know, I think there’s people I know who are great. And I always say, “The most important thing that I’ve noticed is “Are your goals aligned with the doula’s goals?” And they should be 100% of the time, right? If you want something and the doula doesn’t want you to have it or if you don’t want something and the doula wants you to have it, that’s not a good situation. And you just ask. And the common things like, you know, if a woman’s like, “Well, I really, really don’t want an epidural.” And if the doula is like, “Oh, you should get an epidural.” Right? And they know that… And this is, like, at 32 weeks. Right? That’s probably not what she’s looking for. And on the flip side, she goes, “Well, I don’t want an epidural, but I’m open to it if it’s something that I feel that I want.” And the doula is like, “No, everyone does it without. Everyone does it without.” That’s not a good situation. You have just to make sure you’re on the same page so that you too are going almost as partners in the sense as a team.
Stephanie: Yeah. A good doula in any situation, a mother shouldn’t really know what her personal view is, period. If she’s asking, “Should I have an epidural or not?” my job is not to say, “Well, this is my experience and I think you should X, Y, or Z.” My job is to say, “Well, here’s the benefits and risks of each. What are you looking for in your experience? And now with that information, how do you feel about those? How can I help you get to a space that’s comfortable for you with what I’ve just said?” What I have found, I think, Cortney and I professionally, and it’s not always the case, but when you’re having a doula that’s pushing one way or another, it’s usually some kind of birth trauma that they’ve experienced, personally, that they’re trying to overcome through the work, which is an inappropriate place to be.
Dr. Fox: There definitely are doulas who express their opinions to their clients, you know, that you can be very clear what they think and what they believe. I agree that you really shouldn’t, right? The majority, they should just be, “All right. This is what you want? I’m gonna help you get with…” Obviously, we’ll do education. Maybe the woman didn’t understand something or this. Fine. But once we’re all educated, once she makes a choice, that’s her choice.
Stephanie: Totally. A hundred percent. That’s exactly what it should look like.
Dr. Fox: Do you guys ever turn people away, say, “I’m not going to your birth. Forget it”?
Cortney: Yeah. I turned away a neighbor. She was a mom who had a very large family, so a veteran mom, I like to say. And she was really into unassisted home birth. And that’s where there’s no provider there, there’s not a midwife, there’s not anybody there other than the mother and her partner and whoever else she invites into that space. And that just was… And I’m not here to talk about the pros or cons of that, but that was way outside of my comfort zone, but it’s also a liability issue for me as well. That’s not something I wanted to take on because in an emergency, I’m not trained to handle that emergency. I told her, “That’s neat that you do that. I’m glad you had such a positive experience with it before. This is where, you know, my comfort zone is and this is kind of outside of that for me.”
Dr. Fox: Wow. I can imagine.
Stephanie: And to be fair, there are doulas that they’re comfortable assisting women in unassisted birth. So, it’s not to say that you can’t find a doula for that situation.
Dr. Fox: Yeah, just for you guys.
Stephanie: Right. Exactly. So, for us, yes, it has to be comfortable. And I’ll say to you I…
Dr. Fox: That’s a lot of granola. That’s a cupboard…
Stephanie: I wasn’t on that one.
Dr. Fox: That’s a cupboard full of granola.
Stephanie: I wasn’t on that granola.
Dr. Fox: Yeah.
Stephanie: No. But I do think Cortney and I were talking about this before because I was kind of laughing, like, you also get those clients that reach out that you’re like, “Oh, gosh, I hope they don’t call me back.” That was really weird or, like, there’s something they’re not telling me or, like, you know, I’m afraid to kind of show up at that person’s house. Maybe the partner has given off weird vibes. I mean, just anything… You can always kind of come through and find situations like that, but I think the majority of the time they work themselves out, like, you’re either a good fit or you’re not and you pretty much know by the end. So, whether or not they call you back is another issue.
Dr. Fox: Right. Like you walk in and one of them starts rubbing your hand.
Stephanie: Right. Yeah. Exactly. Right. That’s kind of our red flag.
Dr. Fox: Got it.
Stephanie: It’s not a good place to be.
Dr. Fox: In your birth course, as you said, it’s online. It’s available online. How do people find you? Is it just word of mouth? Is it people they Google search you, friends tell them? Is it from everywhere? Have you been able to figure out how people come to you?
Dr. Fox: All of the above.
Cortney: All of the above. We started off on Instagram kind of launched on there. And we obviously had a network of fellow professional doulas and midwives and people that we work with and ask them to help us spread the word. But we actually began a podcast, you know, the “Pregnancy and Birth Made Easy” podcast we hit our year mark this last June. And we’ve actually found that a lot of our students are coming to us from there and we’re so happy that we found a place to reach women and help provide education.
Dr. Fox: It’s great. The podcast is really a good way… It’s almost like interviewing you. People get to see what you’re like, what your personalities are like, what your philosophy is like, what kind of things you teach. And someone who listens to it can say, “I like these people. This is someone who I would be happy to have helping me in birth.”
Dr. Fox: Or someone’s like, “That’s not me because, you know, they’re not gonna have me, you know, doing the unassisted home,” or whatever it is, they’re like, “They’re not for me.” And sort of people can sort of realize who you are on the front end, which is great. And…
Cortney: We tell people that on the podcast. If you’re liking what you hear, you love our episodes, you’re gonna love our birth course because it’s more of us. Right? And, yeah. It’s fun.
Stephanie: And obviously, the opposite is true.
Dr. Fox: And so how does your course work? Is it, like, back and forth with you guys? Is it just a series of videos? How does it work logistically for people who sign up for it?
Stephanie: Yeah. So, it’s a pre-recorded course. It’s very professionally done. So, we have about eight hours’ worth of course content and we set it up in an eight-week series. So, each class, class one through eight will have several lessons within each one. One thing that we did do is we were very straight into the point. So, there’s no fluff. Like, when we taught our courses in person, it was like, make sure it lasts two hours, have a snack break, do these exercises. And this is like, I think, class one lesson one or two when we’re talking about the reasons why we wanna aim for this kind of nutrition. It’s like less than five minutes. It’s quick. It’s to the point, the information is there. And then we have others that are, like, here’s all the different scenarios that can happen during birth or a vast majority of the most common ones, and it’s over an hour. So, it’s set up to go week by week. We also have a quicker, like, if you wanted to do it all in four weeks, it takes you through how to do that. And then there’s a workbook that goes along with it. You’re given assignments each week, videos to watch, meditations to download, labor rehearsals to do. And then we also put you into a members-only private Facebook group. And it has Cortney and I, we answer questions. We just did a live labor rehearsal the other night. We have other birth professionals including postpartum specialists, breastfeeding, bereavement specialists…
Stephanie: …midwives, so that if you have a question in the middle of the night, you can ask somebody and get it answered.
Cortney: Or if Steph and I can’t answer the question we’ll tag one of those professionals who will know the answer.
Dr. Fox: Right. So, this sort of joined the community that you set up?
Dr. Fox: I would imagine that many, if not most, of the people who are in your course are not ultimately gonna have you guys as doulas at birth. Right? Those are separate…not entities, but they’re sort of separate services.
Stephanie: Right. Well, because they come from all over the world.
Dr. Fox: Right.
Cortney: We’ve got Australia and Canada and just all over the place. So, yeah, we’re limited to who we can do it for.
Dr. Fox: Wow. What’s it like for you guys, I was curious, being on call, being on call at night, this idea, you know, “I’ve got someone who’s due”? I mean, I know what it’s like for me, but what’s it like on the doula side?
Stephanie: It depends. When we were first starting out… I’ll speak for myself. When I was first starting out, it was super stressful. I took my phone everywhere with me, I had it in the shower. I felt like I never slept. I was always checking it during the night. And then you kind of get into this, like, “Okay. The groove of, like, doula work. The fact is, I can be anywhere and have to leave. I need to keep my phone near me, but it doesn’t have to ruin my life. And I can take vacations, but I have to schedule unplanned births around that.” So, as far as that goes, just making sure you have the logistics in place, I’d say is the biggest trickiest thing when we’re moms and we’ve got these little babies at home. But other than that, I mean, that’s what you sign up for.
Cortney: I don’t know.
Stephanie: If you’re not planning for it, then don’t do it.
Cortney: I think something magical happens when you become a parent and suddenly become kind of a much lighter sleeper. We had, my husband and I, four kids and five years, I was up in the night usually with someone, anyway. Even my big kids. I’ve got a teenager now, and he’ll still every once in a while. I mean, it’s rare, but he’ll come in for, “I had a bad dream,” or whatever. So, I don’t know. I’m used to being woken up in the middle of the night. Not a big deal than to take a deal of client calling in the middle of the night.
Stephanie: That’s true.
Dr. Fox: And so I wanna talk a little bit about the podcast. So, you said you had your anniversary in June, right? So, it’s been a year and change. And how has your listenership grown? Where did it start? Where are you now?
Stephanie: It started off really slow.
Cortney: It’s been very organic.
Stephanie: Yes. Yeah. I’d say a couple of months in we had like 150 listeners, maybe 200.
Cortney: We were so excited about that.
Stephanie: We were so excited.
Dr. Fox: It’s nice. I mean, it’s flattering that 150 people give a crap about what you’re saying. Right? That’s nice. You go on a room, you never have 150 people listening to you.
Stephanie: That would be amazing. That’s right. Yeah. No. And then I think, you know, we did place at the beginning of the podcast and we started asking listeners, you know, “If you’re liking what you listen to, will you please help us to grow this channel by leaving us a review?” because that’s kind of how the analytics for that work. And so we started…
Cortney: And share it with friends.
Stephanie: Yes. We started getting some reviews, we talked about it, and included stuff on our Instagram and it did really start to grow organically and now we’ve got, you know, over 130,000 downloads and thousands of listeners. And we’re number one for unmedicated birth on iTunes and we’re pretty high up there for pregnancy and birth. So, it’s been a really neat experience watching it grow.
Dr. Fox: That’s really cool. And then how do you just choose your topics?
Cortney: A lot of times it comes in through requests. We’ll ask on Instagram, will pop on there on live or on stories and say, “All right. You guys really loved our… We had a circumcision episode that was really popular because we presented the pros and cons, but what else do you guys need help with? What do you wanna hear about?” And so we try to listen to what our audience wants to hear about and we honor those requests and record a lot of episodes on those topics.
Stephanie: Yeah. And then if we’ve had anything recent, like, I know like things that sparked me or ideas for us will be like recent births that we’ve attended or questions that we’ve taken from our Facebook members-only group. When things come up that we’re like, “Oh, we need to talk about this with a greater audience,” that’s kind of where those come from.
Dr. Fox: Right. And obviously, this is…it’s great information and it’s good advertising for, you know, your course. But what about the podcast do you enjoy the most? What is the fun part of it for you?
Cortney: Oh, my gosh. The reviews light me up. If I’m having a rough day, right, because I think we mentioned we both homeschool our kids. Stephanie works another job. We’re busy women. And there’s times where it can all feel a little bit overwhelming. And why am I doing this? Why did I add more to my plate? And then you get a review on that podcast, you know, on iTunes and you just go, “Oh, my gosh.” It’s women saying, “This has been so helpful. I went from feeling afraid and worried about paying or not sure what this would look like to feeling so excited and empowered and… Thank you so much. These episodes have changed my life.” How can you not feel good about that? How can you not wanna keep going and helping?
Stephanie: That’s my emotional partner speaking. I’m over here like, because I love to talk. I’ll talk all day. And then we get to do it for professional purposes and talk about birth. Sign me up.
Cortney: We are two women who love to talk, so it’s easy to do.
Stephanie: It is easy.
Dr. Fox: Is it amazing, though, that just the idea that you could speak for 30 minutes, 40 minutes about a topic you know a lot about, you don’t have to sit and research it, it’s interesting, you would talk about it hanging out at the beach or whatever it is. But just the fact that there’s such yearning for people to listen to it it’s almost like, “I can’t get this elsewhere,” or, “I don’t know where to find it.” It’s just remarkable that it’s not easier to find good information out there. It’s unbelievable.
Stephanie: Oh, totally. I think that’s what blew us away. We were like, “We have 150 people who care about what we’re saying for 30 minutes? Wow.” I guess that is kind of cool.
Dr. Fox: It’s really cool. And now, Stephanie, I wanted to just veer off to the side for one second. You just completed a marathon. Is that correct?
Stephanie: Yes. Yes, I did. Biggest thing of my entire life.
Dr. Fox: Tell me about that. First of all, what… I’ve done them before. I think it’s awesome. So, we’re gonna talk running for a second. So, what made you do it? How do you train? What was your experience like? This has nothing to do with childbirth. I’m just curious.
Stephanie: Yeah. No, that’s fine. In fact, we just did a podcast how we related it back and forth. It’s something that you hear…
Dr. Fox: I listened. And I think you’re…
Stephanie: You did. Okay.
Dr. Fox: Yes. Yes.
Cortney: There was a ton of similarities.
Dr. Fox: There were a ton of similarities.
Stephanie: And we were told, like, in our trainings and stuff, like, it’s like running a marathon and all this, which is great, but I didn’t have the, like, actual… That’s not why I ran it, though. So, last year, I decided to run a half marathon. And I was just doing it as, like, a challenge for myself, like, I wanted to challenge myself in one part of my life. I knew I could do the physical. And the idea was that it would bleed into everything else, which it totally did. And so when I did that half marathon, which I’d never run over six miles before in my life, and I’d only done that once. When I hit that goal, I just started crying. Like, over the finish line, I was like, “Oh, my gosh. I set out to do this, like, really hard thing and I did it.” And then kind of joking that like this year when I was training for this marathon that I ran a half marathon as just part of the training like five or six times. I was just running half marathons. I mean, it was crazy because when I did that at the end of last year, I couldn’t believe I had run that much. And then I just doubled that this year. So, it was really powerful. And I think… I mean, if you wanna relate that to birth, just the mental state that you have to be in or the mental push that you have to give to allow yourself to be pushed a little further to go a little further, it’s incredible what your mind and body can do. So, it was a really powerful experience.
Dr. Fox: Right. And people usually underestimate their capacity for what they can do.
Dr. Fox: I mean, a marathon is one of those things you’re like, “How on earth would I run 26 minutes?” And you can take someone who’s never run before. And again, it’s just baby steps. If you can get yourself to run a mile, then you can run three. And if you can run three, you can run six. And if you can run six, you can do half marathon. And anybody who ran a half marathon, unless they injure themselves and can’t run, they can run a marathon. It’s absolutely true. It’s just… It’s a matter of pushing yourself and pushing yourself and taking the time. It takes time. But it’s in training. That’s amazing. Good for you. And how did it go? Was it like… When you finish were you just totally flabbergasted?
Stephanie: Yeah. I was amazed. And if you heard the episode, I was mostly amazed because I got an injury about 18.5 miles in that I’d never experienced before. I had some pain with my IT band and we limped for like a mile and a half. And so yeah, when I crossed that finish line, it wasn’t just the emotional like, “Holy cow, I did that,” but it was also the physical, “I can’t believe I pushed my body to do that.” And I still have a limp and I’m totally fine with it. It’s like that’s cesarean scar. You’re like, “I did that thing. I earned that.”
Dr. Fox: That’ll go away. The last marathon I ran, one of the New York City ones, I tore my groin muscle at mile four.
Cortney: Oh, my gosh.
Dr. Fox: Yeah. So, 22 miles of literally like ouch, step, ouch, step, ouch, step for…
Stephanie: Oh, my gosh.
Dr. Fox: It was pretty horrifying, but I trained for 18 weeks with a buddy of mine and I’m like, “I’m finishing this. Forget it.” And I’m in the middle of Brooklyn and it’s 40 degrees out and if I stopped I might drop dead, so I have to get out of here. And my ride is in the city, so there really wasn’t a choice, anyways.
Stephanie: Oh, my gosh.
Cortney: Well, good for you, because I stopped running when I hit 40.
Dr. Fox: Oh, it’s all good. I’m so happy you guys came on. I’m happy to do what you do. I’m happy you two exist and doulas exist. I think you guys are awesome. And I have looked at your website and what you’re offering. I didn’t take your course, but obviously, I think your course would be amazing, and that’s My Essential Birth, which is your website, myessentialbirth.com. And then I’ve listened to your podcast, I think it’s fantastic. Anyone who’s interested in childbirth, either you’re gonna go through it or you’re in the middle of it or you’ve had it and just curious and that’s the “Pregnancy and Birth Made Easy” podcast. And it’s just fantastic. Thank you so much for coming on.
Stephanie: Thank you so much for having us.
Cortney: Thanks, Dr. Fox.
Stephanie: It’s been a pleasure.
Dr. Fox: Dr. Fox. Yeah. Okay. You can call me Nat.
Cortney: Nat. Nat. Thanks, Nat.
Dr. Fox: 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 us to address, please feel free to email us at email@example.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.