Preparing for Labor & Birth: Why Women Who Prepare For Birth Do Better In Labor. -with Michelle Collins, CNM

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(With Dr. Michelle Collins, CNM, Vanderbilt University) How well women do in labor is directly connected to how well they prepared for birth. And it’s downright fascinating. It dates back to the ‘early days of man’ & how we all handle fear.

After nearly 30 years delivering babies, Dr. Michelle Collins has a few insights into how & why women are happy with their birth experience. And when & why they are not.

“I love to see women come in telling me what they would like & questioning what they’ve been told or read” says Michelle, “It’s like anything in life, If you know what to expect you won’t have the anxiety.”  (tweet that quote by clicking here)

Michelle shares why being unprepared can lead to fear. Which can stall labor. Which can make everything more complicated. She explains the science behind “fear of birth” & how it shows up in your body. For example…

Fear comes from questions not askedLet’s say you’re laboring and fear trickles in. Instantly your hormones kick in like Bruce Lee. Your adrenaline gets pumping which means that more blood is going to your arms & legs instead of your core (back in the day this enabled you to flee the Saber Toothed Tiger and thankfully prevent you from having your baby mid-stride, at least until you’re nestled again safe & sound from that dadgum tiger.)  These are known as your Stress Hormones & your body’s Fight or Flight Response.  

With less blood & oxygen being pumped to your core, labor often slows & can stall (during medicated & un-medicated births), which brings more pain (your uterus is contracting its muscles…it needs blood & oxygen to flex efficiently- just like your leg muscles when you run) …and a hot flash of fear into your Preggo mama world.

A Fear-Pain Cycle results. It’s predictable. Providers say they see it all the time (this is why so often labor stalls out when mamas show up at the hospital- stress hormones react to the new environment, different people, things moms see, hear, feel, etc.)  And few people actually teach you to understand, respect & acknowledge fear’s power on your body, then how to kick it in the balls {with pointy toe heels of course} :)  

Well guess what…You can easily prevent this whole fear-pain cycle thing from kicking in. Watch this interview with Michelle Collins to learn how. 

You’ll  Also Learn:

  1. What easy steps you can take to prevent fear of birth & be fearless (which helps throughout your mom career…big time)
  2. Why and how to do it…
  3. Why Dr. Collins, a medical insider who’s helped 1000′s of babies come into this world, wishes “women would just acknowledge their power”.

 Who is Dr. Michelle Collins?

Dr. Michelle Collins lives in the ‘Good ole’ Rocky Top’ state of TN with her husband and 2 boys. Michelle’s kind of a big deal and a total bad a$$: Labor & Delivery Nurse for 17 years, Certified Nurse Midwife for 10 years, is a Ph.D. and is a Professor at the Vanderbilt School of Nursing.  Most importantly, she DEEPLY CARES about helping expectant moms get educated & have the best birth experience possible. We’re all very fortunate she’s willing to share her experience with us! 

  Listen to the Interview(this interview is Audio Only)


What do you think? Share in the comments below…




Michelle Collins

Preparing for Labor & Birth: Why women who prepare for birth do better in labor. 



Steve:              Hi everybody, it’s Steve at Your Baby Thanks for listening to our video today. You know what we do here? We talk about – We talk with experts, moms, and dads to help you learn what they wish they would have known so ultimately, you can make better decisions faster along your journey with pregnancy, birth, and adoption.


                        Today, we’re going to talk to Michelle Collins from Tennessee. Michelle is an expert and a mom. She’s been a labor and delivery nurse for 17 years and has also been a certified midwife for 10 years. So she has almost 30 years delivering babies. She’s delivered close to a thousand babies, and she’s also married to Rich. She has 2 boys and she’s just about to also get a PhD. So we’re pretty sure she knows her stuff.


                        Michelle, thanks for coming out with us today. We appreciate your time.


Michelle:         Okay, thank, and just one thing I’d say I’m a certified nurse midwife only because there’s a difference between certified midwife, certified professional midwives, and certified nurse midwives.


Steve:              Oh wow, okay. I didn’t know that.


Michelle:         Yeah.


Steve:              That’s good to know. So the topic we’re going to talk about today, is there a connection between women – how women do in labor and how well they are prepared for the labor? The answer is yes, and today, our audience, you’re going to learn why. Maybe we’ll start with a quote Michelle. We’ll kind of just jump right in.


Michelle:         Uh-huh.


Steve:              And this is a quote that you and I talked about before the video recording started here. This is something that you said. You’d love to see women that come in and tell you what they would like and question everything they have been told and everything they’ve read. Why is that?


Michelle:         Well, I think it shows me that they put time and thought into their pregnancy and their birth, and you know, nobody is a better advocate for you than you are. So you have to be the one to do your homework, and look into the choices that are available. I love it when women challenge the status quo and they ask the questions about what’s going to happen and what sort of tings – they’ll tell me what sort of things they want. And in our particular practice, we make a birth plan with our patients.


Steve:              Uh-huh.


Michelle:         Now some practices in some hospitals you going to, when you say the word birth plan, they’re going to run screaming from you, right?


Steve:              Why is that?


Michelle:         Well, I think because it implies that that woman has this control, this element of control, and that’s not what we want to see in institutions, right?


Steve:              Uh-huh.


Michelle:         You know, we’re in control and you’re the patient, but that’s just so contrary to what it should be. It’s your birth, and you should be in control, and we’re just there to facilitate the choices that you’ve made. So that’s why I’d really like to see women asking because I know that they’ve read, and they know what their choices are, and they’re asking for my input as far as maybe recommendation or suggestions, and so help them achieve what they want, but again, I’d say nobody is a better advocate for yourself than you are, so you have to, you know, take the responsibility and ownership of that.


Steve:              Got you, okay. That makes a lot of sense. No one’s looking after you better than you.


Michelle:         Uh-huh.


Steve:              At the end of the day. In your experience, what is being prepared, what does that really mean?


Michelle:         Well I think, for me, especially with media the way it is now, it used to be taking a childbirth class, and I taught childbirth classes for about 10 years, and now they’re so much more available. When I first see a patient, I give her a list of books that are good to read, and one of them is Active Birth by Janet Balaskas. Another one is Gentle Birth Choices by Barbara Harper.


                        And I point them in the right direction of books because if you look at the New York Times bestseller list for books about pregnancy and birth, at one time, we learned the books on bestsellers list about pregnancy and birth were written by former playboy bunnies.


Steve:              No way.


Michelle:         So you know, what’s out there is not necessarily quality, so I like to sort of point people in the right direction. You know, some of these books – In one of my courses, we have our students, they each have to take a book and evaluate it, and some of these books are just perfect in what they present to women. So I tell them to read books. I encourage them to go to childbirth class, to attend a breastfeeding class prenatally, and to just network with other mothers. And there are so many different childbirth education methods.


Steve:              Uh-huh.


Michelle:         I also tell them to Google and do their homework on different childbirth methods and see which one might appeal to them because what appeals to you and to pregnant couple may not be what appeals to the next couple.


Steve:              Yes.


Michelle:         So again, the responsibilities on them, I’ll point them in the right direction of where they can find different childbirth educators, but they really need to do their homework as to what appeals to them.




Maybe Bradley speaks to them, the Bradley method. Maybe Lamaze, maybe hypnobirthing, you know. There’s not one thing for everybody.


Steve:              Uh-huh.


Michelle:         So that’s what I really think that is being prepared. And it’s kind of a sad thing to see what the literature says these people are not going to childbirth classes much anymore. It is going down.


Steve:              Uh-huh.


Michelle:         And I suspect that’s because there’s so much interaction online so forth that maybe they don’t feel the need to go out to go to class…


Steve:              Yeah.


Michelle:         …but they’re sort of mixing that what they can learn from others, you know.


Steve:              Uh-huh. What are some examples of women who I guess the babies you delivered or you’re just interacting with or helped out in some way, what is kind of the gambit of their experience with preparation? What was the outcome of their birth experience?


Michelle:         Well, on both ends of the extremes, I can’t think of just one patient. It’s sort of had been generalized.


Steve:              Uh-huh.


Michelle:         Women who are not prepared at all who come into this, they have no expectation or no – Really, no sense of what labor is going to be like at all. It’s almost like they can become – Sometimes they sleep curled up in a fetal position in the bed, and they’re just overstimulated by everything in the room, and it’s so frightening to them when – And that’s a really sad situation to see…


Steve:              Yeah.


Michelle:         …because if they understood what was going on, they would just be so much better.


                        On the other end of the spectrum, I have patients who come in and they know – they’ve been prepared by a childbirth method, and even as long as I’ve been doing this, I should know better than to look at a woman and sort of guess what stage of labor she’s in, but once a while, I’ll have somebody come in, and they look pretty comfortable, and I’ll be thinking nah, they’re probably not in labor, and I’ll check them, and they’ll be like 8 cm. Maybe they’re doing hypnobirthing or some other type of childbirth method where they’re so in control…


Steve:              Uh-huh.


Michelle:         …that it doesn’t even show that they’re in transition. So those were sort of the two extremes.


Steve:              And that’s fairly typical you would say for – It’s pretty consistent that those who prepare in some ways, shape, or form are much more prepared to kind of deal with the uncertainties inherent in, you know, just birth. Obviously, you can’t script it to go exactly in what way you want, but those who are, you know, more unprepared more times or not, are the ones who have the challenges.


Michelle:         I would say so like anything in life, if you know a little bit about what you go into, it’s just going to make a bubble of things just for you.


Steve:              Yeah.


Michelle:         So if you know a little bit about what to expect, you’ve seen a few births on TV, you have videos, or you know a little bit of what’s coming, your fear factor goes down.


Steve:              Okay. What are some of the little things – Are there any little things that you could kind of tell our audience that you just observed through your three decades worth of your expertise in the hospital and in the delivery room, things that moms do just really just kind of help them, you know, get through all those times? Are there any small nuances that aren’t, you know, taught in the traditional classes?


Michelle:         Well I’d say be flexible for one thing because as you said, you never know how things are going to go.


Steve:              Uh-huh.


Michelle:         So plan for the best and make your birth plan – Be flexible in that birth plan because I’ve seen people be disappointed when things did not go exactly how the birth plan said it was going to go.


Steve:              Uh-huh.


Michelle:         So plan and hope that it goes that way, but just have flexibility built into it. That’s one thing I would say.


Steve:              Okay.


Michelle:         The next thing is know your options. You know, I often tell my students and other people that my least favorite place to be is sitting in the baby shower because inevitably, I’m sitting by a pregnant woman. The last time, I was sitting between two pregnant women, and they were both talking about when they’re going to be induced, and you know, I’m trying to sit there with my mouth shut. Don’t say anything. And it just makes me crazy because, you know, women buy into whatever is sold to them and I want to just shake them and say, “Do you know how dangerous that is just to be induced electively for no medical reason at all?”


Steve:              Uh-huh.


Michelle:         So women just sort of buy into things sometimes, and I think, you know, they just do themselves such a disservice, and the whole movement of elective cesarean is a whole other thing where women feel like they’re being empowered when actually, the power is being taken away from them. They feel like oh, I’m empowered. I can choose the day my baby is born, but they really let somebody else have the power over them is what it’s come down to. So that’s one thing, be flexible.


                        Another one of your options, using all the tools available to you that are non-pharmacologic in movement. Knowing that intermittent fetal monitoring is a standard of care, not continuous monitoring.




Now in most settings, they’re going to put the monitor on and then leave you there on it, but that’s not the standard of care for low-risk women. So if you knew that going into that, you would be more empowered to say, “Hey, listen, I know we’re low risk. We don’t need that monitor on the entire time we’re in labor,” and that sort of thing.


Steve:              Uh-huh.


Michelle:         Hydrotherapy. We got the shower available or a bath available. The birth ball. Taking you to the birth ball, your music. Music is so therapeutic. Aroma therapy. Having all these – I call it your tool bag – all these things with you just sort of lend you support and increase your endorphin release. It’s really, really important.


Steve:              Okay. Well, it seems a lot of moms, you know, you kind of mentioned it, would think that, you know, I don’t want to prepare because if I prepare and spend all this time and build these perfect expectations for this perfect day, perfect time, I’m just setting myself up for disappointment, and I’m choosing not having the probability of being disappointed overpreparing, what would you say to that?


Michelle:         Well we know that the great majority of the time, birth is normal, right. So you plan for the best most of the time. That’s what happens. If you don’t make any plans at all, then again, you turn that power over to somebody else to make those choices for you, and sometimes, those may not be the best choices.


Steve:              Uh-huh.


Michelle:         It may not be what you would choose if you knew better, and they certainly may not be the best choices overall.


Steve:              Okay. That makes sense. You also mentioned that for example, being induced, is fairly typical now that you schedule the baby being born, it’s like you schedule whatever, you know, haircut or whatever. Why is that done on the institution side or – We’ve kind of talked about the mom side why should kind of want to do something other than that? Why is that done on the other side or what’s the perspective that, you know, on the flip side?


Michelle:         Well, obstetrics has become a 9 to 5 business when it never was. I mean we’re not like dermatology, or you know, any other specialty that can be taken care of from the hours of 9 to 5, and for some reason, those in this profession have sort of moved towards that mentality and thinking that, well we can induce everybody during the day, and if they’re not done laboring by 5 pm, they get a section. In that way, they can go home and eat dinner with the family and sleep all night and get up and do it all over again the next day.


Steve:              Okay.


Michelle:         But obstetrics is never meant to be that way.


Steve:              Uh-huh.


Michelle:         You know, I tell my students who complain that, you know, they’re up all night. They’re tired being up all night. I’m like you probably should choose a different profession because you’ve got to work weekends and holidays and nights, and babies come whenever they come. You know, it’s really – There’s a good movement across the country now to stop elective inductions of labor prior to 39 weeks because there’s very good data to show that babies who come at that point that they can have problems with respiratory distress. So even though you’re term at 37 weeks, there’s good data to show that babies born on elective inductions, 38 weeks, 38-1/2 weeks, 37 weeks, those babies can have problems with respiratory distress and have longer nursery stays and so forth. So at least at Vanderbilt, we’ve been really working very hard to decrease any elective inductions prior 39 weeks.


Steve:              Okay. And that was my next question was what is – Thinking about the source of – You mentioned the 9 to 5 obstetrics, what’s taught in the school? You know, what’s kind of taught to the new leaders and the doctor and midwifery community to kind of, you know, foster that to change that? Is there anything kind of – Is the being mirrored in the institutions in terms of what they teach or…?


Michelle:         I think it is. It’s in the literature. So any respectable institution that teaches medical students and midwifery students should be keeping up with what’s in the literature. I mean we all want to practice evidence-based care.


Steve:              Uh-huh.


Michelle:         So I think that’s being taught at least I know here it is at Vanderbilt, and there’s a movement across the country. As far as inductions in general, many practices – and I can use ours as an example – there’s good literature that show that up to 42 weeks of pregnancy, especially with appropriate surveillance during the pregnancy that a baby is safe in utero, and so, we give our patients the choice at 41 weeks, you know, if their cervix is right, if they want to pursue with induction they could, but they could also keep going 42 weeks.




And you know, if you let moms have that freedom to go 42 weeks, you do very few inductions because most women will go into labor on their own.


Steve:              Right. The body performs as it was intended to perform.


Michelle:         Yup.


Steve:              Okay. Okay. So here’s a big question. This is something I think everybody faces fear, the fear of the uncertainty in birth. How does fear plan to – How does it directly plan to being unprepared, or you know, what happens where if you become fearful? How does that play out in the birth scenario?


Michelle:         Well, it can be tragic results because when we’re afraid, we produce our stress hormones: the catecholamines, adrenaline among other stress hormones, and so when we’re very fearful or very stressed, our body can’t do what it’s supposed to do. And so women can actually stole out from labor or stop for progress just because of how afraid she is. And then, you know, you talked to me before about fear, tension, and pain cycle…


Steve:              Uh-huh.


Michelle:         …so when Grantly did wrote about that in the 1940s…


Steve:              And who was – Sorry to interrupt. Who was that?


Michelle:         His name is Grantly Dick-Read.


Steve:              Okay.


Michelle:         The last name is hyphenated, and he is one of the first people that ever wrote about this phenomenon, but especially about childbirth preparation, and he coined this Fear-Tension-Pain cycle, and he said, you know, the more – What he observed, he observed a lot of women labor, and he said, you know, the more afraid they are the more muscular tension he saw in them. And so the women who are really afraid were the ones that we say are white knuckling it. You know, they’re holding on to the side of the bed. Their knuckles are just white from squeezing the side of the bed.


Steve:              Okay.


Michelle:         And then the more muscular tension they had the more pain they also exhibited when you ask them what their pain was on the pain scale or they were the ones asking for more pain meds, and then the more pain they had, the more afraid they became.


Steve:              Yeah.


Michelle:         So it was just the cycle.


Steve:              Cycle, yeah.


Michelle:         Yeah. And so, with childbirth prophylaxis with – they’re called cycle prophylaxis – preparing for childbirth. So we can sort of hit that fear-tension-pain cycle in all the places. So for the fear part, preparation ahead of time.


Steve:              Okay.


Michelle:         So that would be reading, talking with other mothers. Sometimes it’s not as helpful talking to other mothers because if they went through the induction, the blah, blah, blah, sometimes they scare the crap out of you, right? So preparing can help with the fear part. Tension. That’s where all your childbirth and methods like guided imagery, relaxation exercises, breathing that’s where that comes into play. They can relax your muscles. And then the more relaxed your muscles are the less pain you feel, so then the less pain you feel the less afraid you are.


Steve:              Yeah.


Michelle:         So you see, we’re sort of breaking up that cycle.


Steve:              Okay. Yoga. I’ve heard quite a bit about, you know, yoga. Any thoughts on that? All the moms you’ve been in contact with, is that – The folks who participated in that, is that helpful?


Michelle:         Yeah, I think it’s awesome. You know, it loosens up a lot of the muscles that you use in childbirth, makes you more limber, and remember this one woman in labor who put her foot up behind her head I was amazed.


Steve:              Awesome.


Michelle:         Yeah, she put her leg up behind her head, it was awesome, but it does. Any exercise that they did that’s appropriate for pregnancy like walking, the fast walking and swimming are two of the best exercises, but anything that you do to physically prepare is going to be your benefit no doubt.


Steve:              Okay, okay. You mentioned that as labor slows, fear induces the hormones catecholamines which induce or it can slow labor. What’s the why behind that? How does that – Why does that work or how does that work or why does that actually slow the labor?


Michelle:         Well, it’s sort of an evolutionary type of response so that back in the caveman days, when you were being chased by a sabertooth tiger and you were in labor, you wouldn’t have to stop and have the baby and get eaten by the sabertooth tiger. You could find the nearest cave.


Steve:              Okay.


Michelle:         So your labor is solved.


Steve:              Yeah, that’s a good thing.


Michelle:         So – Yeah. So what happens when you’re afraid or you’re angry or you’re under stress is that you release adrenaline, right?


Steve:              Uh-huh.


Michelle:         And to be in labor, to have contractions, you need the hormone oxytocin.


Steve:              Okay.


Michelle:         So oxytocin and adrenaline, if you put them side by side, adrenaline will always overpower oxytocin. So very often, how I see it manifest is that a woman will call me from home and she’ll say my contractions are 3 minutes apart, and we’ll meet together at the hospital, she gets on the monitor, and they’re 5 minutes apart. She says, “I swear, at home, they were 3 minutes apart.”




Steve:              Uh-huh.


Michelle:         And I totally believe her. It’s just that she’s so nervous…


Steve:              Yeah.


Michelle:         …excited that her adrenaline has now overtaken.


Steve:              Interesting.


Michelle:         So as soon as she’s settled in and relaxes and get in the tub or the shower, whatever, then her adrenaline will decrease, her oxytocin will kick back in.


Steve:              Okay. And that’s good for audience as well that whether that you envision a medicated or unmedicated birth, the takeaway is that we’re all human, and once those catecholamines kick in that your adrenal gland starts pumping that, you know, for survival reasons that has a tendency to kind of tromp anything that can happen.


Michelle:         Uh-huh.


Steve:              Okay, interesting. Thanks for kind of explaining that a little bit more. What about questions? You know, it’s easy to whether it’d be, you know, rolling into the labor and delivery room and wanting your nurses and your doctors to kind of take care of you and do everything or reading a book and think okay, I got it. You know, do you think expectant moms ask enough questions? Do they really kind of drill down and understand, you know, what the different options are and what the whys behind those options are?


Michelle:         I would say many of my patients do ask the right questions and enough questions, but many also don’t.


Steve:              Okay.


Michelle:         Sometimes at the end of appointment, I’d say, “Any questions?” And, “No.” I’m thinking wow, this is one of the biggest moments of your life. You’re getting read to prepare for it. You know, I would think maybe you might have some more questions, but you know, sometimes, it’s because they had two or three babies, and they know exactly what to expect, and they really don’t have any questions.


Steve:              Yes.


Michelle:         But the first-time moms especially, you’d expect them to have questions. I think what the midwifery model of care, because it’s such a relationship type of base model of care, we spend a lot more time with our patients and so we have more time to talk with them. You know, physicians are usually also trying to juggle surgery schedule and things like that, and they may schedule more in their day than a typical midwife does so they may not have that same time to sit down and talk with patients.


Steve:              Okay.


Michelle:         But when I was a nurse and now a midwife, I certainly remember seeing patients, you know, the docs go in, a few minutes would come out, and the patient never asked one question. You know, they’re just so snapped by that.


Steve:              Yeah.


Michelle:         Yeah.


Steve:              Okay. Being prepared, is it something to kind of be achieved and is it kind of a feeling that you just feel like you’ve done all you can do or is it something that it’s more of, you know, an ongoing approach that starts at some point in time, or you know, is it something that you can just kind of achieve and you’re ready to give birth or is it just, you know, getting kind of a mindset or approach?


Michelle:         I think it is more of a mindset because you never know when you’re prepared enough, you know.


Steve:              There’s always more, yeah.


Michelle:         You know, there are more classes to attend. I think that as a base minimum, you know, people go to childbirth at course, and I recommend the breastfeeding class to everybody because, you know, in this country, breastfeeding – that’s a whole another topic too – is just way underdone, and you know, a smaller group percentage of women initiate it in our country than any other country, and then, by 6 months, we have horrible breastfeeding rates, you know, of birth women who are still breastfeeding at 6 months.


                        So we need to do a much better job on the front end of helping women, helping them get started, helping them know how to position the baby, and all that sort of thing. So taking those classes I think at a base minimum, doing your reading, and then coming with your questions each time to discuss with your practitioner. And you know, we get a lot of patients who transfer at the end of pregnancy into our practice, and it’s funny because it coincides with about the time women are starting to ask questions about their birth to their provider. And so they might sit down with their provider and say, “You know, I’ve been reading about labor and birth, and you know, I really would like intermittent mind training, and I really would like to use a tub, and I’d like to give birth on my hands and knees if that’s okay.”


Steve:              Uh-huh.


Michelle:         And so then the provider says, you know, no. I’m not going with any of that. So then the woman transfers out and she’ll find her way to us. It’s good that women do that, but it’s late.


Steve:              Yeah.


Michelle:         That’s late in the game to be asking those questions.


Steve:              Uh-huh.


Michelle:         Those are questions you want to ask at the front end when you go meet your provider. What is your cesarean rate? Oops, what is your practice of cesarean rate?




                        That’s a key question to ask.


Steve:              Say that one more time. What is your…


Michelle:         Cesarean rate.


Steve:              Okay. I’m sorry, you say…


Michelle:         So practice that you’re going to, yeah.


Steve:              Okay, practice cesarean.


Michelle:         I mean your provider should be able to tell you what their cesarean rate is.


Steve:              Okay.


Michelle:         In this country, it’s around 32%. Internationally, midwives tend to have a cesarean rate around 10%. So that’s one big question. Also, how often do you cut an episiotomy? You know, the surgical incision at the bottom of the vagina to open it, which really has no good signs of basis any longer from all the research that’s been done over the years.


Steve:              Uh-huh.


Michelle:         Only do it when it’s medicated, but it’s far overdone. So that’s another question I would ask. Just full of logistic questions even at your first appointment about how you want your birth to go.


Steve:              Uh-huh.


Michelle:         You know, when I’m in labor, I would like to use intermittent monitoring. I’d like to use my birth ball, be out of bed. I’d like to be in the shower. I’d like to, you know, all these things [0:26:03] [Indiscernible]. Feel out your provider…


Steve:              Right.


Michelle:         …to see if they’re going to support you.


Steve:              Why wouldn’t a provider support you if you want these – you know, assuming there’s no inherent, I guess, you know, it comes down to risk, how you define risk, but – I don’t want to put words in your mouth, you know. Why wouldn’t providers support some of those…?


Michelle:         Things? Those things?


Steve:              …things, those desires, those – yeah.


Michelle:         Birth has become really medicalized in this country, for instance, when I mentioned monitoring before.


Steve:              Uh-huh.


Michelle:         The standard of care most women don’t realize is it’s for low risk women in labor to have intimate monitoring meaning in the first stage of labor [0:26:44] [Indiscernible] every 30 minutes so their baby do a contraction and then we take the monitor off, but it’s so much easier to strap that monitor on and leave it there, isn’t it…


Steve:              Uh-huh.


Michelle:         …and just go out of the room, and all the rooms are usually centrally monitored where the nurses could see at the nurse’s station. So it’s much easier for her to watch what’s going on out there than to be at your bedside and to be taking that off and on, and off and on. So that’s one thing. And I think it’s that medical model, maternalistic model of we know best because we’re the experts, and you might think you know best because you’re the parent to be, but we really know best, and so let us tell you how it should be.


Steve:              Uh-huh.


Michelle:         And that’s just really contrary to what it should be.


Steve:              Uh-huh. Interesting, yeah. How many – It’s interesting because you’re a mom and because you started with labor and delivery, and now you’re – You know, you have 7, almost 10 years of this side of it, doing this side of it. Do a lot of women in your position who are also moms kind of share these beliefs you’re talking about or is it…? Are people so whether institutionalized, whether it’d be the medical profession or any profession, it’s easy to become institutionalized if you’re around it. Do they kind of also share this kind of growing desire and movement to teach moms their options are much more than those to really ask for?


Michelle:         Well I think there’s a difference in providers between physicians and midwives, and our philosophy as a midwife is that birth is normal. It’s not a disease. And if you look at it that way, you will treat it in that way. In other words, we don’t want somebody who’s normal will always be hooked up to a monitor. There’s no need for her to be that continuously because this is normal.


Steve:              Uh-huh.


Michelle:         You know, women should be able to eat and drink and labor. It’s not a disease where we should restrict that from them. They should be able to give birth in what position is comfortable to them, not to me as a provider.


Steve:              Uh-huh.


Michelle:         So it’s really a matter of philosophy. So if you would ask midwives how they feel about birth, you’re likely to get similar answers to what I’m saying. Now, I’m not taking anything away from positions because they have their expertise…


Steve:              Right.


Michelle:         …but their expertise is in the abnormal. Now in other countries where birth statistics are much better than ours here in the United States, we barely make the top 40 for how good of outcomes we have for mothers and babies at birth. People think because our health is very extensive that we’re up near the top for outcomes, and that’s not true.


                        So in places like Sweden and the Netherlands, in the United Kingdom where midwives attend the majority of birth, and the physicians attend the cesareans, you have much better outcomes, and that is probably mostly because of that philosophy that we believe birth is normal, and so we treat it like it’s not a disease.


Steve:              Okay.


Michelle:         Does that answer it?


Steve:              No, it does. I mean it’s…




Experts who train in different ways, and again, yeah, we’re not her to bask physicians.


Michelle:         Right, right.


Steve:              It’s a different skill set used for a different need, of you know, how do you want to say, those have their place.


Michelle:         Exactly.


Steve:              Okay, interesting. Is there any one thing you’d like to – Any one piece of advice you’d like to give our audience? There’s a lot you could say and would want to say. Is there any one you’d like to kind of leave them to take away, encourage them to do?


Michelle:         You know, I think it would be just in general to not be afraid, you know, that it’s such a miraculous thing, labor and birth is.


Steve:              Uh-huh.


Michelle:         I mean I’ve been doing this for a long time, and I still love every birth in that it’s so miraculous that our bodies can form a child, and can give birth to a child, and then nourish the child. It’s miraculous every time I’d see it. And so women need to acknowledge that and recognize what a great thing it is they’re doing, and what power they have as women.


Steve:              Uh-huh.


Michelle:         You know, that’s just an awesome thing. If you was a man you can’t do that.


Steve:              Yeah, right.


Michelle:         It’s an awesome thing…


Steve:              Yeah.


Michelle:         …to just have a life growing inside you. And so if women would just acknowledge their power – I have a shirt that one of my midwife students sold last year. I think it says – Oh gosh, what does it say? Oh it says, there’s a secret about childbirth in America. It’s not that birth is painful except women are strong. And I love that because it’s like that is the secret, right.


Steve:              Yeah.


Michelle:         Women just don’t feel that they can do this.


Steve:              Yeah.


Michelle:         And you know, 99% of the time, you know, it’s all about what she thinks she can do.


Steve:              Uh-huh.


Michelle:         You know, in women who told themselves I can do this, you know, I’m strong, I can do this, they did so well.


Steve:              Uh-huh.


Michelle:         But the women who come in and say – are already defeated and say I can’t do this, I know I can’t do this.


Steve:              Yeah.


Michelle:         They’ve already defeated themselves, you know.


Steve:              Yeah. This is an interesting distinction that my wife and I talked about, and we certainly agree with you that there’s so many things in life that your mind controls and empowers you to do, but something is very unique to birth is that you – As an athlete, you train, train, train so you can grind, grind, grind. Well on this birth, you train, train, train so you can totally submit and get out of the way, and not be the biggest constraint. You use your mind to empower yourself to not let your mind become a constraint, which is just kind of interesting, you know, visual that’s just so different, and maybe it just kind of speaks to the beauty of uniqueness of birth in general.


Michelle:         Yeah.


Steve:              But it’s amazing, you know. I’m only – Geez, I’ve only been kind of researching some of these different ideas or topics for a few months, and it is incredible what – You know, as a kid growing up, it seems like everyone, you kind of see that miracle – the miracle of birth, but when you’re really just look at what happens, just like you said, you can see, you grow, and you – I mean it’s just – The expectation – There’s going to be some discomfort. There’s going to be, you know, you expect that and go into it knowing that. You know, clearly, I haven’t done it, but it’s – You know – Again, it’s very cliché, but nothing in life that’s amazing comes just super easy, you know, and…


Michelle:         That’s it. And their sense of accomplishment, when you work through a labor of birth is just tremendous. You know, it gives women such empowerment that they’ve done that. And for me, it’s just like being in awe just watching women do that.


Steve:              Uh-huh.


Michelle:         And sometimes, when I’m rounding up postpartum mom, I’ve come across a mom who’s having difficulty breastfeeding and they’re worried about they don’t have enough milk or they can’t lactate, you know, did you grow this baby? Yeah. Did you give birth to this child? Yeah. And so what makes you think that you also cannot nourish it?


Steve:              Right.


Michelle:         I mean either you have everything you need inside of you to do this job. So sometimes, women just seem to hear that from us, from most of us down here on the sidelines that you can do it.


Steve:              Uh-huh.


Michelle:         Sometimes, people will ask about our epidural rate, and do I kind of talk people out of an epidural? And I’d say no, if a woman comes into labor, and she says I can’t do this. Have you got an epidural? I believe her because she’s already told herself she can’t do it without.


Steve:              Right.


Michelle:         Or whatever it is. Maybe she says I can’t do this without medication. You know what? She can’t because she’s already told that – herself that, and not that that’s a bad thing, but it’s just like you’re saying that it’s mind over matter, and she’s already told herself what she can and can’t do.


Steve:              Uh-huh.


Michelle:         And so there’s no way I can talk one way or the other. Too bad, you know.


Steve:              Yeah. Interesting. Well thanks for – I think we’ll leave it there. That’s some sage wisdom to end on. I like your quote. Women just acknowledge their power.


Michelle:         Yeah.


Steve:              That’s simple yet profound. 

[0:35:38]          End of Audio


  • Kim Beck

    “Fear often comes from Questions never asked”…OMG this is me. Listening to this interview (Steve did great by the way….kudos to him!) & seeing that picture you have with the quote on it….just gave me a crazy epiphany. Those circles surrounding the quote were so much of my birth educational experience….I went round & round in a circle hearing “about” birth stuff, but never learned (or was taught- isn’t that the point of “class”…hello) what I could do to make things better. It’s so clear sitting here thinking back on it.

    I went to a local birth class & asked questions. Most of the answers I got were vague. I’ll never forget the conversation in front of my class with my instructor after hearing her say “if you don’t progress, you’ll be induced with Pitocin”….to which I asked….”why?”…..she said….”because that’s what needs to happen to help your body birth your baby.”…to which I asked “why? What does Pitocin do, what are the risks in using it?”….and she said “Oh, we use Pitocin all the time, it’s safe.” in a ‘looky here sweety’ tone….& i felt like a fool, shut down & stopped asking questions. Sure enough, as I was laboring and trying to keep things moving…the whole time I was worried about “not progressing”….and when I heard those exact words from my nurse…I felt a bolt of lightning shoot through me. And it’s so clear…it was the fear & all those catechol-thingies you talked about in the interview and my labor slowed more. I got more nervous & had to have been in the “fear-pain cycle” you talked about in the interview. And the cause of it was not getting my basic questions answered on A LOT of things.

    I never knew how something so simple as not getting questions answered could come back & have such a physical effect on my body. Now I’m getting really frustrated just thinking about it…errrrr. Thanks for this interview. I definitely won’t make that mistake again. To other soon-to-be moms out there..please please please learn from my mistake. Get your questions answered!