Ep 64: You're Not Allowed to Not Allow Me - Pathways Article Review

In today’s episode, Doula Rachael and Dr. Shannon discuss the Pathways to Family Wellness article: “You’re Not Allowed to Not Allow Me.  Reclaiming the rights of mothers during birth.”  Although this is an article from 2015, the topic surrounding certain words that providers use is still relevant.  

Our words have power. Words can instill strength or fear and words can give confidence or doubt. The words we think are also powerful.  

This article discusses the word “allow” as it pertains to providers communicating to expecting families about “allowing '' certain things such as VBAC’s, eating and drinking during labor, pushing in upright positions, and various other options.  

“What woman who has experienced nine months of language like “we can’t let you” and “you’re not allowed” is going to suddenly have the wherewithal to refuse an unnecessary surgery - or to even know that she has the right to do so?”

The article concludes with four simple ways to take back that power, to feel empowered with your birth and birth experience, and to create a birth support team that encourages shared-decision making conversations between the provider and expecting family.  

Resources:

You’re Not Allowed to Not Allow Me 

This article appeared in Pathways to Family Wellness magazine, Issue #47 and #64.

Author: Cristen Pascucci - View Author Bio

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Transcript

0:04

Hello hello you are listening to the aligned birth podcasts. doula Rachel here today with me I'm Dr. Shannon we're the hosts of the show. And today we are chatting about a Pathways to family wellness magazine articles we've done these articles in the past two pathways magazine is a wonderful and beautiful chiropractic based publication. However, the magazine that comes out quarterly is full of birthday articles and so they'll have holistic health care providers, oh bees, midwives, doulas and all these wonderful articles about birth families, raising children, like all of the wonderful things that we want to know more information about. So Rachel and I like to pick an article every once in a while and go through it and in talking about what resonates with us, and what we got out of the article, we always link the full text article as well to in the show notes. So that's what we are chatting about today, my friend so it's good to talk with you today.

1:12

Hi, Dr. Shannon, I'm so glad to be back on with you. We've sort of taken the summer off from recording together and I am thrilled to be recording with you again today and this has been nice to have a little bit of a break but yet we did keep recording right it's not like a full full break. We no more solo stuff.

1:34

We did but I when I was thinking this morning I was like I haven't like we haven't sat and recorded the whole entire summer.

1:40

So yeah, and that was kind of the

1:42

goal. Yeah, that was the goal and frame of reference for now. Because we whatever we chatted beforehand before starting this recording I still remember what we talked about like when our when these are coming out these episodes but we just survived the first week back to school. So and in Georgia, we start August 1. I

2:03

was just like a second ago

2:04

and now ever like this is you know it's still summer but like we're like summer break is over. It's very odd. So that's what I mean by like we took the summer off of recording like together I mean, I was gone you had so much going on. And then we were able to squeeze in some like solo episodes, but for us to chat together. We haven't done.

2:25

We haven't I know. But it's fun to be able to do some of the stuff we did with frontloading towards the end of the school year.

2:34

Because I do have to say for those that are listening, you know yes, we haven't recorded all summer but did you notice that? Yeah, new episodes came out every Wednesday,

2:43

right? Which really

2:45

kept it going which is frickin awesome.

2:47

Yeah, yeah. And then like, I mean, there was like vacations and stuff happening with you know, house renovations over here and new puppy stuff. And yeah,

3:00

three weeks. I don't even know what happened. So

3:03

it was cool though, because we got to keep it going. And then towards the end of summer we both did a few solo episodes, which was nice. So it's just it's just good to have the flexibility of what we're doing. Creating the show. But I really

3:19

I know I missed you too. I miss these conversations and it keeps the these fun like birth worker things at the front of my mind. So I think it's important to have that rest and that time away and that break but then also it's so good to get back into this routine and talk.

3:35

All this Bercy stuff. Yeah, I've been looking forward to this all week, because I'm like, I get to record machine.

3:45

Oh, I know. And we love recording this so much too. And at the time that we're recording this. We've had 4000 downloads.

3:53

I saw that this week we cross 4000 Are you kidding? That's really not so bad. Because it feels like it was just a 3000 so it feels like things are growing. It feels like we were just at like 100 Like oh my god. Like right now for some for some. For some people that may not be a big number, but for us. It's

4:19

I think it's big. I mean yeah, you know, you'll hear the other podcast is like 1 million downloads, but I saw I was doing something the other day on social media and I found a podcast and it even had in like the little bio it said like, over 4000 downloads and I was like, Well, damn, that's how we should. So I just like

4:38

broadcasting man, you're right. No, I think it's you. I just think it's different. Everyone has their different Yeah, there was to measure Yeah. And I'm like every week when it's like now, like I love it. Those out there who are listening. Thank you. Oh, well. Yeah, excited. Yes, we do.

5:01

We love it. And we love having these birther conversations. So like, again today. I said we're going to be doing our pathways article. Really didn't tell you what the article was about though. So that's great. But here we're going to talk about it's called you're not allowed to not allow me reclaiming the rights of mothers during birth. And so this is going to be yes, the picture that the article has, that the little graphic that they have with it. It says words have power and we can take back that power in some simple ways. Words do have power. I tell my kids that all the time. And here's the thing. I try to remember that all the time when I'm parenting when I'm with patients when just interacting with anything because you can build someone up or tear them down with just the word.

5:57

aggressively. Yeah, it doesn't even have to be aggressive. It can be subtle and over time. And that's kind of what this article gets at is that the over time nature of how we suddenly take like use words that don't put the power in the birthing person's control. It just diminishes their competence.

6:19

And, I mean, this is total sidebar, but the words that are typically used in the birthing community to already irritate me like the failure to progress, failure to progress like that kind of that bothers me like it. It may have been that failure but like Can we can we flip that script just a bit are like, competent cervix? I'm like I really my cervix

6:43

is incompetent. Now like failed induction.

6:51

All of those words. have power and so

6:54

yes or fail. It's how you feel and it's how you're treated like all along the way. And it's the language that you sort of expose yourself to or that you when I started learning about this just became aware, so that I could like deflect when I was hearing that I in my on my back and flip that script, you know, you can't change the world or make everyone speak differently, but it's how you perceive it. And then how you speak to others when you're sharing about, you know, even birthing people totally innocent by talking about the doctor allowing them to do X, Y or Z you know, allowing me to go beyond my due date, allowing me to labor in different positions, allowing me to push to different places but and they're saying that when they're sharing a universal rate, what will you miss it right? No judgment, but that's because they were told that they were allowed or not allowed to do something so they perceive it as that and then when they're sharing, it's just that ripple effect. So no, and

7:52

you have caught me in that multiple times. Even on the show, like I have learned so much from you as well too, because I will even I'll say something and be like, Oh, well, you know, I mean I just say it. And again, it's I'm not meaning it in that way. But it's almost like that's ingrained condition as well. And so just kind of rewriting that and so that's where I think I can help you right that helping patients to advocate for themselves.

8:23

Well, yeah, and doulas all all providers who are part of a birthing person's journey, right like doctors, midwives, chiropractors, physical therapists, both for therapists lactation consultants, like everyone and then the birthing people themselves have have an opportunity to flip the script and choose providers who have who have who use supportive language, who you know, or who they can, you know, have take the time to talk with them about kind of flipping that script and sometimes it's just bringing awareness and I think somewhere in this article talks about like, you don't have to go into every conversation prepared to convince somebody that it's right, something's right or wrong. It's just bringing general awareness to, you know, the words that they're using and so that the words have Yeah, with our client like that word makes me feel a certain way. Exactly. Yeah. And that was our clients the time to give them questions to ask their providers not in the not in the way of Will you allow me or do you allow me or do they allow me is Do you support or how do you support or what does it look like with you with this? Kind of procedure or, you know, getting opinions extracting information not asking permission?

9:42

That I mean, that's what I've picked up so much from you, too. It's those like, and it's kind of like an open ended question as far as like, explain us this to me rather than just like the yes or no. Now we'll say this article was published, what 2015 And it's got some 2014 like statistics and stuff in it that we'll go through. So just

10:05

to put it out there, but it's still so still relevant. That's not a word prevalent and irrelevant. I just put those words together.

10:14

I think that she paints

10:19

it's relevant, prevalent. It's still meaningful.

10:25

It's still important.

10:26

I printed off this article and I usually do things that I like the points I want to drive home. I highlighted the whole darn thing.

10:36

I know I have an issue too.

10:38

We're going to link the article so you can read it, but we just use it as a catalyst for conversation. We find it kind of fun, and looking forward to come in dissecting this one with you today.

10:49

Yeah, so it starts off. For most women, pregnancy and childbirth are one of the few times we let other adults tell us what we are allowed and not allowed to do with our own bodies. It's time to change our language around this to reflect the legal and ethical reality. That is the patient who allows the provider to do something not the other way around. And to eliminate a word that has no place between two partners, true partners in care. We hear the word allow used regularly by well meaning care providers, family members, and by pregnant women themselves. And so that's what this article is focusing on is that allow work and that's what you need to stick to the script. Even asking,

11:32

do you allow this right it shouldn't be the providers are supporting working people in certain ways. And of course, it's there's the providers are there to look out for the well being and health of the birthing person but it's not to tell them what to do is to provide guidance and recommendation and support so that they can make decisions that are best for them. Period falls I

11:50

think when I when it comes down to like allowing and not allowing. It seems to be that is really looking at the risks that the provider is willing to take, right because that's kind of where it comes to like well, this is too risky for whatever reason, so we're not going to allow it and so when you come in as the one who is giving birth and saying okay, well how do you support this or how can we support this and that can open up the conversation as to why is this too risky? You know, where is this information coming from? Where's this data coming from? And that can open up that curve and it may be even that gives you like, Okay, well I do agree with that. So I am okay.

12:44

It could go both ways. It's not about it's not about combating everything because you don't want to do it or because you're going to decline everything. It's not about that. At all. It's saying that the providers role is to share information based on evidence, current evidence, to look at the individual's unique medical history, unique individual needs, and to like work together. You know, to make a decision that's right for them in that situation, and then put it in their like court for making a final decision. Even if you have an opinion about the way they should go. That doesn't mean that that's what they're going to choose and that's their right. If you have a right to choose what you want for your body and your baby and it's like it's it's, it's complicated, because they're their goal is to look out for the best interest of the birthing person. However, in today's medical culture, a lot of the decision making is based out of fear and risk of something happening to the provider, not to the birthing person, right. It's a lot of like avoiding liability, which again, like that's, I don't, I don't feel bad. I know nothing. I don't feel that I don't want to be in that role where I have to bear that kind of responsibility Like, at all so it's, I don't envy where the thin line they have to walk because I do believe vast majority of providers have good intentions and want to serve or they wouldn't be there. Like it started from a place of really wanting to do something good in the world. But then they get you know they're guarded or overwhelmed by the the industry the way it's operated with insurance and risk and liability. And so then decisions end up being driven based on

14:35

why the liability rather than a normal physiological birthing prior

14:40

Yes, and what is truly best for that, that individual working person. And so it's not just that they're assessing risk because it a lot of people perceive that if well, if my doctor says it's best, then it must be best. And it's like well, you know, you and they know birth or they know intervention or they know you know how to find and treat problems but it's like they don't know you and so kind of coming together and a doctor who sees you as part of that decision making that's what you want. You know, you want someone to support you all along the way. And it's complicated, but I just think it's about for people who are most likely listening to this. It's trying to flip the script on how we talk to birthing people, and choosing providers and driving are like putting our money where our mouth is and choosing providers who are that way so that we can ultimately get more providers on board and realizing oh, okay, like we need to make a change here. But even Yeah, to the last statement you said from the article talking about, like well meaning care providers and family members, you know, using using the word aloud we also have major organizations like ACOG, which is the American College of Obstetricians and Gynecologists and the Society for maternal fetal medicine, putting out statements that again, well intentioned and overall positive, so let's read it and see if you can identify the problem. Here's what they said on NPR. Women with low risk pregnancy should be allowed to spend more time and labor to reduce the risk of having an unnecessary

16:33

language.

16:36

And then, you know, correspondence, responding to this saying that this is a quote that they may mean that may mean that we allow a patient to labor longer to push for longer amount of time and to allow patients to take more time through the natural process. Overall, that's a good statement, right? Like overall you understand the what they're getting at is like, Yeah, we should let people labor. Exactly. Leave it alone. However, they're using words like allowed and these are major you know, this is still the statement for a Tod. Right, this is still the current statement for a Tod. That is what providers use as their kind of guide on recommendations to their client to their patients. So it's everywhere, and then people responding to it saying, hey, they're gonna allow you to, especially if you're low risk and there's no no complications, you're allowed to labor as you want. Thank you. Thank you very much.

17:30

No, I appreciate that. And, you know, I hear those words a lot, too, when I'm talking with moms in the office. And when we're talking about providers and birth plans and those type of things. It's like oh, well, what is it that I hear most, my provider will allow to go past a certain amount of time with the due date. So there's main I think there's themes with it too, because they even mentioned in here as far as like when we're hearing those, the word allow, so it's kind of like allowed to go past a certain due date allowed for delayed cord clamping allow for skin to skin at immediately afterwards. Allowing or not allowing for the birthing person to be able to move while you know like continuous internal fetal monitoring like these. That's this article does focus a little bit on like the the C section aspect of things and like trying to not have as much surgical birth but then also looking at Oh, well, if you've had a C section, you are now not allowed to have VBAC. So, that tends to be the theme of this article, but then it also it does mention or even even to drink and eat during

18:48

all the things that the the tides are changing, that they're going to allow you or not, you know, then we're going to allow you to have intermittent monitoring and then allow you to drink during labor. They're going to allow you to do XY and Z. Wow, that's great. Again, it's it's not that's not the right language surrounding it, that doesn't empower the birthing person to know that they even have a choice in that matter. And that you know, is it based on their individual needs? And this the statement from a cog was to to address reducing the overall Susteren rate in the United States, right, which is like 33%. And we know that 10 to 15% is really necessary. So we have a three fold necessary and right that means a lot of sevens are happening unnecessarily. So there is an effort to try and reduce that unnecessary primary sixth area. But we're, we're you know, there's a lot lacking, and I think this there was an interesting statement in here. She says, Is it ethical to hold women to what an individual provider will allow with the full knowledge that not all providers are practicing? The standard science shows are best for moms and babies and the reality is, is tend to fit our map 10 to 15 takes 10 to 15 years for evidence to catch up and actually become practice. And so we know that a lot of people are a lot of providers might be using outdated information and standards. And so what if we're just putting it all in the providers hands? Is that ethical? Or should it be more share and more open conversation and dialogue between provider and birthing person?

20:36

I know and it's it's that conversation piece that dialogue piece that tends to be missing too and I what I think sometimes do with society we have it so much like, oh, this person has so much extra training than me and so much extra knowledge than me that I maybe I don't feel on the same level as we were able to question I'm doing air quotes question because it's not that you're, you know, questioning that but you're you're just wanting that more information they're talking to they're there to teach you right that's that's the meaning of that word. And so sometimes too, I think this takes a little bit of that shift and change in society. So yes, we can hold them to this higher standard, because they do have this expertise, but our knowledge, it's also like, can we have a you can still have a conversation with them. You can still ask them to explain certain things and explain themselves to us. I'll be useful to help outdated data. But that's that ever evolving flow. And I think what I see from this article, and the point of it too, is to begin to have those conversations with your provider, but then checking in because it gets a little bit, you know, I think at some point to that article that mentions as far as checking in with that language that you hear, and how does that sit with you? And then guess what? You can choose a different provider you know, you can change your hearing that language, but it's all here to becoming aware that like, oh, that language is not supportive. Right?

22:21

Well, yeah, that's a red flag. So when you're having conversation with your provider, and we encourage asking lots of type questions early on in your pregnancy with your with your doctor or midwife about how they support you and a variety of ways and interventions and about, you know, with the pregnancy and going beyond your due date and like ask these questions early and even repetitively over the course of time and make sure how they respond is aligned with you and that they're using supportive language and that they are looking out for your best interest and not just doing things routinely because that's, that's what they do. And you know, no fault. Again, it's not about blame at all. It's understanding that in the hospital system, there's so many people given birth. You know, it's like, doctors get into like a routine and that's what we do this for everybody, because it's easier to treat it in this way then are easier to manage it in a certain way. Because if we give individualized care for everybody to give all the care we need to get up and that's just an unfortunate situation. And I like to say that because I think it's important for people in the role of patient to have that mindset of like, okay, I understand like, they're not all evil or bad. It's just if you come in and ask them questions, it's going to make your experience better. You know, if you take on this role in this way, it's going to help make your individual experience better. And that has a ripple effect over time, and so it's, it's, it's, you know, biting it off one small piece at a time. You know, a good example is if they because a lot of interventions are quote unquote, routine, meaning they do them for everybody, regardless of their needs, and one might be continuous electronic fetal monitoring, and we know that the evidence indicates that continuous monitoring without need is not doesn't change, the outcome doesn't improve outcomes that actually can cause further intervention and problem down the road down the line. So that can be one way if you're asking so you know, what kind of monitoring your hospital provider what kind of monitoring Do you provide during labor, and they might say we do continuous fetal monitoring. And you could say, well, can you tell me more about that, but as I learned about, continuing through the monitoring of that, it's not an evidence based practice. It's not even, you know, what is recommended anymore. You know, and here's where I found that information. And like, that's like one example and then they might say, Okay, well look into MMA, MMA. You know, I can go back and forth and hopefully make a make some progress in that conversation to where they might kind of take down their walls and be more open to doing some individualized care and you advocating for yourself because that's what what it's going to take but you can have that conversation without being confrontational.

25:16

Yes, and that's what we'll go into in a minute to like the God some simple ways to take back some of that power, but there was one statement. And maybe we can segue into those little ways after this one, but one of the ones that I highlighted from here, which I guess kind of also supports the whole article as well as that says, What woman who has experienced nine months of language like we can't let you and you're not allowed, is going to suddenly have the wherewithal to refuse and unnecessary surgery or to even know she has the right to do so. And so,

26:04

a switch muscle that needs to be exercised.

26:10

And so if it's taking if, if the, if the birthing person is also in this area to where it's, you know, they're trying to learn this language. Well, there is that grace period with the providers as well that are also learning okay. I may have learned this in school or learn this a certain way. Especially if communication is complete, you know, like bedside manner, but it's also there's some unlearning, that needs to happen. I feel like both sides of the coin.

26:43

Yeah. And that goes into the next this next section that I wanted to read as well. It says the truth is that women like all US citizens have the right to make decisions about their bodies based on informed consent, a legal ethical standard, which requires the provider to convey all of the information around the suggested procedure or course and treatment, and the person receiving the treatment gets to decide whether or not to take that advice. A cog states clearly about informed consent and maternity care and they say, the freedom to accept or refuse recommended medical treatment has legal as long as ethical foundations and the obstetric setting recognize that a competent pregnant woman is the appropriate decision maker for the fetus that she is carrying. And this stood out to me because actually recently, I had a provider, tell one of our clients that it is quote their job to gather all the professional opinions and recommendations and make the decision for what is best for the working person. Not this is not their job. That is that is

27:46

Yeah, what about the guy who's given birth? right have

27:50

you know like they maker Yeah. And, and I think, again, that provider was trying to say she's trying to explain that she's trying to do her best to gather the information and give a recommendation, but it's truly the job of the provider to share the information she has gathered. share her opinion and expertise, and then work with the working person to make the decision that aligned session with them, and their unique medical and individual needs, plus their desires and preferences. It's like so complex, it's multi layer. It's multifaceted. It's called shared decision making and when we have that, you create empowering experiences where people don't feel like they've been ran over by a bulldozer during the birthing process. Wow. That's amazing.

28:40

I know. And it reminds me of and I've mentioned this before, to the interview I did with Latoya has to do with dual of you. And the fact that she was supporting someone who was giving birth and they had an epidural, but she wanted to move and then the doctor was like, Nope, we have to lay here and that's when the boy was like, okay, so what explain to me if we get her on all fours, what the problem is, and then we can boil down to it, she can't and she just she's got that, you know, beautiful persona, where it's just you just peacefully keeps asking. And I think the provider was fine, like, well, she could fall and it's like, are you can you take that risk? Mama, are you good? Can we do that? Let's try all fours. If

29:31

mom falls and she's chosen to get in that position, I think that's on purpose. Also, like women are strong and capable and when you're in labor and pregnant, it doesn't mean you're incapable. It doesn't mean you're, you know, not paralyzed, but like, handicapped or not in a medical emergency, always. You're not like there's not something wrong. It's like you're in labor, and people burping on hands and knees is a normal position for normal physiological birth, even with an epidural. Like not supporting is bananas. But also I appreciate her approach, but she's like, Okay, if we get her into this position, tell me what the problem is. And then the doctor said she might fall and then you look to the client and say, Are you willing to take that risk?

0:00

so complex, it's multi layered. It's multifaceted. It's called shared decision making and when we have that you create empowering experiences where people don't feel like they've been ran over by a bulldozer during the birthing process. Wow. That's amazing.

0:17

I know. And it reminds me of, I've mentioned this before to that interview that I did with Latoya, who's the doula with doula view? And the fact that they she was supporting someone who was giving birth and they had an epidural, but she wanted to move and then the doctor was like, Nope, you have to lay here and that's when Latoya was like, okay, so what explain to me if we get her on all fours, what the problem is, and then it boiled down to it, she can't and she just she's got that, you know, beautiful persona, where it's just she just peacefully keeps asking. And I think the provider was fine, like, well, she could fall and it's like, are you can you take that risk? Mama, are you good? Can we do that? Let's try all fours. If

1:08

mom falls and she's chosen to get in that position, I think that's on her but it's also like, women are strong and capable. And when you're in labor and pregnant, it doesn't mean you're incapable. It doesn't mean you're, you know, not paralyzed, but like, handicapped or it's not in a medical emergency, always. You're not like something not something wrong. It's like you're in labor and people birthing on hands and knees. It's a normal position for normal physiological birth, even with an epidural. Like not supporting us bananas, but also I appreciate her approach because she's like, Okay, if we get her into this position, tell me what the problem is. And then the doctor says she might fall and then you look to the client and say, Are you willing to take that risk?

1:48

I know all that had to be was explained. Like, it's so simple.

1:51

And then it's like, no, of course I want to be on my hands and knees. This is how I learned about birthing and this is what I feel most comfortable. And we tell people all the time, because avoiding pushing on your back is a thing, right? Like people are either gonna want to push on my back I've heard it's like the worst and we try and flip it and say, It's, here's why. Pushing on your back can be can make for a longer pushing stage or a harder pushing stage. Here's how if you just roll into your side, you open up take pressure off the sacrum and pelvis and allow room for baby to come through. I can be really beneficial. However, some people feel good on their back pushing. So it's not changing any like thing is like really bad. It's like you got to be open and we do this over the course of pregnancy to help build up confidence to trust that they know what is best for them and labor that like it might feel good on your back and it might not but you've got to trust yourself and kind of go where feels good to you. Or if you have a provider saying you can only do it one way you're never going to be able to tap into the potential that that or confidence giving birth in the way that you want and on your terms like being

2:57

able to trust those instinctual things that come and have been during

3:02

and not dampening that not dampening that like David incompetence and going beyond 40 weeks because you're not They say you're not allowed right you're not allowed so therefore they did the dampens their competence and it increases their fear of like, Oh, they're gonna want to induce me or I don't I can't go past my due date or something wrong. I go past my due date. And it's like those simple thoughts over that one. One component of pregnancy has damaging long lasting effects. And that's just one example.

3:32

And that's just one example. Exactly. So, the article goes in to say that words have power and we can take back that power in some simple ways. And so it gives kind of four little like bullet points that we wanted to touch on as well. And now that's, and again, my word of the year is awareness, awareness precedes change. So bringing an awareness to Oh, because the words do have power and well I haven't really thought about how the word allow or not allow, you know, can really affect me mentally, right. And then it changes you know, that can really impact how you are approaching you know, your upcoming labor and birth. So the first one it has it says, don't stay silent when you hear this kind of language and casual conversation. And I think that's that's where that's where I've learned it from you as well as far as like, catch that word allow, and then you can flip it and ask them those questions in that open ended manner. Like you've mentioned, Rachel, you know, how do you support this? So and then tell me more about something exactly. Yeah. Tell me more. Tell me those risks. You even you know, you talk a lot about that brain acronym and I feel like that plays a part here. Where you know, it's it's that you don't have to be confrontational about you don't have to be like, Well, I don't like the words that you're using type of thing. You know, like, it could be just well, how do you support this? And so when you can say it differently, maybe while can help them change the conversation.

5:16

And then next point, this list of tips is that Be gentle while you're being firm.

5:22

It does say that effort

5:24

says in what school? No, I then just it's a great segues in that because it says remember that most people are just repeating something common and accepted and they probably haven't thought much about it. So make it your goal to inform not convince and that's to your point about like being it doesn't have to be abrasive or confrontational and it's also not saying that you have to be all nice and polite about it either. If you feel like you've got to communicate in a certain way, communicate in your way, but it's also trying to see the other person for a human as well. And then they're probably just repeating something that they've learned along the way and it's trying to just inform them of life. Just flipping that script. Gently, like offering up a new way of saying it and I guess you don't have to be gentle, but if we want to be productive, I think we have to be compassionate, right? You have to be like, I was trying to paint the providers not the bad guy, but they're you know, we want to and that's my choice of provider matters. You don't want to go into birth feeling like you got to like fight a war. You want to go into breath feeling if you trust your provider,

6:20

right and I feel like I would say be gentle while you're being firm and respectful. Like there is you can be respectful and still ask to have that. To change the language you know, and so absolutely, you know, it's kind of honoring both sides of conversation.

6:41

Yeah, we often always say, oh, sorry, I

6:45

need to like, you know, we definitely want to paint the picture of like, oh, every OB is out there and they're just gosh, no, no, that's what we're trying to do and you know, pointing the finger and you know, so definitely not coming across like that at all. But yeah, having that respect for that provider too. But knowing you know that

7:03

everybody's for you. So, two ways like you again you how we talked about this before too about like paying attention to how you feel when you're around your provider. You do feel safe and comfortable and trustworthy and competent, or do you feel a little anxious and nervous and uncertain and like inferior? You know, as a instincts, yeah. So it's just kind of hate that. Listen to tap into your intuition that will make this whole process easier. And and then trying to find that provider where it's going to be less of a combative situation. But knowing that not everyone has a choice to change providers, so giving tools and given phrases and giving power to those who don't have the choice of changing providers. It's not always easy, we're available so there's still like work of you. You can still stand up for yourself even if you're not able to, to change providers change got to be prepared to kind of you know, advocate for yourself and have a birth you know, maybe a doula if possible, or, you know, people around you who are there to support you in a meaningful way and look out for you.

8:08

So when that hits those next the next two points though, because this that third one is to choose to give your business to providers eugenic language, so again, yes, if you do have that ability, then yes, yeah. Yeah. So you can hire and fire and you know, interview and all of those things as long as you want during, you know, yeah. But then also you could even mentioned having that like support team and having it's kind of like the partner stand up for your loved one. So that's that last point as well, too. So and whether it's the partner whether douleur Yeah, exactly. Having that person there. Speak up as well and be like, Oh, well, I don't feel comfortable with this language. The partner they can also tap into,

8:59

oh my gosh, yeah, you just demands forward with looking out for you. Because when you're in labor, you're super vulnerable, vulnerable. If your confidence might be waning, your doubt might increase your fear is going to increase so having a strong someone by your side who's gonna have your best interest at stake and be able to speak up for you whether that being an aunt or sister or a mom or your partner, you know, getting them on board. And explaining this to them this language and giving them the tools that we've shared here will help empower them to because you need that kind of support, especially if you don't have a supportive provider. You know, and I also wanted to highlight one other thing that this article says is that the this throwing in allowed and not allowed it's kind of a sloppy way of communicating it's it's reinforcement of deep cultural beliefs about women as passive objects, not full owners of their bodies nor representatives of their babies, and having like lesser decision making capacity than those they've hired to support them. These ideas will take time to change that birth is a great place to start.

10:09

Yeah, that one, that one we're going deep with that, you know, but that's where I mean if we're going to break that down and those words you know, I get a little feisty well, who are you? Oh, man, I can't I can't do something

10:24

like that. It's a systemic that can be a systemic problem. I simply say I'm allowed or not allowed I know right? See how it can be arching my deep running problem that perpetuates you know, mom to daughter, daughter, daughter, you know, like it just keep going.

10:42

Oh, gosh, are we gonna talk about intergenerational trauma here? Okay, we'll say we'll put it in and Alan Oh,

10:49

my guess I mean, yeah, I know. I mean, definitely, uh, speaking of any sort of systemic issues that we have, I mean, this also, you know, these words, it's, they it's all that everybody's giving birth, you know, like, it's, it's tough, and it's really, really changing those deep ingrained word and that's where I felt even when I have even asked me to, like, Oh, they're gonna allow this and like, Oh, why am I saying that? You know, like, I have to kind of check myself sometimes do and be like, No, I need to still flip this in the office and be like, how are they supporting this when I'm talking to moms and asking about, you know, their care providers, right. Yeah. And like, I

11:33

hope that it didn't rain. Yeah, and that's okay. It's okay. So great. Yeah. Okay, but everywhere. You stop yourself and bring that awareness and flip it and say, definitely, they're going to learn and it takes repetition. But I wanted to say this, too, that the legal authority and childbirth lies with a woman giving birth, not the providers of care. So yes, they are a team but of the two it is a woman who truly bears the rights and the risk of childbirth. And our words should reflect that reality. And when, you know, as this article points out, that you know, a one in three average salary right and facilities were practices vary widely, even among individual providers like we're tying women's hands and we continue to reinforce this dysfunction by using words like allow to describe an outdated dynamic that doesn't recognize us as competent rights bearing adults. I get fiery about this, and I think it's so important in it transcends birth. It's beyond birth. This is Oh, yeah, this is what cracked me wide open about going through my first birth experience was what it led to afterwards. All of a sudden, I was taking all of this interested in to care for my child, my own individual care, like how I spoke to my husband about his career, like it just it goes on beyond birth, and it helps us become better like participants in society.

13:03

I 100% agree with that. I know. This is a good article. I like this one I

13:08

really like it. I'm saving it.

13:11

Yes. still fun. chatting with you today.

13:15

It's good to be here. Thanks. Yeah, it was a good one. And if you guys enjoyed this episode, definitely share it on social media. Take a little screenshot you can tag us it's aligned underscore birth. If you feel like you really love what you're hearing, you can always leave us a little review your reviews help more people find and listen to our show, which helps us get to keep doing this work because we love it so much.

13:42

Yes, yes. We appreciate all the love and support and stay tuned next week for another episode.