Ep 161: Asking Questions Isn't Questioning Your Care

In this episode of the Aligned Birth Podcast, Doula Rachael discusses effective communication with your birth team and managing expectations. The main topics covered include building your birth team, effective communication strategies, managing expectations, and handling challenges and conflict. Doula Rachael emphasizes the importance of effective communication in staying in control of your birth experience and reducing fear.

The episode also provides insights into the roles and responsibilities of different members of the birth team, such as partners, doulas, midwives, OBs, and nurses. The use of a birth plan as a communication tool is also highlighted. In this conversation, she also discusses effective communication strategies for expectant parents to use with their birth team. She emphasizes the importance of open lines of communication, establishing healthy expectations, and advocating for oneself.

Doula Rachael provides practical tips and tools, such as the BRAIN acronym, to help navigate challenging situations and conflicts. She also shares client stories that highlight the power of communication and informed decision-making in achieving positive and satisfying birth experiences.

Resources:
Ep 135: Building Birth Support Team
Ep 11: Creating a Birth Plan

Chapters:

00:00 Building Your Birth Team

10:05 Effective Communication Strategies

29:02 Handling Challenges and Conflict

35:41 Establishing Healthy Expectations

39:23 Navigating Challenges and Conflicts

45:37 The Power of Advocacy

49:13 Client Stories: Communication and Empowerment in Birth

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Chapters

• 18:23 [Ad] Modem Futura
• 19:10 (Cont.) Ep 161: Asking Questions Isn't Questioning Your Care

Transcript

Rachael Hutchins (00:02.118)
Hello and welcome to the Aligned Birth Podcast. I am Dula Rachel. I am one of the co -hosts of the Aligned Birth Podcast. I am flying solo today and I am talking about effective communication with your birth team and managing expectations. So the goal of this episode is to help you learn about building your birth team.

which on this podcast we talk a lot about this topic. And so we have several other episodes that discuss building your birth team, but I'm going to review it again today because it's so important. And then we're going to talk about effective communication strategies. We're also going to talk about managing expectations and we're going to talk about handling challenges and conflict. I'm also going to share a few personal stories.

and experiences to highlight these topics, these main things and how to navigate your birth with more ease and with more confidence. This topic to me is so important. It's one that I feel like is a common thread regardless of your history, your previous experiences and regardless of the type of birth you have or want.

But this applies to all. This is this is probably a helpful topic for even new moms or just anyone in general because effective communication and managing expectations is a part of life. And I remember for me personally going through my first pregnancy and birth, I learned so many helpful things along the way that transferred into parenthood, motherhood and beyond. So I think it's a really important topic.

I also feel like it helps ensure that you, the birther, stay in the driver's seat and that it keeps you autonomous, that it keeps you, it helps remind you that you are the one in charge here. And we really want to avoid anyone getting bulldozed or anyone being taken out of that role. It can also help you feel less out of control. I think that's also a common fear we hear about in regards to birth.

Rachael Hutchins (02:25.542)
is that they don't want to feel out of control. And so these tools can help you avoid that. The process of using the strategies that we're going to talk about today will help you feel more confident. It'll help you determine your ultimate preferences and it will hopefully increase your confidence and reduce your overall fear when preparing for childbirth. Fear is pretty common when we are going through something new and unknown, even if we've done it before.

There can be fear about what to expect and what to do when certain things happen. So again, these strategies can help you navigate that. And ultimately, my goal for you in listening to this episode is that you are one step closer to having the best possible birth available to you. And that's the goal for today. So welcome, let's dive in.

Okay, so the first thing we're going to talk about today is building your birth team. So who is your birth team? Let's say the very first person part of your birth team is your partner, your chosen loved one, be it your husband or your wife or your partner, your boyfriend, your girlfriend, your aunt, your mom, your sister, like that chosen person.

who is willing and ready to walk alongside you through this journey. That's your partner. They know you intimately and they love you deeply. The next person who can be considered as part of your birth support team is your birth doula. I am a birth doula. I'm also a childbirth educator. And we obviously, I feel very passionately about this work or I wouldn't do it. And so having a birth doula,

as part of your birth team can help you navigate your unique path to giving birth with more ease and with more confidence. Also on your birth team could be your midwife and or an obstetrician as well as the nurses who if you're giving birth in a hospital setting the nurses there's always a nurse or several who assist you at the hospital. So that's your immediate birth team. There are other people to consider for your birth team too.

Rachael Hutchins (04:45.414)
And we have episode 135 that goes in depth into all of these people. They're, you know, adjacent birth professionals who can help you based on your unique needs and preferences. So this could be, like I mentioned, childbirth education. Fully, fully believe that taking an out of hospital childbirth education class can help increase your confidence by increase your knowledge and therefore increase your confidence.

Some others to consider would be lactation support. You know, I think it's great to partner, find who you want to be as your lactation support during pregnancy. Do that research now, figure out who takes your insurance or where they're located so that you can access, have access to them when you're in the thick of it in that new postpartum period. And a lot of them will offer like a pre -birth consult and a lot of insurances will cover lactation as well. And then there's similarly,

structured and recommendations around pelvic floor therapy, mental health counseling, chiropractic care, you know, Dr. Shannon, the other co -host, she's a chiropractor, prenatal and family chiropractor. And, you know, chiropractic care has many benefits during pregnancy and after giving birth to. And then massage therapy, kind of adjacent to chiropractic care, those together can really help decrease discomfort and help.

you have a smoother, safer birth. And again, episode 135 is all about building your birth support team and goes further in depth in kind of all of those areas. So how to choose the right members for you. You want to aim for supportive practitioners who are in alignment with you and your preferences.

and are willing to listen to you and meet you where you're at and provide that informed and shared decision making. That's another really great episode that we have that highlights what that looks like and what that means. Because some people might loosely say shared decision making, but truly informed and shared decision making looks like someone sharing with you what they're seeing, why they feel like something should be recommended,

Rachael Hutchins (07:07.942)
the risks, the benefits, your options, all of that, and then putting it in your court and saying, well, how does that make you feel? What would you like to do? Do you have questions? And then kind of going from there, kind of giving you all the information and having a conversation along with it so that you feel good about the decision. So really looking for a provider who's going to offer that at every step of the way. And just so you know, in your...

prenatal appointments when you're pregnant and you're going to see your midwife or your OB. Those are your opportunities to determine if that your provider is off is like giving you true informed and shared decision making and is is aligned with what you want for your birth and that they're not dismissive and that they're not rushing you and that they are giving you the space to kind of ask your questions and listen to you and remember things about you.

So really for when you're trying to choose these team members for you. And it looks different for everyone. Well, you might have a best friend who loved this one particular provider or midwife or whoever they're talking about. They loved them. But you go and see them and you're not jiving with them. It's OK. It's all about you and how you feel in their presence and how you feel under their care. So you want to be able to ask questions.

interview different providers. So and like different, you know, research a couple different practitioners within all of these categories. Like kind of knowing what your options are in your area for each member of your birth team. So let's say it's a doula. Like highly recommend researching the different doulas in your area, looking over their websites, trying to find information and get to know them, maybe go to their social media, find out who's in your area.

area who serves your particular birth location, who feels like you would be in alignment with them and then you get to interview them. So same thing with your midwife. It's okay. Like you can meet with multiple midwives or or you know OB practices if you're giving birth in a hospital. Even midwives giving birth in a hospital like or home birth midwives like knowing your options and exploring them and having those conversations while it does take a lot of work and it might feel stressful.

Rachael Hutchins (09:35.622)
Each time you have that conversation, you are learning more about yourself. You're learning more about what's what the birth environment is in your area. You are getting to kind of explore your options and just like you're exercising that muscle of of exploration and advocacy and ownership in your birth. And so I love the idea of like, even if you are planning a hospital birth, like meeting with a home birth midwife in your area, just like having that conversation with them and vice versa, like.

Knowing like if you're having a home birth and you've chosen you've like interviewed a couple or a few midwives and you've chosen a home birth still knowing like the area hospitals and practices so that You're at least a little bit in the know in case you need to transfer feels less scary when you know what's going on you know pretty regularly we have we have lots of consultations with you know people planning for their birth and

they've chosen a birth location and in our conversation, like they are expressing their preferences and we, you know, ask them if they've considered some of the other area hospitals and sometimes they don't even know that they exist. And so, you know, even that little bit of information boosts their confidence of like, wow, I can explore these other options. And at first it might feel stressful and daunting and like, gosh, that's a lot of work. But once you go through the motions and you start exploring your options,

you all of a sudden you're like peeling back these layers and peeling back that the veil of fear surrounding birth of like, okay, I can be involved in this and I have a say in how this goes. And, and so really knowing your options and, and exploring them is huge. So even if you are planning a hospital birth, like meeting with different practices or midwives or whatever, even if you continue to stay on that course and stay at that birth location, like as you started with like,

just going through those options helps confirm that you're in the right place versus just being like I guess this is where I'm supposed to get birth this is you know this is where my OB delivers who I've seen since I was 16 so that's where I'm gonna go you know it's like okay maybe that is the best place for you but did you know there are these other practices who have are in better alignment with what you're wanting for your birth and that doesn't mean you can't go back to your OB because

Rachael Hutchins (11:56.678)
you know, or your GYN, you know, your gynecologist, you can still go to them for your well women care and then choose someone else for your birth if there's another place or practice that aligns better with your needs. So for each area of your team members, you want to know who is in your area, who is providing support at your desired birth location, what options do you have for your four

for various birth locations. So in our area, there's hospitals, there's home, and there's birth center. And then who meets your needs and preferences. So again, knowing your options is huge. And there are, so there are different roles and responsibilities for each person, who are part of your birth team. So starting with the partner, you know, they have, they are your intimate connection. They are your loved one. They are your main,

support person and they are also like the next person who wants and needs to be ready to advocate for you when you're not able to advocate for yourself. So bringing them along this journey with you will be very important. So doing childbirth education with them, having the meetings with the doulas together with your partner, like having them be as involved as possible. So while as the birther you are the one growing the baby, you're the one giving birth, for your loved one it's very important that they be involved in all that.

prep work so that they can feel connected to the process and so that they can know what you want and what your preferences are and you can discuss them with them and kind of have someone on a sounding board to kind of work through the challenging decisions and then you can have someone who's really in like as involved as they can be in the process. The next person is your birth doula. So they are your non -clinical support person. They are hired during pregnancy, typically between like three and seven months of pregnancy.

They provide that informational, emotional, and physical support during pregnancy, labor, birth, and the early postpartum. They are essentially your birth coach. So they are the ones kind of alongside you throughout the entire journey from the time they hire you all the way through the birth and then into the postpartum. I'm a birth doula as part of a partnership. So I have Hannah, who is my co -doula partner.

Rachael Hutchins (14:18.054)
And we are the owners of North Atlanta Birth Services and there's a bunch of doulas on our team. But our model is that you get two doulas and we share those responsibilities together. And so you have someone walking alongside you, two of us, at all the meetings, lots of in -between support, answering your questions that you have after you've maybe had an appointment with your provider, discussing fears, concerns. You know, we do prenatal meetings and then we join you for the birth and we're there like,

In the hospital setting, you know, the midwife and the OB come and go, the nurse comes and goes, even though they're there more frequently than the OB or the midwife. If you're having a midwife at a hospital birth, they're there more than an OB, but typically not a lot and only coming in more consistently towards the end. And then you have your partner and it's a lot to put on them to be like that main, that only support person. So having a doula in the space.

We're there for that continuous support. And that's really where the benefit of the birth doula comes from is that continuous support. Like we're not really leaving. We might go get like take a break and go to the bathroom and get a snack. But the goal is that we're providing that continuous support for you at every little twist and turn that's coming up so that you have that in that person who's trained, who's experienced, who's educated, who is that kind of non -biased party present. And we're there for you.

the birther, we don't you know we don't work for the hospital so we're there to help advocate, help you advocate for yourself and advocate for you when you're not able to advocate for yourself and that's one of the big things we teach too is advocacy and obviously I talk more on this particular topic because I am a birth doula and I've been doing this for a long time and I care about it a lot.

And doulas, another like key thing to know about doulas is doulas do not catch babies. Some people confuse midwives and doulas and midwives have a whole different, skillset and focus point and education and training and all of that. And they're there. I get into midwives next. but they're the ones that catch the baby in the, or the OB. so doulas don't catch babies, but we coach you through the whole process. and we also don't prescribe medication.

Rachael Hutchins (16:37.862)
That's another thing we don't do. So moving into the midwife, they are a clinical provider and there are a whole bunch of different categories of midwives. There's hospital -based midwives and then there are home birth midwives. And sometimes if they have certain credentialing, I think it's typically a certified nurse midwife. Those credentials, you can be in a hospital or home. And they are looking at the whole person and ensuring health and safety for both mom and baby throughout.

pregnancy, labor, birth and postpartum.

They tend to support lower intervention. They, I see a lot of that judiciously watching, waiting and acting when needed and not unnecessarily. More of a like hands off approach than a hands on approach. They can support high risk pregnancies, but tend to focus on healthy, low risk pregnancy and birth. Midwives, like I said before, they're the ones that kept the babies.

So trying to like delineate between how the doula supports and the midwife supports. And a lot of times they are supporting you together. And that's that whole, that like holistic approach of support. And midwives in the hospital setting typically work in conjunction or part of an OB obstetrician's office. They're usually working together. And then if you're, if,

on your journey you kind of what they would say risk out of midwife care even during pregnancy or birth then the OB takes over but in most of the situations I've seen that they continue to work collaboratively together but when things arise that are more in the OB scope then they bring them in. So it's in my experience I see a lot of good collaborative care. Not always but...

Rachael Hutchins (18:39.014)
for the most part. And then you have your OB, your obstetrician. They are also a clinical provider. They are ensuring the health and safety of mom and baby. They are trained in high risk for pregnancy and birth. They are also trained surgeons. So that's one of the big delineating factors for OBs. They tend to view through the lens of pathology. So they're looking for and fixing problems. They tend to be more hands -on.

on than midwives but I've seen hands -off OBs and I've seen more hands -on midwives so it can go all directions but this is just generally speaking and when providers are kind of staying and they're laying and doing what they're supposed to do that's what you would see and again OBs catch the baby but if a midwife is in charge of the birth and the OB is not needed the OB doesn't show up. In the hospital setting how I see it usually go is upon admission

you stay with the midwife when you've been under care with a midwife, you stay under them for the duration of the labor and the birth and the postpartum. They're running it all, which is usually really great. And then if and when things change and maybe become more high risk, they might consult with the OB. The OB is also brought in, at least in our area, at our hospitals.

for instrumental delivery. So at the time of birth, if it is determined that like vacuum is needed or forceps delivery is needed, then the OB steps in, but the midwife is still there. Or if it's determined that a cesarean is needed, then the OB is gonna do that surgery. You know, some people say, why wouldn't you want the more highly like educated or more highly trained? Why wouldn't you want that high risk?

doctor looking after you because it feels like they would be, they would have all the skills for all the things if they arise. and so I totally get that thought process. However, when you're, when you are, when that is more your focus and that tends to be the lens that you view it through. And so again, they might be looking for kind of things being wrong when they're not, when that's not needed, or they might be wanting to use some of the interventions that they're used and more comfortable using, like continuous fetal monitoring.

Rachael Hutchins (20:58.31)
or cervical checks because it's like they really like data. They really like to know what's happening and to kind of more of that active management versus that watch and wait and see. So again, when you're learning about the different types of providers and what that might look like to be under their care and the type of care they offer, there's really not a right or wrong. Like I might have a personal preference about it, but if, if when you're learning about the different providers, you're like, well, that really like,

resonates with me. Like I really feel like I need this type of care. Go with that provider because your overall like emotional mental state surrounding your your birth matters. So you need to be with the provider that's right for you. But assuming that one is right for you and not exploring options for the other types of providers, I think is leaving you a little bit not as fully informed as you can be. Again, something I hear about.

that we see often is knowing that even knowing that midwives deliver in hospitals or that there's midwife centered practices or that they don't have to see the OB if they don't want to only when it's like necessary, you know, can be like, well, I didn't know that was an option and then you can explore it. And that's what we love to be able to do is like give you just like a little nugget of information so that you can, you know, turn over that next rock or take that next step on your journey and.

Because that's if it's not your journey, if you're not the one doing that work and that exploration, like if it's being forced on you or you're being told you have to do it a certain way, it doesn't work. It has to be your journey. The next person is the nurse. So they are also a clinical provider. They are supporting birth in a hospital setting. You know, they're checking vitals. They're administering meds with the OB midwife guidance. They are monitoring the baby. They're monitoring contractions.

They're keeping an eye on your overall wellbeing, you know, making sure you got your ice and your drinks. And if you need to go to the bathroom, they're helping you with that. Or if you need fresh linens, they're changing the linens. they are also helping you change positions if that is something you want and they are skilled in that. I love a nurse that has had like spinning babies training or is just like up for, you know, doing different positions in the, in the hospital setting. but not all nurses have that. So that can be a little bit of a toss up.

Rachael Hutchins (23:21.862)
That's why having a doula there is super important because you don't know who you're going to get for a nurse. Helping you take a shower, they are going to help you discuss your options sometimes if you are exploring them before the provider gets in there. They don't deliver the baby. They can if they have to, but they typically are watching. They are present for the delivery and watching other things, watching the monitors, watching your vitals.

you know, they're helping the midwife or OB in the hospital setting for the delivery as well. So that's a quick overview of the different members of your, who can be on your birth team or, you know, kind of the ideal birth team and that's your media birth team. And like I said, episode 135 goes deeper into like who else to explore for your birth team and also goes deeper into all of those, those areas. So the next thing we're going to discuss is effective,

communication strategies. So the goal here is to help you learn how to establish open lines of communication. This is so important to practice early and ongoing. So the sooner you can initiate open lines of communication with your birth support team, the better. And then doing it throughout.

You can do this during your regular scheduled meetings with your birth team, you know, with your with your midwife, you're seeing them semi regularly early on and then more frequently later on, you know, doulas like you have to typically to prenatal meetings. And then like for us, our model is that we have like unlimited boxers support. And so you have access to us through an app walkie talkie style app and you can ask any question anytime. So using.

all those meetings to establish open lines of communication because that's going to help your birth team be able to support you better. You really want to be able to ask them questions and share your personal preferences, desires, fears, concerns. You want to really communicate with them so that they can help you the best that they can or offer referrals or offer recommendations. Another great way for communication is using your birth plan as a communication tool.

Rachael Hutchins (25:43.782)
So way back episode 11 in the early days, we did one on creating a birth plan and it still is a fantastic episode. We've rebroadcasted, I think even a couple of times. And so be sure to listen to that because it kind of walks you through the how and the why and all of that. But you use the birth plan as a communication tool to learn how to create an effective and individualized birth plan.

So you use those tools to do that. The birth plan is an educational journey that helps you learn more about your options and your individual needs and your preferences. You then take your birth plan to your midwife, your OB, your doula, and you share it with them. This helps open up those lines of communication and gives you a guide for your conversations and meetings. It can even be like, you know, here's my birth plan. Here's what I know I want. Here are things I still have questions on.

and that can again be, help you have those conversations with your provider, and your doula and whomever else you want to share it with and your partner. Like it's a great tool to use with your partner too, because sometimes the partner isn't, doesn't know about all the things that all the potential interventions, all the potential where all the areas where you have like a say and preferences and everything and the creating the birth plan or we like to call it the birth preferences sheet. It.

gives you that opportunity to kind of work through like, you know, for example, fetal monitoring. Okay. What is, if you don't know what fetal monitoring is, like in that moment, as you're working through your birth plan, that's one of the things on there. You go do your research. Like what is fetal monitoring? What is the evidence on fetal monitoring? What different types of fetal monitoring exists? Why do we do it? What are my options in a home setting? What are my optional options in a hospital setting? What are the options?

with my particular provider because like you can do all the research and be like this is the type of monitoring I want. Let's say you want you know intermittent monitoring with a Doppler in the beginning and then you if it's determined you need continuous then you want wireless monitoring. Does your birth location have wireless monitoring? You know things like that so every little thing on the birth plan is an opportunity to learn and doing a childbirth education class is also going to teach you about all of those things.

Rachael Hutchins (28:04.998)
so that you can decide what works for you. Like for us as a doula, we have a workbook that kind of walks you through all the really potential interventions that might arise in birth from labor to giving birth to postpartum. If you need a cesarean, if there's a loss, things like that. And going through it, a lot of people have at least a couple of things that they're like, I didn't even know this was a thing. I didn't know.

you know, what's my option? What's my option here? Like sometimes what comes up under pain management is nitrous oxide. And some people are like, well, what is that? And then, you know, when they learn about it, they're like, well, that sounds like something I would like. And then we have to share with them that most of the birth or all the birth locations, except for the birth center in our area, don't offer it. So is it an option for pain management for labor? Yes. Is it one in your area? No. So, you know,

That's why it's so good to work through it and not make assumptions.

So that's how the birth plan can be used for communication. And then once you're in labor, if you're going to the hospital, then you bring that birth plan with you and you give it to your nurse because you haven't met your nurse before. So your doula is on board, your midwife is hopefully on board, and your OB is hopefully on board. You've had a chance prior to labor to communicate with them. With nurses, you haven't. So you give them the birth plan.

In our area, they're very used to getting birth plans. I rarely, rarely, rarely see a negative reaction to a nurse getting a birth plan. Almost always they review it, especially if it's like one page. So the template we offer to our doula clients is one page and pretty concise because they're busy nurses. They don't have all, you know, a lot of time to read multi pages.

Rachael Hutchins (30:02.342)
I hope if you gave them one, they would still read it. But it's like when we're talking about effective communication strategies, a one page simply written, not a lot of unnecessary words, birth preferences plan or sheet is ideal. And then they hopefully, the goal is that they put it in your file so that when there's a nurse change or midwives can review it, the OBs, you know, anytime there's a shift change or anything like that for any of them, they have access to it.

But when there's a shift change, you can also offer a new copy just to make sure they have it and that they've looked over it. And then they have an opportunity to look over it and ask questions if it feels like there's questions to be asked. And so again, that's how we're having communication using the birth tool as a, using the birth plan as a communication tool. Lastly, for effective communication strategies is asking questions. So highly encourage asking questions to clarify any doubts and ensure,

that everyone's on the same page or as on as much as possible right and keep asking the questions until you understand like I think it's very common for people to have like what's considered like white coat syndrome and that's like not an official term but it's sort of like in that setting where there's a doctor or even a midwife you know the expert in the room asking them questions might feel like you might feel insecure doing that or

Like who am I to ask them questions? But I want you to hear me when I say you asking questions to your provider isn't questioning their care. At least in this scenario when you're just trying to gather information and learn about your options. It is saying I've never done this before or I've maybe only done it once before, twice before. Like giving birth doesn't happen all the time. Not as frequently as providers are delivering babies, right? So they're doing it all the time. So it's very...

second nature for them and very routine for them. This is not routine for you. So asking questions isn't questioning their care. So I want you to kind of take, try to take that fear away of asking questions and say, you know, just like anything, if I don't know it, I want to ask, like if you're going to a new town on vacation, aren't you going to ask questions about where should I eat? What's the best?

Rachael Hutchins (32:22.534)
tourist place to visit? What's the best non -tourist place to visit? When is it safe to go? Is it safe to go? Is there a high season? Is there a rainy season? I don't know. Wherever you're going like you're going to do that research and you're going to ask those questions because you're like I don't know anything about this. So same thing with buying a house or planning a wedding or you know anything you might do in your life it's acceptable for us to do research and ask questions. I want you to see giving birth as the same.

And knowing, know that having a provider who sees that as an important thing for you to do is really important. Someone who isn't going to be offended if you ask questions and who is going to give you good answers, good balanced evidence -based answers, or give you resources to go learn more about it. We do that a lot because I get, we get a lot of the same type of questions. And so we've either created blog posts with all the information or we point them.

to trusted articles on the internet and say, here, read all of this because there's a lot of information on this particular topic. And then let us know what your questions are and how you think this might impact you. So that's OK, too, right? So knowing that asking questions until you fully understand it is perfectly within your right. And in the labor setting, if something is coming up that you haven't prepared for or aren't as informed on, it's really important that you feel good about that.

that decision because it's your decision that you live with forever. The provider, the OB, the midwife, the nurse, this is their job. And I think for the most part, they all care deeply about what they're doing, but they aren't going to, again, for the most part, remember that decision. It's not going to stick with them. It will stick with you. So making a decision because you think that's what they think you should do might have a lingering impact on you. It won't on them.

so that's why asking questions until you fully understand or your partner understands before making a decision is really important. so that you don't have those lingering doubts. Now you still might have lingering doubts no matter what you do because things went sideways and that happens too. So these are just to hopefully increase effective communication and decrease, you know, trauma and bad experiences. you know, I think it's important that you know,

Rachael Hutchins (34:45.318)
This is your birth and you are the consumer, you know, for lack of a better word, you are the one who has the right to kind of ask these questions and say what you want and don't want. And, you know, I think most people don't regret asking questions, but they do regret, regret not asking questions like after the fact, you know, I think I see that more.

I don't see a lot of people being like, I really wish I hadn't asked for more information. But I do see scenarios where it's like, I really wish I had used that opportunity to ask more questions. And you don't know what you don't know. And sometimes that situation is out of your control and unavoidable. But asking the question doesn't tend to result in regret in my experience. OK. The next thing we're going to talk about is managing expectations. So.

Want to help you set realistic expectation and understanding that birth can be unpredictable and that being flexible with your plans is really important. So being like, I like the phrase be the bamboo. We say this a lot to our clients to give them that visual thing to hang on to, be strong, be rooted in what you want, know what you want, be rooted in what you want, and then be flexible. That combination of things tends to lead to.

pretty positive, satisfying experiences, regardless of what arises. There are no two births alike. I've been doing this a long time and have seen a lot of birth. And while there's a lot of things about birth that we know about and are predictable, there are also a lot of things that are different and unique to each individual person. So, you know, your best friend might have given birth a certain way, but that is not going to happen to you in the same exact way it happened to her, good or bad. You know, your mom's...

birth experience or your mother -in -law's birth experience happened to them and good or bad, you know, they're going to share that story with you but know that that is not your birth story. That is their birth story and yours will be different in one way or another.

Rachael Hutchins (36:55.782)
so I want to share some potential scenarios, you know, preparing for different birth scenarios and understanding the potential for changes along your journey. you can do all the things to prep and still need some level of intervention or lots of intervention. You can do nothing to prep and things can go smoothly with no intervention.

What we know is that preparing in a meaningful and intentional way significantly reduces fear and increases your confidence and that how you navigate your journey, not, not, it's not the birth going a specific way, but how you navigate it and how you feel navigating it, whatever comes your way is what lasts a lifetime. So being prepared by gaining education, building your birth support team.

advocating for individualized evidence -based care, advocating for informed and shared decision -making, and then being flexible along the way can really help you have a more positive birth experience and more satisfying. So like some other scenarios, like you can plan for unmedicated and end up with a longer than anticipated birth. And then an epidural becomes the necessary tool for you to get rest and have the energy to push your baby out.

or you can be patient and wait for labor to begin on its own and still need to be induced if it is determined it is safer to get labor going medically than it is for you to stay pregnant. You can end up needing a cesarean even if you followed all the steps to avoiding a cesarean. You know, we can't predict exactly how your birth will go. Understanding birth is a mix of science and mystery and holding both loosely.

can help you navigate your experience with more ease and confidence. And we like the phrase, two things can be true at one time. Say that a lot with pregnancy and birth. There's so much duality that comes up during this time and then that duality persists into parenthood. So many parallels can be drawn between pregnancy and early motherhood. Ultimately, it's a balance of meaningful preparation and uncertainty.

Rachael Hutchins (39:15.046)
Maintaining a positive outlook while being prepared for various outcomes is vital.

Rachael Hutchins (39:22.982)
Okay. The next thing we're going to talk about is handling challenges and conflicts. So identifying common challenges. So let's discuss common communication challenges that may arise with your birth team regarding communication. So maybe you don't feel heard or understood. Here's where you want to keep asking until you have the info you need or until you understand.

So if you don't feel heard or understood, you know, finding other ways to communicate. So an example of this is like in the hospital and the, like an OB or midwife practice where you're going in for your prenatals, you know, maybe they were rushed and you didn't have time to ask your questions. I think it's important to ask for maybe a phone call in, like out of like that meeting out of that prenatal visit and say, Hey, can we just hop on a call for 10 minutes? I have some additional questions I want to ask or send an email.

with all your written out questions because sometimes it's easier to put stuff down in writing than trying to remember on the spot. And being persistent with the communication until you feel like they are listening and they get it. Because sometimes not to anyone's fault, they are just in a different mode or in routine or just aren't fully understanding what you're saying or what you need. So being persistent can help them understand you better and help you understand them better.

Another challenge is, I said it a moment ago, but if you feel rushed, ask for more time and send that follow up with the additional questions. Send an email with your questions or in that moment, ask for more time. Be like, hey, I know you're busy. I just would love 10 more minutes of your time. I have some questions to ask. I definitely recommend for questions to ask your provider or your birth plan. Have just a few things you want to go over with them in that meeting.

and at each meeting with them ask those questions or send that separate email with all of them and say, hey, like, how do you want to address these questions? We can do it in the office. We can do it over the phone. You can send me back an email. Just find whatever way can help you get the information you need. So another challenge that might arise is being told you need something that you aren't sure if you do or not. And this is when my favorite.

Rachael Hutchins (41:46.694)
My favorite Berthie tool comes in and it's called the brain acronym. So we like to say use your brain and this is a series of questions. The acronym is brain B -R -A -I -N and each letter stands for a question that you ask. So we like to encourage you to write it down, put it in your purse, put it in your partner's wallet, use it at your appointments. It's just a great tool that you can use to gather the information needed even if there's something you don't know about.

We like to say, you're not going to know all the things about all the things and that's okay. If you can learn this brain acronym, it can help you regardless of what arises that you're not familiar with. it can be also a great tool to help slow things down. Like if it feels like there's some rush and urgency around the decision, I would say more times than not, it's not an emergent situation and you have time to kind of walk through these questions and doing that kind of just slows the process down, helps everyone take a beat. And that can be really beneficial in the labor setting.

So the B is benefits. What are the benefits to whatever is being recommended or suggested? Whether it be, you know, a membrane sweep during pregnancy, an induction, artificially breaking your water, a cervical check, whatever it is, what are the benefits to this, to doing it? And what are the benefits to not doing it? There are two sides to all of these questions. What are the risks to doing this?

What are the risks to not doing this? What are your available alternatives based on where you're at in your journey? Right? Are you still pregnant? Is it labor? Has labor been going on for a while based on your hospital or birth location or home setting? What are your available alternatives? And then what's your intuition telling you? That's the I. So listening to your gut, trusting your gut, doing that early and often will help you so much in your mothering journey or your parenthood.

journey listening to your gut is so important. So just asking, taking a beat and saying, what's my gut telling me here? What's my intuition say? And then the N is now or nothing. So like, do we need to do this now or what if we do nothing? That's a great way to kind of wrap up the questions because sometimes the answer is what if we do nothing? They might say, well, maybe you'll just be pregnant longer. Okay. Maybe you're okay with that. Like, and there's no big risk or anything like that. Maybe we'll just give them more time.

Rachael Hutchins (44:14.182)
And then after you gather this information, I think it's helpful to ask for the providers like midwife, OB, even your doula if you want, whoever to kind of leave, or you can have your doula stay and they can kind of help you work through that conversation called a little pow wow. And debrief, you know, you can think about, you've gathered all that information and now you can think about how that makes you feel.

what you want to do and kind of talk it out without having a provider standing over you or pressuring you. So you ask everyone to leave, you do the powwow. And then when you're ready, you can invite them back in and say, okay, I'm either ready to do this or I'm not ready to do this. I would like to wait an hour or a day or whatever it is based on the thing being offered. And so the brain tool is really helpful in really getting informed and shared decision -making and keeping you in the driver's seat. So, you know,

Another thing with handling challenging situations and conflicts is knowing when to advocate for yourself. So anytime your needs and preferences are not being met or heard, anytime you don't feel fully understood or anytime you don't fully understand what's happening or what is being presented to you, anytime you need to remind your care team, you...

are the one in charge and that the goal is to work collaboratively as a team. That's when you want to get your advocating hat on and maybe it's the whole time you're in labor and maybe it's moments of labor and some and it happens in pregnancy too. It happens in that immediate postpartum. It can happen in the you know first few days postpartum and then the first you know 12 weeks postpartum like.

advocating for yourself and being prepared to do that can come up at any time. It doesn't end at the birth and it doesn't begin with labor. It really, really any time in life that this is happening to you, that's the time for you to be like, this is my life. This is my experience. It's my body, my baby. Like I'm in charge of myself and that active participation, maximum self -determination. Like you will be the one living with this. And so going into this,

Rachael Hutchins (46:29.606)
With that in mind, I think can help most people avoid unnecessary trauma and that bulldoze feeling. And this isn't like you have to go into every birth, like prepared to fight. It's just being aware of what advocacy looks like, being aware of what informed and shared decision -making looks like, and knowing that if that's not happening, that's the time for you to sort of step up into that advocacy role or your partner being prepared to do it and your doula being prepared to do it. You know, as a doula, we tell our clients, you know, we

don't speak on your behalf and we don't say you do or don't want something to the medical provider. Your partner can, you can, but we can't because you might have told us in labor or in pregnancy that you didn't want an epidural or you didn't want your water broken and then you know you've been in labor a long time it's been recommended to you you've exercised the brain acronym and now you've decided to break that you do want it.

Like if we, you know, step up and say, well, no, she doesn't want that, that's speaking for you. And maybe your mind has changed and you have every right and all the space for your mind to change in the, in that journey. So we don't speak up for you in that way. but we do advocate for you. So if it feels like they're not listening, if it feels like something's being done or started without informed and shared decision -making.

That is when we might pipe up and be like, hey, you know, do you want to use that brain acronym right now? Or sometimes I play dumb and act like, you know, hey, if you said, I'm going to break your water, what does that mean? Or, you know, like, so that it kind of takes them out of their routine and helps them remember that they need to offer more information or ask permission. And so the doula.

helps especially if you as the birther you're kind of in labor land and hopefully a lot in labor land meaning your thinking brain is dimmed and your primal brain is active you may not be as aware of what's happening around you. That's where the partner it's really important that they stay aware but having a dual of present is that very like unbiased and not tied like they're not that intimate partner they're not the loved one.

Rachael Hutchins (48:45.894)
they can easily sort of see everything that's happening and be able to speak up. And it's important that your doula is able to do that in that setting. So those are some ways you can handle challenging situations or conflicts. The next thing I was going to share are some client stories, personal experiences and stories that I've had as a doula. These are anonymous, of course.

but just showing different things that have come up where good communication has helped, informative shared decision making has helped, autonomy has helped. So the first one is she was a first time mom and she took all the classes. She did childbirth education. She did postpartum planning class. I think she did the newborn class. You know, very active participant in her pregnancy.

had a very intentional birth plan, really wanted to avoid unnecessary intervention, did the workbook, kind of did all the research to decide what was right for her, had a really good plan, had chosen a provider that aligned with her. And then like 36 weeks pre -eclampsia reared its ugly head and necessitated an induction. And...

So in that moment for her, it felt like everything flew out the window. But then we talked to her and reminded her of all of her options and how she can have a gentle induction, how she can still avoid some of these other interventions, reminded her of the brain acronym, so to determine how necessary that induction truly was, how much time she had to wait, things like that.

And when an induction comes up for our clients, we have offered like an hour separate conversation all about how to prepare for the induction, what to expect, what happens at each different stage, the different types of things that might be offered, monitoring. We talk about, you know, how to really kind of expectations around how it's going to go and inductions can take a long time.

Rachael Hutchins (51:10.982)
You know, it's great if an induction takes a day, but a lot of times it takes two or three or sometimes four days. And so really helping our clients have that healthy expectation. And they did this. They listened to us. They treated it like a staycation. You know, they went in with very healthy mindsets and said, this is going to take a while, but I'm okay with that because I want to avoid these downline interventions. So that's, they really got rooted in. Yes, we're raising our baby. Yes, we understand we need this even though we didn't want it.

but we're going to take certain steps to avoid downline interventions. And they did that. And it was a long induction, but they ended up just rocking it and had a really, really great birth experience. Needed a lot of intervention, but they really took their time at each point, really, really exercised the brain acronym. One of the best parts of that story was when...

The provider was recommending artificial rupture of membranes and they went through the brain acronym. They asked for some time to think about it and they just weren't sure that was right for them. They wanted, she really wanted her body to be able to do it on her own. And in this scenario when, you know, she was needing a lot of medical intervention, she was like, this is the one thing I really just want to happen on its own. And sure enough, she asked for some more time. And I think within an hour or so her water broke on its own and that felt victorious. It was like, okay, I didn't need the medical intervention for that. My body did what it was supposed to do.

And that was because she took the time to kind of ask those questions and ask for more time. And there was really no risk in waiting at that stage. It just meant maybe a little bit longer of a birth. So that was a wonderful experience to witness because that's not easy, right? That's not like a straightforward, no intervention. Things just went as planned. That's like everything kind of got turned upside down. But with that, that intentional preparation and that advocating for informed and shared decision -making made a big difference in.

and her birth experience and communication. The next one I was going to share was someone who was planning their second birth and was during COVID and in our area, some of the, or a lot of the hospitals shut down to visitors, to doulas. Yeah, not shut down altogether, but like to having anyone with you. And, you know, they were being really strict with masking and.

Rachael Hutchins (53:35.014)
you know, testing for COVID and separating mom and baby if mom had COVID. And this person decided that, you know, we had a conversation. I think they had hired me at this point to be their doula. And really shortly after a couple of conversations we had together about, you know, I'm pretty sure it was one of those situations where they were sharing what they wanted and then talking about what it looked like where they were planning to give birth.

And I was like, have you explored your options? Like, do you know other places you could give birth or other providers who are more supportive or have you explored home birth? And so she listened and asked some questions and then she did some research and met with some different midwives and decided on her own terms that she wanted to switch to home birth. And that's like that autonomy. That's knowing your options.

building your birth support team, using your birth support team to guide you through those hard decisions, weighing out pros and cons. and I love seeing that when that happens, not, not just choosing home birth, cause I mean, I love home birth, but like the exploring of the options, the advocating for your care that you feel like is best suited for you, the individual and just seeing that unfold just makes me very proud as a doula. and another story.

I was going to share is second time mom who had a vaginal birth with the first, but had a pretty negative experience with the epidural and just how the whole birth unfolded, albeit there was a vaginal birth at the end. The laboring process was not a positive or satisfying experience. So this person decided to really advocate for a different.

birth and advocate for a strong birth team provider who aligned with her, you know, did all the things during pregnancy to prepare for the birth that she wanted, knew her options, you know, really good at asking questions, did all the things, right? And in her labor, you know, things got, you know, she had a bumpy road to say the least, you know, difficult epidural.

Rachael Hutchins (56:01.606)
when she decided to get the epidural, she knew she wanted an epidural, but once she got it, that epidural was not as effective as it should have been. So that created a lot of discomfort and a lot of stress and anxiety. and then things weren't progressing in an efficient manner. and so with a good, good supportive care and good active participation and using that, you know, shared decision -making, this birther decided on their own terms.

before it was necessarily told to them that they wanted to have a cesarean. And I think that's like the epitome of empowerment and autonomy. And that provider supporting that and listening and being supportive all along the way was pretty beautiful to witness. And it's not common. You don't see that happen a lot. But through her educational process and with a good provider and good support team and her own intuition,

she was able to make this decision confidently and feel good about it and knew that that was right for her. And that's a hard, hard decision to make when you're in labor. So, you know, very different stories, very different motivations, very different personal histories and individuality, but, you know, using some of those like communication tools and advocacy tools to achieve.

a positive and satisfying experience is really, really beautiful. That's what I love as a doula. I love the bursts that go smoothly and no hiccups, believe me, those are amazing. But I feel like where as a doula and a childbirth educator, it hits home is when people have an opportunity to feel that empowerment and feel that advocacy and use the tools that they work so hard for because...

It's kind of proof that they can do hard things. And I think when we live through hard things and challenging things, that really kind of increases our confidence as a, as a new mom. okay. So that's our show y 'all. I just wanted to review the things we chatted about here. so we talked about who is included in your birth team and their roles and responsibilities. We talked about how to establish open lines of communication with your birth team. We talked about how to manage.

Rachael Hutchins (58:22.854)
healthy expectations while protecting your personal preferences. We talked about how to navigate common challenges and conflicts with your birth team. And I want to share three actionable takeaways that you can do after listening to this. What to do next to implement in your own birth planning. So one is to explore your options for birth doulas, midwives, OBs, and birth locations in your area.

Even like a little bit outside of your area. It's okay to drive for good care too. Next, I want you to create a birth plan or a birth preferences sheet and don't just create the list for sake of list. Cause you can Google like birth plan online and get a pre -made one. And you might be like, cool, I got my birth plan done. You got to do the work too. You got to do the education that comes along with it. So maybe consider doing a childbirth education class and then creating that birth plan. Cause you're going to have more knowledge.

And so having the knowledge surrounding the birth plan is way more beneficial and effective than just creating a list to create a list without knowing what the things on the list mean or apply to you. The third thing is write down and carry with you that brain acronym. It can be on a little piece of paper or post -it note and it can be in your wallet, your hubby's wallet. It's a really useful tool for your care, pregnant or not pregnant, for your kids care after their...

born into this world. Your husband's care if he's going and needs a medical procedure or something like that. The brain tool is highly beneficial so write that down and carry it with you. And I'd love to hear your own experiences with these topics that we've discussed today. If you have if you want to share your own experience or if you have any questions on the topic you can reach out via Instagram, Aligned underscore birth.

Or you can email us at Aligned Birth Podcast at gmail .com. Thank you for listening. And also wanted to share with you guys that for the month of July, so this will be our last episode, our last new episode for the summer. In July, we will be highlighting some previous episodes and doing some rebroadcasting. And then you'll get brand new episodes from us beginning in August. We hope to hear from you soon and hope you'll tune in next week. Have a great day.