60. Informed Consent: Take Your Birth Back by Being Active in Your Care and Asserting Your Birth Rights

Informed consent is a crucial topic to discuss in childbirth. I love helping women take control of their birthing experiences by asking questions and making informed plans, so they can love their birth no matter what!

In this episode, I spoke with Katie Spinks, a doula and childbirth educator, who bravely shares her story of experiencing uterine rupture during an elective induction with pitocin. Katie opens up about her journey, highlighting issues of uninformed consent and medical negligence that led to a severe birth injury to her daughter, Jolene, and the emotional toll it took on her family. She stresses the importance of questioning medical advice, standing up for oneself, and exploring alternatives.

Topics we talk about:

• The lack of information about potential risks and interventions in typical prenatal care…
• The importance of informed consent and necessity for better childbirth education…
• How healthcare providers should be respecting women’s autonomy and choices during labor…
• The uniqueness of each birthing experience and care should be tailored to each woman’s needs and preferences…
• Strategies for self-advocacy and navigating medical interventions confidently…
• …and much more!

Informed consent is vital for respectful maternity care, empowering women to make informed decisions about their birthing experiences. By sharing stories like Katie's and fostering dialogue, we aim to raise awareness and empower women to reclaim control in their childbirth journeys.

Thank you for tuning in to Episode 60! Join us next time as we continue to explore topics related to women's health, empowerment, and informed decision-making in childbirth. Remember, your voice matters, and your birth experience deserves to be respected and honored.

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Connect with Katie

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👋 WHO AM I?

Welcome, friends! I am Beth, a certified nurse midwife, doula, and childbirth educator. My philosophy is rooted in autonomy, informed decision making, and positive mindset to help expecting parents plan for a beautiful, stress-free birth. I am here to provide value to YOU through tips and practical advice, either to guide you through pregnancy or to help you prepare for childbirth, postpartum and beyond. There’s no fluff here - only info that adds to your positive experience and saves you stress and uncertainty.

Transcript

Hello everyone and thank you for listening to episode 60 all about informed consent and us as women, taking our births back! My goal for this episode is to empower you to be active in your care during pregnancy and help you see the side of obstetrics that isn't usually talked about, in terms of questioning the status quo or rather having information to know what you want, creating a plan, and then taking control of your birth, rather than passively following your providers advice without prior education or information. I would love for all women to be centered in their care and for their values and wants to be heard and respected, knowing all their options, as just the standard of care. And this isn't the case today, but the only way it is going to change is if we educate ourselves and each other about pregnancy and birth and change the expectation.

So today, I am sharing an interview I had with Katie Spinks. Katie has a large social media following on Instagram, TikTok, and Facebook where she shares her story of uterine rupture after the routine use of pitocin for an elective induction. I was really interested in hearing her views as not only a birth doula, but also a mom who experienced uninformed consent for the use of a birth intervention mixed with obstetric negligence, that led to her beautiful 4-year-old daughter Jolene to have a severe birth injury which has affected her entire life as well as Katie and her family in many ways.

My name is Katie. I'm 35. I'm located in Northern Virginia. I have six kids. Four of them are living. Two of them are deceased. I lost the last two in my second trimester due to uterine incompetence, um, because of all the scarring I had in my uterus due to the birth of my fourth child, which ended in a uterine rupture.

 I am currently a doula and a childbirth educator, and I landed in that work because of the birth. Of my fourth child.   she was an elective induction. At the time I was made to believe that inductions were safe. You know, my doctor said, we do this to everybody. Everybody who hits 39 weeks is offered an induction.

If you're low risk and you're healthy, then there's everybody does it.  With that information, I agreed to do it  and I want to say I was around seven, maybe eight, eight centimeters. I, my uterus ruptured due to the Pitocin use and a uterine rupture, as you know, is an obstetric emergency. There's just minutes for the team to assess the mom and get the mom back into the OR before she can die.

She could lose her uterus, the baby could die, the baby could suffer brain damage. , so my team did not do that. I went well over an hour fleeting and begging for help and nobody, nobody did anything for me. Even when the doctor came in over an hour later, she just, the only thing she could focus on was my birth plan and the fact that I wanted to keep my placenta.

So she focused on that the whole time as she's walking in the room. And then she assumed position and made me push. through this rupture, even though with a uterine rupture, you can't push through them because, you know, the uterus is ruptured and the baby expels out to the abdominal cavity. You can't push with them.

But she tried to make me and each time I would push, I would pass out. So then she  reached up in me and hooked a vacuum on and then would pull the baby every time I would have a contraction and it popped off. Three times, and at the third pop off, I passed out. She stated in my medical records it was because I was tired, but it was because I lost about thir three thousand milliliters of blood.

So, you know, it's over forty percent.  , so by the time they did take me back to do the C section. I was in,  I was in emergency mode and I had to have a three hour surgery to save my life. And Jolene, my daughter, was born completely purple. She had no heart rate, no, gave no effort to breathe. It took a few rounds of CPR, some epi.

The doctor, thank God for the doctor who was there that night because he started umbilical,

cooling her, because he knew that if she was going to have a chance at life, she would have to be cooled, and slow her whole body down, which he did do that. And they had called for a transfer, the whole transfer team came there before I had awoken from the surgery, woke up from the surgery, , and she was transferred to another hospital that was about an hour and a half away from where I was.

We were separated for like three days, around three days, before we were united, because I had not met her yet,  I saw her foot, before she was transferred and that was it. , so because of all of this.  because of everything that happened. Because I didn't know that a uterus could rupture. I had no idea.

And when I asked why it happened, they just, they blamed it on me. They said, well, you must have a weak uterus. , that's it. They said, this never happens. It's like a one in 1 million chance. And you just must have a weak uterus. But mind you, this was my fourth child.  Um, and she wasn't even my biggest child.

She was actually one of my more smaller ones. And so I just started digging more into it. and realizing that what happened to me was absolute negligence. That women are not supposed to be treated like that. You're not supposed to hold a laboring woman's legs together. You're not supposed to tell them to be quiet.

You're not supposed to tell them they're being dramatic. You're supposed to listen to them. That's the doctor and the nurses. Their job is to listen. If a mom says I'm dying or something is wrong, they need to take it seriously. So when I realized that, I was really mistreated and I was really lied to. It really sparked my interest into just kind of  looking into birth work on my own like I was reading studies and listening to other people's stories and asking questions and just really getting out in the community virtually to see if other people had had gone through this.

Um, and so eventually I was like, you know, I really want to do this, , as a job. I want to be able to go into hospitals and help people and conduct classes and all that. So, that's where it landed me into doing it professionally. Because before, last year, I was just kind of doing it virtually. You know, like, women would come to me like, what is this?

What do you think I should do? Do you have a study to prove this? My doctor's saying this. Do you think it's true? And all that, so I wanted to be able to, , put a title behind my name and be able to give them professional advice with the title behind my name.  Yeah, and I feel like that's how a lot of us come into birth work, is from having an experience that, you know, is less than ideal, that we've had trauma, that things didn't go the way we wanted to, and then later on we realize that Something wasn't right.

I can see a few parallels to in my own story of, I don't know how long it took you to kind of, I'm sure you felt like you were mistreated right away, but did it take some time for you to come to terms with what actually happened and be like, wait, the severity of the situation is much further than what I initially thought, because that's how I felt with my first birth.

It was months later. And I was like, that shouldn't have happened how it did. And, yeah, yeah. It's so unfortunate that it did. At first I really didn't like, and the NICU doctor even Encouraged us to go see a lawyer and I was like, I did. It didn't click right away. Like, why do I don't understand why we need to go see a lawyer?

Like, if this was my fault, it's my fault. So what are , what am I supposed to do? And even it took it took a little over a year to realize that. This, this really was not normal. The way I was treated was not okay. Not okay. Not normal. It was negligent. It was malpractice. It was all these horrific things.

And like I said, you know, I didn't, I didn't realize it because they kind of shifted the blame to me. So I thought it was my fault. And you don't realize it until later on, until you're processing it and really thinking it through. And you're like, you know what? This wasn't my fault whatsoever. None of this was my fault.

This, this was their fault. Right.  Which is so interesting that you say because you had three other kids before having your fourth,, kid that you already had experiences before to bring with you. , I don't know if those were positive experiences or not, but, , in general, like, usually it's first time moms that they, you know, have a birth experience, maybe doesn't go as planned, and then they are opened up, you know, their mind is open to different opportunities and different possibilities.

And then they're like, wait a minute. Things could have also happened better the first time. Let's, how can we make that happen? , that was my, my specific, , take on it, I guess, when I had my first daughter. But yeah, it's like, what can we do differently? And I would love for our families to have more information before they go even to, into that first birth experience, to be empowered and informed.

So things like this will happen. I can't imagine being a first time mom and going through stuff like that, because you are a first time mom, you assume you're gonna go there, have your baby, it's gonna be fine, and you're gonna go home, even though they don't teach you in your prenatal appointments, well, this could go wrong, this could go wrong, this means this, they don't teach you any of that stuff, so you just assume it's gonna go good, and you're gonna go home, you don't think about any of the things that could happen in between, so I can't imagine being the first time going through that.

Right, and you, you have the trust in your providers, like, most of the time, they, of course, they mean well, they're in there to, you know, take care of moms and babies, that's why they got into it, and you just want to have this positive view of everything, but there is a lot of stuff that goes on, I feel like, behind the scenes, too, of, , , , when, when you go in for an induction, , it's more convenient for providers, or, , when you, get certain tests,  we want to know as much information as we possibly can with certain tests just because we can versus because it's actually indicated for the,  medical necessity for a mom or for a baby.

, there's not always all of these things that we have to be doing. And then I feel like when we start, you know, Doing all these interventions are doing all these testing families are kind of like women in general, just kind of trained from the moment that they're pregnant that they always need to be doing something to make things happen.

And I especially feel that in the end when moms are in their third trimester or their, you know, full term at 37 weeks, it's that conversation of. I'm not doing everything I should be to make things happen faster or to make my baby come or why is she not here and I'm 39 weeks and there's just not enough.

information or support around that time when we can go till, you know, 42 or beyond weeks pregnant in a healthy pregnancy and deliver a healthy baby and have a healthy mom, , without the need for things like an elective induction. And I just don't think that's  I agree. I feel like everybody rushes birth now.

Once 39 weeks hits, boom, everybody thinks that they should go into labor. And if they don't, they have to be induced. I see women all the time saying, well, my doctor told me if I go past 39 weeks, my placenta will die and my baby will die. And it's like, that is just, that's just not true. That none of that is true.

And if your doctor is using your baby against you, you need a new doctor. Your doctor should never use the word your baby will, the words, your baby will die, or you could kill your baby. to induce you or to force you to do something ever.  All of these interventions lead to more interventions. And then those interventions lead to more.

And it's just  this domino effect of one little intervention will lead to a much larger one. And we just, we aren't given the information. We're not given the choices. We're not told the risks, the side effects. What could we do instead of doing this? Why do you really need it? Because I mean, being in birth work, we know that if you're having an intervention done, there needs to be a medical necessity.

That's how they should be using it, just the inductions. They were only approved for medically necessary reasons, not just because mom went to 38 weeks and her back hurts and she wants her baby out. Like, okay, that's just not best for the baby though. So, well, I mean, the doctors need to, I feel like some of them do, there are some really good doctors, but more of them need to sit down and just.

They need to take control and be like, no, I'm sorry, Mrs. Smith. You're only 39 weeks. This has proven to be not safer for you. You need to at least hit 41 weeks, especially if this is your first baby. And we can give you options for pain relief.  You can take this or you can use this. We can put you on bedrest.

There are things we can do to make you comfortable. But bringing your baby into the world because you're tired of being pregnant is not a legitimate reason. And I feel like so many women do it. As soon as they hit 39 weeks, I'm so sick of being pregnant. Yeah, we all were.  I think we all were. Yeah.  But it's not like it's gonna last another 39 weeks.

There, there is an end. Once you get to the 42 week mark,  it's, it's  a hit or miss. It depends.  If the baby's still healthy, mom's still healthy, baby's moving, placenta looks good.  Right. Go another couple days. Right. Most of the time women don't even make it that far. They, they hit  that 41 and 3 and they go into labor.

So most women don't even make it to 42.  Right. And that's a question I get all the time from families is like, what do I, what do I need to be doing now to, you know, make things happen quicker? And, uh, what if women, like, what if I don't go into labor naturally on my own? , and my answer for them a lot of the times is we just don't give enough time for moms to go into labor on their own to like show us that it's possible, , because we're trying to intervene too early.

And I feel like that was more of the narrative that we should, you know, support families. And cause that's really all they need at that point. Like I've had so many moms reach out to me, even at 41 weeks or 40 weeks, , that I've never met before. And they're just like, I'm really struggling. My providers say I need to be induced because, you know, I'm 35 and I'm advanced maternal age or, , just different things that maybe they're not technically like high risk medically, but there's like one little thing that they could pull from to say, well, we would recommend an induction today if you wanted one.

, and they'll reach out and they'll just, they'll say, this is what I heard, but , is this true? Or, you know, do I have more time and, and things like that. And I think the, the support and just somebody to talk to, or, , if they're in pain like having referrals to  a chiropractor or go get a massage or if you have other kids at home maybe that's  stressing you out a little bit and you know you're you're done being pregnant at that point and you just need a break and that will just change your mood around being pregnant still  if you feel like you had that  expiration date  which due dates are not good for that.

Mental mindset. I feel like either with waiting and  having that date on your calendar and then it passes and then the next week passes and you feel like something's wrong with you or you feel like  something's wrong with your baby or they're going to be too big and  all that stuff is just Like, made, made for us to believe versus  actual factual things.

It's  a race. They want birth to be a race. How quickly can we get you in and out? Or when they, you know,  when you have women in the hospital and the doctor's like, Well, I have to leave at this time. So we really need to get your baby out. Because if not, then you'll have somebody else. And the mom feels like, well, uh, okay.

You know, she feels like she has to agree to receive a bunch of Pitocin. And things to speed up her labor. I think that's a, that's a terrible one too. I see that a lot. I'm going to leave. My shift is over at seven. So if your baby leaves by seven, they're going to have somebody you don't know. And mom's like, uh, oh my God.

Um, okay. It's like, you don't get a medal for having a baby in, in six hours. You don't get a medal for having a baby in 12 hours. You don't get a baby, a medal for having a baby in five days. Birth is birth. It's supposed to take time. It's not supposed to be in  and out in less than a few hours. I mean, obviously some do, but.

It's not supposed to be, you're not supposed to force it like that. And I think a lot of the stuff in the hospital with the intervention is All about being on the clock, whether that's cervical checks every few hours, or we can break your bag of water since you're here. Why not? Or, ,  let's start Pitocin because, you know, your water broke and your contractions haven't started yet.

And it's been,  I don't know, 12 hours or something like that.  But then it's just kind of like, Oh, well, this is usually the next step. Or this is what I normally do with all my patients. And it's not the individualized care that families really need. And then it's also not that informed consent that we're given at all.

, it sounds like in your, in your situation, were you given any risks of Pitocin for your induction that you had, , conversation about that? Or was it just kind of,  My doctor literally said that it's safe. We induce everybody. , I'll be just like everybody else. I'll go in, start the Pitocin, get the Epidural, and go home.

You know, that was just the normal that I was taught. I was taught that you go in, you get Pitocin, it gets too painful, so you get the Epidural, and then you push your baby out and you go home. , I was never, nobody ever sat down and said, well, hey, you know, there are some risks associated. They might not be common, right?

Here are the less common ones. Here are the more common ones. If you get Pitocin, this could happen.  It might lead to something else and you know, nobody ever sat down and said anything. Nobody not once. Never. I've had four kids Pitocin with all four of them. Never once did anybody say anything. It wasn't until, like I said, when I was processing everything and realizing that it wasn't  my uterus, um, was when I learned that Ketosan can cause a uterine rupture, especially at a higher dose, you know, like once you start hitting 10, , and it gets a little, a little more dangerous, , and being on it.

I think I was on it for like 12,  uh, maybe 12 hours, probably a little bit more than 12 hours with no breaks. As you know, if you're on Pitocin, especially a higher dose, you, you got to give the mom's body a break. You're going to stress the uterus out. The uterus is going to hyper stimulate. It's going to get stressed out.

It's going to stress the baby out. It's just not a good situation. If you're on like two to four, six, you know, it's a little bit safer, not safer, but safer than 14 to 20. Um, being on a dose higher than 10, mom definitely, I should have been given a break at least two to three times. And I wasn't given any breaks.

But I wasn't, so, given any, any information, you know, and I thought birth was supposed to be excruciatingly painful. I thought it was supposed to hurt like that. So I just, I felt the pain of the rupture. And the nurse was like, it's just birth pain.  I just had no choice but to listen to her. Um, even though I felt like in my head that something was still wrong and I kept voicing that something was wrong.

Was wrong and it didn't feel like birth pain because like I didn't have pain in my vagina and I didn't have this stiffening of The contractions there was no rest in between it was this constant pain and it got worse and worse and worse But they just kept saying you're just you're transitioning.

You're getting closer You're probably 10 centimeters and I just kept telling her  it just it just doesn't feel like Like birth pain, just feels like, it feels like I got stabbed in my side,  you know, you know, no one took it seriously, obviously, which is just very sad. Which is, yeah, and then kind of going back to what I had mentioned before about like, when did you start to feel like  it was worse than you maybe had initially, initially thought it was, and it's a lot of negligence up front that could have been avoided when you were saying all these things, when you had all these different symptoms or, um,  Like pushing wasn't making any progress and they had to use the vacuum to bring her down.

Like there's different, different red flags throughout the entire process that, yeah, you were not, you were not at all listened to. And that is just a huge shame on whoever was working and whoever was part of your care. And the fact that, , there was no, like, Even option to get a second opinion, maybe at that point, or, , is there anything you, you would consider maybe changing to like be heard?

Or did you really just feel like  overall you were just, that was your experience and there was nothing that you could do at that point? Was there anything? Looking back that you could have done differently? Looking back, knowing what I know now, I, I could have demanded that they do an ultrasound  because they could have, they should have.

I could have called 9 1 1 while sitting in the bed and telling, you know, tell them like, I'm in a hospital bed and I feel like something is catastrophically wrong and nobody is listening. I could have, Called the charge nurse. Like there, there are things that I could have done to maybe make them listen.

Well, at least try, but you know, who knows? I really don't know. In the end, if I had known then what I know now, I would have never agreed to the induction in the first place. It would have never happened ever, but  I definitely, I just wish we would have. known more that things could go wrong because we didn't even know that things could go wrong.

I thought the only people who needed a NICU were preterm babies or really sick babies or babies with cancer or moms who had, you know, gestational diabetes or stuff like that. I was healthy and she was healthy. So I never, I never clicked that there could be something else that could happen. I think it's so important that women are taught these things can happen because you can't advocate for yourself if you don't know what exists.

You have no idea. I had no idea uterus could rupture, even though I'd had three prior children. I had no clue. So if I had known that that was a thing, I could have used my voice and been like, I feel like my uterus ruptured. And I could have said that over and over. Somebody could have done an ultrasound.

They would have seen that she was out of my uterus and in my abdomen. All the blood and everything and things could have happened. I've been much quicker, but because I didn't know and I just had to keep taking their answers of oh, this is just birth pain. This is just birth pain.  I didn't know what else to do,  right?

Yeah, I mean, there's not a lot even in the moment to when you're that much in pain and whoever's there supporting supporting you If you had people there supporting you, , they don't know what to do in that situation. You're not trained in those situations  But I think it's just important for families to know that it's not It's, it's important to have the information beforehand for sure.

And then if something does feel off or like, even if it's  not an emergency and your provider is telling you something that you just don't feel comfortable with, , or your nurse is doing something you're not comfortable with,  you have the right to say, , I would like a new nurse or go to the charge nurse or not physically go to the charge nurse, but as a speech to the church, , and just  try to.

So just knowing that's an option to talk to somebody else and not take what is being given to you as  factual, I think is just eye opening for families to know that  there's not one way of having a baby, there's not one recommendation, providers are going to recommend all different things, , and if there's a question about literally anything,  there should be an answer that's like specific to the concern and you shouldn't stop until you have an answer.

, of course, yeah, my first birthday, I wouldn't have questioned anything.  And had every intervention that you could have really based on an elective induction that I didn't even need, but I didn't know it was an option. , it was just like forced upon me and, , yeah, so it was just, it's just like not knowing that you have the option and not knowing that you can second guess your provider because you think that the expert, which they are, they've gone to school for a long time, but their way of practicing might not be the right fit for everybody.

So that's important for everybody to kind of take away. Definitely. I wish we had known too. I didn't know that you could fire a nurse. And ask for a new one. Um, you can also ask, uh, like if you ask for an intervention, like say I had asked for the ultrasound and she said, no, you don't need one. Then I should have said, or, you know, you could say, can you please document that in my chart that I asked for an ultrasound and you denied me one, or, you know, just if you ask for something or you're denying something, they can always just put it in the chart for documentation, show that you tried.

I didn't know that you could do that either until afterwards. I think that was, that's really helpful. Especially with raising a child with such severe disabilities is when I ask for things and they say no, you say, well, can you chart that? Usually they change their mind and they say, well, you know, let's talk about a  little bit further.

, they know that they don't have to just deny it might be a little bit more work for them to, to do something like to do an ultrasound for me while I was in labor could have been more work, but it wasn't detrimental. It's not, it's not that hard. That's your job. You're there getting paid. You're getting paid anyway, so just do what you're supposed to.

Absolutely. Yeah. And, and feeling,  like, confident enough to stand up for yourself, I think it's really hard. It was very hard for me as a first time mom, not feeling like I really was prepared or knew anything to be like, who am I to say, I don't want my water broken? Or who am I to say that I, you know, want to be in this position as I'm laboring versus on my back with the monitors hooked up to me for the entire time?

Like, I guess they've done this every single day of their life, you know, as a nurse or provider, like who am I to say anything differently? But it's just so important for people to know that your experience doesn't have to be the norm or what everybody else is doing. It's everybody's body responds to labor so differently.

And if you want to be Hands and knees like in the corner like with the on the couch or whatever like you can be over there like there's not this like only section of the room that you're allowed next to the monitors next to the computer. That's convenient for them. , making the hospital room work for you, I think, is important.

, cause I have a lot of families come to me too that they want like a home like birth, but they want to be in the hospital for that security. And I'm like, well, we can make that happen. We can make the environment different. And, , you can have limited intervention or no intervention and just speaking up for that and feeling confident and prepared before going in to know what you're going to ask for and kind of hype yourself up if you have to.

, not everybody likes confrontation, right? But a little bit of that, and it makes a difference when you're, when you're ready for that. Yeah, and it's hard, like, being, if you, when you're in a ton of pain, or you know, you're in that vulnerable spot, like the laboring woman, but she knows she really wants something, so it's good to have somebody else there who can advocate to, who understands what she wants, when she wants it, how she wants it, so that way when she gets in that transitional phase, you know, where it's a little bit more painful, a bit more discomfort, , and she can't speak for herself, at least her partner or her doula, whoever else is there, can be like, hey, you know, she said.

She really has a goal of not having you guys check her that much. She doesn't want you to increase her pitch. She doesn't want you to do this. She wants to be on her hands and knees. Can you help me get her in that position? Having somebody else there who knows that your goals and knows your wants and knows your needs is really important too.

, and the mom sitting down, I feel like, with the doctor beforehand and at least giving them the plan so that way they know what they want in case they want to reference it. I don't know if they do, to be quite honest, but  Having that plan from like everything you want, from when you check in to the first stage, the second stage, and even the third stage, what you want for the baby.

Literally everything. It's really important so that way everybody can reference it and make sure that she's being respected in case, like I said, you know, she's in that transitional phase. Like my last mom, she handled her transitional phase really well, but she was very in tune with her body and her breathing and she did not speak to anybody.

I don't think that she wanted to talk to anybody, but between me as her doula and her husband, we knew everything that she wanted, so. We could call the nurse in, have the nurse leave, call the doctor, and like, do all these things for her to make sure her birth went exactly how she wanted. , and she said because of that, because she met every single goal, it made her experience so beautiful that she can't she doesn't have anything negative to say about it whatsoever.

She said that she feels like she had the most beautiful birth out of anybody she knows, and like, That's what we want. We want everybody to have a beautiful birth. Nobody deserves to go home feeling like, oh my god, I should have done this different. Or, oh my god, why did we do that? Or, I, I wish I had done this different.

Nobody deserves to go home like that because then it just sets in, you know, with postpartum emotions and hormones and all that. It, it's just not healthy. It's not healthy at all. Yeah, the, the preparation in pregnancy for the moment of birth, cause you don't know what's going to happen. You don't know something unexpected is going to happen.

You never know. But having those conversations ahead of time and those like situational kind of plans of what would happen if, just kind of  also is like a  important way to  kind of let go and surrender to the process. Cause you've already  thought through it once before. So that when you are in that moment and you don't want to talk, , other people have your back.

And. You can  feel confident knowing that other people are there for you too. , and you've already made the decisions versus  having to make a decision in the middle of it.  Yeah.  I've had a few clients recently that had, have had really quick labors and there's just not a lot of time to  ask for things in the moment that knowing kind of their overall goal, , is really helpful.

And when the support people are on. Are on board to it's still can kind of facilitate what they want in kind of a chaotic situation. So, , kind of recommend that for sure for all moms is to have those plans conversations and how is your provider going to handle certain things and making sure that you have confidence in there.

the way that they're going to handle the situation, which is harder in the hospital because you don't know who you're going to get as a labor and delivery nurse or as a provider. But, , being able to kind of navigate those situations, being prepared is much, much easier. Yeah. And having somebody stand, either you stand on your ground as the mom or having somebody else stand your ground for you.

It's so helpful, too, because if you have somebody who's like, oh, well, I guess, I mean, she didn't want that, but I guess then that just, that goes across or goes against her whole plan. And if she's really just zoned out, she's not going to pay attention. She's not going to notice it. Oh, she's just going to probably agree to it.

And then that's going to cause another cascade of either emotion or physical intervention, which just isn't fair.  And having, I feel like also having  a plan B to your plan A is important too, you know, like, even if mom wants a totally hands off birth, no intervention, no, she wants to push in a squatting position, she wants to do everything like in a physiological process, but if she mentally understands, well, Hey, if my baby starts tanking and really can't handle these contractions, maybe it'd be best if I did get on the bed and agreed to the continuous fetal monitoring and had a nurse by my bedside.

No, that would be okay. Or if my baby really just starts tanking and the baby's heart rate is not okay, maybe a C section would be better to,  to keep from anything worse happening. Like having that mental note that, This is the way I want it to go, but if it doesn't,  I'm okay with this intervention, and then maybe even this intervention, so that way you're not like slammed with these interventions when you don't want them, or don't know why they're happening.

It's good to just understand who needs them, what they are, when it's best to use them, and have that little mental note like, this could happen, so let me just be prepared just in case. Right, that, yeah, the situational stuff, even with C sections, or  when a vacuum, or  a forceps might be Recommended  those are scary words when you hear that in the middle or at the end of your labor middle of your labor whenever and you're like, wait, I never thought about that before.

Like, what does that even mean? Or why would I need that? , with my first baby, they said I needed a vacuum and I had been pushing for four hours. On my back. , and I disagreed to it because they said it was either a vacuum or a c section and I was like, okay, well, I'd rather choose the vacuum, I guess. I don't want to be cut open right now.

My baby was fine. I was fine. I literally just could have kept pushing and I just could have asked for more time or just been like, well, I've been on my back for four hours. , maybe I should just try a different position. And that was never an option. Like these little things I can tweak.  your whole entire experience, , because that led to different postpartum complications and postpartum pain and tearing and hemorrhage.

And then because they did a vacuum, my baby had to be assessed for a certain amount of time with like the NICU staff and just stuff like that, that like was totally unnecessary for a healthy mom, healthy baby. But, , If I would have just known better to just been like, no, I'm not interested in that. And everything's going fine, right?

Like, why are you recommending this? Versus just the time on the clock that says I'm a first time mom that has been pushing for four hours. , so I think there's just a lot of, yeah, there's  a lot of things that you can prepare for ahead of time that you might not even realize, , with different interventions.

You know, simple ones like an IV or, , even in pregnancy, like, do I want the GBS swab or do I want, , a cervical check in pregnancy? Like there's all these different things that are recommended and common and standardized, but they're not always the best for you, , as an individual. So yeah, but the information piece and the risks and having those conversations ahead of time, I think are just so vital to making sure that families have.

Obstetrics should be individualized, not.  Everybody, everybody is treated the exact same way, but we're not all the same like our body. My body doesn't mimic yours. Yours doesn't mimic your neighbors like our bodies are all different yet. We all receive the exact same care and we need individualized care.

And I don't feel like we're getting that it's very rare I hear of a doctor. Asking a woman and, you know, specific questions or having an in depth conversation or asking if she even wants something compared to, oh, here, we're doing this. It's very, very rare. We're just, we need to be treated as individuals, as individuals, not.

As a whole, as a group, we're not all the same. Right. Do the same. Right. And we're all comparing ourselves too, as women to be like, what, what, what was her birth like? Or, well, she had the elective induction and all my friends had the elective induction, then it's probably safe for me too. Or, , you know, I, I'm just gonna get this intervention just in case, uh, you know, I'm over 35 or I have a higher BMI.

Based on a certain criteria or different things like that, I guess I'll just take the, the safer way, which is getting the baby out now because we know everything's okay, but it's also like, well, there's risks with the induction as well, or there's risks with these other things like scheduled C sections or, ,  just different things that sound really controlled and great in the moment, and they absolutely could go that way, but they Could also be, be very risky.

So it's just, and everyone's different too, with what risks they are comfortable with, right? Like a risk for one person is not risky for another person, but I can't make that decision for people. , that's something that they have to come to terms with themselves and their spouse and their doula or whoever, and making sure that it's the best for them.

And yeah, you're right. That's just not the norm, which I wish it was for sure. Informed consent needs to be like, I feel like a whole crash course. during pregnancy in the la in the, in the, no, in the second trimester, I feel like, because that's more your happy period of pregnancy. You're out of your morning sickness, the growing pains and everything like that.

It's like your happy trimester. I feel like these crash courses should happen for every woman. Every woman deserves informed consent and should be given informed consent if they're going to whatever intervention the doctor uses or the hospital uses you They should sit down and talk to them or even record, you know, record something and have a mom take it home.

Just something where it explains every single intervention, explain what it is, what the risks are, why they use them, who could benefit from them, who could possibly not benefit from them, why they would suggest it. These are the things that could happen from it. But we're only going to bring it out because of A, B, and C, like the fetal scalp electrode had like a whole crash course on it.

I don't think I've met one mom who understood what it really was. They said my baby had a sticker on its head, like your baby did not have a sticker on its head. It was a screw, a little tiny screw that went in your child's scalp. It was not a sticker.  And they're like, like what? So knowing these things beforehand rather than years down the road or afterwards is important.

We need to be able to, when we're signing these papers, we're not really giving informed consent. We're giving consent, but we're not giving informed consent. There's a huge difference. You can agree to something, but not understand what it is or anything about it. Or you can give informed consent. You can understand what you're signing, why you're signing it.

You could give off all the risks. You could tell them why you're receiving it and just list off all these reasons why you're okay with it rather than just saying, well, I guess. Okay. I would rather say, okay, you can do this because I understand my child is at risk for hemorrhaging or my child and I are going to, we're going to tank if I don't agree to this.

So I'm okay with it rather than just, okay. If you say so, you know, there's a huge, huge difference rather than.  Or, , in between the both of those. And consent  versus informed consent. Two totally different things. It's, yeah, shifting the control over to the mother, or the family, to make their decision based on the information that's given to them versus just consent.

Going with the first recommendation that is the standard for everybody, but I think even if you are in a situation that you were not planning, whether that's an urgent or emergent C section, as long as you were on board and you were a part of that decision, it's like, you know, Usually moms are like, that's the way my baby wanted to come.

And that's okay. And I made that choice versus wait, what's happening? Why am I being rolled back to the OR? Like, is everything okay? Is my baby okay? Like what's happening.  There's a very different feel being part of those kinds of deliveries. , when we just talked to families as though they're, , part of their care and they have the decision because you can say no to even an emergency c section,  you know, if you're, even if your baby's life is in danger, which is, you know, an extreme case,  like you can say no to anything.

It's your body and it's your baby. , and I just don't think there's enough, yeah, enough knowledge about those really strong choices that you have.  It's like they use all these standard, all these policies and everything, and women think that because it's policy, they have to agree to it. And it's important for at least the nurse to be like, well, you know, while this is policy and we do this to everybody, you can say no, and that, that's okay.

We want you to make the decision. I think I've had like one group of nurses ever one time ever tell mom, this is our policy. But if you want to say no, that's fine. I'll just document it in my chart. I'm here for you either way, either way I'm going to give you the exact same care. If you tell me no. And that's how it should be.

It shouldn't change. Well, if you don't do this, your baby's going to die. Or if you don't do this, you're going against policy and something bad could happen. It should be okay. That's fine. I'll put it in my chart. I'm going to give you the exact same care. , good for you for making a decision for your yourself based off the knowledge that you have rather than just the standard and the whole policy thing.

It's policy. It's policy. Policy does not equal the law. Uh, and I think that it gets very misconstrued in there because women think that it's the law, but it's not. It's, it's just the policy.  And it's the fear, too, of, well, what happens if I say no to this thing that is policy? What, are they going to treat me differently?

Are somebody going to call CPS because I'm not taking care of my child or something? Um, and there's a lot of fear around that. So, kind of preparing yourself, too, if you are planning to do things a little bit differently, or your birth plan, you know, goes against some of those hospital, mainstream hospital policies, is just,  equipping yourself with the knowledge to have those conversations.

, like an example of that is, like, GBS. You know, you can not test or test for it, even though it's recommended that you test for GBS, , at 36 weeks. I was tested for that with my second pregnancy. I was positive. My labor went too fast. I did not get the antibiotics. And then they treated me as if me and my baby were infected and we couldn't go home and, , you know, at the ISA for at least 48 hours.

And At that point, I had more information and I said, I'm, I'm okay going home at 24 hours. I had a sign of paperwork leaving against medical advice. And, , had I not known that I would have just been in the hospital an extra day. It wouldn't have been a huge deal, but like, it was a huge thing for me to go home.

My other kiddo was at home. , you know, I, I felt great and I just wanted. to leave the hospital and be in my own bed and be at my house. So, , at that point, it was just, they were taking her temperature every eight hours and checking her respirations and things like that. But, you know, I could do that myself.

Yeah, I could do it myself. And I had access to emergency medical care if I needed. I was very close to nearby hospital. So that's the kind of part of like individualized care, like. If you want to go home, you should be able to go home. I trust you to come back if something xyz is noticed and let's just make sure the situation is the best for you versus like holding me there for a whole extra day.

Like, yeah, you can't rest in a hospital at all.  Like, bless their hearts, they're just doing their job, but yes, and you fall asleep and then here comes nurse Nancy, hey girl, it's two o'clock in the morning, I'm just gonna yank on your uterus a little bit, I'm gonna turn all these lights on and wake your baby up and then they leave and they come back in two hours later and it's like, I Can't rest in here.

I just had a baby. I'm exhausted. I need to rest. Every woman needs to rest at home is the best place to do that. And obviously, you know, competent women, if you just explain it to them, like, Hey, if you're going to go home at 24 hours, this is what you need to look for. You can even get a pen and piece of paper, write down your baby's respirations right down their pulse.

Like check how many wet diapers they're having. Like do, do all these easy things that you really don't need to be here for. And I trust that as, as a loving, caring parent, you're going to come back. If something happens. Because 10 times, a parent will absolutely come back if they see something wrong. And I mean, if like you said, if they're just checking the temperature or the respirations, like all those easy things that you can literally check at home, then let them go home.

There's no IV, no nothing hooked up. Home is the best place for everybody.  Exactly. Best place. Yes. Yeah. And that just knowing the choice that you are not, yeah, not held there or, , held to any standard of anything. Like there is so much more autonomy than is just like on the surface, I feel like. So, , I think it's cool that I'm meeting all these birth workers that are like, like you with these followings on Instagram that are sharing a lot about autonomy and informed consent and kind of changing the narrative, hopefully with.

Hospitals and, ,  and just like mindsets that families can have a choice and be more active in their care because that's going to change the maternity care so, so much. The only thing that's going to change is if women start taking their birth back. The, the more they agree to just do what the policy is, nothing's going to, nothing's going to change.

It's when people start taking their birth back, start saying, no, sorry, you can do a hep lock, I don't want an IV. No, sorry, I don't want Pitocin, I know my birth can take, You know, three days. Um, no sir, I'm not doing that. We've got to start standing up for ourselves. Got to have a good advocate. We've got to take back birth and show them that we, we don't want all this stuff.

We're not okay with all this stuff anymore. Or, Nothing's going to change, you know, our death rates are going to keep rising, the induction rates are going to keep rising, all these interventions are going to keep being normalized, women who have no experience or no education in birth work are going to keep harassing those of us who do, and saying, you know, your doctor knows more, your doctor, your doctor, your doctor, like, your doctor, yeah, they did go to school, they, they're an MD.

They do have a lot of education, but the difference between an obstetrician and a midwife is midwife is her physiological birth, they understand physiological birth, they know it produces better outcomes, and the obstetrician is a trained surgeon. They're there for an emergency, for, for high risk patients.

For the low risk mom, a midwife medulla is a beautiful, is a much safer option. It's just  I think women need to get comfortable with saying no, or saying even no thank you, or even saying I respect your education and I respect your professional opinion, but I, that's not what I want for my birth. Until we start saying no,  our numbers are just not going to change.

All we can do is just keep educating everybody, the ones who want to learn, who want to listen. They'll listen and it'll help them. It'll help them a lot. I've helped so many women just virtually just from sharing what I do Who are pregnant and they use all the stuff that I share and they come back when they had their babies and they're so excited They're like my birth was so beautiful.

Here's pictures. This is how I did it Like this is all the things I was able to deny because I understood why I was denying it and it's just It's, it's a wonderful thing because, you know, without social media, we, we can't share all these things and nobody knows. I would have had no idea that I was not the only one with a uterine, I'm sure, if social media wasn't a thing.

Because I honestly thought, like I said, they told me I was like one in a million. I was like, there's gonna be nobody else in the world besides me with this. But I learned that there are lots, there are thousands and thousands and thousands of others. So, it's just, I feel like social media is a very important part of birth work too.

For the, the trained person. There are some crazy people out there who, who share some, some wild stuff. Wild stuff. Um,  but you just gotta, just gotta keep trying. Gotta keep trying for the greater good. 

Thank you so much for tuning in to Your Birth Bestie podcast today with Katie Spinks. You can find her on Instagram and Tik Tok which I’ve linked below in the show notes. . And I also wanted to remind you that I have a free download, if you haven’t checked it out already, but it’s called ‘Understanding Your Hospital Birth Options for an Informed Birth Experience’ and can be downloaded for free at www.bethconnors.com/choices. This is my number one downloaded resource and I really think you are going to love it, hopefully opening your mind to some options in pregnancy and birth that you probably didn’t know about and that most providers don’t really have time to dig deep into, but are still important to know that you have a choices. As we talked about in the episode, maternity care should not be standardized like it is with constant medical intervention, it should be women-centered and I would love to see more moms engaged and taking control of their care with the collaboration of a professional. You have more say than you probably think you do, it’s just a matter of having the information and confidence to know what choices you have the opportunity to make and actually advocate for yourself. I am confident you can do just that and am happy to be a resource for you also throughout this journey. Thank you again for being here, and I will be back next Tuesday with another episode. Bye everyone!