Part two as promised! Vaginal seeding, home births, and doulas - Supraja and Sara chat about all the things you've wanted to know about these birthing trends. What even is vaginal seeding? Should you be having your baby at home? Do we all need a doula? Listen up
Part two as promised! Vaginal seeding, home births, and doulas - Supraja and Sara chat about all the things you've wanted to know about these birthing trends. What even is vaginal seeding? Should you be having your baby at home? Do we all need a doula? Listen up
Hi, I am
Supraja:Sara, and I'm Supraja, and this isGyn& tonicwelcome
Sara:back to Intimate Convos with your besties.
. Supraja:My stomach is already rumbling, but we are recording
Sara:did you not eat?
Supraja:I can't remember what I ate today. What did I eat today? Oh, I made myself a quesadilla. I'm trying to save money because all, all the enormous expenses coming my way. Getting married, maybe buying a home.
Sara:Oh. Oh no. I hate stressing about money.
Supraja:I know. Although you would just saying the stuff out loud, I sound like an a-hole. No, I'm fine guys. I'm aware of it. How are you Sara?
Sara:Uh, I'm good. Cheers. Thank you for your cucumber spritzer well I was in Newport this weekend.
Supraja:Oh yeah. For a wedding, right? A wedding. Was it? So beautiful. It looked beautiful.
Sara:Yeah. I always like, I actually love weddings so much. Mm-hmm. I love going to them and I feel like I have an nack for getting invited to them.
Supraja:Oh, what's your, what do you do? I've pulled a wedding trick once or twice to try to get invited.
Sara:Really?
Supraja:In my younger years.
Sara:Really
Supraja:like people I hadn't talked to, and then I was like, oh, they got engaged. Let me call 'em,
Sara:stop it
. Supraja:Okay. I actually did care, but it I'll when then I got invited to the wedding, I was like, I think this is just 'cause I called you right after you got engaged, even though I hadn't talked to you in five years.
Sara:So I was gonna say, my trick is I'm just a good friend.
Supraja:Yeah. Your trick is people like you, Sara. Okay. People want you at the wedding. They're not just like, oh, I guess she cares.
Sara:Actually, one of my good friends though one time did tell me, she's like, every wedding deserves a Sara McKinney.
Supraja:Aw.
Sara:Which was really sweet. I was like, When can I be the damn bride? But when can I be the bride?
Supraja:Adam's starting a new job and I've told him to have an eye out for you. All right. No, I think it could work. Haven't we talked about running clubs too? I think you should join one of them.
Sara:I know. It's just, I hate running with people
Supraja:'cause they always, you think they're slower than you?
Sara:No.'cause yeah, 'cause they wanna compete with me. I'm like, I don't wanna compete with you. Okay. I'm only competing with myself.
Supraja:What if you got your run in that you were gonna be competitive about by yourself and then you went and jogged with like the slow jogger, you could just never do it.
Sara:I don't wanna jog with the slow joggers. I don't, I don't wanna marry a slow jogger. The point is like going to the bar afterward, I know I'll just like come in like with like 500 yards left and be like, Hey guys, that was a good run. What bar are we going to? Yeah. Uh, but it was super beautiful and I was like getting so nervous about the weather for my friend 'cause the weather's been so crazy this summer. Yeah. It ended up being the most beautiful weekend. Aw. And this was for one of my, one of my co-residents. She was an intern when I was a chief and I love her so much.
Supraja:Yeah, she's so sweet.
Sara:She's like the best human and it was just such a beautiful wedding and she looks stunning. The venue. It's so funny 'cause when you've been to so many weddings, you're just like, Well, you know, the appetizers and the drink. Like I, I'm like, I feel like I'm a critic and I'm like, Calm down. You don't even have a partner. You don't have like, it's easy to be like Monday's quarterback or whatever the term is, but this wedding was like so lovely. It was all,
Supraja:aw. Laura and I were walking. Laura's who I went to the wedding with, we were walking around for getting breakfast the next day. We're like, okay. Let's talk about the top three things from the wedding. Oh, Laura and I do this a lot. That's cute. We do like what were the top three things? The
Sara:top three things were one., the venue. We love the venue. It was beautiful. I liked it because everything was in one place and like you said that Yeah. 15 feet away. So it was so convenient to the brother speech. Aw. Oh my God. It was so good. I, I cried. I texted my brother. I was like, Look, I'm listening to a brother give a speech right now.
Supraja:This is what he is saying. If you wanna write it down for my wedding.
Sara:I was like, it is spectacular.
Supraja:Oh wow. Like what types of things did he say?
Sara:It was just so beautiful. The way he described Katie was like, well now everybody knows who got married.
Supraja:Everybody knew anyway.
Sara:I'm like talking about this celebrity.
Supraja:Well, I also, her name is Katie, like it's fine. There are other ones.
Sara:Well, and um, but he was essentially talking about how she's always been. His safety net. And whenever he's been like afraid to do something, she's just always been in his corner. And he just described her such a beautiful way that I, and then he described her now husband as her safety net, and he was like, I can imagine what that feels like because you've always been that for me. And I'm so glad you also have that.
Supraja:Are you, you're tearing up. I know.
Sara:I was like thinking I, you're like, who? My net. But it was just
Supraja:me. It was just kidding. Sara: I was gonna marry you and Adam
. Supraja:No, you can. Did I send you the article about people buying homes with their friends?
Sara:Oh, yeah, yeah, yeah, yeah.
Supraja:I legit think we should do that,
Sara:but I love it when, I love hearing wedding speeches so much, like vows. Whenever people, I'm like, oh God, I hope they do vows. Again, it's the way they described each other. Yeah. I just love when you, my favorite question to ask people is like, how did you guys meet and how, what's your love story? Aw, I love asking people that. Yeah, and so I love, like when people get really vulnerable and you hear that side of them, I don't know.
Supraja:That's so cute. I love that too. What? No, that's normal
. Sara:So are you gonna give vows at your wedding? Is that Indian tradition?
Supraja:N no. There's a section of the ceremony where you are, like, you walk around this fire pit together and every circle you make, some people do it as every circle. Sometimes it's, every step is like a different promise to each other. Oh yeah. But it's kind of a set thing. We have considered, 'cause we wanna integrate some. Western tradition. Yeah. So we've considered like doing some sort of vow situation at some point. Sounds like you're strongly pro ... pro us doing vows.
Sara:You give vows 'cause then I'll like fatigue
Supraja:'cause you'll cry.
Sara:Okay. Hopefully I'll cry, but I don't cry notes. Then I'll,
Supraja:I'm just gonna be staring at you during our vows being like, is she crying yet? I
Sara:and if you see me holding a tissue to my and be like,
Supraja:I'll be like, okay, I'm done.
Sara:I just love hearing vows.
Supraja:Do you think about what your vows are gonna be?
Sara:A hundred percent. Have one.
Supraja:Like you just have it in mind for your future person.
Sara:I can't even say my loud. I'll start crying. I'm not kidding.
Supraja:I can tell. You're not kidding.
Sara:I'm not kidding. I have them rehearsed in my head.
Supraja:I can't wait until I meet the person that you're with. Because I know they're gonna be so special.
Sara:Oh, they better be. I've been waiting for a while.
Supraja:Okay. Should we do it?
Sara:Let's do it.... birthing trends, part two. This is fun again, to do this research.
Supraja:Yeah, we were just chatting about it and you seemed hyped. I know. You're like, let's put your vaginal juices all over my face. Sara just tried to propose that we collect our vaginal juices in a tub and sell it in little containers as a facial moisturizer. Did, did you or did you not? Sara. It don't like to our listeners i, it'll
Sara:be the new La Mer, but a Brookline. La Brookline, LA Brookline, La Vag de Brookline who knows? It could be my what, you know. I dunno. But your retirement plan. Yeah.
Supraja:Okay. We're joking. We're not trying to sell our personal vaginal juices on the La Mer Brookline market, but we did talk about it and you did seem hyped and Sara's like, let me teach you about this.'cause I think some of these things I don't know that much about, so. Okay. Tell us about vaginal Seeding, Sara.
Sara:Yes. Okay. So yeah, we're gonna talk about three different things, and I like this more because there was a little bit more, there was more information about all three topics this time compared to the things we talked about last time. Yeah. Like the lotus births, eating your placenta. I forget what the third thing was.
Supraja:Go back and listen.
Sara:But okay. Vaginal seeding. I know it sounds seedy. Well kind of is, but maybe it's good., essentially it's where. There's this thought process that as the number of C-section rates increase, there's also rising numbers of children with asthma, atopic dermatitis, immune conditions, and one of the theories is, is it potentially because we're not vaginally delivering babies and transferring. Maternal mother microbiomes, meaning like the natural bugs we grow in our vagina to our babies, which then help establish protection for them and decrease their chances of getting these different conditions., it hasn't been proven, but it's like a reasonable theory in all honesty.
Supraja:Mm-hmm.
Sara:And so the thought is, Okay, if you get a C-section, what if we transfer that microbiome that a baby would've otherwise naturally gotten onto the baby? So like literally swabbing your vaginal fluid with like cotton or. Something and transferring it to the baby's skin mouth or nose.
Supraja:Oh my God. I mean, I have no judgment, but just like hearing it, my legs just smooshed together. I mean, I would do it for my child if it was proven. And I, again, I think to each their own, and I totally get people's inclination to want things to feel as natural as possible. Having a c-section for a lot of people feels just like very medicalized. Yeah. And moving away from that natural process. So I understand the, like, curiosity about that, but there has actually been like a study or two that comments on it, right?
Sara:Yeah. So there was a randomized study that they did in China, randomized and blinded, which is like pretty good. The, the gold standard for how to do a study. And essentially what that means is, they get volunteers for the study and then the volunteers don't know what arm of the trial they're going into. Are they gonna get the actual treatment, meaning their babies are gonna get vaginal
Supraja:juices all over them?
Sara:Or are they gonna go to the placebo trial where they get just saline or something different?
Supraja:Do you think people are gonna be judged that? Every time I talk about it, I laugh. Feel like judged. I'm not judging you. I'm sorry. If you need me to laugh less message, message me. Okay, go ahead.
Sara:But okay. So like it's, , the patients don't know what arm they're in.
Supraja:Yeah. So in this study it was blinded. They had an arm of people who got the vaginal secretions. The seeding, yeah. And an arm that didn't. Yeah. And then they. Followed up in three and six months.
Sara:Correct.
Supraja:To look at children's neurodevelopmental milestones.
Sara:Right. Which is kind of interesting. They didn't actually study asthma, atopic dermatitis in the immune conditions that were like they were theorizing. They actually looked, does is there neurodevelopmental benefits? Right. And they found that there were actually
Supraja:Okay.
Sara:Yeah. And it's kind of cute. At three and six months, they ask the mom like, this is a little checklist like, What are signs of these neurodevelopmental milestones? Are they smiling? Are they reaching for toys? Like what are little things that may suggest, like, not advanced, but like moving along neurodevelopment?
Supraja:Did it convince you? Were you convinced that vaginal seating improves neurodevelopmental milestones?
Sara:No,
Supraja:I think it's so hard 'cause like, Did your, did this kid smile like probably so many things impact that. Yeah. We know that a lot of those neurodevelopmental milestones or social cues, it's not based on one situation and it's also evolving, so it's just a really difficult. Marker, I would think.
Sara:I think the thing for me that made it difficult is one, only 76 babies were involved. That's not a lot actually. Yeah. And then two there was no long-term endpoint, you know? Yeah. Three in six months. What is that like? That's not very long. And I think that's what the issue with vaginal seeding is we haven't actually proven it to be helpful long term. Like in four or five, six year olds. Yeah. Who, where people are starting to develop some of these conditions that they're we're theorizing about. And so I'm not saying it's bad at all. I'm just like, we just don't know. We haven't studied people for long enough to know if it's actually beneficial, right.
Supraja:And our societies that give guidelines on these sorts of things, like ACOG, which is the OBGYN Society, and the AAP, which is the Pediatric Society, have commented on it. And they basically said, you should make sure you don't have any infections you could pass by taking the vaginal secretions and putting it on your baby's face. So things like herpes, GBS yeah. Um, chlamydia, gonorrhea, those sorts of things, which we would test for some of those things if you're having a vaginal delivery, but not all of them. And then they also said , just be mindful of that because especially in preterm babies, you might be compounding their infection risk. You might be making it way more likely that they're gonna get an infection in babies that are already predisposed to things like that.
Sara:In addition to that, they're saying, You know, if you're gonna do this, you really should be in actually a controlled trial where they're studying it and not just showing it up at the hospital and saying, I wanna do this. Because that hospital may not have a protocol on how to safely do it. They may not understand the timing. They might not be using the right material, they might not be putting in the right place. I mean, there's so many things. Yeah, there's a lot that goes into it. The safest thing may be to, you know, be mindful of like, in what scenario am I doing this and who's administering? Like if somebody asked me to do it, I'd say, I, I don't know how to do this. Yeah, I, I haven't talked about the protocol in a study or like what has traditionally been done. And so I think you have to consider some of those things.
Supraja:Okay, next one. Home birth. And I have so many feelings about this. Like I don't even know how to sort them out. I wanna be not biased about it 'cause I get where people are coming from again. But I think just personally, like I come from a South Indian background. My parents like grew up in a little village in India. They did move around, but like my family is very much still rooted in this village and I just grew up with so many stories of like my grandparents and what they went through, not having access to hospitals. Like my, one of my grandmothers lost her first baby trying to have a home birth. Not trying, she couldn't go to the hospital, so she was forced to have a home birth and the baby died. My other grandmother, had a loss at four months and had like a very traumatic birth. Like my great aunt bled to death at home and , these are stories that I heard all the time. Mm-hmm. Like still very affected by like one of my grandfathers. I remember last time I was in India like a year ago, started sobbing telling me about , my great aunt who died at home'cause she bled out and they couldn't get her to the hospital in time. So I just think it's like so wild to me I'm really close to my family. So it really does , feel very present. Yeah. And that like people now choose that like you have access to a hospital, you have access to all these resources and you just choose not to use them. Like, feels like such a. Uh, turning of the situation. Yeah. It is like pretty crazy. Yeah. But I, I do see that people are really scared of the hospital. They're scared of losing autonomy over their bodies. They're scared of things being forced on them. There's not a lot of trust there, and that's really sad to me too. I get it. And so I try to balance those things, but I'm also just like, Like literally my, my aunt, who would've been my aunt, like died. The baby died 'cause my grandmother didn't have access to a hospital. Yeah. So, Yeah, that's, I just like, I don't know. I have so many feelings about it. Yeah. Yeah.
Sara:Um, I think, um, no, I hear you. And I think it's hard because, we come at it with bias from many different, you know, in many different ways. Like one. You know, personal family history to just being providers and you know, the situation, the home births that we get to see are the patients who are being transferred into our system. Like urgent. Yeah. Who had unsuccessful home births. So that's our experience, that's our bias. Yeah. I'm not seeing the home birth that went beautifully and she changed her mind at the last minute. That's, that's not what I'm seeing. I'm seeing the ones where the baby's been in distress for many hours or the, the baby has passed away and now we're doing stats. We've seen the, we see the sad things, the horrible things. Yeah. We see the bad stories, unfortunately, so our view is very skewed and bias. I'm also, you know, so pro like see my p c p every you there, get, go to the dentist every like, I'm so. I feel so fortunate to have healthcare that the idea of me not taking advantage of those resources is like, it goes against everything I believe in. I am just like so grateful for access. We do, we hear about these stories of women dying in other countries and even in our own country. And so for me it's, it's hard. I bring that kind of. That mindset into it. Yeah. Um, I feel like it would be beautiful if we had a system where someone could have a home type birth but be like staffed by doctors, have the NICU as available, all those sorts of things. So like you could maybe be in a more comfortable environment. And like have parameters around that, that felt safe, but it just seems like that's not really in place in most places. Although, ACOG and The's Pediatric Society, say. Having a hospital birth or a birthing center is what they recommend as a safe place. And I think a birthing center does bridge some of that. Yeah. Where like you have access to really. Important care in case of emergency, but has less of the feeling of a hospital. And I think birthing centers are great. Essentially it's, generally run by midwives and it's like the ones that I've worked with are across the street from the hospital, like literally 10 feet from the hospital. So if there is a complication or a consult as needed, or the patient needs more urgent care, they can literally be transferred across the street like a few feet., But it's really interesting how we've had this shift, , worldwide. Yeah. In many developed countries where it used to be that 80% of births were done at home, and then it suddenly shifted in the fifties and now very few births. Are done in homes, like when I was looking at major developed countries on average about 1 to 3% of people deliver
Supraja:at home except for the Netherlands. 20%. Yeah. In the Netherlands. If you're from the Netherlands, call and let us know what is up. Like, I'm like, what? That's wild. I want, I bet they have. I wonder if they have like a very good system around it, like a robust system that
Sara:works. Yeah. So yeah, I found that really interesting. I didn't know the number was that low. Um, and the number has increased since the pandemic. But not very much. I think it went from 0.9% to like 1.3%. So it Interesting. Really didn't increase very much. But yeah, less than 2% of births in the United States are home births.
Supraja:Um, okay. So there are some potential pros, which I acknowledge other than. Well, not other than including like less maternal interventions, less inductions, um, less likely to have some sort of operative intervention, like an episiotomy or forceps or vacuum going along with that, less likely to have a third or fourth degree tear, , and less likely to have a maternal infectious morbidity like Chorioamnioitis or something like that. But then there are also like really significant risks for the baby. Yeah.
Sara:So the risk of neonatal seizures or neurological dysfunction is twofold that it also includes perinatal death. So that's why that's pretty
Supraja:crazy. Yeah. Like double the risk that there'd be a serious neurological condition or that the baby could die. And so that's
Sara:why ACOG and the American Academy of Pediatrics say like, realistically, the safest place right now to deliver a baby is in a hospital. And if you are going to do this, you know, things to. Consider before deciding to do a home birth is a few things. One, are you realistically a good candidate for this? Mm-hmm. It's like, what does that
Supraja:mean?, yeah so like people who've had babies before. That's a good, is
Sara:a much better candidate. One being the reason you've done this before, you, your body we know can have a vaginal delivery. That's not to say if you've had a C-section, you can't have a vaginal delivery. It's just, it's more comforting to know somebody who has never had a vaginal delivery and now you are. Are we gonna be able to do this? Is her pelvis gonna be adequate for this? A woman who's had a baby before has higher chance of being able to successfully do this, also having a quicker delivery, less likely of being transferred to a hospital compared to women who have not had vaginal deliveries before. Yeah, their deliveries just go
Supraja:faster. Yeah. And I feel like you see all these things on social media, et cetera, of like all these celebrities and their home births, that really highlights. Some of the inequities in access to care because the other big thing is your access to people who can intervene, like your access to nurses or midwives, access to consults with physicians, access to a hospital. I think a lot of people who have a lot of wealth are able to make sure like their doctor is there, there are nurses there and they're reviewing it and they're able to like make a transfer to a hospital really quickly if needed or make changes that you might not have access to if you're just the average person trying to do a home birth. It's interesting and not always representative of the average home birth experience, the home births that are like popularized., but important to know, like you wanna make sure if you're gonna have a home birth, that you're in a really. safe as it can be. System of who's gonna be monitoring the birth, what are the signs you guys are gonna look for, to see if you need to escalate care? How quickly could you get there? Have you talked to doctors throughout the process to make sure the plan is safe for you and like what to do in these different situations?, and then there are some reasons you, like, you absolutely, really should not have a home birth.
Sara:Yep. So, acog. Again, the governing body for OBGYNs says if you have a baby that's not head down, so like a breech baby or a sideways baby, you are like transverse. You should not be having a home birth, which makes total like That's scary.
Supraja:Yeah, it's so scary. I've seen breech. I know. We're like, oh, I just talking about it. Because we see that stuff. We see people coming in with like an emergency in those cases, and it just, It is really scary.
Sara:Another reason to not have a home birth would be is if you have twins, triplets, or more than one baby. Those are in general more complicated pregnancies. And so to add on a home birth and. Like no access to certain
, Supraja:like your second baby can flip positions. You just don't know what's gonna happen. Yeah. Those babies often need more attention when they come out.'cause like two little ones are fighting for the space that only one normally has higher risk
Sara:bleeding.
Supraja:They just held hands intra utero. That's what I like to pretend. I ask them to hold hands now all the time. And they refuse super.
Sara:Just fiance's a twin. Identical
Supraja:twin. Yeah. Um, and then, okay. Or if you've had a c-section before, like you do not wanna be at home having that baby. Those are the cases I feel like of. Transfers That's I've seen most serious complications in. Correct? Same. It's like so scary.'cause you're even in the hospital, having a vaginal delivery after a C-section requires a lot of extra attention because once you have an incision made on your uterus, , it heals together, but it heals together like scar tissue. So it's more likely that it can come apart, called a uterine rupture, and that can be a devastating consequence for you and the baby. In the hospital, not all hospitals will let you do a vaginal delivery after you've had a C-section because they're not even equipped to deal with the emergency of that. Like our hospitals will 'cause we practice at a big academic center. Yeah. But it's just to say like a home birth is a really bad idea in those cases. Yeah. And the risk of transfer. Sara just taught me this and I thought it was fascinating.
Sara:Essentially for women who have never had vaginal deliveries before, they're trying it for the first time at home, the risk of being transferred to a hospital is between 23 and 37%. It's really high. Yeah. In my opinion, that would suck to be laboring. And you're, and I've seen this happen where they're like at eight centimeters for like so many hours. And then they finally get transferred. So
Supraja:not all of those are emergent. Some of them are just, like you're saying, people who don't progress or people who need a C-section or need pain control. And then some of them are more urgent.
Sara:And then for women who have had vaginal deliveries, the risk of being transferred, um, was less than 10% because again, That that woman has, you know, demonstrated she's, her body has been able to have a vaginal delivery and they tend to be quick deliveries. Yeah. I love a multi tip delivery. They're fast., in general. So yeah, I thought this was interesting and I think this is gonna be an ongoing conversation and I do like having this conversation with my patients and I will literally tell, like go through like this is why I think you. It's, you're not an unreasonable candidate. Yeah. I am coming in with my bias and some other, my, some of my other patients. I'm like, you have gestational diabetes, you have high blood pressure that we're controlling with medications, or you've had a c-section before. These are all the reasons why I would be concerned about you having a home
Supraja:birth, because things like that, like medical conditions, everything is just on a high gear. When you're in labor, your body is stressed and because of that, like you often have, Urgent things that happen that kind of exacerbate known problems. So you might need IV medication, like you might need other things. And I, I feel like people hear that and are like, oh God, I don't want medication. But it can have serious consequences. And it's not to say like if you're in the hospital, you have to do anything, but at least you have the option of having conversations around it and you can get it in an emergency if you decide it makes sense for you. Yeah. Okay. Doulas, I'm really into this one actually. I love doulas. Doulas are support people. So what is a doula? A doula is a trained professional who's , has a support person role, and can provide you with like physical, emotional, and informational support. And they're set up in different ways, but can be. intrapartum, but also like after delivery and before delivery. It's actually something that has a lot of good research around it, like has a lot of good evidence that it really does improve people's outcomes and experiences. Yep. So it's interesting that like there's not one standard certification for how to become a doula. And that can lead to some of the differences in how. Involved, they are what role they can really have. But a, a really well-trained doula is awesome,
Sara:but I think that's important for people to know when you're picking a doula, because one, anybody can technically say I'm a doula, Uhhuh. And so I think that's important for the patient. The same way you would shop around for a physician you'd wanna shop around that same way for a doula. What kind of training have you done? Where have you delivered? How many babies have you delivered or how many. You know, pregnancies have you been a part of? That's the same thing. I would ask my own surgeon, my, you know anybody? Yeah. Who's taking care of me. Because there really is no standardized certificate that says you completed 300 hours, you now qualify as a doula. You went to eight hour. Like there's no standard . Certificate. Yeah. I'm sure some agencies require particular things of their doulas, but again, understand. Does your doula subscribe to a particular agency? That doesn't necessarily mean that's a better doula, but like if they're freelancer independent, okay, what? What are
Supraja:the qualifications? Yeah. You might be able to look at that website and be like, okay, all these doulas have these things. This is what it took to get this certification, et cetera, et cetera. So it just provides a reference. Yeah. Um, and it costs money. You know, it costs somewhere between $500 to $3500 dollars. Because it's having more support around it. There are more programs where people can enroll for free. There are more grants around these things, so ask if it's something you're interested in. And even if you don't feel like you could financially do that, ask your physician, like, I know our clinic is trying to provide a free doula program, so there might be other opportunities where it's covered.
Sara:Yeah. Some of our community sites that deliver at our hospital have programs where they have doulas, for , patients who may be more under-resourced and would benefit from having a doula, as the studies have
Supraja:suggested. Mm-hmm. Um, okay. Yeah. So what are the benefits? So, , the
Sara:benefits include improved maternal and infant outcomes. So, higher patient satisfaction. So patients who, , in general when they've been surveyed, who've used a doula have been more happier with their experience in labor., less likely to use pain medications, if that's important to you, that's a big deal. Mm-hmm., less likely to have a C-section. When I see that, I'm like, that's awesome. I love that. That's the part that stands out to me the most. More likely to have shorter labors, more likely to have vaginal births without instruments, like a vacuum delivery or a forcep delivery., their newborns were also less likely to have poor vital signs at five minutes after birth, , so all those things, you know, are awesome.
Supraja:That's like pretty, I want a doula. Yeah. I just want a life doula. Can they, I know, can, can they make me more satisfied with my day to day?
Sara:Well, actually the thing that I really like learning about doulas is, , that they, , can participate in events other than just deliveries. Oh yeah. Like, we have had doulas who have accompanied patients to their terminations. That's awesome. Like as a support person. Yeah. And I, when I learned about that, I was like, oh my God, that's amazing. Yeah. And the cool thing is acog, , and the Society for Maternal Fetal Medicine support doulas. Yeah. And their involvement in deliveries. I think, unfortunately, the crummy thing is sometimes there's just. I don't know, stigma or like the, I don't, sometimes all the groups don't always, um,
Supraja:align. Align, unfortunately. It's hard because yeah, people come in with so many different experiences that have shaped how they interact in the medical system, both from the physician, the nurse, all of the techs to the patient, the doula, everybody. And sometimes it feels like as a physician, that we're being like pitted against the patient support person. Like, oh, the expectation is I'm gonna force a C-section and this doula is here to stop it. Yeah. And that always feels bad, which I know we can take some responsibility of, , people just don't feel like things are explained to them well. Mm-hmm. Like they don't understand what's going on, and maybe there are some cases where they didn't want something and they didn't feel empowered to speak up about it. So. That's totally understandable. But I do think some of the bad rep doulas can get. They don't always, and a lot like we're saying, I'm like, I ... want a doula. Yeah. But some of the bad rep around it that can exist is because it can feel antagonistic. Um, the more that they're around and involved in everything. The less that'll be the case, you know, more because they'll just be accepted , like the role and that communication will be just more standard. Yeah.
Sara:I think for me, I've had great experiences with doulas and I've also had ones that have bummed me out., but I could say that about working with other physicians.
Supraja:You could say that about hanging out with me.
Sara:I'm just kidding. You could I, I mean, I've felt that way about. Certain nurses, certain techs, and I'm sure people have felt that way about me. I know.'cause I've read that in my feedback, my annual
Supraja:review. It wasn't me, I just wrote Sara. So pretty.
Sara:Um, but not everybody's always gonna mesh well, but I think, I think as a physician, like it feels crummy when you walk into a room and sometimes you feel like. You're being made out to be the bad guy., I'm always delivering the bad news, or I'm recommending the interventions that are not minimally invasive. And Yeah. And so, you know, I always try to, , present myself in a way where my job is to just give you information and we make a decision together. And it feels bad when I don't get to be a part of that conversation when we're making that decision. And so I think those have been the experiences where I feel, , bummed out where I'm, I'm the bad guy. Yeah. And, , And, but that, that's not always the, that's not always the case. It's just those are the ones that, you know, stick in your brain. And I'm sure doulas have felt that same way to you. So if
Supraja:you're a doula, know that we wanna be the good guy. Yeah. I don't wanna be the bad guy. I love being the good guy., yeah, and I think like as a, if you're a patient, Like finding someone who you have a really good rapport with, that you trust and is comfortable in the medical system that you're gonna be using. Like a lot of people will be like, oh, I deliver there all the time. I know that doctor. Or you can ask if they ever have conversations with your doctor team beforehand. Like, all those things can make it more seamless. All right. Okay. Three birthing trends. I like
Sara:these birthing trends more than. That Lotus
Supraja:birth, oh God, we, yeah. If you care to know how we feel about Lotus births, listen to birthing trends. Episode one
Sara:for the eating the placenta. You know how many people I've asked, , for their placenta? How many multiple people in the last, three
Supraja:weeks do you think they listened to the episode?
Sara:I don't know, but it's, people have been asking and I'm like, it's a huge thing. Where's this coming from? I've never, in the last three years, I've maybe had one person ask, and in the last month I've had multiple people ask me. Yeah. I was really taken
Supraja:aback. Even this past week someone decided, which is also a good key to us.'cause I'm like, I don't ask people what they want done with their placenta and their prenatal visit. So I should start asking. Basically we all should communicate better and we'll all be happy., our skin will glow. My skin
Sara:already glows. Just
Supraja:kidding. Alright, love you guys. Love ya. Bye. Bye.