S2 E5: Birthing a Bad Dream

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Previously, on the dream.

The supplement industry won, so the FDA has not been able to seize back much power since the passage of that law.

But I think that everyone on both sides knows that there's many cases in which these products are being taken in the same way you'd take an over-the-counter drug, and they're taken as substitutes in many cases for prescription drugs.

And the irony being this is taken by people often who have distrust in the pharmaceutical industry because they think that there's sketchy things going on there, who think that dietary supplements are quote-unquote natural.

Pardon my affliction this week, but I've been cursed with

every podcaster's nightmare, laryngitis.

Most of the time, unless you opt into thinking about wellness, you can pretty much avoid it.

But there are a few moments in life where, try as you might to avoid it, you're inundated by the messaging of the cult of wellness.

And one of those is during pregnancy and birth.

It's well known that once a woman becomes pregnant, her body is no longer her own.

And I'm not just talking about the body being taken over by the new, more important, more precious being inside of it, but the whole world suddenly feels ownership.

This comes at us with unwanted questions and unwanted touching, unsolicited advice about the right way and the righteous way to be pregnant, to give birth, and to mother.

And a lot of that has to do with wellness, eating well, exercising well, sleeping well, taking the right pills and tinctures, and choosing the correct caregivers for this special time.

Often on this show, we're talking about the people and businesses that take advantage of these vulnerable moments to profit from our uncertainty or our attempts to be healthier.

But it's hard to say that there's a specific villain in the birthing industry.

Sure, there are a slew of teas and supplements and crystals that promise to support fertility and pregnancy.

But it's not like there's widespread policies or cases of evil-doing healthcare providers hell-bent on screwing women over at this time.

It's more the culture around birth birth is broken.

And often, the damage comes from inside our own heads.

So today, we're just going to talk about what it feels like to be in one of those vulnerable moments, to be overwhelmed with advice and information, and to be forced to question everything you're hearing.

Because when it's just you alone, you have a right to pick and choose how well you'd like to be.

But introduce a new human whose existence you are completely responsible for into the mix, one who cannot yet voice their opinion on the subject, and things get complicated.

I grew up being told that birth was easy by a mother who'd had three successful natural births and who also claimed until she saw me in labor that mothers who had epidurals experienced less pain and that pain was necessary to create the maximum amount of love women like her had for their children.

Basically, until a few years ago, her thinking was that you had to pay a great price, sacrifice as much as humanly possible to earn true love.

She was also, I might add, 20 years old when she had me, so her bones and joints were supremely bendy, and she had super short labors.

But enough about my mom.

I love you, mom.

Despite this attempt to indoctrinate me, when I found out I was pregnant at 34 years old, I didn't have super strong feelings about the type of pregnancy or birth I wanted.

I basically just wanted the baby to come out however it needed to from pretty much the day it went in.

But then I got a bad pap smear at five weeks.

Something showed up called atypical glandular cells.

And my doctor called me.

She said it could maybe be cancer, maybe not, but that A, they couldn't do any more tests on me while I was pregnant.

So B, our best bet was to try for a vaginal birth because that process has the potential to flush out whatever was creating those cells.

That's what she said.

Spoiler alert, I'm fine.

I just had HPV, like half the planet.

But spending 35 weeks thinking maybe you're growing a cancerous tumor right next to a baby is, well, it was fucked up.

I'd never related to friends on the hippier end of the spectrum who, like my mom, had really strong feelings about natural birth.

But here I was unwillingly thrust into their world in LA of all places.

And I found myself having many conversations with women like my friend Alicia, who had a baby a few years after I did, and who couldn't have been more different than me in terms of how she looked at her pregnancy.

Did you always want a baby?

I always wanted a baby.

What?

I always did.

What I would say is I don't I want to read that chapter in the book of life.

I want to know what it says in the chapter of having a kid and being a mother to somebody.

I helped write the chapter right before that one in Alicia's book by introducing her to the man who would eventually become her husband and the father of her baby.

Ever since she told me she was pregnant, I've had this kind of pride around it, like I did it.

That's my baby.

And as you'll hear, Alicia and I are a lot alike.

That's why we're friends.

We're both producers, type A, et cetera.

But when it comes to the baby stuff, there are some pretty stark differences.

When did you start thinking about what kind of pregnancy and birth you wanted?

Well, I went to a birth class

at a natural birth center, which is a midwife-run, you go have birth there at this birth center.

Why did you decide on that?

So I have like a joint disorder called Ehlers-Danlos Syndrome, so I'm just like very hypermobility.

So I was told that I had a high-risk pregnancy.

So they were like, you have to give birth in a hospital, which I would have done anyway.

I don't think I'd watch the business of being born and I have friends that have trained to be doulas, but I'm not, I wasn't afraid of medicine.

Yeah.

So the avoidance of it,

I didn't think that I would need to protect myself from a medical experience, nor nor was I so interested in the experience of birth that I felt like I needed to control it.

I went to a birth class because I wanted to learn all about it.

The birth class was about 10 couples.

I'd say half the people there were going to have hospital births, half the people were going to have home births.

I, Tracy, flicked it, completely, was taking notes the whole time.

Doesn't surprise me.

Constantly raising my hand, dominating the conversation, barely would let anyone else talk, had researched everything,

would hold myself back from saying what the teacher was about to say.

I would have talked so much shit about you if you weren't with me.

Like annotating, just like clarifying for the group that I think what you might mean, what might make, what I've read is maybe something.

My husband was like, every time you're going to ask a question, you inhale like this.

Because I am holding myself back from like raising my hand like high in the air.

I mean,

and at the end of the class, she goes,

I think what you need to think through in terms of having an ideal birth experience is what makes you feel safe.

For some people, what makes them feel safe?

And then she looks right at me and she goes, might be information.

That might be the thing that you feel you really need to calm you down.

And what I thought was, okay, if I arm myself with information, if I know everything about this process, then I will be able to make really healthy decisions.

I don't, I'm not mistrustful of the hospital experience, but I also feel like there's a lot of credible things I've heard that make me not want to just do whatever they tell me to do.

This is exhausting me even to think about how much you cared.

Like I, to think of the amount of information you sought out that comforted you at the time is like overwhelming me right now.

What's complicated about it is that Because all these decisions are available, right?

Which I think has all been generated

to give women agency in their birth.

I was constantly asked, like six or seven times a day, what kind of birth are you going to have?

Where are you going to deliver?

Are you going to do delayed cord clamping or not?

Are you going to do the vitamin K?

Are you going to labor at home?

Are you going to have a doula or a midwife?

Are you going to have a doula at all?

Are you going to have your friend there?

Who's going to be there?

Do you guys have a playlist?

How are you going to get there?

What hospital are you delivering at?

Are you going to induce?

So I kind of felt like, well, I want to be responsible and have answers to these questions and really think it through.

I remember getting into a thing about delayed cord clamping

where I read about it.

There's a risk of jaundice.

It seemed like a good idea to have all the cord blood in to the baby, right?

I don't know what you're talking about, even.

See, this is what I'm saying.

I shut down.

Like there was a point at which information overload convinced me that there wasn't an answer.

How did you continue to be interested?

I was terrified.

It wasn't interest.

It's not like like I actually, it was not that I am so interested in birth, actually, or really wanted to know the answers, or actually, I don't think I even thought that there was a right answer.

It was that I was completely terrified that I was going to make the wrong decision and something bad was going to happen.

In fact, I was sure that something bad was going to happen.

Why?

Because that's how I go through life:

planning for a variety of contingencies of what to do when something very bad happens.

And that led me-you're not a doctor.

So that led me to a very difficult birth.

The first mistake Alicia made is the same one I made, watching The Business of Being Born, which is a documentary by Ricky Lake about home births versus the medical industrial complex that, according to Lake and her doula, has made birthing more dangerous and less healthy for everyone involved.

It wasn't an illness.

It wasn't something that needed to be numbed.

It needed to be experienced.

It was the most adventurous day I've ever had in my life.

There's this explainer scene in the middle of the movie that anyone who's seen it definitely remembers.

It's an intense and terrifying cascade of what could go wrong if you make the biggest wrong decision after the decision to have a hospital birth.

And that's the decision to get induced.

You get this feeling at a hospital where there's like a limit to how long you can be in labor.

Like, oh, it's been 12 hours, so now you need Pitocin.

Oh, I did know the pressure was on.

You know, as we got into like 20 hours, 21 hours.

At the hospital, I had had pitocin and then that made me itchy so they give you something else for your itching i knew once they gave you that pitocin you need the epidural feel better now that you have the epidural oh my god yes and then things come on really strong so then you get an epidural and if you're uncomfortable we can always give you more it was very easy for them to start doing things that we hadn't really wanted them to do like pitocin and whatnot because i already had the iv in my arm they don't really give you the option you know and then another epidural because nothing was happening you're having a contraction right now I don't feel bad.

They gave me another drug called Stadol.

17 hours of Pitocin.

They gave me that, and I remember that made me, I was like, what's going on?

What's going on?

There's something wrong.

Cervidol is the end.

I hated that drug.

You know, it seemed to me that once they started an intervention, they all just kind of, it was a domino effect.

If you're pregnant and you feel strongly about having a drug-free vaginal birth, or like me, your doctor is telling you that's what you need to aim for, watching that scene in the movie really pushes you over the edge.

So imagine Alicia's frustration when she's faced with this exact worst case scenario.

So I ended up getting induced.

I'll tell the story.

So like I got to 41 weeks, tons of people I know had wanted to have home births, ended up going to 42 weeks, went into the hospital, had had an emergency C-section.

And I said to the doctor, why is that?

And she said, well, what I would argue is we're getting new data that at 41 weeks,

the earlier you induce, if you're going over, the earlier you induce, the baby's smaller, your placenta is younger, and you have a better chance for a vaginal birth.

What I also had internalized is that a C-section is very bad.

An epidural will lead to a C-section.

If I get in an epidural, then I won't be able to move, which then will

interfere with pushing in some way where I won't, where they will then eventually, that will lead to a C-section.

I want to avoid that for a variety of reasons.

The duelist sent me a video, the gist of which was, babies are a ripening fruit on the vine, and some cherries become ripe later than other cherries, and

42 weeks versus 40 weeks is sort of, they never really know anyway when the baby was conceived.

And

I was like, that sounds, that doesn't sound like science.

The thing the other lady said sounded like science.

Plus, my husband has to leave town next week.

It would be cool if he was there.

There's three doctors in the practice, and they had said, like, well, do you want to deliver on a Monday or Tuesday or Wednesday?

If you induce, it's about a 12-hour process.

So, you know, which doctor do you want?

Which morning do you want?

And I was like, Monday.

Let's get it over.

Get the week going.

Yeah.

My doula had texted me just so you know, as you go into this, induction can be kind of a mind fuck because it can take a lot longer than you think.

And I had kind of absorbed that and thought, like, okay, whatever.

It was 55 hours from the second it started.

And every

drug I got, I had the most painful, least productive possible reaction.

So they gave me Cervidil and they were like, you'll sleep through this.

And about an hour later, I was having like one continuous level 10 contraction

that lasted for 12 hours and nothing happened.

I wasn't dilated.

And because I was so scared of getting a C-section, I asked for laughing gas, which also confused them because they were like, I guess they had to go find this machine.

They offered it,

which did absolutely nothing.

My whole body was like shaking uncontrollably.

I was in so much pain.

And the nurse came in at one point in the middle of the night, in the first night, and she was like, How are you doing?

And I was, tears were just streaming down my face, but I was trying to be quiet because my husband was finally asleep.

And I was like, I'm having a panic attack, I think.

Like, I, like, I can't breathe and I can't stop crying.

And she was like, okay,

well,

okay.

He looks fine.

Yeah.

I mean,

so then the doula came.

And she said, you look like someone who is at about the kind, like you look like you're in the kind of pain that someone who's about to give birth is in and you're not dilated at all right so this isn't doing anything I think you should get the epidural

so my doula went home because I wasn't in labor

Every next thing that happened when they were going to break my bag of water, when they were going to give me a different drug, when they were talking about a C-section, the doctor would come in and say it, and I would say, give me a minute.

And I would call the doula, and she would tell me different and new information.

Okay, they want to break your bag of water.

Just so you know, once you start that, you're on a 12-hour clock.

They're not going to let you labor more than 12 hours because your bag of water has been broken and it's a chance for infection.

So if you do not deliver in 12 hours, you will have a C-section.

A day later or whatever, when they're like, I'm going to break your bag of water, I was like, stop, no, if you do that, I can't go home.

I've been there for 48 hours in labor.

I'm not going anywhere.

I can't even, I can't walk.

I can't barely talk.

Like I'm mumbling.

And it's like, you think you're gonna leave?

But it's because I had all these ideas in my head.

Like, oh, I was so afraid.

Like, well, then I can't go home and then I'm gonna lose my, I was just so, like, it was like clawing.

It felt like I was like being pulled off of a cliff and it was like my job to try to stay on the cliff.

What was in my head was, I let, I decided to do this and this is my fault.

So every single thing, I was so mad that I had been surprised at all.

Like, you should have told me I couldn't move around.

You should have, why didn't you tell me that this could take so long?

The doula had to tell me.

So I don't trust you because you told me this was going to be 12 hours.

And I don't trust the doula because, like, she said something about cherries.

So, like,

but like, this is all my fault.

This pain is my fault.

And the baby's going to die for sure.

And that's definitely going to be my fault.

The baby's fine.

But what happened to Alicia is the perfect example of the uncertainty and uncontrollable nature of pregnancy and birth.

We make most of our decisions during during pregnancy with the best of intentions based on evidence we gather from anywhere we can find it.

Some of those decisions are based in science, like we can all agree that it's a bad idea to, I don't know, I don't want to finish this sentence because there's an exception to every rule.

When you're pregnant, there are always people who are like, my mom drank and smoked during her whole pregnancy and look at me now and you're like, yeah, hmm.

Anyway, There are the decisions that we make based in feelings.

Some people choose home births because they feel more comfortable comfortable there, while others feel more comfortable in a hospital.

Some want a scheduled C-section a few weeks early, while others will go weeks beyond their due date.

And who are we to judge?

That mushy space provides us with plenty of choice, which can be a great thing, but it also provides an opportunity for all kinds of messages based in science or religion or emotions or folklore or first-hand experience to come in.

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We love to see it.

After hearing Alicia's story, we really wanted her to have the chance to shake off once and for all any feeling that she actually had control over the outcome in the first place, or that any mistakes were made by trusting her doctor versus her doula versus everyone else in the room, that the baby just comes out however it comes out, and that aiming for natural versus saying yes to medical interventions in the end really didn't matter.

It doesn't say anything about Alicia or about motherhood.

So, Alicia invited her doctor in to talk.

I am Sarah Toogood, MD.

I'm an obstetrician gynecologist with Cedar Sinai Medical Group in Los Angeles.

The thing I've always been the most fascinated about your job is being a doctor in LA,

in the neighborhoods of LA that I think those hospitals service.

Do you get people coming in with non-medical or alternative or

like people getting outside information?

And like, I don't know exactly what to call that kind of a thing.

Yeah, I like the word wellness.

It implies that you're trying to be well and that means something different for different people.

I think using the words complementary

or adjunctive treatments, I like using those words as well because it's not the word alternative medicine used to be pretty traditionally used.

And I don't think people.

are or should be using it as an alternative to traditional Western medicine treatment.

I like it when my patients use it as a complement to what our treatment course is.

Do you remember when you started practicing, like sort of having to contend with patients coming in with questions about it or telling you about complimentary treatments they were doing?

Yeah.

In residency, the focus is so much on

evidence-based medicine and knowing the most current literature and staying up to date on the journals.

And there's not room for a lot more than that because you're learning so much every single day.

We would be in the, in the clinic or on labor and delivery, and it's a patient who had a history of a heart transplant who's pregnant and is trying to deliver a baby.

How acute that medical situation is is very different than a young, healthy woman with her first pregnancy who drinks a cup of coffee every single day and wants to know if she can continue it.

When I became an attending, attending, my patient population changed where it was

predominantly PPO, well-insured, good access to health care population.

And that's when I found myself dealing with patients' questions about these complementary techniques, I guess I would say.

My memory of pregnancy is almost like kind of looking for things to worry about to a certain extent and having

the caffeine thing comes up where it's like it didn't occur to me till you just said that that like oh yeah that's a that's a slightly ridiculous thing to worry about but like it came up constantly in my life with people saying like

are you gonna keep drinking coffee oh my god you're so brave for continuing to drink coffee have the glass of wine waiters pushing me to have a glass of wine should i have a glass of wine reading studies about it talking about it i can't imagine how little stuff like that comes up but it's i mean the thing is it's not ridiculous it's was part of your life before pregnancy Pregnancy is not a disease state.

There are things that are safe that you did before pregnancy that you can continue to do during pregnancy.

But in certain amounts, caffeine can be dangerous.

There is an association with an increased risk for miscarriage in very high quantities.

So that's why I say it's not ridiculous.

Those are questions women should be asking.

It's the women who are really sick and have a lot of complex medical problems almost don't even have the space to think about that.

Since pregnancy is such a common experience, a lot of women think that because something happened to them during pregnancy, or they did something specific during their pregnancy and it helped them, or they had a, you know, a nice delivery and they think this one thing helped them achieve that, they spread that around

like it's fact.

And it's just not.

Let's pause here for a second and talk about a few psychological things that go on, not only with our thinking about pregnancy and birth, but with the idea of wellness in general.

What Dr.

Toogood is talking about here is confirmation bias.

It's a totally normal human thing that we all do, where we seek out info to confirm stuff we believed before we sought the information.

Like, I think if I don't get induced, I'll have a vaginal birth.

Oh, look, I didn't get induced and I had a vaginal birth, so I was right.

It's not scientific.

There's no telling what would have happened in the scenario that didn't happen, but it feels good to distill reality down like this.

We also take it too far sometimes and engage in a thing called apophenia.

I was so happy when I learned that there was a word for this because you see it everywhere in the wellness world.

Apophenia is the tendency to make connections between things that have nothing to do with each other and then to instill meaning in something where there is none.

The most common example is seeing Jesus in a piece of toast.

But it could also be thinking that you landed a dream job because you started drinking moon juice.

These mental tricks we play on ourselves are a shortcut to feeling in control of situations like birth that are often so far out of our control that making sense of them would be impossible.

And also that people comment on pregnant women's bodies.

It's obvious when you're pregnant for most people.

And

I mean, you know, you get on the elevator when you're pregnant and someone looks at you and says, oh, you must be having a girl.

based on what they think a woman carrying a girl looks like, which has been studied and has not been shown to be accurate.

I mean, it's...

Is it like what I heard was like, if you have a Linea Negra, that means you have a girl.

And if you're carrying low, that means you have a girl.

Yeah, I mean, in some studies, I would say some groups say if you're carrying low, it means you're having a girl.

Some groups say if you're carrying high, it means you're having a girl.

And it's just

not true.

I mean, there's just so many factors about why women carry low or high.

And it's different from pregnancy to pregnancy and woman to woman.

But people, people take their own experience and they apply it to everyone who's going through a similar experience.

And by definition, your experience is unique because it's just you on that specific pregnancy.

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Hey, I'm Paige DeSorbo, and I'm always thinking about underwear.

I'm Hannah Bruner, and I'm also thinking about underwear, but I prefer full coverage.

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Same, they're so light and so comfy, and if it's not comfortable, I'm not wearing it.

And the bras, soft, supportive, and actually breathable.

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See site for details.

The flip side of this feeling that there's like a huge amount of information everywhere is that there's no information everywhere and I got an enormous amount of it off of Google.

Yeah.

So I was constantly on Google researching things and then leading me into stuff I had never heard of or worried about.

And then when you start asking questions about it, one of my experiences, I would come in ask a question about a thing I had heard on the internet and a lack of feedback or information about that would then make me suspicious and make me think that it was on me to like truly learn more about it versus being calmed down by a lack of information absolutely you know I get asked a lot about about the cord blood um the delayed cord blood uh clamping i did that to you yeah and i mean and and you're not alone we get that question you know with probably 75 percent of our patients.

Patients were asking those questions.

You might be asking as well.

So, here's what delayed cord clamping is: it's a prolonging of the time between delivery and clamping the umbilical cord, which usually happens within seconds.

Delayed cord clamping lets more blood flow from the placenta to the baby, and on the positive side, it's said to increase blood volume and iron in the baby's blood, which has been shown to benefit preterm babies.

But on the negative side, it can also increase bilirubin, which causes jaundice.

It's not an easy answer.

And I don't have

the answer.

I have information, but that's information, especially with pregnancy.

People can't perform really

well-controlled, tight studies on pregnant women.

Because

if we don't know something's safe in pregnancy, we're not going to expose one group of pregnant women to something that we don't know is safe and the other group not.

And so it's hard to find really solid information in the exact kind of, you know, clinical trials that are considered the gold standard.

Those aren't available for pregnant women.

Do you get asked about makeup?

Yes.

The clean beauty industry is

booming right now, especially in Los Angeles.

And it's based on having certain chemicals and

preservatives not in

the product.

You know, I think that the phthalates within perfume, that's a commonly asked questions.

And I did a deep dive into that too.

And

they might cause some harm, but people concentrate so much on the phthalates in perfume, but they're everywhere.

The most common exposure of phthalates is from receipts.

And no one talks about that.

Everyone talks about, you know, perfume and how you should have a phthalate-free perfume.

But when they go to the store, they don't think about not having a receipt, not grabbing a receipt, and exposing themselves to that.

Phthalates, spelled P-H-T-H-A-L-A-T-E-S, yes, are a man-made chemical that binds polymers.

They make things malleable and sticky.

And they're in everything from plastics to flooring to hairspray and perfume, so it sticks to you.

And they're blamed for everything, from developmental delays to autism to ADHD.

But most comprehensive studies show they only have a negative effect in super high industrial doses.

And that average people who don't work in a phthalate factory don't need to worry.

But then again, we can't do studies on babies and pregnant people, so maybe we should reduce our reliance on them just to be safe.

How important is that?

And what is the decrease that we should use to be quote-unquote safe?

There was this split in the two different kinds of advice I was getting.

And one was from the medical side, it was totally outcome-based, which is all I can look at is information, all I can do is look at empirical information, and all I can really judge and all I can count is outcomes.

So, and then on the other side was experience, which was

sort of believing as an article of faith that if you have a good experience, if you feel right about it, if it feels good to you, if your instinct says, if your body says, if you feel

comfortable, then that is what will determine a good outcome.

If I feel safe during my labor, if I feel, if I feel safe, for this is stuff I was told, if I feel safe and comfortable during my labor, then my labor will continue to progress normally.

If I feel scared or uncomfortable, whatever it is, I don't like the look of someone's face, I don't like the smell of their perfume, that's going to stall my labor.

It's a mindset.

You have to be in the right mindset to do it.

Trust the baby.

Yeah, trust the baby.

She knows what it's doing.

Trust the baby.

Just because you're having a good experience does not mean you're going to have a good outcome.

Everyone wants a good experience and everyone wants a good outcome.

And for some women, they can absolutely have that.

For others, they can't.

And if you want to trump your experience at the expense of your outcome, That's really difficult for a doctor to help guide you through.

I, as your doctor, want a good outcome for you and your baby.

Pain level, I remember being kind of specific to that, where it was like,

like during my birth, Abdula came in and was sort of saying, like, you are in the amount of pain I would qualify is like a level 10, and you're not even dilated at all, so you should get an epidural.

But pain level to, when I was describing all this pain I was in to a nurse or a doctor, the look I would get is kind of like, a bummer, but I can't do anything about that.

But I do remember feeling like, okay, you don't care about that because it's not something you can measure.

Therefore, it's kind of immaterial to you.

So therefore, I have to be the defender of my own pain.

And it's me versus you about that decision, which is very complicated.

I don't think you wanted me to be in pain.

Not you specifically, but like

you were one of many people that came into my incredibly long life.

I don't think that you wanted me to be in pain, but also...

Pain didn't seem to determine outcome.

Where do you see the most tension between those things, of people favoring their experience at the expense of their outcomes?

Yeah, I talk about this a lot because we worked so closely with one of the birthing centers and who I loved working with.

And I trusted the midwives, and I thought they took excellent care of patients.

And we would be their doctors if the patient disqualified for a birth at the birthing center because she developed some complication or you know, an induction was indicated,

or if something happened during labor.

And

by the time they come to the hospital, I mean, they have a 50% chance of having a C-section because they've already veered off of a normal labor course.

And that's why the women who were already in labor being transferred, that's why they had to come to the hospital is they veered off course.

All of their kind of education and childbirth classes were geared towards giving birth unmedicated in a birthing center with limited interventions.

and really no options for pain control except for nitrous oxide.

All of their birthing classes were centered around empowerment and empowering themselves.

And if you feel empowered, you will have a better outcome and you're in control.

Your body's made to do this.

And so for women who have that mindset going into their labor and delivery and they have a vaginal delivery and a birthing center as expected, of course, they feel so empowered because everything that they told themselves was correct, that they trusted their body and their body could do this and they did it.

When those women have to come to the hospital because their labor course is not going the way that they thought, they're disempowered and more so than women who are expecting to give birth in a hospital.

But they feel like they did something wrong, that it was on them that

they, you know, they surrounded themselves with the wrong person, or they weren't in the right mindset, or they, what, whatever it is, they could think of, they, they go through and dissect every minute of every day for the weeks leading up to their birth and think if they had done one thing differently, it would have changed the outcome.

And it's just not true, statistically, that's just not true.

A lot of them feel devastated.

And the outcome was good, right?

But their experience was not good for them.

And it's partly because they blame themselves for it, because they were always told this is how you empower yourself.

So then, if you fail that, you've disempowered yourself.

I had a patient that stuck with me

who had a C-section for arrest of descent, which means that you're 100% dilated and you've pushed.

And the baby is not going to come out of the vagina.

So this woman had a C-section, and the next day, she was

still questioning the decision to have the C-section.

And she asked me, Well, what would have happened a hundred years ago

if I was in this situation?

And I looked at her and I said, You and the baby both would have died.

And I 100% believe that.

And she said, Oh, well, that's dramatic.

Dr.

Toogood is a real doctor and trained doulas and midwives are real health professionals whose presence during birth has been shown in multiple studies to lead to more positive outcomes for mother and child.

And we're going to come back to that later in the season.

The statistics are truly remarkable, especially in underserved communities.

Prenatal care of any sort is shown to have positive effects on pregnancy, the birth experience, and the newborn phase.

But what that care looks like exactly can vary so greatly as to nullify the feeling that any one particular choice is better than another.

At the beginning of my pregnancy, a few studies came out saying that drinking moderately during pregnancy had zero effect on the baby's intelligence.

And then I found some articles that said even one drink could cause birth defects.

I got acupuncture on the advice of my midwives because they said it could increase the likelihood of going into labor on my due date, which would decrease the likelihood of getting induced.

But during one session, I asked the practitioner if I had to believe in acupuncture for it to work.

And she replied, well, yeah, it helps.

I never went back, but I did go into labor on my exact due date.

And the baby was born two days later.

Next time, on the dream.

I think the same applies to many of of these new wellness ideas that if it's not working, the fault somehow lies with you, not the machine.

That's in itself quite insidious as a business model.

But when you start applying it to things like anxiety and depression, that's an incredibly nasty and evil way to approach trying to help someone by telling them that they are the reason why their condition isn't getting better when you're just selling them something that you know that doesn't work, it doesn't do anything.

The Dream is a production of Little Everywhere and Stitcher, written and reported by me, Jane Marie, and Dan Gallucci.

Editing by Peter Clowney and Tracy Samuelson, with production by Stephanie Kira Yuki and Lyra Smith.

The Dream is executive produced by me, Dan Gallucci, Peter Clowney, and Chris Bannon.

Our mixing engineers are Casey Holford and Brendan Burns.

Please rate, review, and subscribe wherever you get your podcasts, and thanks for listening.

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We love to see it.

Hey, I'm Paige DeSorbo, and I'm always thinking about underwear.

I'm Hannah Bruner and I'm also thinking about underwear, but I prefer full coverage.

I like to call them my granny panties.

Actually, I never think about underwear.

That's the magic of Tommy John.

Same, they're so light and so comfy, and if it's not comfortable, I'm not wearing it.

And the bras, soft, supportive, and actually breathable.

Yes, Lord knows the girls need to breathe.

Also, I need my PJs to breathe and be buttery soft and stretchy enough for my dramatic tossing and turning at night.

That's why I live in my Tommy John pajamas.

Plus, they're so cute because they fit perfectly.

Put yourself on to Tommy John.

Upgrade your drawer with Tommy John.

Save 25% for a limited time at tommyjohn.com/slash comfort.

See site for details.

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The dream plus, where you can get every single episode of our show with no ads.

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We're also going to have an amazing discussion board.

The interface has it cataloged under AMA, Ask Me Anything.

But I don't love rules.

So, what I did is started a bunch of threads like ask Dan and I questions, general chit chat, just to make friends and stuff.

And every time I've been in charge of a discussion board, I've made a tab called Women Be Shopping, and it's there.

And we're just going to talk about what we bought.

It'll be fun.

That's the dream.superci.com.

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