Breaking Cultural Norms and Owning Your Birth with Robbie Davis Floyd

Welcome to Mama Goddess. I'm your host, Alexandra J. Johnson. This podcast is all about rocking your goddess life, creating vibrant health and celebrating motherhood and family life. It's about living an authentically awesome life. Let's have.

Hello, I'm Alexandra J. Johnson, and today's guest is Robbie Davis Floyd. Robbie is a medical anthropologist specializing in anthropology of reproduction. After 25 years of teaching anthropology at the University of Texas, Austin, Trinity University, and Rice University, she currently works as an international speaker and researcher. She's also the author of Birth as An American Rite of Passage, and her most recent collection is Birth Models that Work.

Welcome, Ravi. Thank you.

So great to be chatting with you. And I'm so looking forward to this interview. You've done some incredible research that I greatly appreciate, so thank you.

Well, my pleasure. It's been my life calling and my life work.

Fantastic. And I would love to just hear kind of about that life calling. What inspired you to do the work that you do now? And you've been doing this for 25 years of teaching, and I'm just curious of what led you on this path.

Well, that's a very easy question to answer. I got started in the world of birth because I had a baby. It is kind of a tradition in feminist or feminine women's scholarship to study the personal. For example, Raina Rapp, one of our most famous anthropologists in reproduction, had an amniocentesis and had a diagnosis of downs. And that experience was so shocking for her that she ended up doing an incredible anthropological study of amniocentesis. In America, it's just a common thing for women to study what they experience themselves. So when I was pregnant with my daughter Peyton, her birth was an unnecessary cesarean. It took me some time to figure out that it was unnecessary. I felt very manipulated and had by the medical system. My diagnosis was failure to progress and cephalopelvic disproportion. I had gone into the birth thinking I was very well informed, as so many women do, and I might have been informed enough except that I had a very holistic OB who was killed in a car wreck two months before my birth. So I got passed off to his partner, who was not a holistic ob, and I didn't really have the information to. So many women think that they can trust their ob, that they can go into the hospital and have the kind of birth they want just because they tell them their doctors, this is the kind of birth I want, or they make a birth plan. And it just very rarely happens that way because the Hospital system has a way of taking over and bending you to its wishes rather than the other way around. So in my case, I had an unnecessary cesarean. Like I said, it took me months to figure out why it happened. And I started during the process. I was so traumatized. I was one of those women who really wanted the national childbirth. If a woman wants to have an epidural, or she wants to have a highly medical birth with the fetal monitor and all that, then she's likely to get what she wants from the hospital, because that's what the hospital wants, too. But I wanted a natural childbirth. This was in 1979, and I was really determined to achieve that. And when I failed, of course I felt like a failure. And I was very angry at myself and at the system in general. My severing was a very traumatic experience for me. I felt like control had been completely stripped away from me. It felt like a boot was stepping on my stomach and somebody was pulling up shoelaces with my skin. And I did get to see Peyton immediately after birth for a few seconds. And we did bond in those two seconds, but I did not have the instinct getting to hold her that I had been looking forward to. And I left the hospital feeling extremely traumatized. I was in love with my daughter, but I was gray around the edges, is the way I thought of it. For a good nine months after she was born. And that's postpartum depression, as all anthropologists do. I started asking questions of other women to try to understand their experiences so I could try to understand my own experience and what had happened to me. Then I began reading a lot of books about birth and realized that I had been had by the system, that my caesarean had been infected. And I remember getting so angry reading a particular book that I threw it across the room because I realized I'd been not well treated by the. My birth had not been based on scientific evidence. The obstetrical procedures used during my birth had not been medically justifiable or necessary, although their routine certainly were not justifiable or necessary. So I started to get really intrigued, like, what was going on in American birth that so many women were having these birth experiences that they did not want, and they were also standardized. Why was every experience being treated in such a standardized way? So I, about that time, had to take my dissertation topic. So I went out to lunch with my dissertation advisor, and she said, so, what's it going to be? And I explained that I had been studying myth, ritual, and shamanism in Mexico for And had thought to do my dissertation on that, but that there was something really strange going on with American birth. And I just couldn't figure out why these individual experiences were treated in such standardized ways. And she looked at me right in the eye and she laughed and she said. She made a dismissive movement with her right hand, and she said, shamanism. Shamanism, shamanism. Everyone in their dog is setting shamanism. And she held up her left hand and she said, you do women sing, you do birth. And I said, okay. And that was it. That's how I got started interviewing women for my dissertation was interviewing them informally for my own information and edification, and then as a formal study of 100 women interviewing women about their group experiences. Okay. Could you pause for those minutes? Yeah. Okay. Sorry for the interruption. Little household issue to take care of. Where was I?

Talking about your dissertation and that you were interviewing women and studying birth.

Right. So for my dissertation, I needed to do 100 interviews because I'm not very good with math. So. 100. I can do the percentages pretty well. For the actual dissertation, I did 86 interviews. But then for the book, I could get up to 100, like I said, because you can always figure out what percentage 10 is. 10% of 100, you know?

Right.

So I heard a lot of birth stories, Some positive, some sad, some negative, some very tragic. Some women felt literally raped during their birth. Other women felt empowered by their birth. And it all had to do with how much the outcome of the birth matched the mother's desires and expectations for that outcome. My primary research question became, given that birth is such a unique and individual experience for every woman, why is it treated in such a standardized way in American hospitals? And the answer I came up with to that question was that it is because medical procedures, medical routines that are routinely performed, interventions that are routinely performed on birth in women are not, in fact, medically necessary procedures. They are rituals that are designed to turn birth into a technocratic rite of passage, one that ushers the woman into a technocratic microcosm. In the hospital where the machines dominate, where information is more important than people, where the hospital infrastructure matters more than the woman's own individual needs and desires. Where science is not dominant, it's medical tradition that rules. So doctors learn how to do birth by channeling it through a series of procedures, such as immediately putting the woman into a hospital gown. They used to do enemas. At least they don't do that anymore very much. Putting her in a bed, hooking her up to the fetal monitor. To monitor the contractions, her contractions and the baby's heartbeat, giving her Pitocin, usually to speed up labor or to start labor, which is a very unfortunate development. But now doctors are so used to using Pitocin, they really don't know how to do birth without it anymore. Pitocin speeds up labor, yes, but it makes the contractions longer, stronger, harder and more painful, thereby putting the baby at more risk and the mother in more pain. So the mother asks for more pain relief. So they up the epidural, which means you need more Pitocin to keep labor going because your own oxytocin isn't working anymore. It's been replaced by the artificial Pitocin. And then eventually the baby goes into distress because of these longer, stronger, harder Pitocin induced contractions. And the mother is on the fetal monitor so that distress registers. And the mother is rushed off for a cesarean section for a baby that is in distress because of all the drugs and interventions. And then after birth, the mother says, oh, doctor, thank you for saving my baby, when in fact it was the routine interventions that caused the problem in the first place. This is an absolutely typical scenario in American birth. It is one of the huge reasons why our cesarean rate has now reached 34%. Almost everything doctors do to birth these days is designed to have it end up in cesarean, whether they consciously intend that or not. That is certainly the effect. A 34% cesarean rate is simply unjustifiable in the U.S. back in 1970, our cesarean rate was 6%. That was when so many drugs and interventions were not routinely used and when the fetal monitor had not been invented yet and surgeons actually had doctors had skills in their hands. They knew how to deliver breech babies and twins. They knew how to do X ray reversions. From 1970, when the Cesarean rate was only 6%, to today, when the Cesarean rate is 34%. There has been no improvement in maternal mortality as a result of this huge rise in cesarean infections, or perinatal mortality, for that matter. So we're not doing it any better. We're just intervening more. We're more dependent than ever on drugs and technologies and machines for giving birth. Today's generation of obstetricians literally do not know how to palpate babies. The younger ones coming out of graduate school, they don't learn, they don't have hands on skills. They don't know how to determine fetal size and lie by using their hands on the mother's belly. They just know how to use ultrasound. They don't know how to deliver breech baby. They just do cesarean sections. They don't know how to deliver twins. They do cesareans for that. They don't have skills for doing much of anything. Unless the birth is so clockwork that it proceeds just absolutely textbook, it's likely, highly likely, to end up in the cesarean. We have hospitals now in the US with cesarean rates of over 50%. In New Jersey, there are hospital rates as high as 60 and 70%. This is the trend that the nation is heading toward. And women who think they're going to go have a normal birth in the hospital are generally very ill advised to think so.

Right. Wow. So what's your thought on the. That's amazing. Thank you for sharing that. You just were like answering all of my questions that I had. I loved it. So what's your thought on the technology? Like you said, we're not really advancing, but it seems like we're creating more and more technology for women to get all these tests done. And like you said, you just go in and there's routine things that you just need to get done if you're going to give birth in a labor in a hospital. So can you talk about your thoughts on the technology and how do we actually become empowered around this?

Well, the best way to become empowered with birth is to not enter the hospital in the first place. If you want a truly empowering birth, by all means stay home or give birth in a birth center and have a professional midwife attend your birth, whether that's a nurse midwife or a certified professional midwife. Midwives have better track records all around. They perform fewer interventions, they are more compassionate, they spend a lot more time with women, they give much more high quality care. It's an interesting discussion that we've been having in the midwifery community lately. There was an article that came out in the New York Times just a few days ago talking about how movie stars and super rich people are hiring midwives to do births to do their birth and loving the care that they get from midwives, which is so much more compassionate, so much more humanistic, and so much more time oriented. In other words, midwives spend a lot more time with their clients than doctors do and are much more interested in fulfilling women's individual needs and desires than obstetricians generally are. So that's really interesting. It was nice to see midwifery care being touted as what I would call concierge care, because really that's what it is. And midwives for decades in the US have been very self effacing. They say, oh, I'm just there to support the mother. She delivers. She's the one that pushes the baby out. All I do is catch. I try to be invisible. I try to stand in the background. The birth is all about the mother and the father and the family and the baby and any children. I'm just there to help and support and watch other things and intervene if something goes wrong. But otherwise my role is so minimal. And Barbara Katzrafen, this famous sociologist, has started saying recently that midwives should stop being so self effacing and claim the work they do as artisanal knowledge and skills. They are skilled practitioners with hands on skills that obstetricians often don't even have now. And they give concierge, quality concierge care to mothers. That is a message I would really like to get out there. If you want quality concierge care, find a midwife.

Yeah, definitely. It's amazing. And I'm currently working with an awesome midwife, Mary Jackson, and it's amazing how much time and energy and support she gives me. Like you said, you're not going to get that care in the hospital. You're going to go in for 10, 15 minutes or whatever and I can spend two hours with my midwife. It's amazing.

Yes, midwives are great about that. And you're not going to get that kind of care from an obstetrician when you go to his office, never mind the hospital, but you go to an obstetrician's office, you wait for an hour and a half and you're seen for maybe 10 minutes. But midwives don't do it that way. They take on a number of clients that they have enough time. They limit their caseloads so that they have enough time to take care of the people that come to them so that they can give them quality care.

Right. That's amazing. So your advice is, for women who are listening to this and preparing to give birth or start a family, is to start researching midwives and birth centers and to stay out of hospital if at all possible.

Absolutely, stay out of hospital unless you are high risk. And if you are, your midwife will tell you that you should go to a midwife first, not an obstetrician. Because midwives are experts in normal physiological birth. They know when birth is normal and labor and pregnancy are normal and they know what to do, help keep them normal by helping the mother eat right, eat a healthy diet, get enough exercise, dealing with her emotional issues and stress. They know how to facilitate normal pregnancy, normal labor and normal birth. They also know when things go outside the parameters of normal. At that point they will refer you to an obstetrician. But there is no reason to go to an obstetrician for first line care, unless you already know that you have some kind of really high risk condition, in which case that's where you need to be then with the obstetrician and in the hospital. But that would account for maybe 15% of all women. So we have the whole system backwards. In the US Midwives should be giving primary care and attending a labor and birth of at least 70 to 75% of the women in this country. And I'm sorry, let me say that over again. Midwives should be doing 70 to 80% of the births in this country. And obstetricians should be confining themselves to the 20 to 30% of cases that are really high risk, which could be maybe 10%, and then the cases that are count for the others. So we can give obstetricians 30% of the birth and let the midwives do the 70% that are perfectly normal unless intervened with. Obstetricians are the experts in intervening. Midwives are the experts and supporting.

Right. So awesome. I love it. Thank you. I appreciate your enthusiasm. It's so great. You wrote a book, Birth as an American Rite of Passage. Can you talk about this?

What inspired you to write this book.

And what is a rite of passage?

A rite of passage is a series of rituals that convey an individual from one social state or status to another. So think about Marine basic training. You take a young man who's never killed before, who doesn't know how to follow orders, and you turn him into a soldier. And you do this through a very specific series that is very well recognized of hazing rituals where he's made to work very hard to run 80 miles with a heavy backpack on his back, for example, to dig trenches and fill them up, to go through the exercise routine, to have one minute to eat standing up and run to the next duty. These are all to cut down, take away his normal sense of self. His individual clothes are removed, his head is shaved so he looks like everybody else. All the initiates are treated in exactly the same way. This is a leveling phenomenon that is used around the world in rites of passage. You take away the individual's identity because you want to transform that individual from who he used to be to who he is going to become. Soldiers are not born. They Are made. You literally have to go through these intense rites of passage to turn men into soldiers. That's the most commonly recognized rite of passage. But then there are dozens of other kinds of rites of passage. There's catechisms in church where you turn a young child Into a full fledged member of their religion. Weddings are rites of passage that celebrate the beliefs and values of the couple getting married, as well as of the culture. And when I say birth is a rite of passage, I mean that literally birth transforms a woman, physically transforms her from a young woman into a mother, From a pregnant woman into a mother with a baby in her arms. So even just the physical process of birth is transformative. Then we take that physical process and we ritualize it heavily. We run it through cultural and social procedures, Rituals that shape that birth process, that normal birth process, into something that we recognize in our culture as a high technological process. We apply to that normal physiological process Every technological machine that we can throw at it in order to make it appear to reflect and confirm Our cultural value on high technology, the information provided by machines and the expertise of. Of medical experts and the value of the institution. So initiatory rights of hazards Always reflect cultural core values. And in this case, the core values reflected Are those on science, technology, institutions, patriarchy, and the technocratic society that we live in. In general, I call the kind of society we live in today the technocracy. Because it is a society that is organized around an ideology of progress through the development. And in every culture, birth is going to precisely reflect the trajectory and the beliefs of the overall society. So since our society is all about progress through the development of high technologies. And the flow of information through those high technologies, Birth is therefore also going to be about that very specifically. So birth is now all about the electronic fetal monitor, which is the highest of high technologies Applied to the person body. That creates a flow of information, of constant information about the ligament birth. If this information were a good thing, it might perhaps be a good thing to apply this symbol of science and technology to the birthing woman's body and tie her up, literally hook her up this machine and let it read her internal signals. But there are problems with that. First of all, the electronic fetal monitor Produces too much information. We have 40 decades of scientific studies that show us that nurses or midwives or obstetricians Manually listening to the mother's heartbeat With a fetoscope or a doppler every 20 minutes or so, Accurately tracks the progress of labor without giving you too much information. When you have the mother on the monitor continuously. Every single fetal heart rate deceleration is recorded on the monitor strip on the computer screen. It's normal for baby's heart to decelerate during labor. On occasion, when you see every single deceleration, you're likely to conclude there's an emergency when there isn't, and send the mother off for an unnecessary caesarean, which happens all the time. That's problem number one with using the monitor in hospital. Birth is so ubiquitously. And problem number two is that it ties the mother, it tethers her to the bed. It is possible to be on the monitor and get up and be on a birthing ball and rock your pelvis. It's possible to to set your hospital bed upright like a chair and turn around and wrap your arms around the top of the chair and rock your pelvis and move while you're on the monitor. Even with an epidural, those things are possible. Women rarely do them because once you're on the monitor and you have the epidural, you're just lying there and all you do is just stare at the monitor or you doze off and you don't move. The essence of successful labor in birth, the essence of the normal physiology of birth, is movement. Women need to be up and moving a lot during labor. They need to be eating and drinking, which they can't do once she's had the epidural. They need to be moving, they need to be walking, they need to be rocking, doing the pelvic rock. They need to be getting on their hands and knees. They need to be in and out of the water, the shower, the hot tub, whatever. Ideally, they're walking in their gardens or in the birth center. Ideally, they're baking a cake in their kitchen, making their house smell delicious in their labor. Ideally, they're singing and chanting and listening to music and dancing. All of those things are what facilitate normal labor. Not lying flat on your back hooked up to an epidural and a fetal monitor. Those are the antithesis of what makes labor normal. And they are the reason why the cesarean rate has reached 34% nationwide, and as I said earlier, 60 to 70% in some American hospitals. We are doing birth all wrong because we are making it conform to our cultural beliefs and values, on high technology, on the flow of information, and on the absence of pain and the total control of natural processes. Women are terrified of pain just as they're terrified of a river flooding. If you let birth flow, it's an untrammeled natural process that proceeds According to its own rhythms. And that's frightening to us. Nature has become terrifying to us. We don't like it when rivers. Bad things happen. We build all kinds of dams to keep the rivers from flooding, even though those dams may keep fields from being fertilized that would have been fertilized, Even though perhaps the river is trying to change course, needs to change course, but we don't allow it. We control nature in order to live our lives through technology, in comfort and safety, as we choose to do so. We do the same thing with birth. We dam up the natural process of birth to feel safe around that process, who feel that we can control every aspect of it, even though by controlling it so tightly, we are interfering with it massively and leading to more and more and more interventions. Because of the interventions that we start performing as soon as the mother walks in the hospital. Right.

I love this because it's so great, because it feels like for us as women, that we're losing a sense of the sacredness and beauty and our body wisdom of really tuning into the magical and miraculous process of birth. So how do we actually go ahead?

That's a great point. We have almost completely lost, except for women who birth at home or in birth centers, we've almost completely lost the sense of the magic and the spirituality of birth. We think of it now as a technological process. Women sometimes want to schedule their cesarean, just cut the baby out. They don't think the process means anything. But for women who care about their bodies and who care about the experience, the process is the product. The kind of birth you have will affect the kind of mother you become and will affect the kind of baby that you have. Your baby's consciousness will be affected by the manner in which it is born. If you believe that the process is a product, then you want that process to be as spiritual, as profound, as meaningful, and as normal as you can possibly allow it to be.

That's beautiful. So what do you think? As women, modern women, we're surrounded by technology. What are some rituals that women can start doing to kind of transform the way birth is done in America and in the world?

Well, I'll tell you from my own experience. After my unnecessary caesarean with my daughter in 1979, I got pregnant again about four years later. And this time, of course, I planned a home birth because I understood that I would not achieve a normal birth in the hospital. I just figured I would have a long labor, and they don't allow you to labor very long in the hospital. They used to for me, they let me labor 26 hours before they did the cesarean for failure to progress and festival of pelvic. Disproportionately. Some hospitals won't let you labor more than 12 hours, which is quite ridiculous. Something really important that women should understand is that you can be in labor for two or three days, and as long as you don't get to 5 centimeters, that's not real labor. That's latent. They call it the latent phase of labor. That's what midwives call it, latent labor. And it doesn't count. It's useful in that it helps that uterus to tone. It's getting the baby ready to come down. It's preparing your body for real labor. But the latent phase of labor, you can stay at 4cm for two or three days before you go into real active labor. That's 5cm on 5cm and past that is real active labor. Far too many women go to the hospital at the first contraction or two or three hours into the process and then are disappointed when they're only 2 or 3 centimeters. Well, they should stay home until active labor kicks in. Well, how do you know if active labor is going to kick in? How do you know when it has kicked in? Believe me, there is a massive qualitative difference between early labor, which is contractions that are quite painful. They can feel like really strong menstrual cramps, and you're like, oh, this hurts, and oh, I should go to the hospital. If you have a doula with you who's experienced, she will recognize the signs in your body and she'll be able to say to you, it's too early. Don't go to the hospital yet. The earlier you go, the more that they will interfere with your natural labor process. If you're going to stay home for birth, then there's no issue. If you have a good doula, then you just stay home. Or hopefully you have midwives and you're planning a home or birth center. Birth. If you go to a birth center too early, the midwives will just send you home. They'll say, look, this is early labor. Go home with your doula and your family and come back when you're in really active labor. I knew a doctor once who, when he ran his hospital in Louisiana, when he became head of residency, he or head of the department, rather, he instituted a policy that no woman could be admitted until she was a full 5cm dilated. And guess what? Their cesarean rate was about 10%, and their induction rate was extremely low and their outcomes were excellent because really, that's all it's saying, Stay away from intervention until you're in active labor. Once you're really in active labor, then even if they do intervene, you're already so far along in the process that it's harder to screw it up. You had asked me about how women could prepare themselves psychologically or what rituals they could do.

Yeah, what rituals.

So again, from my own experience, to get myself from the trauma of that unnecessary Caesarean and the feeling that I just didn't have the strength or the courage to push the baby out myself, I spent that intervening four years. It took me a year to figure out that I'd really been screwed by the system and why. Then it took me another year to take responsibility for that and stop being angry at the doctor and the hospital because they were just doing what they always do to everyone and it's the only thing they know how to do and to accept responsibility for putting myself in that situation in the first place and not choosing a home birth, which I should have done for the first birth. I just didn't inform myself well enough. So once I took responsibility. Plus I realized taking responsibility helped me realize that I had been living in my head for most of my life. I've always been an academic, I was class valedictorian. I've always lived in books, been reading since I was three and never have really worked on any kind of mind body integration. I've never done any kind of yoga or meditation. I've never done anything that would try to link my mind and my body together and to help me become a more holistic, integrated human being. So I spent a lot of time once I accepted responsibility for that. I spent a lot of time in the last year of my before getting pregnant and then during the pregnancy a lot of times. Meditating, visualizing exercising, sinking down into my body, being my body, feeling my body, experiencing my body, dancing with sacred dances with my body. And then, especially when I was about six months pregnant, I started visualizing giving birth. I remember a long bus ride I took to North Carolina from Tennessee. Sitting in the front of the bus with my feet propped up. It was dark, nobody could see. Everybody else was asleep. Sitting with my feet propped up and just imagining, imagining the contractions, imagining my body opening, imagining my uterus pushing, bearing down, imagining my muscles bearing down, imagining my cervix opening, imagining the head coming through, imagining it crowning and receding. I had seen a lot of birth videos by then. I'd seen A number of births as well. So I just put my mind and my body together to visualize giving birth myself, even to the point of catching the baby myself and holding it in my arms. So that by the time I actually did give birth, I really felt that I had prepared myself for that experience of being in my body and being with my body and being my body, not being a mind and a body, but being all one. I think that is a huge part of why I did succeed in giving birth to my son at home four and a half years after my unnecessary cesarean. And of course I took a lot of pride and pleasure in the fact that although my cesarean has supposedly been successful of pelvic disproportion for a 7 pound baby girl, my home birth VBAC was for a 10 pound baby boy. So no disproportion there. It's usually the case that cephalopelic disproportionately is a myth. Women's bodies can almost always adapt to their bait, to pushing their babies out, no matter what size the baby is or what size their pelvis is, as long as they're allowed to move during labor, to move and let their body open and adjust. Hands and knees positions are great for that, for letting the pelvis open more. But movement is the essence. And I moved a lot during that three day labor, early labor for the first two days and I was moving and then I was resting and I was eating and I was drinking and keeping up my strength. And the midwife went home the night of the first Monday, said, okay, we're going home. You're just an early labor call as soon as it picks up. So all the next day I labored without the midwife. They did come to check on me, but I was just with my family and my doula and friends that were there and cleaning house, doing whatever and having the contractions. And then they slowed down every 10 to every 10 minutes and then they actually stopped on the afternoon of the second day. The contractions stopped altogether for about five hours and I was able to sleep, which was really great. If I'd been in the hospital, they would have said that that was dysfunctional labor and they would have put me on serious. Suppose I'm to make to speed everything up and get started again that at home. And I said this is perfectly normal. Labor does not have to. Your body is not a machine. Labor can proceed in stops and starts, ebbs and flows like ocean tides. There is no rule that your cervix must dilate at 1cm an hour, as they seem to think is the case in the hospital. That's complete nonsense. Sometimes the cervix does do that, and sometimes freedom curve works. But most women are very individual in their labor rhythm. You can make a lot of progress and then not any for a long time. And fits and starts. My fits and starts. On the second day, like I said, five hours of no labor at all. I went sleeplessly. Then I had a massage therapist come over, and he gave me a full body massage for all that night. I had contractions about every 10 minutes. I did get a good bit of sleep. I woke up in the morning hungry, and I did eat. Then. Wow. Around 8 in the morning was when real labor kicked in, active labor. And I went, oh, so this is what they were talking about. Aha. Now I understand. All right. I thought I was in labor before. I would have sworn that I was in labor before. But then I kept saying, no, this is just early labor. Now. This is active. Okay, now I get it. Now, where it really starts. Here is where the fun begins. Right from 8 in the morning until 8 at night when I push my son out. That was one of the most intense, difficult, trying, magical, magnificent, challenging, overwhelming, stunning experiences of my entire life. And I remain massively, massively proud that I hung in there, that I held on, that I did it, that I found the courage inside of me to deal with that pain, that I took those minutes. You know, labor is not 12 hours of absolute, unending agony. No, it's really, really hard while you have a contraction, and then you get a break. So you relax during those breaks. You take socks, you drink some water, you have a sandwich, you do whatever you can do. You move around. And when the next one starts, don't fight it. You just sink into it. You just sink into it. You go, all right, come on, we're having a baby here. Let's go for this. Let's do this. Let's be this experience.

That's so great. I totally got goosebumps, too, when you were just saying you felt so proud that you had the courage to do it. Because I think, obviously I haven't given birth and I will in a couple months. But just that feeling of, you actually did it. You gave birth to your baby. It's such an empowering thing for women to actually go through that huge rite of passage.

Right? Every woman I know or have interviewed or have read about who has given birth on her own says that it was the most empowering thing she's ever done. In her life. And after that, what you hear over and over again is, once I did that, I knew that I could do anything. And I remember for me, a year after giving birth to my son, I was skiing and I took a wrong turn and I end up at the slope with that black triangle and it's full of moguls and I'm not a very good skier. And I went, oh my God, I'm going to die.

Oh my gosh, totally.

It was too late to get back to the easy slope. And then I thought, wait a minute. I pushed out a ten pound baby during a three day labor. If I could do that, I can totally do this. And I did. I got down that huge hill full of some modicum of dignity and grace, but with courage, because I knew I had courage, because I had found my courage when I gave birth to my son. Right.

That's so inspiring. It's so inspiring for all of us women too, who haven't given birth or who want a different birth experience to really use this as an opportunity for transformation and self esteem and confidence. And you'd be a different woman, you know, totally different woman, pushing your baby out.

Absolutely. In some traditional societies, women are still honored as warriors for pushing mate for giving birth. Among the Kumbhman, for example, of the Kalahari, when the young man goes off on his first hunt by himself and kills his first large game animal, that's his rite of passage and he is regarded from that moment on as a man. When a woman gives birth for the first time, that's her rite of passage and she is recognized from then on as a woman with the same respect accorded to the warrior, because the culture recognizes that childbirth is a challenging process and that it does require courage. So women in that culture are honored for their courage in giving birth. Among the Beriba of Benin, Carolyn Sargent wrote an ethnography about the bereave of Benin who totally honor women for their courage in childbirth. Women are celebrated when they give birth on their own and honored and recognized and brought gifts and recognized in the same way that a warrior would be recognized with positive rewards from the culture. Whereas in our culture we go, oh God, why would you want to go through that? You could have had an epidural. Are you crazy? Are you stupid? Or are you just reckless, endangering your child by giving birth at home, taking all these risks? That label of selfish, stupid, crazy, Those are epithets thrown at mothers who choose uncomfortable birth, especially home births. So often it's extremely painful, it's extremely hurtful. And it's extremely ridiculous because women who make those choices never make them lightly. They know they're going against the culture grain. Women who choose out of hospital births choose it because they've done their homework, they've done the scientific research, and they understand the benefits of normal physiological birth and that they will not be able to achieve normal physiological birth most of the time. In most American hospitals, they consciously choose to stay out of the hospital in order to have a safer, healthier, and more rewarding and empowering birth for themselves and for their family. It's a constant, well informed choice. Women should never be criticized for making that choice.

Totally. Yeah. Amen. I love that.

Yeah.

I mean, as my personal experience, that's why I'm choosing to have a home birth. I can see the benefits of the baby and I can also see the benefits. For me as a woman to really step into motherhood, it's important that I go through this journey.

Do you know that Japanese midwives, Japanese independent midwives to run birth homes in Japan are some of. They're some of the best and most skilled midwives in the world. Most of them are older now. They live in their home on the third floor, and then the second floor will be the birth center and the bottom floor will be the kitchen and the living area and the dining room and all that. They live there. So they're obviously on call 24 7. Many of them have younger midwives that come to work with them and study with them. And these Japanese independent midwives say that labor pain is metamorphic, that the most important ingredient to provide that the midwife can bring is patience. Because pain is an essential part of the process of giving birth. They say that every contraction, every moment of pain the mother experiences while being with and in her body during labor is transforming her slowly from a young girl into a mother. And that process of metamorphosis is going to make her a physically and emotionally and spiritually stronger mother. So they don't ever try to rush the process of labor. They simply mother the mother. They're there loving her, nurturing her, feeding her, taking care of her, making sure she's in a circle of love, but never trying to take away one second of the pain. Because for them, the pain is an essential part of the process. They use the analogy of the butterfly. If the butterfly is struggling to get out of the cocoon and somebody goes, oh, poor thing, that must really hurt. It must be really hard on you. Let me cut the cocoon. Do a sudarion on the cocoon so you can get out. That butterfly will never fly because in the process of struggling to escape from the cocoon, that its wings become strong. So exactly in the same way Japanese Zigois say, labor pain is metamorphic, that helps the mother become strong, tempering her, letting her strengthen her wings so that she can fly as an individual, as a woman, as a mother.

Wow, that's so beautiful. That's amazing. I love that. Thank you for sharing that story. That's so great. It's going to be a touchstone for me.

If women in this culture could just appreciate the value of labor pain instead of shrinking away from it and being terrified of it. I think we have a whole revolution in birth. There is nothing to be afraid of. Labor pain is not scary. It's just intense. It's very, very intense. Live the intensity. Let it be part of you. And boy, I'll tell you, I discovered during my labor that there was all the difference in the world between trying to do something about the pain of labor and just surrendering to it. For the first two and a half days, I was walking with the pain, dancing with the pain, chanting with the pain, laughing with the pain, crying with the pain, trying to do something about the pain, meditating about the pain. I was trying to do something about the pain. And then finally there came this moment where I just kind of dove face down onto my bed and said to myself, okay. I said to the pain, I said, okay, I surrender. I give up. Take me. I'm yours. And in that instant of total and complete surrender, my body went into this profound state of complete relaxation. And suddenly it was as if I was floating four feet above the bed. And I could see myself on the bed. I wasn't moving at all. I was in a state of total intensity and total ecstasy. And because I had surrendered to the pain, the pain and I were one and there was no more pain. I just stayed there in complete, intense bliss for around 20 to 25 minutes until my waters broke. And my best friend, my doula rima, was sitting next to me. And when the waters broke, they broke all over her. And she just jumped involuntarily and said, oh. And that kind of snapped me out of my altered state. And I came kind of back down off the ceiling and down into the bed. And then I was back in the middle of the pain. And I never was able to make that dive again. Totally surrender that I had the experience of giving it, of surrendering. And from that second on, I understood that surrender is the most powerful position we can take. On this planet, surrender to what is being, with what is being, living what is. For the rest of my labor, I surrendered in that I could not merge with the pain in that same way anymore. But for the next two hours, I just went into the pain. I took it as a gift. It's like iron gets forged in the fire. It turns into steel in the fire. So the fire of pushing for me was just put all my heart and soul into it and say, yes, give me pain. I'm pushing my baby out. I need this pain. This is what's making the baby be born. This is what's turning me into a mother. This is good. This is positive. This is white shining, bright, light hurt, light shining intense. Push, you know, Come on, push. You can do it. Push again. Oh, God, it hurts so much. It's good. It's shining, you know, it's bright. It was like this white shining light of pain. And of course, the breaks, you know, Remember when they listen to this, it's not continuous. There are pauses between contractions, and you get to take a breath or two, drink some water, you know, and then, well, there comes that moment when the thing that you thought you'd never be able to do is you actually do it. You push the baby's head out, and you're like, I'm home free. The head is out. It's going to be one or two more pushes. The body's out, and you can hardly believe it when the baby actually comes out. That feeling of relief. There is no greater feeling of relief on the planet than pushing the baby out. Then it's often good to just take a second and roll over on your side or just if you're sitting up, just kind of drop your head and go, oh, my God. Oh, wow. Oh, wow. Okay, let me just breathe. And you take a minute for yourself, and then you look at the baby and you go, oh. And then you take the baby up and you touch the baby and you fall in love with that baby. And then you know why home is better and workforce centers are better than hospitals ever could be? Because nobody is spending any here with you and that baby. Nobody's going to take it away to wash it or to weigh it or to fix something in it. It's you and that baby, and the dad and your other kids are all present. You guys do it together. There's no separation. You can pick the baby up. You can touch the baby. You rub the running into the face because it's so good for your skin. You hold the baby that you never Touch the cord until it stops pulsing because you want the baby to get all that extra oxygen and blood that's coming from the cord until it stops pulsing. Nobody's there to interfere with that magic circle of bonding. It's possible to achieve that magic circle in hospitals if the practitioners will be respectful and stay away. If the OB or midwife who catches the baby in the hospital will hand it straight to the mother and not to the pediatrician or not to the nurse and not feel like they have to save it and discuss it immediately. But give that couple a good uninterrupted hour or two. Enlightened hospital practitioners try to do that, but it just takes one interventive person who grabs the baby away to break that fragile magic bonding circle. It's much easier to protect that sacred circle outside of the hospital.

Right? That's so great. So beautiful. Thank you. I was getting all excited. You were just, like, sharing. I appreciate you sharing your story and just that feeling, too. And I love that feeling, that idea of surrendering, too, and letting go of the control, which I think I'd love to hear your thoughts on that. As women, you said earlier, our bodies are not machines. But for so many of us, we've been trying to control our bodies, be it the right way, be at the right size, do this, do that, look like that. Can you just talk about how we can surrender more and kind of let go of that control throughout our pregnancy, throughout birth, and why that's so important?

Pregnancy is a great time to learn how to let control of our bodies go. We do. You're right, we do. We try to control so much about our bodies, how skinny we are, how we look, our hair is, how big our breasts are. Watch our diets like crazy so we can be the size 6 or 8 that we want to be. Control, control, control. Well, a lot of people who control their bodies, supermodels and movie stars even find that when they're pregnant. It's like, wow, time to finally let go of control. Time to eat, because I'm hungry and eat as much as I need to eat because I'm growing a baby. And it's not about how great my body looks right now. It's about how healthy my baby's going to be. Because every bite you take when you're pregnant, you are literally actively growing the child. The child is not a machine. It is not mechanically growing inside of you like it would in a test tube or a petri dish. It's growing because you are actively nurturing it. Your actions are feeding it, your movements are stimulating it. You are actively growing that baby. So women who are able to take pregnancy is a time to say yes, now I stopped controlling. Now I surrender to this process. Now I simply nurture myself. I eat when I'm hungry, I drink when I'm thirsty. I don't worry so much about quantity. I don't care how much weight I gain as long as what I'm eating is healthy. I stay away from sugary stuff and from diet drinks and all of that. And I eat a lot of vegetables and a lot of protein and a lot of really healthy stuff so that I will grow a healthy baby. No, I don't have to starve myself because I know that I need to grow this baby. As you get into that, then you start. If you know that you're actively growing the baby, then every day, every centimeter that your belly gets bigger. Some women are all embarrassed about how they look when they're pregnant and want to hide it. But now it's much more of a cultural trend to really glory in that. You see so many movie stars on the counters, So many movie stars on the counter, on the covers of magazines that are proud of their bellies. We wear tight clothes now when we're pregnant. When you surrender to the process, every little bit your belly goes. You're like, yes, yes, I'm getting bigger. Oh, look, I'm showing. I'm so excited. This is so cool. As you surrender during pregnancy, that helps you get ready to surrender during birth. So great.

And I love it too. Just the surrendering and really honoring our bodies. It seems like pregnancy is such a beautiful time for us to really honor and nourish our bodies, like you were saying, with the right nutrition and the sleep. And it's a perfect time for that. Some women I know really honor that, but I know some women just continue to work really hard and they stress themselves out and not really honoring the process. Do you find that as well that women are trying to be superwoman, trying to do it all and not really honoring the sacredness of pregnancy?

That is happening? Absolutely. That's extremely common. After I did my first book, I did a follow up study of women who were CEOs and lawyers and positions of power and authority in society. And I called the article the technocratic American child versus cultural expression. It's available on my website. And these 32 women that I interviewed, they were all super control freaks and they did not feel like surrendering to anything and they wanted to control the time of birth as some of them scheduled their caesareans. They certainly wanted the field monitor. They certainly wanted the epidural. They didn't breastfeed. They were not interested in milk dripping down their soap wild during the middle of the presentation. So they were all about nannies. They were all about controlled childbearing and controlled child raising. One of them even said. One of them even said, if my husband could do this instead of me, that would be just fine with me. She said, I have no desire to be a biological woman. I want to be an intellectual and emotional woman, but I have no desire to drop down into biology. Their attitude about drugs during labor was, well, I've made myself eat my meat and drink my milk all during pregnancy, so whatever the epidural does to you while I'm a labor tough kid, you can take. I'm not criticizing those women. They have the right to make their choices, and there are a lot of women out there like that. And certainly the system is set up to serve precisely those kinds of women. They have every choice that they want to have. They have the epidural. They have the pain relief. They have the hospital and the monitors. The system is set up for them and generally makes them happy, because the system is all about control, and those women are also about control. So the system and the women maps perfectly well. We don't need to work to advocate for those women. We don't need to advocate for them to have the right to an epidural at, what, centimeter? Or the right to a scheduled caesarean. They already have that right. They can already make those choices. What we do have to advocate for are the women who make countercultural choices, who don't want the drugs and don't want the technology and don't want to be in the hospital. It's their rights that are endangered, not the rights of the women who are under control.

Mm, yeah, totally. That's so great. And it's been a process for me personally, and my husband has been such an amazing. He's an incredible man, but just an amazing supporter of me. Truly honoring the process of, as you were just saying, like, letting go and surrendering and not controlling and not focusing on production and being, you know, producing in the world and just really honoring the process of. I am doing one of the most. And every woman who's pregnant is doing one of the most creative things on the planet, creating life. It's just remarkable to me.

Yes, absolutely.

So I would love to just hear about. There's so much information on pregnancy, and there's so much information on birth and you've given us amazing information on how the whole system works. How does a couple and how does a woman find her authentic path or find their authentic path to, to pregnancy and birth?

Well, women really need to ask themselves what they want out of the experience. They need to ask themselves a fundamental question. Do I believe that the process is the product or do I only care about the product? If you believe that the process is the product or affects the product, then you seriously want to think about a normal physiological birth that will be of the best physical, emotional and spiritual benefit to you and your baby. If you think that the birth process is irrelevant and your baby's going to be fine no matter what, then do what you want to do. If your values and beliefs do not have to do with normal physiology, with being in your body, with breastfeeding and bonding, with living the experience of birth, then you probably shouldn't try for a natural birth because that not what you want, that's not what's in your heart. Then you've got the whole system there for you. You've got the epidural, you've got everything. I just always say to women who want epidurals, please wait till 5cm before you have the epidural. It's not the end of the world to go through labor until you get to 5 centimeters. And it's so much better for your baby and your body if you wait. If you have an epidural before 5cm, it's going to slow down your labor. They will then speed it up with pitocin, then you'll need a stronger epidural and then they will speed it up with more pitocin. See, if you're labeled with more pitocin and very likely that your baby will go into distress as a result. Whereas if you wait until after 5cm, your body's already in active labor and birth is likely to just flow from there and you can have the epidural. My daughter in law, she wanted to give birth in her own way. She didn't want to follow in my footsteps, even though she read my book. She did have a doula. And the doula was one of the midwives who attended my birth, her husband's birth, my son's birth 28 years ago. So this is a wonderful homebrew midwife who also works as a doula. So she was my midwife and my son and daughter in law's doula. And she helped them stay at home until my daughter in law was in active labor. And so she went to the hospital and had her epidural around 6 centimeters. And her body was like, it worked, flowed beautifully. After that, she dilated almost perfectly on Friedman's curve at 1cm an hour. Some women actually do do that. And she had a very normal birth without pain because she had the epidural. That's because she waited to have the epidural. If she had it at 1cm, she would have likely had a lot of complications. So I don't think that's too much to ask of women who want an epidural in a hospital birth, to just stay home for as long as they can and later to not go to the hospital so they're in active labor, to have a doula at home with them, to support them and guide them and help them know when to go to the hospital, to have a midwife in the hospital. You can have an epidural with the midwife, but you're going to get a lot more compassionate care from the midwife. So whether you're an intellectual type who wants to schedule a caesarean, or you're a miss Holistic goddess, earth worshiping pagan who wants to be in the woods to have a baby, in either case you're better off as a midwife. The intellectual woman who wants to be an emotional and intellectual woman, but not biological, will still get morphed in the midwife because she'll get respectful, humanistic, dignified treatment with a lot of information provided to her that will satisfy her intellect. The goddess loving, nature worshipping woman will get a lot more from a midwife because she'll get appreciation and respect for that way of living and that way of thinking and the possibility of having the kind of birth that she wants, wherever that is, even lives out in the woods somewhere, there's that whole spectrum of what women want. Midwives are going to support women along that spectrum much better than obstetricians can most of the time. Unless what you really want is a scheduled caesarean, in which case, of course, you should be as an obstetrician. Again, women need to ask themselves, what do I want in birth? What's important for me? Is it important for me to have an epidural? If so, then how am I going to manage my early labor so that I can hang out until I'm 5cm and then have my evidence based epidural knowing that my baby and I will be much better off because I waited? So then that woman plans a hospital birth. But the hardest, the most careful planning needs to be for the early parts of labor, eating and drinking and keeping up your strength to get to 5cm so that she can then have respidural. The woman who doesn't want any interventions at all is foolish if she goes to the hospital. If you truly want a normal physiological birth, you are foolish to go into a hospital. If your heart's desire is normal birth, stay away from the hospital, I beg you. It's not going to happen. So many women go to hospitals thinking they're going to have this nice, normal, physiological birth with all the support and they bring their doulas and they might even have a midwife. But hospitals routines, procedures and rules, insurance company rules that the fetal monitor must be on, that you must have an iv, that you must have Pitocin, that you must have this and you must have that. Hospital standard procedures are so standard that it's almost impossible to escape them. So if you really want a normal birth and you go to the hospital and you're disappointed, I'm sorry. That you've got nobody to blame but yourself because you were warned in advance that this is how it was going to be, they need to not be silly about their. They need to not have false expectations about what they're going to get in the hospital. They are going to get a lot of intervention unless their birth is so absolutely textbook that there's no reason to intervene and hardly anybody is. So if you really want a normal birth, a really truly physiological birth, then stay out of the hospital and go home with a midwife or a home birth or a birth center birth.

Right. Awesome. Love it. And one last question. As our role as powerful women in the world, what is our role to be the change that is needed in our culture around pregnancy and birth? What do we as women need to do? What are your thoughts on that?

I'm sorry, can you ask that again? I got distracted.

The role as women, being powerful women, like what do we need to do in order to be the change that's needed in our culture around pregnancy and birth?

We need to give birth the way we need to give birth. Each of us needs to look inside herself, decide what kind of birth she wants, what kind of woman she is, what kind of birth will match her own psychology, needs, desires, what for her baby, what's best for her family, but primarily what's best for the mother. Mothers always need to do what's best for them because if the mother does what's best for her, it always works out better for the baby and for the father and for the family. So to be an empowered woman. You need to know yourself, know what's best for you, and have the self confidence and the drive to go for that, whatever that is. Whether you're going to insist on a scheduled Caesarean or whether you're going to insist on a home birth, be who you are, be the change that you want to be. As I so commonly hear, embody it and live it in the way that you give birth. And also work hard to support other women and their birth choices. I do believe women should have the full spectrum of choice, from the scheduled Caesarean to the home birth. Women should be able to choose anywhere along that spectrum and the system should support them. One thing that we haven't talked about is safety, the safety of home birth. And that's something that always people everybody brings up in home birth real estate. We do have plenty of evidence showing that in the United States, the care provided by certified professional midwives, who are our home birth attendants here in the US Is excellent, outstanding. They have better outcomes than hospital births because they have fewer interventions. So there's less iatrogenesis, there's less medical damage. In home birth. The average cesarean rate for a certified professional midwife attended home birth is about 4%, whereas it's 34% nationwide. The fetal mortality rates, perinatal mortality rates for women choosing to give birth at home with a CPM are the same as those for women giving birth in hospitals who are also low risk. So you compare low risk home birth and low risk hospital birth, and the perinatal mortality rates are the same. So there's no added risk to giving birth at home. But birth is never without risk. Out of every thousand births, two or three babies are going to die, no matter where, no matter what. Bottom line, there's always going to be two or three babies, statistically, two out of every thousand who will die. The point is that babies do not die any more rapidly at home than they do in the hospital. When home births midwives are faced with a situation that they think needs to be medicalized, then they transfer the woman to the hospital. Well, in the big CPMS 2000 study that was done on 7000 courses of care conducted by certified professional midwives, it showed that 88% of the births that were planned to take place at home with the midwife did take place successfully at home. Twelve out of every 100 births were transferred to the hospital. And of those 12 transfers, only three transfers were in emergency situations. And again, the perinatal mortality rate of the babies were in home birth. Babies planned hospital birth Babies were exactly the same. So there is no additional risk of death in home birth and there is a much higher risk of damage in hospital than there is at home. So across the board we can say home birth is in fact safer in many ways than hospital birth. It is a reasonable choice. It is a viable option that every woman who wants to should be able to take advantage of.

So I would love to just hear about. There's so much information on pregnancy and there's so much information on birth and you've given us amazing information on how the whole system works. How does a couple and how does a woman find her authentic path or find their authentic path to pregnancy and birth?

Well, women really need to ask themselves what they want out of the experience. They need to ask themselves a fundamental question. Do I believe that the process is the product or do I only care about the product? If you believe that the process is the product or affects the product, then you seriously want to think about a normal physiological birth that will be of the best physical, emotional and spiritual benefit to you and your baby. If you think that the birth process is irrelevant and your baby is going to be fine no matter what, then do what you want to do. If your values and beliefs do not have to do with normal physiology, with being in your body, with breastfeeding and bonding, with living the experience of birth, then you probably shouldn't try for a natural birth because that's not what you want and that's not what's in your heart. Then you've got the whole system there for you. You've got the epidural, you've got everything. I just always say to women who want epidurals, please wait until 5cm before you have the epidural. It's not the end of the world to go through labor until you get to 5 centimeters. And it's so much better for your baby and your body if you wait. If you have an epidural before 5cm, it's going to slow down your labor. They will then speed it up with Pitocin, then you'll need a stronger epidural and then they will speed it up with more Pitocin. See, if you're labeled with more Pitocin and very likely that your baby will go into the stress as a result. Whereas if you wait until after 5cm, your body's already in active labor and birth is likely to just flow from there and you can have the epidural. My daughter in law, she wanted to give birth in her own way. She didn't want to follow in my footsteps. Even though she read my book, she did have a doula. And the doula was one of the midwives who attended my birth, her husband's birth, my son's birth, 28 years ago. So this is a wonderful homebrew midwife who also works as a doula. So she was my midwife and my son's and daughter in law's doula. And she helped them stay at home until my daughter in law was in active labor. And so she went to the hospital and had her epidural around 6 centimeters. And her body was like, it worked, flowed beautifully. After that, she dilated almost perfectly on Friedman's curve at 1cm an hour. Some women actually redo that. And she had a very normal birth without pain because she had the epidural. That's because she waited to have the epidural. If she had it at 1cm, she would have likely had a lot of complications. I don't think that's too much to ask of women who want an epidural in a hospital birth to just stay home for as long as they can in labor, to not go to the hospital so they're in active labor, to have a doula at home with them, to support them and guide them and help them know when to go to the hospital. To have a midwife in the hospital, you can have an epidural with the midwife, but you're going to get a lot more compassionate care from the midwife. So whether you're an intellectual type who wants to schedule a caesarean, or you're a Miss Holistic Goddess, earth worshiping pagan who wants to be in the woods to have a baby. In either case, you're better off as a midwife. The intellectual woman who wants to be an emotional and, and intellectual women, but not biological will still get more from the midwife because she'll get respectful, humanistic, dignified treatment with a lot of information provided to her that will satisfy her intellect. The goddess loving, nature worshipping woman will get a lot more from a moonlight because she'll get appreciation and respect for that way of living and that way of thinking and the possibility of having the kind of birth that she wants, wherever that is, even lives out in the woods somewhere, there's that whole spectrum of what women want. Midwives are going to support women along that spectrum much better than obstetricians can most of the time, unless what you really want is a scheduled caesarean, in which case, of course, you should be with an obstetrician again, women need to ask themselves, what do I want in birth? What's important for me? Is it important for me to have an epidural? If so, then how am I going to manage my early waiver so that I can hang out until I'm 5cm and then have my evidence based epidural, knowing that my baby and I will be much better off because I waited? Then that woman plans the hospital birth. But the hardest, the most careful planning needs to be for the early parts of labor, eating and drinking and keeping up your strength to get to 5cm so that she can then have her epidural. The woman who doesn't want any interventions at all. It's foolish if she goes to the hospital. If you truly want a normal physiological birthday, you are foolish to go into a hospital. If your heart's desire is normal birth, stay away from the hospital, I beg you. It's not going to happen. So many women go to hospitals thinking they're going to have this nice, normal, physiological birth with all the support and they bring their doulas and they might even have a midwife. But hospital routines, procedures and rules, insurance company rules that the fetal monitor must be on, that you must have an iv, that you must have Pitocin, that you must have this and you must have that. Hospital standard procedures are so standard that it's almost impossible to escape them. So if you really want a normal birth and you go to the hospital and you're disappointed, I'm sorry, but you've got nobody to blame but yourself because you were warned in advance that this is how it was going to be, right? They need to not be silly about their, they need to not have false expectations about what they're going to get in the hospital. They are going to get a lot of intervention unless their birth is so absolutely textbook that there's no reason to intervene and, and hardly anybody's is. So if you really want a normal birth, a really truly physiological birth, then stay out of the hospital and go home with a midwife or a home birth or a birth center birth.

Right. Awesome. Love it. And one last question. As our role as powerful women in the world, what is our role to be the change that is needed in our culture around pregnancy and birth? Like, what do we as women need to do? What are your thoughts on that?

I'm sorry, can you ask that again? I got distracted.

The role as women being powerful women, like what do we need to do in order to be the change that's needed in our culture around pregnancy and birth?

We need to give birth the way we need to give birth. Each of us needs to look inside ourselves, decide what kind of birth she wants, what kind of woman she is, what kind of birth will match her own psychology, needs, desires, what's best for her baby, what's best for her family, but primarily what's best for the mother. Mothers always need to do what's best for them, because if the mother does what's best for her, it always works out better for the baby and for the father and for the family. So to be an empowered woman, you need to know yourself, know what's best for you, and have the self confidence and the drive to go for that, whatever that is, whether you're going to insist on a scheduled Caesarean or whether you're going to insist on a home birth, be who you are, be the change that you want to be, as we so commonly hear, embody it, and live it in the way that you give birth. And also work hard to support other women and their birth choices. I do believe women should have the full spectrum of choice, from the scheduled Caesarean to the home birth. Women should be able to choose anywhere along that spectrum, and the system should support them. One thing that we haven't talked about is safety, the safety of home birth. And that's something that always comes people, everybody rings up in home birth real estate. We do have plenty of evidence showing that in the United States, the care provided by certified professional midwives, who are our home birth attendants here in the US Is excellent, outstanding. They have better outcomes than hospital births because they have fewer interventions. So there's less iatrogenesis, there's less medical damage in home birth. The average cesarean rate for a certified professional midwife attended home birth is about 4%, whereas it's 34% nationwide. The fetal mortality rates, perinatal mortality rates for women choosing to give birth at home with a CPM are the same as those for women giving birth in hospitals who are also low risk. So you compare low risk home birth and low risk hospital birth and the perinatal mortality rates are the same. So there's no added risk to giving birth at home. But birth is never without risk. Out of every thousand births, two or three babies are going to die, no matter where, no matter what. Bottom line, there's always going to be two or three babies, statistically, two out of every thousand, who will die. The point is that babies do not die any more rapidly at home than they do in the hospital. When home births, midwives are faced with a situation that they think needs to be medicalized, then they transfer the woman to the hospital. Well, in the big CPMS 2000 study that was done on 7000 courses of care conducted by certified professional midwives, it showed that 88% of the births that were planned to take place at home with the midwife did take place successfully at home. Twelve out of every 100 births were transferred to the hospital and of those 12 transfers, only three transfers were in emergency situations. And again, the perinatal mortality rate of the babies born with the planned home birth babies among hospital birth babies were exactly the same. So there is no additional risk of death in home birth and there is a much higher risk of damage in hospital than there is at home. So across the board we can say home birth is in fact safer in many ways than hospital birth. It is a reasonable choice. It is a viable option that every woman who wants to should be able to take advantage of.

Awesome. Fantastic. Well, thank you so much for sharing all of your wisdom and your enthusiasm and your passion and your research. Can you give us your website so people can find out more about you?

Sure. My website is www.davis-floyd.com davis-floyd.com and all of my articles are freely available there. Almost everything I've published is freely available there, as is my travel schedule. If you'd like to bring me to come and speak somewhere, you can look on there to see where I'm already speaking. What JP Free. And there's a way to contact me through the website. So anyone who wants to do that I'll look forward. But please do read my books and my articles and all my books are also listed on the website. They're not for sale on the website. You can get all my books through Amazon or wherever. Some of them actually. I found out that Birth is an American Rite of Passage is a Kindle E book. I didn't know until somebody else told me I have it.

I have the Kindle book.

Yeah, I have D.O. technology. That's awesome. Yeah. Well thanks. You asked great questions. I appreciate your the thoughtfulness of your questions.

Oh, thank you so much. Well, thank you so much for being with us and have a wonderful day.

We hope you enjoyed this episode of Mama Goddess. Sending you lots of love and blessings. If you'd like to connect more, go to mamagoddess.com until next time. Keep rocking it and have an awesome day.