Birth Allowed Radio

"I’ve got to turn around and go back and dig in to make it better for others." In this episode of Birth Allowed Radio, I speak with Dr. Tracey Vogel, an obstetric anesthesiologist from Pittsburgh who specializes in preventing birth trauma and re-traumatization during birth for people with abuse histories. As part of this care, Dr. Vogel mentors people through the process of filing complaints to hospitals about violating, traumatic, and inappropriate medical intervention. Dr. Vogel walks us through the bureaucratic structure of hospitals and how they receive and process grievances. We also discuss how people can effectively use their voice during birth in advocating for themselves, and the must-have details that you want to be captured if you are pulling together a formal written complaint. Finally, we examine the core issues at hand for many who want their traumatic experiences to be known - for the benefit of closure, and/or to prevent the mistreatment from happening to others - and managing expectations regarding the hospital’s response. Resources mentioned: Visit The Empowerment Equation (http://www.theempowermentequation.com/who-we-are.html) to learn more about Dr. Tracey Vogel and her work in trauma-informed care for obstetric patients. Click here (bit.ly/birth-rights) for all you need to know about Birth Monopoly’s “Know Your Rights - Legal and Human Rights in Childbirth” course and community. Use coupon code PODCAST to get 10% off access.

* Recorded October 2019 * In this episode of Birth Allowed Radio I am honored to speak with Sabia Wade, a Black, queer, full-spectrum doula in San Diego. She is the owner of Birthing Advocacy Doula Trainings, and Executive Director of For The Village, a reproductive justice non-profit providing free doula services to low-income and marginalized groups in the San Diego Area. We dive into the topic of advocacy and doulas - including how advocacy is defined in different populations and communities, and the affects of racism in the birth world. We also talk about the complicated communication dynamics for doulas - including how to navigate tricky conversations, how to read the room, how to identify who you can and can’t talk to you, the value of doulas and the importance of making a sustainable living in birth work. IN HER WORDS: “There’s so many different ways that you can advocate for somebody, and even with the clients that I work with, I feel like advocacy and what they expect from advocacy looks different de-pending on who they are, their income level, their race, their gender, their sexual identity. All the different things contribute to advocacy but it looks different depending on the person’s lens.” RESOURCES: Follow Sabia at her website (https://theblackdoula.com/), and on Instagram @theblackdoula. For more information on Birthing Advocacy Doula Trainings, visit birthingadvocacy.org, or Instagram @birthingadvocacy. Visit For the Village online (https://forthevillage.org/) and at Instagram @forthevillageinc. Go here to see the Evidence Based Birth® article, Evidence on: Doulas, which defines and examines advocacy: https://evidencebasedbirth.com/the-evidence-for-doulas/.

As I celebrated my birthday this month, I realized I had never really talked to my mother about my own birth story. Join me in reliving that experience with my mom, Michelle Pascucci, as she recalls what it was like to give birth - and feed a newborn - in 1979. While she had a great experience with childbirth education, there were times in the hospital she wished she was provided more guidance. “When they said ‘do you want an epidural?’ I’m familiar with it, but don’t know what’s going to happen. And so when I got numb, then I’m realizing ‘oh, that’s what the epidural does.’” As my mom and I delved into some family history, I also discovered some fascinating details about my maternal grandmother--who was a nurse for 50 years--including her relationship with the healthcare system during her time and some deep trauma that she suffered in her relationship with doctors. The story of that trauma, which I had never before heard even a whisper of, blew my mind. “My mom gave herself to her work in the health department - she did it the way she had always done it - but she carried that heaviness of not being able to reconcile his death along with vowing never to work in a hospital again.” RESOURCES: This program is supported by Attorney Susan Jenkins, specializing in business, governmental, and political issues related to birthing rights and the practice of midwifery. Reach her at 866-686-1348. Support Birth Allowed Radio! Contact us here (BirthAllowedRadio@gmail.com).

We are really in the midst of some major disruption for birthing families, in an already fragile healthcare system. In this episode of Birth Allowed Radio, I called on two seasoned doulas and members of the Birth Monopoly "Know Your Rights" community to provide a grounded and strategic perspective for the families who need it most. Miri Halliday of Spokane, WA is a birth doula and childbirth educator, and Lisa Gould Rubin of Burlington, VT is a doula, childbirth educator, and has had a virtual doula practice for over 10 years. Together we tackle the tough conversations surrounding doula access to their clients in hospitals and increased pressure on birthing families during the COVID-19 pandemic. Miri and Lisa reveal what they’re telling their families on how to prepare, what to expect at the hospital, how to cope under societal trauma, and what doulas, partners, and birthing mothers can control. “Everybody’s operating out of this place of fear and scarcity in terms of support and all of this unknown, and it is the worst thing that we want people to be feeling now that they are on the verge of having babies.” - Lisa Gould Rubin “There are going to be clients who are going to say - ‘I refuse. I’m going to have this baby in the lobby unless my doula comes with me.’” - Miri Halliday RESOURCES: Connect with Lisa Gould Rubin at thegoodbirthproject.com (http://thegoodbirthproject.com/), on Facebook (https://www.facebook.com/TheGoodBirthProject/) and Instagram (https://www.instagram.com/GoodBirthProject/). Follow Miri Halliday at hallidoula.com (https://www.hallidoula.com/), Facebook (https://www.facebook.com/hallidoula) and Instagram (https://www.instagram.com/the_oaky_afterbirth/). Click here (https://birthmonopoly.com/covid-19/) for all Birth Monopoly COVID-19 resources, including the Hospital Policy Tracker for Doulas and Visitors. Click here (https://birthmonopoly.com/3-things/) for all you need to know about the updated Birth Monopoly course, “3 Things Every Parent Needs to Know About Hospital Birth.” For the latest COVID-19 research and resources from Evidence Based Birth®, including the Virtual Doula Directory, click here (https://evidencebasedbirth.com/covid19/).

Melissa Pizzo has had four babies by Cesarean, and four completely different experiences! With her last birth, a scheduled Cesarean, she knew what she wanted and she made sure she got it. That included hiring a doula to hold emotional space for her and her husband in the OR. How ever babies are born, it's a special and sacred time, and one where the emotional, psychological, and social needs of the person giving birth should be priorities. In Her Words: I really embrace that this is what was supposed to be and this is how it is and I have these experiences--like, going from my first cesarean to my fourth cesarean, and seeing the progress and what has changed, I think that that part is where I can be like, oh my gosh, I’ve really grown! And I’ve really been able to voice what I want and what I need. And then being able to feel heard is very important. So those things have happened for me compared to that first birth when I didn’t feel heard and I didn’t feel like I had a voice, and I didn’t feel empowered at all. And I walked away very, very traumatized. To then have a completely different experience on the other side of it with my fourth cesarean. Hiring a doula for me [in the fourth birth] was really important for several reasons. One was to have someone in the room so that my husband can kind of focus on his own feelings, his own experience of the birth… And I want someone there to say what’s happening, what’s going, and also how are you feeling right now and rubbing my forehead. Just soothing me, while my husband doesn’t have to. Another thing that our doula did for us is she took pictures, which is amazing. Who doesn’t want pictures of your birth? There were other moments, too. Before I went into the OR, they were having a hard time getting an IV in. I was getting poked so many times, I was having a real meltdown at that point--like, we are not doing this! And Carrie was there, my doula, to be able to really talk to me and calm me down and she took out a little back massaging thing and definitely calmed my nerves, which was needed at that time. Some friends, some family members, might say something like, “You should just feel happy because your baby is healthy and nothing was wrong.” And I think that those words are not helpful. Not one bit. Because it is okay to say I’m so happy that I have a baby and I’m also sad that the birth didn’t go the way I wanted it to go. It’s really, really important that we love our scars. And that we are grateful for them. And that we take care of them. It’s a very tender spot now! It’s definitely still a work in progress, but it’s something I strive for. That I love my scar and that it birthed my babies and that I look at it and I’m like, wow, you are an amazing woman who was able to give birth four times this other way.

Advocacy, burnout, self care, sustainability, and the patriarchy--they're all in this episode! Our guest is Nickie Tilsner, the co-executive director and lead trainer of Cornerstone Doula Trainings, and co-author of RE:BIRTH - The childbirth preparation guide for all people to have an informed, dignified and joyful birth in any setting (due for release early Fall). Also announcing a first-ever collaboration between Birth Monopoly and a doula training organization to offer rights training to new doulas!!! The "Rights Informed Birth Advocate" certification will be offered through Cornerstone starting July 2019. > In her words In order to thrive in the work and have sustainability: feeding your purpose is what really holds resilience and what is actually being trauma informed for yourself and looking at things through a strengths based lens. And feeding your purpose is knowing that you’re effective in the work and being able to really embody the work. And in think that’s what’s going to keep people really going in this and feeling great about the work they’re doing and enjoying it. I burnt out about three years into my practice when I first started and had to take a break and came back with a new way of looking at things. I’m still learning what being trauma informed for myself means. Doulas and birth workers and anyone else in this space need to understand, your brain cannot discern whether this is happening to someone else or if it’s happening to you, when you’re in the situation. And even when you hear traumatic stories, your brain goes into a trauma response. This vicarious trauma is real. I want this to be a part of every dialogue when it comes to birth and birth work… Number one, how we view advocacy as birth workers, number two, how we view ourselves as less powerful than other people in the room, number three, how we are silent and how our silence is complicity. > Resources Cornerstone's next labor and birth doula training, including the "Rights Informed Birth Advocate" certification in collaboration with Birth Monopoly (!!), starts July 12 in Oakland, CA: https://www.cornerstonedoulatrainings.com/sign-up. More to come after that! Contact us at birthmonopoly@gmail.com if you'd like your organization to offer Know Your Rights training, too!

**TW: Alleged Sexual Assault and Birth Assault** This is Katherine DiPaulo's story. She alleges she was sexually assaulted by an obstetrician at a Philadelphia-area hospital in 2005. She has not been able to hold him accountable. Ms. DiPaulo would like to connect with other victims. If you have experienced sexual assault in your obstetric care in the Philadelphia area, please get in touch with us at birthallowedradio@gmail.com or complete this form: https://docs.google.com/forms/d/1SURd8e1KBVdm4vcG47Xab-FwKnqUCXO8tbJeqaWB1_k. Your privacy will be respected to the fullest. > In her words: Had I angered him, it could have been a lot worse. I was doing what I had to do to protect my baby and myself. But I still have a lot of guilt and shame and anger at myself for not stopping it, not doing something. But my body was frozen and in shock. I repressed what happened although it never left me. I started to have chronic insomnia, ... panic attacks, anxiety and depression, difficulty in my marriage. I have flashbacks all the time of this person. I have flashbacks of the event itself. I'm hyper vigilant. I'm scared I'm going to run into him in the grocery store. To be honest, I think if I do see him, I'm going to tell him off, because I'm no longer in that vulnerable position, being in labor and hooked up to all of these IVs and monitors. So, I'm not vulnerable any more, so there's a part of me that still has the strength that if I do see him, I'm going to tell him off. At this point, I'm so furious about it and just want to put it out there so other women can prevent something like this from happening to them. > Related episode: "'I found my voice and I'm not stopping' | Sexually Assaulted by Her OB, Marissa Hoechstetter Fights Back": https://birthmonopoly.com/episode-29/ > Know Your Rights: Legal and Human Rights in Childbirth for Birth Professionals and Advocates: https://birthmonopoly.com/know-your-rights-course/

What do you do when someone in your life has a stillbirth? In this episode of Birth Allowed Radio, Ada Johnson talks about losing her baby Button during birth and the aftermath of that event, and, along with her midwife Sarah, shares how providers and others can respond sensitively when someone experiences a stillbirth. I want to thank both Ada and Sarah for coming on the show and delving back into this deeply personal experience with us. Resources: Consulting and training services from our expert guest, Ada Johnson https://hawthorndoulacare.wordpress.com/provider-consults/ Resources for professionals from Empty Arms Bereavement Support http://www.emptyarmsbereavement.org/resources-for-professionals Compassionate Bereavement Care®Certification through the MISS Foundation https://missfoundation.org/compassionate-bereavement-care/compassionate-bereavement-care-certificationCDC statistics on stillbirthhttps://www.cdc.gov/ncbddd/stillbirth/facts.htm Thank you to Evidence Based Birth for making this episode possible!!

Janelle Hanchett is the author of “I’m Just Happy to Be Here: A Memoir of Recklessness, Rehab, and Renegade Mothering,” out in paperback May 7, 2019. In this episode, we talk about the politics of motherhood and why the idea that controlling our bodies in birth is controversial. Janelle also talks about 'how I discovered I am white' (her excellent post of that title is at her Renegade Mothering blog here: https://www.renegademothering.com/2014/12/09/discovered-white/) and her new book. > In her words this episode: "There’s this larger question: 'Is motherhood enough to turn us into perfect versions of ourselves?' I was really looking into the redemptive narrative surrounding motherhood. Like, this idea that we are saved by motherhood, that we are washed clean by it, that we are redeemed by it, and that the dark part of our self can be erased through love of our children. Spoiler alert, I think that’s bullshit. I think it’s more just subtle erasure of women, right? Because if you erase *any* part of me, you’re erasing me. What that’s basically saying is that the instant a woman has a baby, she is transformed into a vessel of motherhood for this child. She is no longer a fully formed human being. Human beings have fatal flaws! We aren’t that any more. We are now just this clean slate to be used and to nurture this child. And it’s bullshit! So--the book is a story about addiction and motherhood, but it’s really kind of a larger exploration of that theme." Follow Janelle at www.Facebook.com/renegademothering and www.Instagram.com/renegademothering

Marissa Hoechstetter is one of more than 17 women currently suing Columbia University and its associated hospitals for a 20-year "massive coverup" of Ob/Gyn Dr. Robert Hadden's sexual abuse of patients. In this episode, she talks about her long path to justice for the sexual assaults she suffered at Dr. Hadden's hands, getting his name off her daughters' birth certificates, and her ongoing advocacy for transparency in physician conduct and licensing and on behalf of survivors of these kinds of crimes. > In her words: We say support women, believe women, but then you come forward and it doesn't matter.... In my case and in others, there's evidence [the institutions] were alerted to this behavior and they just look away. They don't want to admit it. It's a business choice. With cases like [Larry] Nassar and [George] Tyndall at USC, there's been some high-profile cases of serial sex crimes by medical professionals. The way the media treats it still, it's like it's this one odd weirdo out there. But from the people I hear from who reach out to me now, and from my experience, I think it's more pervasive and present than we want to admit. The people I hear from aren't even sure if it's a crime. They don't know what to do with what happened. We're not talking enough about sexual assault by doctors. > Marissa's story in the news: https://www.buzzfeednews.com/article/albertsamaha/robert-hadden-doctor-sexual-abuse-cy-vance https://www.cbsnews.com/news/columbia-university-hospital-doctor-robert-hadden-sexual-abuse-lawsuit/ https://www.politico.com/states/new-york/city-hall/story/2018/12/09/victim-of-deviant-gynecologist-pushes-for-more-transparency-in-doctor-misconduct-735322 > By Marissa: https://www.bustle.com/p/my-abusers-name-is-on-my-daughters-birth-certificates-i-wont-rest-until-its-removed-12605285 > Learn more about Know Your Rights: Legal and Human Rights in Childbirth for Birth Professionals and Advocates at bit.ly/birth-rights

In a town with one hospital and two doctors, Amy Woods describes her labor and subsequent surgery without pain medication. She also talks about the effects on her and her family afterwards and the hospital's response to the incident. "The doctor said I had to have a c-section because I wasn't progressing. They were kind of, a little messy with the reasons for the c-section. As they were taking my husband to get him all dressed for the c-section, I just remember having the most distinct feeling that I needed to tell him how much I loved him. And that--I was going to die. I thought the safer option for [my baby] was the c-section. Then the OB came in and she did her poke test on my stomach and I told her that I could still feel all of it, that I had feelings in my legs. I could feel everything. And she just started cutting. And she just started going on with the surgery. I feel like at the beginning, I went into a little bit of shock. And then immediately after, I just started screaming."

Alabama doula Kirsten Clark talks about an intense experience watching obstetric violence happen right in front of her, and how her practice has evolved as a result. * TRIGGER WARNING FOR SEXUAL ASSAULT AND OBSTETRIC VIOLENCE * The doctor walked in, put on gloves, and stuck both hands into the laboring mom’s vagina. There was no consent. He didn’t tell her was going to do that or ask if she was okay with it. Moments later, he announced, “Oh, she is tearing already.” I had to look away because I could not physically handle what I was seeing. My body began shaking. I felt lightheaded; I felt frozen in place. [I felt] complete helplessness and fear and anger and grief. I walked away from that feeling responsible in a way for what had happened, and knowing that this mom had just experienced something that shouldn’t have happened, that something was really wrong. And that there was this visceral response in my body to what I was seeing. I just kind of remember being back in that place and feeling like there was nothing that I could do to change what was happening to this mom in that moment. [I knew] my body was responding to something… even though I wasn’t the person that it was happening to, I was still having this response and I needed to do something to work through it. I knew I didn’t want to be in that position again, feeling so helpless and frozen.

In this emotional episode, Jennifer Smith describes having a Cesarean without consent after medical staff ignored her decision to have a vaginal birth rather than repeat surgery, and her trauma afterwards. "I'm numb from the waist down and I have no idea what they're doing to my lower body. I'm just this object lying on a table for them to cut up. And they don't care. And I can't scream out. Because I don't think anybody's going to listen to me. And I'm scared... I'm trying to stay awake. And I remember it was awful because the whole time in my head--and I can't scream out and I was so frustrated because I can't scream out--I'm sitting there going, 'I don't want to do this I don't want to do this I don't want to do this, it's gonna be okay it's gonna be okay it's gonna be okay...' And I remember as this doctor's cutting me up, Dr. R, he's having a personal conversation with Dr. P about the Olympic male gymnast who broke his tibia. And I'm sitting there thinking, I'm not even here. Like I'm not even here. It doesn't even matter. I remember just trying to stay awake enough to hear my baby cry because I wanted to make sure he was okay." WANT TO LEARN MORE? Go to www.birthmonopoly.com WANT TO CONNECT? Email: birthallowedradio@gmail.com Facebook: www.facebook.com/birthmonopoly Twitter: www.twitter.com/birthmonopoly Instagram: www.instagram.com/birthmonopoly WANT TO SUPPORT US? Review us on iTunes, SoundCloud, or wherever you listen to the podcast. Businesses and organizations: Underwrite the show! For more information, contact us at birthallowedradio@gmail.com

WARNING: This story includes graphic detail and may be difficult to listen to. Part 2 of 2: In this stomach-churning episode, nurse "Britany" describes witnessing what she describes as a violation and assault on a laboring woman: a so-called "manual episiotomy" by the doctor--a move she discovered was routine for him. Find out what happened when she tried to report the incident up the chain of command. This is Part 2 of Britany's story. (See Episode 24 for Part 1.)

WARNING: This story includes graphic detail and may be difficult to listen to. Part 1 of 2: In this stomach-churning episode, nurse "Britany" describes witnessing what she describes as a violation and assault on a laboring woman: a so-called "manual episiotomy" by the doctor--a move she discovered was routine for him. Find out what happened when she tried to report the incident up the chain of command. This is Part 1 of Britany's story. (See Episode 25 for Part 2.)