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The Edit Alaverdyan Podcast
Welcome to "The Edit Alaverdyan Podcast," the podcast where insightful conversations unfold, and the depth of the human mind is explored. In each episode, I sit down with a diverse range of individuals—thinkers, innovators, and captivating personalities—who share their unique insights and experiences. Together, we embark on a journey of discovery, unraveling the complexities of the human psyche and uncovering the untold truths that influence our thoughts, emotions, and behaviors.
The Edit Alaverdyan Podcast
Dr. Stuart James | Childbirth, Natural Birth, VBAC | The Edit Alaverdyan Podcast #24
Discover Why Dr. Stuart James Advocates for Home Births and Midwifery Over Traditional Hospital Births
Join us in this enlightening episode as Dr. Stuart James, a seasoned obstetrician and gynecologist, discusses why the medical system is failing women during childbirth. Dr. Stu shares his transformative journey from traditional medicine to championing home births and midwifery, highlighting how hospital protocols often depersonalize and medicalize this significant life event.
In this episode, you'll gain deep insights into the contrasting philosophies between medical professionals and midwives. Dr. Stu delves into systemic issues in hospital birthing practices, rising C-section rates, and the financial incentives that influence maternity care. Learn about his successful collaboration with midwives, which focuses on the natural birthing process and achieves better outcomes for mothers and babies.
Expect actionable advice for expectant mothers, including discussions on the ethical implications of routine hospital interventions, pitfalls of glucose testing, and the importance of questioning medical advice. Dr. Stu passionately advocates for empowering women in their pregnancy and childbirth choices to ensure positive and memorable birth experiences.
Tune in for a comprehensive look at birthing options and women's health, enriched by Dr. Stu's expertise and heartfelt advocacy.
Keywords: Home births, midwifery, Dr. Stuart James, childbirth, natural birthing, obstetrician, gynecologist, hospital protocols, C-section rates, maternity care, empowering women, pregnancy, ethical implications, glucose testing, birthing options, women's health.
If you think your hospital has your best interest at heart because they have very nice radio commercials and television commercials, think again. Their fiduciary duty is to keep the hospital financially viable.
Speaker 2:Majority of things in hospital setting controlled, but also the timing of birth. Everything is so quick. When they insert the balloon right, it's like, okay, maximum, oh, you'll give birth by six o'clock. How do you know these things? They know because they practice this on so many women.
Speaker 1:It would just roll off my tongue and I would say things like do you have any meds? Take any meds. No, Do you have any allergies? No, Do you have any other medical problems? And for the first time in 35 years, a woman looked at me and she said what's the first one.
Speaker 2:When you're in that delivery room, you're in fear and it's very scary and it's understandable, but don't ever be led by that.
Speaker 1:You always fear what you don't understand, and the reason that we keep things a mystery sometimes is so that we can control you.
Speaker 2:How many women I know that after one birth they're like I'm done. It was a horrible experience. I don't want to go through this ever again, but every single person that I've talked to that has had home deliveries. They have nothing but wonderful things to say. Hello everyone, thank you for joining me today.
Speaker 2:Today's episode is with Dr Stuart James, obstetrician and gynecologist. An OBGYN highly respected. He completed his medical school here in the States and completed his residency at Cedars-Sinai Hospital. He has been an obstetrician for over 42 years. He's reteaching twin birth. He supports midwives and home birth. He's an advocate of midwives and a severe advocate of home birthing in the natural way possible.
Speaker 2:And this episode was quite interesting because we delved into birth and why it's considered a disease nowadays instead of a God-given process for women. Women have been fearing birth. Nowadays, the statistics are showing that pregnancies are lower. Childbirth is highly lower than before. I mean, I'm sure you guys know it too. The birth rates have calmed down substantially and it's all because of the fear and anxiety around giving birth. Today's episode was all about how women can gain control in the delivery room and what that really looks like. We dived into the pros and cons of home birth, midwives, home birthing hospitals and etc. So I think this episode is really important for anybody that's expecting, anyone that's wanting to learn about birth and anyone in general that really wants to dive into birth and understand the concept of birth giving and how beautiful it is, instead of looking at it as a fear factor. Enjoy this episode and make sure to subscribe to the channel, as it's super beneficial and a support system for me. Thank you guys. Dr Stu, it's so nice to have you on today.
Speaker 1:Thank you for joining me. It's a pleasure for me to be in Los Angeles and be in your studio.
Speaker 2:It's a real treat. How's your drive?
Speaker 1:Oh, the drive was easy. I've been traveling a lot. I was just done teaching in Minnesota. Up in Bemidji there was a traditional home birth conference there with a lot of indigenous midwives. The Ojibwe tribe is up there and there are Amish people up there.
Speaker 1:And then, speaking of Amish, I went to Michigan and I stayed with the Amish family and taught there. And then I came back home and had a little bit of recreation. I went to Vegas and I played a little bit in the World Series of Poker and I actually cashed. So that's exciting for me. And then yesterday I drove to LA and I'm going to spend a few days in LA with my family. We're celebrating on Sunday Father's Day, my ex-wife's birthday, my daughter-in-law's birthday and my other son's engagement, and we're doing a dinner with all of us together.
Speaker 2:Oh my God, Lots of fun.
Speaker 1:Great things happening, it's good Blessing and the drive is fine, because that's where I listen to things like you know your.
Speaker 2:YouTube videos, your podcast, that's wonderful. Could you tell us a little bit about your background? I mean, I'm sure you don't need an introduction. I mean you're pretty prestigious.
Speaker 1:I don't know that your listeners know too much about me. Please, we would love to hear. I have a very sort of unusual path to where I am today and I'll try to be brief. I grew up in Minnesota. I went to college. I had no direction. Like a lot of people go to college, they have no direction. When I was a junior and a biology major, some of my friends decided to go pre-med and I'm the son of a Jewish mother, so that was really one of the only choices I had and I got into medical school at the University of Minnesota.
Speaker 1:And in your third year of medical school you have to make a decision that you're absolutely not prepared for and the first two years of medical school are essentially classroom, didactic and some anatomy lab, and the second two years you do rotations in different specialties.
Speaker 1:Like you have some core skills, like you have to do pediatrics and internal medicine and surgery and OBGYN, and then you get electives like dermatology and ear, nose and throat and neurology, that sort of thing. But in the third year, as you're finishing your third year, you have to apply for residency programs and you don't know anything and this is something that you probably will be stuck doing the rest of your life and medical students are enthusiastic but they're naive and I came off a rotation as a third-year medical student on hematology, oncology, which I found really depressing. It was a pediatric rotation Kids had cancers, leukemias, lymphomas, and then my next rotation happened to be obstetrics and I was up at three in the morning catching a baby instead of pushing chemotherapy and it was delightful for me. And then I realized that I really liked a specialty that had what's called longitudinal care. Longitudinal care is where you're taking care of somebody over time.
Speaker 2:Wow.
Speaker 1:A lot of the specialties are like whack-a-mole all right, you break your arm, I set your arm, you have an appendicitis, I'm a surgeon, I take out your appendix, but I never see you again. Internal medicine, family practice and OBGYN are really the major three specialties that see people over time and I really like surgery and so the other two didn't have that I really, and I like the fact that OBGYN has a little bit of psychiatry, a little bit of endocrinology, a little bit of internal medicine. Plus you get the benefit of catching babies, where you have patients we call I call them clients now, but we call them patients who really are happy to see you generally and they get well and you see the results of your work and it's very satisfying.
Speaker 2:Very.
Speaker 1:And at that time, as I said, you're naive, so you don't think about liability, you don't think about hours, you don't think about that sort of thing, you just think about what would I like to do. And so I applied for a residency program. I matched in Southern California, at Cedars-Sinai Medical Center here in Los Angeles, which was one of those sliding door moments in your life. On the third Wednesday of March all fourth-year medical students open up an envelope and it tells them where they're going to be spending their training. And so had I matched in Iowa or had I matched in Colorado, I can imagine my life would have been completely different. But I matched in Southern California. I came here with no intention of staying in California, but I got a really good job offer and I ended up spending 40 years here and only recently just left California, sort of semi-retired from active practice.
Speaker 1:But I came out very medicalized, like everybody who comes out of residency, thinking that birth is a illness or disease that needs to be treated, and if it wasn't for modern medicine, women themselves would collapse. They're not capable, they're essentially vessels, not humans. And we save babies. That's how we're trained. And so I began to practice that way and I was the crazy guy in the hazmat suit with your legs up in stirrups, covering you with sterile drapes, washing off your bottom, catching your baby, cutting the cord immediately, showing you the baby and walking it over to the warmer, and never thinking about. Pretty much everything I just described is unnecessary, and yet that's how we were trained to do it. But I had the good fortune of being approached by some midwives early in my career and asked to take their home birth transports.
Speaker 1:Now, I knew nothing about home birth. I knew nothing or very little about midwifery. I probably, like most OBGYNs, thought it was foolish to give birth at home. How can you do that? What if this happens? What if that happens? But I did it because medicine back then was a bit different. You didn't come out and get a job, work a shift, like doctors do now. You came out and you built your own practice. You hustled, you covered other doctor's practices, you covered ERs, you worked at free clinics to build your practice from scratch.
Speaker 1:And so I said yes, and it was one of the best decisions that ever happened to me because slowly but surely, over the next few years, I began to see a whole nother way of practicing, a whole nother approach to pregnancy as normal, which occasionally needs help. And so I began to spend time with the midwives and go to some of their meetings and just listen to them and met their patients and they were all very smart, intelligent women who had made this decision, not because they were hippies and didn't shave their armpits and stuff like that. It was because they had thought this through and they really didn't want what the hospital had to offer. And it made me start to look at what I was doing. And then, after about 10 years in practice, I started a collaborative midwifery practice with two certified nurse midwives in Ventura County.
Speaker 1:Cedric Siney at that time did not allow midwives to have privileges and I wanted to have a collaborative practice and so we went out to Ventura County and we for 15 years we had a really good thing going on there. We had very low C-section rate about 7%. The midwives took care of all the normal stuff, whether it be the annual exams, the pap smears, the prenatal visits catching the normal babies, and if a woman had an abnormal pap smear and needed a colposcopy, I took care of that. She had an ectopic pregnancy. I took care of that. If she needed a C-section or forcep delivery, or if she had breacher twins. I took care of that and to me that was a really good model to practice. Yet we were really never accepted in the community.
Speaker 2:Why do you think that is?
Speaker 1:Fear. You always fear what you don't understand. And the doctors, especially the anesthesiologists and the pediatricians, even more so than the other OBs who we'd be competing against, were very nervous about what we did. Our midwives patients did not want epidurals, they did not want vitamin K or hepatitis B vaccine in their babies, they wanted to go home six hours after they gave birth. And that made the staff nervous because the other OBs there were all very old school. They had section rates three to four times higher than ours.
Speaker 1:They you know a woman broke her bag of waters. They told them to immediately come to the hospital rather than we. They would call us. We would ask him a couple questions. If everything was fine, we'd say okay, go back to bed, talk to you tomorrow, don't worry about it, it's perfectly fine. And their induction rate and their C-section rate was high and their outcomes were not as good as ours. And of course that makes people upset Because ultimately it wasn't about what's best for the women of the community, it's what's best for the hospital and the local doctor's practices. Listen, hospitals make more money when you come in and get induced, when you have an epidural, when you have blood tests you don't need, when they can charge for these things.
Speaker 2:Unnecessary things.
Speaker 1:Right, there's no money in not doing something. And so our clients came in and they didn't want these things. They didn't want vaccines, they didn't want vitamin K, want these things. They didn't want vaccines, they didn't want vitamin K. That doesn't make the hospital's administration very happy and it took 15 years, but they eventually found a way to get rid of us. First they banned VBAC, which is vaginal birth after cesarean, which is completely unethical. To ban VBAC, it's a perfectly reasonable choice, evidence supported and everything natural reasonable choice, evidence supported and everything Um. And then they then they kicked the midwives off staff at that hospital where, which was right next to our office in Camarillo, and then they banned they've tried to ban breach delivery.
Speaker 1:I'd done three breach deliveries in June of 2010 and none of the they were all fine. There was no problem with any of them. Yet it made the nurses really nervous and I got a call from the chairman of the department, said you need to stop doing breaches and I said well, I have a document here that you signed that gives me permission to do breach delivery. It's called a privileging sheet. And he said well, it doesn't matter, if you do any more, we're going to suspend you. So I had a decision to make Am I going to fight them or am I going to move on? And I had very wise advisors, including a lot of my midwife friends, who told me that you can't fight a hospital. It costs you a lot of money, it's an administrative process, people who don't understand that. It's not your legal process. It's not like you have an independent judge or jury. You are accused, tried and judged by the same organization, so you almost are certainly going to lose and if you lose then you get reported to the National Practitioner Data Bank and then this happens and that happens. So the choice was to just let my privileges expire and move on.
Speaker 1:And I started to go to home births and even after 25 years of backing midwives and supporting home birth and being supportive of the decisions, I had never been to one and I was a little nervous, I have to say. The first couple I went to, but my own patients who were due after the time that my privileges were going to expire, because doctors have to renew their privileges every two years and they weren't going to renew mine and they can legally do that and that's fine. It's their football, they can play with it and they can take it home with them. But even after all those years I had never been to a home birth and so I was a little bit concerned about that. But my own patients said to me listen, we've always wanted a home birth, dr Fishbein, but we really wanted you, so we decided to stay in the hospital. We're thrilled. So come to our house and do a home birth with us.
Speaker 1:And I did always with a midwife together with me my whole career. I never really went to a birth without a team, and that included a midwife and a midwife student and usually a doula. And we had a great team. And I then began to practice all over Southern California. So if I was in San Diego or Orange County then I would have different midwives and different teams. But I got to know pretty much everybody and for 13 years I practiced in the home setting. Then I got bolder and I said well, if I can do births at home, why can't I do breeches at home? Why can't I do twins at home? Why can't I do type 1 diabetics at home? Why do they need to be in the hospital? Why?
Speaker 2:do they need to have, which all are. I mean, like when you talk to a physician at a hospital. All those that you just listed are named as high-risk pregnancies.
Speaker 1:Yeah, yeah, I have a real good talk about this. I go around the country now and I teach around the world actually, and I teach a two-day seminar on breach and twin skills and one of the things I talk about, before we get into the actual skills, is nomenclature and language. And one of the things we talk about is high risk and I ask my attendees like so okay, guys, what's high risk? And they'll rattle off oh, diabetes is high risk, hypertension is high risk. I said, is it a number or? And then they think about it for a while and I said I'll make it easy for you. It's not really a number. About it for a while and I said I'll make it easy for you. It's not really a number, it's whatever the doctor's uncomfortable with. They label it as high risk. Age 35 is not high risk, but yet you're labeled high risk. Correct, having a previous C-section doesn't really change anything, but you're labeled high risk. Some things that have far greater risk, like inductions of labor leading to interventions leading to the cesarean section the risk of that happening is much higher than someone having laboring with a previous cesarean section, but that's not labeled high risk. So high risk is what they don't like to do and that's so. It's a label.
Speaker 1:It's not, doesn't really have a meaning. It's like also, community standard. What does community standard mean? Does that mean what everybody in your zip code does? Does it mean what OBs do? Does it mean what midwives do? Who decides? Is it the hospital administration that decides? Is it the national organizations that decide? Is it the malpractice attorneys, the insurance companies? Who decides Ultimately? My community is not the OB community and midwives are in the same boat, but yet they're held to standards that aren't theirs, because people have lost their way. They think about birth again as a disease or a medical problem that needs treatment, and whereas midwives look at birth or pregnancy as a normal function of the human body and they accept uncertainty, but they don't try to manage things. Listen to the terminology we're going to manage your labor. What does that even mean? It's how doctors speak. If you hear the words that come out of their mouths.
Speaker 2:But these are the things that have made pregnancy so fearful among women. I just recently had a podcast last week with one of my friend's clinical psychologists. She was petrified of pregnancy for a long time because of everything you hear Epidurals going wrong, all these tests, these gluten tests, like it's just. I mean, my grandma gave birth to all six kids at home, perfectly fine, and her, you know her, her mom and so on. So what happened? Why these changes? What?
Speaker 1:are all these tests? The medical model fears birth because they're trained that way. And then they project their fear onto the women of our country. If you look at the Amish population, if you look at women from Central America, they may even have more morbidity in their population, yet they have very little fear of childbirth. They just concept it as a part of life.
Speaker 2:Little fear and also they have no issues having children, and I think that that stops you. This fear stops you. How many women I know that after one birth, they're like I'm done. It was a horrible experience. I don't want to go through this ever again, but every single person that I've talked to that has had home deliveries midwives they have nothing but wonderful things to say.
Speaker 1:Listen, there can be bad outcomes in any setting. So there is once the sperm and egg together. Um, there's no guarantee how the outcome is going to happen. But there are doctors on the internet who are really anti-home birth and they're very popular on instagram. They've got a large following and then one recently posted something about.
Speaker 1:You know people think that hospital births are so dangerous. But look at the maternal mortality and stuff in 1900. So they're making a false comparison. They're comparing 2024 to 1900. In 1900, we didn't even know germ theory, we didn't know about antibiotics, we didn't know anything about anything at that point. Compare 2024 to 1970.
Speaker 1:In 1970, the C-section rate in the United States was 5%. It's now about 32%. So there's a 500% increase in the cesarean section rate. So you think, gosh, with all those cesarean sections we must have lower maternal and neonatal mortality. Right, wrong. If anything, it's slightly increased, but even if it's plateaued. You essentially have done millions of unnecessary interventions and C-sections on women for no visible benefit and actual evidence of non-benefit, and yet this trend continues. Benefit, and yet this trend continues.
Speaker 1:So these doctors who project this anxiety onto them, it's because that's how they were trained and I could really get into it. They always say follow the money. Okay, follow the money. Here it's a billion dollar industry. Wow, and who run? You know this? This could be controversial, but it but people can take it and try to analyze it. But really, who runs obstetrics nowadays? It's maternal, fetal medicine doctors. They're called high risk specialists right, they're the ones that run the departments. They're the ones that train the future doctors. When I was a resident and again now I start to sound like my dad Okay, in my day we did this and it cost a quarter to go to the movies. No, but when I was a resident, if a woman had diabetes, we learned how to take care of that. She had hypothyroidism we learned how to take care of that. Now OBs are trained that no matter what a woman has, she needs to consult with a specialist.
Speaker 2:Yes.
Speaker 1:So every single woman in pregnancy just about in the medical birth model, never makes it through without seeing a maternal fetal medicine doctor for at least something. Maybe it's just her 20-week ultrasound, but there's always something that they're consulting with, because I think the people that are training the future doctors are training them to be dependent on the maternal fetal medicine specialty. And they make a fortune. You know, a typical MFM, if they scan your patient like two or three times, makes more money than you do for taking care of the woman and doing her delivery in the insurance reimbursement sort of world. And then there's the thing that they, how they speak to a woman and I'm not sure they do this maliciously, I just think they don't even think about how the stick comes out of their mouth.
Speaker 1:And I'll give you two examples. One is a woman comes in at 20 weeks and she gets a 20-week ultrasound. And your listeners will know that Anybody who's had a baby probably gets a 20-week ultrasound and the baby looks perfect and it's growing perfect and the placenta is in the right spot, but there's one little echogenic focus in the heart or one little dilation in part of the brain. Now everyone knows that in the face of normal genetics and normal everything else. That means absolutely nothing.
Speaker 1:But they freak you out, but they will tell you that, oh, your baby looks perfect. But there's this one little echogenic focus I want to see you back in six weeks.
Speaker 2:Oh, that sends you into this spiral.
Speaker 1:So, rather than hearing the part about how your baby is perfect, what are they thinking about? For six weeks, they're thinking about something's wrong with my baby's heart.
Speaker 2:Yeah.
Speaker 1:And the way we're trained is to believe that pregnancy is a medical problem. In ACOG's own guidelines there's a statement in several of them that say pregnancy itself is a high-risk condition. So that's how they the prism by which they see pregnancy. And here's something that oops, sorry. Here's something that happened to me and here's something that oops, sorry. Here's something that happened to me About five years ago. After almost 35 years in practice, some woman finally called me on something that I had no idea that I was doing.
Speaker 1:But when you take a history, somebody comes in for the first time. You're meeting them. You ask them well, why are you here? And they tell you why you're here. And then you ask a bunch of questions about that. And then you ask them about what medicines they're on. Do they have any allergies, what's called past medical history, past surgical history and maybe family history, and then something called review of systems. That's basically how we're trained to take a history. So when a woman came to see me with her pregnancy and I got to past medical history, it would just roll off my tongue and I would say things like do you have any meds? Take any meds? No, do you? And for the first time in 35 years. A woman looked at me and she said what's the first one?
Speaker 2:Oh, wow.
Speaker 1:Do you have any other medical problems? Me not even realizing that I'm considering her pregnancy?
Speaker 1:to be a medical problem, and that's me, and I was already evolved into the person that doesn't look at pregnancy at first as a medical problem. Yet it was still built into me and even to this day I have part of that doctor stuff that still comes out, and midwives tend to laugh at me sometimes when I do that, but it is the way they're indoctrinated, and so why do women in community fear birth? Look at how it's portrayed in TV and movies and even in the news and stuff. The stories about the outcomes that happen that are good and normal, are not in the news. How many times in the newspaper do you read about planes that landed safely today? You don't but one plane whose wheel fell off. You got video running constantly, 24-7.
Speaker 2:So then, this leads me to this question what are some of the pros and cons of hospital birth and some of the pros and cons of having births with midwives?
Speaker 1:Okay, hospital birth is obviously necessary and ultimately the system is broken, or people will say it's not even broken, the system is just the way it is and it needs to be thrown out, and ideally that would be great and people could have another birthing alternative. The problem, of course, is that I'm just coming up with a number. Say, 10% to 15% of women really need what the hospital has to offer, and if you took the other 85% away, the hospitals would close their units. They wouldn't be able to keep them open. So we have this dilemma. Hospitals are great at taking care of problems, but that's when you have a real problem, like a woman is at 29 weeks and she's in preterm labor, woman is at 29 weeks and she's in preterm labor. A woman develops severe preeclampsia. A woman has placenta previa, or even you know, I won't even talk about placenta accreta where the placenta grows into the wall. We're seeing more and more of those. There's been a fourfold increase in that in the last 30 years, because it parallels the rise in C-section rate.
Speaker 1:So, the treatments that we offer women have downstream consequences that are really never considered. But the hospital is obviously necessary for certain things, but the knee jerk that is necessary for a woman who happens to be diabetic? Why Not? All diabetics are exactly the same, but the medical model doesn't allow that they work on an algorithm. You did Look. They have nurses in the hospital that are well-trained. They have doctors in the hospital who are well-trained, are past their boards, are licensed to practice, and yet they're not free to practice the way they're trained.
Speaker 2:They have to follow the hospital's algorithm. But also this, though why is there such difficulty of giving or helping a woman with breech pregnancy? I mean, if they're so skilled, what is the danger?
Speaker 1:Well, they're not skilled. Yeah Right, I mean the de-skilling of the physician. As I said earlier, it starts. Forces are such that they push women toward doing those things. So the doctor doesn't get paid more to take care of a woman with diabetes, but the MFM or the diabetologist. They get paid to take care of her diabetes, but I, if I'm her OB, I can't bill extra for that. So everything about today's system is wrong, and when I say everything, I'm not being hyperbolic. I list a whole list of things that the hospital does to you when you get admitted to the hospital, and I ask the people that attend my seminars so look at that list now and tell me if any one of those things is done for the benefit of the woman.
Speaker 2:No, I think. Well, from my experience, it's all for the baby, right Doctors will say you know, the most important thing is that we get that baby out safe, like my own doctor said that to me.
Speaker 1:Right.
Speaker 2:What about me?
Speaker 1:Yeah, because the journey doesn't matter.
Speaker 2:The journey doesn't matter, it's only a destination.
Speaker 1:And so you asked about breech and twin delivery. They're de-skilling them. They've gone to cesarean section, killing them. They've gone to cesarean section. Most breech babies can be delivered vaginally safely, and the data actually supports that. But this is data that they choose to ignore.
Speaker 2:Why do you think that is Money?
Speaker 1:Fear and money yeah. And fear of litigation and money yeah. And expediency, boy, if you have a lady who's breech and you're going to get paid the same, whether you bring her in at 7.30 on a Tuesday and do a C-section on her, outbade 15, or you're going to let her labor and your hospital has a policy that you have to be here the entire time she's laboring because she's breech and you get paid the same, why would you encourage her to have a breech delivery? And so they don't learn the skills and then they may even work at a hospital or in a group where the group says you may do breech deliveries, dr Fishbein, but our group doesn't support it, so you can't do them.
Speaker 2:But is this taught in residency?
Speaker 1:No, it's not being taught in most residency programs anymore.
Speaker 2:And what are the risks of delivering with breech babies?
Speaker 1:Well, that's a whole podcast in and of itself. But if you look at the world literature, in properly selected breech and there are criteria that we use to properly select a term breech pregnancy the risks are almost negligible compared to vaginal delivery. The mistake that a lot of papers make is they'll compare vaginal breech delivery to cesarean for breech delivery. But you shouldn't compare those. You should compare vaginal breech delivery to head down vaginal delivery and the difference is extremely small. And the best guidelines, if your listeners want to look at that, are put out by the Royal College of Obstetrics and Gynecology in 2017. They're called the Green Top Guidelines and they talk about the risks of these things in relative risk. But you also you have to convert relative risk to actual risk. Relative risk doesn't mean something If something's four times riskier than something else. That sounds bad, but take it this way If something happens one in a million times and it's four times riskier, that means it's one in 250,000, which is still essentially zero. So until you know what the denominator is, then a lot of times, statistics are used as for lack of a better term medical trickery to coerce you, to funnel you whether it's subtle or overt down a path that the physician wants to take because it's more comfortable for the physician.
Speaker 1:The physician fears breach delivery, therefore they don't want you to choose. That, as opposed to being the ethical physician, would say. You know what Breach delivery in the literature is actually a reasonable choice when properly selected with a skilled practitioner. But I'm not skilled, so you need to find somebody else. That would be an ethical thing to say. But what they'll tell them is oh, the head will get stuck or the cord will prolapse and your baby will have brain damage. And that's not true. That's not true, any more so than it is with a head-down baby, correct. And yet you know they skew their counseling. This is listen, this is rampant. This just isn't in medicine, this is in everything in our lives. Right now. We are being gaslit constantly about everything.
Speaker 2:Everything Right.
Speaker 1:This isn't just obstetrics. I mean, people haven't opened their eyes in the last three or four years about the gaslighting that's gone on with the whole COVID vaccine issue. Then there's no hope for you. There's no hope.
Speaker 2:Well then, help me understand in our audience this Dr Stu. When a woman does want to do I understand in our audience this Dr Stu when a woman does want to proceed with home birth or with midwives, the usual comeback to that is what if something goes wrong? And I know you hear this all the time and it's so frustrating because anything could go wrong at a hospital too. I've had several friends that have had severe issues at hospital birth. So how do you soothe someone that wants to do home birth but is Well, that's an interesting question and we're going to only scratch the surface here.
Speaker 1:My co-host Bliss and I on our podcast, once every two months we have a webinar which we call Bringing the Home Birth Hesitant on Board. So I'm very well-versed in these questions because we get them all the time, these questions, because we get them all the time. But when you leave mother nature alone, nature designs birth over eons. It's been designed the communication, the hormonal communication between mother and baby for nine months and the signals that baby sends mom and mom sends baby during labor that everything's okay and baby's fine and getting mom's hormones. This is well-designed and when you leave nature alone, things rarely go wrong.
Speaker 1:Suddenly you can generally see them coming and, as again somebody who's worked in the hospital for 28 years and then 13 years in the home setting, I can tell you that the sudden deterioration of fetal status that you sometimes see in the hospital doesn't happen at home extremely rarely. Yes, there will be occasions where that happens, but it doesn't necessarily mean the outcome is going to be worse than if you were in a hospital. So let me explain that for a second. So when you don't mess with mother nature, you don't generally see this whole thing where you have this baby suddenly deteriorate.
Speaker 1:The problem is in the hospital, because they're interfering with mother nature. From the minute you get in your car to drive there until the moment you put your baby in the car seat to drive home. Pretty much everything they do is antithetical to nature's design. It causes this whole cascade of interventions and then you're more likely to end up with a baby in the NICU or an emergency procedure, emergency C-section or vacuum delivery because of the way that you were treated in the hospital, because of the you're not moving fast enough, because of the multiple vaginal exams, because of the constant interruption, because of the epidural interferes with mother-baby communication. But why wouldn't you want to have an epidural? You would never have a tooth pulled without Novocaine. Why would you have a baby without an epidural? I wrote a whole blog once.
Speaker 2:Oh yeah, that's my next question. After this We'll get to that.
Speaker 1:So we end up with a situation where that's a very legitimate question that asks and it's usually asked by the dads, by the way. Yes, the fathers ask that question because safety and money are you know. They're our concern. But that's what midwives are trained for. Midwives are experts in normal birthing.
Speaker 2:More than.
Speaker 1:Oh, doctors are experts in problem birthing. They don't even know normal birthing. They don't see normal birthing. Watch the Business of being Born, watch Ricky Lake and Abby Epstein's movie and you'll see. They don't know that. But midwives are trained in normal birthing and as an expert in normal birthing, when something isn't normal, you see it right away. The analogy that I often use is if you lived in the same house for 20 years and you go out for dinner and you come home and you open the front door and the chair in the front hall has moved three inches from where it normally is.
Speaker 2:You notice it?
Speaker 1:right away. You don't know why did the dog hit it? Was there an earthquake? Did someone break in the house? You don't know why, but you know something's not right. If I came into your house as a guest for the first time, I have no idea that that chair was in the wrong place. It's a very simple thing. Midwives are experts in now. Are there good midwives and bad midwives, of course, and are there good OBs and bad OBs, of course? Are there good MFMs and bad FMs, of course. And how do you know? You don't, you don't. And maybe your girlfriend had a great experience with this doctor, but maybe your girlfriend's personality or her desires are different than yours. So you have to interview people and you have to ask questions, and we've done a podcast and the down-to-birth people have done a podcast about you know how to interview your doctor, what questions to ask.
Speaker 2:That's a great question. What are red?
Speaker 1:flags. How do they answer your question? Do you feel better when you leave your doctor's appointment or worse? Did your questions get answered? Did your doctor give you the time? Did your questions get answered? Did your doctor give you the time? A big difference between the midwifery model of care and the medical model of care is the midwifery model of care. A prenatal visit is generally 60 minutes long.
Speaker 2:Oh wow, that's wonderful and a medical model of care.
Speaker 1:It might be 6 to 10 minutes long.
Speaker 2:Correct they don't have time, they don't have time because of the medical design.
Speaker 1:I mean not the medical design, the financial design, the office overhead.
Speaker 1:Yeah, you have to do volume in order to keep up in a system that has third-party payers. If doctors could charge what they needed, they could be less busy, but they can't, so they have to take what some businessman who's got a half a million dollar salary and probably a nice private jet is telling them to do. That's part of the problem. I know I'm having flight of ideas here almost because you ask these questions and I've been asked them so often that so many thoughts come into my head, so I hope I'm answering them to your satisfaction.
Speaker 2:No, no, no, you are. I love them. I have a lot and you're hitting all that because I'm reading through them. I'm like, oh, you answered this, you answered this already. One question that I have a lot and you're hitting all because I'm reading through them. I'm like, oh, you answered this, you answered this already. One question that I have many of the hospitals do these glucose tests during the end of the pregnancies. What are these tests about? Because I literally rejected every single test that was given, especially this glucose one. It doesn't make sense to me to give, you know, an unborn child that much sugar to see.
Speaker 1:Yeah, it's not how you eat, anyway, it's just it doesn't make sense to me.
Speaker 2:So what advice do you give moms that do reject this test? Are they doing the right thing?
Speaker 1:Well, yeah, the problem with testing in general is that it's often set up to catch everyone who's got the problem, but ends up catching a lot of people who don't, or what are called false positives.
Speaker 2:Wouldn't these develop problems though some of these tests?
Speaker 1:Well, hang on a second, Let me just for your listeners. Just there's a thing called sensitivity and a thing called specificity. People, you know what these things are, but you probably may not have heard it that way. A sensitive test is a test that's positive when something is wrong. So the best example of that would be like a metal detector. Right, if you have a gun, metal detector is going to pick it up. A specific test is a test that's negative when nothing is wrong. So the metal detector highly sensitive but low specificity. Keys, belt, buckle, coins in your pocket, those sort of things are also going to ring. So there's going to be a lot of false positives. The problem with tests like the glucose screening test is not only just is it metabolically weird because you don't eat that way, but it's set up to catch you know. So it has a lot of false positives, which then get people labeled yes and you may be labeled as okay, well, you know. So it has a lot of false positives which then get people labeled yes.
Speaker 1:And you may be labeled as okay. Well, you failed your first test. Now you have to do this other test, but does the label that you failed the first test ever go away? And what does that do to your psyche? That you failed the test and now you're thinking that you might have a problem? And then you've read about diabetes in pregnancy, but you've not really read the facts about it, because you read what ACOG or whatever else they make it seem like it's this really big deal, and on rare occasions it can be, but most of the time it isn't. Yet because of the algorithms by which doctors practice off of all diabetics are treated on the same pathway, are treated on the same pathway, and it becomes insane because most people who fail that test are not diabetic and they can be managed with diet alone. So here's the question why don't we just get people on healthy diets in the first or even before they're pregnant, if we can get a hold of them, but at the 10-week visit, why?
Speaker 2:don't we spend time talking about nutrition?
Speaker 1:Well, midwives actually do, because they have an hour to do it in and doctors don't, so they start talking about having you see a dietician at 28 weeks when you failed your glucose test. This is another problem with the medical system and the stuff that's in it. So don't do it.
Speaker 2:I never did, if you want to be tested.
Speaker 1:One of the good ways to test is to tell your doctor you know what. I'd like you to draw my blood an hour after I eat a normal meal.
Speaker 2:Isn't that the pancake test? They call it the pancake diet right, when you eat like a pancake with syrup.
Speaker 1:No, they're telling you what to eat. I wouldn't.
Speaker 2:What I eat. That makes more sense. It does make more sense.
Speaker 1:So I mean cause maybe you don't eat pancakes, Maybe you don't eat 23 jelly beans or whatever it is. Maybe you eat very healthy, exactly, and you eat low glycemic index carbs and you eat a couple of eggs for breakfast with some bacon and maybe an English muffin or some you know tomatoes. That's your breakfast. That is going to be different than someone has a bowl of cereal with some sugar on it and blueberries and that sort of thing. You're going to have different.
Speaker 2:Correct.
Speaker 1:So these standardized tests and, by the way, it's really interesting, they give you the same amount, whether you weigh 120 pounds or 320 pounds.
Speaker 2:It's gnarly so think about that.
Speaker 1:Your volume of distribution is completely different, and a lot of times this gets into something that I often consider a mentor of mine, who's an economist, who's older now. His name is Tom Sowell. People want to look him up. They can look him up, but one of the things he talks about that's influenced me a lot is what's called stage one thinking, and that's thinking that doing something because it sounds good or feels good, without ever asking the question. The second question, which is and then what happens if we do this? And like continuous fetal monitoring, that is a stage one thinking thing. They put it into place before it was ever tested to see if it actually does good. It felt like, oh, if we monitor babies continuously, we'll prevent cerebral palsy. Well, how about testing it first before it becomes universally used? Because it didn't ever do that. As I talked about earlier, all it did was raise the C-section rate.
Speaker 2:So then, how do women take control then in situations like this, because we are just scolded for rejecting every kind of test like this and how do we take control of our pregnancy?
Speaker 1:Just, ask for explanations for things and if you feel like the doctor is getting exasperated or doesn't have the time for that wake up, he's not the right doctor.
Speaker 1:Yeah, get out of there. You're hiring them. Would you hire a painter to paint your house? No, and you said I want coffee, tan, coffee, colored. He says I'm giving you yellow. No, yeah, no, you would never. You'd fire him immediately. So you can fire your caregiver and make pregnancy something that you value. And people say, well, I can't do that because I only have Medicaid, or I can't do that because my Blue Cross only lets me go. To this group of people it's like, no, it doesn't.
Speaker 1:No, it doesn't, You're choosing to not spend your own money and that's a statement of how much you value it and it's a cultural thing. I don't blame people because they don't think they get stuck in their box. They don't think out of their box. You save money to buy a car. You save money to go to college. You save money to have a wedding. Why not save money for your childbearing? And if you have to pay a little extra to see an out-of-network doctor or pay a midwife because your insurance doesn't cover a midwife, or even if you go to a doctor, pay a midwife to do some prenatal visits with you so that you can see the different two models. And maybe your doctor only gives you six minutes, but you've got 60 minutes with a midwife who can help you stay healthy in that doctor's practice and help you guide you, along with hiring a doula which is extremely important for a first-time mom especially who can guide you along the way and give you the answers to the questions. Do I really need to do that?
Speaker 1:And here's the pros and cons, and they'll have the time to give you the answers to the questions. Do I really need to do that? And here's the pros and cons, and they'll have the time to give you the pros and cons. You know it's all these other things. Do I need all these vaccines? At 28 weeks? I'll give you a blunt answer no, you need none of them and you should take none of them. And you should take none of them ever. The flu, the DTaP, which has got aluminum in it, the COVID vaccine. And then they want you to have the RSV vaccine at 34 weeks. None of those ever been tested for safety in a randomized placebo-controlled trial in any human being, let alone pregnant women, violating what's been a precept for eons, which is called the precautionary principle, which is that you don't test stuff on pregnant women.
Speaker 2:You just don't do that. You just don't do that. It's so unethical, immoral to do things like this.
Speaker 1:Yeah, they put people to death in Nuremberg trials for doing that sort of thing. And that's what's going on, with women getting these vaccines and giving your newborn baby hepatitis vaccine, which is a sexually transmitted disease, and it contains 250 micrograms of aluminum into a brand newborn baby. You got to be out of their mind. And, by the way, if you happen to be one of those rare women who's hepatitis positive, your baby generally they're not going to benefit from the vaccine. They're going to benefit from getting H big. But now H big is pooled blood samples. It's caught from you. Don't know if anybody who's donating that is is carrying the spike protein around.
Speaker 2:What about the vitamin K? Why do they push that on babies?
Speaker 1:I mean.
Speaker 2:I rejected both for my, my children, but curious to know.
Speaker 1:Vitamin K has a code that they can bill for. That's my simple answer. Because they're not. If you look at the numbers, the risk of a baby suffering from this very serious thing called late onset, vitamin k dependent bleeding or deficiency bleeding I guess it's called um, but the but the incidence is about six per hundred thousand or one in sixteen thousand that's very, that's not so if it happens's awful, but you're giving an injection intramuscularly to a baby of something that 15,999 times out of 16,000 they don't need.
Speaker 1:And if you read the package insert on that, it has a black box warning against intramuscular injection, and yet they give this dose to babies.
Speaker 2:Meaning.
Speaker 1:It can cause anaphylaxis.
Speaker 2:Which is an eyesight condition.
Speaker 1:No, anaphylaxis is an allergic reaction and possibly cardiac arrest and death, all right.
Speaker 2:And this is on the insert.
Speaker 1:It's what's called a black box insert. It's at the very top in a black box. It says not for use intramuscularly. Now also, vitamin K is. Again, it's a. It's a one dose vial. You're giving the same dose to a baby that weighs six pounds, one that weighs nine pounds and one that you might give to a 30 pound kid. There's no you know with with other medicines for babies. They base it on their weight, like antibiotics and stuff like that. They base it on their weight like antibiotics and stuff like that, which is a whole other discussion about antibiotics. But so vitamin K is probably something that it should be not used anymore, and I will be pilloried for that by a small percentage of people who may very well have had an incident where their kid has suffered from vitamin K-dependent diabetes.
Speaker 1:But, we're giving something that's artificial. And here's the other thing that no one thinks about is, if vitamin K is so important for babies to have, how come they're born vitamin K deficient? How come nature hasn't figured out a way to get babies vitamin K? If they're supposed to have vitamin K, maybe they're not supposed to have blood that clots really good in the first six or seven days of life, maybe because they're developing increasing blood flow to their brain and their heart and they deal with little, teeny blood vessels and they don't want them to clot off. And maybe nature has taken care of it.
Speaker 1:Nature isn't stupid. Nature does things for a reason and one of the reasons and things that nature did is make babies vitamin K deficient. And vitamin K is manufactured in your gut. And when you're colonized babies colonized by the proper bacteria mom's vagina, dad, and mom's skin, that bacteria then their bodies begin to make vitamin K, which is kind of an interesting thing. And again, jewish culture babies who are circumcised and this is not an endorsement for circumcision at all, but they wait till the eighth day of life. Why, now some people say, oh, because they want to make sure the baby's going to survive, and there's a covenant with God and blah, blah, blah Maybe.
Speaker 1:But maybe the ancients knew that by the eighth day of life, babies' clotting mechanisms are kicked in and working fine on their own. This is all you know, but it's all theoretical. You can't prove this sort of thing. But why would nature make babies vitamin K deficient if vitamin K was something they must have? Vitamin K is a money-making deal for every you're giving. You're giving 16,000 unnecessary doses to. Every single baby gets vitamin K and every single baby gets hepatitis vaccine. And you know what? Hospitals sometimes get kickbacks from pharmaceutical companies for the percentage of patients, or doctor's offices for the number of patients they have vaccinated, the percent they have vaccinated. I know this is a fact in pediatric offices and I'm pretty sure it's true for hospitals too. It is Right, it is offices and I'm pretty sure it's true for hospitals too, right?
Speaker 1:So if you think your hospital has your best interest at heart because they have very nice radio commercials and television commercials, think again. Their fiduciary duty is to keep the hospital financially viable and if they have to do more stuff than they need to to keep it viable, that's what they're going to do and I can't blame them. I blame the system for putting that kind of pressure on the chief financial officer of a hospital to make these sort of things. Where we need to do all these things, think about this when you come into the hospital and you're in labor, they make you go into a room and they make you change into a hospital gown. First of all, why? What does a hospital?
Speaker 2:gown signify. Well, they said, you never know what happens.
Speaker 1:Well, why can't you wear your own jammies? Why can't you be naked? You put a hospital gown on because it's immediately disempowering. Secondly, they make you pee in a cup.
Speaker 2:Yes.
Speaker 1:Why they draw blood on you, why They'll say, home, we don't make them pee in a cup and we don't draw blood on them, and they do just fine. These things are done out of, basically, the long habit of not thinking it wrong and the fact that it generates financial revenue. Nobody stops to think why does every single woman that comes into labor and delivery have to have blood drawn? They're perfectly healthy, they're just having a natural function of their body labor and they say, well, what if she bleeds? What if? What if is the whole?
Speaker 2:what if thing. But what is that blood result going to do if the? I mean, I don't understand.
Speaker 1:Well, if she bleeds, they say, well, we have to have a clot in the blood bank so we can get blood for her really quickly. Well, what do you do if somebody comes in with an ambulance, with a car accident or a gunshot wound? You give them O negative blood if you have to give them blood, or you type and cross them really quickly. That's the explanation they give. It's the same thing like why does a newborn baby? For years and years and years, it's beginning to change.
Speaker 1:But why did we cut the cord right away and carry them over to the warmer? And the nurses would say, well, we have to check the baby out. Carry them over to the warmer, and the nurses would say, well, we have to check the baby out. It's like, well, why the baby's on mom's chest doing just fine, Getting its auto-transfusion of its own blood? No, we have to cut the cord and take the baby over there. Well, check the baby. If you want to check the baby, I'll check the baby out on mom's chest. They just do it. They just do it correct, it's a habit.
Speaker 2:It is, and I'll tell you something that that's the scary thing, that most moms are not really conscious and aware that they can refuse that. Don't take my baby anywhere. I want my baby Don't wash my baby. I want my baby Don't wash your baby. Don't wash your baby, please. Yes, I'm not a doctor, but I mean, I learned this from two pregnancies For at least a couple of weeks.
Speaker 1:you can wash them with water, but don't use any soap or antibacterial soap.
Speaker 2:So, but most moms are not aware of these things. So I think that the system is yeah, they're controlling these mothers because they don't know any better.
Speaker 1:Right.
Speaker 1:They don't know any better. It's an industry and, look, there's a power differential in medicine. There always has been, and the medical models sort of. I'm not saying they get jollies out of it, but they like that way because they keep it mysterious. I mean, the history of medicine is fascinating. A guy named Chamberlain invented the forceps I think it was in the 1600s. I think it was in the 1600s and his family kept it a secret for decades so that he could charge more because he was the only one doing forceps. He kept it a secret. Now, forceps is a tough example because people are scared of forceps. But I'm just saying there is a power differential here and to keep people in fear is the best way to control them.
Speaker 1:And when a woman is in labor, it's too late for her if she hasn't dealt with these things ahead of time Because she is in fawning, fight and flight mode. She's not the one. So she needs either. These things need to be with a trusted caregiver, which, in the hospital model again, you have no idea who your caregiver is going to be Because it's all pretty much gone to shift medicine. So you may love your doctor, but you'll have a one in seven chance of having your doctor be the one that's going to be delivering you. So in the midwifery model, you're very likely to get the person that's been taking care of you all this time. But you have to plan these things ahead of time. That's why you need to bring a partner who's on board or a doula who's on board who can help to say no, no, no, she said she doesn't want you to examine her right now.
Speaker 2:Yes, advocate for you Right, absolutely.
Speaker 1:Because you should stay as far away from your cognitive brain when you're in labor as possible. You need to stay in your primitive brain. You need to keep your mind, like any other mammal in labor, when any other mammal in labor is disturbed.
Speaker 1:Oh, they get very aggressive, right Well no, they get passive because they're female and they fall. But they put out hormones that stop the labor so that they can get up and run away. You know the fight or flight thing they're not likely to fight, they're likely to flight. And so if a deer is in labor and a predator approaches, that deer knows that I need to stop labor and I need to get the F out of here. And only when it's safe will labor return.
Speaker 1:This way nature ensures the best chance of survival and we are no different. We are mammals. When we go to the hospital, contracting every three to four minutes and we're asked a series of questions and we made to do all these stupid things, and then they put you on a monitor which they don't really need, but they put you on it because that's the protocol, they find your contractions are now six to seven minutes apart and they're shocked and it's like well, if you understood mammalian birth, you'd understand why the contractions have spaced out. They don't always space out, but I'm saying a lot of times they do. And then they say well, you're three centimeters dilated because they did an unnecessary vaginal exam. And then they say well, you're three centimeters dilated. You know why don't we just start pit pitocin and then that whole cascade begins oh yeah, that's what happened to me Horrible.
Speaker 1:The chance of you ending up with a baby that is born traumatized by cesarean or vacuum because it's got D cells.
Speaker 2:Not to mention your trauma, your trauma, yeah. And the baby ends up with a NICU and the postpartum that comes after it.
Speaker 1:And the postpartum yeah, the rates of postpartum trauma and depression and stuff are high and they shouldn't be.
Speaker 2:They shouldn't be.
Speaker 1:I agree with you 100% and I can tell you the difference between the two models we don't have that kind of those rates in the home birth model.
Speaker 1:Listen, there are home birth moms who have very disappointing courses. They're not happy with their outcomes and they're not happy with what happened. I give you a perfect example. I had a woman who came to me with twins. First twin was breech. Second twin was head down. She wanted a home, beautiful water birth. What happened was she was up to the toilet when she was transitioning with the first baby. Neither twin is out yet and she calls from the bathroom and she says, dr Fishbein, there's something hanging out of me. And I'm thinking well, it's breech baby, it's probably the foot, and that's the normal thing that happens when you know it, when you're a breech provider, you know this and you're not freaked out by it. She says no, it's not a foot, it was like umbilical cord. So she had an umbilical cord prolapse. Now, if a head down baby, that's an emergency because the cord can get compressed by this big round head.
Speaker 1:You could to the baby, not literally choking. Choking is, and that's different. I don't want people to think choking.
Speaker 2:Oh, that's what I know.
Speaker 1:It cuts off their oxygen supply. So but with a breech baby, even though it's a little more common, it's not necessarily an emergency. So we checked the baby's heart rate. The baby's heart rate was fine. We had time for a conversation. I said listen, you and or we can go to the hospital where you know they're going to do a C-section on you, because nobody there is going to be skilled enough to do a breech vaginal delivery with the cord hanging out, and I'm not going to sit here and wait for hours for the with the cord hanging out for you to try to push this baby out. So she agreed to the breech extraction and we did the breech extraction. Baby was fine. The second baby came out. Everything was fine. I saw her again multiple times and then a final visit at six weeks. We had a debriefing about the birth and she was very sort of still I wouldn't use the word upset, but still sort of very sad.
Speaker 2:That it planned out, it made out that way, yeah.
Speaker 1:Right when, even though she got the vaginal birth at home, circumstances were such that she didn't get the one that she had imaged in her brain, and it bothered her, and so you could have that sort of postpartum blues anywhere, but you're far more likely to have it where you are completely disempowered and disrespected, which is more likely to occur in a hospital setting.
Speaker 2:That leads me to this question Is inducing a pregnant woman bad Because they don't let you full term?
Speaker 1:Inducing for non-medical reasons is very bad.
Speaker 2:yes, I mean when you reach 38 weeks of pregnancy, the doctors start pushing it. Okay, it's 39. Now it's 38, now it's time.
Speaker 1:That is completely unethical and incorrect behavior unless you have a true indication. A true indication could be something like preeclampsia that's worsening. It could be something like baby's got true what's called growth restriction not fake growth restriction, which is another topic we might get to, we might not, or something like let's see what was the first one I said Did I say preeclampsia? Yes, you did say that, yeah, or something like true chol. What was the first one I said? Did I say preeclampsia?
Speaker 2:Yes, you did say that.
Speaker 1:Yeah, or something like true cholestasis of pregnancy, which is where you're. It's an itching thing where your liver starts to back up, but you have to have a real high number with that, not just a low number where you have this itching, but a high number where you have an increasing risk of stillbirth, with a number that's like over 100.
Speaker 2:So increasing risk of stillbirth with a number that's like over 100. So then, what's wrong with leaving a woman up to 40 to 41 weeks of pregnancy, 42 weeks, 42 and a half weeks, 43 weeks? I mean, that's how they did it in my country back in the day.
Speaker 1:There is nothing wrong with doing that.
Speaker 2:But they say that there is.
Speaker 1:Well, there is a rising stillbirth rate beyond 36 weeks in all pregnancies. That's not the question. The question is what's the actual rise? Remember, we talked about this earlier. So this even with singleton head down babies, there's a greater risk of the longer the baby's inside there's a greater risk of stillbirth.
Speaker 1:But what my colleagues don't consider is they don't consider the fact that you're artificially inducing to be an intervention, a problem. They don't see the whole natural process of being beneficial. They want to see a live baby in the bassinet and so they're constantly meddling with stuff. They're constantly looking at ways to meddle and they come out with papers that say, oh, we should induce all women at 39 weeks and we'll drop the C-section rate by 3%. Well, that doesn't apply to hospitals that have C-section rates of 30 and 40 and 50%. It applied to an academic institution where doctors are being watched and there's something called the Hawthorne effect. The Hawthorne effect is just a simple thing that people act differently when they know they're being watched. So put people on camera, like these reality shows where there's cameras and everyone. No, people don't always act like that, but when they're being watched they'll act differently. It's the same thing here. So they get false results. And then doctors, because it meets the model by which they want to practice, they use confirmation bias to choose that article. But the articles that say it's a bad idea they ignore.
Speaker 1:And this is human nature, and so with the whole idea of induction it interferes. Pitocin is not oxytocin and baby isn't ready and the cervix isn't necessarily ready, and nature designed a system. Does nature screw up? Sometimes Of course it does, and sometimes that's when induction might be necessary.
Speaker 1:But we reached a peak of quality probably in the early 70s, as I said earlier, because everything we've done since the 70s has done nothing to improve the outcomes of the babies we're supposed to be trying to rescue. And yet we've had all these interventions that have led to, like I said, higher rates of cesarean section, higher rates of induction, higher rates of postpartum depression, higher rates of problems in future cesareans, future pregnancies because of the cesarean. I talked about placentas growing into the uterine wall, a creta, that sort of thing that's quadrupled in 30 years. Nobody takes advantage and then no one talks about the effects of a baby not experiencing labor. As nature designed, the reflexes has to go through the chemical hormonal communication with mom, the microbiome it's exposed to in labor. The handling of the stress of labor might affect the epigenetics of that baby in such a way that it handles stress better later in life it deals with things differently later in life right.
Speaker 2:Oh wow, I didn't know that.
Speaker 1:They don't teach that I didn't know that. I learned stuff pretty much almost every week because of my podcast and because I take dives into things to learn stuff that I didn't know. And I can tell you that most of my colleagues don't know and only a part of it is their fault. Most of it is the system's fault that even if they knew, they couldn't do anything about it anyway. But the lack of intellectual curiosity of people that are practicing is also a fault of the system. They're so beaten down, my colleagues, by the hours that they work, by the restrictions put on them, by the medical legal things, by the cost of overhead, by being managed, by having to do algorithms.
Speaker 2:And fear.
Speaker 1:And, by the way, here's a very simple statement Happy people do not treat other people badly. Yet I hear story after story after story of a doctor who gets huffy because a patient didn't want to do the glucose screening. Or they roll your eyes when you said you want to have a doula, or they storm out of the room or they're short with you. Yes, how many nice, happy people will do that with you? Pretty much zero. My colleagues are generally unhappy. They practice because they're stuck in a hamster wheel and they can't get out. They have families, they have student loans, they have college savings to do and they're afraid to take the leap. I would suggest to any of my OB colleagues who are really unhappy with what they're doing every day to take a look at maybe getting outside the system.
Speaker 2:And you know what's interesting, as you're talking Because you can do it. Absolutely. What I thought about is that not only is everything majority of things in hospital setting controlled, but also the timing of birth. Everything is so quick. I mean the balloon. When they insert the balloon, right, it's like okay, maximum, oh, you'll give birth by six o'clock. How do you know these things? They know because they practice this on so many women. Let's induce you, let's put the balloon.
Speaker 2:It'll take about four to five hours for you to dilate up to nine centimeters Boom.
Speaker 1:You have your baby at 6 pm. Yep, you have been at 6 am. You're out of here, but I'm fascinated by that. You have to. You have to ask the question why do they care how fast your labor is? And part of it. There's two things about that. One is they care how fast your labor is because they have limited space in the hospital, so they want to move you in and move you out. They don't want you hanging around contracting every eight minutes. Maybe that's what your body needs.
Speaker 2:Yes.
Speaker 1:And maybe it takes you 30 hours or 40 hours to deliver. They don't want that. But what's interesting about that and what's absurd about it is, if they bring you in for an unnecessary induction, it may take three days and they're okay with that.
Speaker 2:Because your body's not ready right.
Speaker 1:Well, but the irony is that they're okay with a three-day induction if they're doing it, but they're not okay with you having a three-day labor if you're doing it.
Speaker 1:Think about that for a second right If nature designed you to do it and you're doing it differently than their Friedman curve, their labor curve, we have to intervene. But if we're intervening and you're not doing enough, we'll just keep intervening and keep intervening and keep intervening and we'll turn it off and let you rest and we'll start again the next day. It's like no, just send them home. Why were they there in the first place? If it was that urgent to get them delivered and you can take three days to do it, maybe the reason for induction wasn't there in the first place. I often ask women who tell me about their story of their first baby that they had an emergency C-section and I say, okay, did your doctor say it was an emergency C-section? Yeah, he said it was an emergency C-section. Okay, when they decided to do the C-section on you, emergency, Okay. When they decided to do the C-section on you, how long did it take them to get you from the labor room into the operating room when they started the case Hours? And hours.
Speaker 1:And they would sometimes say, oh, 45 minutes, an hour and a half. If it was 45 minutes or an hour and a half, that was not an emergency C-section. Yet they used the language to I'm not sure exactly why make themselves feel more likely. Maybe they get better insurance reimbursement, I don't know. But it wasn't an emergency C-section. It was maybe urgent or maybe it was just time for a C-section. But they make the woman believe that all the interventions that caused you to have to have a C-section in the first place don't matter, but the fact that we did a C-section and we're able to save your baby look at how great we are. We caused all these problems. Now we're fixing the problem. Look how great we are.
Speaker 1:You asked earlier about we never really answered the question about you know what, if this happens at home and I said essentially, these things generally don't happen at home, when you don't meddle with labor, occasionally they do, and then you, then you call, then you have to call an ambulance and you get to the hospital as fast as you can. But the idea that if you have a true emergency at a hospital, like, say, you have a placental abruption, where the placenta separates and the baby's in deep doo-doo. Well, you often only have somewhere between six to 14 minutes or so to get that baby out before it's going to suffer irreversible damage. Now, at home, that's not likely to ever happen. You're never going to get to the hospital and get that baby out in time. But I can tell you most hospitals can't get a baby out in 14 minutes either. They can't get you back to the operating room, get you on a table. Make sure they have a team of surgeons available, make sure the anesthesiologist is available, make sure the scrub team is available and get that baby out in 14 minutes. There are certain hospitals, like Cedars-Sinai, which has OB residents and dedicated obstetrical anesthesiologists. They can probably do it. But smaller communityologists they can probably do it, but smaller community hospitals, they can't do that. So just because you're in a hospital does not mean it's safer and it's less probably, in my opinion, again less safe, because you're more likely to end up with that whole cascade of interventions that leads you to a C-section. I mean, look at the difference.
Speaker 1:I said our practice, the midwifery practice that we had with the collaborative midwives that I talked about at the very beginning. We had a 7% C-section rate and we took all comers. The busiest practice in that hospital was about three doctors I think. They saw about 30% more patients per month than we did. Their C-section rate was about 24% to 25% Now. This was again in the 1990s and that was about the normal rate. Now it's up to 32%. So their C-section rate was three and a half times higher than ours, with the only real difference being the model by which we managed to and I don't like that word, but the model by which we cared for our moms, the midwifery model of care. If our women broke their bag of waters, we told them to go to bed. If their women broke their bag of waters, they told them to come in and they started Pitocin. They did lots of vaginal exams on them. They didn't do breaches. They didn't do twins, they sectioned them all. They didn't support VBAC. Their VBAC success rate was pathetic. Ours was really high. Ours was over 93% with our VBAC success rate. So again, not tooting our own horn, I'm tooting the model of care. The model of care with midwives who are well-trained, who are patient, who are trusting and honest is the best model there is right now and it's been that way since the dawn of human history.
Speaker 1:I'm reading a book right now called Reclaiming Childbirth A Rite of Passage, by Rachel Reed. She's Australian and we're going to have her on our podcast in a couple of weeks. That's awesome. I'm obviously listening. I'm not reading, I'm audibleizing her book and again, I've read a lot of books on the history of obstetrics and her summary in the first couple of chapters of how midwives went from being the birth keepers and the caregivers and all that to becoming vilified and then witches and then burned at the stake. And then we have a modern day witch hunt going on for midwives. Now they're not burning them at the stake, but they're sticking medical boards and nursing boards on midwives. Hospitals will report midwives all the time for doing things different than the hospital would do them. And because the hospital thinks that they have the market on what's right and what's wrong, yeah, they report them. And then the midwives have to spend time and money to fight them Correct. And midwives don't have time and money.
Speaker 2:I mean, they report midwives, they report parents.
Speaker 1:Yeah Well, child protective services is a whole other thing.
Speaker 2:They report parents. I mean not to that extent.
Speaker 1:Yeah, if you don't give your kid hepatitis vaccine, they may report you to.
Speaker 2:Child Protection Services. That's what happened to us.
Speaker 1:Did it.
Speaker 2:Yeah.
Speaker 1:Do your listeners know that?
Speaker 2:Yeah, I'm very open about that.
Speaker 1:Okay. Yeah, yeah, but I'm very open about that that is an unbelievable violation of medical ethics and I wish someone would sue their ass Absolutely.
Speaker 2:But not to mention the non-vaccine policy. Like you cannot, I mean doctors now are not even wanting to see you if your child isn't vaccinated. So who do you go to?
Speaker 1:It's always these punishments. Well, you consider yourself lucky, by the way, if a doctor says I won't see your child unless they're vaccinated. Oh, that's the law now, because that's not the kind of pediatrician you ever want to go to. Well, you know, people have to choose what they want to do with that law. All right, they can homeschool, they can move, but if you have a state that wants to stick toxins in your baby without any proof of benefit, then you have to decide. Why are you voting for these people? Why do you keep reelecting Dr? What's his name? Ted, no, not Ted Lou. Who's the doctor in Sacramento who just keeps pushing all these? I can't, I'm. I'm glad I've been out of California now for two years and there's a, there's a doctor there that pushes all these vaccine bills.
Speaker 2:He's a, he's a, he's a maniac.
Speaker 1:He's an idiot.
Speaker 2:And I would love I would.
Speaker 1:I would love to sit and debate somebody on a stage with a live audience.
Speaker 2:We should come up with something like that, oh, they won't show up.
Speaker 1:Well, the show won't live. You know what? Look, if I was president of the United States back into 2020, whether I was Trump or Biden- Are you a Trump supporter, Dr Stu? I am. Yes, give me five on that. Well, I'm more of a government sucks supporter.
Speaker 2:Yes.
Speaker 1:And therefore I mean the only one that's really reasonable. I mean RFK Jr. I like a lot of what he has to say, but he won't win.
Speaker 2:Oh, he's very real.
Speaker 1:But let me get back to my point. But that guy speaks truth, my, point was in 2020, when we were debating all this. There was no debate. It was like do what Fauci says, do what Deborah Birx says says, do what Deborah Birx says. If I was president, I would have had Dr Fauci and Deborah Birx on a two-hour live national broadcast debate on the stage with guys like Jay Bhattacharya and Peter McCullough, and have them debate stuff.
Speaker 1:Why wouldn't we do that? For the American people? And because those guys wouldn't do it. They wouldn't show up, right, and if I was president I would have made them show up. But unfortunately, our presidents, you know, they know stuff about stuff, but they don't know much about it. They're not an expert in anything and so they rely on the experts.
Speaker 2:And I'll tell you, you should never let experts govern, because experts have such a narrow, blinder vision on. I'll tell you, my fifth grade English teacher said always question, authority, always question. And that really stuck with me, because you cannot always go by what experts say. You have to have the knowledge and the education to at least do a little research yourself. And I think that today, these women, these families, men and women, what they're going to take away from this podcast is do your research and learn about the birthing process. Don't always go and listen to your physicians.
Speaker 1:Have an open mind and don't buy the thing that this is for your own good or this is for your safety. There's a famous quote by the French philosopher, albert Camus. Oh, I love Albert Camus. That goes the welfare of humanity is always the alibi of tyrants, and this could be dictators, but it could be the person running your local school, or whatever. We're doing this for your children's own good or we're doing this for your own good.
Speaker 2:Never mind what that's like for you.
Speaker 1:Safety is one of the arguments, and was it Ben Franklin or somebody else that said those that would surrender their more liberty or their liberty for a little safety deserve neither. I butchered that quote.
Speaker 2:You did fine.
Speaker 1:But there's something about that where, if you're going to surrender your liberty for the appearance of safety, then you probably aren't going to get neither. You're not going to get more safety and you're certainly not going to get. Oh, it's freedom, not liberty. Yeah, surrender your freedom for safety, and we all did that. Look what we did in 2020.
Speaker 2:Yeah, that's true. You know what I learned from you Not to ever be led by fear. Yeah, I love that. I've watched a lot of your shows, your podcasts, and that's one of the things that you guys, I want you to really process that statement. It's so powerful because when you're in that delivery room, you're in fear. You are, and it's very scary and it's understandable, but don't ever be led by that.
Speaker 1:That's why you have to go in. You have to go in with be prepared. You have to educate yourself. If you're uneducated then you can be fearful.
Speaker 1:Great line from the original Batman movie with Christian Bale, the first one. It says he's talking to the gangster and the gangster says you know, you always fear what you don't understand. There's more to that quote, by the way. It's a great scene in that movie. That guy who played the gangster was a good actor and he had me convinced. But you do, you always fear what you don't understand. And the reason that we keep things a mystery sometimes is so that we can control you. And then I read a book a couple years ago by a guy named Matthias Desmet. It's called the Psychology of Totalitarianism and it's about something called mass formation and it really discussed about what's going on with COVID and how they took people who used to be friends with you your family members, who loved you, your neighbors who loved you and with just a little bit of manipulation they began to turn on you and you were uninvited to the weddings and your neighbor called the police on you because you had more than six people in your backyard.
Speaker 2:It's still like that.
Speaker 1:Right. But how does that happen? And the book defines it. It's kind of like.
Speaker 1:The example he also uses is Nazi Germany. It goes in the 1930s. Germans live side by side with their Jewish neighbors and, yeah, they were always a little bit like the Jews are miserly and the Jews do this and Jews do that. But the kids played with the Jewish kids and they lived next door and within a matter of a couple years they were turning the Jewish families in and they couldn't wait to then pilfer all their furniture and all the stuff from the Jewish homes. How did they do that? Well, they vilified them. They started to point to them as the cause of your problem, and so what happens is is in order to be part of that society, a person gives up their individuality to become part of the collective, and then, when the collective is challenged, they get very, very agitated and they go after the people that challenge the collective. So anybody like me, or, if you're like, if you people know who Del Bigtree is, who, who has the high wire, or anybody in the history who's challenged the status quo, has generally initially been vilified.
Speaker 2:Yeah, prosecuted.
Speaker 1:Prosecuted, persecuted, killed, ridiculed and and if they do that to you, that's, that's that's the defense of somebody with no argument. You should know right off the bat that when they're attacking someone personally, that person is probably correct.
Speaker 2:Exactly.
Speaker 1:And when they call somebody saying it's a conspiracy theory, anybody who says that is probably the one with the conspiracy theory. I agree with you and the other person, because they always tend to label you with exactly what they're doing.
Speaker 2:Yeah, exactly.
Speaker 1:And when the medical model says that home delivery is for pizza, all right. That's an old slogan for a while. That's somebody who has no understanding.
Speaker 2:No knowledge of what's? Yeah, absolutely, it's a very broad thing and they don't really care what women want.
Speaker 1:They don't have a clue as to how important childbirth is to the woman and how she gives birth matters to her. They don't have any standing of history.
Speaker 2:The empathy.
Speaker 1:There are cultures where women, if they don't give birth vaginally they have no standing in the culture whatsoever.
Speaker 2:That's so true.
Speaker 1:It's me not a part of the other women in the culture, but it's part of their culture.
Speaker 2:It is.
Speaker 1:And the paternalistic medical community comes in and they says, well, all that matters is a live baby in the bassinet.
Speaker 2:It's like no that's not all that matters. How many times do you hear that today? A lot, right.
Speaker 1:We've sterilized birth yeah, we in their life. They go through life with never seeing a baby born and they never see somebody die, except on television. They don't, because people die alone or in a nursing home or in a hospice. They don't die in the home anymore and people aren't born in the home anymore. There's an interesting forward to a book. I think it's a forward to Ricky Lake's book, I think, written by Jacques I can't remember.
Speaker 1:Jacques' last name talks about how he was walking around New York one time and he saw a little plaque on a house and it said the birthplace of Teddy Roosevelt. And he said isn't it interesting that probably from this point onward, the only time you're ever going to see a plaque like that will be on the stairs of Cedars-Sinai Medical Center or at Lenox Hospital in New York or something? You won't see, a brownstone anymore with this plaque on it that says somebody was born here. But that's where they were born 100 years ago and within 30 years the medical system took and they took birth out of the home and put it in the hospital, and they did it in the name of safety. But in the process they couldn't just argue safety, they had to vilify midwifery at the same time.
Speaker 1:But they're now less safe. We've gotten the pendulum swung way too far. Women need to take back childbirth. We need to make these demands. If you demand it, there will be someone who will supply it.
Speaker 2:And it's up to us.
Speaker 1:If you continue to bow down to your insurance card, then you get what you deserve.
Speaker 2:Wow, I love that. We need to take our power back. Families need to take their power back, for sure.
Speaker 1:Yeah, Doctors don't. I mean listen, obstetricians don't know anything anymore. They really don't. They don't. They cannot think out of the box, either because they don't want to, or because they're not, even they're not allowed to. I don't care what the reason is, but pretty much everything that they do, everything in the obstetrical model that I learned when I was training, everyone gets an episiotomy. Everyone's in lithotomy position, which is laying on your back with your legs up. That's like the dumbest position to give birth in. Birth is a sterile procedure. No, it's absolutely not a sterile procedure.
Speaker 1:C-section yeah it's a sterile procedure. Birth itself not a sterile procedure. Delayed cord clamping oh, we can only allow one minute because otherwise the baby will get too much blood. It's the baby's blood, it's a circulation. What goes in, comes out and name another mammal that someone rushes in and cuts the umbilical cord. Try taking a baby chimpanzee away from its mother. See what happens to you. Oh, I'm sorry, Mrs Chimpanzee. We need to take the baby over to the warmer Whack.
Speaker 2:Yeah, okay, you're done.
Speaker 1:Right, you know you're done, yeah, but we do that and we just fawn.
Speaker 2:It's just interfering, a lot of interference Women have been taught to just fawn, yeah. Just defer, don't do it anymore.
Speaker 1:Which is a nervous system. Response, you guys by the way.
Speaker 2:Oh, they don't know. Your listeners don't know. It's trying to please you, trying to please your captor basically, yeah, exactly, you just fawn right yeah. Dr Stu, thank you so much for today. That's it. I agree, I want to go over like two hours, I mean I can talk to you for hours and hours. No, I'm kidding, you are so knowledgeable you need to be protected. You do because not a lot of doctors talk about things like this I'm doing great.
Speaker 1:I love the fact that I feel very comfortable and confident in what I'm talking about, that I can back it up. There's data to back what I'm saying. But you don't always need data to prove something. You don't need data or a study to tell you it's safer to cross the street when the light is green.
Speaker 1:Yes, all right Common sense has been beaten out of us. Yeah, if All right Common sense has been beaten out of us. If something doesn't feel right in your gut, it's probably not right, so question it. And if what your doctor's telling you doesn't sit well with you, then question it. And if your doctor doesn't give you the time of day, then seek a second opinion. There's nothing more valuable to a woman in her lifetime than how her babies are born. It's not. A wedding day is really great, you know, graduation day is really great, but the day, the thing that you'll remember most when you're 90 years old will be when you're the day your children were born.
Speaker 2:Yeah, and you got me emotional there and I'd like to give, I'd like to give women better memories. Yeah.
Speaker 1:That's all.
Speaker 2:I love that We'll end with that, because that was very beautiful.
Speaker 1:Thank you so much. You're welcome, you guys. I hope you enjoyed this episode. Of course, I'm glad it worked out, I know, and you have a lovely studio. It's great.
Speaker 2:Thank you. You're awesome and I'm so grateful for you for speaking up. There's not many physicians that you know that, so I think that you definitely are the type of person that needs to be protected and praised because you're doing this is God's work honestly. Thank you, thank you, of course, thank you.