The Resource Doula

Taking Responsibility for Your Birth with Kelly and Tiffany of Beautiful One Midwifery

January 23, 2023 Natalie Headdings Episode 25
The Resource Doula
Taking Responsibility for Your Birth with Kelly and Tiffany of Beautiful One Midwifery
Show Notes Transcript

Show Notes

Welcome back to the Resource Doula Podcast. On today's episode, I chat with Kelly and Tiffany of Beautiful one Midwifery out of San Diego, about home birth, taking responsibility for your healthcare and shifting perspectives about birth.

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Natalie:

Welcome back to the Resource Doula Podcast. On today's episode, I chat with Kelly and Tiffany of Beautiful one Midwifery out of San Diego, about home birth, taking responsibility for your healthcare and shifting perspectives about birth. I'm Natalie and you're listening to the Resource Doula Podcast, a place where we provide information to help you make informed healthcare decisions for yourself and your family. Kelly and Tiffany help naturally minded women who are fed up with the medical perspectives on their female health concerns, guiding them towards solutions that address the root cause of their symptoms and help them regain control. Kelly and Tiffany founded Beautiful one Midwifery in 2018. As young moms and new midwives passionate about normalizing female health education and equipping women to make the changes they desire with accessible information and simple. Tools. Five impactful years later, they have cultivated a lively online community, a thriving in-person clinical practice in San Diego, and an extensive collection of alternative health resources that empower women to take control of their health from home. Hey ladies, welcome to the show.

Kelly & Tiffany:

thank you so much for having us. We're super excited to be here. Yeah, what a wonderful, um, opportunity, Natalie. Thank you.

Natalie:

Yeah, thank you guys so much for being here. So I wanted to just ask you guys what led you to your career now? What made you decide, do you wanna be home birth midwives?

Kelly & Tiffany:

Uh, what, what's kind of funny is that I feel like we were on somewhat similar trajectories, but just kind of parallel not knowing each other. Um, our experiences with our own first pregnancies and births kind of pushed us into, uh, doula support into wanting to be involved in birth work for two totally different reasons. I feel like Tiffany was like, oh man, that was not what I like, was prepared for. I needed some extra support and. My first birth was actually pretty straightforward, but my husband was the one who was like, I felt totally uh, kind of railroaded by it and that's what kind of pushed me towards birth work in general, which was a complete pivot in both of our lives. Um, and it's kind of funny cuz it happened around the same time, like within six months or so of each other, again, not knowing each other, which is kind of sweet.

Natalie:

That's

Kelly & Tiffany:

I w like, there's so many parallels to our story, including as we get to the end of midwifery school is when we first really started wanting to touch base with each other. We just knew each other as doulas in the community who are also student midwives. And anyone out there who's a student midwife, like your life is the most chaotic, craziest thing during this time. In the worst way. Not in a great way. It's an absolute worst way. And, um, and Kelly and I just felt brave enough in one interaction to kind of open up about the taboo of saying how hard it is to be a student midwife. Like it's just not, it's not talked about enough or it wasn't back then for sure. And we both just felt brave enough to say, I don't know if like this is the actual path, if this is the type of sacrifice that it means for my family, my health, my mental health, my relationships, everything. And that's how we ended up partnering together because we both felt like we wanted to create something different out of our own birth experiences. Um, that kind of pushed us into birth work, but also out of just wanting midwifery to look differently for us as we, you know, came into.

Natalie:

That's amazing. Yeah, I think you guys are like the only ones who I've ever seen talk about sustainable midwifery on, well, on social media. But in general, and I know it's challenging cuz most midwives work by themselves and they're on-call like a hundred percent of the time. So Yeah. How did you, how did you create this sustainable framework? How did you start with that?

Kelly & Tiffany:

I mean, it's, it's born out of exactly what you said, right? We, what we witnessed and kind of grew up in midwifery in was a solo midwife with a busy practice and carrying a large load on their back, and, which is. you know, not necessarily in and of itself a bad thing, but we were just recognizing that pace was not sustainable for having young children, for homeschooling young children. All of the pieces in our lives were not set up to support that kind of lifestyle. And so, you know, we really were intentional as we decided to get into practice about how to support each other, how to take turns on certain things, how to not overwhelm ourselves with too many clients at once in terms of not only just. The lifestyle that that means, but also the care that we can really intentionally provide with a smaller amount of clientele. And I mean, you know, just doula work in gen and doula work, birth work, um, being on call is its own thing. So whether or not you're out of birth, just the fact of being on call for it is, um, is quite a bit of responsibility and heaviness too, of always having an exit plan and all of that. And so that's, uh, just kind of propelled us into recognizing that this really does matter both for ourselves, our families, and our clients too.

Natalie:

Yeah. And it's doable. It's actually achievable. So are you guys on call right now or are you off call? What's the status?

Kelly & Tiffany:

We are on call. Yeah, we, um, but we're on call for a friend of ours, and so it doesn't feel quite the same as being on call for a client. It's the same amount of responsibility we have to do the same amount of work. Um, but it's a different kind of joy to be looking forward to being at your friend's side while she has a baby. So we just came off of like a three month off call break, um, which was a huge part of our sustainability plan.

Natalie:

Yeah. Yeah. So you build in time that you're away from birth work. You guys actually close your calendar, right? And don't accept people

Kelly & Tiffany:

We did. And, you know, boundaries can be hard. Things to not only set, but then also keep, and so having to say no to some things that. they're not bad things, right? They're not, uh, saying no to good things in a lot of ways. Um, but recognizing that your no also means a yes to something else that's really also good or potentially better in that season. That, um, made it worth it. But it grew me a lot in my discomfort of saying no, cuz I'm very much a people pleaser. So creating boundaries around this work in particular, uh, has been a helpful growth point for me personally.

Natalie:

That's a

Kelly & Tiffany:

Yeah. And I'm not a people pleaser, but I love to have control of all of the little details. So as we go into this year, not really knowing what it's going to be and just surrendering a lot of pieces to the process of pulling back a little bit, we're in a new space of.

Natalie:

Amazing. That's the same word that I used to describe my life and my business in this last week. I feel like this year it's a year of growth. It's a good thing. Um,

Kelly & Tiffany:

Yeah, and growth can be uncomfortable, but that doesn't mean it's bad,

Natalie:

no, I think it's a good thing. Yeah. Um, so if everybody can't move to San Diego and choose you guys then what would you recommend? I had someone on Instagram ask me what, what to ask you guys. How would you select a midwife and how do you know the home birth midwife is the right one for you specifically?

Kelly & Tiffany:

that's quite the, you know, that is the question, right? of how to figure out because, um, at least, I mean, here in San Diego there are a lot of choices and a lot of different personalities and different practice styles. Um, so I know that that is true in a lot of other places. Sometimes there's not a lot of options, um, in your area. So that kind of throws a bit of a wrench into some things. But, um, one of the biggest pieces is. creating your own vision of how you want to be supported, things that are important specifically to you, and then seeking out answers from different care providers as you're interviewing or you are researching what those options kind of look like to find somebody that not only aligns clinically, but that you can feel comfortable and confident asking those questions with or too, and, um, you know, putting yourself out there a little bit to be okay with, you know, just somebody just putting yourself out there right. Of saying like, I might say no to this. How does that make you feel um, or, you know, researching kind of what those types of options are. Um, one of the big things that we also recommend is reaching out to, like childbirth educators in the area or doulas in the area to ask their feedback on some of the local options. too, cuz those are usually like, you know, direct feedback of I worked with this person, here are my thoughts. I think that our, I think that by the time women make the decision that they want to have a midwife and they want to have a home birth, most women are already partway through the pregnancy that they're making this choice for. So potentially they've, um, already began care with another care provider, maybe an OB or a hospital-based midwife, and they're like realizing along that journey, oh, I don't think this is leading to where I want to go, or what I'm learning in this pregnancy about my birth preferences is turning out that I need to make a different decision about how that is gonna become a reality for me. And so I think that we should be encouraging women to. Be thinking about some of these pieces before they even get pregnant, because it's almost impossible to discern as you're pregnant and emotionally and mentally and physically. Everything is just really culminating and coming to a head, and you need, you need a care provider. So, um, thinking about the different ways that midwifery care is given and the birth preferences that you have in relation to different midwifery styles. I think that concept almost blows most women's minds because they can't believe that the small little niche of. Midwives who would serve women in a home birth setting could be so vastly different and have such a vastly different approach to care. Um, and so as you are potentially working through some of those pieces, learning about birth, learning about physiological processes, learning about the things that are gonna be offered to you in care and whether or not that aligns with your choices going into your interview process already, knowing that there's a certain type of care that you want from a particular midwife would be amazing. Oh, that would be life changing. Yes. Because for sure, a lot of women, um, have a, have a perfectly fine experience with their home birth midwife, but potentially get to the end of that care journey and. Well, that wasn't just, that wasn't quite what I had expected. And if I had known, which sometimes you just can't know until you do it yourself. Right. But if I had known that this midwife was gonna feel so strongly about this particular thing or Right, et cetera, et cetera, then I would, I would have liked to make a different decision. It's one of my favorite pieces of having a social media account also, is when we share stuff about our practice. And not saying that we are the, uh, gold standard by any means, but sharing the way that we personally clinically assess things or the way that we manage certain situations. It is amazing to me how many responses we get of, uh, anywhere from people who have had home births to hospital births who are like, wow, that's, so, other than anything I have heard before, even the women who have had multiple home births with either the same or different midwives. Um, and so it's cool to be able to put it out there of like, uh, it's not a one size fits all. And certainly there would be people who would not be, who wouldn't like care from us for whatever reason. Right? And so that's the, that's the joy of, um, individualized care.

Natalie:

So are there any concrete examples you could give? I know there's a lot of facets and components that go into birth, but if someone were trying to make a decision and they're weighing it based on maybe three to five main things, could you put together a list? Is that a really tough question?

Kelly & Tiffany:

I think the number one thing that women as the consumer of their midwifery care should be aware of is, are you going to a person who is an expert in the type of. Birth that you want to have is that their specialty? To give the type of experience that you're hoping for. And that's gonna change and evolve through the pregnancy as you, as you sort that out. Um, but if you wanna have a completely hands off physiological, just watching over, I just want someone there to watch in case something happens that I know that they'll jump in. Or if I need help, I know that someone will be right there. But otherwise I don't want a lot of direction that's completely different from somebody who, um, is feeling a little bit intimidated about their own ability to give birth. Actually, does want somebody there performing a lot of routine clinical reassurances, right? Like so knowing that the type of birth you wanna have, that you have the right care provider for that. But also I think sometimes as women, we don't give enough credit to our intuition and how we feel in the presence of other people. And so I would say that's a huge thing. You can get a, you can get a whole range of different kinds of midwives, interview them, and they're all gonna have basically the same package, especially in a community, right? We all end up kind of offering very, um, competitive services. But, um, in an interview process, you're potentially going to hear the same exact answers to the questions that you ask. Because if, if you don't have a whole lot of information on how hemorrhages could be handled and every midwife says that they just do handle hemorrhages, like, oh yes, we come prepared to handle a hemorrhage, then you are potentially satisfied with that answer. Um, but if you are able to connect with the way. That somebody answers and the attention they give and the honor that they provide for the place where you're at in your journey and, and what you're trying to figure out and acknowledge all the different challenges that are inside of a prenatal and care, um, relationship, and that settles you in your soul. That is a, I think that's an important thing to pay attention to rather than how things potentially look on paper. Yeah, absolutely. And I think, I mean, just given what, like, it goes along with what your whole podcast is about, right? Providing resources and so, uh, the focus on, in like true informed decision making consent and refusal, uh, I think is just so paramount to a woman's experience no matter where she decides to give birth, no matter where she needs to give birth. And, um, that is something that, Many people, I think, assume a lot of midwives offer that's not always necessarily the case, depending on certain things. And so being able to have conversations about, um, actual true choice can be kind of mind blowing. Um, and I mean that's something that's like near and dear to our hearts too, um, is just that focus on getting the information into your hands and then you decide what you want to do with it because you're actually the expert in your own body and in your family. Like what a big message that is, especially when you're pregnant for the first time. Like to be given that encouragement and wisdom of like, no, you, you're competent to make your own decisions with this information. It's a lot of responsibility, but it's, it's really impactful.

Natalie:

I think informed consent and decision making is becoming a bigger topic. I've seen a lot of people talking about it, which is really exciting and good. Um, but I also hear that when people ask questions to their providers or their whatever practitioner, regardless, you know, if it's birth or not, they get only the benefits of a certain procedure or intervention or change in their care, rather than the full spectrum of here are the actual risks, this is the percentage, all of that. So, are there any resources that you guys would recommend to someone who's starting out asking these questions? Um, do they have to kind of go with their heart and feel is this provider giving me the full story, or is there a way to vet that?

Kelly & Tiffany:

I, I personally feel, well, there's a bit of intuition there, right? If the answer you feel like, ooh, I would, I would like to consent to that thing because how nice you made that sound. Sometimes that's a bit of a red flag, right? You're basically being informed to consent to something. And so rather than actually having true informed, you know, decision making, and so being able to even ask, like, put your provider on blast for their own statistics of what that looks like in their practice, every provider should have at least a ballpark of it. Um, it's, it's an important part of our practice every year to go through and be like, how many people actually said yes to GBS testing or gestational diabetes? What did people choose for that to be able to. What are we offering? What are people accepting? What are they declining? Um, just to keep ourselves as, um, honest in the process as well. But everything should come with ev no matter what. Even doing nothing comes with its own benefits and its own risks, right? And so having somebody actually share with you, okay, well this is a risk. Okay, well what does that risk actually look like? Right?

Natalie:

Mm.

Kelly & Tiffany:

unfortunately, especially, I mean, it's especially notable in hospitals just because that's the kind of down the, uh, conveyor belt of options there. But being able to actually ask thoughtful questions is a skill that needs to be built up, um, along the way. And like Tiff was saying too, choosing to birth in a space that actually, and with a person who actually is the, uh, expert in what you're hoping for, gives you a, I think, a better shot at. true informed decision making.

Natalie:

Yeah.

Kelly & Tiffany:

Yeah. And like we can find research to pretty much back up any position that we would like to. And so I love the concept of evidence-based care and I think that that's a standard that providers need to be held to. And there's an overwhelming amount of evidence that, um, supports for or against procedures or other care offerings, but even. Even with that concept, which is our responsibility as providers to provide evidence-based information, it's not the responsibility of the consumer to make a decision based off of evidence. There's lots of reasons that people make decisions, and it's not always scientific, like we're talking about growing your family and a physiological process in your body. Like there's just, there's so many pieces of that, and so it would be really easy to say, oh yeah, well jump over here. They do a really good job at syndicating the research on this topic, which is true. There's plenty of places that you know do that or ask your care provider. I would like to see some of the evidence that supports your position on that. Here's some that I found. Can we have a discussion about it since yours? Yours is, um, supporting this idea, mind, supporting this idea. You're not the boss of my, my birth or my decision. It's actually me. But I did hire you for your expertise. So please let's you know, let's put, give me some more information besides just evidence. What do you see in your practice? What do you prefer? Can you admit to having a particular bias in an area? We have to do that all the time. We have to constantly say, well, the reason that this ends up being a big part of our care is because we had a situation that went like this, and we would like to not repeat that. However, it is still, you know, like, and so someone who is willing to have some humility inside of what we actually do have control over as the care provider. But I think it's the dialogue. I think women should be looking for the dialogue with their care provider while they're trying to sort out, do they have, do they have somebody who's gonna help them make a truly informed choice?

Natalie:

I think that's really rare, and I think that would surprise a lot of people to even think about approaching a conversation like that with their provider. But it's so necessary. We, they're not experts on every single aspect of everything. And it is, you're hiring them. They work for you so you can hire and fire at will That's what I always encourage people, like, even if you're 40 weeks, sure. Change providers if you need. That might be a little bit of a, a challenge and comes with its own issues, but yeah. You're, you're the boss of your own birth and pregnancy and Yeah. So it's, it's refreshing to hear providers saying this and encouraging people to have these actual conversations with, with their own practitioners. Um,

Kelly & Tiffany:

And how sad is it that like it is relatively rare, um, and that somebody's mind might be blown to be like, oh, I can actually.

Natalie:

mm-hmm.

Kelly & Tiffany:

uh, have a dialogue about this. I can actually ask questions. I can actually, actually potentially even push back a little bit. Um, it's just unfortunate where our maternity care system is, that that is rare.

Natalie:

Yeah. Do you guys see that changing? Do you feel like the trend is, it's changing to more true informed consent?

Kelly & Tiffany:

Yeah. I, I mean, we have the benefit of course, in our own circles because it ends up being really far on one side of the spectrum of, you know, the type of families that we usually interact with. But, um, I think that sometimes we, in in birth workers conversations around better care for women, we sort of paint the care provider or usually the hospital-based care provider as the villain of like, well, they're just trying to follow all these rules and they're just trying to make it easy and fast for themselves and they're just, Brushing me off or whatever. And many of those things are absolutely true, but it is not your care provider's responsibility to provide you with the birth experience that you want. That is, whether it's a home birth midwife or an obstetrician who only does cesareans, it is not their responsibility. It is the woman's responsibility. And I see a really clear trajectory from bringing birth out of the home into the hospital. where women just let go of their power in that particular situation. And the reason, I think, part of the reason that we have the care model in the hospital that we do now is not just because doctors wanna control everything and turn everybody into little birthing robots, it's because it's because they have been forced to take responsibility for something that was never theirs. And so they're taking care of these hundreds and hundreds of women who are like, well, I don't know. You went to medical school, you tell me what to do, or, I didn't follow any of the advice that you gave me. So now you do have to have this intervention. So now we take the small percentage of women who actually want responsibility, they want to take that back, but we have a care model that doesn't support it that way. We don't have that, that relationship piece. So we have plenty of times that we have families in our own practice. Who want us to just be a, a little medical model that's nice to them. And says sweet things, but we're not a medical model. So when we say, actually you do have to make this decision for yourself, we can't do it for you. Or there isn't, there isn't a right decision here. It really is just for you guys to discuss and kind of figure out yourself. Um, it can make them really, really uncomfortable and not like midwifery care because of that, because they, they're more comfortable giving away that responsibility to somebody else.

Natalie:

Wow. That's like a golden nugget that you could cut out and post everywhere.

Kelly & Tiffany:

Tiffany's full of them. There's more, there's more to come. Just wait.

Natalie:

good. Good. Okay. I wanted to move into some of the other Instagram questions that I had. Um, specifically someone who knows that they want a home birth, but the dad is a little unsure. So if you guys have any recommendations on how to quell the dad's worries on specifically emergencies that may lead to a hospital transfer,

Kelly & Tiffany:

Yes. That's probably one of the top questions that we get asked in consultations specifically from dads. They're like, wha how much is this gonna cost me? and, uh, what about my wife's safety and my baby? Right? And so really being able to step back and talk about midwifery care as, um, proactive and preventative care from the get-go. It's not just about the birth. It is this relationship that we're building for months that's individualized to this particular family, to this particular woman, her particular symptoms. Going in depth on her particular lab work. All of those pieces coming together to help nourish her body, well support her body well throughout the entire experience. And then providing information about, okay, in this next stage of pregnancy, here's what we're gonna be focusing on. Okay, we're getting towards the birth. Let's talk about some of those complications even more. Let's talk about the fact that, you know, yes, of course things can happen. And that is one of the gifts of being trained as home birth midwives is that we're so, um, we're so aware of what normal is that if anything pings out of this little normal sphere, we're immediately like, well, that's not quite right. What can we do to help bring that back int back into this little normal sphere? Or maybe that thing pings out there and it stays that way and we communicate, okay, hey, like this thing is happening. let's give it some time. See you, you know, let's try these things, but see what else. Um, you know, the story tells us in this birth, um, and potentially other things start ping and we're like, okay, we need to have an actual conversation about, uh, needing to get some extra resources here. And that's the most often, um, reason for transfer is not like a immediate out of nowhere. It's sort of a story being told of like, this is not the right place. It's usually a first time mom with a really, really long labor. Everything's just kind of pointing to like some therapeutic rest would be so great. Um, but there of course are things that can happen, you know, more out of the blue or. you know, that are a bit more immediate in nature. And we as home birth midwives are incredibly skilled in bringing those things back to normal, whether with our hands, with, um, kind of natural options like herbs and things like that, or with medications, with neonatal resuscitation, with resolving shoulder dystocias. There are major things that can happen that I personally, having seen those things managed both at home and in a hospital, um, resonate much more with the physiological nature that midwives assess the situation with and feel like, um, the statistics point to it being, uh, a, an acceptable and safe way to manage those things at home. Well, and it also kind of, The women are usually the ones who are in the relationship, are moving the midwifery search or the ideal birth vision forward. And so as much as you can bring your partner along on that process, um, the better. Especially if they're having some strong feelings about it. Most dads are just lacking information, so it's out of ignorance that they have this concept of it being a really dangerous situation or they just wanna know, like, do you have a plan if something bad happens? Because we're not here to pretend like nothing bad ever happens that there aren't any risks to home birth, right? But we wanna create, uh, a setting for women to birth. knowing what the risks are at home, and they're choosing those risks over the risks of birthing in a facility. And so making sure it kind of goes back, it just kinda goes back to relationship and responsibility again. Right. And sometimes that takes an entire pregnancy for a dad to kind of wrap his head around like, this is, this is your baby, this is, this is your responsibility. If there's information that you don't have that you need to get familiar with, that's your responsibility also. Um, but again, being able to, being able to talk it out and, and being able to see where the care provider has limitations. We've been asked questions before, like, well, what would you do if such and such happened? And we're like, I mean, we would be, we would be in bad shape if that happened at a home birth. Like that would be a really, really difficult thing to process. We would do everything we could to stabilize our client, but we would call 9 1 1 and hope that they're coming as quickly as possible in order. I mean, that would be a true emergency and the, the parents have to sit with that answer. That's true. Like that is the truth of the answer. But people don't ask the same questions of their ob. Nobody comes up. No one comes into, I mean, what, who is the, tell me the last time somebody said, we're interviewing obese right now, like they've made space in order to try to pr, right. Um, and then you go to your first appointment and you're like, well, this is kind of a trial. I'm happy to have my first prenatal care with you, but I actually have some questions to try to determine if you're a good fit for me or not. Um, the things that women would walk into a midwifery interview with and ask a potential midwife versus what they would feel comfortable asking their doctor, you just would never see those parallels. You would not have the same conversation. Um, and so I would challenge the consumer to have a baseline of no matter where you're choosing to give birth, hold your care provider to the same standard. and feel like you can go into an O'S office and say, what are your limitations? You're, he, we're here inside of this facility where we have a quick response to emergencies, but bad things still happen there too. And how, and how are you going to keep me safe inside of that? Right. You're gonna end up with the same exact answer. Yeah. If something really bad happens. We're, we're s sol we're working really hard to try to stabilize everything. Um, and so there's just a, there's a certain amount of inherent risk in all of life, but especially birth. And I think people are really uncomfortable with that. Um, when they don't have information about it or when they're not used to taking, when they're not used to taking risks. Absolutely. There's, there's no actual completely a hundred percent safe birth. There's nothing in life that's a hundred percent risk free. Right. And so, uh, weighing those risks, On your two hands, deciding the pros, cons, and what actually in, you know, is in line with your family's vision for your birth, uh, how you want to be treated. All of those, like, it's gonna just be a different answer for everybody. I will say though, we talked about this on Instagram, I don't know, many months ago, and somebody messaged us to say, I'm newly pregnant. And I called the three obs that are in my insurance company and one of them, only one said that she could come in for a 10 minute consultation to ask all of the questions that she needed. The rest of them wouldn't even let, they were like, you can, you know, come in and have your first appointment. But she was like, well, I'm gonna take the 10 minutes I'm just gonna go for it and see, and of, I had never actually heard back from her, but, I was like, that is wild to me. Um, how just the two models are just so insanely different and I feel like midwifery provides a transparency that unfortunately where the majority of women are birthing just do, just doesn't have this doesn't happen there.

Natalie:

Yeah, I think it's a case too, when you were saying like birth is being taken out of homes or was a long time ago and it's been in the hospital for so long, all of the media representations of birth, all of everybody's grandmothers and mother's stories of birth can influence. I think more so sometimes the dads, because they, that's what they. they hear, oh my gosh, this happened. I was so thankful I was in the hospital because X, Y, and Z and I was close to this, you know, emergency help. But bringing it back into the home is like a foreign concept, which it, it shouldn't be, obviously that's more physiological, right? But I think it's, it's a scary thing. And the same, you guys probably feel this way about breastfeeding. We've covered it up for so long that it's like foreign to even see a boob or see a baby breastfeeding. And so, so many women don't know what they're doing or don't feel like they're capable enough of breastfeeding their babies because they haven't seen it. They haven't seen it, the example of it to them throughout their life. I dunno if you would agree with that or not.

Kelly & Tiffany:

Yeah, we, we have, we have taken something that is completely foundational to family life, and we've made it unfamiliar 50% of our population as women are going to or have the ability to be mothers and to go through pregnancy and birth, and they arrive to this chapter in their lives and they're completely unfamiliar with something. every woman before them has had to do, right. Yeah. And for sure with breastfeeding when, even now still, but especially when my girls were really young, my daughters, um, anytime we would ever see breastfeeding, I would point it out to them so that they could see and notice. And when my friends were over at my house breastfeeding their babies, I'm like, if you don't mind uncovering yourself just so my daughters can see, like, have some exposure to breastfeeding. Um, it just is, it's such a nod to how unfamiliar this really important concrete part of our lives is in our society right now. and that's one of my favorite things too. I feel like I have so many favorite things, but, uh, this is generat. It's like changes generations, right? Mm-hmm. exposure to these types of things. Seeing your sibling born at home or hearing your own birth story of being born at home, being surrounded by something that is so normal. It's so normal. Um, whether it's birth or breastfeeding, um, pregnancy, all of it that, um, it really can change the way that our kids and their f right move forward as into adulthood. And that, I feel like is where we're gonna start to really see some consumer change as home birth and midwifery care. And all of that becomes more of a, more of a thing right now. Or at least it's like having its moment these last couple years, especially coming back and seeing a resurgence of. Women making different decisions. I'm excited to see what that generation of kids, you know, grows up into. As long as we keep conversations like this going,

Natalie:

Yeah. Well, I'm a prime example. I'll tell you, I was at my two younger siblings births. They were in the hospital, but I was there and I was four years old for one and six years old for the other. And look how I turned out basically, you know, So I think it was, I'm so, so thankful for my mom to bring both my older brother and I into that because we had an idea of where babies actually come from and the work that it takes to get them here. And then she breastfed also, and I was able to see that. We called it milking the baby. When you're done milking the baby, can you do this with me? So that is like a prime example of, you know, I'm familiar and comfortable with talking about birth and I know what it takes and yeah, because I, I think it's really truly, cuz I saw it when I was young, so,

Kelly & Tiffany:

Yeah. A lot of our clients have that question about like, should my child be at the birth? Especially when they're choosing home birth and they're like, well, it's easy cuz they're either asleep next in the next room or just around. And of course everybody's decision is gonna be different depending on needs and desires and, uh, a child's, uh, ability to be able to manage some of those pieces that come along with it. But most of the time, the older kids are still, like, their behavior is even better than it normally is, right? They're just kind of like locked in and it's, it's oftentimes they're more, they more just get bored, right? They're like, okay, mom's making the same noise. Like, I'm just gonna wait for the baby, I guess longer. But how capable they are of like bearing witness to it and what an impact it really has on them. It's pretty rad.

Natalie:

Awesome. Awesome. Okay. Going into some more nitty gritty questions. How do you prevent tearing during delivery? What are some strategies,

Kelly & Tiffany:

There's a lot of strategies out there that women can consume, Um, it really depends on what the women's desires are because, Again, back to the evidence. If we start there, if we start with evidence, we have evidence that there are things you can do to prevent tearing, and we have evidence that a hands off approach actually, um, prevents more tears. And so now we have these two bodies of evidence that conflict with each other, which is actually really beautiful place for us clinically because it provides a lot of freedom for our clients to truly make a choice, um, for what they want. The, the evidence that we have for natural births in an environment where the woman can follow her own instincts and move into positions that she wants to, and, um, really allow for the biofeedback of the pushing phase to kind of guide her and a supportive care provider and environment that allows that. to happen, you know, for her to kind of be able to take charge. Um, a hands off approach generally has better outcomes for moms. So anyone listening to this that is planning on having a different kind of experience, the numbers are gonna mean something different for somebody who is on an epidural, you know, on their, on their back in the hospital bed. So that's an important distinction as we look at the, the outcomes that come out of different providers providing support. But the woman needs to say what kind of support she would like to have. And of course, anybody who is at of birth wants there to be the best outcome for the mom, right? Um, and so anytime that we have the ability to see where we can get hands-on in order to preserve. Tissue, we're going to do it no matter what unless we start to do it. And she says no. Um, but we tend to have a more hands off approach because it kind of just supports the ethos of our care, which is you don't need somebody's hands in your vagina in order to ha for any of this to unfold well, um, unless she wants it. So I would say the, the biggest thing is first time moms who are just terrified because they don't know and they've heard stories and they just think that their perineum, um, giving way is going to be the absolute worst thing that could possibly happen to them. And they have a lot of fear around it. So we really work on it from a psychological perspective of like, well, let's talk about this really normal part of what your vagina is able to do. And, uh, come at it from kind of processing the fear of it. And then we have another category of moms who have had another birth in a, in a different setting usually, and really have had a pretty terrible tear and healing experience. And we'll do the same thing. We'll process all of that through with them and try to pick out like was it, was it your position? Was it the force of the baby coming out? Is it your anatomy? Is it right? And like, let's just see how we can try to support that tissue the best. But if those moms say, I'm gonna feel so much more mentally secure. If you are just holding my perineum the entire time that I'm pushing, then we get to say, absolutely you have all the information and that is still what your request is. Even though it's not our preference. Imagine that not our preference, but you have the information and you are making the request for the type of experience you want to have. That's the opportunity that we have to provide women, um, in that, in that place. But in general, physiological birth, that's hands off where the mom gets to move intuitively, push intuitively, and ask for help when she feels like she needs it. With watchfully observant care providers, that is what is going to give her the greatest outcome with her perineum. Yeah, and to just make a little side note too, there's no, um, Does not mean anything about your particular birth. If you tear or you don't tear, or if you breathe your baby out or you're put, right? Like if you're listening to your body and your body says, I actually do need to get this tissue out of the way completely to get this baby out. Um, then we can also say, well, your body needed to do that. Right? And that's not necessarily a sign of that something went wrong or that it was bad or, um, like just in and of itself. And so I think that's helpful just to be reminded of that. Like sometimes vaginas and perineums, sometimes they tear and uh, and we can also normalize that piece of it as well.

Natalie:

that's a really refreshing perspective. I don't think I've heard anybody say that before. So thank you for saying it, Um,

Kelly & Tiffany:

some pearls of wisdom too.

Natalie:

you do next Instagram question, how do you afford a home birth? How do you access that if you don't feel like you have the money or the resources to pay for it?

Kelly & Tiffany:

That is probably one of the biggest barriers to home birth, and I wish it wasn't that way. I wish money was not a like, An issue in terms of actually accessing the type of care that you would like. Um, generally speaking though, especially when you're looking into getting pregnant, um, there's a couple things just to kind of be thinking about, including just shifting your budgeting and paying over time. Right. Uh, just basically assessing this is really important to me. And if there was something else in our home that needed work on or in our car that Right. We would just, we, we'd need to kind of figure it out. Right. And so, um, potentially assigning just the value that it is worth it to invest in it, it is worth it. Poten, I mean, I'm not a big fan of debt, but it's a potentially worth it to go, you know, check out a credit card situation or whatever. Um, I also recognize that there's a lot of insurance companies that. May be like on the surface, say that they don't cover certain things, but actually will give you, um, a bit of coverage at the very least. And so there are some pieces that become a little bit more affordable or a little more accessible with that, depending on the type of insurance you have. One of our favorite things, um, that we've had many clients work through our health shares. And so those are not technically insurance companies, but they're like kind of a health collective that I think all of them view pregnancy as a preexisting condition. So you would want to get on it before you get pregnant, but the amount, I mean, they'll cover your home birth in full. We've had clients get their supplements covered, chiropractic care, acupuncture, all types of things. Um, that's shared within this little collective that that in and of itself is a worthy thing to. Look into if you're thinking about getting pregnant or you think that, um, home birth may be of interest to you. And it's unfortunate that insurance companies don't recognize how much money we save. Like we save them so much money. Um, but also the change is gonna come from consumers. So if they're like later insurance company, I'm going to this health share, you know, uh, potentially we're gonna start seeing some shift in that maybe. Well, and like I recognize that insurance is a huge part of the health economy in our country in many countries, our who's go, so who's gonna be the boss of your birth then? Like you, you already decided that you didn't want your OB to be the boss of your birth. So are, is your insurance company gonna be the boss of your birth? And I hate to compare it to something that, um, is just very different cuz there's, there's not a lot that you can compare the cost of your birth to, it's just, it's weightier than probably anything else. But how did you figure out how to pay for all your other stuff? Right? How did you, and we're not talking about tens of thousands of dollars here. We're talking about like, I think the country average is like about$5,000 for the entire package of home birth midwifery. And I recognize that there are absolutely people out there who cannot swing it. They just will not, no matter what, be able to find a way to pay$5,000 for their birth. But most women can, most women can borrow money, most women can, um, budget for it. Most women can sell some stuff, pick up odd jobs, cancel their cable. Um, how did you pay, how, how did you put a down payment on your house? who paid for your wedding, you probably didn't, you probably didn't fund your$20,000 wedding, right? Um, so look at your, look at your resources, get creative with your resources, but also barter trade. Um, ask your midwife for a payment plan. Midwives get burned on finances a lot. And so, um, not a lot of them are, are able or feel like they have the capacity to be really generous. But we will let people pay off their fee with us for up to six months postpartum. And so again, it kind of comes back to that consumer demand of like, if we can create more financial space for clients in order to, um, make it happen financially, like we want to be a part of that too. And then also recognizing that you're pay, you're paying for your midwife to. Show up that day, you're paying for her to be available and to potentially provide emergency care on that day, right? She might be at your house for four hours at your birth. She might be there for four days. And there's a certain amount of value that we can assign to this person that we have asked to be there with you, right? Um, and, um, just appreciating the level of care that you get from home birth midwifery. It's not apples to apples. You're not getting the same access that you would with a hospital-based provider. You're not getting the same relationship, you're not getting the same attention to detail. Um, And so it's, it's pretty difficult to compare one thing to another, even though we're ha even though it's like the same, we're we're, it's the same thing, right? We're trying to have a baby inside that space. But I love my, probably my favorite financial option for women is that is a cost sharing, like a medical share. Um, and I know that that doesn't work for a lot of women who are discovering while they're pregnant, that they want to have a home birth, but also that, that would be an encouragement to women who are planning ahead in all the spaces. This is absolutely a worthwhile thing to be planning ahead for. I mean, little girls are picking out the names that they're going to name, you know, like their babies. We start dreaming of how our weddings are going to be. The moment that we kind of like someone that we're dating, we're like, okay, let's, let's start planning the wedding. Um, and so it, it would be okay to put a lot of weight into planning your birth before you're even pregnant. So,

Natalie:

Yeah. Yeah, it just makes sense. It makes a lot of sense. oh, this is what I was gonna ask you. what does your, what does your postpartum care system look like? How does that differ from maybe the average? And what do you guys, what do you guys offer.

Kelly & Tiffany:

we love talking about postpartum care because this is yet another way that women and families have been drastically shortchanged in our maternity care system, uh, especially here. So we provide six weeks of in-home, uh, postpartum care, and within that six weeks, we're coming to our client's house. On average, about of an hour each time, six different times. Within the first week, we're at our client's homes three times, right? The next day, a couple days after that, we're there on week one, just to ensure. Um, adequate healing. Breastfeeding is getting established. There's so much that goes on in that first week especially, but we're back there the following week and a couple weeks after that and a couple weeks after that to just assess how are you, how are you nourishing yourself? Where are you at, emotionally, mentally, spiritually? How is this transition into family looking? Um, how is your pelvic floor? How is your bleeding? There's so many pieces that happen between. Most commonly when women get sent home from the hospital, right, 24 or 48 hours later and have one appointment six weeks later, there's a crazy amount of life that happens in there. There's a crazy amount of things that can go sideways during that time also. Um, and so we love being able to, you know, be as present as we possibly can in that space. We make ourselves really available to those early postpartum clients. But something else that was really valuable to us was, um, creating an, creating an extended postpartum option for our clients that allows us, or allows them to come in, uh, every three months. So month, 3, 6, 9, 12, even if there's nothing clinically going on, just to connect, chat, catch up, share their excitement about their baby's milestones. Uh, we talk a lot about sex breastfeeding, all kinds of things, um, that go on, you know, within that first year of becoming a parent. It is not, no matter how many kids you've had, it's always such a huge transition. And so that's been a really sweet part for us to be able to walk through more than a year. Right. Of caring for a client and witnessing all that transformation, providing all of that support that just is kind of nowhere to be found in any other care space. And like a lot of moms will hear that and, oh, that sounds so nice. Oh, I wish that my midwife would do that. and yeah, it should sound really nice because it's like the bare minimum of what people could possibly need. We take care of the women in our practices and we're like, this is not enough. we're, this is not enough. They need, they, everybody is always gonna need more postpartum support. Right. Um, but it goes back to that consumer demand, women taking responsibility for the type of care that they want to have. And maybe there's nobody in your area, maybe there's no home birth midwives who are wonderful in every other space that are willing to offer an extended postpartum care plan. But then we have to start asking for that. We have to say, I heard about this other model with these wacky midwives in Nia that I'm really interested and I think a lot of women would be interested in that too. And so we start talking about it more and it's the, the mother herself who says, I this is needed. I would implore other care providers to, to provide this service for us as women.

Natalie:

Yeah. Yeah. It almost makes me cry, like thinking about the amount of postpartum care that you provide, and that's like, so significantly more than what is generally offered, like that 1, 1 6 week appointment where the doc says, cool, you're good to go, have sex, like, move, exercise, run, do what? Which kills me talking about pelvic floor. But yeah, it's, it's so desperately needed, so thank you for providing that to women. That just, it makes me very, very happy.

Kelly & Tiffany:

We love being able to provide it. And we think that, just like Tiffany was saying, the more people who hear about something like that, when you realize, oh, that's a, that's an option, um, I feel like your brain kind of opens to the fact of like, I'm, I'm worthy of care and support in this space Also.

Natalie:

Yeah, totally. Okay, so I have kind of a big question. What would you recommend if someone wants to do more research, if they wanna learn all the things, what are your books, resources, guides, everything you recommend, accounts to follow? What would you give someone who's like, I want to learn more?

Kelly & Tiffany:

That is a big question that where do you start? But that's okay cuz we can have a big answer for that. Yeah. I mean, I, I personally as a mom started by watching birth videos and realizing. There's differences here, uh, it seems like some women have just like this different environment, this different ex. That's interesting. I'd like to learn, uh, more about that. It just brings up, um, not only being able to witness labor and birth, but being able to witness how some women are coping with it and some care providers manage some things. And it just ticked off a bunch of questions that made me think or made me just learn more, made me want to learn more, made me curious. And that, um, was really helpful. I don't, I didn't have ins, uh, Instagram was a thing, but probably, I don't know, at my, when I was pregnant with my first, but um, that really was a huge help to me just to see birth, having never been to one. And then that led me down the rabbit hole of, oh, that account suggested this Ina May Gaskin book. That was really insightful for me. Oh, she talks a lot about home birth. Let me check out, you know, this website that talks about it. And so it sort of was a bit of a rabbit trail for me. I think that's a, a ge, like for anybody, that's a pretty general place to start. Yeah. Observing birth yourself in normalizing the observation of it and having that visual in your head for what's possible. I think one of the things that midwifery really does well is low risk. Birth in low risk pregnancy and not just for the mom who just happens to be able to barely avoid being a ticking time bomb, right? The way that the medical care system would sometimes treat women. Um, but that we can keep women low risk because of the ways that we can intervene on a deeper like root cause level. And one of the most powerful ways that we can do that is with nutrition. So no matter where you're giving birth, you can have some control over staying low risk, which just gives you so many more options being having a low risk pregnancy and birth. Um, our favorite resource for that for pregnant women is Lily Nichols, her Real Food For Pregnancy, her Instagram account. She does webinars all the time, and she has a book on gestational diabetes and she has a really great metabolically sound, real food. Perspective on nutrition. And so that would be a great place, um, for women to put a lot of their attention no matter where they're at in their childbearing cycle.

Natalie:

Yeah,

Kelly & Tiffany:

Yeah, her, her account has been incredibly helpful. Her books we gave to all of our clients just because we were like, this is important, and everything that we suggest to you as we bring nutrition up in every single appointment will kind of, uh, that's sort of the crux of it. We love having, um, I mean, we have a love hate with social media but in general, love having a, a place where we can go and post information, post blog, you know, uh, posts. We can share silly reels of us doing something silly, but actually educate and we have had so many people. Comment on those or dms of like, I actually didn't know that was possible. Or, oh, I thought I got delayed cord clamping and I'm learning more about that from this reel that you posted that this is here my que here's my question, or here's what I wanna do differently next time. And it's exciting to us to be able to have a space where we're doing what midwifery likes to do, which is normalize birth and entertain a bit at the same time, but also just educate. And so not to like pump ourselves, but

Natalie:

Please do. Yeah, that's why you're

Kelly & Tiffany:

enjoyable space. It's an enjoyable space to, to be, there are plenty of birth, um, and midwifery accounts out there that usually end. we usually end up sharing too in our staff. Yeah. One of our favorite resources too, for moms that are just in that space of trying to normalize a home birth decision is the podcast Happy Home Birth with Caitlin Fusco. She does such a great job at covering a wide variety of topics, from birth stories to different types of midwifery care, to all of the ins and outs of planning a home birth. And so that's a, that's a wonderful resource for people to go get more information about that type of care. Another resource that we share really often is evidence-based birth. Um, they do a really good job at syndicating research in a way that is mostly unbiased. They're able to really just say like, we looked at all of it for you. Here's the summary. And so for somebody who is not interested in going and diving into all of that themselves, which would be 95% of us

Natalie:

Yeah,

Kelly & Tiffany:

uh, it's a trusted source for research based information that presents it in a way that allows the consumer to see what types of conversations to bring back to their care providers.

Natalie:

Awesome. Awesome. And your guys' podcast as well,

Kelly & Tiffany:

thank you for that extra little pump

Natalie:

Yes, of course.

Kelly & Tiffany:

we started a podcast a a few years ago and we really had a focus on women's health in general. And again, just normalizing stuff about women and our bodies, periods, pregnancy, birth, and it's been sweet to see it kind of grow recently and uh, be able to again, have a space where we touch on some, you know, just varying topics, but that end up, uh, resonating so much with women cuz they're like, oh actually I hadn't heard that before, or I never talked to about, about that to anybody, or, I was, didn't even know that was a thing I could ask my care provider about or whatever. So it's a, it's a cool spot to be able to.

Natalie:

Awesome. And you guys are very funny too. I'll tell you, I like your sense of humor, I listen to your podcast and I laugh, so

Kelly & Tiffany:

our goal has been reached. Then

Natalie:

Yeah. I'd say, um, okay. I have two questions that I ask every single guest at the end of every podcast. So the first one being, what is your number one piece of advice? What do you want every single person to know?

Kelly & Tiffany:

that is a big one also. Um, mine would be, I mean, just surrounding this, you know, conversation in general is that, uh, fertility, pregnancy, labor, birth, breastfeeding, all of these things are normal natural processes that your body wants to partake in. And. Learning about them is a worthy endeavor. Uh, supporting your body and what it wants to do already is a worthy endeavor. Yeah, and I'll piggyback off of that concept a little bit and share that pregnancy or even before you get pregnant and planning pregnancy, those are your very first opportunities to practice parenting. And I don't think women often see the beginning of this journey as priming you for that, but you are going to be parenting this child for the rest of its life and. These are parenting decisions and you're formulating your parenting philosophy and you're making choices that are going to have sometimes pretty big impacts, and you're working together with your partner and you're choosing who you want in your support circle and all of those. All of those things matter as you kind of practice and prepare for the ultimate parenting.

Natalie:

Yeah. I think a lot of people don't realize that birth sets them up for the traject trajectory that they want to go on or need to go on, and it's a keystone component to life in general and parenting and all of the choices. So, yeah. That's huge. Um, okay. Second question, this one is more, it should be easier to answer probably. What is your favorite current wellness habit that you incorporate into your own daily life?

Kelly & Tiffany:

We love talking about this one,

Natalie:

I can tell

Kelly & Tiffany:

Um, currently, well, I have a, uh, I have a few, so actually that feels kind of hard to

Natalie:

Okay. I mean, you can, you can

Kelly & Tiffany:

I know what tips is gonna be, so I'll choose a different one. Well, I think I know what yours is gonna be, uh, per, well this is a longstanding one for me. Uh, seed cycling. That has been a really helpful rhythm that I have gotten into over the last couple years to support my body and support healthier, happier periods and decrease all kinds of symptoms and things like that. So I'm on, I'm on the. Seed cycling train. That's the one I wanna share because maybe your audience hasn't actually heard of it. And so that will send y y'all off on a rabbit hole of your own

Natalie:

do you have a resource on your website for seed cycling?

Kelly & Tiffany:

Yes, we do. So in our shop, we have a whole free resources tab that you can go in and check in all of our freebies. One of them is a seed cycling ebook guide that has all of the information of how to do it, why to do it, benefits, frequently asked questions, all kinds of stuff, and it's free.

Natalie:

Lovely. Okay,

Kelly & Tiffany:

Okay. In mine, I, I have to say too, I just

Natalie:

That's fine.

Kelly & Tiffany:

I think the, I think one of the most important disciplines that I am really leaning into in this season is movement and just regularly moving my body. I find that to just be such a challenging thing to sustain. So I'm working so hard on some of those habits, but, That's kind of boring. So I have a second one that is much more exciting and equally wonderful, um, which is my infrared sauna bag.

Natalie:

Oh,

Kelly & Tiffany:

That has been the biggest game changer of all. Coming from someone who's like, that's one of the stupidest things I have ever heard of to getting in it constantly. There's so many beautiful benefits and I feel so, so good. After it. Kelly influenced me on social media with it and just her own experience with loving it. She had, she had hers for like a year, probably before I was like, gosh, man, I can't pass this up. And I do not regret it. I do not regret my Sauna Bag purchase. It's been one of the greatest tools that I've been able to utilize in taking care of myself.

Natalie:

That is next on my list. So do you have one? Do you guys both have the ones you lie down in or the ones you sit and like, okay.

Kelly & Tiffany:

Yeah. We have the lay down, like sleeping bag style one. The one that we chose is from higher dose and like have been so happy with, um, what they have created. Uh, there's nothing like laying down and being like, I'm just gonna, you know, watch an episode of The Crown or something and I'm just sweating. It feels so good. Yeah. Yeah. It rolls up so we can stash it in a cupboard or under our beds. The, I, I like the idea of the tent one. Mm-hmm. except for, I cannot tell you how many times I fall asleep in my bag.

Natalie:

yeah,

Kelly & Tiffany:

And so I'm so like laying down, who doesn't love laying down? Mm-hmm. Oh, that's one of my favorite activities, which is why the exercise discipline is so challenging sometimes. Uh, but tr truly it is, it's incredibly convenient. It was one of the most affordable options when we were looking at the specs of all things that were out there and we have a affiliate link for people to get 10% off. We can share that with, with you or with your listeners if they wanna check it

Natalie:

Okay. Awesome. I will put it in the show notes with all of the other recommendations you guys had. Can you once again tell us who you are, where we can find you online, what you offer, and what your podcast is called?

Kelly & Tiffany:

Yes, we can. So, uh, we are Kelly and Tiffany from Beautiful One Midwifery, which is a home birth practice in San Diego where our website is@beautifulonemidwifery.com. There is, uh, lots of blog posts backlogged on there, lots of, um, stuff in our shop that is available. Most of it is readily downloadable. All kinds of protocols and, uh, guides and all kinds of stuff of content that we've created over the years. And access to our podcast there, which is at home with Kelly and Tiffany. Um, and you can find us, I mentioned our Instagram also, we are at Beautiful One midwifery on there. I think that's about it.

Natalie:

Yeah, I think so. And when you open your practice doors again, you post that on your website, is that correct? So if somebody was new book to hire you, they'd find that there. Lovely, lovely. Well, thank you guys so much for spending your time and energy with me today. I'm sure our listeners will appreciate it.

Kelly & Tiffany:

Thanks so much for having us. Thanks, Natalie.

Natalie:

My top takeaway from my conversation with Kelly and Tiffany is that the process of planning for your birth experience is really the start of your parenting journey, and you get to make the decisions for how you want that to look. I love how their model of home birth midwifery, honors all the physiological processes a woman's body goes through and approaches any interventions and offerings with the perspective that birth and everything that comes with it is normal. Kelly and Tiffany graciously are offering all of my listeners a free guide to resilient birth. You can find a link to that as well as all of the other resources they mentioned and their social channels in the show notes for this episode. Please remember that what you hear on this podcast is not medical advice, but remember to always do your own research and talk to your provider before making important decisions about your health. If you found this podcast helpful, please consider leaving a five star review in your favorite podcast app. Thanks so much for listening. I'll catch you next.