Justine: Hi, I'm Justine.
Sarah Lavonne: I'm Sarah Lavonne
Justine: We are so glad you're here.
Sarah: We believe that your life has the potential to make a deep, meaningful impact on the world around you. You, as a nurse, have the ability to add value to every single person and patient you touch.
Justine: We want to inspire you with resources, education, and stories to support you to live your absolute best life, both in and outside of work.
Sarah: But don't expect perfection over here. We're just here to have some conversations about anything birth, work, and life, trying to add some happy to your hour as we all grow together.
Justine: By nurses, for nurses. This is Happy Hour with Bundle Birth Nurses.
Sarah: I love when we refuse to talk about these episodes before we actually talk about them because it gives the most candid, most random conversation surrounding the topic. Obviously, we know what we're going to talk about today, and I'm really excited about this one because this is a very long time coming and something that I am very passionate about. I know many of you are passionate about, and so you're going to get the raw conversation all about the most interesting topic of all time, which I'm being sarcastic because, at face value, it probably doesn't sound that interesting, but to me, it's very exciting enough, obviously, about childbirth education and what that means for our profession. I have a lot of ways that we're going to go with this, and so thanks for being here, everyone. Justine's here too.
Justine: Hey. Yes, I'm actually surprised we haven't done this episode yet.
Sarah: Same.
Justine: I mean, how Bundle Birth started.
Sarah: Yes, exactly. You took childbirth education, you became a childbirth educator, right, and taught at a hospital?
Justine: Yes, I was going to do the birth class at our hospital, and then my manager was like, "You should go take the ICEA class." If you don't know what ICEA is, we can even link that.
Sarah: That's my certification. That's the one that I recommend to people.
Justine: Yes, and my story is I went to San Diego for two days, did the class, and realized I don't know anything. I went in pretty cocky of the sense of, "What am I going to learn? I guess I'll learn how to teach families better." Then I went in and I learned so much, so much, and have such an appreciation. I was very egocentric, was that the right word, of L&D nurses. That was my similar experience the first ever Spinning Babies class I went to. I was like, "There's only L&D nurses," and I was like, "Oh my gosh. There's so much more than L&D nurses out there." Doulas, childbirth educators, [inaudible 00:02:34]
Sarah: Yes, like other people in birth.
Justine: Right. I don't know. Childbirth ed is really important, and I'm glad we're talking about it.
Sarah: Yes. My backstory is that the hospital I was at had outsourced all their childbirth educators from an outside company that they had their childbirth education certification, but they weren't nurses. They weren't actually medical people. They were lay childbirth educators that knew nothing about how the hospital worked or the unit or the flow or the policies and procedures or the doctors or anything like that. They were seeing issues that were happening based on outsourcing a program from people that can teach a textbook, I'll say, but maybe don't know the nitty gritty of what actually happens and how actually to advocate and stuff like that.
They were like, "We're going to take it over and we'll have our nurses teach it." They selected a select few of us and pulled us from the floor for four months, and then brought in Ana Paula Markel, who is one of my mentors to this day. She was the president of DONA International. She's amazing, the most renowned doula trainer, childbirth educator, been doing this forever, celebrity doula, all the things, and had the background combined with [unintelligible 00:03:44], who actually now is one of our mentors. She was the manager of the childbirth education program, and they partnered together to train us. Then, together, we put together these childbirth classes. It was really a childbirth class.
Then I eventually helped put together a bunch of specialty classes, VBAC, Coping With Labor, Ask The Anesthesiologist, all sorts of other ones. Anyway, we were pulled, and for those four months, I remember learning from Ana Paula and being like, "How have I been doing this forever, and I am really good at my job, and I know nothing?" That was really, honestly, the spark of my interest in physiologic birth because that was when physiologic birth as a concept was introduced to me. I'd never really heard it, or maybe I'd heard it, but you hear things where this is something somebody says, whereas,we were talking about the idea of what is a physiologic birth.
Then, of course, I was just like, "Wait a second, there's all these other things you can do. Wait, that's how the body works," and all this stuff. I agree. I think childbirth education is really important. If you are an educator out there, or you're a preceptor, or something, or you're new, you're a student, one of the first things that you should be doing in preparation for becoming a labor and delivery nurse/recommending to the new labor and delivery nurses is they have to be taking a childbirth class.
What I love about it is that they then also see what patients are being taught and how also to educate their patients and learn new ways of saying things in a way that they can understand rather than, "Well, [unintelligible 00:05:10] did 1647 clear fluid, and I'm concerned about there maybe now being MAC, and therefore, the NICU will be noted." Your patients don't know what we're talking about. One of the things that makes you a really good nurse is being able to connect with your patients and really help include them in your plan of care, et cetera, et cetera. I agree. I think it's so, so important.
Justine: I was reminded when you said-- okay, so two things before I lose my train of thought. So true about the physiologic birth standpoint. Even cardinal movements, you learn about it [inaudible 00:05:42], you learn about it in school, and then you forget about it because no one's talking about cardinal movements. They weren't a decade ago, right?
Sarah: Totally.
Justine: Now, you were like, "Oh yes, that is important. The baby does have to do stuff. What does the baby have to do? How can I help the baby do what it needs to do?" et cetera, especially when we're thinking epidural, so important. How do we help our patients move that baby down?
Sarah: [unintelligible 00:06:01] 
Justine: Yes. Then, I think about, I don't know about you, but with baby-friendly, how it got so popular and is so popular and whatever, you have to follow a lactation consultant for a certain amount of time. You have to [inaudible 00:06:13] education and learn how to do it, which is great in theory. Why aren't we doing that with childbirth ed? That should be some sort of mandatory training.
Sarah: Yes. I agree. I love all that. If you haven't taken a childbirth class, I don't care how long in your career you are, I think it would benefit you and it might be something really interesting and new for you. Actually, we have an announcement as a result of all that. That announcement is over two years coming. Actually, it's probably more like four years in the making. My background as a childbirth educator, like I said, I was in the hospital doing that. I got certified through ICEA. I'm an ICCE, Internationally Certified Childbirth Educator, whatever that matters.
There is an exam and all of that. If you're going to do one, there's Lamaze, there's Bradley, there's hypnobirthing certifications. There's a bunch of organizations out there. What I love about ICEA is that it's very generic. It's not, "You have to teach our way." There's the Lamaze way. There's the hypnobirthing way. Really, my philosophy on childbirth ed and how I teach, you've seen this, if you've learned anything from me ever is, "Your way is the right way." I want to be able to help patients get all the tools and figure it out for themselves.
Some people are going to connect with hypnobirthing styles. Some are going to really connect with the partner-led birthing, which is really Bradley's focus. Those that don't have a partner, that might actually be really triggering and really hard for them to go through a Bradley class. I really want to be very neutral and not really subscribed to any right way to give birth. Also, with me being a nurse, a lot of the childbirth ed out there is very natural, no epidural focused, and/or has this undertone of stigma of the hospital system, of getting an epidural, or maybe even not getting an epidural, et cetera.
Really being that really safe, nonjudgmental zone to lay out the facts in a way that everyone can understand while also helping patients make decisions for themselves, while also teaching them practical tools of how to communicate with their care team, while also giving them the inside scoop of what's actually happening behind the scenes with your nurses, your doctors in the hospital so that they can navigate and advocate for themselves in the hospital system without creating-- there's not a good enough English word for this. Without creating a choque, a clash with your medical team.
We want you to work with your patients. Let's be honest, we love an educated, reasonable patient [chuckles]. The educated ones that come in that are like, "Well, I don't want this, and I just don't want this," and they don't know why, that's so annoying to work with as a nurse. You're like, "Well, okay, but you have preeclampsia and now you're on MAC. Let's--" "Well, but I don't want a Pitocin," or, "I don't want an IV." You're like, "Okay, but--" and then now you're fighting them on that. Then you become the enemy potentially based on fighting their preferences when, really, you're trying to keep them safe.
Anyway, there's a lot out there on that front. When I approach childbirth education, I love ICEA because it gives a lot of freedom to use your judgment and create the curriculums you want so long as you're following the ICEA standards, which is really just best practice. They have a lot of papers on that. Anyway, I got certified through ICEA. I started teaching in the hospital system. I will say that I taught hundreds of classes. I was teaching three days a week sometimes. I fell in love with childbirth education.
Again, if you've learned anything from me, you know that education is my jam. I love teaching. I love helping groups of people get complex topics. I love like consolidating lots of complex things that are seemingly maybe even don't relate and helping them relate to wherever you're at. That could be nurses, that could be families. Taught in the hospital and then eventually did a bunch of stuff in there, was teaching nurses in the hospital, and then left and went to community childbirth education, and was teaching for Anna Paula at Beanie Birth in the Valley here in LA.
Justine: That was on TV. An episode. What TV was it? The Courteney Cox episode?
Sarah: Yes, 9 Months with Courteney Cox. I don't know. I was on one of those. They featured me as an educator. It was so funny. They brought a film crew and all that. I've done a good amount of little TV gigs. It was fun. At this place, I now didn't just have hospital birthing people. I had birth center birthing people and home birth people. Now, I'm teaching childbirth curriculum that included stuff like what happens in a hospital transfer, delivering at home, all these things. I started to see even more the diversity of the birth world.
At that point, again, I was working with doulas, and I was taking clients on my own and really seeing the community birth stuff, what was happening in birth centers. I did do one birth center birth, and then I had a heart attack because the baby needed resuscitation, and that was my whole thing. I don't do that anymore, but I believe in it. I believe in choice, basically. If you choose that, then you do you. I started teaching childbirth education videos on YouTube in late 2017, early 2018. That's when I started my YouTube channel.
If you don't know, I have a youtube channel. It has all sorts of childbirth education for families that did very well and grew a lot. I have not posted a video for four years up until now because we back.
Justine: It's been four years?
Sarah: It's been four years. Wait, has it been four years? Three?
Justine: I don't know.
Sarah: It'll be three in May, actually. I thought it was four.
Justine: Still three is a lot.
Sarah: Thank you for holding me accountable.
Justine: Time flies.
Sarah: It does. I took a break because it's a lot of work to maintain a YouTube channel, I will say. Of all social media mediums, that's the last one I would recommend. It is by far the most work and the most expensive to maintain. I will say, from a childbirth education perspective, and we'll talk about what our thoughts are on that and I would love to hear everybody else's thoughts on that, send us DMs on that, I feel I have a very strong grasp on the various outlets of childbirth education and what it means to educate.
At this point, we did the math, through our educational programs and through families, millions and millions of families have been educated through our online classes. If you don't know also, by the way, go to bundlebirth.com and you can see all the things that we offer families and we have a new and improved website over there. We're so excited to finally launch back to families. Part of what I did along the way was I did put online classes. For many of you, as nurses, we have on-demand classes available for you. I have, for families, [unintelligible 00:12:56] feedback class, Coping with Labor, Newborn Skills are all online.
Then, are now here with, finally, which I haven't even said yet, that was all the lead up to launching the Bundle Earth class. Now, finally, we are here-- She's laughing at me because I have the Italian [unintelligible 00:13:14]-
Justine: [laughs]
Sarah: -with my hand. I'm talking with my hands. So excited. We finally have this new and improved childbirth class available to the public. It's available to you. It's on bundlebirth.com. We'll link it down below. Really, for me, this is, I feel like, my life's work in childbirth ed from all of the experiences I've had on all fronts and really speaking to the masses and having trained on camera for years, doing YouTube and videos and classes and all that.
I also began teaching physiologic birth and developed the physiologic birth class for nurses. If you haven't taken that, that's your foundational class, please join us in one of our next classes. What I found was that that gap in education with what families are getting and now nurses were getting with physiologic birth, I'm like, "They're not being taught the physiologic birth stuff, and the things they can control, and the importance of motion, which equals lotion, or what's actually happening in their body, or even how their hormones are impacted by the fear that they experience, or how their mindset can play a role."
We are here now to announce the launch of the Bundle Birth class. It really is a combination of the patient version of what you get in physiologic birth. Now, the patient takes this class, you've taken physiologic birth, you show up both with reasonable expectations of each other and being able to navigate and communicate and they can advocate for themselves while working with their care team, not believing that you're the enemy when they walk through those doors because I very much advocate for hospital birth.
I also ask them for grace and understanding on our front of y'all are up against a lot and that, "This is a really important day for you, but it's a day of work for other people. Sometimes you need to know how to speak up, and give some understanding and grace that this is work for them and they have other lives outside of it." Sometimes we miss that and that is the case across life. That's not just in the birth room. Anyway, all of that being said, now we have this new class available, and I'm so excited because I know there's nothing else out there like it. This is the best childbirth class I've ever taught in my life.
When I went into teaching it, I said to myself, "I am going to give and I'm just going to teach as long as needed to impart everything I've ever wanted to say in a very limited amount of time." A lot of times, it's a six-hour class. How much can you really talk about in six hours? Can you really train for childbirth in six hours? Much of it's mindset and prep and settling in and learning your body and all of that. That's not possible in six hours. This is a 10 and a half hour class. There's seven hours of essential learning that we're saying.
Then a bunch of bonus modules. They get the labor warmup in there. They get tips for prepping your body ahead of time and positions for labor, positions for pushing, advocating and working with your team, postpartum, C-section, epidurals, all the things. Then help them make realistic expectations so that when they arrive to you, I hope and dream that you start seeing a trend that those families that take the Bundle Birth class are the dream.
All of that being said, I'd love to transition our conversation because I just talked for a really long time. What is the stigma around childbirth ed? What does the evidence say about childbirth education and why is it important? What are our thoughts and opinions on it? What do you believe about childbirth education?
Justine: It's polarizing. It is we love an educated patient, or we don't love an educated patient. Every time, there's always on the intake forms, "Did you take childbirth ed classes?" "No." I feel like 90% of my patients do say no, but then I'll ask, I'll be like, "Nothing on YouTube, TikTok, Instagram?" Like, "Oh, I watched a few YouTubes." I'll be like, "Great. That's great. You learned about something. What'd you learn about?" et cetera. We can roll our eyes at the people that, well, they didn't do any education, they didn't know that labor hurts, they didn't know an induction can take a few days. What did they expect? Et cetera.
Then you have the patients, they're so educated, they think they know everything, which is frustrating because honestly, they probably do know more than you sometimes. If they take Sarah's class, they might. [laughter] I think that it really matters who they're getting education from. I think that, as labor nurses, we have such a good opportunity because we don't just meet them when they come into labor. We do meet them in triage and we do have the opportunity to talk to providers about what they're recommending for education.
I think everyone should take your class. I got the privilege to see it live, and I've seen Sarah teach a ton. I'm inspired that everyone's going to take this class and then every nurse is going to have a Bundle Birth Nurses Badge Buddy on. Then every patient and every nurse, and we've always said that, is going to be like, "Oh my gosh,-
Sarah: Yes.
Justine: -I know Bundle Birth." It's just this great connection, great for their nervous system, fun for the nurse to be like, "Oh yay." They know that they got great education. It just can be such a huge full circle moment if we do it to our patients to take education.
Sarah: Yes. I agree that it does matter who you're learning from. So much of our education right now is very TikTok. It's very quick. I understand the TikTok generation because I am one of them. I love me a TikTok scroll. Also, how often we've seen that somebody saw the one thing on TikTok, they latched on to, and they don't actually have the full picture. When it comes to something so important, and so meaningful, and so potentially harmful, and so potentially traumatic, for me, my duty was, and where I ended was, "I'm going to give you the class of my dreams and all the things that I hope and dream that someday I can share with the world." I really feel confident about what we've done.
Mind you, going back to your comment about we want them to be educated, but we don't want them to be educated, I think we all need to just take a self-assessment of where do you stand on that, for one. If you're saying, "Uh, they come in too educated. They just need to--" whatever it is, I think that's an opportunity for you to really push into why you feel that way. Or they come in and they've done no childbirth education and you're like, "That's so annoying. How could you not do any childbirth education? Oh God, they're going to be one of those patients." You may instantly think, "I have so much work to do. I can only do so much. Good luck going without an epidural." That kind of thing.
I think those two types of people, and obviously there's a lot in between--
Justine: [laughs] I have to tell you, I didn't always used to be a Bundle Birth nurse. I feel it depends on how jaded you are and how busy it is. I remember I asked this patient, "Did you take childbirth ed?" She was like, "No, I figured I knew how to breathe." I remember thinking, "Well, good luck not having an epidural." I walked out so jaded, and then she got an epidural one second later. In my mind, I'm saying, "That's so relatable. That's so funny."
Sarah: It's so relatable. I'd probably honestly think that as well. I'm not going to lie. "Good luck." That is where I would err on my spectrum of bias, of course, but I think we idolize and we want to make one thing the answer to all the problems, especially what I've heard from providers is, "You don't need to do any childbirth education. We will tell you everything you need to know." I still hear that all the time and my patients are like, "Yes, my doctor told me I don't need a childbirth class."
Let's be having these conversations with our providers, please, because do we believe in informed choice, do we believe that they do have autonomy over their choices, or are we trying to play into the hierarchy of the system? Do we want them to just comply? I realize that makes your job easier. Trust me, we know. If we're trying to level up and level out and be those Bundle Birth nurses that really care to listen and get on their level and help include them in their plan of care, we want them not only included in their plan of care, but owning their experience.
That's been a lot of the vocabulary we've been using when we've been putting together this Bundle Birth website and redoing the copy. It's, "I want you to walk in and have owned it while holding your hand open and not holding so tightly to your preferences that there's no flexibility." Flex and flow, we got that trademark solidified on the plaque and soon to be tattoo. "I'm sure someday you have to be able to flex and flow, but this takes training to be able to be flexible and go with this flow while also holding on to what you can hold on to."
From a provider perspective, when you look at the evidence, does it lower C-section rates? Not directly, no. I will say that especially when you look at the quick evidence, it's, "Well, it doesn't help lower NICU stay. It doesn't help with all the outcomes that all of us are looking for." NTSV, blah blah blah. Right now, mind you, it is in the CMQCC recommendations for supporting vaginal birth. It is number one of five to support the community effort-- I'm not reading this verbatim, so don't quote me on this. Basically, it's have more access to high-quality childbirth education.
That is what we do. Everything's online. Send them to us. We'll take great care of them. Why? Because we know that the whole reason why childbirth education started, Grantley Dick-Read, I believe it was, I hope I'm not quoting that wrong too, is this concept of fear, tension, pain. I talk about this in physiologic birth that when there is fear, it creates tension, which creates more pain. If we take it even bigger, a layer outside of that, from a physiologic perspective, fear equals adrenaline, noradrenaline. Those hormones counteract our labor hormones.
If they have so much fear coming in, so much unknown, so much, "What's this new--" "Oh, look at the room," "Oh, who are you?" "What is happening to my body?" it will potentially affect labor based on what we know about the physiology of how labor works and how it progresses. While there may not be direct correlations, can we say that childbirth education directly caused a C-section or directly prevented a C-section? There are way too many variables. There's not one single study that somebody could put together and organize to prove that to be true. There's too many variables.
There's too many other things going on in the body. We will never have that research. We're fighting the wrong battle. Do we know that it helps people feel empowered and helps them feel they can speak up for themselves? Yes, we have evidence on that. Do we know that they potentially feel better about their birth experience, therefore preventing trauma? Do we care about mental health and PMADs and bonding with their infant afterwards? I hope so. I think we do, but we often forget about that. We know that it helps build them skills and increase their confidence through their labor and birth experience. Many of you might even be that person.
The opportunity that exists during birth, we hear it. It comes out like this, "I have never felt more powerful than when I gave birth," "I have never been more proud of myself than when I gave birth," "I never felt more connected to myself or my partner or my baby than when I gave birth," and they walk away being, "That was the most amazing, transformative, crazy experience of my life," that changed them forever. That's what we want for all of our patients.
Think about how transformational those moments are for that person. We're not seeing it because we're labor and delivery nurses. They are gone and, "Oh, bye. We'll never see you again, maybe the grocery store," and that's it. We have to be thinking beyond the moment of a C-section or not. We also know that when you look at trauma rates, it's not about a vaginal birth or a C-section. It's about did their bodies and their brains receive what they needed in the moment to feel empowered, to feel good about the experience to potentially prevent trauma.
To me, when I hear that, it's, "Well, what are we prioritizing?" We're prioritizing surgery and our own hospital numbers over the patient experience. What we do know is that they feel more confident, they feel they have the skills, they have better communication with their team, they feel more empowered. It supports, especially our underserved populations of people, it gives power back to people who already feel disempowered in their lives, and helps give them a voice to be able to advocate and participate in their plans of care.
We did a whole watch party as a team. One of the things that came out from that, I was just, "Oh my God." That's always my underlying goal, but I wasn't really focused on it when I was teaching the class. The class just came out how it came out. None of it is teleprompted. Maybe the intro, the intros are teleprompted a little bit, but the rest is all just ad lib with a few bullet points of, "Talk about when the water breaks." They walked away and they were like, "It's really deep." I found myself being really reflective.
If you look at the 205-page workbook that comes with the class, it has reflection questions galore and scripts for your partner and additional resources. This is my life's work. I think about how birth ed and what we know there are studies that talk about this long-term impact of their childbirth education class, it's, "What else in your life are you taking a class as an adult about your body to empower you to do something hard?" Remove birth from it, it's such a beautiful opportunity. This is where we're moving as a brand is this concept of labor, birth, and life.
Many of the skills that you gain through our childbirth class-- and also, by the way, we do have another new class that's Visualizations for a Calm Labor, Birth, and Life. You can recommend this to your patients to help down-regulate their nervous system. I give you a little mini class on visualization, the science behind it, et cetera. It's really good. It's only $30. It's also something that's been a dream come true of mine. That's also live.
When we look at that mindset prep and down-regulating the nervous system, and then this concept of all the little nuggets, the reflection questions, the pausing, the feel in your instinct, learning to speak up for yourself, and learning to advocate for yourself, those are life skills. Flex and flow, holding onto what you can control, letting go of the rest. One of my favorites is the teaser for the classes. I have a whole section where I talk about focusing on what is, not what if, and that breaks the cycle of anxiety.
That's where I think about too, "Do we care about the long-term benefit of empowering someone to do something hard and the long-term impact that can take place when they do their childbirth education?" Obviously, I am a supporter of childbirth education. I, of course, want everyone to take mine, but I don't really care where you come from so long as it's going to help empower you to be able to feel like you can own your birth experience through the process.
Justine: Also, if you're like, "I don't know if I want to watch a whole childbirth class," or you're not sold yet by the infomercial we just gave, [laughs] you can-
Sarah: I know. Sorry. I really went on one.
Justine: -watch some of Sarah's YouTube videos. You will instantly get hooked. You're going to learn so much. You're going to be like, "Oh yes." Then knowing that YouTube's free, you can imagine the production value and how much more Sarah put into her class. Also, I want to see the workbook. I didn't think I realized there was a workbook.
Sarah: It is a work of art/a work from the heart [laughs].
Justine: I do want to know everyone's opinion. We need some sort of landing spot for people to tell us their opinion on these topics.
Sarah: Why don't you go to the Bundle Birth class post? I think that'd be a really good place to do it because I would love to start moving the stigma. I understand that, also, you have the patient that comes in overeducated and they think they know everything. That, to me, is also potentially harmful. I'd be curious, what do you do with those patients? If you have somebody that's the know-it-all all, is there any priming that
you do?
Justine: Sarah, I don't have any know-it-alls [chuckles]. There's no know-it-alls. No, my [inaudible 00:29:42].
Sarah: That is so interesting.
Justine: Also, when we do have them, I do feel I would get them because I'm like, "Great, let's do it." I don't have any issues with birth plans, with whatever, with how much education they know. I like to clarify. I think it's important to clarify. I learned this trick from you, "Tell me what tell me what you've learned about Pitocin," "Tell me what you've learned about AROM." Then I can fill in any of the gaps while saying, "Oh yes, that's super interesting," or, "Yes, that is a true statistic that you said, but did you know wthe sample size or did you understand that TOLAC's twice the risk of rupturing? We could talk about what that means."
I don't know, I think clarifying questions-- tell them you're proud of them for doing their education. "That's super great. You took it into your hands, and I'm really impressed with you. It's rare for people to do that these days. You did a lot of work." I think that those statements can go far, especially with their trust because, a lot of times, they'll get all of that education where they'll come armed, they're coming to war. They're expecting to face a general on the other side [chuckles]. When they find you as a person that's, "Wow, you did amazing," and like you've said before, "You did your homework," they want to show you their homework.
I think that that, in itself, is going to diffuse the situation so much because everyone's heightened when they meet you and you're, "Oh, okay, we're chill. We don't have to freak out. She's got it."
Sarah: That is such a good point, Justine. I come from Beverly Hills Hospital where everybody knew more than me all the time or at least they thought they did. Honestly, it was the doulas freaking them out about their doctor, about the hospital, about policies and procedures. "You need to blah blah blah." "You need this and that." How do you disarm a patient in that case? Oh, I did an interview recently for doulas. Basically, they were trying to talk about advocacy in the hospital. I was like, "I'm going to make a controversial statement that I think you need to realize that you are not in your own home. This is the home of the medical world. This is their territory. This is their space."
She looked at me and I could tell she was like, "Oh God, this is not at all where I want this conversation to go." Of course, I kept talking, whatever. I just was like, "And I stand back. If there's something going on in the room, I shut my mouth. I know my role as a birth coach. I know that I'm not the provider. I'm not the clinician. If there's a doctor or a nurse there, it is not my place to speak up." We got into this whole thing where I kept trying to bring it back that, "Your nurses are on your team and you're forgetting that they even exist."
What do we see in our documentaries about birth these days? It's about the doctor, the midwife, and the patient. There's no nurses even mentioned. We know we run the show. Not that I am biased, but I am.
Justine: Okay, [inaudible 00:32:41] how many doulas are just literally ignored by nurses? There's two. It goes both ways.
Sarah: Oh, they are. Right. We need to have this conversation on another episode because I have so much to say about this. They are treated like booty, truly. I had no idea because I only know the nursing practice that I ever did. You know when you walk up in a group, say you're sitting in a circle or standing in a circle, and you walk into a social group and people are, "Oh, hey," and they move out of the way and they acknowledge your existence, it's as if you walk up to the circle and you're like, "Hey," and you're dead to them.
Justine: No one moves.
Sarah: Dead to them. No one moves. No one looks at you. Now, I'm standing here all awkward and you're like, "Ah, I should walk away, but then they're going to see me." That's so awkward. It's awful. I just love nurses so much. I really believe in us. I think there's so much misunderstanding of each other that that's part of the overall picture. In order to disarm a patient, you have to understand that your energy is constantly being co-regulated.
When you walk in that room and the patient's like, "Well, I don't want this," and, "I don't want that," the more in tune we are in our own bodies, the more work we're doing inside to be in touch with how we're feeling. How am I showing up to work today? Am I feeling I have a lot to give or am I feeling like, "Screw the world. I don't want to be here. I hate everybody. I hate my patients. I hate my assignment. I'd rather be doing this. I tried to call out and then they told me no and then I sucked it up," and whatever? I'm coming in with a terrible attitude. "This is why [unintelligible 00:34:22]."
When you feel that elevation, the more down-regulated you are, the more calm, the more your internal nervous system is unaffected. You're like, "Great, I love that. Tell me more." [inaudible 00:34:37], "Well, I don't want this." I'm like, "Okay, all right. I'd love to understand why," or, "Okay, I hear that that's important to you. What about this? Is this also important to you?" Now they're like, "What?" You got to go give them the opposite of what they think they're going to experience. That piece goes such a long way when it comes to building rapport. Then, all of a sudden, what you do is they down-regulated their nervous system to co-regulate with yours.
We talked a lot about this at MOVE or even in Physiologic Coping. Then, all of a sudden, you can have a conversation that then you can push back maybe on some of those preferences. The initial of being, "Well, but what about this?" "What if this--" "Well, this might happen." Meeting fire with fire only creates more explosion versus meeting fire with water. It's, "Oh, okay." Obviously, when something comes up, then you've built that rapport to say, "I know this was so important to you," you've listened to them, they're already like, "Okay, we got a good one," then it's, "Your blood pressure's elevated. I need to take another one. This is where we're going."
Doctor comes in, "You're diagnosed with chorea. What does this mean for your labor? Let's adjust." Even the language we choose is a component of what I learned through childbirth education because what would happen is I'm in classes and I'd use one wrong word and I'd see the whole room start to spiral down the hole of, "No." I got to [inaudible 00:36:04]. Now you're trying to backtrack or I'd teach something and five hands would go up and, "Oh no, what did I say?"
We see that where, the patient, everything's fine. Then, all of a sudden, that one word, they're like zing, they're woken up and they don't trust you anymore. Again, I really think that a lot of the skills, not only that patients learn, but also we learn through learning the process of childbirth education can really be that transformational on the big picture stuff, not just learning the mechanics of labor.
Justine: If we can be that water to the fire and I don't want the fire to be doused, I feel that's not a good-- because I like that they are fiery and they know what they want, but we can control the fire a little bit better for the next nurse because maybe not every nurse is going to practice the way you do, but you can be like, "This is what I've clarified. These are her wishes." You can help set them up for their care throughout the whole time. What can be troublesome when we're listening to episodes like this of, "Yes, I can do what I do and I can be the nurse I am, but Sally's going to come on and ruin the whole thing," which sucks.
Also, when you're giving report to, especially bedside report, and I know a lot of people have feelings about that, but this is where bedside report is so important because, one, you can build up the other nurse in front of the patient, "Oh, this is Sally and I'm going to explain everything to her on your birth plan. We're going to go through everything. We'll talk about all the questions we've gone over and worries," and whatever. Then Sally is going to watch you do that and be like, "Oh, okay. I got to show up. She's just built me up so much that I'm going to create this plan and go through with it." I don't know. I really bedside report, but that's a whole nother episode.
Sarah: That's a very good point because I know it's easier, the patient's sleeping or whatever in certain cases, but bedside report is a thing because of research [chuckles] and it's for the patient as well. The goal is that they're included in their plan of care because you're not hiding anything from them. It creates this transparency and also accountability to how we talk about our patients.
Justine: That's all. This is a good jumping off point for another episode.
Sarah: Moral of the story is we believe in childbirth education around here. The evidence supports it in ways that are also important to us. One of the things I love about this podcast is that it allows us to just sort of rant about random things that maybe we wouldn't have a conversation about or have a hyper-focused conversation about. I hope what you experienced through this episode is just an ability to think outside the box a little bit and consider, do you support childbirth education, do you your patients being educated or not?
My recommendation to you all going forward, of course, is going to be to head over to bundlebirth.com and check out our new website. When you click around, know that Bundle Birth is for everyone. Our whole goal from the very jump is not only-- well, it started from educating and supporting families, and really helping families feel seen, safe, and soothed, owning their experience, and that the experience when they show up is one that is empowering, that is confidence building, that does give them control while also helping you live your best lives by giving back to those patients that you are caring for.
Please take a childbirth class. If you're like, "I already got my childbirth thing down," take the Physiologic Birth class. Keep learning, keep educating, keep getting better, continue to level up your care as always. Head on over to bundlebirth.com and check out all the fun things that we have going on. We'd love if you would recommend us to your patients, to your doctors, to your clinics, to your antepartums. Hopefully, what you're experiencing as a result of that is patients that show up informed, confident, ready to work with you, ultimately, ideally making your job easier where then you can just relate the current situation to the knowledge that they already have.
Justine: Thanks for spending your time with us during this episode of Happy Hour with Bundlebirth Nurses. If you like what you heard, it helps us both if you subscribe, rate, leave a raving review and share this episode with a friend. If you want more from us, head to bundlebirthnurses.com or follow us on Instagram.
Sarah: Now, of course, it's your turn to go and take the Bundle Birth class. We'll see you next time.