#124 | Provider Red Flags: Your Second Trimester

September 15, 2021

We are back today with our 2nd episode in our three-part series on provider red flags. In this segment, we discuss the key issues that may come up in your second trimester and will get you thinking if you are in the right place with the right provider...think glucose screening test, discussions around baby's size, doulas, attention to your emotional well being,  provider punctuality and conduct, etc.  If you haven't heard our first episode on provider red flags, you can catch it here: #118 | Your First Trimester: Provider Red Flags

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You can sign up for Cynthia's HypnoBirthing classes as well as online breastfeeding classes and weekly postpartum support groups run by Cynthia & Trisha at HypnoBirthing of Connecticut

Please remember we don’t provide medical advice, and to speak with your licensed medical provider related to all your healthcare matters. Thanks so much for joining in the conversation, and see you next week!

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View Episode Transcript

Should your provider say anything about your pelvis shape or size, you might want to be thinking about moving on, you want to be with a provider who is also aware that birth is a highly emotional and mental experience, not just a physical and physiologic experience this area, but if they don't support that, or they discourage it. This is such a huge part of normal variation of vaginal birth that to me, that just means what else are they not supporting?

And what they do in many hospitals is they quote, let you have your baby for a few minutes like, Oh, yay, there you go. Congratulations. Take a minute to meet your baby. And then they take the baby away.

They can go onto your shirt if they even need to do that. But you do not ever need to put that horrible crinkly paper piece of crap on your body.

Would you like to cover up? No, I'm good. No, thank you. I'm good. Just the way I am. Are you uncomfortable? Am I making you uncomfortable?

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hello, and welcome back to our red flags series. As you may know, from Episode 118. Last month, we talked about first trimester red flags provider red flags. And we're back this month to talk about red flags that may come up in your second trimester. Are you ready to go Trisha? Yeah, all right, we just can't get enough of this topic. We're going to be back again next month with third trimester red flags. But today we have some important ones to talk about.

There are so many in the third, it's almost ironic how we post through pregnancy, we often post the pregnancy also feeling really good about our provider, but so much goes down at the end of the third trimester. And that's really when you get to know them very well. And there's almost no way to accelerate that process. Because there are some things that you just have to wait until the third trimester to start talking about and experiencing. But there are some really important ones in the second trimester. And that's what we're here for today. So Trisha, what do you have?

And just just to add to that, I mean, it gets a lot harder to change providers late in pregnancy. And of course, that's why we really want to think about these red flags in the first and second trimester and in really become aware of them and hone in so that if we are getting, we don't need to see or how red a flag can get. Right. If we start to see signs of red flags, we make a change before it's just blatantly in our face. Like we have no choice, we have to do something. Right. Markets touches what usually happens right around like, you know, 3738 weeks, oh, my God, my providers not really on board with what I want. Now what?

Yeah, and I think this is why and I think I mentioned this recently, but a really good chunk of the homebirth clients I've worked with over the years, had a home birth only because at the end, they were just out of options. And a home birth midwife accepted them, but they just said, Wow, that like I'm at the end, and no, I can't even transfer anywhere else. You often can. But sometimes after 36 weeks, it does get hard. And it turns out to be a blessing in disguise for people who never considered a home birth before. And suddenly, they're like, gosh, it's not even what I wanted. But I just the other options are not acceptable to me. So they ended up having one witch and it's it just becomes an interesting birth story for a lot of people. So yeah, that's fine when it goes that way. But ideally, we're coming into a home birth, wanting a home birth planning for a home birth from you know, very early on that we know that that is the ultimately the best and safest way to have a home birth. But it's definitely true. This is how a lot of people end up on the path of home birth even. That goes for me remember I had no choice but one provider because I was in graduate school, I had the Yale health plan. I was having my baby at Yale New Haven Hospital with who knows who from the practice, it could have been anybody and residents and all that. And I chose home birth because not because that was my intention from the beginning. But because the other options were just not going to work for me out of options.

The majority of our listeners and the majority of my clients do birth in hospitals, about a quarter birth in birthing centers and somewhere between five and 10% seem to be having home birth. Probably our followers on Instagram might be a little bit higher. 10% range. Yeah, it seems like there's a decent home birth.

Well, nationally, it's only about 1% of people having Homers.

Yes, it's about 1% Right. Yeah, I used to you know if anyone had asked To me in my first pregnancy, who I thought was having all the home births, I would have pictured like hippies, and really laid back personality types who were just sure everything's gonna go well, but actually, it's it's a highly educated population, for the most part a very conscientious people who have are very into their research. And I don't think anyone goes into it with too light of a heart. It's it's always, it always, really makes you think a little bit.

I think it can be one way or the other. You've got the people who make Excel spreadsheets in their spare time like yourself, thank you so much for that.

Are you have, you know, they're really off the grid, people who, you know, there's just no way they're going to a hospital and there might even be free birthing. Right. But then you also have a lot in between there really is I mean, in my experience as a home birth midwife, I've had clients that cover all ranges of personality types, lifestyle, choices, everything.

Yep, absolutely. But back to provider red flags, because this is a process. Unfortunately, pregnancy does last at least nine months and gives us time to really make sure we're going to be with that right person by the time we're in labor. So the first one is now that you've been going to your provider for a few months. Have you noticed if they're taking you on time? Are you waiting a long time in the waiting room? Are you waiting a long time wearing that little paper gown in the office before they come in?

Okay, just stop right there. Why does anyone need to wear the paper gown? Don't put that shit on?

It's very difficult to feel powerful wearing one of those things I think.

I don't know why you're right. You think so? Put that on? Well, then you're just naked. No interviews just stark. Naked. You show them who's boss. Battle try them off. Mmm hmm. Would you like to cover up? No, I'm good.

No, thank you. I'm good. Just the way I am. Are you uncomfortable? Am I making you uncomfortable? No. So just Okay, first of all, there's no need to take your clothes off. For any reason, if you're having a pelvic exam, you can take your bottoms off, you do not need to take your top off, you don't even need to take your top off to have a breast exam. But they can go onto your shirt if they even need to do that. But you do not ever need to put that horrible crinkly paper piece of crap on your body says the expert. No piece of crap shall be on the body.

You know in, in my practice, we use baby blankets to cover up your bottom. So you take your bottoms off, if you're having a pelvic exam, and you've covered yourself without a cute soft little baby blanket. Yeah.

So back to the duration of your waiting time, pay attention to that, track it track when you walk in, compared to when your appointment is. So I'm thinking of why so many things are coming to mind. But I'm thinking of my own days of when I would show up at about 755 for my 8am appointment. And I was kind of stewing by 8:45, when they still hadn't called me in and I was supposedly the first day of the day. This was time and time and time and time again. And all I can say is I can't believe I was ever that person who tolerated that because I would never go to a doctor now who kept me waiting on a regular basis. I think it speaks volumes about that provider and about that relationship and my doctor would and then I would go wait in the room wearing that little thing. I would undress and sit there cold. This was pre iPhone. So you have to have a lot of sympathy for me because I read all this. I always say that because I read all this awful magazine to do with yourself. I read all the magazines I would never subscribe to and was bored out of my mind. And just I really, it was hard to wait because I was feeling so resentful because you know how punctual I am and how I respect people's time. And it's difficult when when, when you can see that your time isn't respected. And I've mentioned this on the podcast before but I once went over to the receptionist and I was like, what is happening? How come every time I come? I make the first appointment of the day. She never sees me before 915 Or so never. And then the receptionist said oh, sorry, she was triple booked at 8am. And I said first of all, I don't know how you can see three people at the same time. But even if she were to do that, she sees me for five minutes per appointment. So she would be seeing me by 810 I am even if I were the third of those three people, where is she? So she was just laid once I saw her just going past an office in the back coming in with her hand back and I was like son of a gun. It was after 9am And I thought she just comes in late she just lets people wait. And then she spends three or four minutes with each person and catches up at some point. So that was how it went. So that was my next comment. How long are those appointments if They're basically coming in measuring the baby, getting your weight, getting a urine sample and saying, All right, any questions, okay, you're good to go, that is falling short of the quality of care you deserve. And there is no way to give you sufficient quality of care. In an appointment that's only 10 or 15 minutes, it should be at least a full 15 minutes. And if you're going to midwives, it will often be 30 minutes, 45 minutes. If it's a home birth, you're looking at 45 minutes an hour, you're looking at a hug at the end of that appointment and a home for the tea cup of tea. It's a whole different experience. You deserve to be seen on time. And you deserve to have a good amount of time with that provider to get all your questions off your mind and you have questions even when you think you don't you're lying awake at night thinking about stuff. They should be your go to, when you're with the right provider to bring those questions. All right, what do we have

you got it? All right. Next is how does your provider feel about professional labor support? Slash doulas? Do they support having a doula? Do they discourage having a doula? Do they totally dismiss the idea? Serious red flag. doulas are evidence based that we know this having professional labor support in labor actually reduces your chance of having a C section by 50%. That's huge. So anybody who dismisses or discourages professional labor support is not an evidence based practitioner and has a big fat ego.

Yeah, I mean, when you think about it, who would want to rob you of having loving hands on and emotional support in your labor. I mean, they say no to that or discourage that

they should be fully on board with that it makes their job a lot easier. But of course, they think it makes their job harder, because the doula is providing support and advocacy for the woman who might be wanting to do things differently than her provider is suggesting. So in that sense, they feel it makes their job harder. But ultimately, if you're with a good provider, they will realize that having professional labor support makes their job far easier and makes your birth safer. I mean, as a midwife, I love it when people have doulas. It's just another person to be there to support the mom to get the things they need to offer, you know, loving touch to it, you know, it's more of a team effort.

I just yeah, it says a lot about a provider if they wouldn't support heaven and doula not not only because it's evidence based, but it's like, Jenna, that whole thing like remember who's in make sure the jewelry members who's in charge, so that they it's like they're discouraging your empowerment, and your autonomy. And I wonder sometimes if they're afraid of having a witness in the room of professional witness in the room to any injustice that might be perpetrated, like and a PC Atomy without a woman's consent, which we know happens three out of four times in this country?

Yeah, I think it just feels like another person to interfere with them being in control of what happens in the birth process.

Right. Next we have back to those prenatal visits. Are they asking how you're doing emotionally? Are they just checking on the heart rate? Are they just checking your blood pressure, your urine? Are they asking how you're feeling? You know, a really good provider is going to know and ask, if you have well, they at least will ask Do you have anything you want to share with me that you think might potentially come up during this birth? Are they giving you the opportunity to share if you've had any experience with sexual trauma, medical trauma, any emotional concerns, any stressors in your relationship, any abuse going on? All of these can come up during birth. And you want to be with a provider who is also aware that birth is a highly emotional and mental experience, not just a physical and physiologic experience?

Yeah, it definitely. The focus is usually on the baby. It's pretty standard to do like, maybe a minimal mental health screen. A simple question, do you feel safe in your home? Something like that, but to really ask, you know, how are you feeling as your pregnancy progresses? Are you having any challenges with your partner? I just what you said, I mean, you kind of already went through it all.

Well, another reason this is just so important is that for a really good percentage of women who have postpartum depression, symptoms began during pregnancy. And I've worked with so many women who can understand why they become pregnant and end up feeling depression and anxiety. So those perinatal mood and anxiety disorders can start in pregnancy and I just I find it unbelievable that this isn't a rote standard part of all medical providers work that they are checking, first of all, educating women. And second of all, checking with them and helping them to understand how to mitigate the effects of those disorders, like getting community and getting support in pregnancy and not just focusing on the physiologic experience of pregnancy and childbirth. I remember I was trained to ask about those things. Or did is it just that the good ones do ask?

I think it's more that they are trained to build a relationship with you. So it just comes with the territory and building a relationship and a friendship. I mean, it's no, we You're certainly trying to screen for domestic violence, and, you know, a woman's safety. But as far as just like her overall emotional well being. Yeah, it's part of the holistic care. So yes, I would say they are trained, but it's also just in their nature, as your midwife who wants to be a trusted partner in your birth, it's normal to ask those questions. Alright, are we ready for the next one?

Yeah, we're ready for the next one.

So this is a biggie, the glucose screening tests, this always comes up in your second trimester. And the glucose gate screening test is done between 25 and 28 weeks. And your provider puts a lot of emphasis on the importance of this test, and may tell you that you have no choice but to take this test. And even if you wish to decline, they may tell you that you can't. And they also may tell you that there are no alternatives to this test. And any of those positions to me count as a red flag, because there certainly are alternatives. And it certainly is an OK test to decline. It is important that if you do choose to climate that you know that you may have your baby may have extra monitoring after birth, it may put your provider on the lookout for big baby even more so. But I think it's more just the concept that you know this, that there are no alternatives to this test. And that there that is a mandatory test is a red flag for me.

If anything is presented as men as being mandatory, well, if you're ever told you don't have options, no matter what it is, that is always a red flag.

This just to me seems like a test where in most cases, women are being told that. So that's a red flag for a lot of providers. I mean, even a lot of midwives are going to tell you that. So then you have to dig a little deeper with them, I guess and determine why, why what why are they saying that is mandatory? What are they so concerned about, and obviously, with gestational diabetes is what we're screening for. And with gestational diabetes, there are certain increased risks to you and your baby and late pregnancy. But this is really more just about if your provider says there's no alternative, there are alternatives. If your provider says you have to have the glucose screen test, you don't have to have the glucose screening test, if you don't want to, you have to know that there may be certain things that you will be subjected to, or your baby could be subjected to blood sugar testing, you know, post birth, something like that, but you always have choice. And this is one that providers, most providers are going to tell you that you have to do. And if they are unwilling to listen to your reasons for seeking an alternative or declining the test and I consider that a red flag, There absolutely are alternatives. And there actually are alternatives that are far better indicators of how your body actually metabolizes carbohydrates than the one hour glucose test.

Okay, the next one I have doesn't really have a succinct term to go with it. But it's basically around whether you feel belittled, whether you feel talked down to whether you don't sense you're being taken seriously. So here are some examples that that I would identify as red flags. One is that I personally feel a red flag going up if a provider ever tells me not to do my own research. You know, I've gotten some of the most important information in any of the work I've done in my life online, you just have to know what resources to find online, I would never go to like a news article where you don't want to get your information from the wrong place. But there is data that is published on the Internet, whatever it is, you want to be looking at the data and if you're able to do that, I'm willing to do that. And anyone dares to discourage that. I think that's a red flag. Another one in this category would be if they are discouraging your childbirth education, that is a major red flag or if they're trying to get you to take the childbirth education class offered at the hospital and focus on a childbirth education class that isn't teaching what happens in childbirth because that's not really the information you need to know what you need to know is how to make your choices. So focus on a class that teaches you how to choose for yourself how to have autonomy because you don't need to know what happens. That's really what the cervix like, that's just gonna happen, your body's gonna do what your body's gonna do.

You don't need to know. That's your that's exactly what is the case in HypnoBirthing. Because the deer doesn't know. Right? That elephant doesn't know. Right?

You don't need to know.

They don't, you don't need to know, it's, it's nice to know, sometimes it's interesting, if it brings a bit of trust, but you don't need to know. It's always a matter of restoring to trust. And then really what I what I like to say to people is, look, this childbirth class would be about three or four hours long, if we were all still just giving birth out there in nature, it would just be a few hours long, how do we really relax the physiology and focus the mind and calm the mind. But we're giving birth at a very unusual point in history, that there is so much more to learn around procedures and protocols and these unnatural circumstances in which we're giving birth. And that's where the real value can come in. And in managing that provider relationship. Anyway, back to this red flag. If you're discouraged in any way, remember, you have the right to get educated wherever you want to Google, whatever you want to make whatever birth choices you want. And you're looking for a provider who respects you in making those decisions. Because it is your birth, it's not theirs.

And a good provider will give you some guidance on that. They'll say hey, go check out this fabulous person's blog, I really support what they believe or go, you know, look on evidence based birth, something that is known to be good information, good quality information, anytime I've ever published in this field. It was such an exhausting and stressful process for me, because I was meticulous about citing all of my sources in the article because I wouldn't expect people to simply read what I was putting out there and take it as law I would say a study in 2007 showed this the World Health Organization published this in 2012. And then people can take that and go read the research. But what I can't believe and when I could never believe when I was doing that research was how much is out there, where it's just a regular journalist who says yeah, sure, I'll write something about childbirth. And then they just call a doctor. I was, I think it was Fox News. They offered to come to my business and do a whole mini segment to do a whole segment on my work, because a client of mine had a home birth and they whatever long story George Bush's daughter was involved in, in that, in that anyway, when they when they contacted me, they said, Well, we're also going to have an an obstetrician in the segment, just to comment on the things you say. And I was like, You know what, forget this. I'm not going to have some doctor who just because they're a doctor to say yeah, no, that's not right. There's no way if I speak I'm going to cite the evidence. And but that that white code is so powerful, that they can put rhetoric out there, and it usually is enough for a journalist to publish.

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Should your provider say anything about your pelvis shape or size you might want to be thinking about moving on.

Your pelvis is too small actually, when I was in midwifery school, we did learn how to assess pelvic shape and size and it was even charted for what that was just what kind of topics they have. It's no longer a practice like we know we not we know we've always known that the pelvis changes in birth the pelvis shifts and moves and as it's practically pliable, it opens it expands right it gets bigger.

Well we know it can increase 30% by weight depending on what position you're in. We know that the hormone relaxin plays a huge part in it that is really not just about the bony shape of the pelvis. So if anybody tells you that your pelvis shape is too small, too narrow, where your body size is, you know, high risk if you're four foot 10 baby's probably not going to fit through all of that is nonsense. You're body will grow a baby. That is the appropriate size for your body and your pelvis will shift and move in pregnancy. And we talk about this all in birth. Talk about this all the time that how your baby's position is so much more important than much pelvis looks like.

Okay, and the next one that we're going to cover is what are the standard procedures and protocols around bonding and newborn measures after the baby is born, you have to just envision if you're birthing in a hospital that they likely do serve many hundreds, if not a couple 1000 women a year and they have their routine way of doing things. And when you're pregnant, it's easy to just focus on the birth, the birth, the birth, but once you have a birth story to tell after the fact, a lot of what you're going to talk about is what happened after the baby came out. And that's because a lot of our satisfaction has to do with how thoroughly we were given space to bond wholly with our babies short of a medical indication around the baby, if the baby comes out a little blue, they need oxygen, if they come out with an inordinate amount of meconium. They might need some cleaning, they might need some suctioning, but short of any medical need, there should be no separation of your baby from you. It wouldn't be evidence based to do so. Now you might be thinking, don't they have to weigh the baby? No, not really, they can eventually get around to weighing the baby, but there's no need to really weigh the baby. They'll eventually do that maybe in a couple of hours. You want to put the baby's skin to skin right on your stomach and let your baby adapt and just get kind of re acclimated to being on the outside and recognize where they are and take their time, crawling up and maybe latching on. And you might be thinking don't they have to bathe the baby? No, they don't have to bathe the baby, your baby is covered in vernix, which is really precious and valuable to your baby and is intended to go in through the skin into the bloodstream. So if and when they bathe the baby, there's no rush to do that your baby comes out. Clean, your baby comes out immaculate. You can fully decline bathing the baby and bathe the baby in a day or two. Okay, if the baby with that, don't pay the baby, don't pay the baby, you can eventually bathe the baby in days, there's no rush to be the baby. But nothing should be more sacred than keeping that mother infant bond intact. Again, if there is a medical need to separate the baby, you'll be the first to know it, you'll be the first to let go and say take the baby help the baby.

Even if the baby did need some sort of medical intervention, we'd be keeping the mom and baby's still connected and doing whatever we needed to do next to the mom or on the mom, even if it were possible.

That's that's that's true. Well can you name an example.

So let's just say the baby wasn't breathing and the baby needed a little bit of positive pressure ventilation, like to take the first breath. Rather than cut the cord and separate the baby. Keep the mom and baby together bring you know the Ambu bag over to the baby and give the baby a breath or use your own mouth. I've even asked moms to blow into the baby's mouth. If the baby is having a hard time starting to breathe, pick your baby up to your mouth, put your lips against theirs and give them a little bit of positive pressure. That's the thing that helps open up the lungs. You don't actually have to separate them in the hospital that would be quick. Baby's not breathing, clamp the cord over to the warm where we go. Now the mom and the baby are 15 feet apart. The cord has been severed and they're not getting any more of their own blood that's helpful for their body and their oxygenation. And you know, we're resuscitating them far away.

You just touched on another important one that they should absolutely support delayed cord clamping so your baby gets all of his or her cord blood. But yeah, thanks for that reminder, Trisha, they can and just you know examining the baby, if a baby's born mostly we're it's a lot of visual examination, we might want to listen to the lungs and make sure that baby's breathing, we can listen to the heart back and all be done on the mom.

Absolutely. And what they do in many hospitals is they quote let you have your baby for a few minutes like Oh, yay, there you go. Congratulations, take a minute to meet your baby and then they take the baby away. That's what we want to stop. There are many hospitals still who have a nursery where they put all the Healthy Babies after they're born. And just by design, there is separation. And that sometimes so the pediatricians can check the babies without having to interface with the parents but you can decline you can say there will be no separation of the baby from us. And they can't remove the baby from you if you don't allow that. So this is again choice that you have, but it is evidence based to keep the baby with you.

I do want to add one thing, sometimes after immediately after birth and after the mom has had a child To see her baby, examine her baby smell her baby. I do see that sometimes women, they want a moment, you know, they want this, they want to sort of just recoup and recover. And they may put the baby next to them or pass the baby off to be skin to skin with the Father. And so that's I just want to make sure that mothers don't feel like if you separate from your baby for five minutes, you're doing something wrong.

Yeah, it's, it's, it's your choice. And sometimes you need to sleep and sometimes you need rest afterwards, but it's worse. Or sometimes it's just a few minutes of like, oh my god, I just finished giving birth and I just can't even I can't eat. I've seen moms have a hard time just holding the baby.

Right? What we're looking to avoid is the is the postpartum couple or the mom herself who says, I want my baby, do you have to take my baby? And they say, Yes, this is what we do. No, that doesn't have to be what they do. It is entirely your choice. To what extent you're holding and bonding with your baby post birth.That's the key. Should we throw one more out there? Yeah. Okay. Because this will most likely come up in your second trimester also in your third but more likely in your first or second. provider who discourages or flat out denies trial of labor or a VBAC. major red flag. If they do not support vaginal birth after cesarean. They are missing a huge element of a normal variation of vaginal birth. Outside of the very, very few exceptions were vaginal birth after cesarean is not possible. Okay. We're not talking about those ones. We're talking about the vast majority of people who can have vaginal birth after cesarean. But if they don't support that, or they discourage it. This is such a huge part of normal variation of vaginal birth, that, to me, that just means what else are they not supporting? That's normal in childbirth. It's one of the reasons that cesarean rate our cesarean rate in the US and other countries is so high because so many people are having repeat cesarean and not being offered vaginal birth after cesarean. 80% of the backs are successful, and that number should actually be a lot higher that number in homebirth is closer to 90%.

And this includes VBAC after multiple C sections, not just one, because all things equal in the United States, there is an exponentially higher rate of denying a woman the right to a VBAC, if she's had more than one cesarean section. I cannot believe what women who've had two cesarean sections have to face like they go to having almost no provider who supports them, they have to go through so much more effort when they have every right to have a vaginal birth, as a woman who has had one cesarean section, again, any special circumstances not withstanding,

I'm not sure what the percentage of women is that's having a vaginal birth after toussis variants. But we know that the percentage of women having vaginal birth after one cesarean is only 13%. And it's probably like less than one person after two. And we just have to deduce from that that it's provider support. If if vaginal birth after cesarean is so successful, and only 13% or less of people are having it, and where why it's coming from providers. So for us, this is a big one, this is a big red flag. And it's a huge reason that we see so many of our members of our community change providers. After looking at this list, and the sounds like we've probably eliminated most of the providers out there. Good luckGood luck with not finding a red flag. Yeah, it's like, good work just as long as you're aware of the provider you're dealing with, you'll learn how to manage them better. Don't take it too hard. This, these are very high standards. But if you're going for those high standards, you know, we're laying it out for you. Again, if you see a red flag or two, it just helps you to manage that red flag that much better if you are sticking with that provider. But we have a little bit we all have a little bit different threshold of how red we allow a flag to get before we make a change. So you know, you don't have to leave your provider the first time they make you late for an appointment. Don't do that, you know, like, but the second time they are out. Second time, no one knows if I'm serious. No. The other thing is, you know, sometimes, very frequently, I have clients who are they're just conflicted, like they take the first class, they're like, oh my gosh, I don't know. I don't know. I don't know if I want this provider. I thought I did. And I don't know what I'm having doubt. And what I say then is listen, you don't have to make a decision right now. Just when you feel that way. switch into observation mode. Just observe. Let a part of your mind simply detach and observe and just take notice of what's going on. That's all and promise yourself. You're not going to make a decision let's say for depends on how far along you are. But let's say you're going to give yourself a two week or one month. brake you will not think about you will not talk about whether you're staying or leaving. But you're just going to keep observing, you're going to be neutral and you'll keep observing and taking in information. It's just going to calm you a bit. But you more into your rational mind, the answer is going to bubble up and come up for you but you don't have you can't sit down and force yourself into a decision to suddenly you really do need to sit with it, and let your intuition rise up. So that's all we have for you today. Thanks for tuning in on this red flags in your second trimester episode, you can always reach us at downtobirthshow.com or on Instagram @downtobirthshow.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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