Welcome to the July Q&A episode with Cynthia & Trisha. Today, we kick off the conversation with a story of an OB commenting on the "tightness" of a woman's perineum. Next, we jump into our questions on when sutures are or are not needed after a tear; placenta previa and a prolapsed cord; the risk of infection after rupture of membranes when GBS negative; how to get oxytocin flowing when your spouse is not present at birth; are there risks in pregnancy and postpartum if you have Irish twins; could I have birthed my frank breech baby vaginally even though the hospital said I could not, followed by Trisha's story of her one and only breech birth experience as a midwife. In the extended Q&A, we discuss the difficult decision one mother faces when the only available midwives don't align with her birth choices; a woman whose toddler developed significant tooth decay and questions teething oil over breast milk as the culprit; another mother who is told her baby is not gaining weight well because her breastmilk has an insufficient amount of calories, and a woman who is struggling with appetite due to her stress and anxiety and worries how it will impact her pregnancy. Finally, we close with a round of quickies including Cynthia's and Trisha's biggest pet peeves in life. Work with Cynthia: Work with Trisha: Please remember we don’t provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
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Welcome to the July Q&A episode with Cynthia & Trisha. Today, we kick off the conversation with a story of an OB commenting on the "tightness" of a woman's perineum. Next, we jump into our questions on when sutures are or are not needed after a tear; placenta previa and a prolapsed cord; the risk of infection after rupture of membranes when GBS negative; how to get oxytocin flowing when your spouse is not present at birth; are there risks in pregnancy and postpartum if you have Irish twins; could I have birthed my frank breech baby vaginally even though the hospital said I could not, followed by Trisha's story of her one and only breech birth experience as a midwife.
In the extended Q&A, we discuss the difficult decision one mother faces when the only available midwives don't align with her birth choices; a woman whose toddler developed significant tooth decay and questions teething oil over breast milk as the culprit; another mother who is told her baby is not gaining weight well because her breastmilk has an insufficient amount of calories, and a woman who is struggling with appetite due to her stress and anxiety and worries how it will impact her pregnancy.
Finally, we close with a round of quickies including Cynthia's and Trisha's biggest pet peeves in life.
Work with Cynthia:
Work with Trisha:
Please remember we don’t provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
Hi, Cynthia and Trisha, this is Alexandria. I love your show. What are the ways to check for a placenta previa, and the potential of a prolapsed cord during birth, I love listening to your podcast and I just feel so prepared for my home birth coming up. Unfortunately, my husband will be overseas and won't be with me when we welcome our baby boy. So I was wondering, what are some other ways to get the oxytocin flowing, but without my partner? My third question is, could I have actually declined the C section and they would have had to let me burst the way I wanted to, you know, where's the filter? Like? Maybe you had that thought? But why are you saying even having the thought, you know, they say your thoughts or what do they say your thoughts are like on your, on your forehead or something you're like wearing your thoughts. I believe that if you're if you're having thoughts like that working with women, we consider your line of work.
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.
Yes, I'm here. I was reflecting on a birth story processing session we did. And I just thought we should talk about it because I like to. I like for us to point out the you know how extreme some providers are. And in this case, the woman at her 36 week prenatal appointment, the doctor felt her perineum. He like assessed her perineum. He touched on it. Why? Well wait to hear this. He he evaluated it. And this is what he said to her. He said, You have a tight perineum, you're definitely going to need an abuse Yatta me
it that's gross that's like when your OB told you at nice tan lines. That's what it reminds me. Oh, that was it. Yeah, that wasn't my OB that was my first ever annual GYN appointment. I was very very young woman. So inappropriate. Nice, nice tan lines. Yeah.
We don't need to comment on the the tightness or lack thereof of anyone's perineum.
I mean, pair names are intended to be tight, their taut skin that they're everybody's everybody's a little bit different in that way, but I mean to say you're gonna need an episiotomy is so false. And I just think we need to point that out because perineum does stretch when the baby crowns.
Regardless, it's still better to tear than having a Pz Atomy true because if even if it is tight and more prone to tearing, if it tears, at least it's a tear. If you snip it first, it is more likely to tear further.
And if you tear your best off not being sutured in many cases and yes, and healing naturally. But you know, it's the kind of thing that you know, he gets away with saying to every single woman if he so chooses, because what do we know about whether that's a type perineum or normal, right? I mean, he says that and it's, it's done. The negative belief is there.
Well, also, I just think it's inappropriate to be evaluating somebody's perineum, but it just feels totally. It feels like shit her evaluating him you're scrolling, right? Let's see how tight or not your scrotum
- ah, that would be rude. We can't have that.
Just like when they comment on the size of their, you know, a woman's pelvis just come right back at him with the size of their penis.
You can't No, you can't do that when you're alone in a room with a man. You can't make comments like that. But then he can't make comments like that. That Well, there you go.
So let's just not make these comments to each other.
Okay, so, wait, was there a story it was there? Were you going to read something?
No, no, I just was remembering that and I was just feeling a wave of offense because it's very sad to me. You know, we're joking about this stuff because it's, it's crazy and it's you know, there's there we can we can see it. humor in this theoretically, but when you actually think about the fact that a woman was sitting there and heard this, she easily could conclude she was going to need that intervention. She hears that she'll believe it.
100%. And that's it. Yes. I had a woman just the other day who had an episiotomy, and I was floored. I was like, who's still doing that? Yeah. Why?
Well, anyway, there's no shortage of stories like this, of course, routine episiotomy? And I would say 99% of the abuses atomies that are performed probably don't do anything. But harm, right. Yeah. Never done. One. Never done one. You've never done one. We're done.
All right. Shall we start our questions? Yes. All right. Let's get to it.
Hi, Cynthia. And Trisha. Thank you guys so much for everything that you do in educating and sharing with us moms, birth workers, anyone who's interested in listening. I had a question for you. I couldn't find anything on tutoring when I searched the podcast. But my question is in regard to declining sutures. I had my daughter around this time last year, and I had two very minor tears. One was a label and one of them was a perennial. I gave birth at a hospital, the midwife with my permission, she did not give me a numbing agent, before stitching me. So she was like, this is literally only going to require one stitch on each of these. And I didn't know better at the time of like, oh, well, tears that are minor, like just let them heal on their own. And so yeah, I consented to getting the stitches without a numbing agent or anything. And I think I would like to know how I can be more informed as to when is a more ideal time to go along with the stitching? And when would be fine to decline? If and when I do decline. Next time. How does after care look differently? So? Yes, thank you so much.
Are you gonna say your bit about two sides of the same vagina finding each other from across the room?
Yes, if you put two sides of vagina in the same room, they will find each other no matter how far apart they are,
like long lost loves. Yeah.
So I can't not attract each Oh, when does it make sense to suture.
Anything that's in the third and fourth degree territory require sutures anything in it, first degree and some second degrees do not. So first degree almost never second degree, that's where you really kind of have to leave it up to your provider to determine I'd say more often than not, you can probably leave second degrees without sutures. Because the vagina does heal very well. And this, the suturing is just you know, it's actually putting all more breaks in the skin. But it is really important. If you don't get stitches, the benefit of the stitches is that you know that tissue is held together more tightly. Sometimes too tightly. Lots of women have problems with the sutures being too tight and it causing pain afterwards. But if you don't do that stitching, you really have to keep your legs together to kind of let that skin heal. Because if you aren't careful, has two sides of the same room, they truly cannot find each other and they know they can find each other actually stay together.
They truly have to be put together.
They have to stay in contact. Yes. Right. And they'll find each other but then they go apart and then they get together and they go apart.
So when you when when this mom asked about aftercare, if she were to avoid suturing your is that the entirety of your advice that you just basically have to keep the legs close together as much as possible. And you need to be more conscientious about it. So you're not sitting in like a cross legged position when you're breastfeeding, because that's really tempting to do. You're keeping you know, when you're getting out of bed, you're trying to kind of keep the legs a little bit more together. I mean, you don't know worry. We're also staying in bed, so we're not going up and down the stairs, we're not taking walks on day four, not going to the grocery store. We're resting, we're letting the body heal. And we're kind of being conscientious about keeping the legs together using your postpartum soothe products, doing some sets bows, and that really should be sufficient. But like I said, ultimately, it's going to kind of be up to your provider when they're the one really in there looking at it and they're going to be the one that needs to give you the guidance on what to do.
Next, Hi, Cynthia and Trisha, this is Alexandra love your show. I do have a question. What are the ways to check for a placenta previa and the potential Have a prolapsed cord during birthing. Thanks again. Okay.
Well, first of all, if you're in labor and you have a placenta previa, you're going to have bleeding, because the placenta is open over and open. That's why That's why placenta previa is grounds for C section. Like, that's dangerous. And then of course you can feel,
I thought it was dangerous because the placenta comes out first. And the placenta is what sustains the baby. And the placenta is no longer attached to its nutrition source. It's oxygen source. That too, but it's also the bleeding factor. Yeah, yeah. You could bleed Well, profusely. This really had to happen in through history, this had to be a very real risk for women.
This was yes, that's a situation where a mom and baby could die. Very much so. But full placenta previa is not common by at all. No, because even if it attaches close to the cervix, as the uterus grows, it's usually moving away. So unless it's really embedded straight over that opening, it often moves out of the way.
Hello, I have a question. I do love your podcast. I felt pregnant and I started listening to your podcasts and I plan my dream birth. I had a midwife and a doula at a birth center in the hospital. So my question is, what is the risk of infection after waters break? My waters broke at 9pm on Friday, and the next day, I was advised to start Pitocin. I was at about 20 hours. They said I was only two centimeters, dilated, 80% effaced. I wasn't labor, like I was having contractions and they were consistent. But they were just worried that I was I would be infected, I wouldn't have enough energy. That just it wouldn't end well. So I was advised to start Pitocin Pitocin was the one thing I desperately did not want to do. But I was scared. So out of fear. I chose to use the Pitocin. It was a high leak. So it wasn't a gush. It was just like, slowly dripping. So they ended up actually breaking my waters like fully later on. Anyway. So we ended up with Pitocin, which ended up with me requesting an epidural. And we ended up with a vacuum delivery, he was in distress, his heart rate was not good. I actually needed the epidural because I wasn't able to move because the only way his heart rate was study was when I was on my back. I wasn't able to use water, I was able to use movement. So my question is what is actually the risk of infection after your water's break? And they do minimal digital exam? I was GBS negative, please let me know. Thank you so much for your show and everything you do.
Well, in the case of premature rupture of membranes, we know that women will naturally go into labor almost all of them by 48 hours, more than half of them will go into labor within 24 hours. So really, we shouldn't even be thinking about anything before that time. And women who do decline to be induced beyond 48 hours will still go into labor at some point especially if the bag of water is more frankly ruptured, meaning that it's like fully ruptured where she described having a high leak. That may not put you into labor as easily as if the bag of water is fully broken, but it also decreases your risk of any type of ascending infection. She's also GBS negative, so that's the most common problem with you know ruptured membranes is that the GBS bacteria can ascend into the uterus and infect the amniotic fluid or the amniotic sac that's called choreo. And that puts the baby at risk. So if the mom gets an infection, then the risk is to the newborn, that the newborn could get an infection. But if you keep everything out of the vagina, you don't have vaginal exams, the risk of infection is very small. It really is okay to wait for labor to spontaneously happen.
Even ACOG is saying that these days now, I don't think they say up to five days, but they certainly say we're four to four and let me check. Yeah, hang on. Yeah, I've got it right here. ACOG guidelines February 2017. When membranes rupture at term before the onset of labor, approximately 80% will go into labor spontaneously within 12 hours, and 95% within 24 to 28 hours. Induction versus expectant management, which means waiting for labor to begin was studied with no apparent difference between the two. Waiting from 10 hours up to four days was studied and for informed women. The choice of expectant management may be offered and supported for women who are GBS positive however, antibiotics should not be delayed. So you can still get the antibiotics and not be induced exactly also, but this Yeah, so they found nothing up to four days. They just didn't study any longer. But that tells you a lot.
You yet, women are still being pressured to come in within 12 hours of their bag of water breaking. Exactly. It's pretty clear, especially in this case, her water wasn't even fully broken. So that waiting in declining induction is perfectly reasonable, and probably a safer option than induction. Honestly, most, most. Definitely.
Hi. I love listening to your podcast, and I just feel so prepared for my home birth coming up. Unfortunately, my husband will be overseas and won't be with me when we welcome our baby boy. So I was wondering, what are some other ways to get the oxytocin flowing, but without my partner, my sister is planning to be kind of like my personal support dog in a way. So how can we get, you know that love hormone flowing without being too, too much? I don't know. Thank you guys. Bye.
Well, women have to understand that what we're looking for in labor is oxytocin. Now remember, you're naturally going to get that. So mainly, we don't want to intercept that we don't want to have you feeling stress or fear or anxiety or self consciousness or humiliation or tension, which would halt the secretion of oxytocin, but you aren't getting it by default. So basically, everyone there who's taking care of you just needs to keep you there. And it doesn't have to be sexual. Just because we get oxytocin when we're having sex or leading up to sex doesn't mean in labor, it's coming from that sexual place, it can be there, you can employ nipple stimulation or something like that. But really, everyone just has to keep you happy. So stroking your head, doing little light touch massage on your arms or your back, staying quiet in the room having you hear what you want to hear whether that silence or the sound of water running, or the music that you love. Just that that's what nature is giving you. So it's not everyone's job to get you there. It's their job to keep you there.
To create the right environment to support your own natural endogenous xe jobs, and you do not have to have a husband there in foreplay, and sexual touch to have a side lover or anything.
I mean, that can help a lot.
In fact, throughout most of history, men weren't present at birth anyway. Yeah, that's true. That's weren't there. And we did just fine with our oxytocin.
Hello, I'm so happy I found your podcast, I listened to it just about every single day. My question is, what are the risk factors or symptoms, that should be of greater concern when experiencing a second pregnancy right after your first. So my second is expected the same week that my first baby turns one, so I'm having Irish twins. And any concern or symptom that I have, and I expressed to my OB, I'm told that it's my fault for getting pregnant. So soon. What happens when you're not responsible? Don't worry, I've switched to a midwife care. But I'm just curious to see if I'm at in greater risk for interventions for delivering again within a year. Thank you so much. You guys are just so motivational and build so much confidence, and I'm so thankful for you guys. Thank you. The doctors Wow, why did he say it's all your fault? You have morning sickness, it's your fault. Because you had a baby too close together, your pelvis hurts. It's your fault, because you had babies too close together. You can't sleep. It's your fault. Because you had babies too close together.
You had sex with your husband, your fault. Terrible. Did she say she fired him? She did well, that that took care of her risk of unnecessary intervention in the next birth. So I think she's asking if there's any inherent risk, if she's trying to find out if it's really her fault that she's having more symptoms in pregnancy because she had her babies too close together? And the answer is no. However, there is a slight increased risk of postpartum hemorrhage in moms who have had many, many, many babies or babies too close together. So that's legit. And postnatal depletion is something to think about. So it takes a lot out of the body to grow a baby, it takes even more out of the body to breastfeed a baby. And if we don't have time to adequately kind of restore and nourish our bodies again. I think there is some validity to the postnatal depletion. Right? So maybe really focusing on her nutrition and on a relaxed focusing on her arrest really focusing on having support. It's a lot on the body. It's a lot on the mind, you know, but to say that you're having like worse pregnancy symptoms. That's just mean. Unnecessary. You know, where's the filter? Like? Maybe you had that thought, but why are you saying
even having the thought? Like when I would feel so guilty having thoughts like that about clients having judgmental thoughts like that, like, what do you don't you shouldn't, you know, they say your thoughts? Or what do they say your thoughts are like, on your, on your forehead or something you're like, wearing your thoughts. I believe that if you're if you're having thoughts like that, working with women, reconsider your line of work.
People just bring their own experiences, their own triggers their own whatever, into the into the picture, and, you know, people may or may have those thoughts, but the important thing is that you refrain from sharing them, and then go work on yourself.
Hi, Cynthia, and Trisha, my name is Veronica. And my question is in regards to hustle policies and my own rights. So I delivered my son via C section reluctantly in February. due to him being frank breached, I tried all the spinning baby steps and worked with our doula and had an unsuccessful ECG at 38 weeks. Leading up to this I had done a lot of prep work, including HypnoBirthing and felt very competent about going on medicated for my birth. When I found out he was breached, I was devastated. But I still felt confident in my ability for physiological birth. I asked him that my providers to let me birth naturally, but they all declined. I went into labor the day before my scheduled C section and actually arrived at that hospital nine centimeters dilated, so begging to let the still begging them to let me deliver him naturally. But they wheeled me into the O R, for an emergency C sections. And so I was so far along, and I was actually 10 centimeters before they started this section. So my question is, could I have actually declined the C section and they would have had to let me burst the way I wanted to. And just for reference, he was six pounds one ounce, so I was not trying to birth a big breech, baby. Thanks so much. Look forward to hearing the answer.
This is so frustrating. Here she is 10 centimeters, ready to push her baby out. And everybody's in a panic, rushing her off to the ER to surgically remove her baby, because they don't know how to receive a breech baby vaginally infuriating.
It's so unfair.
I don't understand that. How does she not have the freedom to make her own choice?
Well, she could have I mean, you know, her question was, could I have refused to go to the bar? And she said, Yes, yes, she caught up. But. But like, we always say in the moment, these are very difficult decisions. And it's very hard to hold your ground when everybody around you is panicking and saying we don't know what to do. We can't do this. We don't do this here. We don't we don't do it. I mean, she literally would, she could have gone into the bathroom and just birth her baby by herself. But you know who's gonna do that?
And if, if she had done that, they might have been so abusive as to say you just took your baby's life into your hands. Your baby could have died, they could have made her feel of course guilty or selfish, when really that's a perfectly normal way to give birth.
Now, if she would have been, you know, in her car for another hour and walking through those hospital doors with their babies, but hanging out, no, they would have been like, Oh my God, here we go a breech baby and they would have just caught it and everybody would have been overjoyed.
I had a client years ago, who was birthing her first baby, it was going beautifully, perfectly. The bottom was coming out and they rushed her into a C section with the bottom already presenting. Can you even believe that? Can you imagine what she went through now? It's unbelievable. She had a great feedback, but it's it's it's no consolation,
but I don't know if I ever shared on the podcast about my one breech birth experience. I was a brand new midwife bike bike had been working less than a year. Yeah, you shared the story in I think it was episode 128. I did. I had it's the I won't give away the punchline.
Well, oh, no, I'm not gonna I'm not gonna tell that part about the balls. I'm just gonna skip to the part where you have to okay fine. All right. So so again, brand new midway Oh crass. Had never attended a birth by myself before. I mean, typically, you wouldn't attend a home birth by yourself anyway. But it was holiday. It was Thanksgiving. And this woman lived down the street from me. So I was very quick to get to the birth. And when I got there, I was listening. I was listening to the baby and something was not quite right with a heartbeat. I didn't feel great about what I was hearing. So I asked if I could do a vaginal exam. And you know, I needed I also needed to know if I should call the midwife to the other midwife, the head midwife to come to the birth So she agreed to a vaginal exam. I did the vaginal exam. And I felt not ahead. You know, I felt this soft, squishy thing and my first thought was, oh shit, oh my God, then we're having a cord prolapse. Like, this is the cord I'm feeling and that's where the heart rate didn't sound right. And then I, you know, took a breath, calm down, felt, felt around a little bit more and then I'm like, wait a minute, that doesn't quite feel like a chord. It's not like Slippery like that. I don't know how long these thoughts are going through my head and then it just like hit me like, you know, like, bam, balls about the scrotum. And I was like, Oh, shit. Okay, I was so relieved that it wasn't a cord prolapse. But here I am feeling a baby boys testicles in between my fingers. I'm like, Okay, we got a breech baby. Got a breech coming through. She's fully dilated. She's having the urge to push testicles first. So Frank breech. And so I called the midwife and I'm like, What do I do? And she's 45 minutes away. And this mom's wanting to push, and she's like, what does the mother want to do? You know, we're five minutes from Yale New Haven Hospital. She's like, what does she want to do? And so I asked the mom and she's like, What do you want to do? You're having a breech baby. I've never done this before. You know, SARS is on her way. She's gonna be here in 45 minutes. And she's like, I don't want to go anywhere. So in the Midwest, visit Cali. Ms. Have them there, just in case. So we call the EMS and you know, 15 minutes later, firemen, policemen, all these guys are in the room. They did, like, come in like, check, you know, check on her introduce themselves. And then they kind of went to the corner. And she's like, I'm not going anywhere. Because they were still trying to convince her to go to the hospital when they arrived. And she's like, I'm not going anywhere. She had her back up against the wall. And I just remember being like, Oh, my God, like, here I am. I'm going to have to catch a breach. And I don't know how to do it. I've never seen it. I was not trained. I read about it in Barney's midwifery text, you know, one page. That's it. Thank God. My midwife had midwife Cyrus arrived who had done a breech birth in time. She arrived just as the baby's blood was coming through. And it was beautiful. And she had a beautiful breech birth at home, but came through one leg came down, second leg came down. Do remember that she had to use a tiny bit of like, inserted her finger and pull down on the chin a little bit to get the head, the chin to come down a little bit to birth the head. So it wasn't a completely hands off breech birth like they often are. Everything was perfect. The baby didn't need any resuscitation. And you know, we just let it happen. And it was the mom, she was like, I'm not going anywhere. I'm not giving birth in the ambulance. I'm not doing this at the hospital. I feel good where I am. And that was it. Most important that she had a choice.
Yeah, that was her choice he chose.
So there we go. That's how women feel at peace with their decisions when they actually choose. Thank you for that testicle story. It's a good one. All right. If you are with us on Patreon or Apple subscriptions, it's time now to move into the extended portion of this episode. Otherwise, it is time for CO wikis. Here we go. All right.
What are your thoughts on walkers and jumpers? You know, those little walking things and jumping? I don't know my thoughts on those. They're probably fine. I think we have to ask occupy contract baby. Yeah, I mean, I have to say the jolly jumper was my kids went crazy for that thing. And it was so helpful because I'd be cooking in the kitchen. And they would be you know, happily trapped between that crawling and walking stage, wanting to move. And you said to him and put him in that jolly jumper and they would just bounce up and down for a long time, that stage when you hold them on your lap, and they're constantly extending their legs to crawl out of your arms, just always standing to straighten and strengthen their legs. It's like your arms are just bobbing up and down.
I am okay with it. You know, I think a little bit of time and a walker a little bit of time and a jelly jumper is fine. I am breastfeeding my five month old can I test prolactin levels to understand if my period should return soon? Yes, you can. But I can't promise you it's gonna tell you anything useful. prolactin levels vary so much throughout the day. And depending on when you breastfed, and everybody's prolactin threshold is a little bit different for when their period returns. So, you know, so many people ask about so many people are really eager to get their period back after breastfeeding. I never really thought about that. Why? I don't know. I think maybe people want to conceive a little closer together.
Maybe I didn't even think about it. When I got it back, I was like, Oh, right.
Yeah. Meaning they're out about this. But you know, I guess if you're wanting to kind of have your family planning planned out, then maybe it's more important. We get a lot of questions on that it just Carrie do. Oh, here's a good one. How to know when you're done having kids. This is not a quickie. I think for some people, it's really obvious. Some people just No, I think Johnny is for the people who don't some people really know they're not done. And then there's that really difficult place of being unsure. But I kind of like the advice of like, if it's not a hell yes, it's a no.
I think when we free ourselves from consciously thinking about certain things, the intuition gets an opportunity to rise up. And if you basically feel like peace, after that period of giving yourself freedom, if you feel at peace, then it would indicate you're really, you're really okay to move on with your life. It is a feeling of holding your breath. So you have all your kids it is frightening. That's not uncommon.
All right. I am pregnant with my second and in my first trimester, and my energy has been depleted at times. Is this normal? Oh, God. Yes. I'm yeah. Yes, that's a hell yes. And for the next few years, that discourage you,
but I mean, the first trimester can be just like debilitating Li militating, tiring, like you just can't get off the couch tired? That is totally normal. If ultrasound, if ultrasound shows the baby hasn't grown in two months at 37 weeks, is that a reason to induce? That's a long time. That's a lot. Yeah, I would be concerned. I would be concerned.
It's a very long time.
Your thoughts on fondle massage, we get this one a lot will funnel massage as a again, like the pit proactively prophylactically funnel massage prophylactically preventatively is not necessary. Funnel massage should only be used if you have a bleeding and a uterus that is not contracting in getting firms. So the uterus should be firm after the placenta is out. But if there's bleeding and it's baggy, then funnel massage is an appropriate next step. The problem is that people are checking your fundus all the time, and then they just go in there and start massaging it while they're checking it. And that's not necessary. And it's painful, really, really uncomfortable. So only used appropriately. It's okay, but use routinely. It is not. This is my second home birth and I really want to call my midwives after the birth. Is this a bad idea?
She's dreaming of a free birth. But she's having a backup. Yeah, right.
I mean, is it good, bad idea? I don't know if that's our place to say it's a bad idea. But you know, if everything goes beautifully, well, then fine. It was a good idea. But if something isn't going the way you want, you want to have a person there. You know, if there's a problem with the time of birth, or there's a problem immediately after birth, it is wise to have a birth attendant.
Yeah. And what what is it that she really wants? Would she ideally want them there but maybe in the other
room in the other room? Right that? Yeah. Absolutely. What are your thoughts on the GBS swap? I think swab swab and antibiotics and labor.
What are we swapping? Exactly? What are your thoughts for the GBS swab? What about labor in labor?
What are your thoughts on the GBS swab and antibiotics and labor? Well, we've had this one also previously,
yeah, we we really want to refer everyone to our GPS episode from Fall of 2022. I thought she meant GPS test in labor, which is great. Those are quite accurate, but most providers aren't willing to do them. The bottom line is there are risk factors that make you more likely to have a baby who contracts GBS from you. And if you have those risk factors, and to the extent that you have one or more of those risk factors, that is the extent to which it makes more sense to consider the antibiotics. But you can go now on that deep dive through the episode, because it's complex, very complex, and the data is not very clean either. And we went through all the data from decades and it's you know, they all provide little windows into it without very consistent takeaways, but we do know of risk factors and that's very helpful. And they handle it differently in Europe. What what are you smirking about our next question? Okay. What is your biggest pet peeve?
Um, I have a lot of grammatical ones. Of course, it's, I know that Oh, no, not that one. I one of my grammatical pet peeves is when people use the word myself instead of I. And when I when I worked in corporate, there were people who did this all the time. And I just, it was something I really wish I could have just corrected for them. Like they would say like, Oh, John and myself are going to Brazil next month. That doesn't Oh, they were like, you can call myself if you have any questions like no, it's just me just oh yeah, there are people who say myself for everything because I think could because they're just not sure either they think it's fancy.
Or they don't Oh, sounds smart, but it doesn't. Or they just really don't know when to say I versus me. But that's a big one of mine. I should tell everyone when to use myself. It's when you're the recipient of the verb like I, you know, I look at myself. So you're the sub as you're the object. Yeah, you're the subject, and you're the object. And in Spanish, that would be a reflexive verb. Now, it's true. Learning a foreign language makes those in German. How's it to the German? How's it to it makes it it makes it easy to learn that stuff when you study another language. Alright, go ahead. What's your courses about? Cold coffee? Oh, cold coffee. You mean like hours old?
Yeah. Well, no, no, no. I mean, like, not steaming hot out of the park coffee. The second it starts to get cold and I'm irritated.
Right? You always ask for extra hot when we go out? Yeah, okay. Right.
But I do have one birth related. Okay. It's when people say we are pregnant. Oh, yeah. I do not like that.
No. Anything that's overly politically correct. But it's just disingenuous. It's ridiculous. We are responsible for this baby.
It's nice that you're trying to unify on this. And it's a way of the partner trying to show their support, but there is just no part of it. That is we are pregnant, like she is pregnant. That's it. He is not never will be. And I just don't love that. Yeah. And people say it all up.
I just thought of another pet peeve that I never talked about. I don't like and sometimes you see it in TV shows or whatever. But I don't like when people say I apologize. Why? If I'm sorry. Yeah, it doesn't feel heartfelt. I apologize. I feel like they're saying then I say I'm sorry. That's how I hear that word. Like when when you really feel bad. I don't think you go on. I apologize so much, right. That doesn't go. I feel like it's intellectualizing the emotion. That's just how it strikes me. I'm not making a grammatical lesson here. I don't know. But that's how it strikes me. I have never uttered those words. Because it just one I feel sorry, though. That's like one of the last words that would come to my mind.
I must have another pet peeve.
Um, another one. This is a great question. I love these little personal questions. There's really good month after month. Get us.
You guys get us thinking. Jeez, yeah, these are good to do some self reflection. My daughter leaves a half eaten banana in my car every single day. Bothers me. It's the worst. To leave it good. Like and what do I do with it? Every day? Yeah,
it'll be ready to be made into banana bread by the end of the day. Every day. I'm
like, I'm throwing away half a banana and why am I throwing out your banana every day she eats it on the way to school or on the way to practice chapter finishes it half to three quarters, that's it always leaves the rest. It's like, I'm not going to eat it. Give it to the dog. Dogs love bananas. I throw it in the woods every day when I get home. That's why you had a beer in your woods the other day. That's your
meeting here. It thinks it's a meal. There's a half banana there for it every day. Very predictable. Every day. Crazy. It's dinnertime.
That's a wrap. That's a wrap for the July q&a. Thank you, everyone. Thank you for submitting your questions. Thank you for being fans. Thank you to those of you who write podcast reviews on Apple podcasts. It's so exciting and wonderful for us every time we see one of those beautiful reviews, it really does invigorate us and inspire us. So thank you. Please don't forget that you can come over and talk live with us on Patreon two times a month and seriously our our probably our best content is really happening for sure. Right? Yeah. So it is a worthwhile place to be I know it's annoying to download another app and have another place to check in. But there is some good stuff.
It's a lot of fun. It's interactive. You ask your follow up. It's great. We have a great time doing it. Alright, have a great one everyone. We'll catch you next week. We'll be back bye
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