#266 | The ARRIVE Trial Reaches Overseas: Birth Culture in France with Nicola Thompson and Her Daughter

Much of the hospital routines, the typical for prenatal care, and hospital routines are very, very similar to the US. And now sadly, at least in Paris, the arrive study has arrived. And they really kind of sell it as something that's going to help women avoid a cesarean and things like this.

They had women in that group who developed conditions like preeclampsia, as you would imagine, among the 1000 women, some will, they had some who just got tired of being pregnant and they wanted to be induced, some were induced for medical reasons or for preference. And unbelievably, they kept them in the study, they kept them in the expectant management group. And in studies, you always have the people, you have to kick out, because they no longer meet the requirements of the classification that they're in, which grossly misled the public, she just said, flat out, you know, the other day, we had one woman who did not get an epidural in the hospital, and she was bothering everyone making noise. How can you have informed consent, and then you write in your study that 82% of women are getting them on their own accord? Because I think there is the feeling that well, it's an epidural, everyone does it. And I can still have a physiological birth and except you can't and it's a really important point that everybody understands that it sounds like in the, in the culture of birth in France, there is no such thing as physiologic birth.

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.

Well, Nicola, and Sasha It is so nice to have you both as mother and daughter here on down to birth show, we received a beautiful, very well written I will add email from Sasha Nicola where she was just basically singing your praises as a mother. As a midwife, you've had a tremendous amount of experience in multiple countries. And if you don't mind, we would just love to start the episode with each of you introducing yourself starting with Nicola, the mother.

Nicola Thompson
Thank you so much for inviting us to come along. We're both big fans of your of your podcast. I'm a mother of three really wonderful grown up children. And Sasha is my eldest child. And I am also a grandmother to three little girls. And now one grandson, as I said, just born 17 days ago, and actually another grandchild coming in the summer, my biggest role in my life, and I am a nurse in the UK and the USA. And in actual fact, though, I'm originally from the UK, most of my work experience as a nurse was in the USA in New Jersey, so not too far from us. And I worked for about 35 years, almost always in prenatal clinics, women's health, a little bit in a birth center that the hospital had opened, but primarily actually in a level three hospital which seemed to be completely opposite what I initially imagined kind of wanting to be maybe, yeah, working more like a home birth midwife. I was a registered nurse, I had plans to go to continue my education as a midwife, but I but I did not do that children and family and life was very full. But I you know, I had many, you know, wonderful years at the hospital and I learned so much and I met so many wonderful families and wonderful, you know, doctors, nurses and midwives. But you know, really right from the beginning, they're all what we're seeing what we're talking about so much these days was already got, you know, it was going on. And I always kind of felt very uneasy, and it felt it just felt very, you know, very wrong. What was going on? About? Gosh, is it in 2015 kind of made a big life change. I was thinking to go back to the UK from the US. But then I sort of was at a crossroads and I thought I can go anywhere. So I came went to France because I'd always just really like trance. And I did have a bit of an I imagined that I didn't know it was all like Michelle or dawn Kleenex or something like that in the way of birth. And it certainly is not. I thought perhaps I would be able to work in the medical system in France, but I that seemed too complicated. And I met a British doula who was actually a British midwife waiting for her paperwork and she introduced me to sort of doula work and she said, Oh, you'll love it even more. And she was right because you're not chained to protocols and things. You're really with women and families so I've I've been doing that now most of that the time that I've been here. I've also always been involved in breastfeeding. And I in the last few years, became a lactation consultant. So I'm working as a lactation consultant and doula. And now because of the situation that Beth is in, and there's so few choices really women have, I find my work has sort of naturally expanded to birth keeping or being a birth guardian. For those women who want to birth outside the system.

Cynthia Overgard
IBCLC, Nicola, yes.

Nicola Thompson
yes, I took the exam for the International Board Certified Lactation Consultant. So I am now an ibclc. And I felt I felt proud of that, actually, because it was so many years of meaning to do wanting to do it. And I finally got it together and did it. And so I'm really enjoying that as well. I'm really enjoying that. So many of the birds, you know, involve many, many interventions, and I feel in France, instrumental beds are higher than the US actually. And that I really do see a lot of babies who have been affected and having breastfeeding difficulties because of the use of Vaughn to sew forceps. And, of course, the whole other, you know, array of things that they've experienced during the birth. Nicola,

Trisha Ludwig
can you just explain to us if you did, you were a labor and delivery nurse in the United States? Where are you from?

Nicola Thompson
I'm originally from Wales in the United Kingdom.

Trisha Ludwig
Okay, you're from the UK. Did you become a midwife in the UK? Or did you become trained as a doula and just sort of fall into more of becoming like traditional midwife through your doula and birth keeping work and experience? Yes,

Nicola Thompson
yes. No, I'm, I'm a, like a registered nurse in the UK and the US. And I was saying, I sort of had in my, as a young woman I imagined I wanted to go to go on to further my training and become a midwife. But I didn't but yes, exactly. As you described, I then went into doula work, birth keeping, I like the word birth guardian, because I feel like birth, women need protecting.

Nicola Thompson
And I have two little girls of my own, four and two, and I'm pregnant with my third baby. Now, I live in Paris, I left the US about 10 years ago, right after finishing law school. So I'm a lawyer by training. And all the while because of my mother and her work, birth has always kind of had a central place in my life. But especially since getting pregnant and having my own babies, it's become an area of interest professionally as well. I continue to be fascinated, but also just just very discouraged at how slowly progress seems to be happening. And I've been very, it's very interesting living here in France and having babies and France, and comparing that to, you know, friends and family experiences in the US. I mean, there are a lot of similarities, not positive, necessarily similarities, but it has given me perspective about some of the universal challenges, I think, that the birth and women are facing. But I feel very grateful to have had my mother, as my mother, to have kind of provided me an education that became so clear when I was pregnant myself and giving birth.

Cynthia Overgard
Nicola, did you serve as the birth attendant for all of your grandchildren?

Nicola Thompson
Well, I was present for all of them. But Sasha's first a baby, I was there, and there was also a very lovely French midwife there as well, who was very, yeah, very hands off. And then for the other three years, I was there as the yes, the only other person there was

Cynthia Overgard
So it was essentially, I guess, the way most traditional people in the industry would describe it, they would say that was essentially a free birth that you attended. But with all of your vast experience, you really are more of a traditional midwife who learned on the job over the years. What's unusual about that is that most of your on the job training was in this medical system, with which you're not very aligned. So where did you learn the trust of birth to be able to serve as the attendant to your grandchildren's births? How did you separate those decades of hospital experience to be able to really play the role that you wanted to play and that they needed you to play for a more hands off physiologic birth support?

Nicola Thompson
I've actually often thought about that. And I sort of trace it back. I know as a teenager, I really, I really loved biology. And I remember, you know, reading books outside of the biology class And I remember falling upon spiritual midwifery and read that, you know, as a teenager. And then also very early on before I had children myself, I read Michela dance book birth reborn, and actually saw him in New York at multiple times, speaking, and I was beginning my work in, in labor and delivery. And everything was saying it just made such sense. It just kind of resonated with me completely. Of course, it couldn't, you couldn't necessarily practice that way, in the hospital, but in sometimes, you know, in a busy hospital, they're too busy to come and do anything. So you would be and you would, I would see how, how perfectly, birth would unfold, you know, in all kinds of situations. It was a level three hospital. And there were actually a lot of, of women and babies who actually did maybe even have a real risk or challenge or whatever. But even in those situations, I would see how almost always, it worked so beautifully, and so safely, and just also feeling, you know, seeing the physiology work so well in all kinds of situations, and really feeling without trying, but really just feeling that sort of sacredness of birth, and it just touching me so much. And I, having seen so many things, I think, in actual fact, at certain points, I've thought, oh, goodness, this that wasn't I've been exposed to all of that, yes, it's going to tarnish me, but it didn't, because I still saw how wonderfully birth worked in all kinds of challenges. And, and yeah, so it's actually given me a certain piece in a way because somebody can say, oh, but I'm, but I have this problem. And I can say, Oh, well, actually, no, usually, that's fine, too, you know,

Trisha Ludwig
I think it's really important to see the variations of normal breasts so that you understand when something is still within the normal range. And that actually gives you a confidence in security to have a little bit wider net of normal, when you have seen a lot of the variations of abnormal, and what your experience to me is describing as outside of it being necessarily in the hospital, and quite medical is just the the the wisdom of a woman who is like the village, birth person, like the traditional, this is like the traditional midwifery model where you you have the passion, the desire, the connection, the understanding the calling to women's work, and you surrounded yourself with that throughout your lifetime. And then you bring it back to like, the family Village. And now here you are attending all of your family and this little community of women in France, it's beautiful.

Nicola Thompson
Thing. Thank you. I do feel like it's such like a life's pass. Yeah, this is exactly where I'm meant to be. And I can't imagine. Yeah, just can't imagine not being that, you know, yeah,

Trisha Ludwig
I think that's a common theme in midwives that it's, it really just is a deep calling within a woman to do this kind of work, because it's difficult. Yeah. It's difficult and it's beautiful. And it, it takes a certain level of competence, calmness experiences is part of that. But you know, also, it's a tough lifestyle. You

Cynthia Overgard
also have to be emotionally resilient, because especially being a woman like you, you keep seeing births, that you must have gone home after work many times and not felt so great. You were practicing your nursing in New Jersey, which has had among the highest C section rates in our nation. Were you in the New York metropolitan area of New Jersey, northern New Jersey, or were you in southern New Jersey?

Nicola Thompson
I was in the New York metropolitan area in Newark, New Jersey

Cynthia Overgard
in Newark. So a real inner city experience. Wow. So that was very unusual in itself. So did you start there in about the 80s? When did you start practicing in New Jersey?

Nicola Thompson
I did Yes. In the 80s.

Cynthia Overgard
So if you did, then you would have seen a very dramatic rise in C section rates through the 30 years that you were practicing. Were you aware of it when it was happening? Did you ever look back and say it wasn't like this when I started in the earlier 80s? Did you observe from a separate perspective and witness what was happening or were you just in it? Did you see how the C section rates were skyrocketing because they were in that time period? Yes, I

Nicola Thompson
certainly saw saw the severity rate increase and inductions induction really, really, I feel like that even impressed me more than this isn't viens that it just seemed I mean, now it's you know, it just seems like every other woman is is is having an induction and that's actually not even an exaggeration.

Cynthia Overgard
Sasha Do you want to jump in there?

Nicola Thompson
Yeah, I was just gonna say because the thinking about, you know, the ways that my mom has impacted how I feel about birth, and then my actual choices that I've made her birth, I think, obviously, you know, you can imagine just from hearing her speak that she just kind of admits this trust and respect and admiration for physiology and a woman's ability to birth. And so that was there from the beginning. And that has been such a huge gift, especially given, I think, the fear that's instilled in us about birth. But also, it was the stories that coming home from the hospital that we always wanted to hear, but you know, what her day was like, and often there was, you know, it was these medical interventions that was not were not necessary, and then maybe led to serious consequences. But I think that was also so important for me to know, from an I carry that, you know, I think, unconsciously feeling that I could trust my body, but also, knowing that I needed to be aware of the risk, what I was, would be walking into in a hospital environment. And I think that really served me well. And I think it's a hard balance sometimes, because I think sometimes there's a tendency to sugarcoat, you know, the risks that are there. But I was very grateful for that awareness. And certainly, I didn't have an idea about giving a birth at home when I was pregnant. But I remember when I visited for the first time, a clinic here in Paris, which was not run, but attended by midwives, who were committed to physiology, and, you know, very pro, unmedicated birth. But still, it was a clinic environment. And my body immediately had a really visceral reaction, like tensed up, and was just like, No, this is not where I feel comfortable. I can't see myself going through a smooth and undisturbed labor. I just had a very strong physical reaction that I wasn't expecting. And then also, I had a comment from the French midwife that I had initially met with, when asked about who could be in the room, and she, she said, Well, who do you want there? And I said, Oh, my mother, and she knew my mother was working as a doula in Paris. And she was like, Well, if she's there as your mother, I guess it's okay. But if she's there as your doula, no, because midwives and doulas have a complicated relationship here, and I ended up changing midwives, because that just turned me off so much. Felt like wait a minute. It's mostly I'm the one supposed to be deciding whoever makes me feel secure and comfortable, you know, it should be in the woman's service and not the other way around. So but I think it was really that awareness that my was instilled in me through my mom's experience about there are very real risks of unnecessary intervention that can disturb the process. And I'm feeling that when I stepped in that room, it was a powerful experience.

Trisha Ludwig
Can you tell us a little bit more in general about the culture of birth in France? So our midwives common? Are they generally hospital based? What's the homebirth culture like there? What's the C section, right? Like in France, and obviously, you said, with this midwife, the midwife was not very supportive of midwives, and doulas working together, which seems like a big red flag to us. So tell us a little bit more.

Nicola Thompson
Midwives are very common, very common there. And most of the even public and private hospitals, the midwives almost are a bit like the labor and delivery nurses in the US, you know, they would follow the order of say, a private doctor or the attending physician, and then they would be, you know, accompany the woman through the labor. And but then for the birth in most places, if you had a private doctor, the private doctor would come in for the actual birth, much of the hospital routines such as prenatal care, and hospital routines are very, very similar to the US. And now sadly, at least in Paris, the arrive study has arrived. And they really kind of sell it as something that's going to help women avoid us as Aryan and things like this. There's a huge, I don't know, I can't believe that it's every woman just by chance that aren't in meeting but also some of my doula friends and things have the same experience of everybody has been told their baby is too big and that they're going to need. This is very, very common. The induction rate even other than the arrive is also there's a lot of suggestions for cesarean or usually an induction This is Aryan rate is a little bit lower. But I would say it's on the rise. It's in the 20s, whereas the UK in the US, I believe, is in the 30 percents. Yeah, that's lower. The instrumental birth though, as I mentioned earlier, is higher. It varies of course from hospital to hospital, but it could be 10 to 15%. I would say it's up there some hospitals it's even goes up to close to 20%.

Trisha Ludwig
Isn't that interest thing how we know it takes an incredible amount of time for research to go into practice in hospitals. And yet here we have this arrive trial that's crossed the Atlantic Ocean and landed in the French birth culture and a matter of years when we still can't even get women to be able to drink and eat freely in labor in many hospitals across the country, because the arrive trial allows for more intervention and more control over birth. And so it's quick to be implemented. Whereas, you know, returning to physiologic birth, and any study that we ever have that promotes that, who knows, when it will enter practice.

Cynthia Overgard
Let me just give a minute to the arrive trial, because I'm always thinking of the person, the couple who just started listening to the podcast and has no idea what that is. So just in a brief synopsis, we do have a one hour class that Trisha and I have posted on our Patreon page for anyone to go get a deep dive on the arrived trial. But in a nutshell, this study was done with only 6000 Women in 2018, they set out to see if induction made birth safer. And it showed that it did not. And that was really what the arrive trial was looking to do 39 weeks at 39 weeks if induced at 39 weeks. So 3000 women were induced at 39 weeks 3000 women were not in that group. And it showed that induction did not make births safer or save lives. But what happened was it wasn't a blind study. So remarkably, rather than everyone having a C section rates and the 30%, as we do in the US, one group had at the induction group had a C section outcome, I believe it was 18.6% and the other group of 22.2%. So they seized that and said, Oh, look at this, though, if you induce we have fewer C sections and what they're not including, first of all, again, it wasn't blind. So already, everyone got their C section rates way down by being a part of the study, which is fascinating right off the bat. But importantly, in that expectant Management Group, which indicates you leave these women alone, and they are not induced. They had women in that group who developed conditions like preeclampsia, as you would imagine, among 3000, women, some will, they had some who just got tired of being pregnant and they wanted to be induced, some were induced for medical reasons or for for preference. And unbelievably, they kept them in the study, they kept them in the expectant management group. And in studies, you always have the people you have to kick out, because they no longer meet the requirements of the classification that they're in. They kept them in which grossly misled the public into thinking this is what happens with the expectant management group. In fact, that's the group that ended up with high risk women, and they didn't belong in the study anymore. So again, there's more to that study. But even a tog even the American College of Obstetricians and Gynecologists have announced that study needs to be redone. But what we're seeing sadly, around the world, now we're learning from you, obstetricians, and even midwives are pouncing on that. And going away with this headline to have induction lowers C section rates, and there is just no way, there is no way in a clean study that is likely with all the risks that come with induction, especially to women who don't need to be induced, which is what they were doing. Right, it was a left of induction comments to add to that Nicola, again,

Nicola Thompson
gets me infuriated because it's really being sold there. And one of the doctors sort of is like the professor, head doctor of, you know, specialized hospital, and it's sort of, you know, as if he has some, you know, great knowledge and authority on this. And it just comes down to this this. It's, it's a flawed study. And yeah, it's you're misleading the women. Now, it's really sad. It's a great

Trisha Ludwig
tool for convincing mothers that they should go ahead and schedule that induction at 39 weeks. And now the rhetoric is simply that, you know, a baby is better on the outside than it is on the inside. Once we hit 39 weeks, I literally providers will say, there is no benefit to keeping your baby in longer, there is no benefit to going into spontaneous labor.

Nicola Thompson
I mean, it's it's so shocking. It's a it's

Trisha Ludwig
a just like it's a completely erasing and ignoring nature and biology and common sense. And common sense.

Cynthia Overgard
It really is, you know, you

Unknown Speaker
follow nature. You

Trisha Ludwig
follow biology. That's yeah, it makes sense.

Nicola Thompson
I think I had said to you in the email, Cynthia, that one of the things that seems it seems as if and I really don't mean this in a disrespectful way. But it seems as if we're one so much so many times, it seems that the medical world ignores the studies that they did that shows that you know, not just being is actually the health that you get brings the healthiest outcomes for mothers and babies. And then it really does seem that that there is not an understanding of, of the physiology of birth and I really don't mean to, you know, but I mean, just that the practice have, you know, the most basic things, you know, just respecting the human needs of, you know, oxytocin and things like this. I mean, it's completely, it does, it just doesn't sort of exist, even things that really could be, you know, you know, you could create that sort of environment in a hospital. But so you do wonder, and then I've been in teaching hospitals, that hospital that I worked at was a teaching hospital, and smaller hospital to more recently I was working in, and it just, you know, the students, you can just see they're taking in this and several of them, you know, they didn't think that you could give birth without an epidural and things like this, like, you know, they could know any position other than, like the lithotomy, they just thought was, you know, so unusual, impossible.

Trisha Ludwig
What's so important to understand about that is, when you observe a woman in labor with an epidural, you are no longer observing physiologic birth, you're not going to see the same process, and actually a woman giving birth with Pitocin. And an epidural does require more intervention, she does require more monitoring, she does require Pitocin at the end. So if that's all you're seeing, then to believe that these are necessary interventions for every birth for birth to be safe, because you are never actually seeing true undisturbed birth. Right

Nicola Thompson
now. That's a very good point. And that is true. Yeah. So. So that's the situation Oh, going back to the front. So I was gonna say the home birth rate is low there. I think it's about 1%. And, you know, of course, as in the hospital and home, you know, you have some really wonderful midwives that, you know, unfortunately, I do feel that more and more, just in the last, say, five years, that meant that many of the protocols are being brought to the home, l being brought to the prenatal care, and that there are there are more reasons to whatever you want to say risk out a mother that she can't give birth at home, then terms,

Trisha Ludwig
such as like going beyond 42 weeks, or having gestational diabetes or something. Can you can you elaborate on that? Yes.

Nicola Thompson
When one good thing I'll just say is that the the due dates in France are based on 41 weeks. So that gives you a little bit of extra time. But yes, so there would be let's say

Cynthia Overgard
you are based, just think right out that the due dates are huge on 41 weeks. And that was a new day. So they don't even they really don't have anything to say to women until 41 weeks, when did they start to get really nervous is 42 weeks still the point where they say, whoa, whoa, whoa, 40? Or do they go out to 43? Because Holland goes out to 43?

Nicola Thompson
What do they do? No, I'd say 41? And six? Yes.

Cynthia Overgard
Oh, God. So that 41 weeks, your baby is expected by 41? Late, but really it's a 35 day, normal gestation window. 35 days, but they narrowed it down to six. That's really incredible. So it really doesn't end up helping us that much. A

Nicola Thompson
little bit that 14 weeks and people are not hovering over you. But yeah, 41 they begin to talk about it. And some some will say 41. And two, but you know, the one I never the longest is the actual on 42 weeks. Yeah, you have to they

Cynthia Overgard
stop? Yeah, yeah.

Trisha Ludwig
So are they still recommending induction here in the United States? It's 39 weeks is sort of that that threshold for when it's safe to induce what's happening in France? And if they're considering a baby, not due until 41 weeks, or?

Nicola Thompson
Yeah, until this the last year or so that the the arrive? They really weren't starting to talk about okay, what are we going to plan for until about until you 41? reached your?

Yeah, and now

Cynthia Overgard
they're pushed. They're they're making a leap all the way back to 39 weeks? Because of that? Yes. Is 32 weeks. That's huge. That's why she and that's millions of women. That's the vast majority of women in that window unnecessarily induced for non medical reasons. Sasha jump in here. Yeah, no, I

Nicola Thompson
was gonna say on that, that induction point, I've heard more and more women just to me, and actually a lot in this specific hospital, which is thought to be one of the best where there is this head of maternity pushing this arrived, that, that it's not only to just to reduce these actions, but it's actually so that the less chance that your baby will die? The inducing at 39. So that's

Trisha Ludwig
Hold on, though, because that study did not show any differently. No. How can you even say that,

Nicola Thompson
but I've heard I've heard that from multiple people coming from this one hospital, which is kind of setting I think, you know, would would set an example for others as this is a big hospital in Paris. And that's what message that they're they're passing on which was even more shocking to me because it's even that you know, you don't get that anywhere from the study. This

Cynthia Overgard
is why we want to get them into research as much as possible because we shouldn't have to do this research on her On as women, we should be able to entrust our providers. But clearly we're in a place where we can't, Trisha Go ahead. They're

Trisha Ludwig
literally just pulling that out of thin air from the study. They're literally just making up a conclusion that actually the study says the opposite. Yeah.

Cynthia Overgard
We've seen that Trisha, there was an obstetrician going around Instagram, he was looking in the camera. And he said, Well, now because of the graph trial, I mean, there's no question about it. I mean, women and babies are much, much safer being induced at 39 weeks, this is not even a question anymore. So did it and he went on and on talking, and I thought, This is unbelievable. He's just looking in the camera saying all of this, none of it is true. And how many women are going to give that heart and feel relieved and go with that? Simply because they believe it? And again, we shouldn't have to do this research ourselves as women. But here we are, we do. It's just with anything else, especially in the United States, with our health care with nutrition. With a toxic free lifestyle, we have to make these decisions ourselves. Because we're not getting that information in an unbiased way, from any authority. There's money everywhere in this nation, especially there's just money everywhere. So really, you just we we just have to take greater responsibility for our health care here. That's the bottom line.

Nicola Thompson
Yeah, and I think another you know, the epidural rates are very high. I think the last data they have is around 83% of women get epidurals I think has been more in Paris attire. But But yeah, I wouldn't be surprised if it's, this was a couple of years ago. But I was funny in that, you know, they have the one official report that's published across France, with all these statistics and the epidural rate had gone up since the last publication, and they said, Oh, epidural rates are still high, all in accordance with the wishes of women. Because, and that is, you know, I had fairly few experiences with the kind of the traditional medical institutions here because I was I was seeing a private midwife and having home birth. But the one meeting that I had with an OB in the hospital in case I was transferred, and I didn't even tell her that I was planning a home birth because I didn't you know, the end of my pregnancy, I didn't feel like getting the whole spiel. But she just said flat out. And this was for my first daughter. I really tell all my first time mothers that it's best to get an epidural, you'll just be calm that way. And you can enjoy the experience. You know, the other day, we had one woman who did not get an epidural in the hospital, and she was bothering everyone making noise. And like, Oh, my God, and then you know, this is after I had been researching a lot of the risks of epidurals as well. And so I asked her, What about the risks? Are there any risks for epidural labor? And no, no, no risk? And I was so angry that I

Cynthia Overgard
was drawing list of like three dozen risks. no risk, no

Nicola Thompson
risk. And I think I thought that was so wrong. Such you know, really cut like malpractice in terms of how can you have informed consent, and then you write in your study that 82% of women are getting them on their own accord? Because I think there is the feeling that well, it's an epidural, everyone does that. And I can still have a physiological birth and affix

Trisha Ludwig
except you, except you can't. And it's a really important point that everybody understands that it sounds like in the in the culture of birth in France, there is no such thing as physiologic birth. If over 80% of women are having epidurals nobody, no nurse, no doctor, no midwife working in the hospital. So it would only be the homebirth midwives, which are 1% or less understand anything about physiologic birth. So you can't you can't even support it, if a woman wants it. If she if she does want to go in there and have I mean, your example of the of the your providers saying that one woman did it and she was bothering everybody with her noises. And

Cynthia Overgard
women, it doesn't take much for women to feel self conscious as it is they're always going into birth, worrying about who they're going to disturb what's going to happen. That was almost brilliant that she said that it was bothering everybody what a concept to place.

Nicola Thompson
And I mean, I think this exists everywhere, right? That it's the power dynamic between the provider and the woman. But I feel very, very strongly here that the room to push back is it's almost like sacrilegious to go against what a doctor or midwife but especially a doctor is telling you. And so that's why I love especially the language you use when you say you know fired provider, we're just reinforcing that. There's at the end of the day, you're the client, the consumer and then the provider, but it does not feel that way. And it's very it's really an uphill battle.

Trisha Ludwig
How does this so I'm really curious how this translates into new motherhood in France for like early postpartum and and kind of getting back to that. Earth, Mother Nature, all natural biological parenting. Is that happening in France? Or do you see that the birth culture really influences the postpartum culture?

Nicola Thompson
I think it affects it enormously, right? Just that you weren't mentioned in confidence, right? That's kind of all been all been stripped and then the, the interventions with initial breastfeeding, for mom and baby during the hospital stay, most mothers I've talked with have been offered formula or the baby's been given formula for a reason. It's like one of those potential risks. Or if you want to go home, well, the baby, you know, the weight gain or this or that, so many of them, I would say, you know, 99% of them are really, it's not necessary. And then that cause can continue on because it it break interferes with them the confidence that they that the milk that you know, their breast milk is adequate, or that all of these things. So let's say they do do a couple of home visits, usually most hospitals, there will be a midwife who will do one or two home visits. But then after that you're sort of dropped, which I know is also in the US. Okay, see you in six weeks. So the thing, but I feel as if there is not even a mother culture, where of you know, mothers circles, playgroups, or whatever you want to call it, that seems to be missing. I work with a lot of Anglophone expats, you know, and most of them British, Australians, Irish, and American, too, will be saying, oh, gosh, you know, in my country, there's, there's this kind of connection from others. And that does seem to be does seem to be missing that I feel like mothers feel quite isolated. During that usually in Paris, at least the women to go back, of course, it's much longer than the US but for for Europe, it's quite a short maternity leave of about 16 weeks, and many women to go back in,

or you will take four weeks before you give birth. So really, you have about 12 after the baby's born. Yeah,

and there's a lot of sort of preparation and for going back to work, the the government does can can sometimes help you with crash, you know, with a daycare, and breastfeeding is very brief. You know, prolonged breastfeeding is not common at all.

Cynthia Overgard
This is in France, you're saying yeah, it really varies a lot from country to country, including the maternity postpartum leave, varies a lot there. There are nations in Europe where it's over a year, between the couple and in Germany, I think it's six months minimum. And I think it's up to a year. I'd love I would love for each of you to comment on what it must be like, I would just want to hear from each of you what it's like to have, you know, for Nicola for you to attend the birth of your grandchildren, Sasha, for you to have your mother attend your births. What is that, like? Well,

Nicola Thompson
it's one of the I mean, it's such a, I'm so privileged, but because I've all I've always had the privilege of having a mother with this incredible experience, but also just love and respect and trust for for in all of us in women, which it's a it's so empowering. And so her presence feels just like the best balance of trusting, completely trusting but a feeling of security as well, through her experience. And I think, you know, that sort of greater midwife historically has been that presence is very powerful. And I know that, you know, obviously me and my sister but all of my, my mom's clients feel that and I, I wish, I think, you know, every woman deserves to feel that. And that's exactly what you need the calm sense of security. So it's such a gift. No, thank you. I

don't know if there's one word but I feel like it was just yet an experience completely of the heart, you know, like completely, just love embodied in you know, seeing my daughter, my grandchild, just in this kind of, you know, light of love, just round it and it just, it was just incredible. And I remember Sasha's face when she was well all of their faces when they first looked at their baby and just their face was so filled with love and oxytocin and just like you know, there's a different look, you know, in the eyes and the face and just to see that, to see that and feel it and and be a part of it is just, it's extraordinary and just feels like pure love. Like you're in the center of life and love.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.

Cynthia Overgard
Is there any fear for you when you're at the birth when the stakes are so high into your own daughter's life and your grandchild's life? Is there any extra emotion of fear?

Nicola Thompson
To be honest, my experience now four times? No. And I That surprises me that surprises me. Thankfully, you know, my daughters and their babies, they are very healthy and had been very healthy. I mean, I know things can happen even with healthy moms. But no, no. I, I could see they just were moving with the birth so beautifully. They were moving through the labor so beautifully. They were they weren't pulling, you know, pulling out or asking for anything. They were just you know, right there. And I just felt very calm. But yeah, I had in previous years. As I mentioned before, like a long time ago, I kind of thought oh, I can't imagine that. Or now I can't imagine not being there. But no, I didn't. I'm surprised.

Trisha Ludwig
I think there's an energy there no, there's an energy admitted in Bert admitted in birth when birth is going smoothly and well. And you feel that and you trust it and you so there's no reason to be afraid because you don't your senses aren't picking up on anything. I mean, that's one of the skills of a great midwife is to have that intuitive sense when something is kind of veering off course and not feeling right. And so if it's feeling right, it's feeling right and there's nothing to fear.