#314 | April Q&A: Epidurals, Pushing Too Soon, Castor Oil Risks, Parental Coping, Gestational Diabetes & Big Babies; How Tall Is Arnold Schwarzenegger

Hi, Cynthia and Trisha. This is Mary. I'm 28 weeks pregnant, and in my past pregnancies, I have used castor oil to induce labor, so I don't go over 42 weeks. And I was wondering, no one has ever told me, what the risks of the midwife sprue castor oil induction are. So would you ladies be able to share that with when asked about a reason, about for these extra interventions, they aren't giving her a straight answer, and they keep coming back to you had a big baby, and on her chart, it says history of macrosomia. So she's a little confused as to why there's so much attention put on her previous baby's birth weight, but then to look back retrospectively and say, Oh, we must have missed something there. Give me a break. Come on. And she is now technically high risk because she had a big baby the first time. That is absolutely crazy. She's going to be treated differently. Her birth is going to be managed differently, and the only way out of this is to get out of the system.

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.

Spring is here at long last. Welcome to the April Q and A so I think you had something, right? Are we? Are we without anything?

No, no. We had a couple different things. Never, oh my gosh, never. We have decades of content. I know it's like, is it organized? That's the real question. Is it organized? Now, is it ever organized? It's too much to organize. That's an insurmountable task. Um, well, so we had a couple different we had a couple different options for opening today, but I think this is kind of fun. I mean, you know, we always like to have a little fun when we open. And this was something that we were discussing on Instagram a few weeks ago about some mother wrote in and was just at her wits end. And she was like, please, how do mothers cope when they hit that breaking point? And I was like, wow, that's a great question. We need to hear we need to hear people's coping strategies. We all have our own, but maybe we have some great new ideas out there. So, and we did get some very unusual, great new ideas on how to cope. So, so one mother wrote, sometimes I pretend to be a dinosaur, so I can yell. My kids actually think it's funny.

Well, if she's acting like a dinosaur in the process, that's that's a good strategy. If she's not sure if she's not talent, well, I don't know. They're all kind of terrifying, if you think about it's not, it's not like the herbivore dinosaurs are very friendly, very cute, round features, I know, but still, it's a dinosaur Trisha. They're the size of buildings. So you know, if your dog were the size of a building, you might feel differently about your dog, too. Oh, come on, Clifford, the Big Red Dog.

So, well, the thing is, in all seriousness, I think it's a great strategy, if she's playing dinosaur Well, she said my kids think is funny, so that must, must be working. Yeah, it sounded that way. A hot shower going outside crying and praying, a hot shower and then going outside stark naked and crying. This is what she's saying, right?

I guess when it's really bad, she does all three, one after the other. Does the order matter? No, probably not.

So she's outside. She's stark naked, like soaking wet, and just standing there with her arms at her side, head bent a little bit, and just sobbing.

Yeah, she probably has an outdoor shower. That's what I would think. Well, then again, it all works. It just the details really matter on these strategies. Apparently, what's next?

We're giving more ideas. Okay, I go outside. Lots of go outsides. I go outside, throw everyone in the car and get a coffee or something.

Okay, that works. The first thing I heard, you know, the brain works very quickly. And the first thing I heard was, go outside and I throw everyone, like, right before you said, in the car, I was, I was like, I was picturing, like, a pile of leaves. And she's like, hurling her kids into the pile of leaves. I go outside and I just throw everyone into a pile of leaves. Okay, but she said, in the car and she gets a coffee. Okay?

She probably does throw them in the car. I mean, do you remember those? Do you remember those days of like, pinning your kids down to try to get the car seat straps around them, like having to just hold them in that car seat because they would be thrashing and not wanting to go anywhere? I don't think that ever happened to me, but I remember when my I remember times it's so funny when you look back. But it's so impossible when you're in it. I do remember times when they magically turn their whole body into like, like a board. And yes, that's what I'm talking about, exactly what I'm talking about, but not thrashing when they just go into a board. Just, you just need them to bend at the hips so they can be in this. It's hilarious how kids have that power, like the survival skills that people and animals have. They turn their body into a board try to so they don't fit in the seat. I think it's a power kids have. Okay, anyway, it's I think it's hilarious. And I thought it was hilarious back then as well. It's so funny. Okay, gone. What's next? Actually, a lot of people wrote in that they put on their headphones and listened to a podcast for a bit, so just kind of disengaging for a little bit, then take them off and re engage. That seems like a very safe, calm strategy, yeah, and educational at the same time. Hopefully they're listening to down to birth, which means, right now, someone listening is, you know, this is like they're enraging their little lifeline. Okay, be outside with the kids as much as possible. Yeah. I mean, the outdoors just changes everybody's mood instantly. It's really amazing, yeah, if you have an inconsolable child, just get them outside and watch them stop crying. Just say, Oh, we have to walk to the wherever the curb or the mailbox, if your mailbox is at the end of the driveway or and you'll see somehow they stop crying.

I live in the Midwest, so it's pretty cold this winter, I've been going out to my zero degree porch to legit chill out, cold therapy, shock yourself out of it, that would put me in a much worse mood. And I think you do.

Yeah, I know what it's like in the Midwest. Like I want to cheer up right now, and I'm just going to go stand on my freezing porch. But good for her. She's what she's doing. Okay? In all seriousness, again, what she's doing is called Changing your state, and that actually is a good strategy, and it is instinctual for us. She's changing her state. So to go into cold it is, is good, yup, getting outside, sitting on the porch, going for a walk, or just drive with the windows down, it definitely makes a difference if the windows are down, Mm, hmm, doesn't it? I mean, everything is just like next level. When the windows are down, you just feel it's like the breeze blows away the stress, or even on some really loud rap music and drive through your quiet neighborhood.

That's funny. Okay, I put my phone away, turn off the TV, get some fresh air. It's simple, but it works for now. Yeah, you know that phone can really put us over the edge totally, because it's the multitasking, multitasking, multitasking. Then your kids need something from you, and you're trying to respond to a text and you're frustrated that you're interrupted, like, put the phone away for an hour or two a day. Don't go to it until your kids are napping or it's quiet, or, you know, they're occupied, it'll be much less stressful. It's too hard on the brain. It is. Our brains have not evolved to keep up with this level of speed and overwhelm and multitasking different directions and short attention spans and all that's really not good. All right. Knitting, nice knitting is great. Drinking coffee, not for caffeine, but I but to have something I don't have to share that's cute, something all for me, a nightly shower where no one can come in, no one bangs on the door, and my husband watches the children and I pray, hmm, lots of one, lots of people responded with praying, meditating, praying. I mean, that's all very self calming. I started counting in my head to 30 Mississippi, one, Mississippi, two, Mississippi, 30 Mississippi, and that helped me get my centering and grounding back. That's good. I like that. Good. It's nice to have practical things like that.

Whoever came up with that one Mississippi thing really deserves to be a millionaire, multi millionaire. Is that that just freaking took that? That was before social media, that thing went viral.

Was it football? Did it start in football? It's like a football thing. I do remember being in first grade. The whole theory is that as long as it takes you to say One Mississippi, that's exactly one second, which is a ridiculous theory. It's totally we all talk at different paces. When you're going down to the second, I think I can count seconds in my head pretty accurately, but it's not relying on the word Mississippi. I can't believe how that took. What a trendsetter, all right, somebody tell us who that was and where it came from. We are socializing, and we need to work.

Okay.

Hi. My name is Melissa, and I just got back from a friend's house, and she and I have very different. Views on birth. And you know, I've done two birthing center births, and you know, I just she did a hospital birth, she was just very upfront that, you know, she was not going to do any of the stuff that I did, which is totally fine, her choice. But, you know, hearing her story about how things started to get intense, and she got to the hospital, so she got her epidural, and she's so happy with with all of it, and it just, I just keep asking myself, why do I put myself through an unmedicated birth when I could just, I don't know. I think I'm just looking for some encouragement. Why? Why do I I know why I do it, but why? Just encouragement on how important each of our decisions are, but I just, I'm hoping to, I don't know, get some insight. Thanks. I don't know about you, I found that to be very touching.

Totally. It made me have a big heart smile inside, and I actually can't believe this is the first time we're getting this question.

Well, I mean, it's she's not just outwardly, intellectually asking, What are the benefits of a natural birth? What's happening is she's grappling with her own commitment to it, and I understand that. I remember when I was planning my natural birth with Alex, I was really excited and really scared. And I remember going to one of my best friend's bachelorette parties. We spent the weekend together, and one of her other really close friends who I really liked, she was already a mom of two, and she was just in this really cool, laid back way. She was like, just get the epidural. It's great. It's so easy. Just get the epidural. And she just made it all look like Cynthia. Why do you have to make such a big deal about everything? Why do you have to make everything so hard? Why do you Why can't you just be like Michelle and just be cool and relax and stop making a big thing and like, just do things the easy, comfortable way? So I understand that feeling. I think that's what I was hearing. She's just having that heavy heart, that heavy mind, why am I doing this? And I don't think it comes down to quote, the benefits. I just think some women are compelled to go the road less traveled.

Well, it's actually the road a lot more traveled, just less traveled in recent history. Yes, the norm, and I only meant in recent history, but it is currently the road less traveled, and you do feel more isolated. And you do feel like more scared. Usually, I don't know, women get to a point of being much more scared of medical intervention. That's where I landed. But I understand, like, why do i Why can't I just do things this way? But I think the bigger issue is, like, why she and her friend are discussing it? I think her life and her friend's life will be a lot easier if they just don't get into it with each other. It's just too private. I find it strange that so many women do talk about it openly with friends, because it is very, very private.

I mean, I think it's worth saying that a physiologic, unmedicated birth when your biology is left alone to do what it is designed to do along with your baby. It is a pinnacle experience in life. It is like profoundly life changing. It is, I mean, we can talk about all the all the benefits to your baby, into your body, into your brain, but you know, we really shouldn't overlook the fact that nature does have a perfect plan for how babies are meant to be born, and there is a lot to be said for that. And I think that's, you know, that is like the natural instinct, and we've been kind of just conditioned to think that we don't need that through, you know, the modern birth. I mean, for me personally, I was, I It wasn't even a consideration. I was far more terrified of an epidural than birth. I'm just trying to reflect on what I heard in her voice. What do you think you heard in her voice?

Yeah. I mean, she, she was wondering, why should I put myself through something that she has been conditioned to believe is more scary and and difficult than the other thing?

I think sometimes women are just compelled, and we don't need to make a list of pros and cons. And I think this is something that we forget a lot in life, we did none of these decisions we make in life come down to a list of pros and cons. We can easily make that list. We can easily make a list of why you and your baby will benefit by avoiding unnecessary intervention. Because we're believers in necessary intervention, but you we we firmly believe you and your baby will benefit. We know this by avoiding unnecessary but I still think that she is forgetting the thing that just can't go on that pro or con list. She's compelled. It's just who she is, even though she's scared, it's her instinct. Like I was compelled, I was super scared of it that I think sometimes we're just compelled and. There's not really anything anyone can say other than just sit with yourself and realize it's who you are. It's why you're pulled toward it, and other women aren't pulled toward it, and that's why we don't need to all talk with each other and agree or come to consensus, because it's such an intimate decision.

Hi, my name is Sam, and I just started listening to your podcast, and I just listened to one about cervical checks and how they're not recommended. But my question is, what if you have a cervical check and they you feel like you're ready to push, but your doctor or midwife says you're not quite 10 centimeters and you can't push. That happens with my first I felt the urge to push, but I had just a little bit of cervix left, and they were telling me I couldn't push. It would be dangerous. How dangerous is it really? I guess, if you feel the urge to push, and you do, but you're not quite 10 centimeters, like what would happen? Or how do you know? Like, what are the risks of that? Thank you. Have a good day. This is the dilemma of the anterior lip. And I've said it on the podcast before, and I'll say it again. Rachel Reed has a great blog post on this, and it has been traditionally taught, and I think most medical providers believe, in practice, that you really need to be fully 10 centimeters, no anterior lip, no nine and a half, whatever nine and a half means before you start pushing. And that may not actually be the truth. We do get the urge to push before the cervix is fully gone, and it may not be a bad thing to do so. And if we weren't always confirming whether a woman was 10 centimeters or not, it probably wouldn't matter that much. I mean, there are cases where mothers get the really premature urge to push where she is, you know, feeling the urge to push at, say, five, six, even four centimeters and prolong pushing at that stage would certainly be, you know, not the right thing to do that can cause swelling of the cervix. But when you have the urge to push, and you're just pushing spontaneously with your body's natural urges. If your cervix is going to get out of the way completely, the baby's going to come down. So you should follow that natural urge. And if there is not progress in the baby coming down, which usually a mother can feel then, then maybe, then you do check the cervix and find out, okay, maybe we need to make some adjustments here. This doesn't seem to be working the way we were anticipating. Sometimes women do get the very premature urge to push when the cervix is still thick and there's a lot of it left, and that is not a good situation. And that usually has to do with the malpositioned baby, or posterior baby, or the way the baby is coming, coming down, and usually positional changes for the mother resolve that. And sometimes she does actually have to just trying to breathe through that urge to push for a little bit and let it pass. We don't always need to confirm that a woman is 10 centimeters or the absence of cervix, of cervix before she starts pushing. If birth is slow or stalled, or she's pushing, but there's, you know, no progress in that pushing, then maybe that's when we ask to do a cervical exam and see if there is, you know, a reason that she might be having a premature urge to push. But if everything is just kind of progressing along the way it is supposed to, and she, as she gets these urges to push, she kind of like is working with her body and feeling that baby come down. I mean, why do we need to check? Just let it happen? Well, because what about that little risk, if there's a lot of cervix left, that that's the haunting that she's going to have, right?

Yes, but this is where your provider, being a skilled provider, and watching the woman is really helpful, because a good midwife or a good OB who understands what effective pushing looks like. And when a when a baby is progressing through the pelvis, you can see it. You can see it and how she how she grunts, how she groans, how she moves, how she breathes, and then there's always the little purple line on the back you can check, all right, yeah, okay. What is that called the purple line? It's called the purple line. Maybe there's a text from the body is called the linea negra, and the one on the back is called the purple line. I think it's just, I'm sure it probably has a name. In the beginning, they were like, We're going with Latin. And then they're like, man, just call it the purple line.

It doesn't seem to show up on everyone, but when it's when it's there, it's real, like it lengthens as your cervix is dilating. It's pretty amazing, one of the many mysteries. Okay, let's go the next one.

Hey, Cynthia and Trisha. Thanks for all you guys do. I love your show so much. I have a super quick question. I don't have a ton of info, but I wanted to know your opinion, just based off the information I have. I just spoke with a friend who just had her first baby. It ended up being a C section. She said her water broke, so she went to the hospital and labored for three days, and they told her her baby was stuck, and so they would have to have a C section, because she pushed for three days and couldn't get him out. When they went to do the C section, they found that he was actually in her vaginal canal, and they had to pull him back up and out, and when they did that, that she said they ripped her uterus all the way down to her cervix. So obviously I didn't ask any questions. I just told her congratulations on her baby. But I just wanted to know if you've heard of this happening many times before, and if you think this was just a simple failure to progress and maybe she went to the hospital too early, or what your thoughts were, thanks again. Bye.

I know that voice you do that is, yeah, do I know who it is? No, it's funny lactation clients. I know I know that accent so well, oh, now she's thinking, I don't have an accent. You have an accent. That's what everyone always says, yeah. I guess everyone thinks they don't have an accent, and the other person does well. I wish I knew more. I don't know. I mean, failure to progress is failure to progress, but sometimes babies need to be born by C section. Sometimes there is no further progressing. Absolutely, we don't know. I don't know if the babies was in distress. I don't know what was going on when they were doing the C section. And if the baby was really in a urgent, urgent place, then they would be more aggressive with, you know, kind of pulling that baby back up through the pelvis and and out of the abdomen. And certainly, yes, that could cause damage. I don't know. I don't know if she went to the hospital too soon. We just don't know the details of her birth. What we do know is that failure to progress is very often called way too soon, and women are not given enough time. Maybe this baby could have been manually rotated. Maybe if she got rest a little bit earlier in labor and epidural a little bit earlier gave her body time to energize. But again, this all depends on the baby's the status of the baby, which we don't know. So if the baby needed to be born expeditiously and the baby's head was down in the pelvis, actually in the vagina. They do have to push the baby back up through it's terrible.

I had one client who who went through something similar. She had a beautiful V back, which is what I like to think about when I think about her now. But her first birth, she was laboring beautifully. She was in a local hospital here, and when the baby was coming out, they saw the baby's bottom, and unbelievably, instead of supporting a breach, a frank breech birth, they rushed her into a C section, and had to just that poor baby too. Like to put the baby through so much it was just coming out, and they took that. Just really upset me when I heard that, I just couldn't believe she went through such an incredibly difficult experience. But we don't, we don't know. We know this baby made it out of, you know, past the cervix, if the baby's in the vagina, but we don't know. There are babies who can be that far along, and they are, they could be asynchronic. The head could be tilted. They could legitimately not be able to come out. It's possible that was not an unnecessary C section. It just what we do know for a fact is she and the baby went through an awful lot. That's all we know. Yeah, there's always this difficult place where a provider has to make a decision about using a instrument to deliver the baby, like forceps or vacuum and try to get the baby out and down through the vagina, or go the other way.

I wonder if the tearing of the uterus could have been avoided if that was just an unskilled or reckless provider, though, that's why I was saying. I think it depends on the condition of the baby. If they were really urgent with time, you know, if time was really of the essence, they may have been a little more aggressive and would take a tear, or the baby could have been fine, and they could have just done a bad job. I don't know. All right, if you are with us in the extended version, which is available on Patreon or on Apple subscriptions, and by the way, it is just a mere $30 a year. Is that right? $30 a year?

It's it's $30 a year. No ads ever, all extended episodes, and they go naturally into your feed. There's nothing you have to do. So basically, you get twice as many Q and A's, right? We get twice as many questions in every Q and A episode, and it's just such a nice way to support our good, hard work, which we're doing all the time. It would just be a field, a good feeling, and I think, a very, very nice reward. And so yeah, please support us on Apple, and if you don't use Apple, then on Patreon, where you all. So at any level, on Patreon, get all our extended episodes, always ad free, and so it's much more. All right, okay, so in the extended version today, we are going to talk about, we have a question about castor oil and what the risks are of using castor oil and labor. Should you or should you not? We have a question about macrosomia and a big baby in the first pregnancy, and how her subsequent pregnancy is being managed based on those results. And then the last question in the extended episode is a bout night weaning, night weaning off breastfeeding.

All right, let's hop to it. And if you are still clinging on for dear life to the regular episodes, it is then time for quickies.

It's quickie time. Quickie time is my favorite time. All right, okay, here we go.

Quick answers.

Yep, I get it. Give me that look. It's not always me.

Right? Is White on a baby's tongue an indication of tongue tie? Sometimes yes, sometimes no. It could be. It could not be. There's more than one reason for why down a baby's tongue. But yes, sometimes it is associated with poor swallowing, which is related to tongue tie, but sometimes it has nothing to do with tongue tie, like a big baby, oh, that was the extended portion. So everyone doesn't know what we're talking about, but like that be and the presumption around a big baby, but now they're gonna have to go back and subscribe and listen to the extended version. Thank you. And I did not intentionally do that. It's just natural for us to have the whole episode in our head after we record the whole episode before quickies. I never heard that about white on the tongue. That's news to me.

Yes, interesting. So I was gonna say more, but it's a quickie. So no, I'm not. All right, is my risk for hemorrhage greater in a C section with a partial placenta. Previa depends on what they do with the placenta if they try to take it out, yeah, as opposed to what they have to take it out well, or letting the body have a role in that after a C section, they can do that. Well, it depends on it depends on how they take it. Yeah, yes. I mean about Yes.

Wait a second, I have to know this. Are you saying after some C sections, women vaginally birth their placenta? No, no. What are you talking about? No, the the placenta may naturally separate, still.

Oh, yeah, right. Usually it's in a big damn hurry to, like, sew her yes, and usually it's manually removed. But isn't it always because of the risk of infection? Do they ever stand around waiting 15 minutes or whatever it might take for the placenta to detach? Do you think any doctor is doing that? It would be wise, I think probably in some cases, to to not just manually extract it. That does increase the risk of hemorrhage. But have you ever heard of a provider not taking it up manually after a C section or not? Um, I actually do not know the answer. I don't know theoretically. I guess the question, I guess what you're saying is theoretically, if they were to let it detach naturally, but because they almost definitely don't. Yes, this the risk is high. Well, I think it depends on, yeah, I think it just depends on, well, now we've gone way too long into this.

No, no, it's okay. Look, we've got a forgiving crowd. I think it depends somewhat on how it's how it's managed, and, yes, I guess a placenta preview Could, could? It depends on how deeply it's embedded. There's, you know, there's placenta previous that are more embedded than others, like, I don't, yeah, don't. I don't know. It's not exactly, but it's not a quickie. It's not a quickie. But I wouldn't worry about it. I wouldn't worry about it. You're having a controlled placental delivery anyway, in a C section, and they're going to manage it, so as they should, as they should with Pitocin, Yeah, makes sense.

What are the best resources for breath, work in labor?

Oh, I would say HypnoBirthing, but I don't know. I don't know if it's fair for me to say the best, because we don't know everything in the world but their yoga breathing techniques. I'll give everyone a takeaway. And after teaching breathing for about an hour and a half in my course, the big takeaway is, don't be a perfectionist about it. Yes, there are optimal breaths for optimal points in labor. For sure, the one that calms the nervous system, the best one for birthing your baby out, the best one for relaxing during surges. But the takeaway is, the longer and slower and deeper you breathe, the better. The more oxygen to your baby, the more you're going to combat the risk of fetal distress, and the more you're going to keep your physiology relaxed so that you can continue to secrete endure. Rather than catecholamines. It's a quickie. I've got more thoughts, but I'm going to stop right there. Just take my HypnoBirthing class. Become an expert in the in the whole breathing thing before you give birth.

Learn how to meditate and in use your own breath. The more you are comfortable with your own breath and use your breath to control your physiology before birth, the better it's going to help you in birth, whatever technique that is. And yes, take Cynthia's HypnoBirthing course.

Yeah, because the extra part of the whole thing is your physiology at large and your where's your brain, that the most important birthing organ. So when you put all of those together, it's a very powerful technique. Next, if I had a retained placenta in my first birth? Will I have one in my second birth? Okay, first of all, you probably didn't have a retained placenta. Placenta serving called retained aggressively, right? If it's 30 minutes or more, it's called retained some placentas take longer than that, so yeah, you might, but it's not really retained.

And if it was retained, it doesn't mean she will again at all, no if it was truly retained. But, you know, I have very strong feelings about retained placentas, and the fact that, you know, all the interruptions that we that we begin with, as soon as the baby is born, the lights going on, the separation of the mother and baby, the early cord climbing. All of this is contributing to placental problems. Placentas taking too long. Stop separating moms and babies and you won't have retained placentas, alright? And a host of other problems.

Help. I never feel like I get enough protein for breastfeeding.

Okay? You know how I said the brain works so quickly, and you just said, Help. Guess what came to my mind? H, E l, l, p, help, help syndrome, right, right. So weird, right? Because we just had a conversation this week about it, so I guess it was still top of my mind before. SOS was that that came up first? What did it say? I got all distracted after I heard help, H-E-L-P help. I never feel like I get enough protein for breastfeeding. Spirulina, algae, you never have to worry about it again. You just pop 10 of those bad boys. You get your protein needs met.

Okay, it's a quickie.

I have an exclusively breastfed seven month old. What are the signs of decreasing milk supply? Definitely not feeling like your breasts are less full. That is a sign that a lot of women think means that their milk supply has gone down. And it's not true. That's seven months postpartum, your breast can be totally flat and still producing plenty of milk. So I would say it comes mainly from the baby weight gain. Monitoring weight gain and your baby's behavior at the breast. If they're complaining and fussing and pulling and tugging and acting, you know, frustrated during feeds, then your milk supply might be going down, although some amount of milk supply decreasing after six months once you start introducing solid foods, is also a little bit normal. Seven months is maybe a little early, but it does start to change. What is the infection rate after 24 to 72 hours of your water breaking? I think that the statistics, I think I haven't looked at this lately, but it's around like in general, if your water is broken for a prolonged period of time, the risk of infection is around maybe 10% it goes up higher later. And it, of course, has to do with what you're doing and how you're managing your water being broken. And usually, when a woman has her water broken, she's getting exams. She's getting checked. The first time you get checked, your risk of infection goes up. The second you push any type of vaginal bacteria up into the uterus, your risk of infection goes up. Is tugging or windmilling the placenta necessary? How about fundal massage after the placenta is out? Well, windmilling was not a term I was ever taught, but I can imagine what that is. So, tugging, tugging the placenta. Is it necessary? No, is it done? Yes. Windmilling, I would imagine, is like a little bit of a like trying to twist the placenta off, like you're trying to unscrew a tight cap on a jar that should be illegal.

That sounds like human torture. I just like I cannot even bear thoughts about this. I can't believe women go through this. It. It makes me so sad for them. We only got this in Episode 200 with Barbara Harper, everyone should listen to that episode. Episode 200 with Barbara, we talked all about third stage of labor. That's so wrong. Okay, go on. I'm not the only time I can the only time I can see tugging the placenta or trying to manually remove the placenta as being necessary is, if a woman is bleeding, if she is bleeding excessively, you need to get that placenta out so you can stop the bleeding. But other than that, no, it's not necessary, and it's a bad idea. Last question, a personal one. Of course, if you could only watch one movie for the. Rest of your life? What would it be?

No, I can't do one. You gotta pick one.

Oh, God, almost my whole life. I would have said West Side Story, of course, the movie I've seen so many times that I just never get sick of is quiz show. I think it's perfection, and I bet that's on nobody else's list. No, it is. I might. We went on a triple date a year ago for our friend's birthday, and we all went around the table asking favorite movies, and another husband at the table and I were like, high fiving over quiz show. It wasn't it was an Academy Award winning Robert Redford directed movie in the 90s, and I don't remember the first time I saw it, but it's been a probably my favorite movie for at least 15 years. I just think it's, I think it's perfection. I love it.

It's an excellent movie. I enjoyed watching that. Yeah, I know

everyone watch it. Everyone has to watch it with me. So yeah, thank you. I enjoyed that evening that we watched it too. It's incredible. Everyone should go watch Quiz Show, and it's a true story, and it's takes place in the 50s. Anyway, go on. We'll go. We'll go over you. Now I'm gonna get all quiz show excited. Now, what?

What about there are very few movies that I have ever watched more than once, very, few. I can count them on one hand. It's always, it has always like you had one for most of your life. Yours was West Side Story. Mine was Legends of the Fall.

Oh, Brad Pitt, of course. But now, no, I don't know if I'd watch that movie again now. Now I guess the movie I've probably watched the most of and could still tolerate watching again, is Top Gun. Oh, okay, that's a great movie. I mean, every time I watch it, I I enjoy it.

Puts you in that old romantic frame of mind, and it's like the only movie that Ruby watches, literally the only movie she's probably watched it 100 times. So I've seen it a lot of times, and nice, I don't I don't get tired of it. Nice. Yeah, that is a wrap. That was a great, great questions. Great episode, fun conversation. Loved going off topic with you as always. And hopefully I'll see you for breakfast at your house on Sunday morning, and you can traipse on Sunday at 10. Very enticing. Thank you for the great questions.

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