Encore: Birth as a Rite of Passage with Dr. Rachel Reed

Today's guest: Dr Rachel Reed is a midwife, academic, author, and international speaker who focuses on childbirth physiology, midwifery practice, and women's rights (and rites). She has provided midwifery care for many women and has attended births in a wide range of settings and circumstances. Rachel is the author of the award-winning blog MidwifeThinking and the co-host of The Midwives' Cauldron podcast. She has published widely in journals and magazines, and her first book Why Induction Matters is a popular resource for women and care providers. Her most recent book Reclaiming Childbirth as a Rite of Passage: weaving ancient wisdom with modern knowledge will be published early 2021. Further information about Rachel and her work is available at www.rachel-reed.website. and….she’s just delightful.    I find myself getting sucked into her blog archives for hours at a time, and for today’s episode I decided to ask her about several topics that she covers quite wonderfully there.  I know you’re going to deeply enjoy this episode.  With that, let’s jump in!    Show Notes:   Big Babies Most women having homebirth in Australia have “big” babies, and they’re not scary.  In hospital, however, it can be a different story.  If a doctor diagnoses a mother with a “big baby” on ultrasound, it can begin to cause stress and fear for her. Dr. Reed mentions that the research does not separate healthy, normal big babies from those whose mothers have gestational diabetes.  These babies tend to have bigger shoulders and can have more difficulty coming out (though most of them come out just fine, too). “Big babies don’t scare me, but what people do about big babies does scare me.” Women who are told they have a big baby: C sections, tearing, poorer outcomes are more likely— so it’s the outside causing the problem. A care provider’s fear of the big baby can cause many of the interventions   Gestational Diabetes as a label— fairly nonsensical If there are abnormally high blood glucose levels circulating, that does impact the baby and potentially the birth.  However, the blood glucose levels being used are not evidence-based In Australia, around 17% of women are now labeled as a gestational diabetic. When Dr. Reed was training, we only tested those who had risk factors. The issues with challenge tests: it’s an abnormal test— many pregnant women are not drinking sugary drinks, so the tests results can be very off.   VBAC- Mountain or Molehill?  Is this as dangerous as the medical community seems to happen? Research related to this is mixed with those who are having inductions and those who are not— when we remove those who are having inductions, we see the already small number of issues become all the smaller. Statistically a <1% chance of uterine rupture, compared to all of the issues that may occur during a Cesarean (there is a higher chance of losing the uterus due to hemorrhage during c-section than having a uterine rupture). Inside the hospital, there’s been higher support for VBACs… if it’s done the right way: prepared for surgery, continuous monitoring, etc. Many women are choosing to have home births because they’re having VBACs to avoid all of the issues that can occur in the hospital   The woman is the decision-maker.  It’s her body, her baby, her experience.  Dr. Reed discusses how the care provider’s role is to support the woman in whatever decisions she is making.   It’s so important to make sure that the midwife and client are on the same page at the very beginning of the relationship.    “This is who I am, this is what I want, this is what I expect of you” from both client and midwife.   Fear Around Childbirth   Dr. Reed considers fear to be an important aspect regarding birth, as ancestrally we always would have had some amount of respect/fear for birth.     Separation Phase (early labor)— There’s anxiety and stress because you’re feeling the contractions begin.  The neocortex needs to be functioning at that time to pre