Podcast: Cultivating Self Trust with Guest, Midwife, Dr Rachel Reed

Cultivating Self Trust with Guest, Midwife, Dr Rachel Reed

Season 2, Episode 7

When journeying through pregnancy we tend to just hand ourselves over to our care providers, on whom we rely to tell us if we are healthy and well and what we should do to bring our babies into the world safely.

But is this really the best way to be navigating pregnancy, birth and parenthood?

Self trust is a vitally important quality in birth.

How much do we trust ourselves to know what is going on for us.. and if not much, what can we do to cultivate a sense of self trust?

Dr Rachel Reed (Midwife, Author, Researcher, Educator and Podcast Host) joins me to answer these questions and more.

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TRANSCRIPT

AI GENERATED

Hey, it's Megan.

I hope you're loving this series so far.

I wanted to hop on ahead of this week's episode to tell you a little bit more about birth-ed and how we can support you on this journey through pregnancy and preparing for the birth of your baby.

Before I started birth-ed, there seemed to be two kinds of birth prep options available to families.

The standard antinatal course pathway, which kind of just listed pain relief interventions and taught you how to change an API, but didn't really give you any practical tools on actually navigating the maternity system.

Or on the flip side, there was quite a narrow branch of hypnobirthing, which kind of put home vaginal water birth on a pedestal and sometimes left the women that didn't have that kind of birth feeling pretty let down.

It was really important to me that we bridged this gap, and that is exactly what birth-ed sets out to do.

Our multi award-winning online and in-person courses provide you with an understanding of how birth works and what influence we have over that.

Gives you an understanding of your choices, your options and potential interventions.

Giving you practical skills in decision-making and communication as well as a toolbox of hypnobirthing techniques to support you to feel calm and confident whatever kind of birth is right for you and your baby on the day.

Hopefully, this is something you see reflected in all our free content here on the podcast, over on Instagram, on our Bump Club mailing list and in our Facebook groups.

But if you are ready to take the next step in your birth preparation, our online course is just £40 or $49.

It's currently being used by thousands of families in over 100 countries around the world.

Check out the link in the show note to sign up today.

I'm Megan Rossiter from Birth-Ed, and you are listening to The Birth-Ed Podcast.

If you're currently at any stage of your parenting journey, from trying to conceive to pregnant to new parents, you are in the right place.

Join me for some inspiring, informative, and often challenging conversations with the world's leading women's health experts, from midwives to obstetricians, doulas to activists.

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Ready to meet today's guest?

I just want to start this episode with a tiny caveat.

I was actually recording this at seven o'clock in the morning, literally after I'd just woken up, and as Rachel, my guest, lives all the way in Australia.

I was then due to rush off on the school run and join a school trip to the farm for the day with my eldest, and I was very excited about having Rachel as a guest.

So my excitement kind of comes through in this episode as slight verbal diarrhea, but there's a lot of golden nuggets of advice in there from Rachel.

So please forgive my overenthusiastic rambling, and I do hope that you enjoy it anyway.

Hi, everybody.

Welcome back to The Birth-Ed Podcast.

Today, I am honored and delighted to be joined by a very special guest, Dr.

Rachel Reed.

Dr.

Rachel Reed has been a midwife for over 20 years.

She is also an author, speaker, teacher, and midwifery consultant.

She has practiced midwifery both in the UK, where she is from, and Australia, where she lives right now.

She holds a PhD in which she explored midwifery practice during physiological birth.

She has penned two best-selling books, Why Induction Matters, and Reclaiming Childbirth as a Rite of Passage, which is one of my favorites pregnancy and birth books.

I would wholeheartedly recommend it.

She is the writer behind the fantastic blog that you might have heard of called Midwife Thinking, and she co-hosts the insightful podcast, The Midwives Cauldron, which if you enjoy this podcast, you will love.

So, Rachel, thank you so much for joining me today.

Thank you for having me in that lovely introduction.

So, there are a million different topics I could have picked your brains on today.

Lots of research or kind of specific pregnancy conditions that we could have talked about.

But I think a helpful thing for everybody to know is that your podcast, The Midwives Cauldron, does this absolutely brilliantly.

So, I actually didn't think it was helpful to kind of repeat something that you guys are already talking about on there.

So, I wanted to focus on something that is like a huge focus of my work.

And when I read your most recent book, Reclaiming Childbirth as a Rite of Passage, I was like delighted that this was like a really key thread that ran throughout the book.

And that is the idea of developing self-trust when it comes to giving birth.

So, I very much know what I mean when I talk about self-trust, but I'd love to get your thoughts on this.

What do you mean when you talk about self-trust in relation to somebody giving birth?

Yeah, so it's really about developing self-trust mostly in the preparation phase, so that's in pregnancy.

So it's about, instead of focusing on knowing all these external things, it's about focusing internally and connecting to instincts, trusting your body.

Now, by that, I don't mean trust birth because that's often said, isn't it, trust birth.

But in reality, birth is a bodily process and we hope that it's physiological, which means that it is a body working healthily, but sometimes it's pathological and that's still natural birth.

So nature includes pathology and it includes complications.

So it's not about just trusting that you will have a physiological birth because the chance is all you will, but you also might not.

So it's about connecting into that self trust of knowing your body, knowing what it is that you need and trusting that you will know if things are not going well or you'll know what help you need to draw on.

So that's kind of what I mean by self trust is trusting yourself.

Yeah, literally, and something that I always like is thinking of yourself almost as like a little being that is literally like inside you, like a whole nother person, that instead of putting your trust in kind of external things, it's this little person inside us that we are kind of tuning into and relying on.

And we quiet this voice inside ourselves for like most of our lives, don't we?

We're constantly telling children to finish their plate, even though they don't feel hungry or whatever it is, like from a very, very young age, we're kind of almost like conditioned to rely on external expectations or other people's kind of opinions rather than actually what is coming from inside ourselves.

So why is this important?

Why is self-trust important?

Why wouldn't you just hand yourselves over to the people that see birth day in, day out and let them get the baby out safely?

Well, you don't really need self-trust.

If you're gonna go and birth just at home with nobody else around you apart from your family, then I guess you're going to have a physiological birth because part of the physiological process is actually switching off that neocortex when women are in established labor.

So that's dampened down.

And the reason that happens in a physiological birth is because safety is instinct.

So when you are in that altered state of consciousness in labor and birth, you are deeply connected to your body and baby and everything is shut, from the outside is shut down and you're moving instinctively, you're responding instinctively, you're connected to your baby.

But it's very difficult to do that in a setting where you have people doing things to you, assessing you, telling you whether or not your baby's well by using their technology.

So it becomes really difficult.

And a lot of the things that are routinely done during labor and birth actually disrupt women's physiology and send birth off into all kinds of directions.

That's kind of, unfortunately, most of the practices that are cultural norms in maternity are not evidence-based and they actually work against physiology and work against what the woman's body is trying to do.

Do you have any examples of these kind of standard practices that we probably take for granted when we're thinking about our birth experience?

Can you give any kind of examples of what kind of things might disrupt us?

Oh, goodness, where do you start?

Even just leaving your home and going into a setting with a group of strangers in a place you've probably never been, that is already disrupting physiology.

And a lot of women, you have to, your nervous system is already on edge in that scenario.

So it can take some work to, as midwives, we know that that's going to happen.

So we have to work with physiology to help settle the woman in and allow her physiology to kind of kick back in.

The clinical assessments that we do, we do things to women to find things out.

We don't ask them, how are you?

How is your baby?

We straight away stick a monitor on to listen to the baby's heartbeat.

We're assessing progress according to timelines that make absolutely no sense.

So we're plotting women's bodies onto graphs.

And of course, to do that, we're doing vaginal examinations, which don't tell us anything and disrupt physiology.

So we kind of, all the way along, the things I was taught to do as a midwife, when I look back and when I've now looked at the research and evidence is like, I was basically taught to meddle with physiology.

You know, that was what I was taught to do.

Something that we kind of often do in our classes is I get people to kind of think about what are these potential disruptors that you're in your head, you're picturing when you're pregnant, you're picturing them as like completely standard, expected, that's what everybody does when they have a baby.

And when I ask people to think about, you know, what might trigger adrenaline and labor?

What might pull you out?

I talk about feeling like you're underwater when you're in that kind of really deep place in labor, like everything goes sort of quiet, you're sort of muffled, you're not aware of kind of what's going on around you.

And I talk about kind of asking people what would pull you out?

What would get you to stick your head back above the water?

And often people kind of leap to, oh, the baby's heart rate's gone down, or a doctor's walked in the room and said you need a cesarean.

And it's much less than that, isn't it?

It's tiny, tiny little moments of, again, what we kind of consider what we have a condition to think of is like completely normal and potentially good or helpful.

And it might sometimes be, but often actually can potentially do more harm than good.

And I suppose it's really important just to kind of emphasize that all of these things are kind of optional and it's for women to kind of decide which parts of it they want to engage in and which parts they don't.

So why don't we trust ourselves?

How did we get here?

Well, as you said, we're groomed to not trust ourselves just from children onwards.

We're in a culture now where we tell children to not listen to their instincts.

Don't do that, be nice.

You need to be nice to that person, even though instinctively the child knows that actually they don't like that person.

We groom that out of kids.

This is probably off-topic, but the other day we had somebody come to the house and my cats, now they're usually fine with people, just did not like this person, and both of them were out of the house.

That was an instinct.

They just immediately felt uncomfortable and off they went.

Now, if that was a child, we'd be saying, no, you need to be nice to that person.

So we don't listen to our instincts.

And we're taught not to connect to our bodies.

But we're really disconnected from our bodies and constantly living in our heads and online.

And so it's no surprise that when a woman comes into pregnancy, that she feels disconnected to her body and she's not used to trusting herself.

She's had a lifetime of being told not to trust herself.

And then standard antenatal care is centered around external experts checking you and your baby to make sure that you're meeting particular parameters.

So that again, just grooms women to be looking outside of themselves to know whether they're well and whether they're progressing.

And by the time they get to labor, that's who they're looking for, you know?

And however, even though we say that, we all know as midwives that it's the woman who tells us that she has a feeling something is wrong, who is usually right, you know?

You always listen to women.

If they're concerned, it's usually because there's a concern.

And we know that, you know?

When I think about my career, the number of times I have picked up something that's wrong through a clinical assessment that I've done in labor or in pregnancy, without the woman having first said, look, I feel that there's something not right here, or can we check for X or Y because I'm concerned?

You know, it's usually the woman who is the person, you know, surprisingly, because the baby's inside her, who will be able to tell you about the baby's wellbeing, far better than any of your tests.

And it's funny, isn't it?

Because this isn't given the weight that it should be in kind of clinical assessment from a kind of hospital maternity care perspective.

And something that I absolutely loved about your book and particularly kind of the use of language.

You talked about something called Her Story throughout it, which is a kind of, I suppose, play on the word history, but it's the story of kind of what's happened through maternity care in the past, through birth in the past, how we got to like this moment that we're in today, but looking at it through a lens of like femininity and womanhood and the female body and the female kind of history, rather than the kind of obstetric model, where when you normally look at kind of birth history, that's what we're looking at.

We're looking at these doctors that did experiments or they did this work or they did that work and all really kind of medicalizing it.

And we've actually got a great podcast episode with a male midwife.

And he talks about how, basically how like the male and female brains differ and particularly kind of in relation to birth and how when something is a kind of a male approach, there's very much that kind of trying to stick everything in a box, trying to categorize everything.

And some more of the language that I loved in the book is just kind of getting rid of the first stage of labor, the second stage of labor, the third stage of labor.

And again, these are things that we just think of when we do antenatal classes, when we kind of prepare for birth, that we're like, oh, that's what it is.

So it's one stage and then magic, and then we like suddenly flip into another stage, or we're in the latent phase, and then we're in established labor.

And it's not that, these are boxes, constructs that we have created, aren't they?

Yeah, and those constructs rely on somebody putting their fingers inside a woman to plot her cervix onto a graft to say which stage of the process that she's in.

And you know, that comes out of her story or history where, you know, the birth in institutions is fairly recent and it emerged at a time of industry and where we were looking at bodies as machines.

And so the knowledge, the obstetric knowledge was developed from conceptualizations of a body as a machine.

So, you know, processes that could be made more effective.

And, you know, women's bodies historically being seen as broken and not functioning.

So now there were machines that didn't function and that medicine could fix that.

And also pathology, because, you know, the early physicians didn't have access to physiology.

They were only able to access pathological birth.

So a lot of their learning was looking at basically dead women and babies and dissecting women and babies and then drawing pictures of that, which became the textbooks.

So, you know, a history or her story of birth is steeped in this idea of pathology and that women's bodies don't work and that they function like machines that are ineffective.

So we need to do things to them to make them more effective.

And that's reflected in all our language.

We talk about mechanisms of birth, stages of labor, you know, it's graphs.

We have measurements of baby skulls, categorizations of pelvises.

And it's all just a cultural norm, but it's not evidence-based and it isn't aligned with women's experiences.

And I stopped using the term stages of labor when I was doing my PhD.

And I made a commitment, I'm not gonna use those terms.

And I managed to not use those terms.

And I managed to develop and deliver midwifery degrees with midwifery students without any stages of labor, apart from to talk about why we weren't using it.

Because you can discuss the physiology of birth in depth without talking about stages like machines.

And that's kind of the basis of my book is to do that, to put a different framework on the physiology of birth that really centers women, not old ideas about how bodies work, which are not true.

Yeah, and when we focus in on it being this kind of medicalized mechanical sort of process, what that completely ignores is it's just looking at the kind of the biology, like what is happening on a kind of scientific perspective.

And it completely takes away the kind of spiritual experience, the emotional experience and those things are all connected and all influence each other.

And in my midwifery training, I was like shocked at how little I really understood about how the emotions that you're feeling actually influence the like physical unfolding of birth and how that your mind plays into birth and all of this experience.

And I suppose this is the kind of the whole concept of your book is that birth is a rite of passage.

So can you just tell me or tell everybody listening a little bit about what do you mean when we say like birth as a rite of passage?

Yeah, well, rites of passage theory is anthropology.

That's where it kind of came out of.

And Van Genep and Turner really did a lot of research back in the early 1900s about rites of passage, but they were really looking at other cultures.

So, which is easy to see as an outsider, ceremonies of rites of passage from boy to man and girl to woman.

And really it was Sheila Kitzinger and Robbie Davis Floyd who brought it into the kind of childbirth world and started to look at childbirth with this framework.

You know, we often get a little bit confused around thinking of rites of passage and practices as ritual because we think that's something outside.

So, you know, ritual is often considered to be lighting candles and, you know, smudging and doing like, you know, weird stuff.

But by understanding childbirth as a rite of passage, which is just simply a transformation, a life transformation, and it's a bodily rite of passage because we have, you know, graduating a degree is a rite of passage.

Learning to drive is a rite of passage.

And it's somebody who is going from one status or role and they're transforming into another.

And, you know, historically, communities have built or cultures have built ceremony around that in order to message to the person who's going through their rite of passage, what is required when they step into their new role.

So a girl becoming a woman, there would be a ceremony constructed to transmit to that girl what was required when she became a woman.

We don't have ceremonies now in kind of Western modern culture, but those rites of passage are still happening and people are still picking up messages about what it is to be transformed into the next phase.

So when it comes to childbirth, that's the rite of passage into mother and that's the rite of passage into mothering this particular baby, because a lot of women will go through a number of childbirth during their mother phase of their life.

So each one is a transformative process where they learn about themselves and they learn about what society thinks and what the beliefs and value systems are around being mother, being a mother in this culture.

But really it's about, for me, it's about harnessing that transformative process for the woman to learn about herself and to step into motherhood, knowing that she is the expert and trusting her instincts and feeling confident and strong to mother her baby.

And if that's the end result and what we are wanting for mothers, then we need to consider every action that we do during her Rite of Passage as a ritual that reflects and transmits to her that message.

And modern maternity doesn't, it actually transmits and reflects almost the opposite message about one's capacity.

And do you think this kind of contributes then to, I think some people will absolutely be listening and going, yes, that's it.

I came out the other side of birth and that is how I felt like I felt like a person transformed.

I felt like there's that wonderful, I can't put it as a proverb of some kind where it says, when you give birth, a mother goes to the sky, the woman goes to the sky and comes back as a mother or something like that, goes to the stars and comes back as a mother.

And some people that will absolutely be resonating with and they'll be going, yes, that's what I had.

Like I had this Rite of Passage.

But a lot of people will be listening and going, I like came out the other side of birth feeling like even more nervous, even more worried, even more concerned about my baby because of the way that I was cared for or my experience of pregnancy and birth and the kind of disruptions that were potentially caused along the way.

So when the vast majority of people listening to this will be accessing maternity care in the modern maternity system, in particularly now in like a post sort of post COVID world where in the UK we've got a midwifery shortage.

I don't know what it's like midwife wise kind of in Australia.

Like how do you navigate it?

What do you do to ensure that that rite of passage is protected so that hopefully you do come out the other side with that like really transformative, having had that really transformative experience?

Well, there's a difference between transformation and empowerment.

So the rite of passage happens regardless of whether you're conscious of it or not.

And transformation occurs regardless of how you birth your baby.

A woman is transformed with any pregnancy, even a miscarriage, there is a transformation of self that happens during that process.

So a woman who has, for example, a medical birth that wasn't something that she chose will be transformed in a different way to a woman who chose to have a medical birth.

And that was her Rite of Passage.

And she feels empowered by that because she got the epidural that she really wanted and was listened to.

So it's not necessarily about how the birth unfolds.

Physiology mirrors the Rite of Passage in its phases, but a woman who has an elective caesarean also has just as powerful Rite of Passage as a woman who has a physiological birth.

So if we're looking at transformation, it happens anyway.

And unfortunately, you're right, a lot of women come out of that, not transformed in an empowering way, not feeling strongly confident, but feeling broken.

And some of my research looked at that traumatic birth.

And we found that a third of women who had what they called a traumatic birth, two thirds of them, so a third of women had a traumatic birth, two thirds of them, it was about what was said and done to them.

It wasn't how their birth ended up happening.

It was about how they were treated.

So what we're doing during the Childbirth Rite of Passage for a lot of women is not centering them, regardless of how they want their birth to be or how it ends up happening, it's not centering them.

So that they come out the other end lost, that is their transformation.

And that's why I kind of wrote about how important our words and actions are because they massively influence how a woman will feel at the end of her rite of passage.

So what can somebody start to do like practically then in pregnancy or ideally kind of before pregnancy to begin to cultivate self-trust?

So that will depend on the individual woman.

So I have worked with women who want to satisfy their brains and I'm a bit like this, I like to know how something works in order to trust that it works.

So for those women that will be learning about how their body works to trust that it works, other women it won't be.

So it's very much about supporting as midwives, supporting the woman, what is it that you need?

How can we help you to develop self-trust?

Because for some women it will be yoga, for other women it will be meditation, for some women it will be none of that at all.

It'll be talking to friends about their births and hearing positive birth stories.

So there isn't a prescription.

And I've looked after, when I first started as a midwife, I wanted to tell women all the things that I thought they needed to know so that they'd make the right decisions.

And kind of learned now actually there isn't a right decision and women will navigate their own way through.

And I'm kind of just there to share the map as I call it with them.

And I've looked after women who have known absolutely nothing, having home births who have first babies who have just said, I don't want to know how anything works.

I just trust that it will work.

Can remember one woman in particular and she wouldn't say, don't get that pelvis out of your bag.

I don't even, I want to see it.

And she birthed, you know, amazingly just birthed her baby, herself in a birth pool in her front room and she hadn't prepared.

So there isn't a prescription around how to prepare.

However, I think there is to some extent a prescription about how to support a woman from a midwife or a doula or somebody who's in that childbirth education role.

And I call that the sharing the map.

So that's not necessarily telling women how their body works unless that's what they want, but it's talking to them honestly about the map, which is the terrain that they're planning to birth in, which will be different for different women, you know, which hospital they're going to, what model of care they're in.

What does that look like?

What are their rights within that?

You know, how can they exercise their rights within that?

I think that's where we can help women to understand how to navigate through the birth terrain that they're choosing.

But in terms of them cultivating self-trust, you know, it could be, it's really interesting because when I talk to women after their births and I say, oh, what did you learn about yourself?

And you know, it can go as far as the fact that, well, I need to, you know, what I've learned about myself is if I'm in a setting where there are external experts, I will end up doing what they say because that's actually normal, you know?

That's a normal thing to do.

And that that's what they've learned about themselves.

But I can remember talking to one woman who I'd actually cared for who was planning a home birth, ended up actually with a medical birth in hospital.

She had a cesarean for breach because a labor just wouldn't, it wasn't working.

So it was, she'd had a big curve ball thrown to her and then had a cesarean section during labor.

So I asked her, you know, what was the most empowering thing about your birth experiences?

So I'd now looked after her for three babies and two of them home births and this one, which was her first baby.

And she said, oh, the most empowering experience that I had during my three births was my first one when I was in hospital and my baby was breech.

And, you know, I was in labor and an obstetrician came in and was telling me all these terrible things that could happen and that I needed to, you know, be on the bed and had to have a monitor and had to do all these things.

And, you know, we basically, she didn't because we advocated that she said no.

And then the next doctor came in who was a different, completely different doctor with a new shift and came in and just said to her, how exciting, this is amazing.

You're gonna birth your baby, breach.

If you need me, I'll be there.

I'll be just outside of the room, but this is great.

And in that moment, it wasn't what the two doctors had said.

She suddenly realized that people who were outside of it had different perspectives on what was happening and had different things that they wanted her to do.

And actually, this was all about her and what she wanted because other people had all kinds of different ideas.

And she said that was the most empowering moment for her, was having two opposite perspectives on her birth.

So it wasn't her amazing home births where I was there and being the midwife.

Sorry.

It was her hospital birth.

So I think we need to really talk to women about what it is that they find transformative and what they learn about themselves because it might be not what we think.

Yeah, no, that's so true.

And I love that story.

I think that's absolutely brilliant.

And I think that's a really helpful thing for people to know because there is this expectation and we do put our trust in other people all of the time because we go, well, they've trained for years, they're experts.

And yes, like often doctors can be experts in pathology, midwives can be experts in physiology, but there is this missing bit that we sort of nobody really ever considers themselves an expert.

And you're like, well, actually you've lived in your body for 20, 30, 40 years.

You have felt it every single day.

You have been with this baby since the moment it was conceived.

You know what you're feeling and your body isn't lying to you.

If you're having sensations, you're having them for a reason and they won't always kind of make outward sense in terms of what is going on, what you're picking up from the outside in terms of putting it in those tick boxes and things.

But if you're feeling something, you're feeling something and that's really kind of valid.

And the other thing that a few of the things you've said have actually made me think of that I think is a helpful thing to raise particularly is definitely a bit of kind of British culture.

I don't know what the kind of culture is like in Australia, but we're all very polite.

Like we don't like to upset people.

We don't like confrontation a lot of the time.

And so it can sometimes, I think sometimes people feel afraid of if they say no to something that is recommended, or if they say, actually, I'd like a bit of time to make that decision, or I'd like a bit of time before we do X, Y or Z, because I'm feeling this, that or the other.

It can feel confronting, and it can feel like you're being rude, and you're not listening, and you're not respecting them.

I always just want people to be aware of, don't let politeness steal your kind of expertise or steal the birth that you could be having, just because you want to appease somebody else, that you only get to give birth to this baby one time, and you won't regret advocating for yourself or your baby, even though it can feel uncomfortable.

And it doesn't have to be, I think sometimes definitely like a lot of the chat on kind of social media and things is, if somebody says, well, I don't want to do this, and you get lots of comments being, oh, just say no, they don't know.

It doesn't have to be like a battle or a real kind of confrontation.

You can say no politely and still feel kind of comfortable in the way that you were behaving, if that feels more comfortable to you, but you don't have to kind of blindly agree because exactly as your story kind of demonstrated, one doctor, one midwife in one moment might be recommending or saying something completely different to the next person to kind of walk in the room.

So as we've kind of talked about already, there is like a wealth of information available now in courses, in books, online.

There's been something kind of particularly recently with regards to like specific birth positions that I've seen kind of all over the internet that's like this is the best birth position because of X, Y or Z reason.

How do we make sure in ourselves that this doesn't become more important than what our own body or baby is telling us or kind of communicating with us?

How do we make sure that we're able to tune into ourselves rather than somebody saying, you've got to be upright when you're in labor.

If you're upright and walking around in labor and it's really uncomfortable and painful and you're really exhausted and you want to lie down, I think sometimes people are like, oh, but they said, I've got to be up, I've got to be up.

And you kind of, again, quiet that instinct or that self that's inside you telling you what to do.

How do you kind of make sure that you're listening to you and not preconceived ideas?

I think definitely in my first labor, I decided that I was going to give birth on all fours because it reduced the chances of tearing and I had gravity on my side.

So I decided, and then I was in labor and it was just really, really bloody uncomfortable.

I didn't want to be there at all.

And fortunately, it was so uncomfortable that I had no choice other than to do what was comfortable.

But it can be this kind of seed of doubt in your head of like, oh, I'm supposed to be doing this.

I'm supposed to be doing that.

Yeah, well, it's just to, you are an individual.

Your body is not somebody else's body.

Your baby is not somebody else's baby.

And you and your baby are in this together.

And if you're working instinctively, you will get into positions that work for your baby that might not make sense from the outside.

So it's really reinforcing to women.

And that's why I really steer away from any of this prescriptive, yes, there's research on birth positions, but they're general in nature.

They're kind of, if we look at the pelvis go, oh yeah, well, it works kind of best in this position.

Well, yeah, it does.

But for that individual woman, it might not because of her pelvis and her baby and what's going on for her.

And we can't, as outsiders, we can't see that.

And the woman doesn't know until she's in labor how her baby's gonna make their way through her pelvis.

I have seen some really weird birth positions.

And this was after I'd stopped advocating for birth positions when I realized that actually women knew what they were doing if I just shut up, I saw some amazing birth positions that made no sense from the outside.

And then once the baby was born, it was like, oh, I wonder if, you know, this was happening.

I saw one woman, I've told this story before, one that really sticks in my mind as a woman, birthing practically standing on her head, you know, a head on the ground and a bottom in the air and the baby was going uphill and it was a third baby.

So like it was taking ages because the baby was literally going uphill and sliding back down.

And then once this baby was born, the baby came out with his placenta.

And I think his placenta had actually been really low and her doing that had taken the pressure off the placenta.

She didn't consciously do it, her body just knew to do it.

And I've seen that so many incidences of women moving their bodies, you know, releasing shoulder distortion themselves without you doing anything because they can feel the baby.

So just reassuring women and anybody who's listening to this, you have those instincts.

You are the expert on the birth position that you need to be in.

Just listen to your body.

If something's uncomfortable, move.

You know, if that position doesn't feel good, change position.

There isn't a perfect position or a correct way to birth your baby.

Yeah, you're interesting.

Your uphill story is very similar to my first birth.

I had an induction and was fortunately alone at this point on the antenatal ward.

And again, like new, I should be moving, which would kind of go up and down the stairs.

The only position that was comfortable was laying on my back in the bed with my legs and my bum propped up on the kind of top bit of the back of the bed, almost in a kind of like semi shoulder stand.

And I'm so glad that I was on my own at this point, because I know had somebody walked in, they'd have been like, oh, get off the bed, go for a walk.

And this is just, it was just the only place I could find a comfortable position.

And in hindsight, I now look back and I know that it was the baby tipping himself back out of the pelvis so that he could turn.

And then once I was out of that position, he was born very, very shortly after I then kind of stood up again.

But yet on paper, there's absolutely nothing in inverted commas that makes sense about wanting to stick your bum up in the air and be in a shoulder stand when you're in labor.

It just doesn't fit what the textbooks say.

And say, one thing that I always say when I kind of working with clients anti-natally, most of the people that I kind of work with do have a real interesting kind of, what are the hormones doing?

What is your body doing?

So we talked through all of this and then I get to the end and I basically say, now forget everything I've told you and go and have a baby because it's all helpful, it's all interesting.

It's nice to kind of know if you're interested in it, but ultimately it should never trump what your body and what yourself and what your baby are saying to you in labor.

So take it, learn it, and then basically forget it and just trust what your body is telling you in that moment, whether it's telling you that everything is good or that something's not quite right.

So I think it's something that is often kind of overlooked when we certainly tend to think of pregnancy as a thing, birth as a thing, and then like the post-natal period or parenting as a thing.

And we very rarely link the three together as a kind of continuum where one thing influences the next, which influences the next.

How often do we really hear people talk about how your birth experience impacts your breastfeeding experience or the kind of potential disruptions that birth might cause for breastfeeding either for baby or for mum or whatever.

And so what are the kind of longer term implications in your opinion of kind of self-trust as we move into the kind of post-natal parenting period?

If we've been able to kind of cultivate self-trust in pregnancy and feel it in birth, how does that then play out into like the rest of our, the kind of new season of our lives as mothers?

Well, ideally, if we have as care providers enacted actions and words around the woman that reinforce her self-trust and she's able to cultivate self-trust and then she births connected to her instincts and trusting herself to make decisions that she needs to make, then that will carry forward into mothering.

She's not gonna reach.

It just, it amazes me that we spend our antinatal care reinforcing ourselves as external experts and encouraging women to reach outside of themselves for all the information.

In birth, we do all the things to women and reinforce the fact that we know if you're progressing, we know if your baby's well.

And then once the baby's born, we expect them to just go off and know what they're doing.

And then we kind of go, oh, God, she doesn't even know how to breastfeed, or she keeps asking for help about this thing, or she's worried about this thing with the baby.

That, well, she stepped into motherhood, not trusting herself to mother.

And of course she's gonna seek external reassurance because we groomed her to do that all the way through.

So if we haven't done that and we've reinforced the woman as central and her expertise is the dominant one when it comes to her body and her baby, she is the expert, then she'll step into mothering like that.

And of course it doesn't mean she'll not have issues and problems.

Not many of us managed to do that, particularly the early parenting without lots of problems propping up and lots of challenges.

The difference is that she's going to seek knowledge about her baby and herself from herself.

And she's going, yeah, that doesn't mean she's not gonna seek external help, but she's gonna trust her instincts to know if this baby has a problem that needs to seek external help, or entrust herself that she can settle her baby when the baby's unhappy or crying and needing.

She'll know when the baby needs to feed that she won't need to read a book and have charts about how often she's feeding her baby, that she'll follow the baby because she's trusting the baby as well.

Yeah, yeah, absolutely.

I think that's just like a really valuable thing to be able to, a really valuable place to be able to start parenthood from with that because it is like you're in charge of an entire human being.

And it does feel like, particularly in late pregnancy, you've been seen like pretty much every week, the very kind of final weeks of pregnancy.

And then come between five and 10 days after the birth usually, it's like, okay, bye, see you later.

Go and look after this child that is now yours and you're basically in charge of shaping them as an entire human.

And the responsibility can feel kind of super weighty.

The final thing that I suppose plays into all of this is just how sort of secret pregnancy birth and like the early parenthood bit is now in kind of the modern world.

Like another question that I always ask when we're kind of doing, we talk about infant feeding on our like preparation for the postnatal bit.

And I always say to people, how were you fed as a baby?

Less than 50% of people even know, like they have never even been told or asked or wondered or considered how was I fed as a baby?

What was my parent, what was my mom's breastfeeding journey like?

What was my mom's bottle feeding journey like?

What was my birth like?

And some people are told, I certainly know some friends that have basically been told their whole lives that their birth was absolutely awful.

And this is the only message that they've ever received about birth, is that their birth was awful.

And almost like they hold some responsibility for this birth being awful.

And so it's either not talked about, we don't often hear much about our own birth experience or our own experience of being kind of a very newborn baby.

And even really like amongst friends, amongst kind of colleagues, the kind of slightly wider society, we don't talk in depth about what birth feels like.

We often when we're hearing birth stories, we go, oh, and then I was five centimeters dilated when I got to the hospital.

And then I like, I don't know, then I got an epidural and then it was four hours before I was 10 centimeters dilated.

And again, the stories that we're telling have this focus on the kind of external measurements rather than I was in labor and my back was in so much pain.

And actually a hot water bottle in my back was really helpful and soothing.

And that's the kind of bit that's missing from conversations around birth.

And something that I absolutely love in your book is that you talk about the science, the what is going on from a kind of scientific perspective, the biology, what's going on inside the body.

And then there's this kind of story that runs through, which is like a woman's birth story.

So while X, Y or Z is going on inside her body, what is she actually experiencing?

What does it feel like for her to be having a contraction or to be feeling the kind of expulsive pushing stage of labor?

Those are the bits I think that are missing from a kind of birth preparation.

And it's so secret that we're going into birth, we're going into parenthood.

Most people have never seen a baby breastfeed until they have their own baby potentially kind of on their chest, sort of like flailing their little face around trying to attach to the breast.

And is it any wonder that we don't feel prepared for birth or feel prepared for that early parenting bit when really nobody talks about it?

No, and it has always been.

So, and that's one of the reasons that I wrote the first chapter in the book is to understand what's happening now.

We kind of need to look back at what used to happen.

So, historically birth has always been to some extent secret in that it happened behind closed doors or away from the public view and was women's business.

And as a collective culture of women at birth, we would have attended lots of births.

So as a girl, you would have, the people who attended births were the woman's female, relatives and friends.

And sometimes a midwife would be there if the woman had one and could afford one.

But the main birth support were the community, the women in the community.

And as women in a community, you would have attended numerous births.

As a little girl, you would have been sat at a birth, listening to the noises, smelling the smells, hearing the stories, watching the birth and the breastfeeding.

So it would have just been an normal part of life that you would have understood and had experience of by the time you did it.

And you're right, now we're kind of, the only access we have to that is media now, really.

When very few of us have attended a birth or particularly more than one before we do it ourselves, we don't see a real one.

And we're reclaiming that a little bit through social media and access to movies of birth.

And that's relatively new in terms of outside the system births.

So we're reclaiming it a little bit in that now as a woman who's pregnant, you can go on and watch lots of women giving birth and hear the sounds and read their birth stories.

And that's great.

But another thing that's happening is we're, like with everything on social media, we're curating it.

We're editing the birth movies to show the bits that we want to because that's what we do with everything.

And that's normal human behavior.

So we're still not really coming to birth, being experienced or knowing it.

No.

And so it's asking, I always think asking those stories.

And when somebody's telling you a story, just get them to pause and just ask them to like, just go a bit deeper.

Like, what did it fit?

But what did that feel like?

Were you scared?

Were you joyful?

Did it really hurt?

Like, because we otherwise, we just get the, oh, it really hurt.

And then a baby came out and then it was amazing.

And like, and that's kind of the most of most people's stories.

And everybody likes to talk about their birth, like whether it was good, whether it was bad, like there's always something that you can take from birth experience.

So if somebody is happy to share, which often people are, then just ask and kind of keep digging and keep asking those questions.

When I did my research, it was a collected birth stories.

And what was interesting was because this was, I was just looking at physiological birth because I just wanted to know what midwives did when basically they didn't need to do anything because it was physiology.

But a lot of the women said, oh, well, I haven't really got a birth story.

And I realized that a lot of women who had, you know, straightforward physiological births where there hasn't been any dramas in quotes and complications and having to be saved, they feel like they don't have a story.

They almost all, they feel guilty about sharing a story that was, you know, where they had an amazing birth experience because they feel that other women didn't have that, you know, I don't want to share that because that might make somebody feel bad because my experience was amazing, you know.

So I think women are still shy about telling birth stories that are empowering experiences and yet, you know, very happy to share emergencies in dramas because, you know, that's seen as a story.

That's a proper story is where you rushed into emergency and, you know.

Yeah, yeah, and there's measurements and there's little like checkpoints along the way to kind of highlight.

My husband's version of our second birth is absolutely hilarious.

It takes him about 10 seconds to say, he's like, oh yeah, well, her water's broke and then she went into labor and then the baby came out in the lounge.

And that's basically his version of the story.

So I totally get that feeling like there isn't really like much to say, but deep there is.

There's like, there's feeling there and there's transformation there.

So we're kind of running out of time.

So the very last question that I ask people on the podcast is if you could gift a pregnant or birthing woman one thing, what would you give?

Oh, I'm going to have to say self-trust, I have to follow that.

I guess I would just, I would really like women to step into the Childbirth Rite of Passage and motherhood knowing that they are the experts.

They already have the power and to trust themselves.

Yeah, yeah.

And we've just explained why.

Thank you so much.

So, so helpful.

I'm going to ask you if people want to kind of find you where they can look.

But before I do, I just want to kind of personally recommend both of your books.

So I'll put the details to purchase them and all of kind of Rachel's links and things in the show notes of this podcast.

So two books, Why Induction Matters and the one we've talked a lot about, Reclaiming Childbirth as a Rite of Passage.

I also wanted to just kind of doubly recommend if people are after free resources, Rachel's blog, Midwife Thinking is just like, it just hits the nail on the head all the time.

And I don't know, I was wondering when I was thinking about this, I don't know if you can describe blog posts as seminal, but if you can, then there are kind of two particular blog posts that are probably like two of my most shared resources.

One is called The Curse of Maconium Stained Lycol and one is called Big Babies, The Risk of Care Provider Fear.

And I will put links to both of them in the notes so that you can kind of read them.

Just offering kind of slightly different perspectives than the ones that we might be kind of most familiar with.

And finally, The Midwives Cauldron podcast, my two favorite episodes, I think probably go in line with everybody's two favorite episodes are the kind of gestational diabetes ones about Pac-Man, which is again, just like explained in a way.

When you've got a 15 minute midwife appointment, you don't get two hours worth of conversation about what that potentially looks like for you, but on the podcast you do.

So you can certainly find Rachel in all of those places.

Where else can people find you if they would like to follow or learn more?

Oh, I guess Rachel Reed website.

And Midwife Thinking is on Facebook and Instagram.

Yeah, there is Midwife Thinking.

Amazing.

Thank you so much for joining me.

That was incredibly insightful and very, very helpful.

I am sure.

Thank you.

Thank you for having me.

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