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Finding The Support You Need In Birth

Listen to the Podcast here.

Topic: Finding the support you need in birth

RC: Hi Everyone, I’m Deb Flashenberg. Welcome to yoga for babies podcast, produced by Prenatal Yoga Center. We will be diving into everything, Prenatal Yoga, birth and baby-related, hoping to inspire, educate, and empower you through your journey into motherhood. Thank you for listening.


Deb Flashenberg: Hi everyone. I’m Deb Flashenberg. I’m your host for yoga birth babies and today we’re speaking with Stephanie Heintzele and she’s a little bit of everything. She is a midwife. She’s a Doula. She’s a lactation consultant. She’s an acupuncturist. I’ll tell you a little more about her in a moment, the kind of full scope, but we’re having a wonderful conversation about midwifery obstetrics, a midwifery in other countries and comparing to the US how to get your Doula to be the best support for you and what to do if you have a care provider that maybe are not totally in line with and how your Doula can really help support that, that relationship. So before we jump into our conversation, let me tell you a little bit about Stephanie. So Stephanie Heintzele is a German educated midwife and acupuncturist and US educated Doula and ibclcs or lactation consultant.

She is the founder of the New York Baby, a team of 20 Doulas and baby specialist, Aka baby nurses. Stephanie was born in New York City, but grew up in Germany where she found her enthusiasm, fin referee at the age of 12 early for many things to her little brother, brother being born, and since then she’s delivered over 2000 babies and loves being part of this special phase in a pregnant person’s life. She is also one of the writers for health and baby. It’s pregnancy APP and baby app. And with that, let me welcome Stephanie. It is so exciting to speak to you. Thank you so much. Hi. Thank you for having me. Absolutely. So I’m really excited to jump into our topic about midwifery and Doula and your work in Germany. I mean, when I looked at your bio I was like, you do everything. Midwife, acupuncturists, Doula, childbirth educator, ibclcs. Like you’re like a one woman shop. It’s kind of amazing. All right, so let me start with just asking you to talk to me a little bit about your background as a midwife and Doula and what brought you to your work.


Stephanie Heintzeler: So, um, I’ve actually always wanted to be a midwife. I became a midwife. I’m pretty much right up to school when I was 20, but this a big urge was already a part of my life since I was 12. My, my little brother was born, so it’s his fault that I jumped on the midwifery line a pretty early on and I try to study and wanting to go maybe become a teacher or a doctor and, but really the passion was there. I did a lot of internships in delivery rooms, starting 16 years and just was hooked very early on. And um, yeah, went to midwifery school pretty much after school and um, follow through very quickly and then started working in a hospital in Frankfurt and um, what for many years, uh, in 2003 I moved to New York. Um, didn’t know about Doulas, didn’t know that midwives really work here and um, did a lot of other things, worked in a Gyn office, um, and just, you know, looked at birth and pregnancy from another perspective and 2006 someone told me about doulas and so became a Doula that same year here in New York, um, continue to work in Germany. So for quite a few years I commuted back and forth, which got a little exhausting. And so six years ago I decided to stay in New York full time.


Deb Flashenberg: Doula work mostly here now. Back up to one thing you said. So at 16 you were interning in delivery rooms? Yes. First of all, amazing because I think of where mentally and maturity wise I was at 16 and I don’t know if a delivery room would be the place for me. Um, but how did, how’d you get that to work? Like how did that get started?


Stephanie Heintzeler: That was luck in a way. It was my dad having, he had a, he was in rotary club and in my, in the close to Frankfurt where I grew up and the CEO, whatever, like one of the main doctors at the hospital in our town, he told my dad to contact him and he said I might be able to shadow a little bit. Um, and they thought maybe a couple of days, but they really liked me and I liked being there and so that took me on for months during summer vacation, which, yeah, my friends were just like looking at me and like they’re at the beach and I was like working in. I didn’t really, you know, I mean it was an internship but they paid me a little bit. I did like night shifts and it just really excited me. And also seeing other people’s reaction to be like, Whoa, like, what did I even got to deliver a baby two years later? So I continue to intern and uh, in other hospitals. And then two years later it was very busy day. I ended up catching a baby with a doctor who just came running in. Because no midwife was available and um, and you know, that even hooked me more and so yeah, it was really excited me.


Deb Flashenberg: How do you think that shaped your perspective of birth differently than your friends at the time that you know, just kind of went on what I put in quotes, kind of like normal understanding of birth and that world because at 16 that’s young to start to dive so deeply into that kind of physiology of birth.


Stephanie Heintzeler: Yeah, I mean I was way ahead with, with like birth and babies and that’s what a friend of mine recently said. I’m a mother of God, mother of one of her and I was there, um, during her birth. And so she was like, you know, you were a part of this, like you knew about all this 10 years before we did and then we kind of followed and you taught everything and now we’re like ahead of you in terms of we moved away from that phase again because now the kids go to school. And so, um, yeah, it was, it was something very for me. I think it made me kind of overly mature a little bit because um, for me it was very normal and you’re pregnant and well then you’ll have the baby and what’s the big issue? You know, it wasn’t, it was a very normal thing for me and it became such a routine at the same time in a good way because I was standing in a delivery room so early on and in Germany birth is seen as a little bit more normal and not as dramatic and moms can move around and give birth wherever they want and Harrison will different.


Stephanie Heintzeler: And um, so I think that’s, I got a quite some relaxation which helped a lot of my friends who were then I delivered their babies as a midwife and because for me it was just something while you’re pregnant, well you’re having a baby, there’s a contraction and you know, it was like, oh my God, you know, it was more very normal because I had seen it for so many years and, and I was so young and kind of got into this kind of naive and yes, it was kind of scary in the beginning because of the birth didn’t always go the way maybe it was expected, but at the same time knowing that there’s a whole team that can help and, and, you know, make sure this mom is supportive. I’m just, yeah, I think let me have a very good philosophy, um, which at least that’s what I hear from clients here that I bring in a lot of confidence. And that’s what helps a lot of moms.


Deb Flashenberg: Well, I was going to get to this later, but since we started it, and let’s go further. So from your experience having worked in the US and Germany, can you talk a little bit about the two different birth cultures?

Stephanie Heintzeler: So yeah, sure. It’s um, I mean on one hand it’s sort of the same because Germany is as modern as the United States and we have all the testing and pretty much the same going on ultrasounds. Um, it’s a little bit different in terms of the care the mother does have, usually has a um, ob Gyn or the Gyn who takes care of her medically, um, during pregnancy. And in addition to that, she has a midwife who she books early in pregnancy it’s paid by insurance 100 percent. So it’s usually alternating, which is great for birth, the mother chooses the hospital, so she usually interviews literally goes to open houses and like out of the 10 and the city she lives in, she chooses the one she likes the most. So we usually as a midwife, every two weeks we had an opening night and hopefully a delivery and one was a, they had a lot of and we made beautiful lighting and candles and oils and you know, made it all pretty with cookies and to kind of lure them in and say hey, deliver with us because we give you the best experience possible.


Stephanie Heintzeler: And every hospital does that. So every hospital has water birth, every hospital has mats and beautiful lighting and we call the rooms like earthlight and birthing Ireland and we have all these different kinds of beds with different shapes and you know, one room’s blue and one is more orange and one it’s more earthy in Winchester, more on this, more like a sky with beautiful lighting. So it’s, you know, for many moms after they’re like, well I didn’t really care but it’s kind of Nice because they come and arrive, being relaxed and they know they can go on the top. They have the monitoring why are less. And at the same time they have the C-section if necessary next door they can have an epidural. We do have a lower epidural rate like here in New York, it’s like 90, 95 percent. With doulas it’s a little less because of the moms don’t feel the need.

Um, but here it’s more the people are more pushy. Doctors and nurses are more pushy. I’m in Germany, the rate is 40 percent. Big Difference. So it’s much, much lower. Yeah. And it’s really, I think because the mom can be in the delivery room early on, like she can arrive at the hospital in early labor and she could linger around in the delivery room for a day or two. She gets her room or postpartum room. She goes back and forth and she’s a little worried but she’s there. So I think that’s something that relaxes moms versus here when you’re like, you have to show up at the hospital as late as possible and stay home as long as you can. And then they’re like, well, does it too early? Is it too late? You know, it’s, it’s really scary for mothers to feel like maybe my baby’s coming soon and I don’t want my baby in the car.

I don’t even want to ride the car right now. I’m and a Doula can help with that, but at the same time it’s still scary for the mother to have this decision and to know, oh, I have to hop in the car and arrive at the hospital and then answer 100 questions. In Germany we have everything. So the mom arrives. I’m like, Oh yes, your file. No more questions asked. So it’s more relaxed. Generally. I think the approach is more, you know, it’s, it’s just more laid back. We see birth as something normal. If the baby comes, if the mom arrives and the baby comes right away, we’re like, oops, okay great. You know, catch the baby and here’s like don’t push, you know, we need your papers and your insurance and your doctor isn’t here. And so it’s, I think genuinely more dramatic. Um, which, which sometimes, you know, worries moms.

It’s not even that things are worse here, it’s more of that there is so much different staff and so many people who do different things. It’s not in one hand, Germany, the midwife opens the door, the, you know, the birth is led by the midwife. By law, the midwife has to deliver the baby and the doctor might be present if you want to certainly floating on the floor so you always have someone available, but it’s in the same hands and I do the paper and I do the monitoring and so there’s not five people coming in. One draws blood, one does the paper, one does the admission. When does the monitoring and then the doctor comes in and does the exam. So you brought up so many.


Deb Flashenberg: where my brain’s at all places because they want to talk about it. Completely relate, but then I want to kind of highlight. I’m going to throw some questions, we’re going to go through them, but for those that don’t know the difference, we’re talking about the difference between Ob Gyn and midwife paused and they also want to just highlight what we. And you’re also a childbirth educator as am I. and what I always try to tell my students is that when we get into your delivery room, making it as Homey as possible, you know, shutting off the lights, bringing in pictures, making it, you know, because there’s that, that feeling of I’m in a strange place, it’s very bright, it’s kind of cold, weird smells. And then the body, you know, the adrenaline goes up, we go into that fight or flight. So in, in the other, in the German culture where it’s, it sounds like it’s inviting.

It’s not like, okay, now I have to do the work of creating the space spaces faces there. So that’s awesome. And then I love what you said about kind of the open houses, like what I try to remind the students all the time is that it’s a paper higher with your care provider. And I feel like sometimes that’s forgotten that the birthday person has a right to say yes or no and it doesn’t always get set up that way, you know, because maybe limitations of insurance, which we’ll talk about like how to deal with that. But I like that you’re creating the please hire me, I, you know, here, here are my attributes and hopefully we’re a good combo. But it, I feel like in our culture and the American culture, that’s not how the relationship seems to be. Would you agree with that?


Stephanie Heintzeler:  Totally. Yeah. I love that you guys do an open house. Um, so they already know that they’re going to deliver there. So there’s not a lot of options. Not that they can say I don’t like this, I want to go somewhere else. Um, and there’s not the same thing is that it’s not like customer service. It’s not like we are. And maybe there’s a video, maybe they can view a room, but it’s not that the room is anyway inviting. I mean a few bigger. So if new hospitals have larger rooms, but it’s not that they’re like beautiful and, and look cozy and inviting and here’s the tub and it’s more like, well, if you need to take a bath, this might be possible, but we don’t really. It do.


Deb Flashenberg:  You have also arriving? I know as a Doula that was always something I try to be, especially a new, when I was at new Doula, I mean I will admit I’m going to say there was moments where I’m like, let’s just get to the hospital [inaudible] I don’t know. As I got more seasoned I started to understand from listening and looking where things were, but that takes an eye and an experience and if a couple doesn’t have or even just the birthing person doesn’t have someone to, to overview and know with that education, it can be very anxiety producing if the kept saying you don’t want a lot of interventions, stay home and then there’s that nervousness of like, am I too late? I don’t want to give birth in the cab or the Uber. So I think the fact that the system is outside of the US is saying, come in, please be here.

We’re here for you. It really does. I didn’t, I didn’t know that. I didn’t know that that was a possibility and it really can take the anxiety away. Alright, so let’s back for. Thank you. That was amazing. I kind of shattering for me, so for those that are maybe newer to the birth world, um, a lot of people and I say like I was a dual, they’re like, oh, so you catch babies? I’m like, no, I’m say I’m not purposely are people that will say can I have a midwife and an ob and, and here in the states it’s, it’s not as, it’s not as cohesive and working together. So can you talk about the different, the differences and the different roles and then how you see in the u. s them working together.


Stephanie Heintzeler: So, um, Germany is more, it’s more separated, but at the same time it’s more together. So during pregnancy the mom has both, so usually she has her doctor once a month and towards the due date maybe every week she can see a midwife, especially when she has that midwife book for postpartum. Every mother gets 30 postpartum home visits by a midwife paid by insurance and yes. So that’s amazing. It’s really amazing. But the problem is that midwives get literally paid $30. No, sorry. It’s the euros per visit no matter how long the visitors. So the problem is on the side of the midwife because the midwife struggling to survive with these home visits, so we have this huge movement right now with like Midwest trying to earn more money with the home visits or mom’s not being able to get a midwife because there’s not enough midwives right now.

But that being said, I did a lot of home visits of course in Germany and I loved it because you do get to know your client and your patient in that regards. If I was lucky, maybe I even delivered her. And so, you know, it’s the midwife is doing a little bit before the birth and then a lot postpartum. The mother does not see an obstetrician after birth at all. The midwife was making all the medical decisions. She’s weighing the baby. Checking on John does. The pediatrician might have to be to the scene, not after two weeks. Um, you make you draw blood, you give injections, you do everything that the mother would get from her ob and the pediatrician. So that is really nice because it’s in one hand and it belongs together. And at the hospital she, the mother will be greeted by the midwife, taken care of by the midwife.

The midwife does what the Doula would be doing here and midwives in the hospital if the mom had chosen a midwife. So the midwife does the medical part and the support part, the emotional part, she might of course I have to take care of two, three months at the same time. So she’s not like constantly there but it’s one shift. So she’s there for like eight, 10 hours and the doctor shows up for like medical emergencies or huge decision. So oftentimes when we had burst that took longer or that were more medical or of course an epidural. And we were like well the blood pressure is dropping. You had the doctor in the room. So there was usually one doctor responsible for, you know, a delivery room with like five rooms and three midwives. I’m just like going back and forth and checking what’s going on and always present for the birth at least on the floor. So if not in the room, then they were around and then we had a, another doctor there who were able to jump in for like C-section. So there were two doctors and one midwife, but also for C-sections, the midwife has to attend the C-section because she’s the one responsible for the baby. So


Deb Flashenberg: how’s the scope of practice different here?


Stephanie Heintzeler: Um, one big difference is that because by law the midwife has to deliver the baby. The doctor is not allowed to deliver a baby by him or herself, you know, we’re more empowered. We just, we can make decisions. I do the Pitocin, there’s no putting in the order, nothing like I do. I did everything myself. I decided when to do, when to break the water, when to admit when to decide for vacuum. Call the doctor and I called the doctor. Things like that, resuscitation of mother or baby. Everything is done by a midwife. Um, but what we don’t do as midwives in Germany is care for non-pregnant women. So here midwives can also, do you know, a union exam as well. Women care and are trained in that. And we don’t do that in Germany, so the midwife is really only there for pregnancy, birth postpartum and conception and contraception as well. And um, and then we’d, like I was trained in acupuncture and midwives are the only people in Germany who are allowed to acupuncture to do acupuncture on a pregnant person. So pregnant people only saw midwives in the delivery room or outside and that was paid by insurance. So we have a lot of acupuncture and wonderful results with that.


Deb Flashenberg: If someone is pregnant and they were just having heartburn and they wanted, like right now I do the midwife, it wouldn’t be a separate action.


Stephanie Heintzeler: No, because the acupuncture is the one, they are not trained. There’s a few who took on a certain training to be allowed to give treatment to pregnant women. But there are certain points that you can use when people are pregnant and also accurate insurance wise during pregnancy insurance agreed to pay. Um, but if a mother is, you know, if someone is not pregnant then they usually don’t pay. And so the mom, of course, they’ve, they want to see the midwife, um, because they get reimbursed. That’s another reason


Deb Flashenberg: I didn’t realize how much, how different the midwifery role was in Europe. Is that kind of standard? Pretty Standard.


Stephanie Heintzeler: Okay. For sure. UK, Netherlands, Netherlands, they have what, 60 percent of home births, um, led by and a friend slept by midwives, Italy, Spain. They have less home visits. So it’s not as common to do like those 30 visits that Germany’s really, you know, very, very, very good with that and has wonderful results. But the UK has it. So usually the United States and UK especially here, like when I got trained with lactation for example, we always look at studies and numbers in the UK because, you know, we’re used to be a British country. So it’s like usually we compare ourselves with the UK


Deb Flashenberg: and our birthing is so different. Yes. Yep. So what would so say someone’s newer to the birth and you’re just listening to this and they’re hearing the difference between ob Gyn or midwife in Germany. What would someone expect here in the states?


Stephanie Heintzeler: I mean, you know, if someone has early pregnant, I would strongly recommend to hire a midwife instead of ob because the midwife can do, of course just as medical stuff as the ob and would refer if something gets really tricky. Um, but that being said, you need to have hired your midwife usually by what, eight weeks of pregnancy. Even the good obs are getting booked by like eight or 10 weeks of pregnancy. Um, but most mothers also my own clients, I’d say 95 percent are with an obstetrician already when I get in touch with them or they get in touch with me. Um, and there are amazing obstetricians. It’s more like knowing what questions to ask. So it’s not that every obstetrician is super medical. They, there are a lot of them like birthing center obstetricians who, you know, Lennox Hill has a couple of like Mount Sinai, they have wonderful obstetricians who are super hands off.

So it’s more choosing the right ob and knowing who is maybe working like a midwife. I have a couple who I adore and they work like I would work as a midwife. And um, and then if you have more medical approach doctors just knowing your questions, hire a Doula and the Doula is not against everything but the Doula will give the mother the questions so it’s more like empowering the mother and knowing what to ask. I had a mom last year who worked with an obstetrician who I really don’t like and I don’t like working with this doctor and the mom was like, you know, I don’t want to switch and I think I can work with this doctor. I’m, I’m strong minded and you know, I’ll fight for things and I’m already fighting for a lot of stuff. Would you mind being my Doula with this doctor? And I said okay. And we had a wonderful outcome because the mom kept fighting the whole pregnancy and always questioning him and, and at some point he just kind of relax and he got that she was the friend and didn’t want everything the doctor wanted and really gave in and welcomed me. And it was perfect really. So I think if a mom has is feisty and is like, okay, I can, I’m strong enough to fight for things, that’s great, but there’s not a lot of moms who want that and it’s hard


Deb Flashenberg: energy. We’re talking about. Let’s shift gears a little bit. So can you talk a little bit about the scope of practice, what a pregnant person should expect from a Doula? Because a Doula, I have so many people that when am I going to do a little like, oh really? What they don’t know. So what would you say someone should expect and not expect? Like what the scope and what’s in the scope?


Stephanie Heintzeler: So doulas or nonmedical, that’s the most important thing. Um, doulas don’t make medical decisions. They don’t give answers or without fighting with the doctor. But doulas are for the advocate, for the mother, during neighbor mainly. And of course for the partner, they’re a person who is usually, we call it, sometimes they call themselves the expert in the room, which in fact was true because they see both perspectives. They see of course the medical part and they see what the mother wants, what’s doable, what’s not. I’m a Doula is a coach, a birth coach who is a guidance through all phases of pregnancy, labor and birth and postpartum. So it’s like the one constant, um, and really a person who wants to find out what does the mother want for pregnancy, but mainly of course for the birth and postpartum and how do we get there knowing, for example, the obstetrician, knowing that team, knowing what protocol this hospital has, knowing what’s doable and what’s not and really there’s a lot of training and communication, like how to communicate maybe when the mother doesn’t get what she wants and sometimes I’m buying time so because I’m not in labor and I’m not like panicking and knowing what the situation is and knowing that it’s not an emergency.

Um, even as a new doula because the nurse told me. So for example, um, the buying time by asking power questions like, you know, is my client okay. She okay. Is there anything going on medically with her? Is there anything going on with the baby? Is there any stress? The baby has like dips, heartbeat things, and then if the doctor says, well no, mom and baby are fine. Then asking the famous question, can we have more time? Which is, you know, so often the doctors like, sure. And you’re like, Whoa, okay. So it’s often the parents think of that because maybe in that moment they’re like, whatever, I don’t care, let’s do the resection and I know that this kind will ask me forever and ever was that the right decision after birth? Right. It seems very convenient right now. But then after she’s like, should we have taken more time and often that half hour, that hour where the Doula gets the time to do stuff with the mother and that’s the other thing, to do less trained and positioning the baby, opening the pelvis, moving the mother around.

Um, you know, knowing where the baby needs to go in which phase up to using breathing techniques, like making sure the mom opens her pelvic floor as much as possible. Um, that helps tremendously. And oftentimes doctors don’t mind as long as they’re being asked. Right? And, and they give the, okay, I’ve had a mom when that February, oh my God, it took forever and she didn’t progress and we didn’t know what was going on, what we found out in the end, which I figured was the cord was wrapped around the neck, so the baby was just kind of bouncing back or the time, um, but also the baby mouth position for a while. So I put the mom in downward facing dog in the delivery room on the bed, was the nurse left and ride in an epidural. We’d literally lifted her up like she couldn’t move. She fell in the legs and the Dr. allowed it and we were able to turn the baby and it was a vaginal birth. So, you know, you have to be creative and know spinning babies and there’s lots of training students do and that I think as a client, as the key to ask the Doula your interview with what other training do you have? I mean a new doula can still have other trainings, spinning babies and breathing techniques other than the weekend training that she does to become a Doula.


Deb Flashenberg: Yeah. Yeah. I love that fit because the Doula does have hopefully, you know, other trainings and other knowledge that um, the traditional obstetrician probably doesn’t think about or know. I remember being in a birth and asking something about baby position and the doctor’s saying like, that doesn’t really matter and I felt kind of shot down because I had just talked to my clients about let’s find out. I think it’s malposition let’s do this. And that may not be in their realm of practice because that’s not, you know, that’s not where they’re thinking and you know, baby position is huge. And for to have a support person that can recognize that and have that information of how to move them on move the baby can make a huge difference on the functionality of the birth. Yeah. Yeah. So what about when into, your client did this before she, she kind of fought for what she wanted, but how can someone utilize a Doula if they’re, if they don’t have a care provider that they like or they’re kind of stuck. Because I know some in New York City, there’s a fair amount of people to choose from and you know, fair amount of insurances, but there’s more rural places are some places that just don’t have as many choices. So how can I do to help support that?


Stephanie Heintzeler: A big thing is really stepping back and being like, okay, what was your initial birth plan? Where are we at? Let’s say the big thing is usually induction, right? So induction overdue or induction because the baby hasn’t been growing properly or not enough amniotic fluids. And so let’s say in the mom calls me and she’s on her way home and she’s crying. She’s like, I’m supposed to be going tonight. Um, and then really looking at, okay, I’m, I’m not telling the mother to say no to this because if a doctor has a medical reason, there’s a medical reason, but it’s more asking the mother, okay, how important or how strongly did your doctor advice on that? And how much wiggle room do you have? And where are you at this point? Because if, you know, if, let’s say I took her mother out of this induction, she might have a sleepless night.

She gets super worried. The doctor made her sign a consent form that like, it’s her. I don’t really want that. Um, so it’s more looking at, okay, what’s the reason? And yes, I get that you don’t want this, but you know, how strongly that the doctor advice to you for you to do that because sometimes they like, well, let’s do this tonight because we have some space tonight. And if she called the doctor back and she’s like, you know what, this is freaking me out. I’m super nervous. Can we please postpone with Switch Mara? What this medically safe like, is my baby going to be okay tomorrow? Many doctors say, you know what? Yeah, that’s, you can wait until tomorrow. You can maybe do some natural induction methods tonight and try a couple of things. And they are okay with that. It’s oftentimes a scheduling thing, um, for the hospital, of course, for themselves.

They’re on duty right now and they would like to be there themselves. But if the mom relapses with that and says, okay, Tamara would be someone else, but I’m okay with that. I can buy more time, that can help. Um, sometimes it’s also just calming down the mom. I mean, we don’t, we might not want this, we might not want the induction or we might not want whatever, the water being broken, but it’s more telling the mom why this makes sense at this point. And if, when I confirm, which of course for me it’s kind of easy because I’ve done midwifery and you know, I’ve been a Doula in New York for like 12 years now, so I know exactly where the doctor’s coming from. An a huge thing is auto liability and not taking some risks and being like, well yeah, let’s wait another week.

And then something happens to the baby, God forbid. So I could see where they’re coming from. An also tell the mother, you know what, we want to be safe. Everybody wants to be safe. We want to make sure the baby’s growing properly. And it’s always the question, is your babies safer inside the womb or outside? And the transition might not be great for, for you, but you know, rather have an induction where the baby’s getting monitored and we know baby’s fine in early labor then having some risky situation five days later when you’re in early Labor at home and we don’t even know what’s going on. So it’s more telling the mom, you know what your is cautious and that’s a good thing. And, and then oftentimes they’re like, oh, so it’s really, I don’t ever want to be one of those doulas who’s fighting against.

No. And we want the natural approach and it because we want a healthy baby and a good outcome and as in a safe environment and emergencies might happen. You just, you don’t know. And I’m here. Yes, it’s a little bit more about control in this country, right? And making sure everything is fine, but there’s a reason for that because unfortunately there are a lot of lawsuits against obstetricians and so they have their reasons. And oftentimes I really agree like, you know, looking at maybe the mom is way overdue or the baby hasn’t been moving properly the last few days. I make, you know, you notice those signs, so it’s, it’s not coming out of the blue and it’s not something that is completely, you know, not necessary. Um, so I think that is really a big thing to discuss with a Doula and hearing the options and maybe even then talking about, okay, how can we make this as comfortable as possible and when the doula would arrive and what to expect.

That’s a huge issue and anxiety that the mom has. She doesn’t, she’s freaking out because she has no idea. Like the baby’s going to come tonight. And I’m like, okay, hold on a second. This is an induction is going to take 24 hours and overnight you might even be sleeping. And this is usually a process that takes quite a while. And so you have some time to adjust. And oftentimes I’ve certainly had inductions that went beautifully with no other medication other than what was needed for the induction, no epidural giving birth, like squatting, you know, it’s. So it’s not always a overly medicated birth if that’s not what the ones,


Deb Flashenberg: what, how, what would, uh, what kind of birthing person expect from their doulas who say they know they’re not on board, that the Doula and sorry, the, the mother and the doctor and not totally eye I what way. So you’re talking about, you know, the Doula, it’s not a medical person. So is there anything that the birthing person should be expecting the Doula, like we don’t want to put the Doula in middle, but like what can the Doula do?


Stephanie Heintzeler: It’s more, you know, if I’m in the room, one thing is like I’m not in the room and it’s like the mom coming home from the doctor’s visit. It’s a little different. But again, it’s more me like, okay, if you really don’t kid, he don’t want this. If you don’t want this induction for example, right? Or your water broke and they tell you to come and you really don’t want to. This is your responsibility. So are you okay with that? That’s your responsibility. And you might have to sign something. And I okay with that. And some moms are like, great, yes I am. And they give it a few more days or they wait or go back home, come back the day later and they signed a waiver and the doctor was off the hook and away, um, if I’m in the room, um, for births and I’ve had inductions of course, or other situations where the mom came in through the hospital and something was done and she really didn’t agree at all, but we were just like, okay, this is your doctor telling you this.

And the doctor literally refuse to take care of my client. If she refused to do whatever they wanted to do. So then what can you do? There’s not much you can really switch providers. You’ve, you know, it’s, it’s not great, but at the same time, thank God I haven’t had this happen often. If I’m in the room, um, let’s say, you know, the doctor wants to break the water or I see the doctor wants to do something like an internal monitoring. They can little hook on the baby’s head. Um, I usually, you know, one thing is that I give my client and tell my client, hey, you know, Dr wants to do the internal monitoring or breaking the water. Are you okay with that? And I have this um, little insider knowledge with my client that if I asked her, are you okay with that?

She knows I am not so, and if I tell her this is why your doctor wants to do that, then she knows I’m on her. I’m on the doctor’s side. So that’s a little secret have with my client because when I asked my client, are you okay with that? My client is like, hold on, or her husband or partner is like that. And then they can ask the question and I’m not in the middle. Um, and then usually the doctor explains, oh, I want to do the internal monitoring because you know, we don’t have constant monitoring. The BB keeps moving and, or I want to break the water because it, things haven’t progressed. And then the husband or partner can ask the question and if they didn’t ask everything that I feel should have asked them, I asked questions and you know, if I still feel well, we could wait a little bit then I sometimes say, is there anything we can do?

We wait to wait with us because it was a, I remember that it was a huge, um, wish of yours. And I look at my client, I remember this was very important to you to not have the water broken artificially or to not have that into an internal monitor. Is there anything we can do? So that’s as far as I go, I don’t ever want to be like, we really don’t want this or because you know, first of all the ob could send everybody out of the room, the partner and me and be like, I do this now and second, there’s a reason why doctors want to do certain things. Um, and usually that doesn’t it?


Deb Flashenberg: Yeah. The average Doula, same thing. Is there anything we can do? Anything we can do, but you know, the kind of the code of like, I don’t agree with this, you know, ask more questions, but the average do, it doesn’t have the kind of medical background. Do you do. So what could the, how could the Doula support? I guess just keeping asking questions.


Stephanie Heintzeler: Yes, that’s what I train my Doula. So I have an agency with 12 other jewelers, right. And we do monthly meetings and just recently we had a meeting about interventions and you know, what kind of interventions are there and Alyssa the questions that could be asked. Um, so the Doulas, many experience Doulas knew of them and then the new ones when it, oh my God, this is amazing. But um, I think that’s a big key to just really keep asking questions. And also I think, you know, I might not even ask a lot of questions because I feel the doctor really wouldn’t answer them, but then I’m like, okay, asking my client again, are you okay with that? And what other questions do you have and I want you to be okay. So then I really turned to my clients say, I want you to be okay with this. What else does your doctor need to do? What else do we need to do in order for you to feel safe with this? It’s really less and every dude I can ask this question.


Deb Flashenberg: Yeah. So it’s using the Doula to help the mother find her voice to ask or the partner because if the mom’s really laboring and kind of that that’s the case and she hopefully isn’t in her frontal brain thinking. Yeah. So it’s really using the Doula to recognize where questions should be asked and that can then take the confrontation because some, some care providers don’t necessarily like doulas that are two issues. So it’s, it’s kind of helping them find her voice, is that you’re saying it’s.


Stephanie Heintzeler: Yes. Yeah. And it, it, it can be hard. There’s certainly doctors where I know it’s difficult and I’ve certainly had situations where I was just like, let’s just do this. It’s not the end of the world. It’s the water, you know, for example, of what, of being broken or drawing or giving you IV fluids. That’s another thing where I’m like, okay, it makes, will be happy if we don’t fight against, is there more important things that’s just let’s just do this. And sometimes I tell my clients sometimes like to, you know what, I think it’s fine and that’s just everybody’s happy with this and um, if you don’t mind, that’s maybe just move forward with this. It’s not a huge intervention tool. Yeah.


Deb Flashenberg: Tool for Doulas to hear, but also for laboring people to hear if they’re choosing to do, like how to really utilize them to their, to their vest. So I want us, I know you have to hit Austin so I want to come up with them. If so, since you’ve seen birth and multiple cultures, is there one or two lessons that you’ve seen elsewhere that you would love to see in the US? Any practices or just kind of wishes like, oh, it would be great if this was here evidenced based shows this is better or even just kind of something you personally like.


Stephanie Heintzeler: I mean positioning is a big, big thing. I was just at a talk yesterday with amazing obstetric team, right? And it was a talk about pelvic floor and the functional pelvis. They were there, it was wonderful. And you know, it’s really a big thing is positioning and letting the mom deliver the way she wants at Lenox Hill. There’s a couple of doctors who think they don’t care. The mom did the risk squatting hands and knees standing, whatever. They, they just, they’re just whether mom is and saying, well, you know, bob and other of course doctors. And that I think is a huge thing because in Germany and the UK and other countries, the mother can deliver on hands and knees and you know, moving her pelvis and deliver in a way where she makes sounds and doesn’t do this. Like, you know, had to chest. No sounds, push everything there.

Everything down. Um, because that might hurt her pelvic floor more and it might make her feel she’s out of control. So letting the mom push sheet the way she wants and utilize her power and maybe the sound and use the position. And yes, if the hospital protocol needs to mom to be on her back, whatever, then okay. But then she could be standing up until the baby’s coming like the last two minutes, she needs to lie down and there’s some doctors who do that, which I think that’s wonderful because the mom can move around in the last two minutes. She can handle, you know, she can handle it to lie down. But I think that’s a big thing because we see less tearing if a mother is allowed to deliver on her side or hands and knees with an epidural. She could be on her side, um, if she pushes the ways she can and just giving her more time with that. Um, and that I think is the biggest, the biggest thing. And just letting the mom doing her sounds. There’s some doctors who like, oh, in my rooms, nobody screams or my room. Nobody makes them make some noise. And I’m just like, that doesn’t, it doesn’t matter. It’s not pain. Yes. For moms it is sometimes. But oftentimes they use that and they make those loud noises. And it sounds amazing and some partners are amazed and you know, it’s powerful for the mother, right?


Deb Flashenberg: Wrote an article and coin this open throat open vagina road is opened because there’s a connection between soul and if it’s a high tight sound, we know the pelvic floor is titan contracted with the traps and we know if it’s an open lower kind of vibrant sound, the pelvic floor open. So I look for those, you know, I encourage that because it’s going to help release. Is going to be the endorphins? Yeah. I can’t stand when care providers tell people to buy it


Stephanie Heintzeler: into the ball and then the pelvic floor is close. And so I think, and that’s something that’s easy to implement. I’m not even someone was like, oh yeah, everybody has to give birth at home or I think, you know, why not have to safety of a hospitalist for the moms who feel like they wanted in the home birth moms. It feels safer with a home birth. I mean really, you know, have your options. But it’s, it’s, it’s about the pushing phase, giving the mom a lot of empowerment and, and guiding her. Um, and that is not difficult for a doctor. And the midwives, midwives usually are totally fine with that, right? But it’s not that difficult other than yes, they might have to bend over and go in their hands and knees. I mean I saw Dr Ng Lenox Hill a few weeks ago and she was like crawling under lion and delivering it, but she was like, I can still do it, you know, I’m like, I’m fine with my age maybe when I’m 60 at Penn, but right now I can so you do your thing.

And that was beautiful. We all caught the baby because the mom was standing so there was six hands on me and the and the doctor and that was beautiful, you know, and that’s how it should be. And for a mother to look back on that and also really having the feeling that I delivered this baby and not, I was delivered that. I think that’s a huge difference. And you have that feeling more when you’re lying on your back and there’s like eight pairs of eyes looking down on you, your vagina and Everest. Yeah, that’s not very good. So just turning away from all that and sticking your butt towards those people that need it makes a huge difference because you have your own private little area.


Deb Flashenberg: Yeah. Are there any final tips that you want to offer as we start to wrap up?


Stephanie Heintzeler:  You know, I think, I mean, every mom was interested in hiring a Doula or has a few questions, can certainly reach out to me. Um, ask questions. I do love the lactation consultant questions or even the who needs of care providers sometimes. Of course people want to switch. Um, another thing I really think that sometimes people don’t, don’t keep in mind is like, you’re giving birth. Take care of yourself. Really make sure you feel comfortable. I don’t want any mom to hear, I haven’t slept in a month. And then she goes a neighbor if you didn’t sleep, if you don’t feel way seeing an acupuncturist, chiropractor, make sure you feel as comfortable as possible before you go in neighbor because it is like a marathon. So you do want to feel fit and you know, a great and amazing. And if it’s a little more costly, okay.

But at least you go in labor and you feel fine and you have a much better both outcome. Um, so don’t work until your due dates. But take that time, sleep, take care of yourself and do yoga. I’m, Oh my God, I’m a huge yogurt fan. And, and do the breath work. Really connect with other moms who are in the same stage. That makes a huge tribe. Absolutely does. I’m going to make sure everyone has all your information on our show notes. If they do want to reach out, they can find you. And thank you so much. I love chatting. Thank you. Yeah, same here asking so many wonderful questions. Enjoy your afternoon. Take care.

RC: This has been an episode of Yoga birth babies produced by Prenatal Yoga Center. You can catch us on Facebook, twitter, Instagram, and periscope. I am dead flesh and Berg. Thanks for listening.