#122 | Provider Green Lights: Interview with Barbara Harper on Holistic, Respectful & Supportive Birth Providers

Barbara Harper is an internationally-published author and the founder of Water Birth International.  Her best selling book “Gentle Birth Choices” has been translated into nine languages. Her latest collaborative project was published in May 2021, entitled, “Bringing Birth Home.”  

Barbara joined us on Down to Birth to discuss all the benefits of water birth in episode #100.  Today, she is back to share her insight and experience in training obstetric professionals around the world. She helps to identify the qualities that indicate a provider is respectful, supportive, and holistic in his or her view of pregnancy and birth, and details the “green lights” to look for when choosing a provider to support our highest and best birth desires.  

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Transcript

And I turn to the audience. And I say, just by changing your thoughts, you can change the progress of labor, what your mind thinks her body feels. So why are you pursuing all of the things that could go wrong? Why are you having the energy that says that this can go wrong, where you focus your energy, that's what you receive. That's what you perpetuate. Please teach it to every medical student, because it would change the face of birth for everyone.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

All right, Barbara, we are so excited to have you back on the show. You are Episode Number 100 was one of our best of all time and we have so much we want to talk to you about so we're thrilled to have you back on the show today.

Thank you so much. I, I love that episode and the reactions that it got. I've been getting DMS from people who have listened to it. And even my family liked it. My daughter is my best critic, or my worst, I don't know. But she she loves me totally. And she said, Mom, you did a great job with them. And they are awesome, awesome interviewers. Oh, great. Well, that's fabulous. That's quite a compliment. She was around a lot of births as a young child and growing up in a household where pregnant women paraded through all the time. And she chose to she works for WIC women, infants and children. And she sees clients all day long. And she teaches breastfeeding and, and she's been doing that for most of her adult life like 20 years now. So so she she sees the efficacy of what I do in the results of who she sees. And I think about the the things that influence women. I've been reading a great book by Rachel Reid on reclaiming the the childbirth as a rite of passage. And so I was thinking today that I'd really like to talk about how women can recognize whether their provider is reviewing them as a whole being or just looking at the medical aspects. Do you understand what I'm talking about?

This is a perfect topic to talk about today, because one of our favorite subjects on the show is provider red flags, which are the warning signs of a provider that's not supportive. So to hear another perspective, and to look at really the key things, the green lights that go ahead, women can use to help understand if they're with the right provider is spot on.

Thank you for giving me that green light. I'm really excited about it. Because you know, I've been teaching online, and I retooled my whole business so that I could do professional workshops. And I went to Wisconsin. Two weeks ago, I got on a plane and I flew for the first time since February of 2020. And, and drove to Auclair which is a small college town. And they have three hospitals in that town and I was hired by Sacred Heart Hospital, to educate their staff and they opened up the session to people from other hospitals in both states. And wait, we had altogether about 50 providers over two days. I did two sessions back to back one morning and afternoon and one evening so I could get two different shifts. What I witnessed in giving the information to these absolutely amazing family practice doctors, nurses, midwives, both local midwives and midwives in the hospital. What I recognized was kind of the vibe between how they look at pregnancy, birth and postpartum. And it's easy to see that it doesn't take much information at all, to get them excited about really seeing the the mom as the progenitor of the UN and teaching them that the baby is the driver that that was like mind blowing for some of these nurses and, and just little things, and they would come up to me and say that nurses would say I am never ever going to ask a woman in labor, if she's in pain. Oh my gosh, concept put into place. Because when they understand how the mind works, and the woman in labor, is in a very open theta state, where she's open to suggestion, I, I kind of weave those principles into what I teach. And I said, Don't ask her if she's in pain, ask her if she's comfortable. And then do something to offer her more comfort. offer her the shower, offer her the bath offer her just to sit beside her and touch her. And at least nurses were like, ah, water concept. So when I'm working with parents, I say, pick your provider carefully and and see if they have the understanding that birth is a rite of passage and that you have the right to not just your belief system, but do you support and respect the physiology of both mother and baby. And so you can ask very specific questions that will reveal how supportive they are. Do you want to know some of those questions we would love to hear? Okay. Okay. Let's Let's start with When should I come to the hospital? And then we get into? Well, as soon as your water breaks, you need to come in? Oh, no, you don't? We don't. So please don't. So if if your provider says to you, let's talk about the green lights. Well, we want to make sure that your labor is well established and infection rates are are not that high by waiting even up to 24 hours. That's your provider. Okay. That's your provider. And there's this reassurance that what you're looking for is this reassurance that labor is normal. Yeah, go ahead.

Yeah, I just want to make a comment for our listeners that the two main reasons I would say you don't want to get to the hospital when your water breaks or when your membranes release is first that in the majority of instances, it does not indicate you're in labor yet. But the odds are extremely high, just over four in five, that 24 hours after your membranes release, labor will have begun. This says nothing about when the baby will arrive. But if your membranes release at 3:30am when you're lying in bed on a Tuesday morning, it when many women believe that means they're in labor. So they marched down to the hospital and nothing's happening. And but the reality is, by 3:30am, the following day, there is a more than 80% chance labor will have begun. So the question is how do you spend that day? Because if you bring yourself down to the hospital, it's only a matter of time before you start doubting your body. Your provider says things about using pitocin. And you know the number one reason versus arion section in this country failure to progress. So it's part of this perfect storm that originates with the misinformation, exactly all are ascribing to this belief, this false, this false belief that means you're in labor and it doesn't.

Well, it's it's a very good litmus test. Okay, you're in interviewing a provider. I don't know if you remember but in the back of gentle birth choices, the the book that that helped shaped lots of different lives and to have gentle births and, and so many providers who, who kind of stepped over to the other side, and that's how I want to be in the back of the buckets questions to ask a potential provider And that is one of the questions. So those questions are the are the are the litmus test to see if, if this provider will believe in the direction of normalcy. And, and that's exactly what you were talking about Cynthia, when when you mentioned that it's normal to have the membranes release before labor begins, but only about 5% of women will do that. That's right. And, and those 5% have to feel confident. And as long as we produce rules and regulations that say that it's not normal, then it puts women in a more difficult place to trust their bodies. So along with a provider that that believes in normality, you also need a provider that, that trusts the woman's own wisdom, and trusts her body, and trust the baby. And I add this trust the grand design. And I don't care how you define the grand design. But for most people, it's that there's a force outside of this that's greater than we are, as a whole. You can call it I don't want to call it religion, but we, we see this in, in working with women, teaching them hypnosis, teaching them to, to understand how their brain gets wired. And it's so simple. It's so simple when you look at it, but the culture is influencing so many women today, when we look at Instagram, and Facebook, and it's a hotbed for the the insurgency of a of women taking back their births. It's because in in my classes, I actually give my favorite podcast, go listen to down to birth, you know, I, I actually link it and say, go listen to some of these episodes, because it's really going to move you from that place of not trusting yourself to more trusting yourself. So in June, I was teaching a seven week course to 23 doctors and midwives in Cebu, Philippines at a clinic that's been open for 18 years. It's called glory reborn. And it's a Christian organization. And the doctors and midwives that work there are just phenomenal, just phenomenal. And they wanted to learn waterbirth because they'd had requests and oh my god, it was so good. It was so good. But the very first lesson we did my time I did 8am to 10am, every Tuesday morning. And so I roll out of bed, get online, and I see the everybody there, and I go, so what did you learn this week?

And the very first person to talk was an OB. And she said, Well, I'm a bit concerned because in this first three sessions, I have to say that I disagree, because I was taught in medical school that I had to be the captain of the ship. And what you're asking me to do is to turn over that Captain position to the mother. And that just isn't safe. Because I know other things that could go wrong. And she doesn't. And so I sat with that. And then I asked her some questions. So So if our purpose at birth, is to make the woman comfortable, to support her to support her normal physiology, how can you change your mindset to view her as normal? What will it take for you to release the reins and give that power back to her? Because it's not about controlling her from the outside. Because you know that you cannot do that. You have to recognize the the pre programming of the intricate and delicate interaction of the hormones from her body and the neuro behavioral program. Have the baby that is is programmed in its brain. It's a biological imperative to get out. And it's recognizing that the baby is the driver of the experience. And when you recognize that, you then ask the question, How can I support that? What can I do? How can I move a woman from her place of fear and move her to a place of peace, comfort and relaxation. Just think of all the things that provider can do to reassure a woman that everything is normal.

The provider doesn't have to wear on their sleeve, that they know things can go wrong. What they need to do is presume things are gone beautifully, and to not intervene until something goes wrong until they have a medical indication.

That's a gentle birth principle. If we look back at even when we wrote the Coalition for improving maternity services Kim's and we rewrote the manifesto of how to support normal birth. That was 1996. We met at Mount Madonna, we were we were an organization of heads of organizations. I Anna Mae was there, john Travis, he was representing the holistic physicians, the only people that the only organization that did not show up as with a representative was guess a card. Thank you. Yeah, a group was the only one that did not show up: The American college of Obstetrics and Gynecology for our listeners, Obstetricians and Gynecologists.

ACNM was represented the American College of nurse midwives, Manor midwives alliance in North America was represented EWN, the Association of women's health and neonatal nurses showed up, and we had discussions like you wouldn't believe? How can we support normal birth? It took us three days just to write the introduction to the Kim's document,
it begins by them witnessing normal birth. Yes, that's the problem. They never say remote birth. So the threshold for intervening is so much lower than a provider, like a midwife whose circle of safety for normality is so much greater.

Trish, that is the whole point. Because when I'm standing in front of a group of physicians and nurses and midwives, and I just I do a litmus test, have you? Have you seen a woman? Give birth outside of the bed? No. Have you not ever used stirpes? Sometimes, maybe, maybe. Okay. Have have? Have you seen a water birth? No, no. So when this woman in the Philippines at glory reborn said, I have to be the captain of the ship. That's what I've taught. And so I spent the next six weeks proving to them, that there is a grand design, and that the baby is the driver. And their final exam was week eight. And I did a case reports I made them up by I spent like two days writing eight cases with histories and physicals and monitor strips and giving them all of the information that they would need to make decisions whether you should go on and use water to normalize the birth, or should you go straight to a Cesarean. And I gave them the opening. And we broke we divided up into groups. And each took two cases. And then we came back together and studied them. And and every single doctor and midwife found every reason to support no malice, even with complicated cases.

It's like what what I feel that what I envision happening when you're talking to them is you're showing the providers, I think initially on day one that they spend with you, they might fear that you are telling them they're not important. They're not valued. They're not primary. But what happens is you're saying you're so important. You're so important to these birthing women, but not in the way you think you are. You're not there to give birth for her. You're there to reassure her because you would know if intervention were required.

Well, it was so easy to lead them down that path and to reassure showing them that no one's taking anything away. No, we're giving you a gift. There was a doctor. This was life changing for me. He'd gone through the whole workshop and I asked for questions. And he raised his hand and he said, Okay, let me I mean, let me get this. I watched the woman. I don't touch her. I don't pull the baby out of the baby. It has a reflex that, that that works with the contraction and an end it expels itself. And I leave the court intact. So So my question is, how do I justify my fees if I don't do anything?

No, great. Yeah. Well, you know, he said it. He got it out there. That was I that's admirable.

And so he wanted to be able to do something. Right. Right. And this is the perplexity of modern medicine. I want to be able to do something, fix it, fix it, fix it. Exactly. She's a machine, the baby's a product. And what I did in that moment, I looked heaven word. And I said, I before I even finished my prayer to ask God to give me a really good answer. It just came right out of my mouth. Does the lifeguard get paid on the beach? If he doesn't have to rescue someone? I said, you know, what normal, you should know what normal looks like, what it feels like, what it what it smells like, what it tastes like, you have it in every fiber of your being. And you are there as a guardian. You're a guardian of normal. You're the not the guardian of the galaxy. You're the guardian of this galaxy, right in front of you. And I started teaching a workshop I started in Mexico, Guardian is done last me and both the guardians of birth, birth guardians. And on the third day of a five day workshop, for obstetricians, neonatologist perinatologist, it's when the reality comes in. And I love the third day of that workshop, because, because there's lots of tears, there's lots of revelations, there's lots of like, Oh, my God, I have to die. There's recognition of the normalcy of birth, because I show him film. So I take birth, and, and all of a sudden, it becomes normal for them. And they can't wait to get back and practice it. They can't wait to support women. So the the doctor in the Philippines on Earth, after we did the case studies, and we're in the circle, online, and it's as if we're holding each other's souls. And, and she said to me, she she raised her hand, and I recognized her. And she said, remember me from the first day? I said, Yes, yes, you were the captain of the ship. So how do you feel now, and she goes, I know that my job is not to get the baby out, but to support the woman to find her own power. And I'm there to protect her and guide her and love her. And, and witness this miracle. called birth.

I start to cry.

And she started crying and, and about half of the other doctor started crying. And I immediately went into this. In my Jewish brain, all I could think of was, may the Lord bless you and keep you may the Lord shined his countenance upon you, and may the Lord bring peace upon you and every person, every woman that walks in the door, may they feel your peace. Because you know what normal looks like. And, honestly, it was, it was the best graduation that I've ever attended. Because I know that those doctors are even though they have that training. it's it's a it's a conversion process to from, from captain of the ship to guardian of the galaxy. And that's what you're going to look for in your provider.

This reminds me of the story I think I said when we were speaking to doctors do about my friend He was in obstetrics school at the same time that I was in midwifery school. And we would sometimes get in the hot debates about the difference between midwifery and obstetrics. And she wasn't necessarily that supportive of midwifery and at one point she just said, It's not fair. Why do you get to have all the fun with the births? Exactly, exactly. The story you just told explains exactly that you know, you can change your mindset and birth can be fun for you too.

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So I love doing sessions and and teaching hypnosis to providers. So let's go back to 2018. I'm in Buenos Aires, Argentina, yes, I'm teaching waterbirth to individual hospitals, they're my supporters take me around. And there's Part Two in Argentina. And they invited me and they did this. And they also brought in 250 medical students, doctors, midwives from all over the region, Chile, Peru, Uruguay, Bolivia, Colombia. They're all in this auditorium at the University of Buenos Aires. And I have them for three days to teach them instant hypnosis at the bedside. It's a provider course, that Laura wood and I have have designated designed and designated for providers so that they can look at the power of the mind. And I have them chanting, what my mind thinks my body feels. And then I switch the tables and I do this experiment, I bring up like a dozen people out of the audience. And I say six of you are going to pretend to be pregnant, and you are going to be the clients and six of you are going to pretend to be physicians in with this woman at the bedside. And I take all the doctors over and I put them the pretend doctors and I put them in the corner. And I say to them, I want you to have one thought and one thought only. I don't want to be here. I don't like you, I have to get to my clinic, I just I've got all these other things that I'm thinking about. I and I don't want you to make eye contact and and then I bring them back. And I don't tell the women or the people that are pretending to be pregnant anything. And then I set a timer for three minutes, and they stand in front of each other. And the doctors, some of them really play it up there. They're looking at their watches, they're folding their arms, they're, they're acting bored. They, you know, they're they're just doing anything but being physically and emotionally and spiritually present. And it gets very uncomfortable in the whole room. Because all of a sudden, the you can see that the pretend clients are having physical responses. And so I stopped it at three minutes and then I pass the microphone and please tell me what you were experiencing emotionally and physically. And this one had a sore throat. This one had a stomach kick. This one felt like she was going to throw up. This one wanted to run away. It was a sympathetic response. You were in your ventral vaco and and I use it as a demonstration to talk about how we cycled back and forth between our ventral vagal and our dorsal vagal and our dorsal vagal is about calm connection and peace. And our ventral Vega is about fight flight freeze or, or fate. And then I turn to the audience and I said Repeat after me what my mind thinks her body feels. And then I reverse them. And I take the next group of doctors over into the corner and I say, I want you to think one thought. You're amazing, you are so beautiful. You're the most beautiful person I've ever met.

And I want you to look her in her eyes. And I want you to stand there and take a deep breath, and feel how centered and grounded you are. And I do this centering exercise with them, and they go back, and they stand in front of the clients again, and I set a timer for three minutes. But the exercise never last more than about a minute and a half. Because after a minute and a half, they're hugging each other. And, and they're both in tears, because just by changing your thoughts, you can change the progress of labor. And I turn to the audience and I say what your mind thinks her body fields. So why are you pursuing all of the things that could go wrong? Why are you having the energy that says that this can go wrong, where you focus your energy, that's what you receive? That's what you perpetuate, and, and of women in the audience stood up, and she was in tears. And she said, Can I teach this in our medical school program. And I said, Yes, with my blessings, crazy teacher to every medical student, because it would change the face of birth for everyone.

When we work directly with couples and with women, we know they need to be educated, and they need to be empowered. And if you think of day one of your workshop with all these doctors, the last thing they would expect is going to happen in that process is that you would empower them, they might show up, some of them with their chest puffed out and feeling strong. And they're the pilot of this plane, and they're the captain of the ship. And then suddenly, they're in tears days later. And they finally discovered their true power is bestowing that respect and space and empowerment onto the people that they serve. And it's in serving that they actually are empowered. It's it must turn their world upside down.

It turns their world completely upside down. And, and the letters that I get the the DMS that I get. When are you coming back, I want to learn more I want I want to take every workshop that you teach, I feel and they say that I feel so empowered to be with women like I've never felt before. It's by by I call it doing a Marie Kondo on your closet, your closet of thoughts, feelings and behaviors. Take them out and look at what makes sense. I do the same thing with couples. What What thoughts, feelings and behaviors Do you have your behavior is a chemical response to the environment. And so the environment of medical school was torture. Yeah, and you learn how to pass that torture on. And so you've got to get them back to a place of where they originated as an innocent being who chose to be in a physical body at this time. It's about nurturing their souls. It's all about nurturing their souls.

Because intuitively, they have always known that they were missing something in their care.

I have heard that 100 times from doctors. I knew something was missing. And, and this is this is the key that opens the door.

I feel like I can't imagine the self love they get to experience after this process.

Oh, okay. After this process, and I make them journal, I make them write affirmations about what an incredible being they are. What a talented and, and perceptive physician that they are. So, and after three or five days, you know, depending on the group that I'm with, I just kind of float out and because there is so much love in the group. And as I'm passing out their, you know, their certificates of accomplishment. It's it's just one of the proudest moments of my life in seeing them blossom into this Cry, this divine being that they have always known that they were but they were caught in this system that that diminished their capabilities of experiencing their divineness. Much children have always said, Mom, you're doing sacred work? How can we support you? And I used to say, on my tombstone I wanted, at least she tried. And my daughter recently when I brought that up, because I'm seven years old, okay? And I have this, I have this gift of realized mortality in front of me, because I know I'm not going to be traversing the world for a long time. And this is why I'm writing this new book, gentle birth wisdom. Because I've got to pass this on. And, and my daughter recently said, Bob, you've done more than tried, you've succeeded. And it's with with people like you, the two of you, who who feel your divineness and, and, and put it out into the world. And that's why I so love being with you, because you get it, you really get it. And and, and you put these little droplets of love all over with every episode that you do. So thank you so much for having me back. Thank you, Barbara. It's our honor Barbara. And in Judaism in Judaism, it's there's a section in the atonement. And I think I've put this on my Instagram before but you're not required to complete the work. But you are required to begin it is powerful. And our job here. It's it's the thought that that our job here is tikkun olam, which is God created the world to me, put us in it to make it better.

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It was 2018 and I was I was flying 100,000 miles every year guaranteed. And on this flight I was sitting next to somebody that I did not know. He was very handsome and people kept stopping and putting out like a napkin or a piece of paper and asking for his autograph. And so I knew he was somebody famous, but I had no idea who he was. And so I as soon as the light went off, and we could unbuckle, I went up to the front. I was in first class and I talked to the flight attendant I said, you know I'm sitting beside and she goes let me look him up on the manifest. Okay. And she looked him up and she was like, Reginald somebody or whatever. No, because I think he's a rap star. I think his his rap title is ASAP Rocky.

I was so afraid you were about to say George Clooney or something.

No. And so I can't tell you the whole thing. But we talked and I told him what I did. And we had a very nice conversation. And I said, ASAP. We need to run right now we need to write a rap song about women taking back their births. And so and, and we sat there for an hour on the flight and I'm writing down lyrics and and he's going it's my body. It's my baby. It's my birth. It's my body. It's not Baby, it's my birth. Leave me the fuck alone. Because I know what to do. Respect me now. It's my body. It's my baby. It's my birth.