1

Speaker: Motherhood is all consuming.

2

Having babies, nursing, feeling the fear of loving someone that much, and

there's this baby on your chest, and boom, your entire life has changed.

3

Speaker 2: It's a privilege of being your child's safest space

and watching your heart walk around outside of your body.

4

Speaker 3: The truth is, I can be having the best time

being a mom one minute, and then the next time questioning.

5

My life choices.

6

Speaker: I'm Lo Mansfield, your host of the Lo and Behold podcast, mama of four

Littles, former labor and postpartum RN, CLC, and your new best friend in the messy

middle space of all the choices you are making in pregnancy, birth, and motherhood.

7

If there is one thing I know after years of delivering babies at the bedside and

then having, and now raising those four of my own, it is that there is no such

thing as a best way to do any of this, and we're leaning into that truth here.

8

With the mix of real life and what the textbook

says, expert Insights and Practical Applications.

9

Each week we're making our way towards stories that we participate

in, stories that we are honest about, and stories that are ours.

10

This is the lo and behold podcast.

11

Lo: If you are currently expecting a baby, or maybe you've had

one in the past, I'm sure that you are very aware of the fact that

doulas can significantly impact birth outcomes for the better.

12

And if you didn't know that, well, now you do.

13

It is very, very true and it is also very evidence-based that they can

just remarkably change what happens in your birth with a lot of specificity

related to rates of induction or rates of cesarean, things like that.

14

They play.

15

Obviously a massive role.

16

So if it's something that you can afford or you can add to your birth

plan, it is something that I almost universally would say Yes, go for it.

17

Go for that doula.

18

Today I got to talk with Sarah Osborne.

19

She has been a full-time birth doula for 17 years

and has attended over 900 births as a doula.

20

She is also a birth photographer.

21

I love her birth photography, a childbirth educator and a doula mentor.

22

If you are considering being a doula and you have any interest at all in

some sort of mentorship, definitely check that out via Sarah's website.

23

Sarah lives in the Pacific Northwest, so there's a little

hometown love connection with her that I obviously love as well.

24

She lives with her husband and her three big kids, and of course.

25

Her two cats.

26

I so enjoyed this conversation with Sarah today, not

just because we broke down some basics for you, right?

27

I want you to know what a doula is, what they can do, what they can't do, why it

matters, but also because in this convo, we kind of delve into navigating the work

that doulas do in the birth world, and then social media and how there's kind of this.

28

Overriding narratives between what people think about doulas or how

they speak about doulas, and then also how a doula has to kind of

show up and present themselves in the world when those narratives

are flying around above our heads, whether or not they're true.

29

I found this conversation super interesting.

30

You'll see that Sarah has just a beautiful heart for birth for the families that she

serves, and I think that comes through very clearly as you guys listen to us chat.

31

Hi, Sarah.

32

I am so excited to have you here with me.

33

Why don't you go ahead and introduce yourself a little

bit and then we'll just jump into our conversation.

34

Sarah: Yeah.

35

I am Sarah Osborne.

36

I have been a doula for 17 years full-time.

37

I've attended over 900 births as a doula.

38

I'm also married, I have three kids.

39

I live in Washington State.

40

Lo: Sarah and I share that little connection so we know each other kind of professionally.

41

And I would say like friendship now too.

42

But as soon as I found out she was from Washington State, I feel like my heart

just like lit up a little bit because I just, I, I still love where I'm from.

43

Yeah.

44

I'm actually gonna be back there soon.

45

Present day.

46

We're recording this right before the 4th of July, and I'll actually be up

there over the holidays, which is like the best time to be in the Northwest.

47

So.

48

Yeah, I felt like a little kindred spirit.

49

Yeah.

50

Which probably makes no sense, but just from that right away.

51

So.

52

Okay, so before we started recording and hit record,

Sarah and I were just talking about kind of like.

53

Why she does what she does.

54

And I had said that, I recently had, I woke up, I had a friend

call me, she's pregnant, she thought she was going into labor.

55

I said, I'll be your person in the middle of the night to watch your kids.

56

So she called me at 2:00 AM I ran over to her house, was

there, she ended up actually coming home the next day.

57

It was false labor.

58

But I was exhausted.

59

I was telling Sarah, I was so tired.

60

And so I kind of was just saying like, man, I, I hated

being on call as a nurse and I hated working nights and.

61

I obviously like, loved the work, but hated that part.

62

So essentially what I'm getting at is one, Sarah, you're amazing.

63

All doulas are for doing this work over and over and over again.

64

And then two, how did, why, how'd you end up here?

65

I know you've been doing this for a very long time.

66

Sarah: Yeah.

67

How'd

68

Lo: you get here?

69

Sarah: Well, how did I get here?

70

I mean, I started slow, right?

71

Yep.

72

I, I, I knew I wanted to be a doula.

73

When I learned what a doula was.

74

Lo: Mm-hmm.

75

Which

76

Sarah: is when I was pregnant with my second baby.

77

Okay.

78

That's when I found out doulas are a thing.

79

I actually hired one for that birth and ever since I learned

that was a job, I was like, oh my gosh, I totally wanna do that.

80

But I had to wait, you know, for like timing to be right and all of those things.

81

And so I started out slow, you know, like got my training and all of that, but.

82

It takes time to, like, I have clients hire you

and, slowly work into like a full-time practice.

83

But I just never quit and I loved it.

84

And so, you know, it just, it's slowly built over the, I

think my goal in my first year was to go to like 12 births.

85

Okay.

86

In my first year as a doula, which is kind of a lot actually

like, but like one a month is what I was thinking and I did it.

87

And then from there it just like, you know, snowballed.

88

So, yeah.

89

So I was a full-time like solo doula Okay.

90

For the first 12 years.

91

So like, everything was just me.

92

I was the only doula on call and now I have a collective where I

work with two other doulas and my workload has not gone down at all.

93

In fact, it's probably increased, but it seems like it has.

94

Yeah, I do have like that load of sharing, like some

on-call time and you know, other responsibilities.

95

So yeah, it's pretty great.

96

However, I do, I do pretty much live on call.

97

Lo: Yeah.

98

Yeah.

99

It feels like you are.

100

Sarah posts like this little thing on her Instagram each time

she says, I'm basically, I'm birth bound, like headed to a birth.

101

And obviously our algorithm doesn't feed us

everything actually immediately when it's happening.

102

But I source sometimes I see your account.

103

I'm like, she's been at 12 births in the last four days.

104

How is this possible?

105

So it does seem like you are just helping a lot

of families and that you are, I guess, just.

106

In it consistently.

107

Yes.

108

Like you're saying that there's not a lot of breaks or pauses or still miss, so, yes.

109

Yeah.

110

So that I, in that answer too, I, there's a

couple things I want to zoom in on really quick.

111

One of them sounds maybe a little bit fundamental, but why don't you just

explain to everyone what a doula is and kind of those boundaries of this is

what I can do and this is what I can't do, so people understand that difference.

112

Sarah: Yeah, that's a great question.

113

So.

114

A doula, how I describe it mm-hmm.

115

Is like a labor coach.

116

So I am like your, the parent's personal hired person to be labor support.

117

So I'm helping with position changes, comfort measures, pain, coping

ideas, education, information, making sure you know that they know.

118

All the pros and the cons.

119

Yeah.

120

And like, you know, have, feel like they're getting all the information to make

informed decisions and that they're communicating well with their care provider.

121

And, you know, there's also like a little bit of advocacy in there,

but also as a doula, like legally I cannot speak for someone.

122

So I'm never gonna tell a doctor, you know, don't do,

I'm not gonna speak to the doctor and say, don't do that.

123

Instead what I, this is how I explain it to clients, is I say, instead, I will just ask a

question in front of everybody and say, so say the doctors wants to cut the cord, right?

124

And maybe they want a delayed cord clamping.

125

This is just my example.

126

Instead of me talking to the doctor and saying like, don't do that.

127

I'm instead asking.

128

In front of the doctor to the parents, like,

oh, it looks like he is gonna clamp the court.

129

Are you ready for him to do that?

130

Like, is that okay with you?

131

Did you wanna wait?

132

So it's like bringing to the parent's attention, like, oh, this

might be something that wasn't in your plan, and giving them the

chance to speak up because maybe they don't care and I don't care.

133

Right, right, right.

134

Like I just want them to, yeah.

135

Make their own decisions, but it's also like when I say it out loud,

then usually the doctor's like, oh, whoa, wait, maybe I need to wait.

136

Yeah.

137

Lo: It's actually like that specific piece of it is like

obviously the labor support hands on stuff so valuable, right?

138

Yes.

139

But that part right there, I actually think is almost one of the most

valuable pieces because in the hospital we just do the things we know to do.

140

Right.

141

And I'm guilty of that too.

142

So I'm not saying, oh, put me on a pedestal and all these other nurses.

143

Down there like.

144

The placenta comes out, we hang that bag of pit, we're ready to run that Pitocin, right?

145

The cord clamps are on that delivery table.

146

That's just part of the delivery process, right?

147

Like there's all these things and yes, we should be pausing and saying and

confirming with those parents each time, but the reality is, is we're not.

148

Yeah.

149

And we should be.

150

And I think in an excellent nurse and excellent provider, they are.

151

Right.

152

And you can feel that difference and you can see that difference

when you are delivering with someone like that, right?

153

But since most aren't.

154

Maybe they're in a hurry.

155

Maybe they've got two moms delivering at the same time.

156

Maybe they have to run to the, or whatever the, I'm gonna say excuse might be.

157

Mm-hmm.

158

The truth is they're, you're just not always gonna get that like pause and

that informed choice with each of those things, and it really should be there.

159

So I think so much of the gift of a good doula is exactly

what you just said, is just making that pause happen.

160

Right.

161

Like being the person in the room who hits that

button, because sometimes they think the nurse is well.

162

Won't speak even if they want to.

163

You run into that issue of the doctor, like why are you always overstepping?

164

Or you might have that feeling from the, I'll say like head provider

where they're saying, why are you constantly kind of questioning.

165

The things that I'm, you know, suggesting to

the mom or that's our normal standard of care.

166

And so I think as a nurse that can be a little bit of a dance.

167

'cause you are obligated to those relationships and your protocols as well.

168

For sure.

169

Yeah.

170

But your doula's only obligation is to you.

171

Yeah.

172

Like your job is to serve that family and so you don't have.

173

To worry about Right.

174

What the nurse or doctor thinks of you.

175

And that's a gift.

176

Right, right, right.

177

For sure.

178

Sarah: Yes.

179

Yeah.

180

So, and there's, there's just so, there's so much, I mean,

like, I feel like that's just the tip of the iceberg.

181

Yes.

182

But yeah.

183

Yeah.

184

Lo: So really quickly too, I, I do want people to know a little more What's it look like?

185

Hey, prenatally, this is what I do for you versus in birth.

186

'cause so many know Yeah.

187

You, you show up at my birth.

188

But there.

189

What's that look like leading up to labor birth?

190

Sarah: Yeah, so every doula is gonna work a little bit different, right?

191

In what that looks like.

192

But, for me, I do like, I usually have a Zoom call to like interview

with someone and see if it's a good fit and we wanna work together.

193

And I think that's really important.

194

I actually just read on a, on a Facebook group

yesterday that there's a doula who doesn't do that.

195

And it kind of shocked me.

196

Lo: Yeah.

197

Sarah: Because I'm like, how can you just let someone hire you

and you have never chatted with them like that is seems not great.

198

Lo: Mm-hmm.

199

Sarah: Because it's, it's a mutual thing.

200

Like it's not just them interviewing me like I wanna know, am I good fit for them?

201

Do mm-hmm.

202

Do we vibe, you know.

203

So there's that.

204

Once someone, one wants to move forward, they hire me.

205

That's like contracts, money, all that stuff.

206

And then usually I give everyone, like, I have

a separate number aside from my own cell phone.

207

That's like my, my on-call number.

208

And so they have access to that right away to ask me questions.

209

If they need like, resources, information.

210

If they're wondering about like, books and classes or they read

something scary online and they're like, oh my gosh, is this true?

211

Like, what do you know?

212

All of that.

213

Like, I'm just there.

214

Basically I say, I'm your Google now.

215

Like, don't Google anything and just text me instead.

216

Yeah.

217

Yeah.

218

And then I just do one prenatal visit in person.

219

Okay.

220

A lot of doulas do two to three.

221

Okay.

222

But I'm so busy and I find that my clients are busy and they're

usually working and they don't, we just don't need to do two.

223

So, yeah.

224

So I just do one and it's typically between 30 and 32 weeks.

225

Lo: Mm-hmm.

226

Sarah: Yeah.

227

And it's pretty long.

228

It's like a, it's like two hours.

229

Lo: Okay.

230

Nice.

231

It's like an intensive, right.

232

And then, but that open access to you, like the idea

of truly walking away from Google if they do that.

233

Mm-hmm.

234

Also a gift if they recognize that too, right?

235

Yes.

236

You mentioned too in there, just like other things

I'm thinking of as well for any moms right now.

237

Asking themselves, should I have a doula?

238

What's this gonna look like?

239

Doulas can work in practices.

240

Mm-hmm.

241

So maybe if you can speak to that a little, like, what that

might mean for a family who hires someone who has partners.

242

And then I recently had a student who delivered, and she worked with like a,

an on-call doula group almost, where you just are like, Hey, I'm in labor.

243

And I think they kind of send out whoever's on call.

244

Got it.

245

So.

246

Like, to me that doesn't feel ideal.

247

My guess is it's also more affordable.

248

So there's a lot more that goes into that conversation.

249

Yeah.

250

But just maybe questions that may a family could

ask in those situations to kind of navigate like.

251

I'm not actually going to get Sarah, or I might get Sarah.

252

Right.

253

So how could that decision process look like for them?

254

Yes.

255

I

256

Sarah: think it's really important to know like, how does this

doula work, if she's a solo doula, like who is her backup doula?

257

Mm-hmm.

258

Because you ne sometimes people wanna hire a solo doula and that's great.

259

And that's the majority of doulas out there are just Yeah.

260

Solo doulas.

261

And, but every, but knowing like every once in a while it's, she can't

come, like, she's gonna be sick, she's gonna have a kid that breaks a

leg, she's gonna have a funeral or whatever, like this has all happened.

262

Mm-hmm.

263

Right?

264

Mm-hmm.

265

And if that happens, she's gonna send you a backup.

266

And so that backup to you is probably a stranger.

267

Mm-hmm.

268

And

269

Sarah: that is a real huge bummer.

270

Like it works out.

271

It's just not ideal.

272

And so sometimes people then.

273

Sometimes people are fine to like take that chance of like

99% chance it'll work and I'm, I'm gonna get my doula.

274

But knowing it doesn't always, and then there's also like the

partnership model and that can work in a bunch of different ways.

275

I've seen doulas who have like built-in backup support, but they kind of still.

276

Have their own clients that hire them within like a group.

277

So you're still kind of guaranteed that one doula that you pick, but mm-hmm.

278

You know who the backups will be.

279

And then I've, I actually have a, a collective

myself, so I work with two other doulas and we rotate.

280

So, that's a different model too.

281

So I think just.

282

Parents like, need to understand what, what this really is gonna look like.

283

There's pros and cons to all of them.

284

Yep, definitely.

285

And so just feeling like what feels like a good fit for you, but in my collective.

286

Basically our clients, they hire the three of us, like as a team.

287

So they are, we are all chatting with them on that, all

on-call number, and we all go to the prenatal visit together.

288

So they're not like getting to know one doula better than the others.

289

Lo: Okay.

290

So all three of you are at that first, that appointment that you're talking about?

291

Yeah.

292

Okay.

293

I like that model.

294

Yeah.

295

But then they don't know, your parents, parents wouldn't know who when they go into labor.

296

It's like whoever's on call that week.

297

Yes.

298

For your collective or whatever.

299

Okay.

300

Okay.

301

Yeah, so ultimately, and we did chat about this before we were starting too.

302

It's not.

303

Too dissimilar from kind of picking a provider.

304

Mm-hmm.

305

A delivering provider.

306

Right.

307

It's the same questions, right?

308

Like, do you work in a practice?

309

Like what is the vibe of your partner if they commit Right.

310

You know, like it, it pays to do that work.

311

Yeah.

312

Because is a very good chance, the doctor that you love is

not going to be the one who actually delivers your baby.

313

And I'm sure in a doula collective.

314

It's similar, right?

315

Like you probably are gonna have a favorite, but they might not be the one Right.

316

Who gets to come in.

317

Yeah.

318

Yeah, yeah.

319

I think, another thing inside of all of that too is

you, you mentioned earlier the word like vibe check.

320

Is there a specific way you think that families can.

321

Do that vibe check or any questions that you think are so valuable.

322

Like when you hear a family say, Sarah, tell me X, Y, z. Fill in the blank for me here.

323

Like where you can tell they're really trying

to do the work to see if you guys fit together.

324

Sarah: Yeah, that is a really great question and I wish I had a super great answer.

325

So, I mean, I, I think a lot of times parents will.

326

Like print off the Google questions of like, here's the questions to ask your doula.

327

You know, if you're interviewing a doula, and a lot of, a lot of those aren't like.

328

They don't pertain a lot or they're just mm-hmm.

329

Like, it's almost like they're just checking off

the boxes to like, ask like very generic questions.

330

Yeah.

331

Lo: Yeah.

332

Sarah: So it's okay to like, throw that list away and come up

with your own questions, like it's really more personality.

333

'cause you're gonna, you are gonna spend intimate time with this person.

334

Mm-hmm.

335

And you want to feel comfortable around them.

336

You want to enjoy them, like get along with them.

337

So it should be like, oh, this is someone I like and that I wanna

spend time with, and I feel very comfortable and like I trust them.

338

Mm-hmm.

339

It's, it's trying to ask the questions to where are,

how are you gonna find that out as fast as you can?

340

Versus like, how long have you been a doula?

341

What's, you know, like those questions.

342

Right.

343

But,

344

Lo: yeah, I think the reality too is those questions are different for each of you.

345

Mm-hmm.

346

Like, let's say I'm just.

347

Get honest.

348

My mom died right in the middle of me having my first baby.

349

Like maybe I'm asking questions 'cause I wanna a doula with my second baby around that.

350

Right?

351

Like, yeah.

352

What's your experience with loss like, this is

gonna impact the way it feels like a hundred.

353

You can't really, the genericness generic list, they

add some value for kind of fundamental things, but like.

354

So much more of fit really does go with what is my,

speaking of myself, my personal history, and Right.

355

How do you feel like you can step into that for me?

356

So you, you're right.

357

I guess I'm just affirming, like we have to be really thoughtful about

questions that go beyond the handouts and pertain to what's gonna trigger right.

358

Anxiety for us, or fear or joy.

359

And how can that doula maybe step into that?

360

Sarah: Yes, a thousand percent and and you know, sometimes.

361

Parents will, there'll be like.

362

This question of, like, what's your birth philosophy or mm-hmm.

363

Some, sometimes, okay.

364

I don't know how to really phrase this, but I'll just say my example.

365

Just say it.

366

Sometimes there's, I feel like a lot of doulas get into doula work because.

367

It's their passion, right?

368

Mm-hmm.

369

They are passionate, like usually it stems from their own birth

experience and like it didn't go well or it did go well or whatever

in the middle, and that spurs them onto like, oh, I wanna be a doula

and help everybody else have this great birth, and that's fantastic.

370

However, if a doula is.

371

If, if she's in birth work to try and have everyone

get her ideal birth, that is not a good fit.

372

Yep.

373

For anybody, right?

374

For anyone?

375

Nope.

376

Yeah.

377

So like maybe you're, maybe this doula you're

interviewing thinks like a home birth is the best thing.

378

Like that's her ideal birth.

379

Mm-hmm.

380

Lo: But that

381

Sarah: might not be your ideal birth, and it's okay to have.

382

Differences and not like everyone's gonna have their personal preference on

how they want a birth that doesn't, that doesn't extend to everyone else.

383

Mm-hmm.

384

So I think somehow gathering how you can find out, are they passionate for you to get

the birth that you want and help you figure out, even if that looks different from there.

385

Mm-hmm.

386

You know, for per perfect birth.

387

Lo: Yeah, I like it.

388

I talk about that a lot related to my own education in my course, because I'll

tell people, students all the time, like the thing, I feel like the things I

teach or the way I teach, they're not the ones that are gonna go viral, right?

389

Like there's not this bias or this slant or this.

390

I'm gonna use the word aggression like, but this aggressive movement towards this

one specific experience, because I don't get to decide what ideal means for you.

391

Right.

392

Nor does your doula, we, I'm certain that Sarah, you have

your own idea of ideal birth and that, so do I, right?

393

I, my guess is ours aren't even exactly the same.

394

Right.

395

But we don't get to put that.

396

On our students or our clients, like you're saying.

397

So our job, like you're saying, is to say, Hey, tell me what your ideal is and

I'm gonna work like hell to help you achieve what feels right for you guys.

398

Yeah, and I would agree that a lot of birth providers.

399

Across the spectrum, like from doula to OB and everything in between.

400

We likely bring our stories in maybe too much sometimes and, and, and it's such good

important work to keep like the client's ideal centered and it can be really hard.

401

Sarah: Yes.

402

Yeah.

403

No, I totally agree.

404

And I think even, and this is a whole nother subject, but I think even

sometimes like doula trainings are not, are not great at that, like mm-hmm.

405

Even the training that they take can be biased.

406

And that's a problem.

407

Yeah.

408

Lo: So I, that kind of like brings me into this other thing

that, and maybe you can say no, that's not that pervasive.

409

So it's not that big of a deal.

410

But I do think sometimes there's this mental mentality

or narrative that doulas, they're gonna fight for you.

411

Right?

412

Or they're gonna, they know how to fight provider like that.

413

There's just this, kind of underlying sentiment of.

414

The system is gonna wreck you, but I'm gonna help them not wreck you.

415

And I'm willing to fight and I think a doula should be willing to, to step in and help.

416

Mm-hmm.

417

Like you're talking about earlier in in, yeah.

418

In a way I think that is done well appropriate, but yeah.

419

What, I guess, how do you kind of get around that narrative?

420

Like I know you're not a doula who practices that way

of like, I'll fight and I'm aggressive, or whatever.

421

What, however you wanna say that.

422

Yeah.

423

And so how do you kind of get around that with a client and kind of address

424

Sarah: Yeah.

425

That

426

Lo: or even publicly on your platform if you're teaching.

427

Sarah: Yeah.

428

So I mean, I think, yes, that is, a lot of doulas come out

of their training, kind of like the system is be, is evil.

429

It's going to not be, you know, they're against us.

430

Mm-hmm.

431

And we're fighting for this.

432

Lo: Mm-hmm.

433

Sarah: That is not.

434

Helpful usually for someone's birth experience, right?

435

Lo: Mm-hmm.

436

Sarah: My goal as your doula is to make your experience more positive.

437

Lo: Mm-hmm.

438

Sarah: And I want you to have like a good day

and have happy memories and not be traumatized.

439

Right?

440

That is kind of my, like underlying sounds so simple,

441

Lo: right?

442

But yes.

443

Sarah: And and of course that again is gonna look different for everyone, right?

444

Yeah.

445

Because everyone.

446

Some people love their doctors and their hospital systems of, of even like

highly intervention and some people that is the last thing that they want.

447

And so I have to adapt to fit with what my client wants.

448

But I do think going into this, the medical system, feeling like

I am, we're against them and we're fighting for something is not.

449

Helpful.

450

It's just not like

451

Lo: mm-hmm.

452

Sarah: I wanna work with them.

453

I want them to like doulas and see the value in doulas.

454

Mm-hmm.

455

And if I'm fighting them or like causing a, I mean, obviously

if I'm causing conflict that the parents are gonna notice that

and that is like tainting their birth story in a negative light.

456

Mm-hmm.

457

I think.

458

And so if there's something that, that I think really needs to like.

459

I've maybe done this twice or three times ever.

460

So this is not common.

461

But sometimes I might like talk to a nurse out in the hallway or even talk to a provider

out in the hallway and that's, that's because I don't wanna do it in front of the parents.

462

Yeah.

463

Yeah.

464

So I think, I don't know if I'm even answering

your question, but I think I, as a doula want to.

465

Paint doulas in a good light to the medical staff.

466

I want them to trust us because there are good doulas out there who

are, we're doing our jobs correctly, and we're not like interfering.

467

Mm-hmm.

468

And I want the, I want the medical personnel to know that.

469

Mm-hmm.

470

Lo: Yeah.

471

It's no different than, you know, you just said there

are good doulas out there and there are bad ones.

472

Yeah, there are, and there are good midwives and there are bad ones.

473

Right.

474

And there are good nurses and there are bad ones.

475

And you know, we could keep going forever.

476

so I think that's kind of true for so many of us, especially if we

have a platform where we're also trying to teach and educate while

doing whatever work in our real day to day too, is dancing that.

477

That dance of like, Hey, this, this is actually,

this is the expectation of care you should have.

478

So yeah, fight for this.

479

Like you don't have to settle for less.

480

But then also kind of walking that line of.

481

This is actually not the way it's supposed to be, and I disagree with this.

482

And I want you to have a good picture of what, like, I'll use the word

like a healthy, you know, relationship with your provider looks like, or

a healthy relationship with your doula looks like, or a healthy approach.

483

Like, it's just, it can feel like such a battle to present

yourself, but also to to say like, I'm in this world.

484

This feels biblical.

485

It doesn't mean to be in this world, but not of the world like this.

486

This is practice that I believe in.

487

This is how I do it, and this is what I, I think is true about doula work or whatever.

488

Right.

489

Gosh.

490

Yeah.

491

Go ahead.

492

You were gonna say something?

493

Yeah.

494

No, I

495

Sarah: was just gonna say, it's hard.

496

It's like me going in knowing like, I wanna paint us

in a good picture and I wanna get along with your team.

497

I wanna work with them, not against them.

498

Yeah.

499

But that doesn't mean that I'm gonna just go in and like agree with everything.

500

It doesn't mean Right.

501

You're not just gonna roll over.

502

That's not your

503

Lo: job.

504

Exactly.

505

Right.

506

Sarah: So yeah,

507

Lo: there's

508

Sarah: a way to do it.

509

Well, it is.

510

It can be like a learned skill.

511

Lo: Yeah.

512

Oh, I think it is for all of us, whether that's a nurse or a doula like, but especially

when, you know, our system has a provider, again, above the nurse and the doula.

513

Good reason these delivering providers know more skills, et cetera.

514

But that automatically puts you like under somebody.

515

So then it is that, you know, respectful communication, informed conversations.

516

These all flow from typically a healthy space where everyone is treating

each other well, honoring what everyone knows and brings to the table.

517

But there are those kind of.

518

Like that hierarchy does exist.

519

And so learning to navigate that and where, where you are in

that, but also being confident to help your family, right.

520

Kind of move through that.

521

Yeah.

522

Just tough.

523

I, I don't know that there's a question in that

either, but It is, it is a dance for you guys for sure.

524

Sarah: Yeah.

525

So, I recently, I don't know if you saw this too, and I don't

even know who said it, but there was somebody on Instagram or

social media that said, and she was at OB I think, and she said.

526

Recently that she thinks doulas should be like, held accountable for giving, you know,

medical advice or, teaching their clients about like the pros and the cons, or giving

them a, a say in like, maybe we should go this way or not that way, or whatever.

527

And that was, did you hear that?

528

Did you see that?

529

No, but I'm going,

530

Lo: I'm assuming this is like negative towards doulas, right?

531

Well, yeah, it is because she's like that you're messing things up, causing bad

532

Sarah: outcome.

533

Yeah.

534

Yeah.

535

Because you're not a doctor.

536

And so is that not our job?

537

Is that not your job?

538

Well, the problem is is that like, and I get where what she's saying, like if, if

you're telling your client really terrible advice, that is gonna be like detrimental.

539

Like that's not cool.

540

Probably that doula actually doesn't know what she's doing.

541

Right?

542

Yeah, yeah.

543

But on the other hand, it's making it so that the

OB is just the final, like you're final, final say.

544

Mm-hmm.

545

Because that's.

546

That's not cool.

547

Mm-hmm.

548

Mm-hmm.

549

Yeah.

550

Yeah.

551

It's, it's social media's we, gosh, we can't question you or Right.

552

Have other that's, you know, I don't like that.

553

Lo: Yeah.

554

I feel like social media has changed these conversations so much because.

555

Maybe a lot of people aren't aware of this because they don't

follow like obs and midwives and nurses probably like you and I do.

556

But you do see these like in the cloud happening attacks

of like obs versus doulas or obs calling out nurses.

557

It goes the other direction too.

558

Yeah, right.

559

Like, don't get me wrong, I'm sorry.

560

I'm sounding very slanted and the nurses like

calling out obs and everyone's up here like arguing.

561

But gosh, we have to think about that trickle down because what about the lay person

who is seeing this and, and it just, I just feel, I guess, I guess ultimately I just

say I kind of hate that, that these public forums and arguments are playing out.

562

And we think maybe we're winning our point with some doula we're arguing with online.

563

But what about everyone following that doula and that nurse, right?

564

And now they're like, gosh, these providers don't get along this system.

565

They're all gonna fight with each other.

566

I don't know who to listen to because this one's being rooted.

567

This like, there's such an impact on, right?

568

These public conversations that we're having, including this one, I get it,

that you and I are having right now on a podcast, but I just don't know that.

569

We're thoughtful enough or that it's even possible to keep

boundaries around these back and forth combos that are happening.

570

So we're putting a lot of, I don't wanna say responsibility.

571

Our, our patients and clients can handle education, but they're just

getting a lot of inputs and some that they don't necessarily need when

they're seeing these kind of arguments and attacks and things play out.

572

I just don't know that that's adding value to their experience,

but they're definitely, it's getting put in front of them.

573

Right?

574

Sarah: Yeah.

575

And I think, like, honestly, the big question, and this goes for

everybody, like doulas, nurses, obs, it's like, who is this about?

576

Like this is the parents.

577

Yeah.

578

Like it's their experience.

579

Give them their options.

580

Let them choose even if it's not what you would choose, like Yep.

581

That's really what this is all about.

582

Lo: Yep.

583

It's perfect.

584

I mean, it really is.

585

It's so basic and somehow it's gotten a lot really

complicated, but that is a hundred percent the truth.

586

Give them their options and let them choose.

587

Right?

588

Like we should be able to trust them with that.

589

Right.

590

They're going to be parents and raise that tiny life,

like they can be responsible for making choices, you know?

591

Sarah: Right.

592

Lo: So, okay.

593

That, I wanna talk about one last thing with you.

594

Yes.

595

That's kind of related to this social media thing we've been talking about as well.

596

So.

597

Sarah and I had been texting a while ago because there was a post

that went up from a doula, and I'm sure, I know when Sarah saw it,

she was probably annoyed because it was part of this like, oh, great.

598

Now I wanna go and speak to what this doula had said.

599

But essentially the doula had shared a post, and on one of the slides,

you can add more to this, if you, onto one of the slides, basically had

suggested that lying to your provider, is an appropriate choice or like an

option, like just lie to them about what time your water's broke, right?

600

And, like that that is your right.

601

And so there was different options, she said, but she included very clearly that lying.

602

is is your right?

603

I guess I'm sitting here going, well, it is your

right technically, but it was a suggestion, right?

604

Like right.

605

Hey, lying is a possibility.

606

Here's an option I'm gonna give for you, is to lie.

607

So I don't have a question in that, but I know

that you had feelings about it and you went live.

608

Yeah.

609

So speak to us a little bit about that.

610

I

611

Sarah: mean, she, she literally was saying, you know, like.

612

So it was something about like, autonomy, like

613

mm-hmm.

614

Sarah: Once you give that up, like once you tell them the truth that your water has broken

615

mm-hmm.

616

You

617

Sarah: are giving up your autonomy to like, make decisions and

it's gonna change the trajectory of your labor and birth and.

618

No, that's not, that's not true.

619

You can still have your autonomy even if you've given all the facts.

620

Mm-hmm.

621

And yes, that might be look different than how they were hoping or have more

conversations than you wanted to have or feel more like an uphill battle.

622

But ultimately the decision is still up to the parents.

623

Like providers cannot force you to do.

624

Anything.

625

Lo: Mm-hmm.

626

Sarah: But I also just think that's bad advice in general.

627

Right?

628

Because there're, you know, Yik like, yes, most of the

time it's fine to stay home after your water's broken.

629

Like, I think 90, of course, 95% of the time.

630

I think that's fine.

631

But like you don't know if this person's in that 5% and maybe

something bad is gonna happen because you didn't give that information.

632

And I'm always.

633

I'm always, especially on this topic, like I'm the doula who will tell

people, if you think your water broke, like just text me, call me.

634

Like, I'll help you figure it out.

635

Mm-hmm.

636

And like if you're meeting the, the healthy milestones

of like, it's clear and it doesn't smell bad.

637

Bad, yeah.

638

Your baby's moving and all these things like it's.

639

It's fine.

640

Your GBS negative, like it's fine to stay home.

641

Mm-hmm.

642

If you want to, you, here's, if you call your provider and tell them like they're

gonna tell you to come in, but also you can still call them and say, no, I

don't wanna come in, or like, I'm gonna totally home for 12 hours or whatever.

643

You wanna decide what they say.

644

Does isn't.

645

You don't have to do it.

646

Like you can negotiate with them and still tell them the truth, right?

647

Lo: Mm-hmm.

648

Sarah: So I'm never, I'm never gonna encourage lying.

649

Lo: Yeah.

650

Yeah.

651

It was interesting because the whole post.

652

I felt like I agree with like 98% of the rest of it.

653

Right.

654

'Cause it is true, you know, a hospital system

kind of puts you on a clock when your water breaks.

655

Right.

656

And interventions may then be suggested sooner because that

water has been broken or they want you to come in right away.

657

Which I can tell you as the receiving nurse, they're, like

you said, we're throwing out this number guys 95% of the time.

658

But the majority of the time you actually, you do not need to to be there.

659

Right, right, right away it's just, It's, I'm gonna say the

way we talking about the system's, the way we like it, right?

660

We can check on the baby, we can do a quick monitoring, and, and once you're

there, you're stay in if your water's broken until you've had your baby.

661

So I think it, it's just a way to exercise some.

662

Some control and know, okay, this mom's water's broken,

she's here and she'll have her baby, you know, at some point.

663

And so I don't wanna say none of that's so true.

664

It is true.

665

You and I have both seen all those things play out, but with that

post specifically, I think it was like the second that it said,

just lie about the time your water broke and like that then.

666

This entire thing.

667

I'm like, stop.

668

Like this is something I felt like back away from.

669

There should not be a relationship with a provider

in which you have to lie to them to navigate it.

670

There are so many other options, especially like you just said, like you can see what they

say and you do not have to take their advice or the suggestion like that's your autonomy.

671

That's a powerful step to say, thank you.

672

I'll come in in 12 hours, or I'll call you back in eight, or whatever.

673

Right.

674

But lying Yeah.

675

Is just such a, a, a shaky foundation.

676

And there's so many more choices.

677

Assuming this is, you're gonna the hospital mm-hmm.

678

And you're gonna finish your process there with them.

679

Like, if that's what we're doing, if that's what

we're even encouraging as a choice, I don't know.

680

It just feels like, gosh, yeah, too bad we can't back up and fix and

correct this way before we got to this point where we think lying should be

681

Sarah: Yeah.

682

An

683

Lo: option for sure.

684

Sarah: Yeah.

685

Lo: And then I would say clinically too, like.

686

I am not someone who says, rush to the hospital.

687

I waited till the last second to go to the hospital with all of my

children and almost waited too late for two of them, and it was very.

688

Exciting.

689

So I don't think you should rush to the hospital,

especially if you want unmedicated birth, you know?

690

Right.

691

A thousand, just interventions and interruptions that happen.

692

It's just true.

693

But we need to know what time your water broke, because let's say it is 32 hours

down the road, like there are some significant risks that can come into play

specifically based on the time, amount of time your waters have been broken.

694

Sarah: Right.

695

Lo: Like, why are we going to suggest lying about a number like that?

696

We can suggest autonomy after that choice.

697

Sarah: Right.

698

Lo: But to suggest that I'm like, that felt wild to me as I know it did to you too.

699

Yeah, and I think ultimately trying to, like back to the dual conversation,

I think it's frustrating to see a provider that you share, like you're

a doula as well, and then you think, oh gosh, it's super frustrating to

have a doula say this or share this when you disagree with what's Yeah.

700

Shared.

701

Then you feel like you're correcting.

702

Sarah: I don't, well, and I don't know who's reading that.

703

Oh yeah.

704

Labor and delivery nurses, obs and then they're thinking,

oh, doulas are just encouraging our patients to lie.

705

Well then to lie, yeah.

706

They don't like us because then they're Yes.

707

You know?

708

Lo: Yes.

709

Yeah.

710

And again, that's fact.

711

We already talked about this, but that's social media thing.

712

It has kind of like brought some of these relationships very public.

713

Mm-hmm.

714

And it's

715

both good and bad and value and not valuable, but.

716

I do think it can be complicated 'cause you feel like I wanna do

my doula work and I wanna do it well, but shoot, now I have to

get online and correct all these things that are happening online.

717

Yes.

718

Too much work.

719

It's too much value.

720

I'll

721

Sarah: say I do, I love, one of our local hospitals is

so great and they have a super large, midwifery practice.

722

Lo: Mm-hmm.

723

Sarah: And those midwives.

724

See a lot a, a huge amount of births, but, they will let a

mom stay home, will let wait, they will let a mom stay home.

725

They're, they're comfortable with up to 20, for up to 24 hours after her water has broken.

726

Even if she's GBS positive, they'll have her come in

That's awesome for antibiotics and then they go back home.

727

Mm-hmm.

728

Mm-hmm.

729

Like that is how everywhere should be.

730

Lo: Yeah.

731

Yeah, my girlfriends who have delivered out birth centers out here, same.

732

And she's been GBS positive with some of them.

733

And I think I actually love considering, Hey, how does a birth center handle this?

734

Even if you're in a hospital or that's where you

wanna be, how does a birth center handle this?

735

How do other countries handle this?

736

Like it's, you're talking about digging deep in education and a lot of times

I think courses and stuff will say, Hey, also this is what, you know, like.

737

Royal College in the UK says, and that stuff's actually really valuable

because you're not just going on a whim saying, well, I'm good with 24 hours.

738

Right.

739

It's like if another country's practicing something.

740

Yeah.

741

They feel really comfortable about the evidence in place to practice

that way, which means you can check that out and lean into it as well.

742

Well, and I,

743

Sarah: and I will say that to my clients, like if they're seeing a, a more high risk OB

at a different hospital, who wants 'em to come in like right away if their water breaks?

744

I tell them like.

745

Well, you know, obviously I'm not a provider, but

you know, these midwives at this hospital mm-hmm.

746

Will let you stay home for 24 hours.

747

Mm-hmm.

748

Like it, if you were their patient, they would be fine with that.

749

Mm-hmm.

750

And so that tells me it's not really all that risky.

751

Mm-hmm.

752

You know, if other providers are practicing that way.

753

Mm-hmm.

754

And so mm-hmm.

755

Like, I hear that this is what your doctor's

saying, but just know that that is kind of on the.

756

Very conservative side of mm-hmm.

757

Mm-hmm.

758

Recommendations.

759

So I think that's all just like good in info.

760

Info for, yeah.

761

For like how you tell your clients that stuff.

762

Lo: Well, and that goes back to what you said when we started, right?

763

Like there's a spectrum here for all of this.

764

I know we're talking specifically about water breaking, but a lot of these

choices about when to go in or what to do next or when to start meds or when to.

765

Call failure to progress or whatever, like, obviously are so incredibly

talented, valuable, many of them have delivered so many babies.

766

But I think it's understanding like their.

767

In this spot on the spectrum.

768

Yes.

769

They know me personally.

770

And that matters too, like what is my health history?

771

'cause I can't just compare myself to the woman next door.

772

Sarah: Yes.

773

Lo: And so I think that's why like your job saying like, here's the whole spectrum.

774

Mm-hmm.

775

Here's A, B, C, D, E, and F. Provider suggesting F, you're

allowed to look at these other ones and then decide.

776

You know, what feels right is, again, just such the value of a doula is just making

sure that you keep reopening that conversation so that your clients always do know.

777

This is a suggestion.

778

This is another way it can be done.

779

This is another way it can be done.

780

And then I get to decide.

781

Right?

782

Lo: And birth, especially if we're talking about

labor and birth moments, everything's so quick.

783

Mm-hmm.

784

That the ability to pause and ask for time and space is so, so valuable.

785

And I think that that is just one of the gifts of you guys in that room is just saying.

786

Everyone stop.

787

Pause.

788

We need a minute.

789

Uhhuh.

790

Yeah, Uhhuh.

791

And who cares what you decide, right?

792

Maybe your client agrees, but even just saying like, pause.

793

Yeah.

794

And then they're gonna leave and then you can agree with them in five minutes.

795

I just wanna know that you felt like you had a minute.

796

Yes.

797

Sarah: A thousand percent.

798

Yeah.

799

And that's what I say in my classes.

800

I'm like, if you, you know, to take that.

801

Moment to go through like the brain acronym, which I'm sure you're familiar with that.

802

Lo: Love it.

803

Teach it.

804

Sarah: But it's good, you know, if I always say like if you decide to do

exactly the same thing, your provider is like, great, that's great and fine.

805

Yeah.

806

But you'll feel different about it if you made sure it was like your decision.

807

Lo: Mm-hmm.

808

You will know what I'm talking about right now, but in my mind when I think about

my students and sometimes try to like put myself in their place, one, I try to

remove that I'm a labor nurse and just be like, remember if you're just like the

one in the bed and I think about when the nurse turns their eyes and looks at

you, the doctor's at the foot of your bed looking at you, and you have like two to

four pairs of eyes looking at you as the doctor or the midwife, whoever is saying.

809

Let's go ahead and start some Pitocin, like you've

been laboring for six hours, haven't changed.

810

And I just think about when you're sitting there

and there's all these professional eyes on you.

811

Mm-hmm.

812

But that is the moment where you just need someone if you don't feel comfortable

saying like, can I just have a few minutes with everyone not looking at me?

813

So I can just think?

814

Yep.

815

Because that, I think about how many times I've been

like looking down at a mom and in my head I think.

816

I'm there and I'm supportive and whatever, but you're also standing above them, right?

817

Right.

818

If they're in the bed and you're literally putting a spotlight

on them, sometimes actually, literally with the spotlight

going and what a crappy position to be in to make any choice.

819

Right.

820

Even when you're more than happy with what they're suggesting,

you just don't feel like you are owning it, you know?

821

So that moment, if you can step into that, if your doula can

step into that and give you those spaces like chef's kiss.

822

Sarah: Agree.

823

Lo: Okay, Sarah, let's pause right there.

824

Although I wanna ask you two quick follow-up things.

825

One easy.

826

Where can people find you connect with you if they're local to

the Washington area where you are, maybe even work with you.

827

So share that with me.

828

Go ahead.

829

Yes,

830

Sarah: so my, my doula collective website is,

the birth collective, PNW for Pacific Northwest.

831

Mm-hmm.

832

That's also our Instagram.

833

My website and Instagram is the expert doula.

834

Lo: Mm-hmm.

835

And Sarah shares some Awesome.

836

She's a photographer as well, so I love.

837

Remixing her birth photos.

838

She's given me full permission to do so.

839

Okay.

840

Yes, I love it.

841

And then explaining what we're seeing and what's going on.

842

'cause she takes some really beautiful photos and I love seeing like the

interventions, if you will, in a photograph so we can break it down and talk about it.

843

'cause obviously everyone's using different tools.

844

With a doula and without to, to have their babies and so, so good to see them.

845

I always say like, when we see birth, we do birth better because so many of

us don't get to see it, and so I know, yeah, it's really valuable to see it.

846

Sarah's photos are amazing, so definitely check out her personal account

as well, just to see things honestly that maybe you've not seen before.

847

Okay.

848

Last question.

849

You can be as thoughtful as you want about it or just top of

your mind, but what's something right now that is sparking

joy in your life, just bringing you a ton of happiness?

850

Sarah: Oh, it's bringing me a ton of happiness right now.

851

Is that your question?

852

Anything?

853

Yeah.

854

Spark

855

Lo: and joy.

856

It could be

857

Sarah: Cheetos.

858

Lo: It could be your kids.

859

I don't care.

860

I don't care

861

Sarah: anything.

862

It's not my kids.

863

Lo: Okay,

864

Sarah: that's fine too.

865

I am loving the sun, the weather.

866

It's great.

867

Lo: I've had a lot of people saying that this summer.

868

Yes.

869

My people are ready.

870

Sarah: As you know, from living here.

871

Like the, yeah, the fall, winter, spring is long.

872

The fall, winter,

873

Lo: spring, you mean like the 11 months?

874

It's great.

875

Sarah: So now it's, it's like the sun is out.

876

It's like seventies.

877

It's perfect.

878

It's,

879

Lo: it is.

880

It's, there's nowhere more beautiful.

881

When it is beautiful.

882

There it is.

883

Sarah: I put flowers on my porch and I can smell them, which I feel like yeah,

in the past I haven't really been able to smell 'em, and that just is wonderful.

884

Lo: It's, it's alright.

885

Perfect.

886

I love it.

887

All right.

888

Thanks Sarah, so much for your time.

889

Yes.

890

Okay.

891

Talk to you soon.

892

Okay.

893

Bye.

894

Speaker 4: Thank you so much for listening to the Lo and Behold podcast.

895

I hope there was something for you in today's episode

that made you think, made you laugh or made you feel seen.

896

For show notes and links to the resources, freebies, or discount codes

mentioned in this episode, please head over to lo and behold podcast.com.

897

If you aren't following along yet, make sure to tap, subscribe,

or follow in your podcast app so we can keep hanging out together.

898

And if you haven't heard it yet today, you're doing a really good job.

899

A little reminder for you before you go, opinions shared by guests of this show are

their own, and do not always reflect those of myself in the Labor Mama platform.

900

Additionally, the information you hear on this podcast or that you

receive via any linked resources should not be considered medical advice.

901

Please see our full disclaimer at the link in your show notes.