BIRTHFIT Podcast Featuring Henci Goer


 

[0:00:00]

 

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[0:05:00]

 

What’s up, BIRTHFIT community? This is Dr. Lindsey Mathews, your BIRTHFIT founder. This is a super special episode that is going up the week of the BIRTHFIT Summit. So, before we get started, I have a few announcements. I know I mentioned the BIRTHFIT Summit. This is an annual BIRTHFIT Summit gathering of all the regional directors and any exceptional coaches, professionals that have just made marks in their territory and their communities.

 

And we are having the BIRTHFIT Summit this year, this week in Venice, California. There will be over 50 women gathering. Machete’s eyes just got really big. We are going to try to record one of the longest podcasts ever on Saturday. So, stay tuned for that or be on the lookout, better yet. So, yeah, this time next year, we will have a BIRTHFIT Summit as well. And I want to share with you that we are moving the BIRTHFIT Summit to Austin, Texas next year. And we will have a day that is dedicated to everybody else.

 

So, if you’re not on the BIRTHFIT team as regional director or as a coach or a professional, we will have a day where we will have speakers and just awesome people that are leading the way and that will be on Saturday next year. It will most likely be at the first or second weekend in June. We have not nailed that down. But if you are wanting to come to the BIRTHFIT Summit next year, write that down, Austin, Texas, first or second weekend in June. I’m pretty stoked about that.

 

A few another announcements. We have the BIRTHFIT Coach Seminar happening in August both in Raleigh, North Carolina and in Colorado. So, Colorado, basically, has like four spots left. So, if you’re on the fence, you better make it happen because that’s going to sell out quick. Raleigh, North Carolina is also pretty full. I think we have about six spots left. So, make that happen.

 

The last BIRTHFIT Coach Seminar of the year will be happening in New Jersey, Hawthorne, New Jersey, the last weekend of September and the first day of October. If you missed Colorado or North Carolina, you better get in in New Jersey because that’s the last chance.

 

Also, BIRTHFIT Professional Seminar Dallas, mid September, North Carolina, mid October. Dallas is, basically, already full. I think we have about four spots left there. So, get in where you fit in. And then, I think, we’re about half full for October with the BIRTHFIT Professional Seminar in North Carolina. The professional seminar is open to any chiropractors, any physical therapists, any doulas, any midwives, OB-Gyns, anybody that is a professional. So, get there. We’ll talk about pre-natal care, postpartum care, and all things in between. So, I hope to see all of you there.

 

And don’t forget, if you’re not near a regional director and you can’t participate in all the fun classes that they have then join us online with our pre-natal program or our post partum program. I selfishly wanted to release this episode the week of the BIRTHFIT Summit because this is somebody that we look up to so much. We read her books. We check out any blogs that she’s written. And she’s just been a trailblazer as far as changing the maternal care system in our country. It’s not changed yet but it will get there.

 

Her name is Henci Goer. You might have heard of her because she’s the author of The Thinking Woman’s Guide to a Better Birth. She’s also written another book called Optimal Care in Childbirth. She’s just a legend. She’s an award winning medical writer. She speaks all around the globe. And she is acknowledged as an expert on evidence-based maternity care. So, that’s what goes into all of her books.

 

She definitely started as a childbirth educator and gained some of her interest through her own experiences. But she took time out of her busy schedule to chat with me for about an hour and I freaking am blown away just by the amount of work that she’s done and how motivated she still is to make things happen. So, at the end of this conversation I asked her who some of her mentors are and I would definitely say she is an inspiration to us and a mentor to many of us on the BIRTHFIT tribe whether she knows it or not. We are pumped to have her. This is Henci Goer.

 

[0:10:12]

 

I’m so happy that I got you on the BIRTHFIT podcast. I don’t know if you know anything about BIRTHFIT but we have a big team that worships the ground you walk on.

 

Henci: Oh, gosh.

 

Lindsey: So, when I let them know you are coming or speaking on the podcast, they were pretty stoked about it. So, yeah, hopefully, we kind of respect your time. We’ll get in under 60 minutes, if we can, and ask all the questions.

 

Henci: I did review your website and I was — Yeah, it really looked cool.

 

Lindsey: Awesome. Thank you. Well, for those listening, can you share a little bit about who you are and what you do?

 

Henci: Oh, gosh.

 

Lindsey: It could be your two minute elevator speech because we’ll get into it.

 

Henci: So, I essentially spend my time reading the obstetrics research and synthesizing and analyzing and repackaging it for others to get some information about it, like where [0:11:25] [Indiscernible] women making informed choices. So, the way I sometimes describe it is I stroll through the gardens of research gathering blossoms to form into bouquets for others to enjoy.

 

Lindsey: I love that. How long have you been doing that?

 

Henci: Let’s see. Three decades, roughly. I actually got involved in birth issues in 1978 and started writing — Well, okay, I’ll let you guide the conversation. Where do you want to go with this?

 

Lindsey: No, totally. I was going with you, yeah. That was my next question. How did you get involved with it? And what kind of motivated you to become this birth activist?

 

Henci: Well, I think, like many people in the field, it had to do with my own personal birth experiences. In this case, the contrast between the birth of my first and second child in that the first, my son’s birth was perfectly uneventful from the medical point of view and deeply traumatizing to me, and the second birth was terrifically empowering and changed how I thought of myself forever.

 

And after that, I really wanted to be involved in telling women that the choices that they made were crucial in terms of how they were going to end up feeling about themselves and their partner and their child. So, the first thing I did was decide to become a Lamaze teacher and I also got involved with a group that was trying to start a freestanding birth center and a woman’s resource center. And that’s where I started.

 

And then as I’ve started teaching Lamaze classes — I majored in Biology in college. I really hadn’t done anything with it. It’s one of those things where if you look at that time it felt like you’re making a bunch of random decisions. But then if you look back it’s almost like there’s an arrow pointing down a path.

 

Lindsey: Totally.

 

Henci: I was interested in the research about birth and I realized that there was a total disconnect between what my Lamaze students were telling me and what I started finding out really made for a safe healthy satisfying birth experience. So, I started writing about that. I started putting together materials for my classes and then I got involved with — You’re probably way too young to remember. Penny Simkim used to have, used to publish penny press, which published pamphlets of various kinds. I worked with her on some of them.

 

And then I realized, well, other child birth educators — We really need to have a book that has the research in it so that when our students say, “Well, my doctor says a nice clean cut is better than a jagged tear,” that there would be some research that they could stand on to say, “No, actually, episiotomies promote bad tears.” So, I wrote Obstetric Myths versus Research Realities. And that took off.

 

[0:15:04]

 

And then I thought, well, pregnant women really need to have this information. So then I wrote the Thinking Woman’s Guide to a Better Birth, which–

 

Lindsey: Is awesome.

 

Henci: It kind of became the princess bride of birth books. People knew about it. It certainly wasn’t What to Expect Ehen You’re Expecting.

 

Lindsey: Yeah. It’s way better.

 

Henci: But it did well. And so then I realized it was time to update OB myths. I brought in a woman that I had gotten close to and I really respected who is a nurse midwife, Amy Romano. And then we wrote Optimal Care: The Case for a Physiologic Approach. And that has done very well. And then my original plan was to get all the new research and then turn around and do a new addition of Thinking Woman’s Guide.

 

That didn’t work out because the editor who was just this — He’s just an awful person. I mean, the terminology I would use, I wouldn’t use on a family oriented broadcast. But he wasn’t interested in having a new edition of the book even though the research was — It’s a research-based book and it was now out of date. Because the book is still selling, and so he didn’t want to get involved. So that left me really, really stuck.

 

And after some — I do my best thinking in the shower and what I came up with is sort of this gestalt moment that what I really needed to do was take it to the internet. And so that was the origin of Childbirth U, which we can talk more about later. But essentially, and the reason I had to take it to the internet was because this publisher said, “Oh, and by the way, don’t think you can take your book anywhere else because there’s a non-compete clause in your contract.”

 

And after consulting with a lawyer about could I get out of this, because they have treated me so horribly, and he said, “No, actually, if they put your book between covers and publish it, you’re stuck with that contract and they will come after you if you try and publish somewhere else because they don’t want a precedence of it.” So, it’s like, okay, I’m stuck.

 

But I realized, on the internet, I am now selling — They’re streamable only so, you see, it’s a different medium so it doesn’t conflict with, it’s not being “published.” So, I’m selling lectures, individual lectures at $5 a piece or you can get an annual subscription that gives you access to all of them. And it’s kind of like Amazon Prime in that it’s a little bit of money and then you have an account and then you can stream it to any device.

 

Lindsey: That’s awesome.

 

Henci: That kind of takes us up to the present.

 

Lindsey: Yeah, the current. So, like the current, obviously, is we get information online. But let’s take it back a little bit. You said you originally started writing for the penny press and things like that. How did women that wanted more information find out more information? Was it mainly through like magazine publications, word of mouth, especially before the internet came along?

 

Henci: I think it was more books. And a lot more middle class women, at least, were taking childbirth classes. Women really have stopped taking childbirth classes. So, it was more person to person.

 

Lindsey: So interesting.

 

Henci: And even from its beginnings when there were — I mean, in the 90s, I was doing posts for — what was it called? Parent’s Place, which eventually got taken over and taken over and taken over. I think it’s probably disappeared by now. But those original were grassroots group of people who understood how the internet worked getting together to form a place where pregnant women could get information. And then everything sort of grew like topsy and became corporate.

 

Lindsey: I mean, I think childbirth education is so needed just in the general childbirth sense because half the world or society is not even taught childbirth education nor do they see it. But what do you think was the initial drive for people wanting to know more about childbirth education? Did it have to do with maybe the births moving into the hospital or I don’t know?

 

[020:04]

 

Henci: Well, there were a couple of ways. This is interesting now because I am — What you can now read as the history of the childbirth movement is my lived experience. Okay. So, I don’t quite go back this far but, actually, where the interest in childbirth education started was, the watershed moment was, an article that appeared in 1958 in Ladies’ Home Journal called Cruelty in Maternity Wards.

 

And a nurse had written in her personal experiences what she was seeing. In that time, it was all about twilight sleep and then they knock you out for the birth, cut a huge episiotomy and drag the baby out. So, she was writing about her experiences and Ladies’ Home Journal said it’s hard to believe that this is really going on. And they invited their leaders to write in and they were inundated.

 

They had enough to do two articles of people telling stories or other nurses saying what they had observed. It is not serendipitous that Lamaze, as an organization, was founded in 1960 and so was ICEA. And, I think, Bradley was not far behind. And those were the big three for many years with Lamaze being the biggest of them. And there was this idea that natural childbirth, it actually went back to the [0:21:40] [Indiscernible] in the 40s, but it really didn’t attach as being a thing to do.

 

And there, it was about a couple of things. It was not being drugged out of your minds. It was un-medicated birth. And also, it was about having someone with you, which in that case was your husband, end of story. I’m using that word deliberately because that — But literally, there were some things that made headlines like a New Jersey father that handcuffed himself to his wife so they couldn’t be separated.

 

Lindsey: Oh my gosh.

 

Henci: Yeah, this was — So then childbirth education, and this is kind of what the middle class did was about, how do you get through labor without drugs and having a loved one with you so that you weren’t alone during this experience? And then there wasn’t that much interest in how women were being treated in labor at that point. It was just these two issues.

 

But starting in the 70s, the caesarian section rate started to rise and electronic fetal monitoring was coming in and this whole sort of medicalization of childbirth. And, of course, episiotomy was a big issue. But a lot of it was the caesarian rate rising. And then there was a couple of watershed books published. One was Suzanne Arms’ The Immaculate Deception. And also you had the hippie back to the earth movement where you had Ina May Gaskin getting involved with midwifery and natural childbirth and, no, you don’t need a hospital to do this. So, that’s what ignited how are we treating women in labor and is that the right thing to do? Which is kind of where I came in to the story. However…

 

Lindsey: Yeah. Basically, it all happened at the same time.

 

Henci: Right. But what happened next was that — And this, I think, was kind of really appealing, was this sort of obstetrics sales job that this was really — That really, that bringing in electronic fetal monitoring and in the increase in the caesarian rate was going to save babies. And it seemed like a reasonable story. I mean, if you start from the premise that birth is this horribly difficult and dangerous experience then, obviously, we can do better at rescuing babies from the untrusthworthy bodies of their mothers.

 

And that’s a very compelling argument. I mean, if you say to a pregnant — If you were an authoritative person, I’m sure they’d believe it too. But if you say authoritatively that we really need to do this to you because your baby could die otherwise, I mean, you can say to a pregnant woman we need to cut off your arm to save your baby and 99 out of 100 women would then hold out their arms and say, “How high?”

 

Lindsey: For sure.

 

Henci: So, little by little, it started to come out pretty much almost under duress because it’s — People will defend what they believe.

 

[0:25:10]

 

And it’s very hard to attack something that they have faith in. But little by little, it began to come out that, no, really the high caesarian rate wasn’t improving outcomes and electronic fetal monitoring wasn’t improving outcomes. But we’re still living with that. And the whole system has been set up to be organized in that way. I mean, if you want the standing on one leg version, the problem is, if you’re going to put surgeons, specialists in the pathology women’s reproductive organs in charge of all birthing women, this is the system that you’re going to get.

 

Lindsey: Right.

 

Hence: It’s totally predictable.

 

Lindsey: Yeah, you talk about that a lot in the Thinking Woman’s Guide.

 

Henci: Right. And that to a large extent really hasn’t changed. But the battle is on. I mean, interestingly enough, in the 90s, grassroots organization like the international caesarian awareness network nearly disappeared because you now have a culture in which it was commonly assumed that, yeah, women are pretty likely to have C-sections and that’s all to the good. And it was nicer. I mean, you didn’t have nurses being mean to women in the same way that you did.

 

So, the modern birthing women of the 90s and the early 2000s was like, high tech birth was like, well, that’s what modern people do. It’s so much better. And then, of course, what happened in the 80s and 90s, which I always feel like was a kind of like Snow White’s witch with a poisoned apple, was epidurals. Because epidurals cause a lot of problems. And epidurals guarantee you’re going to need a high tech birth. But no need to suffer anymore. We have this wonderful technology which will spare you the agonies of labor. And it’s perfectly safe. Who wouldn’t want that?

 

Lindsey: Right. Especially when they spin it like that.

 

Henci: And again, this isn’t people — Well, I guess, there is a lot of commercial interest behind this. But, I mean, this isn’t people who want to be mean to women. These are all people who in their deepest beliefs think that they’re doing the best that they can.

 

Lindsey: Right. So, just to — I want to give some education out there. Can you elaborate on, let’s start like maybe with the fetal heart monitoring? Like when that came about and maybe what the purpose or what it was intended for? But now it’s just routine use in almost every hospital.

 

Henci: Right. So, the original premise of the fetal monitor was that there was a certain number of babies who got into trouble during birth and the idea was that, well, just listening to the heart rate intermittently isn’t saving them. So, if we had a machine that would keep track of the fetal heart rate and what it does in response to contractions, that will enable us to intervene earlier and rescue babies and save their lives and it will decrease the cerebral palsy rate, which can come from neurological injury.

 

There were a number of things wrong with that theory. Here’s the interesting part and this was kind of shocking to discover. The people who pushed electronic fetal monitoring were people who had financial interests in the company that was manufacturing the equipment.

 

Lindsey: Not surprising.

 

Henci: And not surprisingly. And what’s more? When somebody said, “Hey, we really–” And then they went around the country making all these claims about how many babies would be saved with continuous monitoring. And they actually obstructed attempts to conduct trials because it was one of those like, “Well, we already know this is wonderful that we don’t need to test it.” So, there’s some shocking news for you.

 

But in any case, when they finally did get around to testing it, they discovered that it didn’t actually work. It doesn’t prevent deaths and it doesn’t prevent cerebral palsy. And if you think your way through that you can, well, for one thing, a lot of the problems that babies can get into are from events that happened prior to the labor. Another thing is that some events happen so suddenly you can’t rescue the baby.

 

[0:30:04]

 

And there are many number of times that the heart rate looks fine all through labor and the baby is born in trouble. But this is kind of like the definition of insanity where when they discover it didn’t work, they didn’t say, “Maybe there is a problem with our theory.” What they said was, “Oh, we don’t have common definitions of what these heart rate patterns look like.” So, they got some groups together and they came up with standardized definitions.

 

But then they discovered like — Again, this would have been utterly predictable. Everybody could agree on what a normal heart rate looked like and everybody could agree on what really abnormal heart rate looked like and where intervention should happen soon, which by the way you can detect with listening. You don’t need an electronic fetal monitoring. And then there was broad range in the middle which really didn’t have any great predictability. Most babies who have mildly abnormal heart rates, they’re just fine, thank you very much.

 

And so, what do you do with those babies? So, what that meant was that the next year, which was, okay, we’ll get computers to analyze patterns and we’ll have like red, yellow, green codes. It’s like obstetricians weren’t any better off because there was still this broad mid range. What do you do with these people?

 

And then what they totally ignored is that a fetal heart rate that starts to look abnormal is actually the body that the baby compensating for lowered oxygen. So, in most cases, that’s a normal accommodation. Because one of the interesting things they discovered is that in cases where there had been a slowing down of the fetal heart rate, those babies did better in long term than babies that the heart rate looked fine but the baby was born in real trouble. Because what that does is the metabolism of the baby shifts to protect the brain and the heart and the internal organs.

 

Lindsey: It’s natural.

 

Henci: It’s a natural response to stress. And, of course, what they left out all together is you really want healthier babies, stop doing things to mothers that stress their babies. Because some of those babies who are little on the fragile side won’t be able to tolerate that. If your goal is healthier babies at birth, stop intervening in ways that stress their mothers.

 

Lindsey: Right. Yeah. I feel like that was — I love that explanation of the fetal heart monitor. I feel like it just picks up more than it would and that would lead down to more, like a cascade of effects similar to like, okay, an induction or an epidural. All three of things can lead you down the road of that’s not really what we intended for.

 

Henci: Right. Well, because if you’re sitting there looking at an abnormal heart rate, it’s probably okay. But what are you going to say, “Geez, I think we better operate.” So, fetal heart monitoring increases the caesarian rate without improving outcomes.”

 

Lindsey: And you could say that about basically epidurals and inductions, am I correct?

 

Henci: Oh, yeah. Now, I’m not saying that you should never use one. Actually, back in the day, it can be used. But it’s like fire. If you use it properly, use it to what’s really helpful. So, for example, if you have a baby that isn’t doing well and you’re trying to figure out if the things that you’re doing are improving things like changing her position or giving him more oxygen or whatever it might be to see if you can get the baby to be doing better, continue with monitoring is a big help.

 

Lindsey: Right. Makes sense.

 

Henci: But to do it to everyone…

 

Lindsey: You have just routine across the board. You come in to the hospital, you get it. So, would there be an optimal time or a good time to do an epidural or what are your thoughts on epidurals? Because they’re so common now.

 

Henci: I know they are.

 

Lindsey: And they don’t even tell all the risks that are associated with that.

 

Henci: But again, any of the interventions can be a godsend and I certainly wouldn’t want to say for any woman where her enough point is.

 

[0:35:02]

 

Lindsey: Right.

 

Henci: But where I stand is women should be making informed choices about epidurals and about everything else too so that they have a clear understanding of what they can get and what the problems might be and how often they’re likely to occur. They also, especially in the case of epidurals, have to have access to a wide range of other options. Because this is a point that is too little made.

 

Judy Lothian, who is a nursing professor, made this point in a book called Push a number of years ago. If people blame women for having epidurals but if you’re going to take a woman and you’re going to stick her in bed with IVs and fetal monitoring and maybe a pump on her legs to keep her blood flowing through her legs so she doesn’t develop clots, what other option does she have for coping with her pain?

 

Lindsey: Yeah. She’s stuck.

 

Henci: She’s stuck. So, the other piece of the puzzle is that she needs to understand what her, and have access to other options in order to make the best choice for her and her family. I mean, I can tell you in my own family — That was [0:36:26] [Indiscernible] on my desktop, sorry. In my own personal family, with my daughter-in-law’s first child, she had an extremely long labor. She was not making progress. Fortunately, she was in a very progressive hospital because everything was fine in the end. But in the same way that you might choose to have oxytocin to make contractions stronger, she made the informed decision to have an epidural so she could get some sleep.

 

Lindsey: Nice. Yeah.

 

Henci: And that was absolutely the right choice for her because she woke up fully dilated.

 

Lindsey: Yeah. I’ve seen it or actually been to a number of births where that’s happened. The woman just needs rest. She needs sleep, get through the night. Okay, we’ll start again fresh as soon as we take a little nap.

 

Henci: Right. And so, again, where I stand and I hope I stand there honestly and I’m not really hedging my bet is that the woman should understand the pros and cons of all her options and she should have access to a full range so that she can make the best choice for herself. I’m not going to criticize any woman who has that and still says, “Yeah. But when I arrive at the hospital given who I am, and I understand that there could be a downside to this, but I want an epidural when I walk in the door.” I’m not in her shoes.

 

What makes me angry is that women aren’t told the downside of epidurals. They’re told there aren’t any problems. And sometimes both. They don’t really have any other options that they can use because the standard policies and treatments in the hospital prevent them from dealing with their patient being effectively in any other way.

 

Lindsey: Totally. Yeah, sometimes they’re just — They’re limited in their choices.

 

Henci: Oh, and they get leaned on. This is a whole other issue, is that from the hospital’s point of view, again, there’s a financial interest in having every woman have an epidural. Because you have to, if you want to provide anesthesia around the clock, which I really think is a good idea because you might need one for surgery in the middle of the night, but that cost a lot of money and you need to spread out the cost of that over as many people as possible. You don’t want your anesthesiologist sitting around twiddling their thumbs. Or if you’re using a group, they want to make their money.

 

Lindsey: Totally. Totally.

 

Henci: Here’s something else women don’t consider is that they make it an unpleasant price because insurance covers it to various degrees. So, they may end up with a large bill assuming that it would just be part of the package.

 

Lindsey: Oh, right. I’ve actually had a few clients say, “Oh, I got billed for every single thing at the hospital and I didn’t know I was.” That’s a really good point. Yeah. So, thinking about all this, what would you say are some of the biggest issues with the current maternal care system in the US?

 

Henci: Oh, wow.

 

Lindsey: I mean, I’m sure there’s a few.

 

Henci: You know what it all comes down to? It all comes down to not putting the woman at the center.

 

[0:40:05]

 

Hospitals are big bureaucracies and they run to serve the needs of the people who work there. It’s not a healthy system. And I’ve written about that extensively.

 

Lindsey: Yeah. What would you — How do you think we got to where we are? I tell people it’s a mess and we’re trying to clean it up now but…

 

Henci: Well, I think every large institution works that way whether it’s a school or corporation or bureaucracies work that way. Also, the other thing that gets us into that position is something that’s endemic to the entire medical system which is this extremely hierarchical authoritarian model of the doctor being on top and then the nurse and then women being a long way down at the bottom.

 

Again, this is true of corporations and a lot of other places. There isn’t a sort of mutual collegial respect that different people have different sets of skills and they all have something to contribute. So, for example, ACOG decides to put out some guidelines, do they then fight all the stakeholders who might be interested in how those guidelines might work for them? No, of course, not. They get a bunch of doctors together, which an article a long time — I always love this — dubbed GABSAT, good old boys sat at table. Although in this case, there are a number of women obstetricians than men. So, maybe it should be GAGSAT.

 

Lindsey: Yeah. But I feel like even though women doctors are indoctrinated with those beliefs you talked about earlier, they have faith in that system and for the most part they feel like they’re doing the woman good but they don’t know any kind of life outside of the hospital.

 

Henci: Right. They are embedded in the culture that reinforces their beliefs. And cultures and cultural beliefs are extremely powerful. I mean, I think a lot of women doctors, where they tend to be different is that they tend to communicate better. So, if you’re not so hot on what they’re proposing they are more likely to try and explain it to you better because clearly you didn’t understand them. But it amounts to the same thing in the end which is that you don’t, the woman herself doesn’t have the ultimate decision making power, that she needs to be persuaded and then, unfortunately, if that doesn’t work, believe coerced or whatever.

 

My latest blog post that I just put up yesterday on CBU, I tend to put them up in groups, and one of them is specifically on that issue. Do pregnant women, do laboring women have the right to make medical decisions?

 

Lindsey: That’s pretty good.

 

Henci: And the answer to the question, and it goes through the article, and the commentators on it, is actually not. I mean, it is enshrined that all patients, pregnant or not, have the right to make decisions about their care including refuse it, refuse medical intervention. Except as you go through this article, you’ll see that an ethics lawyer hospital administrator and a prominent obstetrician who works on ACOG policies disagree. I mean, they sort of — Read the blog post.

 

Lindsey: I know. And everybody listening.

 

Henci: It’s childbirth-u.com. And on the home page is the most recent blog post that you can just click through.

 

Lindsey: Awesome. So, speaking of that, let’s talk about the childbirth education course that you have online. Let people know a little bit about what that is.

 

Henci: I’m not quite sure how much to say. For the moment, right now there are individual lectures that can be purchased for $5. Or you can purchase an annual subscription for $25 that gives you access to all of them. I am at the very beginnings of changing my model.

 

[0:45:02]

 

I have hooked up with a marketing person and I just realized hooked up has a whole different connotation [0:45:10] [Indiscernible]. But the old-fashioned version of that. And what she said to me was that my model for what I’m doing online, which is thinking of the analogy being chapters and a book being the annual subscription, but that what I actually do have is a course and that I should be selling the whole enchilada.

 

We are at the very initial stages of talking about how to modify the website and move in that direction. But I can tell your listeners that when I make that conversion and one of the reasons I’m going to make it is I’m going to charge considerably more than $25 for the course. I mean, the annual subscription will, in effect, become a course because it will give you access to all the lectures. So, anybody–

 

Lindsey: So, sign up now.

 

Henci: Exactly. Because anybody, I will grandmother in anybody who is already on the books so that they have–

 

Lindsey: I’m going to sign up.

 

Henci: It will be a course. And actually, at that point, I’ll be looking for affiliates.

 

Lindsey: Awesome. I’m down.

 

Henci: I know. It’s like you’re on my list to contact later when we begin to set things up.

 

Lindsey: So, what kind of lectures do you have on there right now that they can check out?

 

Henci: Okay. Hang on a second. I may just go on to the website and I’ll read you the catalog.

 

Lindsey: Good thing you have your son, the Apple guy.

 

Henci: Oh, he won’t have anything to do with.

 

Lindsey: What?

 

Henci: Where’s the whole internet connection? What the?

 

Lindsey: You’re like, “I’m on a podcast. There’s got to be internet.” So, when did the child–

 

Henci: So, I’m on my desktop. This is the second time this is happening where it doesn’t like my desktop. Since I am on my laptop, can I go elsewhere without messing things up?

 

Lindsey: Yeah.

 

Henci: All right, let’s do that.

 

Lindsey: Or tell people the website where they can find it, at least.

 

Henci: Oh, hang on. This is coming up fine. No, I don’t want this.

 

Lindsey: Technology.

 

Henci: And, of course, it’s going to. All right.

 

Lindsey: Childbirth U.

 

Henci: Here we go.

 

Lindsey: One of our favorite phrases that you say is, I think, why childbirth and, I think, you say this in a book too, is because there will be a test.

 

Henci: Yeah. You know where I got that from? Actually my marketing person doesn’t like it. So, maybe your people can give me some feedback on that. She thinks I should be more positive. But what I was going after is the standard thing that they said to women is, “Well, you know, labor isn’t a test.”

 

Lindsey: But it’s like your ultimate test, like whatever–

 

Henci: But it is, actually.

 

Lindsey: Yeah. Totally.

 

Henci: And I really was — Well, I kind of wanted to be a little cute there. But really it’s a test in a sense that if you don’t know what you’re doing they’re just going to put you on the conveyor belt and take you through the sausage factory. So, on the one hand, I mean, if you were going to take any class you would study for it. But then the other hand, it too is that, it is a rite of passage. And everybody has the right to make choices about that but, nonetheless, it is a time which is transformational in powerful ways.

 

[0:50:03]

 

And, I think, women need to be conscious about that. I mean, there are other — It really is a powerful event. So, in that sense, it is a test. Anyway, so I’m online. So, I have under Making Birth Choices, I have Obtaining Optimal Care, 13 issues, ten issues to explore. I have my brand new one, Labor Support Options, Who Will Help You Get Through the Night.

 

And then under Labor and Birth, I have Preventing the Preventable Cesarean. And I have Electronic Fetal Monitoring, a House Built on Sand. And then I have Coping with Labor Pain, No Pain No Gain? And then I have To Plan VBAC or Not to Plan VBAC. That is the question.

 

And then I have coming up in process, I haven’t started yet, but my next two lectures are going to be Preventive Induction of Labor, Mother Nature Knows Best. So, by preventive, I mean, there’s not a medical reason that the baby needs to be out sooner than later. And then the place of birth, location, location, location. I actually always intended this to be a university with other “faculty members.” And that lecture will be via my first faculty member who is not me, who is a genius. I mean, she’s just a luminary in the field of, actually, home birth but she knows all of the birth issues. My brand is I will always give women the evidence.

 

Lindsey: Yeah. I love that. Yeah, non-biased, here you go. Here’s the information and you can make your own choices.

 

Henci: I don’t claim to be unbiased because I don’t think that’s possible.

 

Lindsey: I think you said that in the book somewhere.

 

Henci: I claim to be as transparent.

 

Lindsey: That’s it. I love that. Awesome. So, where the website for Childbirth U, is it chidbirthu.com?

 

Henci: It’s childbirth-u.com.

 

Lindsey: Awesome. What has been the biggest change that you’ve seen over, let’s say, the last 20 to 30 years as far as the maternal care system or the childbirth world that you’ve witnessed? And it can be good or bad.

 

Henci: Well, it kind of goes in both directions, I would guess. But, I think, the biggest change, and it’s mostly been bad, is the bringing in of high-tech into birth. Because back in the old days, it was pretty easy to say to a woman, “Well, if you don’t want to be drugged out of your mind you shouldn’t have to be. And if you want to have loved ones with you through this experience, why shouldn’t you?”

 

It becomes much more difficult when you have an expert saying, “We need to monitor your baby every second,” or, “We need to do a caesarian because we think this baby is too big,” or all of the things that kind of came in. Like how do you argue with that? So, I think that was the change that really has tilted things in a negative direction. Now, I think, there are some — I don’t know if this is of interest to your hearers. I think there’s some interesting things in terms of efforts to reform childbirth which is coming out.

 

Lindsey: Yes. Yeah. What do you think is going to happen next or how do you think change is going to happen?

 

Henci: Well, I think one thing is that back in the early 80s, the people who were involved in childbirth reform were, and I’m putting air quotes around this, just moms. They were women who were at home with their kids and have the free time to do this. But now, the women who are involved in reform movement have professional skills which give them better traction when you’re in a David versus Goliath fight. They’re accountants and they’re software engineers and they’re lawyers and they’re just all kinds of — There’re marketing people. So, there are people who have professional skills.

 

And then the second thing is the internet because you can — I mean, there’s a lot of crap on the internet but you can get your message out essentially for free and you can then work and network to people and form organizations essentially for free where you don’t have to be in the same space. And I’ll give you like an example of that, was a like a few years ago, the International Caesarian Awareness Network had its 25th anniversary conference.

 

[0:55:02]

 

They invited all of the women who had been directors during the course of their history including Esther Zorn, who is one of the founders, to talk about what went on at ICAN on their watch. And Esther talked about a couple of things. One she talked about was they started locally but then it kind of spread by word of mouth and suddenly she was getting long distance phone calls from Chicago, that kind of thing.

 

So, here they are, they are forming a national organization but they’re making their long distance late at night so that it would be cheaper and they were getting materials out on one of their member’s mom was a teacher so she had a mimeograph machine in her basement. So, can you imagine trying to run a national organization in that way?

 

Lindsey: No. No. That’s wild.

 

Henci: So, those were the two things that I think make reform more possible. And then I think there is some really, there’s some opening things that could go somewhere but it remains to be seen if they will. Like who would have dreamt that the American College of Obstetricians and Gynecologist in conjunction with the maternal-fetal of medicine doctors would come up with a statement saying we’re doing too many caesarians and here’s how to reduce them.

 

Lindsey: Yeah.

 

Henci: And they’ve actually come out with a new one and I did a blog post on this too, which was kind of like — On the one hand, it’s like the sun just came up in the west. But also, the way they hedged their bets and whatever was almost funny. But basically saying, “You know what, we’re intervening in birth too often.” I was like I dropped my jaw in that one.

 

So, there are these things that are like maybe there’s potential for real change here but it remains to be seen. I mean, it’s been a number of years now where there’s been a real push to reduce the caesarian rate. And again, this was my most recent blog post yesterday, was that the 2016 rates are out and it’s like, wow, it has been going down, four years in a row it went down. Isn’t that exciting? Well, not really, because in four years it went down one percentage point.

 

Lindsey: It should go down a lot more.

 

Henci: Our grandchildren will be having children before we get back to what it was in the early 80s, which was already way too high.

 

Lindsey: Right, right. What would you give to a woman as a piece of advice? And I want to take away the answer due your childbirth education. For a woman that’s been raised middle class American and she’s been ingrained with the ‘go to the hospital and have your baby,’ what is something that maybe you would ask her, tell her just to help her bring some awareness to her journey? Because I think you said it. Like there needs to be some awareness around this process. I think that’s huge.

 

Henci: I think the awareness that is, I think, fundamental to all of this is that things mostly go right and that physiologic care should be the default because every intervention brings with it harms as well as benefits. So, if you’re intervening where there is little or no benefit to be gained you’re exposing women to the harms, and their babies, with no counter-balancing benefits.

 

But, I think, there’s two pieces here. Because again, I don’t want to be one of those people that shame women for the choice that they make. I think just start from that principle and start looking for the sources of information that, first of all, are transparent. And also that present you with information and not feelings. They don’t play the dead baby card.

 

[1:00:00]

 

And then put some deep thought into who they are, what they want, what they need, and then I hope that I’m providing service to help women make some of those determinations that they can then enact them and get from A to B. And to look for the websites and the content that will further them.

 

Lindsey: No, that’s good.

 

Henci: I’m sure that ten minutes after we end this podcast I will think of something brilliant and witty but it’s not coming to me.

 

Lindsey: You’ll write a blog. Yeah. So, last question. I’ll be sure to get information.

 

Henci: I guess, what it will be is make your choices consciously, being aware of who you are, what you want and what those choices involve.

 

Lindsey: That’s powerful. That’s good. Yeah. Who have been some of your biggest mentors and leaders that you look up to?

 

Henci: Well, the first person that leaps to mind is Penny Simkin. So, I first encountered her when I went to my first conference, birth conference. The journal Birth used to have conferences in San Francisco and so I went to one and she was speaking and she was talking — Actually, she’s kind of moved away from that but what she was talking about is what I do now. She was talking about the research that supports the physiologic model for doing birth. And it was like I want to be Penny Simkin for a while. And I sort of did.

 

Lindsey: Yeah.

 

Henci: So, she is high on my list. Another woman who is a dear, dear personal friend. Her name is Harriet Palmer. She’s a nurse midwife. She’s in her 80s now. When I trained to be a Lamaze teacher, at that point it was actually local groups. And so she was one of my teachers but she also lived locally and I asked her to be my preceptor when I started teaching Lamaze classes. One thing that you do at the end as part of your certification process is you teach a set of classes for your preceptor and then you get critiqued and then all of that. So, we got to be very close friends and we’re still dear friends. She’s just a wonderful midwife. She’s a home birth midwife.

 

Lindsey: Nice.

 

Henci: And she’s a nurse midwife, which is less common on home birth midwives. And she’s just a wise, wise soul.

 

Lindsey: I love that.

 

Henci: And then there are hoards of people that I just admire like Gene Declercq. Here’s another website. It’s called Birth by the Numbers.

 

Lindsey: Oh, I’ve seen that.

 

Henci: Well, it’s a whole website and they have different — I mean, it started with him doing this video, birth by the numbers, which is then updated. But it’s a whole website. They have lots of different materials on it. And he is the best lecturer. So, here he is lecturing about, not only is he lecturing brilliantly about statistics but you can understand every word and how he puts things together. But he does it off the cuff. I’ve never seen him look at in his notes. And he’s hilariously funny.

 

Lindsey: That’s awesome.

 

Henci: I always wanted to be able to do that.

 

Lindsey: Yeah. That’s amazing to be able to remember numbers and studies and stuff like that. I don’t have that type of memory.

 

Henci: So, yeah. Those are the three that come to mind.

 

Lindsey: That’s awesome. So, looking on websites, do you have any other websites where people can find you or social media?

 

Henci: Me or one that I recommend?

 

Lindsey: You or your like books or anything like that? Where can people find stuff that you do?

 

Henci: I think that the two — Well, do people still read books?

 

Lindsey: Yeah. They’re going back to reading now.

 

Henci: So, one book I would recommend is the latest edition of the Birth Partner, which is Penny Simkin, which is all about how to get someone else through childbirth and it was a wonderful book in its first edition and it’s only gotten better over the years. The second book I would recommend is Pregnancy, Childbirth and the Newborn, in which I’m not sure she’s the first author anymore. Again, it’s been through multiple editions. But again, it’s a wonderful book and evidence-based.

 

[1:05:03]

 

And the other is Giving Birth with Confidence, which is Lamaze’s official book which, again, is soundly based in the research and really gets in a lot of information about making choices.

 

Lindsey: I love it. Anything else that has come to your mind or your heart that you want to share that maybe we did not touch on during the podcast?

 

Henci: Well, I wish any woman who is pregnant out there a safe easy birth to a beautiful healthy baby.

 

Lindsey: I love that. Thank you so much for giving us an hour of your time. I really appreciate that.

 

Henci: It’s been my pleasure. Thank you for having me. This has been a blast.

 

Lindsey: Thank you. Bye, Henci.

 

Henci: Bye.

 

Lindsey: I hope you enjoyed that because that was freaking awesome. We had a legend on the BIRTHFIT podcast. All right, I want to give a special thank you out to all of our BIRTHFIT Summit sponsors. Be ready, I’m going to read the list here. [1:06:12] [Indiscernible] rye, Original Nutritionals, US Wellness Meats. PS, use the code BIRTHFIT17 for 15% off. Caveman Coffee, Topo Chico, DEUCE Gym, Strike Movement, Primal Kitchen, Phat Fudge, Traditional Medicinals, Scopa Italian Roots, [1:06:37] [Indiscernible], Expectful, ICPA, Pathways to Family Wellness, and [1:06:44]] [Indiscernible] Drink. Thank you all for sponsoring the BIRTHFIT Summit.

 

If there’s one thing that you could take away from the lovely Henci Goer, I think that would be to find information that is evidence-based and that is transparent. Meaning, they don’t have any room to gain money, financial, anything like that. Find somebody that actually gives a shit about the woman. And I didn’t mean to cuss. I know this is a family broadcast. But, yes, I think she said it all too well. This is a transformative experience that needs to have some awareness and to seek out those information sources that are transparent and provide evidence-based information. And she’s awesome. So, thank you again, Henci, for being on the show.
[1:08:00] End of Audio

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