BIRTHFIT Podcast 124 Featuring Elizabeth Bachner of GraceFull Birth Center in Los Angeles, CA

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Dr. Lindsay Mumma: [00:00:01] We are very honored to have Elizabeth Bachner back again today. She was at the BIRTHFIT summit last year. And it was just a huge magical discussion about one of the things that she touched on that really hit me was the hats that we wear. So especially for those of us who are in the mother role, when you are in labor you have to take off the other hats because the hat that you’re wearing at that time is laboring woman and that’s the one that needs to trump all of the other hats. So I need to take off my chiropractor hat and my BIRTHFIT Regional Director hat in order to be able to birth my babies. She’s got a lot of amazing insight and so officially the midwife is in.

 

Your Hats

Elizabeth Bachner: [00:01:04] So now that I’m down in the south I get to say “Hi y’all”. So I am going to do some talk and I’m going to I’m going to speak to what I spoke to last year because in my world I don’t think you can hear it enough. And also I want to make sure there’s plenty of time for questions so if you’ve got a question coming up in you just kind of put it on a bookshelf write it down and then we’ll get to it after. Right? All right. So let’s talk about the hats. All right. This is the work of Ray Castellino. And for those of you who don’t know the background of pre and perinatal psychology I’ve also done a lot of trauma work. I’ve learned a lot and I’ve actually done a lot on myself, so I have an internal sense of what I am saying. So the hats, we all have different hats that we wear. So I’m gonna speak about myself. I have the daughter of my mother hat. I have got my midwife hat. Right now I’ve got on a teaching hat and if I was to be pregnant and go into labor I would have the mother of my child hat. All right, so how this works for a woman in labor is if I was to go into labor and say I’ve got the mother of my daughter hat on and I’m inviting my mother to come into the labor room. And I got to let all of you know don’t have the best relationship with her. We’re all we’re both doing our best. But when my mother shows up, I start to take care of her. I start to to try to figure out if she’s okay. I want to make sure she’s eating well. And I’ve got this relationship that that’s what I do. And then because I’m doing that and we haven’t had a conversation about that, I will then turn into a belligerent 13-year old and I’ll be like I don’t want to take care of you and I don’t want to do that. Right? And so like do you see what my body is doing as I go into that belligerent 13 year old? Like how’s the baby going to come out of my vagina this way. It’s not A: 13 year old isn’t supposed to birth a baby. B: I’m turning into that emotional, angry place and my whole body–see what my whole body is doing. Right? It’s not going to come out that way. So if I was to go into labor, it’s really a good idea for me to not invite my mother, because that way I’m not wearing the daughter of my mother hat.

 

Investigating the Roles You Have in Life

So we start to look at all the roles that we have and we start to understand which hat we are wearing and then which hat we need to take off. This is really simple to do if you’re working with mothers. Just explain it to the hat and the best way to do that is get to know yourself. Get to know what different hats you wear. All right. And then when you’re working one on one if you’re a coach, you put on your coach hat and you speak from the place of being the coach. And then if you are a Doula, you put on your Doula hat you’re taking off all the other hats. Does that make sense? All right. This is the same for partners in the room. So with a partner if the partner let’s say I’m going to be hetero normative and say partner is male in this discussion. So say that he has on the hat that is I don’t know the partner of the woman in labor. That’s one way of wearing a hat say that he is wearing the hat of the the father of the child. That is another hat and say he’s wearing the hat: The son of his father. Say his father is an E.R. doctor. And say his father only knows about birth in emergency situations. If he turns into the father, the son of his father, he’s going to look at what’s going on as an emergency situation. As opposed to what you might be educating them about is about low risk childbirth and high risk childbirth and how amazing the body is and how it works. So you want to make sure the partner in the room also has the right hat on. OK. Making Sense. Still with me. Great.

 

Thinking Brain vs Primal Brain

All right let’s talk about another layer. Is anybody here a neuroscientist?OK. Good because I’m just about to really simplify something complicated. So anybody watching. I don’t mean to insult you. OK. Two parts of the brain. You got the thinking brain. You got the primal brain. The thinking brain, we are all having a conversation right now in our thinking brain. You go to your prenatal visits, it’s in your thinking brain. You go to childbirth class, it’s in your thinking brain you’re working out at the gym. Mostly the thinking brain, sometimes the primal right, but mostly the thinking brain. Okay. When one goes into labor which part of the brain do we want the pregnant person to be in? Yes. Thank you. So you’re in the primal brain right? The thinking brain has big long conversations. The primal brain what comes out? “*grunts*” Right? Sometimes a long version sometimes a short version of that, but it’s short words it’s yes’s and no’s. So if anybody here hasn’t been with a woman in labor before you need to know that when she gets into her primal brain she is not going to have a long conversation with you. When she is in her primal brain you just want to be asking her yes and no questions. That’s it feel “Good? *grunt* Move? *grunt* right? Shower? *grunt*”. Like that’s what you’re going to get. Don’t expect something different. And the thing is we want the pregnant person to be in that part of the brain because what starts to happen when they’re in that brain they start to drop into a rhythm. They start to not be thinking of everything external and they’re going inside right? And we want to hold a space so that they can go inside. OK? When they are in the primal brain when they drop in. That is the magic place where then we have the layer of the hormones. Have you talked–does anyone here know about the hormones and labor yet. Yeah there’s a couple nods.

Hormone Love

So we’ll repeat, three hormones that are my favorite that I want to talk about: oxytocin, adrenalin, and endorphins. Oxytocin. Does anybody know about oxytocin? Love, right. We fall in love. OK. Has anybody here experienced oxytocin in their life at some point? Yeah looking into partners eyes, looking into a baby’s eyes, and orgasm. It is a love drug. It’s how we fall in love with each other. It’s also been scientifically proven. Trust creates oxytocin, oxytocin creates trust. What is a simple simple way to help a pregnant person have oxytocin while they are in labor? Is just sitting there with in yourself and trusting. And I’m not talking about trust as in like “I trust everything’s gonna be fine. Okay I trust that you’re gonna have the perfect birth”. Can you hear my voice and see where I’m going? It’s kind of a disassociated place. I’m talking about a grounded trust and a responsible trust. I’m talking about “I trust that your body through the vital signs is going to tell me whether you are low risk or high risk. I trust that your baby will talk to me through the heartbeat and talk to the care provider whether you are high risk or low risk. I trust that your body will speak out if it needs another layer of support”. So you’re trusting in the relationship you are trusting in the communication you are trusting in the process as it unfolds.

Okay a little tip for anybody here who is in the birth room with a pregnant person and there happens to be, say my mother walks in or a mother in law or somebody who is like not like trusting the process and they’ve used this before, is I look at that person and I say it’s usually a mother who might be a little nervous it’s like is there any point in your in your life in your relationship where you actually trusted her? And it’s like oh yeah that’s right there was that time when she was like 13 and she was iceskating and I was really nervous about her iceskating, but I like trusted that she was going to be okay and I say to them I want you to go back to that time of when you trusted. Okay and that will help the pregnant person.

One of the reasons we want trust and we want oxytocin is it creates the contractions in the body. The love drug, the trust creates the uterus to contract and that’s what we want for the pregnant person in labor. All right. Oxytocin. Endorphins. Anyone know what endorphins are? Yeah it’s nature’s opiate. So here’s the thing, whatever has created this process in whatever name you want to call it and I’m just gonna call it like the nature’s intelligence right. When a mom has a surge in her body when she has a contraction in her body, there is a starting, there is a middle, there is an end and in between the contractions there shouldn’t be any pain going on. OK? So when the beginning starts and she comes into the peak, the body is going to create endorphins to meet her during that time. And how do we get those endorphins to be released? We get her to relax into it and it’s so–there’s a mind piece here which is counterintuitive it’s like “Wait a bit my body’s going to give me pain and you want me to relax into it? That doesn’t make sense I’m supposed to fight that right or push it away or not do it”. This is that mind peace where you’re creating a safe place. You’re creating that trust to get her to drop into that primal brain so the endorphins can then meet her. And then on the way down she might have that feeling of like spaciousness. She might feel a little like all turned a little Lucy goosey right. So someone like myself if I was in labor I’d be like “Right on. That’s awesome reminds me of college”. Other people might be like “Oh my god I’m not in control. I’m not in control. I’m not in control”, right. And the people who feel like they’re not in control they might want to choose something that helps them be in control.

So here’s another tip if you’re holding space for a pregnant person in labor: find some options of what they can control when those endorphins come what can they control. They control the music they can control all the music in the room. They can tell you they hate with being played and you got fast forward on it. Right. Attends unit ten units are awesome for giving pregnant person something to control in the lower back and they make them specifically for pregnant people now they get to control what is in the room. They get to control what goes into their mouth like you can say “Do you want watermelon?” “No”. “Do you want pineapple?” “No”. “Do you want to have a protein bar?” “No”. Right. They’re in control of something so you can take that control piece that they need and you put it somewhere so that it will allow them to really stay in their primal brain still.

All right next one: Adrenaline. Where does adrenaline come from? Yes. Fight or Flight. Fear “Oh my god. Oh my god I’m so scared I don’t know what’s going to happen”. Which is true. You don’t know what’s going to happen. But it’s like “I’m scared because I don’t know what’s going to happen” right. And now all of a sudden we’ve got adrenaline going and adrenaline stops contractions. Which is very different than being like “Oh my god I’m just so scared”. And then somebody in the room reflects back and goes “Yeah it’s scary”. Okay that is a way of expressing it in a safe container. Which is different than expressing it in a fearful container. Okay. Are you still with me. So making safe consents. Making safe. Making Sense. OK. Good. So all of these hormones are contagious.

All right so we have a mom. She is rocking and rolling. She’s in the primal brain it is like “Oh” and she’s got the Surges going and she’s got her doula next to her. She’s like “Oh my god you’re doing such a great job. Your body’s great. Just keep listening to it”. And then like she’s in it and then all of a sudden we got somebody walking in, a medical professional, and is like “How are you doing”. Are you feeling it in your own body? You know it’s yeah. The reaction I saw you right there. I have the same thing it’s like *gasp*. Like you know. So the body goes like this. What’s going to happen? It’s going to stop a contraction in the body. It’s going to get mom out of her primal brain and into her thinking brain for good reason because all of a sudden it’s like “Threat. Oh I got to stop the threat. Like how am I going to do it” right. Starting to make sense? How to hold space in that room how to make a container in that room. These are the different layers that we’re looking at. OK. So when mama bear. Physical bear goes into labor physical bear and a lot of momma bears here. But when physical momma bear goes into labor, Does she choose the beautiful grassy knoll with the sun streaming down and the poppies and the view of the sun setting magically in the West behind the line of trees? She’s not doing that right. Why? Because I don’t know. Predator might come and see her young. So where does she go? She goes into a cave. The cave is dark. It is warm there. She’s not being observed by a lot of different people. And there is one door in and one door out and she can look up not disturb her primal brain and go back into it knowing nobody’s there. Where in almost everybody’s house and every hospital and every birth center is there a cave? Yes, say it louder. Bathroom unless you’re in the Hollywood Hills of Los Angeles bathrooms don’t usually have a view. OK the bathrooms. So if you’re supporting a pregnant person in labor and like she’s in her head and she’s freaking out but you know everything’s good. What are you going to say to her? “You have to go to the bathroom?”. OK. What pregnant person is going to say no to sitting on the toilet to try to let some pee out? “Don’t you have to go to the bathroom”. “Oh yeah. Thanks for reminding me that I have to go every 10 minutes”. Yes right. She sits on the toilet. There is usually a wall behind her and it’s dark and she can stare usually at that one door in one door out. We are doing that to settle the nervous system.We’re doing that to create safety. Were doing that to create dark, warm, unobserved. It’s just having that understanding of it. Now we can know how to use that right. OK. So Mama Bear is like in her cave or on her toilet. Just allude to a physical bear. Physical bear is in the cave and then she’s going for it. And then all of a sudden she sees the dinosaur poking its nose through with ginormous teeth. Right. And it’s going “I’m going to eat your young”, right. What happens to her body? Adrenaline and adrenaline is going to “Oh no” that is a good thing because guess what she’s going to protect her young from being eaten by the dinosaur.

So do you get that that’s not bad. It’s how we are created to actually take care of our young. But it’s being translated differently now. So now that you have an understanding of that experience and what that is, you can start working with it to support the pregnant person to actually create a safe space.

I don’t know if I shared this last time about my own sex life. Oh ok. I’m gonna share about my sex life. I’m gonna share way too much with you right now. So if you want to help a pregnant person prepare for labor and they’ve never done this before and if you’ve never done this before because I’ve never done this before, but it makes sense to me inside when I speak about it this way. If you think about who you are when you have sex and what your needs are, that is very similar to giving birth. OK. So for myself I actually like to know the person at the other end of my vagina. It is important for me it’s not important for everybody. I mean granted I’ve had those times in college, but usually I was altered. So when I am wanting to be present and I really want to go into a really deep place that I know is going to allow me to have this amazing orgasm. I like to have trust and relationship with the person at the other end of my vagina. I like to be able to know that if I say no, they will hear me. They will see and they’ll hear me. It allows me to open up. The other thing is is I like a dark room. I don’t like bright spotlights on top of me. Not a fan of that. I know some people are okay with it, not me. I don’t like a lot of people watching me. Doesn’t work for me. I also don’t like to be cold. I like to be warm. Right. And if all of that is there and I am having a felt sense of safety in my body. This is a felt sense of safety for me. This is who I am as an individual. I will get out of my thinking brain, I will get into my primal brain, and the oxytocin starts to flow and the next thing you know I don’t know if it’s been two minutes or two hours because I’m in the rhythm of what’s going on in the moment. And for myself put on some really good music that I can hear because I’m an auditory person. It’s even better for me because that’s who I am. Other people they might need something really soft on their body, right. So think about who you are as a sexual person and what makes you feel safe to go deep into that place to have that amazing orgasm and you can start to think about that’s what I’m going to need in the bathroom.

So you can always talk to your people they’re pregnant people about that to help them understand. OK. So one last thing. Humor me for a moment. We’re going to do a little guided meditation while you’re sitting here. So we’re going to have a felt sense of what the somatic body is. It’s really simple. OK. So. I’m gonna do it with you. All right. So feeling your butt on the chair and your feet on the floor. I would encourage everyone to close their eyes, but if it’s not your jam don’t worry about it. So imagine for a moment that the most beautiful Meyer Lemon has just been placed in your outstretched hand. And this Meyer lemon is like heavy with juice and it’s so silky that Meyer lemon smooth skin is the most beautiful yellow color. And as you are holding it and touching it the lemon oil gets released and it’s so fragrant and flowery and you just inhale that and it’s like “Oh my god in anticipation. I cannot wait to experience this lemon” and then magically a really great knife appears and you safely cut this Meyer lemon in half on a wooden cutting board in front of you and as you cut it in half the juice starts to drip down the sides and that yellow color and that fragrance, that lemon flowery fragrance, hits you and it’s like “Oh my god this is the juiciest most perfect Meyer Lemon I have ever had in my entire life”. And then you safely cut it again in a quarter. And as you do so you’re just looking at the pulp which is just exploding with flavor and juice and that color. And it’s just like “Oh my gosh this is amazing”, and you take a quarter. And you’re lifting it up to your mouth and you open up your mouth to take a bite and what is happening in your body right now? Is anybody else salivating or am I the only one? OK. I want you to take a look at your hand. There is nothing in your hand. That experience has been had because of your imagination. Your imagination through your senses see, hear, smell, touch, taste can create a reaction in your body of salivation. So if you think of the pregnant person in labor right their the see, hear, smell, touch, taste can create reactions in their body that are not happening in the moment.

So how can we work with that. Well we can work with it by putting together. I always say mixtape and then you’ll know how old I am. But I do I do respect that we are at that with MP3 players we’re past that. The playlist, Spotify. So so you put together music you say “Hey, put together some music of when you met your partner, of when you were road tripping, of when you were happiest in your life”, right. For me I always go back to 90s hip hop that is my jam. That is when I am back in college and I have no cares in the world and I’m just having a really good time, right. And that comes up in my body. Or maybe it’s a love connection or maybe it’s remembering family. There’s traditions there. So you have them put together different playlists for that, OK. And then you’re going into smells maybe it’s aromatherapy you know. Maybe there’s something that reminds them of their childhood or maybe it’s a taste and maybe the mom you know she’s been eating clean her whole time, but like Dunkin Donuts is the thing that she shared with her mom who passed away. You know what? Go get that cream Dunkin Donuts and bring it into the birth world and have her feel that connection. We don’t know what that is, but it’s somatic. It can also work in the reverse. It can work as in somebody walks through the room. And this is a true story, true story. So we had a–I was working with a family. And it was all about “Let’s make sure that we get like this nurse at the hospital whose a friend of mine is a becoming a midwife really soon” it’s like “I hope she’s on call. She’s only on call two days a week”. She walks the door and I’m like “Oh my god she’s here she’s here she’s here”. You know, we have been planning for this and she is like “No”. And I was like “What? Like you don’t want her here like we’ve been talking about this for like months now it’s like amazing. She’s even on call” and there just like “No”. And my friend walked up to her and said I might not be the right person for you but we’re going to find the right person for you. It was literally she just walked in the room. So here’s the thing, my friend has got like incredible orange red hair. The only thing that we can think of, because they’ve never met before because you don’t know each other at all, is that I don’t know maybe she was 13 and betrayed by a redhead. OK. And her and seeing my friend walk through the door was like her 13 year old was back and was like in that betrayal and her whole body is saying no. And because my friend who is a nurse at this hospital understands all this. The thing that she was able to do which helped mom have a vaginal birth was actually called honoring the ‘no’. If mom has a history of abuse of some kind and she may not even know it herself. Or she may know about it blocked it out she may know about it and think it’s not going to come up during labor. But if they younger self comes on board that has the no about something foreign coming out of the vagina that they’ve never felt before or somebody coming into the room that triggers them. If this is a person that is triggering it and they say no. The best thing that person can do is say you know what you know yourself so well that you’re saying now and I’m going to honor that ‘no’. That can create safety. And if it happens to be from the inside out. I want to encourage you to all the pregnant people that you work with tell them “If you have a history of PTSD or trauma please let me know. Not from the point of view we’re going to have therapy. Just let me know”. And what you can then do is you help them put their present-age adult hat on and it’s a very simple tool. You get them to open their eyes and look around the room. Can I do this with you for a second. Right? So I’m going have you open your eyes and I’m going to say to you. What color is my shirt?

 

Dr. Lindsay Mumma: [00:27:29] Blue.

 

Elizabeth Bachner: [00:27:31] What color is the floor?

 

Dr. Lindsay Mumma: [00:27:32] Brown.

 

Elizabeth Bachner: [00:27:34] What color is the couch?

 

Dr. Lindsay Mumma: [00:27:35] Taupe?

 

Elizabeth Bachner: [00:27:38] Good. What color is the wall?

 

Dr. Lindsay Mumma: [00:27:40] White.

 

Elizabeth Bachner: [00:27:41] So what we’re doing is we’re getting mom to open her eyes, look around. We’re using the brain. We’re moving from side to side. She’s naming things. She will come into her present self and you can even get more technical and you’re like what is your name?

 

Dr. Lindsay Mumma: [00:27:58] Lindsay.

 

Elizabeth Bachner: [00:27:59] And then and then. How old are you? You can make up an age if you don’t want to tell people.

 

Dr. Lindsay Mumma: [00:28:04] 32.

 

Elizabeth Bachner: [00:28:06] Right. So it’s like “I am a Moomoo I am 32”, see what we’re doing? ‘Moomoo’ did I say that right?

 

Dr. Lindsay Mumma: [00:28:12] ‘Mumma’.

 

Elizabeth Bachner: [00:28:13] OK. I’m not going to go there. So I’m gonna butcher it again. So what we’re doing is we’re having her put her present age, presence self, hat on because the present age present self has chosen this birth team has chosen to have this baby, has worked hard to do it, and we’re bringing her back into that place in relationship to herself and the other people in the room. And I think that’s all I have time for. Yeah okay. God. What? OK great. Questions, anyone have questions? I really couldn’t have been that concise.

 

Elizabeth Bachner: [00:29:11] Yeah. So the question is: Is in working in a hospital setting and I’m going to use some words in working in a place where there’s possibly not trust. Would that be correct? Or working with people who don’t know the difference between low risk childbirth and high risk childbirth. A couple of things here. First. Can I Mention the E-Book? Ok, so I’ve just written an e-book that really goes into a lot of this for all the pregnant people, because what I’ve learned is that people don’t know what questions to ask in order to be seen and heard. So the first thing is it’s a free e-book it’s going to be launched in a couple weeks online. You can see for yourselves or for the pregnant person you’re working with to get that e-book and it literally talks about what I just talked about and all the questions to ask. That’s one thing because you want to do your best to set yourself up before you go into labor to be seen and heard. And if you have a care provider who answers in a way that doesn’t feel right, we’ve got to get people to call their insurance and let them know. Insurance in America is currently running obstetrical care doctors aren’t bad people, midwives aren’t bad people, nurses aren’t bad people. It is the system of insurance that is telling them what they can and can’t do. OK that’s one. The other thing is that one has to do work on themselves to find out where–what’s going on inside of them when they see somebody who isn’t trusting or I’m going to use the case of a doctor who is not trusting because that tends to be a little more general. What I have done is I’ve done a lot of work on myself and I got to know my own story. To do healing not just healing work, but integration work to find spaciousness within myself to be around it. And the other thing that I do when I can’t go there is I actually go to the place of gratitude within myself. “Oh my gosh thank you so much”. And then the thoughts I’m having are “What can I thank them for”. OK so I’m not going to say it out loud but I’m going to say “Thank you so much for getting up at 3 o’clock in the morning to be here. Thank you so much for everything that you spent your 20s learning to make sure people are safe. Thank you so much for feeling a place inside of yourself that wants to be with a pregnant person”. And there are misogynists out there and there are people who are racist out there and if you find that the pregnant person has that as a doctor try to get them to change. But for the most part you don’t have someone who wants to hang out with a pregnant person and wake up at 3 o’clock in the morning because they hate the whole experience. Somewhere. When they first decided and made that choice to become OBGYN, to become a nurse on labor and delivery, to become a midwife. It was because they wanted to help families come into the world. And if you can find that place in yourself, you light it up within yourself and then you speak to that place in them and it shifts everything. I really have never had a problem with a doctor as a doula. I was always the one they were like “Well what’s your name? Because like you’re a really great doula”. Because I really sat in that space with myself of like “I’m going to talk to the healer in you”, even though there all these other layers, and just that in itself and feeling your feet on the ground at the same time can actually shift the whole energy in the room. Any other questions? No one.

 

My Vagina is Magical

Okay so last night you might have seen the magical vagina T-shirt. So I have a whole thing. Midwives have been saying for years that the vagina is magical. We will sit in an unmedicated birth and we’re going. “I have no idea how the baby’s going to come out of the vagina”. Because literally I’ve tried everything that I think I’m supposed to do, every position. And I will sit there going “Oh my god are we going to transport end up in a surgical birth”. And I just sit in that unknown comfortably, because everyone’s safe, and then all of a sudden out of nowhere mom starts to push and I didn’t do anything it’s because the vagina is magical that’s like the tip of the iceberg. And I am wanting to teach high schoolers, college-age people, men, women, fluid, whatever about how amazing the vagina is. I won’t go into details now so I brought a couple t shirts out, but Lindsay and I–oh we propped them out there on the table. What Lindsay and I want to do is we want to do a little something we’re going to post on social media. So ready for that selfie? Oh everyone stand up. Everyone stand up, stand up. And then on the count of three. We’re all going to say ‘my vagina is magical’? I mean yeah. OK! Ready. One two three.

 

Audience: [00:34:24] My vagina is magical!

 

Elizabeth Bachner: [00:34:35] Before I go, I don’t know if this has been said, but I just want to give a shout out to Lindsey for organizing this. Bringing all these people together. Thank you. I mean and I just–all those babies coming in under this energy and this trust and this wisdom. I mean it just touches my tears. So thank you.

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