Birth, Baby!

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Welcome, this is Birth, Baby.

Your hosts are Ciarra Morgan and Samantha Kelly.

Ciarra is a birth doula, hypnobirthing educator, and pediatric sleep consultant.

Samantha is a birth doula, childbirth educator, and lactation counselor.

Join us as we guide you through your options for your pregnancy, birth, and postpartum journey.

Today, we have Anya Casteel with us.

Anya is a mom, midwife, doula and childbirth educator who's been supporting women on their childbirth journey since 2015.

She deeply believes in every woman's ability to give birth.

Her ultimate goal is to inspire and empower women around the world.

And we have her here today to talk about a really fun topic, which is big babies.

Thanks so much for being here today, Anya.

Of course, thank you for inviting me.

So tell us a little bit about you and your family.

Okay, well, as you said, I'm a mom.

It's the first thing that comes to my mind.

I have almost seven year old son.

And that's my story into the birth world become, started before that, but he definitely made me who I am right now.

And his birth made me the midwife I am right now, I believe.

So I came to the States when I was probably seven months pregnant, very, very, very much pregnant.

The whole idea was to give a home birth.

I always wanted it.

At the time, me and my son's dad, we live in Europe, in Hungary, in Budapest, where home births were illegal.

And you kind of can't have a home birth, but no one can assist you in it.

And it's illegal for the provider.

So we were thinking about moving anyway.

And so we were like, what?

This is a good time right now.

I'm pregnant, let's just start it in a different country.

We moved here and I was trying to find a home birth need life back in 2016, which was really hard because everyone was fully booked or they were like, who are you?

Yeah, seven months pregnant, that's pretty difficult to find a provider at seven months pregnant.

Even more, I didn't have a prenatal care before, I kind of did the prenatal care for myself.

I was very radical at that time.

I was 22 years old.

I'm like, I can't handle it all by myself.

And everyone was a little bit scared of me.

It feels like now I understand, my English was zero.

So only one thing I could do is typing through the Google Translator.

I couldn't even talk.

You know what I just thought of?

You know how there's all those scams that go around?

Yes.

So people probably thought you were a scammer.

100%.

Like, I'm speaking English and I'm seven months pregnant and I need a midwife for home birth and I haven't had any prenatal care.

Like that just screams scam.

I actually met the midwife.

I don't remember who was it.

And she was like, I remember you emailed me and I thought that this is scam.

And literally 90% just did not respond to me even.

You know?

I don't doubt it.

I don't doubt it.

Was this in Austin?

Okay.

So the rest were, they were responding and the story were fully booked, you know, we cannot take care of you.

The 10% that responded me, I didn't align with, you know, because I was, again, as I said, I was really radical.

I was working as a doula before, already before my pregnancy, I started.

And I'm like, I don't want the Doppler, I don't want the Vaginal exam, zero.

Like, and I was, you know, so firm, you know?

It's not like, well, maybe one exam, no exam, you know?

No Doppler, maybe a little bit.

Sometimes when you're, no Doppler.

So I was like, I want this, I want this, I want that.

And everyone was like, you're crazy, okay?

And actually I ended up not having a midwife, you know?

And I am originally from Russia, where the situation with the home birth is the same as in Budapest, it's illegal.

You can have a home birth, but it's illegal for the provider to assist you, you know?

And that's why you hear, not a lot, but you hear the stories about the unassisted birth, you know, because unfortunately, that's the only one option, you know?

Not safe, but option.

So, and I've heard about that and I start researching it.

And I was like, okay, I guess, I don't, I literally, I don't have a midwife, you know?

But I want to have a home birth.

So, I'm just gonna do it by myself then.

And young people really are like invincible.

We really think when we're young that we're invincible.

So you're probably like, oh, these people don't know what they're talking about.

I'm 22, I've got this.

I'm gonna have my own darn baby at home by myself.

Exactly, you know?

Definitely, there was lots of thinking, you know?

There was lots of thinking and lots of preparation, you know?

I read obstetric books, you know, like that.

I was just like, whatever I could find.

You know, I read a lot of Dula, not like inspiring things, but things that can go wrong, you know?

Like how I can, on a natural way from what I have, stop the hemorrhage.

Or I took resuscitation, the unable resuscitation course.

So, you know, like I've been like very, very much pregnant and just to know what to do if my baby needs resuscitation, you know?

Like I really took resuscitation.

It was not like, you know, airy-fairy, oh, I'm just gonna do it at home, you know?

And everything's gonna be fine.

Now I knew exactly what can go wrong, you know?

And what I can possibly do.

And I remember talking to myself mostly, that it was a really big shift in my mind.

I clearly understood that it's, for example, if there is shoulder distortion, I cannot do anything, you know?

It's impossible.

And he's that who is the only one person who won't be able to do anything, you know?

He did not read any books.

He was not really participating much in it.

But I knew that because of my, maybe stupid, who knows, decision, he can die, or I can die, because if it's a true hemorrhage, I won't be able to stop it with herbs, or whatever placenta, or if it's a retained placenta and stuff.

I knew that it will take five minutes and we won't be able to get to the hospital in time.

And I can die.

And I remember thinking about that.

And I remember like, is it worth it?

And I was praying.

I was meditating.

And I listened to myself.

And at some point, I felt like, yes, it's worth it.

And I know now that I would never ever be able to have the birth I had, anywhere or with anyone, because he was full 42 weeks, full, full, full, on doc, on a doc.

And exactly.

And he was 10 and a half pounds, 10.5.

Oh my goodness.

Exactly, you know.

Amazing.

And exactly, you were listening to me.

If you would see me, I am five, five, seven, and my weight usually 100.

Yeah, you're teeny tiny.

But teeny and tall, yes.

I'm teeny tiny and tall, exactly, ballerina, so that's, I feel like that's what makes me who I am, you know?

That's what really put me into the, you know, questioning.

Date, size, you know, stuff.

And I know we're not, I know we're here to talk about big babies, but I do have to ask you, I know this isn't technically a birth story episode, but I have to know how long you were in labor with that big old baby.

So, from the first contraction I ever felt, like first, first, like, you know, the one I was walking outside and was like, ah, bricks and heaps again, eight hours until he was born.

So, yes, I was walking in the evening for two hours, and I was keep having the contractions.

And I remember at some point I start stop stopping, you know, because it's like I just cannot walk through it anymore.

You know, I stop and then I walk and I stop and then I walk.

And I remember Leah's dad, he's like, are you in labor?

And I'm like, no, this is just bricks and he's like, are you sure?

I'm like, yeah, I'm 42 weeks girls.

I thought that he's going to live inside me until 18 at least, you know, because, I mean, he's never coming out.

He's chill, he's good, you know, he's safe, he's protected.

You know, I'm like, there's no need to come out, right?

You know, I'm totally like, I'm never going to be in labor at the time.

And then I remember, like, last thing he say after like, maybe 30 minutes, he's like, well, Anya, just so you know, your breaks and hicks every three minutes.

And I'm like, thanks for letting me know, okay, you know.

We went back home and everything just started picking up really fast, you know, from these eight hours, two hours, I was pushing.

Wow, that's amazing.

Big baby.

Big baby.

But I think that's such a, like, birth is kind of designed, I say this in my, in my childbirth class, birth is designed to happen with no one else around, right?

Like our bodies just kind of know what to do.

And a lot of times if people are left to be undisturbed and to listen to their bodies, it is going to go faster.

And it is when you are so in tune with your body and trusting in yourself and all that preparation you did, I'm sure helped so much.

You don't know, you don't, you know, like in the beginning, that's what I taught, I teach every my client, distract yourself in the beginning, you know, don't start laboring, don't start breathing, you know, doing your technique or whatever, don't even wake up your partner.

I always say, just you start feeling it, well, I don't know, trying to lay down, trying to take a bath, walk, you know, read a book, do something like, no, this is Brexit Hicks, I'm not in labor, you know, because it will really mentally, it helps you so much because you're, you don't even count that you started, you know, laboring yet.

And because this part can be very long.

And I believe, you know, that, you know, again, on the ideological level, closer to birth, our body is more relaxing, you know, everything is opening, everything is shifting, everything is getting more ready.

So if you weigh, and yes, sometimes it's 42 weeks, you know, but your body did so much work, invisible work before that.

I love that, invisible work.

So I know you said that you were a doula before and that he really made you a midwife, kind of.

What got you into birth work before even having your own kids?

Because I know that some people do, but I'm always so intrigued at what got them into that work.

Right.

I was completely not in esteem, you know.

At first, I was a theatrical actress.

I studied in Russia in the theatrical academy.

Then I went to Budapest.

The reason why I moved to Hungary to study ballet.

So, you know, I went to a dance ballet academy, a really big one in Europe.

There was people from all the Europe, from Germany, from France, from Poland, from Italy.

And I studied there for a year.

And either I still do not understand, either I got really burned out, or but I remember feeling that I'm wasting my time.

You know, I'm like, I'm not changing anything.

I'm not doing anything.

You know, I'm like, who cares about that?

You know, at some point, you start feeling that like, all I do is, you know, just for fun, and doesn't have any impact.

And I got into such a deep feeling.

I left.

And I at some point, I went back to Russia and stayed for a couple of months with my mom.

I don't know, we were not even talking.

You know, I was like, I did not know what to do.

I was completely lost.

And at some point, I woke up in the morning and I'm like, I want to go to India.

I was doing yoga since I was, you know, 18 or 16, something like that.

And I'm like, I want to go to India, study yoga.

And, you know, I don't know, it's absolutely irrational thing, you know?

But all my best decisions in my life, you know, I made, it was all irrational.

When I listen to myself, I was like, well, I don't know, it sounds crazy, but I'm going.

And my mom is the same way.

And she's like, whoa, sounds cool.

Yeah, do you need the, I have money for the tickets.

I don't have money for anything else.

And I was like, thank you, mom.

So she supported me.

And I went to India for a month, studied yoga.

And that's where I fell.

We were meditating a lot, practicing a lot, living in a shuram the whole time.

And that's where I felt I want to work with women.

I did not even understand what does it mean.

You know, I swear, at the time, I did not know the word dual or midway.

I was so far from all these births, you know, and kids and stuff.

But I very, it's physical or in your body, you feel like you want to work with women.

And I'm like, OK, now I start, you know, logically thinking, where are all the women?

Prenatal yoga, right?

So from India, I went to China, and I took the big prenatal yoga course, prenatal, you know, instructor course.

And our instructor was a doula.

And she was telling us all these stories.

And I'm like, oh, this sounds like so amazing.

And I came back to Europe and I started reading all the books.

And I had my classes, first classes, yoga, you know, I was like, I'm not a doula, you know, come on, you know, I'm a yoga instructor, you know, and I started having clients and big classes.

And one girl comes to me once and she's like, I really like your voice and I like your presence.

Can you come with me on the Birth?

Like, I don't want my, my husband is really, you know, makes me insane.

And he's not helpful in all of this, but like, can you be my doula?

That gives me the chills.

Like you weren't even out there looking for clients.

You just want to be with women and she comes to you and finds you.

She comes to me.

And yeah, we still are friends, you know?

And I'm like, yeah, of course, I'm a free woman, you know?

I don't have kids.

You know, you can be on call, just call me anytime.

And that birth, I still remember it.

Yeah, now I have chills, you know, because I vividly remember her moving, her sound.

You know, it was my first birth, you know, like I've ever seen in my life.

And it was beautiful.

I was lucky because I know many stories of different midwives and doulas who had a very rough beginning.

You know, I was very, very lucky.

It was beautiful.

First time, hospital birth, you know?

And I remember night, it took night.

I came at 9 p.m.

and at 6 a.m.

I left, you know?

And I remember I was staying at the bus stop and I swear I was calling every single person I could.

You know, I called my dad first.

He was always my support.

I was like, Dad, you cannot imagine.

I've seen a miracle.

You know, that was a miracle.

That was so cool.

And he was like, he's just listening to me all the time.

You know, he's really good listener.

And then I called everyone.

I called my mom.

My mom's like, how can you be interested in that?

I said, Mom, you don't understand.

Seriously, you know, she had both traumatic births with me, my brother, you know, very usual.

And then she's like, this is not sound good.

You know, I called everyone.

No one understood.

I was like 20 years, you know, 21 or something.

And everyone was like, what are you talking about?

And I was like, guys, that's how you find a birth worker in the wild when we, when we can't shut up about it.

Cause it is, it's such a miracle.

I mean, all of us have, I've been doing this for so many years now.

And every time it's still like that birth high and you know, a million times, but it's amazing.

You know, it gives me when you said, you told her, just call me anytime, you know, I'm free.

I can come.

It made me think for just a second.

Like, can you just imagine being before the time and being a birth worker before the time of easy communication with telephones and how, I mean, I'm constantly attached to my phone.

My phone is my lifeline to all of our clients and being able to have them have access to me anytime.

It just is such a wild thing to think about.

Like somebody might have had to come and get you from your house.

Exactly.

From your house or from someone's house during the day, you know, trying to call everyone and see where you are.

Yeah.

Exactly.

But I feel like we have, we have a downside with it.

You know, we are a little bit on the, you know, chronic underlying stress and a little bit of anxiety.

I think all three of us have our phones right here in our eyeline and our grasp just in case.

We all just picked them up.

You guys can't see at home, but we just picked them up and showed them.

Like there was no second delay, zero second delay from us.

All being able to pick them up.

But you're right.

It is also a downside because also our clients feel that they can just reach out to us anytime, which in one way I'm glad that they have that support, but also sometimes it makes them not listen to their own voice and kind of rely on the outside source.

Yeah, exactly.

And that's what I see is the most in my world.

And again, coming from my experience, that shaped me.

I do believe that no one knows better than the woman.

No one doctor, no one midwife, no the concilium of doctors and midwives all together.

I tell all my clients like, well, I can share my knowledge, I can share my experience, my wisdom, but I'm not in your body.

You are in your body.

You know better.

Because many women, you are afraid to trust your insignia, you don't know.

It's interesting because so many women ask, no, as a doula, which position?

How should I breathe?

And in the beginning as a doula, I was like, yeah, let's try this, let's try that.

Thinking, again, logic.

And now I constantly ask them, how do you feel?

What works better?

I don't know.

And some of them get really annoyed by me, but I was like, yeah, you chose this.

So you went from doula, who was kind of just watching and trying these things, to then deciding after you had your son that you knew that was going to put you into midwifery care eventually, and you had a really big baby.

So would you say that you having a big baby also and having a free birth influenced how you approach midwifery care?

Because I know you said before, it was kind of a crazy idea and radical, but that changed how you practice.

100%.

You know, I mean, again, I come from the idea that woman has to have a choice, you know, and this is the most important thing.

It's not like, well, yes, the risks are this and this and that, you know, but you cannot push woman, you know, to get an induction just because of these risks or something, you know, because I do believe she needs to understand that.

And that's what I see in my role, you know, to explain her.

This is the risk.

This is the benefits, you know, but we have three ways of knowing, you know, our, you know, modern knowing is like all this evidence-based information, facts, statistics, numbers, all of that.

Our instincts, you know, completely irrational things, our gut feeling, you know, but you know, like, yes, this is insane.

It's like, I don't know, it might be not safe, but I feel like it, you know, and primal knowing from our ancestors.

It's, you know, again, like a very like animal thing.

And you can make a true informed decision only putting all this knowing together, because otherwise, you know, it's one side.

And again, birth, we are more like animals.

You know, we cannot just come from the brain, from the statistics, from the numbers.

Yeah.

And there's a saying, you can or you can't, in whichever way you think, you're right.

And I think that, you know, for example, we have a client right now who is said to have, she's going to have a very large baby.

She's like 5'11, her husband 6'3, and they're estimating that her baby's going to be very large, but she's afraid of it.

And her gut tells her that she shouldn't have a big baby, even though she is a tall woman.

And there are other things that are making her gut say, I don't think that this is safe.

And then we have other moms who are like, I can totally have a big baby.

I'm not afraid of that big baby.

And both ways are right.

And I don't think it's necessarily that you were scared so then you couldn't do it.

I think it's your body knew something would go wrong, and so you didn't choose it.

And then the other way, your body knew you would be okay, and so you were.

And so I think that listening to that instinct is so, so huge.

It is huge.

It's the key.

Listen to yourself.

Always, always, always, and get into this.

Because yes, I've seen it for the past years.

I've seen sometimes women choose the homegirls and nothing is progressing, and nothing is moving, and we're stuck if you don't understand what's going on.

But then as soon as we move to the hospital, everything just unfolds and you have a baby in two hours.

Well, somewhere deep inside her, she felt more safe at the hospital, near the surgery, near the NICU and stuff.

So you really need to listen to yourself.

This is the key.

There is no right or wrong place to give birth.

That's for sure.

That's huge.

So, so huge.

And we push that.

We talk about that all the time with our clients.

Your gut is the most important thing when we're talking about where to give birth.

Yes, statistically, birthing at home is safe.

Birthing with a midwife is safe.

And we think that in most cases, that's something that should be considered at least.

But if your gut is telling you not to deliver at home, that that's not where you should have your baby, then exactly like you said, we might be looking at a stalled labor, where we end up having to transfer anyways, and your body doesn't allow that baby to move until we get to the end.

It's something that us ideas workers see all the time.

I want to add just one thing.

This is what I like right after birth, and I keep thinking about it years and years and years.

I believe if someone would tell me, Anya, you're going to have a 10 pound baby.

I don't think I would do it.

I'm pretty sure I wouldn't do it.

Definitely wouldn't do it by myself.

And I'm not sure I would do it at home.

Because my logic would turn on for sure.

And I was like, are you crazy?

He is definitely going to stuck.

Yeah.

You are not meant to.

That shoulder dystocia you said that he wouldn't.

He is huge.

He was huge.

So I mean, from there, again, shoulder distortion is something, another big topic that I'm passionate about.

It took three contractions from birth of his head to birth of the baby.

Is it shoulder dystocia?

I don't know.

Maybe.

You don't need to qualify it as anything.

Right.

And I don't think that she would mind me sharing this, but we recently had a mom who kept being told that she was going to have a 10 pound baby.

You're going to have a 10 pound baby.

And she was like, Ciarra, I'm not worried about having a 10 pound baby.

I'm not worried about it.

And my belly is not that big.

I really don't think it's going to be a 10 pound baby.

When we get to the hospital, she's doing great.

And she, people keep coming in and saying, Oh, you're the one with the 10 pound baby.

They had written it on a board in the nurses area.

Room so-and-so suspected big baby.

And at one point she lost control of her pain management and being able to deal with it.

And she looked at me, she's like, I need an epidural.

I need it.

And I was like, you know, we talked through it and she decided to get one.

And she looked at me afterward and she goes, they scared me.

I was really afraid that he was too big or she was too big.

And the baby was nine and a half pounds, but she did great.

And her body was fine, but her body did not open until we got that epidural and relaxed and slept because she was so scared.

And that's exactly.

And that's good that it worked out because I had a mama, it did not work out even though it was her second baby.

First one, almost nine pounds, easy birth in Russia, back, you know, no complications, no epidural, unmedicated, you know, she's capable.

This time, of course, ultrasound, ten pound baby and risk of shoulder dystocia.

And unfortunately, obviously pushed her into induction, every single appointment called her, she stopped picking up the phone, you know, and in labor, we come to the hospital, she was, as soon as we come, I think she was seven or eight.

And since that, we had two doctors who come and explain all the worst case scenarios, if the shoulder dystocia happened.

And I've never even heard about being like that.

And I already had my education, my midwife education.

But this doctor said, sometimes when the head is worn, but the body is not worn, I will need to push the head inside and do the C-section.

And it can, you know, damage the baby's neck and the baby can be paralyzed.

And I'm like, this is...

And what parent after hearing that is going to go, yeah, let's try it.

Let's try it.

Yeah, exactly.

Sounds good.

You know?

Yeah.

I still believe in myself.

You know, because...

And she's like, from our point, she's like, I don't care.

I don't care.

She was trying to block it, you know.

I don't care.

I don't care.

I don't want to listen to it.

And she was saying, I don't want to listen to it.

And they were like, we have to, you know, we have to explain, you know, we're trying to save mama, save baby.

This is our ultimate goal, you know.

Girls, she never opened up more than eight centimeters.

Yeah.

We've been in the hospital for 12 hours.

We got an epidural.

She did not want it for pain management at all.

But the doctor said, I think you should get it, you know, because you're like, you're stalled, you know, your body is like, and we got an epidural.

Nothing changed.

She got a C-section in the end.

And it was 8 pounds, like 12 ounces baby, like her first one.

Totally normal baby.

Totally normal baby.

So what is a big baby?

And how do doctors decide that you have one?

Exactly.

This is a good question.

So ultrasound, you know, this is the thing.

We are, as the midwives, you know, we feel, we feel the baby, you know, we feel the growth.

And you see you come and you constantly checking, you know, okay, you can approximately feel like, okay, this is the size of the head.

This is, you know, this is how big the baby is.

And you're kind of more involved in, into the, you know, into this growing process.

Doctors, not really.

They do believe ultrasound more than their hands, you know, or eyes, even for years, you know.

But no one talks about margin of error with the ultrasound, especially closer to birth, you know, it becomes less and less accurate.

But most of the time, this becomes the, you know, the reason for all the reductions, or even sometimes, funny enough, clumsy sections, unfortunately.

It wouldn't be funny if I was not to do it for that month.

Yeah.

And that's why you see, you know, you can believe in women as much as you want, but then you hear the doctor who says, you know, you're going to have a big baby, whatever.

And the big baby, they, everything was nine and more, they call big baby.

So over nine pounds.

Over nine pounds.

Everything was over nine pounds.

Not eight pounds, 12 ounces like that other girl.

You know, this is so huge too, because my husband plays soccer.

And when we went to one of his soccer games, I actually had a mom in labor texting me and I ended up having to go.

But one of the older women there knew what I was doing.

I knew that I was like, maybe going to have to leave because I was talking to everybody about who could drive my husband and my kids home because I was going to be taking her car.

And she said, oh, did you know that with my oldest son, they told me I had to have him at 37 weeks because he was too big.

And I said, oh, that's interesting.

And she, this was like, you know, 25 years ago.

And I said, well, what happened?

And she said, well, I had him at 37 weeks because they told me I had to because he was too big already.

And he was born at five pounds and had to be in the NICU.

Surprise, surprise.

Yeah, shocker.

And I was like, you know, that is what we see.

We see that the margin of error here is huge.

And, you know, we had a mom that was told that her baby was going to be 11 pounds, 11 and a half pounds, they said.

And she ended up having a cesarean for extremely high blood pressure with a very last minute, 40 weeks in one day.

And I only reason I was excited we were having that baby at 40 weeks one day is because I got to see how big the baby actually was when they said that's when it was going to be 11 and a half pounds.

And she was nine pounds, five ounces.

And this was a big, beautiful Brazilian woman who knew that her body could have a big baby.

And she was like, I'm not afraid of a big baby.

But then she was like, ha, it wasn't an 11 and a half pound baby.

And so we're trusting this tool that actually, the further along you are in pregnancy, the less accurate it is.

And at that 36 week mark, all of a sudden people are calling it the Bible on whether or not we're having a big baby and we're making decisions based on that.

It's wild.

Even more, there is literally last month, I had one mama like that and my colleague, she had two doula clients with different doctors, different even hospitals, but same idea.

We can research it.

There is whatever.

And it's not even new research.

But by measuring baby's abdomen, I think if it gets like over 50 percentile, I'm not 100 percent sure or something.

All these doctors and I researched all the internet.

I couldn't find this information.

But all these doctors said it's 100 percent shoulder distortion.

100 percent.

You cannot say 100 percent.

Nothing is 100 percent in this world in general.

Let's set our bets here, folks.

No, 100 percent.

I'm calling Vegas.

A place to make.

Exactly.

I was like, okay, sounds good.

Obviously, my mama is the second birth.

I was her doula first time four years ago.

Beautiful, amazing birth, and I was like, okay, well, let's see.

And her plan was if she doesn't go into labor by 39 weeks, they schedule C-section at 39 weeks, because shoulder dystocia, and apparently now shoulder dystocia is more dangerous than C-section.

And we're not even going to try to induce at 39 weeks?

We're just jumping to C-section?

We're just jumping to C-section and a second baby.

Second baby.

And obviously anything what I'm saying is nothing to compare to that.

There's big research, 100%.

You know, of course, of course.

And on the birth, she goes in labor at 38 weeks.

You know, all's good, somehow.

And it was insane, guys, how they prepared for the birth.

They put the steps to, you know, and I know, you know, I know, like it's for, you know, for the nurse to press on the shoulder and stuff.

Full, big room.

Everyone, there is like NICU team.

Everyone, like they literally, 100% shoulder distortion.

Like we're already there.

Everyone is so scared, so nervous, you know, like it's in the air.

Baby was eight pounds, like one ounce or something.

And come all in one push.

Amazing.

Like doctor did not even have time to manipulate, you know, she was like, he was like, I was just flying out.

Oh, I love to hear it.

That's amazing.

For people who are listening, for people who are listening and didn't understand the stool reference, we've had some people lately go, you guys understand things that we don't understand, and then you don't explain.

So I have a feeling this might be one.

So if you, if, if there is a shoulder dystocia or a suspected shoulder dystocia, they will bring a stool up next to the bedside to help a nurse be a little bit taller so that they can reach on top of the mother and apply pressure to her abdomen, to the top of her fundus, to push the baby out and try to manipulate the baby inside so that the baby can be able to come out vaginally.

And it's kind of not super comfortable for mom, and they pull her legs back really far.

And this is like somebody from the outside trying to push it.

There's a lot of different maneuvers that they can use.

Yeah, this one is for suprapubic pressure, mostly.

There you go.

She knows the terms.

Exactly.

When the nerves press right above the pubic bone, so because that's most of the time, that's where shoulder's stuck, just this bone behind.

And she just presses it really hard, very forcefully, and it just unclogs it.

Helps to get baby's shoulder to kind of pop down a little, so they can move down under.

When men hear about someone's penis getting hurt or their testicles being hurt and they cringe, when you said the thing about pushing down on the pubic bone to get the shoulder, I felt my gut retract.

I could feel that.

I don't even have a uterus anymore.

I've had a hysterectomy.

I felt it.

My uterus was in there for such a long time, feeling that pressure.

But the reality is, it's not comfortable, but the reality is, just for anybody who has ever had to have this or who may have to have it in the future, they do this because that's still safer than some of the other maneuvers that they do.

And there are other maneuvers that they would try before that, especially if you are with a talented midwife like Anya who has done all of these trainings for shoulder dystocia.

Yeah, this is the thing.

It's all about the movement.

You're not on your back.

Exactly.

You're not on your back.

When you're on your back, your diameter of your pelvis decreases, I think, almost like one and a half inch or something.

Here we are.

Sometimes you just need to move to your hands and knees, to the lunge, get out of the tub or all the movements.

Most of the time, that's the first step.

Absolutely.

There are lots of things you can try, you can do.

There's lots of maneuvers.

And again, I've never read in any obstetric book that you can push the baby's head inside and do a C-section.

This is not safe.

She shouldn't say it out loud, because if I was a mom, I would definitely sue her for that.

This is maybe your really brilliant idea, but you can kill the baby this way for sure.

And so we just kind of gave a glimpse into one of the next questions we had for you, which is you're saying, you know, move positions and things like that.

But what does someone with a big baby need to do differently?

Like, what are some things that you suggest when someone has a, quote, unquote, suspected large baby?

Or what do they do differently to help make their outcomes better?

Definitely movement is a key movement, you know, and I am still doing yoga.

I'm still in my deep heart, a yoga instructor.

And I value it a lot.

And I see how, you know, how certain positions in pregnancy, you know, can help you to open it up and just generally, especially in this country.

I do believe that's one of the big problems why we, I don't know, labor stock, we have, you know, higher intervention rate and stuff.

We sit way too much.

You know, we sit at home, we sit at work, we sit in the car.

Even to go to walk, you need to sit before, you know, to get to the place to walk.

I remember that was insane in the very beginning.

And at least I tell, I mean, I tell everyone, doesn't matter what size of the baby you're having, you should walk at least two hours a day.

You know, start with one and bring it up to two closer to birth.

You know, what it does, it really, you know, it lubricates all your pelvis and it makes it movable.

It makes it flexible.

It just, you know, makes it breathe all what we need.

You don't even need to do, I don't know, any exercises or anything special.

Just go for a walk.

You don't need to curb walk.

You don't need to jogging up a hill.

Just go on a sidewalk.

And I think that that's such a big thing too, because people are trying to do all the things and then they're like going hard, right?

Going real hard with all of the exercises that they're doing, but not all of those exercises are actually serving you well for preparing you for Birth.

And especially in the United States, we just are so freaking busy that we're constantly sitting because we're on our computers or whatever, and we're not going down to the river to collect water and squatting down and cleaning our floors on our hands and knees and things like that, which makes it a requirement that we actually put in an effort to take a walk.

And I also think it's interesting that you say that, because there are some people that will say, don't tire yourself out before labor, and going on a couple of hour walk could potentially really tire you out.

But if you've been doing it your whole pregnancy, it's not going to be as tiring.

Yeah, 100%.

Second thing, I ask my clients to throw out the chair and sit exclusively on the bowl.

Everywhere you go, bowl goes with you.

Dining chair, bowl.

Computer chair, bowl.

I want to see some people rolling up to...

Don't sit on the couch.

Don't lean back.

Bowl.

I want to see some people rolling up to Chili's with their birth ball in the back of their truck and just say, hey, I'm actually going to use my chair.

Thanks.

I love it.

That's fantastic advice.

Yeah, because sitting on your sacrum is so awful.

So sitting on your sit bones beside your sacrum and that birthing ball or whatever makes it a little bit more difficult to sit back on your sacrum.

It makes it rigid, all the bones.

And especially if to the big baby, we have older mama who's maybe over 35, and her bones are more rigid.

It's just physiology.

But it doesn't matter.

She needs to do more.

She needs to walk more.

She needs to exactly work on this mobility.

I always talk, try to exactly, because we're definitely overdoing, all of us, especially women, it feels like.

Just try to incorporate it in your daily life.

Turn on the music while you're cooking, while you're cleaning.

Move your hips constantly.

Don't stay just solid.

There are so many fun videos right now about that.

Just moving your hips and the amount of energy and positive energy that that brings to your body and it kind of shakes out all the negativity.

It feels kind of silly, but it works.

It works, and it's so easy.

You don't need to do anything special.

Because you're going to clean no matter what, you're going to cook no matter what, you're going to brush your teeth no matter what.

Just make it fun.

You bring oxytocin up, you bring dopamine up, you move your hips, you make it all again.

Bring more air in between the bones.

It's not that difficult to be very honest.

And then the posture, too.

I explain how our posture affects on the baby position inside of the uterus.

Because I believe it doesn't matter what size of the baby.

This is about the position of the baby.

It can be a seven-pound baby who can get stuck and have a horrible shoulder dystocia.

I've seen it.

And it was a seven-pound baby.

Who would be prepared?

No one was prepared, and it was a hospital birth.

People don't think about it.

No, you don't think about it.

You think like, yes, a ten-pound baby means shoulder dystocia.

Not necessarily.

As a provider, just generally, you have to be ready for shoulder dystocia for every single birth.

I am ready for every single birth.

Doesn't matter what size of the baby.

You can put everyone into the induction at 38 weeks.

You cannot just schedule C-section for everyone at 39 weeks.

It's not safe.

It's inhumane.

But you're a provider.

You need to be prepared.

I have a random question for you real quick, and this is totally out of order, and this wasn't on your list.

I tell people all the time that the biggest danger of having a big baby is the provider that is afraid of a big baby.

Can you explain why?

And it's not only about the big baby.

It's about everything.

You know, provider who has lots of fears and doesn't trust into the birth process is not going to be a good provider for you.

That's just it.

When you have the fear, it just turns out your brain, again, you stop thinking rationally.

And you're intervening.

And most of the time, it's not what it's needed.

It's lack of patience.

The same with shoulder dystocia.

They call shoulder dystocia everything.

If the baby's body does not come after baby's head, they call it shoulder dystocia.

I've been talking about this in my classes lately.

It's needed every single time.

We don't call it shoulder dystocia.

It's a two-step delivery.

I'm sorry.

Exactly.

I'm sorry.

It's lack of patience and lack of contraction.

We need a contraction.

It's not the baby stuck.

We need the contraction for this force to help this baby to turn and come out.

So for those listening.

When I say two-step delivery and there are people who are like, I've never even heard of this.

We're in some Facebook groups for like labor and delivery nurses and things like that, just because we're always wanting to learn and see what people are experiencing.

And the baby's head comes out, and then the provider oftentimes will pull on the baby's head.

And then they'll say that the baby's stuck because the baby's shoulders are not coming out.

Right away.

Except that that's not what happened.

It's that when your baby's head comes out, they sit there for a minute until the next contraction, right?

And they restitute.

And that's what's happening.

Yes.

Their shoulders turn.

So they are an active participant in their birth.

They are rotating a little bit.

I call it the football spiral.

And they're coming down.

And then when that next contraction happens, I feel like that's a dirty word.

I never say it.

It sounds really weird coming out of my mouth, but when the next contraction happens, the shoulders rotate and the baby is able to come out very easily.

And most of the time, that's what midwives do is they wait for that next one.

And then the baby comes out because the mom pushes again and it works out great.

But the providers in a hospital setting are not patient.

And they immediately start pulling on the baby's head.

And they call it a shoulder dystocia, even when it's not.

And another thing that's going on is we're inducing early for suspected big babies.

And we're wanting to, you know, jumpstart the process to try to have the baby not waste so much when it comes out.

The danger there is the baby may have been repositioning.

And two weeks from now, the baby may have been in the perfect optimal position.

But right now it's not.

Now we're shoving pitocin at it or we're preemptively breaking the waters so that we can start labor.

And now the baby is in this crap position.

And it's even harder to get this quote unquote big baby out.

And we're inducing labor.

We're adding all these medications that are just, it's not what labor feels like normally.

And so it is harder to deal with.

And more people are likely to get epidurals, which means that you are more likely to be laboring on your back, which means that you're decreasing the pelvic, you know, the space in your pelvis.

You are literally in the breast or shoulder dystocia.

And helping, you're not helping your baby.

You disconnected from your body.

You disconnected from your baby.

It's a whole thing.

And unfortunately, if you don't see the problem in it, like I cannot talk anything.

Yeah.

Yeah.

And I think that's important too.

So if y'all, anybody listening, what we're saying is that a provider shouldn't be making these choices for you.

If you feel that you need an induction at 39 weeks for a suspected big baby because you have a gut intuition that something is wrong, please go do that.

But don't do it because the doctor is scaring you out of your birth plan and out of a spontaneous natural birth.

So yeah, if you want to get an epidural, go for it.

We are not saying that.

We're saying that the cascade of interventions that happens when unnecessary interventions are being imposed on you because of provider preference, rather than evidence, that's when the big problem comes.

And I think this goes back to what Anya was talking about in the beginning of this episode where just about shared decision making.

We have all of these different ways of making decisions, and some of that is the evidence.

And what are the risks and the benefits?

We always want to talk about that because it is helpful.

And that is where your provider can come in helpful.

But they are not inside your body.

They do not have your primal instinct.

And you have to supply that and make that decision together with your provider.

The problem is also the words, the words we are using.

And it is hard because I'm trying to do my best, I'm trying not to even answer, because all the clients ask me, what did you do with Leo?

Like, vaccines, or I don't know, or whatever circumstances, anything, like, what did you do?

I was like, well, this is my decision, I made it, I read lots of literature, I made it, here is the literature for you, I made it, I don't want my decision influence yours, because the same, that's the biggest one, especially when we're talking about the induction, how every single doctor says, risks of stillborn baby double, you know, when you go post-date, it sounds horrific, even for me, and I know the numbers, and I'm like, when I hear it, risks of stillborn baby double, and you're like, oh my God, I don't want my baby stillborn, I mean, come on, no one wants, Because mother, this is the weakest spot, house of your baby.

You can just touch it slightly, and she will agree to anything, obviously, because she wants her baby healthy, she wants her baby alive.

And the numbers are, it goes from 0.03 to 0.06.

It's not even 0.1.

When you say doubles, but when you say doubles, it sounds like there's 50% chance, like that's how our brain interprets.

It's how our brain interprets, you know, and even mine, you know, me too.

You know, you're like, my goodness, it's like, exactly, it's like 50% chance my baby is gonna die, you know, but it's not even one, it's 0.06.

Yeah, and we have a friend who's a doula, who today right now, Sam, I didn't tell you this, was at that birth of a mom who's 43 weeks, three days.

And she fired her provider, and she's been without care, and she has been checking at home with a Doppler.

And that's just what she felt.

She's a third time mom, and she just has this instinct that she's fine.

Her waters released this morning, heavy meconium went in, they wanted to give this baby, have a cesarean immediately, and mom said no.

She said, I'm not even gonna consent to a vaginal exam.

They put her on the monitors, the baby's fine.

And she just had her baby, and her baby's fine.

And it's like, but all of us are sitting around going, 43 and three, you know, the doctor and the nurse pulled the doula aside when she went in with them.

And we're like, what is going on here?

Like, why are you guys coming in right now?

And she's like, I bleed horse to water, you can't make a drink.

Like she wasn't gonna listen to me.

This is her choice.

This is not a doula's choice.

This is the mom's choice.

Shared decision making.

Yeah.

Yeah.

You gotta know what you know.

Even, I was just listening to Rebecca Decker, who does the evidence-based birth website.

She had a post 42 weeks birth with one of her babies.

And she is a nurse practitioner who is like, she writes all of the evidence.

She has everything.

She is a scientist and she felt safe to do that because that's what her body told her was safe to do.

So, listen to your body.

Exactly, this is hard, you know, I know because we need, for walking, we need two legs, you know, and we need this support.

Most of us, like I don't know many women like me who would say, I don't need anyone and send her husband in another room and just literally give birth by herself without doula, without anyone present, you know.

I don't know many women like that.

Most of us, we need support and it's a teamwork.

And one of the leg is like your internal, you know, support, your intuition, your like, I don't know, your feelings, your confidence, confidence, all along like that.

And then your birth team, your partner, your doula, your midwife, your doctor, your hospital, you choose.

And most of us, we need two legs, you know.

And this is hard when you have this internal feeling and internal confidence, but the other leg is like, ah, I'm not sure you can do this, you know.

Yeah, and so many of these things go together.

Like, it's funny, we were gonna, you know, we're calling this the, you know, Big Baby's episode, but so many things go into this.

So Big Baby, shoulder dystocia, intuition, post-dates, like, you know, we may have to change the name of the episode, but we're gonna have to have you back to talk about more of these things that people are so stinking afraid of and, you know, break it down a little bit.

I think that this has been so awesome and that was not how we anticipated the episode to go, but we are loving it.

Sorry, I have to tell, yes.

No, don't be sorry.

In the very beginning, probably, because I had a birth this night and I literally slept like four hours.

It took me a while.

I couldn't fall asleep.

Adrenaline and everything, you know?

So literally four hours after we're recording this episode and I'm like, okay.

We're getting the fruits of it.

This is such valuable information for our people to know.

I know.

I mean, I think, honestly, I think this is gonna be such an amazing episode for our listeners because this is such valuable information.

And I just have to tell a quick little story before we move on to our last little thing here.

And we had Anya supporting one of our own mamas and she had a big baby, was told she had a big baby and it was a whole thing all the way through.

Mama ended up having a cesarean because her ginormous, absolutely huge ginormous baby decided to be breached.

So she just felt like what was best for her was to proceed with the cesarean.

Her baby was not that big.

I don't remember.

She was like eight pounds or something.

I think she was big eights.

Yeah, like upper eights.

Yeah, she was just fine.

Normal, normal.

But this mom came home from the hospital and got to have Anya do her postpartum care.

And she had all of these influences from the hospital about how her baby needed to eat this often.

And there was all of this fear about taking care of her baby.

And Ciarra and I were like, okay, well, one of us has to get over there so that we can help her with this and just help her reconnect.

And then Anya went over for her postpartum visit before we got to go.

And she just called us and was like, Anya's amazing.

She just helped me reconnect with my body and my baby.

And I just feel so much more capable as a mother now because I had Anya there to help me reconnect with myself.

And I think that's just so, so beautiful.

Starting off motherhood with that power is so important.

And that's why we do what we do, right?

We want mothers to feel that power.

And it's gonna bring tears to my eyes.

She goes, she told me to just stop with all this triple feeding and just to nurse my baby.

And oh my gosh, it's amazing.

Like once everything just got out of the way.

Yes, and empowered.

You feel how women's changing.

And because exactly this is, I'm thinking about the past months probably a lot.

Why am I doing what I'm doing, you know?

Because I do believe we are changing the world, you know?

It's not about the birth, because this is influence you as a mother, as a woman, you know, like in all your aspects, in staying with you.

Generations.

Like exactly, the way I am right now, I was absolutely different person before the birth, you know?

The way of confidence, the way of love I have to share with my son, with everyone around.

It goes from there, you know?

We need, like, especially now, you know, all these wars, all this craziness, all the madness around us, we need more love.

Yes.

So we need more oxytocin.

And we need little boys that are growing into men, that know what normal physiological birth is.

And we need little girls that grow into women that know that they are capable.

And I have one of each in my home.

You have a little boy in your home.

Samantha has one of each in her home.

And the influence it has on them, without us even realizing it, does.

They listen.

They hear our conversations with moms, you know, with families on the phone.

So we just are just so thankful that you're willing to share your knowledge with us.

And if you guys are in the Austin area, you have an opportunity with Anya.

She also has an amazing social media presence.

So if you would like to kind of work on it, you would like to girl, you working on it.

We're in the grave if you're just working on it.

You want to share how people can find you and then we'll also add that information in the show notes.

Yeah, so mostly I'm on Instagram, probably that's not the best way to connect with me.

I'm Anya Casteel, A-N-Y-A-T-A-S-T-E-L, and that's pretty much that's where you can find my website, you know, and work with me as a doula or the midlife or as a childbirth educator.

We'll see, you know, I started to put more attention to my social presence, because I don't know, we'll see how it goes.

But at some point, I would like to be a travel midwife, you know, and I don't want to stick in Austin.

I want to be able to move around.

No, absolutely unacceptable.

We're gonna cut that part out, because you're staying here.

We cannot lose you.

We just got you.

Eight years here, it feels like it's my home already, you know, because I'm definitely this is this literally feels like my home.

I have all my, all my community, all my friends, everyone's here, my family, and my parents live here too.

So yeah, yeah, yeah, but we'll see.

We'll see how it goes.

So that's, that's how you can contact me and, you know, ask the questions and we'll see how I can help.

I love it so much.

Thank you so much for coming on, Anya.

This was amazing.

And we're blessed to have you in Austin and we can't wait to have a million babies with you.

Thank you.

Thank you so much.

Thank you for joining us on Birth, Baby!

Thanks again to Longing for Orpheus for our music.

You can look him up on Spotify.

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