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Now let's talk about childbirth.
It's hopefully the last time you touch your mom's vagina. And I learned about child birth firsthand because I recently had a baby.
I don't know, she was right here, I don't know. You can't have it all, can't you.
Now.
I chose to have a home birth because I wanted to ruin my couch, And it turns out I was pretty lucky because whenever I talked to a woman who has given birth in a hospital, it's almost always a horror story. The labor was painful, the doctors were rude, the nurse pooped on the table and blamed it on me. But there's a reason why hospital childbirth leads to all these horror stories, and it's something I want to talk about. So lay back and put your feet in the stirrups
for tonight's long story shirt. Childbirth is the number one reason why people go to the hospital in the US. It sends more Americans to the hospital than the allergic reactions.
And oh, I don't know how this got's stuck in my butt. That's a light bulb, just so you know.
And every year the healthcare system makes fifty billion dollars from childbirth, and yeah, half of that is just from Nick Cannon, but it's still a booming industry. And why is childbirth so expensive? Because, like everything in America, healthcare is a business, and hospitals look at our uterus like it's an atm.
Delivering Moms are increasingly being charged sky high prices for absolutely every service or supply provided to them and the baby. And those bills aren't just high in many cases, they're bloated.
Every time you walk into the hospital, they look at everything that happens to you and say.
Can I build for that?
It's because they can, they can charge more. Nobody's asking questions, and so they do and they get away with it.
Doctor Marguerie Dwayne delivered naturally just twelve minutes after arriving at the hospital and only stayed one night.
I noticed I have been charged for two hospital nights.
I was charged for medications I didn't receive, such as oxytocin nine hundred and fifty eight.
Dollars for his nursery stay.
And he didn't spend one minute nurse and he didn't spend one minute in the nursery.
One woman says she was charged four hundred dollars for motrand and a stool softener.
Four hundred dollars for a stool softener? What is this a hotel mini bar? If you don't have stool softener in your hotel mini bar, you gotta go to a better hotel. And all that money doesn't even equal better care, because, like I said, healthcare is a business, and a business wants to be efficient, but childbirth isn't efficient. Labor could happen at any moment, or it could take over eighteen hours.
It's kind of like orgasms.
Is this gonna be a quickie or is someone leaving here with carpal tunnel?
Nobody knows.
Childbirth is messy and unique and complicated, and it needs the mother to walk around and stretch and bounce on a yoga ball and go to the bathroom because maybe you're gonna take a dump.
Or maybe that's where you're gonna have the baby. I'm serious.
That happens a lot, and it's beautiful, But the hospital would rather have us laying down with sensors attached to our bodies because it's more efficient to monitor all of it at once from a computer screen. Even those screens should be for raising our children, not birthing them.
So here's what happens.
Now you're lying in a bed and your labor slows down, so the hospital speeds up the process by pressure you to take the drugs that induce labor, even though those drugs affect the heart rate of your.
Baby and increase your pain.
So then they suggest an epidural where the jam a needle a fentanyl to your spine to numb your lower body. But now you can't feel your lower body, which means you can't help push through through your contractions. And now you're slowing down your labor again. Your baby's heartbeat is going up and down. It's like a little ravenside your uterus, and the doctor comes and say.
You're not progressing enough. The baby's heartbeat it is erratic. All the shit we made you do is made everything worse. Why would you make us do all that shit to you?
And that brings us to the biggest medical intervention.
Of all sea sections. Americans have them at.
An alarmingly high rate, and it doesn't even and it doesn't always have to do with the health of the mother or the baby.
An alarming number one in three women giving birth in America today having a sea section, but too often sea sections are not needed.
Sometimes doctors or hospitals may rush a sea section simply because they think labor has gone on long enough. For because the maternity ward is especially busy.
Another reason for the major increase, just for the sake of convenience.
Softer's are rushed. I mean, when someone's giving birth bachually, it can take a.
Long time there in labor, it can take days, sea section very quick.
You're ining your out.
Sea sections are major surgery and they carry all the risks of surgeries.
You give a sea section in twenty eighteen, you have a ninety percent chance of having a sea section the second time.
A second time it's some more complicated surgery, and the third time it can be like operating on a melted box of crayons.
Melted box of crayons.
Jesus, what happens the fourth time?
We don't even need to do surgery. It just pops out like.
Alien And sections aren't just risky for the mother, they're also risky for the baby. Children born via sea sections are four times more likely to develop breathing problems. And if my kid is gonna have trouble breathing. I want it to be because I raised a douchebag who vapes.
Is that cotton candy?
There's got to be a better way to do this, and thankfully there is, and it's not some new fangled silicon valley birthing pod. It's one of the oldest childbirth technologies there is, midwives. A midwife is a clinician who helps you either birth inside of a hospital or outside of a hospital. And for women with uncomplicated pregnancies, midwives are a great idea, mostly because they don't do unnecessary interventions and they're all about patient autonomy. Can you imagine
that woman having autonomy? Not in my America, Let's go Brandon. In fact, midwives used to be the Norman delivery until they got pushed out in favor of Marle doctors.
In the early nineteen hundreds, physicians someone on a very effective smear campaign against midwives. They would make posters showing a black branding midwives and a very poor home delivering a baby and saying would you want this kind of person to deliver your baby? Joseph de Lee of Chicago called midwives relics and barbarism for me, it.
Appears brutal midwifery, not up. It is not the portable, but it is the man behind the comm.
The man behind the forceips is what counts. No, you idiot, We don't need you, your forceips, your racism, or that weird landing strip go to you got going on? Really the point I want to make here the hospital doesn't just emphasize efficiency and speed over the mother's health and comfort. It emphasizes the doctor's role over the mother's particularly when
obstructrics was being created by men. And it's such a male thing to think that pulling the baby out is the entirety of labor when all mothers know that's the easiest part of the whole thing. It's like pulling a piece of toast out of the toaster and saying I'm the toaster. So long story short, for women thinking about having a child, no, and understand what your options are and what and that this is your birth, not the hospitals,
not the doctors. And look, don't get me wrong, there are pregnancies that need medical interventions, but when the hospital needs don't align with yours, remember you have choices. Just because you're in a hospital doesn't mean you're sick. Childbirth isn't a disease. It's powerful and natural and we should give women the chance to experience that. And as a side benefit, it'll free up all the hospital to figure
out how this got up my book. When we come back, I'll talk to an expert on childbirth, Doctor Stewart Fishbine.
So don't go away. Welcome back to the Daily Show.
My guest tonight is a community based practicing obstetrician and advocate for the midwifery model of care and human rights and childbirth. He also co hosts the Birthing Instincts podcast and teaches seminars on breach and twin vaginal birth around the globe. Please welcome, Dr Stewart Fishbeine. It's so great to have you here.
It's an honor to be here. And I just have to say the last segment was you covered so much. That's so true, and I, as a male physician, was embarrassed. I walk in the footsteps of all the midwives that came before me and taught me what I didn't necessarily learn in residency.
I see, Look, men can give credit to women. It's great. Thank you, thank you.
You know you've been You've been in this field for so long. Why do you think there's so much fear around childbirth?
Because fear is the strongest emotion that you can control people with. And I think the reason that we have so much fear in the Western medical world is because the people that are practicing, the doctors are taught to fear birth. They're taught birth is a medical condition, that it needs treatment, that it's chaotic, and that we have
to control that chaos, and so they're fearful. And if you talk to most birth workers, they have that sense of fear, and then they projected onward to the women who of America in other countries and so and it's all you see. I mean, not that the media is always bad, but sometimes there's a lot you know, when you see birth and it's very dramatic and it's you know, it's very and there's a lot of fear, and so it's propagated that way, and then you can control people when you have fear.
Yeah, right, Yeah, it's a very good tool.
And you know, and child birth can be such like a lovely thing, and it should be a lovely thing because you.
Know, we are all you know, we're all born at some point and it's just.
Your entrance into the world, is I think significant?
And if I can say, if we just take a step back for a second and we look at how other mammals do it, this can give us a vision into why what we're doing is not working so well. Because when a mammal goes into labor, where.
Does she go?
She goes off by herself, who does she go with? Nobody? And when she's hungry, she does this amazing thing. She eats, thirsty, she drinks, and if she's uncomfortable, she moves. And when she if she's interrupted in labor through the predator approaches or the little kids run into the bedroom, the mammal will put out hormones like adrenaline which will stop their contractions and they'll get up and they'll run away, and
only when it's safe will nature will labor return. And this way nature ensures that the best chance of success. So what we do in the medical model is essentially antithetical to nature's design. From the moment a woman gets in her car to drive to the hospital, and actually I would say all through the prenatal care period two to the moment she puts her baby in the car
seat to drive home. Pretty Much everything that's done to the woman is opposite of what nature has designed, and it not surprising that labor then doesn't go as well as it should. That we have such high intervention rates thirty forty percent c section rates some countries it's seventy to eighty percent. We have we're inducing women set thirty fifty eighty percent of women, and certain hospitals are being induced.
I mean, how many cows get induced? You know, that's sort of it's just the medical model sees birth as a problem. The Midwiffery model sees birth as a normal function of a woman's body that they trust that nature has a design, and every time you intervene in that design, you will cause some ripple effect downstream, whether immediate or later.
Yeah.
And it's interesting because I think we forget that we are animals because and particularly in birth in my case, it's like it was the most animal you feel. You know, you end up you're in these positions where you're like, I don't I never pictured. I didn't know how my birth would go, and I never pictured what actually happened. But it was like, you do you get in these
whatever positions, most comfort. You're making these guttural sounds you've never made before, and all of it's just happening to you. And I was lucky enough to experience it in a way that you know where I was at home and it was it was comfortable, and I was allowed to do all those things.
Yeah, if you let a man will do or a woman do what she wants to do, it's amazing to watch how they will. They will move, they'll do something. The baby's not sitting right in the pelvis instead of laying on their back with an epidural numb and they can't help their baby. They can move. You'll watch them. They'll put a leg up on the side of the bed, they'll squat, they'll get on all fours, they'll do certain things.
The medical model has taken all that away, and now we're stuck with you know, eighty percent of women getting induced and in some hospitals ninety percent of women getting epidurals, and that breaks that connection that women and their babies have. It's a beautiful symphony of hormones that's been going on from the moment of conception, and once that gets interrupted, the baby's sort of left on its own defend. When a woman gets an epidural, it's mom is no longer
being able to help it. And so you see that, like you described in your last segment, you see that change in the fetal heart rate, and then we've got to do something. And then they get a baby that's perfectly fine from a C section and they say, great, we saved your baby, and actually it was all the iatrogenic stuff that happened in the first place. Midwives, on the other hand, is because they trustpers so well and they accept uncertainty. And I can tell you from experience,
and I've been doing this forly forty years. The first twenty eight of them I was in the hospital, the last twelve or thirteen I was in the home birth world. We don't see that sudden deterioration of fetal status that you see in the hospital when you don't meddle with mother nature.
Yeah, and you know, I think we really understell how you come into the world is important. And I just I wish more women knew that this was an option, even because a lot of women they would never even you know, it's become.
Like a it feels like people are like ooh, this like.
Kind of alternative like woo woo, you know, like, oh, you're very odd you had a home birth.
And I was like, I don't know, I just maybe maybe I'm lazy.
No, I mean, people will often this is an interesting thing when when we talk on the podcast we talk about the c setur raping too high or epidural rping too high. We'll get letters or direct messages or whatever, but tell us that we're shaming somebody. We're not shaming anybody, but they're starting to project a little bit of their own guilt on the fact that maybe things didn't go
the way they wanted to. All we want to do is let people know that they have these choices and these options, and that's not something you're getting in the medical model. You can't do in a five minute, six minute prenatal visit what a midwife does in an hour
prenatal visit. You just can't. And I feel for my colleagues that are sort of in the hamster wheel of the medical model that they can't get out because the one thing that's really happened that in my lifetime that I saw that was really bad was doctors became employees of hospitals and hospital systems, and then their loyalty and their fiduciary do became compromised because as a solo practitioner,
my responsibility is the woman that I'm caring for. As a doctor working in a hospital setting, if they don't want you to do vbacks vagual birth after sincerity, where they don't want you to let anyone go past forty one weeks, then you'll have to skew your counseling to get the woman to do what your system wants to do, not what the doctor wants to do. And you know, I don't know that there's a lot of happy obstetricians
out there. I don't think that a lot of them really like what they do, and that's why a lot of them give up ob They go through all that training and then they come out and they just don't want to do it anymore. A lot of nurses leave nursing, they leave ob nursing because they just can't watch what goes on there.
And my experience with a midwife is that I got a lot of prenatal care, but which is very important, but I also got a lot of post natal care, which is also very important. Now my midwife came to my house every day after the birth and then you know, like every couple days, and she was very involved in the after birth process, and I think that's also something that's missing.
It's almost like you.
Have the baby and then you're pushed out of the hospital, like literally in a wheelchair, and then.
It's like naig luck, I'll see you in six weeks. Yeah. Yeah.
When I was a resident, you never see a normal birth as a resident because you're not watching women in labor. You're called to the deliver room or to the labor room when the nurses need you to do something, so they never watched the sounds that you make, or the things that you're saying, the guttural sounds, or the movements that a woman that makes. You never know what the normal progress of labor is. So nothing is moving fast enough. So every time you're called to the room, you're asked
to do something. You put on a glove, you do a vagil exam, you order potocin, you rub your membranes, you do these things. And this is how young doctors are being trained to look at childbirth when they really should back off. Maybe fifteen percent of women need medicalized hospital based care. The other eighty five percent, if the hospitals would leave them alone, could do it without much intervention at all. The problem is is that hospitals don't
make money doing nothing. They make money doing something, and so there is they won't do that, and they just they will not leave a woman alone. And they can't make a hospital more home like adding curtains and a hardwood floor to a labor room doesn't make it more like home. They just they don't know how to leave a patient alone. They just don't know how to do it. And even calling them patients, I just made an error. We call them clients in our world because they're not sick.
It's like breathing or it's like digestion. These are these are innate functions of our body. They're primitive brain functions. Fortunately, most of us don't have to think about breathing or digestion. Can you imagine thinking breathe in, breathe out. You can't do that. But when you have pneumonia or when you have colitis, you need a doctor. But you don't need a doctor to breathe, or to digest food, or to get pregnant, or to go through your You're prenatal care,
or to deliver a baby. These are all natural functions that nature has designed. And again I want to reiterate, every time you intervene in Mother Nature's design, there is going to be consequences. Even my co host Bliss likes to say, even if when you walk in the room when a woman is in labor and you quietly ask them can I get you anything? Or how are you doing, you're actually bringing them out of their primitive brain into their cognitive brain, and you're slowing down the labor process.
Yeah, it would be nice if we could just believe, you know, women can do it.
Well, I'm living proof that they can.
Yeah, And.
I'm living proof that somebody who went through the medical model. You know, I was trained in a very academic program. I was actually very lucky because the program I worked at was affiliated with a very, very busy hospital. It's actually the busiest hospital in the country back in the early eighties, and so I learned the breach and twin, but I also learned that it was a medicalized process.
And only coming out and being open to the fact that I was approached by midwives to take their home birth transports and I didn't do it because I thought midwifrey was smart or homebirth was smart. I probably thought
it was stupid, like most doctors do. But I did it because I wanted to make money in those days, right, But I was pression enough to listen to what the midwives had to say and to learn from the women who were in labor that they didn't have all the things that I thought they needed, and they still did find right. Right.
Yeah, amazing, it's amazing.
It's really, it really is amazing. Thank you so much for coming on to talk and thank you. Thank you for doing the work that you do.
I really appreciate it.
Welcome.
Can I say one more thing good?
Today is my daughter's twenty seventh birthday, and I want to wish my daughter medal in a very happy birthday.
Happy Birthday.
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