Today I talk with educator, birthworker, and owner of Birthsmarter, Ashley Brichter. Birthsmarter started as a result of Ashley’s own births not going as planned, and her noticing the gap between birth education and the reality of giving birth.
We discuss the value of birth classes (whether it is your first child or third child), how physiological birth works, the history of birth in the US, and birth preferences vs birth plans.
If you would like to attend one of their birthing or postpartum classes go to their website to find 1) pre-recorded, on-demand classes, 2) classes over Zoom, and 3), in-person classes in a few select states.
Follow along on The Sad Moms Club's Instagram: @the.sad.moms.club
Today I talk with educator, birthworker, and owner of Birthsmarter, Ashley Brichter. Birthsmarter started as a result of Ashley’s own births not going as planned, and her noticing the gap between birth education and the reality of giving birth.
We discuss the value of birth classes (whether it is your first child or third child), how physiological birth works, the history of birth in the US, and birth preferences vs birth plans.
If you would like to attend one of their birthing or postpartum classes go to their website to find 1) pre-recorded, on-demand classes, 2) classes over Zoom, and 3), in-person classes in a few select states.
Follow along on The Sad Moms Club's Instagram: @the.sad.moms.club
Hey everyone. Welcome back to the sad moms club. Today I get to talk to an educator at birth worker and the owner of Birthsmarter, ashley Brichter Birthsmarter started as a result of Ashley's own birth start going quite as planned and noticing the gap between birth education and the reality of giving birth. We discussed the value of birth classes, whether it is your first or third child, how physiological birth works, the history of birth in the United States and birth preferences versus birth plans. If you would like to attend one of their birthing or postpartum classes, go to their website, at birthsmarter.com. You can find prerecorded on demand classes, classes that are offered over zoom, as well as in-person classes in a few select states. I'll link their website and emails in the show notes and let's get started.
Welcome to the Sad Moms Club. Welcome to the Sad Moms Club. Welcome to the Sad Moms Club.
Joni:Okay. Let's just dive in. So today we have Ashley Brichter with us and I was hoping Ashley, you could just introduce us to you and Kind of tell us your story about what led you to create Birth Smarter.
Ashley:Yeah, thanks for having me. I am an educator, a birth worker, now sort of a business owner, entrepreneur. That's a newer identity for me, but one that I think I'm happily leaning into. And I'm born and raised in New York City. That's where I got started. I always knew I wanted to be in the education world. Actually not in the birth world. So I pursued a teaching career for a long time and, knew that I wanted to support. really young kids, but always really wanted to support the family and the parents of young kids. And so in a journey of pursuing education, those babies got younger and younger into supporting, supporting parents. And I became a birth lactation counselor and a child birth educator. And once I found child birth education as a career path, I was pretty sold. Um, so I did all of that work in New York. I taught birth classes for about five years and then after having my own two kids who are now nine and six I realized that, um, Um, and I think that, you know, a lot of the current models of how we teach people, how we prepare people to have babies are, are a little bit flawed, right? Like they do the best that they can, but they're not really setting people up to feel, like they have the agency and to feel like they can improvise. It's sort of a one size fits all. Do this or you struggle with some sense of failure. Giving birth is really complicated. And so I had my stories and I saw lots of my clients struggle with expectations versus reality. And so I worked on a new curriculum and that curriculum turned into this class that I called birth smarter and that turned into a company.
Joni:When did you create that class? At what point was that in your story?
Ashley:it started. So I started teaching group classes in 2013, 2014, and I taught for a lot of different, like I taught for a big hospital system. I taught the hospital based class. I stopped for sort of small boutique organizations that gave me a curriculum or sort of let me fly. But, actually in all those places, I didn't have a ton of, nobody was really watching me. So, I started creating Birth Smarter while I was teaching, I think that's the educator in me that was constantly trying to figure out a better way of saying something, or a more powerful activity, how can I distill this into something that's, Just a takeaway nugget for these folks. But really, I would say after my son was born in 2017, there were certain things I was committed to never teaching again. So really beginning of 2018, I had the core foundation of what became Birth Smarter.
Joni:Your son is your younger
Ashley:My son's my youngest. Yeah.
Joni:Okay. So did something, you don't have to be specific if you don't want to, but did something happen during that birth experience that changed things for you fundamentally?
Ashley:Totally. Yeah, I mean, I knew that I wanted to teach birth education differently after my daughter was born in 2014 because my complications in her birth really showed me how much, um, I had prepared mentally, but I hadn't prepared physically. And so after that I knew I wanted to start incorporating sort of pelvic health and whole body alignment, into birth education. And I was not the only person to do that, but I was like certainly one of the first people that was really starting to bring that in. I was a, just a really good birth educator from 2014 to 2017. I was incorporating pelvic health, I was creating really fun activities, like I taught a really good class, but the core foundation was the same as every other class that's taught. Um, and then when my son was born in 2017, I labored in a way that I had never seen before as a doula, that my doula and my midwife had never seen before. And basically I had contractions that lasted for longer than two minutes but they weren't coming back to back. So often if you hear somebody who has really long contractions, that's like in this phase that's called transition and it's really short. But I didn't for about, 7, 8 hours. I had two minute long contractions, but I had brakes in between that were 11 minutes long.
Joni:Weird. Yeah.
Ashley:Weird. Yeah, it was super weird. And in the weirdness in the moment, like I was having a contraction taking a break saying, I'm never going to teach the stages of labor and this linear textbook version of what is supposed to happen because if I knew a little bit less, I would be so worried right now. I would be so scared that something is wrong. And I know that nothing is wrong. I know that this is just what my body is doing, but I want to teach people about birth in a way where they get to just trust the process unless there's a clear red flag.
Joni:That's really cool. I took a lot away from, so Ashley let me take her one of the, I guess, core classes online. And, I went to nursing school, so we learned like the three phases of birth. Is that the, what did
Ashley:Yeah, the three
Joni:stages? Yeah. So I learned those and I was like, yep, that's what happens always. Like my very limited knowledge, uh, you know, I'm not a birth worker. I'm not seeing multiple births, but, it was such a different approach and a different way to learn it and a lot more flexible, and adaptable to like each person's experience. So, I can see why you would want to just empower women with this information so that they're not concerned about. About their body not fitting a mold that doesn't fit for everybody.
Ashley:Yeah, right, and I think that's that's the issue that we're having sort of across the board is when you get pregnant and you get this one size fits all advice. Or maybe there's a few different paths you can choose like a, B or C, right? Do I want to have a home birth or a hospital birth? Do I want to get an epidural or not? But within those tracks, there's one way that looks like the right way. And I know as a postpartum doula and as a mom, how you feel about how it went stays with you forever, right? And so that's going to like lay the groundwork for your mental health when you start to parent. And I just, I just, I feel like my whole perspective and mission as a birth educator is to make sure that at hour two, no matter what just happened, somebody is like, okay, cool. I'm ready to take care of this kid, the birth was the birth and I'm not traumatized by it. I am now ready.
Joni:Yeah, let's talk a little bit about birth trauma. Do you have, Clients come in and talk about, like, my last birth was really traumatic. I'm trying to prevent that. What are your thoughts around birth trauma? How often do you see it?
Ashley:So the main product or service that Birthsmarter offers are classes for expectant parents, but we do run postpartum support groups. We run them virtually and in New York City and probably soon in Salt Lake, so we see a pretty good amount of birth trauma in our postpartum support groups. We see a handful of people come into us every month who have had one or two births who are trying to do something differently, who will come to class. But most of what we see are people preparing for their first birth. And so I'll sort of talk about birth trauma in all three of those different categories.
Joni:Okay. Oh,
Ashley:the one thing we're really inspired by, there are now I guess nine Birth Smarter teachers and so we meet regularly and so in our team when we're talking about our clients and we get feedback from them, the thing we feel like helps us grow put one foot in front of the other on some days and like we know we're doing a good job is that the common theme in the birth stories we get is this didn't go according to plan, right? Like here's a picture of my baby. My birth didn't go according to plan and I feel really good about it. Thank you,
Joni:I love that. That's so, so powerful.
Ashley:right? Like, wow, it was totally unexpected. What a ride. I think you sort of mentioned that it wasn't going to go like this. But what we're seeing is we're seeing people be able to flex, be able to improvise and not get hit with that. As opposed to what's happening when people And not everybody, right? This is not like a promise we make, but as opposed to people who either aren't taking a birth education class at all, or people who are taking a class that tells them what is going to happen. It's like the what to expect when you're expecting model. Sort of like, okay, here's the plan, right? Those are the people who then didn't know there were options. They didn't know how to think creatively or improvise in the moment. And they feel, they wind up I would say most of the time feeling somewhat victimized by the experience. And so I don't know from your perspective, but what I would say is really when we see trauma is when expectations don't match reality. And when the team around the person giving birth is not, prioritizing that person's individual needs or desires or feelings in that moment. So it feels like somebody is sort of on the conveyor belt of, like, this is the birth machine, as opposed to, like, you're a human having this one baby, this is the birth experience you get, and we're gonna make sure that you feel safe. Um, and so, um,
Joni:The common theme of birth trauma that I find is feeling powerless. And like a lack of communication, not really understanding, their options, feeling pressured into a decision that wasn't necessarily emergent. Some experiences sound traumatic. Some experiences sound not as traumatic, traumatic to me, obviously, like I wasn't there, but I, I was just surprised by how many patients who had at least in our society, birth as usual, but for them it was very traumatic. Yeah, so that, that feeling, that powerlessness, not having that communication. And then as well as what you said, that is, um, All coming into play. And then you're right. It impacts how they can parent and it can impact attachment with their baby because they're going through this big trauma and still reliving it. Maybe they're more anxious because of it. Maybe they're depressed. Maybe they feel like a failure. There's all these things that can carry on, into starting to raise a child.
Ashley:Yeah, and I think that it's a really hard line for me, and I think a lot of people in the birth community, because What we know when we work with new parents is that the birth really matters, like your birth story, your birth experience, it really matters, but it's really hard when you haven't had a baby to know that. And so it's really hard when you're educating families or, you know, quote unquote, marketing to families to communicate that without scaring anyone.
Joni:Yeah.
Ashley:are so committed to, like, never fear mongering because parents get way too much of that. I don't want to tell anybody you could have a really crappy experience, so come take our class. Like, that's not the point. But I think that probably it's just about having more and more people who have had babies tell folks when they're pregnant. Like. It really matters. Let's like open up and be honest about this experience because that's something too in our society, right, is that we generally hold the, the trauma or the struggles or the guilt or disappointment or shame, really close to our chest, uh, and then, you know, you don't help somebody else prevent the next experience. Part of this came from, so my son's birth was wonky timing wise, right, and I changed a lot in our curriculum. But my daughter's birth in 2014, the first time I gave birth, was on paper a traumatic birth. I mean, I, I really did almost die. I was transferred from a planned home birth, which I felt very good about. I had a wonderful medical team, a midwife and a midwife assistant, my mom, my husband, my sister in law, and my daughter was born at home. And I, within 30 minutes, I couldn't maintain consciousness after giving birth. I had to transfer in an ambulance, and was basically like, it was like a Grey's Anatomy episode. I was sort of met by a team of white coats when I got off the elevator. We had a funny interaction about me signing a consent form for general anesthesia and I was like, you know, advocating for myself. I was like, no, I can't. I'm sorry because I'm breastfeeding and I can't have general anesthesia.
Joni:gosh.
Ashley:And my midwife luckily made it in time because I really trusted her, right? We had built a relationship and that was part of me feeling really good about all this, is she was like, you are past the point of self advocacy, Ashley. You are going to do what these doctors tell you to do. My husband wasn't allowed in the room. I was like unconscious in less than two seconds. The anesthesiologist was awesome. And I had developed really severe internal bleeding and it was causing a hematoma. So I had three blood transfusions postpartum an unexpected hospital stay and I loved my birth and I'd do it again tomorrow.
Joni:Wow.
Ashley:Right. It was really scary, and obviously, you can do something really scary the second time when you know you're gonna make it through, so I have that confidence, but I, I loved how I felt, I loved the team that I created, I loved the work I put into it, I didn't feel powerless. Right? I felt really powerful and I felt really supported and, I got really lucky because I had the birth that I wanted at home and I had the medical care that I needed at the hospital. I lived very close to a hospital. I think that's another consideration, right? And I'm really grateful for the balance I was able to achieve between, having this out of hospital experience and really using medical interventions. And I think the other thing that's really complicated about people setting up their birth experiences from a perspective of preventing trauma is that they don't have great options in the U. S. It's worth saying that It's really hard when we're putting such big, important decisions on an individual. You know, an individual person or a couple or one family because, it would just be so much easier if our system was set up to allow for flexibility and improvisation and patient centered care. But instead we have all these people now having babies who are trying to reinvent the wheel in order to have an empowering experience where they're not on the conveyor belt of sort of the, like, industrial side of birth, but where they can also take advantage of life saving medical interventions and the knowledge of the obstetrical community because it shouldn't be one or the other.
Joni:I feel like the class I took, you guys did a really good job of giving people questions to, to find a provider that would fit their needs and kind of interviewing them and. Figuring out what they are comfortable with doing, what they're not comfortable with doing. But you're right, it would be easier if there was just a system that you could walk into and you don't have to do the legwork of finding a provider that can, meet your needs and like advocate for you appropriately. You guys are doing a good job of changing it grassroots in a way, but but it's hard Takes a lot longer.
Ashley:Yeah, it takes a lot longer, and I mean, it's certainly. It's certainly something, you know, we're asking all of our clients, all of the Birth Smarter families to go in and ask their OBs if they're in a hospital system, why can't I do this, or how can I do this, and just trying to put pressure from within to say, hey, we know we have more options, we know there are more things out there, like, we want this to change, OBs can go and continue to put that pressure on the administration of a big hospital system, but, yeah, that's it. It's really hard and big and complicated here.
Joni:Yeah. In New York as well or just you mean like United States.
Ashley:I'm in the United States. I think it's been very interesting for me personally moving from New York City to Utah because New York is a much harder place actually to have a baby. You know, New York City birth is a lot like New York City real estate. So, you know, rooms are small, turnover is quick, there's a ton of people, it's really fast paced. There are some, sort of more, mainstream places to have babies in Utah and people who are not getting great patient centered care. But by and large, there are really wonderful options like around Salt Lake. there's a lot of out of hospital birth with really smart providers. There's a lot of great midwifery care. Um, a lower epidural rate. There's a lower cesarean rate. So things like that are really interesting to look at.
Joni:That is interesting Okay, so I want to talk a little bit about the content from your class to Just kind of, I guess, give people a taste of what they may learn. One thing I really appreciated in your class is your discussion around flexibility, and so you can work on those expectations so that people don't have unmet expectations and then feel guilt and frustration around their birth. Did that come from your own experience or when did you start The importance of flexibility.
Ashley:Yeah. So to break it down for everybody listening, right? What happened for me is that I realized that the current model of teaching about birth really follows the stages of labor, right? Like the body has contractions, those contractions get longer and stronger over time until they fall into this pattern of early labor and then active labor and then transition. And then you push baby out. When you're around enough people who have babies you're like, oh that happens a lot, but not always and so After my births after you know working with all these clients I literally out loud asked myself and I asked my husband what has to happen to have a baby? Because that clearly doesn't, right? I don't need longer, stronger contractions. I don't need to feel this intensity. I don't need, whatever we're telling people about the textbook progression of timing, doesn't have to happen. So what does? What has to happen, and this I just sort of iterated on over, you know, probably two, three years, but what has to happen is that you have to have contractions. Your uterus does in fact push the baby out. But part of the uterus that people don't understand is that the cervix, which people think a lot about in terms of dilation, right? The cervix has to open up. Everybody's talking about that. That dilation is actually not something we can cause. It's not something we can say, okay, we need to go in there and like open up your cervix. The way the cervix, which is the bottom of the uterus. The way the cervix opens is by first getting really soft, and then allowing the uterus to pull it out of the way. So the top of the uterus this is how I think about it, some people don't love this analogy, but I think that the uterus is sort of like a garage, right, and when you get pregnant you grow an expansion onto your house, you're like, oh we gotta build a garage, make room for this baby. And then the cervix is the garage doors. But the way the garage doors open is that there's a mechanism somewhere on the ceiling of the garage that's going to lift those doors open. The doors don't open themselves. And so, as your cervix gets really, really soft, it starts, instead of it feeling like the tip of your nose, it'll like progress and start feeling like the inside of your cheek and the uterus contracts. The uterus is going to be pulling and opening that soft tissue. There you go. And so I was like, okay, those things have to happen. How do those things happen, right? The uterus contracts primarily with this hormone oxytocin. So we need to feel safe and trusting. We need to be relaxed in our environment. And evolutionarily, this is the smartest thing I've ever heard. This is like my favorite, coolest part of understanding how bodies work, right? Because if someone was pregnant and giving birth in prec civilization, and let's say they're in a forest, they start having contractions and they can hear a predator. They're gonna get scared. They're gonna get spooked. And so your body then goes into sort of a flight or fight response. And you start producing a lot of cortisol and you get worried. And in that, you stop producing oxytocin. You're not going to produce the hormone you need to have contractions. And so what's happening is we have a fail safe mechanism for keeping human newborns safe and postpartum parents safe. So if I feel scared, it does not make sense for me to have a baby because somebody is going to come and eat my baby or somebody is going to come and eat me. So I was like, this is awesome. This makes so much sense. I can run with this as a theory. Then, like, how does the cervix get really soft if we need the cervix to get really soft? That happens with the release of a hormone like substance called prostaglandins, which nobody remembers the name of, but essentially, it's just like something is secreted on the cervix when there's pressure on it. How is there pressure on it? Ideally from the baby's head. So we need to get the baby into a really good position, That happens through our movement, right? Babies are mass and mass is subject to gravity. So when we move around, babies find different positioning. They put pressure on the cervix. That cervix gets really soft. The oxytocin causes contractions and pulls the cervix up and out of the way. And then as a baby has to move through the pelvis, which is a fixed bony structure, the baby's gonna have to continue to move. So what we came up with is And, and looking at this from a lot of angles, right, is physiologically only three things need to happen in order for a baby to get out. We need to have contractions. We need the cervix to get soft. We need the baby to rotate. In order for that to happen, we need to feel trust and safety in our environment and we need to move around. We need freedom of movement. From there, you can get induced. You can go into labor spontaneously. You can give birth at home. You can give birth in a hospital. You can get an epidural. You could not get an epidural. None of the details, none of those choices matter, as long as at the core of what is happening in a birth environment, you're working with increasing your sense of safety and relaxation and continuing to move around.
Joni:It's a much simpler way of conceptualizing it, especially as someone who doesn't have any medical background. Like, okay, I can work with these three things and I know how to feel more safe. I'm going to have like a good birth team around me. That's going to support me. I'm going to have some education around it, or I'm going to be in an environment that I feel comfortable in whatever. And then like you guys teach some movements, whether you have an epidural or not that you can do to help move the baby in the right position. It feels much more like tangible and almost Not that you can control birth, but I know some things I can do to help this process along instead of feeling like I'm just having my body's just doing whatever. And I don't know what I'm scared. I don't know. I feel like it's very empowering.
Ashley:Yeah, I mean, I hope so. And that's certainly how I feel. And that's how I think a lot of people feel after they understand the concepts is. Wow, this makes sense, one, right? This makes sense. I can trust this process. Two, I have something to do here. Like I am an active player. And it's not just for the person who's pregnant, right? For partner support, this is a game changer. Because how many partners do we see who are terrified? I don't know what to do, I don't want her to be in pain, I'm really scared, she's just gonna like squeeze my hand and break it. And so we say based on this framework, there's not very much you have to do. You have to keep up the oxytocin, you have to keep her hydrated, you have to breathe so she can produce that oxytocin, and oxygen can get to baby. And you have to keep her moving around. So when we're in class and we're breaking out what we call these partner responsibilities, it gives everybody a sense of purpose. And we all love that. We want to be part of the process. And then what we hope is it gives people a way of Understanding and analyzing medical interventions in a way where nothing is vilified for the sake of vilifying it. But we get to really say if somebody comes in and says, I want to break your water, or I want to start you on Pitocin, or I want to give you an epidural, You can say why, And you would understand based on the physiology that now you're gonna make a decision that can be different than your sister or your best friend, but this is what's gonna work for you. So for some people, an epidural, let's say you have somebody who really, really wants an unmedicated birth. But something about how their baby is descending and how those contractions are hitting is way more intense than they expected. And And maybe it's an okay really intense and maybe it's not. Maybe something is funky with the baby's position. But they're not coping very well. If an epidural in that situation is used to help somebody feel more safe, where they can relax, that is a great use of an epidural, right? That's really going to help the physiology of birth progress. Amniotic fluid, for example, has prostaglandins in it. So if somebody says, hey, we want to break your water, they're going after the release of prostaglandins to help the cervix soften to speed things up. And so knowing that is really the first step of then saying, oh, okay, cool, but we don't want to do that. We're not actually in a rush. You guys might be in a rush, but we're not.
Joni:I love it so much. Especially if it's your first kid, like you guys are saying, everything is new. And so just going in with more information is going to make a huge difference. And I feel like when I first became a nurse, I talked to a lot of friends who were having these births that were traumatic for them. And They're like, well, they told me I had to do this. And I just found over and over again, a lack of advocacy, they weren't able to advocate for themselves or their partner wasn't able to, whoever was with them. And so it sounds like you guys really are addressing that problem that people don't feel like they can advocate for themselves. Cause they assume and. Yeah, the, the providers do know more, but it's helpful to know the why, it's helpful to know the other options, it's helpful to have a conversation about it, so that you do feel like you have a choice. And then if something happens, that you weren't anticipating, you feel like you, you chose that instead of it happened to you. not all the time, but much more.
Ashley:Yeah, I think that's exactly right. The thing I've become really aware of that. helped me tremendously, not see this space as black and white and not see these binary choices because I think there are a lot of people who feel very pro or anti specific parts of birth, across the board and parenting choices for that matter, is that I know. I had to figure this out in my brain and I feel really lucky and grateful that I did and we got really good feedback on it. But I also know that nobody in the hospital is thinking this way. Really awesome individuals who have become labor and delivery nurses, or OBGYNs, or in some cases midwives, they, are taught, they have come to sort of feel attached to a certain timing progression of labor, and in that progression, certainly there are some indications where if you're in labor for too long, there's a risk of an infection, or there's a risk of, other complications where we want a baby to be born, but outside of those risk factors, looking for a certain progression of a contraction pattern, or a certain progression of dilation, It's really only happening because that's the model that they understand. And we haven't introduced an alternative yet.
Joni:That is a helpful framework to understand. one thing I was going to, I guess ask you or just say another thing I appreciated in the course was talking about having five birth preferences over a birth plan. When did you start recommending that and what's the reasoning behind it? Probably similar, like being flexible, but just wondering what your thoughts are.
Ashley:Yeah, that definitely didn't come from me, and I'm trying to think where I learned that. I think a lot of doula than a lot of birth educators just sort of collectively are like the, the birth planning language. Let me think about how to explain the history. So. If you back up and really approach how does birth happen in the United States, it is a, it is a windy road. And at no point has it been particularly, great for the people giving birth. When European settlers, whatever word we want to use there, came to the United States, they came without lay midwives, without community midwives, without the people who knew how to support birth. So, really what we saw at the beginning of the history in the United States especially in communities with really large slave populations, is that there were black women from Africa that had all of this knowledge. And they were black midwives, or called granny midwives, that were starting to oversee the birth of many, many, many people in our country, because they had sort of the ancestral wisdom. The field of obstetrics didn't really exist. Women gave birth within their communities with their sisters and their friends. And if they had access to someone, it was someone who had collected wisdom over the years. In their community. If you sort of fast forward in history, the field of obstetrics at the same time is growing in Europe, and it comes over to the United States, primarily because there was the introduction of the tool in the 1700s of forceps. And forceps are a life saving tool. Not necessarily life saving for a baby, but life saving for a mother, right? Because sometimes babies get stuck. Birth is not a perfect science, it's just a really, really good one. so forceps really helped babies be born, but what happened with the invention of forceps is what happens with a lot of medical interventions, Doctors got really excited to use it on everybody when it wasn't necessary. Male obstetricians had this technology. They were like, let's just do this all the time. It'll be way easier. We'll standardize it. They started really wanting to hoard power, which is not based on history in the United States and lots of different industries, like not surprising, but very unfortunate. And so in the United States, especially what we started to see, was really intentional, smear campaigns against midwifery care, scaring people and saying, the women in your community, whether they were granny midwives and black midwives or, Women who had collected this information like sometimes it's like cowboy midwives in the West. Women who knew a lot, these women didn't really know anything and it was like the witch hunt, right? So, the safest thing that you can do for your family is come and use this new technology, deliver in a hospital. with us. We're still very much in a world that was created where obstetricians and midwives had to fight against each other instead of being collaborative. And in many parts of the world that doesn't exist. There's a strong collaboration between midwifery care and obstetrical care because they complement each other. Midwives are trained medical professionals who can care for. Low risk birth. Low risk well woman care. They're like, we know all the things, we know what to look for, and then when there's a red flag, we're gonna go and get this doctor who can help us navigate these complicated situations, especially right now providing cesarean birth or doing a C section. Because midwives can't operate. But, the United States, most people I talk to, and I don't know if this is true in your community, most people assume that a midwife is basically like a labor and delivery nurse. And the person you have to go see is an obstetrician. As opposed to thinking actually the choices between an obstetrician and a midwife And then you get a labor and delivery nurse if you're in a hospital. Okay, this is a very long winded answer to the birth plan, but I'm gonna get there.
Joni:learning a lot.
Ashley:I'm probably gonna get there. Okay, so then we have, for, decades, we have rising interest in hospital birth. And in hospital birth, it is that conveyor belt model. Okay, Right? You're going to come in, we're going to give you a bunch of medication, we're going to get the baby out, really, and you're going to be so grateful to us because we've handed you this baby. And small things got interrupted, or small in the moment, but huge in terms of family bonding and, and physiology. So like babies were born and then immediately taken away and they were given a bath and they were wrapped up and they were kept in the nursery. And we know what immediate skin to skin contact does for bonding and imprinting on each other. And baths are not great for newborn babies because they can't regulate their body temperature. That I would count as like a small thing, a big thing. was, one generation of women who were given twilight sleep, which everybody thought of as, like, the most amazing pain medication because you could go into the hospital, you didn't know anything, and then you had a baby and you didn't have to experience the pains of childbirth. But, it's actually, let me get the words right, it's not an anesthetic, it's an analgesic. Basically, It makes you not remember. It doesn't make you not feel pain. So Twilight Sleep, if you look at the pictures, also came with essentially like straight jackets. So women would be like writhing in pain having their babies. They couldn't move around. They didn't have anybody in there to support them. But they left having no memory of the experience. And so, birth got complicated, right? Like, very much out of our communities, in somebody else's hands, somebody else is pulling all the strings. In the 70s, there was a much bigger movement to say like, this is not okay. This is not okay. And really like Lamaze as a childbirth education organization, Bradley as a childbirth education organization, they said, no, we can figure out how women can be awake and in charge of their births. and how partners need to come into the room to help advocate for them. This should be something that the family does together. And so then we had like a little bit of time, in the 80s where that was standard of care, now dads are in the delivery room, but they don't know what to do. And we're still living in the aftermath of you're not actually in charge when you're having a baby, you should be grateful to the obstetrician who's gonna give you an alive baby. In this, transition moment as a society, people are saying, I need to educate myself, I want to know all the information, I want to make sure that this isn't happening to me, that I'm not sort of treated poorly. Because the other side of it is that the outcome of it as a society is that rates of, you know, epidural, cesarean, birth and maternal death and morbidity, that's increasing. So the United States has the worst statistics for the most developed country. That's the other thing people will be like, well, maybe this is a better model, but it's not working. People are really suffering physically and emotionally. Families are starting to like, quote unquote, fight back And part of that is by taking birth classes. that really give them information and by making a birth plan and saying, no, you're not in charge, I'm in charge. In response to that, the system is like, No! We're not built for this. Your husband isn't gonna catch your baby in a tub of water surrounded by candles. That's not what we do here. And so thinking about it as birth preferences is like, okay, learn a lot, take a lot of this information in, but at the end of the day, what are the things that really matter. Is it that you get to move around? That should be number one. Freedom of movement is so important. So how can I increase my freedom of movement? And probably, how can I have immediate contact with my baby postpartum? So if we have some core elements like that, or maybe one of the birth preferences is that all cervical checks and medical interventions, you have to ask for consent. Because that's maybe not a given everywhere. So, I want to make sure that, my partner and I or my doula and I know, what you're proposing and that I have a chance to respond. Because, again, going back to what we said at the very beginning, it's a expectations versus reality thing. We want people to go in. Not with gloves up, ready to fight a system, but feeling like they're ready to participate in the system. That's what they've chosen. That is where they feel the most safe right now. But they want to do it in a way where they feel like they're active participants and they have some agency So coming up with just, your core few preferences allows you to relax into working with the system and allowing the system to work for you in the way that it can
Joni:that was a long winded answer, but very informative. So thank you. I appreciate it. I will say something that, and it just reminded me of this while you were talking about the history, I feel like you guys do a really good job of supporting women in what they want. So whether that is within a hospital, it's at a birthing center, it's at home, if they want to use an epidural or nitrous oxide or, you know, these other options too. It, it seems very like inclusive and accepting of this is your body, this is like your birth, this is your pregnancy, we just want to give you information so you can make choices for you. And I, I love that model cause I, I don't know if that's always the case. I know my mom delivered us at birthing centers and at home and she had very Intense emotions towards like the hospital system. And so it's nice to see everyone's accepted here. Anyone can benefit from these classes, regardless of what your preferences are in your birth.
Ashley:Yeah, my background is in New York City, and in New York City, there is, have of a freestanding birth center, like it, it's not consistently I don't know if I'm going to get this exactly right, but I think that Brooklyn and Queens, just two boroughs, not even including Manhattan, Brooklyn and Queens, two boroughs in New York, has a larger population than Utah, Idaho, Wyoming, and Montana put together. Something like that. And so there's a huge discrepancy in terms of care and access to out of hospital birth in, in New York in particular, but in most metropolitan cities in the United States, So my landscape here, my starting place is supporting people who are having hospital births and want to have a better experience. And what we realized, because I planned a home birth with my daughter, and some of our teachers have delivered in a hospital, some of our teachers have delivered at home, some of our teachers have had epidural, some of them had had cesarean birth, the thing that unites us as a team of Birthsmarter educators is that primarily none of us got the birth we thought we were going to get. That continues to come up for us as a theme. We know that the work we're doing can really help anybody who's getting ready to have a home birth or a birth center birth because we're teaching the core principles of how birth happens and we're giving you a framework by which you can like, go play, you know, but we, we are doing really important work for helping the people who are giving birth in a hospital navigate that system.
Joni:So cool. I have recommended you guys so many times since I learned that you existed. So I, I totally agree.
Ashley:okay.
Joni:of processing birth trauma in some ways to start. So if you do have a birth that was traumatic, how do you start dealing with that?
Ashley:Okay, so I would say for processing birth trauma, I think this is true for most trauma, but definitely something that is some sort of a brain and body connection, right? I think this, the hardest thing about birth trauma in particular, if somebody is then moving into parenting is a distrust in their body Or, that feeling of failure that something isn't working. And what we really need, whether somebody is choosing a breastfeed or not your body is on the line postpartum. Like your baby is attached to you, and so if you're feeling like something about, you You, your decision making, your physical body wasn't working. That's such a tricky landscape. Obviously it's working with a mental health professional. But the small, like, tips and tricks that we have are, to create some sort of a rebirthing moment. or ceremony with your baby and oftentimes that's like drawing a nice bath, getting in the bath and holding your baby skin to skin in a bathtub, lighting some candles, and that like this moment. Right? Where we take pictures of us cuddling, this moment is going to be like our reset.
Joni:Hmm. That's cool.
Ashley:Another thing that can be helpful for people who have more questions and maybe had a more complicated story is getting your medical records of everything that happened that they charted. It can be really helpful to go in there and put timestamps on your memories and rehash what happened. You can go and get a second opinion with a midwife or an OB and just talk through your birth and get more information. that in and of itself can be very helpful. Writing down your birth story to figure out what you remember versus where your questions are. And some people then want to go back to the midwife or the OB that they worked with with those questions, and other people never want to go back to that person, and that's okay too, right? At two weeks you can find a new OB and go in for a postpartum visit with somebody else and process. I think those are just some things I would think about is like definitely doing some sort of reconnect with your baby, do some journaling, get your medical records and get the medical advice that you need. And then do whatever you can in terms of postpartum movement, somatic therapies, body work to sort of regain your strength and your power and your trust.
Joni:I like all the ideas. I've also heard someone say talking it out with people, like bringing your friends or your family around you and, and sharing it with them to not like keep it all inside, but to talk about what was hard for you and let yourself cry about it. A lot of trauma can kind of start fizzling out, not everybody develops PTSD who has trauma and it can start fizzling out if we let ourselves feel it. I've seen that to be very helpful for people just to be able to, you know, Share their story and be validated and cry and and all that
Ashley:Totally. I wanted to talk about it all the time. I wanted to tell the birth story to anybody who would listen, and I think it's one of the things that's really valuable about something like a postpartum support group is that you have folks who really can empathize with exactly where you are, as opposed to your friends who, you know, Whatever, they've got their own life going on, they're not in that, that postpartum phase. I work with a doula in New York who's a, a wonderful writer. Her name is Sarah Nolan, and she has a service where she writes your birth story. For you with you it's a zoom call and you talk it you just like tell your birth story and she dictates and suggests edits and cleans it up and it's such an efficient way to get your birth story out because who has time with a newborn to like sit and write, especially if you sort of self edit in your head. It can take a really long time or it doesn't happen. But I think that's true for partners as well is like doing some healing because if you have birth trauma your partner witnessed it. That's really hard that can be hard on them It can be hard on your relationship and the only other thing is not to put a time stamp on it like You don't have to deal with your birth trauma at four weeks postpartum. I had a great postpartum experience with my daughter. And then when I was six months postpartum, I had some really bad anxiety and insomnia. And like everything just sort of bubbled up at the six month mark. And when I really had to look into it, it was like, Oh yeah, I almost died. Yeah. Right. Oh, yeah. Oh, yeah. That was sort of a big deal. Like, oh, yeah. Like, what if this baby was here and I wasn't? But it took me a really long time to get to a place where I was comfortable having those feelings and conversations with people.
Joni:yeah, that's a great point. I had this conversation with the therapist a while back who Said like a lot of my mom's had these traumatic births But then they were never processed and so they're kind of integrated in their whole motherhood experience And so I guess you don't have to even be Directly postpartum to, to work on that and to process through it. With a therapist, with, with body mind movement, there's all sorts of things, but it's never too late to address it whether you're six months or a year or three years or 10 years or 20 years past it. The whole body keeps the score thing.
Ashley:Totally. I can tell you, I'll try and tell this in a quick way before we wrap up, but in knowing that, How, visceral my experience was, I wanted so badly to keep it from my daughter.
Joni:Hmm.
Ashley:like, if you had a traumatic birth, that's your baby's birth story, right? And so that was something I was really aware of. And even in our pictures and our storytelling, everything was like, Oh, here's a picture of you. You were born at home. And then I went to the hospital to, so the doctors could make sure we were healthy. And then we went home and. Everything was so good. It was so perfect. you know, My daughter who is now nine and like an old soul nine, like she just like gets how the world works, you know? She has struggled for a long time without like sharing her, her life. She's just struggled for a long time with being very, very scared. In like, what's gonna happen situations. At nine she has a really hard time watching certain shows and movies. She can't handle stress and uncertainty. And something dawned on me. On her birthday, basically, and I was like, I think she needs to know, like, what happened. Because the body does keep the score, and if I'm wise enough to know that for me, I need to be wise enough to know it for her. And, when she was born, there were a whole lot of people that she loved who were really scared, wondering if I was gonna be okay. I don't want to get like too woo woo, right? But I was like, I think she probably picked that up. And we had the most amazing conversation. I was just like, I want to talk to you, and I want to talk to you about when you were born. And she started to cry right away. And she was like, what happened? And I was like, why are you crying? And she was like, why are you crying? And I was like, well, you didn't ever really know the whole story. And we just, like, walked through the hospital transfer and the surgery and that she was with us. My mom and then her other grandma and, and my husband and, and it was very simple, you know, I just said I wanted you to know and here are some pictures of when I was at the hospital that we never showed you and, she was awesome. She was like, this really helps. It's really good to know, like what happened and thanks for telling me. And I'm glad you didn't tell me when I was three because I wouldn't have understood.
Joni:Oh, that's really cool. Thanks for sharing that. so to wrap up, can you just tell us about. What you guys offer is Birth Smarter if someone wants to participate in one of your virtual or in person classes. Tell us, a little bit about that.
Ashley:Yeah, we really want everybody who's pregnant, whether it's your first or second or third baby, like, If you're having a kid and you think, huh, I want to have a pretty good experience, come take a birth class. The easiest and most affordable is a pre recorded class, that's what you watched, so it's like you buy it and then you get all the video lessons and you move through it on your own. We also have live classes that meet online. They are Eastern time zone, but if you can, work with the times, then you got a small group of other expectant families and a live educator, and that's really nice for, accountability. We have to show up. We have to participate, and you get to hear what other people are asking, because some people don't, um, Um, and then the most intensive is in person classes which we teach in Salt Lake City and in New York City in a bunch of different formats. And we just try and be as accessible as possible. So all Birthsmarter classes have alternative pricing to meet people where they are financially. Um, they come with office hours, they come with a workbook, they come with lots of online resources. I think what we're realizing is some people, I think that Birth Smarter is like a big company because our name is catching on, but like we're a tiny team of people that care a lot and so you can basically just like email or call any of us and we'll all try and help you have a better birth or postpartum experience.
Joni:So cool. Okay. So the best way to contact you guys is through your website. Is it birthsmarter. com?
Ashley:BirthSmarter. com. I'm Ashley at BirthSmarter. com. Info at BirthSmarter. com. Yeah.
Joni:Awesome. Thank you so much for your time, Ashley, and teaching us so much today. I appreciate it.
Ashley:Thank you.
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