(00:00:00): I live in Georgia, the state that has the worst maternal death rate in the United States. (00:00:05): Outcomes here are so terrible that we rank below nearly 100 other countries, (00:00:09): including several war-torn regions. (00:00:11): Abuse during birth is normalized and accepted and expected. (00:00:16): When I was pregnant, (00:00:17): I chose my care team diligently, (00:00:19): educated myself, (00:00:21): and engaged in birth preparation like I was preparing for a war. (00:00:24): Because in a world where women die of medical neglect, (00:00:26): both of over and under treatment, (00:00:28): birth is a battle zone. (00:00:30): I felt confident in my choices and in my team of doctors and midwives, (00:00:33): and I felt good going into my birth. (00:00:36): When I was 37 weeks pregnant with my first child, (00:00:39): the hospital at which I had planned to give birth pulled the rug out from under me (00:00:42): and made a stunning announcement. (00:00:45): It would no longer be offering water birth. (00:00:47): Oh, but it was so much worse than that. (00:00:49): It would also be forcing some groups of women to have medically unnecessary (00:00:52): C-sections that their doctors did not want to perform. (00:00:56): It would force certain interventions regardless of their medical necessity. (00:01:00): It was clear that there was a cultural shift toward controlling and terrorizing women. (00:01:06): Women have a right to say no, even when they are giving birth. (00:01:09): These policy changes were illegal on their face and clearly designed to control and (00:01:14): dominate women. (00:01:15): I panicked. (00:01:16): I didn't know what to do and I had only three weeks. (00:01:19): I reached out to local feminist organizations, but none of them were interested in helping. (00:01:24): It was my first real introduction to anti-mother misogyny, (00:01:27): to how little we care about what happens to women during birth. (00:01:30): I finally realized that if no one was stepping up, I had to. (00:01:34): So I gave up sleep. (00:01:35): I rallied the women I knew. (00:01:37): I wrote press releases, (00:01:38): reached out to national birth justice organizations, (00:01:40): and got in touch with a team of lawyers. (00:01:43): Within a day, (00:01:44): I had a group of nearly 3,000 women who were ready to protest at the hospital all (00:01:47): day, (00:01:48): every day, (00:01:48): until the policies changed. (00:01:50): They wrote letters. (00:01:51): There were dozens of media stories. (00:01:54): My husband, (00:01:54): a lawyer, (00:01:55): contacted the hospital detailing the lawsuit he intended to file on my behalf. (00:02:00): The hospital lawyer quickly got back to us and let us know that they would not (00:02:03): impose these policies on me, (00:02:05): but of course they would be happy to make an exception for me. (00:02:09): They clearly viewed me as a threat and hoped to defuse me. (00:02:12): But to quote Audre Lorde, I am not free while any woman is unfree. (00:02:17): I thanked the lawyer for his written commitment to honoring the law, (00:02:20): then shared his behavior publicly and continued with my protest efforts. (00:02:24): The backlash was swift. (00:02:26): I began receiving death threats, as did many other women. (00:02:29): The hate lobbed in my direction told me I was a threat. (00:02:32): I embraced it rather than shrinking away. (00:02:35): The hospital PR team tried to depict us as hormonal, irrational women. (00:02:40): So I told them that we, (00:02:41): being irrational and all, (00:02:42): would line the street in front of the hospital during rush hour traffic, (00:02:46): hundreds of us carrying signs and megaphones until they abandoned their war against (00:02:49): us. (00:02:51): They then tried to pretend we were crazy natural birthers ignoring good science in (00:02:55): spite of the fact that we had our doctor's support. (00:02:57): So I told them that we'd stand at every hospital entrance during our protest, (00:03:00): ensuring everyone who entered or exited the hospital knew the danger and abuse they (00:03:04): faced. (00:03:05): The hospital lawyer, (00:03:06): who had no medical training and apparently no brain, (00:03:10): made the mistake of inserting his own opinions. (00:03:13): So I told him I'd send my pregnant protesters down to his law firm along with the (00:03:17): media, (00:03:18): and that if they tried to do anything about it, (00:03:20): the images of them arresting peaceful pregnant women asserting their basic human (00:03:23): rights would end up on the news for days. (00:03:26): The hospital's leadership team finally agreed to meet with me. (00:03:29): So I took along a handful of other pregnant friends and advocates. (00:03:33): I wanted a group that represented the diverse range of attitudes toward and (00:03:36): experiences of birth, (00:03:38): multiple C-section mothers. (00:03:39): women choosing epidurals and women like me who were choosing unmedicated births. (00:03:44): By the time we arrived in their office, their fear of us was palpable. (00:03:49): We scared them. (00:03:51): They didn't know what to do because they had never been pushed on so hard, (00:03:54): so publicly for so long. (00:03:56): At one point, (00:03:57): the hospital lawyer asked us if we could teach him how to write emails without (00:04:00): misogyny. (00:04:02): They finally acceded to our demands. (00:04:04): Not because of their own goodness, but because we have the law and justice on our side. (00:04:08): And because we made clear that we would rain down consequences on them and make (00:04:12): them miserable until they stopped. (00:04:14): Patriarchy does not respond to niceness. (00:04:17): It does not give into logical arguments or well-articulated moral claims because (00:04:21): patriarchy has never been about logic or morality. (00:04:24): It is about control. (00:04:26): Patriarchy expects us to roll over, (00:04:29): but women are the majority and mothers are the majority of women. (00:04:33): We are the ones who make and sustain life. (00:04:35): We are the ones who decide whether the species continues. (00:04:39): And when we refuse to roll over for patriarchy, patriarchy has to roll over for us instead. (00:04:45): There is power in motherhood if we ignore our conditioning, (00:04:48): ignore the messaging of patriarchy, (00:04:49): and tap into our maternal rage. (00:04:52): That rage connects us with other women. (00:04:54): If we build solidarity with them, (00:04:56): including women we don't like, (00:04:57): including women who are different from us, (00:04:59): we become unstoppable. (00:05:01): Motherhood can be a source of power. (00:05:03): Birth, (00:05:04): however we give birth, (00:05:05): as long as we are safe and supported, (00:05:08): can be a transformative experience from which we derive significant purpose. (00:05:12): It can be a catalyst that empowers us to break the shackles of patriarchy. (00:05:16): After all, patriarchy is all about controlling birth because misogynist men fear its power. (00:05:23): Hi, I'm Zonva Lyons, and this is the Liberating Motherhood Podcast. (00:05:27): As always, (00:05:28): I'd like to ask you to help support this podcast by sharing it on social media, (00:05:32): by leaving a positive review on your favorite podcast platform, (00:05:35): by heart reacting it on Substack, (00:05:36): and by leaving comments or otherwise engaging. (00:05:39): As many of you know, (00:05:40): social media algorithms are trying to drive away feminist and leftist creators. (00:05:44): The most effective way to push back is to give the algorithm what it wants, which is engagement. (00:05:49): You can also sign up to become a paid subscriber and get at least one bonus podcast (00:05:53): episode a month. (00:05:54): These actions to promote the podcast really do help as subscribers are the sole (00:05:58): reason that I'm able to do this work and your support and promotion helps me keep (00:06:02): doing it. (00:06:03): I will never accept advertiser money or allow this work to be censored. (00:06:07): So I am dependent solely on you, my listeners. (00:06:10): Thanks for being here. (00:06:12): Today's opening vignette is a little bit different because it is my story. (00:06:16): I wanted to share it because in many ways it is my origin story. (00:06:19): But I received so many stories for this podcast, (00:06:21): and I want to share some of them so that folks can understand how truly dire things (00:06:25): are in birth culture. (00:06:27): So I'll be posting some of them in the show notes. (00:06:30): My guest today is someone I first met through that protest, (00:06:33): who stood beside me and supported me and taught me, (00:06:36): and who has been a beloved friend ever since. (00:06:38): I'm here today with Kristen Pascucci of Birth Monopoly. (00:06:41): Hi, Kristen. (00:06:44): Hi, Zahn. (00:06:45): It's great to hear your voice. (00:06:48): I am so glad to have you here. (00:06:51): So let me tell you guys about Kristen. (00:06:53): Kristen is the founder of Birth Monopoly, (00:06:56): and she has worked tirelessly to protect and help pregnant people for more than a (00:06:59): decade, (00:07:00): has masterminded numerous activist campaigns, (00:07:03): including mine, (00:07:04): supported lawsuits, (00:07:05): and worked with organizations such as Improving Birth. (00:07:08): She teaches activists, (00:07:09): parents, (00:07:09): and experts about birthing justice, (00:07:11): birth rights, (00:07:12): and self-advocacy in birth. (00:07:14): She's contributed in some way to almost any improvement in our maternity care (00:07:17): system that has occurred over the last decade that you might think of. (00:07:21): And I just love her so much. (00:07:22): I really do, Kristen. (00:07:23): Oh, my God. (00:07:25): That was so sweet. (00:07:27): Thanks. (00:07:30): It's nice to hear other people say nice things about me. (00:07:34): Well, (00:07:34): I know that a lot of people say mean things about you because the more you push on (00:07:39): patriarchy, (00:07:39): the more it pushes back. (00:07:42): Yeah. (00:07:43): Yeah. (00:07:43): When you said you got death threats for your efforts at the, (00:07:48): you know, (00:07:48): against the hospital there, (00:07:49): I was like, (00:07:51): oh man, (00:07:51): I remember those days. (00:07:53): I don't get those anymore, but I do have bad memories. (00:07:57): Yeah. (00:07:57): Yeah, it's so dark. (00:08:00): It's just so dark. (00:08:01): So before we get started, (00:08:03): I want to add that Jeff and I did a podcast about a year ago about the state of (00:08:08): childbirth and a patriarchy, (00:08:09): why patriarchy wants to control birth, (00:08:11): how it does it, (00:08:12): and just how bad things are here in the U.S. (00:08:14): where birth is getting progressively more dangerous, not less. (00:08:17): So if you're not familiar with these issues, (00:08:21): I recommend starting there because that's where we get into the statistics and we (00:08:24): share a lot of people's experiences. (00:08:26): Kristen is here to share some additional science, (00:08:29): but also as a witness and as a sort of friendly big sister to give advice on (00:08:36): self-advocacy in this awful abusive system. (00:08:39): Thanks. (00:08:43): So, okay, Kristen, I'm so excited to finally be interviewing you about this. (00:08:47): Yay. (00:08:49): I think it would be good to get your introduction to this issue. (00:08:52): Tell listeners what's going wrong with birth and (00:08:55): And how is that related to patriarchy? (00:08:57): How does it uphold the patriarchy? (00:08:58): Like what is happening? (00:09:00): Oh, wow. (00:09:01): Okay. (00:09:01): That's a huge question. (00:09:02): I mean, I think your introduction did a really great job explaining that. (00:09:10): So, (00:09:10): I mean, (00:09:11): so you're talking about something that happened, (00:09:13): you know, (00:09:13): to you as an individual and then to like a... (00:09:17): a group of community members that came down from the policy level at the hospital. (00:09:22): Um, (00:09:24): you know, (00:09:24): those things, (00:09:25): it, (00:09:27): it just replicates throughout the larger system, (00:09:30): you know, (00:09:30): that kind of stuff, (00:09:31): the same thing that happened to you, (00:09:32): the same kinds of like super restrictive policies happen all over the country, (00:09:39): um, (00:09:39): fairly arbitrarily. (00:09:41): Um, (00:09:45): And like you said, there isn't there isn't a lot of like logic or morals happening there. (00:09:52): But because because women are up against this. (00:09:59): this, (00:10:00): uh, (00:10:01): this, (00:10:01): I guess, (00:10:02): archetype of like hysterical, (00:10:05): emotional beings who aren't capable of making really important decisions. (00:10:12): Um, the conversation has really never been equal. (00:10:17): Um, so all that misogyny is, it just like permeates at every level, like from, um, (00:10:27): from individual, (00:10:28): I think like interpersonal interactions when you're pregnant with, (00:10:31): you know, (00:10:32): the family members and members of the general public. (00:10:37): And then it like, (00:10:37): you know, (00:10:38): it goes up through all the layers of the system all the way up to, (00:10:41): you know, (00:10:42): when we're talking about like the justice system and policy that comes down from (00:10:48): the federal level, (00:10:49): it all just kind of, (00:10:52): it tends to replicate those, (00:10:55): you know, (00:10:57): paternalistic leanings. (00:11:00): It's total paternalism. (00:11:01): And so like, (00:11:02): yeah, (00:11:03): I have this theory that pregnancy and birth and early postpartum are kind of this (00:11:09): process of getting women to accept the like devalued identity of motherhood. (00:11:14): So then they will really just feel alone and accept all of the labor society voice upon them. (00:11:22): But that doesn't seem to be how a lot of people feel because what I hear from a lot (00:11:25): of people is, (00:11:27): well, (00:11:27): if the baby's alive, (00:11:28): that's all that matters. (00:11:30): And, well, it's just one bad day. (00:11:32): And people often – (00:11:35): Try to pretend that this is just about like unmedicated birth and like crunchy mothers. (00:11:41): But I see this on people – I see this among people on the other side of things too. (00:11:45): Like I had a friend who had a really significant trauma history and who didn't feel (00:11:51): safe giving birth vaginally. (00:11:52): And so she wanted an elective C-section, which is like a completely reasonable thing to want. (00:11:57): It's medically necessary for her. (00:11:58): Mm-hmm. (00:11:59): And the system pushed just as hard on her about that. (00:12:03): And then, yeah, finally, it granted the C-section. (00:12:06): It did everything it could to make that C-section traumatic for her. (00:12:10): Yeah. (00:12:11): Like when we talk about birth justice, (00:12:12): we're talking about the fact that we don't honor any woman's choices, (00:12:15): autonomy or safety. (00:12:17): across the spectrum it's like it's like it's seen as a punishment you know it's (00:12:22): like the process of birth is seen as a punishment and I don't know if that goes (00:12:26): back to you know um the the literal genesis of Christianity that we're all taught (00:12:33): that you know it's a curse that like childbirth is a curse and um it's almost like (00:12:39): this um you know it's like the retribution on you for being born a woman or (00:12:45): something yeah um (00:12:47): I don't know. (00:12:48): You know, (00:12:48): I wonder how like how deep that that programming goes, (00:12:52): because I think a lot of us I, (00:12:55): you know, (00:12:56): especially in red states, (00:12:57): which, (00:12:58): you know, (00:12:58): you're in Georgia, (00:12:59): I'm in Kentucky. (00:13:03): Those stories, those start they start really young, you know. (00:13:09): And so I think, you know, in some ways, we're almost like primed as women. (00:13:15): You know what I mean? (00:13:17): Yeah. (00:13:18): It's like your punishment. (00:13:21): Childbirth is the punishment for being a woman. (00:13:23): Yes. (00:13:24): And we're also taught that the rational way to be about birth is to not have any (00:13:29): specific feelings about it. (00:13:31): I have a number of women who (00:13:33): who like take great pride in being like, well, my birth plan is to get a healthy baby. (00:13:38): And I'm like, (00:13:39): but is it really, (00:13:40): shouldn't it also include not having like lifelong bladder dysfunction and not (00:13:45): having trauma? (00:13:46): Like, don't, don't you think that you deserve that? (00:13:48): But I think that, you know, we kind of know, (00:13:52): That it's not really safe to give birth in this system. (00:13:55): So we just fall back on this thing. (00:13:57): Yeah. (00:13:58): And, like, I mean, speaking of safety, you know, there's some psychological safety. (00:14:03): There's a level of psychological safety in, like, releasing your expectations, you know. (00:14:08): In not saying I'm going to... (00:14:14): put my hopes and dreams into this being um an empowering non-traumatic super (00:14:21): supported you know life-changing experience like it's scary you know to like um to (00:14:31): want to to want birth to be that good you know to want it to be (00:14:38): or something that we imagine that it could be and that few of us actually experience. (00:14:44): I think there is some psychological safety and thinking, (00:14:49): Just letting go of all of that and being like, I just want to live. (00:14:53): I just want to survive. (00:14:55): I'm just going to focus on the baby. (00:14:56): I'm going to almost disassociate my experience from the experience, (00:15:04): even though you literally are the center of the experience. (00:15:07): Yeah. (00:15:09): I don't know, (00:15:10): like, (00:15:10): you know, (00:15:10): I know that there have been times in my life when I have, (00:15:15): you know, (00:15:15): that has felt easier and safer and more comfortable to be like, (00:15:20): you know what, (00:15:21): I just have to get through it. (00:15:23): And whatever happens, I'm just gonna live through it. (00:15:27): And that's all that matters. (00:15:29): And of course, you know, it's it's a little bit of a (00:15:34): It's a false sense of comfort and security and safety because we're still (00:15:42): traumatized, (00:15:43): whether or not we're fully present in the experience or we have dissociated from (00:15:48): the experience. (00:15:51): You still get hit with that trauma. (00:15:53): It might just be something that's more protracted and more more under the surface, (00:15:59): which really makes it harder to address later. (00:16:02): And I think that, (00:16:04): you know, (00:16:04): a lot of women believe that they don't have expectations about the experience. (00:16:13): But you're still vulnerable. (00:16:14): You can still be traumatized. (00:16:17): And, (00:16:18): you know, (00:16:18): I will say I've talked to so many women when we're talking about this, (00:16:24): like, (00:16:24): oh, (00:16:24): it's just a natural birth thing. (00:16:27): I've talked to so many women who... (00:16:31): they weren't abused trying to have a natural birth. (00:16:34): They were abused with the plan of going along with the, you know, going with the flow. (00:16:39): They were like, I went in trusting my doctor and they fucked me. (00:16:45): Do you know what I'm saying? (00:16:45): Yeah. (00:16:46): Well, I think that's often when people do get hurt the most. (00:16:51): And I think that we've, (00:16:52): It's just like the classic victim blaming narrative of like, (00:16:55): well, (00:16:55): these women with their bizarre ideas about birth, (00:16:57): of course, (00:16:58): they're going to have bad births. (00:17:00): But, (00:17:00): you know, (00:17:01): most women aren't like me going into birth with like a lawyer and like a very (00:17:07): specific list of demands. (00:17:09): And yet most women leave birth with some degree of trauma. (00:17:14): And so it's not, you know, that you're wanting the wrong things. (00:17:17): It's being a woman in the system. (00:17:19): Yeah. (00:17:20): And also, (00:17:20): you know, (00:17:21): speaking of what it is that we all want, (00:17:24): the research is like pretty consistent that the majority of women don't have super (00:17:32): specific asks. (00:17:33): They're not going, I don't want this procedure. (00:17:36): I do want this procedure. (00:17:37): I don't want this. (00:17:38): I do want that. (00:17:39): Most women have the idea that birth is first and foremost a physiologic event. (00:17:49): That might need medical intervention and not the other way around. (00:17:53): Yeah. (00:17:54): So most women already think that way, (00:17:57): which I think is like a very, (00:17:59): a very reasonable starting point, (00:18:01): like a very, (00:18:04): very rational and logical starting point that, (00:18:07): yes, (00:18:07): like we are mammals who give birth. (00:18:10): We're going to give birth, whether or not there is medical intervention. (00:18:14): However, (00:18:15): medical intervention can make it better at times, (00:18:18): can make it more safe, (00:18:19): can save lives. (00:18:22): And then... (00:18:24): as we all know, if you over intervene, you can make it more dangerous. (00:18:29): So like, (00:18:29): it's actually like a super evidence-based perspective to say, (00:18:34): first and foremost, (00:18:35): I see it as a psychological, (00:18:36): or I'm sorry, (00:18:37): well, (00:18:37): it is psychological, (00:18:38): but a physiologic event. (00:18:40): And then yes, sometimes it needs medical intervention too. (00:18:45): That is already the perspective of most women. (00:18:48): Yeah. (00:18:48): Yeah. (00:18:49): And those are the women who are still getting abused and traumatized. (00:18:54): Exactly. (00:18:55): Sorry, what did you say? (00:18:57): Context matters here because with our youngest child, (00:19:01): I mean, (00:19:01): I am a natural birther through and through. (00:19:04): That's my personality. (00:19:06): That's what I want. (00:19:07): People, women are allowed to want things no matter what patriarchy tells us. (00:19:12): But with our youngest child, I had the unmedicated birth without an epidural. (00:19:17): So in that regard, I got what I wanted. (00:19:18): But (00:19:20): We had a number of complications. (00:19:23): So I ended up after four days in labor having to get some Pitocin. (00:19:28): And my team was like really supportive and helpful. (00:19:31): You know, we did a low dose. (00:19:33): They unplugged me when I no longer needed it. (00:19:35): Like I could move around. (00:19:38): And then she was born with some respiratory distress. (00:19:40): So like I got to hold her for like a second and then she had to get intubated. (00:19:45): But there again, like they brought her right to me. (00:19:47): You know, there was they didn't do any more than was necessary. (00:19:51): And so it was still a good birth. (00:19:53): But if that had been the birth of my first daughter, (00:19:56): who did not need any of those things, (00:19:58): you know, (00:19:59): it would have felt traumatic because then it would have been, (00:20:00): well, (00:20:01): they did all these things and they separated me from her for like no reason. (00:20:04): So. (00:20:05): This is not about like wanting to avoid medical intervention. (00:20:08): It's about like don't interfere with the mother's body, with the mother-baby bond. (00:20:13): Like don't do to women things that are not necessary that they don't want. (00:20:17): And like maybe we should start telling women that you are allowed to want things. (00:20:23): Like there's this idea in patriarchy that like we're not allowed to want anything, (00:20:27): you know, (00:20:28): whether it's a certain birth or like a Mother's Day present. (00:20:32): Yeah. (00:20:33): Yeah, I know. (00:20:34): It's – (00:20:36): I remember that being one of the really frustrating things when I first started (00:20:41): doing this work because I felt like I was coming at it from a pretty logical point (00:20:46): of view. (00:20:47): And then I just kept hearing what you just said over and over where people couldn't (00:20:56): get past the idea that I wasn't supposed to have an opinion in the first place. (00:21:02): When I said, (00:21:03): you know, (00:21:04): hey, (00:21:04): the evidence shows this or, (00:21:06): you know, (00:21:06): the the options are that or, (00:21:09): you know. (00:21:13): Having any kind of a voice whatsoever, (00:21:15): it was like, (00:21:17): oh, (00:21:17): no, (00:21:17): no, (00:21:17): no, (00:21:17): that's actually a nonstarter. (00:21:19): We don't want to hear from you. (00:21:21): If my doctor or midwife were to speak on my behalf, that would be seen as acceptable. (00:21:28): But for me to say, (00:21:30): I want this or I want that, (00:21:32): it was like, (00:21:33): oh, (00:21:33): well, (00:21:34): you're automatically suspect. (00:21:35): Like you're not a credible witness right off the bat. (00:21:39): Yeah. (00:21:39): Well, and there's this framing of women as selfish, entitled, spoiled princesses. (00:21:47): when actually they're the people who love their babies the most and who are most (00:21:51): invested in their baby's well-being and who will have to live with whatever happens (00:21:56): long after it's a distant memory for the birth team. (00:22:01): Yeah. (00:22:02): Yeah. (00:22:03): Well, (00:22:03): I mean, (00:22:03): and that's just actually wild to me that people say that someone could be selfish (00:22:08): about giving birth. (00:22:09): Like, giving birth in itself is, like, one of the least selfish things you can do. (00:22:17): It's wild that anybody could try to... (00:22:24): diminish that, (00:22:25): you know, (00:22:26): that, (00:22:27): that act of sacrifice, (00:22:31): um, (00:22:31): by saying you're selfish, (00:22:32): like, (00:22:33): like it's, (00:22:34): it's like, (00:22:35): it's like, (00:22:35): I'm saying I'm making this huge sacrifice and I'm making this sacrifice on my own (00:22:39): terms. (00:22:40): And people are like, how dare you? (00:22:43): Well, (00:22:44): I think you're hitting on something there because I, (00:22:46): I do think diminishing all of the really intensely meaningful aspects of birth is (00:22:51): kind of the goal here. (00:22:53): I mean, I think (00:22:54): that a big part of the reason that we have patriarchy is because it seems to me (00:22:58): that women are the ones who have the most natural power, (00:23:02): given that we make people. (00:23:04): And I think that's very scary to men. (00:23:06): And I think that patriarchy has been the story of men trying to control and yeah, (00:23:13): just trying to control our ability to make people. (00:23:15): And I think we see that in the battlefield that is obstetrics and (00:23:22): Yeah. (00:23:23): I mean, for birthing women to exist in the patriarchy, you have to be a vessel. (00:23:28): Yeah. (00:23:28): Like, that's the only way you fit into the picture. (00:23:33): And so that is why I think there's all this pushback when a birthing person shows (00:23:37): up as someone with agency. (00:23:39): Yeah. (00:23:40): Yeah. (00:23:41): Okay. (00:23:41): So when Jeff and I did our podcast on birth about a year ago, (00:23:45): we got more negative feedback on that than any other topic. (00:23:48): And I didn't feel like we were making very controversial assertions. (00:23:51): You know, (00:23:51): we were talking about how racism is a known fact in maternity care and sexism is a (00:23:56): known fact. (00:23:58): But most of the feedback that we got was from doctors and other clinicians who (00:24:03): depicted themselves as like the real victims. (00:24:07): They're being maligned and it's not fair and it's hurting them. (00:24:10): and who denied the existence of racism and sexism in maternity care. (00:24:13): This is like so alarming to me because the people who are creating and replicating (00:24:20): a harmful system feel aggrieved and victimized. (00:24:24): And because the research has proven these biases exist, (00:24:28): and also that the more you deny the existence of your own bias, (00:24:33): the more likely you are to weaponize those biases against your patients. (00:24:41): I definitely think the way we treat women during birth essentially sets them up for (00:24:45): all of the maltreatment motherhood entails and that that strong backlash we get (00:24:49): when we start talking about that speaks to that. (00:24:53): But what do you say to these skeptical doctors who are like, (00:24:56): oh, (00:24:56): we're just being bullied by the natural birth warriors? (00:25:05): It's just... (00:25:09): I'm trying to, by the way, how am I diplomatic about this? (00:25:15): I guess it just seems like such a replication to me of like historical power (00:25:23): dynamics that have, (00:25:24): you know, (00:25:25): we've seen this throughout history. (00:25:27): Guys, (00:25:28): pick up a history book, (00:25:29): figure out who you are in the, (00:25:33): you know, (00:25:34): on the stage, (00:25:35): in the play that's happening. (00:25:37): you can see what part you're playing, (00:25:40): and then if you can have, (00:25:42): like, (00:25:43): a little bit of perspective on that, (00:25:45): then you can see really clearly that you're the ones with almost all of the power. (00:25:50): Yeah. (00:25:53): It's just kind of laughable to me that they would, (00:25:59): that someone would, (00:26:00): you know, (00:26:00): try to call themselves a victim as the person with all the power. (00:26:05): That's not to say that they can never be victimized, but it really is about perspective. (00:26:12): You know, I look at it as like, you know, I'm a white woman, right? (00:26:15): I... (00:26:18): am both victimized by the patriarchy and I also get some benefits as a matter of (00:26:24): fact, (00:26:25): especially in my proximity to non-white women. (00:26:29): So (00:26:32): I can be, (00:26:34): and I'm sure I have been an oppressor of black women while also being severely (00:26:41): abused by white men. (00:26:43): Like it's all about perspective. (00:26:47): In fact, (00:26:47): like before we even, (00:26:49): I think started recording, (00:26:50): we were, (00:26:51): we actually had a little bit of a conversation about sort of like victimhood in (00:26:57): general. (00:26:58): And yeah, (00:27:00): It's an interesting... It's hard to get into because, you know, it really takes... (00:27:06): it takes self-awareness and inner work, (00:27:10): I think, (00:27:10): to be able to get to a place where you can even, (00:27:15): you've got to be able to like beat through the cognitive dissonance that you're so (00:27:20): kind of enmeshed in to see yourself clearly and to be able to process, (00:27:28): I have hurt people. (00:27:30): It doesn't mean I'm a bad person. (00:27:32): You know what I mean? (00:27:33): Like, (00:27:35): It doesn't mean that you are an irredeemable villain. (00:27:42): It means that all of us at some point hurt other people. (00:27:47): Now, in this case, there's a really identifiable pattern to the hurt. (00:27:53): And so I think it's really crucial for anybody to have self-awareness about where (00:27:59): they fit into the... (00:28:02): the kind of like oppression matrix, you know, um, (00:28:07): Yeah, I don't know. (00:28:08): I mean, (00:28:08): you know, (00:28:09): closing thought, (00:28:11): it's kind of silly to me that a health care provider would consider themselves to (00:28:18): be a victim. (00:28:20): Actually, you know what? (00:28:22): Let me tweak that statement a little bit. (00:28:24): I could see how on an individual level that could possibly be true. (00:28:29): On a systemic level, absolutely not in any framework that you're looking at. (00:28:36): Yeah. (00:28:37): I mean, at a certain point, we have to just tell people, be serious. (00:28:42): If we want to talk about, (00:28:43): oh, (00:28:44): these crunchy moms are not listening to science, (00:28:48): the people who are not listening to science are the people who are not listening to (00:28:52): the overwhelming science showing that racism and misogyny, (00:28:56): not to mention classism, (00:28:57): ableism, (00:28:58): every other ism, (00:28:59): are rife in birth culture and that these have real effects. (00:29:03): So if you want to be a scientist, (00:29:06): pay attention to that too. (00:29:09): Yeah. (00:29:10): It makes me think of, (00:29:12): I know this is going to sound, (00:29:15): you know, (00:29:16): dramatic, (00:29:17): but it reminds me of when one of my, (00:29:21): one of the women I have worked with for years now who was assaulted in birth, (00:29:29): she referred to, (00:29:32): she said, (00:29:34): the hospital is my Brock Turner. (00:29:37): Wow. (00:29:38): And it was. (00:29:41): You know, (00:29:41): it was it's just like a story form of what you're talking about, (00:29:45): where she was physically assaulted. (00:29:48): She was first defrauded in the you know, (00:29:50): in the first place to in going to the hospital because they had promised her (00:29:55): certain services that did not manifest when she got there. (00:30:01): And then she was physically assaulted. (00:30:04): psychologically traumatized, (00:30:06): you know, (00:30:07): had PTSD for the first time in her life, (00:30:09): being a super healthy person physically and mentally prior to this birth. (00:30:16): So she came out of it both psychologically traumatized and debilitated physically (00:30:23): because of primarily because of a nerve injury that she received at the hospital. (00:30:28): And she ended up suing the hospital and she (00:30:32): The whole trial, you know, they portrayed themselves as kind of the victim in the situation. (00:30:38): You know, it was very just, you know, they were just being the good guy this whole time. (00:30:47): And they just did everything they could to save her baby. (00:30:50): And it's too bad she's so ungrateful about it. (00:30:54): Yeah, it's too bad she just wanted her baby dead. (00:30:56): Like, we say that about women without saying that about women. (00:30:59): And it's so false. (00:31:00): All the time. (00:31:02): Yeah, it's, it's super frustrating. (00:31:04): I mean, (00:31:04): it's like, (00:31:07): you know, (00:31:07): speaking of perspective, (00:31:09): like, (00:31:10): I'm, (00:31:12): I'm risking my life to have this baby. (00:31:15): And you're gonna tell me that I am willy nilly. (00:31:24): making choices that would throw my baby's life away because I want a better experience. (00:31:31): That happens over and over and over and over. (00:31:35): You know, (00:31:35): I've seen so many apology letters or heard so many apologies, (00:31:42): hospital or doctor to patient, (00:31:45): where it's very... (00:31:48): you know, (00:31:48): we're sorry that you didn't get the experience you wanted, (00:31:53): but we had to keep your baby safe. (00:31:56): Now, the unwritten part of that is from you, right? (00:32:01): Like, I'm sorry you're a bad mom. (00:32:03): Yeah. (00:32:03): I mean, that's what they're implying that the mother is prioritizing. (00:32:08): Gosh, back in the day, it was always... (00:32:12): She didn't get the, you know, the scented candles she wanted and, you know, the low lighting. (00:32:18): And that's why she's so mad. (00:32:19): And it's, you know, it's just a false narrative. (00:32:25): I mean, you look at you look at any of these stories. (00:32:27): Girl, nobody's getting traumatized by not having the right candles in the room. (00:32:32): You're getting traumatized by. (00:32:35): Because you're completely helpless at the mercy of strangers who have no (00:32:42): consideration for your autonomy, (00:32:45): for your psychological welfare, (00:32:48): for the bonding, (00:32:50): not interfering with the bonding, (00:32:52): or recklessly interfering with the bonding between you and your baby. (00:32:56): Yeah, that's enormously traumatizing. (00:33:00): And, you know, and a lot of times it's people who... (00:33:06): Consent is not even in the room. (00:33:09): It's not a discussion. (00:33:11): You're told what's going to happen to you. (00:33:14): And unfortunately, (00:33:16): that is largely determined just by where you happen to be when you give birth. (00:33:22): What they happen to do at that hospital, (00:33:26): not based on who you are as an individual and your actual medical, (00:33:32): physical, (00:33:33): emotional, (00:33:34): psychological needs. (00:33:35): So, (00:33:36): you know, (00:33:37): it's like if you're put on this like assembly line that might involve somebody (00:33:45): cutting your perineum with a pair of scissors. (00:33:51): Like, yeah, that's a little more than, you know, not getting the candles you wanted. (00:33:57): Yeah. (00:33:58): Yeah. (00:33:58): But it's all, we guilt mothers for everything. (00:34:02): Because again, we think mothers are not allowed to want things. (00:34:05): And we also think that anything a woman actually needs to be okay is just a want. (00:34:09): Like women don't have needs and they're not allowed to have wants. (00:34:13): We're just vessels. (00:34:14): It's just enraging. (00:34:15): Yeah. (00:34:15): I mean, you see this in postpartum and like, you know, that's like, it's enraging. (00:34:21): Like, you know, like the women who like, um, (00:34:27): You know, I see them on social media all the time. (00:34:29): Yeah. (00:34:31): I mean, I know what you're about to get into because it's just. (00:34:34): Yeah. (00:34:34): And like just the throes of postpartum and they've got a they've got a partner (00:34:41): who's complaining that they're being, (00:34:43): you know, (00:34:43): woken up in the middle of the night from the baby crying. (00:34:46): Yeah. (00:34:48): While this person is recovering from major surgery or recovering from a vaginal (00:34:54): birth, (00:34:55): which may or may not have involved, (00:34:56): you know, (00:34:57): stitches or, (00:34:58): you know, (00:34:59): some kind of operative delivery or, (00:35:01): you know, (00:35:01): whatever. (00:35:03): Not to mention, (00:35:04): like, (00:35:04): even if you had the least complicated natural birth in the whole world, (00:35:08): you still need... (00:35:10): a lot of recovery time. (00:35:11): Yeah. (00:35:12): Your body was like feeling a wound inside. (00:35:15): I was shocked by how, you know, with my first, I mean, I had like a textbook natural birth. (00:35:22): I mean, it was like a long labor and she was big, but I didn't get injured. (00:35:26): Everybody took great care of me. (00:35:28): I also have like a great partner who was truly doing his share. (00:35:32): And I was shocked by like how vulnerable I felt in the recovery. (00:35:37): And I remember thinking like, (00:35:39): I don't see how any woman in the world who does not have a good partner like survives this. (00:35:45): I don't see it because it's so hard and so vulnerable. (00:35:51): Yeah. (00:35:52): Yeah. (00:35:52): I mean, I didn't have a partner and postpartum was – it was miserable. (00:35:59): I also didn't have like a robust support system. (00:36:05): You know what I mean? (00:36:05): Yeah. (00:36:06): I had people who were like – (00:36:08): absolutely willing to help if I asked for help right yeah um and and like that is (00:36:13): it is like no knock on them like they did everything they thought they were (00:36:19): supposed to do you know what I mean like they were absolutely acting out of like (00:36:23): the best motives and out of love and care and compassion and all of those things um (00:36:29): however you know it is just like this cultural thing that women are first expected (00:36:36): to um (00:36:38): um be responsible during postpartum as opposed to like oh hey you're terribly (00:36:47): vulnerable during this time and this is it is like the job of family neighbors (00:36:54): community support systems to come in and make sure that like you don't have to (00:36:58): worry about anything like (00:37:00): Like you shouldn't have to worry about laundry and dishes and, (00:37:05): you know, (00:37:05): God forbid taking care of a partner or other children that, (00:37:12): who could be helped by someone else at that point. (00:37:15): You know what I mean? (00:37:16): Well, and it's like, what does the village do instead of like stepping in and helping? (00:37:20): It goes like this, you know, woman comes home from the hospital. (00:37:24): She's probably got an injury statistically. (00:37:26): She's statistically probably experienced some trauma and probably hasn't had a (00:37:31): partner who's been there to help her during this huge rite of passage and has (00:37:35): undermined it in some way. (00:37:36): So she's already got a psychological and a physical wound. (00:37:40): And then she's going to be sleep deprived while the lazy man next to her doesn't do anything. (00:37:45): Then she's going to struggle with breastfeeding. (00:37:47): There's going to be chores. (00:37:48): There's maybe going to be other kids. (00:37:50): She's going to be more exhausted than any human being could imagine. (00:37:54): And then at some point she'll post on like a mom group and be like, (00:37:59): so I had birth trauma and now I'm paying myself and I had all this stuff happen to (00:38:04): me during birth that I need to process that I can't. (00:38:06): And (00:38:07): my partner's not participating in the child that he helped make and I'm not sleeping. (00:38:12): What should I do? (00:38:13): And the first comment is always, have you been screened for postpartum depression? (00:38:18): Instead of like, have you been screened for having a shitty partner in a shitty system? (00:38:23): And I feel like as soon as she accepts, (00:38:26): oh yeah, (00:38:26): it must be my crazy woman hormones causing me to feel this way. (00:38:31): It's like, then the loop has been closed and she has finally accepted her (00:38:35): denigrated, devalued role as a person who is not entitled to anything. (00:38:42): Yeah. (00:38:42): It's always just, it always just ends with, well, this is just how it is. (00:38:46): Yeah. (00:38:48): And like, it doesn't have to be. (00:38:51): No. (00:38:51): And I'll tell you what, (00:38:52): as hard as postpartum was, (00:38:53): I would have been suicidal if I had to also take care of a partner during that (00:38:58): time. (00:39:00): Or not even take care of just like, (00:39:05): watch that person not help yeah or um you know make more work for me I don't think (00:39:13): I could have like literally could have handled that I'm not even joking when I say (00:39:17): that like (00:39:18): I mean, (00:39:19): the amount of, (00:39:19): like, (00:39:20): abuse I see from women with partners, (00:39:23): when I did my survey of women's postpartum experiences, (00:39:27): it was something like 80 or 90% of them who experienced some form of abuse from (00:39:32): their partners in the immediate postpartum period, (00:39:34): whether it was, (00:39:35): like, (00:39:36): forcing them to have sex, (00:39:38): calling them names, (00:39:39): hitting them. (00:39:39): For a lot of them, the abuse started for the first time ever in the postpartum period. (00:39:44): Truly horrific events. (00:39:46): To see what we are doing to women. (00:39:49): And also, like, truly a testament to how strong women are. (00:39:53): That women endure this. (00:39:54): And then they just get up and live their lives. (00:39:57): Yeah. (00:39:58): Yeah. (00:39:59): But, I mean, there's a cost, you know? (00:40:00): Yeah, there is a cost. (00:40:06): You know, (00:40:07): when you're describing those things, (00:40:10): all I can think of is, (00:40:11): like, (00:40:12): you sound like you're describing... (00:40:16): People who are property. (00:40:18): Yeah. (00:40:21): And that's what we want women to be. (00:40:26): Like, that's what this is. (00:40:27): It's the complete dehumanization of women. (00:40:30): Yeah. (00:40:30): So let me, okay. (00:40:31): I'm going to like talk about the other side of the coin just for a minute here. (00:40:36): I'm going to talk about rest and healing. (00:40:39): Yeah. (00:40:41): As an antidote to this is just the way it is, (00:40:44): which is being hurt, (00:40:47): injured, (00:40:48): traumatized, (00:40:49): devalued, (00:40:50): degraded in all of these ways. (00:40:53): To... (00:40:56): To heal from trauma, like your brain literally needs rest. (00:41:02): It can't heal when you're continuously in survival mode, (00:41:06): which is what postpartum usually is, (00:41:09): is like absolute survival mode for a really long time. (00:41:13): Yeah. (00:41:17): The rest part, it's like the rest is necessary for the healing. (00:41:24): And the healing is necessary for the wholeness, you know, for... (00:41:31): and it's not even getting back to, (00:41:33): you know, (00:41:33): there's, (00:41:33): there's really no such thing as going back to a normal. (00:41:36): It's you, (00:41:37): you have now become a different version of yourself post post birth, (00:41:41): post post parenthood. (00:41:43): You are a different version of yourself. (00:41:45): There's no way that you can't expand, you know, in certain ways to meet that. (00:41:52): And I think about like, (00:41:55): from the perspective of, (00:41:57): like, (00:41:58): energy and creativity, (00:42:00): how I have watched those things wax and wane in my life, (00:42:10): like, (00:42:10): directly, (00:42:13): direct, (00:42:13): in direct correlation to (00:42:17): where I am like on my trauma scale, if that makes any sense. (00:42:20): Yeah. (00:42:22): You know, there were so many years when I was so... (00:42:28): sleep deprived and literally traumatized, (00:42:30): you know, (00:42:31): like I, (00:42:31): I had, (00:42:32): I had an amount of birth trauma, (00:42:34): nothing like, (00:42:35): you know, (00:42:36): most of the women that I work with. (00:42:38): Um, (00:42:38): but I did have an amount of birth trauma that really did not come around for me for (00:42:43): like 10 years. (00:42:44): Like it didn't even, I, you know, I said for years, I did not have a traumatic birth. (00:42:49): Um, and I didn't really face that for like 10, 10 years. (00:42:52): Um, (00:42:54): And then, you know, I had all these other, you know, pressures in my private life. (00:43:01): And it wasn't until, (00:43:02): like, (00:43:03): those pressures released for various reasons that suddenly I found myself able to (00:43:10): write or to draw or to paint or to embroider, (00:43:19): to literally... (00:43:21): have like a part of my creative brain light up that had not lit up in years. (00:43:26): And one of the really important, (00:43:29): I think like critical aspects of this is like the part of your imagination and your (00:43:34): creativity that allow you to imagine a different future. (00:43:38): Yeah. (00:43:40): So the years that I was like really stuck in like deep trauma and (00:43:46): I could never imagine anything else. (00:43:49): It was just, you're in this tunnel and you're going to be in this tunnel. (00:43:55): And that's it. (00:43:56): Like there was no... (00:43:58): there was no vision beyond that whatsoever. (00:44:02): And so when we're talking about sort of like the longer term costs of all of these (00:44:07): things, (00:44:09): I look at it as like losing years of my life. (00:44:13): You know, (00:44:13): those were years that I was able to keep myself alive and keep my baby, (00:44:19): my child alive. (00:44:22): And yeah, (00:44:23): I don't feel like I did much more than that. (00:44:26): You know, it was, you know, survival mode is not living. (00:44:32): It's being alive, but it's not living. (00:44:36): Well, I just want to point out, I like, I believe you and hear that that's the mode you were in. (00:44:42): But you did a lot in survival mode. (00:44:44): So I (00:44:47): I think, you know, that's something I always keep in mind. (00:44:49): I did, but that's all I did. (00:44:51): Yeah, that's true. (00:44:54): So, okay. (00:44:55): And it's funny you say this because I was just thinking about this the other day. (00:44:57): I was thinking about the difference between my interior experience versus, (00:45:03): like, (00:45:03): my, (00:45:04): you know, (00:45:05): what other people would see happening, (00:45:07): right? (00:45:08): So you might come over to my house and go, oh, my gosh, this is so cute. (00:45:12): I love how you've decorated things. (00:45:15): Things are neat and pretty and, you know, whatever. (00:45:20): And wow, (00:45:22): you've, (00:45:24): you know, (00:45:24): you're speaking at these different conferences around the country and the world and (00:45:29): you've put out all this material and you're whatever. (00:45:32): But (00:45:35): It took every bit of energy I had to make any of that happen. (00:45:39): And I didn't enjoy any of it. (00:45:42): It was just like my interior experience was I have to get up again today. (00:45:49): God damn it. (00:45:52): Oh, I really don't. (00:45:53): I don't want to. (00:45:54): Yeah. (00:45:56): But I have to meet these markers. (00:45:58): I have to my house has to look a certain way because, (00:46:01): you know, (00:46:02): somebody stopping by, (00:46:03): you know, (00:46:05): it's got to look like this. (00:46:06): I didn't enjoy it. (00:46:07): It wasn't like, oh, I love my home. (00:46:11): And, you know, I I just like delight in existing in this beautiful environment. (00:46:17): Yeah. (00:46:18): No, not at all. (00:46:21): It was just like, God, I got to keep up the, you know, sort of keep up appearances in this way. (00:46:27): But but but also from like a very realistic point of view, (00:46:30): like not just keep up appearances, (00:46:32): but like you you can't neglect basics like, (00:46:35): you know, (00:46:36): eating and, (00:46:37): you know, (00:46:38): having clean dishes and having clean clothes and stuff like that. (00:46:42): So like, I don't know, like from the outside, it might look like this person's fucking (00:46:45): functioning great um and wow look at all this work she's doing but like what was (00:46:50): actually happening like behind closed doors was I didn't do anything else except (00:46:56): just manage to like produce the the work that other people saw yeah um I wasn't (00:47:03): like there was no like enjoyment of life like it sucked I hated it well and that (00:47:12): does suck for someone who's contributing so much to like (00:47:15): not enjoy it. (00:47:16): But the reason I raise that, well, I raise it for two reasons. (00:47:19): Well, hold on. (00:47:20): Wait, let me say one more thing. (00:47:21): Sorry. (00:47:22): Because I think this is important. (00:47:24): I also think, (00:47:25): and I totally did not pick up on this at the time, (00:47:27): it was only, (00:47:28): it was later that I realized that (00:47:32): I was driven by my trauma, like the trauma that I didn't acknowledge for 10 years. (00:47:37): That was what was driving me. (00:47:39): So if other people look at those things, (00:47:42): whatever I did, (00:47:42): if they see it as an accomplishment, (00:47:45): it didn't feel like an accomplishment to me. (00:47:47): It felt like I had to do it in order to survive, (00:47:51): if that makes any sense, (00:47:52): because I was actually being strongly driven by my own trauma. (00:47:56): So that was... (00:48:00): you know, (00:48:00): it was a very different experience to me than to like what someone might have (00:48:06): looked at from the outside. (00:48:08): Like there was no point where I was like appreciating the accolades and being like, yay. (00:48:13): It was like, no, actually I'm super depressed. (00:48:18): The more I get into this work, the worse it is. (00:48:23): Okay. (00:48:23): Sorry. (00:48:23): I just had to say that. (00:48:24): No, no. (00:48:25): It's I'm glad that you said that because so I kind of have, (00:48:29): I have a counter experience. (00:48:31): And I often hesitate to talk about how birth affected me because so many people (00:48:36): have had really horrific births. (00:48:38): And my first birth was really a wonderful birth. (00:48:43): And I have a wonderful partner and a network of women who helped me. (00:48:48): And so the effect of giving birth and then going through postpartum for me was magical. (00:48:56): It was like a process of (00:48:58): stepping into my power and becoming a fundamentally different person who felt like (00:49:05): a strong sense of solidarity with other women. (00:49:08): Because after my birth, (00:49:10): I didn't come away saying, (00:49:11): oh, (00:49:12): like I'm so special because I birthed that way, (00:49:14): or it's so different for me. (00:49:15): I came away thinking, oh my God, look at what women do. (00:49:19): And it has, it's driven me. (00:49:22): And (00:49:24): It made me much more aware of how many women are deprived of that experience and (00:49:29): how depriving women of that experience is depriving them of really immense power. (00:49:35): And that's not an accident. (00:49:37): And it's not like something that we can just ignore. (00:49:41): Birth can be an immense source of power and meaning no matter how you give birth. (00:49:46): And it should be because it's hard and because it's making life and because it's a (00:49:51): rite of passage and you should be supported. (00:49:53): And instead, (00:49:54): we take this moment that should be a source of power and we turn it into a source (00:49:58): of degradation. (00:49:59): And I just will never believe that that's an accident. (00:50:03): Yeah, well, as you're saying that, I'm thinking of the parallels with sex. (00:50:10): Something that, (00:50:11): you know, (00:50:12): there is a strong parallel in, (00:50:14): you know, (00:50:14): when it comes to, (00:50:15): like, (00:50:16): consensual experiences. (00:50:18): You know, if you go through sex that is not consensual is rape, right? (00:50:25): It's an assault. (00:50:27): And you can say the same thing about sex. (00:50:32): maternity care that is forced or non-consensual, that it is an assault. (00:50:38): And many women will also say it feels like rape. (00:50:42): And yes, I know how that sounds. (00:50:44): And for many years, I wouldn't even say that publicly. (00:50:48): But the reality is I can't tell you the number of women who have like unprompted (00:50:54): said my birth felt like rape. (00:50:58): I think that these things are, they're actually so closely tied. (00:51:05): Coming out of a rape situation. (00:51:09): is a soul killer. (00:51:11): As someone who is a survivor myself and can speak to it, (00:51:17): it fundamentally alters your sense of self. (00:51:20): It changes the way you think about the future, (00:51:23): about your identity, (00:51:24): about what you're capable of, (00:51:26): about how safe the world is, (00:51:27): about whether you can trust people. (00:51:29): I mean, it changes, it alters your path in life in a lot of ways. (00:51:35): I can't speak for everyone, but I think that's true for most people. (00:51:40): And, but you can also say sex can be a literal sacred experience. (00:51:49): It could be life changing in the best way, right? (00:51:53): It can be like this incredible, almost spiritual thing that opens like totally new doors in you. (00:52:02): And I would say the same about birth. (00:52:05): You know, these are, these are places where (00:52:09): they're moments where transformation is possible and deep transformation in (00:52:17): different directions. (00:52:18): And so it's like even more reason to take so much care in that space, (00:52:25): um, (00:52:25): as support people and medical providers to like safeguard the psychological and (00:52:32): emotional wellbeing of that person. (00:52:34): Um, um, (00:52:40): I can't, like, I'm trying to think about, like, how to... I don't know. (00:52:46): It just seems so obvious to me, you know, to, like, to think of. (00:52:52): And I'm like, oh, how graphic do I get with this? (00:52:55): But, like, it just seems really obvious to me. (00:52:57): Like, (00:52:58): you know, (00:52:58): the difference between, (00:52:59): you know, (00:53:00): healthy sex and rape could be someone saying... (00:53:06): Oh, are you okay? (00:53:09): You look off. (00:53:10): Yeah. (00:53:11): Are you sure? (00:53:12): Is this what you want? (00:53:13): I mean, I think that's a great parallel. (00:53:16): And it's actually one, (00:53:17): I mean, (00:53:18): I have also talked to so many women who say that their births are like rape and (00:53:22): immediately intuitively understand why that is and what they mean. (00:53:27): But this is the first time I've really thought about kind of the parallels between (00:53:30): like essentially non-consensual birth practices and non-consensual sex. (00:53:35): I think you're spot on. (00:53:36): Yeah. (00:53:37): Well, (00:53:37): and I also want to say, (00:53:39): you know, (00:53:39): like I said a minute ago, (00:53:40): I didn't say that publicly for a really long time because I felt like, (00:53:44): ah, (00:53:44): that sounds really extreme. (00:53:46): It sounds really, you know, like wacky. (00:53:48): Like only someone who's like mentally unwell would make a statement like that, (00:53:55): which was my own... (00:53:57): misogyny honestly yeah um because the more i heard that statement and the more i (00:54:04): realized that like actually this is coming from rape survivors who are saying this (00:54:10): they have experienced both of these things and they are comparing them this isn't (00:54:15): just like some like wacky feminist activist who's like making up shit you know (00:54:21): these are again unprompted un um (00:54:26): unsolicited comparisons by people who have experienced like both non-consensual (00:54:32): maternity care and non-consensual sex. (00:54:36): And they're saying they felt the same or similar. (00:54:40): Well, (00:54:40): I also think that mentally unwell comment you made is so interesting because (00:54:45): there's such a concerted effort to police what women activists say publicly. (00:54:51): And we turn that policing on ourselves and are constantly afraid of (00:54:56): misstepping. (00:54:58): And often the way that we're afraid of misstepping is by being crazy and asserting (00:55:03): that someone like cutting open your vagina is like rape is about the least crazy (00:55:09): thing I can think of. (00:55:11): But we all have these worries of appearing to be crazy because patriarchy wants us (00:55:16): to just be quiet. (00:55:18): Yeah, you know what? (00:55:20): I'm going to take this a step further, (00:55:21): and I'm going to say, (00:55:23): just to really, (00:55:23): like, (00:55:24): fuck with people's minds, (00:55:26): think about this. (00:55:28): There is also, ready? (00:55:30): There is sexual assault that occurs in maternity care. (00:55:38): I think the statistic is something like 6% or 8%. (00:55:41): It's pretty high. (00:55:43): Yeah. (00:55:45): So, and here, like, we got to, like, (00:55:48): define some things. (00:55:49): Right. (00:55:50): Um, (00:55:53): whether we are talking about the perspective of the victim or the, (00:55:57): we're going to call them perpetrator is important because I think you would have a (00:56:03): much higher percentage of patients and women saying that felt like assault, (00:56:08): like a sexual assault. (00:56:10): Yeah. (00:56:11): Then you would ever, ever, ever have a provider saying I intended to commit a sexual assault. (00:56:17): Like I'm a predator and (00:56:20): a sexual predator and I prey on vulnerable women in the birth setting. (00:56:25): Right. (00:56:26): Is is it is an infinitesimal number compared to the providers who inadvertently who (00:56:34): are committing acts who women interpret as sexual assault. (00:56:38): All right. (00:56:39): So stick with me here on this nuance. (00:56:42): There are though, there, or there is that small number, which I don't know that number. (00:56:48): And I, I haven't heard that six to 8%. (00:56:50): I would love to see where you, where you got that, you know, what they had to say about that. (00:56:57): But yes, there are also people who like intentionally commit sexual assault in birth. (00:57:03): And I've talked to (00:57:05): many of their victims. (00:57:08): And do you think that a woman can prove that she was sexually assaulted by an OBGYN (00:57:15): or a nurse midwife or a nurse in obstetrics? (00:57:20): It's almost impossible to (00:57:23): It takes so much... (00:57:25): It takes, (00:57:26): like, (00:57:27): you know, (00:57:27): 1 million percent evidence to prove something like that. (00:57:32): The cases that you'll see, (00:57:34): if you were to Google it, (00:57:36): it's people who did it for 10, (00:57:38): 15, (00:57:49): 20 years and had dozens, (00:57:42): hundreds of victims before anything was... (00:57:47): You know, (00:57:47): action was actually taken. (00:57:49): And often lots of witnesses who... (00:57:52): either ignored it and did nothing or who thought, (00:57:55): well, (00:57:56): it must not have seemed like, (00:57:58): or who deliberately covered it up. (00:58:01): Oh, absolutely. (00:58:02): Well, I mean, you know, and, and many hospitals do that. (00:58:05): We know this, (00:58:06): you know, (00:58:06): like that's, (00:58:08): um, (00:58:09): one of the things that I do, (00:58:10): um, (00:58:12): is, (00:58:13): um, (00:58:14): I help people report instances of abuse in obstetrics and, (00:58:20): um, (00:58:22): one of the things we know is like the first thing that most people do or think of (00:58:27): when they think like, (00:58:28): Oh, (00:58:28): I want to come. (00:58:29): I want to make a complaint or I want to report this to someone is they go directly (00:58:33): to the hospital where the act took place. (00:58:37): And who y'all like, (00:58:39): if you think that hospitals are like waiting to hold your hand and, (00:58:44): and you know, (00:58:46): go take accountability for this stuff and make sure it never happens again. (00:58:50): Like, do you have another thing coming? (00:58:52): That literally does not happen. (00:58:55): It doesn't happen. (00:58:56): And in all of these lawsuits that you look at the hospital, (00:59:00): I mean, (00:59:00): there were all kinds of reports made and the hospital deliberately, (00:59:04): you know, (00:59:05): made a choice. (00:59:08): Somehow this dude's still working there 10, (00:59:11): 15, (00:59:15): 20 years later, (00:59:11): you know, (00:59:13): I'm thinking of, (00:59:14): in fact, (00:59:15): like, (00:59:16): A colleague I work with really closely now who I met through my work, (00:59:22): she was actually more of like a client than a colleague back then. (00:59:25): I don't know, maybe 2017, 2018. (00:59:26): She contacted me because she was a nurse and she (00:59:35): she had witnessed a doctor commit a physical, (00:59:39): like a pretty violent physical assault on a birthing person, (00:59:43): a woman. (00:59:44): And when she went to report it, she got in trouble. (00:59:49): The, (00:59:50): the, (00:59:50): you know, (00:59:50): the first thing they said was her manager, (00:59:53): whoever it was, (00:59:53): the, (00:59:54): you know, (00:59:54): the person above her, (00:59:55): the person above the person above her said, (00:59:58): when you write that report before you submit it, (01:00:00): we need you to edit it. (01:00:02): You can't call that, you can't use the word assault. (01:00:03): Yeah. (01:00:04): you're not qualified to make that call. (01:00:11): You can't call that by that name. (01:00:15): Only a doctor would be able to determine if that was what we would call an assault. (01:00:24): So that was a nurse who firsthand witnessed what happened and (01:00:32): Put her name on a report, (01:00:34): you know, (01:00:34): like what more can you ask of people like that's she did what she was supposed to (01:00:39): do. (01:00:40): And she was told, don't use that language. (01:00:44): And then she was, you know, essentially let go after that. (01:00:50): And, (01:00:51): um, (01:00:52): and they, (01:00:52): you know, (01:00:52): they kind of came after her even, (01:00:54): even after that with like punitive measures. (01:00:57): So that's the kind of stuff that that's, that's, that's normal. (01:01:00): Like, that's what I see as like a normal response. (01:01:04): Yeah. (01:01:04): That's just so disheartening though. (01:01:06): But I, (01:01:07): I think it's really important for people to know that for every public allegation (01:01:12): you hear about, (01:01:13): there are tens of thousands you have not heard about. (01:01:16): And for every woman who tells you a horrifying story, there are (01:01:19): many more for sure yeah majority of women you know like who have not told you yeah (01:01:25): and like that woman um that nurse you know i it was three or four years later she (01:01:32): got another she got a message from another nurse um at that facility saying he's (01:01:37): still doing it she is you know i mean of course he is why wouldn't he (01:01:45): So, OK, so for my I think this is my last question for you. (01:01:49): You know, one of the most important things that you do is you just educate women. (01:01:53): And this is kind of limited to American women, (01:01:55): at least in terms of the law, (01:01:57): about their birthing rights and their right to say no. (01:02:00): So you have the chance to tell women what they should know going into birth. (01:02:06): What do you want them to know? (01:02:09): Well, I. (01:02:11): There's not a silver bullet. (01:02:13): Like, I could say you have an absolute right to say no. (01:02:19): But unfortunately, it's a lot more complicated than that. (01:02:22): I think you should utilize that right. (01:02:25): But you also have to, like, understand the potential repercussions of doing that. (01:02:30): I... (01:02:35): I wish, (01:02:36): like, (01:02:38): if I could genuinely, (01:02:40): like, (01:02:41): honestly say what I wish women would do, (01:02:45): I wish they would boycott the system. (01:02:50): I wish that they would and were able to and had access to midwifery care or an (01:03:01): alternative to what is really a (01:03:06): a profit driven paternalistic obstetrics, (01:03:13): you know, (01:03:13): system in the U S it's such a tricky thing to navigate. (01:03:19): It's like, (01:03:22): you know, (01:03:22): know your rights, (01:03:24): get educated on your rights, (01:03:26): hire a doula, (01:03:27): make an advocacy plan with your doula, (01:03:30): have a, (01:03:31): have a, (01:03:32): an additional support person or two who, (01:03:34): who are also trained on your rights, (01:03:37): you know, (01:03:38): who go in with, (01:03:40): um, (01:03:40): with information and with their, (01:03:42): you know, (01:03:42): the handouts that show like, (01:03:44): actually, (01:03:44): these are the guidelines and this is what the law says and, (01:03:47): you know, (01:03:47): all this stuff. (01:03:48): And it's so much, (01:03:50): you know, (01:03:50): it's so much for so little guarantee of anything, (01:03:53): you know, (01:03:54): there, (01:03:54): there is no guarantee. (01:03:55): Um, (01:03:58): I truly believe that it's a system that it only responds to financial incentives. (01:04:07): And leaving that system en masse is like my dream for American women. (01:04:20): And I know that that's also not very realistic because the alternatives are so restricted. (01:04:28): So I'm sorry you don't have like a nice, neat answer for you. (01:04:31): I think it's good that the answer is not nice and neat because the other bit of (01:04:38): this is that the fact that we ever have to talk about self-advocacy and (01:04:45): self-defense and all of that in a system that is ostensibly supposed to keep us (01:04:49): healthy is (01:04:50): speaks to what is broken in the system. (01:04:52): Because if the system were decent, (01:04:55): you would not have to have any particular skills to enter the system and survive. (01:05:01): Yeah. (01:05:03): So, (01:05:03): I mean, (01:05:03): I think, (01:05:04): you know, (01:05:05): I will say just because I have to, (01:05:08): Kristen has a ton of amazing materials that are really helpful and that are a lot (01:05:13): more than just like (01:05:15): Oh, well, because there are things that you can do. (01:05:18): But, (01:05:19): you know, (01:05:19): the fact remains that it's not the victim's fault and you can do everything right (01:05:23): and know everything and choose the right care provider and all that stuff. (01:05:27): And you can still end up being assaulted or traumatized or mistreated when you are (01:05:33): giving birth because we live in a patriarchy and that's what patriarchy does to (01:05:37): women. (01:05:37): Yeah. (01:05:39): Yeah. (01:05:41): Yeah. (01:05:42): Yeah, (01:05:42): all the things I have to tell people about how to navigate it, (01:05:45): it's like, (01:05:46): imagine like a war zone, (01:05:51): you know? (01:05:52): And I'm like, there's this one foxhole, you guys. (01:05:57): If you can get this equipment and you can get this, (01:05:59): you know, (01:06:00): if you can get this protective equipment and you can get this one weapon and you (01:06:03): can make it to that one foxhole, (01:06:05): you might be okay. (01:06:08): That is what it's like, isn't it? (01:06:11): Yeah. (01:06:11): And I hate that. (01:06:12): I mean, I hate that. (01:06:13): I hate that, (01:06:14): you know, (01:06:14): I don't have like a super positive, (01:06:17): like, (01:06:18): you know, (01:06:19): do the things on this list. (01:06:21): Well, (01:06:21): and let me say this, (01:06:22): if you're like a medical provider listening to this and you're feeling defensive, (01:06:27): you know, (01:06:27): we talked earlier about how that defensiveness you should sit with and that's a (01:06:32): problem, (01:06:32): but I would also point out like, (01:06:34): okay, (01:06:35): so if you are one of the good guys, (01:06:38): then you have to believe that statistically you are an anomaly and that your (01:06:42): patients have mostly encountered the bad guys. (01:06:46): So rather than getting defensive of yourself, (01:06:49): think about all that your patients have been through and all that you have not (01:06:53): seen, (01:06:53): but maybe you should have seen. (01:06:54): Yeah. (01:06:56): Yeah. (01:06:58): And I'll add to that. (01:07:02): There's a lot going on in the nurse world as far as... (01:07:07): really leaning into and fully owning the advocate role. (01:07:13): It is still, (01:07:16): you know, (01:07:17): a fringe-ish movement, (01:07:18): but it's very, (01:07:20): it's very real and it's, (01:07:21): it's very much happening. (01:07:23): I don't see that in the physician world. (01:07:25): I am not aware, you know, of this, like a, a similar push to the, (01:07:35): aggregate the good guys and educate each other and educate your peers and go to (01:07:43): conferences and speak about these things. (01:07:46): Um, (01:07:47): and you know, (01:07:48): show up and write papers talking about obstetric violence and how we need to, (01:07:54): you know, (01:07:55): stop committing obstetric violence and what we can do instead. (01:07:58): Um, (01:08:01): I mean, you're allowed to do that. (01:08:03): You're allowed to speak up. (01:08:05): You're allowed to organize. (01:08:10): You're allowed to do all of that. (01:08:12): Go for it. (01:08:14): Yeah. (01:08:14): Be someone who slows the abuse and who speaks out. (01:08:19): Because what matters most in our lives is what we do with power. (01:08:23): And so when you are the person who has the most power in a system, (01:08:26): you have the highest obligation to protect your fellow human. (01:08:31): Yeah. (01:08:32): And OK, you just made me think of something. (01:08:36): I I remember. (01:08:40): So one of my one of my colleagues is a black woman from Georgia, (01:08:46): like one of my close colleagues, (01:08:48): favorite people who I talk to a lot. (01:08:52): And I remember one time saying to her, like, I just feel so helpless. (01:08:57): Like, (01:08:58): you know, (01:08:59): there's just so much work to be done and it just feels so daunting and, (01:09:04): you know, (01:09:04): et cetera. (01:09:05): And I expected her to like commiserate with me. (01:09:09): And what she actually said to me was, if you feel helpless, think how we feel. (01:09:20): And I'm paraphrasing. (01:09:23): as a white woman you have exponentially more power than i have as a black woman and (01:09:30): yet i am organizing with my peers teaching people about advocacy educating birth (01:09:39): workers um (01:09:42): leading a movement, if I can do this, what more could you be doing? (01:09:48): I don't want to hear that you feel helpless. (01:09:51): So again, we're back to like perspective. (01:09:55): Yeah, I am in a position like, you know, in the position I'm in. (01:10:00): Yeah, it does feel daunting. (01:10:01): And it does feel all of these things. (01:10:04): But also, (01:10:07): I actually have my position of power is not such that I am at the bottom of the barrel. (01:10:18): And we've seen over and over again that Black women keep making things happen despite their... (01:10:29): despite the way that they are viewed and the way that they are treated and the way (01:10:33): that they are marginalized. (01:10:35): So I think a lot of it is like, it kind of lives in our heads as far as, um, our helplessness. (01:10:44): And I, (01:10:45): I hope that like, (01:10:47): I hope that providers can hear that and, (01:10:49): and find some hope in it actually. (01:10:52): Like I'm telling you from my position, you have a shit ton more power than I do. (01:10:57): And (01:10:59): look at what I've done. (01:11:03): I love that. (01:11:04): And I think that's a great note to leave this on. (01:11:06): Kristen, (01:11:07): thank you so much, (01:11:08): not only for being here, (01:11:09): but also for just being you and for the incredible work you do and have done. (01:11:14): We are all better because you are in the world. (01:11:17): I will put all of Kristen's information in the show notes. (01:11:20): Kristen, any parting words? (01:11:22): Thank you. (01:11:23): No, I was just going to say kind of like right back at you. (01:11:27): And it always like tickles me whenever I'm just like out in the world and I see (01:11:34): something of yours pop up on my social media or something. (01:11:40): Not from you, but you know that some random stranger in the world is like (01:11:46): you know, putting some Zahn stuff out. (01:11:48): It just like cracks me up. (01:11:49): I'm like, oh, look at that. (01:11:51): Oh my God. (01:11:51): So I'll see it. (01:11:52): I see it all the time for you too, (01:11:54): where someone will be like, (01:11:55): oh, (01:11:55): I just discovered this like woman birth activist and she's not a lawyer, (01:11:59): but she seems like a lawyer. (01:12:01): And she's like really intense, but also really charming. (01:12:04): And I'm like, I know it's Kristen. (01:12:05): I know it's Kristen. (01:12:07): And then they'll like get to the end and they'll be like, her name is Kristen. (01:12:09): Like, like Pasca Ketty. (01:12:12): I'm like, yeah, it's Kristen. (01:12:14): Yeah. (01:12:17): All right, so that's it for this one.