Ep. 13 Birth, Babies, and Circumcision w/ Robyn Pool

credit: Jill

credit: Jill

In this week’s episode, we have the wonderful Robyn Pool joining us from PUSH Midwifery! She sits down with Alexis to talk about being a midwife, the difference between home and hospital birth, and why informed consent is so important for the birth process.

Alexis met Robyn when she was pregnant with her second daughter. Since Alexis chose to have a VBAC (vaginal birth after C-Section), she needed to find the right doctor to assist with it. Now that Alexis is a doula, her and Robyn have worked on births together, and help women have informed, autonomous birth experiences—though they can’t guarantee you’ll love labor ;)

We all know that reproductive rights is a hot topic in our current society, but Robyn chooses to remain quiet on her stance. This is to help keep her business from being labeled, and so that she can serve as many women as possible, no matter their political views.

Unfortunately, women’s reproductive health has become a political issue instead of a personal one. Every woman is entitled to their own opinion, and feeling safe is the most important thing to consider.

Alexis is no stranger to how traumatic pregnancy can be. When she was 16, she became pregnant while using heroin. She was extremely unhealthy and knew she wasn’t fit to be a mother at the time, so she terminated the pregnancy. Five years later, Alexis had her first daughter. Her second pregnancy was extremely high-risk and she was advised to have an abortion—she chose to carry on because her circumstances were completely different, thankfully Dakota was born a miracle.

Stories like these are what inspired Robyn to help women give birth. She is a Licensed Midwife (LM), but explains there are many different kinds of midwives. The two biggest categories are Nurse Midwife (NM) and Licensed Midwife (LM). While an NM gets their RN and certification for midwifery, a LM does not typically follow the medical model, and studies women’s bodies, reproductive care, birth, and health care.

The basis of midwifery knowledge is on informed consent, and that doesn’t always exist in hospital-based obstetrics.— RP

Hospitals nowadays tend to be more focused on hitting a number of patients every month, and applying every intervention necessary. Midwives on the other hand, are focusing on what the mother wants.

Midwives tend to work with low-risk cases, especially if you are wanting an out-of-hospital birth. They follow the same standard of care you’d receive with an OB, and offer the same testings while retaining autonomy and decision-making on the mother’s part.

Alexis points out that a lot of women aren’t aware of hospital procedures, and how rushed the birth process is made. Instead of being rushed, midwives can offer the same IVs and antibiotics a hospital offers, while slowing down the process for the mother’s comfort.

Robyn points out that there’s a cascade of intervention that should only be used “as needed”, but are now considered routine procedure. Between induction, PITOCIN, and epidurals, women are stuck in bed, hooked up to several monitors, often unable to get comfortable or walk around.

Remember that birth is a vulnerable state of life, so it is difficult to advocate for yourself in that state. This is where doulas and midwives can really be of service. As advocates for parents, midwives offer moments of pause, emotional encouragement, and stability when it’s needed most—during birth! A doula can refer back to the original birth plan, ask doctors questions when needed, and asks the mother, “What do you want?” or “Why are you doing this?”

These simple questions are the basis of informed consent when giving birth.

Many women that Robyn sees have had traumatic hospital/birth experiences in the past, and are desperately looking for that connection and care. Your relationship with your midwife is nurturing and comforting, a kind of connection not possible during 15 min OB appointments in crowded offices.

Because Alexis has had both a midwife birth and a hospital birth, she can pinpoint the major differences. She felt like “part of the machine” in the hospital, and as a survivor of sexual abuse, felt uncomfortable with the amount of people staring and prodding. This experience can bring up past trauma for anyone who’s been through assault.

Alexis has also found that many women who request C-Sections are survivors of sexual assault or are simply afraid of labor, based on stories they’ve been told.

This is why she works as a doula: to break the stigma. She can help women break down those walls and holistically address their trauma.

Midwives support all aspects of birth. They support autonomy and rights for women, and at the end of the day, support whatever makes the women feel safe. Most women will recover better emotionally if they’ve had a connection with their caretaker, and had things explained to them along the way.

Robyn explains that not all hospital births are negative, and that every intervention is necessary at one time. C-Sections and medications are necessary in some cases, but not in all. Unless you are prepared to fight the hospital system, they may argue about what’s truly needed.

For example, certain hospitals do not allow VBACs, and usually are not looking out for a woman’s best interest. Just because a hospital is VBAC tolerant, does not mean they are VBAC friendly. You have to ask yourself if this hospital is the right choice for you. And even if it is the right choice, you cannot be guaranteed a magical birth.

No matter if you are at home or in the hospital, there is always chance for complications. It is good to know, however, that midwives have about 8% transfer rates. Which is pretty amazing!

As far as babies born with the cord around their neck, it is not usually a risky issue. Many times, the cord can be lifted over the head, and it becomes a non-issue. A good midwife will catch these problems before they even become a major issue and you’re rushing to the hospital. They will also have antibiotics and IV on hand, so you might not have to transfer at all.

Robyn’s ultimate hope is for complete informed consent in hospital settings and strives for autonomy and making the best decisions for mom and baby.

Circumcision is a topic that is raised quite often in Robyn’s office. She is seeing less and less parents doing it, but it is still happening at a higher rate than it should. But as a midwife, she values informed consent, and is supportive of every parent’s choice.

Just like with abortion, some women never have abortion themselves, yet are able to say they don’t want to take that option from someone else. We just need to ensure everyone makes really informed decisions.

Do what feels right for you. You don’t owe anyone an explanation.


Terms to Know:

VBAC: vaginal birth after cesarean (C-Section)

IBLCs: International Board of Lactation Consultant Examiners

Standard of Care: a high quality level of care received in any birth setting

PITOCIN: a synthetic form of oxytocin that can be injected to help induce labor

C-Section: (cesarean), surgical procedure to deliver baby straight from womb instead of vaginally

Induction: the stimulation of uterine contractions before labor to get birth started

Informed Consent: the awareness and explanation of a women’s rights during birth; their right to making an informed decision

Epidural: pain medication distributed during labor to reduce contraction pain

Transfer Rate: the percentage of home birth/birthing center births that must be transferred to the hospital

Important Links:







If you are interested in working with a midwife, go to PUSH Midwifery’s site and learn more.

If you or someone you love needs help please visit alorecovery.com