with Anne Margolis

Transcript

Debra Pascali-Bonaro: What words do you think of when you think about birth? I love to ask this question in all my classes from our doula workshops, to our online classes, pleasurable birth essentials and my advanced practitioner retreats. We always discuss the words that reflect what our family and society have conditioned us to believe about birth. I hope you’ll take a pause right now, write down your three words, tag us and get ready to consider how to love your birth.

Hi, I’m Debra Pascali-Bonaro, Co Founder and Director of Orgasmic Birth, and host of the Orgasmic Birth Podcast. I am so excited and honored to introduce you to my guest today. She is one of the featured midwives in our documentary Orgasmic Birth. Anne Margolis is a Licensed Certified Nurse Midwife, a Licensed Femme, Teacher, a Certified Clarity Breathwork Practitioner, a Yoga Teacher and Practitioner. She’s a third generation guide to mama’s birth and babies in her family. And she’s helped thousands of families in her 28 plus year midwifery practice and has personally ushered the birth of over one thousand healthy babies into the world. She’s also guided countless human beings to heal from emotional pain, inner stress and trauma, tapping into their strength and power to live fully, vibrantly and reclaim their radiance, joyfulness, calm and overall sense of well being. Her clients describe her as passionate, sensitive, big hearted, and playful, a ball of light. When she’s not helping mamas around the world, you can find her doing yoga anywhere and everywhere, dancing, walking outside around nature, riding your bike, paddleboarding, swimming, taking are facilitating powerful growth and healing workshops, and enjoying family time, playing with their dog, Max, watching comedy and historical drama. 

Oh, my goodness, and reading even all about you and knowing you are coming today just lit me up as it brought me back to the several births that I’ve attended as a doula with you, and having you a part of our documentary. So it’s beyond a joy and honored to have you join us today.

Anne Margolis: I think one of my clients has her birth story in your book.

Debra Pascali-Bonaro: Yes. So we’ve had lots of connections. And I know that for so many of us that are in the birth field, it began with our own stories. I’m wondering if you could share a little bit about your personal journey with birth and birthing your children.

Anne Margolis: So I knew when I went to nursing school, as soon as I did my nursing clinical in obstetrics, I knew I wanted to be in obstetrics. So I worked as an obstetric nurse before I became a midwife. Actually, working in a community hospital as an obstetric nurse where I got fear of birth. Birth was a crisis, an emergency meant to happen, a loss that we have to prevent. We always have to look for the problems. I started to see these normal, healthy women coming in, and they were just given this cascade of interventions. Put on a hospital gown and all these all these things, and then we were ending up way too often in the operating room. Or we were having forceps and vacuum births, assisted births, and outcomes were not always good. I went into my first pregnancy scared, and we didn’t have the Internet back then, of course. I went into my first birth, I hired the chief, one of the heads of the obstetric groups in the hospital where I worked and I told him, I’m really scared. I don’t want to have a cesarean. I’ve seen a lot of major abdominal surgeries, sometimes the outcomes are not good. I’m really scared. He says, you’ll be fine. And that was it. But I was scared. I was given the royal treatment when I went in. One of our staff is in labor, but that royal treatment was still the standard medical care. I was this healthy, 24 year old, told to wear a hospital gown. 

So in those days, we assumed that that’s normal. I know that it takes away your power. You’re in this ugly dress that people have died in or are sick in. And you just assume surrender, you’re just like an assembly line, right? I have to get in the bed. I can’t eat or drink. IV continuous monitoring. So no animal could labor like that, right? So of course, my labor stopped. I was contracting, and the doctor kept coming in and he just kept an internal exam every hour out the door. He would tell my colleague, she’s still four, she’s still four, and so give her a pit. Now, if I wasn’t a nurse, I wouldn’t have known what that was. I had took some really excellent childbirth class, but give her pit. When the nurse came in to put it in my IV. I said, I don’t want that. I don’t want that. I know what that’s gonna do. And that’s gonna make everything harder, stronger, faster, more intense. And she says, but honey, you don’t want a ceasarian, do you? You’re vulnerable at that point. So they gave me the pit and then my lamaze went out the window. It’s almost inhumane to cope with the unnatural contractions of Pitocin without an epidural. So of course,that came next. And between the two, my baby’s heart rate crashed. So then it became a stat section. The worst fear is happening. So everyone’s looking panicked, and I’m in a panic, and we rushed to the operating room, and I was left by myself. I’m watching the clock, 10 minutes, 20 minutes, I knew they had 10 minutes to get my baby out, given the bradycardia, given the heart rate situation. 10 minutes, 20 minutes, half hour, 45 minutes, an hour, the assistant surgeon hadn’t come yet. 

So in my head, in my body, I was like going from, my baby’s gonna die, my baby’s gonna be damaged, my baby is damaged, my baby’s dead, and I left my body. That’s a typical PTSD reaction, post traumatic stress, to such a traumatic situation. The medications took over, I got out of the way, I was somewhere else. And suddenly, I started pushing. I called for help, the doctor comes running and cuts a huge episiotomy screams for a vacuum. And he’s in a panic, and he vacuums out my daughter. And he was like, do you want to see the baby? And I’m like, no, I couldn’t handle seeing a dead baby. And he goes, your baby’s fine. So I was like out of my body. My baby’s fine. It took a long time. I wasn’t fine. It took a long time for me to process that. So that meant that, number one, if she legitimately needed an emergency caesarean, the hospital still wasn’t ready for that in an hour so we would have had a dead baby. Like if there was legitimate distress, or would have had an unnecessary severity because she was born screaming. She was vigorous. I would have had an unnecessary severity and had a healthy baby when there was no distress at all. And there was no consideration for my emotional trauma sensitive care, there was no consideration of my experience. It took me a while to go back to work. I definitely had PTSD, we have birth trauma. 

There are many organisations that like in the trauma of birth to a rape, very similar because it’s a very intimate, very scary, it’s involving intimate parts of your body, things are being done without your consent. I didn’t want the doctor to keep coming in every hour sticking his hand without talking to you. I was just so much there, but I could go into that. I was speaking to a friend and I was like, my hands are tied as a nurse. This cannot be the way people are supposed to have their babies, it’s not humane. I want to help other women so that they don’t have this situation. She says, why don’t you become a midwife? I literally said, what’s a midwife? I went to the library and I was like, I came home, I was reading, it’s like a whole different paradigm. It’s not like a birth is an emergency waiting to happen so that women know how to birth their babies. Their bodies know how to breathe, and their hearts know how to beat. We just have to get out of its way. And that birth was part of the home, normal life throughout most of history. A whole different paradigm. 

How do we support the normal, and most birth is normal, and that the countries in the world that have the best outcome are countries where there’s the midwives take care of normal, healthy, leaving the obstetricians to do what they’re best at their surgeons, they’re best at diagnosing and treating diseases complications, medically and surgically, but that high risk care is not serving the vast majority like the normal healthy, right? So when midwives are working as a team together with obstetricians, we’re getting the best outcomes. The United States has the worst outcomes of mothers and babies dying, or being severely ill from damage from birth. So when I went to midwifery school, I was like, I came home. So when I was pregnant with my next baby in midwifery school, I said, of course, I’m going to use a midwife. But I said, I’ve had such birth trauma. I didn’t know necessarily about PTSD like I do now. I was scared, but I believe intellectually in midwifery. I absolutely believe that my healthy body knows how to get hurt. I know it, but I have to viscerally feel it for me to go promote this. And I told her that and she says, she’ll be fine. You’re gonna see it’s gonna be so healing, and that birth was just so healing. Yeah, it was a totally physiologic normal birth.

Debra Pascali-Bonaro: Where were you? Where was that?

Anne Margolis: So it’s interesting. I was still, where was that you?

Debra Pascali-Bonaro: In a hospital.

Anne Margolis: Completely physiologic birth in a hospital. And it was night and day. So I think that once I felt that I could do that, then I was just on a mission. My first job as a midwife, so I have four kids. The other births were just so healing, and I was on this mission in my own practice to just help people have that experience in the hospital. I did do out of hospital clinical in a birthing center in New Jersey, and I just felt my first experience I wanted was, I was given a great job. It was a job in Brooklyn, a position in Brooklyn where there was called Doctor Midwife Team Care. And they modeled their practice after the UK where the doctors are, they’re just there for problems. Don’t even bother them. They knew that the midwives were taking much better care of the healthy normal, and even somebody with insulin dependent, diabetes, or high blood pressure would still benefit from midwifery care, but they would manage the problem. And we did vaginal breeches. We did twins, VBACs. It was just a great first job doing that for a while. Then I had my fourth baby, and then I was done commuting to Brooklyn. But I was so grateful for that experience. It taught me that you could still have a physiologic healthy birth in the hospital. Then when I didn’t want to commute, I was ready to start my home birth practice, which has now been almost 30 years. 

1997 was our first home birth. We started it from scratch. I started with a doula, and she became my nurse, and then she became a midwife, and we co managed that for about 10 years. We were still close with each, moved on in different ways. She’s going more towards the birth center and ongoing more towards home. I went more towards home. Home birth is really where I feel I can practice authentic midwifery. In the hospital, we were still able to, in that hospital, for example, but I didn’t want to commute to Brooklyn. So I was finding that the hospitals in my area I applied to, the difference was when I applied to Brooklyn in that hospital, they were like, we love midwives, welcome aboard. When I applied to some of the local hospitals, I was told in the privilege meeting, we’re not so crazy about midwives. You’re gonna have to follow the ACOG guidelines. Don’t go sneaking food. You can just tell a marathon runner to run without any hydration or eating nourishment. There were so many protocols that were just not authentic to me, and it was getting stricter and stricter. So I felt like practicing to have the moms most empowered, beautiful, sacred, transformative, undisturbed physiologic natural birth. I felt that the home setting was where I could really guide people best, and so that’s where I stayed for three years. I did some hospital shifts between here and there, and I would just go in and get everybody off the bed. I’m not gonna mention names, but there’s a hospital, there’s a lot of immigrants that go there, and they get free care. These women are coming from countries where they gave birth in their house, they just gave birth like they do. They breastfed. Their moms did that, their sisters did that, their aunts did that. So they have a very strong community support, and they come to America and think America is great. 

But I come and do my shift, and everybody’s in bed with an IV on the monitor. I would just take them off and get them off the IV, and we would dance. Let’s just dance this baby out. I still had the doctors in the back. I had to help people who were able to have a really home sweet home birth, like experiences in the hospital. It’s a lot more work today, especially in certain hospitals. You can’t go expecting a natural, physiologic, empowered, transformative birth where your hospital has a 50% or 60% cesarean rate, high rates of inductions. And everybody gets an IV. You’re gonna have a lot more fighting, respectful advocacy. I don’t want people fighting. Let me just tell you something, I had a mom, she contacted me in her rural area. She had an obstetrician who just doesn’t know about natural births. She took my courses, and she took my whole course, and she wanted to read my book. She wanted a totally natural, beautiful birth, but it had to be in the hospital because there were no homebirth midwives in her area. And she wasn’t going to give birth. 

She had this doctor who said she’s never seen what you’re talking about. They don’t teach us natural birth in our residency or in medical school, and everybody in my practice has an epidural. So I’m sure you’re gonna want an epidural. And he had a cesarean rate that was very high. 80%, I don’t remember. It was like crazy, very high rates of medical interventions and inductions, stuff like that. And I told her respectfully, you have your preferences and you just said that you’ve done your research, and you just want him to be a fly on the wall and not interfere when everything’s going well. And he’s gone. I don’t know how to do that. You’re going to need to find someone. But anyway, she convinced him. It didn’t have to be a fight. But she convinced him and went, she was prepared. She had a doula. She had a most beautiful experience in the hospital. Who do you think was brought to tears besides mom and dad? The physician? He’s said he’d never seen anything like that. I can’t change hospital policies. But if we have a passionate mom speaking up and advocating for themselves, you can even have that experience. The nurses were rolling their eyes, then she said, this is what she wanted, and she prepared for it. And it was possible for her, but I think it’s harder today.

Debra Pascali-Bonaro: It’s getting harder. You’ve given us from your own stories to all your wisdom and your experience so much, but I’m going to ask you to go deeper for all the people that are listening. I am going to have to respectfully advocate, or maybe change providers, or change place of birth. But I know you prepare people, you’re gonna teach us how to love their labor, love their birth. What are some tips you can give to people?

Anne Margolis: This is a whole part of my course. Today, we have to realize, we are living in the West. I don’t know the audience, but in the westernized culture. I’m not talking to people who live in countries like Sweden where it’s just the norm that everybody goes to a midwife if they’re healthy. I’m talking about if you’re living in a country where everybody pretty much goes to the hospital, and there’s a lot of fear around birth. We’re not even in communities, the internet. I have a love-hate relationship with it, but it’s not the same as a community. It’s not the same as being around everybody. Breastfeeding and home birthing, there’s a lot of trust in, I don’t know. Since COVID, there’s a lot of distrust. A lot of people just trust modern medicine and technology over themselves and don’t know anything about birth. It’s a practice, and it’s a mindset shift. Look at it as a dance performance, or running your marathon. I had a mom in labor tell me, this was like mountain climbing. She’s one of those professional mountain climbers who climbs these 90 degree angle rocks. And in the heat of labor, she told me, this is like mountain climbing. I’m not going to engage her left brain and have a conversation and transition to the hate of labor. But afterwards, I asked her, and this woman doesn’t wing it. She’s had a lot of training to do what she does. So you could say, if you’re telling me my body knows what to do, why do I have to prepare? You have to get your mind out of the way, and then sort of how to get your mind to work with you to tap into your sensual, tap into your primal. And so the reason she said that that it was like climbing a mountain is, she had a mindset of climbing the mountain. Not like that, I’m going to try this naturally. But if I need an epidural, I’m going to have it, I’m going to do this. So the same kind of thing. 

When you’re in a hospital and you have a mindset, I’m going to try naturally. And if I can’t, I’ll do an epidural. If an epidural is an option, and it’s given commonly, and a person is not using gravity on their back and given medications and things like that, it’s probably likely to happen. And especially if someone doesn’t have support, but there’s so much about the mindset like, I’m gonna do this, I can do this, I’m gonna find my strength, I can do hard things. She was climbing the mountain, she was climbing the mountain and she got to the top and she was like, I did this. And then she saw another mountain double the size and she’s like, okay, gotta eat more, gotta drink more. Things are hurting me a little bit, but I’m going to climb a mountain. I’m not going down. And so it was really her mindset. You ask any athlete and Olympic athlete, sports athlete with a lot of pros, it’s more mindset than the physical training than their physical acuity. Michael Jordan isn’t like that, I’m going to try to make the shot. He says, I knew I’m gonna make the shot, that’s why he gets all these points in the last seven seconds from three pointers. There’s no way she had this inner knowing. And people need to convince me, like, it takes time to have this inner knowing. You have to dig deep, what is your inner knowing? 

It can’t be just like an intellectual thing. You really have to spend time with yourself and educate yourself so that your body knows how to give birth. Women have the ability to give birth. All animals, their bodies know how to give birth. Humans, our brain gets in the way, especially in culture. So she’s climbing this double size of the mountain and things are hurting. She’s like, oh, my god, how am I gonna do this? And she finds her strength and gets up there. And then she sees something four times the size, so she’s exhausted, she’s done. The hardest part of labor where we’re done and we might say, I’m done. But she’s not going down, the baby’s coming out, the baby’s not going back up, labor is not going to stop. So to her, it’s like a non negotiable choice. She’s going to climb, and she finds her strength. We as women have to know that billions of women have done this before all of us. And when we’re in labor, there’s 300,000 on average women who have given birth before us, we connect to that power. So she found this power, the strength that was in her, and she didn’t even know she had it. And she just Google, that’s when the adrenaline kicks in whatever it was. But so much of it was her mindset because she just didn’t give up. I can do everything. Proud of myself and the strength she didn’t know she had.

Debra Pascali-Bonaro: Great analogy.

Anne Margolis: Yeah, I love that analogy. There’s so much educating yourself. There was a YouTube video that went viral a while back about this woman who was trying to poop, and then this person comes in and starts taking her blood pressure. Someone comes in and starts taking her labs, and someone comes in and measures the peristalsis of the poop coming out. And someone is asking her how much weight she gained since last week. And it’s very, very similar to what is happening in labor. Eventually, there were 10 people in the room. And then at the end, it was like, could she poop? So this is a biological process. I am very holistic and spiritual in my approach. We are not just a body. We are mind, body, heart and spirit. Our bodies know how to do it. But now, we have to put ourselves in an environment, and we have to prepare so that we can allow our bodies to know how to do it. We’re breathing, our hearts beating, our kidneys are working. And so birth is very much the same thing. The more that a person prepares and educates themselves, and sets themselves up with the support that will support this, then you’re more likely to succeed. Now, why do I say I love your birth? Because not everything is in our control. I always say to expect the unexpected. 

For example, I had a birth where mom wanted a water birth, and everything was around the water, everything like that. But she lived in a sort of loft, and it was a beautiful setting. But things weren’t happening in the different positions. We were trying in the water, and I just made the suggestion, you want to get out and try the squatting rope? And it was like, okay, well, the thing is, it was some modern, interesting kind of half, there were no doors. My squatting rope goes above the door, and then you have to close the door. Even the bathroom had these like two glass things you go in, I don’t know. There were no doors except to the boiler room, and so it just happened. So I put it in the boiler room, and it worked. She was rocking it in bed when the baby was coming in. She wanted this waterbirth, but the thing is, when you’re in labor, you need to kind of surrender. You make your preferences, and then expect the unexpected. So that could mean that you wanted to birth in this room, or that room, or you wanted to water birth. She had a water view. 

But sometimes, that means medical interventions aren’t evil. Sometimes, that might mean like, I had a woman who was just in labor on and off prodromal labor for five days. It was her first baby. By the time she needed to push, she was done. She was exhausted, and she kept vomiting her whole labor. So she was so dehydrated. And I said, I think if we give you IV fluids, you could do this. And in the beginning, she didn’t want it. But then it was just like, okay, I’ll take the IV fluid. And she had her baby. That’s selective use of intervention that enabled her to have her natural home birth. I still call that natural because, yes, the natural birth even if birth ends in a cesarean. A cesarean is a birth. And I encourage and it takes work. It’s not easy to love your experience. No, it’s easier to love your experience, actually. But not always. Some people have trauma if they don’t get the birth they wanted, if they ended up with medical interventions. But if you did everything, and those medical interventions are needed, and it’s given with trauma sensitive care, right? Gentle Family Centered Cesarean. Can we get to that place, that spiritual level where everything’s happening for us, not to us, and be grateful for all of it because it was perfect, because it was so beautiful.

Debra Pascali-Bonaro: You’ve given us so many nuggets, and I know that people are gonna say, how can I be in touch with you? What courses do you offer? Can you share how people can reach you and some of your offerings they can take advantage of?

Anne Margolis: I have my Anne’s Guide To Pregnancy, Birth & Postpartum, and includes newborn and breastfeeding, but it’s how I prepare the moms in my practice. It kind of came from one of the first interviews I had years ago, a woman who asked me for a doula. She was interviewing me. She happens to be in film and marketing, but she just loved my page on Instagram. She wanted to know, do you travel? And we would travel to San Francisco and be my midwife. And I said, no, I’d love San Francisco, but I don’t travel. We need to get you making a course, you have a course. How do you prepare people in your practice because I did not want to have to transfer someone who needed an epidural nor normal labor sensations not once. I have a 5% cesarean rate, 7% transfer rate to the hospital. How do you prepare? She is actually the one who encouraged me to make this sort of like, how I prepare people in my practice to inform them, to give them the tools that I feel that are most effective through supporting yourself postpartum, through birth and pregnancy. I have my natural birth secrets book, there’s a whole story about how that happened. But it’s a deep dive into the research if you want, deep dive into the discussion of the hot topics. It’s like a bible of all the holistic modalities of how to deal with heartburn, depression, insomnia, constipation, healthy living to have mind, body, heart and spirit, and just dealing with all the common ailments from the whole journey of preconception through postpartum and beyond. And that’s about 580 pages. So yeah, that’s why it’s not an audio book. It’s more like a reference book. But if people want to know what are the studies on home birth, or what’s the decision about, all these different things.

Debra Pascali-Bonaro: And then where can we find these? Can you share on your website?

Anne Margolis: My website is homesweethomebirth.com. And it’s not just for home birth, it’s having the home sweet home birth model of care, which is what I’m saying, the respectful, the compassionate, the trauma sensitive, the encouraging the most healthy outcome, mind, body, heart and spirit. Natural physiologic undisturbed, allowing that to happen, selective intervention if needed. But most of the time, I’m amazed how often we don’t have to do anything. There’s that, and then I’m a yoga teacher and have found that to be life saving for me. There’s a lot of research on how it can enhance, so many benefits from this conference in pregnancy to enable people to help themselves feel more grounded and balanced, master their inner calm and assume positions for active birthing, stuff like that. So I have online classes for that. The other book is The Trauma Release Formula, which is a whole other discussion. How I healed my birth trauma, a modality was so powerful to help other people heal the birth trauma, because you can’t heal trauma with talk therapy or medication. It’s a somatic relief. It’s like the trauma lives in our body, and the nervous system has to be reset. And there’s different techniques, EMDR, somatic experience, and conscious connected breathing. That book goes more into, people say I had such a traumatic birth, how can I get rid, heal from that and prepare for a better birth this time around? So I also do online coaching. So if people want to come see me in person, they can do that. But it’s homesweethomebirth.com, holistic, gynecology. And I do the breathing work for people.

Debra Pascali-Bonaro: Thank you so much. And for everyone listening, these are all in the show notes. I really hope you’ll visit Anne’s website, follow her. Anne, you give us so much wisdom. I totally have loved having this time with you. I’m sure everyone is really thinking about all that you’re offering and sharing. For those that are listening, please tag us. We always love to hear your favorite takeaways, what you’re thinking about in planning and loving your birth. And we thank you for joining us for this episode of the Orgasmic Birth Podcast. We always appreciate your rating and review of our podcast. It helps us reach so many others as well to inspire them. And we hope you’ll join us next week on the next episode of our podcast. Thank you so much.