In this episode, Sara confronts the topic of ethics in the birth space. Unfortunately, ethically objectionable things happen frequently in the birth space. Even more unfortunately, they are often not recognized as such. Using the explanations of ethical fading, Sara explores many ethically questionable things that have been justified to be regularly done during birth.   REFERENCES: Betrán, A. P., Torloni, Zhang, J., & Gülmezoglu, A. M. (2015). WHO Statement on Caesarean Section Rates. Bjog: An International Journal of Obstetrics and Gynaecology, 123(5), 667–670. https://doi.org/10.1111/1471-0528.13526 Betran, A. P., Ye, J., Moller, A., Souza, J. P., & Zhang, J. (2021). Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health, 6(6), e005671. https://doi.org/10.1136/bmjgh-2021-005671 Centers for Disease Control and Prevention. (2022a, February 25). Stats of the states - cesarean delivery rates. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/sosmap/cesarean_births/cesareans.htm#print March of Dimes. (n.d.). Total cesarean deliveries by maternal race: United States, 2019-2021 Average. March of Dimes | PeriStats. https://www.marchofdimes.org/peristats/data?lev=1&obj=1®=99&slev=1&stop=355&top=8 Maturana, H. R., & Varela, F. J. (1992). The Tree of Knowledge: the biological roots of human understanding (p. 247). https://ci.nii.ac.jp/ncid/BA04994769 Tenbrunsel, A. E., & Messick, D. M. (2004). (Links to an external site.) Ethical fading: The role of self-deception in unethical behaviorLinks to an external site.. Social Justice Research, 17(2), 223-236. https://doi.org/10.1023/b:sore.0000027411.35832.53    

After a two-year hibernation, Birth Words is being reborn! Season 2 of Birth Words will offer monthly episodes, plus a new twist... listen to this episode to find out more!   REFERENCE: https://socialworklicensemap.com/become-a-social-worker/what-is-social-work/   TRANSCRIPT: Intro: Welcome to birth words. Words are powerful. What are you doing with yours? In this podcast, birth doula and Applied Linguistics scholar Sara Pixton invites you to be intentional, reflective, and empowering with your language as we come together to honor those who give birth. Hello, this is Sara with Birth Words, and I am thrilled to be back in this podcast space with you. The last episode that I published of Birth Words was episode number 78 in June of 2021, so over two years ago. And since then, Birth Words has been in hibernation. I've still worked on a few things here and there, but for the most part, I've shifted over the last couple of years, my attention to other places. I did a lot of work as a birth doula, spent a lot of time on call, attending a lot of births, and just needed one less thing on my plate as I did that. Now I'm kind of shifting my rhythm again, and I am ready to come back with Episode One of Season Two of Birth Words. I am going to be working on Season Two at a little different rate than I did with Season One. Rather than weekly or bi-weekly episodes, I'm planning to release monthly episodes. So this is the August 2023 episode of Birth Words, Season Two. Coming into Season Two, I will be adding a new angle into the work of Birth Words here in the podcast and in other work on social media and elsewhere. I am starting another master's degree. And when I get a new master's degree, I just have to add it into my podcast work. Many of you who are with me from Season One may know that I, during Season One, was pursuing and then graduated from a master's program in applied linguistics. And that was a lot of where much of the content came from for Birth Words Season One. As I would learn about different topics in my applied linguistics classes, I would reflect on their application in the birth space, and then come up with episodes to discuss and think about the impact of language on the way that we give birth and the way that we experience pregnancy and postpartum. With my new master's degree, I will be building off of that work, always incorporating that background of linguistics. But now, I'm also going to bring to the podcast, the new perspective and understanding and knowledge that I gain during my work in my Masters of Social Work program. And we will incorporate the perspective of social work and healing talk throughout the coming podcast episodes. So briefly, I just want to share a bit about my journey and why I decided to get another master's degree. I likely mentioned at some point during the 78 episodes of Season One of Birth Words that my long-term plan was to work as a doula for a while and then go back to school, first for a bachelor's in nursing and then for a master's degree in nurse midwifery, so that I could be a Certified Nurse Midwife and be the care provider in that space, and catch new babies and watch and empower and support and love my clients as they brought new life into the world. And that is a beautiful dream. And I have watched many of my doula colleagues go on to choose a path in midwifery. And it is beautiful, and I am so thrilled that they act as care providers in that space. And the longer I worked towards it, and the more I was on call, and the more I attended births at all hours of the night, I realized that it was taking a big toll on my mental health and my family life to be on call, always needing to have my phone with me and ready to go to a birth at any time, and that the irregular sleep schedule is really not something that was going to work long-term for me to be in a mentally healthy place. And so, I decided instead to focus on mental health—my own by making a choice that will work much more naturally with my strengths and my own needs and family life—and one that will focus on the mental health of my clients in the future. So I'm pursuing a master's degree in social work to become a licensed clinical social worker. And for those who don't know, a licensed clinical social worker is one of the many different qualifications you can have to be a therapist or a counselor, meeting with clients. So I'm thrilled and look forward to that work, to be able to sit with my clients, especially those going through this childbearing journey, whether they're trying to conceive, and having difficulty with that, or whether they're facing challenges during their pregnancies, or in the postpartum time, especially as mental health becomes a concern for many people during that time. I am going to sit with my clients and listen compassionately to them and offer them the care that a therapist can offer. So like I said, Birth Words is going to evolve a little bit to incorporate some of that perspective that social work brings to the table and the work of healing talk. So stay tuned for that. I'll come back at the end of this episode and talk a little more about what that might look like. But my invitation for you now is to go back and listen to past episodes of Birth Words, Season One. I highly recommend starting with the first five episodes; they lay a pretty good groundwork for the work that we do throughout the rest of Season One of the podcast. They kind of help you to get an idea of what we're doing in this Birth Words space. And they're each only about 15 minutes long. So it's not going to take five hours of your time just a little more than an hour. And then, after you've listened to those groundwork episodes, it's makes a lot of sense to just skip around and find topics that are interesting to you whether that's infertility; or the word “deliver;” or what to do when somebody starts telling a birth horror story, and you're pregnant or giving birth, or supporting somebody who is; and many, many other topics. It makes a lot of sense to just jump around and find the ones that stick out to you after that. Here's a brief summary of Season One of Birth Words: Our words matter. Language is a meaning-making system. We make meaning out of these words, through our lived experience and the associations that come with the language that we've had during those experiences. Because birth, the act of giving life has historically been co-opted by the field of medicine, which is for treating the sick or the injured, the language surrounding birth has been affected. There's a lot of medical, paternalistic, and disease-related language that comes into this life-giving space. The power has been taken out of the hands of the birth giver too often and into the hands of the care provider. Too often, birthing women are treated like machines or broken in the way that we talk about them. There's a lot of industrial or machine metaphors or language that are used to refer to the process of labor and birth. This affects our experiences as birthgivers. And it affects our experiences throughout pregnancy and postpartum. The way that we hear and the way that we talk influences our beliefs and our feelings, and those impact the experiences that we have. So, Birth Words is, as the tagline says, “language for a better birth.” And I definitely want to include in there, pregnancy and postpartum as well. Birth Words is an invitation for those who are giving birth and for birthworkers to be reflective, intentional and empowering with their words. The invitation is to be reflective. To consider which words are ways of talking that I hear or use, don't center the birthgiver. Which words or phrases pathologize birth and treat it more like a disease than a life-giving act. The invitation is to be intentional. To choose words that center the birthgiver, and acknowledge that birth is a natural, physiological process; that pregnancy is awe-inspiring; and that postpartum is identity-shifting, and it's a magical time where support is needed and recovery should be the first priority. The invitation is to be empowering. Stop and think just a minute about how incredible pregnancy and birth and postpartum are. Growing a human. Bringing that human into the world through an orifice that stretches to accommodate life. Hours of the largest, most powerful muscle in the body contracting and releasing and changing its anatomy to have a large opening in the bottom of it for a baby to pass through. Growing and disposing of a whole organ as part of this process. Holy freaking cow. That. Is. Power. Let's make sure that the way that we talk acknowledges that power. As I mentioned, we're moving into a new space with Season Two, and there will be a new twist as I pursue my Masters of Social Work. I want to share with you here a definition of Social Work from socialworklicensemap.com, and the reference is in the show notes. The definition says, “social work is a practice-based profession that promotes social change, development, cohesion, and the empowerment of people and communities. Social work practice involves the understanding of human development, behavior, and the social, economic and cultural institutions and interactions.” That is just rife with opportunities to explore in Season Two: the social change that we're working towards in the space of pregnancy, birth and postpartum; the development that occurs among people and communities in that space; the cohesion—the coming together—of different professionals, different perspectives to support birthgivers; and the empowerment of individual people and communities. Birth is an opportunity for that, if we will work to make it so. This definition says, “social work practice involves the understanding of human development.” That is not just physical, but also emotional, mental health focus, and how our developing as people happens and affects our experiences during childbearing. Also, “behavior and the social, economic and cultural institutions and interactions.” There are so many social institutions, economic institutions and cultural institutions at play in the birth space. And we're going to be diving in and looking at all of those different topics in the coming season. But if you are a word nerd, and you're here for the language stuff, don't worry. We will still make sure there is a healthy dose of that. We're just adding in this social work perspective to expand and consider the perspective that social work and mental health focus offer to the work we're doing here at Birth Words. I'm really looking forward to this season. I hope that you are too, and I hope that you will join me again next month for the September 2023 episode of Birth Words. Outro: Did words play an important role in your birth experience? If you're interested in sharing your story on the podcast, go to www.birth words.com. If you're liking what you hear on the podcast, please leave a review on your podcast app. For more resources about harnessing the power of words to benefit the birth experience, visit birthwords.com

In this episode, Sara discusses what to do when family, friends, or others start telling birth "horror stories" at baby showers or in birthing spaces. She uses the framework of narrative analysis to offer ideas about constructive ways to respond in these situations. REFERENCE: Riessman, Catherine Kohler. Narrative analysis. Vol. 30. Sage, 1993.   TRANSCRIPT: Welcome. This is episode number 78 of Birth Words. Today we'll be talking about what to do when you're in a birth space or at a baby shower or any sort of event like that. When someone starts telling a birth horror story Intro: Welcome to birth words. Words are powerful. What are you doing with yours? In this podcast birth doula and Applied Linguistics scholar Sara Pixton invites you to be intentional, reflective and empowering with your language as we come together to honor those who give birth. The work of birth words is to elevate the language surrounding pregnancy, birth and the postpartum period. Nothing in this podcast should be taken as medical advice. Hello, welcome to today's episode. I have some news. I don't know if it's good, bad, exciting, interesting, or otherwise. But I will share the news as we start this episode. We are coming up on the end of the second full year of the birth words podcast. The end of June marks the end of the second full year of this podcast. And I have learned so much; I've loved connecting with guests; I've loved delving into lots of topics relating to pregnancy, birth and the postpartum period. And I've loved learning about hosting podcasts and connecting with people that way. And I'm going to keep doing it through this third year of the birth words podcast, but I'm going to be doing it less frequently. So the first year of this podcast, you can go back and listen to all of the episodes that were released. Every single week. Every Monday, a new episode came out. And then moving into the second year I went to a bi-weekly, every other week, schedule. So for the last year, I've been releasing an episode not each week, but every other week. And now moving into year three of the podcast I'm leaving this platform open as a space to talk about the importance of birth and language and pregnancy and language and the postpartum experience and language. But I'm not going to be releasing episodes on a predictable schedule. When there's a really important topic that arises naturally in my own experience, I will create an episode and share it with you. Or I have an opportunity to connect with a guest that I'm interested in sharing their story or their wisdom as it relates to the birthing year and the power of words, I will share it with you on this podcast. But the times in which these episodes will be released will just be a little bit less predictable or regular. So stay tuned. Please keep checking back in for new episodes. Please keep following me on Instagram and Facebook @birthwords or check out content at birthwords.com. But just know that it won't be coming quite as regularly. The reason for that is I am at the very beginning of an exciting journey towards becoming a certified nurse midwife, but I first need to get a bachelor's degree in nursing and then a master's or possibly a doctorate in nurse midwifery after that. So, my original bachelor's degree was an elementary ed. and then I got a master's degree in applied linguistics. As you know, I've combined information from that master's degree with my passion for birth work here in this podcast. And I've loved doing that. And I feel called to keep working on this, in this work, and to become a care provider and to give empowering, intentional, and reflective support to birthing families as a certified nurse midwife, but it's a long journey. There are a lot of classes that I need to take between here and there and I just need to shift my energy a little bit as I begin that path. So, there's my announcement, exciting and mixed with just a little bit of a slower pace here at the Birth Words podcast. Please keep checking back in. Now, I mentioned in the welcome to this episode that we're going to be talking about an important subject. What do you do if you're in a birth space… Or if you are at a baby shower… Or if you're just in a conversation with a pregnant person and somebody else and a birth story arises that is not the kind that will invite positive birth experiences. We call these birth horror stories or terror stories or you've heard people probably tell these sorts of stories that incite fear, or worry, or anxiety, lack of reverence and respect for the birthing process, whatever it is… Invite negative feelings about the birth experience. What do you do if you're in that space and you're kind of a bystander when this sort of story comes up? Unfortunately, this episode topic was inspired by a recent experience at a birth I attended with a client and I will not go into details for several reasons. But at that birth, a story was unfortunately shared that was not at all helpful to my client that she was laboring to bring her baby earthside. And the way that I responded, looking back, I don't think that I responded terribly. I also think that if I'd had weeks to ponder on it beforehand, I would have responded in a slightly different way. So, I'm taking this space to think through those sorts of experiences. With you. So that each of us, when we're in a space like that, can be ready to respond in a different way. Also, I want to backpedal just a little bit for another reason I chose this topic. Yes, it was inspired by this recent unfortunate experience. It was also inspired by the same conversation that made me want to pursue doula work four and a half years ago, after my son was born, when I was speaking with my friends on the playground and they said how, was his birth? And I said, “it was amazing. It was incredible. My body did this amazing thing and I felt so empowered… and powerful… and wow, I loved it. And I remember looking at my friends’ faces and the look of surprise that came across their faces because they weren't expecting a story of empowerment and awe and wonder from that birth experience. They were expecting one of these more negative stories like they'd encountered maybe at their own baby showers. Maybe by people in their birth space, maybe from their own mothers, or aunts or sisters or neighbors or friends. And I think that we really need to do some work to change the narrative of birth. Of course, there's a caveat that there are traumatic birth experiences. People do experience birth in a traumatic way sometimes, and I honor and hold space for that. I accept that as true and acknowledge that that is the unfortunate experience of some people. I also feel that there are many instances where stories are told in ways that amplify the negative rather than amplifying the positive and especially when the story is not someone's own, but is rather repeated for effect. For the “wow, can you believe that happened?” response. Those are the sorts of stories that I want to change. And of course, if people have negative or traumatic or difficult birth experiences, I am in no way saying that they aren't allowed to speak about them. But I am saying let's find the right space for people to have those conversations in a way that can be healing for all people involved. Okay, so, in many of these episodes, if you've been listening along for a while, you know, I kind of like to take a topic like this—birth stories—and specifically, disempowering or negative or traumatic or horror stories, and take a linguistic framework and meld the two and say, “what can we learn when we apply this linguistic framework to this experience?” So the framework—the ideas that I'm using today—come from a book called Narrative Analysis Catherine Kohler Riessman. And you can see the full citation for that work in the show notes. It is a Qualitative Research Methods series publication that is outlining the way to do narrative analysis. Linguists sometimes take narratives or stories and analyze them and break them apart into pieces and discover the whys and hows and wherefores of stories that people tell, of narratives. So, in narrative Analysis, the author, Catherine Riessman, begins by discussing what we do when we tell stories or narratives—what that process entails. And so, I'm going to read several quotes from her book, and after each quote, take a moment to stop and apply it to the experience of telling horror stories about birth. So, here's a quote from Catherine Riessman in Narrative Analysis. She says, “we do not have direct access to another's experience. Se deal with ambiguous representations of it: talk, text, interaction and interpretation. It is not possible to be neutral and objective: to merely represent as opposed to interpret the world.” She says that on page eight So here, Riessman is saying, we can't directly access and other people's experiences. There is necessarily… barrier is a bit strong of a word. A middle ground through which someone's experience travels before it comes to us. And that middle ground partially is language. It’s impossible, she says, to be neutral and objective, to merely represent an experience. Always, when we represent an experience, we are simultaneously interpreting it. So, applying this to the instance of, let's give an example of, you're at a baby shower and somebody starts to tell about, “Oh, when I had my baby 15 years ago, you wouldn't believe what… la da da da da. I don't need to fill in the blanks because that is not helpful. But let's say somebody launches into a story that is unhelpful, like that. This quote reminds us that both for the teller of the story and the hearers of it, there is a filter through which the story is being told, and a filter through which the story is being received. And of course, as a receiver of the story, we have no control over the filter that the teller of the story is using to portray and interpret the narrative. But we do have control over the filter with which we receive their words and we receive the experience. So, as Riessman reminds us, it is not possible to be neutral and objective as we receive or tell stories. Let's take that as an invitation as a hearer to say, “Okay, I cannot be fully, wholly, neutral and objective as I receive narratives.” So let's take the filter of being compassionate with the person telling the story, understanding where they might be coming from, but at the same time, understanding how we are, where we are—especially if I'm the pregnant person receiving this story. I need to be aware of how this story is impacting me. And if I need to step out and suddenly have an urgent need to use the restroom, or if I'm the friend of the person who we’re celebrating in this baby shower, and a story like this starts I could invite my pregnant friends to go to get something from the car with me. “Oh, I have something, I wanted you to come to the car with me. Come let's go grab it,” or to go to a bathroom break or to go get snacks to separate yourself from this experience that feels like it could be a negative one for you to receive. Okay, so Riessman goes on to say that as we are having an experience, we attend to that experience. We see what stands out as important. She says, “there is choice in what I notice: a selection from the totality of the unreflected on, the primary experience.” So the person who experienced the story to begin with, that is then related as a horrible, fearful story, has attended to that in the story. “There is choice in what I notice: a selection from the totality of the unreflected on, the primary experience.” To me, this acknowledgment that there is choice and what I attend to is important as a listener when I hear stories that come across as entirely negative. I remember that this person experiencing that had choice in what they noticed, and there were other things going on in that experience. And just because they're not represented in the retelling of the experience, doesn't mean that they didn't exist. So as a listener, who is hearing a story that is negative, as I remember that there were other things going on in this story, I can evaluate in that moment, the appropriate way to draw attention to those other things that had happened in that experience. Sometimes it might be appropriate to ask the person telling the story, details about other things that were left out. If all of the details that are being focused on are negative, you could ask for details about more positive things. For instance, if they're telling a birth story that has a lot of negative and fearful details, you could ask questions about, “oh, and what color was your baby's hair when he was born? And did you remember what he smelled like and who got to hold him first? And how much did he weigh?” Reminding the teller of the story that there were other things going on in that story and other details to attend to and then shifting the focus of the experience for the receiver. And you could do that if you were pregnant and listening to a story like this, or birthing and listening to a story like this, or if you're supporting somebody in that space, you can shift the attention to draw attention to the other things that were maybe not noticed or made important in the retelling of the experience, but certainly did exist in the experience, to draw the importance away from negative things that are being conveyed. And then, one last quote I wanted to reflect on from Catherine Riessman’s book about narrative analysis. She notes that in the telling of a story, “meaning also shifts in other ways because it is constructed at this second level of representation in a process of interaction. The story is being told that particular people. It might have taken a different form if someone else were the listener. In telling about an experience I am also creating the self, how I want to be known by them. My narrative is, inevitably, a self-representation.” So Catherine Riessman reminds us in this quote, that narratives are shaped by audience, right? That a story might be told in a certain way because of the people that are in that space. Sometimes a teller is aware of the audience and the impact that their story might be having on the audience. And other times they might be more careless about the impact that the story might be having on the audience. And there are ways that as listeners, or as less-direct listeners, like helper listeners—for instance, a doula who's in a birth space and hears a story being told that might be negative to the birthgiver—can maybe be attentive to how the story is represented and how that might impact the people in the space and whether there might be opportunities to invite the storyteller to be more considerate of who is in the space and how it might be impacting them. For instance, at the recent birth I attended, it was an anesthesiologist who was sharing a story that was really not helpful for my client. And I attempted to draw his attention to this by bringing my client’s experience to the forefront of the conversation. Where he had been telling a story about previous experiences that were negative and inducing fear, I brought my clients experience and what was going on there and now to the forefront of the conversation, which shifted the focus and reminded the anesthesiologist—hopefully, I'm not exactly sure how effective it was as far as whether it will shape the future conversation for him—but hopefully reminded him of who his audience was and how the story might be being received by that audience member, and why it's important to be mindful of the fact that when we tell stories, it's not just a one-way process. So those are some principles that I pulled from Catherine Riessman’s Narrative Analysis to consider this question of what we do when we're in a space, and a birth horror story is being told? It's important to recognize that we don't have direct access other people's experiences. Any story that is being told is being passed through a filter. And when we remember that you can help us to draw attention to other details, or other perspectives that may have existed in that story, or that may exist in a space where the story is being told, and shift them towards creating a new experience in a new time in place that is separate from the experience that's being told. I spoke with a few doula friends in advance of making this episode. And that was a repeated theme that came up, that sometimes stories are told about a different time and place. But something that we can do as support people, or even as birthgivers ourselves, is to draw the attention back to the experience that we are currently creating. And recognizing that it is separate from stories that are being told to us. It is unique, and whole and different. And it has its own life and is in the process of being created. And as we experience and then go on to tell narratives we can choose what we make meaningful in those spaces. And we are agents in those stories. We can fill in this gap between what's going on and how we tell it by focusing our own autonomy and being the tellers and the heroes of our own stories. Outro: If you're interested in sharing your ideas or experiences on the podcast, go to birthwords.com. If you're liking what you hear, please leave a review on your podcast app. For more resources about language for a better birth, subscribe to the monthly newsletter at birthwords.com and follow birthwords on Instagram and Facebook.

In this episode, Sara interviews pelvic floor PT Betty DeLass. Betty discusses the importance of normalizing pelvic health through talking about it! She also makes an exciting announcement about how she's working to improve the perinatal experience for *everyone*!    TRANSCRIPT: Welcome to episode number 77 of the Birth Words podcast. Today, I am thrilled to introduce you to Dr. Betty DeLass, a pelvic floor physical therapist who has so much good stuff to say. Intro: Welcome to Birth Words. Words are powerful. What are you doing with yours? In this podcast, birth doula and applied linguistics scholar Sara Pixton invites you to be intentional, reflective and empowering with your language as we come together to honor those who give birth. The work of birth words is to elevate the language surrounding pregnancy, birth and the postpartum period. Nothing in this podcast should be taken as medical advice. Sara: Dr. Betty DeLass is a concierge physical therapist in the Salt Lake City, Utah area. She comes to your house for each session. Her passion is to serve, educate and empower all of her patients to live life to the fullest. She is super passionate about everyone's journey along pelvic health and wellness. She treats women of all ages. She specializes in pelvic floor treatment of bowel, bladder, sexual and abdominal dysfunction, including incontinence, constipation, diastasis recti, preconception, pregnancy, postpartum pelvic organ prolapse, frequent urination, pelvic pain, painful intercourse or sexual activity, urinary urgency, urinary retention, and perineal tears. She uses a combination of an orthopedic physical therapy skill set with her pelvic health skill set to individualize your care. She provides local one-on-one concierge mobile pelvic floor PT, remote consultations, and out-of-town programs. You can find her on Instagram @drbettydelassdpt and on Facebook at Reborn Pelvic Health and Wellness. Her website is www.rebornphw.com. Welcome, Betty, to the Birth Words podcast. I'm just so thrilled that I get to talk with you about pelvic floor health tonight. I'm going to jump into some questions. And the very first one is, “Why do people, why do so many people, suffer needlessly with pelvic health issues?” Betty: All right, well, thanks, Sara, for having me on here. And I'm just as excited too, so I guess we'll just dive right into those questions. And so I think there's a variety of reasons why people suffer needlessly. I think the biggest thing is just awareness that there is pelvic floor therapy and other therapies that can help with all different sorts of things regarding birth and the pelvic floor. So, I often classify this into five phases of pelvic floor health and wellness. And so, there's five different stages of pelvic floor awareness that you can be in. So one would be people who are like, “what is the pelvic floor? I don't even know what you're talking about.” They have no clue. So it's more of that awareness part. Second group of people would be, “I've heard of it, I know what the pelvic floor is. You do kegels, right?” And so that's kind of another class of people. And then the third class would be, “I've been, I've been dealing with some stuff down there, I've Googled some things. I don't know why these kegels aren't working. Maybe I need some help in this area. No one's really addressing this leaking. I still have pain with intercourse, I've got some nagging, low back pain. And sometimes, you know, I just don't think this is normal, maybe there's something I should do.” And they've heard maybe from a friend or a neighbor, or a parent or something, “oh, you should maybe look into some pelvic PT.” So that's another classification of people. And then after that, there's the people who have done pelvic PT, and they're like, “oh, my gosh, this has changed my life.” And they just want everyone else to know about that. And then the fifth category of people that I would classify in that pelvic health and wellness journey is kind of just continuing with their optimal health and wellness and doing things in life without leaking without pain and enjoying and challenging their body in many different ways that maybe they didn't even think were possible. So those are the stages: the five phases of pelvic floor health and wellness, if you will. And I think so many people are in those one through three phases, and they just don't know, they just don't know. And so, that's kind of my life mission is to just spread that word of hey, we're here. We're here to help, and we're here to help you experience all of the goodness of life that you can do without leaking without pain without, you know, dysfunction and all that stuff. Sara: Yeah, that… I mean, it was a little bit of a leading question, because I think that absolutely… many people just don't know. And why do they not know about pelvic floor muscles, pelvic health? It’s because we don't really talk about it that much. I mean, you talk about it all day long. Betty: Yeah. Sara: Outside of people who are actively seeing and seeking help from pelvic PTS, it's often not talked about. So clearly, though, there's a need if there are so many people that have issues that could be resolved… you told me stories when we were talking before about, clients that you worked with, who after four visits totally changed their urinary incontinence, right? Betty: Mmmhmm, mmhmm, yep. Sara: Things can happen if you just know where to turn for help and what questions to ask, but you have to open the doors to conversation. And that's…  Betty: Yep, absolutely Sara: …why I wanted to talk to you on this podcast, where we talk about the importance, the power of language and words, and just having conversations about these things is huge. Betty: Mmmhmm Sara: But… Betty: Absolutely Sara: …it's maybe not something that everybody's ready to just start talking about. So how do you introduce this topic of pelvic health and how important it is? To people who don't feel comfortable talking about it? Betty: Great question. So I I love, love, love this question. So I there's many different things here too. So oftentimes, I'll say, “Okay, we go to the dentist a couple times a year for preventative health, right? We go to the doctor, we go see a massage therapist, we go to the chiropractor, we do all these other things. And we should also do the same thing for our musculoskeletal system? Why wouldn't we go and get just a full body examination of how are we moving, how is our strength, how's our coordination, how's our range of motion, and kind of address those things from a preventative wellness standpoint.” So that's one area to kind of just think about. Another area too, is we should be doing self breast exams, we should be doing, you know, getting regular pap smears every three years, I think that's the current recommendation. And then shouldn't we also probably do, you know, an internal pelvic floor muscle exam as well, just to make sure things are working optimally? And then another point on that, too, is, oftentimes, if we have… tear our ACL, or we tear a rotator cuff, and we go and have surgery on those things, what do we do after that? We do rehab. But we grow human beings, and we give birth, and we're just thrown to the wolves. “Six weeks, you're good, go back to doing everything, you're clear.” And it's like, “whoa, whoa, whoa, wait a second.” We do so much more for so many other body parts of our area, or areas of our body, that it's like why, why aren't we doing this? And it's really sad, especially in America. I think the tide is shifting a little bit and the pendulum swinging the other way. But in Canada, in Europe, the standard of care is 12 pelvic PT visits postpartum, off the bat, that’s what you get. And so I would love, love, love to see that here in the United States. And I think that’s shifting too. The people who are a little bit more proactive about it, are actually doing, you know, pelvic PT in preconception pregnancy and postpartum, because on another note that I want to make too is, we know with research that if you were to go have a total knee, or total hip replacement, and you're prepping for something, and you do what's quote, unquote, called “prehab.” So you rehab before you had the surgery, you actually have better outcomes, post-surgical. So why wouldn't we apply that to our pelvic floor? Let's do it. Right? So I very much like to focus on that of the upstream side of things of, “Let's do preconception appointments, let's do pregnancy appointments.” And then we have a better understanding going into birth. And then also, can we work on a couple things so that our birth outcomes are better? Because I've also seen people too, that have had, you know, C-sections that weren't quite planning on it. But then after the fact, it's like, wow, your pelvic floor was super, super tight and elevated, and you had no idea and so that might have, you know, had we worked on that ahead of time, could it have prevented a C section? Possibly, right? I can't guarantee anything, but the conception of… the concept of that is, is valid, right? So I think at all those points, it's just, we have, we have, we should just treat that like any other part of our body, right? There's muscles down there. But it's just like you said, it's not talked about or it's a kind of taboo. We poop and pee every day. We also brush our teeth every day. So if we're taking care of one end of our body, we should probably take care of the other end, too. Right? And so it's just normalizing that conversation and having, you know, having conversations about it and talking to your friends about it. And if someone says, “oh, yeah, I just, you know, cough and sneeze and pee my pants. It's okay. It's just normal.” It's like, “wait, wait, wait, no, it's not normal. It's common, but not normal, let's… you can do something about that. And, and just having those open, honest, real conversations with each other, and, you know, in front of other people in front of your kids talking about it earlier. I think that's a key piece, too, is just normalizing that. We talk about kids and babies poop all the time, like, “oh, did you see that color? Oh, that was uh…” You know? We shouldn’t stop, just keep talking about it. Right? It's normal. So, normal human body functions. Sara: Yeah, I love that normalizing. I love how you talked about all this preventative care that we do for other parts of our bodies. And that point that you made about the rehab/physical therapy, if you tore your ACL or whatever, what different kinds of training you would get, compared to if you birthed a human out of your pelvic floor. Betty: It just, it just doesn't make sense. Whether it's your C section, both of those are, you still grew a human being, it was still on your pelvic floor, and your abdominal wall is attached, fascially-speaking, to your pelvic floor. So it's all of those things. We definitely need to rehab those if not prehab them as well. Sara: Yeah, and I love your point about, “at what point are we not allowed to talk about these things anymore?” And obviously, privacy is something that we should honor. But I also just love saying, yeah, talk about this with your friends. I feel like, as I've come deeper into birth work, that's something that I'll be in a group of women and someone will be like, “Okay, I know, this is kind of TMI, but have you ever used a menstrual cup?” or whatever. And I'm like, “I love menstrual cups. Let me talk to you about it,” whatever the topic is. Betty: 100%, yes! Sara …that comes up, right? And to not be like, “Oh, that's not TMI. That's actually something really cool that I want to tell you about this one that I tried, and this one that didn't work as well,” or whatever. Betty: Mmhmm Sara: And I also thought of this story that I thought you might appreciate. So I'm going to share. Betty: Yeah, absolutely. Sara: So I'm currently taking prerequisites for nursing school so that I can go on and become a certified nurse midwife. So I was taking anatomy, I'm getting a second bachelor's degree, and I'm just in this 200 level anatomy class randomly given a partner to do homework with and he's, I don't know, somewhere in his 20s year-old man; he's a newlywed. And we're learning about, I think, the female reproductive system. And during… we watched the lecture virtually because of COVID policies being different. So we're watching the lecture virtually together. And then we're supposed to pause and teach and question each other throughout the lecture. So, to make sure that we're understanding what she has just taught us what our professor’s just taught us. And our professor had mentioned something about how after birth, often, people struggle with urinary incontinence and those sorts of things and pain, sometimes. And so, during my little chat with my randomly-assigned 20-year-old newlywed guy that I'd never actually met in person, it was like, “just so you know, if you go on to have a baby, and your wife has trouble afterwards, with urinary incontinence, or any sort of pain or dysfunction, or whatever, she doesn't have to suffer, she should reach out to a pelvic floor PT, even though it's common, it doesn't mean that should happen. There's so much that you can do.” And he was like, “Okay, thanks for the infomercial. Moving on.” Betty: I love it. I love it. I love it. Yeah, it's so good. And if you don't mind me interrupting you, Sara: No, please! Betty: I believe that is just absolutely wonderful. And I often think of that, too. Even if people aren't receptive to hear, you know, they're like, “Okay, you can get off your soapbox. It's all good, I heard ya.” Or they're just not interested. I just think of it as kind of like seed planting. You just don't know yet. You're gonna hear this, this little conversation, and maybe five years from now, 10 years from now, you'll be like, “Oh, I see.” And it just becomes more important at that part of that person's life. So the more we just talked about it and the more we’re like, “Hey, this is an option….” The more seeds that get planted, the more awareness that is out there, the more people actually know that you have a pelvic floor, right? Sara: Yeah, I feel like I can totally be a witness for that, too. Because I can look back at the times of, “oh, this conversation planted a seed.” And maybe it was kind of like, “why are we talking about this right now?” Betty: mmhmm Sara: But, planted a seed to normalize that this is something that we talk about. So… Betty: Yeah, absolutely. Sara: Then I knew who to open up those conversations with later when I realized how it was relevant. And then I knew to start talking about my pelvic floor health and just other similar, related topics. Betty: Absolutely. Sara: …to be a seed planter. So Betty, if you could design the ideal prenatal to postpartum comprehensive care program, what would it include and what role would pelvic floor PT play? You've started talking about this. So this is just, what do you want to add to what you've already said about this, and how can we work to make that dream a reality? Betty: Oh, I have so much to say on all these questions. I'll try and keep it brief. So in a nutshell, a little birdie is telling everyone a secret who's listening to this, I'm actually working on creating an online program that is, is pelvic floor PT focus, but holistic in nature, from my pelvic PT perspective. And so, included in that will be some holistic things of like nutrition, mental health, spiritual health, and then coming around with breath work and the nervous system and the fascial system, and how to do some mobility exercises, how to do a self-exam on yourself, do a self-screening. There's all sorts of things that I'm putting in this comprehensive program, if you will, that can be used at any point in time of life, whether you're, you know, before kids, during pregnancy, after pregnancy, later on in life, when your kids are all older and grown out of the house. It doesn't really matter. It's never too early. And it's never too late. In my view, the sooner the better, great, but you can…  the oldest person I've helped was 92 years old. So it's totally possible to do it later, too. So, kind of bringing all those things that I have acquired knowledge-wise, throughout my clinical practice, and then also just personal experience to kind of blend it in there as well. I've had two kids myself. And so I'm super, super excited to have that be out in the world and available so that everyone can have access to it. Because honestly, I can only treat so many people in a day or a week. And there's so many people who do that. And there's there is not enough pelvic PTS to go around for the needs. I mean, literally every person walking on the planet has a pelvic floor, including men. Right? Sara: Right. Betty: So that's kind of what I'm working towards. And then, making that a reality is just letting you guys know that it's going to be coming. And stay tuned for more details of when it's out and ready to be purchased. So I don't have a date on that yet. But you can spread the word a little bit that it's a work in progress. So Sara: Yes, I'm so glad I asked, so I know. It was a hypothetical, “if you could…” and you're like, “well, actually, I’m currently doing that.” I love that. How do we make sure that we're updated when this happens? How can we follow you? Betty: Yeah, you can follow me on social media is probably the best way. Instagram is my primary mode of social media. So you can find me @drbettydelassdpt, and that's Dr. B, E T T Y D E L A S S D P T. [***UPDATE: Dr. Betty’s new handle is @rebornpelvichealthandwellness.***]  And then you can also find me on Facebook at Reborn Pelvic Health and Wellness. I do have a website, which is also www.rebornphw.com. And that is currently almost ready to be published. So it'll be announced on all three of those platforms once I get there. I don't know, I don't even have an estimated timeframe frame. But my goal is before the end of the year to have that out into the world. So I'll put that out there in the universe. And we'll see. I'll hold myself to it. Sara: And I love that because you're based in Utah like I am. But my listeners are all over. And so I love that they can follow you find out some of the awesome goodness that you're sharing with the world without being local, since they can't actually benefit from receiving care from you. So that's awesome. Betty: Yep, so I also have people from all over. So, we've moved all over, through the years, throughout the United States. And so that's important to me to be able to reach other people. I also do offer other options too, for people to work with me, not only locally, I do a concierge service. So I go to people's houses. And then I also offer remote online consultations where we can help work on making a plan of how do we get to the right providers and get you started on a couple of things in the right direction to optimize and know what questions to ask your provider so that you're getting to the right provider at the right time and not jumping from one person to the next person, the next person searching and searching and searching and not getting answers. So I do offer that to people who are outside of the Salt Lake City, Utah area. And then I also do offer an intensive, out-of-town program. So if someone were to really, really want to work with me from outside of Utah, they can travel here, and then I can come to their hotel room or if they are staying with a friend or whatever. And that, I do two hours a day of treatment for a week long. Sara: Wow. Betty: Yeah. And so I can do that as well. If people are like, “Oh, I really want to work with you.” So you have to be pretty committed for that one. But it's totally doable. And I do have a couple of people that do a little bit longer sessions that are even three hours away from Salt Lake City. They'll drive in here and we'll do a two-hour session. And then they'll come back in a few weeks, and we'll do another two-hour session. So we can mix and match a little bit of whatever works for you and what's going on. So there is opportunity to work with me, even if you're outside of Salt Lake City area. Sara: That's awesome. I love that you're being really creative and thoughtful about how you can reach beyond where you can physically reach. That's awesome. Betty: Absolutely. Okay, I just have one last question for you. I know this is kind of a whirlwind. And we all want to hear more. So I'll have to have you back on once you launch your comprehensive care plan, and you can give us all the details once it's ready. Betty: Sure, I’d love that! Sara: But for today, last question, if you could choose just one word to describe pelvic floor health and your feelings about it, what would it be and why? Betty: This is such a hard question. This is so hard. It's so hard to pick one word. Let's see. Let's just go with “necessary.” Sara: Oooh Betty: It's just totally necessary. Yeah, I think that sums it up pretty well. Sara: Awesome. I love it. And that is what the name of your episode will be with a subtitle to give more information about what we talked about during this episode. But they'll know just from looking at the first word that pelvic floor health is necessary. And that is what we've been talking about today. Thank you so much for taking a little bit of your time and talking about this necessary work. Betty: Thank you so much, Sara, I enjoyed this so much. Outro: If you're interested in sharing your ideas or experiences on the podcast, go to birthwords.com. If you're liking what you hear, please leave a review on your podcast app. For more resources about language for a better birth. Subscribe to the monthly newsletter at birthwords.com and follow Birth Words on Instagram and Facebook.

Sara summarizes fetal hearing development, then describes the benefits of talking to your baby during pregnancy--for both you and baby! REFERENCES: Nelson, Lauren J., and Anthony F. Fazio. "Emotional content of talk to the fetus and healthy coping behaviors during pregnancy."  Infant Mental Health Journal 16, no. 3 (1995): 179-191. Moon, Christine, Hugo Lagercrantz, and Patricia K. Kuhl. "Language experienced in utero affects vowel perception after birth: A two‐country study." Acta paediatrica 102, no. 2 (2013): 156-160. TRANSCRIPT: Hello, welcome to episode number 76 of Birth Words. Today's episode is especially for expectant parents, and we'll be talking about why you should talk to your baby in utero. Intro: Welcome to Birth Words. Words are powerful. What are you doing with yours? In this podcast, birth doula and applied linguistics scholar Sara Pixton invites you to be intentional, reflective, and empowering with your language as we come together to honor those who give birth. The work of birth words is to elevate the language surrounding pregnancy, birth and the postpartum period. Nothing in this podcast should be taken as medical advice. Welcome to today's episode. Expectant parents, this is especially for you. Any other birth professionals who are listening, feel free to stick around, but I'm addressing this episode specifically towards expectant parents. We'll be talking about why you should talk to your baby during pregnancy. So, for some background developmentally on how and why and when you should start talking to your baby. During the second trimester, earlier on in the second trimester, is when baby's hearing starts to develop. And at first, you are the only one who your baby can hear. Because rather than being able to really hear in the same ways that we do, the hearing that baby can do initially is just this body-to-body connection. So you carrying your baby, speak to your baby, and that makes vibrations within your body which your baby begins to recognize as sound, and begins to understand what that means and starts to have experiences with hearing through that body-to-body sound vibration that can only happen between you and your baby. At this time, anybody else who speaks to your baby, your baby won't be able to hear them. But as their hearing continues to develop throughout the second trimester, that will shift, and at that point, they're able to hear outside of your body. So your spouse or your partner or your parents or friends who speak to your baby, your baby will begin to be able to hear sounds that are exterior to your body. So there's a little background on the development of hearing in utero. So, why would you want to talk to your baby while they're in utero? Well, one reason is that it can help to facilitate bonding with your baby. It can be difficult sometimes to form a relationship with somebody that you can't even see, though you can feel your baby growing inside you and developing, especially as they get larger, but talking is another thing that you can do to facilitate bonding with your baby. So this can look like a one-sided conversation in which you could fill in for your baby's talk. Or imagine what your baby might be responding, where you just say, “Good morning, Baby, how are you feeling?” And you could speak to them by their name or Baby, or whatever feels comfortable to you. You could narrate your activities. “We're gonna go for a walk now, do you like that?” And have these conversations with your baby. And you'll notice that these are the kinds of conversations that you may sort of have with your baby after it's born. Because even once you're able to see your baby, he or she will not be able to respond to you for at least a year. Linguistically, right? So this is one way to start. Now, for many people, that feels a little bit uncomfortable, though. For some people that feels totally great and natural to have these conversations with your baby in utero, but for some people that feels a little uncomfortable. And so there are other things that you can do instead of talking specifically to your baby in this sort of one-sided conversation. One is that you can read aloud. Whether that's children's books, or whether it's your textbook for a class that you're taking, or a work document that you're reading, reading aloud still gives your baby the opportunity to hear the sounds of your language and start to become accustomed to what language sounds like and develop in that way. And then, of course, if you are speaking with others around your baby, obviously, if your baby is in your body, then anybody that you're speaking to is also around your baby, and your baby can also hear those conversations as well. One reason that it might be useful to have the sorts of conversations we were initially talking about where you're directing talk towards your baby, is that back in 1995, Nelson and Fazio, some researchers, found and published their findings in the Infant Mental Health Journal—which I will link to in the show notes—they found that pregnant parents tend to engage in positive talk with their unborn baby. They had parents record the sort of talk that they did with, as they spoke to their baby in utero. And they contrasted that with their self-talk—what they would say, to and about themselves—and found that that tended to be more negative. So we know that it's helpful to stay more, a lot more often, in a space of positive talk, and having the opportunity to have these conversations, one-sided conversations with babies tend to be more positive. So it's an activity that you can engage in that is likely to be a positive one for you, in contrast with perhaps more negative self-talk. Of course, those are generalizations and just the findings of these researchers with that specific study, but it's something to consider as we're thinking and being mindful about the talk that we give towards our babies in utero, and the talk that we give to ourselves. Clearly, both you and your baby are worthy of positive talk. So, be mindful and purposeful about the way that you speak to yourself as you carry this baby and the way that you speak to that baby. So, so far, we've talked a bit about why talking to your baby is a positive thing to do during pregnancy for babies’ hearing developing and facilitating this bonding relationship with you and having positive impacts for yourself as you engage in more positive talk. But, more recently, some other researchers in 2013, Moon, Lagercrantz, and Kuhl, found and published in Acta paediatrica—again, I will link to that in the show notes—they found that from the newborn stage, babies do recognize the unique sounds of your language, in contrast with other languages. So, before this research was done, it was thought that through the first several months of the child's life, they begin to differentiate between sounds that are only present in their parents’ language versus sounds that are found in other languages that they haven't had exposure to. And while that's certainly the case, that that is a differentiation that occurs both receptively and productively throughout infancy, it's also the case, they're finding, that even before birth, babies are able to begin to differentiate between sounds that are found in the language that they've been exposed to most—the languages of their parents that they've been surrounded by—and other languages. And you may wonder, how on earth do you test something like that? You can't ask a baby, “hey, have you heard of this vowel sound before?” What they do is they have pacifiers in these babies, and they watch their sucking speeds, and different speeds indicate novelty versus something that's familiar. And so they found that when they expose them to vowel sounds, specifically of the language that they'd been exposed to in utero, they reacted in a way that said this with their sucking on the pacifier in a way that showed the researchers that these sounds are familiar to me. And when they were exposed to unique sounds that they hadn't heard, that were only found in other languages, those vowel sounds elicited a different sucking response from the infants that indicated to the researchers that this is novel. This is new. I haven't heard this sound before. And even from the very early days of life, those differentiations were present, leading researchers to believe that in utero—before they're born—is when this differentiation begins. So you are a language instructor for your baby from the moment your baby's hearing starts to develop, and they hear you speaking with others, as their language con- - as their hearing continues to develop, you are giving the first language lessons to your child as you simply speak to others, to your baby directly, or as you read aloud, or do- - engage in any other sorts of speaking activities. You are your baby's very first language instructor, teaching your baby the language that they will, after they are born, grow up to learn and speak, and converse with. So that's pretty cool and powerful. And of course, as you continue to talk to your baby after birth, it encourages linguistic development, which in turn leads towards gaining literacy skills in later childhood. So we talked before about how something you might do as you're speaking to your baby in utero, would be to just narrate your day. “Now we're going to go for a walk. Are you excited?” And when you do those same sorts of things with your infant, and with your toddler, you're encouraging their linguistic development and their literacy development as they recognize the symbolic meaning of words, the power and ability of words to communicate. And seeing you model that behavior encourages them to engage in it themselves as they grow and develop. And that growth and development starts not from the moment of birth, but from even earlier, in the second trimester as hearing begins to develop. So I hope this has given you some food for thought, some things to think about with regard to language development, and positive talk and bonding with your baby, and all of the many great reasons to engage in talking with your baby. Outro: If you're interested in sharing your ideas or experiences on the podcast, go to birthwords.com. If you're liking what you hear, please leave a review on your podcast app. For more resources about language for a better birth, subscribe to the monthly newsletter at birthwords.com and follow Birth Words on Instagram and Facebook.