Elaine Welteroth on Planning a Joyful Birth, from The Second Opinion

Dr. Sharon Malone 0:00

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Intro 0:02

seconds, welcome to the journey to launch podcast with your host Jamila Souffrant as a money expert who walks her talk she helps brave journeyers like you get out of debt, save, invest and build real wealth. Join her on the journey to launch to financial freedom in 54321,

Jamila Souffrant 0:33

hey. Jamila Souffrant here, host of the journey to launch podcast, and I want to share something special with you. I found a podcast that has been invaluable to me as a resource as I try to navigate America's fraught health care system. As a woman of color, on the second opinion with Dr Sharon women take back the conversation on health with straight talk, real experience and the care we all deserve, hosted by Dr Sharon Malone, a leading OBGYN and perimenopausal expert with over 30 years of experience, this weekly show features prominent female advocates, experts and patients just like you and me. They share how they confronted gaps in our healthcare system and got or created second opinions that save their lives. And you know, on this show, we talk a lot about building wealth and financial freedom, but your health is a critical part of that journey. Medical costs can derail even the best financial plans and the ability to advocate for yourself impacts everything you do and how you enjoy the life you're building, understanding the health care system and taking charge of your well being isn't just about feeling good, it's a powerful financial move alongside each guest, Dr Sharon tackles the questions and topics we've been conditioned to ignore, the ones we search for at 3am but never bring up at the doctor's office, from dismissed symptoms to systemic failures, she pulls back the curtain on what's really going on in women's health and gives us the tools to advocate for ourselves and each other. Right now, you're about to hear an episode from the second opinion podcast. In this episode, Dr Sharon talks to former Teen Vogue Editor and journalist Elaine welteroff. When Elaine first became pregnant, she imagined the birth she saw depicted in television shows and movies, joyful, safe and supportive. But after eight different doctor visits and no luck finding the right type of care, Elaine pivoted to Midwifery, where she found the comfort and support she was seeking. She discusses her birthing journey, how she's working to make birth joyful again, and how her new nonprofit birth fund is helping families get access to life saving midwifery care. Okay, here it comes. You can get more insights into your health on the second opinion with Dr Sharon Malone, wherever you get podcasts Now, let's listen in

Elaine Welteroth 3:04

when I found out I was pregnant. It's actually so it's funny, I was so deep into the pandemic mindset that I read my and I was in shock when I got my pregnancy test results. That I looked at the pregnancy test, and I went, oh my god, I have covid. And then I went, Oh, no, this is so much worse than covid. This is so much worse than covid.

Dr. Sharon Malone 3:28

This is gonna last a long time.

Dr. Sharon Malone 3:36

This episode was brought to you by alloy health and rivian, although I spend a lot of my time talking about menopause, believe me when I say I know my way around the delivery room, because I have delivered more than my share of babies. Today we're discussing our guest journey around birth, planning what she thought would be a hospital birth ended up being a journey into something else altogether. Elaine Walter Roth is here to talk about how she wants to make earth joyful again. Okay, so let's do a quick intake. Elaine, you are a New York Times bestselling author of more than enough award winning journalist. You are the mother of two, and just welcomed your second son into the world last November, your first home birth experience with midwives completely changed your perspective on birth, your body, your agency, and changed your entire life and now you are the founder of birth fund, a maternal health nonprofit that advocates and invests in midwifery care. Welcome, Elaine, thank you for having me So Elaine, you had an unplanned pregnancy with your first correct I did doctor. And you know what? Let me just say, I'm a big fan of unplanned pregnancies, because I have a feeling that I was probably one myself being baby number eight with the last child being sick. Seven years before me. Wow. I have a feeling my mother was expecting menopause, and she got me instead. So wow, woo hoo for that. So that's a very special child.

Elaine Welteroth 5:08

I love that. See, good things can happen on the other side of accident.

Dr. Sharon Malone 5:12

See, you never know. You never know. So let me ask you, what did, what was your plan? If this was unplanned, what were, what were you thinking? You know, it's a good

Elaine Welteroth 5:21

question you ask. I don't know if we had a plan. Our only what I can say is this was not the plan, okay, but we didn't necessarily have a plan in terms of family planning, and it's so interesting because you plan every other aspect of your life to a T, your career, your next moves. We had just moved from New York to LA in the middle of the pandemic. I had this new job on television. Was working every day and going back and forth across the country. I mean, I just, I would, my plate was so full. The last thing I was thinking about was getting pregnant and having babies. I think it was, if anything on like a five year plan, like one day, it'll happen. I knew I wanted to be a mom one day, but just not that day. And so when I found out I was pregnant, it's actually so it's funny, I was so deep into the pandemic mindset that I read my and I was in shock when I got my pregnancy test results. That I looked at the pregnancy test, and I went, Oh, my God, I have covid. And then I went, Oh no, this is so much worse than covid. This is so much worse than covid. This

Dr. Sharon Malone 6:33

is gonna last a long time.

Elaine Welteroth 6:37

So that just tells you a little bit about my mental state, I was in complete shock. And I think no one tells you to prepare for the identity crisis that can hit when you find out you're pregnant before you had planned on it at any stage of your life. You know, I think there is this idea that if you're a teenage mom, okay, then oh my gosh, it's this huge, life altering thing that can change all your plans, but frankly, at any stage of your life, at any stage of your career, it can still really, you know, send you for a loop. And so I was, I felt clueless. I didn't know where to start. And I thought, Okay. When I was getting my bearings, I was like, Okay, how hard can this really be? People have been doing this for generations. People with a whole with a whole lot less, can figure this thing out. Yes. And I was doing my Glenn and Doyle, we can do hard things, Mantra, and so yeah, I the first step I thought is, let me just find a doctor, like everyone else has done. I texted some friends, asked for some recommendations. I live now in LA access to the best doctors in the world, as they say, and so I set out to find a doctor, and I found it much harder than I thought to find a doctor that made me feel safe,

Dr. Sharon Malone 7:53

you know? And it's so funny, because my birth story would be the exact opposite of yours, really. I think there was probably not one aspect of my pregnancies that I didn't plan from Okay, now is a good time. I'm done with residency. I actually was delivered by one of my partners, so I had a, you know, a long standing relationship with my doctor. She was a friend, she was a mentor. So coming into that really feeling safe and secure. And I picked the days that I was going to deliver, because when you are when you're in obstetrics, what you learn is that you don't want to inconvenience anyone. So I wouldn't just want to leave that to chance. And plus one of my partners was going to be delivering me. So we'd look at the calendar and say, Okay, so my due date is May 30, so I think we should do this. It's Memorial Day, wow. And we planned every delivery except the last one. But, you know, it just goes to show you, there's all different ways to come to this. Yeah, but at the end of the day, we end up in the same spot, yep. And so now that you that you had sort of gotten used to the idea, okay, there's a baby, yes. What did you think your delivery was going to be like? What did you plan you were looking for this doctor?

Elaine Welteroth 9:15

Yeah, yeah. I thought I was going to find a doctor, fall in love, hopefully with the doctor, deliver my baby in the hospital like my grandmother on both sides, my mother had done. And similar to you, my mother gave birth to both myself and my brother with an OB that she had been seeing since she was 18. So it was a there was a bond, there was a real sense of trust there, and she couldn't relate at all to what I was experiencing in these doctor's office visits. Every single one I came out, and I just felt rocked. I felt like, what is happening?

Dr. Sharon Malone 9:56

What were you expecting? Because I'm. What was the disconnect between what you expected and what you actually saw when you got into these doctor's offices?

Elaine Welteroth 10:06

You know, I don't think I had high expectations, because I didn't know what to expect. Frankly, you know, that book What to Expect When You're Expecting. I didn't know what to expect from any of it at all. So my expectations were pretty low. I just thought, I want to meet a doctor that makes me feel heard, seen, understood. I want to be able to ask my questions and get really clear answers. You know, no asshole policy that always helps. Yes, that's pretty much it. I really didn't ever imagine that it would be challenging to find a doctor that I had chemistry with or that I could trust, given the fact, you know, I'm a journalist, I know how to easily find a rapport with people. I know how to ask the right questions and also to educate myself. And so I really, really was surprised when I found myself in these doctor's appointments that felt so rushed, and I didn't feel like my questions were honored. And there were different things about not just the individuals, but the system that shocked me. For example, I thought you choose a doctor that is going to be there the day you give birth, and so when I learned that these doctors basically, you know, they, what they can promise you is that they'll be there for your appointments, they'll give you 15 minutes, and they may or may not be there when you're delivering. It really just is up to luck. And so that was the beginning of just a series of revelations that shocked me, that I never heard anyone talk about and that truly do help me understand why women are finding themselves in such traumatic situations in birth, because there isn't that sense of collaboration and partnership with one individual who is responsible for your for you having a successful birth outcome. And so by the Eighth Doctor, I remember she stood up in the middle of me asking my questions, and told me that I had exceeded her three question max per visit, three three questions, and she walked out of the office and just dismissed me and my questions as if they didn't matter. That same doctor actually when I had asked a really important question, which, by the way, I think any pregnant person should ask their doctor when they are consulting different physicians to try to find the right person to trust with their childbirth. I asked, What is your intervention rate? And she scoffed at me and said, What do you mean? Everybody needs something? She said, I don't think. I don't know what you think this is, but you can't just walk up into a hospital, pop a squat and have a baby.

Dr. Sharon Malone 13:04

Okay, well, that's a bad, a tad insensitive, I would say a tad insensitive.

Elaine Welteroth 13:09

Imagine that bedside manner on the day you're actually giving birth. I said, No, thank you, and I will find a way to pop a squat and have a baby without interventions, the way that women have been doing since the beginning of time, if I don't need them, and that's that was the point of difference that I needed. I needed a doctor that could acknowledge that not every birth requires a medical intervention, and that if there is a birthing person who seeks to have a an unmedicated birth, that they should have that option and that they could plan accordingly. And then, of course, the day of the birth, you never know how things will go right, right. So you might need a medical you might need medical intervention, and and I wasn't opposed to that. In fact, I imagined the birth that I saw depicted in television and in movies my whole life. I thought I would my water would break and I would scream, we got to get in the car. We rushed to the

Dr. Sharon Malone 14:09

hospital, and an hour later, you'd be looking at your baby. But also

Elaine Welteroth 14:14

in between that period, I would scream, give me the epidural, and I'd be cussing my husband out, and I would my legs would be in stirrups, and I'd be screaming, and it would be like this really dramatic emergency situation, and I would need that epidural. So going into it please be, please know, like, I'm not this home birth. You know, crunchy girl who girly, who came in here, like, really seeking an unmedicated birth like I was, like, pass me the epidural. I'm going to need that. But going through this experience, I learned that there is another way, and a way that could be nothing like what I've ever seen birth depicted as on television or in Hollywood. And ultimately, what I got was the exact opposite of. Of that image, I got a birth that was peaceful, beautiful, joyful, and one that didn't I wouldn't even describe it as painful. I told you, I didn't even find my midwife until I was in my third trimester. I had no birth plan, no doctor, no idea what I was going to do, and I felt so lost when I found myself in the hands of my midwife, and within that last stretch of my pregnancy, she really helped not just advocate for me, but she helped me. She helped me face my fear, and she helped me understand how fear has been used for too long to manipulate women into making decisions or to allow other people to make decisions for them during their birth process, that in some cases can be detrimental. And I, I will tell you giving birth outside of the hospital, and birthing and laboring in my shower for hours, silently meditating with my husband, was one of the most beautiful and empowering experiences of my entire life, and I wouldn't have had it if I made the decision to give birth in a hospital. You

Dr. Sharon Malone 16:34

Yeah, I think that that, I think a lot of people don't understand what's happened to medicine. Generally, it's not just obstetrics, you know, and that was really the reason why I wrote my book, was because I said a lot of stuff has changed even in the 30 years that I've been practicing medicine that a lot of people are unaware of. And I And if you don't know, I want you to know what's happened to medicine. If you look around now, most doctors practices have been bought either by hospital large hospital centers or private equity groups have come in, bought and they bought individual groups, smashed them all together. And that's a now, it's a business, and so you as the patient or you, as the, I would say, the consumer, if you're coming in, you need to know, how can I maximize this experience? What kinds of things can I do to be ready for that? And if I want something else, a lot of times, it's going to depend on, not just what I want, but also, for a lot of people, what you can afford. Yeah, so there are kind of ways to go about it, but it's harder, and I understand that. And I think when what it erodes is that sort of the trust between the doctor and the patient, you know, for someone to say, you know, hey, I got you. I trust you. You know me, but I hate to tell you what the next iteration of this is, Elaine, and that is now for deliveries. There's a movement away from your doctor that you even see in the office being the doctor that will even they won't even be at the hospital. Hospitals now are hiring laborist And these are doctors that do shift work at the hospital. So this would be very likely someone you've never seen before. I think they're already doing they've been doing it here at Kaiser and for some other large hospital systems such that they're just shift workers. You come in, you have your baby, and that's not the ideal experience. I understand, and that's certainly not the way I practiced for 30 years. But then I don't deliver babies anymore, so, and a lot of that is because doctors are choosing the doctors who really want to give you that kind of care don't really have the ability to do it anymore, and that's terrible sad.

Elaine Welteroth 18:58

It's so sad, you know, I feel like I learned a lot about what some people call the medical industrial complex around birth through this documentary. It's an old documentary that Ricky Lake executive produced called the business of being born. It was the first thing that I watched when I found out I was pregnant. One of my best friends told me, you have to watch this documentary, and it opened up my eyes to all of the reasons why ultimately I would experience what I did inside those hospital settings. It's interesting because even with all the knowledge, I still there was a part of me that was like, but that can't happen to me, but my experience will be different. And I think there's this misnomer that your privilege can protect you from becoming a statistic when we when we hear about these statistics around the maternal mortality crisis that black women. Men are three to four times more likely to die during and after childbirth. I think we think that's happening to people who maybe don't have access to the best doctors or don't have health insurance. And the reality is, when you really dig into the research, you'll find that wealthy black women are still dying at at higher rates than poor white women in this country, which helps us understand that there's something else going on here. There is systemic racism and and bias at play at every stage of your interactions with the medical system, which is part of why it's so important for us to seek out a physician or a midwife, a care provider that makes us feel safe, that does take the time to invest in getting to know us, that does that can help us feel a sense of peace of mind going into this very scary experience, you Know. So I'm just curious what your perspective is about that. Oh,

Dr. Sharon Malone 21:03

when you know I have one, I know you got one, all right, so there's a lot, there's a lot to unpack. And I think that, yes, there, there is, there's a definite role for midwifery in modern day deliveries. Yes, you know, and I have, you know, really no ax to grind with that. I was delivered at home by a midwife, as were six of my six of the eight children in my family, we were delivered by midwives. Wow, but the first four of them were delivered by midwives because there was no alternative. The maternal mortality at the turn of the century. At the turn of the 20th was horrendous, if you think it's bad now it was to give you an idea, I did a little research for my book to figure out, you know, what was the maternal mortality rate at the turn when my mother was born? And it was something like now for black women, it's 55 or so per 100,000 women will die in child as a result of childbirth, and that's about three times higher what it is for the rate for white women in 1900s it was 1200 not 55 1200 per 100,000 women were dying, and those are the ones that you kept records of, you know, because, let's be clear, a lot of people were not, you know, you lived, you died. No one even knew you were there. So the magnitude of the problem today is, you know, orders of magnitude less than it was. And that's because a lot of things that we can credit at least modern medicine with saying, you know, we have antibiotics. Women have access to C sections. Now, you don't just labor, you know, obstructed for days on in until either you or your baby die. So yay for that. You know, we we the overall number in terms of the maternal mortality rate has gone down. What hasn't really budged is the the ratio of like, what is the, what is the disparity between black women and white women is so, yes, the disparity exists, but let's be clear, it's a smaller it's a much smaller number, and maternal deaths are still rare, but I want people to have some perspective, because when you're talking disparities, the disparity is true, but yes, we are way better than we used to be.

Elaine Welteroth 23:31

Can I just chime in really fast there? Because I agree that context is important. I think the missing context, though, is when you look at the rates of maternal mortality in this country versus what's happening in other industrialized countries. We have the worst birth outcomes in all of the industrialized world by 10 times. But that is an important element, but

Dr. Sharon Malone 23:58

it's also considered compare the United States to France or to Sweden, because we have far more people. We have far more diverse population. They're still when you're talking about maternal mortality, it's complicated, because it's a lot of things that go into that there are people who are uninsured. I don't think it's an accident that the states where the maternal mortality is the highest, or in the states where you have poorest people, you have the most uninsured women, rural areas. I mean, believe it or not, New Mexico has an atrocious there, right on par with Louisiana and Mississippi, because there are no doctors there. There are no hospitals there. So, you know, I say this to say that there is an issue in this country, and race runs through all of it, yep. And so I want to talk, though a little bit about birth fund, because I want to talk about how what you are doing to address this issue. And. You know, and how did you even get started on this fund?

Elaine Welteroth 25:02

Well, listen, I mean, where do I begin? Because there's so many things you said that I actually would want to respond to the thing that gave me hope and that really led to my aha moment, which led to birth fund, was this statistic that 80% of the maternal deaths in this country are preventable. This is not a foregone conclusion. That we just need to be dying three to four times the rate of white women, and that, by the way, 50% of American women, no matter your background, define their birth as traumatic. That is unthinkable in one of the wealthiest countries in the world with the most advanced technology and access to great medical care, right? So I was like, this is this is the starting point of a different kind of conversation that we should be having, and one of the solutions that we know about, that we know data tells us would help improve our birth outcomes is midwifery care. And from my own personal lived experience, I got to I got to experience firsthand the difference in this holistic, compassionate, culturally competent form of birth care, which truly was night and day from what I experienced in the hospital system, and I remember having to go through this process of unlearning everything that I had learned about birth in order to trust myself enough and to trust A midwife enough to to go through this experience outside of the hospital, and what was on the other side of that was one of the most, as I said, the most beautiful, empowering experiences of my life. And I thought this should be available to any birthing person who wants to go this route and and when I got to the point of understanding that in many other wealthy countries in the world, midwifery care is the default birth care model and contributes to their better birth outcomes. I thought, How is this not covered by insurance in this country? So I built birth fund to do a couple things. First and foremost, we wanted to help families get access to life saving midwifery care, if that's the choice that they made for themselves. But on top of that, we really wanted to inform and educate all people around what it really takes to give birth in this country and some of the things that can come along that took me by surprise. I wanted to help people feel supported and feel like there's information out there for them, including information about alternative paths to better care for them, which for me, was midwifery care. And so we wanted to mainstream Midwifery, help de stigmatize Midwifery, and ultimately help fund this, this, this incredible model of care, and help fix the broken pipeline, because there are also so many systemic barriers in the pipeline to even becoming a community birth worker, which is kind of, you know, Our next phase of work, but it's been the most rewarding work of my life. It is I've done a lot of things, and I it's all kind of come full circle, and I think being a storyteller has really helped us break through to a different generation and a different set of women that maybe would not have considered midwifery otherwise.

Dr. Sharon Malone 28:43

And, you know, and I, you know, I don't disagree with a lot of what you said, but the one thing I want to everybody to be clear about is the fact that, you know, midwives are trained medical professionals. They're not you know someone who you know slept in the Holiday Inn last week, and now they're gonna deliver your baby. Thank you. They and they are, they, they're professional. They're medical professionals. They know what they're doing, but we also need to be very clear about what the limitations are about either home births or birthing centers, yes, and that they do low risk delivery, absolutely, yes, you know. And the one of the other issues is that we have so many women entering pregnancy with pre existing conditions, and we have got to address that, because those women still have to have some place to go, and still the best place for them is still going to be at a hospital because they are at risk for other things that low risk women are not absolutely.

Elaine Welteroth 29:47

Midwifery is not for every it is not for everybody. And we're right, yeah, and I also want to be clear, and that's probably why I'm sitting with you right here, we are not anti doctor and we are not anti hospital. If anything, what? We are here to do is to say, midwife, there's a place for midwives as

Dr. Sharon Malone 30:05

well. And you know, here's another point I want to make, that there is no you know, doctors and midwives are not in opposition. No, each other, no. You know, midwives. If you qualify to deliver a for a low risk pregnancy and you deliver in a birthing center, that's one option for you, but there are also midwives who deliver in hospitals, and we have to understand that midwives are going to be a big part of the future of obstetrics, because remember all those things that I said about how the field of medicine of OB GYN is changing, and we're going to need more trained midwives, because the pipeline for getting doctors through that is too long, and they we are having we also have these medical deserts, yes, where we have places where there are no OB gyns, and the only way we're going to sort of fill that gap is with nurse midwives. So we're on the same we're definitely on the same page there about where this field is going.

Dr. Sharon Malone 31:14

But the one thing that I would say in our in our real takeaways from this is that one that the whole planning for pregnancy, and sometimes you don't get to plan but, but the whole issue is, really, what do I need to do to prepare for pregnancy? Yes, okay, because you shouldn't just roll up into this thinking you're going to do all the things you've been doing before because it matters. Yes, pregnancy outcomes really depend upon how you enter the pregnancy, and the more things you come in with, the more difficulty you may have during the course of that pregnancy. And I would say, and the last thing that I would say about how we have to reform our obstetric policy is the fact that it does not end when you deliver that baby. Yes, there should be ongoing care. Patients should leave the hospital with instructions. If this happens, if that happens, you come back right away. No, you don't wait for that. And if you call on the phone and someone tells you, Oh, you're fine, you need to know, just as you said, no one knows how you feel better than you do, not some disembodied voice on the other end of the phone line who's telling you that's normal, you need to learn how to speak up, and that's really My mission, and I think that we are all coming to this. You know, you're coming from one direction, I'm coming from the other, but hopefully where we meet will be at a place where every mother can expect, whether they go into a hospital or whether you qualify to be in a birthing center, that you deserve a good outcome. We all have a part to play in this absolutely. And I just want to say thank you, because you're doing your part, I think we're going to meet somewhere in the middle, and we'll have many, many more conversations about how we're going to make sure that every mother and every baby is healthy and happy. So thank you,

Elaine Welteroth 33:25

Elaine, thank you so much for having this conversation

Dr. Sharon Malone 33:28

and to our audience. Thank you for tuning in. Keep joining us each week as I break down complex medical issues and give you actionable advice on how to secure that second opinion.

Speaker 1 33:56

Don't forget, you can get the episode show notes for this episode by going to journey to launch.com or click the description of wherever you're listening to this, and you can still grab your jumpstart guide for free to help you on your journey to financial freedom by going to journey to launch.com/jumpstart

Jamila Souffrant 34:13

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