Embracing Advocacy: Mary Buffington’s Mission to Improve Maternal Healthcare

0:00 Hello, today I have with me Mary Buckington, msn RN. Mary is a nurse, a presenter, an advocate and a coach. She has worked as a nurse since 2006 and worked in oncology, end of life home health and psychiatric nursing. In 2018, she began working as a coach and served frontline nurses during the COVID-19 pandemic. After experiencing a traumatic birth in 2021, she launched Arrow and Key Wellness, a wellness company dedicated to helping people reclaim and redefine their physical, mental and spiritual health in a way that honors their individuality. She believes better health comes when we honor the individual and their unique journey.

0:43 Mary currently offers coaching, energy work and wellness classes, both virtually and in Shepherdstown, west Virginia. Connect with Mary on Instagram at arrow and key wellness or by email arrowandkeyllccom. Mary. Welcome and thank you so much for joining me. Thank you so much for having me. I'm so glad to be here. So today we're going to focus on your birth journey. At some point we're going to go back and focus on your expertise in the birthing process and what you have to offer with all of your background. But today I want to know the origin, the where that passion came from and how you've channeled the experiences that you had during your birth into helping others.

1:30 Sure, I have been a nurse since oh my goodness, 2006. So I have some years underneath my belt and I actually worked in OB when I was in nursing school as a tech, and so I was around birth prior to my actual birth. I mean, I was there with a lot of my friends who are in their births, but I was there working and taking care of patients when they were getting birth and afterwards, before they went home. So birth was not something that I was so scared of because I had some familiarity with it. However, it was someone that started my whole entire birth journey really late in life. I met my husband in my 30s and then we got married around when I was 33. And I wanted to have a kid, but I was having some issues with fertility.

2:13 I was someone that didn't need to get some help. I tried to do an acupuncture and all the natural things, my first little bit through. However, none of that worked. So I started talking to different reproductive endocrinologists and I tell you it took me a couple of times to find the right fit and I eventually found one that you know. He was amazing, very supportive. He approached me and not as I needed IVF, he actually looked for ways to work with what my body needed and so I had to do some injections of I can't remember I think it was FSH. I can't remember what the name of the medication. If I get it wrong, I am sorry, but I did that. So I had to do injections. We tried naturally the first time and then we used IUI the second time and we're successful in getting pregnant and my pregnancy was pretty uneventful by the like, the grandest scheme of things.

3:03 I mean, my first trimester was miserable. I didn't want to eat anything. Everything smelled horrible. I about killed my husband when he decided to cook a steak in a frying pan like that. No one should do that, I tell you to a pregnant woman. It was awful and I still don't even like steak to this day because of it. But I had dealt with that. I dealt with some carpal tunnel in my hands, but beyond that, like I was okay, I was getting around, I was still coaching, and that's when I was doing primarily for income at that point in my life and in a pretty good place. About 32 weeks we went in for one of the ultrasounds because I was one of the AMA women. I was over 30. I was 35 when I was pregnant and they were, so they watch you a little closer and you're a little bit older.

3:46 They make you feel like your enemies are, like you know, ancient, like by saying geriatric pregnancy they got to work on that language. I think they are by the historical. I just call them the golden girls. They had Blanche and Sophia, but any who. What ended up happening was they went in there and I was a full breach. So my baby was up. His head was up underneath my liver. I thought it was this like feet kicking me because it really hurt. But no, that was his head and his feet were pointing down. We did decide to go through ECV, I believe at 35 or 37 weeks, I forget when it was. We did have a successful flip. My kid was the right way down. We did decide to go ahead and move forward, however, with a scheduled induction, because I am a big researcher as a nurse, I went through PubMed and found research that women that are over the age 35 do have better outcomes if they have their baby before.

4:39 They don't go over 40 weeks and they usually go at the 39. So I made that decision to go ahead and move forward with that and went through about an 80 hour induction where we literally tried everything. I went through all the processes of TOSEN and the little string thing they put on there against your I don't know what it's called. It's like this little piece of paper. They put it against your cervix. We tried the site of tech servidil Servidil, thank you. I was like the thing it's like a string and you can't really you gotta be careful about moving with it. And then we did the site. We also tried side tech pills and honestly I didn't have epidural or anything at first with it and the contractions never really bothered me.

5:20 I remember feeling like, oh, it just feels like something's squeezing inside, and my husband's like, yeah, that's a contraction, you're the nurse, honey. And I'm like, yeah, but I mean like there's a level that, even though it was sort of this, I think my biggest complaint up to that point was really that the bed was hard and there was, I mean, like the setup there. They did not have the wireless monitors and what they had they were like scrubbing my belly with like almost a sandpaper thing to try to get it in here and it just wasn't working. So I was like basically stuck to the bed a lot during my induction and that bed was flipping hard because they're like, when I was like, can you flip the mattress? And they're like, no, we can't, because if you start having to go into labor then we have to flip it back, which I just think it's lazy.

6:03 But that's my two cents. What do I know as a nurse? Because I've been a lazy nurse. I will own that. But either way, that's where we were and I guess things really started to just go sort of down like what was Friday evening, and we were when the pitocin drip in my son started having D cells, which basically means his heart rate dropped during the contractions with the pitocin and that was a sign that he was in distress. So the decision was made like they let him settle out, and then the decision was made, hey, we should probably just go with the C section, like it was a merchant. But it wasn't like, oh my gosh, your baby's going to die, it's like if we don't go the second. So it was like, all right, we're prepping, we're going, and it's like one o'clock in the morning we get back there to the, to the OR, and they, after they, shaved you up and everything like that could you?

6:50 You know that little mallet downstairs is what I called it. It was not. I tell you it's something. But get back there and they put you. You're in T shape. If you're not familiar with the C section, your arms get strapped up because they don't want you to grab them and move in. So you know, like they're doing a surgery, they need things to stay still and you are awake during that surgery usually and they utilize the epidural that you have in your back to get medication, sort of control pain. Well, I remember telling the guy that the my anesthesiologist that was there in the room like I want to make sure I get serfram because I hear people get really nauseous and I would look cute, a little cute for my first picture of my baby, and he wouldn't even look at me. He was just like doing a say I'm like hello, hello, and then I heard the timeout start and I'm like what the fuck?

7:35 Like that's basically like the pain starts and I'm like he's not listening to me and I see him go sit down by the computer, starting to chart on Epic and my husband, sitting is, comes in and he's there and the drapes up there and then basically they started going in, started. I started feeling things happening. Now I didn't really feel like the initial cuts or anything like that, but as they start going deeper I started feeling everything. It wasn't pressure, it was tearing. It's not only described to people like I could feel things moving and I saw in that scene the other side of the curtain of a C-section. Like if you're not been on the other side of that C-section curtain, it's a little bit like they're pulling their mimic things around, so they're making one cut one way and then they're pulling the abdominals all the way to get down.

8:16 There's a lot of layers to get to the actual uterus and get to where the baby is. And I was basically feeling everything and it was tearing and I was clenching my hands, I was trying to breathe, I was biting my lips and finally I just started screaming. And I look back and I'm seeing my anesthesiologist sitting by his computer about three, four feet away from me. He was not interacting with me at all and I actually I don't remember everything. I screamed at that point but I remember like screaming, I'm going to die, you're going to kill me and I was basically that level, screaming frantically through that birth. I remember being so relieved hearing my son's first cry, like that's it. And it wasn't because I knew my son was okay, but because I knew that it was over, that he was out.

8:58 They were great that there was no more that they would do. And at that point I started. He went up and he started putting more stuff in my IV. I think he put Adavan and some other medicine in and then at that point they actually started medicating me and I remember going to I didn't get to see my son right away. They took him over there to like check him out with the neonatologist and then they came. I did get to see him for a second and then they took me way through the post-op area for recovery and in that space we basically I mean like I was feeling better because they gave me Adavan, they gave me fentanyl, they gave me dimmerol to help me stop him with the shakes that were happening from the pitocin, and I was actually I was feeling good, I was chatting with Kathy, I was good and I got to see my son.

9:40 It was good at that moment and there's a level that you know I was like my son's okay, we're okay, we're here, and so I don't know if it was a medications I don't know that I saw my son or if it was some of the stuff I've done on my own mindset work, that work. But I was okay at that moment. And then we got back to the room and I got, you know, actually got to hold my son for the first time at that point and it was beautiful like getting to hold him and see his face and be like I made. I made this creature. I was just like this beautiful Bonnie moment. And after my pain started creeping up at that point and I put on my call bell for Tylenol because I didn't want to do a lot of opioids. That was my big goal with my personal birth land.

10:21 I wanted to avoid as much opioids as possible and stay on Tylenol and ibuprofen just to keep my pain under control. And I rang once and they were like okay. And the second time it was about 15 minutes later. I'm like okay, like I'm really worried my pain is going to start getting bad. I put on the light again and I'm like I'm really need my Tylenol and the nurse came in that was taking care of me. She basically told me I needed to calm down and that surgery. I should expect surgery to hurt was two of the things I remember of that conversation and I remember getting angry because I was coming in as a registered nurse. I worked with surgeons for forming some of the most complicated abdominal surgeries, like whipples and you know, taking the bowel out, which is not that much different than a C-section, and cutting into an hemocleactobies remembering parts of the bowel for cancer patients and so I was pretty well versed and I've been in the rooms with them, those surgeries.

11:12 Having someone say that to me. I was like, yeah, I know it hurts, I've taken care of whipples, I've taken care of that, that's why I need my meds. And she gave me it and she sort of disappeared. And then another nurse came on for the morning shift. I think they did a dual report, but I cannot remember that piece. But there was almost like this condescending attitude with that nurse about, like what I was doing, a pain management. No one had asked me how I was doing at that point and it wasn't until a surgeon came in at 12 o'clock and said, hey, how are you? How was everything? She was the first one to ask me that and I just broke down crying and say like I thought everything. I just want to go home, I don't want to be here anymore, because I was so frustrated I was.

11:53 I have never been treated like this by a nurse before and no, mind you, this was my first admission to a hospital but I've never been treated like this by a nurse before and I expected to receive better care than what I went through I expected. You know I did. I didn't like say like hey, I'm a nurse, or pull like the nurse card really hard, but I mean like people, I was first said, yeah, nurse, and I coach nurses and so you know I try to be cordial with my team taking care of me. But it was almost like at that point I was a burden and I did something bad. It wasn't until that doctor came in. It was like, are you okay? That surgeon asked me that simple question that things change, and she listened to me.

12:37 I basically told her everything that happened, everything from the birth experience, what happened with the nurse. I just wanted to go home, I wanted to go get out of there and she was like you know, I am so sorry this happened, that's not something that would happen in my OR. And that's where everything changed for me and I realized that it was not safe for me to be someone that was just trying to be a patient, that I needed to basically be a nurse and I something clicked and I just went back into my nurse navigator mode that I normally did and I was just like at that point now no longer the new mom. That took away that whole entire experience for me and I spoke to her further about it and she basically had the head of anesthesia come in to talk to me about what happened.

13:22 I had so many different people in that room and the nursing care dramatically improves. My nurse I had that evening she listened to me actually received good quality care that night. It was the first time on it. It was one of the few times that I stayed at my care, basically stayed consistently good through the end of it. And you know it was sort of fun because I tell you what the anesthesiologist like he was trying to of course protect, cover his butt and protect his person. I was like you know, I'm sorry, I've been in enough rooms in ORs so that is not normal and if this is happening to your family, members like you would have an issue with it and this is not okay. You need to address this with your staff. Like I went, I was basically not very I was a very pleasant at that point.

14:02 So we ended up sort of getting to a good place and we got out of there about two days after I had my son. We got home and my milk was having issues coming in and that was something I had planned to do was breastfeed my son, and they were saying, you know, it should come in at some point and honestly, never really did it Probably has to do with some of my fertility issues, but I then had to basically deal with the fact that my son needed to be put on formula and I had a lot of story and thoughts around that and you know, it just felt like I'd be a day, I don't know, like I had been hit by a whole entire train with the birth piece of it. Now I had some personal family things that were also really hard happened shortly afterwards. Then I'm not going to share this podcast, but it was basically like I didn't get a break and it was just.

14:47 I didn't really have space just to process what was happening for me and I was just trying to get through, to get through and take care of my son and take care of what was happening with a family member and, honestly, just struggling to keep things together. When we went to our postpartum follow-ups at six weeks which I have some strong opinions about I did that whole entire checkoff thing and there was nothing that really was meeting, really addressed, where I was, like it sort of says, where you feel glued, you feel like the world's on top of you. I was able to check off like two things, but it wasn't showing me as having postpartum depression. However, I was having issues with put with intrusive thoughts that were coming in, like reliving what happened in the surgery room, reliving what happened with the nurse afterwards and trying to figure out what I could have done better.

15:31 How can I fix this? And I realized that these were signs from my other my psych experience, that I was having signs of PTSD. So I sought out a therapist immediately and started working with a therapist and seeing somebody weekly. This made a huge impact when we worked on some coping strategies to help me manage some of the symptoms, because they were happening before I was going to bed. I mean I started listening to certain music and doing certain exercises and helping reset my nervous system and just sort of getting through that whole entire feeling that what I should have done differently. Now, overall, through this process, eventually I got to a better place. It's been a long journey to get here, but it was honestly one of the hardest things I went through and my traumatic birth was not due to anything I did.

16:14 I refused to take any blame of it. My birth was the fault of poor care and the healthcare system and most of this was due to the fact that they didn't care that there was a customer focus or patient-centric focus. It was almost like I was dispensable at that point and they were just going through processes and I do think that there was a level of burnout and that is a big reality in healthcare right now and at that time, and also we were dealing with COVID and I have very strong opinions. What we did to women throughout COVID, and mothers during COVID especially, is criminal, like taking away their support system in one of the most scary and vulnerable times of their lives. Women until recently died in childbirth like 20% of women died in childbirth less than a century ago, and now women can go through that, but then they're left to clean up the mess.

17:04 We don't have good support system for women after birth to really sort of navigate any of the challenges they face. And I know I'm not alone. I actually joined Facebook groups. There was a traumatic Facebook group and I honestly have a lot of respect for the admin for that group because she ran a really tight ship, like would let people do sales, would not let people that were therapists or anything like try to do any work or studies in that way, and she basically gave a place for people to process their birth experience. However, I was in a group that was on a traumatic birth group and I said like this is my experience with my alone and there were so many women that said, oh my gosh, I thought that was just me, like I felt everything. They would share things. Like every time it's my kid's birthday, I cry because you know, I just think about what happened to me and I tell you that's something I do appreciate now that we're two years out.

17:50 There's always a moment, like the evening before, where things just hurt. There's this pain and the interesting thing is, I think a lot of people look at traumatic births and they always want you just to get over it. They want you to be like well, you're okay, not at least you have a healthy baby, but you can't ignore that trauma that happened. And I'm someone that has chosen to share my trauma because I don't think what women go through is fair. I don't think it's ethical. There's no reason at this point that anybody should be going through a birth experience and be completely left that shattered from it or left that broken or left it worse than what they came in.

18:31 And that's a big part of why I changed my practice from just focusing on nurses, because a part of my work when I was working as a nurse was an advocacy as a navigator. So when this sort of crap happened to my patients, I basically knew where to go and I was able to give them those resources, and I actually have done that for a couple of my friends and sort of gave them those recommendations as well about what they should do, what they should ask for and not being afraid to speak up, because the reality is, in the United States, a lot of people do not see a birth until they're actually having their own child. It's not common. Most people, when they're giving birth, they either have their mom around, their husband around, or their partner and then themselves. You're not usually seeing like a bunch of women, like what used to happen back in the day when someone was giving birth.

19:15 And I mean that's what my hope is with Aaron Key is to be able to tell people bad things do happen and bad things can happen to you in healthcare, but that doesn't mean it has to be a permanent thing. You know, looking back, there's one person that I'll always have a lot of gratitude towards and it was a surgeon that asked was the first person to ask me how are you doing? How did everything go? Those questions might not seem like they matter, but if you look at research on PTSD, the sooner someone's able to process what happened to them, the less likely they have long-term challenges and problems related to their PTSD. She validated me. She didn't basically try to explain things way like the head of anesthesiology did.

19:55 She basically is like I'm sorry that happened to you. And one thing, because I called back and tapped to the patient advocate, which, if I could give one advice for anyone, you always have a patient advocate in every hospital's requirements. You can always reach out to them and they are there to basically get in touch with someone to get to help. If you're having bad care, they'll talk to a manager. They'll even go up as far as they need to the CEO. Now my problems were dealt with, but I did have the CEO come visit me on a Sunday, my last day before I got discharged. So you know, just saying that, or was it Monday, it was like the July 5th, it was like right around the July 4th holiday, but he showed up but at that point the care had been improved. I'm like I think we're in a good place now.

20:35 But when I did call back, they did let me know that the surgeon sent any anesthesiologist for peer review and professional conduct for my experience through the C-section and that really meant a lot to me and I will always respect that surgeon till this day. And if someone wants to go back to the hospital I'd be like go to her because I know that she'll take good care. And the surgeon that did my surgery, he did a beautiful job. I have like no scar, like I have the most beautiful C-section ever imaginable, like you could barely see it. But afterwards, you know he just sort of played off and said things like well, that's their role and you know I don't really get involved with anesthesia, but that is a concern, anything to hear from a provider. They should be able to talk to members of a care team and a colleague and say, hey, you need to do something.

21:19 They could have shoot my husband. I'll be like, listen, we need to put her under and we're gonna put you out here for right now. They could have done that. They could have used nitrous oxide, they could have had other things available and resources to basically deal with what I was dealing with. I mean like shit. I mean they could have even put a leather strap in the fucking cart. I wouldn't have cared, I would have bit down on a leather strap. But I mean, like just leading someone to basically suffer through something, not communicating to them, is not acceptable in this day and age. We are more informed consumers and I'll be honest, like I'm a medically savvy person and if I'm going into having this experience, I know that this is happening to other women in that hospital that may have barriers such as a language barrier. They might be a lower income, lower education levels.

22:01 I have a master's degree in nursing. I've been a nurse for a long time, so this is why we need to start speaking up about this and why I'm speaking out about it? Because there's no reason that any of this should happen to women, and I think my experience how the providers were not listening is why women die afterwards because they don't know that they can basically raise a ruckus, and I think it's time we raise a ruckus. Yeah, absolutely. That's why I'm trying to raise a ruckus. So you kind of answered this question that none of the surgical team acknowledged your screaming no it was like the only person that actually acknowledged my screaming was my husband and, in all fairness, we don't think about secondary trauma, but that is a real thing. That happens Like he basically watched me screaming through a C-section and there's nothing he could do.

22:45 I'm the medical one in the family, like he does computer stuff. He's great with computers, but when it comes to medical stuff I manage everything because I'm the nurse, and that's a very common thing that happens to nursing family members, unfortunately. Yeah, did you get an epidural before your C-section? Were you at that point? I did, I did actually. First they called the C-section. No, I think they would have done a block if they would have done, or whatever that's called, where they just go in and out. I had the catheter in. They were giving me something. I don't know what they were giving me. I should know these things. But something. because I was, I mean that was why. Because I mean I just didn't know if they had access. Oh no, they had. So I had an epidural place Because, remember, I did an 80-hour induction, which was Ugh, I mean like hindsight 2020, I didn't really say this earlier when I was talking, but my kid has cord wrapped around his neck twice.

23:38 There was no way homeboy was coming down like he was not descending at all. But I got the epidural before they did a balloon, the balloon thing, and they were doing the balloon and pitocin and I mean it was great because overall I did the only thing. I felt things at the top of my ribs, but overall I was like I was fine, I was like whatever. I think the most annoying part was actually the having the fully catheter during that time period and having to be stuck on my back and bed. It was all apparatus. There's like this metal thing I don't know how to describe it, but I can only describe it like when we're doing radiation to someone, like for their prostate cancer. I couldn't see it now, mind you, I had a belly in the way and I was also one in epidural, but there's a level that I could not move the balloon that we usually use.

24:21 There's a couple. You can either use a foley bulb which is just like on a you know it's a foley bulb with varying sizes or you can use what's called a cook's catheter, which has a balloon on one side and then a balloon on the other, and they put one balloon inside the uterus and then the other one is on the outside of the cervix. They create kind of like pressure on the cervix and help those prostaglandids be created to help soften the cervix. Some providers will put them on traction, so it's possible. They're on some sort of traction, and maybe that's the metal device. That could be the case. Some just attach it to the stat lock to get a little bit of traction. Some will actually attach it to like a bag of LR to have actual weight on it. Typically I don't have patients on my back.

25:03 I was on my back with the balloon. You know there's regrets I have and I want to be closer to my family. I picked a hospital because they did nitrous oxide, because I wanted alternative pain relief. I really don't want to do an epidural. When I was planning before my baby flipped breach. But I did all my research. I did the things that you're supposed to do and I was not doing anything like out of left field, like these are normal things to look for when you are going for like surgery or you're looking for a procedure, you're going to look at okay, what is the person's outcomes? What do they offer to help to manage pain? These are good questions. As to your surgeon before any surgery, and the fact that people get guilted if they're having a baby blows my mind a little bit Like no, you should just throw your birth plan out the window. I don't think it was asking for anything out of left field.

25:44 I basically wanted to. You know, as a MacV, I tried flipping, we tried doing all this stuff and I was willing to try it. But you know, like hindsight 2020, I should have just been like, no, we're done with this, let's just go ahead and get to a C-section. But I got a lot of fear around a C-section and because it was surgery. Understandably, nobody wants to have surgery if they don't have to. But you know, my C-section was most flip and traumatic but I wanted to, first of all, had it with the doctor that I really liked, that I know would have advocated for me. I don't know man. Yeah, here's the thing you don't know what you don't know. I mean, even though there is a lot of resources and information out there's, some of it is not helpful and I mean like I was trying to navigate that.

26:25 But COVID really changed things. I could only have one percent of room at my time and I actually had a dual love. She can't be there for a C-section, and that was back in July of 2021. They started opening up things a little bit more so I could have two people in the room at the same time, but before that they had to retain it out and so it was just like if I had to do it over, I probably would have just gone with like straight for the C-section because I like that surgeon, and then been like maybe forward with it and I hate to say that and I don't want to discourage you on to get an ECB and stuff like that. But my kid had his cord wrapped around his neck twice. His cord was really stretched then. I'm very fortunate that we did not try to go through birth because that could have been really flipping, dangerous, like a vaginal birth with him, because I mean like it was really stretched then.

27:07 Yeah, and that's not something we can see either. There's no way for us to know what exactly is going on in there with the cord, so it's possible that it wouldn't have mattered. I'm surprised the ECB even worked. We keep referring to it as the ECB. That means external cephalic version, which just is a fancy way to say that we're trying to flip the baby from breach to head down. But if the cords are up around his neck two times sometimes, that's the reason that he's breached. So I'm shocked that that it was even successful. You know it's crazy. So my husband and I, we had our cords around our neck. Both of us did. I think mine was once, his was once. I mean we're both poor, sick babies. Because of that it's a weird saying, I don't know because they were worried about getting out. Yeah, One of my cord was around my neck so I wasn't coming.

27:49 I was stuck and so they had used the four steps I guess help get me out. I don't know, like his mom had to do something for him. Now my husband has a big head. That's another thing. I mean like knowing how big my kid's head was. I honest it was like a hundred friends since I was like, oh my God, I don't want that, I don't need that in my life. So I guess I got spared that Like there's a level that I do use dark keyword to sort of cope with things and yeah. It's how I cope with my trauma. Thank you. You know there's moments I do get emotional thinking about what happened. But yeah, like it was, yeah, it was just sort of one of those things where, like man, that should have been a sign of too much, but had our cords around our neck and then our kid had it trapped twice.

28:30 But he like I mean to be fair the same thing happened to my kids and I was able to have a vaginal delivery. So it really just depends on the type of cord. Yeah, I mean like big juicy cord. That is it. Long did it? Is it loosely wrapped, is it? tight. It all depends. I've seen sometimes it makes no difference if it's a big juicy cord and if it's a really thin cord and it's a tight cord, then it's likely to make a big difference. There's I mean just literally every birth is so different. Yeah, my sense was pretty thin, I mean. I'm not saying you're right or wrong for for not proceeding with the C section. It's there's so many variables in childbirth. Right, Absolutely. I've talked about it before. We have to look at the reality that there's 600 years worth of damage that's been done towards women in the birth space.

29:13 Since the beginning of humankind. Yeah, birth is traumatic and we have not done much to help that. As a true statement. Honestly, a lot of the fixes I don't think are big, dramatic, like we need to change a whole flip and hospital system to fix as simple as maybe considering. Maybe we need to have someone that is just solely an advocate for people that are giving birth, like when a mother is in their labor, you know, like she's talking to someone before, like there's any issues, you call me and that person is basically checking on the math towards because most of our mortality rates I think are postpartum these days in the United States and where they'll go home and then they have a complication. Having a nurse, navigator or someone that is trained to sort of ask the right questions or go over something could make it could basically change that conversation or even, you know, like actually having trauma informed providers.

30:03 Yes, I was about to say that. And there's a lot of women that have sexual trauma going in and giving birth as one of them. So I mean I've dealt with most of my stuff but out of like, you give up a lot of your control when you're in the birth space and the hospitals, which is why I think women look for home births because they want to have control over what's happening to them and not to feel like guilted if they want to do something a little bit different, absolutely. You are fully aware of the state of healthcare. Yeah. Like with the staffing shortages, and not just staffing shortages. It's not something that just happened. It got made. Exactly that's what I'm trying to say. It got made because it's money. It's purposefully short staffing under the guise of utilizing resources.

30:43 I love that. Like stewards of our resources. Right, oh my gosh, that's a whole entire another podcast. Right, it is totally and this is why it's happened. And when you say things like if somebody could call and follow up on these mothers, I hear in my head hospital administration saying, oh, but we do. We have the nurses call. Okay, let's talk about that. Most of the time it's the nurses calling during some lull in taking care of actual patients. They're not trauma informed in a way that they are certified. We have dozens of hours of online training that we have to do. Most of it is not in a meaningful way. It's just a bunch of lists of crap that they want us to memorize and then overly dramatic videos about how to deescalate, and it's the same video every year.

31:31 It's not anything where we're actually going through a meaningful trauma informed program where we would have the and also we're traumatized. Yes, you know. So we're on the clock, we're under the gun. They're trying to make us have these conversations and I'm not the one doing the calls right now, because, I mean, it used to be a thing when I was in postpartum but they want us to do it under a certain amount of time, under all of this pressure, and you can't focus on your patient, on their emotions, on their, on anything you can't. It's not being done Well, and so if a human being that is Sully focused on that, we're given the tools that they needed to actually follow up with these people, and the tools were good.

32:18 Not just that are you feeling weepy? You know, like if we actually focused on perinatal mental health disorders, perinatal mood and anxiety disorders, not just depression, as it fits into this little category of what we Consider to be female hysteria after birth, right, or depression. I'm sad. Yeah, that's not. That's not the reality. I'm overwhelmed, I am anxious. I'm having intrusive thoughts. Like you brought up, I'm having symptoms of OCD that look different when you just had a baby. They don't look like regular OCD. It's a specific bubble that you need to be treating. It's nothing is set up.

32:59 Nothing is set up for women. And then you said the six-week check-in, which Not soon enough. That is not soon enough. We've gotten through that whole period and now you're gonna check on me. So you know who actually provide the best place part of care for my whole dark experience my pediatrician for my, because that falls on them. It was so well. No, it was so funny. So she was actually pregnant. I love my pediatrician I refer to everyone, which is probably not a good idea because she has, honestly, she helped me Survive because I was a total disaster when we were going in there because I was actually set up with her to see that first week and if I didn't have her I don't know where I'd be. Like. I'd be honest with you. There were two angels through my whole entire expo three. I had my friend.

33:39 That was where my doula as much as she could be with the circumstances that, she just was very there for me. That Surgeon that just asked me two simple questions. And then my pediatrician. She actually did the Edinburgh screening on me. Well, they do. They're supposed to. Now I didn't know that well, she did that on me and yeah, but you know she actually told me this and I really appreciate her saying this. Like you know, I had to go to therapy after birth of my first kid because, you know, my husband was in his residency far away. I was doing this on my own. She had a family member there but she was navigating it and she actually sought out therapy and she told me that, and so that will always stick with me because I do think, as healthcare workers, if vulnerability that's done well, like you don't need to lay down your life fucking story for a patient.

34:22 Don't do that. I hate when people do that. It's a good thing. It was a narcissism too. We just like well, let me tell you about how hard it was for me. Like no, it's just like you know I get it, like I've been in your shoes and you know that's what I did, so that way you could be like a leader for them. And you brought up some great points about the healthcare system. Like the Healthcare system is really damaged and that's all there. Another podcast. Because when you have people that have never worked in that arena of healthcare making decisions about what's happening, whose house your staffing is, versus Looking at someone who's actually been in the arena, who has been there, who is savvy with business. The support is completely different. In your right, health streams are not enough. When it comes to trauma informed care, especially in the birth space, because I've done the health stream same this how you're supposed to do this and there's some tidbits out gets stuck in my brain like earworms.

35:11 But trauma informed care doesn't have to be really complicated. It's about asking like are you okay? Is it okay if I touch here this, telling people what's happening to them and balding them in the conversation, like when I take care of all my patients, I would say like all right, here's one. I'm accessing a port. I'm using an example like we're cleaning it for a good two minutes, so we're describing way all the germs and then we'll let that dry really well so that way we can make sure it doesn't get irritated underneath. People do well with prompting, especially when you have a situation where you're out of control. And now I know there's times where we are just like going because we're trying to save a life. But that's wasn't my situation and I would say a good percentage of what happens with birth that's not the situation either with where the trauma happens, like it's because people aren't communicating Well, they're saying BS, like your body's just going to know what to do.

35:59 No, it's not like an instinctual thing. Your instinct is I need to make my kid not cry. That's my instinct. I need to keep this thing alive. If we're gonna call that instinct fair enough, but that is not a very useful way to be. You're a fight or flight. You're not actually making rational decisions or the best decision. You're looking for something to make things okay. And I tell you, I think we also need to have better conversations about how do we support people Without discouraging. Just explain, like I want to make sure you know what happens with a C-section, what to expect, and also say and here's what happens with vaginal birth afterwards and Doing that in a way that's meaningful. I don't think you have to overload people, but say things like you know, sometimes people have tremors from the pitocin. That would have been helpful information walking into it.

36:40 Or hey, your feet are gonna swell up like a couple sausages, like your toes are gonna like little, like this Vienna sausages in the can. These are things we can do to sort of prompt people to be more prepared, because that actually lowers anxiety. We know this in studies. The more we do to set people up with meaningful knowledge and information, the better they'll do. You don't need to like go down the rabbit hole, be like and we're gonna do this and this and this. This is what to expect, so your family is all informed, and what you're doing to take care of them, creating that safety net. Yeah, that's actually a huge reason why I'm doing the podcast, because I love it. Just listening to stories and listening to how people are going through stuff and their experiences, it's a little less overwhelming in story form and it helps both sides kind of start that healing process.

37:24 But I realized it wasn't enough and so I'm moving into the coaching space as well to prepare people for hospital birth specifically because that's where a lot of the trauma happens, because they're treating your body and Not necessarily your mind and spirit, and so to go ahead and work on your mind and spirit, going in and then talking about what to expect, I think it's super important, because there are there's just too many variables in a delivery, like you said, and it's too overwhelming to talk about all of them, and so to focus on the individual, I think is super important. And you know, like if someone's starting to have preeclampsia, okay, well, this is what this means your provider can only talk to you about it for like 15 minutes before they can move on to another patient, because insurance won't pay more than 15 minutes.

38:06 You know so let's. Let's move into this space where we can help you process what's going on with you and fill in the gaps where you need to understand what's gonna happen. I think that's so needed in the space. It just our healthcare system is not set up for that and so it has to be individuals that are doing that. That's so needed in a space because people don't know what they don't know, and I have very strong opinions that we need better support and care and the money's there. They can be like, well, where's the money? Like having people that are just there to sort of, whether you call a coach, well, they're called navigator. Having someone there, the money's there because you're gonna help serve you. Like all right, you know what. Your bladder control is not working because you had a severe tear.

38:47 So, and right now, like you've had a lot of trauma down to that area, let's go in and get you into a pelvic floor specialist which works with our hospital down in our rehab area and we're gonna basically help you get your bladder control and function back. So that way you're not gonna be 30 year old and wearing something to make sure you don't pee yourself when you laugh or giggle at something. It's also there for helping support smoking cessation. For my big one and this is what drives me bonkers the gestational diabetes and what they do to people like, come on, they should be followed, not just dropped afterwards. They should be followed by someone. Continue to work with a diabetic nurse, educator, working with an endocrinologist, whatever. Most hospitals have some level of diabetic support service in it, whether it's a diet tissue or something.

39:31 There should be someone monitoring them, because we know that a lot of people with gestational diabetes Do convert to type 2 diabetes. These are where I mean like, if we want to play like the whole entire cost thing, which is what unfortunately drives, unfortunately, the business model is so prevalent that I think they don't see the healthcare is the priority Right now and the healthcare system, but the the return on investments. They are having stuff like that and then also knowing you provide this person in a hospital, that's basically going to provide the source, the support. That income might not be direct income, but it's going to be long term because they're going to stay with that hospital Because of the read, because of that, that care that they're getting and they're going to tell their friends like I had the best person that's just stayed with me.

40:14 You know, because I'll be honest with you, like those are expensive. So I'm in my my poor friend, like she paid over $2,000 and barely could use her doula Up in Maine it was awful for, and I mean like there is ways to incorporate doulas in the practice and make it in a way that's meaningful when I think that there's stuff that they could take from oncology care and apply. I worked in oncology. There's the basic principles that you have a life changing illness or a life changing situation are similar your, the person afterwards is going to have a lot of changes to their body and they're navigating that piece of it and the fun part about having to navigate someone that's with them before they can sort of spot things other people might not.

40:54 As a clinician with like concerns about, like P P, mads, p, mads. Mood and anxiety disorders. The one where they actually have psychosis. Oh, postpartum psychosis, yeah, yeah, okay, I was like thinking with some of the growing degrees, yeah, but they could actually, as a nurse, you could be some that's actually spotting things, because the thing is, when you are a family member, like a husband or something like that, you're trying to survive to like you're both running water or are another partner in any way, like you're training water, trying to navigate. I've got to support this person that's had surgery. I'm glad to do this, and then it'll be like, hey, I have concerns or hey, I need help as a navigator and cancer. I could. Basically there are people that would come volunteer, their volunteers in community I could connect them with, and I really think we need to have that level of service because our birth rates have declined in the United States and we need to do think more things right now to support.

41:43 I mean, like I'll be honest, like we need a future generation and we need to make sure that this future generation isn't being taken care of by someone that is basically so traumatized that they're basically training water. We need to do what we can to support these people and I think we can do in a way that is cost effective and beneficial to the hospital from a financial point of view. Oh yeah, you know. Did you know that in Maryland Apparently Medicaid is going to cover a doula program in Maryland? Now? Excellent. I'm glad you hear that, to be honest, because God knows we need. I think that that is probably the most important part is sort of realizing that a lot of people don't see birth before they go in that hospital. And having someone that is not your husband, who is also going to be shell shot, like no matter what you get through, that that partner I mean you said husband, but I mean it could be it really can be any spouse, any gender, wherever your gender identity is, or it could be even a friend, like that's going to be your support for someone when you get home, or a family member, like it's still going to be a shell shot situation going into it because you know it's a brand, it's brand new to you.

42:42 Yeah, I think that there just needs to be a whole, a whole setup, a whole care setup, and I absolutely. I it's great that Maryland is moving towards covering doulas with Medicaid, but then I've noticed that there's there's a need for doulas to be trained specifically for hospital birth, and then doulas bouncing from hospital to hospital without knowing the policies, and then we're having we're having issues with care you know, in turf wars and it just gets to be ugly, and so there has to just be a whole integration with absolutely with all of it and working with birth centers, there should be a way to refer somebody to a lower level of care. Because, you know, hospitals are geared most hospitals are geared towards the higher risk situations and there we need to have women's hospitals essentially, you know, because there's just there's so much that goes into it and it just it's so piecemeal right now it is with how birth is treated.

43:34 It's not, we're not treating the whole woman. A person needs to be treated throughout that whole process. There needs to be more check ins. There needs it shouldn't be the pediatrician that's checking in there should be tele visits. There should be doula visits, there should be midwives. There should be so much more, so many more layers of care than there are, especially when there's birth complications. And, like you said, it's not just the women that are telling their friends about the hospital when they have good care. I feel like there was, like maybe 10 years ago, a push to like make each hospital like invest in the birthing area. It was going to be more family friendly and all this stuff. And I've seen it kind of back away as staffing has gone down. But if you're going to spend a whole lot of money on labor and delivery, which you should be.

44:17 It's because women are your consumers. Everywhere across the board, women are consumers. They are the main consumers for everywhere for the family and so if you want people to come to your hospital, you need to make those moms happy, and because they're going to bring their children to the hospital and their children's children. Let me just tell you that one of the hospitals that I work at, I see people that are grandmas now, that were born in the house that I work at, and if that's not return on investment, I'm not sure what is. Absolutely and so you're looking for generations to continue to utilize your services, and it starts with taking care of your women. I don't know who's listening, that might flip a switch, but hospital administrators, that's what you need to focus on.

45:00 Yeah, absolutely, like they actually done studying. Women make the care, make the care decisions, and their families I do. I tell you, I pick where my husband goes, I pick where my husband doesn't go. My husband's like, okay, I'm like, here's your appointment list, here's my son's appointment list. And, honestly, over in Colorado, denver, there's a hospital called Rose Medical Center and it's a part of Health One system but they're known for delivery and this is where people go to have their babies and they're Rose babies. It's a whole entire thing. It's a brilliant marketing plan. I mean, let's talk about business, because I think that there's a level of people think nurses don't get business but the reality is. I mean like if I knew that that woman in that bed would have probably beat down the road making decisions about where their person's going.

45:41 I would be working with her and be like all right. So you know, making sure she is feeling pampered, she is feeling like she's well taken care of there, because that's going to make her more comfortable having her child go there. That child gets sick with anything. That's going to make her more comfortable with her husband. Again, that colonoscopy is going to need when he turns 45 or 50. And any other care someone hurts themselves. Otherwise, like I said, I will not get back to that hospital. I will not recommend that hospital and it's sort of tragic because there were some good nurses in there. But that experience of having an anesthesiologist not do his job, like he had one job. His job was to manage my pain, that's what he's there for, that is his role, he. And to keep me alive and to manage my pain, that is his job. And homeboy, did not?

46:23 He dropped the ball. I mean I'm alive, but beyond that he really dropped the damn ball. And you know, like they. Here's the thing. Like you can probably risk stratify postpartum care and all fairness, like it's not, by basically looking like do they have S3 of sexual abuse? Do they have S3 of anxiety or depression or any other mental disorder? So that way it's like okay, like just checking in and seeing how things going and, as I said, I don't know if we sit on this podcast yet or not, but like the Edinburgh, that little model for postpartum depression, that thing is not a good tool for navigating other mental illness, like dealing with people such as postpartum to PTSD or if they're dealing with some other things that are going on that could potentially lead to problems down the road.

47:07 Yeah, and it. Really. These don't have to be expensive fixes, they are literally easy fixes. Hiring someone you know it's like what $80,000 to have a nurse like his average, I think and their role being like, I'm going to make sure this person gets through there's all these pieces and that we're doing things to feel there's failed support for so long before the birth. So long after the birth You're going to see more retention, you're going to see less leakage out to other systems and you're going to hopefully catch some things and refer them to services within the system when they can actually stay in. And you know I'm going to stop there in case a hospital minister is looking at like trying to address these things, I'm happy to have conversations. This was a project I actually sort of worked on when I was in my master's degree program Because you know we've done wonders in oncology to improve care and most of the biggest improvements in oncology care and survival rates have actually been by incorporating navigators into programs, because they're making sure people stay on treatment track, they're making sure people are keeping up with their appointments, they're getting their survivorship care and they know what they're doing.

48:11 These are not overpriced fixes. These are things that are working well and you know I did a basic breakdown of where income could come in and he would easily and this was mind you back pre-COVID. You're looking at $600,000 of revenue. You can make off a navigator with a hospital with a small, relatively small sample size, so I know it's possible. Well, and the thing is like it's just systems. Yes, it is. It's investigating where there are holes in the boat, in finding systems to repair. And when you focus on individualized care, you start to see trends and those are the holes in the boat. If you don't do the work to figure out where that's happening, then you're just going to keep having holes in your boat that get bigger and bigger and bigger, and that's what we're seeing in healthcare right now, especially in women's health.

48:57 So I mean, yeah, there's definitely so much that can be done. How was your postpartum period for you? I mean it was challenging that you had a family member that you were helping navigate an illness and, on top of healing your own trauma, and then that you needed to formula feed. And you did mention before your interview that you have a medical health condition that required you to do the fertility treatment and then meant that it was going to be really hard for you to breastfeed. So you knew all that going in. I didn't, though. Like I knew about the fertility, about the breastfeeding, oh, you didn't. Well, I knew about the breastfeeding piece. I knew about the fertility stuff by coming into the breastfeeding. So there was. I will appreciate this lactation's consultant because she's like you know, there's a possibility, because of this medical condition, you might not have a lot of milk and you might need a formula feed, okay, and I actually really appreciate that, because I do hear stories where there's a lot of pressure on women to breastfeed, and I'm going to confess this because I don't really give a crap anymore.

49:53 I hated breastfeeding, I hated it. I hated it, I hated it. I hated it because I didn't produce enough milk. You are not alone. Yeah, another swim night. This was so wonderful. I'm like you know, I tried breastfeeding, but I tell you what my son still bonded to me. I mean, like we did do some breastfeeding, but about 11, 12 weeks that stopped and, honestly, it improved my relationship with my son because, as opposed to being frustrated that I couldn't feed him, I was saying it'll be like, all right, you're fed, and then he would just go to sleep in my arms and I loved it. And you know what I mean. Like my son is. I mean like breast milk and formula. I think they made a lot of improvements with breast milk in the past 20 years. I know that there's some old research about breast milk being better and this is a IQ stuff, but that is like minimal, like two, three points.

50:36 I formula is a reasonable choice. Formula's been around a long time, even before recently, like women needed it, but they had wet nurses. They would hire and stuff like that because that would. And then here's some messed up part about wet nurses. Guess what? Where they get their milk from is because they had a baby and so their babies would have sometimes go to orphanages, so that way they could, you know, survive, and that was how that was like. Basically, thank God for formula, because formula keeps babies alive. So exactly, or they were slaves and they were having to feed their master's babies over there. Very true, and so either way babies died because of this. So just something to appreciate knowing about that. We are living in a point of time where we have really good formula out there and there are centers that you can go get breast milk from that people donate to.

51:22 I have not done that personally, but I mean, like I bought my formula, I was very fortunate I didn't have to deal with the shortage till the end of his being, just the formula days. But I don't know my kids like he's still. He's still bonded to me, he still loves me. I don't know he's a little independent, little dictator right now because he's a toddler, but you know he's like he's doing great, right. That doesn't have anything to do with formula feeding, though Clever little thing. He's clever as all get out, and that really comes from the fact that there's a lot you can do to support your kids. Neuro development without just thinking about breast milk is the only thing you can do. Oh yeah, absolutely yeah. One of the hospitals that I work at has breast milk in the NICU, so don't eat breast milk in the NICU and there's very, very strict standards for how that is, and the reason being is that it reduces the rates of necrotizing and urocholitis in NICU babies.

52:10 Yes. So we have been able to mimic the neurological benefits of breast milk to some degree. The immune function hasn't quite caught up, but regardless, just feed your baby. Yeah, yeah, I'll be real for a second. It should be political, yeah, and I'll be real for a second. Just let your kid play outside when they get older. Go outside barefoot. I know that's going to mess with our minds, but seriously, like that is I mean, like that is where they're going to be building up their biome is going outside of being barefoot and playing and getting dirty. Go to daycare. Like, let me tell you, daycare is a great way to work on that immune system and my immune system and everybody else is in the house Like that's really goodness, I mean feeding your baby, giving your baby alive by giving them enough calories and enough macros and the things that they need right Nutrients and whatnot is, first and foremost, like if we think about Maslow's hierarchy of needs.

52:59 No one should be feeling guilty because they didn't breastfeed their baby Is your baby alive and healthy, then you did a good job. Period. Yeah, I'll be honest with you. Nobody should be ashamed for not liking breastfeeding. Oh my gosh. Okay, we all have different experiences. Have you seen some of the stuff they have women doing? I get it. I'm not going to be like negative to those people like do you? But they have these things where they basically have like this tube that you hang up. That's really complicated. My friend tried it and I was just like I don't know how you have the experience for that in your life, because I mean I'm always already exhausted. But you hang this thing up and then you put like this like little tube right by your nipple and you tape it and then like there's, I keep on you and they're pulling that milk and I'm probably going to peed off some lactation people. But I mean real. I was in survival mode, Like I was struggling.

53:40 There was no way I got time to set up like an ID breast milk thing or on top of everything else. I'm making sure it's, it's just and it's also a lot of waste too. I mean like that was just to me, yeah. I mean like make it easy and if it's for support, yeah. If it's what that mother baby dyad wants and is able to, it has the bandwidth to, if that is how she wants to nurture and feed her baby, because that is what is filling her cup emotionally and helping her bond with her baby, yes, absolutely. Have those tools, but don't force them on people. Absolutely, and also, like with women going through the process, I think that there's a reality. Be careful with language, language matters coming on the other side, cause I did carry a lot of guilt, and a lot of my friends have carried a lot of guilt, because they couldn't feed their babies.

54:26 So the point they were getting is look at medicines from Canada online, like I was like the hell, I love you, but no, actually not make formula the enemy, but instead do it as you know. Yes, that is an option. I think we can do better with language and supporting them, working moms that maybe for them they need to rely on formula. It's okay. This is about supporting the family, not just the baby. We have to start looking at it as you brought up earlier the mother baby unit and needs to also be looking at the support person. So, because people co parent a lot more than what they used to, you don't have just the mother being the sole support that baby. You have a father or mother or whatever that other support person is in that relationship who needs to also be included in what's happening, so that way everyone's being supported, not just being like well, at least you have a healthy baby in your life.

55:15 We can do better. Yeah, we can Absolutely. So what specific therapy or modalities did you use for your emotional healing? CBT. So CBT if you're not familiar with that, that is cognitive behavioral therapy and is evidence based with. It's one of the best forms of therapy to use with people. You need to have a good therapist that you click with and I was very grateful. My first service I clicked with really well. It was what I needed and she did a fantastic job with me, basically working through those emotions and helping me recognize like I did experience a trauma, not just trying to brush it away and just keep keeping on because nurses do this. We're really bad because we get traumatized so much at work.

55:56 Anyway, I mean, we're just like what is this fresh BS stuff? So I did that they do and I mine was online, so I never did the eye thing. They had this rapid eye movement thing and I didn't get a chance to try that I did and then I started doing a lot of self-care practices. So I would take a walk because I lived in a small town. We've moved out of the country further but I would go outside at least once a day because you do get stuck inside and you need to get outside. That is honestly like it's a little thing, even if it's rapid. I would put my baby. If I couldn't get away from my son, I would put him in his little wrap and then take him out and go on a walk and he would just sleep while I'm walking, and that was really helpful.

56:37 I had to wait for a little bit because of my C-section healing. I waited about, well, first few weeks I didn't really leave the house just because I was C-section recovery, but it's not, like I say, about like six weeks out. I was wrapping him and taking him on walks and but before that my husband would watch our kid and I would watch him while he was napping and I would go take a walk just to get out of the house. I think there's a level that you feel like you have to be with your kid 24 seven and while that's true, I want to just point out nowhere in nature does any, but there's very few animals to actually stay with their baby 24 seven that are even mammals Like they basically they like, leave them in a safe space. Now, mind you, like, if you don't want to save space for your kid, that's the difference, put them in the stroller, whatever you need.

57:17 But and that also helped begin into the idea of getting my kid out like and start working on that thing Like I had this other being. I need to make sure it's with me, because I was so afraid about leaving my kids somewhere. I was so scared about that. This is awful. Like the emotions that come up when you're trying to leave your child are just overwhelming. Is there anything that maybe we didn't touch on, that you wanted to talk about? That isn't? A whole other podcast which we will do. You know, if I could give one piece of advice for any woman that's experiencing you know they think they had a traumatic birth. They're feeling like there was stuff that just is unsettled with them from their birth. Go find a therapist or someone that you can talk to.

58:00 That's not going to say, well, you're out. Well, at least you're all okay, because families are great, but they are not always the best place to get good support here because they're not trauma trained, like be realistic. Like I love my husband but he was like trying to navigate his own like those stuff with this and recognize like they might if they also went through it, they might be having this too. Now, it's not your job to get them into therapy or stuff like that, but it's your job to work on yourself. So go if you're feeling unsettled, something doesn't feel right. You're having like truce of thoughts about the birth and it's just not going away and it's upsetting you, not like we haven't like flashbacks. You mentioned flashbacks, yeah. Well and yeah, where you're having stuff about your birth, come in and you're just like, and you just keep reliving it, and not in a positive way, like oh honey, my son for the first time, and you're feeling joy about that, but instead you're just feeling unsettled and anxious.

58:47 That's a sign you need to get help. That's a sign you might have experienced some trauma with your birth. I am not going to, I mean, like, you get to label your birth what you want. If you don't want to call it trauma, that's fine, but I would still go at least talk to a therapist. I've been in my mind for about 12 weeks and I've wasn't a pretty good place with everything I went through, because but I think also I had a lot of support at the first part of it with the, with the surgeon basically being like this was not okay, the other pieces there is always, always, always, a person. They might not be on duty when you're there, but a what is the word I'm looking for? A advocate, a patient advocate. You know what I'm talking about. All in duty you can call, even if it's. You know they're not usually there on the weekends, but they'll. They'll follow up with you and if you can't get through. You can basically work your way up. You can make like pretty miserable for hospitals because they're very it's important to have good press and when it comes to stuff like this, like a traumatic birth, this is something that doesn't look good on any hospital.

59:36 Like record, you always have the right to access the advocate. If you don't know how to get in touch with them they don't have the number in the room you can call the main hospital number and ask for the patient advocate and they'll transfer you to. It's important to basically make sure that you are using your resources wisely and also, even if you go through a traumatic birth, it doesn't mean that's the end of your story and that's mine still sits with me and there's times, like you know, I knew going into this, I had to basically be in a very specific space when I was talking about it, because there are a lot of emotions when I go into the deep parts of it. But there does get to a point where you don't think about it every day. There gets to a point where your child is doing all these amazing things and growing and developing and you are able to focus more on that piece of it and you know, remembering that it's you know you, you help bring this amazing being into this world.

1:00:27 And that was you going through your stuff. I know that it's hard at the beginning and people will want to just sort of brush it off with at least you have a healthy baby, at least you're alive, and stuff like that. But it doesn't mean that your experience is not valid. You're going to be alive and still be in traumatized. So I hold both of those yeah. And one thing that I basically have always focused on is how can I find purpose? And what happened to me and that was something that sticks with me with my therapist. She said to me was we know the five stages of greed, which are like anger, bargaining, acceptance, things like that. But there's also purpose and for me I talk about this, I share what happened with this and I am actually speaking at the Lacan in Denver about it coming up because to me, I want to make sure people know this is happening to and it can happen, and we shouldn't just be explaining the way.

1:01:21 We should be speaking up about it and advocating for better. Yeah Well, mary, thank you so much for all of your insightfulness. I really feel like a lot of people are going to be helped with this, and I'm very happy that you are using your experience to help others and trying to make it better for everybody that comes after you. Absolutely. And thank you for all that you do. Oh well, thanks. I'm happy that you're also doing this so that you can help your child, because if we don't work on our own trauma, then how can we help our children with their emotions and their experiences? Absolutely, thank you so much.