Speaker 0
Welcome to the Free Birth Podcast, a supportive space for people who are learning, exploring, and celebrating their autonomous choices in child childbirth. Together, we'll unpack truths, share personal stories, and claim our ability to birth freely and intuitively. Here's your host, Emilee Saldaya.
Speaker 1
There are lots of different ways to interact with free birth society and our work in the world. We have our flagship course, the complete guide to free birth, which is an incredible online course jam packed with everything we think one would want to know to feel confident to birth in their power. We also recently released a companion course full of meditations, sacred rituals, and journaling prompts to support in releasing fear and tuning in to your ancient womb wisdom. We, of course, have our private membership if you're looking for a community of like minded, radical, and wild women, and you can apply for that on our website. We offer personalized one on one transformational coaching with a focus on learning the tools to move out of victim consciousness and into self responsibility, which is, quite frankly, freedom. And it's worth mentioning that if you've been drooling over our mother loving retreat in Dominican Republic this coming February, we do have a few spots left open, and you should totally come join us in a magical week in paradise. Find out more about all of this on our website, free birth society dot com.
Speaker 2
If you know me or follow me, you know that I am obsessed with the book Everything Below the Waste, Why Healthcare Needs a Feminist Revolution. The author is Jennifer Block, and I am happy to say she's on the show today. You may know of her from her previous book, Pushed, which rocked the worlds of birth workers and parents alike. Everything below the waist is a continuation of the work she did and pushed and is now broadening the conversation into all elements of female health care. Yeah. I'd like to just back up a little bit and and ask you where the impetus for this book came. On the one hand, it feels kind of obvious because it was such a, important book that needed to get written, and you were obviously the woman for that job. But I'm wondering, as as someone who read Push and, just another. Just such a critical important important important book, for this country at that time, and it's still super relevant even though now it's like kind of an old book. It was o seven. Right?
Speaker 3
Yeah.
Speaker 2
Crazy. I still feel like it's o seven, but, you know, it was actually kind of some time ago. So, what happened in between that book and this book, and were you in the creative process of this book most of that time, because it's a pretty big gap, I guess.
Speaker 3
It is.
Speaker 2
And, I've been kind of wondering, because push was so, from my sphere as a birth worker, so successful and so impactful. I definitely had had the thought of, like, where is she? Is there another epic book coming? And then there was. So I was very, very happy to see that. So, yeah. Tell me a little bit about that that time frame and then the birth of this book.
Speaker 3
Thanks. Well, first of all, thanks for having me on the podcast. And, and thanks for your kind words about Push. Yes. There was there was quite a gap. I wasn't intending it to be so long, but life happens. And, you know, I moved across the country a couple times, had a baby. Those things sort of got, you know, got in the way of of this work. Yeah. Not not got in the way in a bad way. I really wanted to be a mom, and I'm I'm glad that I
Speaker 2
So your child your child came after pushed?
Speaker 3
My child came after pushed. Wow. I had not experienced pregnancy or childbirth when I wrote pushed, which surprised a lot of people. Actually, some some reviews assumed that I must have had a horrible birth experience that led
Speaker 2
to the
Speaker 3
book, but I actually felt that that the fact that I hadn't had, you know, gave me a a unique perspective and and kind of, solidified my credibility as an outsider journalist, not someone who had an axe to grind. Mhmm. So, yeah, the book I mean, this book really grew out of Push very directly because I still had a lot of questions after Push, especially about the, feminist movement and, this lingering question about, where the feminist health movement was, what happened to it. So I had that question. And I also came out of push knowing that having having learned through reporting and research that, you know, that maternity care, the vast majority of maternity care in this country is not evidence based, that there's a lot of overtreatment, there's abuse of power, that, I think my my one of my friends now who blurbed this book, Alisa Albert wrote that it's like the one last bastion in the United States where it's okay like, where violence against women is accepted routinely. So, you know, and we didn't have those words when I wrote Push. We didn't have overtreatment. We didn't have obstetric violence. And so I looked up from that, and I started to meet women who had had hysterectomies that they felt were unnecessary and had very much harmed them and their quality of life and their sex life and their mental health. And I, you know, I started looking into fertility medicine. I started looking into hormonal contraception. I even started looking to into overtreatment, in abortion care. So I just saw these patterns repeating in all these different areas of the health system and all the all the touch points where where women get treatment. And the other theme that I started noticing was that, you know, just like in the context of maternity care where there's this physiological process that we routinely undermine with technology and try to mimic and, often fail to match in you know, we we don't usually do as good of a job as the body can when it's supported. I just kept seeing this playing out, as a as a pattern that starts much earlier in in women's lives. So, you know, when we're teens, we're recommended, hormonal contraception to regulate our cycle. So we, stop the normal physiology and replace it with this hormonal technology. And then, you know, if you're educated middle class woman trying to have a profession, a career, you're pushed to your early forties to have a family. And then again, you have to look to technology to replace the the biology that would create a a conception normally, physiologically. Of course, we do it in maternity care, And then, you know, you see it at the in the later stages of life as we enter perimenopause and menopause where we've defined the stage of life as a, you know, period of estrogen deficiency and, you know, our uteruses are no longer have any they no longer have any value. We just dismiss the physiology and the organ itself. We still do we do, like, twice as many hysterectomies in this country as in Europe. And So gnarly. I still am seeing OBGYNs on Twitter right now, who are incensed about that cosmopolitan article. I don't know if you're following this at all. Mhmm. I'm
Speaker 2
not on Twitter for my own mental health.
Speaker 3
About it.
Speaker 2
Yeah. Great. Tell me about
Speaker 3
it. But I still see this defense of hysterectomy as, you know, well, the research shows it has no impact on women's sexuality.
Speaker 2
And my logic.
Speaker 3
Well, it does define logic. But my own research, you know, when I asked experts about this, like, where does this claim come from? What is the research? They say, actually, there's very little research, And the research only follows women one or two years out from their hysterectomy. And it only measures things like how frequently they have intercourse. It's not asking them about orgasm, about you know? Because no. It defies logic. And one of the things I do in this book is I go to a surgeon, like, probably the most experienced surgeon I could find who really understands the, female pelvic anatomy and performs these surgeries. And he walked me through a procedure, and he showed me how, a hysterectomy include when when it removes the the whole uterus, including the cervix, you the the vagina, you know, is turned into a cuff. So your vagina is short. It's inevitably shortened. Even if the best surgeon does this, it's inevitably shortened. And now we know that there are these nerves in the cervix, and one of them connects to the clitoral complex. And so that's removed. So it doesn't make sense that it wouldn't somehow impact. And thank goodness some women don't have a huge impact. They they still can have a you know, maybe their uterus was causing them so much pain and trauma that getting rid of it was, you know, enabled them to enjoy Yeah. Their pleasure again. So it's it's not true for everyone. But to say that it has no impact, it doesn't make sense and that to call the research in when the research is so limited is is disingenuous or ignorant. It could be that
Speaker 2
That happens all the time in the medical field.
Speaker 3
Yeah. Yeah. Funny way. So I just I saw the same patterns that I saw with pushed repeating throughout the lifespan, and I tried to I tried to touch on all of them. I really actually wanted to do a separate chapter about the fourth trimester and how these same patterns play out on the on the newborn infant. Mhmm. And it had already been twelve years since I published much, so it was time to birth this thing. But Sure. Sure. Yeah.
Speaker 2
Yeah. It's something that just going back to what you said about the the, you know, medical system calling out this research and then it's actually quite unfounded or or quite ignorant. I have been thinking a lot about that lately of how we're no longer allowed as women to rely on our own innate intelligence and our own, what would feel like instinctual logic without the backing of research and evidence. So an example being, we we put out a lot of content about, you know, normal physiological birth, and the hormonal blueprint, and mother baby, and and the optimal mammalian, you know, unfolding of bonding and all of this stuff. And very often when we talk about breastfeeding, we are met with where's the evidence. You know, we talk about maybe perhaps it's, just that objectively breast milk as an alive substance curated for this baby is objectively healthier than formula. That doesn't mean, that doesn't mean, you know, obviously, fed is best, duh. And breast milk is biologically optimal, also, duh. Okay? But there's a lot of, controversial, evidence, quote unquote, around this. And so, my business partner, she just such a great analogy the other day. She said, it's like someone saying, you know, where's the evidence that a penis may feel better than a dildo? I was like, where's where's the evidence? You know, it's like, what happened to logic? And that we don't get to have, you know, and I understand logic is subjective and I I I get where that could get hairy and all that, but in terms of instinctual, you know, biological intuition and our innate intelligence, we're really just so lost in this patriarchal, you know, scientific method, very paternalistic way of of proving things and the the kind of comical, though frustrating, you know, irony of the whole thing is that the evidence keeps coming back to prove what we've always known, you know, as as women and as mothers.
Speaker 3
I think we do get carried away with this. I mean, the the evident the movement for evidence based medicine and the movement to look at science and to respect science, I think, is very good and Totally. Good Yeah. In a, you know, development in medicine for and and, you know, in maternity care, maternity care was one of the worst offenders of introducing new interventions without any evidence. And once it's introduced, of course, it's very hard to take it away because then the burden of proof seems to be on the on the the taking it away that we don't know.
Speaker 2
Yeah.
Speaker 3
If you know, we need evidence that so, you know, electronic fetal monitoring and episiotomy and, you know, induction before a certain time. Like, all these things now we have evidence that we've been causing harm, but they were introduced without the evidence. So it's important, but I also think that it can be weaponized, you know, to, and we get carried away with demanding, you know, so much evidence when, right, the logic is very powerful on its own. Right. And, you know, there was a a great, documentary several years ago. I think it was called Breast Milk. Mhmm. And I I saw a screening of it. I met the filmmaker, and I think her name I don't wanna mess it up. I I think her last name is Ben Ari, but I would wanna I would wanna look that up. It's been a while. But I really loved what she said because she was like, you know what? The evidence is separate. I'm gonna set that aside. This movie is not about the evidence. I did not I mean, I asked her, you know, it was the movie really focused on, these women's experiences. And and it was at a time when there was this book out, you know, his breast fast. And there was this, like, this academic argument. And and Hannah Rosen had written a piece in The Atlantic, the case against breastfeeding. And there was all this, like, you know, well, there's, you know yes. There's evidence, but there's also evidence that it's not that big of a deal. And and this filmmaker was like, you know what? You don't I don't need evidence to tell me that a fresh raspberry is better than a frozen raspberry. Like Right. And men don't need exactly the point you're making. Men don't need anyone to tell them. Right. Right? So, yeah, I think we I think we can get carried away. And Well, that
Speaker 2
that's part of what part of many, many, many, long laundry list of why your book is so amazing. But one of the reasons is with respect to what we're talking about that it provides evidence and personal narrative, but it provides so much research that totally validates what so many of us have felt intuitively and logically for so long. You know, so many of us, you know, I'm in this community of women who who are, mostly birthing outside the system, mostly mothering outside the system, and really leaning into what does it mean to take responsibility for my life and my motherhood, and and what feels most intuitive and and right for, you know, each of us as individuals. And, so many of us are talking about this book and all kind of saying the same stuff, you know, that hormonal birth control was put on us as teenagers and it just didn't feel right and it didn't feel it didn't feel intuitive, it didn't feel, like, the wise way. And so as soon as we, you know, got awoken to being able to make our own choices, you know, the the very common story is that we all ditched it, you know. And and it goes on to every chapter really of your book that you were, you know, you gave such a gift to women, I mean, and men and babies and everybody, but that you are providing this really intelligently woven evidence based book that is super validating to stuff that also is really obvious, but we need this to have the conversation, you know. And so you've really I think you've just really given a lot of people, a tool that we can share and that we can circle around and that we can reference and, yeah. Anyway, so
Speaker 3
Well, thanks for saying that.
Speaker 2
I mean, I
Speaker 3
I, you know, I think that, we're we're at a little bit of a crossroads with this question of of, you know, what's valid, who's whose information is valid. And, and this is something that I think I, you know, I credit the the feminist health movement with with disrupting because, you know, they at the time, there was no Internet. There was, you know, this was pre Our Bodies, Ourselves, pre bookshelves full of books about, you know, women's health and anatomy. And all they had was what they were being told by a very male dominated, patriarchal, paternalistic medical establishment. And they stood up and said, you know, no. We need to get together. We need to talk to each other about what we're experiencing. We need to look at each other's bodies. We need to write our own books. We need to create our own knowledge base because the textbooks and what the what we're hearing from the MDs is not our experience and we're, you know, we're hurting. And so, you know, they they really disrupted that notion of, you know, only some knowledge is, and what we mean by that, of course, is male knowledge. Like, you know, the the elite at the time, like, the the the, medical doctors and their books. And but I think now we're at this we're we're kind of back at this point where, like I said, research is being weaponized. The whole idea of, you know, what's what it's called authoritative knowledge and scholarly terms. And, it certainly shows up in the context of birth. You know, midwives are, they have a soft credential. Mhmm. You know, you if if if you look at, you know, stories in the media, you they go to doctors for the expert opinion.
Speaker 2
Of course.
Speaker 3
So and I think, you know, the, feminists are just as guilty of dismissing knowledge that's, you know, soft. It's from it's only anecdotal. So the leap the leap thing I mentioned, there was this, I thought it was a fantastic piece. It was something that I wish I had reported and written, about the LEAP procedures that are done on, abnormal abnormal cervical cells.
Speaker 2
Wait. Is this the Cosmo article?
Speaker 3
Yeah. Okay. I'll have to look at it. And the the writer is Hannah Smothers, the reporter. And, you know, she was paying attention to the Facebook groups of thousands of women who feel that they have been harmed by a lead. It's called Let's in England. And, they feel like, you know, some of them lost their potential their ability to orgasm. Some of them have no sexual sensation anymore. Someone some of them lost it for years and then some of it came back. You know, there's varying experiences, but these are thousands of women who are saying they're having these experiences. And she also went to some researchers and experts who validated the those experiences with the anatomy of the nerves and the cervix and the the information that, you know, the training to do these procedures is uneven, and there's no guidelines about how deep to cut, etcetera, etcetera. I thought it was really, really well done piece. It's being attacked because, you know, these are anecdotal reports. And the research shows that hysterectomy has no impact.
Speaker 2
Right. Invalid, invalid, invalid.
Speaker 3
Yeah. And and, I mean, the this I think we need, you know, we need to bring back some of that, the skepticism that the seventies feminist health movement had, and also listening to people, listening to women, recognizing that, okay, we might not have research evidence. We might not have a gold standard randomized controlled trial yet, but we have not significant numbers of women having similar experiences. And we need to listen to them and and recognize them and look at that. I mean, that's I I did, one of the one of the things that delayed this book was, the reporting I did on eShore, the the contraceptive coils that I mean, it was a similar story. You know, it started with a Facebook group of thousands of women complaining of weird things, like pain bleeding, but also, like, hair loss, tooth decay, vague malaise. You know? Like and it took years of them with more and more women, joining this group on Facebook, more local media paying attention to it. And then, you know, finally, the, maker of the device there stops, selling, stopped marketing in the United States late late last year. Wow. All the while saying that there's nothing wrong with it. But, you know, it's like that same thing. There is no randomized controlled trial proving this. There's no part you know, you can say, well, the research doesn't improve it.
Speaker 2
Mhmm. Exactly. It's a great way to shut women down. It's a great way to silence. I mean, there's no
Speaker 3
Yeah.
Speaker 2
And there's not a huge incentive from big pharma or the medical paradigm, you know, to to validate, you know, to validate this this voice of women. And it makes me think of I I had emailed you, I spent a couple days with Carol Downer in New Mexico recently and Mary Lee Singleton, and and we did a cervical, exam circle and learned menstrual extraction, and, she, you know, Carol has great stories about what happens for her, you know, and she's now eighty six, so has been doing this for a very long time, and, you know, obviously through many decades, and what happened, the myth busting that happened when women gathered, you know, and women who were, as we are today, living very separated lives and very individualistic lives, and, you know, everyone complaining about community, but no one really living in community, and, and how quickly these lies that women have internalized about their bodies can be dissolved when women just share each other's stories, or when they look at their own cervix. And, she just had these great stories of them just legs splayed open, you know, speculums and mirrors and flashlights and just laughing and looking at each others and and you could just feel the, and I've experienced this myself, you know, as well, you can just feel, the power coming into the room, and and it doesn't have to be looking at each other's cervixes. It could be in a woman's circle, it could be in a birth sharing circle, it could be in any way that women gather, and that's always the, that always comforts me, how simple and quickly shifting can happen, you know, within our own, otherwise limiting beliefs that have been fed to us about our bodies and about, you know, how many women say that they were told they were fertile, infertile and then they get pregnant, how many women were told, you know, all sorts of bullshit about their bodies by a a typically a male doctor who doesn't know them and this whole internalized belief that the expert is outside. Yeah. And but what's so exciting about it and what always inspires me is that to take it back can happen literally in a thought. It can just happen. It's just a, it's a remembering, you know, or it's a being shown a new way in sisterhood, in circle, you know, being around other women who are questioning these things. And Mhmm. It's just so you know, everyone always asks. Actually, one of the questions that someone wanted to ask me to you was what form of activism has the greatest potential for creating change, and I'd love to hear your answer, and I guess to finish my thought, I would say it's just gather. If you're a woman, gather with other women and talk. And because I've seen firsthand how quickly, and I I mean, I don't even know that I'd call that activism, but how quickly, yeah, just this misogynistic lies and and and myths about our bodies can be dispelled.
Speaker 3
Yeah. Well, I think we also we limit ourselves and our health and our healing if we only think of one kind of medical practitioner as being legit and authoritative. You know? I mean, I've talked to so many people who have not found the answers through repeated visits to medical doctors, and they found the answers with a massage therapist, or they found the answers with an acupuncturist, or, you know, fill in the blank. And I I think what I think what the most innovative, medical professionals are realizing is that everyone's bodies are so different and everyone's, you know, the solutions to people's problems are so individual that everyone is kind of, unfortunately, on their own path. There's not usually, you know I have asthma and, like, there's a magic bullet there. You know, pharmaceutically, like, that was a major advance, you know, diabetes. Okay. But there are a lot of things, there are a lot of ailments that we don't fully understand. There's a lot of autoimmune diseases that the solutions are, you know, very individual and mysterious. And I think, you know, it's it's when people are open to other ideas that maybe an MD has poo pooed Mhmm. You know, that they start to find solutions. So, gosh, in terms of activism, I mean, I think in this moment, I think the bravest work is, you know, collecting misoprostol pills and learning how to do menstrual extraction, manual vacuum aspiration, you know, relearning the methods of of bringing back the men'sies, AKA early abortion because, I mean, I think we are looking at a a highly likely scenario of several states where it's completely inaccessible and illegal. I mean, I don't know if that's the vision I I hope for, you know, but but it's the reality that we have right now. And if we're going to keep it, safe and accessible to people, then a lot of people need to step up again just as they did, pre Roe and be, you know, be helping people. I mean, I think, like, the the the real vision is what the, the really radical feminists wanted in the early seventies, which was repeal of all the laws so that there is no restriction. And it's not and we don't legislate this medical procedure at all. I don't know when that's ever gonna happen, but, you know, some states are taking some measures to, you know, I don't know if most people know this, but Roe basically, limited the procedure to physicians. And at the time it was passed, physicians were very anti, doing it in office. It was like it had been a surgical procedure. It had been the DNC for so long. And just as Roe was passing, the technology was changing, and it was becoming this much more low tech, easy, procedure that I that I write about in the book, that that fascinating history that I think we don't we don't really know because we don't like to talk about the details of abortion. But, you know, it hasn't been the surgical procedure. You know, we always talk about it as, like, surgical, nonsurgical. It hasn't been surgical for at least forty years. And it's, the MVA is an extremely low tech, safe, procedure that around the world, most of the people who practice it are not doctors. Right. You know, they're nurses, they're health workers. Midwives. Yes. And we so we could have a scenario in the United States where, you know, a whole lot of people are able to do it. It's within their scope of practice. So could be midwives, it could be physician assistants, it could be nurses. And so in New York and California, I believe certified nurse midwives and physician assistants Yeah. And nurse practitioners are now able.
Speaker 2
But they don't.
Speaker 3
Right. Right. But there are still all these barriers. Yeah. Insurance, their hospital, their yeah. The practice, they could be afraid, legitimately. So yeah. And actually, in New York, I know that it's been a lot longer that physician assistants could do it because there was a there was a case, brought in the nineties. And so there but there was only, like, one doing it. Yeah. The one who brought the case.
Speaker 2
Yeah. I don't know anyone, any midwives in in California. I know that their CNMs are legally it's within their scope, but I don't know one who who is doing it.
Speaker 3
Yeah. I mean,
Speaker 2
I'm sure there's some at clinics, but in terms of Right. A midwifery practice.
Speaker 3
Right. Yeah. And I just I think, you know, it's unfortunate that we have this scenario right now where, we're we're, like, hanging on to clinics by Mhmm. Our fingernails, because it's, like, that's that's where we've ghettoized abortion into this other place, into outside of the health care system. And, you know, as I write about in the book, it's not an experience that most people find pleasant. I I mean, not that an abortion is ever really pleasant, but, you know, having to wait in a waiting room, having to go to a a provider who you don't know. Mhmm. You know, the fact that we can't just go to our doctor who knows us in the privacy of their office Mhmm. And have this very simple procedure, is, you know, the it's it's not very dignified.
Speaker 2
Well, many clinics don't allow a support person, you know, so you're in there alone. If you have high anxiety, you know, they don't have anything to offer you other than sedatives. It's
Speaker 3
Right.
Speaker 2
It's really isolating and it's really dehumanizing.
Speaker 3
Right. Right. And the sedatives are overkill.
Speaker 2
Oh, yeah. It's you
Speaker 3
know, and I think the reason that people get them because they are led to believe that abortion is is this surgical procedure. And and a lot of clinics, they have to, like, be set up like operating rooms. Right? So it's like it it it's almost you think that you're getting cut into. Mhmm. So it's like, yeah. Of course. Put me out. When people realize that it's it's so simple and over in five minutes, and then, you know, if you're not sedated, you can just get up and walk go out to lunch or whatever you need to do.
Speaker 2
Well, I remember Carol saying over that weekend, she said, you know, and you don't have to be worried, when inserting, the the tube. The name's escaping me right now.
Speaker 3
The cannula.
Speaker 2
Yes. Thank you. Because, you won't perforate, you know, the uterus because the woman will be awake and she will tell you how it feels. And it was this, like, amazing moment in my head, because I used to run a nonprofit for abortion support in LA and and, you know, I had my volunteers in clinics and I've kind of have been exposed to it from the clinic side, not from the menstrual extraction side. And I was like, oh, right. Duh. Like, it's it's and and yes, it's a little bit different than what we call surgical, you know, in Right. Clinic, which is not surgical like you said. But what a powerful thing to remember that if a woman is awake and you're tuning in with her and you're Right. Having a woman centered extraction that you can just, oh my god, ask her how she feels. Right. And she could use her voice. Like, what a freaking concept.
Speaker 3
Right. It makes it much much safer. Yeah.
Speaker 2
Right. And it actually makes it safer. Exactly. Yeah.
Speaker 3
Yeah. Okay. So one question
Speaker 2
I had for you was, was there a particular piece of research that blew your mind, surprised you when you were digging into all of this? Does anything come to mind when I asked that that you were like, oh, yeah. That blew my freaking mind.
Speaker 3
There is a birth related one. It's I think it's the last listening to mother survey that just looked at California. And the among the women who were not induced and did not have epidurals, only one percent had cesareans.
Speaker 2
Woah.
Speaker 3
Yeah. That data point, like, blew me away.
Speaker 2
What year was that survey done?
Speaker 3
And that might I, this is not too long ago. This was, like, the last, the most recent one, and it was only in California. Wow. And you'd have to go look to see if it was, like, just first time mothers.
Speaker 2
Sure.
Speaker 3
But, but that really blew me away.
Speaker 2
Says a lot.
Speaker 3
Because that really speaks to how what the impact of all the intervention is. Mhmm. I mean, the other thing that that was really surprising to me was what the what the GYN surgeons complained about, which is, that the residency for OB GYN is shorter than for other surgeons. Mhmm. And that they have a whole lot more on their plate to learn. And so the actual amount of time that OB GYNs get trained to do pelvic surgery is very short. Whereas other surgical specialties do five solid years of surgery.
Speaker 2
Right. We need to separate those two professions. OB and gyne should not be in one person's. I mean, my opinion
Speaker 3
interesting. That's what a couple of them said to me. Like, that
Speaker 2
Oh, really?
Speaker 3
That was their take that Mhmm. And and the history is that they were separate. Right. And that GYN was really more part of surgery. And they kinda got together because OBs needed more legitimacy, and the surgeons didn't really want GYNs in their space anyway. And probably there was, like, stigma of woman stuff and whatever. There were all sorts of reasons, but, they got together in around nineteen fifty. And it is a really interesting question that I still have about what the impact of that was on surgical training, on skill, on on knowledge of the anatomy, and and on outcomes. Because, you know, as I delved into the, the vaginal mesh stuff and the and, the and hysterectomy and the controversy over the the power morse later, which, you know, you can go Google it if you haven't read the book yet. But, as I delved into that, you know, I kept hearing surgeons complaining that, well, you know, this would that this is happening because it's being marketed toward less experienced surgeons, or this device isn't used in surgery. It's only used in GYN surgery. Why is that? And, so I that's a question that I still have. Yeah. About the the impact there and, and and we just keep keeping more. I mean, I've I've been saying, you know, it's kinda like OB GYNs have five different jobs because they're doing what midwives do in most other countries. Right. Low risk, normal birth. They're doing high risk OB. They're doing well woman care. Now they're doing primary care since the nineties because during the whole health care reform negotiations, OB GYNs wanted they didn't wanna have to be referred to Mhmm. By a primary care doctor. So they got status as primary care doctors. That meant they had to add on a whole new, you know, all of that into their training, into their four year residency. And then they're doing hormones. You know, they're they're doing endocrinology, basically. So they are doing a lot and it kind of, you know, it makes you wonder, like And not very well. The Superwoman complex. Like Yeah. Exactly. Like, that's the woman doctor, and we just throw everything. Right. And it's really a good
Speaker 2
service because It's too much.
Speaker 3
There if anyone has any complicated hormonal, diseases, you know, PCOS, endometriosis, they need really, you know, they they need people who are specialized in those areas. The anti sufferers need surgeons who are really specialized and experienced and skilled in navigating the pelvic anatomy. And it's, I mean, it's like removing cancer. And there are very few in the country who can do it the proper way. Most women are just getting zapped with lasers and creating more scar tissue, requiring more surgeries. So we're not being served by this.
Speaker 2
And even the doctors, like, I'm from LA and that was where I was a a birth worker for a long time and, you know, the really high end kind of famous doctors that people wanted to be present at their birth, well, shocker, everybody was induced because they were working nine to five in their GYN clinics, and they were doing surgery all day, and they were and they, it I mean, you could feel it was literally that one person cannot do everything that's on his or her plate, and people really suffered. People really suffer. You know, women and families really suffer from this, like you said, superwoman complex that's that's, there's there's literally not enough time in the day, and then we add the unpredictability of labor. And so, of course, we have to then make it predictable to fit into, pretty much an impossible, you know, capacity or an impossible bandwidth. Okay. Let's switch channels here. Because obviously, you can't cover everything in your book, and you lightly touch on, you you do mention surrogacy, which has increasingly become a very big topic for for me personally, and really learning about it and and how, staunchly against it I have become as a as a woman rights and human rights and feminist issue. I'm wondering kind of what was it just because you can't put everything in a book? Like, I I know you mentioned it, maybe there's like a chapter or so on it, but any anything to add to any thoughts around that?
Speaker 3
About surrogacy specifically? Mhmm. Yeah. I wrote a piece about surrogacy a few years ago for Babble. And, I mean, I think it's, yeah, it's really complicated. It's, you know, it's a it's a huge, it's a it's a risk. It's asking a person to take a huge risk with their body. It's putting, you know, a price on it that is hard to quantify, you know. And and it's so tricky because, it it threatens a woman's autonomy. I mean, once you have, like, a fetus in you or two fetuses or three who are contractually owned, claimed for by other people with their own interests, then, you know, where is the woman's body in that? Like, can she eat what she wants? What if she wants a home birth? What if she doesn't want three fetuses in her? So that was the case that I wrote about was someone who was, who had offered to be a surrogate for friends. And, the when she went to have the, embryos implanted, while she was under sedation, she was she signed away consent for three to be implanted.
Speaker 2
Yeah.
Speaker 3
And, you know, that is completely unethical. That should have been a conversation when her when she was, like, upright with her clothes on in an office, not, flat on her back sedated. And the the physician said, oh, don't worry. There's, like, no chance that they'll all take. Well, they all took.
Speaker 2
Oh my gosh.
Speaker 3
And this was a person who was very pro life. And the quote, unquote owners, the parents, the genetic parents didn't want three. Oh. They wanted one. And this woman did not wanna you know, she was really, personally against abortion. And she she ultimately agreed to reduce to two. She I think she got a vaginal birth, but did not wanna have a hospital birth and ended up having one. Anyway, you know, and so she she really, you know, she came out of that really questioning the decision to do it. She actually didn't get she didn't wanna get paid. She was doing it out of altruism. But, you know, I mean, I I don't, you know, I try to maintain a distance from these issues as a journalist. And, you know, so just, you know, to tease out the the issues and the complications and, talk to, you know, the scholars who have done all the thinking about it and who have strong opinions. But I do think it raises all these thorny questions. And and the the big, you know, as a as a, you know, as a feminist, as a person who's, like, pro autonomy, you know, I think it's it's problematic. And then it's and it's, you know, I think it just, I wouldn't, you know, I wouldn't ever wanna decide for someone what they should do, whether they wanna be a surrogate or not, or whether two people should hire a surrogate. It's not really for me to decide, but I do think that those issues need to be, more at the forefront of of these conversations and on how people think about it. Mhmm. Because I don't I don't know that people are thinking about it in that way that, you know, the the what's the word? You know, the seriousness of what they're asking of another human being, and and the and and what kind of, you know, boundaries can be put in place so that person's autonomy is is intact and dignity and, you know, everything else.
Speaker 2
Well and I guess I would say that that's not possible when you're renting a womb and buying, you know, or taking that person's baby. Yeah. Yeah. I had Mary Lou on to talk about this who's really articulate, and I'm curious to see what the response will will be because we go pretty hard on it.
Speaker 3
Well, I love listening to really opinionated people, and I I look forward to that. Yeah. I'll send it to you. And then That's something I you know, personally, I you know, we all make our own personal decisions. I I decided at a point, like, if I don't you know, if if I miss my window, I I'm I miss my window, but that's my decision. You know?
Speaker 2
You wouldn't go buy a woman.
Speaker 3
But, you know, there are people who do it for free, like this woman I interviewed.
Speaker 2
Yeah. Well, you're still renting a woman.
Speaker 3
Yeah. But, I mean, that's, you know, it's loaded language and not everyone who who does this would would agree with that.
Speaker 2
Yeah. I guess, I mean, it would I would
Speaker 3
respect that too.
Speaker 2
Yeah.
Speaker 3
That person's autonomy to decide that she wants to do this for someone. You know, there are sisters who do it for each other.
Speaker 2
Totally.
Speaker 3
You know, but, yeah, I decided that I would not wanna ask that of someone else. Mhmm. And be responsible for what because now I'm you know, I would feel responsible for what happens to that person
Speaker 2
who loses her uterus as a result. God. Totally.
Speaker 3
Or worse. I mean, yeah, one of the women I now remember, she nearly died. I mean, she nearly bled to death, because of complications. And so it's a, you know, it's a serious thing. And I think
Speaker 2
It was a surrogate baby?
Speaker 3
The yes. The surrogate the the woman who was carrying the baby for you know? Yes. But I think what what I think the what this relates back to to my book and my, you know, the my, like, thesis is that we have not reconciled the biological clock with our culture culture and our, you know, late capitalist culture where we have to work and work and work. And if we, as women, wanna have a career, wanna be academics, you know, wanna be CEOs or whatever, like, we are expected to work through those fertile years, and we are expected to, you know, just go to technology. Mhmm. And the egg freeze you know, egg freezing has been sold as this insurance policy, and it's not it's not that. It's it's, you know, got very low effectiveness. It's hugely expensive. I, you know, I think it's a lot of it is very exploitative. And now we're seeing essays from women who, you know, froze their eggs five, ten years ago, go to thaw them. There are only, like, five that are viable. None of them take, and they're that's it. Now their next, you know, their next option is is surrogacy. Right? Like, they're out of you know, they're forty six. They're out of options. I just think we have to like, if we're gonna be bold and visionary, we're gonna fight for the the ability to have families while our biological window is open because it's the least painful, the least costly, the least risky. Mhmm. And, like, when I talk about, you know, this physiological justice, that's what I mean is, you know, like, recognizing that we have biology and we can only do so much to it. You know? We can we don't we we don't do anything natural anymore. Like, I don't you know? What does it mean? You know? But I'm living in a in a in a house with four walls, and, you know, I have unnatural heat, and I have a fridge. And, like, you know, we don't do things natural, but, but we can only do so much to manipulate our bodies. Mhmm. And I think that we've been bear as women, we've been bearing the burden of fitting into this timeline that was not you know, it was built for men by men.
Speaker 2
Yeah. And this concept that it's not that a forty six year old woman who finally goes to try to get pregnant is infertile. She's post fertile. You know. Right. And that we're not using that language anywhere, you know. You're not infertile at forty four years old. That you're not. You know, you're you're post fertile and I think it's so like you said, it's just so important to, be having this conversation and and to be right that the most revolutionary thing is to how to how do we integrate families if they're wanted while we're working and not just trying, you know. I mean, it's like the old way of feminism to be like feminism is just women or men, You know? Yeah. But obviously, that's not serving us, and that's not, that's not where we're
Speaker 3
Yeah. If we just want what men have, then we're really limiting ourselves. Yeah. And I think we need to we need to look at the, you know, the notion of, you know, people have a right to have a family. You know, at what expense? At at whose expense? I just think we need, you know, we need to ask those questions.
Speaker 2
I'm glad you say that. This idea that everyone's entitled to parenthood, but what that actually plays out to be is typically wealthy white people. Right? So if everyone was entitled to a child, what what would that even mean? You know, that would that that that's that's obviously untrue in so many ways. Biologically, it's untrue. And socially, it's untrue.
Speaker 3
And Right. And we're talking about the right to a genetic baby. Right. Like, a lot of kids need parents.
Speaker 2
Right. Exactly.
Speaker 3
Exactly. People don't typically wanna adopt a nine year old. Mhmm.
Speaker 2
Yeah. So couple quick things before we close. One thing I was wondering about, and maybe it just didn't fit into that chapter, but I was wondering about your thoughts if you had done any research on copper copper IUDs, and if it was a intentional, you know, choice not to include it in obviously, you were talking about hormonal, so that's not that. But any any thoughts on that?
Speaker 3
I don't know a ton about copper IUDs. I know that there's, you know, there are some adverse events even with those. Sometimes they break. Sometimes they, you know, they cause women too much pain and bleeding. That my understanding is that they sort of irritate the lining of the uterus. But I, you know, I think, like, people have to do what works for them. And, you know, if, if they need something that's discreet and that they don't need to remember and, hormones don't work for them and they don't want them, then I think it's it's good that it's there. You know? But I would I would love to see more discussion of the, fertility awareness method and the fact that it actually is backed by study and works shockingly well, and it's not, like, super rocket science. Not at all.
Speaker 2
Very simple.
Speaker 3
It's kind of unfortunate that, you know, the recommendation is that you take an eight week class. And, you know, I I think that's great, but most people can't do that. That's not, you know but I I just think the even even spreading the information about the basic knowledge of that, you know, that when, you know, people are cycling or only fertile for a few days and there are ways to tell. And just that basic knowledge would be so empowering to people. And, you know, I just think it's still sort of stuck in the fringes and dismissed as the rhythm method and Totally. You know, not acknowledging. Even withdrawal. Mhmm. I love the researcher I talked to who was like, I love talking about withdrawal. It's, you know, it it's totally more effective than it gets credit for. And, like, we just aren't talking about these things. We're just so focused on effectiveness and getting that, like, ninety nine point five percent effectiveness that,
Speaker 2
that, you know I
Speaker 3
I just think we could re reframe the conversation a bit. I mean, that was the problem with the with the way eShore was marketed too. Interestingly, when eShore came out, there was very little IUD on the market. I think it was just the ParaGard and, none of the hormone newer hormonal, IUDs were on the market. And so this was, like, this was the solution to for people who, you know, had had their babies and, were definitely not wanting any more kids, but, you know, could do this without, having to get a tubal ligation. And I just kept thinking, okay. But if you're, like, forty two, you've only got a few more years of needing a contraceptive. So it's like the way it was sold was, like, you know, permanent contraceptive. You'll have to you'll take care of the rest of your life instead of you only need something for about five more years or ten more years. This is gonna be in you for the rest of your life. And it you know, we only studied it on four hundred and twenty three women or whatever it was. So just the the framing of that, I just thought, like, why didn't weren't people offered an IUD? That would've you know, if they wanted something, set it and forget it, that would've been a great option. Set it. It's you know, take it out in eight years. You're into you're into perimenopause at that point.
Speaker 2
Totally.
Speaker 3
Right.
Speaker 2
That definitely would have made more sense. Okay. Well, then let's wrap up with, with what's next. Is there anything is there anything particular on the, on the docket right now that you're working on that you can speak about? Or and also, I mean, you just got this out, so I'm sure it's mostly just promoting this and and getting
Speaker 3
Yeah.
Speaker 2
Out and about. And also, was there anything about this book that you really wanted something to be in it, but it just didn't have space for it? Like, you mentioned maybe the fourth trimester or Oh, yeah. I'm sure so much.
Speaker 3
There are so many things that I was But, no. I mean, in terms of what next, I do have I have an article coming out about, the situation in New York, specifically in the history of, like, midwife licensure in New York.
Speaker 2
Nice.
Speaker 3
And why CPMs are still not recognized in New York. Upstate who's being charged with, like, five different felonies right now. And it's a it's an it's a really interesting history. And my midwife, happened to have lived in New York and left because she saw what was happening. So it ties in with my with my own, choices, and I tell my birth story in this article. So
Speaker 2
And so where do you
Speaker 3
will be on mom read.
Speaker 2
So with your with your journalism, do you have a website that you post all your work, or is it just wherever it gets picked up?
Speaker 3
Yeah. I have, I have jennifer block dot com, and I, you know, I tweet
Speaker 2
Yeah. You do.
Speaker 3
Occasionally. I try to tweet, at writing block, and I'm on Facebook at jennifer block author and on Insta as at Jennifer Block author also. So I'm trying to spread my tentacles.
Speaker 2
Yeah. We're doing it. Well, we're all we're all helping you. That book just spread like wildfire in our community. And everywhere I go, I'm like, anyone wanna join our
Speaker 3
book club? We're reading Jennifer Bach's book. Well, thanks for reading the book, and, thanks for having me on the podcast.
Speaker 2
Yeah. Thank you. Hope to have you back someday.
Speaker 1
That's it for today, everyone. Join us next week for another episode of the free birth podcast. Thanks for joining us, and remember, your body, your choice. Lots of
Speaker 3
love.
