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You are not allowed to not allow me

When talking to families in interviews or prenatal visits or in my childbirth education classes, I can’t stress enough how important it is to choose your care provider wisely. This amazing article on Pathways for Family Wellness (a site well worth checking out) does a great deal to emphasize some of the red flags you should be aware of when meeting with potential doctors and midwives and how to empower yourself with appropriate questions to weed out those that might not be a good fit. 

I know in my prenatal sessions and classes, couples tend to get anxious waiting for me to FINALLY get around to the things they thought they were coming in for–What does labor look like? How do I know when to go to the hospital? What are the tools for having a “natural” birth?–as I spend the entire first pregnancy consultation or the first two hours of my first prenatal session talking about your birth team. 

I have to remind them that all the squats and yoga breathing and mantras in the world aren’t going to make an impact if you have a care provider who doesn’t believe birth is an event not necessarily full of management and intervention and doesn’t really seem committed to helping you have an unmedicated birth. 

One of the ways you can figure out if they are going to be harmful or helpful to your goals of a physiologically appropriate birth is by paying attention to language like “We don’t allow” or “I don’t do that.” If you’ve done your research and know you want to have a water birth, why would you stick with a care provider who says something like, “Oh some doctors/midwives do that, but I don’t.” or “We don’t allow births in the tub here.”? It’s amazing how often I hear pregnant folks say something to that extent and either don’t know that they can switch providers, or know that they have other options, or for whatever reason just don’t think it’s going to be a big deal in labor. IT IS A BIG DEAL! And though having a doula can be enormously helpful in advocating for your wishes in birth, we can’t make decisions for you or fire a nurse a doctor or a midwife for you, and so there’s only so much we can do in the end. 

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Sadly, we in the United States have grown accustomed to poor medical care, a lack of true informed consent, and being told that we can’t possibly know much about our bodies. With most women hearing horrible stories of near-death births left and right, they’ve grown to think that they must also have this kind of traumatic birth, so it doesn’t matter if they “like” their provider much, as long as they’re there to rescue you and baby. It’s precisely this culture of fear and misinformation and lack of choice and trust in care providers that is driving the rising maternal mortality rate in this country (we are the only country–developed or otherwise–which boasts a rising rate). 

So, it does matter who your provider is and where you choose to give birth. If you are currently seeing a provider who uses language that takes away choice and support, SWITCH! Even if they have a nice smile and good bedside manner, if they’re not on your team, fire them. Now and not when you are fighting them in labor. That’s not fair. If you are early on in your pregnancy interview a bunch of different providers. Seriously. How much time did you spend picking out a stroller or car seat? Spend 10 times that amount talking to care providers and staff at the place where you choose to give birth and don’t stop till you’re sure in your gut that you’ve found the best fit. Take a month to do it. Make them sit down with you for an hour and answer all of your questions. 

If they don’t want to give you their cesarean rate, but avoiding a cesarean is your biggest concern in pregnancy, keep hounding them or leave and never look back. 

You are 100% entitled to having the birth you want. There’s no being “selfish” or “smug” or “bossy” or “difficult” in asking for care that is supported by evidence and is kind and supportive. Choosing an appropriate care provider who gives you options, supports your choices, and practices according to informed consent is also not just for parents hoping to not use pain medication in labor. This isn’t you not being particularly nice to a waiter somewhere, this is arguably the most important day of your life and what happens in labor has long lasting effects for you, for baby, and for your family. It’s not about being a “smug hippie” or trying to win an award for best mom, this is about you taking control of a very normal, natural process that shouldn’t leave you battered, scarred, and needing therapy. 

Do not allow them to tell you you’re not allowed. 

If you want more information like this, sign up for a pregnancy consultation package or hourly conversation. That first investment can save you stress, time, money, and help you connect to a care provider in line with your wishes and needs in pregnancy and beyond.

Pregnancy Challenge Week #3 -- Sign up for an Independent Childbirth Education Class

I’m starting a series of challenges to expectant parents to encourage them to take small steps toward better care, more informed decision making, and a smoother transition into parenthood.

Over the next few weeks, I’ll be posting on action item in this vein, with some information for why and some resources for how. I imagine the challenges will be steeper for some families than others. I also imagine that it will vary person-to-person which action items are more difficult than the others. Some families, too, I imagine won’t face a ton of barriers, but just needed some guidance on the fact that these things are available.


What’s on the docket for Week 2?

I challenge all pregnant persons to sign up for an independently run childbirth education class.

Ever heard of tocophobia? It’s a term used to describe the fear of childbirth. Researchers in Sweden have found that when expectant fathers experience tocophobia, it may have negative effects on the birth experiences of their partners, particularly male partners.

The study, titled Psychoprophylaxis - Antenatal preparation and actual use during labour, by Malin Bergström found that many of these men were fearful not only of the process of childbirth, but in their roles as parents as well. There have been some signs to indicate that tocophobia contributed to an increase in cesarean sections, pointing to the need for birth professionals to address these fears with expecting parents.

The since the study, the Swedish Medical University has begun providing childbirth preparation classes featuring the use of psychoprophylaxis (relaxation techniques) for all expectant parents with good results.

Unfortunately, only 30% of expectant parents in the U.S. take any sort of childbirth education, the majority of those taking the shorter and more restricted classes taught in the hospitals.

Independent childbirth educators encourage both mother and partner to participate in class discussions to try and address these common fears about labor and early parenting. Educational models such as the Bradley Method, Hypnobirthing, and Birthing from Within place a great deal of emphasis on the partner as a strong yet calm source of strength for the woman in labor by teaching the partner relaxation techniques like massage and affirmations.

In another study on childbirth education classes from Lamaze International* the researchers discovered the rate of attendance for childbirth ed courses, and particularly courses lasting more than one session, has been decreasing over the past several years. Couples are encouraged to take lengthier courses, independent of the hospital preparation courses to get a more complete training in birth support.

Additionally, hiring a doula can help parents receive one-on-one training in these techniques and a sense of security in asking questions concerning any anxieties in an intimate and supportive setting. Doulas also help the partner to feel comfortable that everything is going well in labor, knowing that the mother will never be left alone and that there is a constant source of guidance and expertise by their side.

Unfortunately, the way the American medical system is set up, there is so little time afforded to any one patient/client at a time. How is it possible to fully go over all of the major changes of pregnancy, build trust, talk about preventative care, go over routine tests and if they’re necessary, talk about a birth plan, talk about what to expect, discuss routine newborn care, teach someone about breastfeeding, go over partner involvement, discuss family planning options, and touch on the politics of informed consent and refusal in a 7-10 minute visit with an OB (that’s the national average)? It’s impossible!

This is the reason why the majority of women in the U.S. get their prenatal education from books and online articles. While that sounds innocuous enough, the unfortunate truth is that there’s a lot of garbage out there and unless you are an expert in birth, it might be hard to figure that out. Take for example, the horrible What to Expect series, which is sometimes dubbed “What to Expect When You Expect Everything to Go Wrong,” which is not written by birth experts at all and is full of factual errors. Or the even more offensive, “Girlfriends Guide to Pregnancy,” which is so horrible I don’t even want to waste my breath on explaining how.

There is inherent bias in all of these guides–there is clear bias even in my reviews of them above, obviously. The point is whether or not you can see the bias, and then having the tools and feeling empowered enough to take it or leave it. It’s scary to do that when you have your life and the life of your baby at stake, but truly, birth is primarily a safe and normal process, which doesn’t need a whole lot of bells or whistles (or surgery, for that matter), and going with your gut and getting the birth you feel is right for you and baby really is the only important bias to consider.

Talking about the politics around pregnancy and birth is not the fun, gooey, warm stuff most people want out of a course on natural childbirth. I’m fully aware of that. However, after attending births in almost 20 different settings, in 4 states and abroad, I can tell you that many of these topics related to the political aspect of birth are way more essential to understand than a mantra or supported squat. Those sorts of amazing “natural birth” things actually happen on their own because we’re biologically programmed to do them, but they can only happen if you are in a supportive environment where you feel safe and empowered.

Another great reason to take an independent childbirth education course: Understanding the principles of informed consent and informed refusal.

Some basic principles of evidence-based health care are:

  1. Question common assumptions. Be skeptical! Many widely held beliefs about health care do not reflect the best available research. This may lead to poor care and health outcomes. Don’t hesitate to say: show me the evidence.

  2. Consider the best studies. Quite a few studies are poorly done, and many have weak designs. Poorer quality studies should not be used to guide decisions. When a new study is reported, we should ask: what is already known about this question on the basis of the best available research, and what, if anything, does this study add?

  3. Look for the “Gold Standard.” When available, well-conducted systematic reviews of research should inform care decisions. If systematic reviews are not available, individual studies with randomized controlled trial designs can provide a good alternative. It may be important to consider other types of studies as well. (See more about systematic reviews and randomized controlled trials below.)

  4. Make informed decisions. When making decisions about your care, it is important to consider the best available evidence in combination with your values, preferences and circumstances. Also, take into account care setting issues, such as the skills of caregivers and available forms of care.

Informed consent is rarely a topic discussed in the classes taught in the hospitals themselves, for somewhat obvious reasons. The deferred starting point of medical decision making is doctor-centered, not parent-centered, so why discuss an alternative in the preparation courses?

One class I highly recommend, both for it’s discussion of informed consent as well as a deep dive into the important emotional preparation for labor is Rachel Yellin’s YES to Birth, which you can take in person and online.

From her site:

Using hypnosis, relaxation, meditation, breathing, the power of your mind, and the connection with your baby to give birth the way that nature intended.

Classes are appropriate for pregnant women who either know that they want a natural birth or who want to try for the most natural birth possible. Hospital, home birth or birth center birthers are all encouraged to attend.

Rachel offers private classes and one-on-one depth hypnosis sessions to prepare you for labor, as well. You can also download all of her guided meditation tracks on the site, which are a HUGE help in childbirth and beyond. Folks I’ve worked with who have taken Rachel’s classes and/or used her guided meditation in pregnancy and birth have felt more confident in their ability to advocate for themselves in labor as well as feeling safe and satisfied with the laboring process. Their partners feel well prepared to be the primary support persons and all report feeling so grateful they took such an honest and in-depth class. It’s well worth the time commitment, I promise! You can use the code “ebd” at checkout for a discount on downloads and “25BUCKSOFF” with my name (Emily Flynn) to get $25 off any classes you register for online or in person.



It might seem like a crazy amount of time to set aside (many independent childbirth education classes are 6-12 hours spread over a few weeks), but considering what a monumental difference your experience of birth can make for your long term mental and physical health, as well as that of your baby’s, it’s well worth investing several hours becoming informed.

If you participate in these #pregnancychallenge ideas and want to share, please comment below, send me an email, or tag us @Rosewoodrepro on instagram and let us know how you are doing! Happy learning!

Home or Hospital?

I got the chance to be a part of a truly beautiful, peaceful, powerful, well supported, safe, mother-and-baby centered home birth attended by two incredible midwives yesterday. This little one came almost exactly 9 years after I attended my first birth (also at home) and felt like a wonderful full circle.

If you are exploring your options for safe, patient-centered, evidence-based care in pregnancy, birth, and postpartum, I’d like you to strongly consider at least interviewing some home birth midwives in your area and doing some research around why home birth is a reasonable option for most pregnant folks. I’ve included some videos and links here and look out for my upcoming longer article on midwifery care here on the blog.

For those who are concerned about the out of pocket cost:

Pregnancy Challenge Week #2 -- Save for a Doula

I’m starting a series of challenges to expectant parents to encourage them to take small steps toward better care, more informed decision making, and a smoother transition into parenthood.

Over the next few weeks, I’ll be posting on action item in this vein, with some information for why and some resources for how. I imagine the challenges will be steeper for some families than others. I also imagine that it will vary person-to-person which action items are more difficult than the others. Some families, too, I imagine won’t face a ton of barriers, but just needed some guidance on the fact that these things are available.

What’s on the docket for Week 2?


I challenge any expectant family to start budgeting for a doula.

budgeting for a doula


So I might need to start with answering What is a doula?

A doula is a secondary support person trained in non-clinical support in the childbearing year and sometimes beyond.

Doulas are not primary caregivers, so they work in tandem with midwives, doctors, nurses, midwife assistants/apprentices, lactation consultants, etc. Most often you will hire a doula independently, though some birth centers and hospitals have on-staff doulas you can or are required to choose from. Most doulas work primarily in a hospital setting, but can join you for an intended home or birth center birth, as well.

Evidence shows that the one of the best ways to reduce the number of unnecessary interventions, improve maternal and infant birth outcomes, reduce disparities in care and outcomes, and create more satisfying birth and postpartum experiences is to have continuity of care that includes continuous labor support. Most families are very surprised somewhat late in their pregnancies to discover that they aren’t going to get that from their primary care providers in a hospital setting (and this includes hospital-based midwives who work on a shift schedule), hospital staff, or pediatricians. This is where doulas have come in and where the evidence shows that they can help families have better birthing experiences -- both in emotional wellbeing and in reducing unnecessary medical interventions. Following the first publications of these findings, one author famously said, “If ‘doula’ was a drug, it’d be unethical not to use it.”


Most birth doula packages include 2-4 appointments prenatally to discuss your individual pregnancy and desires for birth as well as common coping practices, community resources, advice on having good communication with your primary care providers and other staff and loved ones that might be present at birth, your options in pregnancy and birth, the typical stages of labor, and some newborn advice. They are on call for you 24/7 for a window typically two weeks prior and two weeks following your guess date (it is a total guess when your baby will arrive, btw). They are available for phone, text, and email support throughout your contract. They will set a plan of communication around the early stages of labor to be your primary point person for what’s going on in your individual birthing situation. They join you when you are in active labor and need additional support and help you stay at home longer if birthing at the hospital help with the communication around when to call your midwives if you are birthing at home or a birth center. A doula will then go with you/stay with you at your intended place of birth till baby has arrived and for a short while after to help talk about baby feeding, what to expect in the first few days, and to check in on how you’re settling in after birth. Most doulas include 1-2 follow visits in your home in the first two weeks following birth to cover a wide range of topics on healing, feeding, newborn care, and other items of need.

Postpartum doulas focus primarily on care for parents and infants in the first 2-4 months after birth. Some birth doulas are also postpartum doulas and are available for extended care packages through the childbearing year. However, it is possible to hire an additional or exclusively work with a postpartum doula, too. They typically work either daytime shifts of 3-5 hours a few days a week or overnight shifts that shouldn’t be longer than 8 hours each. Though it may seem amazing to hire a postpartum doula for around the clock care, most families feel very well educated and supported with having a trained, thoughtful person come in to check on them 2-3 days or nights per week. Ideally, you are working with them on a tapered system where there is denser coverage in the beginning that fades to maybe one day or night shift a week to help you transition into caring for baby on your own once you have a rhythm established.


The cost of a doula varies based on what’s typical in your community, what their packages include, and their level of experience. It is possible to work with a doula who works on trade, sliding scale, or on a volunteer basis, though I encourage you to explore the value of the time, effort, and resources this person is putting in to being your support person in this immensely intense time in your life. Having said that, if you are really wanting to work with a doula and it isn’t in your budget, there can be lots of avenues for finding a fantastic doula that can fit your economic needs. Many doulas will be more than happy to reach out to their community to find you a good fit or to connect you with an organization that offers volunteer support.

Even in high income areas, the upper reaches of birth doula fees are typically under $3,000 for full care and the national average is around $1,500. Postpartum care, especially overnight care, can run into the tens of thousands of dollars over the course of several months. The highest fees don’t always reflect the level of support you’re getting or denote who might be your best fit, so it’s worth researching a wide number of doulas and asking even the higher fee doulas if they’re willing to work within your budget or have a strong recommendation for someone who can.

For this challenge, I want you to imagine setting aside at least $2,000 for doula support if you can. According to Fortune, folks spend an average of $1,300 on Amazon per person per year. Individuals in the US spend about $1,500 each on vacations per year. The average cost of a wedding is almost $26,000, which is also an enormously important day for many, but also just a single day and doesn’t carry quite the same lasting benefits and risks as having a positive birth experience...I mean, even the cost of the cake on average is $500. What would it mean to put that towards several hours of personalized postpartum doula care?

You can make up these costs in a lot of different ways. I have an earlier post on how postpartum preparation can help save you a ton of money you can put towards doula care I’d encourage you to take a peak at, but the gist of it is

BUY LESS BABY STUFF

Can I challenge you to try this : Every time you are about to purchase something for baby, can you either do without it (the answer is almost certainly yes) and put that same amount into a savings fund for a doula? Or can you put a matching amount in that savings fund? Many useless baby items will run you about $35 a pop and will likely wind up in the Goodwill pile where $35 is about the hourly rate of many postpartum doulas. That $120 countertop sterilizer machine…? Guess what, there’s no sound evidence on sterilizing bottles and a lot of good evidence on why not to so there’s $120 closer to your birth doula fund. There is no gadget out there that can replace having quality labor support or someone helping you to navigate the tricky first months with a newborn.

Friends, family, and co-workers are often very very excited to help you greet your little one and want to show you. This often leads to them purchasing a ton of stuff, and it’s up to you to direct them into another option, if you really want support around having a doula. Don’t be shy about talking about your process of hiring a doula, trying to reach your budget goals, and that if you’d prefer it, that you’d rather have some money to put toward doula support over another book or pile of onesies.

What about expensive gender reveal or baby showers? Can you have a celebration with friends around this that isn’t full of cheap decorations you’re just going to throw away? Have it be a potluck with fun games around baby names and the like and ask your guests to chip in to your doula fund in lieu of obligatory baby gifts you might not ever use. You can ask your doula to attend, even, and talk to your guests about how beneficial their support might be to you in the long run. If it doesn’t feel too tacky, you can put out a box/jar/whatever with the label “doula fund” and even if you just get a few bucks, you’re a few bucks closer to $2,000.

Or, if you don’t feel like making a ton of swaps to your plans for celebrating before baby arrives, can you just set a goal of how much money you’ll set aside per week till you hit your doula fee goal? If you have a partner, you can ask them to do the same and set up a mutual savings spot and even make it kinda fun somehow. Maybe get an old school piggy bank and smash it when you’re ready to hire your doula!?

Did you go out for a regular giant fancy coffee drink or regular cocktail that you’re abstaining from in pregnancy? You could calculate how much that cost you per week and put that money directly into a fund for your doula, who will be your new self care and indulgence guru.

Have you ever found yourself saying something like “I’d pay $X for a nap right now?” Well, put a number on that, start setting aside a few naps worth, and think about the beneficial rest your postpartum doula will help you take once baby’s here and think about paying them to help you achieve that when you need it most.


If $2,000 is an unrealistic goal for you or is much more than you need based on fees in your community, just pick a different amount and save away!

To read a bit more about the true cost of a doula, you can check out my article on the cost breakdown here.

If you want more information on how to find, save for, and hire a doula, you can set up a 1hr phone consultation or sign up for one of my full pregnancy and/or postpartum consultation packages where I’ll talk to you about doulas, how to save money in this process, and much more.

If you participate in these #pregnancychallenge ideas and want to share, please comment below, send me an email, or tag us @Rosewoodrepro on instagram and let us know how you are doing! Happy saving!

Health Consulting through Stopping Hormonal Birth Control

Have you recently decided to go off hormonal birth control or are considering doing so?

Wanting some guidance and support through this process?

Want to know more about your options for hormonal rebalancing and non-hormonal birth control options?

Thinking of ending hormonal birth control to start a fertility process and want to know what to expect and how to best manage this new step?

Rosewood’s got you covered!

Hormonal birth control can be an absolute blessing and godsend for many folks for a huge range of reasons. Many are on some sort of regulated hormonal birth control from a very young age and don’t have a good understanding of their “normal” cycles — the good and the ugly.

However, the synthetic hormone replacements in birth control are not the same as those that our bodies produce on their own. You may have been having side effects you didn’t even know were connected to these medications. You may experience a major shift in a variety of physical and emotional systems in your body once you decided to stop taking birth control like :

  • Unusually heavy or light periods

  • Irregularly spaced periods

  • Cessation of periods all together

  • Acne / Cystic acne

  • Changes in mood and appetite — moderate or severe

  • Weight changes

  • Unusual hair growth or hair loss

  • Fatigue or Insomnia

You’re not alone!

Regardless of your reasons to switch away from hormonal cycle regulation, you don’t need to simply accept the changes your body will make in adjusting back to it’s own rhythm. There are ways to ease the discomforts, even if it’s mostly just being informed and supported in what’s going on.

With our extensive intake forms and commitment to non-judgemental one-on-one consultations and evidence-based resources, Rosewood can be a huge help in taking some of the burden and stress off this decision. We work with you on a wide range of holistic fronts :

  • Education on what’s happening in your body

  • Tips on finding high level research and information to help you make the best decisions for YOU

  • Connecting you with compassionate, knowledgable, affordable, and most appropriate care providers to help ease your transition off the pill/shot/ring/IUD

  • Nutritional and herbal counseling

  • Virtual or in-person followups that acknowledge that this is going to be a process spread out over at least many months

Spending a few hundred dollars on personalized consultations around this topic can wind up saving you a ton of money and time you might otherwise spend on treatments, products, wasted time with providers who aren’t supportive, etc., and can help get you feeling stable and supported right from the start. Rosewood doesn’t get kick backs from any product, company, or provider, so our aim is to objectively find a great fit for you through this process. We offer consults by the hour or full 6-month consultation and support packages aimed at personalizing your care to get what’s right for you.