Ep 221: Healing Through Birth Story Medicine with Amelia Kriss

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Have you heard of birth story medicine? Today’s guest, Amelia Kriss, is a therapist who helps parents work through unresolved issues connected to the experience of giving birth. Not everyone will necessarily need to work through their delivery narrative with someone else. But for those who experience trauma it can be a helpful tool.

When people are unhappy with their birth it’s generally not because of the specific course it took but rather because they hadn’t anticipated the possibility of it deviating from what they envisioned. Even if you’re sure of the birth you want, it’s important to explore all possibilities. You can’t control birth so the best thing you can do is educate yourself so you can be prepared.

In this Episode, You’ll Learn About:

  • Why it’s important to process your birth story
  • What a drama therapist does
  • How to balance processing your birth story while staying in the present moment
  • What you can do during your pregnancy to help shape your birth story to be more positive
  • How our narratives about our birth stories affects us in the long term
  • How your opinion of your birth story can affect your opinion of yourself
  • What the most common reasons are that people seek counseling for their birth
  • Why it’s important to acknowledge that not everything about parenting is great

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Transcript

Dr. Nicole (00:00): This is a really great interview with Amelia Kriss about processing your birth story. Welcome to the All About Pregnancy and birth podcast. I'm Dr. Nicole Callaway Rankins, a board certified OBGYN, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(00:51): Hello there. Welcome to another episode of the podcast. This is episode number 221. Whether you are a new listener or a returning listener, I'm so glad that you're spending some of your time with me today. In today's episode, we have Amelia Cri. Amelia is a drama therapist and certified coach in private practice in the Bay Area in California. She lives there with her partner and her two powerhouse daughters. She's also a certified daring Way facilitator, and she works primarily with recovering people, pleasers and nice girls to deconstruct self shrinking patterns and find more ease and joy. Amelia is deeply committed to birth story medicine work, which is about helping folks integrate and move forward from unresolved issues connected to the experience of giving birth. She's proud to be listed in the newly formed pro-choice therapist directory, and she's dedicated to redefining postpartum support as a holistic, inclusive, radical practice encompassing vast and various experiences.

(02:03): We have a really great conversation about what is birth story medicine, how birth is an initiation of sorts, why it's important to process your birth story. What are some potential negative consequences if you don't process your birth story? How you balance processing your birth story, which once it happens is going to be a past event with living in the present moment of having that newborn baby in front of you, and some things that you can do to positively influence your birth story while you are still pregnant. This is just a really honest and insightful conversation about giving birth and the realities and the challenges that come along with that, and you're really going to find this conversation useful. Now, something that kind of goes along with birth story is birth plans are more appropriately called birth wishes, and I would love to have you join me on Tuesday, August 29th for my live class, make a birth plan the right way.

(03:11): So birth can't be planned even though I said it literally in the title of the class. But you definitely can have some things that you want and there are things that you can do and should do ahead of time in order to set yourself up and to be in the best possible circumstances to get the things that you want for your birth. You cannot just print out one of those pieces of paper that you found online, bring it with you to the hospital. That's just not going to cut it. You are potentially setting yourself up for major disappointment and disaster if you do that, because what if you get to the hospital and they don't honor anything that's in the birth plan? So you really need to make your birth plan about having a conversation during your pregnancy about the things that you want, and making sure that your doctor, the practice in the hospital where you give birth are on the same page with you about the things that you want for your birth, and they're ready to support that.

(04:09): And inside of my birth plan class, I teach you a step-by-step process on exactly how to do that with questions to ask, how to write the birth plan, all of that. Good. Great stuff. So join me in the class. It's on Tuesday, August 29th, live at 7:00 PM Eastern Standard time. If you can't make it for the class, you'll get access to the replay video. And if you have any questions, you can ask me in the private Facebook group and you can join the class. I should probably say that drnicolerankins.com/birthplan or drnicolerankins.com/register. Either one of those websites works, and I would love to see you in class on August 29th. All right, let's get into the conversation with Amelia. Thank you so much, Amelia, for agreeing to come onto the podcast. I am really excited to talk about this topic. It was really fascinating and interesting to me. So why don't you start off by telling us about yourself and your work and your family, if you'd like.

Amelia (05:16): Sure, absolutely. So I am a drama therapist and a certified coach here in the Bay Area in California. Okay.

Dr. Nicole (05:26): I'm on the opposite coast. I'm in Virginia.

Amelia (05:28): Okay, great. I'm from South Carolina originally, so I heard your little twang. I know it. I know it quite well. But I'm out here now with my husband who's from here originally, and then we have two daughters. We have an eight year old and a three and a half year old. Okay.

Dr. Nicole (05:42): Okay. All right. And you said you are drama therapist and a certified coach. What does that mean? What do you do exactly?

Amelia (05:49): That's a great question. I'm going to try to give you a brief answer, and then if there's more you want me to share, I'm happy to do that. Okay. So drama therapy, it is a modality where we use the sort of acting and theater techniques therapeutically. So often people have heard of art therapy or music therapy. Often they're more familiar with those. So the master's program that I went through is a very similar, it's like a counseling psychology program. Any other, and then on top of that, you're learning the drama therapy techniques that you would also use with clients.

Dr. Nicole (06:27): Gotcha.

Amelia (06:30): The first thing internship that I did when I was in graduate school, I worked with incarcerated folks at San Quentin. They have a Shakespeare program there, so they put on these shows there. And that was a really interesting experience because as you can imagine, it's an environment where there are certain kinds of expression that are maybe more vulnerable or don't feel so emotionally safe. But if you give someone a character that's maybe a little more feminine or a little silly or a little weak, there are facets of themselves that they can explore and express without it feeling quite so close. Right.

Dr. Nicole (07:14): Gotcha. Okay. Okay. Alright. So

Amelia (07:17): The work I do now is not so performance oriented, but it was a really good learning experience for me to be like, okay, what does it mean to meet people where they are and give them a way to explore parts of themselves that maybe regardless of it doesn't have to be prison, but whatever environment they're in or grew up in, for whatever reason it didn't feel safe to explore this, how do we maybe create a situation where it feels safer and what can we kind of learn from that? Gotcha.

Dr. Nicole (07:44): I love it. I do this podcast obviously, to bring people who are pregnant and having a baby information, but I also do it. I like to learn new things too. So I've learned something new today. I didn't know what drama therapy was. And so you are trained as a therapist. You didn't just open up TikTok or Instagram or whatever and say, I'm a therapist or I'm a coach. You actually did training for it. Yes, yes, yes. And I think that's important. I like to highlight that especially in this day and age where there are a lot of people who are calling themselves coaches or providing information. I just want my audience to know, and people can do whatever they want to do. Absolutely. But I just want my audience to know the information that they're getting, who they're getting it from, and what their background is. And you are trained at master's level and your work?

Amelia (08:40): Yes,

Dr. Nicole (08:41): Absolutely. Okay. All right. Love it. Love it. So what led you to become interested specifically more in birth

Amelia (08:47): Work? Yeah, so a lot of things. I think that primarily it was my own postpartum experience. My own birth and postpartum experience was my first child. So she's eight now, so it's been a

Dr. Nicole (09:00): Minute. Right. What happened?

Amelia (09:01): Yeah. So I was already a therapist, and obviously I took a break from that work when I had my child. And I remember, I think if I were to say one moment, the thing that happened is Vera, my older daughter was probably about a week old. And my husband, I remember he looked me in my eye and he was like, how are you? And really asked me. And I remember just being surprised by what came out of my mouth because I said to him, I feel like I just got back from a war and everyone else is acting normal. And my therapist's brain was like, let's note that

Dr. Nicole (09:47): I should remember that. I

Amelia (09:51): Was like, I'm in the thick of it right now. I kind of knew I can't really deal with that right now, but we need to come back to that. And I'm not comparing my birth experience to a literal war, but that was the emotional texture of it to me, was that I had come back from something that had changed me,

(10:13): And I didn't quite know how to articulate that. But it wasn't just, oh, now we have this new person. Something had happened inside of me in terms of my own identity and my own experience in the world that I didn't know a name for, and that wasn't being reflected back to me in a way that I could understand my family and my people are so kind, and I feel very lucky. And now that I work with folks in the perinatal time, I know how broad the experience can be in terms of how met or not people feel by their family and their village. So very grateful for that. And basically it was like, how's the baby? Isn't this wonderful? And there was a part of me that really resonated with that. And then there was another part of me that was like, I'm going through something huge and I didn't know to expect this.

Dr. Nicole (11:10): Sure.

Amelia (11:11): And I have now come to learn that that is part of it for many of us. And without that context, we feel like What's wrong with me or what's happening to me? And so now that has become the focus of my work with moms and parents is like, nothing's wrong with you. This feels huge because it

Dr. Nicole (11:32): Is. Yes, yes, yes. And you are a new person after you have a baby, whether you realize it or not. Yeah, absolutely. So then what is birth story medicine?

Amelia (11:43): Yeah, great. So birth story medicine, it is a methodology that was developed by a midwife. Her name is Pam England, and she has a birth story school where she teaches this method with some other folks that she's trained. She

Dr. Nicole (11:59): Also wrote, what is the book she wrote? Why am I

Amelia (12:02): Blanking? She's written a couple of books she wrote Birthing From Lynn.

Dr. Nicole (12:05): Yes. I love that book. Yes,

Amelia (12:07): Yes, yes. And she has several others now too. And much of her work is about this kind of idea that birthright is this initiation, birthing is a developmental process that we move through on an identity level. It's not just like, oh, we have a baby, but birth story medicine is this sort of process that as a drama therapist makes a lot of sense to me. I didn't know it existed when I did that training, but it's a very good fit for me because it's basically a form of storytelling where when folks come to me to do that processing work, they know they're coming to talk about their birth, and often there's some piece or pieces of the birth that feel unresolved for them. Got it. And rather than just telling the whole story, which I think we probably all know in social situations, sometimes people will tell the birth story or people will ask about the birth story.

(13:04): And so many of us have told and heard these stories over and over again, but not a lot of processing tends to happen there. It's just this kind of spewing of this experience. And I think that's because there's a need to be witnessed in how big this experience is, whether it goes whether it's unresolved or difficult or not. I think it's a big enough experience in our development that there's just a need for it to be seen and held in a certain way. And I think there's evidence of that by the fact that when you're pregnant and you're just trying to go about your day, people will be like, I'm going to tell you about my birth. And it's like, no, you're not. I think that happens because of our need for that and our lack of spaces where that actually can happen in a held way.

(13:48): So anyway, birth story medicine, it is this process where, and there's lots of people who do it, I'm not the only one, but when people come to me, they know we're going to talk about the birth. And basically without going into all of the nitty gritty, the core of it is there's what happened, whatever happened during the birth, and then there's the meaning that gets assigned to it. So often the work we're doing in birth, ary medicine is helping people untangle. So this moment happened where you felt like, let's say this intervention happened that you didn't want to have happen. I'm making this

Dr. Nicole (14:26): Up.

Amelia (14:28): And then the story you told yourself about it is, if I had advocated more, that wouldn't have happened. So then the belief is I'm weak. So then what you carry forward from that is, I'm weak. Probably you carried the story of I'm weak into the birth, which is probably why you interpreted it that way to begin with if you really go back. But often what we're trying to do in this, and I'm not telling them the meaning that they're assigning, I'm helping them explore, okay, so what did that mean about you? When you believe it means about you that it happened that

Dr. Nicole (14:56): Way? Right.

Amelia (14:58): Because those beliefs that get kind of planted in the meaning of it that we make about it, those are the things that I think really hold us back and keep us stuck and actually make postpartum and many things after that much more difficult than they need

Dr. Nicole (15:15): To be. Yeah. Yeah, absolutely.

Amelia (15:17): So when I can do the work with people where it's like, okay, so that happened. We don't get to change what happened at the birth. And sometimes that's part of actually the deeper work is, okay, if I let go of the story that I'm weak or the story that if I had done something different, this would've gone differently, then we actually have to deal with the grief and sadness of maybe we don't get to control how it goes. Maybe that's just what happens. Right. And so I think sometimes these stories we tell about ourselves are kind of self-protective. If I can figure out what I did wrong the next time, whether it's birth or some other experience, I can avoid these hard feelings. But some of it is like we don't get to

Dr. Nicole (15:58): Sure.

Amelia (15:59): Especially birth. I'm like, we just don't get to plan how that unfolds. And so when we attach how it unfolds to how good we are as parents, it's a really terrible setup.

Dr. Nicole (16:12): Yeah. 1000%. Definitely. Definitely. Definitely. So then I guess mean, you kind of touched on it, but then it sounds like it's really important that we process our birth stories. So why is that important? And then if you don't do it, then what could happen?

Amelia (16:35): Yeah, I think that's the piece of it that's really important is certainly for folks who, when folks come to me, they usually know that they're stuck about something. And obviously there's some people who have a birth experience where they're more or less, which is great. I love that. I want that for all of, and for a lot of folks, that's not how it goes. And I think there's, for many people, I don't want to say all, but for many people, the basic issue is they had expectations about how the birth was going to go or should go that often they weren't even consciously aware of until they did not get met.

Dr. Nicole (17:17): Right. Gotcha.

Amelia (17:18): And then they're on the other side of the birth experience going, that wasn't what I wanted. And I'm feeling some type of way about

Dr. Nicole (17:26): That.

Amelia (17:28): But I think what's hard is, let me see if I can articulate this. And I think for a lot of people, the birth experience is sometimes the first real confrontation with the fact that control is an illusion, and given that you just had a baby, you're going to confront that over and over and over. Now as an initiation into parenthood, it's very well designed.

Dr. Nicole (17:57): That's

Amelia (17:57): True. And also it's very hard. And so I think what happens is the birth experience in a very beautiful, but also kind of brutal way serves us exactly what we need to become parents. And if we don't take the opportunity to do that work, then we're going to get it over and

Dr. Nicole (18:19): Over until we get the message that, right. Yeah.

Amelia (18:22): And it is painful no matter when we choose to do it. And I think it's the most painful when we keep not choosing to do it.

Dr. Nicole (18:30): Sure. It's like the old saying of God or whatever you believe sends you a message in versus a rock like a little pebble, then it's going to be a rock, then it's going to be a brick, then it's going to be a boulder until your attention is

Amelia (18:48): Exactly. Yeah. And I think it is tough when we talk about it in this way because I don't ever want to imply that there are obviously really hard, there can be very hard and traumatic things that happen during birth, and I don't want to say that those things are meant to be

Dr. Nicole (19:06): Absolutely for certain people.

Amelia (19:08): There are horrible things that happen in the world, birth included, and I'm not trying to be like, what's the gift? What? What's the lesson? What I'm trying to say is there is an initiatory experience for all of us, even when it goes well, that if we're paying attention has challenging elements. And I think the more we allow ourselves to be challenged by that, the better off we are in the longterm.

Dr. Nicole (19:35): Yeah, for sure. Now, I'm curious, I mean obviously you can't say specifics, but do you find a lot of the people who you work with, is it that they had a specific laid out birth plan and nothing went according to plan and they weren't prepared for that possibility? Or is it like, I didn't want to get an epidural and I ended up with an epidural, or I had a C-section and I didn't want a C-section? Or what are some of the things that you see?

Amelia (20:03): Yeah, I see a lot of things. Like you're naming a lot of things, like even using the language birth plan. I know some people are starting to soften it to birth preferences, which I like better, but even plan I feel like is so

Dr. Nicole (20:17): Misleading. It's very misleading. I tell people all the time, you can't plan, the only predictable thing about birth is that it's unpredictable, so Right.

Amelia (20:24): Please know for sure. So yeah, part of it is the idea that if we prepare in some right way, that we get to have the experience that we want. I think the other thing that's really challenging for folks sometimes is this idea that they even know what they're going to want. Because I think that's another piece of this that we don't talk about in a particularly useful way is, and this is one of the things that I find really, this is a real challenge for me in doing birth work, and I think probably for many of us as providers, I would be interested to know if this is universal for us, is how to be more honest and more direct, especially with folks who have not yet had any babies who are having their first birth experience and then postpartum experience after that. How to be more direct and honest about what it might be like without trauma dumping or fear-mongering.

(21:33): Because I think that there's a fragility that we project onto pregnant people and onto women in general. Let's be clear, that is actually doing them a lot of disservice when they actually meet the moment of labor where we don't want to worry them, we don't want to scare them. But then actually what happens often is they're in that moment like, holy, oh my goodness, no one told me it was going to be like this. And then it's like, we actually haven't really mentored them in a very loving way because they're right. We didn't tell them it was going to be like this. And some of it is because I think in terms of the way initiation works is you learn it by experiencing it. If we could tell you it, then we could just tell you it. So I think part of it is that it's not conveyable by talking about it, but I think part of it is that we're scared to scare people.

(22:34): Sure. And so I think it's always trying to find a way to be like, and then this is a bigger conversation, but I think it's also about the way that the messages about birthing are so polarized, and this is reductive, but if we think about it as two different camps, if we think about a highly medicalized message that's like, birth is an emergency, we're going to manage it, the professionals are going to do it. You're just here. We'll let you know when you and your baby are safe. Or we think about the other side of it, which I think they might call themselves a sort of natural birth community, but I just want to say that all birth is natural. So I don't want to put it over there, but if we think of the opposite of whatever the highly medicalized version is, I think that message is very much trust yourself, trust your body, trust birth, your body knows how to do this. And I'm not saying that those things aren't true, it's just I think it leaves birthing people in a position where they either have to choose, okay, it's all fear or it's all trust and it's not one or the other. It's an experience in honesty for most of us that involves both.

(23:47): There is fear in the experience, there is trust in the experience. It is an organic, ordinary, ancient thing, and it is scary and edgy and intense. It's all of those things. And I think because we don't know how to talk about it with people in a way that is more whole and more true, we are sending folks to this experience deeply unprepared, very informed in a certain way, but very under-prepared. And I think that is a part of what I grieve about it both as a parent and as a provider, is I want better for all

Dr. Nicole (24:29): Of us. Sure, sure, sure. Yeah, it's really tough because both camps are, and it's very much so people, they're both sides and both sides are wrong. 100% wrong. There's something in the middle, so to speak. And especially when you have the highly medicalized version, like birth is an emergency that sets people up for interventions that they probably and often cases don't need. The trust yourself can lead you down a path of not getting interventions when it may be the most appropriate thing. So that's certainly a lot of what I do is try to present, here are the things, here are the options, or here are the possibilities that can come. But you're right, it's definitely a balance of helping people know what possible things could occur, but also recognizing the beauty and that it can be a great experience. So there's definitely, definitely a balance and something that we all go through. Is there anything that you think people can do during their pregnancy to help prepare themselves better for managing that? Because yes, there is some certain element of you really don't know until you're in it, but anything else, like your first hike or your first drive or your first anything, you can still go into it even if you haven't done it before with some preparation. So what are some things that you recommend that people can do during their pregnancy to help shape their birth story to be a more positive experience?

Amelia (26:10): Yes. I love this question. So I have so many light bulbs from my brain, and I'm not sure where I want to start my answer. But the first piece is, I love that you said hike, because I use that analogy with pregnant folks a lot as a way to kind of bridge these two extremes. If we're talking about the polarization and the messaging around birth, it's like if we take this extreme on the highly medicalized version, it's like if you imagine being at the bottom of the mountain, that side is just like, we're just going to airlift you in the helicopter, take you to the top. You can't do any of this. Right? The other side is like, you can walk, right? Go.

(26:52): So what I say to pregnant folks is, you can walk, right? And that doesn't mean that we would not train and think about who I am, even if I've never hiked this mountain before. I've done other challenging things before, and I know myself well. So I actually, I run this group coaching program for pregnant folks. It's called Uncharted. And it's about preparing for birth, not deciding how the birth is going to go, but how do I want to show up for it? And much of the work we do in that group is about, okay, what's my relationship to pain discomfort? What do I know about how I cope with challenge? And that we don't know how the labor's going to go, but if we think about it as a hike, it's probably a situation where there's going to be less opportunity for rest the further we get into it, which is not a great design, but here we are. That's what it is.

Dr. Nicole (27:50): That is the reality.

Amelia (27:52): And I'm not going to be able to get my MapQuest directions and be like, how long is it? I'm actually not going to get to know that. And so what are the water stations that I know work well for me? Who are the people or the tools that I know are not my jam? They should not maybe be hiking with me. Right? And that there are things we can do, because I think that's part of, for me, the empowerment piece of this is like, yes, if you haven't birthed before, and even if you have every time is another is other thing. Hundred percent, 100%. And so is something about, I think there's something about having reverence for the beginner's mind of that. And I do know myself, and I think letting clients, letting birthing people bring the full knowledge of who they are into that experience and be like, okay, and even what are the stories and the messages that you're carrying about birth from your family, from your culture, from your tradition, your religion? What's gotten in there in terms of these two camps that we've been talking about? What of this do you even believe what is yours? And whatever. Maybe let's not bring it in there. Let's certainly not let it write your birth plan.

(29:14): And very similar, I think, to the way we make meaning of experiences. And the way we were talking earlier about this, it makes me think about people hiking mountains or running marathons. People don't just do that because they want to suffer. People do those things because they're meaningful to them because meeting those challenges and doing something that brings them to the edge of themselves changes the story they tell themselves about they wrong. And so that's the other piece of this is that when we don't have that same reverence for the journey of birth and postpartum, actually and parenthood, period, we lose the ability to actually give ourselves the gift of actually how amazing what we're doing is. So we're in the suffering and the shame and the self-blame of not having done it better or differently or whatever. And we don't actually even get to integrate, wow, however I got up this mountain, here I am. And there's something about that that I think we are meant to have to,

Dr. Nicole (30:22): Yeah. And we also don't give enough to use the word reverence. You used that a good part of the hike is growing a human inside of your body 100%. You have grown an entire human being. That is not a small feat. No. So just even recognizing that in and of itself is really, really important. So these are all just really important things to, and is it fair to say you can't, even if you do this work and you do the things, you can't guarantee a specific outcome. But what it does when you think about it this way is to help you deal with whatever outcome is presented to you without it kind of derailing you, or I mean, is that fair to say?

Amelia (31:19): Absolutely. And I think even doing the work of noticing even the preparation work where we look at what stories am I already carrying about birth? And some of it is hard to look at, and it is important that we do it with as much compassion as we can. My friends or relatives or people who've given birth, maybe if I haven't before, what have I told myself about their birth? It's

Dr. Nicole (31:43): True.

Amelia (31:44): And what are my thoughts about breastfeeding versus not, or having a cesarean birth or a vaginal birth, and what judgments have I carried about those things

Dr. Nicole (31:52): A hundred percent?

Amelia (31:53): And being like, okay, I got that honest, we're all swimming around in the same water with the same messages about that and going, okay. But I think even having the awareness, we're all carrying stories around about all of this, then postpartum, I can go, okay, the story I'm making up about the fact that that nurse didn't like me or

Dr. Nicole (32:13): Whatever.

Amelia (32:14): Even just having the awareness that I'm making up all these stories all the time, we all are, gives me some space where I can go, do I want that? I don't get to prove it. It's not like I'm going to go back and go back into that moment and study in the lab if that nurse liked me or

Dr. Nicole (32:28): Not.

Amelia (32:29): It's not happening. It's only happening internally. And it's like, I don't know if that's true or not, and I know for sure it's not serving me, so what if I just let that one go? So I think just even having that awareness that we are choosing so much of this allows for some room, some breathing.

Dr. Nicole (32:48): Absolutely. So then speaking of postpartum and being in the postpartum state, so you have this new baby, you're trying to enjoy this new baby, but you're doing this birth story work where you're processing, how do you balance the two where you're not so focused on the past and what happened, but you're able to, and maybe that's the goal of therapy, period, I guess. So processing period to how you're not so focused on the past, which you're able to enjoy the moment and the fact that you do have this beautiful baby. So how do you reconcile that?

Amelia (33:22): Beautiful. Yeah. I think this is such an important question because I think often we have this idea that when we do processing work or when we revisit things from the past, whether it's birth or whatever else, that is taking us out of the present moment. And I think the opposite is often true. When we think about, I'll try to give you an example, but when someone gets triggered, what that means is that I'm in a present moment here with you and the trigger is when something in this present situation reminds some part of my survival brain basically of something that happened in the past, if I can go back to that thing that happened in the past and process whatever's left over there, then that means I'm not going to get triggered in the present with you, which means I don't have to time travel. I can actually stay.

(34:16): So in some ways, it's kind of a paradoxical thing, but I'll try to give you an example because I think it's just so much easier in the concrete. So let's say, I'm going to make this up, but let's say that in the first grade, I couldn't stop talking in class. And let's say that my teacher got frustrated and she made me go sit in the hallway. And let's say that I felt all of this embarrassment and shame and I felt alone. And let's say when I explore that, I see that the belief that got rooted in then was like, I don't belong. I'm going to make this up. And then fast forward to I'm now in a postpartum mom's group and I'm having trouble breastfeeding, and I'm now formula feeding my baby because that's what I need to do. And I'm not going to go into my rant about how that is best, and I want everyone to know that. But what's happening is my impression is that the other moms in the group are breastfeeding, and I don't get to do that. So then what happens is what may get triggered in that moment is this age old story in me that I don't belong.

(35:21): So then I'm back inside. I might not even know it consciously, but I'm back inside of this really old, actually past belief about how I don't belong. Whereas if I can do the work with a therapist or someone to trace that back and go, oh, okay, I'm an adult now, I can go to that six-year-old part of me and go, listen, you were talking, you were six years old. It was the first time you had to sit for hours on him at a desk. Sure. You now, as an adult can understand that teacher had 30 kids to look after. I'm sure she was overwhelmed, but that was not your fault. That never meant you didn't belong. How about let's let that go.

Dr. Nicole (36:00): Gotcha.

Amelia (36:01): I mean, I'm doing a very simplistic

Dr. Nicole (36:02): Version of this. Yeah. But no, no, I totally, yeah, I get it. So then

Amelia (36:05): Fast forward, I'm in the mom's group. I might still have really hard feelings about the breastfeeding journey. I might still be, I mean, I'm allowed to have feelings about that, but maybe I get to stay in that present moment and have those feelings rather than having this past thing about how I don't belong. Yeah.

Dr. Nicole (36:22): Gotcha. Gotcha.

Amelia (36:23): So I think the processing is connected to us getting to be present.

Dr. Nicole (36:26): Okay. That makes sense. That makes sense. That makes sense. So do you think everybody needs to process their birth story?

Amelia (36:33): I don't think I would go so far as to say everybody. I think people know when they have something that they need to process, whether it's birth or not. And I think that looks usually one of two ways. Usually people are experiencing intrusive kind of thoughts, almost kind of flash backy things they can't go of, or people are having the opposite where they can feel themselves avoiding thinking about something really actively avoiding it. Usually those are signs that something needs some attention from

Dr. Nicole (37:04): Us

Amelia (37:05): When we can give it. Sometimes. Sometimes people come to me to do birth story medicine work, and their kids are a couple years old. Sometimes that's as soon as people can take a breath.

Dr. Nicole (37:16): I was going to ask, at what point do people usually come to you?

Amelia (37:18): And sometimes people will come and they'll have a six week, eight week, three month old baby and anything in between. Got it. It's usually not earlier. Usually when folks have come and their babies a month old or less, I will often listen and do a session of just being with them. But usually I don't do the birth story medicine that early because it's still so fresh. There are things that are still landing from that experience. Or sometimes we'll do a little bit and then we'll meet again in two months and they'll be like, okay, now this.

Dr. Nicole (37:51): Got you. Got you. Gotcha.

Amelia (37:53): So I can kind of feel usually where we are in it. Yeah,

Dr. Nicole (37:56): That makes sense. That makes sense. Yeah. Okay. So then ask me wrap up. Is there anything else that you want to add about first story medicine work before I ask my last few questions?

Amelia (38:08): Let's see. I just love it so much. And I think the other piece is that as I've been doing that work, which I love, I've been thinking a lot about this kind of preventative medicine if you go work, which is why I've been now starting to do this more work with pregnant folks, starting to ask myself the question, what might I be able to do where people would never need to come to

Dr. Nicole (38:34): Me for this? Gotcha.

Amelia (38:36): And again, I'm still struggling with quite how to answer that question, but I am loving working with pregnant people and starting to kind of explore what does it mean to prepare for this in a different

Dr. Nicole (38:52): Way. Sure, sure. I love that. I love that. So then what is the most frustrating part of your work?

Amelia (39:01): I think it's the struggle that I mentioned earlier about how much to share, how directly, I don't don't know how much you hear this, but when I work with folks postpartum, I almost always hear some version of, nobody told me, nobody told me it was going to be like this. And often they're talking about postpartum, sometimes they're talking about labor itself, but there's this over and over, this refrain of, then I had my child, and then people came out of the woodwork and were talking about all these complications and all these feelings and all these experiences, and all these people were in my life before and

Dr. Nicole (39:42): Nobody told me.

Amelia (39:44): And so there's something there that I haven't cracked yet, because again, because of the role that I'm in, I'm not these people's girlfriend. So there's also boundaries about what I would share in what way. But I think the frustrating part of my work is finding the balance between really wanting to, there's something about, and this is rooted in my own sort of political worldview and in my own feminism and my own sense that we don't treat women like humans or adults, and then we expect them to birth and parent like adults, then we're surprised. And I think there's a great disservice that we continue to perpetrate against women and against mothers. And along the same lines that women continue to believe that there is something wrong with them when actually there is something wrong with all of us. There is something wrong with a system that makes women, and particularly women of color, and particularly women of lower social economic classes. There's a whole caste system within

Dr. Nicole (41:14): It.

Amelia (41:16): And I felt this way working with incarcerated folks as well. And that's not to say that there aren't some problems are individual problems, but none of them are happening in isolation. They are connected to systemic problems that when those are not named people think, oh, I'm the problem. And I'm like, why are you the problem when we're the only developed country that doesn't have paid parental

Dr. Nicole (41:45): Leave? Right, exactly.

Amelia (41:49): Why are you the problem when black mothers are continually disbelieved and getting worse care and worse outcome? The math is not math

Dr. Nicole (41:59): At all.

Amelia (42:04): And so I know on my soapbox now, but I'm on my soapbox because all of it is connected

Dr. Nicole (42:10): 100

Amelia (42:10): And because when I sit across from women and mothers and families who are in deep distress and believe that it's because they're doing something wrong or they missed something, when we continue to settle for a world that isn't good enough for us or our kids, it's not okay with me.

Dr. Nicole (42:32): Yeah, I hear you. I hear you. I hear you. Well, then on the flip side, what's the most rewarding part of your work?

Amelia (42:38): Well, I think the most rewarding part of my work actually is that the flip side, the very flip side of that is that I get to be at least a small part of hopefully people's awakening to the idea that the fact that some of this is hard is actually not because there's anything wrong with

Dr. Nicole (43:01): Them. Yes.

Amelia (43:03): And that is so beautiful. And so, I mean, I will never be sick of it. I love it so much.

Dr. Nicole (43:14): Yeah, for sure.

Amelia (43:16): For sure. I think one of the things that always stands out to me and that I find so beautiful is being a parent in this particular moment where I think we're having this reckoning as parents where there is this sort of turning point where I think as parents, we're starting to just generationally be like, I want to do this differently. And when I see parents with their kids, I'm with my own kids. I see us out here being with our kids, being like, it's okay to have big feelings. I see your big feelings. There's room here for your big feelings. There are no bad feelings. I'm going to be here. In some ways, it can feel so small, but it actually is a very revolutionary thing the way that I think we're making room for our kids to be fully human. And what I love about the work that I do is being able to advocate for and being able to remind hopefully all of us that we get to have that too. That that's not just for our kids, and we're not just teaching them that by giving it to them. We're also teaching them that by doing it for ourselves,

(44:27): By going this, at least for me, I'll speak for myself. The parenthood journey is incredibly joyful and beautiful. And also there are things about it that I, it's

Dr. Nicole (44:39): Hard. Love hard. Yeah.

Amelia (44:41): I love my children immensely. Sure.

Dr. Nicole (44:43): Yeah.

Amelia (44:43): But there are things about this job that are like zero stars. Im not waking up in the morning. I can't wake to pack these lunches. Like,

Dr. Nicole (44:50): Ooh, I love this. Exactly.

Amelia (44:52): And I think normalizing. There are pieces of it that are frustrating, tedious, boring, not my thing. And letting that be okay. And giving us all permission to have mixed feelings about all of it, because we do don't not have those feelings because there's no permission to have them. Sure. We just have them secretly and feel like I'm bad. And everyone else on Instagram has it figured out, but the truth is all of us have it mixed up and don't know what we're doing. So the most rewarding part is to sort of let that cat out of the bag and feel with everyone, this commonality that we're all just muddling through it.

Dr. Nicole (45:31): Sure.

Amelia (45:32): And then I think the parts that feel really good and are beautiful, we get to fully feel them because we're not all wrapped up in secret. Shame about the fact that some of it is hard.

Dr. Nicole (45:41): Absolutely. Of course it is. Yeah. So then what is your favorite piece of advice that you would give to an expectant mom?

Amelia (45:59): Oh my gosh. There's so many things I'm like, I don't know. I think we've been talking about, I run this postpartum mom's group, and we've been talking a lot about this. So this will be the one that I shared today, which is people often ask me about how do I set boundaries with family and they do these things I don't want them to do, but then it's like my parents and they didn't live with me. So then they're like, but I did this with you and this whole thing. And so I started in the moms group letting people write these short sentences that are scripts that they just say over and over so they don't have to know what to say. And so that's my best advice right now, is someone a relative will be like, well, we did this with you. And I recently had someone in the group who wrote the script, and I think what she wrote was, we talked to our doctor about that and that's not how we're doing it. And then she just said that over and over to everyone about everything. Instead of arguing for

Dr. Nicole (47:05): 15 minutes. Yes. She said she dumped it off on somebody else and kept it.

Amelia (47:10): I throw my doctor under the bus and then I just keep it moving. There you go. And I was like, I love that

Dr. Nicole (47:14): For you.

Amelia (47:15): I was like, I'm going to tell everyone to just

Dr. Nicole (47:18): Throw, and I can tell you your doctor's happy to be thrown under the bus.

Amelia (47:25): Right. I was like, your doctor is unconcerned. Your doctor is busy. Your doctor is out there doing stuff. I think a lot, especially in the raw first two months, it's even the cognitive parts of your brain that can have the debate about it are so tapped

Dr. Nicole (47:40): And you're just

Amelia (47:40): Like, and other people get in their feelings. You're criticizing and you're like, I'm really

Dr. Nicole (47:44): Not. Just

Amelia (47:45): Please use the blue pass and don't talk about it

Dr. Nicole (47:48): Anymore. There you go. So where can people find you? What are the things that you offer? Do you have things virtually? Tell us about that.

Amelia (47:56): Yes, happy to. So you can find me at my website is birthing for real.com. And let's see, I have a program for pregnant folks called Uncharted, and it's about navigating the kind of wild terrain of birth. So it's some of the work we talked about earlier in terms of how to prepare yourself for that experience rather than planning how that experience should go. And it is virtual, it's six weeks and it's usually a small group, and we meet weekly and it's like 90 minute live sessions. And then we have outside materials and homework that folks do, and then we get back together and discuss and do exercises together. And then at the end of it, people have what I call a birthing support plan. And so it's like a blueprint for how they want to move into that experience and what support they want in place rather than what they want the birth to look like.

(48:59): So that's really great and I love it. And then I do birth story medicine sessions and that's all there. I also have a newsletter which you can sign up for. They are called Soft Cheese, which is a pregnancy and birth newsletter. And it's about weekly, not perfectly weekly, but about, and it's just things that I write about from all kinds of things like historical and cultural trends in birth and how that has changed over time to resources that I love and little exercises that are similar to what I do in Uncharted, but kind of bite-sized versions you can do on your own. But it's meant to be just kind of a companion for that time to sort of move towards the birth experience with hopefully a little more awareness.

Dr. Nicole (49:41): Right. Gotcha. Gotcha. I love it. And we'll link all that in the show notes. Well, thank you so much for agreeing to come onto the podcast. This was a really helpful and insightful conversation, and I know folks are going to love it. Oh

Amelia (49:52): My gosh. Thank you for having me.

Dr. Nicole (50:00): Wasn't that a great conversation? It was a little bit challenging because I know we love some things sort of up in the air. Some things are difficult and challenging and complicated potentially about birth and some of the various things that we go through, especially when it's your first baby. But this is part of why I am here and the work that I do is to help you work through these things and help not be some of those extremes. I'm not the person who's just only going to say, trust your body, trust your body, or You got this, or You can do this. Or on the other extreme that medicalized birth is an emergency type thing. I'm here to help you find a peaceful, evidence-based, reasonable middle ground, and I hope that you get that inside of the podcast. All right. Now, when I have a guest on, I do something called Dr.

(50:51): Nicole's notes, which are my top takeaways from the conversation. So here are my Dr. Nicole's notes from my conversation with Amelia. Number one, in my experience, people are generally unhappy with their birth, not because it went a certain way, folks are unhappy with their birth because they were not expecting that it could go any other way than what they envisioned. This is where preparation is so, so important, and it's important to think about birth and think about the things that you want for your birth, but it's really also important to think about the other possible things in curve balls that can come your way. You can't just sort of keep your head in the space of these are, I'm only going to look at the things that I want because you can potentially set yourself up for being really disappointed if things don't go exactly that way.

(51:43): So what's most likely to cause disappointment is not being prepared for all of the possible things that could potentially occur or for the possibility that things don't go exactly as you expect. And along those lines of pairing and managing those possible expectations. Yes, birth is very unpredictable, but my second note is that there are things that you can control and you can control what you can control. I actually have that as a sticky note on my computer, on my desktop computer. It says, control what I can control. Because a lot of times things feel out of your control. They feel out of your ability to really do anything about them, but there are a lot of things that you can control when it comes to birth. One of the biggest things being how prepared you are going into it. And no, you cannot be me.

(52:44): You can't be a board certified practicing OBGYN by the time you get into your birth. But there's a lot that you can do to feel very prepared, to feel very ready to manage things that come your way and do so in a way that just helps you feel good about the experiences and helps you navigate things and helps you feel okay when things don't necessarily go as you anticipate. I'm not saying that it's going to make you feel like roses and sunshine about every single part of your birth experience, but there really is something to helping you feel good. You're really going to feel good if that you did all that you could do beforehand. If you controlled all of the things that you could control beforehand, that means something, and that's going to help you feel so much better about your birth experience.

(53:37): Of course, part of that is making a birth plan or birth preferences. And again, I like to invite you to join me in my live class, make a birth play in the right way. That's on August 29th. If you can't make it that day, then you can catch the replay video. It's a really fun class. It's one of the things that I most enjoy doing is teaching the class live. So check it out, drnicolerankins.com/register or just head to drnicolerankins.com and sign up for it there, and I would love to see you in my class. All right, so there you have it. Do share this podcast with a friend. Sharing is caring. I'm on a mission to reach and serve more pregnant folks, and I see y'all sharing the podcast because my download numbers are certainly increasing. So I certainly appreciate you sharing the podcast and helping me spread the word and spread all of this good, good information that we're providing here.

(54:30): Also, be sure to subscribe to the podcast wherever you're listening to me right now. Leave an Honest Review and Apple podcast. It helps the show to grow. Apple is kind of the biggest podcast platform, so it helps the show to grow. If you leave a review there, it helps with the women. Find my show or just shoot me a dmm and let me know what you think about the show. I'm on Instagram @drnicolerankins. If you have ideas for something you want me to talk about, then just shoot me a message there. All right, so that's it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.