How to Have the Hospital Birth You Actually Want

This one is such an important episode.

I’m talking to Sheva Mintz, a labor and delivery nurse at a high-risk hospital in Florida, mama of three, and someone who is deeply passionate about helping women walk into birth feeling educated, calm, and empowered. She believes in movement, breath, trusting the female body, and also in the value of medical support when it’s actually needed.

If you’re planning a hospital birth and you want to feel informed instead of steamrolled, this one’s for you.

We get into what advocacy really looks like in the delivery room, how to ask better questions before saying yes to interventions, what fetal monitoring is actually telling you, and why preparing for birth is about way more than just packing a hospital bag. 

In this episode, we talk about:

•  what advocacy in the hospital actually looks like 
•  the difference between informed consent and just going along with whatever is offered 
•  what to ask before interventions like breaking your water 
•  what fetal monitoring, decels, and positioning really mean 
•  how to choose a provider who aligns with the kind of birth you want 
•  why hospital birth does not have to mean giving your power away 

And a reminder... I’m also doing a free webinar on Sunday, June 7th all about how to prepare your body for birth. The details are linked here, and I would absolutely love to see you there. 

If you’re pregnant, planning to be, or know someone who is, send this one to her.

Links:

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Join the waitlist for Millie Schweky and Zoe Corin's Core Girl's Club!

Follow Millie:  @milliedpt

Join the Core to Floor community: https://millie-schweky.mykajabi.com/intimacy 

Get out of pain guide: https://milliedpt.kit.com/ca03c82c95

Decrease Your Risk of Tearing Guide: https://milliedpt.ck.page/fec34a522f

Sheva Mintz IG: @birthandbeyondrn

Free Webinar on June 7th: https://www.milliedpt.com/prepare

Transcript

Dr Millie Schweky (00:00)
Hey sis, and welcome back to What They Didn't Tell You From Core to Floor. We're here in season four with our guest, Bot Sheva Minz. We're talking about birth again. This was a very interesting episode for me to record, especially coming off of last week's episode with Liat Buckman speaking about home birth. Botsheva is a labor and delivery nurse at a high-risk hospital in Florida. She's a mother of three, and she's also a

Passionate advocate for trusting the wisdom of the female body, and this is where her and I align. She approaches birth with a deeply holistic mindset, believing in movement, breath, and a woman's innate ability to give birth. And at the same time, she intentionally chooses to work within a hospital setting because she values both natural birth and medical safety, recognizing that unexpected complications can arise and that women deserve access to every resource if needed.

But Sheva's greatest passion is helping women enter birth feeling educated, empowered, and confident. She believes knowledge is one of the most powerful tools a woman can bring into the delivery room, and she creates a supportive space centered on trust, preparation, and empowerment. This is very different than last week's episode. I think there's so much to gain from it. And

If you are expecting heads up that I will be giving a free webinar on Sunday, June 7th about how to prepare your body for birth. Sunday, June 7th, 1:30 p.m. Eastern, 8:30 p.m. Israel time. There will be a replay available for a limited amount of time. I would absolutely love to see you there. The link is in the show notes. You can also go on millidpt.com, click on the button that says masterclass.

and sign up there and please send it to any pregnant wing woman in your life. And yeah, enjoy this episode. I'm so excited to have you. Hi Chevell. Welcome, welcome to What They Didn't Tell You. What's Going On.

Sheva Mintz (01:56)
Hey, thank you so much for having me on. I'm so honored. It's so cool.

Dr Millie Schweky (02:02)
I'm pumped to talk to you. I have a lot of questions. We're gonna jump right in, but before we do that, can you tell everyone who you are and what you do?

Sheva Mintz (02:10)
So hey guys, my name is Sheva Min. I am a labor and delivery nurse for the past six years. I work in Miami and I help women give birth every every day I'm at work and I love it.

Dr Millie Schweky (02:23)
That's amazing. How many births would you say you're at on average, like in a day or in a week? So it

Sheva Mintz (02:27)
In

a day, the most I've ever done is three births because we do everything. Like we manage the patient from when she comes in until she gives birth. It's not like a doctor where they just come in and catch the baby. So they could do like six births a day because they're literally coming in when the patient is complete and ready to have a baby and they catch the baby or a midwife. But we sit there with the patient, we manage her, we give their medications, we do everything with the patient. So it's like a big process.

I would say the most births I've ever done in a day is four and that was out of control crazy. Like I stayed in the hospital until like I think it was eleven o'clock charting. Wow.

Dr Millie Schweky (03:06)
Okay. Getting into the nitty-gritty, I stalked your Instagram account. You definitely are someone that is outspoken and has an opinion. ⁓ the thing that stuck out to me the most about your account was that you love to empower women to be informed consumers about what's going on in the hospital. So can you tell us, Sheva, what your definition of advocacy is in the hospital?

Sheva Mintz (03:34)
Yes, I love this question because a lot of people think advocacy is combative, is being loud, is being heard. But advocacy really means like advocating for your birth, for what you want. So for some for one woman it's going to look like advocating for when she wants an epidural, and another woman is going to be advocating that she doesn't want to have monitors consistently on her until she has an epidural, until she's on medication. So

To me, advocacy is really the way you talk and the way you use your language. And it's not only like informed consent that people think like the inf informed consent is is that's where you're gonna show your advocacy or you're gonna give the your nurse your birth plan, that's you advocating for yourself. No, there's so far more to advocacy than just informed consent than just voicing your opinion.

Dr Millie Schweky (04:30)
So what is it exactly? What is advocacy? It's the way you s communicate with the staff at the hospital?

Sheva Mintz (04:36)
Yeah. It's expressing what you want in your delivery. Informed consent is let's say, for example, the doctor says, I want to rupture you, right? So I want to break your water. Informed consent is the patient saying, Yes, I consent for you rupturing me. Advocacy is more like, why are you rupturing me? To me, advocacy is why. Give me why give me the reasoning, why. And if you can't advocate for yourself that why

Dr Millie Schweky (04:41)
Formed consent is

Sheva Mintz (05:06)
is down, is minimized. So

Dr Millie Schweky (05:08)
Going back to your point about informed consent like let's say the example with ⁓ rupturing the water, right? I don't know, I actually had this at my first birth. Hey, we want to rupture your water, it might speed things up. And I actually was like, I'm giving birth after sunset because I want my birth my baby's birthmail to be on expo. I was just crazy. I was like, I wanted to be like after the Holland or whatever. And I had to ask questions, how how much could it speed it up by? Are there any pros? Are there any cons? Like

I asked a lot of questions before I said no because I wasn't informed. Like there's consent, right? They're saying yes. But then there's like informed consent. Like, what am I saying yes to? So do you have like a list of questions or, you know, things that you should ask before any intervention? Abs

Sheva Mintz (05:53)
Absolutely. And I think that's what advocacy is. It's not just the informed consent. It's the why. It's the questions that you ask in the moment. So you get the results that you want. So for example, let's say if the doctor comes in and says, hey, let's rupture you. So what I would ask is, a why. Why are you rupturing me? Why it's important for you to rupture me right now? Like what is the what is help?

Dr Millie Schweky (06:17)
Like what's okay, what's the point? What's your goal? Right.

Sheva Mintz (06:20)
What's the goal is is your goal to speed things up? Or what if I don't want to speed things up? I like let's say I I don't I don't wanna speed things up. I don't need it to be faster. Like I I'm totally fine staying in the hospital bed for three more hours as opposed to you rupturing me and putting me on a time clock. So that's why. What's the purpose of of you rupturing me? What dilation in am I at that you're rupturing me? So a lot of times doctors rupture their patient.

Because they want to put you on a schedule. So let's say, for example, in the morning, a lot of doctors come in and rupture their patients, no matter what dilation they are, because the rule of thumb is 12 hours is the sweet spot after you after you're ruptured. We want you to deliver. So once we rupture you, then we can say, your water is ruptured. Let's start pitocin. So a lot of times the doctors rupture you in the morning because it works for them. It doesn't necessarily work for you.

Dr Millie Schweky (07:14)
It's so interesting to me because there's this is clearly like a protocol that's part of this larger system. And you're a nurse, you're medically trained, and you kind of see through it, from what I understand. So it's like people need you in the hospital. Like I would kind of ask you, like, so why don't you do home births? Because no one has to advocate for themselves at a home birth to the extent that they need to do it.

in a hospital or in a birth center, right? Like it's so different. But I guess I don't know, you tell me. I see it is that like these women need you because who else is gonna give them this empowerment?

Sheva Mintz (07:53)
Right. And that's the problem is although like I have it all of n a lot of knowledge and I am the nurse, at the end of the day, the doctor, if he or she comes in with fear based knowledge and the patient has seen her for her whole nine months of her visit, if the doctor recommends something to this patient, they're gonna take the doctor's advice as opposed to my advice, even though whatever I'm telling you is more beneficial for you. Just on Monday, I had a patient who

I prepped her before because I know her doctor. I know how he works. I prepped her before. She was one centimeter dilated. ⁓ and I was like, listen, don't let him rupture you. You're one centimeter dilated, your cervix is still thick, your baby is still up high in the sky, like you're in in induction. Don't let him rupture you. Let your body kind of, you know, let the medication work for your body before you let him rupture you. And he came in and he was all this like matcha telling her all these like medical terminology that

that didn't even make sense, half of them, but she doesn't know what he's talking about because he's her doctor and she's like, Yeah, yeah, yeah, I rupture me and he did. And her ending was a C section.

Dr Millie Schweky (08:59)
Wow. Was it a first time mom? Yeah, yeah. That's like pretty that's actually interesting 'cause in the research it shows that the C session rate in inductions for first time moms, I don't remember the number offhand, but it's pretty high. Higher. So that's like a lot of interventions to be induced and do A Rom. Okay, fine.

Sheva Mintz (09:12)
A lot higher.

But that's the reason it's a lot higher, because we're trying to rush it. But if you an induction, people need to understand that it's us trying to do something to your body that's your body is not ready to be doing. So by me giving you a medication, just one medication might not kick your body into labor. So when you're there for an induction, you have to be patient. And just because one medication didn't work, it doesn't mean you should stop. Doesn't mean all the medications are not gonna work.

So give it another try. Like what is another twelve hours in the hospital in the grand scheme of things? Having a C section or not having a C section is it can cost you twelve hours or not. So who cares? Like I always tell my patients, and you you come in for an induction, it might take seventy-two hours and that is normal. That's your body's normal like way of getting into this process of labor. And there's nothing wrong with you. But I think there's such a big rush from the patient's aspect actually.

And it's which is so funny, it brings me to another topic. Like a lot of people say, Don't let the doctor do a cervical exam. You have your rights. You have this, decline it, decline it, decline it. It's so funny because so many times my patients actually ask me to do a cervical exam. When are you gonna check me next? When can you check me? Can you check me? No, I just checked you an hour ago. I'm not checking you again. What do you want our results to be like? I want when I check you, I want our results to be a lot bigger than what it was before. So if I check you an hour later, then

then our results are is not gonna be a lot. It's gonna be a half a centimeter.

Dr Millie Schweky (10:48)
So we can talk about cervical exams. I think the thing about cervical exams is that we get three pieces of information, right? We get dilation, we get effacement, and we get station. What where how high or low is the baby in the pelvis? And I'm actually really supportive of physiological birth. And you could totally do that in the hospital setting. I I totally believe it. I literally teach an online program that advocates for it. And it's just funny because like when what our patients asking you

after the exam, how dilated am I? Or where is the baby in the pelvis? And how and they're not asking for the station. The station is a lot more indicative of where you are in labor than how many centimeters dilated you are, because you could be 10 centimeters dilated, baby's high in the pelvis, and negative two or whatever. Either they'll tell you, okay, start pushing right now, because you're 10, and that you're gonna have a really long pushing phase that is probably gonna end in four steps vacuum

Psiotomy, could be C section sometimes if you're pushing so long and the heart rate starts to go down, right?

Sheva Mintz (11:52)
Yes, hundred percent.

Dr Millie Schweky (11:54)
So it's funny because a lot of patients aren't asking for cervical exams because they're looking at it like from eight, okay, blah, blah, blah. I'm only four. And then it gets in their head and it's not a crystal ball. Like I used to be like, I need to know everything. I need to know everything. And I was pregnant with my second, guess what? I walked around for three weeks at four centimeters. And I thought, any day now, any day now. And I I walked around for three weeks like that.

So it doesn't really literally anything. I know people that went into the doctor, they were zero centimeters, and then went into labor that night and had their baby. So survival exams could be such a good tool, right? But what what are you using it for?

Sheva Mintz (12:36)
Exactly. That's a very good point.

Dr Millie Schweky (12:39)
So I want take a step back because we're getting into a lot of nitty-gritty for a minute. There's so much to know. There's like people might even be listening to our conversation and they're like, I don't even know what they're saying. If somebody wants to learn about not only like a classic childbirth education, like what is labor? How does it start? What is like great. Okay, amazing. Someone wants to know what interventions are available, when should I do them? When should I not do them? Like, where are we getting our information from? Where should we be getting it from? No one's reading their studies.

Sheva Mintz (13:09)
Right. So that's a really good question. A, you can take your birthing class that I know you started, which it's really, really cool. And I actually signed up for it because I just love listening and hearing other people's perspective. I myself have pre-birth class. The one thing that you need to know is that you don't need to know everything. You don't need to come in as a labor and delivery nurse giving birth. There is specific

Categories that you should be informed of. For example, cervical dilation. What does it mean? There's like a whole box. But me as a nurse, when I come in in the morning, yes, I explain it to you. And yes, I I sit there and I and I try to make it make sense to you. But at the end of the day, you're not my only patient. So I can't sit in your room and give you a six hour class of labor. Like when you're in labor, that's too late. You need to do the preparation before.

There is Instagram accounts that are good, but a lot of also the Instagram accounts are very anti-hospital, very anti like epidural, very anti like less, which I disagree. Right. And I'm actually very into giving birth in the hospital because I've seen way too many bad outcomes come out from a home birth that to me it's just not worth it.

Dr Millie Schweky (14:17)
Anti interventions.

Sheva Mintz (14:34)
even if you are a low risk pregnancy, to me personally, it's not worth it. So that's why I do advocate for hospital birth. And that's why I do teach how hospital birth can be so beautiful and amazing. And you can come out of your birth feeling like a bat. And I think it's the education that you do prior to giving birth that can have that result.

Dr Millie Schweky (14:58)
For sure. So you think a course is the best way? I'm scared of Instagram because again, you get that undertone of like, you know, anti any intervention. Whereas you might be a great candidate for an epidural, you know, like there's always pros and cons and I think social media lacks the opportunity to show new

Sheva Mintz (15:13)
Although there's so little. Like in a reel you could do what? Fifty seconds? Yeah, I mean

Exactly. So to me, a course is the best way to empower yourself and have an educated aspect on labor. ⁓ and again, you need to just do your research on whoever you're taking the course from. Like if you're taking the course from a doula as opposed to taking a course from a nurse, as opposed to taking a course from a doctor, it's very, very different.

Dr Millie Schweky (15:45)
Experience.

Right. I think it should be evidence based. I think that's the at the end of the day. Like if it's evidence based, it's evidence based. Correct.

Sheva Mintz (15:54)
I mean I follow ACOG. It's like the American Academy Association for obstetricians. That's what I go by. That's why I follow. That's what we practice in the hospitals. Of course. And it's and it's not as like there's not so many machines that you need to be on all the time. Like people think, I'm gonna go to the hospital or I'm gonna be plugged up. Yeah, like we're gonna take your vitals, we're gonna monitor your baby, but

If you know how to advocate for yourself, you don't have to have all those machines on you all the time because you know what language to use to get what you want.

Dr Millie Schweky (16:32)
So tell us about that. Let's jump into like fetal monitoring and intermittent monitoring, regular monitoring. Do you mind explaining to everyone like what that is, but the pros and cons are for each?

Sheva Mintz (16:41)
Absolutely. So first and foremost, fetal monitoring is we take two monitors, one for your contraction and we put it on top of your pelvic of top of your uterus where it gets really, really, really strong. So we can detect when you have a contraction. And then there is the US monitor, the ultrasound monitor, where we put it for the heart rate for the baby. So they're both on. You can have wireless monitors, you can have them attached to the machine, just depending on what kind of

labor you want. Let's say if you already have an epidural, you're not going to have the wireless one because we're going to give them to a different patient who doesn't want the who doesn't have an epidural. And basically what it monitors, it monitors the baby's heart rate at every single at every single second. So we're monitoring the baby's heart rate to make sure that it's within 110, 110 and 160 beats per minute while you're having a contraction. So a lot of times there is like

Decelerations that happen is when the baby's heart rate goes down with contraction. So not every deceleration is a bad deceleration. When the baby's heart rate goes down with a contraction, called early decelerations. And that's good. That means the baby is head is coming down into the pelvic area. It's coming, it's it's lowering, it's lowering and it's becoming more favorable for a delivery. So that's good. We love early B cells.

When we see a early D cell, it's like, yes, the baby is is getting the point. Then there is a variable where it's it looks like a V when it comes down. It could be with a contraction, it could be without a contraction, it could be after a contraction. It's a certain kind of D cell that those we don't really like, we don't like at all. And we then come into the patient's room and we inter we do little interventions. Even you could do a reposition your like reposition yourself from one side to the next.

And it can fix everything because variables is the cord compress, usually. It's something with the cord. So a lot of times it's cord around the neck, a lot of times it's cord around the body. And it happens all the time. We delivered hundreds of babies with cord around the neck. It's not a medical emergency, it just happens. But a lot of times, if you reposition the baby in a different position or the mom in a different position, that cord that's compressing anywhere is getting a little bit loose. And then there's another kind of decel where it's called late deceleration.

And those are not good either. ⁓ so those we don't like at all either. And then there's a prolonged deceleration. It's when the baby's heart rate goes down for a long time, for more than two minutes. Those are if they don't recover soon or fast, that's a medical emergency. The other three decelerations that we spoke about, the early decelerations, which we like, but it's still a decel, the variable deceleration and the late deceleration, they're not a medical emergency.

There's interventions that you could do when you're in labor that can fix them fast.

Dr Millie Schweky (19:36)
Okay, I'm happy

I asked this because one of the main things I hear when a patient comes to physical therapy is X, Y, and Z happened. I was having decelerations and it ended in a C-section. Or it ended in a lot of instrument assists, such as vacuum and forceps, pziotomy, and then we're cleaning up scar tissue, whether that's vaginally or via C-section scar. So

Can you tell us what options patients have in the hospital room if they say, Okay, there's a deceleration that is not, you know, just an early one. Yeah, we could reposition you on the ball. What else could they do?

Sheva Mintz (20:10)
So yes, reposition is the best thing ever because it's just reposition your body and the baby also repositions itself. So anytime I see a D cell, A, I come in, I reposition the baby, the baby, I reposition the patient. I always, always, always give the patient a bolus, like a fluid bolus, because a lot of times when your uterus is contracting very, very, very, very strong, it a lot of times it lacks that hydration. So the uterus is a muscle, right?

So the muscles are going to con contract even stronger when they're dehydrated. So it's the same thing for the uterus. So I give them a bolus of a fluid bolus to help help that muscle get a little bit, you know, more refreshed, if you can think about it like that. I stop whatever medication the patient's on. So let's say if she has pitocin her, I stop it right away and we stop it. And then we if it's really like, you know, still going on all those.

D cells, then I'll give the patient oxygen and and try to help with that. But usually when you do those few interventions, usually the baby works. Yes. Yes. And also like it depends when you have these D cells. Like a lot of times you have these D cells when the patient is going from, you know, three centimeters to ten centimeters really, really, really fast. And the baby is just doesn't know what to do with it itself. So it's like obviously it's D celling, but those D cells are not necessarily bad.

Or picture. Exactly. Or let's say the baby is having, you know, like going from negative three to negative one or even zero station, still no cervical change, but the baby station, you know, dot got like lower in the pelvic. So that's also going to cause some D cells. But a lot of kinds, these D cells are not medical emergencies. When it's a true medical emergency, the room becomes like it's it's like almost goosebumps. Like

And that's a true, true medical emergency. And true medical emergencies are are not so common. Like you're gonna see more staff coming into the room. You're gonna see your nurse, you know, her face is going to probably a little bit change. She's going

Dr Millie Schweky (22:23)
Arieling means that they tried everything, nothing nothing worked, and there's no other explanation for the baby's heart rate going down other than there's a compression going on and it's urgent. Kind of it.

Sheva Mintz (22:35)
That

or sometimes there's urgent C-sections and the baby comes out and it's like, ha ha,

Dr Millie Schweky (22:43)
Yeah, right. Right. So that's kind of why I'm asking this question. Do you think that being monitored continuously versus intermittently causes more detection of decelerations, which causes more of a cascade of interventions?

Sheva Mintz (22:58)
So yes and no. If you are receiving medications for whatever reason, you have to be on in monitoring because the medications can yeah, because the medications that you're given can cause the baby's heart rate to decel. And if we just stop it, then the baby is gonna be happy go lucky. So when you're on medications, you have to. Also, it's just the hospital policy. And yeah, like the hospital policy is not Torah, but at the end of the day, like I cannot

not follow the hospital's policy. But I

Dr Millie Schweky (23:30)
Saying, let's say mom comes in, regular first time mom, labor's going well, it's going slow. She's doing like one or two centimeters of violation per hour, or one every two hours, and she comes in. Should she be monitored continuously or intermittently? Like, I mean it's not one size fits, but still like a regular, like low risk case. She's just like a regular first time mom.

Sheva Mintz (23:51)
Great, absolutely. Yes, and that was my other point.

Dr Millie Schweky (23:54)
I'm saying I'm saying continuous or intermittent, like which one of the two would you recommend?

Sheva Mintz (23:59)
In terming one hundred percent, why not? ⁓ one hundred percent. Right.

Dr Millie Schweky (24:03)
So that that's what I'm trying to get at. Like, do you think if they're monitored continuously in this low risk situation, there's more detection of a D cell being picked up and then more unnecessary interventions taking place? ⁓ Good question. I got you.

Sheva Mintz (24:17)
I know. Yes and no also, most of the time when a mom comes in and she's laboring on her own and she's not on any medication and she's progressing in labor, the baby is happy and the baby is behaving. Like there's no it's chill.

Dr Millie Schweky (24:36)
Exactly. I was like ripping the monitor off. Like, my guys, everything's fine. I kept ripping it off and then I come back to what if I got I'm like, please don't come back.

Sheva Mintz (24:37)
When we start doing possible.

Right. So that's where your advocacy comes and that's where your ed pre-birth education comes in. Because if you're coming in three centimeters dilated, there's no reason why you should be on a continuous monitor. You should be walking around, you should be doing your exercises on your ball, you should be doing your squats. So hospital's policy is yeah, we put you on a continuous monitoring. But if you tell the nurse or the doctor, hey, I'm low risk, I don't have any complications.

I literally have been the most perfect patient the entire pregnancy. Put my baby on the monitor for twenty minutes, get a good reading of my baby and of my contraction, and then let me be free for the next forty minutes.

Dr Millie Schweky (25:31)
Love that. That's real advocacy. 'Cause you know what you're talking about.

Sheva Mintz (25:34)
Exactly, but you only know this if you prepare. Exactly. Because with every list.

Dr Millie Schweky (25:40)
A lot of moms are like, I don't want to take a course, like it's final ring. Like, I don't think I need to know anything. Like, when you're in the hospital, like, listen, I'm not on the ground, right? I'm with everyone before and I'm with everyone after. I'm not of the birth. So as a nurse on the ground, do you see a difference in your patients who are either over prepared and know too much, underprepared and are clueless, which I think is the majority of moms, or and then the third category, which is probably the rarest, which is like

empowered, informed moms that know exactly what they need to know and how to advocate for themselves. you see a difference in that?

Sheva Mintz (26:17)
Absolutely. The moms who don't know anything are usually those moms that are in that sink section poll that are high, a lot of them. The moms who know too much, I love them, and I don't care that you know too much and I don't care that you're driving me crazy and the doctor crazy because it it pressure place. I'm happy I'm happy that you know so much. I'm happy that you're speaking up. I'm happy that you're telling the doctor no when you think it's the right to tell no. So the moms who know too much, I love, I don't care.

The more you know the better. ⁓ moms that are like grounded and know the perfect amount, those are the moms who have those birth that are like, wow, like you're so lucky. Type. And the moms who know too much are the moms who are like, they they may have a beautiful birth, but it's just like so stressful to be in their room. Like, my gosh, why are you why are you doing this? Why are you doing that? I don't want to do this. I don't want to do that. Listen, mom, like I'm doing this, X, Y, and Z because X, Y, and Z.

Okay. And then you have the same thing with the moms who don't know anything and they're like cool as rupture me. Yeah. Yeah. Reposition me. Yeah. Yeah. Well, how is my baby? your baby's not doing good. We need to reposition you. Come on, let's do it. As opposed to the moms who know. And like, hey Ma, like your baby's having Adissa, let's reposition. Okay, let's do it. And they just go to the side and then it's fine. So there's a huge difference and I think really, really, really learning what the labor process is and even learning like

when to come to the hospital, what to do when you're in the hospital, how to talk, how to communicate, when to start pushing. Like all these things make such an impact on your delivery. And again, like you have those moms that have the most beautiful deliveries and they didn't do any research, but they got lucky. Like they did.

Dr Millie Schweky (28:05)
that going off of what you just said, let's say there's an intervention that a doctor wants to put on a patient and the patient actually doesn't know what that is, doesn't know anything about it. How can we make a decision in the moment? What should we do? What should we ask?

Sheva Mintz (28:22)
So I love that question. And there's actually an an acronym. It's called Brain. So the B is for benefits. What's the benefits of this intervention? Like, what is it going to do for me? The R is the risk. Like, what are the risks of this bet of of this intervention that's going on? The A is alternative. Is there any alternative that I could do now instead of whatever the intervention that you're proposing? I is intuition. What is your core gut telling you?

in that moment to do it or not and N is nothing. What if I do nothing? What happens? Then if I wait, what happens? So I love going off this one because it really answers all of your questions and and like it really like takes you a second and you're like, okay, like you can get a better understanding and a full picture.

Dr Millie Schweky (29:11)
That's such a great acronym. I hope everyone listening that's pregnant wrote that down because that will get that that could save you. That could save you stitches. That could save you from interventions that you don't want. I really love it. I want to go back in time actually. Before we even get into this conversation, how would someone choose an OBGWN? Because it we know there's doctors that push more interventions and doctors that are okay with less and doctors that

strictly want to support physiological birth. What you know, a lot most people just kind of go to whoever their mom goes to or who their friends go to. But if you wanted to properly put some thought into what you're not realizing is such a big decision, what are the could we go with like three questions? What are three good questions you could ask a doctor before you decide if that's who you're gonna go with?

Sheva Mintz (30:02)
Okay. One question that I would ask is what's your C section rate? Lane, what's your C section? 33%, and that's high.

Dr Millie Schweky (30:10)
Yeah. So you basically are making sure they're under average.

Sheva Mintz (30:15)
Yes, but you want them to be a lot under average. But with that being said, you also want to ask them like ask them how many births and then ask them what's their dissection rate. Because if let's say that we

Dr Millie Schweky (30:27)
Too many patients at the same time, they may not even be at your birth.

Sheva Mintz (30:30)
Right. But also if they have so many births, then if their C suction rate is twenty percent out of a thousand patients, that's a lot. But if they they have no, that's a little. But let's say if they have eighty patients and their C suction rate is thirty three, then right? I understand. Does that make sense?

Dr Millie Schweky (30:52)
You're you're just saying make sure that if they have a g check their percentage according to the n the number of patients and make your decision based off of how many C sections are you actually performing. Not just dash that.

Sheva Mintz (31:04)
Exactly. So that's a that's one of my questions that I would ask. Another one is what is your perspective on inductions? Do you tell your patients at 39 weeks without any medical need to have an induction or do you let them go on? And if you do let them go on, what do you implement that to make sure that my baby is safe?

Dr Millie Schweky (31:28)
So crazy that we have to say let them. Like my doctor has to let me go past a certain amount of time. Like, what do you mean let me? I'm pregnant with a big thing. Like, don't tell me who I could when I could give birth. Like it's not up to us. Like, it's so crazy to me.

Sheva Mintz (31:43)
So crazy. It's so crazy. But then like

Dr Millie Schweky (31:46)
Go

Pat, like what are you like you're a man, you never Please

Sheva Mintz (31:50)
Can you please give me a prescription for when I

Dr Millie Schweky (31:53)
Like and that's such a novel idea. ⁓

Sheva Mintz (31:59)
No and then you Nuts. Then you also the like then you have these like girls that go past I don't know what and like it's funny.

So that's that's there you go. So if your past thirty nine weeks or forty weeks, like what do you do to make sure that my baby is safe? So like the doctor says, I bring in my patients once a week to make sure the, you know, the I fear the fetal heart rate. No, that's not good enough for me. Like I want you to be able to go to your OB twice a week. I wanna make sure that I have a twenty minute reading of your baby. So it's called an NST, a non stress test.

It's basically when you're on the monitors for 20 minutes and we track your contraction and we track your baby's heart rate and we make sure that the baby is happy. So that's what I would look for. Like, okay, you let me pass 39 weeks, 40 weeks, 41 weeks, but what are you doing to make sure my baby is safe? That would be my second question. And my third question would be just like it sounds so stupid, but it's their answer that they give you. It's what's your opinion on birth and birth plans?

And not because I I I'm I have an elaborate, like an annoying birth plan. I just wanna see their reaction. Not I their reaction is inspire you. What is a birth plan? Like I'm like how

Dr Millie Schweky (33:20)
communicative are they gonna be about that? Like I remember when I was the first time mom, I I told my doctor, like, when do we start discussing my preferences? And she was like, You can discuss them whenever you want. Like, whatever you want to know, like you can ask me. And it was great, like it was an ongoing conversation during the pregnancy of like, like, do I have to get birth in my back? I'm gonna have to hold my breath. Like, she's like, You don't have to do anything. Like, she was actually amazing, but I don't think that's the norm.

Sheva Mintz (33:46)
Right. But there is amazing doctors. Like I work with maybe 30 doctors and out of those 30 doctors, like we have so many amazing, amazing, amazing doctors.

Dr Millie Schweky (33:59)
So tell me what climate like in the hospital you're at? Are they saying, Okay, get on your back, feet wide, knees wide in the stirrups, hold your breath like you're going underwater and push? Or are they or are they more like, you know, just letting the mom kind of flow into what she's feeling? Like how does it go?

Sheva Mintz (34:16)
So it really how it goes, it's depends on your doctor, which sounds crazy, but it really at the end of the day most patients do deliver, like do push on their back, ⁓ and do hold their breath. They do that whole like, you know, take a deep breath, hold your legs and push, push, push, push, push, push, push, push, push.

Dr Millie Schweky (34:21)
Sure how it

So I don't wanna demonize it. There's situations where I'm sure you've seen it work great, but it's not the only way.

Sheva Mintz (34:41)
Absolutely. It's not the only way. And there you are again as a patient. Advocate for what you want. So on Monday, my patient wanted to push on all fours. And I was like, yeah, let's do it. Why not? Let's go. So we started pushing on all fours, but she literally didn't do anything. Like I put my hands inside and I literally like I saw her working so hard. She was on a plank, pushing on all fours.

Like really she was working, like and and she's like she had the urge to push and she was really pushing hard and I saw her like exerting all that energy, but the baby did nothing. And we sat there for like twenty minutes because I like I wanted her to be able to like feel like, wow, like I pushed the way I wanted to push, like this was amazing. Like I had the experience that I envisioned in my head. So we sat there and we pushed, and then after twenty minutes, I'm like, listen, like

I know that this is the way you were hoping to deliver and this is the way you really want it to, but we're gonna be here for another three hours. And pushing on all fours for three hours is also not good. So we turned on to the side on her back and then we like we turned on to the side and I was like, let's try this. Let's see if pushing on your side works better. And she pushed on her side, literally two contractions she put. So she gave me thick pushes.

And I called the doctor, the doctor came running in, the baby came literally like so fast.

Dr Millie Schweky (36:10)
So you're a great nurse because you communicated with her so beautifully. You validated that that was the vision that she wanted. And she probably felt amazing that she got to experience it, you know, like that's really what she envisioned. And then you didn't just stick her in the thought of me, like you got her to try another really cool position that supports the way the baby actually leaves the pelvis.

Sheva Mintz (36:31)
Great. And it was amazing. And she had a great birth. But a lot of times, like a lot of people have these ideas of like, let me push like this, let me push like that. When you have an epidural, it doesn't work always as you you envisioned. So yeah, you can try, but like it's different. I told her and I was like, if you didn't have an epidural, your baby probably would have come like this. Right. But you have an epidural, you choose to, you know, labor all these fifteen hours without pay, which that was your choice and that's what you wanted to do.

But now we have to, you know, intervene. Do it something else.

Dr Millie Schweky (37:04)
One

of the coolest parts of my practice that I actually don't speak about online is that I do this three part birth prep package with my patients where we go through or I'm not gonna get into it now, but a bunch of different things in the clinic to help them have a more efficient labor and delivery. I'll actually go into it for a second. I'm trained in something called body ready method. I don't know if you've heard of it. It's amazing. And we basically use the patient's alignment to determine

possible positions of the baby during pregnancy and labor. And then we give them exercises to use their alignment and breath patterns to get the baby into their happy position so that they can leave the pelvis with a really good labor and no no extra pushing, no extra interventions, things like that. So I go through all these exercises with them. We do body releases and it really is super effective. And at the last session, I ask the patient to come in with her husband. And

I go through a bunch of positions that you can do in labor and that you can give birth in. And I have this whole cheat sheet and it's like all read out and it's so beautiful. And I show them all the positions starting at like 35 weeks. And then they go, Okay, this is always a question, right? So my positions go by like where the baby is in the pelvis, how high is the baby. And a lot of the times you're laboring at home. You don't know how high the baby is. You don't know when the baby's in the top of the pelvis, the middle of the pelvis, and the low pelvis. You don't you just don't know like physically from an exam.

So that's always a question. And this is my big message. These exercises and positions are not a prescription. I am showing you your options. I'm showing you positions that you may be able to get comfortable in. You might hate some of them. You might hate some of the things I'm showing you, but at least you know that you might find one that you really like. Then when you're in labor, absolutely do not pull out my cheat sheet. Not allowed. You this is Jordan birth. No one's telling you what to do. You

Sheva Mintz (38:33)
Yeah.

Dr Millie Schweky (38:55)
Flow through it. You use your intuition to get into the position that you want. You might not remember it. So now you have your husband who watched you do it a thousand times and he could suggest to you something that might help you because he saw you. And now you also have the range of motion flexibility to get into it, right? And then they ask me, but how am I gonna know where I'm supposed to do the positions for early labor and and mid-labor? And I'm like,

Because the early labor ones are not gonna feel good anymore. You're just gonna know. No one has to tell you because it's yours. You own it. And when you go into a hospital, you know, there's bright lights and it's a little bit cold and there's all no people that you never met before and there's beeping noises and you might lose that intuition. You you gotta train for the birth a little bit. Like you gotta put something in. Sorry for my TED Talk. This is your interview. But anyway.

Sheva Mintz (39:51)
Lub C

Dr Millie Schweky (39:51)
It just drives me it just drives me a little bit nuts to be like, Okay, here's a protocol, this is like all the positions, blah blah blah. I'm like, here's your options, you figure it out, you have the answer.

Sheva Mintz (40:01)
It's like a marathon. When am I gonna know when the when the marathon starts? You're gonna hear the boom, you're gonna see all the people running. It's the same thing. If you don't prep for your marathon, you may or may not get to the end of it. It's just a matter of the whole process of how you got to the end of it. And that brings me to another point is your mind is such a powerful tool in labor. You can control so much.

Like when you come into your labor room, it doesn't have to be like a dark, gloomy, like scary room with lights. Bring cute can't like lights and decorate. Your husband can decorate your room. Bring a scent that you absolutely love to you put on. Bring music. Bring things that make you happy and make you a joy. Like if you love a a pillow, go ahead, bring it. If you love a blue weighted blanket, if you love like a warm, you know, something, bring it.

Nobody's gonna checking you in and telling you, it's not airplane, it's not like you can't bring whatever you wanna bring. Bring your whole house if for all we care. Make the labor room something you're going to remember. Something that you're gonna wanna in your head, you're gonna wanna go back again.

Dr Millie Schweky (41:13)
Make it feel familiar. Yes. Also the playlist, right? You gotta have the playlist.

Sheva Mintz (41:18)
Come on, like when I come into a patient's room and there's no music, I'm like, Hi guys, like what's going on? Where's my jam? Like what we're pushing with nothing? Are you joking?

Dr Millie Schweky (41:29)
When I was pushing out my oldest, my I like I picked out a song that I wanted to push out to and it wasn't on when I when I was pushing. Like it just it happened so quickly. And my husband literally mid pushing is like, Do you want me to change this song? And talk to her is like, I don't think she cares about that, right?

Sheva Mintz (41:46)
It's funny. I say like in my next delivery, God willing, I want like a full on party. Like I just want like I've done the dance, I've done the quiet, I've done the, you know, whatever. I want a party. I w

Dr Millie Schweky (42:00)
So it's actually funny. I feel like you don't know until you're there. I have a pump up if you want it, I could send it to you, a labor and delivery playlist. It's like pumped up. Like I remember I was like bouncing on the ball to the black eyed peas and like rest in peace, Kanye West, we don't like you anymore. But I was like listening to all this and the nurses were all coming in and partying with me. And then like at the end of the birth, I was like, Hey, guys, it's don't keep poor.

We're all parties and it changed dramatically. And then I remember like my next birth was completely different. I was like spa music, meditation music. Like that was the vibe. So I I feel like we should make two playlists. You gotta tell everyone, you need you need two, because you don't know the mood you're gonna be in. And you can't plan for it, which is what I wanna ask you about, because you're saying your mind is so your mind is so powerful. How could women enjoy labor or just kind of like be in it better instead of being like

distracted by everything that's going on.

Sheva Mintz (42:56)
So A prep the room to something that you enjoy looking at, something that you enjoy smelling, something that you enjoy listening to. And B, remember that each contraction that's coming and going is doing a purpose. Each contraction that peaks up is bringing your baby closer to your arms, closer to your chest. And I think that when you have that concept in your brain, when you're having a contraction, it changes everything.

And I reinforce that to my patients over and over and over. Bring it in. Remember, what is this contraction doing? It's bringing you closer to your baby. So take a deep breath, let it build, let it get strong, because the stronger it is, the more powerful it is, and the closer you are to your baby. And I think like letting it come as opposed to like being scared, my gosh, your contraction is coming, got contraction, no, no, no, as opposed to like,

Bring it. Let it let it let it come. Let it come. Let it come. Let it come. And then let it go. Let it go. It that's it. And remember that every contraction lasts so long. It's 60 to 120 seconds and you're done. That's it. You're done. You're done. The peak of the contraction lasts five seconds and then it's done. Like it's not something that's going to last forever. It's a period. It's a time. And then it's

Dr Millie Schweky (44:00)
Good.

Woman, you're you're great. I'd love to have you holding my hands. Well Yes. Tell us a little bit about the Instagram account that you started. I know you mentioned that it's new. You have over ten thousand followers. What the heck is that? It took me years to grow my account. Can you tell us what the main messages that you want to get across to people that find you online?

Sheva Mintz (44:40)
Yes. So I started it because I've been in the hospital for so long and I often hear horror stories and I often hear people saying, I'm never gonna deliver in the hospital because X, Y, and Z, the hospital policy, the hospital this, hospital that and it's not the hospital's fault for for for your, you know, traumatic delivery. Like it's not everything you can't blame everything on the hospital and a lot of it is is like up to you.

And my the reason why I created this account is because I want women to feel empowered. I want women to feel like going into that hospital room, they'll know a little bit more than they knew before. And also like I feel like I get to deliver these women and like hold their hands, be there for them. And then once I'm done the delivery, once my shift is over, that's it. Like it's done. And I like crave that connection. I crave that like

wanting to help. Yeah, like I want it to like be there for the woman. Everybody needs like somebody that's going to hype them up. Some somebody that's going to tell them, You're gonna be okay. I promise you, like, you got this. So that's why like another reason why I created it. Another reason is because people need to be educated. And a lot of the stuff that we see on TikTok on Instagram are ⁓ BS. Like, my gosh.

Dr Millie Schweky (46:02)
A lot of fear what a lot of fear based info out there.

Sheva Mintz (46:05)
Yeah,

a lot of fear base and a lot of stuff that are not true. Like, if you tell your mind that if you call a contraction a surge, if you tell your mind that it's you know, like it it's not that big of a deal, ⁓ you're gonna have a great experience, you're gonna have a great lady. That's not true. A contraction is meant to be painful. What it does it literally or your is contracting your baby for your baby to come down. So like, yeah, you can lie to people and tell them that, you know, like

It's not painful, but at the end of the day, like the per it's supposed to be painful. It's supposed to help your baby come down. It's how you manage that pain that your outcome is going to be different.

Dr Millie Schweky (46:45)
Totally. So is so that yeah. So again, like social media does lack that nuance and your algorithm's just gonna kind of feed you what it thinks you wanna hear. So that's really interesting because you you gotta use you gotta really use your brain and filter through it. I actually have sometimes put a disclaimer on my posts, like don't listen to things on the internet, including my posts. Like research it. Do your own research. Looking on Instagram is not research. So if somebody wants to work with you, you said you do have a course, you have a course that's active right now.

Sheva Mintz (47:14)
Yes, I actually just started my course. The new one is coming. The new course starting February 26th. So if anybody wants to join. I do it very, very, very small group just because I really want to be able to connect with each woman and give her the pointers that she needs. And I really want to make sure that every patient who I, you know, I have ⁓ that takes my course.

goes into labor as if it's her third birth. Like I don't want you to like n not know what's going on. Like and that's what my course is all about. It's simple, easy, tangible goals. So

Dr Millie Schweky (47:54)
Do

you walk into the hospital knowing what?

Sheva Mintz (47:57)
Knowing how to talk to your providers and your nurses so you can get what you want. It's knowing what positions to position yourself so your baby can come down more. It's knowing when to ask for your epidural if you want one. It's knowing how not to to ask for an epidural or tell your nurse I don't want one, but when a lot of times the language that you use is going to affect the care that you get.

And it's ass at end of the day, wall human.

Dr Millie Schweky (48:28)
So it's an ad it's really like a self advocacy and info to like navigate the hospital course.

Sheva Mintz (48:33)
Yes. And how to act like how to navigate your delivery.

Dr Millie Schweky (48:37)
Awesome. So if someone wants to find you, where are you?

Sheva Mintz (48:40)
So I'm on you can go on my Instagram, it's birth and beyond RN. And in my Instagram, there's like a little link in my a website.

Dr Millie Schweky (48:47)
Amazing. Wow. Chevro, I'm so happy we connected. I feel like we could go on and all and I have a lot of other topics that I've I think we could totally dive into. So maybe we'll do a part two. But thank you so much for your time. Hope to talk.

Sheva Mintz (49:00)
Thank you. Fun.

Hope I didn't ⁓ scare anybody, but I just want everybody to know that giving birth in a hospital is really amazing. Doctors really do love their patients. The nurses really do take care of their patients. It's a team. We're really a whole team and it's not you or me and you have to come in knowing that.

Dr Millie Schweky (49:25)
I love that attitude. Thank you much, Eva.

Sheva Mintz (49:28)
All right, thank you. I had such a good time. Have a good one.