Born Free Method: The Podcast #83 - Kristine Lauria: What Does Birthwork Look Like Without Access to a Surgeon?
Kristin Lauria is likely the most highly skilled birth worker on the planet. She started in the U.S. as a traditional midwife, but, when her kids flew the coop, she joined Doctors Without Borders and has been attending to births in a variety of resource-poor settings, including Afghanistan and a refugee camp in South Sudan. Because surgery is hard to come-by in these locations, she has become highly skilled at facilitating vaginal birth - low-lying placenta, breech, TOLAC, etc. In this conversation, we talk about the de-skilling of obstetricians in the U.S. due to our low threshold for using our surgical steel. We also talk about her role as the caretaker of orphaned children resulting from maternal death in childbirth, hepatitis E, blood transfusions without a blood bank, and sitting with the death of a newborn. Kristine is a gift to the world of birthwork, and I am honored to call her my friend.
Made possible by:
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[00:09:00]
- Kristine has attended more births than most people in the world
- From home birth to Doctors Without Borders
- 25 breech births per month in Afghanistan
- South Sudan refugee camps are in desperate need of healthcare
- C-sections were rare because surgeons had to be flown in
- OBGYNs in the U.S. have been de-skilled
[00:17:00]
- Kristine’s c-section rate has always been <5%, and almost never for arrest of dilation/descent
- Almost never for placenta previa (unless truly complete)
- Never for breech
- C-sections create more risk downstream
- What if OBGYNs practiced as if c-section was only used if absolutely necessary?
[00:23:00]
- Maternal deaths and near misses
- Hemorrhage, infection, botched abortion
- Transfusion requires donation from family (malaria, malaria-free)
- Hepatitis E and a maternal death
[00:35:30]
- Kristine reads her poem: “Temporary Mother”
- Per WHO, a child is orphaned in this part of world if their mother dies in childbirth
- Birth and death are inseparable
- Mothering a dying baby
[00:55:00]
- Working with Breech Without Borders
- Truly informed consent is not taught to doctors (or many midwives)
- Speaking nicely isn’t enough to avoid trauma in birth
- Trauma-informed care
- Midwifery Wisdom Conference
Connect with Kristine on Instagram
Find me on Instagram @nathanrileyobgyn and my practice at: www.BelovedHolistics.com
Music by: Labrinth and Preservation Hall Jazz Band
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