EBB 252 – A Candid Conversation about Doula Advocacy with Doula and EBB Instructor Leslie Greene

Listen to EBB 218 – The Evidence on Perineal Massage during Labor with Dr. Rebecca Dekker here.

Check out and follow all of Leslie’s work:
o   Leslie’s Evidence Based Birth Childbirth Education site can be found here
o   Leslie’s Doula Services can be found here
o   Follow Leslie’s work on Instagram here

 

Rebecca Dekker:

Hi everyone. On today’s podcast, we’re going to talk with doula and Evidence Based Birth® Instructor, Leslie Green, about advocacy and doula work.

Welcome to The Evidence Based Birth® Podcast. My name is Rebecca Dekker and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details.

Before we get started, I want to let you know that we do have a few content notes for today’s episode. We will discuss the murder of George Floyd, maternal mortality for African Americans, the polarity following the 2016 and 2020 presidential elections, obstetric violence, racism, and forced cervical exams, along with a description of perineal massage with baby shampoo. And now I’m excited to introduce our honored guest.

Hi everyone. Today we are so excited to welcome Leslie Greene. Pronouns, she/her. Leslie is a birth and postpartum doula, childbirth educator, baby wearing consultant and Evidence Based Birth® Instructor and founder of Peridot Births. Leslie’s work reflects her passion for birth justice and she has a special interest in supporting black and brown birthing families, people of color, and members of the LBGTQIA+ community. Leslie is also the mom of a rising first grader and loves to spend her time with her adopted Shih Tzu and tabby kitten when not working. And Leslie, like many of you, loves coffee. Always iced coffee. And we are so excited that Leslie is here to talk with us about her important work. Welcome Leslie, to the Evidence Based Birth® Podcast.

Leslie Greene:

Thank you, Rebecca. I’m so excited to be here.

Rebecca Dekker:

I have to say, when I met you in 2021 at the EBB instructor retreat, I knew you would be on the podcast someday.

Leslie Greene:

Really?

Rebecca Dekker:

Oh, yeah.

Leslie Greene:

Thank you. Thank you. Thank you.

Rebecca Dekker:

You just brought so much energy to our conversations and I’m thrilled that you’re here.

Leslie Greene:

Thank you. That was one of the most pivotal events of my life, so thank you. Thank you for that and thank you for this and all of that. I feel like a celebrity right now.

Rebecca Dekker:

We’ll give you the treatment. All right. So Leslie, tell our listeners what inspired you to go into birth work and then your story with finding EBB when you’re ready.

Leslie Greene:

Oh yeah. Well, they go really close in hand. And I didn’t have an interest in birth work. I think a lot of birth workers, we aren’t actually going to college to become doulas. But actually when I was in college, I learned about the black maternal health crisis, but that was in the 1900s. And back then we would talk about it as being a problem, especially in DC because people didn’t know that the birth rates were so bad in DC for black women and black families. It was about drug abuse and insufficient prenatal care and-

Rebecca Dekker:

Poverty.

Leslie Greene:

Not taking advantage of resources and teen pregnancy and all of these things. It was very much about the choices that these parents were making and how they were not good choices. I actually became a mother myself in 2016, and then in 2020 during the pandemic, the George Floyd event happened. And it really opened my eyes to a lot of things. Right around then I was getting a lot of social media and news articles and stuff about the black maternal health crisis. And I was just like, wow, if I were religious … It almost converted me to being a church going Christian. Because I was getting so many signs and signals.

I had some personal experiences that made sense to me. Somewhere I heard about the black maternal health crisis being about racism or because of systemic racism, not because of personal choices. And this conversation seemed like it was happening a lot at the same time as the George Floyd was happening. All the synapses just started firing for me and I was like, oh, okay. I had heard that having a doula helps black moms, but I didn’t really understand why. And I wanted one when I had my baby, but it wasn’t in my resources, so I didn’t have one. And that’s a whole nother story.

So I said, well, okay. If I’m being called to come and do this work, I’m not interested in it, but I am not going downtown. I do live in the DC area. I’m not going to marches. That’s not me. I’m not physically fit. I’m not going to go spend time outside doing that kind of activism. I was like, but I can go to a birth. I can help support families. I can help spread education and information. So I signed up for the first training I could find and thank goodness that it was a great training. The most amazing instructor. And I signed up for the first one that I could find so I wouldn’t chicken out. And then I immediately signed up to be a childbirth educator and postpartum doula also, to learn how to do all of those things. And then I signed on with an agency so I could get to work right away. Because I am famously self-employed and I don’t want to ever work for anybody. But I was afraid that if I waited until I got my business going then I wouldn’t actually get to work.

I was like, I got to get to work and see what’s up. So while I was in my initial training, we used a lot of resources from Evidenced Based Birth and we talked about Evidence Based Birth® as a resource a lot in our training. And I was like, “Oh wow, this is amazing.” So I looked up the podcast. Oh my gosh. I don’t know how many episodes I binged. I binged a lot of episodes and I found out that you had an educator program or a childbirth class. And I was like, perfection. I want that. And right around the same time, I’m sure you remember, you closed the instructor program for remodeling. And I was like, what? And I was really impressed though that you said the reason you were closing it for remodeling or restructuring was to address the black maternal health crisis more directly. And I was like, well, that’s perfect but I’ll go ahead and learn how to teach a childbirth class.

I am a digital marketing geek and I really love the structure of a class. And I was like, well, maybe I can recreate it on my own. And also being in the instructor program required a year of experience in birth work, which obviously I didn’t have. No. I hadn’t even started. So I figured, well, I’ll be okay. It’ll be fine. I’ll get by. And then before I even got around to finishing, getting my own stuff together, because it’s a lot of work, the program opened again. And I wasn’t technically qualified, but you were having the retreat. And because of the pandemic, that retreat had been put off for a couple of years and it was on my birthday. And I don’t usually celebrate my birthday, but I was like, you know what? I need this. This will be my motivation to get my application in. And I actually didn’t finish my application in time and I was like, oh well. And then I got an email or something that it was due at midnight, not at noon. And I was like, what?

So then I sat down and got … Finishing up my essays on my little phone. I had signed onto the agencies right after I started working and I was offering birth support, childbirth classes and newborn care classes and everything. And also postpartum support. And I’d never done it before so I didn’t know what an appropriate load was. And so in the fall I did a lot of interviews and prepping. And then in the spring I went to a lot of births and I went to a lot of classes and I went to a lot of doula shifts. I think the May of that year, I worked 250 doula hours, not including being a mom, being a human, and having my other businesses to take care of. So the application due date was a day after I came off that rollercoaster. I had my son’s birthday party and I was like, okay, the day after that, I’m taking the day off, I’m going to relax.

And I actually rented a tent at a lavender farm and I went. I was like, I’m going to relax now. And I was like, I missed the deadline, but too bad. And then I saw that I had until midnight and I was like, okay, let me see if I can get my wifi up. And I got it in and then I pleaded. I pleaded for you to make the exception to let me in. And I got in. And I was like, oh my god, this is amazing. So that’s how I got to Evidence Based Birth® and that’s how I got to being a birth worker.

Rebecca Dekker:

Yeah. And I do want to say in terms of the exception, they are rare usually for very gifted birth workers who are almost at the requirement.

Leslie Greene:

Yeah. And I mean technically-

Rebecca Dekker:

You were really close.

Leslie Greene:

I was. And the training started after I was well qualified. But the application due date … I was like please. I think I wrote two extra essays or something begging.

Rebecca Dekker:

And you got accepted.

Leslie Greene:

But I got accepted and I almost died. I was just like, wow. And I was like, I almost didn’t even finish the application.

Rebecca Dekker:

Yeah. And then the retreat was shortly after that right?

Leslie Greene:

It was. It was shortly after that so the rollercoaster kept moving.

Rebecca Dekker:

One thing I remember about you coming to the retreat is that it was a really big leap of faith for you because you didn’t really know us that well and you had to drive to Lexington, Kentucky from DC. And tell us a little bit about that experience.

Leslie Greene:

Oh yeah. I was so embarrassed. I love to drive. I love to drive. But driving from the DC area to Lexington … It’s all through West Virginia and it was all through the mountains.

Rebecca Dekker:

Through the mountains.

Leslie Greene:

Yeah. I basically cried the whole way. And it was eight hours. And I was like, oh my gosh. I was like, I think I’m just going to move to this valley right here because … And there’s so much construction and twisting and turning. And I was like, wow, I dream of being a truck driver. It’s not a small secret. And I cried driving through the mountains to get to this retreat. And I was like, maybe next time I’ll just fly. But the week before I had gone to Alabama to visit some family. And since I became a mother, I haven’t had the stamina for driving like I used to. I used to just get in the car and drive the whole day or drive the 14 or 15 hours and go and spend a couple days and then come back. And so I hadn’t been able to do that pretty much in five years. I just didn’t have the energy to do it. So it was my first time trying again to do it.

And I am a single mom, so it was just me and my son and my dog and we were going to give it a try. And I was so anxious. And we did it and it was great. And I came back because I had to teach actually a childbirth class to a private couple. And then I got in the car and came to Kentucky. So I was really tired. I remember that first night when there were cocktails and stuff and I was like … All of a sudden I was like, “I have to go to bed right this minute.” I was like, “I might be back in a couple of hours.” But I was like, “I’m so tired.” I was crazy. I was crazy. But I was determined to make it there. And it was a really big leap of faith for me.

I don’t know. I think that it happens to a lot of us. And I really feel like in the last few years since the George Floyd event and the pandemic, a lot of us have started to see things differently than we used to. A lot of rocks have been turned over and there’s a lot of stuff under those rocks that I think most of us are shocked about what was under there. Also, with Donald Trump being elected as president. That one definitely gave us, I think, a signal of how much polarity there is in ways that we think inside of our own communities when it used to be something private that we didn’t really talk about.

And so in my experience, especially in that first year in birth work, I was finding a lot of disappointment and insincerity. I was working with organizations and a lot of performative “allyship”. A lot of companies saying, “Oh yes, well we support black and indigenous and people of color and all the queer people,” and not really doing that. And I learned about decolonization and breaking apart these systems. My brother-in-law makes fun of me all the time because he’s always like, “You say everything’s about slavery.” And I’m like, “Unfortunately in America, everything is about slavery.” Everything is based in this horrible thing that happened in our past and it still affects every day. And I was nervous because you’re white. And I said, it looked like you were sincere, but I wasn’t positive. And typically getting to know organizations more intimately is where the heartbreak comes.

I try to work with a high level of integrity, but once something changes and I’m like, oh, if I find out that we’re not really speaking the same language, well then I can’t work with you anymore. And I didn’t want to take a chance. I was like, I just finished the training for the instructor program. I was like, I’ve been waiting. I’m so excited about it. And I was like, now I’m going to go and meet them in person and what if I get there it turns out you’re just like everybody else? And so I was really, really nervous. And then I cried because of driving through the mountains and I was so tired because I had just done too much.

And I also did something crazy. I have jet black hair and I decided to bleach it out. On the one day that I was home between my two trips. And it’s taken a year, but now I like it. But it’s taken a lot of work to get it to where it was. But I was like, okay so I look like this … I don’t know. Funny match on fire. My hair was crazy. So I was insecure about the way I looked too. And I was like, oh my gosh. There’s a lot riding on this little bitty weekend. But I was extremely pleasantly surprised. It was so much better than I expected.

Rebecca Dekker:

That’s awesome. And what was your experience like being with the other instructors and with our team?

Leslie Greene:

It was so awesome. I really pushed myself to make it to the retreat because I’ve been very afraid of the virus. Because the type of work that I do I’ve been really, really cautious. And I hadn’t even seen my grandmother the whole time and I used to see her frequently and she’s really high risk. But because of the pandemic, the numbers of people that were going to attend the retreat were so small. I was like, oh my goodness. I’m going to get one on one time with the people. I was like, I’ve got to try to make it to this. And it was like, I’ve got to make it. And I got there and indeed it was a small group. Well I think it was-

Rebecca Dekker:

Around 20 people.

Leslie Greene:

Yeah. Maybe.

Rebecca Dekker:

We were mostly outside under a tent.

Leslie Greene:

And I think half of us were your team. So it was really intimate and it was really great. I guess it was meant to be like that because everyone was fantastic. Lots of people I wasn’t expecting to see. Nurses and midwives and nurse midwives, old, young, black, brown, everything. All different genders. It was really amazing for such a small group of people to come together to work collaboratively. And then of course you were wonderful. I was like, oh, Rebecca’s wonderful. Okay. I was so nervous because she’s blonde haired and blue eyed. I’m sorry.

Rebecca Dekker:

I know. I know.

Leslie Greene:

I have a lot of family that’s blonde hair and blue eyed. Okay. My son’s father’s a red head with blue eyes. But we approach blonde haired blue eyed people with a little bit of caution because typically it’s a negative experience. And it was wonderful. I cried a lot that weekend. Cried in validation. I think even in my family … Everybody’s family is a little hard to be around even though you love them. So I remember feeling like that was the most accepted and authentic I’d ever felt in my life. And I was just like, I’m exhausted and I look crazy and I’m twice the size I want to be and my age is so much more advanced than probably most people there. Just all these things. And I just really felt so accepted and welcomed just the way I am. And that was really validating also. And then we talked about all the things that …

I think that when it comes to racism, I think when it comes to parenting, I think when it comes to being an American, I think when it comes to being an adult and just being a person who thinks at all critically, you feel a lot like you’re the only one and that you’re a pariah and you’re some strange weirdo who’s having these experiences and you’re the only one. And coming to that event, it really opened my eyes that no, it’s not just me and it’s okay. We can talk about these things and we need to talk about these things and talk about how we can make changes to some of these things that are really problematic and taboo. But we’re going to talk about them and we’re going to do it.

And you’re not crazy because you’ve been thinking about it. We’re all thinking about it. We all notice. We all notice that black women approach blondes and blue eyed women with a little bit of caution and that’s not cool. That’s just the way we are in America for a very good reason. And it’s not supposed to be like that or it can’t be like that anymore. How about that?

Rebecca Dekker:

It can be different I guess is what you’re-

Leslie Greene:

It can be different. How about that?

Rebecca Dekker:

It can be different. Yeah.

Leslie Greene:

It can be different. And it’s definitely a collaborative … It takes everybody participating. And racism has typically been something that is a black people problem or a gay people problem. It’s our problem to fix. And I was really relieved when I met you that you were like, “No, it’s our problem.” We have a responsibility. All of us do. It’s not just on the marginalized.

Rebecca Dekker:

And I have to say, it takes a lot of self-awareness. And I’ve attended enough birth worker events that I had seen how things can go wrong. Why black birth workers would be hesitant and afraid to even enter some of those spaces. It took years of me learning to be able to feel like I could finally create as safe as an environment as possible. It’s not just something that happens by chance. Our team spent a lot of time and work trying to create that atmosphere. And I think it helped that it was smaller. It was August 2021. There was a big COVID wave at the time and every time you hear someone cough, everybody’s like, oh. It was-

Leslie Greene:

Yeah. And it was hot.

Rebecca Dekker:

But it was so nice to meet with you in person. We aren’t having another retreat anytime soon just because of the logistics of doing them. But I feel like there was a reason and a purpose that we got together. It was meant to be, even though it wasn’t the way we had envisioned it because it ended up being so small. After you went on from that event, you were fully trained, you had attended this retreat and you were starting your work as an EBB instructor. How did you go on to start using the materials over the next year and working with your clients? And being in the DC area, which I know is not an easy place for birth workers. There’s a lot of difficulties with getting evidence based care in the hospitals there.

Leslie Greene:

It’s true. Yeah. We have some great hospitals here and we have some really great providers and some really great birth workers, but we also have some really … I don’t know how to say it nicely. Really disappointing, really scary, hurtful number here in the DC area. So it does feel like a lot of fighting. There’s a lot of pushback and resistance. So yeah, it’s not easy. It’s not easy. Well, when we got back from the retreat then it was time to apply for the childbirth class instructor.

Rebecca Dekker:

So you started doing that second part of the training to teach the childbirth class.

Leslie Greene:

Yeah. That was much more challenging. That was much more challenging. But I got it and got the class together and then worked on putting together my marketing and things. And I think just that whole summer … Just that whole experience with Evidence Based Birth® in all those ways really helped me improve. I hate to say improve, but it gave me some extra to work with in my birth work. And also of course a new format to teach my students. I don’t know how to say all of that. It made me more of an advocate in the birth world. I mean the birth room. There was a lot of debate at that time, and I guess it still is. I guess I’ve moved past it. Of what our role is as an advocate in the birth room.

Training, I was really afraid of being an advocate. I was like, “Do doulas have to go in and be security guards for black people?” That’s what I thought the job was. I was relieved that it was like, oh no, it’s not. They can talk for themselves, but I can coach them. But then I went to some births. I was like, okay, black and white people and Hispanic and all of us need more than just coaching. Sometimes you need somebody to step in and actually say, “Hey, hey, you’re not going to do that.” And it felt like coming to the Evidence Based Workshops and trainings gave me the confidence to be able to support my clients in a way that was going to get them what they needed and not feel like I was making some kind of big violation on their rights and what their needs … Yeah. The doula code wasn’t being violated. There’s definitely a difference in being a white doula and a black doula. And even when I’m serving white clients, I still go in confidently just like if I was supporting a black client.

Rebecca Dekker:

They still happen.

Leslie Greene:

Our birthrates are bad in America. Overall it just gets worse. So I do see things happening in the birth room that shouldn’t be happening. So I’ll tell you one thing. The easiest thing that happened for me is that I started wearing Evidence Based Birth® t-shirts to every birth. And that’s really fun. It’s a really good conversation starter. And I do it for a few reasons. So my favorite way to advocate, in case you didn’t notice, is that I get along with everybody and I’m really good at making a laugh and I’m really good at making friends and making a collaborative environment when I come into the room.

Rebecca Dekker:

You brighten the room Leslie.

Leslie Greene:

I brighten the room?

Rebecca Dekker:

Yes.

Leslie Greene:

Thank you. I like to think of myself like a warm light.

Rebecca Dekker:

Yeah.

Leslie Greene:

As a warm supportive light. And birth is hard and-

Rebecca Dekker:

Stressful and anxiety.

Leslie Greene:

And being a doctor is hard.

Rebecca Dekker:

Yeah.

Leslie Greene:

Yeah. And I’m positive that being a nurse is hard, even though I’m not a nurse. I have huge respect for nurses. I know a lot of nurses on labor and delivery units are afraid of doulas. I’ve seen a lot of doctors that are afraid of us too. They’re like, “Oh, she’s got a doula.”

Rebecca Dekker:

They’re watching me.

Leslie Greene:

Yeah. What’s going to happen? And I’m like, “No, we’re here together. We’re a team.” So then when I have something to say, they’re much more responsive to it. It’s like, I’m not trying to fight you. I am not trying to take over any baby catching. That is so not what I do. I’m actually a little bit squeamish. But she doesn’t want you to do that and you need to respect that they’ve asked you not to do that. And can we come up with another solution? So wearing a t-shirt gets the conversation started easily. Most nurses say, “Oh, I love that podcast. I was just listening to it the other day.” And then if you only knew there’s so many other things that … It’s more than just a podcast, which of course we’ll get to. But also it gets people right away aware that I’m the doula and also I’m informed. And it really gets them thinking. And that’s what we really want. It’s not just a job. Yeah, you’re a labor & delivery nurse and it’s a hard job and it’s not fair the challenges that you have at that job. However, it’s more than just a job. You need to come into this room and be this person’s nurse, not all the other things.

And just having the badge of honor on, it gets them thinking, “Okay, well what could I do better? What did I hear on this podcast or that podcast?” Or, “Well, why are they saying that or why is that a choice that she’s making? What’s the research on that?” And it really is not offensive I guess. They get really excited and they’re like, “Oh, I learned something.” It takes all the tension out of the room. Now of course I go home and kick the refrigerator for 20 minutes after every birth. Privately there’s always something that made me very upset but my clients always get to leave happy.

Rebecca Dekker:

You have to pick your battles in a way.

Leslie Greene:

Yeah. Yeah. You pick your battles. The way a person feels about their experience is what’s most important. They need to feel like things happened for them and not just happen to them. So if they’re really happy with the way everything came out, to me, in my head, I’m like, “You didn’t need that epidural. You were almost done.” But, if you’re satisfied with that and you’re happy with it, I’m not going to take that away from you. Come on. But there are things that do piss me off. Something that I’ve noticed in 2022 is coming in and having to sign … Have you seen this? These documents that the hospitals are starting? If you’re listening and you haven’t seen this yet, some of the hospitals, at least here in DC, have started giving to their clients … I guess they call them patients. But to my clients before we come in, “Oh, it’s really great if you have a doula. This is a list of the things that doulas do. Here’s a list of things that doulas don’t do. And if your doula does any of these things, they’re not a good doula for you.” And then when I get to the hospital, they have something similar that they give me a copy of and I have to sign before I can come into the birth.

Rebecca Dekker:

What kinds of things are they saying you’re not allowed to do?

Leslie Greene:

Oh, let me see if I can pull one up for you. I want to ask if I can keep a copy but they want me to keep a copy. They want us to all know.

Rebecca Dekker:

It’s a contract. You have to keep your mouth shut and your patients need to do as they’re told.

Leslie Greene:

And it’s just the unmitigated gall. The audacity. Look, I’m going to go kick the refrigerator right now. I should have had this pulled up already because it is just … Oh, here’s one right here. From a gorgeous hospital here in DC. It’s gorgeous. It’s in a part of town where … You know how there’s rich people and then there’s rich, rich, rich people and you know they exist, but you don’t know them? Okay. They live in DC. Their neighborhood hospital is gorgeous. Gorgeous. Everybody wants to have their baby there.

Rebecca Dekker:

It’s the luxury … It’s like, everybody’s like, oh, that’s the place to give birth.

Leslie Greene:

Yeah.

Rebecca Dekker:

Okay. So what are they telling you if you have a doula?

Leslie Greene:

Their average cesarean there is like 33%. If you’re not a 17 year old blonde hair with blue eyed, perfect sized girl, you’re getting a C-section. When you come to … And then it says a highlight. “Please share them with your doula. So what should a doula do during labor? Offers guidance and helps you with your comfort, fosters a positive environment and supports good communication, provides physical and emotional support for you and your partner, protects your privacy. What they should not do …” Of course, I’m just hitting the bullet points. “A supportive and well trained doula does not perform clinical or medical tasks, interfere with medical treatment or disrupt the positive birth environment, does not speak for you or make decisions for you. Rather, they encourage you to ask questions about your care and treatment, diagnose medical conditions, or present your options for medical care. Instead, they support the communication of the medical staff.”

And then the last one is, “Object to the following policies of the hospital and the director of your healthcare team. As they support you in your labor they will …” I can’t read that word there. The direction of the … I guess follow the direction of the doctor or nurse and cooperates with the request. Then doula certification or registration is required. Certification is required to receive approval to work at … blah blah, blah, blah. You also have to have your Covid vaccinations. And if you have any questions about what’s appropriate to bring to the hospital, call the hospital. This is written out to the families. Oh, wait a minute. I didn’t see this part at the top. “This handout lists guidelines for your doula when they are working to support you in a labor and delivery setting. Your doula will likely be familiar with them. They are based on positions from the DONA. Doulas of North America.”

Rebecca Dekker:

I was going to say, it sounds just like DONA’s. Which DONA does not govern all doulas.

Leslie Greene:

No, they don’t. And I was DONA trained and we can talk about DONA because I go back and forth with them. I loved all of my trainings from DONA. I thought they were very complete. I didn’t feel like in my trainings that I was told anywhere that I could not speak on behalf of my client. My understanding was that if I needed to speak on their behalf, make sure I’m not taking away their chance too. I’m not going to come in and just be another person telling them what to do. And I respect that, but not interfering and … If you’re doing something that’s harming somebody in front of me, I’m not going to not say something about that. I don’t care if I signed a paper. It’s just so-

Rebecca Dekker:

Yeah. One example could be they’re trying to do a vaginal exam and your client has said no and they continue to do it. So according to this hospital, you should just support the doctor in continuing to assault the patient.

Leslie Greene:

And it is assault and it’s horrible. And I was just at a birth recently on Labor Day weekend and everything was actually pretty good. I actually knew the attending. I was actually his doula. His postpartum doula for his wife when he came back to work. And everything was really good but there’s a thing here that they do in the DC hospitals. It’s very common is they use baby shampoo, which just blows my mind. I’m an aesthetician in my day life.

Rebecca Dekker:

They don’t just use baby shampoo on hair. What are they using it for Leslie?

Leslie Greene:

Let me tell you what they’re using it for Rebecca.

Rebecca Dekker:

Because I don’t know if some of our listeners going to understand what you mean by using baby shampoo.

Leslie Greene:

Listeners, let me tell you something. This is what happens in a birth at a hospital commonly. This is a routine practice. Doesn’t have to happen like this. But it routinely happens that a doctor will come in and a nurse and they’ll have a client or patient laying on their back to birth the baby. And as the baby is crowning, they wipe away all the birthing fluids and then they get baby shampoo and lather it up and wash around the vagina and the vaginal opening. And then they will usually follow that with putting their fingers in the vagina to do what they call a perineal massage and stretch the vagina to make space for the baby to come out.

When I ask them, “What’s up with the baby shampoo?” “Oh well we’ll use it mostly as a lubricant for …” And then they’ll demonstrate the … Okay, first of all, why do you need a lubricant for something that’s wet and gushy already? Why are you washing away the birth fluids to get a lubricant? Number two, you don’t need lubricant if you keep your hands out of her vagina. How about that? Why are you putting your hands in their vagina? Why are you asking me why I don’t want you to use baby shampoo? What? Let me ask you, why are you putting your hands in his vagina or her vagina or their vagina? To help the baby come out. Does that make any sense? That absolutely doesn’t make any sense. Also, I’m prejudice too because I happen to know that Johnson & Johnson’s baby shampoo is horrible. It’s full of carcinogens. It’s dries out the skin.

Rebecca Dekker:

It’s basic genital hygiene is that you’re taught not to put soap up there.

Leslie Greene:

Soap in your vagina. Right.

Rebecca Dekker:

Uh-huh.

Leslie Greene:

It’s basic. And at this particular hospital, even though everything was great, I think maybe four or five different people mentioned we’re not using baby shampoo. And I was like, my goodness. They were so passive aggressive about it.

Rebecca Dekker:

Wait. What do you mean they were saying we’re not using baby shampoo?

Leslie Greene:

Every time somebody would come in, because I had mentioned we’re not going to use baby shampoo. I was like, you don’t need a lubricant.

Rebecca Dekker:

So you told them the client doesn’t want baby shampoo.

Leslie Greene:

I did. Yeah.

Rebecca Dekker:

And then every person who comes in says, we’re not using baby shampoo sarcastically.

Leslie Greene:

Yeah. Yes.

Rebecca Dekker:

Like they’re annoyed by your request.

Leslie Greene:

Yes. It was like, this is one that we didn’t talk about in advance. That wasn’t even my client. I was a backup. I was called in as an emergency backup. And I said, “I’m sorry. I know this is our first time meeting, but trust me.” Okay. So I said, “So what is the baby shampoo used for?” And when the nurse explained what it was used for, the client was like, “I don’t want you to put your hands in my vagina.” So every time they would come back in, they were like, “So we’re not using baby shampoo.” And then at one point the resident was like, “Okay, so I’m just going to touch the outside here just to see where the baby is.” And I was like, “Okay.” “But I’m not going to use baby shampoo and I’m not going to put my hands inside.” I’m glad we’re on the same page but you don’t have to be passive aggressive about it.

Rebecca, why are they putting their hands in the vagina? I don’t understand. What are you going to pull the baby out? No. Right? It doesn’t make any sense. Thankfully that baby was … Her head was mostly out. When they turned on the lights we were like, oh wow. Okay. So could you take a deep breath and puff out a little bit? Oh well here’s your baby. So I was like, oh thank God it worked out like that.

Rebecca Dekker:

Yeah.

Leslie Greene:

But it usually does though, right? If you guys stop interfering and getting in the way. I can’t think of many … No. I can’t think of any births I’ve been to where anybody needed to put their hands inside. I have been to a forceps assisted birth and at that point when forceps needed to be used, it was a whole thing. Not baby shampoo in hands. So I’m sorry. I get very upset.

Rebecca Dekker:

So that’s the kind of thing that makes you come home and kick the fridge.

Leslie Greene:

Exactly. So it’s like, even though everything is great, I’m like, why do I have five people being passive aggressive to me about baby shampoo? I was like, I don’t even let my clients use Johnson & Johnson baby shampoo on their babies. It’s not good shampoo. It’s not even good baby shampoo. So I’m like why?

Rebecca Dekker:

So how many hospitals in the DC area are still doing that?

Leslie Greene:

I can tell you I have seen it at at least four, maybe five hospitals off the top of my head I’ve seen it out here. There are more hospitals that I go to more frequently. And I think all but one of them, I’ve had this conversation. Out of the ones that I go to most frequently.

Rebecca Dekker:

Is it mainly the physicians using it and the residents or the nurses or-

Leslie Greene:

The physicians.

Rebecca Dekker:

The physicians.

Leslie Greene:

The physicians or residents. So this particular time I was able to say it in advance because I saw it on the counter when I got there. They had it set up on the counter.

Rebecca Dekker:

So if they have baby shampoo sitting out at the birth, that’s a sign that they’re planning on using it.

Leslie Greene:

Yeah. It was like, wow. It was a whole little spread and I was just like-

Rebecca Dekker:

Oh, there it is. It’s like your little nemesis.

Leslie Greene:

Yeah. And I was like, “Can you put all those things away so they’re not being exposed to the environment?” I’m not a germaphobe, but sanitation’s important to me. I was like, and now you want to use some baby shampoo. Yeah. Sorry to go off on a rant. But it’s really dumb. It’s really dumb. And nobody knows about it in advance. Most of the time you don’t know it’s even being used.

Rebecca Dekker:

It’s not something you necessarily cover in every childbirth class because you don’t expect it to happen. I think it still happens in pockets of the country.

Leslie Greene:

I think that must be it.

Rebecca Dekker:

I think it’s cultural. Probably most of the residents are graduating from a program there that teaches that and then they go on to do that at the local hospitals.

Leslie Greene:

It must be.

Rebecca Dekker:

And I know there’s other pockets of the south where it tends to happen. I haven’t heard it so much up north. It’s sporadic. You don’t know exactly what the culture is till you get there.

Leslie Greene:

That makes sense. A lot of the things that are happening in the … Let’s just say it, in hospitals is cultural. Right?

Rebecca Dekker:

It’s cultural. Yeah.

Leslie Greene:

Well cultural based on the hospital. And this was a teaching hospital. It’s really frustrating. I feel like in my advanced age here, I’ve been learning a lot that when you feel triggered by something, when you start to really dig a little bit deeper, it turns out that it really is not just you being sensitive. It really is something bad or something not great. To me it’s baby shampoo. Is anybody going to put, don’t use baby shampoo on me on their birth plan? Of course not, because most doulas are not even going to think to tell you to put that on your birth plan. Nobody would think to do that. But when we ask the question, so what do you use it for, it comes out it’s so that they can do perineal massage. Well that’s something you may or may not … You want more information about.

Rebecca Dekker:

That’s another intervention you want information on.

Leslie Greene:

Yeah.

Rebecca Dekker:

Which we covered in EBB 218, the podcast, the evidence on perineal massage during labor and we talked about the baby shampoo issue and the evidence on it. And the evidence actually supports the hands off, keeping your hands away is more protective of the perineum.

Leslie Greene:

Yeah. So the idea is that helping to massage that area is going to help prevent tears, when really washing the area and putting your hands in-

Rebecca Dekker:

But in all of the research on perineal massage, they always use a water soluble lubricant. Baby shampoo and soap is never part of the research protocols. Not only is there no evidence for what they’re doing, it’s actually completely different than what the research studies.

Leslie Greene:

Yeah. And it’s just a small example of these little things that happen. And the other thing is that to use baby shampoo … Just seeing the baby shampoo on the counter also tells me that they’re going to want to do some perineal massage, which also means that they’re probably going to want the birthing person be laying down on their back, which is not a natural birthing position and it’s not a comfortable birthing position for most people. So it gives me a whole … It signals off a whole lot of stuff.

Rebecca Dekker:

Seeing what’s out on the counter or on the bedside table tells you a lot as a doula.

Leslie Greene:

It’s already telling me what we’re going to be working on. Like what’s going to be coming up and what-

Rebecca Dekker:

Yeah. What you’re going to have to advocate for.

Leslie Greene:

Yeah. So I can prep my clients for that too. No, it’s just baby shampoo. It seems like such a small thing, but it’s not a small thing. It’s a lot of factors that go along with it.

Rebecca Dekker:

There’s a lot of things that go along with that.

Leslie Greene:

Yeah.

Rebecca Dekker:

They’re going to expect you to be on your back. They’re going to expect you to receive a lot hands on your genitals and vaginal checks. So Leslie, before we go, do you have any positive or inspiring stories from … You work as an EBB instructor and doula. Where you’ve seen successful and positive births? I know you talked about how your clients have positive births, but you’re still coming home frustrated. Are there any improvements or any situations where you’ve come home feeling really good?

Leslie Greene:

Oh yeah. Definitely since I’ve become an Evidence Based Birth® Instructor, I feel very much more like I come home very satisfied from the births. And I will tell you that the way that I feel the most satisfied, honestly, is when I hear feedback from my students after they’ve had the baby. I did have a class this spring where I had two of my clients were in the series and then there were two other families. And so it turned out the two clients … I took them because they lived really close by to each other. So they were able to connect and we ended up having some … It was a really great … The group environment was really great.

Rebecca Dekker:

That was the EBB childbirth class with them?

Leslie Greene:

The EBB childbirth class. It also saved a lot of work for me as far as educating my clients. I do require all of my doula clients to take a childbirth class and I strongly encourage them to take one from me, even if I have to figure out how to make it fit into their budget. Because if they take the series where you do all the teaching and then I just do the coaching, it makes it a lot easier for me but also we get to have deeper conversations and they’re more educated. They don’t have to think about things when we go into the birth room. It just rolls off. It’s just natural to them. It’s like what they know about childbirth is what they’ve learned from the EBB class and from the experience of going through it with me. And it really just makes the whole birth experience just so much smoother, easier, and so much more satisfied.

I think my first EBB student, I actually … I don’t want to give too much of her personal information. I asked her though, to write to you and offer to be interviewed with you on the podcast because she sent me a picture of the baby being born in the kitchen. And I was like, “What happened?” And she’s like, “Things just happened really, really fast.” And I was like, “You’re not supposed to take this class so that you will have your baby at home in the kitchen.” Maybe it made her a little too confident. But she felt really safe and everything. She’s like, “Yeah, I didn’t even freak out. Everything just happened really fast and then we called the ambulance and they came. Yeah. I felt so safe. So Thanks for that.” And I was like, “Okay. You’re so welcome.”

Rebecca Dekker:

Well, and we have had precipitous birth where you give birth in less than two hours. Sometimes less than 30 minutes. It’s not super common, but it does happen. And we have had some graduates of the class say that when it happened to them, they were able to stay calm because they understand the stages of labor. They knew it’s too late to get in the car. We just need to have the baby right here and call for help. And they stayed calm. That could be a very scary experience.

Leslie Greene:

It can be.

Rebecca Dekker:

So it’s cool that when it happens they feel like, okay, even if this happens, we can handle it.

Leslie Greene:

Yeah. Yeah. And just like you said, some precipitous births … I think that because of our culture in America, our idea of what childbirth is, a precipitous birth sounds luxurious. One that goes very quickly and from zero to a hundred and then it’s over.

Rebecca Dekker:

Just baby falls out.

Leslie Greene:

But most people find … Yeah. And the baby falls out and then it’s just done. But most people who have that experience don’t feel like it was a dream come true. They really have a lot of negative feelings about that experience.

Rebecca Dekker:

A lot of anxiety. A lot of fear.

Leslie Greene:

Yeah. A lot of anxiety, a lot of fear comes from that experience. And so to take the class and then, oh well it’s happening. Thank you so much. That is totally different. So we can super be appreciative of that. I love teaching the childbirth class. I’m trying this fall doing an accelerated version of it. Just because it’s six weeks long and in my head scheduling is easier if I make it four weeks. I’m still getting comfortable with that one. But yeah. I love it. My students love it. My clients love it. Yeah. If you haven’t taken the class you should. I don’t like to should, but it’s a good recommendation. But the way that it’s set up is that pretty much most of what I normally would teach in a childbirth class is some of the orientation. And then the rest of it is just getting deeper and having some rehearsals and some practice having conversations. If you walk into the room and you’re the supporting partner and you see all of these things are out and you have to have these hard conversations, how do-

Rebecca Dekker:

What do you say? How do you do it?

Leslie Greene:

What do you say? Because in real life … And I see this happen a lot. I see a lot of educators and doulas too, informing their clients and they come into the hospital expecting to see some two headed goat monster coming in and saying, “You must get on your back.” And it’s never like … Okay, I don’t want to say never. I haven’t ever seen that. I’ve always had wonderful experiences with the staff. They’re all nice. They’re all doing the best that they have. But that doesn’t mean that they’re not putting you down on your back, putting their hands in your vagina even though you don’t want that and then having their students come in and put their fingers in because they want to see what it feels like. And all of these things that you will walk away from this experience being like, “wow, it was great but it was horrible and I don’t understand why.”

Rebecca Dekker:

Yeah. People can be really nice and you can still get non-evidence based care.

Leslie Greene:

Exactly.

Rebecca Dekker:

That doesn’t respect your rights. So I think being able to have time and classes. And for any childbirth educator, not just the EBB instructors. I think that’s one of my big pieces of advice for childbirth educators is to role play these things.

Leslie Greene:

For sure.

Rebecca Dekker:

And to talk about … Channel your inner Leslie and make friends with them and create a positive atmosphere. It’s amazing. You can say more when you’ve spent a few minutes building that rapport with people. You can be a little bit more honest and you can speak your truth without feeling like you’re going to derail the whole experience.

Leslie Greene:

Exactly. And that there are going to be repercussions for it. In a dream world, I don’t have to step in for anything. My dream as a doula is to just come into a birth and just massage your butt and make you feel really comfortable until it’s over and not get any juices sprayed at me and everything be lovely. So doing the role playing, it does help to make that experience really more pleasant for everybody. And that’s really special.

Rebecca Dekker:

And even if you don’t need to use it, you could use it in a different aspect of your life. Because as your child grows up, you will have to advocate for them. As you know Leslie. You’re a parent as well.

Leslie Greene:

I need a first grader doula.

Rebecca Dekker:

Wait until they’re a teen. That’s all I have to say.

Leslie Greene:

Oh my gosh. I have just the one. Parenting is a whole different challenge and a lot of us focus on the birth and getting through that one experience and then it’s immediately after the baby’s born and you get some skin-to-skin time with it, now you’re responsible for it forever. It’s like now what? And you need to not feel like your body didn’t know how to birth the baby. Everything you thought was wrong. Nobody’s on your side. You’re just a vessel for the baby to come through. No, I need you to come out of this birth feeling like, “Wow, I did that and now this thing wants to eat all the time for weeks and I’m going to do it because I love to do it because I can do that. And one day maybe I’ll get a return on my investment.” Which is at three months when they start smiling back at you.

Babies, they don’t give a lot back in the beginning. And for you to come out of a birth feeling like a loser and like you’re incompetent to even birth it out of your body, which is what you’re here for. Not what you’re here for, but your body’s made to do it. Could you imagine going number two and having somebody coming in and coaching you through the whole thing and putting their hands in? It doesn’t make sense. It doesn’t make sense at all. And how are you supposed to parent that baby that only takes from you for a while and doesn’t give you much back to say thanks if you feel like you can’t even let it out of your body? You can’t even get it body.

Rebecca Dekker:

I was going to say even for people who need medical intervention and even lifesaving situations, they shouldn’t be made to feel that way. That’s part of the problem in our culture and medical system is we label people with terms like failure to progress or failed induction or failure to descend.

Leslie Greene:

Yeah. So many things. So many things. I’m not going to get off on it too far, but I know from my own birthing experience that I was very grateful for my whole team. I worked really hard to try to … I changed insurance so I could have my regular OBGYN as my provider that I wanted since I was like 14. She delivered my sister’s children. All of this. And I went in and had a very textbook induction that turned into a cesarean for failure to progress with stuff that I didn’t know until I took my doula training. And I was like, no wonder all if this has been sitting so uncomfortably with me. And it really felt like I was supposed to be infertile. I had always been told as a teenager and coming up that if I wanted to have children I would have to have fertility specialist support. And then I got pregnant and I wasn’t expecting it. And I was just like, I couldn’t believe it.

And then I go to have him and I didn’t dilate so I had to go in and be induced. Then he had be cut out of me and I was just like, wow. I thought there was something wrong with me. And that validated that there was something wrong with me. He lost a pound in his first week being born, I knew there was something wrong with me. The lactation specialist said that his latch was perfect, but he’s not getting fed. What kind of a parent am I? And it’s just all this invalidation. And we need parents to not be invalidated. We need parents to be strong of mind so that they can feel competent.

Rebecca Dekker:

So they need support. Yeah. When you start having those down thoughts, have somebody who can remind you what you’re doing well.

Leslie Greene:

And I really do believe that supporting birth and the birthing experience is really the fastest way to social justice and change in this world. Parents giving birth and feeling like they can take care of this baby that is all covered in birth goo.

Rebecca Dekker:

And they weren’t traumatized at that really critical moment in their life.

Leslie Greene:

And weren’t traumatized and don’t need a whole lot of people to come and fix everything that they did wrong. No. This baby here, I birthed this baby. Maybe I needed an intervention and thank God for these amazing life saving techniques that were available to me. This is how we need to be feeling. And not just like, wow, I was just a pile of rags that just couldn’t do anything right. Which is the routine birth experience in America. And we need confident parents. We need parents that feel like, “Yeah, things got tough and guess what? I was able to have a Cesarean and then I survived and so did my baby. I was up and walking a few hours later and I got to walk down to the lactation consultant and I got this. I can do this.”

And then all the choices you make after that as an adult, but especially as a parent, you make completely different choices after that. I learned the word boundaries after becoming a parent. You learn how to ask for help and all of these things. And they don’t happen the same way in the way that we traditionally give birth in America. I don’t even want to say traditionally because it’s not traditional. It’s a new thing.

Rebecca Dekker:

Yeah. It is a new thing.

Leslie Greene:

It’s just the way we’ve been doing it the last hundred years.

Rebecca Dekker:

The last hundred years. And I still chuckle about how in the beginning, and you talked about, “back in the 1900s,” which … Okay, so we’ll end there Leslie. Our time has run out, but I am so glad you came on the podcast. I knew we’d be able to have a really good candid conversation.

Leslie Greene:

Thank you for having me. I try to-

Rebecca Dekker:

You’re always wonderful. And I hope that our listeners are inspired by your energy and your passion and your advocacy work. How can our listeners follow you if they want to see the work you’re doing in DC?

Leslie Greene:

Oh yeah. Thank you. You can follow me on Instagram. On Instagram I’m Leslie the doula. Doula, D-O-U-L-A. I’m not perfect at posting my curated content because I have about 10,000 things that I do all the time. But I try to keep up in the stories. And if you want to take a class with me, my class website is EBB with Leslie. L-E-S-L-I-E. And otherwise you can DM me on Instagram or whatever because I will talk. I will talk. It’s just getting in touch with me.

Rebecca Dekker:

Well thanks for talking with us, Leslie. It was wonderful.

Leslie Greene:

Thank you. I’m so glad to be able to spend a little time with you. A little one-on-one time.

Rebecca Dekker:

Today’s podcast was brought to you by the Evidence Based Birth® Professional membership. The free articles and podcasts we provide to the public are supported by our professional membership program at Evidence Based Birth. Our members are professionals in the childbirth field who are committed to being change agents in their community. Professional members at EBB get access to continuing education courses with up to 23 contact hours, live monthly training sessions, an exclusive library of printer-friendly PDFs to share with your clients and a supportive community for asking questions and sharing challenges, struggles and success stories. We offer monthly and annual plans as well as scholarships for students and for people of color. To learn more, visit ebbirth.com/membership.