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Unknown
Welcome to Hello Uterverse, where perinatal peeps come for more evidence, more clarity, and fewer WTF for Jen and Heidi. Labor nurses, educators, and research obsessives here with you in podcast form. From deep dives to surprising rabbit holes, we're here to help you think differently about the work you do every day. Let's launch.
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Unknown
Welcome back to hello, Uterverse And today, Jen, I'm going to blow your mind a little
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Unknown
I'm so scared.
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Unknown
I know. Okay. So I came across a study when I was doing just, you know, my normal searches that I do. And I found a little qualitative study that I wanted, I want to discuss.
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Unknown
It's on a topic that we've actually talked a lot about lately, and we talk about it in Speedy Delivery.
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Unknown
And for those who don't know, speedy delivery is sort of like our 2.0 to pitocin paradigm. So pitocin paradigms very much like about like the normal labor process, speedy deliveries like the 2.0 of like yeah, but I have this induction.
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Unknown
How do I get them to deliver the fastest for them? Right. We just don't want to slow them down by doing different
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Unknown
things. Right.
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Unknown
that's what speedy delivery is. If you all don't know, it's about how like basically like a speedy induction class
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Unknown
because that's the world we're living in is a lot of patients. We're taking care of our being induced.
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Unknown
And so
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Unknown
don't want to put them through that old 72 hour
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slog. No, we
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actually a lot of evidence and research of ways that can optimize the environment and the tools that we're using, and even like the interventions that we're offering to get them delivered quicker.
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Unknown
So
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Unknown
okay,
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Unknown
decided to do something a little different today on the podcast of like, so Heidi knows what we're talking about.
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Unknown
And I have
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Unknown
she has a no idea
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Unknown
what we're talking about,
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Unknown
Yeah.
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Unknown
I know it's about a study and I'm going to have to like, read and evaluate the
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Unknown
study sort of like
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Unknown
in real time.
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Unknown
Yeah. Okay. So just to preface it a little bit, just give you a little thing. So I set up something. Oh I'm loving it.
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Unknown
This is something that we've been talking about. And we do talk about regularly about how influential we are as the nurse.
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Unknown
Okay. So do you want to kind of try and guess what it is?
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Unknown
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Unknown
Nurses use of Starburst candies in speeding labor up both them, eating them and the patient eating
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Unknown
them. Okay. That's really funny. No, it's not about that. But I do have a funny little story about starbursts and labor. Okay. So when I gave birth to my daughter, Kenzie,
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Unknown
my husband Brody was obviously there at the birth. But he is not a medical person at all.
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Unknown
He is a farmer. He's like a big, burly Canadian hockey player guy.
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Unknown
Oh. Live it up, ladies.
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Unknown
Like yes
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Unknown
it is what you imagine.
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Unknown
Beard
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Unknown
Canadian farming, former hockey player. We joke we imported our husbands because mine also is
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Unknown
We did. We did import our husband hot husband. So he was nervous about the birth and was really really worried about passing out.
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Unknown
Oh, because he's a vegetable farmer, to be clear.
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Unknown
Yeah. Not there's
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Unknown
not like animal,
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Unknown
He's not birthing calves or anything. No.
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Unknown
The only liquids are like, dirty vegetable water. Sounds like good time. Yeah. Anyway, so he was really nervous about passing out, so he
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Unknown
packed Starburst, and any time he would feel a little queasy, pulled out a Starburst.
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Unknown
He was like. And he didn't pass out. And he was like, this is the key to, like, surviving labor. And so, like, I remember I was pushing and he was like, adamant he wasn't going to look, not because he was like grossed out about how my body was going to look or anything. He just was like, I'm going to pass out.
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Unknown
and I can't be the drama king,
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Unknown
right? So as I'm pushing
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Unknown
just hear these papers,
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Unknown
he's just eating these freaking starbursts and then leans down to me and he's like, babe, I just looked and I did not pass out. And I'm like,
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Unknown
in your head starts spinning to be like, okay.
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Unknown
For me, it would be like the Starburst would not be my candy of choice in that
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Unknown
Yeah.
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Unknown
have to unwrap and sometimes they get a little
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Unknown
stuck. And if your hands are a little sweaty
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Unknown
and a little steady and it's like you're like, you know, there are purpose made
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Unknown
items for this. There's like gels for like marathoners or try like
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Unknown
even like a gummy bear,
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Unknown
a gummy bear.
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Unknown
Something
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Unknown
I know Joseph
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Unknown
been over there with this, like hydro goo, whatever.
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Unknown
Oh my gosh.
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Unknown
switched to the sour sea candies from Trader Joe's for
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Unknown
his training. Oh, the Scandinavian swimmers. The sour ones.
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Unknown
Those are so good. I know it really is. But anyway, so he was just like, this is the holy grail to surviving your partner giving birth. If you feel like you're going to pass out.
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Unknown
Yes. So then subsequently, any of our friends that were then pregnant and about to deliver, he was like sending their partner Starburst.
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Unknown
can just imagine him being like, hey man, line it across the table like I
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Unknown
Feeling a little queasy? Pop a couple of pinks and orange starbursts. Fine.
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Unknown
you're going to want these. The dad to me is like, what?
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Unknown
what is happening? Anyways, we digress, but so today I'm surprising you with a study, right? It's not. It's not Starburst. Do you have any idea of what you think it is
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Unknown
Okay, so a study that I don't know because we talked about in well-versed our newsletter last month. We talked about nurse sensitive indicators. And it's like you know, classic like Joyce Edmonds stuff. And then we've got newer stuff from definitely a gal in the universe, Katie Roberts at all talking about, you know, yes, it is both people's belief in in physiologic birth, but also
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Unknown
years of experience.
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Unknown
Right. Really plays into that. We don't know if it's chicken or the egg. Like as you become more experienced, do you believe or trust physiology more or
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Unknown
is that part of like something that was just like popular back then, or are you just more skilled or what is it? So those are the ones I'm familiar with. But you're like, no, it's not, it's not any of those, okay, but you're on.
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Unknown
I'm not going to give you a full ding ding ding. I'm gonna give you a partial ding. You're you're correct that it does have to do with nurse sensitive indicators, but it's a different angle on that. Okay. Hit me with it. Here's the angle
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Unknown
okay. Is it. Did you print it this big. Because I'm.
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Unknown
43. Senior citizen sized font printed in booger on.
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Unknown
No. It just that's okay. How I printed it. Oh, okay. This is interesting. Okay. I'm going to read you guys the title of the article. Okay. Personal birth experiences and clinician attitudes about cesarean birth across sectional study with female labor and delivery unit staff
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Unknown
that own it just came out March of 2026. So it's our own personal experiences with birth.
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Unknown
Okay okay. Let me to give you a quick little rundown. So this was done
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Unknown
across like a multicenter hospital in Arkansas.
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Unknown
And they gave a survey to nurses. Shout out Arkansas. What's up Arkansas?
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Unknown
About their personal beliefs on on C-section.
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Unknown
And what they found is that what was really influential on their C-section rates, their like their nurse sensitive indicator was whether or not they themselves had had a C-section.
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Unknown
And they found that nurses who had had a C-section were much more likely
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Unknown
to try to call it early for their patient and be like, they just need a C-section, because that's what had happened to them. And they felt like it was sort of like a saving grace for them or that,
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Unknown
it's not that big of a deal to have a C-section.
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Unknown
Like there was an added. It wasn't as bad as it was, like thought out to be, because there is kind of a little bit of a stigma towards it that like, oh shoot, we got a roll to the back like that. It's seen as a failure, which it's totally not. It's not right or it's like, right, the the lesser of the outcomes or something like that.
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Unknown
And then people who have gone through it, maybe they know, oh, I am bonded with my baby. Oh,
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Unknown
you know, nobody's really asking me about it now. We kind of think of it as like, is it this, you know, bad? You're going to have to wear the rest of your life. Like people are going to know you were the C-section.
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Unknown
And then for nurses who had a vaginal birth, they were more likely to push for a vaginal birth and avoid having a C-section because it was, like, scary to them.
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Unknown
This is like a little bit blowing my mind.
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Unknown
what was their end? So they had there were 331 that ended up being included in this qualitative study.
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Unknown
And it was all nurses that identified as female, and most of them had all given given birth themselves or they had had like someone really close to them that had given birth. And I just thought that this was kind of an interesting angle, because the other thing that they brought up in this study was that labor and delivery is kind of not, I don't say the only, but kind of one of the only areas in the hospital where the nurse is most likely to also be the patient.
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Unknown
Right. It's not like nobody thinks if you're, you know, an uncle nurse like they do in labor and delivery. Our patients ask us, have you given birth? Yeah. Nobody's asking their oncology nurse in expecting a yes with the frequency. Yeah. Have you also had cancer? Have you had a quadruple bypass yourself, you know. Yeah. Exactly. So there is that.
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Unknown
And I know as a when I was a, I was both a newer and a younger nurse, I did I worked my first ten years not having had a baby. And, but people would ask like, oh, do you have children? And at the time I had a dog named Cosmo, which for Portland is like a unique name, but not weird, right?
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Unknown
If I had said biscuits or something like that. So I dog also was named Cosmo, so I could just be like, oh yeah, I have a three year old named Cosmo. Oh, wow. Because it's important sometimes to our patients. Yeah, they're kind of like, am I just like out, out to sea alone in this? Or, you know, it just it kind of creates this point of connection, like, okay, she's been through this.
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Unknown
She looks mostly okay. I'm going to be okay, right? Yeah. We turn into their birth support person, I really do. They're quasi friend. I mean, I think I mean, I didn't have when I worked med surge patients being like, oh my God, we could totally be friends outside of here. But how often does that happen at the hospital?
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Unknown
And we feel that way, too. There's certainly patients you'd be like, okay, that patient was cool. Like we would have a good like you, you do because we for most of your career, you're the same. I mean, up until your 40s, you're the same age as your patients, right? Right. That first half of your career, you are both a peer, a friend.
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Unknown
And then you move into the more like I feel like I'm getting to the point now where it's like the big sister, the ant, that sort of a thing eventually will be the grandma's, the mom's, grandma's of our patients. Right. And so we have those sort of like proxy roles that we fill. But you this angle, what's coming to my mind of our experience is that we there's something I call it evidence based bias, which is our own biases that we bring to the evidence based process, where also known as cherry picking or selection bias, which is we are going to more heavily weight things that fit our perspectives or our worldview or that confirm
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Unknown
what we know or believe. And so before I had a baby,
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Unknown
you know, it's hard to even think back like, what was I was I influencing patients in one way or another versus today? I did have a vaginal birth, but it was like by hook or crook, literally. Yeah. OP async clinic at 41 weeks. I mean, did some damage.
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Unknown
Yeah. I mean, I am still I'm 12, 12 years postpartum, so I'm six years postpartum. You're basically just off of maternity leave. I am it's a perpetual state of mind. It is. It's an eternal state of being. So I'm barely back from maternity leave. Jen's just figuring things out again. Yeah. So I definitely can see where this plays a part.
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Unknown
I remember I you know, when you give birth, you tend to give birth in like sort of like like a lot of your friends or, you know, acquaintances are also in that time of their life. And I remember the my friend Jess, who was also the person who would cut my hair, she had a second stage C-section. And I have always felt like as a nurse,
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Unknown
like I failed if my patient had a second stage C-section, like you get them that far, how did you not help them get their baby out?
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Unknown
Like, what is wrong with you? So I've always been fascinated by second stage C-sections. Yeah, but she
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Unknown
ultimately did have a C-section. But she afterwards, she said her nurse came to her and was like, oh, I'm so relieved you finally said yes or that that you said yes when they offered you the C-section. We were all sort of like thinking that was going to happen.
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Unknown
And she was like, the nurses thought they were being supportive and saying, like, you can do it. Keep going. If you want to, we're here for you. But what she heard is you crazy bees all knew I was going to have a C-section for the last like five hours and didn't tell me, and you let me go through that.
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Unknown
And she did not find it to be supportive. So I could see where that ever since she told me that story, it even though it wasn't my experience, it was someone so close to me that I was like, oh, we do have to tell them this is what I'm seeing, right? And that's that second layer of the evidence is like filtering it through our perspectives and our our perspectives are valid.
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Unknown
And, you know, I mean, we can't change what experiences we've gone through. But I think that the study just like points out, like how important it is to acknowledge that. And also, you know, like how important it is to like, talk through our, our experiences and work through that and, and not with a friend or therapy with a friend or therapist so that, you know, we are mindful about how we are impacting our, our patients.
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Unknown
Like making sure that like, oh man, I had this really traumatic birth and I don't want my patient to go through that. So I'm going to, you know, you're kind of projecting your own things on it, which can actually end up causing harm to them in another way. And we've known this. I mean, it makes sense, right? It makes sense to say it.
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Unknown
But I find that fascinating that they were like, we're going to go ahead and like put a number to it. We're going to put it in, we're going to get the evidence for this phenomenon that we know happen. I mean, intuitively, it makes right a lot of sense. Yeah. But I love that they went ahead and went out to to do this.
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Unknown
So
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Unknown
the the premise, it sounds like just like glancing at it was like, hey, we're trying to increase our NTSC, which is null term singleton vertex like that. Yeah. Those patients who really should there's no like they're not breech. They're not twins. They're not preterm. Right. These are ones that are like they should be delivering or having a vaginal birth.
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Unknown
Right. And we're trying to as a country. Right. We're looking at all kinds of things. Right, right. Trial or let them go longer or early.
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Unknown
Aram, all of these things. But these are like the first people to ask the question, like. Yeah. So they were like, there has to be something else. And it and I don't think that it's just like one thing, it's all of these things kind of compiled together.
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Unknown
And so they were kind of like asking the question like, yeah, like, okay, everyone is so focused on lowering C-section rates. And we say that nurses are impactful on that. Like, but why? You know, what's another thing? Because we've talked, as you had mentioned before, you know, you've talked about experience in in years in the specialty and the nurses own belief on physiologic birth and where that comes from.
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Unknown
And then a lot of it does like stem from our own experience. The other thing that I thought was interesting is, did you know that there's not actually like a published number of like, how many labor and delivery nurses have actually given birth? Like there's not like you can't find a statistic on that. Right? Because all of our stuff comes from our birth certificates and no one's asking.
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Unknown
There's probably occupation. Yeah, but I don't think search it in different ways. Well, you know, I so I'm currently very getting a little more obsessed per a recommendation of a very notable researcher to get into the wonder database saying, like, you can figure out anything. And she really encouraged me to do that. This is making me think, oh my gosh, as soon as we hit stop on this, we're like, we're going down that rabbit hole.
00:18:09:09 - 00:18:15:20
Unknown
Yeah. Is there a way to extract that data? But we might just have to.
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Unknown
Yeah. Do a survey. Yeah. So you said there was about 300 nurses responded. Oh it's staff. It was nurses and physicians were physicians. And it looks like they had 50% delivered, had delivered batch or had a vagina birth, 20% was C-section. Only 9% was both. So they'd either had a vaginal birth and then a C-section or a C-section and then a vaginal birth.
00:18:47:07 - 00:19:21:01
Unknown
It doesn't say which, though. And then because that would be interesting of like patients who had V backed. Right. Were they different and then no experience were 20%. So interesting. And they found the ones that had actually experienced the both were more cognizant of unit culture of like, oh, like this provider, whatever tends to C-section their patients a little bit more, or they were just like a little bit more aware of like they were your Switzerland's.
00:19:21:02 - 00:19:42:04
Unknown
Yes, they were your neutral party. Yeah. They so really they had seen it both ways. And they, they truly were. So gosh wow. This is such a great study. So you had said that this was, is this qualitative or quantitative. It was qualitative. Yeah. Okay. So they had a survey but then they could also like do measure it.
00:19:42:07 - 00:19:52:20
Unknown
They could do written responses okay. So it's a labor culture survey. And they used a bunch of subscales. What does smart. So I'll just say who the researchers are
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Unknown
Shout out to researchers Tori Van Gopal, Selig Manning Smith Greenfield and Callahan Kuru. They're on to something here you were on to something how novel and unique and like, touches on evidence based bias. And also, another thing that we tend to talk a lot about is that we do not make decisions based on data. We all think we do.
00:20:21:13 - 00:20:52:05
Unknown
I'm so neutral I'm so you know whatever whatever the best evidence I am, I'm evidence based. I'm going to give evidence based practice. No. We make decisions based on how we feel about the data. Unless we really, really reckon with these biases that we all have. Yeah. But one I probably would not have considered was that to be to be totally transparent and honest, I think about I do value the physiologic process.
00:20:52:06 - 00:20:57:16
Unknown
Yeah, I do value, you know, patient autonomy. I value,
00:20:57:18 - 00:21:16:03
Unknown
you know, using all of our nursing skills. Right. They have a lot I have some acknowledged biases that I have like that I have a bias that nurses are incredibly impactful, that we do have lots of tools, that birth in the hospital can be great and wonderful. I had not considered my own birth.
00:21:16:04 - 00:21:22:11
Unknown
Yeah. How fascinating. Oh my gosh. Well, thank you for setting that. I'm definitely going to read this whole thing.
00:21:22:13 - 00:21:35:04
Unknown
So interesting. Okay, well there you go universe. A little food for thought. So just take some time today whenever you're listening to this to we'll put we'll link the study in the show notes.
00:21:35:04 - 00:21:49:17
Unknown
and we'll link the other articles to that we mentioned at the beginning of the episode. Yeah. And email us, fill out the contact form on our website at and like share what you think about this or send us a DM
00:21:49:19 - 00:21:50:19
Unknown
on Instagram.
00:21:50:20 - 00:21:59:23
Unknown
If you come across a particular rabbit hole, either question that you want us to answer in the well-versed, you know, Birth Nurse Hotline newsletter.
00:22:00:01 - 00:22:12:03
Unknown
If you've got an article or a question that you want us to address on the podcast, we would love if you would go. If you would go, and we'll put the contact form below in the show notes also.
00:22:12:05 - 00:22:24:02
Unknown
Okay, well that was fun. I finally, like totally surprised you on something you did. That was a good one. That was juicy. Yeah. Okay. All right, universe, we'll see you next time. See you next time. Bye bye.
00:22:24:04 - 00:22:26:17
Unknown
Thanks for listening to Hello Uterverse!
00:22:26:19 - 00:22:30:08
Unknown
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Unknown
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Unknown
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