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The Better Birth podcast: Maternal assisted caesareans with Dr Elphinstone

In this episode I talk to obstetrician Dr Natalie Elphinstone. Dr Elphinstone is an Obstetrician working on the south coast of Australia. She has witnessed the birth of over 1500 babies and believes in supporting women and families to make individual choices that feel right for them. And if that choice involves a caesarean section, then she’s a keen advocate for making that the best possible version of a caesarean birth it can be! Her videos of Maternal and Partner Assisted Caesareans have gone viral on Instagram, prompting discussions with healthcare providers all around the world, and inspiring no less than at least 5 other countries to follow her lead so far. We talk about what a maternal assisted caesarean is and why you may want one, how they're done and how to advocate with your obstetrician to have one if they haven't done one before. You can find Dr Natalie on instagram at @drnatalieelphinestone where you can find lots of amazing videos of her caesareans.


Erin (00:03):

Welcome to the Better Birth Podcast. I'm very excited today to be talking to Dr. Natalie Elphinstone. Dr. Elphinstone is a obstetrician. She works in Australia, and she's witnessed the birth of over one and a half thousand babies. She is a fierce advocate of supporting women and choice, , and she has performed lots of maternal and paternal assisted caesareans, which is the topic of today's podcast. so thank you very much, Natalie for agreeing to come on the podcast today. I'm very excited to talk about this topic.

Dr Elphinstone (00:38):

Well, I'm certainly very excited to talk about this topic as well. It's definitely a passion of mine and I love the idea that we're just calling this better birth. Like how good would it be that if everybody could say that they had a better birth than what they're perhaps even imagining? So that's my aim as well.

Erin (00:53):

Fantastic. I'm, I'm really, I'm really, really happy that you've agreed to come on the podcast because I think people that have caesarean, and I know from, from a lot of people that I speak to on Instagram when they choose to have a caesarean, either, you know, an elective or because, you know, circ stances have, have dictated that caesarean birth is the best option for them, I think they can feel quite disappointed, quite negative about the prospect of having a surgical birth. They can feel quite upset and feeling like that all of their choice and all of their control has been taken away. , so I think it's really fantastic that you are promoting the idea of a maternal assisted caesarean, because that puts some of that control and power back to in the hands, literally in the hands of the person who is giving birth. So do you want to start off talking a little bit about what a maternal assisted caesarean is for those people that are listening that dont know what that is?

Dr Elphinstone (01:56):

Oh yeah, absolutely. Cuz I think there's a lot of words out there at the moment where we can get them a little bit overlapped or confused. So we talk about maybe Gentle caesarean or we talk about h anized caesarean, , or natural caesarean, which I'm not sure what that means. But, , maternal assisted caesarean get thrown into the mix as well. And so what we are talking about when we say the word maternal assisted caesaree or partner assisted caesarean is that, , me as the obstetrician or the surgeon will, , start the caescarean in the standard sort of technique whereby we operate and take the baby out. Normally, you know, most often babies are coming out head first, so I will still, , let the baby's head and arms first come out. , but then at that stage we have prepared the mother or the partner or whoever's performing this be ready beforehand. We can talk about that for sure. They are then able to reach down themselves and then, you know, grab their baby, hold their baby, and lift their baby up out of their own uterus and hopefully, you know, straight onto their chest themselves. So it's really sort of empowering them to play this active role in their own birth, even though we're now sort of talking about it as a surgical birth. It's really exciting.

Erin (03:17):

It's amazing and I think it's so powerful to give that, give that, give that role back to the mother or the partner to be involved in that caesarean. , so how do you prepare, you know, the, the mother or the partner for doing for doing that? What kind of discussion takes place?

Dr Elphinstone (03:38):

Yeah, that's a good question, right? So I think there's sort of two parts of that answer. There's one is that what is that sort of antinatal preparation? What is that discussion? And of course then there's the, what is the actual physical preparation of the woman on the day mm-hmm. <affirmative>. , so certainly this conversation does start well in advance of the actual day of the birth. There does need to be this conversation held beforehand about what it's gonna look like, what it actually involves, what sort of rules if you like, She needs to be aware of, and I hate using the word rules, but when we're talking about an operation or a surgery, there are still certain surgical rules that we need to sort of abide by because that allows for the safest, , outcomes for the mother and baby. We need to not forget sometimes that this is still a surgery.

Dr Elphinstone (04:28):

So there are still certain rules that we need to abide. And I'm talking about sterile rules. So there's some things that we're not allowed to, or where we're aiming not to sort of break when it comes to rules of sterility. So we need to have this whole conversation beforehand. sometimes or often I will even do maybe like a mock run through with her and her partner ahead of time so they know what that's even gonna sort of physically look like. Like, you're gonna put your hands here and then you're gonna put your hands here and this, you know, you, you're gonna touch your baby and it's gonna feel warm and wet and slippery and you're gonna lift straight up. And sometimes that's hard, you know, So talking through all of those sort of minute details and talking through, under what sort of circumstances we may not be able to proceed with the maternal assisted caesarean as well.

Dr Elphinstone (05:18):

We very much need to be prepared that in the very small percentage of people where there may become, , surgical complications or anesthetic complications or reasons why, even though we are prepared to do a maternal assisted c we can't do that safely in the midst of the actual operation itself. she's sort of mentally prepared that if I say, look, unfortunately we can't do that part of it, that she's accepting of that as well. so there's all of that sort of preparation beforehand. And then the preparation on the day is about actually undertaking all of those sort of sterile procedural, , side of things. So that involves getting if we're just talking about a maternal assisted caescarean and that involves getting the mother to wash her hands the same way as me as the surgeon would be washing my hands.

Dr Elphinstone (06:11):

So there's all this sort of special technique that we're supposed to use and do it for a long enough time with a right amount of sort of soap, et cetera. and then, get, so we do that first of all, so she's sort of sterile. Her hands are clean. There's still some normal parts of the procedure that have to be undertaken in the normal way, such as the spinal anesthetic, lying her down on the operating table, putting a catheter into her bladder. And then there's the next stage of the preparation, which is again getting her hands, , clean and sterile again. swapping her hospital gown over for a surgical gown, so a sterile surgical gown and putting sterile gloves on her hands as well. , and then again this rule based thing about where she can put her hands, what she's allowed to touch, what she's not allowed to touch.

Dr Elphinstone (07:00):

and then yeah, then comes this magical moment. So it happens fairly quickly in the procedure, you know, when we're doing a caesarean and it's usually quite surprising to people about how quickly the baby emerges in the scheme of the operation. that very soon after we're preparedand we've started that within minutes I'll be able to instruct her that she can sort of now, you know, look down and reach down and touch your baby. And it's such an amazing moment to get to just watch their faces because yeah, like I get to now take my hands off, I get to take a moment to pause at that point as well and just let her discover and, and you know, find her baby see it. Maybe she wants to declare to the world of, you know, it's a boy or it's a girl if they're not sure. and you know, witnessing her face is one of my most special moments of getting, just to see that overwhelming joy that very typically comes when this happens.

Erin (08:00):

Yeah. Oh that sounds beautiful. And I've, I've seen so many of your videos on Instagram because I actually didn't find your account first. I think your videos of the the caesarean have been reshared all over social media are quite a lot mean lots of be birth workers have picked up on them and they are amazing. And every time I've reshare one of them, the amount of comments, from people saying, that looks amazing and, you know, it's fantastic and I'd love to have that. So what, what's kind of the, the opinion, you know, amongst your colleagues and how, how common is it in Australia? Because in the UK we were saying before we started recording, it's not very common in the uk, if at all. so is it something that is picking up with popularity in Australia and, and what's your colleagues' opinions on this type of caesarean?

Dr Elphinstone (08:53):

Yeah, I, I think that we still acknowledge that this is something that's not commonly known about as even a possibility mm-hmm. <affirmative>, which is why I think the videos have become so powerful. , and you know, that sort of things took me by surprise to be honest. I wasn't ever setting out with this intention of let's try to make say a viral video, right? I just went, Oh, we've got this video of this amazing thing, let's share it because it's amazing. And neither, I was so totally overwhelmed by the response of people just saying, Whoa, like, I didn't even think that was a possibility. And here you're showing that it's been done like amazing. but yeah, no, even in Australia it is not a common procedure to do and it's not even a commonly known option for people.

Dr Elphinstone (09:44):

I think on the whole, it tends to still be mainly in the realm of private hospitals rather than public hospital. I know some public hospitals have done it mm-hmm. <affirmative>, , but on the whole tends to be a private hospital thing. and therefore it really comes down to the individual provider, the individual obstetrician, typically or the hospital policy or protocol about whether or not they're happy to offer that as an option. Mm-hmm. <affirmative>. so I think this is where and why I'm going to continue to show my videos and share because the more I can, share it and the more it does become widely known, then I think that's really gonna help twofold. Like the patients themselves, the women themselves, be able to show their obstetrician look, here's a thing that can be done. Can we maybe do that?

Dr Elphinstone (10:34):

And it also shows the health providers themselves. It shows the obstetricians themselves. Other people are doing it. Maybe I can as well. In fact, to be honest, that's how I fell into it myself. , I'm not ever gonna claim that I I'm the first person to do this, or I'm the only person that does this. , the way I even, , came about doing this was because one of my patients saw it on somebody else's Instagram account and said, Can we do that? And I went, Sure. Well, I went, Oh, probably. let me see if we could make that happen. and that's how that sort of all unraveled so to speak, in such a positive way.

Erin (11:09):

So if somebody's asking obstetrician to have a maternal assisted caesarean, what kind of things, because I'm guessing that, you know, that may make some people feel quite uncomfortable, the thought of venturing into the realms of unknown things that they haven't done before. So I mean, how did you go about researching and finding out whether you could do it and what the risks were and how to do it? Because I'm guessing it's not, like, it's not something that's taught when you qualify, so you're kind of having to find your own way a little bit?

Dr Elphinstone (11:44):

Yeah, exactly. I think it often becomes challenging as a healthcare provider when say a patient asks for something that you've never done before, because instantly it puts us in a very uncomfortable position of A) maybe, identifying that we're inexperienced at something mm-hmm. <affirmative> and B), because it often does challenge us if we're put into a place where we have to think about changing the way that we normally do things. You know, most of us are creatures of habit, let's be honest. We get to know something, you know, we're trained, we've trained to do us as area in a certain way. We feel like we're probably quite good at it. we've done it literally a thousand times in this kind of set way. And now we are being asked to maybe change that and do it in a different way.

Dr Elphinstone (12:34):

And not everybody's necessarily willing to embrace the idea of that. And then the next thing that is a bit of a barrier can be that, not only then from an individual perspective of I've never done it before, but what if the hospitals never done it before? And in most cases, I would be suggesting that for a new procedure to be undertaken, that there's sort of a way that you have to go about doing it in the hospital system whereby you perhaps need to write a policy or have a procedure in place, that's accepted by the broader hospital community as well. It's not necessarily just that I, as the obstetrician, am happy to perform it, but I have to have the whole team in theater happy to go ahead with this as well. And so that means having say the anesthetic, my anesthetic colleagues happy to, because they need to adjust the way they're doing things as well.

Dr Elphinstone (13:33):

I need to have my pediatric colleagues happy to do it because they have to adjust the way they do things as well. the theater staff. so everybody when they're unfamiliar with this new procedure have to be on board. Otherwise it just doesn't happen. It's not just about me and the patient, it's, it's everybody. And so there is a bit of a way to do it. And the way that I then approached it, given that I knew it had never been done, in my hospital was to be honest, I was in a privileged position where I was able to just go straight to the CEO of the hospital and sit down and have a meeting with her and say, What do we need to do this? And she was right on board with it from the beginning, which to be honest, yeah, probably took me a little bit by surprise. I probably was expecting to have a little bit more pushback at that. But thank goodness for open-minded people at the top level who said, Okay, well sure, all you need to do is this, this and this. You know, it involved, you know, me writing a policy, it involved me then presenting that policy at a few different levels of admin, if you like and getting it approved. an so that's what I did.

Erin (14:44):

That's <laugh> it sounds easy. It's, I mean, it's not, it's not as, it, like you're saying, it's not as simple as just going rogue and doing it. Like you actually had to write a policy and you actually had to go through procedure and at various different stages to get that pushed through and approved. which is really impressive. Cause I'm sure lots of people wouldn't go through that effort and just go, No, we haven't done it here before. Sorry, we can't do it.

Dr Elphinstone (15:10):

Right. Yeah. That definitely the easy answer. The easy answer is to go, Yeah, well we've never done it before and therefore there's no policy, so therefore we can't do it and full stop. , but I, I guess my response was, Well, we've never done it before, but let's see if we can make it happen. I'll go and find out what I need to do to make it happen. Yeah. and then go through that process. So yeah, it did involve a bit of work and it involves not just that sort of preparation, the policy and, you know, but when it comes to then fronting up to those meetings, if you like. And in then, talking about this kind of new procedure to a wider audience of say, other surgeons and the admin people and the, you know, the powers that be in the hospital, that was a little bit daunting, <laugh> and there was quite a variation of responses to that mm-hmm. <affirmative>, , as you can imagine, that ranged anywhere from, you know, sort of quiet contemplation and support to downright criticism of that sounds like a ridiculous idea. you're gonna break all of the rules, that's not how we do things. this is too risky. this sounds like it's a recipe for disaster. you're gonna have bad outcomes. All of those things were said to me at the time. And so you have to just, you know, grit your teeth and, and have an answer to those things as well. I think we're maybe call it a good situation or maybe not, but at the moment, because it is such a new procedure and it's not getting so widely done, to my knowledge, I can't find any good evidence that backs this up. or that denies, you know, or, you know, suggest that there's a problem.

Dr Elphinstone (17:10):

There's just, there's no evidence out there. So we can take that in a positive way and put a spin on that that says, Hey, you know what, there's no evidence that it increases maternal infection rates, which is a common concern that people sort of have. So at least I do have an answer, even if it actually is just an answer of saying we actually don't know. Yeah. but I would like to believe that it doesn't increase maternal infection rates. Of course, not only because I don't want to put anybody in harm's way, but I feel like we are taking those steps necessary to mitigate that risk and to ensure that, you know, the mother herself is undertaking all of the same kind of sterile procedures that I, as the surgeon am undertaking. And she's not even putting her hands into her open uterus. She's just actually touching the baby. And once the baby's out of her, it's not sterile. So, you know what, what's the big deal?

Erin (18:03):

I think it's amazing that you've, because you're kind of, you're pioneering this new technique and I think you're setting a precedent because I think by you putting that policy in place and performing these types of surgeries, you are making it easier for other people to be able to do this because they can say, but look, it is doable because somebody over there is doing it and they've done it several times and it's really successful and they haven't had infections and they haven't had bad outcomes. because somebody needs to kind of stick their head over the parapet and kind of go, You know what, you know, I'll do that. I'll give it a go, I'll take It.Yeah. so, you know, the work you're doing is amazing. It's really, really, I mean it's really important. It's fantastic. we were talking earlier before we started recording that I'm not aware of any maternal assisted Syrians that have been performed in the uk but you said that you think that there potentially has been some or one in the uk.

Dr Elphinstone (19:04):

Yes. I'm definitely sure that there's been at least one that I am aware of. And so of course, I mean, I don't know then how many there possibly has been. but yeah, I think I have been shocked at the response that I'm getting to my videos whereby I have been contacted by lots of different patients and healthcare professionals from around the world. I started a list at some point when I realized that I was getting asked for this a lot and I started making a list of all of the different countries that those people represented who were eager to gain more information about that and who I had then been able to share, say the policy that I'd written. And I'm up to, I think actually like 11 or 12 or 13 different countries now that have contacted me or that I've shared information with.

Dr Elphinstone (19:50):

And I know that at least five of these countries now have come back and shared with me that they have performed now a maternal assisted caesareanean. and I feel so privileged to have maybe played a small little role in, in helping make that change. And so yeah, one of those countries I know was the UK because I remember very distinctly, during the course of actually one of my work days being contacted via Instagram, of course, you know, the power of social media. Yeah. by a, I think it was a midwife that was standing by the patient who was about to undergo her caesarean and they had managed, I think to talk the obstetrician into performing this maternal assisted caesarean by showing them a video that, one of my videos and they were on board and they were about to go and do this maternal assisted caesarean, but they didn't actually know all of the finer details, like, where do I now put an IV <laugh> and so they were contacting me in the middle of the day going, she's about to go into the operating room, where do we put it? Where do we put it? <laugh> <laugh>. So luckily I got that message at the time and was able to read it and respond in the moment, , because I imagine that, you know, five or 10 minutes later it might have all been too late. but yeah, then they said, you know, they got back to me a couple of hours later and said we've done it. so yeah, there's at least one, hopefully happy, patient in London who's had a maternal assisted caesarean in the last number of months.

Erin (21:21):

That's fantastic. And again, it sets a precedent, doesn't it? Cause you know, nobody in the UK can now say, Well, it's never been done in the uk because it has. So it is, it's possible. I just, I'm so excited that there's just more choice and there's more options to make, you know, a surgical birth more positive for people. because it's important, it really is important and that that feeling of control and being involved and making that a positive experience, I think has, well not think, I know it has long reaching impact on both mother and baby for the rest of their lives. So the part that you are playing in that is really, really important. And you definitely shouldn't downplay, you know, it's not a small part you've played, I mean that's like loads of countries globally that you have influence. Like you should own that. That's a really, really, that's a really amazing thing.

Dr Elphinstone (22:16):

Yeah, I I think people are eager, aren't they? I think people are keen to want to improve on the way that things have been done or, or subset of people are eager to improve on the way that things are done. and you know, I, I don't, I don't like when people suggest to me of, Oh, this is just a new trend. this is the fad. this is just the way we're gonna do things now. Because actually I'd be hoping that this becomes the way that it might be done more commonly in the future. In fact, this might become almost the standard. I mean, how exciting would that be? Because for too many years our very traditional way of doing a caesarean and of course has been to treat it like an operation. Yeah. And it is, and as I said, we'll always remember the surgical element, so let's not take that lightheartedly, but it is also the birth of a baby and the birth of your baby should be this momentous, joyous, love filled triumphant, you know, whatever other words we wanna use moment.

Dr Elphinstone (23:23):

And so much in the past, you know, for a caesarean birth has been just treating the woman as, you know, the surgical subject. she's anaesthetised, she can't move. We probably won't even talk to her where maybe if we're lucky gonna lift this baby up and show it to her over the screen and then we're gonna take the baby away somewhere. Maybe again, if we're lucky, we might bring it back to her all wrapped up in the blanket and she might get to see its little face shining out and maybe she'll get to kiss it and then we'll take it away again and she won't see it for two hours. and that's a common story. do you feel triumphant and victorious and love filled if you are the mother in that situation? No. You often feel cold and distant and inanimate and you can see all this stuff going on around you and you don't feel involved.

Dr Elphinstone (24:12):

And somebody said, this was your baby, but you didn't see it come out of you. How do you even know that's your baby? Like, ugh. that's not what birth should be. so this, it's so far removed from that and it's so much closer to what we, you know, might sort of standardly expect at say a vaginal delivery. and that's what I'm excited about and I see it and I hear it from people talking to me about that experience that they've then had, especially for perhaps people that have had previous caesarean before. So they're able to actually compare what happened to them previously, what this experience was like and they've said to me, it's black and white, it's completely different. and that's not only about how they felt during the moment, but as you said, like how they now feel emotionally about the birth of their baby is so much more satisfied and involved and that's exciting.

Erin (25:13):

Yeah, it is exciting. It's, and it's important. You're right. I mean, it should be this wonderful love filled, you know, oxytocin, you know, kind of event, shouldn't it? and you know, people saying it's a fad. I mean people, people said that with with Gentle caesareans, you know, you know, , and I mean I know I've had clients in the UK who still come up against being told, no, no, you can't have immediate skin to skin. No, you can't have ECG dots on your back. no, you can't have a lotus birth. I mean lotus birth is another thing which is, you know, probably seen as quite a fad and I've had clients who've been told, No, you can't have that. and I've also had clients who have had lotus birth. So again, they've had a lotus birth. So again, it sets precedent, you know, if anyone doesn't know what lotus birth is, it's, it's leaving the baby attached to the placenta and not cutting the cord at all, and waiting for the umbilical cord to shrivel up and drop off at the belly button so you leave the two attached. and there's an opinion that that's not possible. And it is possible because there have been people who have had that.

Dr Elphinstone (26:29):

So I have, I have done a maternal assisted Lotus caesarean before <laugh>.

Erin (26:33):

Amazing. So there you go. Yeah. So there's another thing you can say. It has been done. there's pictures to prove it. Exactly.

Erin (26:44):

So I think if somebody does want to have a maternal assisted caesarean and they're not sure or, or hasn't been done in the hospital as as a pregnant person, how would you advise they approach that with their obstetrician to try and get them on board with it?

Dr Elphinstone (27:05):

that's probably the most important question, isn't it? Because you as then the pregnant person, so number one, yeah, ask your obstetrician and do it, you know, perhaps in a lovely, gentle, inquiring way, like it should always be just this two-way communication. hopefully it's never that whole us against them. It's not doctor versus patient. just have a two-way conversation. So, maybe not coming all up in arms of I want this and it's my right. You know, because we're people and, we tend to be a little bit more defensive if that sort of thing happens. So, so I would say first of all, just ask in a gentle inquiring way because you're probably going to be met with a no answer, because it's the standard and, but, so then follow that up. So then, you know, I would say ask them why they've said no, Find out what that reason is because if that reason is say, Yeah, we don't have a policy for that, or we've never done it at the hospital, then you can come back again and say, Well, can we make a policy for that to happen?

Dr Elphinstone (28:10):

What will it take to make it happen at this hospital? So you can always follow up, continue to just ask. I think what's a really important step in this process is to maybe start off by explaining to your obstetrician about why you think this would be a really important thing for you to do. because maybe again, if they're just thinking, Oh, you've seen it on Instagram, so now you want the latest thing, is maybe not a great reason. What you want to explain to them is why you think it would make such a difference to your birth experience and, and why you think it would be really important to, because maybe it is about overcoming the birth tra a that you had previously. Maybe you had an emergency caesarean and last time around and you felt really outta control and disenfranchised.

Dr Elphinstone (28:57):

And so it would be really healing for you to have more involvement this time. you know, so explain those reasons because I think, again, as an obstetrician when the easy answer would be to say, No, we can't do that for you. If you explain to me about why it was so important to you, I may be more inclined to therefore do the work that it will require if it's never been done before. Because let's be honest, it will take work on, on the behalf of the obstetrician. So they have to feel impassioned to be able to work on your behalf. so don't just assume that that's gonna happen, sadly. so just, you know, as I said, to have that conversation and then just follow up what their reasons are for saying no, because a lot of those things could be sort of potentially overcome if they understood why.

Dr Elphinstone (29:45):

And then at the end of the day, if they will still continue to say, Look, it really just can't be done because of X, Y, and Z because the other thing is maybe they're saying no, it can't be done because of the specific sort of surgical circ stances or pregnancy complications that you might be facing. So there might actually be a relevant reason. and they should be able to explain that to you as well. but at the end of the day if there's, if there doesn't seem to be a great relevant reason, you could also then of course ask to, you know, is there anybody else that does do maternal assisted caesarean in this hospital or at a different hospital? Can you maybe point me in the right direction? Because potentially, you might want to be thinking about changing care providers.

Dr Elphinstone (30:32):

Now I, you know, I don't wanna say that because I don't want to be, you know, the obstetrician that says you can just jump ship at any point in time, but you have to find the person that is right for you because at the end of the day, it is going to be your birth experience that you are gonna probably remember for the rest of your life. And if you've got any disappointment or regret about that and you think that you could have done something different, then of course you should pursue that as well. And so even if that means changing care providers during your pregnancy, of course you have the ability to do that even at say, 38 weeks pregnant or you know, your caecarean just around the corner, it's, you can absolutely, you can do that. So, just, I just keep chasing it down, you know, bring it up again, talk about it.

Dr Elphinstone (31:18):

So talk about it early because if it does need to be, say, a policy that needs to be written, that will take time. and it may be that there's not enough time in your pregnancy, but I would still then say, pursue it anyway. Because what I also say to like my public patients, for example, that maybe contact me on Instagram and say, Oh, I see you do it in your private hospital, Natalie, do you do it at the public hospital? And I say, Well unfortunately we can't yet because again, no policy, et cetera. but I tell them, if you're not seeing me and you're seeing a different obstetrician ask that other obstetrician, and then when they say no, there's no policy, and your next visit you see a different person, ask them too. Because more and more essentially you hound them or the more perhaps they hear it from a bunch of different people as well, they might understand that this is something that, you know, that the general public, if you like, are eager to pursue. And if we could see that sort of tial wave of opinion coming, that may also just shift the boundaries a little bit as well. So even if you can't make it happen for your own pregnancy, I would still ask you to fight that fight because that might help change it for the future and help change it for, you know, other women after you as well.

Erin (32:29):

That's a really, really good point. I think sometimes when it comes to, you know, the midwives or the obstetricians that we see, sometimes we do just take the first answer. and it is something that I tell a lot of my clients that you can change, you can change hospital, you can change midwife, you can change consultant. and sometimes you just need to speak to somebody else and you get a completely different answer. I mean, I've had clients who have asked for, you know, various different things with their caesarean and at their pre-op appointment and were told, no, no, no. And then I said, go back, go back and speak to somebody else and get a second opinion. And they've spoken to someone else and they said, Absolutely, yes, you can have all of those things. They wouldn't have got it if they hadn't asked for a second opinion. So it's a really, really good point. and I think it was also a really good point that, you know, not just advocating that for yourself, but for future people, having a caesarean and I think is a really good point as well. so if anybody wants to speak to you or wants to see your videos, where can they find you online?

Dr Elphinstone (33:35):

Yeah, I think certainly my Instagram is, is my online presence. So I'm not enough up with the times. I'm not doing Twitter, I'm not doing Facebook, I'm just doing Instagram, so you have to check me out there. so my Instagram username is @drNatalieElphinstone, that's all just one word, that's a doctor with a dr. And then, yeah, I know it's really long Natalie Elephinstone, just maybe just start, maybe type some letters in there might come up, and, and you'll be able to see loads and loads of different videos of sort of, you know, different little variations because you know, certainly even, , over the time that I've been doing them, I've been sort of fine tuning the techniques that I wanna sort of do as well. So you'll see that sort of evolve over time. and then you'll be able to, you know, grab those videos and then take them to show other people mm-hmm. <affirmative>, you know, your other pregnant friends and your healthcare providers and your midwives and your obstetricians. and then yes, if you need help advocating for yourself and want like that nitty gritty of policies and I've got a lovely,I say lovely, sorry, I've got a PDF of like a PowerPoint presentation where I did step by step how to get the patient prepared, which is helpful I think for say, healthcare providers who are now trying to figure out where do I sit the patient, where does her hands go, where do I put that iv, All of that kind of stuff. , so I've got all of that that I'm very happy to send to people. So if you then just send me a message via Instagram, I'll be happy to help you out for sure.

Erin (35:07):

That's fantastic. That's so helpful. Thank you so much for your time. I really, really appreciate it. and I hope this, even if one person listens to the podcast and ends up getting that positive experience, it was well worth the time, but I'm sure it's gonna be hundreds because, you know, I'm sure those people are gonna listen to this. So thank you very much for your time and , thanks for chatting.

Dr Elphinstone (35:32):

Oh, thank you so very much for inviting me. I think likewise, if we can can just change one birth and make it a better experience, then that's a win. But if we can change it for, you know, tens of people or maybe even hundreds of people, then wow, what a better world we're gonna be living in.

Erin (35:49):

Yeah, for sure. And that's down to you, so thank you. I mean, genuinely, it's amazing thing that you are doing

Dr Elphinstone (35:57):

Well, we'll keep fighting, right? We'll just keep, I'm just gonna keep on putting those videos out there. You're probably gonna get sick of those videos. Yeah. At some point. <laugh>, I'm very repetitive. but I like, you know what, I don't get sick. I watch them over and over again myself and you know, show my patients and share them. And I, you know, I showed somebody one of them today and I still cried when I watched it and I was there at the time, <laugh> dear, that's a beautiful thing.

Erin (36:24):

It's not sad at all. I've, I share a birth video in my course and I've watched it hundreds of times and every single time when the baby's born, as soon as the baby cries, I start crying. I don't know why. Cause I know what's coming cause I've watched it so many times, but it just, Yeah, <laugh> makes you well up, doesn't it? It's cuz it's amazing. Birth is amazing.

Dr Elphinstone (36:42):

I think, you know, people that are passionate about what they do, is a really helpful and useful thing because, you know, then we are keen to, , spread that to the people around us as well, including the patients themselves. So, yeah, I I'll keep sharing, I will keep sharing.

Erin (37:01):

Good. Thank you. Take care.

Dr Elphinstone (37:04):

Thanks very much.

Disclaimer: The information and provided on this podcast does not, and is not intended to, constitute medical or legal advice; instead, all information available on this site are for general informational purposes only. We reserve the right to supplement, change or delete any information at any time. The information and materials on the podcast is provided "as is"; no representations are made that the content is error-free. Whilst we have tried to ensure the accuracy and completeness of the information we do not warrant or guarantee the accurateness. All liability with respect to actions taken or not taken based on the content of the podcast are hereby expressly disclaimed. Your use of content contained in or linked to this podcast is entirely at your own risk. The Better Birth podcast accepts no liability for any loss or damage howsoever arising out of the use or reliance on the content.

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