Happy Spring! And welcome to the May Q&A!

We start with a listener email we loved, followed by a discussion on creativity and why it matters, especially in the early years of motherhood when it can feel completely out of reach.

Then we get into your questions.

We talk about postpartum hemorrhage and how it’s defined, including whether 500 cc of blood loss is truly cause for concern, and the use of Pitocin and Cytotec in that context, particularly for VBAC mothers. We also revisit RhoGAM and walk through when it may or may not be necessary, especially if you’re not planning future pregnancies.

One listener asks how to handle being the only one in the family making different choices around birth and parenting. We share our thoughts on boundaries, restraint, and when saying less is often the stronger position.

In quickies, we cover induction at 42 weeks, complete placenta previa, vitamin D for breastfed babies, pelvic floor therapy access, low libido in pregnancy, newborn weight checks, birth combs, and how to get through the third trimester in the summer.

Finally, when one fan asked our opinion on which of us may be the better driver, one of us shares an old story of getting a reckless driving ticket!

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In today's episode, Kristina shares her breech birth story following a long journey marked by cycle irregularities, miscarriage, and difficulty conceiving. At 40 weeks, she learned that her baby was breech and was scheduled for a C-section, despite having been told throughout pregnancy that the baby was head down.

Unwilling to move forward with surgery, Kristina sought out an alternative and ultimately found a physician in Connecticut willing to support a hospital-based vaginal breech birth. She describes the pressure she faced from both her care team and loved ones, the process of transferring care late in pregnancy, and the decisions she made to stay aligned with her instincts.

This episode offers a detailed look at late breech diagnosis, informed refusal, and the realities of navigating hospital-based breech birth. Kristina also shares what she would do differently and what this experience taught her about trust, decision-making, and preparation.

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In today’s episode, Cynthia and Trisha are joined once again by Nancy Wainer, award-winning author, longtime home birth midwife, and the woman who coined the term VBAC in her 1980s book Silent Knife. With decades of experience supporting women through vaginal birth after cesarean, Nancy brings clarity to a conversation that is shaped by fear, false information, and shifting medical standards.

This episode is part free-flowing conversation and part Q&A, where we take listener questions and explore them in depth. We cover topics including delayed postpartum hemorrhage after cesarean, uterine rupture, scar thickness, “uterine windows,” closely-spaced pregnancies, doulas in a home birth setting, and VBAC with twins or breech babies. We also look at the common reasons women are given for repeat C-sections and where those claims hold up and where they don’t. 

We wrap with Quickies and a personal question Nancy's never been asked.

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In today's episode, we speak with Stephanie about her stillborn daughter, Penelope, who arrived at 39 weeks and 6 days. After two healthy births and a completely uneventful third pregnancy, Stephanie found herself facing the unthinkable: an awareness of no fetal movement, confirmed by a silent Doppler and finally a hospital ultrasound. What followed was labor induction, birth, and the impossibility of leaving the hospital without her baby, riding home with her innocently cheerful toddlers in the car.

Next came shock and denial, pleading with God, managing her milk coming in, and experiencing an isolation so extreme that even a friend of fifteen years told Stephanie she couldn't handle maintaining a friendship in the face of something so grave. Stephanie also reflects on the impact to her equally-devastated husband, the family members who ranged from phenomenal to absent, and facing the disorienting task of caring for her two children while grieving a third. To this day, Stephanie grapples with how to answer the question mothers usually enjoy: "How many children do you have?"  

Our conversation later turns to grief, faith, 'God winks' that seem to show up everywhere as signs of her daughter's love and presence, and Stephanie's evolving sense of peace, even hope and eagerness, as she looks toward continuing to expand her family. 

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Welcome to the April Q&A with Cynthia and Trisha! Today, we begin with a conversation about one of the most personal questions women face: is there a best age to have children? We talk about the pressures around timing, fertility, career, and spacing, and why this is one of those decisions that depends entirely on the individual woman, her life, and what feels right to her.

Next, we get into your questions, starting with a mother who experienced a very fast labor and wants to know if precipitous birth can be prevented and how to better handle it mentally if it happens again. Another listener shares her experience of a difficult pushing stage that resulted in ruptured blood vessels in her eyes and a long recovery from an anal fissure, and asks what she may have done wrong. We talk about why women so often assume fault in these situations and what actually influences outcomes in the pushing stage. We also address pregnancy weight gain, how much control women really have over it, and whether calorie restriction or tracking has any place in pregnancy.

As always, we close with a round of quickies covering the purple line in labor, nursing to sleep, deciding whether to have a second child, ways to reduce the risk of preeclampsia, tips for managing morning sickness, hand pumping while breastfeeding, long first labors, frequent night waking, evening milk supply, shoulder dystocia, and more.

Thank you for your excellent questions and please continue to call them in to our hotline at 802-438-3696 or 802-GET-DOWN.

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Today, we talk with Tiffany Belanger of @cosleepy about some of the challenges that may arise for co-sleeping families, whether you're trying to reduce night feeds, prepare for another baby, or simply want your bed back. We discuss how these transitions often unfold, including moving a child into a crib or floor bed, and why the experience can look completely different from one family to the next, depending on lifestyle, a child’s temperament, and the parents' mental and emotional states, like guilt, anxiety, exhaustion or embarrassment.

This is a free-flowing, honest conversation, not a set of rules to apply. The goal of this episode is to prepare you for these transitions, normalize some of the challenges parents face, and offer a range of ways to move from one stage to the next that most resonate with you and your family.

Tiffany on Instagram @cosleepy

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We are back with another breastfeeding-only Q&A episode. In today's conversation, we respond to several listener questions related to nursing, sleep, and fertility after breastfeeding. One mother who is co-sleeping with her 15-month-old, who wakes three to five times per night to nurse, asks how she can help her toddler sleep longer stretches without abruptly stopping breastfeeding. Another listener with a 4.5-month-old who has never taken a bottle is planning to attend a bachelorette party when her baby will be about nine months old and asks how best to prepare. We also hear from a mother who recently weaned her two-year-old and then experienced a very early miscarriage, often called a chemical pregnancy, and wonders whether she should consider hormonal support before trying to conceive again.

As for our Quickies: Is it concerning if a 12-week-old drops slightly on the growth curve while still gaining weight, what the issue is with the Boppy pillow for breastfeeding, and can you continue breastfeeding while taking antibiotics for mastitis? We also discuss healing cracked nipples after a tongue-tie release, whether milk will come in normally if you breastfeed during pregnancy, and whether lactation cookies or brewer’s yeast actually increase supply. As also cover oversupply with a second baby, postpartum chills when milk comes in, storing breast milk and keeping pump parts clean on long drives, preventing recurrent mastitis from oversupply, whether a mild tongue tie should be released if breastfeeding is going well, what a “nursing holiday” is and whether it can help supply and latch, and how to help a bottle-fed newborn latch to the breast.

Just us on Patreon for our upcoming all-Quickies episode, exclusive to patrons-only.

Controversial article we discussed in this episode:

My Decision Not to Breastfeed with Elise Hewitt

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In today's episode, one of Trisha's clients, Holly, shares the story of two very different births and two equally different breastfeeding experiences, and what shifted between them.

Her first labor began spontaneously but ended with a vacuum delivery, and the demoralizing message that her “pushes weren’t productive.”  Breastfeeding was just as difficult, leading to a year of mostly exclusive pumping and undiagnosed postpartum anxiety. 

Four years later, she approached birth with real preparation, a clear plan, and a timely transfer of care to a midwife who immediately changed the tone of her birth experience.

This episode examines how preparation, autonomy, and the right support can change not only the course of a labor, but the way a mother understands her own strength.

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Water birth has long been controversial, but more recently, a wave of claims has emerged from the natural birth community that water birth is dangerous for babies and disruptive to the physiologic process of birth. In this episode, we sit down with midwife Barbara Harper, the world's leading expert on water birth and founder of Waterbirth International, to explain the preponderance of evidence supporting the safety of water birth and to dispel circulating fallacies.

We talk about the idea that babies can aspirate water, whether the diving reflex can fail, and the claim that water immersion interferes with a mother’s ability to respond to her baby during birth. Barbara explains what actually initiates a baby’s first breath, how the transition from fetal to newborn circulation works, and why arguments that water immersion causes a disruption to physiology that compromises babies don't hold up when you truly understand the physiology.

 Join us for yet another educational and fascinating discussion with Barbara.

Catch our other episodes with Barbara here:

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Welcome to the March Q&A!

We begin today’s episode with a conversation about the strange, intrusive, and sometimes downright insulting comments women receive in public while pregnant. We also share a listener story about a home birth that took an unexpected turn when a woman’s mother, meant to support her during labor, ended up creating some chaos after drinking too much wine.

Next, we address feeling unusually irritable toward an older child during pregnancy, what to consider after experiencing shoulder dystocia in two previous births, and whether an intact bag of waters could contribute to tearing during a very fast birth. We also discuss whether it ever makes sense to remain in an uncomfortable labor position in hopes of helping labor progress.

As for Quickies, we cover questions about nursing pillows, pregnancy spacing, breastfeeding and fertility, bras for labor, sleep regressions, breast pumps, retained placenta, building a freezer stash, one of Cynthia’s favorite homemade salad dressing recipes, and the most famous people we’ve ever met. Thanks for being here, and enjoy today’s episode.

PS: Check Patreon for more from Cynthia on salad dressings!

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Down to Birth Show

Call 802-GET-DOWN

Watch full videos of all episodes on YouTube! Please note we don’t provide medical advice. Speak to your licensed provider for all healthcare matters.