In this episode of Radical Childbirth Education, Joni Edelman takes on the diabetes debate with zero sugar-coating (pun intended). She breaks down how your pancreas actually works, why gestational diabetes diagnoses skyrocketed after the 2020 guideline shift, and how the fear of ‘big babies’ fuels unnecessary inductions and interventions. Expect a mix of physiology, politics, and birth sovereignty that will leave you questioning everything you thought you knew about glucose tests. Whether you’re pregnant, a doula, or just birth-curious, Joni dishes the real talk: controlled blood sugar means healthy outcomes, and women still deserve full autonomy over their care.

00:00 – 02:15 — Welcome & why diabetes in pregnancy matters

02:16 – 07:20 — Anatomy & physiology refresher: pancreas, insulin, glycogen, glucagon

07:21 – 12:23 — Type 1 vs. Type 2 diabetes: causes, history, lifestyle, and diet

12:24 – 20:20 — Gestational diabetes explained & global testing differences

20:21 – 27:36 — The 2020 parameter change: how diagnosis rates jumped from 1 in 20 → 1 in 5

27:37 – 36:45 — Fear of large babies, shoulder dystocia, and malpractice pressures

36:46 – 44:43 — Induction for “big babies,” the role of relaxin, and why outcomes aren’t improving

44:44 – 52:26 — False positives, dietary restrictions, growth-restricted babies, and rising inductions for “small babies”

52:27 – 56:54 — Joni’s personal stories: birthing 10–11 lb babies & testing alternatives

56:55 – 1:02:38 — Key takeaways: controlled diabetes = healthy outcomes; autonomy in care

1:02:39 – End — Call to action: your body, your baby, your choice

STUDIES:

• Metzger BE, Lowe LP, Dyer AR, et al. Hyperglycemia and adverse pregnancy outcomes (HAPO) study. N Engl J Med. 2008;358:1991–2002. Link ➝ Found continuous relationship between maternal glucose levels and risk, which influenced stricter diagnostic criteria.
• Farrar D, Simmonds M, Bryant M, et al. Hyperglycaemia and risk of adverse perinatal outcomes: systematic review and meta-analysis. BMJ. 2016;354:i4694. Link ➝ Supports nuanced view: risks rise with uncontrolled hyperglycemia, but cutoff thresholds are contested.
• Crowther CA, Hiller JE, Moss JR, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352:2477–2486. Link ➝ Treating GDM reduced serious outcomes, but also increased induction rates.
• Boulvain M, Senat MV, Perrotin F, et al. Induction of labour versus expectant management for large-for-date fetuses: a randomized controlled trial. Lancet. 2015;385:2600–2605. Link ➝ Induction slightly reduced shoulder dystocia, but increased maternal complications.
• American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin: Gestational Diabetes Mellitus. Obstet Gynecol. 2020;135:e237-e260. Link ➝ Current clinical guidance, including diagnostic cutoffs and management.

After a six-month break, Joni returns to the mic with an honest and fiery episode. She shares updates on her recent apprenticeship, dives into the tangled history of midwifery, and speaks candidly about licensure, free birth, and the deeper questions of autonomy in birth work. This episode is part personal reflection, part history lesson, and part call to reclaim traditional wisdom in the face of state control.

00:00 – 02:30 Introduction, welcome back after a long break, intention-setting for the episode.

02:30 – 07:30 Apprenticeship experiences, counting numbers for licensure through the PEP process, and reflections on traditional vs. licensed midwifery.

07:30 – 12:30 History of midwifery: ancient practices, witch hunts, granny midwives, propaganda campaigns by Rockefeller and Carnegie, rise of hospital birth.

12:30 – 18:30 Medicalization of birth, Twilight Sleep, patriarchy in maternity care, and the second-wave feminist movement’s impact on birth culture.

18:30 – 23:30 Licensure battles across U.S. states, legal diversity, CPM recognition, and restrictions on practice (e.g., twins, breech).

23:30 – 27:00 Personal story: leaving an unaligned apprenticeship, integrity in midwifery, being reported to the licensing board, reflections on autonomy vs. state regulation.

27:00 – End Fundamental problem with licensure: loss of women’s choices, example of type 1 diabetes in pregnancy, autonomy vs. risk-out requirements.

• Historical context:
  • Ehrenreich & English (1973), Witches, Midwives, and Nurses: A History of Women Healers.
  • Wertz & Wertz (1989), Lying-In: A History of Childbirth in America.
• Hospital vs. home birth safety:
  • Cheyney et al. (2014), Outcomes of care for 16,924 planned home births in the United States: the Midwives Alliance of North America Statistics Project, 2004 to 2009. Journal of Midwifery & Women’s Health.
  • Hutton et al. (2016), Outcomes associated with planned place of birth among women with low-risk pregnancies. CMAJ.
• Diabetes in pregnancy (autonomy vs. risk-out debate):
  • Feig et al. (2014), Risk of adverse neonatal outcomes among women with diabetes in pregnancy. CMAJ.
  • American College of Obstetricians and Gynecologists (ACOG), Gestational Diabetes Mellitus: Screening and Management (Practice Bulletin).

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Personal Instagram

Birth Instagram

Email me: [email protected]

All about care providers in pregnancy, labor, birth, and postpartum. But first we'll address medical research in maternal-fetal medicine and the ways it fails us and how we can better make decisions during the childbearing year.

OB/GYNs to traditional midwives and everyone in between. We talk about education and outcomes.

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Personal Instagram

Birth Instagram

Email me: [email protected]

We're back after a (long) summer break.

Today Joni reviews the 24 births she attended over the summer.

Comparing outcomes between hospital, birth, center, and home, you get a first hand accounting of what is what.

***

Whapio

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Personal Instagram

Birth Instagram

Email me: [email protected]

ep. 10 | Induction of labor (part 1)

CONTENT NOTICE: discussion of fetal and maternal death in this episode

Today we're talking about labor induction.

Why might your OB be recommending it?

When might you need it?

When can (and should) you say no?

Is it really dangerous to stay pregnant past 42 weeks? These questions and more are answered on this episode.

Resources/research mentioned in this episode:

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002838

https://pqcnc-documents.s3.amazonaws.com/sivbdoc/sivbeb/16MgmtofposttermpregnancyguidelinesJournalofPerinatalMedicine2010.pdf

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Personal Instagram

Birth Instagram

Email me: [email protected]

ep. 9 | Should I hire a doula?

Today on the podcast Joni talks doulas.

What do they do?

What is their scope of practice?

What is the difference between a midwife and a doula?

Do you need one even if you're getting an epidural or having a c-section?

Resources/research mentioned in this episode:

Austin Birth Company

https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292163/#:~:text=Doula%20care%20patients%20were%2089,compared%20to%20standard%20care%20patients.&text=The%20Embrace%20participants%20had%20a,likely%20to%20have%20cesarean%20deliveries.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Personal Instagram

Birth Instagram

Email me: [email protected]

My top 4 questions to ask your care provider during pregnancy.

See them on IG here: https://www.instagram.com/p/C20MLoZp-4h/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==

While most folks are asking the important question about c-section rates, that is not the only important thing to ask. Join me as we explore four alternative questions to consider when you are choosing a care provider.

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Instagram: www.instagram.com/joniedelman

www.instagram.com/13moonsbirth

Email me: [email protected]

Is my baby too big to fit through my pelvis? Probably not.

In this episode, Joni addresses the "big baby" fear. From personal to professional Joni shares her experiences with dystocia, discusses how they usually happen, and WHY physicians are so fearful of a "stuck" baby.

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Instagram: www.instagram.com/joniedelman

www.instagram.com/13moonsbirth

Email me: [email protected]

Links to valuable info addressed in the episode:

https://www.cochrane.org/CD000938/PREG_induction-labour-or-near-end-pregnancy-babies-suspected-being-very-large-macrosomia

https://pubmed.ncbi.nlm.nih.gov/16098852/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279180/

Can you handle the pain of labor? Of course, you can. In today's episode we're talking PAIN.

How to talk to yourself about labor sensations matters. Your location and support team matter.

Learn about the Fear-Tension-Pain connection and the importance of interrupting those fear signals.

Grad your free handout: https://thirteenmoonsmidwifery.squarespace.com/resources

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Instagram (personal): https://www.instagram.com/joniedelman/

Instagram (birth): https://www.instagram.com/13moonsbirth/

Email me: [email protected]

Links to valuable info addressed in the episode:

Orgasmic birth with Debra Pascali Bonaro: https://www.instagram.com/orgasmicbirth/

What's wrong with birth in America? A few things.

Today we're talking about the how maternal medicine got where it is today and how we can do better.

Find me:

Radical Childbirth Education @ https://www.13moonsbirthwork.com

Instagram (personal)

Email me: [email protected]

Links to valuable info addressed in the episode:

http://www.birthful.com/podcastperineum/

https://www.cochrane.org/CD006672/PREG_perineal-techniques-during-second-stage-labour-reducing-perineal-trauma