Epi 5: The Hands That Catch You: Midwives, Lactation Consultants, and Pelvic Floor

Episode 5 (Extended Show): The Hands That Catch You: Midwives, Lactation Consultants, and Pelvic Floor Physical TherapistsIn 1900, midwives delivered about half the babies born in America. By 1975, fewer than one in a hundred. That did not happen by accident — and you are still living with the consequences. In this special episode, Dr. Av introduces the three practitioners most mothers are never offered: the midwife, the lactation consultant, and the pelvic-floor physical therapist.In this Episode We Explore:•     How American birth moved — the where and the who — in barely forty years, and who ran the campaign.•     Why the evidence at the time did not support the campaign, and why the midwife was not losing an argument about safety.•     The part of this history that has not softened: the Black granny midwife, the written examination, and the licensing machinery that replaced skill with literacy.•     The number that is climbing back — the share of certified nurse-midwives and certified midwives who identify as Black, rising every single year since 2019.•     CNM vs. CM: the same graduate education, the same national certification exam, one different entry point — and why state licensure matters to you.•     The misconception worth breaking: as of 2022, CNMs and CMs attended nearly eleven percent of U.S. births, and roughly ninety-five percent of those births happened in a hospital.•     What the 2024 Cochrane review actually found about midwife continuity-of-care models — and why the finding is about continuity, not about who is safer.•     The IBCLC credential, what it solves in the first month, and the lactation benefit most plans are already required to cover with no cost sharing.•     Why where you live determines the lactation help you can reach — and why you build the team before the four-a.m. problem.•     The pelvic-floor physical therapist: how common these conditions are, how rarely anyone asks, and the one sentence that gets you a referral without a negotiation.•     The tool: the Three Doors.Chapters00:00  Cold open — “Fifty years later, that world went extinct.”01:30  Welcome — the correction I owe you from Episode 403:35  Decode — how birth moved: the where and the who07:10  The part that was not an accident — the granny midwife and the written exam12:25  The braid — what a midwife is today, the Cochrane evidence, and the hands that caught my babies17:45  The lactation consultant — the credential, the evidence, and the benefit you already have20:35  The pelvic-floor physical therapist — the specialty nobody names23:40  The tool — the Three Doors25:40  The close — the room, the inheritance, and one sentence to say out loud