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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In this episode, Abby shares her VBAC birth story following an emergency cesarean. Determined to experience a vaginal birth, she prepared carefully while navigating limited provider options in Alabama. What unfolded during labor and delivery underscores how provider behavior, rather than maternal physiology, often determines birth outcomes. Abby describes how a manual vaginal extraction caused a nearly catastrophic fourth-degree tear, requiring three subsequent surgeries in the months that followed and significantly disrupting her early postpartum period with her newborn.

We ask Abby whether she has considered legal action against the doctor and hospital, and we explore how birth trauma shapes future decision-making. Abby explains why she is choosing a repeat cesarean for her third baby after this traumatic vaginal birth, and what autonomy and dignity can still look like within surgical birth.

She also reflects on how faith, support, and intentional processing helped her move forward, and what she hopes other women will take from her story.

Learn more about Abby here: http://www.abbyevelynphotography.com

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When Trisha was pregnant with her second baby, she read Gentle Birth, Gentle Mothering — a book that completely reframed how she understood labor, and to this day remains her favorite book on pregnancy. Trisha's second birth unfolded in just three hours, a stark contrast to her first. That book was written by Dr. Sarah J. Buckley, and we've long dreamed of getting her on the show. That day has finally come!

Dr. Buckley is a New Zealand–trained family physician and leading researcher on the hormonal physiology of childbirth, and today she walks us through the science of oxytocin and why it matters so profoundly in labor. We explore how the maternal brain modulates pain, how safety and privacy influence hormone flow, and why certain features of modern maternity care can unintentionally trigger stress responses that disrupt physiological birth.

This episode is a deep dive into the biology of labor — and what women truly need for it to unfold as designed.

In this episode, we discuss:

• The "Safety Triad": Why feeling private, safe, and unobserved is a biological requirement, not a luxury.
• The Pitocin Paradox: The shocking truth about synthetic "oxytocin", its unknown half-life, and why it doesn't offer the same brain benefits as the real thing.
• The Epidural Gap: How numbing the sensation of labor interrupts your natural hormonal feedback loop.
• The Baby’s Experience: What the fetal catecholamine surge is and what it means for your newborn’s first moments after birth.

Sarah Buckley

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Six seasons later, we are revisiting one of our first episodes of this podcast: Using evidence-based care to plan your birth.

Much of what happens in labor is presented as standard, routine, or unavoidable—but that doesn’t mean it’s evidence-based. Birth care hasn’t become more complex because women need more intervention. It’s become more complex because intervention has become the default. If you’ve ever wondered whether what’s happening in labor is truly backed by research—or simply “standard protocol”—this episode is for you.

In this conversation, we get back to the basics, examining how modern birth is typically managed, where that approach aligns with evidence, and where it too often doesn’t. This episode gives you an evidenced-based framework, so you can better evaluate the care offered and recognize when something supports physiologic birth or when it may quietly interfere with it.

Listen with your partner, take notes, and use this episode as a guide for thinking more clearly about the choices that shape your birth.

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Welcome to the February Q&A! We begin with a brief reflection on a mother's need to find time for play (not with her children but for herself) and creativity during early parenthood, before diving into your questions. Today’s episode addresses a common pattern in maternity care: past birth experiences being used by providers to justify predetermined interventions in subsequent pregnancies.

One listener asked, do women need to get out of the tub for fetal heart rate decels, and is this based on policy or physiology? Is Pitocin given after heavy bleeding in a prior birth justifiable for routine use in a subsequent birth? Additionally, we explore the long-term impact of episiotomies and membrane sweeps performed without consent, and address myths about posterior (OP) babies and whether those conditions are mother-specific or unique to each pregnancy. Finally, we talk about water breaking before labor and how much time most women realistically have before intervention is generally recommended (and whether it is actually needed).

As always, we close with quickies, including our best beauty tips (no, it is not a product you can buy).

Thank you for the excellent questions. Call us anytime at 802-438-3696. That's 802-GET-DOWN! Oh, yeah, if you loved this episode, leave us a 5-star review, and thank you!

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In today's episode, mother of two, Samantha Collignon, joins us to share two very different birth experiences separated by thirteen years. She gave birth to her first baby at 18 with minimal support and limited understanding of her options. At 31, married and deeply informed, she approached birth with education, confidence, and a strong sense of autonomy, resulting in a profoundly different and blissful birth experience.

Samantha reflects on how age and life stage shaped the way she was perceived by medical providers, shares how IVF factored into decision-making during her second pregnancy, and why an induced labor can still be a everything you wished for in birth.

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Down to Birth Show

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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.