Birth Untethered

In this episode, join Shellie, Kemi and Dr Stuart Fischbein as we explore how birth outcomes can be shaped by system design, not just clinical skill, or lack thereof.
We discuss how time pressure, immobility, fear, monitoring and routine intervention can create the very problems they are then used to solve. Epidurals, coached pushing, early admission and continuous monitoring can influence labour, malposition and intervention rates, while evidence is often focused on short-term outcomes and hospital-based measures rather than longer-term effects on bonding, breastfeeding, the microbiome, child development and future reproductive health.
From breech caesareans and synthetic oxytocin to postpartum decision-making, we ask whether the outcomes we measure are always the outcomes that matter.
We examine how induction thresholds, routine scans, escalation protocols and arbitrary time limits, such as the 24-hour waters-breaking and 42-week thresholds, have become rigid rules rather than prompts for individualised decision-making.
We also explore continuity of care, responsibility and professional power. Trust and familiarity can influence decision-making, while fragmented responsibility can allow harmful practices to continue because everyone is simply “following the system”.
Ultimately, this is a conversation about who owns birth knowledge: who controls the tools, who is allowed to learn and teach, and who gets to decide what is considered safe. From the historical secrecy surrounding forceps to the medicalisation of midwifery and restrictions on independent birth workers, we question when professional control becomes disguised as safety.
Become an Untethered Rebel:
https://birthuntethered.kit.com/products/untethered-rebel-subscription
Book time with Shellie:
https://www.theserenitydoula.co.uk/bookachatwithshellie
Book time with Kemi:
https://kemibirthjoyjohnson.com/work-with-me
Website:
https://www.theserenitydoula.co.uk/birthuntethered
Patreon:
https://www.patreon.com/14193903/join
Spotify:
https://open.spotify.com/show/1kKvf6pjLGDJ5nDBMKPCjB
Apple Podcasts:
https://podcasts.apple.com/gb/podcast/birth-untethered/id1836371735
YouTube:
https://www.youtube.com/@birthuntethered
Instagram:
https://www.instagram.com/theserenitydoula/
https://www.instagram.com/birth.untethered/
https://www.instagram.com/kemibirthjoyjohnson/
Support us with merch:
https://www.theserenitydoula.co.uk/merch
Buy us a coffee:
https://buymeacoffee.com/shellie
https://buymeacoffee.com/dujube

This episode continues the episiotomy discussion, focusing on what it is, why it’s used, the evidence against routine use, the risks and complications, and the importance of informed consent. Become an Untethered Rebel: https://birthuntethered.kit.com/products/untethered-rebel-subscription Book time with Shellie: https://www.theserenitydoula.co.uk/bookachatwithshellie Book time with Kemi: https://kemibirthjoyjohnson.com/work-with-me Website:⁠ https://www.theserenitydoula.co.uk/birthuntethered⁠ Patreon:⁠ https://www.patreon.com/14193903/join⁠ Spotify: ⁠https://open.spotify.com/show/1kKvf6pjLGDJ5nDBMKPCjB⁠ Apple Podcast:⁠ https://podcasts.apple.com/gb/podcast/birth-untethered/id1836371735⁠ Youtube:⁠ https://www.youtube.com/@birthuntethered ⁠Instagram:⁠ https://www.instagram.com/theserenitydoula/⁠ ⁠https://www.instagram.com/birth.untethered/⁠ ⁠https://www.instagram.com/kemibirthjoyjohnson/⁠ Support us by buying our merch: ⁠https://www.theserenitydoula.co.uk/merch ⁠ Buy us a coffee:⁠ https://buymeacoffee.com/shellie⁠ ⁠https://buymeacoffee.com/dujube⁠

Shellie and Simon break down what this surgical cut actually does to the perineum, why it was normalised for decades, and why the evidence now strongly supports restrictive use instead of routine intervention.Shellie, joined by her husband and co-host Simon, takes you inside the anatomy, history, and real-world consequences of episiotomy. From the pressure of crowning to the structures that can be cut, torn, or damaged, this episode exposes the gap between what birthing people are often told and what the research shows.You'll discover:What an episiotomy is, how it differs from a natural tear, and why the direction of the cut mattersWhy midline, mediolateral, lateral, J-shaped, T-shaped, and radical incisions each carry different risksHow episiotomy became routine through outdated obstetric ideology, not evidenceWhy forceps births are one of the few scenarios where episiotomy may genuinely reduce serious anal sphincter injuryWhat women report about pain, healing, sex, breastfeeding, anxiety, and the long shadow episiotomy can leave behindThey also unpack the consent problem head-on. Shellie and Simon discuss how often episiotomies happen without meaningful consent, why pain relief is sometimes withheld or minimised, and how being on your back in hospital can increase the likelihood of intervention. Become an Untethered Rebel: https://birthuntethered.kit.com/products/untethered-rebel-subscription Book time with Shellie: https://www.theserenitydoula.co.uk/bookachatwithshellie Book time with Kemi: https://kemibirthjoyjohnson.com/work-with-me Website:⁠ https://www.theserenitydoula.co.uk/birthuntethered⁠ Patreon:⁠ https://www.patreon.com/14193903/join⁠ Spotify: ⁠https://open.spotify.com/show/1kKvf6pjLGDJ5nDBMKPCjB⁠ Apple Podcast:⁠ https://podcasts.apple.com/gb/podcast/birth-untethered/id1836371735⁠ Youtube:⁠ https://www.youtube.com/@birthuntethered ⁠Instagram:⁠ https://www.instagram.com/theserenitydoula/⁠ ⁠https://www.instagram.com/birth.untethered/⁠ ⁠https://www.instagram.com/kemibirthjoyjohnson/⁠ Support us by buying our merch: ⁠https://www.theserenitydoula.co.uk/merch ⁠ Buy us a coffee:⁠ https://buymeacoffee.com/shellie⁠ ⁠https://buymeacoffee.com/dujube⁠

In this episode Shellie and Kemi discuss the side effects of epidurals and how frequently they occur to give you evidence based information upon which to make your own informed choices. They also explore the impacts of epidural on physiology and how these cause effects to the mother and baby.

If you are wanting to make a more informed decision about whether you would like to accept an epidural in your labour, or you are a birthworker wanting to have a more in depth knowledge about epidurals to help support the families you are serving, this episode has you covered.
Become an Untethered Rebel: https://birthuntethered.kit.com/products/untethered-rebel-subscription Book time with Shellie: https://www.theserenitydoula.co.uk/bookachatwithshellie Book time with Kemi: https://kemibirthjoyjohnson.com/work-with-me Website:⁠ https://www.theserenitydoula.co.uk/birthuntethered⁠ Patreon:⁠ https://www.patreon.com/14193903/join⁠ Spotify: ⁠https://open.spotify.com/show/1kKvf6pjLGDJ5nDBMKPCjB⁠ Apple Podcast:⁠ https://podcasts.apple.com/gb/podcast/birth-untethered/id1836371735⁠ Youtube:⁠ https://www.youtube.com/@birthuntethered⁠Instagram:⁠ https://www.instagram.com/theserenitydoula/⁠⁠https://www.instagram.com/birth.untethered/⁠⁠https://www.instagram.com/kemibirthjoyjohnson/⁠ Support us by buying our merch: ⁠https://www.theserenitydoula.co.uk/merch ⁠ Buy us a coffee:⁠https://buymeacoffee.com/shellie⁠⁠https://buymeacoffee.com/dujube⁠

On this week's episode Shellie and Kemi discuss what actually happens when an epidural is placed, why the consent process is far too rushed and how the medications involved can affect the mother and baby. From the surprising chemistry behind the medications like bupivicaine, to the real-world consequences of reduced mobility with epidural. We also discuss some different kinds of epidurals and what benefits they can provide.

If you are interested in Shellie's Birthing Biomechanics course you can find it here: https://birthuntethered.kit.com/products/b-irthing-biomechanics-online-lectu

If you are interested in reading more free information about biomechanics, you can do so on Shellie's website: https://www.theserenitydoula.co.uk/techniques

Become an Untethered Rebel: https://birthuntethered.kit.com/products/untethered-rebel-subscription 
Book time with Shellie: https://www.theserenitydoula.co.uk/bookachatwithshellie 
Book time with Kemi: https://kemibirthjoyjohnson.com/work-with-me 
Website:⁠ https://www.theserenitydoula.co.uk/birthuntethered⁠ 
Patreon:⁠ https://www.patreon.com/14193903/join⁠ 
Spotify: ⁠https://open.spotify.com/show/1kKvf6pjLGDJ5nDBMKPCjB⁠ 
Apple Podcast:⁠ https://podcasts.apple.com/gb/podcast/birth-untethered/id1836371735⁠ 
Youtube:⁠ https://www.youtube.com/@birthuntethered⁠Instagram:⁠ https://www.instagram.com/theserenitydoula/⁠⁠https://www.instagram.com/birth.untethered/⁠⁠https://www.instagram.com/kemibirthjoyjohnson/⁠ 

Support us by buying our merch: ⁠https://www.theserenitydoula.co.uk/merch ⁠ 

Buy us a coffee:⁠https://buymeacoffee.com/shellie⁠⁠https://buymeacoffee.com/dujube⁠