Hello there and welcome to the True Hope Class podcast

where we take a deep dive into mental health's,

many physiological and psychological aspects.

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Today I've got the pleasure of welcoming Dr.

Daryl Martin to the podcast. Now, Dr.

Martin's a gynecologist

and healthcare advocate with over four decades of experience

and expertise in women's health.

He's testified before Congress championing the rights

of certified nurse midwives

and patients' freedom to select their healthcare providers.

Dr. Martin takes great pride in having played a pivotal role

in more than 5,000 births, marking a legacy of life

and joy he has helped bring into the world.

Today we're gonna be discussing women's health

and informed consent.

Enjoy the show. Okay. Hi, Dr. Martin.

Welcome to True Hope Cast.

Thank you so much for being with us today. How are you?

What is going well?

Uh, it, it's all going well.

I'm in the mountains of North Carolina at about 4,000 feet

in tremendous weather.

Uh, enjoying the hiking

and, uh, all the other outdoor activities

that I can do up here.

Beautiful. Well, that sounds absolutely lovely.

Well, just as an introduction to the show, we're going

to be discussing women's health and informed consent today.

You've got a very interesting history

and I'm looking forward to learning more about, about that

and, um, your opinions on many different

topics around women's health.

But as an introduction,

would you mind just letting us know a little bit about

who you are and what it is that you do, please?

Well, uh, I am a retired, uh, uh,

for the last two years physician,

an obstetrician gynecologist by trade.

Um, and I practiced from

1977 through 2022.

Um, during that time did obstetric surgery, uh,

and gynecological visits.

Currently, I'm trying to find things

to occupy my time over the last two years.

One of including is I just finished writing a book

that was launched in August

and now I'm doing a few podcasts.

Amazing, amazing.

Can you tell us a little bit more about the book?

The book is called In Good Hands,

and it's a book that started out as a narrative of my life,

principally because, uh, as I joke in my last year

of pre-retirement, I would share with my patients, uh,

and they would ask, what are you gonna

do for the rest of your life?

And I, and I suddenly, I, I'm gonna write a book. Alright.

Uh, I can't come off the retirement tour like, uh,

rock stars do and go back, go back singing again.

That's not easy to do as a physician, apparently.

It's easy if you're, you have a still have a voice

and can play the guitar.

But at any event, uh, yes.

Uh, trying to enjoy my retirement

and not say too often in front of my wife that I dislike it.

'cause that implies that I dislike being with her.

So, so that's, that's always a danger zone.

Amazing. And, um, I'm looking at the book right now.

Um, if you wanna go to darryl martin books.com, you can see

that for yourself as well, those people who are listening.

Um, and there's a gr amazing picture there.

I just wanted to ask you the question.

Is that picture from one of your births?

Yes, sir. It is.

Uh, entering that picture was taken in 1980,

and it was on the front page

of the Nashville Banner slash Tennesseean paper in

Nashville, Tennessee, where it occurred.

Uh, it was the birth that I was required to do

because the hospital wouldn't allow her

midwife to do the delivery.

And so I was then as the backup force

to become the primary Mm-Hmm.

Individual, uh, that is four sets of hands.

As, as you look closely at the book, uh,

that is the Baby's Hands, that's the father's hands,

that's the mother's hands.

And my hands. Wow. The only one, not with gloves.

Well, two pair without gloves, the baby and the Mama Uhhuh.

Uh, so I allowed him

to help facilitate the delivery in the birthing room.

Uh, what it kind of as a circle

of life continuing is when we did the book launch, the, uh,

couple that are there, the Logans, um, have

still live in Nashville.

So they were at the book launch along

with their daughter Jessica, who's a little baby.

Jessica is now a professor of psychology at Vanderbilt.

So apparently my, a traumatic delivery went well.

So, uh, that, that's the picture.

If you look closely, you don't wanna look too closely.

That is actually the baby coming out of the vagina.

That's amazing. It's so funny

'cause you could have just said, no, I just got

that picture off the internet.

But there's an absolute gorgeous backstory to it.

Yes. It's a great lead in. Uh, you know,

It sure is. And that, that, that

book's titled In Good Hands a Doctor's

Story of Breaking Barriers for Midwifery and Birth Rights.

So I think that, I know you were talking about like

what you were looking to do after retirement, I think

of this book is going to, um, support

and educate and help a lot of people.

So, um, that's wonderful. That's just absolutely wonderful.

Um, I wonder what led you into the world of women's health?

Well, I, I, I always, from the time I was growing up, I,

I, I was moving in the direction of medicine mainly

because of the exposure to my uncle who was a, uh,

family practitioner in, um, Virginia,

in Arlington, Virginia.

And his, his soft spoken demeanor, his way

with people and the adoration

and affection that he received just left a,

a large impression in me so that I, so,

boy, I would like to be like that.

I would like to be like Uncle Lee

and he's chapter one of the book.

Uh, so that drove me to the desire of going into medicine.

Uh, what then subsequently led me to do obstetrics

and gynecology was, was the broad aspect of the field,

meaning you're taking care often

of people for many, many years.

So there's relationship building much more so than,

let's say a general surgeon.

Mm-Hmm. Would have, but yet you see people in the office,

you take 'em to the hospital, uh, for the miracle of birth,

which is just absolutely incredible.

And then surgery. And I enjoyed surgery

and I enjoyed that aspect.

And I would often joke, the person

who does a back surgeon might see them

back again for the back pain.

The person who removes a uterus

or does a hysterectomy, doesn't see them back

for another uterus to be removed.

That's right. So there was much more defined work and,

and it was a lot more relationship building,

which I, which I enjoyed.

Yeah. Well, that's a really wonderful, um,

tale into like why you wanted to go into

medicine in the first place from your uncle,

but also like the specific, um, area

of medicine in which you wanted to, to be involved in.

'cause it sounds like that community,

that relationship building part was a, was a huge, uh,

motivator for you to, to get into the,

the women's aspect of, of medicine.

Absolutely. And taking care

of women is a whole lot easier than taking care of men.

We tend to be whine a lot more than they do.

Yeah, that's very true. I've been to a couple of births

with my kids and yeah, I dunno how my wife got through that,

but like, uh, I needed somebody to hold my hand through it.

And, uh, yeah, absolutely.

It's a, it's a, it's a miracle without question.

And yeah, I think that of, with the introduction for,

for yourself, for the show,

I think you've been involved in 5,000 births and I,

and I, I, I guess it doesn't get boring after 5,000.

They're all unique. The the more elated

and the more into the birth the family is,

the more you get into it.

Mm-Hmm. If they're not that into it, then it becomes rote

and becomes kind of automatic.

Now, I would say out of those 5,000 birth, maybe 75

to 80% were me attending

or being around for a midwifery delivery since the bulk

of the birth that occurred that I was responsible for

the primary person was the midwife.

So, okay. That's a perfect segue into midwifery,

and I'm sure most people listening

and watching have heard the word midwife.

There's a very popular British show called the,

the midwives as well.

Yes. Which I think a lot of people would've watched.

Would you, do you, would you be able

to tell us a little bit more about the, the, the origins

of midwifery and how it, um, has sustained itself today

and some of the challenges perhaps that that's experienced?

Sure. And I think among many other things,

probably England, uh, and the British aisles have it right,

because primary births are either done by midwives

or even nurses there, uh, as well as in Japan

and some other industrialized countries.

But any event in the early 19 hundreds, if we go back

that far, right at the end

of the 18 hundreds primary births in,

in the United States were done by midwives.

Well, about that time, physicians become

professionalized in quote, they wanted to

have specific criteria for who could practice medicine.

So they developed the medical schools, et cetera,

and they professionalized meaning the licensure control.

And in the early 19 hundreds, there was the decision made

to say that instead of birth being a natural event,

it was a pathological one Mm-Hmm.

And by, by definition, changing that.

And that was done by physicians so

that they could train physicians,

because if it's pathological, that would tend

to eliminate midwives.

And that's where they instituted, uh, like scopolamine,

which is an amnesiac to really, often women don't even know

where there are, uh, episiotomies, forceps,

all those interventions that were not practiced by midwives.

So the number of births never grew with respect

to midwives, even until the eighties, nineties,

now into the, the two thousands.

Um, and it's about 10% in the United States,

which quite frankly, it should be a lot more than that.

And this is the,

the history you've just explained there about, um,

birth going from a natural event to a pathological one.

This is, you're talking about the US

Absolutely, yes. The

us in that respect, I wanna say what else?

It's got wrong, but that's one, that's one, uh,

that's the one thing that in my opinion,

it's definitely got wrong.

And it, it was all about power and control.

And what's interesting about that is like, men often seek

that over, you know, over women, over white, over midwives

and over nurses, I guess like that.

Yeah. I, I would say, um, excuse me for interrupting,

but, um, of course, uh,

in the 1970s when I finished residency in the late seventies

out of my residency class,

there was one woman in the residency class and about 20 men.

Now the numbers are far in the other direction.

Um, and then by extension, typically,

but not always midwives or women.

And again, uh, I, I'm a strong advocate that

still given the choice women would, the best choice would be

to use a midwife for a delivery.

Why, why do you have that opinion? Because

There's more connection,

there's more time spent in the room.

There's less intervention, uh, by a midwife, typically,

uh, they're focused primarily on, on births.

Mm-Hmm. As opposed to, uh, obstetricians

who might do the sections would be off doing surgery,

would do office visits.

So they don't spend near as much time with the client

and the husband or the, um, or the patient herself.

Interesting. Do you, you spoke a bit about Britain

and you spoke a little bit about Japan.

Like where around the world do they, do you believe

that they have this model, this balance?

Correct.

Well, I think England is an excellent example.

Japan does, uh, more of the European countries seem

to have the balance correct.

You know, um, quite frankly, it's, it's about

economics in the United States.

You know, interventions provide more money

in insurance coverage to a hospital

than a non intervenous delivery.

If they leave quickly, it would be less income.

If they deliver at home

or they do a birth center, it's less financial

remuneration to a hospital.

And also physicians, by the same token, you know,

the c-section rates in the United States are escalating into

the 35% number.

Uh, and, and,

and the size of babies has not dramatically

increased to account for that.

Well, do you put, so how of that 35%

of deliveries in the US are being done by c-section of

that 35, what do you,

what percentage do you think is necessary

c-section delivery?

Well, I mean, there, admittedly,

there are some complications depending on

how high risk of practice is.

But let me say, in a general practice,

when we were practicing our rates were below 10%.

Okay. So, and,

and the more inductions,

it's been many articles would say an induction, which

takes someone to the hospital

and starts their labor artificially,

will at least double the rate of c-sections. Yeah.

Yeah. We see those statistics in, in Canada as well.

And, um, my children are five and three now,

and these are things we were looking at when we were talking

about, uh, birthing plans, having these conversations

with our midwives and talking about like a, a, um,

postpartum plan as well.

These were, these were things we were,

we were certainly having conversations about.

So, just so I get this right, so once this switch between,

um, childbirth going from the categorization

of being natural to pathological

when these interventions come in, um,

and the more of those interventions are used, is that

that's, there's more money going somewhere.

Like is there an incentive to use more drugs, more, uh,

equipment, um, you know, the, you know,

a c-section is a serious, serious surgery.

There's gonna be multiple people involved in that.

It needs the space of an,

or like, can you talk to us a little bit about that?

Well, yeah, I think, you know, there's a,

there's a comment that I heard years ago,

and this could re with be respect to any

of these physicians in quote, uh, if the shoe fits, wear it.

So if you have a lot of guilt when you hear this,

then you're probably practicing that way.

I'm not saying all people do, but inductions are typical.

If you let me use the example, it's some hospitals here

where I, uh, live now, uh, in Atlanta for the last 40 years,

uh, of a large hospital.

Let's say that a person goes to a practice

and they see a physician,

and that's gonna be their provider.

But partway through the, the pregnancy, that kind of,

the light dawns on them because they've seen

that provider every visit say, well,

what happens when I go into labor

and say, well, I have a partner, I have an associate

who will cover when I'm not there, but I want you.

And, and, and they'll say, well, you know,

I can't be available all the time.

I have a family in quote. So, but well, how can I have you?

And they'll say, well, I'm on call every Thursday,

so if we induce you on a Thursday, then you can have me.

So that's, that starts, that starts the ball rolling

to an what's called an elective induction.

Right. Which to me, should not occur

so often those inductions will start, let's say at eight,

nine in the morning, and then when they're starting having

contractions, then they put in an epidural.

And an epidural will allow for a certain amount of control

and when that delivery's gonna occur.

Right. If they, if they're having loss of sensory control

and even some motor, they might not know when

it's time to push.

Okay, well, so the doctor gets outta the office at five

and he comes over, well, let's get things going if often

by seven 30 or eight, they're not delivered.

Well, you're not progressing. It's time to do a c-section.

That's, that's a horrible timeline of events.

Uh, uh, and it,

and it, it can be one

of the reasons why we're seeing such an escalation

of c-section rates.

Mm-Hmm. I, I don't believe that the fear of lawsuit

is the primary driver

for an increase in the C-section rate.

You know, you would,

you would be hard pressed if you looked at the data that

very few times, is a physician gonna get sued

if he does the c-section?

Right. There are some complications.

You can make a hole in the bladder

or you can do certain things,

but typically the baby is fine.

Mm-hmm. Right. But that may may not be true sometimes

with a prolonged labor.

So there may be that kind of rationale

for jumping to a c-section more quickly, the fear

of litigation.

But just the idea of pushing things along

and not letting nature take its course

and any intervention is gonna slow down labor. You know?

Yeah. I mean, it, it, I, since, since I started studying

nutrition and the, and, and anatomy and physiology,

and especially the hormonal system

and how complex it is with within, within a woman, um,

it only makes sense to me that you would want to work

with the natural biological, um, let's say surges

during labor rather than throwing these interventions to,

you know, counteract these or, or,

or block these natural, these natural remedies,

not remedies, but these natural, um, biochemicals

that are produced and very deliberately,

um, flooding the body.

And it, it just doesn't make a whole lot of sense to me

that they would throw in all these interventions to get

that baby out safer and quicker.

It's, it's, it doesn't really compute

Well, it only makes sense if you think that it's, it's,

it's if they're doing a thousand deliveries a month in the

hospital, it's moving people in

and out if they're not in labor for 16 to 18 hours.

Right. You know, uh, also if they have an epidural put in,

it becomes more difficult.

There are some walking epidurals,

but more difficult for people to do,

or women to do naturally what should occur.

They should be ambulating in labor,

and that diameter of the pelvis increases

with squatting and being up.

Right. It, it doesn't help to be lying flat on your back

or even a 45 degree angle to do a birth.

Mm-Hmm. You know,

and there's some physicians that you can move people around

to for any potential complications that need to have

that mother have motor function.

Right. Right. So if you have an epidural,

that's, that's pretty difficult

Within your profession, within your industry.

Do, did you find a lot of people, a lot of other doctors

shared your, like, opinions on, on this,

on your, on, on midwifery?

'cause you've, you've been to, you've been

to Congress on behalf of this, this, you know,

so like quite clearly, you, I would guess

that your opinion is in a minority state.

Well, let me give you a couple of quotes. Now.

We, you gotta remember that I started out

of residency on faculty at Vanderbilt from

1977 to 1980 when the real problems occurred

that caused me to essentially get

blackballed out of Nashville.

Uh, so some of the quotes back then, which were,

were well documented, uh, one was by a physician said,

they're starving obstetricians in Nashville,

so we shouldn't have midwives do births.

Uh, another, which would, you know, it was hard not

to laugh when he said that, but he was serious.

Okay. Um, and then another one that when

they were questioning me for wanting

to have midwives do birth at the hospital, they said,

I just can't understand why you want to do that.

Uh, having a patient question, a physician

is like questioning motherhood apple pie and Chevrolet.

And, and, and another that caused a little bit

of laughing on my part, which was not helpful at all.

But, um, it was so intense that, um,

they ultimately, when they couldn't push us out,

because to stop midwifery you a, you either

block the policies and procedures at the hospitals.

You require women, for example, to not walk.

You require them to do certain things like preps and enemas.

This is back in the 1980, or you attack the physician.

A physician is the supporting arm for the midwives.

And if you attack that person,

then you've effectively eliminated the, the midwives.

And that's what happens. They pulled my malpractice

insurance in the fall of 1980,

and that involved all the litigation,

the congressional hearing, the antitrust lawsuits.

Now that took 13 years for that to resolve from 1980

to 1993.

And what was the, what was the resolution there? Well,

We won.

I mean, we won that victory.

It wasn't, it wasn't, it, it was very helpful, let's say,

if you would speak to the midwives in that era.

There were multiple attacks on midwives occurring throughout

the United States, around 1980 for the principle.

The reason I've described, because number one,

there's never been a study that showed

that midwives are unsafe.

Okay. Never been one. So, so they can't use that argument.

And so all these attacks were occurring primarily at the

physician because without the physician support,

then it becomes very problematic for them to, well,

they can't work in a hospital.

Uh, and so all these attacks were

pretty effectively stopped within a two to three years

of 1980 when we had a federal trade commission

antitrust lawsuit against the malpractice carrier.

And so that stopped a lot

of the attacks in the United States at

that time for a period of time.

So, um, it was,

it was a big win for midwives.

And their congressional hearings helped for that,

and the litigation helped for that as well,

because they, they lost and they admitted guilt.

Wow. And then how has the state of midwifery,

um, gone on from there?

I think it, it would be by location.

There are some states where it's still difficult,

extremely difficult for midwives

to work in the United States.

There's other states where it's much more open.

So it's a state by state issue in the United States.

Okay. Interesting. Okay.

Um, yeah, I'd love to talk more about like the, the kind

of the system that, that that you've been involved in,

the systems that's kind of controlling all of these,

and you've been, you know,

challenging these established norms

to pursue a more compassionate

and effective healthcare system for, for, for mothers,

for parents, for babies coming into the world.

Where do you think, um,

these systems have have gone wrong?

Well, for one,

it's would be the training of medical students

and the physicians

who are going into obstetrics and gynecology.

If there should be some method of collaborative training

where they're getting some

of their training in normal obstetrics, predominantly

by midwives, so that they, so that the, the people,

the professors are just telling them what to do

or what might be an option,

but they're showing them by example.

And the best example would be to be taught

non-interventional obstetrics by midwives.

So that would be the way to ground all

of the physicians into, in any specialty, for that matter.

The importance of collaborative practice.

You see it, um, in the United States a lot, for example,

with anesthesia.

There's many, many advanced practice nurse, an ethicist

and anesthetist people who work

with anesthesiologists quite well.

Uh, it's, it's, and there you have family practitioners

and family nurse practitioners who work quite well.

Uh, it's not been as predominant in the field

of obstetrics, uh, at least as a percentage basis.

And, um, any time

there's a big pie to be divided.

If, if you're in a community, if there's a,

and I call the pie the number of deliveries.

Right? And so you get your share of the pie.

To me, it should be based on the kind

of care you give, right?

People are drawn to you

because they're seeking this kind of care.

So that can drive the bus, so to speak,

for women, by them being educated

and them demanding these kind of services.

And then the physician groups are gonna have to decide,

am I gonna join the team or am I not gonna join the team?

And economics will drive that bus. Mm-Hmm.

Wh when you were, when you were studying this,

what was your, what can, what was your recollection of, of,

of learning about this?

Well, it, it, I learned first some of the wrong things

to do when I was in medical school.

Literally, this is a true story.

Uh, I was watching a, as a second year medical student, uh,

obstetrician do some births.

And it was commonplace

to use a drug called scopolamine back then,

which is an amnesiac.

And women just don't remember anything.

And they can say things they probably shouldn't say.

Uh, and I walked in on a lady who had had a dose

of scopolamine and found her under the bed,

barking like a dog.

So that experience said, you know, first you look

and then, then you're quite taken aback.

Mm-Hmm. And it's sad. It's really sad.

So the empathy, uh, occurred at that point for me.

And in medical school, we didn't have the fancy monitors,

so we were listening with do tone.

So we were hands on board

with the patients sitting next to the bedside.

And so that allowed much more engagement.

And it was tremendously rewarding to,

to not just be a technician, so to speak,

but to be really engaged with the family, getting ready

to experience one of the great, in my opinion, one

of the greatest things you can do in your life.

It's to experience the miracle of a birth.

There's nothing, nothing that to me can top that

of all the other experiences I've had that is incredible.

Uh, so that, that would help.

And then I think consumers should drive the bus.

You know, they should get educated and, and,

and don't believe the, the hype

that it might be more dangerous.

Right. You know, uh, I mean, 'cause that's fear.

And I often encountered in those early years,

wouldn't necessarily be the mother, the future mother.

It might be the future mother's mother or the grandmother

or the mother-in-law

or the father who didn't really understand

and were immediately dis guy, oh,

you must use a physician 'cause that's safer.

Right. And that was, that was, um, propagated

by physicians, right.

So that they could, uh, not have this system in place.

Interesting. I think the, the themes of, um,

the control certainly come up in regards to, um,

these physicians looking to be able to, I, I guess,

dominate that the whole birthing industry.

Well, yeah. It, it's,

it's immediately it would take more time

and a visit to actually engage

and interact with someone rather than just

arbitrarily tell 'em what to do.

Yeah.

And I feel it's very challenging for probably physicians

all, all over the world at the moment, to be able

to have the time to kind of formulate those relationships

with their patients and to be able to create the time

and have the availability to be at the birth

of each of their patients.

Like you mentioned earlier about, um, a a physician,

you know, scheduling it, scheduling in that they're free on

that Thursday and they could do the induction that day.

Like that's, um, that doesn't quite sound like the, um,

one of the reasons, like, for example,

that you got into medicine for that relationship building.

No, I quickly found

because of working with midwives in medical school,

well in residency essentially, that

that was just a better way to practice.

I can't be all things to all people.

And I have other duties that I'm torn to do.

And yet, and I said, I used to joke with patients

and they'd say, well, do I have to pay more

to ha do, do I pay more?

Do I pay less? 'cause I'm gonna have a midwife.

And I say, well, actually you're getting two

for the price of one mm-Hmm.

So you're getting a better deal. Uh, and,

and they say, well, that, that makes sense.

That makes sense. And

so safety would always be an issue usually with everybody

besides the mother, you know,

that would come up from the people

who weren't really engaged in the process.

'cause the connection was built

between typically the physician

and the patient or the client. Mm-Hmm.

Yeah. We had, um,

we had a naturopath on the show very recently talking about,

um, pregnancy and postpartum

and the preparation in regards for both of those things.

And, and the key takeaway I got from that was having a

good quality community around the birth

and the planning of that,

and having the, the, the partner, the mother of the,

the mother of the mother, like involved in, in being able

to actually make decisions in the, you know, the absence

of the, of the parents being able to do that

and just having everyone kind of on board as, not just

as a support system,

but to have, you know, like when everything doesn't go

perfectly smoothly, to have, you know, a little bit

of a procedure in place.

Have you seen that be, be, be an effective way of, of,

of going into, um, birth as well as postpartum?

Yes. I've seen, and we use a term,

I don't know if it's a similar term in Canada

and Great Britain, but doulas, doulas are, are usually paid.

They may be a friend,

but they paid to be the advocate for the couple.

So if things are getting a little tense,

that person can step aside and,

and really engage

and be the advocate with Mm-Hmm.

The caregiver. Right.

I've often found that the more trust you build during that

six or seven months,

however many months that you're seeing them in the office,

leads to a much smoother labor and delivery experience.

Uh, there are times when you have plenty of time

to explain the rationale

for why you're advocating something in labor.

And when you have that time, if you've built a relationship

throughout the pregnancy, there's a lot of trust there.

There's a lot of trust as opposed to someone

who walks in the room you've never seen before.

Yeah. Uh, so you have to have that trust building

before you get to that point.

And then there are times then,

because they respect that trust, if,

you know those rare occasions when the heart rate bottoms

out and you've gotta take 'em back

and do something, they trust you.

Yeah. And, and, and, and,

and there are times when you don't quite have enough time

to totally explain what's happening.

They understand when that heart rate bottoms out,

that something is happening.

So that trust that's built up over a lot of months,

I think is essential for, uh, a great experience.

And that, and the last thing I'd say with that is

some people get too,

there should never be an advocate in the room that

perhaps at the end makes the mother feel guilty.

Right. She wants this experience to be

how she has in her mind

and how she studied for, sometimes it doesn't work that way.

And sometimes a, a person can push her a little too hard

into doing something

that if she doesn't accomplish it, then she feels guilty.

Sure. And we know that the ultimate outcome is just a

healthy baby and a healthy mother.

How we get there is, is based on

how we relate to each other.

For sure. Yeah. I mean, it's obviously for mother

and father, you know, it's a very,

very vulnerable space to be in.

Um, and having to make decisions very, very quickly.

Being in that position is very, very challenging.

I've, I've experienced that myself.

But to have, yeah, we had a doula, I had a midwife at both

of our births, and we had these, these people

who knew our plan, they knew who we, they knew

what we wanted to do, and they were able

to make decisions on our, on our behalf.

And yeah, I'd highly recommend that to people to have

that circle of individuals by your side.

And I think historically, if you look back,

that would be a very typical way in which we would,

we would give birth, you know, as a, as a community.

Um, I'd love to talk to you about informed consent around,

around, around pregnancy, around childbirth.

Um, first of all,

would you mind telling us a little bit about

what informed consent is

and kind of wrap that into your wheelhouse?

Uh, I think to explain it in a, as, as simple as I can,

in lay terms, it's trying to explain all the risk, benefits

and potential complications that might occur

in the event that's gonna happen.

And in this case, a birth or subsequently a c-section.

You know, you see just in the side, you go into the hospital

and you sign your life away with a bunch of forms,

which you're never gonna read.

Which if you don't sign them, nothing's gonna happen.

You're not going through the door.

So, and you don't understand all those, all those papers,

but you do the best you can to inform them of the potential

that this is not always a perfect event.

So that's informing.

Now, there was an interesting study done years ago,

and it was on cardiac surgery and they filmed

and recorded the informed consent for every person

who was having that cardiac procedure.

They then talked to that patient six to eight weeks later

and said, were you told this?

No, I was not told that at all.

And I was told, then they showed them the film

where they actually were shown that Yes.

Every one of those things

that they didn't think they heard Sure.

They were actually told. So there's a lot

of anxiety when you're, when you're, you're hearing that,

you know, how much of that are you hearing and, and,

and taking in.

So interesting.

I, I think no matter how much informed consent,

there are plenty of litigations that fortunately I never was

sued as in the 40 years of, of practice, uh,

and lost a lawsuit.

But often informed consent is one

that a plaintiff's attorney will go after.

Well, that wasn't really fully explained to me. Okay.

They just made me sign some papers, you know,

and it is, there's a lot that can go wrong.

You, if you, I'm sure you've seen,

I guess there's commercials for medications, uh,

that you see like we have in the United States,

and they'll say, these are the benefits

and this is why you should take this medicine.

And then there's somebody coming on for another minute

who lists about 45 complications

that could potentially happen, including death.

And you begin to wonder, why do you want

to take a chance and take this medicine?

That's only after the, um, beautiful imagery of the,

the old man running through the field

with his grandchild playing, playing football or something.

Yeah. I, I've, I've only ever seen them when visiting the US

'cause that's not, that's not allowed on

tv. Yes. Anywhere else.

Goodness. It is. Yes. That's, that's, that's ridiculous.

It's ridiculous.

But yeah, that's, uh, that's a very important point.

And it's usually like read out at ridiculous super speed.

Yes, exactly. So nobody's able to actually compute

that anyway, because it's not like how people talk.

No, no. So that's a difficult one.

I mean, you do your best, you can.

And the, I think from a, from a

obstetrical point of of view, it would be, you know,

here are some things that could happen

that may require you to have a c-section.

Right. And some of them go away before you get there.

Like, you don't have twins

or triplets, you're not in preterm labor.

But most of the time

before you make a decision to move in a direction,

you're allowed to redo more specific informed consent.

Yeah. As opposed to gen general informed consent.

Beautiful. Um, just

before we finish up, I really wanna talk about your book

as well, like who that's for.

But I would love you to just, in your experience

that you've had, what are some of, what are some

of the like vital key roles of a midwife?

Well, first education, first it's education.

Ideally with the visit before they get pregnant.

Uh, so that they're, they're preparing them ahead of time

with education, with nutrition, with exercise.

Uh, and then it's labor observation.

You know, it's not, nurses are good labor

and delivery nurses are very good,

but often you'll see physicians will still be in the office

and maybe ordering epidural.

They might not see the person necessarily

until it's time to birth.

Yeah. And they're, they're expecting that nurse

to let them know if there's a problem with the heart rate

or they're trusting them for,

are they progressing in dilation as opposed

to the midwife who's there all the time.

Yeah. I mean, that's their job.

You know, they don't have other jobs.

That's, that's their job.

Uh, and so that, it makes so much more sense,

you know, to have a midwife there and even a doula as well.

You know, I think that the, not the more the merrier.

That's probably not a good term,

but, uh, the more informed people there, no, you know,

a mother-in-law is probably not the best person or a mother

'cause they're so emotionally tied in.

Sure. Uh, to be that kind of person.

Uh, you know, I I I, I get disappointed when I see,

I don't mind if there's three or four people in the room,

but I I, I don't see the point

of them sitting in a chair in the back just observing.

Sure. You know, that's, that's,

they might as well go watch a movie. You know,

It's a participatory role for

Sure. Yeah, absolutely.

It's, it's for participation.

Yeah. No, I think that's, that's wonderful.

And I think, yeah, the idea of having a midwife,

somebody who's got that education, somebody who's got

that experience, like, if I have the choice of jumping out

of a plane with somebody who's doing it for the first time

with me, or somebody who's done it 5,000 times,

I'm gonna strap myself to that individual every single time.

And it's so vital to have that.

I think that that, yeah, that experience,

but that calm in the room when think, you know, you,

you know, when things might, might get a little bit intense

for you, especially as a, you know, as a first time parent.

So vital to have that, that that calm in the room,

that patient's in the room, you can't really put a price on

that to, to have that as an option.

Absolutely not. It's a team. It's a team event too.

I think I would often, even though I wasn't gonna be part

of the delivery, I would go in and meet the family again,

or pray for the first time, meet the extended family.

So kind of allay their fears. There's someone here.

If there needs to be someone here, we're here to help.

And that anytime you can reduce anxiety. Yeah.

You know, anxiety and tension in my experience in

labor, slows down labor.

That's a big muscle that's gotta work there.

That uterus has gotta work in sync.

And when there's other stressors going on

that doesn't let it work as well.

Beautifully put. Yeah.

That anxiety piece, again, is absolutely huge in regards

to like what a woman can

and can't do with their physical body in that moment.

Um, so back to your book.

Can you tell us a little bit about who, who that's for?

Is it like just, is it a memoir?

Is it something people can obtain to, to, to learn from?

Like, how, how would you describe the book and who it's for?

Well, it is a memoir

and it started as a narrative from the day I was born

until I retired the principle part in, in, in the,

and it was meant for first for, for women

and for, for my patients.

But it does teach the experience of choosing a midwife

and why and how the medical establishment can block that.

Mm-Hmm. And why

and how you can make some informed choices to move in

what I would consider a better direction.

Uh, so it, it, it, it, it tells the bad what happened to me

and then the good that came came from it in the context

of why I got there.

I mean, the first part of the book, first few chapters is

how did I get to be an obstetrician gynecologist?

Well, it's an interesting story

and I think that any book that's helping people, um,

educate themselves around the idea of midwifery

and how they can actually advocate themselves to, to be,

to have that as a part of their birth, I think that's just,

that's, that's absolutely wonderful.

And yeah, if you get the opportunity to get

to daryl martin books.com and check out even just the image

and then listen to the story of, of, of Darrell explaining,

um, the importance and, uh, beauty of that picture.

It was very, very worthwhile.

But, um, thank you so much for coming on

and sharing this information with us.

I think it's such, I was generally super, super excited

to learn more from your perspective in regards to midwifery.

'cause there's not many people out there

in your position talking about this,

talking about the importance of it.

Um, so thank you so much.

Is there, is that the,

is your website darryl martin books.com, is

that the best place for people to learn more about you and,

and get hold of the book?

That would be one way.

Uh, the book is available on Amazon. Okay.

Like everything else is in the world. Right.

We, and the United States can order anything on Amazon

and have it delivered to our front door.

But that, and it's in all the major bookstores.

But, um, yes, my website then leads into the

Facebook page and it's a little bit more information.

But, um, yeah, it was, it was, it's a, it was, um,

something that I just started one morning

and worked several hours a day for months.

And, uh, the, the person who helped me write it had

to the reduce it from 125,000 words to 65,000 words.

So Oh, wow. So some of the, some of the stories, some

of the hilarious stories may be coming in another

format in, in the future,

Maybe in the shape of a podcast. That could be cool.

Uh, a podcast. I, I would go for a movie as well.

Uh, okay. Yeah.

We were actually approached to do a movie in 1981,

but that was just the beginning

of the story when everything fell apart.

So now it's maybe the,

the ending is better than the, the beginning. So we'll see.

Well, it could certainly make

for an interesting documentary.

I think a lot of people, um, not just people who are looking

to have babies, but people who are strong advocates of,

of the practice, of midwifery and doulas

and the informed consent for mothers.

It's a, it's a huge, hugely popular topic.

So I think that you would, uh, not struggle for eyes

and ears whenever you decide or

however you decide to do that.

So, okay.

Thank you again, Dr. Martin for coming on the show.

I really appreciate your time today.

Thank you very much. I enjoyed it

immensely talking to you. Thank you.

Beautiful. Thank you.

Well, that is it for this episode of True Hope,

the official podcast, or True Hope Canada.

I will share links in the show notes if you wish to connect

with Dr. Martin or grab a hold of his book,

which I highly recommend that you do that.

I'm gonna do that as soon as I finish up here.

But you can leave us a review on iTunes if you want to.

You can leave us a review on Spotify.

That is it for this episode. We'll see you next week.

Thank you. Thank you very much.