Inside Childbirth Cases: Lessons from Attorney Gina Mundy | 116

GINA MUNDY POD 


Quick note, this podcast is for educational purposes only and does not replace your medical advice. Check out our full disclaimer at the bottom. of the show notes. 


Of course we started talking before we hit record and I'm like, hold up. We've got to talk about this on the podcast. So welcome Gina. 


Gina: Thanks for having me, Trish. I'm so excited for today's conversation. 


Trish: Me too. So tell me how you got into this field of working with childbirth cases. Like how did you end up specializing with that? 


Thanks 


Baby may pass away during childbirth or mom. So these are serious cases. And I was at that age too, where I was, having a baby was on my radar. So I'm like, wait a minute, I got to stick around for this job and, make sure what I was seeing in these cases didn't happen during the birth of my own kids. 


Trish: And that's why I wanted you on here because we don't want you guys to end up needing to be in a case like this. And so I figured what we could do is talk about what are some safeguards that these parents can put in place and how can they advocate for themselves? What is your advice to let's say one of your friends is pregnant or your family members what do you tell them? 


What does Gina tell them at the dinner table? 


So yeah, I started to write and then as I started writing, it became quite apparent that this is information that would just not help my kids, a lot of other, Families, so I direct them to chapter one and basically chapter one. Those are the lessons from the baby cases So it's a lesson we can learn from the past to help prevent the future but lesson number one Huge very important. 


You must prepare for childbirth. You must get ready. You must get ready Just take those great courses. I know you offer an amazing course, but just taking those great courses and just having an understanding of what you're walking into is so crucial. It'll help things like communication on decision making. 


So the number one lesson by far is just getting ready, preparing for childbirth. Now in chapter one, I do have all of the lessons and then each lesson is then a subsequent chapter. Yeah, that's number one, absolutely. And then also in that chapter, I write and I tell parents like, Hey, you're a mom, you're the decision maker, your delivery team and your nurse and doctor. 


They can't, start Pitocin. Let's just 


Trish: face it. Some of them think they can. 


Gina: So that's why it's super important again, that parents. The expecting parents take courses like yours, read a book like mine. They're going to be like, wait a minute. What? I'm decision maker. And oh, wow. 


And decisions are really important. And so are, especially the good decisions. But yeah, I know how they communicate. I've been, I've been their attorney for 21 years. I've analyzed OBGYNs. Literally, that has been my profession. So I know how they communicate. And some, it's they tell me and I'm like, I'm your attorney. 


Yeah. Sometimes. 


how many patients I admitted that when I'm getting to know them, I'm a very hands on, like as much as you want me to be a part of your room and in there, I'm going to be in there with you. But I would ask them, did you take a birth class? And the majority of them would say no, or they took the hospital provided one. 


And I'm sorry, like I am adamantly against them. I was asked many times about teaching them at different hospitals that I worked at if I wanted to head that up. And the curriculum is very much about be a good little soldier, here are the policies, these are the procedures, and not really explaining the patient's rights. 


So being bold without knowledge doesn't work. Having knowledge, but not having the ability or the confidence to speak up. doesn't work well either. And then the third part is that mindset and the belief in your body and knowing that your body was built to do this. And you have to have all three. You have to have all three to be able to really navigate that. 


And that's one of the things that we've done that's a little bit different than any other birth course. is that we have got our courses. And of course, anyone can just buy it and do it and never reach out to us, never take part. But we also meet with our moms every Wednesday on Zoom and we help them really digest and understand what they're learning and then how to apply it. 


But this might be a time you should, so it's really about that whole puzzle piece. And having that, all of that. And I love that you said I start out my free classes saying one of the biggest birth mistakes I see is winging your birth. 


Gina: Hundred percent. Yeah. Hundred percent. And I, okay, audience. 


I love this as the child birth attorney who only sees the bad, you're lucky you got to see good and bad. I only, for 21 years, professionally has seen the bad. And I can tell you what you're teaching your students and clients is. I am, I'm just, I'm blown away. I am so incredibly happy right now because that is going to help parents have a healthy baby. 


All day long sounds like an absolute dream. So I think 


Trish: We're both doing the same thing. We want to, the majority of my students who have already had a baby are coming to me because of trauma one way or the other, one degree to the other, and I can't prevent birth trauma, obviously, because there's such, it's such a subjective range for trauma. 


But what I do know is if they take my classes and they participate, They will not leave their birth, no matter how it turns out, thinking, what if I done this? What if I done that? They will know that they navigated it and they made decisions alongside their care team. That I know. 


Gina: Okay. And that will unequivocally reduce, possible birth trauma, with your clientele. 


You can be healthy and still have significant birth trauma. And I've been on a lot of shows actually with moms who they started the show. because they had a significant birth trauma and they don't want other moms to experience it. Yes, their baby's fine. Yes, they're fine. But mentally, they went into it, unprepared and not, and just not ready. 


It's a moment you dream about your entire life. So getting ready for it. I cannot stress enough how important that is as an attorney specializing in childbirth cases. 


Trish: And I tell them all the time no matter how many babies you have, you only have that birth with that baby one time and do what you can. 


What is in your control? What is in my control? What's in my control is educating myself, communicating with my team, preparing a support group, whether it's your partner or a doula or whatever, and preparing my home because like you said, there's a lot of things that can and talking about trauma when what I was taught in training to be a labor nurse is that birth trauma. 


And part of that membership includes weekly hangouts with our postpartum moms. And I'm just going to be completely transparent and some, a lot of my listeners have heard me say this, but it's still It's still, honestly, there, there have been times I've laid in bed just like what in the world because, and the reason is we started hanging out with them every Thursday, the postpartum moms. 


We're trying to breastfeed, our nipples are hurting, our butt hurts. Kids are running around. You don't have time to sit and say, Hey, I know that my baby's healthy. I know that I'm healthy, but I'm, reliving my birth because A, B, or C happened. And. The very first postpartum hangout we had was one of the most powerful experiences we've ever had with a group of women. 


The VBAC lab is specifically for someone who's had a C section who wants to have a vaginal delivery. I always kept them apart, right? And so some of those students, this is the first time they met. Part of the reason I kept them apart is that I don't want these moms who wanted a vaginal birth so badly and didn't get it. 


to talk to this mom who had this perfect vaginal birth. They started healing together because we had one mom that on the outside she, she had a two hour labor, she got to the hospital, she delivered really fast, and It sounded like an amazing birth. Perfect. She cried and shared with us for five minutes talking about her emotions because it happened so fast. 


But it was so apparent to all of us that she was traumatized and we were able to walk through that with her. And that has been life changing for me as a labor nurse. Honestly, to experience that with these moms, that was a shocker to me. 


Gina: Yeah. You 


Trish: know? 


Gina: Wow. Yeah. It sounds amazing that cause you're right. 


You would only see him for the first couple hours. See ya. Have a nice day until you start that group. Wow. What a great resource. I wish I had something like that when I was Oh, me too. When I, my oldest is 20 now. Youngest is 9 but I know you have 7 kids. You 


Trish: sound like me. My oldest is 34 and my youngest is 9. 


Oh my goodness. 


Gina: Yeah, you have a huge gap. 


And yeah to be able to process that trauma and to walk through, and I'm not saying that some of my students have had some, I've had students have had losses there, they've had fetal demise, which is for those of you guys listening, they've had babies that have been stillborn and, you know, one of them that I'm thinking of, she's pregnant with her second baby after her loss, and she's still one of my students. 


She's involved in my community. I love her dearly. Support is everything as well. Sounds like 


If she even talked to a mom during pregnancy, she'd be a fact witness. So doulas are definitely doing great things too. 


Trish: Okay, hold up. Let's pause. What you're saying is that These worst case scenarios who are suing doctors and hospitals, right? That's what we're saying. Don't have doulas. They 


Gina: do not have doulas. 


Trish: There's a connection there, people. 


Gina: Yes. And so once I figured that out when I wrote my book, again, I'm in my just litigation attorney world. I focused on, okay, what are the common facts, common issues in the baby cases? That's chapter 11. Just so that way parents know, I give the top 10, that way they have a heightened sense of awareness. 


Those cases are few and far between. And I know. I'm going to start screaming in a second. Yeah. Then I got to tell you this then. So do you want to try to guess the number one most common fact and issue in a legal baby case? 


Trish: Pitocin, probably. 


Gina: Yeah, you're right. A hundred percent. 100 percent the most common fact. 


And it was a very specific patient who I labored with her all my whole shift. I was night shift at the time. She was amazing. She did not need Potosin. She did not need intervention. I knew damn well that this doctor did not like to stay long. He liked to get, he wanted to get home. He was pushing her. I sat by her bedside as long as possible. 


And this was a very healthy, spontaneous labor. She did everything right. They talked her into Pitocin because it wants you, you were doing really good, but we, we don't want this to turn into something. It doesn't need to be. Ended up on Pitocin despite my. Because at the bed, this is why I do what I do. 


Because at the bedside, I have to just follow his orders. Now, if he's doing something grossly negligent, obviously I'm going to go to my charge nurse. But basically, this is hospital policy, this is standard, this is what we do, which is pretty much puts you all on Pitocin for one reason or the other. And so she ended up on Pitocin, then it just, 


Oh, have you ever seen Ricky Lake's documentary, by the way? 


Gina: No. 


Trish: You need to watch 


Gina: it. All right. I'll watch 


Trish: it. It's what's really interesting about it. It's called the business of being born. And what's very interesting about it is that her. Partner and videographer, like the person who's video is pregnant and ends up with an emergency preterm c section. 


And there's a scene where they're like, did you up the Pitocin? on? What's the Pitocin on? Is the Pitocin up? Have you put it up? When's the last time you went up? It's like Pitocin. That is so freaking accurate. 


Gina: Yeah. It's crazy. I wrote my book to expecting families to help them. 


Pitocin being, I don't just identify pitocin as the number one most common factor in a legal baby case. I'm like, listen, based upon my 21 years traveling across the country, whatever, researching the drug, cross examining OBGYNs extensively on this drug, you name it. I wrote chapter 14 and that is how to have a safe pitocin induction. 


Let it hit your sweet spot. I have a whole 


Trish: lesson on this. Stop it. I have a whole lesson on this in my course. Slow and steady. Starting and the studies have shown Slow and steady. That is what's effective. And. Oh, this is so maddening starting low and going slow and stopping it when the body takes over. 


And I can tell you as a 16 year labor and delivery nurse, that it is very apparent to all of us. It's a very different pattern presentation of Pitocin contractions versus her body taking over. We know when it happens. And they want us to just go up, crank it. So 


Gina: the labor and delivery nurses have been using my book, so they, against the physicians. 


So they don't have to up it because they don't want to up it. And so they're like, no, I was that, 


Gina: my God. That's yeah. This wow. Oh my goodness, this makes me so incredibly happy because you know what, somebody may need a Pitocin induction. 


The introduction to my book is my niece's story. She had a rough childbirth and but she basically, she went in at 38 weeks. There were concerns about the baby. I saw the heart rate. There were legit concerns. And yeah. And that's 


Trish: again, it's necessary when it's necessary. Yeah. 


Gina: And she had two choices, pit induction, C section. 


Yeah. Yeah. Yeah. Yeah. And it was a good choice for her and that obviously it was crazy slow, crazy, steady or whatever. Yeah. Even then it was still hard. 


Trish: And I'm just going to be very real with you. The doctors have a very easy time convincing the moms that they want to go up because the moms are tired of it. 


Would then do exactly what the doctor said, despite what I told them and even warn them would happen, and so I, there's let me just tell you this really quick. My very first labor and delivery job was at a birth center. It was a freestanding birth ward. Okay. At a freestanding hospital. 


But they had decided that they wanted to go to become a high risk. So they were starting. Up until like around the time I got hired and why they hired so many of us. Now I came into this blindly. I just wanted to be a labor nurse. I didn't know anything. And they hired all of us, which was a nightmare in itself. 


The majority of their patients were inductions and they were transitioning to this high risk status. Like they were taking not, they, I don't, they had a, they were transitioning to a level two NICU. Before that they had just a nursery and they were trying. Yeah, they were trying to move up from like maybe even going to level three. 


What? Yeah. 


Gina: Oh my goodness. And none of us, 


Trish: none of us had a clue, right? And so I took my first travel assignment because we needed some extra money and I heard about it. It was a four week assignment in California. I thought it was going to be a one time thing. I learned more in that four week assignment with union nurses who don't do shit unless they want to. 


It was, and I never saw that anywhere else, but it was a nightmare. A nightmare. 


Gina: Yeah. And, yeah. It's so scary. 


Trish: It is scary. 


Gina: I'm telling you. That's what I keep, that's what I tell people. I always say, I'm like, I was hired into a team of 20 people. This is all we did. Baby cases. I know nobody knows we exist unless you have an unfortunate labor and delivery, but yeah. 


Yeah. The stuff, this stuff happens, but it's, again. Getting ready, understanding, it would be much better off. Just my students, 


I think she was 41 years old and I don't remember, but he told her that if you, like nobody, like if you, basically no one delivers without being induced, like it just doesn't happen. 


Gina: Oh my goodness. So hold on. I was on the phone with the doctor. Hold on. And he said, he told me the standard of care. So that means what a reasonable and prudent physician must do or does. 


If a patient is a good candidate for an elective C section at 39 weeks, the standard of care is that he or she, the doctor, must offer that patient an elective induction per the standard of care these days. That's what he's telling me. I'm like, what? I was, oh, my stomach went upside down. Do you, I need to 


Trish: start a book with some of the bullshit these people say. 


So if you're going to have an abduction, something you need to talk to about, with your doctor, during your pregnancy. If it's something that happens, at the hospital, you didn't want it, but you know what? That's going to be a good choice. Given your labor, you should have a basics so you understand it. 


So then you can talk to the doctor, but I have them in the book no, stop the Pitocin at 10, your order can only go to 10, not 20. And, I don't even want them to get to 10, but if it does that, maybe that everybody reacts to it. Put those in different if it is what it is. But yeah, no, I think you'd find that if you haven't read it. 


And the other thing is, 


Real quick, 


Gina: in the baby cases, that's the biggest issue. And here's the deal. Here's the deal, everybody. So I, like I said, I've traveled the country meeting with delivery teams and doctors and nurses and everybody. has different opinions on how to administer Pitocin. So for instance, I have a case involving Pitocin. 


I have to retain expert doctors to look at the case and they will look at the care. They'll look at the medical records and they'll tell me, was the care that mom and baby received, was that good care or bad care? Was the Pitocin induction reasonable? within the standard of care or was it unreasonable? 


So I, so when that doctor told me that, I was so like, how is that possible? So I asked her, about the first doctor. I said I probably, 


Trish: probably because the second doctor was like, shit, this is exactly what I do. And if I say it's wrong, then I'm wrong. 


Gina: Yep. So that's my opinion. So I said listen, the first doctor said everything was done wrong and they blew the baby out of the uterus with the Pitocin. 


Trish: Yeah. And the thing about that, the thing about that's so maddening is that they come up with. 


ways to support whatever it is they want, no matter whether it's the right thing or not. And I've seen that through the course of my career because when I first started, they didn't it was not the norm to be induced, right? Then I went through a season of my career where they were scheduling an elect an induction at the very first prenatal appointment. 


Then they, clamped down on them and said it had to be a medical reason if it was before 39 weeks, cannot happen after 39 weeks, then we get this whole stupid ARRIVE study, which is bullshit. In the book. Bullshit. Chapter 14. Okay, thank you. I'm gonna order your book because it's so frustrating. 


During a VAT exam 


Gina: by any chance? Yes. Yes. Oh, weird. Yeah. By the way, water breaking is huge. 


Trish: I know. And I tell my, I, so my students are told not to allow them, if they decide they want to it, not to do it until they're in late active stage of labor. Oh my 


Gina: gosh. Listen to this. Ready? Chapter 11. 


Trish: And the thing about it is the studies show that it only shortens their labor by 30 minutes. What the hell? Now there are times during an induction where breaking the water will speed things up, but it's not worth the risk. It's 


Gina: not. So if mom has already had a baby, so mom's on baby two, she's having a pit induction and yeah, she doesn't really want to increase the pit. 


That might be depending on mom, a good option in order to avoid, increasing the pit and getting that the natural Contractions. Yeah. Let me tell you, let me tell you 


What? That makes no sense. It does. They encourage actually drinking and eating, which is the best. Oh, okay. So I started the IV and then hung fluids and she was like, did, why did you put fluids? But on the East coast, we started IV, we do fluids. They only get ice chips. That's the norm. 


Gina: Yeah. I'm on the East coast. 


Yes. Yeah. What are you doing? In 


Trish: Seattle. They see birth as a natural process and you only intervene as needed. IV fluids, that's an intervention. If you have a healthy mom who is consuming fluids. Now I go either way with my students. If they don't want to have an IV site, that's their choice. I personally would rather have one at, a hep lock in because I don't like to get an IV. 


And. I get we move back to Nashville and I get my first job and we had a provider who would come in at 7 a. m. on all of his inductions, whether they came in the morning or the night before he would, oh, just it gets worse. He would break their water with an FSC with a fetal scalp electrode and put it right on. 


At half a centimeter. Wow. 


Gina: That is I talked about that in my book, the doctors who come in at 7 AM and they'll come in because they'll, they want to be home for dinner. They want mom delivering by lunch and they do these seven o'clock rounds and how do I know? And what 


Trish: they do? 


Like, where is she at in her labor? No. No. No. They don't care. 


Gina: Yeah, I know this, obviously, so this is not a good practice. And I talk about in my book, individualized care, not your generic care. That would be generic care. Again, you got to ask questions again, like you said, advocate. Now do you teach them at all about the fetal monitor strip? 


Trish: I teach them everything. Okay. They, my, my students will say to me there's a couple of things that I hear all the time. One is Trish, you were in my head the whole time. The other thing I hear a lot is that their nurses will be like, Oh my gosh, as much as I do, like, how do you know all this? 


And then the other thing that is really common with my students is most of them, the majority of them don't get to the hospital till they're seven or eight centimeters. 


Gina: Oh, nice. Which also prevents 


Trish: a lot. 


If there's a concern or if they want to do something, if they want to do something, it's typically, it stems from the baby's heart rate. So like chapter, I actually, chapter eight are the different types of fetal monitors. Chapter nine is how to read the baby's heart rate. Cause I've had doctors testify. 


I teach 


Trish: them that as well. 


Gina: They're like, Hey Gina, the only way a baby can talk to me during labor is their heart rate. And I'm like, ding ding. Hey mom, the only way, if you can read your baby's heart rate, apparently they can talk to you. So let's go over that. So again, basis, but then yeah, chapter 10 is I go through all the interventions too, because again, it's so incredibly important because the doctor, this it's not concern from the baby, concern of the baby's heart rate on the baby and the monitor C section. 


It's concern and then you have your interventions. And so it's really important to understand those, before, before you go into labor. So I love that you teach that. Yeah. That's 


Right when I admit it, how to read the strip, how to tell, is this a sleeping heart tone or is this a minimal variation? And so I have a whole lesson on that in the part, I have a birth coach class and I actually, I, they, I encourage them both to take all the classes. But in the birth coach class, I usually teach them. 


more thoroughly. Because when mom's laboring, her only job is to labor. She doesn't need to worry about the monitor. She doesn't worry about need to worry about advocating. At that point, her partner should be as educated to speak up for her. And so I do teach them how to tell because I can't tell you how many hundreds of doctors over the course of my career have come in and they're like, you've been at this for a while and I want you to look. 


Gina: Oh yeah. And I love your support person. I actually, my book chapter seven is baby advocate. 


So it's husband, grandma, best friend, doula. Yeah. But it's the 


Trish: problem, the problem with the doula though is that the doula's hands are tied because they cannot accept or refuse anything for the patient. The partner can during those things. But 


Gina: Yeah, but even though the doula, I like because the delivery team is typically a less You know, besides doctor, but they're usually not at the hospital. 


Sometimes they are, if they have a shift or picking up or they're checking, coming in to check on me, the delivery team though, is also typically who's scheduled to work that day. So that's why I always liked having the doula come in. And again, this is more from when I published the book to okay, Doulas must be doing great things. 


Trish: Yeah the studies have shown that having an educated support person consistently at bedside and the studies really lean more towards that being a doula. But I truly believe that if your partner and for sure if they take my courses, because we go through positioning and every, they know everything. 


But if you have an educated support person at bedside. You are more likely to have an uneventful vaginal delivery. You're less likely to have interventions, less likely to have a C section, more likely to perceive your birth experience as positive, and your baby is more likely to have a higher APGAR score. 


That's by having an educated support person. 


I love it. Boom. Your course. I love that your course covers all that. This is people. This is how you have a healthy baby. You walk in with the knowledge from Trisha's course, and you will have such a great understanding of what's happening and you're going to have such a great, such a, a better experience. 


And then they're 


Trish: filled with the what ifs. Yeah. Oh, that's what I'm saying. There's 


Gina: a really good chance they never. They never would have met someone like me. And I'll tell you the guilt. So we talked about this. I'm going to launch my own podcast here coming up. But the first person on my podcast, a mom who delivered a baby four months ago, four months ago from now, and she's a nurse. 


And she did not prepare for labor and delivery. She's obviously not a labor and delivery nurse. She walked in with a healthy baby and she left and her baby is permanently very sick. And the amount of guilt and the amount of anger that she has every day it's overwhelming. And she just it's heartbreaking. 


But yeah, that's how I started, but no, I didn't sleep that night. And I knew that. What me and you are doing right now is so incredibly important to help parents have a healthy baby 


Trish: Yeah and that, yeah, it's, oh, it's just, oh my goodness. It's the problem, the disconnect. And where I have such a hard time is I'm so passionate about what I do. 


My course is so low priced and I include so much support. I've got a team of doulas there. We're there. We really are hands on with them. The maddening part. is getting them to understand how crucial this is before they're sitting at the table with you or before they're sitting alone in the room and thinking, Oh my God, why? 


It's these first time moms. And it's I don't want to sound salesy, but every time they ask me, what can I do? I'm like, take my class. That's what you can do. I promise you. It is the thing you have to do. And one of the things I asked during my free workshops is, why do you think that HSA and FSA and insurance covers childbirth classes? 


There's a reason because it costs them a lot less money if you're educated because you're not going to end up doing all the things most likely obviously, like we said, there's a reason for all of these interventions and there are reasons that are 100 percent necessary. But insurance companies are ahead of us because they know that an educated mom. 


We need to talk more about that. But thank you so much. Let everyone, can you tell everyone, and I'm going to link to her book and to her social so you guys can find her, but just tell everyone where they can find you. 


Gina: Oh, sure. So always the best spot. Easy peasy. If you know my name, Gina Mundy. G I N A M U N D Y dot com. 


Obviously, Trish, I'm putting your course up on my website. I love it as a huge recommendation. I love it again. And these, when, if a resource goes up on my website, it's because something I have vetted out and I would recommend to my family and friends. 


Trish: Thank you so much. And I really enjoyed this conversation. 


Did you hear Gina say that none of her cases, those mamas had a doula? That is so true. It's powerful. Use the coupon code POD50, go to labor nurse mama. com forward slash calm and get 50 off, join and come to our hangout every Wednesday on Zoom. Okay, you guys, as always, hit subscribe, write a review, tell me how much you loved this episode because I'm sitting here blown away and I'll see you again next Friday. 


Bye for now.