Building the Best for Our Babies and the Rest with Rebeckah Orton

Episode 82 • 8th October 2022 • Ramble by the River • Jeff Nesbitt

Rebeckah Orton

Saturday, October 2022, I'm your host, Jeff Nesbitt. and we've got a great show for you today. The guest on the podcast today is Rebeckah Orton Rebeckah is the owner of the Astoria Birth Center and Family Medicine, Astoria's first freestanding birth and primary care center. It's an awesome place. If you're local, you've probably already heard of it.

They're doing great things over there. Rebeckah came to talk about all kinds of stuff regarding women's health, birthing midwifery.

So if you've ever been curious about what a midwife is or what a midwife does, or what a doula is, or what a doula does, and how those things are different and things like that, stick around cuz we're gonna cover all of that today.

But first, , breaking news.

Too many lives have been upended because of our failed approach to marijuana. It's time that we write these wrongs. Um,

federal French, federal fences. With a simple possession of marijuana. Thousands of people were convicted for marijuana possession who may be denied employment, housing, or educational opportunities. As a result of that conviction, my pardon will remove this burden Second. I'm calling on all governors to do the same for state marijuana, possession offenses. Third, the federal government currently classifies marijuana as a schedule one substance, the same as heroin and LSD..

And more serious than fentanyl makes no sense. So I'm asking the secretary of health and human services and the attorney general to initiate a process to review how marijuana is scheduled under federal law.

[: 00:01:44

now obviously this should have probably happened in 2000. When marijuana was first legalized, but it didn't. Things move slow in the government. So good job Joe. I'm glad you got it done. And also props on that delivery cuz you only fumbled maybe one to two max sentences in there.

And that's pretty good.

Washington, October 6th. This is coming straight from Reuters President Joe Biden took steps to overhaul US policy on marijuana on Thursday by pardoning thousands of people with federal offenses for simple marijuana possession, and initiating a review of how the drug is classified.

Biden said thousands of people with prior convictions could be denied employment, blah, blah, blah. Nearly 40 US states have legalized marijuana in some form. It remains completely illegal in some states, and at the federal level. Reclassification would be a first step towards wider legalization, a move backed by the majority of Americans,

and would usher in sweeping changes for companies and law enforcement. These changes would impact millions. The president's decision fulfills a campaign promise and is likely to please members of the left leaning political base ahead of the November midterms

a senior administration official said that this could affect more than 6,500 people with prior federal convictions. That's a lot, but I feel like it's probably more that's doesn't seem like enough.

Shares of cannabis growers and sellers surged following Biden's comments with Tilray brands and Canopy Growth, both jumping more than 20.

Supporters have welcomed the move and its impact on racial imbalances within the US Justice system.

Some Republicans who US voters prefer over Democrats for addressing crime related policies have criticized the move in the midst of a crime wave and on the brink of a recession. Joe Biden is giving a blanket part into drug offenders, many of whom pled down from more serious charges. Republican Senator Tom Cotton said on Twitter.

This is a desperate attempt to distract from failed leadership. Well, that's pretty judgey, Tom Cotton.

I don't know. I think it's pretty clear that the legalization of medicinal marijuana and then subsequently recreational marijuana in Washington, Colorado, Oregon, and a subsequent ton of other states has proven to be a pretty good move. It provides tax revenue. It has not led to major social problems or issues It does seem crazy that people are sitting in jail for something that's legal. So I'm glad he did this. We'll see how it goes. Moving on

In other news, McDonald's workers are begging customers to stop ordering the new adult Happy Meals

th,: 2022

And the employees are venting on social media like TikTok and Reddit. Y'all, please stop ordering these posted. One employee on TikTok and another employee wrote they going crazy with the adult Happy Meals. Over a video showing the number of Happy meal orders. New adult happy meals are killing me. Said one post on the McDonald's employees ire it.

We ran outta boxes the first day. We had 'em ran outta toys on the second, and on the third day we had to say, The truck doesn't come tilt tomorrow. Wrote one commenter elsewhere on the subreddit. It's been dot, dot, dot. Not fun. Another user wrote

Leading up to the launch, we prepped crew with training and resources and anticipation of higher traffic in restaurants. A McDonald's USA spokesperson told Fortune Magazine continuing to say that our restaurant crew members are the best in the business and we appreciate everything they're doing to serve the customers during this limited time promotion.

ed a hassle for the staff. In: 2017

The chaos was worsened by poor communication from McDonald's as to which restaurants were taking part in the promotion and which ones weren't. Meaning customers flock to Sourceless restaurant. The chaos happened again in 2021 when McDonald's revived.

Its Pokemon Happy Meals Complete with collectible cards to celebrate the video game franchise's 25th anniversary. Unfortunately, the promotion occurred during a bubble in the Pokemon trading card market in which cards could be flipped for 350 times return. Some restaurants were forced to restrict sales of the Pokemon Happy Meals to stop scalpers from buying up all the available Happy Meals and flipping the included trading cards on eBay.

And it's not just McDonald's. Last year a tweet from a purported Starbucks employee went viral after the worker complained about the customers adding too many modifiers to their drinks leading to other baristas complaining about similar shit. What a week ending on that article. I, I spice it up a little bit.

well you get the gist.

I find it crazy that just a little novelty, just a little novelty. So many sad, boring people that just a tiny taste of novelty is enough to create a pandemonium lines around the block. I'm sure. Just so people can get outta their boring everyday life really makes you think.

I mean, who is getting these things?

I might check 'em out.

So how have you guys been? I've been good. Pretty good. Super busy. Just living life. Grinding as always. It's a good time though. I'm, I'm enjoying my life. I'm in a cool place. This weekend I'm running the Great American, or no.

I'm running the Great Columbia Crossing. It's a 10 K race that goes from Washington across the Astoria Mega Bridge and into Oregon. I've ran it a few times now with my daughter and it's uh, it's a lot of fun. It's a little bit of fun. It's some fun. With, and you know, it'll be a good time. I'm not looking forward to it.

I'll be honest, I'll level with you guys. I don't want to do it this year. Haven't been training. I haven't really ran more than a handful of times since Hood to coast, cuz I just didn't wanna, I've been working on other stuff. I've been fixated on this new app that I got. Yeah, yeah, I'll talk about it. I, I got a new app, so I like to make music.

I like to sing, and I like to play around with software and things like that. I don't really have any real training or experience. I've always been into music, but I've never stuck with any one area long enough to, you know, actually call it a skill. But I really like to do it. This, I, I'm always on the lookout for software that makes it super easy so I can actually have fun with it.

Because what I find a lot of the time that happens is I'll be like, I really feel like making some music. be like, Oh, you know, I have a recording studio. I'll just go out there and make some music. I'll lay down some tasty licks, make a cool hot jam, you know, drop a new track. And then I get out here and I record myself singing or rapping or doing, you know, slam poetry, whatever.

And it sounds like shit. And it depresses me a lot and I'm like, Oh yeah, I forgot. I don't know how to make music. But things have changed and now there's apps that will do it for you. Do all the hard parts. The hard part being like, Mixing it, getting the volume right, figuring out what plugins work for your voice, figuring out what styles of music you like, feeling out, figuring out all that stuff.

If you just wanna like go in and you just feel like singing and you want it to kind of sound good, almost like you wanna do karaoke, get this app I'm talking about, it's called Vo Loco. I got the free trial of it, and it was a seven day free trial and I never actually tried it.

And then I the morning after the seven dates was up and I was like, Ah, I never tried that app. And now, It probably subscribed me automatically and I checked, and of course they subscribed me for a year. So I'm like, might as well check it out.

And I opened it up and it's pretty much been a blur since. You can do it with just regular headphones, like from the iPhone, little just with a mic on it. Just really simple. Or you can plug it into a professional recording studio like I have done a few times. You get a pick a beat, and then you get a pick what kind of plugins you like your voice to sound with.

Like, you can sound like a robot or you can sound much cleaner. You can turn the auto tune off, you can do it various, um, intensities, and then you just sing. And it's fun as hell. I've really, really enjoyed it. So I, uh, yeah, so I've been writing songs, I've been just playing around having fun and it's been really, really enjoyable.

And I'm, obviously, I'm not great at it. It's, it's something that's, I'm just doing it cuz I enjoy it and it's fun. But I, uh, I would love to make stuff that's actually fun to listen to and fun to consume. So when I, when I even hit for just a little portion of the song that I made, or even just a little section that I'm like, Oh wow, that actually sounded really good.

Or, you know, I get little glimmers of real music. It's exciting. I get a little rush from it. So when I'm listening to it back, it's, it's not super stressful, even though I know it, it doesn't sound professional or it doesn't. Sound probably good to most people, but it, to me it is. I'm just like, Oh , I made this, this didn't exist.

And now it exists and it's, it's kind of cool. But needless to say, it has taken up some time because that stuff sucks up a lot of time and I haven't been doing as much podcasting lately because of that. So I just follow the dopamine. You know, most of the time podcasting is exciting enough, but lately it's just been this.

Strong drive to play and play is important. I think it keeps your brain healthy, keeps your brain young, keeps it pliable. You gotta play, you gotta mix it up. You gotta feel embarrassed sometimes. That's probably the most beneficial part of singing and doing music is that like, it's very humbling.

I brought my sister over to the studio today and we just wanted to play around a little bit and record some stuff. And she likes to write and I like to write. So we both have a bunch of scrambled little bits of songs and so I figured, yeah, let's just do it. And, um, It's very hard. But we did some vocal exercises and kind of opened up and just doing that like some la la la la la la la la that kind of stuff. Kind of hard, kind of difficult just to sing and like actually let out your real voice.

With another person there. Even when I'm out here alone, it's hard for me to just like really belt it just to let it fly. It's really difficult because there, there's always that voice in the back of your head that's like, ah, what if Linda can hear you through the walls? Linda's my neighbor, and, um, things like that.

And honestly, who gives a fuck? Linda doesn't care, I don't think. It's just, uh, you know, that small voice that tells you you're not good enough tells you what if people laugh at you just for wanting to do something artistic and creative. Uh, but I don't care. I, I gotta, I mean, you gotta get over that. We only get to do, we only have so many years to do stuff

we're humans. We're supposed to make stuff and do stuff and have fun and, you know, sometimes fail and sometimes suck at things That's.

yeah, it's been fun. But if you're the kind of person who likes to make music, but you're not very good at making music, check out voco. It's an app. It's on the app store, I think. Yeah. Seven day free trial. It's 50 bucks a year after that.

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[: 00:15:23

I would like to extend my condolences to the victims of Hurricane Ian. God, just looking at the records from that is so depressing. My heart goes out to you. If you or any of your loved ones where in Florida or any of the areas that got hit, that's so, so awful. The world is a rough place right now.

It's really easy to get down and get depressed about it. It's discouraging, but I think that there's a lot of us who are trying to see the bright side and there's always a bright side. Just gotta look for it.

Horrible protests and violence over in Iran. Sparked by the death of a young woman who was killed by the morality police for not dressing properly. I'm not even sure exactly what she didn't have on or did. I don't know what she did, but she didn't deserve to die, and I think a lot of Iranians believe the same thing.

So they have taken to the streets and there's a lot of violence and death and destruction is terrible. Their internet was cut off it. It's a bad situation. A hurricane in Florida flooding all over the Middle East. It's rough. It's starting to feel very apocalyptic, so don't add to the negativity. Don't add to the hardships.

Try not to ruin anyone's day tomorrow.

I know that's not always easy, but I think we just need to spread. Love this. I just, That's what I'm gonna try to. I love you guys. I'm glad you're here. Thank you for listening. I really do appreciate it. Oh yeah. One more thing before we go. This podcast is full of really great information and great opinions and commentary on women's health and birthing and all that. So if you know anybody who could benefit from that information, send them this podcast. I know I would appreciate it and I bet they would too. Thanks. Enjoy the show. So without further ado, please enjoy this lovely podcast with the knowledgeable and highly talented Rebeckah Orton.

[: 00:00:00

My husband is a musician, so he records.

[: 00:00:08

[00:00:09] Rebeckah Orton: for that. His, uh, his setup isn't as nice. We, we've we're upgrading things slowly but surely. So yeah, it's got some stuff that's really good and some stuff that's,

[: 00:00:20

[00:00:37] Rebeckah Orton: Do I have a cough

[: 00:00:37

[00:00:57] Rebeckah Orton: Oh, I appreciate you asking. Um,

[: 00:01:01

[00:01:04] Rebeckah Orton: But yeah, we might wanna steer away from staffing.

[: 00:01:07

You can ask me now. No, I'm, I'm record. I'm just joking. It's okay. Um, alright. I'm

[: 00:01:14

[00:01:16] Jeff Nesbitt: That's the stuff I'm, I'm pretty interested

[: 00:01:18

[00:01:23] Jeff Nesbitt: little, I almost never ask about specific people.

Um, cuz I can never remember people's names anyway. Um, fair enough. I I'm more about like what it is they're doing, what's exciting. Pretty much. I like to capture people passionate about stuff. So if you, if you have certain ideas that you really like or, uh, something that's been really successful or really unsuccessful, just things that are, that you're passionate about and that you like to talk about, it can be something as like small and unimportant as like the way you like your fruit.

To be, you know, put in the bowl versus I feel

[: 00:01:54

It's about the passion. It's about the passion. Yeah. Yeah. No, I get that. I feel that way about babies and women, so.

[: 00:02:12

[00:02:17] Rebeckah Orton: Cool. And should I wear this

[: 00:02:20

Um, if you're not going to, would you put a sh put 'em on the floor? So don't we don't get feedback. Yeah. Or even just unplug them. That's fine. Just pull that. Oh wait. Nevermind. I taped it up. You're good. Just pop him on the floor. Perfect. Yeah. Okay. Thank you.

So first of all, welcome to Ramble by the River. It's really an honor to have you here. Um, your birthing center recently delivered my nephew Nash Nash, Nashville. Yeah. Yeah. And they had very nice things to say about that whole place. Thank you. It's nice to have you here. Thank you. So, you wanna introduce yourself and tell us a little bit about who you are.

Uh,

[: 00:03:01

And I became really surprised by that. When you grow up with it, you're just kind of used to like, that's the way it is. Um, and then living around different places, I, I realized there was a bit of a deficiency in choices. And so my husband Where did you grow up? Oh, here in Astoria. Oh, okay. Sorry. Not here.

We're in. Yeah. Anyway. I grew up in Estor.

[: 00:03:45

[00:03:49] Rebeckah Orton: not until

[: 00:03:49

[00:03:55] Rebeckah Orton: page. Yeah. , so yeah, I grew up in Astoria.

Um, I mean, the population there hasn't increased in like a hundred years. And so there's a lot of routine, a lot of, you know, same old, same old, and it's a lovely place to grow up, but you don't realize how much more there is in the world until you leave and see it. And so, um, I was studying biology in, uh, in university in Idaho and was wanting to study high risk obstetrics.

Actually, that was kind of my primary goal. I really liked the idea of helping women and babies and, and, uh, knew that we had a problem at large in the United States with maternal health and infant health, and I wanted to be part of that solution. And, about senior year, uh, felt kind of this draw, to something else I know, like Right, right track, wrong destination or something like that.

Um, and I was studying for the MCATs and I just felt kind of wrong about. That particular path. And so I was looking at the grad schools I was applying to, and , I noticed the term for the first time in my life, nurse midwifery. And as something kind of in the back of my brain kind of woke up and said, You need to look into this more.

And then I learned what a nurse midwife was and I thought, Oh, that's the thing I wanna do. Cool. Uh, yeah. And so that's kinda what started the whole, the entire line of questioning about birth, about women's health, about all of the perinatal data, and then ultimately to my hometown. So.

[: 00:05:22

[00:05:25] Rebeckah Orton: Uh, so a nurse midwife starts out as an rn, so registered nurse, every nurse you've ever met. Um, and then they go on to an advanced degree of education and certification. So they have a master's degree or higher. before long it's probably gonna be required that all of them have a doctorate level. , and they're specifically trained in midwifery.

So just like you have a doctor who may specialize in obstetrics or family practice or psychology, nurses can then go on to specialize in that way too. So it's a nurse who specializes in midwifery

[: 00:05:53

The standard medical system, Is it a or is it just another part of it? That's a loaded

[: 00:06:14

[00:06:21] Jeff Nesbitt: rambling. Yeah. I need one little adjustment on, on your mic. Yeah.

Sure. Is that good? Yeah. And if you wanna lean, just lean a little bit over it so that you're almost talking across. That's how it works really. I like to use some like that. Perfect. Yeah. Okay. Yeah. Beautiful. . All right, go ahead. Okay, so the, the unloading of that was forms the ugly question. I wasn't exactly sure what I was trying to

[: 00:06:39

It's not a bad question people ask all the time, so it not weird.

[: 00:06:43

[00:06:53] Rebeckah Orton: the crunchy choice.

Yeah, yeah. Choice of hippies everywhere. Exactly. Uh, yeah. So we're totally associated with that. Um, so let me define midwifery for you cuz I, I think that that will help because there is a, a pretty market difference between midwifery and western obstetrics. Okay. So midwifery is the world standard of maternal healthcare through like, since there have been women having babies, there have been midwives to catch them.

, and the, the word midwife means with woman. and it. It refers to this traditional model of treating birth as a normal physiologic process. It's not a pathology. Usually just like driving a car doesn't usually result in an accident. Um, and if you follow the rules and wear your seatbelt and don't drink driving during the daytime, things like that will really greatly.

It's, it's very difficult to get into an accident, In fact, and midwives view birth much more like that, just as like any other thing that a human might do. Um, now they're trained medical professionals and there's all different kinds of midwives. There's um, and I won't even go into like how many different kinds there are cuz there's traditional midwives that have no formal education, um, not gonna delve into that.

then there's midwives who, uh, have like a bachelor's degree in midwife. From a specific, like midwives, College of Utah is a popular one, and then there's, uh, midwives who have a master's degree in midwifery. And so that's all they've ever studied is, is midwifery. , and then there are nurse midwives who study nursing and midwifery.

it's the, the highest level of education that you can have as a midwife. , then they can go on to have like a doctorate in this as

[: 00:08:29

[00:08:38] Rebeckah Orton: Yes. Several. Okay. There, there are many different ones. , but the thing that midwives, whether direct entry or nurse midwives have in common is that, , the, the primacy of the client's needs that, , the woman is central to that care and the woman is viewed as normal and uncomplicated unless. It's like an innocent until proven guilty.

So no need to start in the hospital, no need to start in the hospital, in, unless there's a problem. Now, we love hospitals. We don't have anything against them. my kids were born in hospitals because that's what I needed. , so I, I have a great deal of respect for our colleagues who are obstetricians and who do study that higher level of risk and are trained to intervene and train to perform life saving surgeries.

this is just a separate field, so occasionally we do need obstetricians. But, if you look all over the world in the places that have the best outcomes, uh, the, the common thread like the Netherland, Sweden, Japan, Italy, all the places that have like top world outcomes for maternal and infant mortality, they all see midwives first.

And then if you need an obstetrician, then certainly you get um,

[: 00:09:39

[00:09:50] Rebeckah Orton: list.

No, it's at the bottom of the list. That's pretty there. Some unsettling. Yes. Uh, and, and I don't know an obstetrician who would disagree, they say part

[: 00:09:58

[00:10:08] Rebeckah Orton: uh, for me was kind of a personal choice.

When I, I realized that there was a problem. I knew that a long time ago. Uh, but how I wanted to be involved in this solution is what changed for me. , because I could see on the one hand intervening and being that person to perform these life saving procedures and the C-sections and the, the neonatal care, , when babies aren't doing well.

, and the more I learned about midwifery, the more I realized that that's very much in prevention. , , midwives have far better outcomes when you're just comparing apples to apples. Low risk women to low risk women, uh, fewer of them that start with midwives have C-sections. Fewer of them have preterm births, fewer of them die.

, and now that it, that doesn't mean that if you go to an obstetrician that you're gonna have like these poor outcomes. That's not what I'm saying. And I wanna be careful that that's just D tools, Right. But it's different tools. And when I realized how much data there was that like, if we are spending more time with women prenatally, it is not like a.

It is not a complicated model of care, but if you're spending more time with women and getting to know them, , really on all the levels and asking questions, not just like a wait and a measure and you're out the door, but like, how is your life? How is your stress? How is your love life? Are you safe at home?

What are you eating? What are all of these things? They're small factors, but they do affect a pregnancy and all of them collectively have a large effect.

[: 00:11:27

[00:11:33] Rebeckah Orton: like any doctor, right? Yeah.

Yeah. But it's, it's not tenable financially to spend an hour with each client. Yeah. They don't

[: 00:11:39

[00:11:43] Rebeckah Orton: a tremendous emotional investment and I understand. Why many people choose not

[: 00:11:49

If you got 30 minutes to talk with your patient, you're, you're probably not asking about how their relationship with their mother is. Mm-hmm. Like the things that might be stressing them out at work. Like it's just not part of the model, but it affects their health.

[: 00:12:04

Really know a lot of doctors who don't wish to have that conversation, but there's a system currently in place that doesn't really allow for it.

[: 00:12:14

Yeah, I do notice that it would be, if I was really rich, I would hire a personal doctor. Ask me those questions and you know, but

[: 00:12:31

Um, they're not the people that are at the highest risk of the poorest outcomes. The highest risk of the poorest outcomes are people who are black, people who are brown, people who are, um, queer people who, uh, have a history of drug abuse or homelessness or poor socioeconomic standing. , and those are the people who can afford the very least to do what you were just talking about.

Yeah. Is to have that. Conversation and to be able to be connected to all of these other resources and have someone truly know them. And that's one of the things that makes me so passionate about midwifery is that, , we work really closely with both Oregon and Washington Medicaid with the, uh, state health so that we can have this equalizing effect where we can have those conversations, not just with like wealthy white chicks, by the way, are fine and also deserve those conversations, but with everybody and it becomes a social justice issue as well in what

[: 00:13:38

That's great. That's good to be thinking about those issues. Uh, do you, in your personal life, since you know the stuff, do you keep better track of like your own health metrics and do take extra care or, I imagine you're pretty busy .

[: 00:13:51

And I am aware of, I think maybe more aware of them than I would've been otherwise. But I did I stress you out more? That I put myself off sometimes. Yeah. I mean, I talk to my therapist when, about it. When you think about, Yeah. Uh, it doesn't stress me out that I put it off, but I am aware of those things and I do try to prioritize them, , because there's a, you, you can't pour from an empty cup, and so yeah.

I, I see a therapist, I go to a doctor. That helps. But if it's between choosing me and choosing a client, like admittedly, I'm gonna choose the

[: 00:14:28

[00:14:37] Rebeckah Orton: Uh, four, seven, and 10.

Whew.

[: 00:14:39

[00:14:52] Rebeckah Orton: all of. I don't, Well, that's what everybody says.

[: 00:14:56

[00:14:58] Rebeckah Orton: That seems to be recurring theme right now. I don't know if it's pandemic related, that everyone's just sort of in like struggle bus mode right now. Yeah. , but, but truly so my husband that we haven't talked much about, we've been married for 14 years and congratulations. Thank you. I feel like anymore that is an accomplishment, isn't it?

That's a long time. Um, he's fantastic and everything that we've decided to do, we've decided to do together. So is he

[: 00:15:22

[00:15:24] Rebeckah Orton: his job and is a stay-at-home dad, so I would say yes. Wow. Yeah. Yeah. And um, that it's been a huge transition cuz I've historically always been the stay-at-home parent until the last two years.

And so we had like a full on role reversal, but coming home until the end of the day and I'm tired and he's like, he's the one who makes dinner. He's the one who's getting the kids ready for bed and all the school stuff. , And then what's really telling about why this works is that it's like nine or 10 at night.

I'm exhausted. He's tired. We just got the kids to bed. We're sitting down to like Netflix and chilling. My phone rings and a client's in labor. Oh, and, but what, what I think says volumes about him is he's like, I love you. I'll see you soon.

[: 00:16:07

[00:16:07] Rebeckah Orton: you ever relax? Well, I do. I find time. That would be so hard, but, But it, A guy is so hard on a marriage.

Noble, but he, I've never gotten anything other than total support from him. I love you. I'll see you soon, or I'll see you eventually. He says a lot. Yeah. Because it could be a couple days sometimes.

[: 00:16:24

Or are you the kind of person who can compartmentalize and block it off and go about

[: 00:16:39

Mm-hmm. about it because I felt guilty about like not being the stay-at-home mom. And I felt guilty about, you know, missing my kids' bedtime and guilty about being gone sometimes for days on end. Um, but he said, This is our dream. This is a thing we want to do. And so it's good. That's

[: 00:17:12

Take

[: 00:17:17

Yeah, I bet. Available 24 hours a day, you know, for any amount of time is hard when you never know when your phone's gonna ring or what it's gonna be. Um, and I think that burnouts a big deal. Mm-hmm. .

[: 00:17:47

Oh, you're not a midwife? You're, No, you're just in

[: 00:17:56

[00:18:08] Jeff Nesbitt: person. Sure, Yeah.

Primarily like scientist. I'm just

[: 00:18:11

Have a bunch of kids. Zero stars would not recommend . Don't

[: 00:18:34

[00:18:40] Rebeckah Orton: perpetually curious person. Mm-hmm. But I've known I wanted to do midwifery and, and nursing was required and says like, Okay, this is, I'm ready to take the next step, which is what nursing school was for me.

It was just the next step that you, A camera and a goal. Yeah. Wow. But it's very, You maybe I picked like too many ad ones.

[: 00:18:56

[00:18:58] Rebeckah Orton: the thing. Yeah. And

[: 00:18:59

They are gonna grow at the same rate regardless.

[: 00:19:09

I, I worked there kind of before, um, in an administrative capacity and I would work as a doula. So it just help as a support person during

[: 00:19:31

[00:19:35] Rebeckah Orton: is a doula compared to midwife? Totally non-medical person. Um, but that's a normal question. People confuse that all the time.

, a doula, like if I had to use like two words like birth coach, , they're trained in birth, they're trained in support, like all the deep breathing and the positioning and the relaxation and the advocacy and things like that. Doulas are good at, and , also huge statistical benefit to have one. . And when I was first looking at going back to school to become a midwife, most of them want a doula experience.

And I was like, Well, what's a doula? And so then I, I went through the training and worked in Seattle for a while as a doula. That's when I started to see that really big disparity, like we were talking about that , the people who benefit most from having one, have the least amount of access to them.

Yeah. And so that's what drew us back to Oregon was that Oregon Health Plan covered doulas. And I was like, Oh, perfect. Then I can, I can serve like my key demographic mm-hmm. , um, and provide the most amount of, , support where the most amount of support is needed.

[: 00:20:29

Maybe they're on the other side, uh, doing more coaching and the partners just kind of like trying not to get in the way?

[: 00:20:40

Mm-hmm. . And so doula should make them look really good. Yeah. I

[: 00:20:52

They act like they don't do much. How involved are do in general, how involved do you see the dads being in the whole process? Do you encourage 'em to, to get in there and, and be a whole part of it?

[: 00:21:18

, and so I know there's a lot that I haven't seen. Um, but as a doula, part of my job is to support dads. And so I see really, really active, involved dads and partners. , but then that's also like kind of conent to like, My role there. And so I can't say what a usual person that doesn't have a doula do.

Cause I don't know. Yeah. Um, but then also at the birth center we see that a lot, very, very involved partners who are there, you know, doing the hip squeezes and getting the cold rags and talking 'em through it. Doulas still help in that way, but it's, it, it's more like, Hey, try, try putting your hands here.

Try, let's try this position. Let's go here and, um, go. That would be really helpful. Yeah. Yeah. Like birth

[: 00:22:09

[00:22:15] Rebeckah Orton: Yeah. And so, no, they don't replace partners. Yes, they do support them. Um, and I think that's like an important distinction to make because.

Doula, first of all is like a terrible word. And I, Where does it come from? It's Greek. Okay. It means woman's slave. Oh, well that's not great. It's not, um, it problematic and it's been sort of, uh, changed I guess culturally and, and now people say like it means a woman who serves, uh, but a doula doesn't need to be a woman.

and is certainly not a slave, certainly not a servant, but, , but a helper. Mm-hmm. . And, uh, I, I'd like to think of it more like a concierge. Um, do you know of any male doulas? Yes, I do. Not very many. What about midwives? I know too male midwives. Yeah. Also, is that common? No, but they do exist and um, people say, Should it be a mid husband?

And the answer is no, because it, the word means with woman and a man can be with a woman too. Yeah.

[: 00:23:09

I'm a man who carries a purse. I'm okay with it. I appreciate that. Yeah. Yeah. But that's neither here nor there. Um, let me get to my questions because I don't wanna get too far in without actually asking you. But,

[: 00:23:30

No, it's fantastic.

[: 00:23:33

So our nation seems to be facing kind of a difficult time culturally with birth and women's rights in general. Mm-hmm. , uh, what do you think are the most important things for young people to be aware of in that regard?

Pretend I'm just an idiot man, who knows very little about women's rights. See if we can get there and then, uh, teach me some stuff. I'm

[: 00:23:55

[00:24:04] Jeff Nesbitt: am.

Okay. And I, I have daughters. I have a mom, I have a wife. But still, it's, I don't think a lot of men are in that mind state a lot where you're thinking about how could I help? How could I be part of the solution? So yeah, educate me. I'm ready.

[: 00:24:17

And I, I think the, the thought experiment that I would invite anyone to participate in, especially men, is how would I want to be treated? In that situation. So the, the hot button right now is Roe v Wade that just got overturned, which was a devastating blow to women's rights. This is not a question of whether or not a woman should have an abortion.

At all. The question is who gets to pick? Who gets to make that choice? So imagine whoever you are that you are pregnant and, and it's really easy to imagine wanting that baby cuz you have kids. And kids are awesome and we all agree that like babies are amazing and babies are our future.

Um, but imagine not being able to choose to become pregnant. Someone got you pregnant, let's say, against your will. You went to the cops or maybe you were afraid and you couldn't go. Because you wouldn't be viewed as a man. You would be viewed as like, Oh, I shouldn't have made that choice then this is your fault.

That's problem number one. And imagine that, you don't have a choice. You didn't get to choose to be pregnant. You don't get to choose to stay pregnant. Imagine that you find out that if you stay pregnant, you'll die, or that your baby will die. You don't get to pick anymore. , and how does that feel?

[: 00:26:02

[00:26:04] Rebeckah Orton: Yeah. It's, And I've, I've never been personally even in that situation, and it feels uncomfortable for me. and then imagine, , looking at your own body, your, your hands, your feet, your eyes, your hair, , and saying, you know, I wanna change something. I want a tattoo. I want surgery.

I want. Any number of things and having to go through someone else before you can make that

[: 00:26:26

[00:26:30] Rebeckah Orton: or not having the option altogether. Um, until very recently, women had to have the permission of their husbands to get a tool or to take birth control. imagine not having access to birth control, um, having a partner, it's called stealthing, where they take off their con and don't tell you, geez, it's a thing that's

[: 00:26:53

Uh, what would the context for that be,

[: 00:26:58

[00:27:05] Jeff Nesbitt: Oh, well, most certainly does. But that, I mean, like, what? I can't imagine a situation where it would be more convenient. Sneakily get somebody pregnant. I, I feel like that would be a light.

That's not

[: 00:27:16

[00:27:21] Jeff Nesbitt: ch a piece of human garbage.

[: 00:27:22

[00:27:25] Jeff Nesbitt: Don't, I don't care if I get you pregnant or, or give you std.

[: 00:27:28

The outcome of that is now your responsibility. Yeah. And so then you have to sit with that and you have to do what is legal or maybe not.

[: 00:27:43

[00:27:44] Rebeckah Orton: The full weight of that rests on women. Men can get women pregnant and walk away. Women cannot get pregnant and walk away.

[: 00:27:55

It this is the wrong decision to, to block women's rights. Certainly it's the wrong decision to block anybody's human rights. Mm-hmm. , can you. Play the devil's advocate and help me understand how, what, what is the argument that they're making? How did they get this to be approved? How is this even possible?

What mm-hmm. , what are the benefits that they're claiming By repealing this, I would also

[: 00:28:23

[00:28:36] Jeff Nesbitt: for example, seen is religious.

All I've seen is about protecting babies or, or, you know, some kind of puritanical Bs. But, Oh yeah.

[: 00:28:45

[00:28:47] Jeff Nesbitt: to, doesn't Yeah, absolutely. Please tear

[: 00:28:49

[00:29:02] Jeff Nesbitt: is definitely, I mean that's said so much, but it, it's not logical.

[: 00:29:08

Insofar as we are able to do that, we will guarantee the responsibility of the person who got them pregnant for 18 years, no exceptions.

[: 00:29:41

We're not, we're not for spending a bunch of money.

[: 00:29:56

So, midwifery is relatively inexpensive. Midwives are cheaper to produce than doctors. They're make a little bit less than doctors sometimes, a lot less than doctors, , to be able to provide this type of care that improves outcomes.

[: 00:30:27

[00:30:32] Rebeckah Orton: classes or, Well, doctor has to go to medical school.

You have four years after your bachelor's degree, so you're eight years just a start. And then you have your specialty. So sometimes they're, you know, they're 10, 12, or more years deep in medical education after a bachelor's degree. It takes two or three years to become a nurse midwife. So, So it's just more, it's less education.

Yeah. And it is very specific. It doesn't mean they're less qualified to deliver a baby. , but it's very, very specific.

[: 00:30:59

[00:31:07] Rebeckah Orton: I mean, there's an argument for it and, and there's an argument that people who are going through so much education should be using that education to intervene in the highest risk cases where that knowledge will be the most effective.

Um, but that's not my argument

[: 00:31:20

[00:31:26] Rebeckah Orton: exactly, Yes. Thank you for saying that. It, it's,

[: 00:31:29

[00:31:33] Rebeckah Orton: in Yeah. Like maybe like a dentist and an orthodontist.

Oh, perfect example. Or, or a dentist in an endodontist. Would be like a, what's an endodontist do? Like the person who does the root canals, who does like oral surgery. Yeah. I worked with one of them. And you don't necessarily need to go to the oral surgeon if you need your teeth cleaned. Mm-hmm. , right? Yeah.

And I think that's similar. And like you don't see the dentist in the endodontist, like in fighting and like having a market share issue. Mm-hmm. . Um, but that is very much prevalent in the obstetric and midwifery world, but, um, back to like the women and babies and, um, how it would be so costly. And the funny thing is, is, um, I suspect, based on what I've seen, that it would save a tremendous amount of money.

So the abortion rate would go down undoubtedly if we just supported women being pregnant and made it so it wasn't so disastrous.

[: 00:32:21

[00:32:22] Rebeckah Orton: burden. It's a tremendous burden. It's a, it's a huge burden on our bodies. Um, one I was happy to have, but like I wouldn't force somebody to, um, it's a huge burden on our finances.

Babies are expensive. We don't have, there's no guaranteed maternity leave in the United States, whereas other countries, you have up to two years, some in some places of paid maternity leave, which makes sense. Yeah, it'd be useful. Um, but then that money all exists. It's just where are we putting it? Um, and so we say, yeah, it, we would say that it would be like really expensive to provide maternity leave, but what's more expensive?

That, or the fact that the number one cause of, , perinatal mortality is suicide. Oh, that's sad. . I mean, you just, That's that's a true fact, huh uh, hemorrhage and suicide. Wow. Yeah. Last I checked they were their neck

[: 00:33:09

[00:33:11] Rebeckah Orton: uhhuh. Oh yeah. Yeah. Most partum hemorrhage and, uh, suicide are main causes of, of, uh, postpartum death.

[: 00:33:18

[00:33:26] Rebeckah Orton: Yeah, but it's, it's what's more expensive to you? , there are certain societies in the world where they have really high tax, right. And we sort of bulk say how, how can you do that?

But then, uh, and I had the opportunity to ask somebody when I was traveling abroad, and he's like, Oh, you must be an American. They always ask about our tax rate cuz it's like 50% here. And, um, Where, where we were, we were in Denmark, and, and he said, um, the thing that you guys don't understand is that we are not okay with having people be homeless.

We're not okay with, women not having healthcare. We want everyone to have healthcare. We, we feel like that's a basic human right. And in the US you guys are all okay with that. You're okay. If you can't afford it, then you don't deserve to have it. And we just disagree.

[: 00:34:08

It's, it's cause, I mean, if you picture the pyramid, the base of the pyramid is, is gonna always be larger than the point with this many people. I don't know. How many are you in this country? 350. Three 50 million or so? Yeah. That's a lot of people at the. Like it's Denmark. They're known as one of the happiest countries on the planet.

Right. And maybe they don't mind so much to pay 50% of their income because all their needs

[: 00:34:33

[00:34:47] Jeff Nesbitt: the bottom 50% stop halfway through that list they cannot

[: 00:34:51

Right. Cause you can't afford the rest of it. Yeah, sure. And then in Denmark, you start with $20 an hour and you bring home 10, but then you keep 10 and then the rest of those things are covered for the common good. Everyone gets healthcare. Yeah. It doesn't matter if you're poor, it doesn't matter if you're black.

That would just great. Get the same healthcare that anyone gets. And I think that's totally doable here. Yeah. Do

[: 00:35:11

[00:35:14] Rebeckah Orton: A hundred. I do, I, it, it, it will not be without tremendous hurdles, but I do think that it's very feasible and I think that we will see an overall reduction in cost when people are not afraid of getting healthcare, putting off their healthcare, rationing it, and then ultimately using an emergency room, like a primary care facility.

[: 00:35:31

Like to, for me to go to the doctor when I'm not really sick or really injured, it is almost impossible. I like, The idea of it just seems crazy. Like, but I know that you're, you should, you should go to the doctor periodically, regardless of how you're feeling. Mm-hmm. just to make sure everything's all moving Right.

Everything's good.

[: 00:36:04

[00:36:11] Jeff Nesbitt: make sure, and I do do that because I work with chemicals, so I wanna make sure I'm blood clear, but, uh Oh, good. But yeah, no, I, I think that we do have the whole, the whole country has a cultural ideology about health.

That's, that's not healthy.

[: 00:36:25

[00:36:50] Jeff Nesbitt: Well in the, right now in this country, there's a lot of really poor people. I don't, It seems like the divide has grown a lot in the last five years. Yeah. The, and again, I don't know what I'm talking about. I'm just one person. I'm just taking from what I see in media sources, but it seems like the problems are accelerating, not, not slowing down.

Mm-hmm. , we're gonna need to do several mass overhauls, like you said about obstacles. Like there's gonna be obstacles to improving the healthcare system. We we're gonna have obstacles either way, like it's either gonna collapse or, or it's gonna have to be fixed. So either way, there's some major obstacles ahead.

I think the same thing is happening in education. Yeah. And, and honestly, a lot of institutions like the, just the general family, like people, it's. I, I feel like our, the cultural establishments in America are very flimsy all of a sudden. Mm-hmm. and I don't really know how to fix it, but I don't know. I think honestly, just talking about it is helpful.

Yeah. It just help people organize ideas and figure out like a consensus. Cuz that's how we understand reality through consensus. And when everybody's living in an echo chamber online, it's hard to establish a consensus reality of like what exactly is going on out there.

[: 00:38:00

What problem am I gonna tackle? What thing am I gonna fix? What contribution will I have to society? And, and, and you kind of hit it that like we're seeing, and I think it was very, very magnified over the course of this pandemic, how many systems that maybe did work, don't work anymore, how much dysfunction we have and In, in midwifery, bringing it back to that, , that is my contribution.

That is the hill I will die on because it is one thing, but it starts. It, it's not just the start of life. It's not just about this baby. It's about a family unit. And if we're giving more respect, more support, more time to the single family unit, regardless of its presentation. Yeah. Um, and say, we'll meet you where you're at.

We'll assess your needs and say, Okay, I can see you have some food insecurity here. Let's connect you with this resource. Let's get you up and running. I can see that you were both raised, or maybe one of you was raised in a dysfunctional family. Let's talk about that. Let's talk about how we can interrupt this cycle of abuse.

Let's talk about how we can give your kid better than what you had and why it's okay to do that. midwives wear a lot of hats Sometimes. We're like, it feels very therapy heavy sometimes. Yeah, it sounds like it. It, it can be. but that is what it is to be with a person. With the woman, with the family, with the baby.

Um, and so I don't view it as just like evidence-based, you know, obstetric model, an evidence-based maternal care model. It's like a family model. You're

[: 00:39:41

[00:39:43] Rebeckah Orton: Yeah. And, and the family is the fundamental unit of society. And we tell that to a lot of our clients. Like, you're the most important people.

Yeah. There's not a doctor or a lawyer or a legislator who is more important than a single family unit. And then to answer your question about young people, that's it. Family is the most important thing to our society. If our healthy families exist, there will be a trickle up from there. So what we need from young people, what we need from legislators is support to make a family possible.

[: 00:40:13

So I was, I was like, Eh, do I even wanna say that? , but it's true. I think the family really is a fundamental unit of society. It's what everything else is built on. And it doesn't matter to me if it's two guys, two girls, guy and a girl, whatever, two adults that can support each other and, and provide support and help to grow a group of kids.

That's a family. Mm-hmm. , that's what

[: 00:41:03

[00:41:08] Jeff Nesbitt: They're, it's fostering up the next

[: 00:41:09

Like we're, we're seeing this lack of sustainability at large. Yeah.

[: 00:41:27

[00:41:38] Rebeckah Orton: Oh, well, I mean, you can't start something like that and then not finish it.

So let's have it there. There is

[: 00:41:42

I don't face a lot of, of the institutional racism or , the major problems with race and ethnicity that our country faces on a daily basis and people in minority groups are dealing with as an everyday of their life. I don't see a whole lot of that in my everyday life, but I know it's there.

Do you come across that in, in your profession? Are, are you seeing like, issues with race? Does that come into play?

[: 00:42:26

, uh, that problem comes up disproportionately with our, uh, community members who are, uh, from like in the, the Latin population.

[: 00:43:16

[00:43:21] Rebeckah Orton: And so I, I see that a lot, the lack of access to care. , Because of those barriers.

[: 00:43:26

Right. So yeah, there are, there are ways that we could structure society that would definitely improve that

[: 00:43:51

[00:43:54] Jeff Nesbitt: Yeah. You just gotta do it. Yeah. But you gotta know about it. You gotta understand the problem, and you have to be in a position of power to do that. So coordinating all those things, I think is the hard part.

And that's just what takes so much time. Mm-hmm. , it's a, it's a slow process. Yeah. And, that can be pretty frustrating, I think to a lot of people. That's feels like no progress and that's where people get negative.

[: 00:44:15

It's a very small rudder and it's done by degrees, slowly, steadily, and then progress is made. And so, , I've been really pleased in working with like Oregon Health Plan, um, working with people on the state level and the Oregon Health Authority because they have been listening. And I'll say, Hey, you know, we have this rule.

Why do we have this rule? This, this rule doesn't make sense with, you know, and then the rule goes away, or the rule is modified. And, and sometimes it does feel like death by committee, but, um, but progress has been made in order to do this and, and for younger people and really anyone wanting to be involved.

I think people undervalue how much progress one person can make when they're committed to that process. It's a lot of work and we like to see instant gratification and instant results, but just not how, That's not how the

[: 00:45:16

[00:45:19] Rebeckah Orton: set up that way. And sometimes it's good that it's that way.

Sometimes it's really aggravating that it's that way. Yeah. But the fact is that like you are a person who doesn't have a uterus, but you do have a position of maybe greater authority than someone who does just by what you were born into. It's not your fault. Um, but to use that power and to use that voice and say, I don't think that somebody who was born with different genetics than me should have different rights than me.

[: 00:45:45

And to do that, you have to assume their experiences. You have to take on whatever factors are influencing their behavior. But that's hard. It is hard, but the only way to do that accurately is to assume that we're all just people. They are just a drop of consciousness , in a body that had that set of experiences in that environment.

And this is the result. The behavior is the coalescence of all those factors. Mm-hmm. . So if that were you, you'd be doing the same thing. It's, it's just. The way it is. Like we are all just basically the same thing. Uh, people like to just create separation. Oh, they're different. I wouldn't do that, but you probably would if, if you were in that position with the same experiences, you'd probably do the same thing.

Yeah. So when I'm in that position, I'm like, Oh, well then we should all probably treat each other equal. That's a no brainer. Well, it

[: 00:46:53

So you would think, or one might think that a person who is pregnant can choose where to have her baby and with whom to have her baby. I would hope you would. I would. Um, but if you are, let's say, dependent on state. Um, if you actually, let's back up. Let's say you have a private entrance. So you have like regions, okay.

Region says, Okay, have your baby and we'll pay for your baby. Just make sure your provider's in network or you know, whatever. Um, and sometimes they ask for medical records to review things, but that's like pretty standard that once in a while you do an audit to make sure you're not being defrauded. It's a good business practice.

Um, Medicaid, uh, said we get to pick and so then we have this control of access for our most vulnerable population. Medicaid says, Okay, you can have a baby out of a hospital with a midwife at home or in a birth center, but we get to pick whether that's okay, case to case, Uhhuh case by case. We have to, um, go through a tremendous amount of administrative time to submit what's called a prior authorization to, uh, state Medicaid by a certain number of weeks, um, which was determined.

I don't know what happens between before that day and after that day with a pregnancy. That makes one okay. And one not. But, um, you have to submit a prior authorization with full medical records to have a, a small group of people review those and say, We think this person should have a baby out of the hospital doctors.

Or they shouldn't. No. What are they? Um, RNs, I think.

[: 00:48:38

[00:48:40] Rebeckah Orton: labor delivery. Rn, uh, not people who ha have a, a great command of midwifery or out of hospital birth or even women's health. Mm-hmm. . But I, I think largely RNs, if I, if I had to venture, I guess, I think most of them are.

Um, and then they can say, Well, we don't like this risk. And so it's not your choice to assume that risk. It's our choice. And, and then the counterargument when we say, Aren't you restricting their options? And they say No, they can still choose to have an out of hospital birth. We just won't pay for

it.

[: 00:49:11

[00:49:15] Rebeckah Orton: Uhhuh . So I disagree. I

[: 00:49:17

[00:49:23] Rebeckah Orton: all. Poor systems, I would say cuz even the people, these choices. I have some, uh, a lot of respect for the people making those choices because they're just subject to whatever rules are in existence.

It's the rules I have a problem with. That's a

[: 00:49:37

[00:49:37] Rebeckah Orton: to make because even in insurance companies, I, I have endless conversations with people in private insurance say, Hey, what about this thing? What about that thing? And like, I get the big heavy sigh from the other end and like, we know it sucks.

Yeah.

[: 00:49:48

[00:49:49] Rebeckah Orton: They're the ones who have to deal with, I mean, they have to feed their families too. Yeah. They have to have a job. And so I, I do feel like it's an important distinction that it's not the people, it's the system. Just reading

[: 00:49:57

How, why did I sign this? Mm-hmm. like, it, they didn't give me any benefits. I'm gonna, This is the deal. You send us $250 a month and we do nothing. That's the deal. . Yeah. Best case scenario because that's, if you don't get

[: 00:50:15

Um, And whether or not you, you know, see anything back. Um, so with insurance it's not exactly but akin to a Ponzi scheme that like you pay a monthly premium and then you, you pay that monthly premium to have the privilege of paying a copay. Yeah, exactly. And then a deductible. Exactly. And then co-insurance, which are all fancy way saying Yeah.

Which is all a fancy way of saying that you'd paid for the privilege of paying more. And um, and then you have like this out of pocket maximum and I see those just going up and up and up and up that I see people have like $20,000 out of pocket maximum. It's like who has that kind of money? Yeah. Why even have insurance before insurance will finally cover something at a hundred percent.

Yeah. Um, and then all these different, like, well, we'll cover this at this percent and that at that percent and also the same restriction of trade that some insurers will cover obstetrics at a very high rate, but they will cover midwifery at pennies on the dollar. Hmm. Um, which is another way that subtly a woman's choice is restricted.

Financially. She says, Well, it's cheaper for me to go here because they'll cover more, they'll cover more of my services. Um, a lot of in insurance is now because of the Affordable Care Act, they must contract with birth centers uhhuh. So thank you Obama for that. Um, but there's some ambiguous language like, well, how much do we have to contract for?

Yeah. Um, how much do we have to do? Can we make it still, you know, even though it's an insurer's benefit to pay less for like better outcomes or even to pay more for better outcomes because the outcomes are better and on the back end they're still saving money.

[: 00:51:54

[00:51:59] Rebeckah Orton: Yeah. But it's, there's more complication than that too, because we're still talking about a woman's, Right. And I,

[: 00:52:06

The, I'm sure there's good insurance companies out there. I don't know, maybe, but yeah, it's, I've had very, very bad interactions with them.

[: 00:52:27

Which is says volumes. I think

[: 00:52:37

[00:52:45] Rebeckah Orton: all private. I mean, there's Medicaid, you, if you qualify, of course you can have that. Um, there is actually, this may be interesting for you to hear.

Um, in both Oregon and Washington, there's a bill right now that's being considered by what's called the Ways and Means committee. Are you familiar with that? Mm-hmm. , um, that would, uh, allow for Medicare for. For Oregon or Washington residents. Well, that'd be cool. And those are both, um, under committee, I believe, next year.

Wow. And so we're actually closer than you might think to having that option. And I think it's gonna have to be state by state. But if Oregon can pull this off, if Washington can pull this off, then we'll become a model.

[: 00:53:21

[00:53:27] Rebeckah Orton: Um, that, that we can have this model and say, Hey, look, this is actually financially stable when we, when we. Allow people to just have access and then let people choose for themselves what they need and choose with their healthcare providers what they need rather than have a third party like constantly trying to determine what they'll approve.

What they'll deny. And you never really, like, you'd never go to the store to buy a gallon of milk and then check out without knowing how much that milk costs. Yeah. And then they tell you, this is $6,000 milk. Yeah. And then you say, Okay, yeah, sure. You would either like go put it back on the shelf or like not get it in the first place.

But healthcare is like the only place where we do that. Yeah.

[: 00:54:07

[00:54:14] Rebeckah Orton: argue endlessly.

[: 00:54:15

[00:54:24] Rebeckah Orton: very nice.

Well, imagine you're the insurer and as some provider submitted a claim to you for $10,000, if you could spend $1,000 paying someone to make it so that you don't have to pay. More than $4,000 for that claim. Uh, you're out $5,000 and you just saved yourself five. Yeah. So you wanna talk about conspiracy theories?

That's mine. I think they pay people to make it complicated so that we give up. Oh, I think so too. I quit fighting it. I don't know that I'm sure

[: 00:54:51

But the, the amount of people who are gonna be continuing to be aggressive against such a large enemy mm-hmm. for very long is it's a very small

[: 00:55:07

You can't not cover this. You are not allowed legally to deny this claim. Um, and they'll say, Well, we're denying it. And they'll say, Okay. Here's the Affordable Care Act. Please read it and then inform me of how you choose to comply with the law.

[: 00:55:36

Yeah, and cuz they don't wanna have that on recording that,

[: 00:55:47

[00:55:49] Jeff Nesbitt: they don't want to agree. Oh right. They are at fault on the recorded line like that. They, they will wait and sometimes they

[: 00:55:55

Winning, sometimes losing. But, um, if we could have this system, if we end up doing, you know, going this, this Medicare, medicaid for all. At least I would only have to argue with one entity.

[: 00:56:18

[00:56:21] Rebeckah Orton: And we could, we could be more heard in all, all midwives, all birth centers, all obstetricians, all audiologists could argue with the same.

Like we could all kind of come together and say, Hey, this is what we all collectively see needs to be fixed rather than having our attention divided, uh, betweent, different insurers mm-hmm. , um, we could all come together and have a civil conversation with one of them and greatly streamline. That

[: 00:56:46

Yeah. And you think that

[: 00:56:48

[00:56:55] Jeff Nesbitt: cool. We've spent an hour talking about the healthcare stuff. Do you have any other, uh, specific points on, on maternity or, or midwifery or healthcare that you want to talk about?

Or shall we just talk about random

[: 00:57:09

[00:57:15] Jeff Nesbitt: ImpressM, I'll circle back to

[: 00:57:16

We need to reduce those barriers. We need to increase reimbursements. Um, I have become intimately aware of, first of all, the seven year burnout. and the fact that so many birth centers and so many midwives are only open because they're owners or they're, um, the owner's usually a midwife. It's weird that I'm not a midwife and I own a birth center, but, um, the owner's usually a midwife.

They don't get paid. And the only, Yeah, why not? Because of the, the reimbursements from insurances and uh, for Medicaid and stuff are so

[: 00:58:11

[00:58:17] Rebeckah Orton: and, and the only reason they're able to maintain some semblance of a sustainability is at their own cost is because like, I I just is recently is yesterday, uh, a midwife texted and, and said, You know, the only reason we've been able to stay open is cuz I, I don't pay myself.

I don't have to pay someone else if I can do it. Geez. And, and she said, But I'm 60 years. By that

[: 00:58:42

[00:58:44] Rebeckah Orton: paid. Yeah. Um, so really small. It's like comparing McDonald's to, um, like aray coffee house or like someplace like that. You're gonna get better food at a, a man paw shop at a privately owned place.

The ingredients are gonna be local, it's gonna be better quality, it's gonna be made with more love. It's gonna be like, but a far less streamlined process. So it's more expensive to operate Astoria Coffee House than it is McDonald's. Cuz you don't have the supply chain discounts. You don't have like a huge corporation to fall back

[: 00:59:12

More expensive for them and for the consumer. Yes. Yeah. Cause it's more sacrifice on their part.

[: 00:59:17

Um, and then the, the reimbursements are so much lower, but the costs are actually higher.

[: 00:59:37

[00:59:39] Rebeckah Orton: how do they Well, it doesn't, and that's the answer. Hmm. Is it's not

[: 00:59:43

[00:59:49] Rebeckah Orton: What do we prioritize as a nation?

What's important to us? Money. Women's choices. Women's health. No, no. Babies.

[: 00:59:57

[00:59:58] Rebeckah Orton: no, no, no, no. And, and so it's just where we're willing to put money and it's not there, Dan. That's grim. It's rough. But we're fighting. Uh, we will continue to fight. This is very much my life's work. Um, and there are other people for whom this is their life work, life's work.

Um, and so, Like on we go, like we could, I, I could easily move to like the Netherlands and become a midwife there and it'd be awesome because they have a super functional system and it's like the best place in the world to have a baby. But I'm gonna stay here and I'm gonna work until we're as good.

[: 01:00:40

It,

[: 01:00:43

[01:00:46] Jeff Nesbitt: But you might make a lot of progress. Hopefully and it could

[: 01:00:48

Sounds like it. Yeah, they are. And we need to be paying them. We need to pay them at a non-live wages. Yeah. Would be, you know, really ideal. Cuz you're talking about, I could go into other reasons, but, um, I

[: 01:01:13

Who don't work and so the people who do work should get paid well. Mm-hmm. , I don't know. It seems like there's plenty to go around. It just, I don't know, It doesn't make sense to me that, that we could pay somebody under $10 an hour and expect them to live on that. Yeah. I know it's not a communist country, so it's not like when I say we, it's not all of us making these decisions together, but it kind of is cuz the economy is determined by broader systems than just like the owner of a small business who can't afford to pay his employees well because he has to pay taxes and healthcare and all this stuff.

Mm-hmm. the system's got some flaws. Yeah. Yeah. Okay. So I've been wondering,

four and a half years ago, my wife, , gave birth. Well before that though, she, her water broke. Yeah. When this happened, I happened to be standing in between her legs. Mm-hmm. , and she was sitting on the edge of the hospital bed. I was standing there like, I don't remember. We were just having a conversation, I think.

Sure. And so this, uh, the water breaks and I was looking down when it happened and it was surreal to see because I mean, you hear, you hear about it your whole life and in sitcoms they're like, it's always just like they fake it. It's, Oh, there's water on the floor. None of those jokes are real. That stuff is not water.

Sure. It's not clear. It looks like a pan. After you made poached eggs, like

[: 01:02:42

[01:02:46] Jeff Nesbitt: I was expecting it to be just like, Oh really?

[: 01:02:48

[01:02:50] Jeff Nesbitt: Really? Okay. See,

[: 01:02:52

But yeah, but, but continue. I wanna hear about your, Oh, yeah. Your pan of poached eggs.

[: 01:03:00

Like it's, this is a dream come true, even though it was also that mm-hmm. , but it was like surreal, uh, because it's just such a unique experience. And I knew that I was gonna get a vasectomy afterwards. Uh, so I was like, This is it. Soak it in, buddy. This is all only time. This is, you're gonna get to do this.

So I really tried to just be present, but I remember that being particularly startling. Another thing, No, nobody warned me about the, uh, that first poop that is like very odd color. Like that

[: 01:03:38

[01:03:39] Jeff Nesbitt: That's the stuff. , so Amelia, she's just let her rip on the way out.

So she's just swimming in this stuff and it's everywhere and it looks, I wasn't sure if I, I mean, I concluded that it was. Fecal matter of some type, but it does not look normal. And nobody warned me . They should let 'em know

[: 01:03:57

[01:04:01] Jeff Nesbitt: uh, my final thing about the, the birth process that I found the most fascinating was the placenta.

Mm-hmm. that I did know was coming, They did warn me about that. So I was ready. And when it came, um, flying outta there, it, I, I had no ex, I, I pictured it looking like a pile of ground beef or something, but it was the most beautiful thing I've ever seen. It looked like a galaxy, like all of the, the vasculature on that thing.

Every time I say this, people act like I'm a weirdo. I've said it a bunch of times, but that is an amazing organ. I can't, I cannot believe that. My wife and daughter made that kind of as a team right there on the spot. That's a cool way to think about that. Isn't that kind of the case though? It's, it's, Well, yeah.

Yeah. I mean, it's produced, I mean really all of it's produced through Melissa, but mm-hmm. The, the, the, the fetus has a lot to do as a construction of the placenta. Right.

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[01:04:59] Jeff Nesbitt: Oh, there we go. And aren't, um, aren't they just like full of stem cells and all kinds of like,

[: 01:05:04

Yeah. A lot of midwives I know call it like the tree of life cuz it has that look to, it doesn't, and it has like this Rudy, you know, bottom and it's got an

[: 01:05:14

[01:05:19] Rebeckah Orton: And like, no other time in your life do you make an organ.

That's like limited use. Yeah. And then you like that organ has a lifespan and then you're done with it and then like you have another baby and then you make another one. Yeah. Which is kind of cool. I

[: 01:05:32

Sure. Put it back in. Yeah. Why not? What do you guys do with them? What do we do with them? What do you do

[: 01:05:42

There was this guy, and we're gonna call him Placenta Todd. Um, this old guy, he would, he would come in like maybe once a week and without many words, like he'd come in, he'd be polite and they knew him there. And so they would go back into the freezer and they'd pull out this huge bag of placenta and give them to him with very little exchange of words.

And I was too, too young and too afraid to like say anything. And so, um, he would come in and get this bag up placenta and sign a piece of paper and then he'd leave and like every week, every other week something, he would do this and they're like, Oh, there's placenta Todd. And um, and then finally at the very end of my internship there, I was like, Okay, like can someone tell me what the deal is with placenta Todd?

And this older guy had apparently like one Idaho state fair many years in a row for his prize roses. Oh wow. And all he ever did was plant them with a placenta and they really hire an iron and I guess roses like a lot of iron or so I hear. Um, and so he would, that, he would plant his, these placenta's with a.

Rosebush. Wow. And then grew

[: 01:06:55

[01:06:57] Rebeckah Orton: fertilizer. Yeah. And so some people will take them home and like plant a tree with them. They're like, That's my placenta tree or my baby tree. And it was like planted to hear their baby was born. So it's all special. That is cool. Um, some people do take them home and they'll take them to like a placental encapsulated, so they'll have it dehydrated and powdered and then put it in little gel caps and they'll eat it at like, you know, consume.

So that, so crazy. Um, I mean, it's not for me, but like, and, and there's, the reason it's not for me is like there's not a lot of scientific data around it. There's like a ton of anecdotes, so people's experiencing, Oh, I just love it and it was great for this or great for that. Um, it makes sense by what's in it.

Sure. I mean, it's like high protein, high iron and stem cells, so many stem cells, like loads of stem cells and um, you know, and so people go for it, for, you know, on those.

[: 01:07:44

[01:07:48] Rebeckah Orton: they're cool to look at though after they Very cool to look at, to kind explore like that thick sort of media side that's the maternal facing side with all its vasculature and like the really thin, shiny part.

Um, that's like, Oh, this was your baby's home. Like your kid was in here. Yeah. I

[: 01:08:02

[01:08:14] Rebeckah Orton: more like an external liver.

[: 01:08:16

Yeah.

[: 01:08:18

Like, it's cool. It is really cool how that all works is just like, I wonder if it's got any neurons in it. Any what? Neurons. Neurons? Uh, not that we know of. I, I don't think that they have any sensation. Hmm.

[: 01:08:44

So you get information traveling between the gut and the brain, but you don't get sensation from that. It's just,

[: 01:08:58

[01:09:04] Jeff Nesbitt: same with the heart. Like there's brain cells in your heart. So like when people say you're, you're going with your heart or you, you're, you literally make can think with your heart sometimes.

Yeah. It's going with your gut too. It's interesting like the, uh, the brain is not all within the school. Did you know your eyes were made outta brain tissue?

[: 01:09:24

um, that, uh, different parts of your eyes come from. You have like endoderm, endo, uh, mesoderm ectoderm. Um, and different parts of your eyes come from different layers from those, they're called germ layers. Your original like, like embryonic layers, parts of your eyes are ectoderm and part of them are endoderm.

Um, and that come from which skin? Right? Well, some of them endoderm becomes like your, uh, your intimate organs and your musculature ectoderm. You're talking about

[: 01:09:59

[01:10:01] Rebeckah Orton: Like the skin, like when you're Yeah. When you're talking like, like a teeny little, you know, embryo. . And so different parts of your eyes and your brain come from different parts of those original germ layers and that Yeah.

Some, some of the tissues that end up eye tissue come from the same tissues that end up brain tissue and your eyes are like set in your brain and your optic nerve runs right back through there. And yeah, it's pretty neat. Yeah. It's all, it's all very

[: 01:10:24

The fact that they evolved in the first place is amazing to me. Mm-hmm. especially because it was a react. Like if natural selection is a reactive process or like random mutations and then it either works or it doesn't work. Mm-hmm. , how many iterations would that have taken to just even create a cell that, uh, is photosensitive, let alone one that, three different ones that can coordinate and create sensory perception?

It's amazing. It really is amazing. I can see why, uh, creationists think that there has to be. Person or some entity somewhere that that created all that. I totally get that. Even though, yeah, I don't necessarily always believe that, but um, I think that, like, I do think it's amazing miracle

[: 01:11:08

And people that say that I only believe in science. Like I don't see why that can't actually just be the same thing. They're not mutually exclusive. Like why couldn't God abide by scientific method? I think that's how he did it. Right. Seemed like a good system. Doesn't, doesn't, God's not like in from my perspective and other people can have theirs, but I I, I wouldn't view God as like a genie who was like, poof day one, poof day two.

Poof. Adam and Eve. Yeah. But like maybe went through billions of years of iterations to like figure out how do I make a photo sensitive cell? I don't know. Yeah. You know, like I agree. I view God as a

[: 01:11:45

That's what God is to me. Cool. It doesn't ha And you can have a personal, personal relationship with something like that because it's everywhere and all and everything all at the same time. Sure. But also, you don't have to, if people don't want to, that's fine. I love you. Just the same. That's fine. Yeah, exactly.

Okay, let's see. Did the placenta question? Oh yeah. Cord blood. Cord blood. Yeah. I remember being, uh, asked if we were gonna donate the cord blood. Mm-hmm. , Do you guys do that at the birth center? We don't. What did

[: 01:12:26

So, um, at any given point about a third of your baby's blood is in the placenta in like this external liver. Right. And it's kind of cool because when you think about it, if a third of your blood volume is outside of your body, it makes you smaller. So you get to deliver like a little bit of a smaller package.

Right.

[: 01:12:48

[01:12:50] Rebeckah Orton: Yeah, it totally does. So then your baby comes out. and then, um, I dunno if you noticed this after the baby is born, but the cord will like be pulsing like with a heartbeat and that's your uterus. Uh, uh, contracting back down and squeezing like a sponge, squeezing all of that blood that belongs to the baby back out of the placenta and into the baby.

And then when it's done doing that, there's this stuff on the inside of the court called Horton's Jelly. I did not make that name up. And I think it sounds a little bit repugnant, but it does sound gross. Yeah, cuz white is it always a food name, you know. But

[: 01:13:23

Really? Yeah. An interesting nickname. Yeah. I'm gonna have to let him know that the inside Horton's goo of a umbilical cord is called Horton's Jelly.

[: 01:13:33

[01:13:38] Jeff Nesbitt: His is like Horton. Here's a who.

[: 01:13:40

And at that point then we know that all of the baby's blood has been returned to the baby where it belongs. How long does that take? Uh, it can take a few minutes. It can take, I would say like no longer than 15 probably. So you,

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Cause you gotta let all that

[: 01:14:16

Um, but in a birth center, when we're not faced with that type of thing, um, midwives actually view it very opposite that like, if you need it, like baby needs help breathing when they come out, as they sometimes do. And we have to do like a little resuscitation. Rule number one is don't cut the cord.

because they're still getting blood and oxygen through their cord. And so while we're working on getting their lungs going, we know the baby's fine. Yeah. It's like this little grace period that you get to like get baby breathing.

[: 01:14:55

Shouldn't it go

[: 01:15:02

[01:15:08] Jeff Nesbitt: What if it's you and you're the baby? Do you want them to take the cord blood or do you want to take it for yourself? I'm the baby, I'm not gonna be thinking about it. Well, let's say you are a baby.

You're, you're right Now I what you're

[: 01:15:17

I had no idea. Or that it can be used for research in order to help because, um, cord blood is very rich in stem cells. So people that have, uh, a moral obligation or not, sorry, a moral, um, opposition to, uh, using aborted fetuses for research. It's not something I'm. Really a big fan of, um, there are other ways to get, uh, really good numbers of stem cells that can be used for research cord blood to be a great way to do that.

And it's not a huge amount of blood babies that get their cords clamped early. Like, don't go to Harvard with fewer, They don't go to Harvard. No, I I They don't go to Harvard less often. I know. Then they're delayed cord clamping counterparts that I know of. I don't know that's been studied, but like I don't, we can assume it's probably, Yeah, they probably do just fine.

And the, the benefit of giving the baby all that blood is a reduced risk of anemia for like up to a year and anemia is a big deal. Um, it can cause developmental delays and things like that and so makes sense that we give baby their blood back. Um, but in the event that they don't like, we just watch their iron

Yeah.

[: 01:16:50

[01:17:04] Rebeckah Orton: Uh, there you can find some articles if you're looking on up to date about CBD use. Um, I know

[: 01:17:09

[01:17:12] Rebeckah Orton: is that what they're currently saying?

Yeah. The last couple things I was hearing is like the CBD lotions and things like that are pretty benign.

[: 01:17:18

[01:17:24] Rebeckah Orton: Just like any organization, they're made up of people. Yeah. And a lot of scientists and, and the thing about science is that it's not this exact, uh, you know, thing that we've often make it out to be sciences a process.

Yeah. And so I, we used to, we used to tell women in the forties that like, they should smoke cigarettes while they were pregnant cuz it would make a nice small baby and help them keep their appetite down. Yeah. And, and I were like, No, don't do that. Um, and so the more we learn, the more we study and oftentimes those studies are, uh, incentivized by a dollar.

You know, that can happen. Um, that's

[: 01:18:00

[01:18:17] Rebeckah Orton: to say, then we just say no.

Yeah, Yeah. And so what we know is that, uh, thc, um, the psychoactive ingredient does condense in breast tissue and in placental tissue. And so we have, we get kinda itchy when we hear that somebody is using marijuana during their pregnancy. Um, because. While we don't know with a high degree of certainty, um, what that does to a developing brain.

Um, there are some studies linking it to developmental delays and things like that, intentional problems. What we do know for sure is that, um, it does condense in breast tissue and in placental tissue. So whatever you're getting, there's a strong likelihood that your baby is getting more. Yeah. For being such a small human

[: 01:18:59

[01:19:04] Rebeckah Orton: there for a little while.

Three days. Yeah. Yeah. Um, and then cbd, I don't, I couldn't speak to it. I don't know as much about it, but ham on the street is that it's fairly benign.

[: 01:19:13

[01:19:17] Rebeckah Orton: say talk to your doctor, your midwife about it. Yeah.

[: 01:19:21

Anecdotal evidence in places like Jamaica. Mm-hmm. , where they've used cannabis pregnant or not for years and years. But that does not mean it's the same everywhere. Like if you're, if you're, if there within a population, if there's been exposure at low levels forever and then it become part of the culture like that could have a completely different effect than if it were somewhere where no one's ever done it and then all of a sudden, boom, you start,

[: 01:19:47

[01:19:48] Jeff Nesbitt: population shift.

Exactly. Yeah. So it's definitely something to be careful with. Yeah. Seems like some potential though, especially mostly for the nausea. Nausea, nausea. What do you say? That's

[: 01:19:58

[01:20:02] Jeff Nesbitt: I just wanna say nausea, but it sounds, I say nausea, It sounds, um,

[: 01:20:06

[01:20:11] Jeff Nesbitt: Just one of those words. Yeah. One of those words. Upset. Stomach works just fine.

[: 01:20:16

[01:20:18] Jeff Nesbitt: Okay. Let's see what, any other questions. What else? I'm, I've actually burned through all of my, uh, professional questions. Okay.

[: 01:20:26

[01:20:27] Jeff Nesbitt: questions. Okay. Yeah. We usually talk about all kinds of stuff.

Okay. Um, so just general human life. I, I, I tend to think about everybody is basically the same. Mm-hmm. . So depending on, we've, I've already covered this a little bit, but depending on what you've been through, who you are, what you believe, what you've been taught, what foods you like, what music you've listened to, who, who has hurt you in your life.

All these things contribute to who you are. Right? Sure. Your profession is one part of that, usually one very large part of that, but, um, it's just one part of that. Sure. So who, who's the rest of you?

[: 01:21:00

Um,

[: 01:21:08

[01:21:15] Rebeckah Orton: is. And actually, I like the question and I, I was reading an article in Psychology Today the other day that was, it is kind of been on my mind lately because it talked about how we spend so much time thinking about who we've become, um, and how far we've come over the last few years, and all these things you're saying, who's hurt you?

Who's, who's been in and out of your life? Um, but that we don't spend relatively or, or comparatively little time thinking about who we're going to become. Oh, that's way more useful too. And like, who, who do you wanna be? Who do you wanna be in 10 years? Who do you wanna be in five years? Um, and, but anyway, that aside,

[: 01:21:47

[01:21:52] Rebeckah Orton: Not in the context of who I wanted to become, but of what I wanted this system to become. Certainly. Um, but I, I have been stopping to reflect a little bit to see like who, who am I, what does it all mean? It's

[: 01:22:04

[01:22:07] Rebeckah Orton: it's, we can be silly and cliche here if you Exactly.

So who, who am I? So I would like, I'll, I'll tell you who I'd like to be. Perfect. Would, would that do, That's actually much better. Cause I, I kind of think I'm on the way.

[: 01:22:20

[01:22:23] Rebeckah Orton: So I, I identify strongly as a mother, um, and I've been a mother since I was eight. I've been a, the first time I, cuz I'm the youngest of eight kids, and so I felt like I totally got like screwed outta heaven, younger siblings.

Um, but my oldest brother had my oldest niece when I was eight years old. And I was like, You're mine now. This is, this is mine. And, uh, became very much like second mother. Mm-hmm. and would, you know, chase them around. All babysit you guys go out to dinner. Like, I would've loved to have had a version of me

Yeah. Um, and, and I've always been a mother, um, whether to my kids or other people's kids or other people or mothering my siblings or, you know, um, that's in there. And I, I hope that that doesn't change. Because I love that. I love the nurturing aspect. The like, Oh, you need something and I can give you that.

Let me give you, let me make it feel better. You

[: 01:23:15

[01:23:23] Rebeckah Orton: Very much so. And I love that. I love having an environment in which I can do that. And I think that the people that I work with love that too.

They're all very mothery. Um, and then I, I would hope so. I've failed a lot, um, over this process. And just in life, people do you fall in your ass if you're trying to do

[: 01:23:43

I might be able to get this one played in India. They don't like the swearing over there.

[: 01:23:56

[01:23:59] Jeff Nesbitt: I'm gonna, I'm gonna try. I have never actually put out an episode. This is gonna be this. 81st episode, I think. Oh wow. And it will be the first one that will be, uh, not restricted.

Ooh. Okay. So as long as we don't get into anything too, uh, you know, untoward crazy

[: 01:24:14

[01:24:33] Jeff Nesbitt: failures cuz it makes it sound like you're ashamed of things.

The trials,

[: 01:24:38

that can say things that are efficient and true in a way that they are heard in a way that is efficient and true. And what I mean by that is, uh, because I do so much work with legislations and with, um, large systems, which is not efficient, No, not at all. Um, one of the things that's very hard for me, a big challenge is to see things the way that I see them.

And they seem very black and white. Like, of course we should be supporting women. Like that's why are we not doing that? And it creates like this cognitive dissonance. And so I haven't figured out the way to speak to a room full of people yet. And, and without saying, Because it oftentimes when you say, Hey, the system is broken.

People take that personally and they're like, Well, I'm broken, and you're meany head, you know? Yeah. They

[: 01:25:53

[01:25:54] Rebeckah Orton: But yeah, the, I was it Ruth Bader Ginsburg that, I will totally butcher this, but she said something to the effect of like, do what you're going to do in a way that makes other people wanna do it with you.

Um, I think that

[: 01:26:05

[01:26:07] Rebeckah Orton: Yes. It wasn't that, but it was something like that. And, and, and I hope to be able to do that. I hope to be that kind of person that like draws people in to this common fight that doesn't have to do with political parties. You're right.

Therefore, I'm wrong. Or I'm right. Therefore, you are wrong. But like, like back to the abortion thing that like, some people are like, No, babies should never be killed. It's murder. And other people saying babies, it, it, it, mothers should never have their rights taken away. And like both things are maybe true.

[: 01:26:36

[01:26:41] Rebeckah Orton: decides. Yeah. And so I, I wish that we. Well, for me, I wish that I could be the kind of person that could say like, Hey, person, way over here on the left, and hey person, way over here on the right. Let's find the common ground and let's work with that.

I, I wish that I could be, I, I hope for myself to become that kind of person.

[: 01:27:01

You're, you seem like, you, you are, you're putting an effort into trying to consider multiple outlooks. It's nice. It's, it's just being nice as being a nice person. Yeah,

[: 01:27:26

[01:27:30] Jeff Nesbitt: Well, that's not nice either. Be, be just letting people walk all over you is not the same as like being a humble person.

Like humility and cowardice look a lot alike, but they're not the same thing. Whoa,

[: 01:27:41

Oh, that's beautiful. That's, that's a little clippy. But, um, but there's, there's something to be had for that. And I think that like, true confidence, and this is something I want for myself too. Um, and I, I see the buds of it in there. They're coming. But, um, I think true confidence is knowing exactly what you are, scars and all warts and all.

You know what you are and you know what you're not. And then it becomes so much less offensive when people don't see you that way, cuz it doesn't matter. Yeah. Cuz you already know,

[: 01:28:25

[01:28:26] Rebeckah Orton: re and if somebody doesn't confirm it, see that or doesn't wanna take the time to see that, that's on them, it becomes their problem.

And, and I've, I've struggled with that all my life that like, Oh, you don't think so? And like, are you a people pleaser? Yeah. To a terrible fault. It's hard not to be. Yeah. Um, but it's something I'm working on. Mm-hmm. , um, is I, I, I think Brene Brown was talking about this, that like, the older I get, um, I become less nice, but more kind.

[: 01:28:55

[01:29:00] Rebeckah Orton: just pleasant. Yeah. Um, out of obligation, people pleasing. Yeah. But kind in that like, I see you, I see that you are a person worthy of existence, worthy of awesomeness, that you have this internal like radiance. Yeah. Um, and that you can see that and respect that in any person.

Like it's the meaning of Noce Day, Right. Is like, the goodness in me sees the goodness in you. And I think that starts with like, I have to see the goodness in me. I have to see that it's in there and to respect that. Like I am deeply. I am trying to do the right things regardless of all my screwups. Um,

[: 01:29:34

Sure. Yeah. You are able to see it in other people. Yeah. And you're able to forgive people when you

[: 01:29:44

[01:29:46] Jeff Nesbitt: don't see it. Yeah. Yeah. I think that's the foundation of good communication. I think before we have that, there's no chance, there's no chance you can communicate with people when you don't have, like, you don't provide a generous interpretation of their actions.

Like there are certain things that you have to do just on a human level to be able to be on the same team. Mm-hmm. and. That's a great place to start.

[: 01:30:07

Mm-hmm. is to this level of confidence in these boundaries. Like, I, I feel very recent, and this is pretty personal, but I mean, here we are, um, over the past two years, I've just poured my heart and my soul into this business, into this dream, into this system that I'm hoping against Hope will work. Because if we can make this sustainable model doing this thing, then, then that means it can be done.

Yeah. If it can be done, then anyone can do it. And I that like makes me Yeah, exactly. And that makes me so excited. Um, but now like so many other humans, That have put their heart and souls into something, it makes your heart and soul very tired and very vulnerable. And so I'm at that point in my life where I'm redrawing boundaries back around my heart and soul and saying, Okay, this is where I end.

And you begin, were you

[: 01:31:06

[01:31:13] Rebeckah Orton: I think good boundaries from the beginning. Mm-hmm. are how you avoid that and um, and how

[: 01:31:20

[01:31:24] Rebeckah Orton: well, but first you agree to be on call and then you realize that that's the boundaries that you're available, you know, fully when you're on call.

That's just part of it. And you either accept that or you do not. And if you do not, then you find someone else who can. Yeah. Um, and so

[: 01:31:38

[01:31:43] Rebeckah Orton: Yeah. That being on call isn't what burns me out. Um, having my heart and soul.

On call 24 hours a day. Yeah. For two years is what burns me out. That I need to have, I need to step back just a little bit and, and let this thing start to run on its own. Mm-hmm. , um, let it

[: 01:32:02

[01:32:07] Rebeckah Orton: my life. Yeah. Um, like I, I love being really involved with my children too.

And um, like I wanna teach them every little thing and then I need to like, you know, a sea turtle from finding emo, like, let us see what Squirt can do, you know?

[: 01:32:21

[01:32:27] Rebeckah Orton: Yeah. And not have to pay

[: 01:32:28

Save up that, clone that, uh, cord blood. Well,

[: 01:32:31

[01:32:34] Jeff Nesbitt: Yeah. I mean, there's stem cells, right? You can, you just need a little bit of your dna. There you go. Some cord blood from somebody else.

[: 01:32:39

I changed my mind. I don't wanna clone

myself.

[: 01:32:45

[01:32:48] Rebeckah Orton: It would be my evil twin

[: 01:32:49

[01:33:00] Rebeckah Orton: you down?

I don't have feelings about that. About

[: 01:33:03

[01:33:05] Rebeckah Orton: Like, should we clone humans?

[: 01:33:07

[01:33:11] Rebeckah Orton: Pieces. Sure, yeah. Go nuts. Like we could grow a heart and Ari dish and like, have that be a transplant. Like hell yes. Mm-hmm. just shoot. Yes. Heck yes. You're gonna like, strike that from the record.

Believe it. So this can be played in idiot, I think. Totally. If we can grow human organs for transplant, we're close. Let's do it If

[: 01:33:27

[01:33:27] Rebeckah Orton: there. Yeah. Now I haven't been following that

[: 01:33:29

[01:33:39] Rebeckah Orton: food.

Yeah, for sure. Yeah. Um, interested. Yeah. Yeah. Anything that seems legit. I mean, would that, So here's, here's the question about cloned meats. Um, if you're vegan, can you eat them? No.

[: 01:33:51

[01:33:52] Rebeckah Orton: if like an animal wasn't hurt in the process, like you're, you're not like a, a dietary vegan, but like a, like a ideolog or moral, moral vegan.

if it, if an animal wasn't hurt. So, So you like a biopsy, a cow, and the cow is fine and he recovers, and then you grow that meat and a pediatrician make a burger out of it. Like it's cow. It's cow meat. You're strong heart hurt. Yeah. So like, could you be an ethical vegan and eat, or, or would you just then not be a vegan?

[: 01:34:21

They were disturbed and disrupted. And so I'm just thinking if there's a big field of corn or you know, whatever mm-hmm. , thousands and thousands of little animals are just getting demolished when they're running the, whatever, the combine over that. Mm-hmm. . So I don't know if there is such a thing as a vegan who doesn't have anything killed during the process of their meal.

So actually really I think the vegan who's eating the, the, you know, the t-bone that was grown in a lab might be more ethical than the standard vegan.

[: 01:35:14

[01:35:17] Jeff Nesbitt: Wow. Not to mention the carbon footprint. Sure. That combine just drinks the

[: 01:35:21

Again, I know we talk about that a lot, but, um, . Hm. That's, That gives me a lot to think about.

[: 01:35:35

Yeah. Real sustainability is not very flashy or exciting. It's kind of dirty and smelly. It's a lot of work too. And it's small scale and it's a ton of work. Mm-hmm. . Uh, but I think if we don't kind of start pushing systems towards that, at least on a small scale, like where it's possible mm-hmm. people with, with property and, and resources and affluence and time that can do like community gardens and, and composting bins and things.

Yeah. Things

[: 01:36:12

Like what are we gonna do? Who cut off from the stores? Yeah. Like, who's gonna do the toilet paper and who's gonna do, you know? And so we've, we've been talking about that a lot and, uh, talking with my neighbors, they're therapists and, and which is part of the reason I love them, but there's a lot, um, . And so we share ideas all the time.

And like I know how to build like stuff out of wood because my mom did that a lot growing up. And so there I, like, I helped them build something out of wood and they helped me to like, like with my employment, like, like communications as an employer and things like that. And they were talking about, Well, this guy knows how to do that and that one knows how to do that.

Like, um, there, there's a name for it. It's like, oh, I don't remember the name for it. But it's the idea of like turning inward neighborhood. Well, yeah, I mean neighborhood for sure. But she had, she had like some other fancy word for it, but it's the idea of like turning inward for them, having your needs met.

Like one neighbor has a garden, this neighbor has a garden. Maybe we like share our produce and like, I'm a nurse, so like if somebody needed, I don't know, like an IV or to. Stuff nurses can do, Um, that I can do that. Um, small community that's, yeah, like these little micro economies, these microsystems that make us less reliant, like having solar or, you know, things that make us not need this big

grid.

[: 01:37:47

[01:37:59] Rebeckah Orton: saw? I, I saw this in my neighborhood and I thought this was like beautiful. So it, back in March of 2020, this is when we were talking to that guy in Denmark.

We were there when like all the flights got grounded and we're like, Oh, we live here now. Okay. Oh, you got stuck in Denmark. It's not a bad place to be stuck. No, I guess not. Um, no. We, we were able to come home as the president at the time said all US nationals traveling abroad, either prepared to return home immediately or stay indefinitely.

And we seriously considered staying indefinitely. Um, We looked at an apartment . Things got pretty rough here around that time. Yeah. But then we came back and it was like, it was sort of zombie apocalypse esque. Yeah. So we came back and we couldn't go to the store cuz we were on quarantine then. Right.

Because we had just been traveling abroad. So we stayed home and right before we had left, we had like, uh, we have like food storage in our house. We believe in that. And like, just being self reliant so far as you can. And so right before we had left I was like, we really, we should probably like stock up on some stuff.

So I did this big grocery run and like tons of toilet paper and tons of flour and yeast and like all the things you would need. And all of a sudden, like we couldn't go to this store. We couldn't get fresh fruits or vegetables, but we had like a ton of can stuff. We had flour in yeast. I made our own bread.

And like, Did you see how in the pandemic everyone learned how to make bread? Yeah. Every, like seriously, everyone can make sour donut and how you, you don't even need yeast. You just leave flour and water on the counter for a while and like it will grow a culture and then you can make bread from it. It is amazing.

And I'm sure that's how it was discovered. So, but I saw that. When we came back and everything was quiet and the stores were closed and it just was like no one was even outside. And then after a while, people started, Well, we can go outside. And they would go for walks and we left our windows open. We saw our neighbors come by and we needed something from this store there.

There's some, I don't remember what it was. Someone was like, Okay, I'm doing the neighborhood grocery run. What do you need? And they came to my house and they passed it to me through the window and it was like this person I'd never met before, like doing this act of kindness to like help sustain my family.

And um, and then we were like making bread for the neighbors and we were like trading stories. And it became like actually a really beautiful development of community. And that was my first real taste of that. Because like, if you need red, like it's weird for you to ask your neighbors anymore, you have to be self-sufficient and go to Costco yourself, like a big girl.

Yeah. I mean, you gotta

[: 01:40:16

[01:40:20] Rebeckah Orton: Like, Hey, do you have a red onion? Do you have any yeast? And like, and then they need something and we have it. And it feels now like very natural and very comfortable to have those conversations.

Like, I'm gonna Costco, what do you need? Chicken. Got it. Mm-hmm. , because people are always like, No, nothing. It's okay. Yeah. And then they'll go to Costco 20 minutes later on their own. Yeah. You know?

[: 01:40:37

[01:40:41] Rebeckah Orton: Yeah. But, um, but I, I did see that, that semblance of like, I, I feel like maybe what the original American dream maybe was.

Yeah. We

[: 01:40:51

[01:40:53] Rebeckah Orton: balance. This sort of like collective living. This sort of like, and, and really. This is like a very Christian thing. Yeah, it can be. Can I will say that the good parts like, like Christianity in like his truett sense. Yes, exactly. In

[: 01:41:09

[01:41:10] Rebeckah Orton: loving your neighbor.

Like there were two big commandments. Just like one of them was Love your neighbor. The

[: 01:41:15

[01:41:17] Rebeckah Orton: one. And so, and but at the root of that is just like this truth. Yeah. Right. And I think that like this truth is, is involved in like loving your neighbor and like caring for your

[: 01:41:27

That truth is that we are all truly just one thing, right? Like we're all one big organism and Totally, it makes the most sense to treat it that way. Mm-hmm. because it, if, if I'm treating you well, you're treating me well. We're, we're treating the earth

[: 01:41:39

[01:41:41] Jeff Nesbitt: all in symbiosis.

Mm-hmm. , it's a good, good relationship. Yeah.

[: 01:41:46

[01:41:50] Jeff Nesbitt: the, the food storage thing got me thinking about, um, I'm hearing a lot of rumors lately about an impending food shortage. Mm-hmm. and potential fans. Sure. Yeah. I hear about that too. Worldwide. Yeah. I, uh, I feel impulses to go out and buy food stockpile.

I mean, nothing crazy. Like I, I might get a hundred pound bag of rice cuz that's like 50 bucks and it'll last forever. But yeah, I, I'm worried that there, because I haven't seen a whole lot of coverage about this. I don't hear a whole lot about this. I'm just seeing it mostly on social media. Mm-hmm. from independent creators.

Sure. It, I'm worried that it is actually a much bigger deal than, people are realizing, and the reason we're not hearing about it is the same reason that Fauci told everybody, masks don't work right at the beginning. Even though later he is like, I was just getting they work. Um, it's because he didn't want everyone to go out and buy all the masks and then healthcare workers wouldn't have them.

So. Right. That was a definitely mistake, but the, the sentiment was like, we have to keep the economy moving in a way that that will serve the most people. So I'm worried that there might be a, a way worse problem building, um, than we know about. What do you, what do you know about the food shortages and what have you heard?

[: 01:43:02

[01:43:13] Jeff Nesbitt: Yeah, that was really scary.

[: 01:43:16

[01:43:20] Jeff Nesbitt: meat section was what really got me. Yeah. Cause yeah, I went to, I think it was Fred Meyer in Astoria or in Warrenton.

And there was no meat. They had no meat. I was blown

[: 01:43:30

[01:43:32] Jeff Nesbitt: one was quick. That was like the first week. Yeah. It was gone with the toilet paper. Yeah.

[: 01:43:38

And, and maybe even more times than that in little, you know, micro,

[: 01:43:55

[01:43:58] Rebeckah Orton: other commodities. We've seen gas shortages, We've seen gas price hikes where like suddenly it's no longer sustainable to like, fill your car because no one has that kind of money just lying around maybe.

Mm-hmm. . Um, we've seen what it looks like when people panic and run to the store and like, buy everything up. Yeah. And so, Sure. I think that like to deny that that is possible. It would simply be to deny reality. And so what it makes me want to do is, um, turn inward again to my community to say like, Hey guys, what are we gonna do about this?

And then like, we planted four trees and cuz we don't really have space for more than four, but we planted four and, and they grew like a half a pound of cherries. Oh, nice.

[: 01:44:40

[01:44:43] Rebeckah Orton: And make. . Yeah. And then we have a little garden box in the back of our house.

And, and it's not everything, but it's something, and it helps us to feel more autonomous and it helps us learn like how to plant and grow food. That's a dying art. Yeah. People don't know. Like, and it's

[: 01:44:59

[01:45:01] Rebeckah Orton: work, but it is. Yeah. You get like your one little tomato and then when the deer come and smash them in the, you're like, I will eat venison.

Yeah. And I will feed it to my children. Mm-hmm. . Um,

[: 01:45:11

And uh, even though I have very little experience with it, I've, I've eaten Wild game my whole life for free, and now I'm gonna decide I don't like it. Um, and after a couple years of just kind of, Mindlessly judging. I did some research and realized like, Oh, hunting is great for conservation. It tastes delicious.

It's very healthy for you, and the stocks need to be managed. There's not that many downsides unless too many people do it or they do it wrong. Poaching and that kind of thing. Yeah. But I, I got, I've only hunted successfully once, and I've only hunted two different years, but I got so much satisfaction out of just wandering the woods trying to find food for my family.

Yeah, it's a very primal feeling. It feels very, Human. Yeah. To just, And like I'm a big forger, I like to go out and get food that doesn't run away , but, um, Hunting mushroom. Yeah. Mushrooms. Berries. That kind of stuff is a lot more fun. Do you ever do any mushroom picking? Um,

[: 01:46:24

Most people are pretty secretive about their spots. Yeah. He'll bring them to our house sometimes. And like I, it's funny cuz I can go to Costco and buy like a two pound container of mushrooms and sometimes, like, I regret to say this because I hate wasting food, but like sometimes they go bad in the back of the fridge.

But when he brings me like one king elite. It's like sacred. Yeah. And I will take it to my cutting board and I will cut it into thin strips and then I will dry it out in the oven and then I will store it. And then it will make like this phenomenal mushroom stock and it'll make soup. And my whole family loves it.

And it's like this experience and my children are like, Oh my gosh, we're gonna eat Dave's mushroom soup. That's awesome. And because I, I think you have like soup, so much more respect for the food you eat and are so much less inclined to waste it when you realize what does actually go into growing it.

Yeah. To procuring it. To preparing it. I hope to instill that my children, Yeah, it's a really

[: 01:47:20

It's like it's gonna replenish my body. I like that idea. Do you

[: 01:47:33

Yes,

[: 01:47:47

[01:48:01] Rebeckah Orton: Well, I wonder that cuz like, um, say for example multiple sclerosis, um, it is regional.

Did you know that? No, not the fewest people get MS all over the world. Um, but around the equator is the lowest incidence of people with ms. And the farther north you go, the more people have it. And I've wondered if this has to do, cuz also the farther north you go, the more vitamin D deficient there and there are some links between vitamin D and development of ms.

Um, I don't know if it's like causative, correlative, whatever, but, um, but I wonder, uh, ever since my husband brought this up, like if we ate just what grew out of the ground here, Like what is indigenous to like the Pacific Northwest, Um, Salmon. Berries. Mushrooms, like the things that grow here, all of those foods are like very high vitamin D and like yeah, oysters.

Um, would we have, like, would we have the same disease patterns that we.

[: 01:49:01

[01:49:08] Rebeckah Orton: D because, Well, I wonder that they have to, I don't know if they do, but, but I know that mushrooms are really high in vitamin D. Yeah.

And there's like a ton of them here that are like edible. Yeah. Um, and so I wonder, I wonder

[: 01:49:19

[01:49:20] Rebeckah Orton: And I think it, don't quote me, but I think Salmon is maybe high vitamin day two, and like some of the other things that we would eat here that grow naturally here. Mm-hmm. . So

[: 01:49:30

Not even a fantasy, but I've imagined sometime doing like a year where you just eat whatever you can grow. I've seen people do this. Oh, I'd love that. Yeah. Eat whatever you can grow or catch. Mm-hmm. and just see what your life becomes. I have a feeling it'd be a very, like up and down year. Like you'd have times where you're like, Why did I do this?

This is so dumb. I hate it. But, and then there'd be other times where you're like, I just prepared this meal from this beast that I caught and these plants that I grew. And you'd probably feel ultimately satisfied. Yeah. I think that would be really fun. But I wonder what kind of changes it would bring about in your life.

Especially with me where I'm used to, like I have adhd, so my diet is always chaotic and just like, it's so hard for me to be like a consistent, routine driven person. Mm-hmm. . Um, except professionally for some reason. I can do it at work, but I can't do it in my own life. Um, but I don't know. I, I think that kind of thing is, is fun to just shake it up.

Mm-hmm. , try trying something new. But I don't know. I think I'd be curious to see what would happen.

[: 01:50:32

[01:50:41] Jeff Nesbitt: would be fun. Yeah. You would have to build like a storehouse or like, you'd have to really do your research and how you can grow What, Meet all your nutritional needs.

I'd have to like get a goat.

[: 01:50:50

[01:50:54] Jeff Nesbitt: that. You'd also have to convince your family. Uh, I think they'd be

[: 01:50:57

[01:51:10] Jeff Nesbitt: I grew up hating them. I still really don't love most of them. They, they're hard for me to eat, but, um, I just love the woods and so I was always in the woods and I, they're there and once I knew what they were and what the value to other people. Yeah. Was it felt like seeing $5 on the sidewalk and just walking away from it?

Yeah. Right. So I was just like, Oh, I gotta pick these things and then I learned to just love it. It, my brain really likes that level of stimulation. I

[: 01:51:37

Actually.

[: 01:51:49

Thank you so much for coming. This has been not only very informative, but also very fun. My pleasure.

[: 01:52:11

[01:52:13] Jeff Nesbitt: Like you're doing really, really great things in the community and I commend you for it, and I applaud you that none of it sounds easy. It sounds like. A really, hard existence that benefits a ton of people.

So, Good job.

[: 01:52:26

[01:52:29] Jeff Nesbitt: Come back and talk to me again. Thank you. I'd like that. Hopefully by, by then we'll have a much better studio. .

[: 01:52:36

[01:52:40] Jeff Nesbitt: Yeah, yeah. The healthcare system could use some work, but yeah, keep working on it. All right. Thank you. All right. Thank you everybody for listening. We'll talk to you next time. Bye.

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