00:00:00:23 - 00:00:22:12 Speaker 1 Welcome to the Rounds, a podcast of Marshfield Clinic Health System. I'm your host, Adam Hocking. The rounds brings together medical experts to discuss fresh, fascinating and important topics from the world of health care, whether overseas or right here in the United States. Research has shown that making midwives a central part of the care team equals better health outcomes for moms and babies alike. 00:00:23:00 - 00:00:44:12 Speaker 1 Still, Americans have not been as quick as some other countries to embrace midwifery. What are midwives? What makes their approach to patient care different from a doctor? And why are people experiencing such good outcomes in the care of midwives? We'll explore those questions and more today with our guest, Katie Van Dreese. Katie is a certified nurse midwife at Marshfield Medical Center, Eau Claire. 00:00:44:23 - 00:00:54:16 Speaker 1 You won't want to miss Katie's touching personal story about why she became a midwife or her insights about why this approach to care works so well. 00:00:57:06 - 00:01:00:06 Speaker 1 So, Katie Van Dreese, thank you so much for joining us on the rounds today. 00:01:00:07 - 00:01:03:02 Speaker 2 Thank you so much for having me. I'm really excited to be here. 00:01:03:04 - 00:01:15:11 Speaker 1 Excellent. So we'll start kind of simply and I think people have an idea of of what a midwife is, but can you kind of give us a working explanation of what it is that you do and what a midwife really is? 00:01:15:12 - 00:01:36:22 Speaker 2 Yeah. You know, my husband always introduces me as a nurse practitioner, and I think that that's the simplest way to put it. But I always correct him because I don't like it because then it doesn't help describe what I actually do. So I'm a certified nurse midwife. So essentially I'm a nurse who went back and got her masters degree. 00:01:37:19 - 00:02:07:11 Speaker 2 And you specialize in midwifery. And what that means is when I'm in the clinic, I see women for birth control. Well, women exams. We do different procedures, all of your normal health screenings. And then, of course, we do obstetrics. So we see people in their reproductive years for trying to get pregnant. Postpartum. We follow women across the life span. 00:02:07:11 - 00:02:31:13 Speaker 2 Really. So it's really nice when we're able to see someone become pregnant. Postpartum. We follow up with their all of their physicals and then we see people into their menopausal years. So in my role as a nurse midwife, I get to do I get a little bit of the best of both worlds. So I get some clinic time where I get to know my patients and build my own practice. 00:02:31:14 - 00:02:52:16 Speaker 2 I definitely have physicals that I see every year now, which is really fun. And then I also get to have my call time. So I'm in the hospital. We get to have 24 hour call shifts. I say it's we get to it's definitely a privilege and a and a struggle sometimes. But we started at 830 in the morning. 00:02:52:16 - 00:03:11:05 Speaker 2 We go to 830 the next morning and whatever happens in between happens. And it's nice to have a balance of both because sometimes you get sick of like, you know, just being stuck in the clinic and you just need a birth to pump you up and kind of keep your own. So yeah, we get to do a lot of fun things. 00:03:11:22 - 00:03:29:11 Speaker 1 And how does it differ if my wife and I were to come and establish care with you? How does that differ from maybe the more traditional setup that people are? Are are maybe more customarily used to, which is, you know, setting up with a with a pediatrician and then an OB. 00:03:29:16 - 00:03:59:21 Speaker 2 So it's unique to the Eau Claire Center that we have nurse midwives in in our department. Once you're pregnant, you typically see either a nurse practitioner or one of the nurse midwives for your first OB visit. That doesn't necessarily mean you have to stay with us. We pretty much do your complete history. We do a lot of teaching and then we kind of introduce you to the OB practice and the CNM practice, and you absolutely get your choice of what you want to do. 00:04:00:08 - 00:04:18:09 Speaker 2 We actually have most of our patients stay with us. Most of them aren't high risk enough that they have to go see an OB, and a lot of them want to stay with us once they meet us because we do so much education and they already feel like they get to know you really well during that first visit. 00:04:19:10 - 00:04:44:16 Speaker 2 We do strive for low cost effective care, so we don't do ultrasounds every visit. We definitely have our trusty Doppler with us all the time, and that's probably the biggest difference. I always tell people, you know, we are nurses at heart. And what that means is that education is at our forefront. So your visits get to be a little bit longer. 00:04:44:21 - 00:05:06:09 Speaker 2 You get to just learn more about yourself in this awesome time. We really love to you know, it's not just with first time moms, but with, you know, whether it's your second or third. We just really love to have that education piece there. And remind people that this is the best This could be a very, very impactful time in their life. 00:05:06:17 - 00:05:27:12 Speaker 2 I mean, having your first baby can set you up for the rest of your life. I mean, I don't know if there's anything more impactful than teaching a woman to be confident in herself and learn about herself and then have her first or second child and and feel like I can do this. I'm going to go home with this baby. 00:05:27:18 - 00:05:45:08 Speaker 2 I may not know what to do, but I can do this. And they get that from learning about trust and all of the education that we provide through that time. So I think that just sets women up to just be successful in life. So I think what we do is really important. 00:05:45:18 - 00:05:58:10 Speaker 1 So that education piece to you is really about empowerment, about not only while you're in our care, but even afterwards setting women up and kind of arming them with the tools to to sort of take control. 00:05:58:11 - 00:06:27:05 Speaker 2 Absolutely. Because when someone comes to you with a problem, you're not just telling them how to solve it. You're teaching them about what it is you're teaching about how their lifestyle or what they do. How can we make that work with them? You know, you're talking about individualized care at it's basics. I mean, we want we want to get to know you so that we can help you, so that we can make an impact. 00:06:27:05 - 00:06:45:03 Speaker 2 And then that just helps them long term. I mean, they feel like they have a provider. They have someone that they can go to with questions and they don't feel stupid asking these questions or I don't want them to, or it just gets us set up to keep talking and keep learning about what's going on with them right then. 00:06:45:09 - 00:07:04:23 Speaker 1 So well, and I know as someone that has my wife and I have had two children, especially the first time, that piece of being able to ask a question and not just one question, not just through a patient portal, not an email question, but a conversation and an ongoing conversation. I think that piece is really important. Yes. 00:07:05:05 - 00:07:29:00 Speaker 2 I think I have so many appointments all the time that I'm just like, Do you guys have any questions? And I will ask you that four or five times. And I realize that you're probably like, Did she forget? No, I don't have any questions, but it'll spark something. And then sometimes that five minute appointment turns into 20 minutes that you just have these ongoing things coming up because you're not necessarily thinking. 00:07:29:00 - 00:07:47:23 Speaker 2 And some people are like, Oh, was I supposed to prepare questions? And some people come in with lists and I'm like, Let's go for it, let's do it, let's get through that list, because you want people to be comfortable. Some people come up with questions early, some people later because they just haven't dived in. They just haven't looked. 00:07:48:11 - 00:07:54:09 Speaker 2 So, you know, that's there's just always a time and an opportunity to expand on anything. 00:07:55:12 - 00:08:19:10 Speaker 1 I had read a study in preparation for this interview from the the American College of Nurse Midwives, and it showed that women cared for by certified nurse midwives compared to women of the same risk status cared for by physicians, had lower rates of C-sections, lower rates of labor induction and augmentation reduction in the incidence of third and fourth degree. 00:08:21:10 - 00:08:21:22 Speaker 2 Perineal. 00:08:22:06 - 00:08:24:09 Speaker 1 Perineal perineal. 00:08:24:09 - 00:08:26:05 Speaker 2 Tibial lacerations. Yes. 00:08:26:14 - 00:08:39:14 Speaker 1 Lower use of regional anesthesia and higher higher rates of successful breastfeeding. Yeah. So we talked about the education piece, and maybe this is too simple a question, but sort of why do you think the midwife approach is creating these outcomes? 00:08:40:00 - 00:09:04:07 Speaker 2 I think let's start from just, you know, just the impact of trust. Okay? We have a practice of six midwives and some people might say, Well, I just want one practitioner and I absolutely understand that, but that practitioner can't be on call. 24 seven 365 days a year. So it's nice that you kind of have a mix of people. 00:09:04:21 - 00:09:41:15 Speaker 2 You get to know everybody. You'll definitely have your favorites and the ones that you're like, I don't know about, but once you're in labor and you kind of have that trust there with someone, that can make a huge impact. The other impact that we see is all about continuous labor support. So one of the biggest studies, and it's probably very relative to what you were reading, is all about continuous labor support, increasing the rate of spontaneous vaginal deliveries, decreasing C-section rate in all of these all of these awesome, awesome stats. 00:09:42:09 - 00:10:11:02 Speaker 2 And even the American College of Obstetrics and Gynecology is ACOG. They say one of the most effective tools that improves labor and delivery outcomes is the continuous continuous presence of support personnel. So that could be a Dula that could be a midwife. But having that continuous bedside care is invaluable. And some people are like, Well, I mean, I don't want you staring at me and it doesn't have to be like that. 00:10:11:02 - 00:10:31:04 Speaker 2 We're just helping you transition when you go into labor. It's not like one thing at a time, you know, it's not it's not one straight forward little curve. You want someone there with you that knows what's happening because we're going to guide you. We're going to help you move through each of these little stages that you're going to go through. 00:10:31:11 - 00:10:54:01 Speaker 2 And we really pride ourselves on bedside care and that we we fight against things that take us away from the bedside. And I think you'll understand, you know, when even when you hear from the nurses we work with were there, you know, like unless the patient is working really well and with her partner and, you know, you read the room, right? 00:10:54:02 - 00:11:19:04 Speaker 2 If people are working together and you just check in and you, you know, you suggest things they can do, you're trying to honor whatever they want to do, whether they want to get an epidural, whether they want a water birth, whether they're like, I don't know, and you're just trying to guide them somewhere. That continuous labor support piece is absolutely crucial to what we do. 00:11:19:10 - 00:11:44:06 Speaker 2 And we we defend it. We defend it till the end because of the outcomes. And in our practice, the national average for a C-section rate is 32%. And over the last ten years we average 10 to 12% in our practice. It's amazing. And just this past year, half of our C-section rate were just for breaches and repeat C-sections. 00:11:44:12 - 00:12:06:23 Speaker 2 So I think it just shows it shows that, you know, what we do really has an impact and that's why we're just trying to spread the care of the midwife. I mean, we just we want everyone to have access to that because we see the big, big picture. We see what difference does that make? You know, you have so many people are like, I don't want pain. 00:12:06:23 - 00:12:35:02 Speaker 2 I want a C-section. But when you look at, you know, having, you know, how many kids do you want to have and what impact is that going to make? You know, people who have C-sections say we need C-sections, we need them around. You know, they're they're a huge part of of modern medicine and we need them. But if you can avoid them, that's what we want to do to lower your risks lifelong. 00:12:35:21 - 00:12:40:22 Speaker 2 So so continuous labor support is is absolutely the key in that. 00:12:41:12 - 00:13:02:22 Speaker 1 When you talk about continuous labor support, I can imagine physical things that you're doing in terms of helping women reposition or get comfortable or breathing exercises or whatever it might be, What percentage or what aspect of it do you think is maybe mental of just having somebody there that it's huge to ask a question or say, I'm nervous? 00:13:02:23 - 00:13:20:09 Speaker 2 It's absolutely huge. You know, we definitely have people that, you know, they we have wonderful nurses, but they don't know the nurses. And so when they say, like, I would really like to talk to Katy about that or I would like, you know, I would I would want to think about it. That's all we ask you to do. 00:13:20:09 - 00:13:46:13 Speaker 2 These are choices that you are making, and we're just trying to help you make the right decision. So really, it's always going to be a team thing. Mental preparation is key and the more trust that we have with patients, the more comfortable they are with decision making because they feel like they're getting all the facts. They feel like what we're doing is what they would want. 00:13:46:13 - 00:14:05:08 Speaker 2 You know, we have people that make birth plans a lot, and I always tell people I love it when you make a birth plan or a birth guideline more or less to kind of because you've dug in, you've seen what's out there, what you think you want. But most of the time we do all of the things you want anyway. 00:14:05:08 - 00:14:26:03 Speaker 2 But in case, you know, if I'm going to like, maybe break your bag of water, I'm going to talk to you about it first. I'm going to let you know what's going on. You know, we can be as noninterventionist as we like or we can be very intervene tive in our practice. It's really, really awesome because we see a are both practices obstetrics. 00:14:26:11 - 00:14:50:17 Speaker 2 But if any of our patients get, let's say gestational diabetes or high risk things like preeclampsia, we have a very unique practice and that we work very closely with our OB-GYNs and we get to keep our patients. We get to we do get to do consults, we get to collaborate, and we get to stay with our patients. If our patients go to C-section, we stay with our patients. 00:14:51:01 - 00:15:13:15 Speaker 2 We get to provide breastfeeding and skin to skin right after that baby's delivered. I think this is a critical time for the midwives to stay with their patients who have been with us, who trust us. And at that moment, if I have to like, you know, if I would have to leave to be with another patient, it's a critical time for them to be alone. 00:15:14:09 - 00:15:35:10 Speaker 2 You know, they're they get scared. This wasn't in their plan. Or even if it's a planned C-section, they they'll say, are you guys going to be there? Absolutely. Because we understand the importance of staying with you in that continuity. It is really important in our practice. But the other thing is, is that we're helping Dad know where he can be. 00:15:35:12 - 00:15:56:11 Speaker 2 You know, this is or any partner that's involved, we want we want them to be involved. This is your birth either way. So we want to we want to make that special in whatever capacity it is. So we have a very unique practice in that we get to really stay with our patients no matter what's happening. 00:15:56:18 - 00:16:21:23 Speaker 1 And you touched on it, and I'm curious about how you work with the rest of the care team, obstetrics and whoever and the nurses and whoever else might be involved in the care, because I think and I know even for my wife and I, one of the things that we were nervous about because we didn't know about midwives before, we went through a process and we had midwives help us with our first birth. 00:16:21:23 - 00:16:32:13 Speaker 1 But I think we had misconceptions of what is a midwife. So I wonder if you could talk about sort of how you coordinate and work with the rest of the quote unquote traditional care team? 00:16:32:16 - 00:16:54:18 Speaker 2 Absolutely. So we have four OB-GYNs right now that take call and we work super closely with them. And I always remind people they are literally right down the hall. They are steps away. So if I need a consult, if I need a quick ultrasound, I'm not sure what's going on or just any questions that we might have. They are there for us. 00:16:55:14 - 00:17:08:18 Speaker 2 One of the biggest reasons I wanted to be a part of this practice was because of that collaboration. I knew that I was going to be able to do more high risk things because we had such a close, tight relationship. 00:17:09:18 - 00:17:31:22 Speaker 1 Again, kind of going back to the experience that my wife and I had had when we with our first child, when we decided that that we were going to choose midwives for for our care, there there were some some misconceptions. And in my mind, I think in my wife's mind of what is a midwife, and we talked before this interview of almost thinking of it like, is it alternative medicine? 00:17:31:22 - 00:17:47:02 Speaker 1 Is it it's almost, you know, is it outside of Western medicine? And in none of that really was true. As I as I came to find out. But can you talk about sort of one, what the training is like to become a midwife and maybe some of those misconceptions that you were? Yeah. 00:17:47:12 - 00:18:04:08 Speaker 2 I think very common myths because concept organs are that we only do home births. I think that's one of the biggest ones out there. And so when patients come to me, I want them to know they will be having a hospital birth home because yeah, it does get confusing. Or they're like, I don't want to deliver at home. 00:18:04:08 - 00:18:34:09 Speaker 2 And I'm like, You don't have to. So that's a big misconception. Most of nurse midwives are in the hospital, and when I say nurse midwives, there are many types of midwives across the United States and really I'm only an expert in my field. So basically I have an hour in a registered nurse degree and then you go back to school and you get your master's. 00:18:34:21 - 00:19:04:01 Speaker 2 So that's usually at least three years that you're doing that. And then you have the opportunity to do home births or out of hospital births like birth centers and then hospital births, of course, I think another big misconception is that we don't prescribe any antibiotics, we don't do any prescriptions. I think people just don't you know, they they don't really know what we do. 00:19:04:11 - 00:19:07:16 Speaker 1 Right. Like if you have a midwife, you can't have an epidural. Yeah. 00:19:07:16 - 00:19:27:07 Speaker 2 Yeah. So and I think people when they first meet us in these new O.B. visits, they think, well, I like you, you're great, but I want an epidural for sure. And it's like, All right, let that. Let's have that. The plan. Then you know, we do all of those things because you have a masters of nursing. We are like a nurse practitioner. 00:19:27:12 - 00:19:54:17 Speaker 2 We see you, we evaluate you, we treat you. But we're definitely you know, I think the best part about our practice is that you're definitely getting to know someone and going back to that individual eyes care, creating care plans that work for them. But yeah, definitely for birthing you can have anything from a water birth, you can have a land birth, you could have an epidural birth. 00:19:56:11 - 00:20:17:10 Speaker 2 You know, it's come what may come what you like. And some people don't realize that. Yeah. Oh you like standing let's, let's birth standing in there. Like what? And I remember when I was a student, you know, you start having births and you're like, Oh, yeah, this is awesome. And, and my first three were all standing or squatting. 00:20:17:16 - 00:20:35:15 Speaker 2 I hadn't birthed in the bed and I was like, I don't even know. I don't even know what to do. Like, I didn't know how to birth anything that way. So it kind of took me a little bit to just, you know, even even know how to, you know, birth in the bed. And now I just kind of sit there, sit in it, sit with them. 00:20:36:15 - 00:20:45:15 Speaker 2 But yeah, I mean, we you know, however you want, a birth is how we want you to birth however you're feeling. You know, we just kind of go with it. 00:20:45:21 - 00:20:59:05 Speaker 1 And you mentioned care sort of beyond the pregnancy. And I think that's another maybe misconception that folks have of, hey, you know, we're with you for nine months, and that's pretty much talk about a little bit more about what's beyond that. 00:20:59:05 - 00:21:35:00 Speaker 2 Yeah. So definitely after I think, you know, just for a timeline sake, when you come back postpartum, when you're thinking about possibly doing birth control, you know, we place IUDs or intrauterine devices. Most common ones are Morena and pare guard. You know we place different types of birth control like next plan on we can do pills you know anything that you really like we pretty much do because that's a huge part of what women want in their family and, you know, kind of trying to plan or design what they're looking for for the next couple of years. 00:21:35:07 - 00:21:59:06 Speaker 2 So we do a lot of discussion about all of that because it's very important and we're going to do all of your screening exams. So your speculum exams, we definitely have a lot of providers. You know that at your primary physicals they don't do your pelvic exam anymore. And we have plenty of people that show up and we just do their pelvic exam every year besides just your annual physicals. 00:21:59:11 - 00:22:23:14 Speaker 2 So it does it goes way beyond birthing. And I think that's why our patients keep coming back is because they're like, oh, she she got my baby. She's going to do this. She's going to do that. And she's the only person I need down there. You know, that's how people start to feel. So they just keep coming back and we just welcome it because we love hearing about their kids. 00:22:23:14 - 00:22:27:23 Speaker 2 We love hearing about what they're doing next. So it's awesome. It's really great. 00:22:28:07 - 00:22:49:16 Speaker 1 And if you have, let's say, a couple or a mother expecting mother in your office and she's kind of trying to make the decision of what route am I really going to go with here, or a couple is trying to make a decision of how are we going to proceed here? What would you tell them? Not not not a sales pitch, but but what do you tell folks in that situation about, hey, here's what we offer and here's the advantage. 00:22:49:20 - 00:23:08:21 Speaker 2 I think the biggest advantage and I've already really hit on this is education. I mean, when I talk about things, I want it to be a discussion. I don't want to be telling you exactly what you need to be doing or what you should be doing. We need it's it's an open forum. It's an open forum of questions. 00:23:09:05 - 00:23:35:00 Speaker 2 But we're also trying you know, we're trying to lead you with the healthiest lifestyle choices that's that are going to work for you. But just above and beyond, once you start talking, talking to people, they really don't want to see anybody else, you know, because you're you're making that connection and you just get so excited about this pregnancy and you start seeing the future of your pregnancy. 00:23:35:08 - 00:24:03:11 Speaker 2 So, yeah, I don't know. We just captivate them, I guess. As and I definitely tell people, if they're not sure they can meet with one of the obese, there's nothing wrong with that. I mean, we love them, we love them, they love us. So we just want them to be comfortable. But honestly, if they if they want that labor support and that can be in so many forms. 00:24:03:20 - 00:24:25:20 Speaker 2 But, you know, our OBS, our surgeons, they have they have consoles, they have surgery that they're doing. And we have the privilege of being open to be at your bedside during labor. And I think that that is always a key feature that we point out. We're not coming in to catch your baby. We will be there while you're pushing. 00:24:25:20 - 00:24:57:18 Speaker 2 We will be there before that and way before that. So once people kind of get there, they're like, Oh yeah, that might be nice. So so I think that that's a big piece of it. And, and we appreciate what they do because we need them. But I hope that they appreciate what we do and what we have the privilege of doing and just helping people through this, you know, this time, because it can be very impactful, it can be very traumatic. 00:24:57:18 - 00:25:10:08 Speaker 2 We talk about birth trauma all the time and sometimes things go wrong. And so as long as you have that person there, it makes it a little bit easier. So I think it's really important what we do and that we're there. 00:25:11:02 - 00:25:22:15 Speaker 1 You're obviously very passionate about what you do. I'm curious, what kind of was the initial motivation for for pursuing this line of work and what makes you passionate about it? 00:25:22:15 - 00:25:47:07 Speaker 2 I, I think I read, yeah. So I did My sister definitely gave my cousin. My cousin was pregnant. It was a really long time ago. And my sister, who is going to school in Madison, gave her a book on a may Gaskin spiritual midwifery. And I and if you've read the book, awesome. If you've seen it, there's a lot of big seventies pictures in there that are a little scary for some people. 00:25:47:14 - 00:26:10:05 Speaker 2 But I looked at that book and I was just taken I mean, I was like, This is what I have to do. And my parents were like, Hahaha, no way. It was like a joke. And so I definitely always thought, maybe I'll do like medicine. And then I got really into French and this story could go on and on. 00:26:10:05 - 00:26:32:22 Speaker 2 But I lived in France for a year and I learned what nurse midwives were there. Actually they were called sash farms, so they were wise women, which I was like, That sounds cool. And so anyway, just kind of like when I came back, I was like, Maybe I'll do French. And I was like, I just like, really love this concept of midwifery. 00:26:33:06 - 00:26:52:04 Speaker 2 And I had no idea what a nurse midwife was. And my parents definitely did. And they're like, There's no way you're catching babies at home. And, you know, they they just thought that was wild. And my dad's a chiropractor. So I was like, you know, man, like, you're in the natural fields are, you know, so why didn't they just they were like, You're crazy. 00:26:52:04 - 00:27:15:23 Speaker 2 So I ended up going into like a physical therapy chiropractic type aerobics. I was like, I loved the way that my dad was able to help people through not really natural medicine, but adjusting and just learning about the body. I think the basics I really take from my dad is education and I talk about it all podcast long. 00:27:16:20 - 00:27:42:19 Speaker 2 You really educating people and making them think about their bodies and and that's all you really need. That's the basics. Every morning I had a nutritional lecture, so, so I feel like I've been taking it for so long now it's time for me to, you know, dole it out. But I had this, I had this religions class. I made it. 00:27:42:19 - 00:28:09:06 Speaker 2 I've said this before, too. I had a religions class at UW Claire and I'll never forget it. It was just like a world religions. And you had to try out different techniques that that were involved in different religions all over the world. So we had to listen to this music for about 5 minutes and I wish I knew what it was and I wish I could redo it again. 00:28:09:06 - 00:28:31:04 Speaker 2 And you had to close your eyes and just listen to it. And then after it was done, you had to draw a picture. Now, I did this with my husband, my now husband, and he drew this, like, weird spoon, like it's like dripping out gold or something. I don't know. But mine was just hands on this wall. It was like this hill. 00:28:31:04 - 00:28:58:04 Speaker 2 And it was obviously a mother's belly and it was my hands. And I was like, This is crazy. And I was like, This is what I have to do. And I had just met my husband that year, and I think it was all perfect timing because his mom had had all of her children with nurse midwives. And I don't think she'll ever forget or I'll ever forget when I was like, I have I think that's what I have to be. 00:28:58:04 - 00:29:14:12 Speaker 2 I have to be that. And I you know, I knew that they were in the hospitals. I knew that there was advanced training. I brought it to my parents. I think they were still a little like, okay. I mean, you're going to do it. You're doing it. And it was awesome. Like, I finally felt like that was my goal. 00:29:14:12 - 00:29:35:16 Speaker 2 That was what I wanted to do. So that is really my story of how I got into it. And it can be a long story, but I think it was just it was very much of like a magical thing for me. And it was and, you know, I'll never yeah, I can always count on my husband Z like, you know, it's all because of me. 00:29:35:22 - 00:30:06:09 Speaker 2 I did that and so, so yeah, that's how I knew. And I went through nursing school and with my first labor and delivery job, I definitely thought it was really, you know, kind of the factory women were in and out and it was it was different than what I expected because I started out with this. I may GASKIN kind of like this is what birthing should be like. 00:30:06:09 - 00:30:37:04 Speaker 2 And my first clinical rotations for labor were with this set of midwives that I work with now and I will always remember after being there, even just a week, just just being tearful, like I know about how I thought, this is where I belong, this is what birthing should be like and I'm obviously exhausted from call and very emotional. 00:30:37:04 - 00:31:04:04 Speaker 2 And, and it was it was just like a high it was an aha moment that this is what I was born to do. This is what I, I wanted women to be respected and give them the opportunity to have these power, powerful, powerful moments. And it's really it's really them that make me passionate because I can talk all day long about what I do. 00:31:05:00 - 00:31:29:06 Speaker 2 But what they do for me is like even bigger. I mean, when you get the opportunity to see whether it's two people or two partners or their family change, I mean, when you get to see that and help them, oh, there's nothing like it. There is nothing more satisfying than saying, Oh, look at her. Like, look how beautiful she is. 00:31:31:00 - 00:31:54:19 Speaker 2 And it can be when she's, you know, showing me strength through like a natural birth, whether she's finally doing it in her epidural birth, I mean, it doesn't matter what it is. We see so much strength in women, you know, when they go through losses. I mean, you really see their power and how and how well they just they they can recoup over time. 00:31:55:03 - 00:32:17:10 Speaker 2 And we love being a part of that. You know, when you finally see someone who have suffered losses and then they get pregnant or they make the decision to adopt, you love being a part of that story or not even a part of the story, but witnessing those stories come to life. So it's really the women that we see that keeps that passion going. 00:32:18:01 - 00:32:47:12 Speaker 2 You know, we get tired like I am right now. We get tired and, you know, you get the clinic day to day and the demands of just working. And then it's like you get these moments with people that you just are. They're just indescribable. They're wonderful. And I think once you you know, I love projects like this because it makes me like really like, oh, yes, it's so great what we do. 00:32:47:12 - 00:32:54:08 Speaker 2 It's so awesome. So, yeah, you know, it's really the people that we serve, they show us so much. 00:32:54:18 - 00:32:58:04 Speaker 1 Katy Van Dreese, thanks so much for joining us on the rounds. It was really a pleasure. 00:32:58:09 - 00:33:04:10 Speaker 2 Thank you so much for having me. And I just loved I love talking about it. So come back anytime to Eau Claire. 00:33:04:20 - 00:33:38:07 Speaker 1 Great. Thank you. The Rounds is produced by Ryan Maderic and supported by the Marketing and Communications department of Marshfield Clinic Health System. You can subscribe to The Rounds and download episodes via iTunes or by visiting Shine365.MarshfieldClinic.org. I'm Adam Hocking and I hope you'll join us next time on The Rounds.