EP 24 – The One With The Amish Midwife, Kim Osterholzer

What is is like to deliver babies without electricity in Amish country? Are these women who have so many babies stronger than most? Do they recover quicker? In this podcast, we interview the author of “A Midwife In Amish Country” to learn about stigmas in birth, dysfunctional labor, and core rehab in quiet communities. What tears us down can be part of the healing process, and this episode will leave you better informed and smiling with pure joy over the simple things in life.

Get Kim’s Book HERE on Amazon via our affiliate link!

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Show Transcript

Chris Behnke:               Hey, everybody. Welcome to Fit2B Radio. My name is Chris Behnke and I’m going to be your host for today. I’ve got with us Beth Learn, she is the CEO and founder of Fit2B Studio, and we also have with us a cool guest I’m excited to talk about, Kim Osterholzer, and we’ve been talking in the pre-show about your last name, and I’m not sure if I said it right or not. I practiced, but I’m excited to have you on. Thanks for spending some time with us today. Where are you in the world? It looks like you might be in your bedroom.

Kim Osterholzer:          I’m in my bedroom.

Chris Behnke:               Bedroom, okay. Where is that bedroom?

Kim Osterholzer:          In Colorado.

Chris Behnke:               Colorado. Okay.

Kim Osterholzer:          Colorado Springs. Yeah.

Chris Behnke:               Colorado Springs, and are you a Colorado native?

Kim Osterholzer:          No. I’m from Michigan.

Chris Behnke:               From Michigan, and what brought you to Colorado?

Kim Osterholzer:          I’ve only been here four years.

Chris Behnke:               Four years? Okay. How did you end up in Colorado?

Kim Osterholzer:          Well, my first husband died in 2007 when my kids were teenagers, and then my kids grew up, and then I met Steve. He’s actually also from Michigan, but he’s in the … Well, he retired from the Army, but he was stationed here, and then he said, “Hey, do you want to get married?” And I said to my kids, “Hey, what if I get married and move away to Colorado?” And they said, “As long as you come back sometimes.” So, bam. I’m here.

Chris Behnke:               And there you are. And how do you like it?

Kim Osterholzer:          I really love it. It’s so pretty. It’s sunny. It’s dry, but it’s so sunny. And I realized after about two weeks being here, when you pull out onto the main road and there’s Pikes Peak, I said, “Nobody would move back to Michigan for the scenery, really, or the weather.”

Chris Behnke:               Yeah. I love Colorado Springs. I just love that whole area. It was on our short list of places to go. We didn’t end up there, but it’s really beautiful there. Took the drive to the top of Pikes Peak, saw the signs about being light headed in the parking lot, thought that was silly, and then was super light headed in the parking lot walking over to the gift shop. It’s just so high, and that’s the highest you can drive, right, in the state?

Kim Osterholzer:          I don’t know. I can’t remember for sure, but we climbed it last year.

Chris Behnke:               Oh my goodness. That sounds …

Kim Osterholzer:          It took us two days because I have this … My breathing is not ideal. But yeah, we climbed up right up to the top. That was kind of fun. Now every time I look at it I say, “Look at that. I climbed to the top of that.”

Chris Behnke:               Yeah. That’s a-

Beth Learn:                  That’s a good feeling.

Chris Behnke:               That is amazing. Well, so Kim, you are a midwife, which is really cool, but you’re a midwife that serves Amish people. That’s correct, right?

Kim Osterholzer:          Yes. The Amish communities I served are in Michigan. So when I moved out here … My daughter is also a midwife. I turned my practice over to her, and any time I’m home, I still do births there, but in Colorado my clients are English.

Chris Behnke:               Yeah, got it. That’s very interesting. I’m excited to learn more about that. How did you and Beth meet? You ….. Wait, Beth …

Beth Learn:                  I have the book.

Chris Behnke:               If you’re listening to the podcast, not watching this, Beth is holding up a book right now. Can you tell us about that?

Beth Learn:                  Yes. This is the book that Kim wrote, and I was one of the lucky few to get an advanced copy that is bigger than the actual copy, and I got this nice little note from her so that I could review it.

Chris Behnke:               Okay. So what’s the book for the people that are only listening?

Beth Learn:                  Sorry. It’s A Midwife in Amish Country, and it is her memoirs of and so many cool birth stories. It’s beautiful. Such a good book. Get your hands on it. Yeah, and now, Kim, now you can tell them how you met me.

Kim Osterholzer:          Okay. I’ve been serving moms, pregnant moms, birthing moms since 1993, and that was my apprenticeship. And I also had two babies at home in the early 90s, and of course at the end of having my son, I had a two to three finger breadth diastasis recti, and my midwife said … I said, “What do we do about this crazy thing going on in my belly?” And she said, “Basically, it’s just what happens to moms when they have babies, and if you want plastic surgery you can fix it.” And that’s all we knew then.

Chris Behnke:               Wow.

Kim Osterholzer:          And then of course, I had that sacroiliac joint discomfort and the weak back. It was everything, and then sneeze and pee. I enjoyed all of the things that we enjoy.

Beth Learn:                  Enjoy.

Kim Osterholzer:          Our rewards of birth. And it was just like, yeah, this is the price you pay, so lucky you. And that never really set very well with me because I just don’t believe … I do believe God made our amazing bodies to birth, but I also believe that it’s not supposed to cost us our vitality. And so, it was one of those things that as you’re serving moms and they’re telling you about their aches and pains, it was the thing that I always went away from visits heavy hearted about because I didn’t know what to say.

Kim Osterholzer:          And I did go to a conference in Michigan somewhere around the time, like 2007, 2008, I think, and a physical therapist had a whole bunch of ideas about how to handle some of these issues, and I brought my friend to the physical therapist too. I made her come, and long story short, we started having some solutions or things we could say, “This is what you can do for your sacroiliac joint, here’s some ideas to start getting your diastasis recti closed,” and things like that.

Kim Osterholzer:          But we still … It was like we felt encouraged because we were on the way toward getting people to a better place, but then I had a client, and it was interesting because she had her fourth baby and she’s one of these really slim moms, so she looks great. At the six week visit, we evaluated her belly and she didn’t have a DR at all, and so we said, “Wow, yay. You’re fine.” But she couldn’t reach … If she reached down to pick up the baby, her back was really weak and she was like, “I can barely pick this baby up,” and she said, “What do you think of that?” And I said, “Gosh, that’s terrible. I have no clue.”

Kim Osterholzer:          And she is a researcher, and so she started doing some research online and she found you, and she tried the totally transverse and she measured herself before, even though she was minute, and then she did it for like five days in a row and she trimmed off an inch or something or maybe two and her back, within that week, was so much stronger. And she said, “Kim, you gotta check this woman out.” So I got online, we had terrible internet at the time, but I got online and my daughter, who she wasn’t married and didn’t have her kids yet, but she also had a two finger breadth DR even though she …

Beth Learn:                  Yeah, ’cause it can happen even if you have not had kids ’cause it’s not caused by pregnancy, it’s caused by pressure. Yep.

Kim Osterholzer:          Yeah, so we were like, “What in the world?” So we found you and we did the … So we struggled through the … It looks so simple when you watch it,

Beth Learn:                  It is. It’s deceptively deceiving.

Kim Osterholzer:          Yes, it’s deceptively deceiving, definitely. So we were like, “Oh my gosh.” We finally figured out you have the get the breathing with the movement, that’s the trickiest part, and so we finally managed … It’s a 10 minute video, took us about an hour I think, and then we were sore for several days. And then I said, “Oh my gosh, this is amazing.” So I basically, from then on, I just followed Beth and I forced her to be my friend over time.

Kim Osterholzer:          And then the interesting thing is, though, two thirds of my clients in Michigan are Amish and they can’t get online to do an online program, so Hannah and I just spent forever and we still do it. We have these little conferences sometimes where all the Amish moms would meet in somebody’s barn and we would teach them how to your routines. And I’m sorry, we wrote it all down because we had to.

Beth Learn:                  That’s okay.

Kim Osterholzer:          So we wrote it all down, we gave you credit though. We always credited you.

Beth Learn:                  Thank you. Yeah, so that when those Amish ladies go online … No, I’m kidding.

Kim Osterholzer:          Like, never. But it was amazing because one of the moms we … Do you mind? I just keep rambling on about this.

Beth Learn:                  Go for it.

Chris Behnke:               This is amazing. I love it.

Kim Osterholzer:          I’m super excited because … So there was a mom I served, she was Amish and she switched to me, I think, when she was having her fifth baby, and this was about maybe a year and a half before I discovered you. And I think we did the conference and found you online about the same time period. First of all, it was kind of a fire hose of information, so we were overwhelmed, but we learned a lot. And then our visits, all of our prenatal visits and post partum visits became twice as long ’cause you’re trying to explain to everybody how to do everything, and then we’re all laughing because we can’t figure out the breathing even though we teach it like five times a day.

Kim Osterholzer:          So this mom was having her fifth and she switched to me from another midwife, and she warned me ahead of time, “Yeah, I have really fast births, so when I go into labor, you have to come immediately.” And I said, “Okay.” So she called and Hannah and I flew on down there, and I could see her contraction pattern was really irregular and she wanted me to check her and she was five centimeters.

Beth Learn:                  So she wasn’t going as fast as she normally did.

Kim Osterholzer:          So she wasn’t, no. And then the contraction pattern was irregular, and I did say, “Well, you know, this is what I see as women get older and have more babies.” It’s almost like their bodies go, “What? We’re not doing this again. Forget it.” And you kinda have to sweet talk it into clicking into gear. But I remember saying, “Why don’t you get in the tub for a while and let’s see,” and I wasn’t that worried about it being irregular because I knew it would kick in.

Kim Osterholzer:          So she got in the tub and after about 20 minutes, I could hear her crying, so I thought, “Okay, better do something,” and I had her get out, put her on the birth stool, and I checked her. She wanted to be checked again and I checked her and it was like, “Oh my gosh, she’s five centimeters still,” and I didn’t … She said, “What is it?” And I said, “Just a second,” and I basically swept my finger around a couple times and she just, every time I swept my finger around, she would dilate another centimeter and she started to get a contraction when she was like nine centimeters and I said, “What don’t you just give a little push?” And I handed her her baby and she went to bed, stopping crying, went to bed.

Kim Osterholzer:          But the thing is, that’s really dysfunctional. So even though it was like that’s awesome that we were able to go from five to ten that fast, blah, blah, blah, but it was just a dysfunctional labor. So after she had the baby and when she was like six weeks, I think by the time she was six weeks post partum, we had learned enough about how to find a DR. She had a five finger breadth DR. And I said, “I think this is what happened. I think this is part of what’s happening.”

Kim Osterholzer:          So about three or four, maybe half a year later, ’cause I … Okay, it must have been like six to nine months later, my friend who’s a physical therapist, we did one of these little gathered all these Amish ladies into one room, taught them everything we knew, and then my friend went ahead and we had this curtained off area and she just evaluated everybody’s belly and said, “This is how many finger breadths, this is how many you are, and here’s our suggestions.”

Kim Osterholzer:          And so, this mom came to that, and I think this is when we realized she was five. I don’t think I knew how to check at her six week, but she was already pregnant again. And we said, “Wow, you’re five,” and I remember thinking, “We’re just looking at another dysfunctional labor.” But Clarissa gave her a lot of suggestions and we had her start doing the totally transverse routine, and by the time … So we didn’t know, of course, once you’re nine months pregnant, you don’t really know how broad the DR is. I mean, it didn’t even cross my mind to check, but she was definitely having fewer complaints, and she had a beautiful labor. I mean, we almost missed it. It was like three hours, just like before, and post partum, so this was her sixth baby, and post partum, at the six week visit, she was only two finger breadths.

Chris Behnke:               Wow.

Beth Learn:                  There it is.

Kim Osterholzer:          So this is after the whole pregnancy, and really, all she did was the totally transverse and squatting. So that was when we really said, “Wow, this is definitely …” That was probably when I said, “Beth is gonna be my friend. She will love me.”

Beth Learn:                  And I do. Anybody who does birth, but especially the way that you approach it, is so refreshing, and I love that you took what you knew and shared it. I mean, this information is information that every woman should have, every midwife should have.

Kim Osterholzer:          Absolutely, yes.

Beth Learn:                  And the fact that they don’t, that the knowledge has been so lost and so jumbled is a tragedy. And I’m not the only one sharing the information, but I’m just the one that you found.

Kim Osterholzer:          Yes, and you have a really nice down to Earth, fun way of addressing it. At least it’s relatable for me and my clients. I mean, my clients … The clients who can get online, they love you and appreciate you.

Beth Learn:                  Aw, thanks. Well, I appreciate hearing that.

Chris Behnke:               How was it trying to get Amish women to do a fitness routine? I mean …

Kim Osterholzer:          That’s challenging.

Beth Learn:                  Yeah.

Chris Behnke:               But you figured out how, right? I mean, it sounds like, obviously, this woman did what you said and practiced and it she must have done it pretty consistently and strictly.

Kim Osterholzer:          She was diligent.

Chris Behnke:               Diligent.

Beth Learn:                  Well, and the reason why I giggle is because these are already strong women. These women are, they’re already doing a lot, they’re living pretty active lives. I imagine that one of their first thoughts is, “Lady, I’m already going without electricity, and you want me to do what with my body?”

Kim Osterholzer:          It’s more like, I have six children. I get up at three o’clock in the morning. Yeah, I don’t go to bed till they drop into bed exhausted. That’s the thing, they aren’t strong in the sense that … If you just work really hard, but you don’t actually take care of yourself, it’s amazing what your mind can force you to do when you have to do it, but they’re not as strong as they should be, need to be, etc. If they’re having babies, these women … This is one thing I really discovered. After we discovered my own daughter had a DR, then I started noticing that my first time Amish moms, almost without exception, came to care with pretty significant DRs.

Beth Learn:                  Before they even had their babies?

Kim Osterholzer:          Oh, yeah. And you really have to wonder, I have all kinds of little interesting theories about it, but one thing I know for sure is if you have a ten year old girl hauling a five gallon bucket of water across a barn, that’s a lot of pressure. That’s a lot of … You’re just asking for dysfunction.

Beth Learn:                  Yeah. And of course, they’re not stopping and training that motion. It’s not like they’re teaching a kettle bell carry, you know?

Kim Osterholzer:          Right.

Chris Behnke:               Right, right.

Kim Osterholzer:          It doesn’t occur to them, go ahead and tighten everything up before you lift the load, which when my kids were little, I did have some instinctual understanding of this stuff and we heated our house with firewood, so we did a lot of stuff with firewood, which I was heavy. And I would say to them, “All right, we’re gonna be picking up all these logs, tighten your bottom and tighten your tummy.” And I remember my son was like, “Please don’t say tighten your bottom.”

Beth Learn:                  But that works.

Kim Osterholzer:          He’s like, “My friend’s coming today to help, please don’t say tighten your bottom.” I said, “Hun, we’re gonna do what we have to do to not get hernias.”

Beth Learn:                  Yep.

Kim Osterholzer:          So anyway, but that was one thing was realizing these women are coming … So you can work really, really hard, or it’s like a roofer that spends his whole life working on roofs, he’s strong and can work long hours, but that doesn’t mean he hasn’t debilitated his body while he’s at it.

Beth Learn:                  Yeah.

Chris Behnke:               Right.

Beth Learn:                  And that’s exactly what we’re seeing.

Kim Osterholzer:          Yeah, so the Amish women, when you say … Like, I would say, I had this little checklist of things I asked. Like, it’s literally on, “Are you doing transverse abdominis? Are you doing your inversion?” I have like [crosstalk 00:18:59]

Beth Learn:                  Oh, that’s so good.

Kim Osterholzer:          “Have you seen the chiropractor? Are you drinking your water?” This whole long list of things. I’m the professional nagger, basically.

Beth Learn:                  You need it.

Kim Osterholzer:          “And have you exercised? Are you doing any regular exercise?” And they’re just like, “Hello?”

Beth Learn:                  Yeah, “I’m hauling buckets of water.”

Kim Osterholzer:          “I chase the children and I wash the laundry by hand.” And you’re like, “I know you’re working hard, but that’s not the same thing.”

Beth Learn:                  No, there’s a difference between wear and tear and rebuilding.

Kim Osterholzer:          Yes, exactly.

Chris Behnke:               But from a cultural standpoint, doing something physical for no functional reason is crazy. It’s gotta be.

Kim Osterholzer:          It is crazy. And they don’t understand … And that’s the thing I’ve really tried to take the time to explain to them too is like if you will take the time to create strength, build strength and health, and we also look at what they eat, then you actually will have more energy to do your work and your body will handle the work you do better. When I say, “Hey, are you doing these exercises?” They’re like, “Oh, I don’t have time,” and I just remind them that if you want your bladder to stay in the right place and your uterus when you’re 50, this is about keeping your organs where they belong.

Kim Osterholzer:          And then they know that because they’re moms. I mean, I can’t tell you how many Amish moms … I’d go see a mom and she’d say, “Hey, could you stop over to my mother’s house because she thinks something’s falling out.” And then we’d go and look this mom over and it’s like, “Yeah, sure enough. There’s your cervix.”

Beth Learn:                  Do you ever … I don’t know if this is within your scope. Do you ever fit moms for pessaries at that point? What do you offer them at that point?

Kim Osterholzer:          I usually would bring my friend Clarissa down. Poor Clarissa, I just dragged her all over creation. Like, “Are you busy on Thursday?” I’d just bring her down. But a lot of times … So then those moms that actually had something falling out or fecal incontinence or something that’s dramatic, then we would try to get them regular visits with Clarissa ’cause she took … She’s a physical therapist and she took … Oh, Bruce LaBrecque is the physical therapist in Michigan who, he came up with a program like … If you don’t know him, you guys would love each other.

Kim Osterholzer:          So he has an advanced program for physical therapists who wanna work exclusively with women and their issues, so I’d drive her to his class. It was a midwifery conference and I brought her, and then she went and took his course, and so that was amazing. But some of the moms, again, it’s like, “Wow, your uterus is falling out. You should really not do the heavy lifting in the barn anymore. Let’s get you fixed,” and they’re just like, “That’s not happening. I have to do my …”

Chris Behnke:               Right.

Kim Osterholzer:          But we tried, did our best.

Beth Learn:                  What I’m hearing too is that … I don’t like calling them excuses. I just feel like that cheapens it ’cause they are valid reasons, but whether you’re Amish or English or whatever, your reasons for avoiding doing this stuff are similar.

Chris Behnke:               Yeah, and it’s avoidance of self care. So I think sometimes it’s … You guys tell me if this is true. There’s a certain amount of avoidance that everyone has to do physical exercise most of the time, unless they’re like Beth and crazy and really do wanna go lift weights or something for real. Most people …

Beth Learn:                  And you. Kim likes to lift weights too.

Kim Osterholzer:          Yes, I do.

Chris Behnke:               Most people avoid, but then there’s a different kind of avoidance that’s the avoidance of the self care because I need to put myself last, I need to be serving. There’s that angle and that, I feel like, is far more powerful. Is that assumption true?

Kim Osterholzer:          Yes, it’s almost like the self care is frivolous. That’s what I see, and I think that’s what you’re saying. And moms are notorious for that, and then I think Amish moms are even beyond that because there’s nothing they do in their lives that’s for aesthetics. They’re not gonna … It’s interesting because they’re pretty normal women like the rest of us. If they’re chubby, none of us women are that comfortable with how we look ’cause of our culture. So even the Amish are, they don’t wanna be chubby or whatever their definition of, they can think you look great, but they don’t think they look great. But to do an exercise program to change the way you look, and that’s how exercise is sometimes perceived, exercise to look better.

Beth Learn:                  Oh, that’s how most of it is sold. Most, not us, which actually makes it hard for us to sell ourselves.

Chris Behnke:               Right, which actually is a challenge we’re always facing in our marketing discussions. But anyway, go ahead.

Kim Osterholzer:          And that’s the thing too, it’s like, what I try to explain to moms is like, if you were to exercise properly and eat properly, the gain is your health and the side effect is, yeah, you’ll look better, but who cares of what you look like if you’re nonfunctional at 40 years old or you have to go get your bladder tacked back into place? The crazy things you hear about. So the Amish moms that really embrace your program and the diligent exercise, they’re the moms that are like, “Wow, I just had the most horrible birth I’ve ever had and I can’t do this again five more times.”

Beth Learn:                  Yeah.

Kim Osterholzer:          [inaudible 00:25:12]

Beth Learn:                  Yeah, we get a lot of moms that have had several children who want to have several more who feel defeated and betrayed by their own bodies.

Kim Osterholzer:          Absolutely. And don’t you think … I know after birth, I put moms in a … Once they’re up, go to the bathroom, come back to bed, I put them in a binder. We used the tummy team binders, and then I just say for the first six weeks, 24/7, be in your binder. And then we evaluate their belly, evaluate their bottom, and then make recommendations from there. But it’s interesting too how the talk of feeling defeated, I think there’s even … If your belly’s not, if you have a serious DR, I don’t know, I think it has a psychological … There’s some kind of a psychological. You’re more prone to depression.

Beth Learn:                  Yes.

Kim Osterholzer:          And I don’t think it’s just because of how you look or how you feel about, something else is going on. [inaudible 00:26:16]

Beth Learn:                  I haven’t seen, and I wish somebody would. Hey, maybe you and I should get our heads together, Kim. Research the incidence of depression. I mean, maybe it would be as simple as running a survey if they’ve been diagnosed with diastasis and if they’ve also been diagnosed with depression and what’s the correlation there? I mean, I don’t know if it’s causation, but I think the two can definitely go hand in hand and it’s not just because of aesthetics, but because our mid centers do so much for us.

Chris Behnke:               Well, it makes perfect sense if you kinda step back and look at it as you are your body. You can’t really be disconnected from it, and when you are faced with that realization that, “Hey, this is broken,” and it’s not from doing some wild living or something, it’s broken through a natural situation, then it feels like you’re flawed. So then you have this kind of, “Well, I guess I’m flawed, so that sucks and now I’m depressed.”

Kim Osterholzer:          And that kind of feeling like your body has betrayed you and that motherhood has betrayed you. But that’s the thing too, they say that wearing your binder diminishes post partum depression, so there has to be some … Like you’re getting a hug all day or something.

Beth Learn:                  Yeah. No, I mean, Kelly has said that. She’s gone on record.

Kim Osterholzer:          Oh, really? Okay.

Beth Learn:                  Yeah, she’s done a couple of case studies and I believe … It seems like I did see a study that was done, it was just a small one where they used binders as part of the protocol along with medication, but I can’t speak coherently on that, so let’s just set that aside for right now. But I mean, if they haven’t done that, they should.

Chris Behnke:               There needs to be the study.

Beth Learn:                  Yeah. You know, along those same lines, do you think that there’s more of a stigma in the Amish community, in these more conservative communities in general when it comes to a mom who feels like she can’t have more kids and what that does to her mentality?

Kim Osterholzer:          Well, let’s see. It’s really challenging in the Amish community because if a woman … If you serve one woman through the course of her child bearing years, each one of these women have this point where we both realize, even if she doesn’t quite vocalize it, that she’s hoping that somehow she doesn’t get pregnant again very soon or at all, and that’s challenging because any kind of birth control, a lot of them may even feel like just abstaining from sex to not get pregnant is a sin. So I feel like that goes so far beyond a stigma, it’s considered sinful. So that is a huge … They just really struggle with that.

Kim Osterholzer:          And then they also struggle with feeling guilty for not wanting more children, but then if they get pregnant … It’s just interesting because then if they get … They do love their babies. I think they wouldn’t mind having 12 kids if maybe they didn’t have to give birth to all of them because, and it’s really, birth is challenging, but I think it’s also the wear and tear on their bodies. They just kind of age quickly.

Beth Learn:                  Yeah. Well, and they’re working so hard.

Kim Osterholzer:          Yeah.

Beth Learn:                  I think we have a perception from the outside looking in that they just crank them out easy peasy, and they’re just strong, and this is just what they do, and it’s just easy, and they just love it.

Kim Osterholzer:          Yeah, that’s not … No.

Beth Learn:                  No. I was reading your book. I was like, “Whoa, this is very insightful,” and it plays into that psychosomatic, the mind body. Like Chris said, we can’t just divorce ourselves from our bodies. I believe we are soul, spirit living inside of this physical shell, but they’re connected, and there’s this hesitancy, I don’t know if you’ve encountered this, Kim, in the physical therapy and midwifery world, this hesitancy to use the word broken right now.

Beth Learn:                  And I wrote a blog about it, like, why I don’t have a problem with the word broken, why I don’t think we should ban that word. ‘Cause they’re like, “Let’s not use avoidance speech, let’s not use terminal speech, let’s not use condemning speech.” And I get it. “Let’s not use the word can’t, let’s not use the word avoid, let’s not use the word broken, let’s discourage our clients from using those words,” and I’m not sure I’m on that side of the fence because I think we need to be clear.

Beth Learn:                  And as I pointed out in my blog, when I was a kid growing up in a family where my dad could fix anything, if something was broken, that wasn’t a sense of damnation, it wasn’t the end of the world. It was you bring the pieces to daddy and say, “It’s broken,” and that’s the moment you get help, the moment that you say, “This is broken. I need help. It needs to be fixed. I need duct tape, I need screws, I need something.”

Chris Behnke:               I think the difference is when you have something broken and you bring it to someone and they say, “Let’s fix this,” and the difference of a woman coming to a doctor and they’re like, “Yeah, that’s just how it is. It’s a bummer.” That’s a big difference, and then you don’t wanna use the word broken if that’s the mentality ’cause then it’s like, “I don’t wanna be broken my whole life.” It’s more of an acceptance, but the problem is that that’s wrong. That’s where the real problem is.

Beth Learn:                  In this case. Yeah, with diastasis.

Kim Osterholzer:          And I haven’t really thought of it in terms of words, necessarily, because I don’t know … When women are talking to me about their bodies, I don’t think either of us are trying to … It’s like, “What’s going on with your body? This is what’s going on with the body. This is how, let’s do this and this and this, and see if we can achieve a repair and rejuvenation.”

Beth Learn:                  Yeah, in that moment, you’re not trying to censor yourself or say the right words, you’re just trying to get to the bottom of it, literally.

Kim Osterholzer:          Yes, literally. And I don’t know, I guess maybe I’ve never … I haven’t heard the whole terminology argument. Sometimes I think I’m just so busy doing what I’m doing that I’m just doing what I do.

Beth Learn:                  Yeah, which is great.

Kim Osterholzer:          That’s the thing is I’m not necessarily afraid of the fact that something is broken, like you said, and I also had a dad who was a serious fixer, so maybe he did set me on the right mentality of about it. But when somebody says … Like, I remember when my midwife said, “You just have a two to three finger breadth DR and unless you want surgery …” And I remember thinking, so I was probably 25, I thought, “Well, okay, I’m not gonna get surgery, but if these muscles aren’t stuck together like they’re supposed to be, I’m gonna train them to lay near each other so that at least we’ll just …”

Kim Osterholzer:          So I started doing by myself, I mean, I’d hold it together and do little crunches, and I did that three times a week for 16 years. And then I went to that class with the physical therapist and he was talking about how here’s how to find your DR and, of course, all these midwives are sprawled across the floor, we’re all feeling our bellies. And I was like, “Okay, I haven’t even checked.” I never did recheck. I just said, “Well, we’ll just get it where, put everything where I want it and we’ll strengthen it there,” not knowing anything, obviously.

Beth Learn:                  Yeah, which is part of it. Yeah.

Kim Osterholzer:          And I don’t have a DR at all, and I was like, “Well …” It was kind of neat to be sitting there and go, “Yeah, you can fix it. This is fixable.” And I mean, after I had my kids, I wet myself. I mean, it’s interesting to be almost 50 years old and to have core and floor that is better than almost any other woman I know, just because I followed these little principles way before I knew what they were, and then once I met you and went to these classes and learned the actual terminology and this is how you actually do it, and it wasn’t even me just sort of trying to make it better on my own, so I know for sure you can be functional.

Kim Osterholzer:          And I think that is one thing that worked with my Amish clients when their moms and I, we’re the same age, and nobody had to say, “Do you want what your mom has or do you want what I have?” But one of those things you don’t have to say it. They just look at me and I say, “You can fix yourself. We can do this if you will set the time aside.” And then some moms prioritize it and some didn’t.

Beth Learn:                  Now, you’ve also picked my brain in the past about lifting weights because you do CrossFit and you work out at a box and they asked you to lead something because you were saying all this stuff.

Kim Osterholzer:          Yeah, so then I called you.

Beth Learn:                  Then she calls me and she’s like … Well, how did that conversation go?

Kim Osterholzer:          I said, “I’m about to teach this class. You should come and teach it.” Basically. But since you can’t come … I think I just had some questions and had some thoughts and ideas I wanted to make sure they were valid. Yeah.

Beth Learn:                  Yeah, I remember you asking me about some of the breathing with different things and we talked about deadlifts because the breathing with that can get tricky ’cause there’s so many complex moves, especially if you get into clean and presses. And so, we just had this phone session and it was so good. I do wanna come visit.

Kim Osterholzer:          Yes, I would love to have you in our midwifery community. The midwifery community is a little, there’s things going on in it right now, but once things settle down a little bit, I think it would be great to have you come and speak.

Beth Learn:                  Okay.

Kim Osterholzer:          I would love that.

Beth Learn:                  Let’s set it up.

Kim Osterholzer:          Yeah.

Chris Behnke:               Do you feel like in the community there’s more and more awareness for this, in the midwifery community, or is it still resistant there too?

Kim Osterholzer:          If there’s any resistance, I don’t really think it would be so much resistance. What I see more than anything, this is what happens with midwives. We are interested in learning and in improving the care we provide our clients, that kind of is midwifery in a sense. Let’s make this the best it possibly can be, and then of course, you get really busy with all your clients and your family and you’re just really excited if you got a shower and brushed your teeth and food today, sometimes. So talk about self care, you really have to be intentional in that department.

Kim Osterholzer:          So sometimes when you say, “Hey, here’s a whole other venue of learning here,” people can be like, “I’m exhausted. I’m going to bed.” But we …

Beth Learn:                  I’m done.

Kim Osterholzer:          Yeah.

Beth Learn:                  I’m done.

Kim Osterholzer:          But then we just keep talking about it and that’s one thing I love about midwifery too is we’ll all get together in conferences, we get together in peer review groups, and get together and talk about what we’re learning and what we’re doing with our clients and sharing information. And so, the more we share …

Kim Osterholzer:          So once I went through, I had taken what I learned about the transverse abdominis and made it into something that we could use with the Amish ladies, just that little couple pages, and there was two other midwives in the area that served the Amish. One of them, it was my preceptor, and the other one is like one of my heroes. She’s done like 2500 births, she’s amazing. And we all got together in Sue’s kitchen and they were like, “Tell us what you’ve learned.” And so, we went and brought the papers and said, “This is what we’re learning.” What we’re learning. That was the thing, it’s not like what we’ve learned and we’ve got it. So then I know they’re taking, everyone takes the information and disseminates it in their own way.

Beth Learn:                  Yeah. You know, it’s the benefit … What would you say the benefit is to midwives to have this information about the core and pelvic floor and how those muscles actually work, how to bring those muscles back online, how to integrate the core and pelvic floor in birth, how to be able to bring that into some of your support methods? What’s the benefit to you?

Kim Osterholzer:          Oh, it’s super easy. I mean, it’s the same as with the chiropractic care. Yes, for your sake as my client, I want everything to function properly, and the reason I want it to is the same reason you would want it to. It’s like, “Do you want a quicker, easier, less painful birth? How about repair? How about recovery? Do you want a quick, easy recovery? Do you want it hard or easy?” It’s super simple. So if you have a mom … That’s the thing. We were really lucky with that mom who stayed at five centimeters for a while and I was able to get her on the birth stool and sweep her cervix open.

Kim Osterholzer:          We’ve been with other moms, I had a mom several years ago that she was having her sixth or seventh, I think it was her seventh, and her core and floor was, and this is well before we learned about any of the repair, any of this core rehabilitation. So I remember meeting her, like, she’s super cute and she looks really good, but the first time I met her, I thought she had told me she was 12 weeks pregnant. And so, I showed up at the door and she looked like six months pregnant, which of course I did not say that, but I just thought, “Oh, I must have misunderstood what she said about her dates.” And then we sat down and I started asking questions and it’s like, “No, she’s 12 weeks.” And then she laid down on the floor and I felt her uterus and her uterus was definitely 12 week uterus, but I don’t know what her DR would’ve been. I didn’t know to check it.

Beth Learn:                  It probably was pretty wide.

Kim Osterholzer:          It was just like there was no support. So then she wound up with a pendulous belly when she was nine months pregnant, so she didn’t have her abdomen holding her baby up and in the way it’s supposed to, so pressure on the cervix the way it’s supposed to, so enough stimulation to really get her body to kick into labor. So she did this labor pattern that was enough to annoy her, not enough to start her labor for, I don’t know, five days, and she couldn’t quite get to sleep at night.

Beth Learn:                  That’s exhausting.

Kim Osterholzer:          But it was like a five to ten minute apart contractions, and finally, I said, “I think we’ve gotta go in. I think you just … We’re gonna have to do a little bit of Pitocin.” And we went in and I called ahead just to say we were coming and it was a [inaudible 00:42:14] and this is what’s going on, and they gave her a little bit of Pitocin, and 40 minutes later, the baby’s out. But that’s the thing, it’s like I know, what I’ve learned since is if she had the core and floor she needed …

Beth Learn:                  Or if you could’ve splinted her during that time or done some [crosstalk 00:42:33]

Kim Osterholzer:          Yeah, which I do think we tried. I think I had put her in a binder because we did understand that the belly needed to come up and in, but … And I another, I had an Amish mom having her tenth baby that we actually used the binder to bring the baby down. She had to keep it on, she wouldn’t go into labor, and so we experimented with it, put the binder across the top of her belly, and then we stayed for a while and monitored the heart tones and had her do kick counts. She finally went into labor and she had to keep that binder on till she was like seven or eight centimeters.

Chris Behnke:               Wow.

Beth Learn:                  Wow. Yeah, ’cause the transverse abdominis, when it’s not functional, the splint can kinda stand in, it does stand in, but the uterus knows it’s not the same. It’s not the same kind of pressure. And so, we do our best with these manmade things, but the ideal is that the core be made functional again and that’s what we’re really trying to do here is teach women how to exercise their core muscles. It’s really more about connecting with them and being in control of them. And lately, I feel like those words resonate really well with the crowd that is not wanting to, quote, unquote, exercise. Okay, you know, let’s connect. Let’s just get you to connect with your core.

Kim Osterholzer:          Oh, that’s so interesting. [crosstalk 00:43:59] That is definitely true.

Beth Learn:                  Yeah.

Kim Osterholzer:          And it’s interesting, one thing I’ve discovered with moms too that’s so interesting is touching, if you touch … I tell moms, “When you’re doing your transverse abdominis, touch it ’cause it somehow connects you.” And then I had a mom who came to me late care this year and she had had a second degree tear with her first baby that went unrepaired, and she was complaining about her nether parts and I said, “Well, can I just assess your vagina?” And so, I just did an assessment and I went around to about here and could feel something of a gap, but when I had her try to do a Kegal, nothing happened.

Kim Osterholzer:          And I was thinking, “I’m gonna send her to the physical therapist,” but as I was even thinking that, I said, “Do you mind if I just stroke your vagina some?” And she said, “That’s fine,” but I just took my fingers and just drew them down and I said, “While I’m doing this, see if you can focus on doing a Kegal,” and it was like she immediately did one. And that got me thinking, I don’t know, I’ve used that a lot since then. I’ve said, “Put your own fingers in there and touch and reconnect.”

Kim Osterholzer:          But we use that too with women catching their babies, that if a women, that you want her to birth her baby gently so that she doesn’t have a bad tear, you can have her put her own hands on her bottom while that head is coming out. It’s amazing how she immediately governs, recalibrates, and will change how she’s pushing and then makes it work, and then out come these babies with minimal damage to their perineums.

Beth Learn:                  I just read a couple days ago a study that showed, and I don’t know how they did this, I don’t know how they checked it, but when the perineum is relaxed, I think it was like 50% less tearing as opposed to when everything is tense and tight, which, hello, you’re trying to push something through …

Kim Osterholzer:          Right, and you have to be intentional about that. So one of the people on my launch team is a physical therapist.

Beth Learn:                  For your book?

Kim Osterholzer:          Yeah, for my book, and her name is Jenn Stone and she said that she developed this pushing protocol, and I said, “Well, tell me it.” So she sent it to me and one of the things she has moms do is while they’re pooping is to practice really relaxing the perineum and she says, “Huff like you’re gonna fog up a mirror and get the muscle memory,” so that once you’re in labor, you don’t have to say, “How was I supposed to do this?” But you do it every time you poop and I’ve been having moms do that.

Kim Osterholzer:          And that was the thing I was realizing too is that when we talk about not pushing too hard, some of the moms were so worried that they would push too hard that they told me later, “I think I was tensing my bottom to try to slow it down.” So this is one thing I’ll say is we’re constantly learning as we go and I learn a lot from serving my clients and a lot from listening to my clients. But I really loved that where Jenn has this really specific way to train your bottom, your perineum to relax while you’re giving birth, and it’s making a big difference, and she’s seen a lot of good results in her own practice. And she just had a baby and I’m pretty sure it went well. It’s out. It looks like a beautiful baby, and it was big too. I think close to ten pounds.

Beth Learn:                  Wow. Well, I mean, birth is birth and you and I both know that we can do all the right things and still have baby do something completely different.

Kim Osterholzer:          Yeah.

Beth Learn:                  I have a dear friend who is a physical therapist who did all the right things, but then baby got head hyper extended and they had to C section ’cause it just flat out got stuck.

Kim Osterholzer:          Yep.

Beth Learn:                  And big old tailbone bruise right on the baby’s head ’cause it was just jammed in there. It’s a symphony and everybody has to play their part, all the muscles, the baby has to play its part. This is why I nerd out on birth ’cause it’s just so fascinating to me and I think it’s so great how you talked about your own hands on stuff you can do and I wish more midwives would develop that scope of their practice because they already have a license to touch, they already can get in there.

Beth Learn:                  We interviewed Jacob Mearse who’s a male midwife and he talked about how he does things like that in his clinic where there are certain things he can do with them. Instead of having a 20 minute appointment, have a 45 minute appointment, and he goes, “They’re reporting things, I get in there, I exam,” and he’ll do some scar massage and he’ll do some teaching release stuff.

Kim Osterholzer:          Oh, I’ve been teaching people about scar massage.

Beth Learn:                  Yeah, it’s huge.

Kim Osterholzer:          It’s amazing.

Beth Learn:                  Especially in smaller communities where your clients may not have easy access to physical therapists or to good doctors who know what they’re saying and aren’t just referring them for needless surgeries that is body trauma on its own, you guys are really that front line that’s right there. You’re already looking at it.

Kim Osterholzer:          Yeah, and they’ve already given you the permission and trust you to touch. I mean, we still, any time I do anything, touch moms and touch anywhere, you’re getting permission.

Beth Learn:                  Always ask.

Kim Osterholzer:          But yeah, it is interesting to … That’s why I thought I should send this mom to the physical therapist, but I said, “Do you mind if I try something?” And to have it work that quickly, and then I just said, “You and your husband, why don’t you do that every day?” And then it was really …

Beth Learn:                  I’m sure he won’t mind.

Kim Osterholzer:          And it was very different, I could barely feel that gap later. So technically, if you have a second degree tear that goes into the musculature and you don’t repair it, they say that because that’s the elasticity of the muscle that it can’t just go back together.

Beth Learn:                  No, when there’s that full avulsion of the levator ani muscle, it gets pronounced different ways, and it actually is very similar to common sports injuries that women get if they tear or land on their crotch wrong when they’re doing sports. Here’s the real tragedy is if they’re an athlete and that happens and then they’re having trouble and they’re having trouble peeing their pants, and then they’re referred to an MRI, and then it gets treated. But moms and pretty much, and it’s like over half of all forceps deliveries result in that, and so this levator ani avulsion, ani. I always go back and forth.

Kim Osterholzer:          I have no idea.

Beth Learn:                  Well, that’s probably that gap you felt and I think that they said it’s usually on the right side.

Kim Osterholzer:          Oh, it was on her right side. It was on the right side and it was like at seven o’clock.

Beth Learn:                  Yep, that’s it. Uh huh. There are some, you can google it, levator ani avulsions.

Kim Osterholzer:          Interesting. Well, by the time she gave birth, we could hardly feel it, and then after birth …

Beth Learn:                  With therapy, it can get better.

Kim Osterholzer:          And then at six weeks, it was like I can’t find … And so, she got a weird first degree tear. The only reason I had, I just repaired it because nothing, like the skin … It was like one of those things where if I don’t repair it, you’ll never look the same.

Beth Learn:                  It’s not gonna heal right, yeah.

Kim Osterholzer:          And so, I just did that, and then at six weeks reassessed her bottom and it was like you never would’ve known what had happened before. I love when that happens.

Beth Learn:                  Yeah, and we can facilitate that.

Kim Osterholzer:          [crosstalk 00:52:10] itself I feel like was part of the healing process because I do actually think a really good birth … I’ve had more than one person come to me after a bad first baby tear, like a third degree tear, and we go over a lot of things, like how to soften scar tissue, practice how to relax your perineum, and then if she can accomplish that second birth gently without another second degree tear, it almost puts her back where she was before. I mean, it seems like it fixes it. So it’s interesting what we think breaks us down can actually be part of the healing process.

Beth Learn:                  That is a good statement to end on right there.

Chris Behnke:               That’s good.

Beth Learn:                  What tears us down can actually heal us. So good.

Chris Behnke:               Kim, this has been very interesting getting to listen to the two of you geek out on this. I like these podcasts, they’re always very informational for me. I appreciate your time today. It’s super cool to hear some of these stories and to hear you fighting the battle on the education side as well. It’s very cool.

Beth Learn:                  Yeah, thank you so much for being on our show.

Kim Osterholzer:          Thanks for having me.

Chris Behnke:               Real quick, real quick, where can people find more information about you and find you?

Kim Osterholzer:          Well, I have a website, so I’m at kimosterholzer.com, and then my book is actually on Amazon and Barnes and Noble, and almost all the Barnes and Noble stores carry the book right now.

Beth Learn:                  It’s so good. Everybody go out and get it.

Chris Behnke:               We are going to list those in the show notes, and super cool. Thank you so much for spending time with us today. Really appreciate it.

Beth Learn:                  Wait, wait, wait. What’s your favorite exercise, Kim?

Chris Behnke:               Oh, I keep forgetting that.

Kim Osterholzer:          My favorite exercise of all time is squatting ’cause I feel like it’s a really … And squatting without touching anything because then you’ve got the neural thing going on, which I think is probably Alzheimer’s prevention too. Anyway, it’s like an all body exercise, as long as you’re doing your squat properly. I feel like a poorly done squat is probably one of the most destructive things you can do too.

Beth Learn:                  Oh, good point.

Kim Osterholzer:          So a properly done squat, that’s my favorite exercise.

Beth Learn:                  Awesome.

Chris Behnke:               I love it.

Beth Learn:                  I’m with you on that. All right, have a great day.

Kim Osterholzer:          I’m learning.

Beth Learn:                  Yes, yes.

Chris Behnke:               All right, thank you.