Ep 174: Midwifery Uncovered: Navigating Holistic Maternity Care with Casey Selzer
Fertility Forward Episode 174:
What if your pregnancy care was centered on your values, offering personalized support every step of the way? In this episode of Fertility Forward, licensed midwife Casey Selzer shares her two decades of experience advocating for holistic, patient-focused maternity care and demystifies the role of midwives in today’s healthcare landscape. We explore how midwifery offers a holistic approach to pregnancy and birth that complements nursing and doula care. Casey explains different care models and encourages early reflection on birth values to help patients choose the best provider and setting. You’ll also learn how innovative practices like Oula Health (where Casey is Senior Director of Patient Programs) integrate midwives, OBGYNs, doulas, and specialists in a team-based model that prioritizes education and continuity of care, ultimately transforming maternity care to be more accessible, supportive, and aligned with patient needs. Tune in for valuable insights on navigating pregnancy care options, dispelling misconceptions, and advocating for your unique journey toward parenthood!
Rena: Hi, everyone. We are Rena and Dara, and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients, because knowledge is power, and you are your own best advocate.
Dara: Today on our podcast we are here to welcome Casey Selzer, who is a licensed midwife with two decades of clinical experience in both private practice and public healthcare models, including birth centers and LMD Midwifery integration. She has a passion for education, surveying as adjunct faculty in the Columbia University School of Nursing. With a vision to bring midwifery perspective to a broader patient-focused population, she founded ParentCraft, a Brooklyn-based perinatal education collective that served the community from 2017 to 2021. Currently, she serves as a Senior Director of Patient Programs at Oula, a collaborative maternity care practice based in New York City and expanding to Connecticut. She's the proud parent of three kids, including a set of identical twins, and is based in Park Slope, Brooklyn. Thanks for being here today, Casey!
Casey: Thank you so much for having me. It's fun hearing all that back! A little journey to where I am today. We're always on the journey.
Dara: You've accomplished a lot.
Casey: I am super passionate about midwifery. And I think all midwives have a little bit of a, we sort of think of it as a minor, like certain area where we focus in our work. But it's fun to see how that evolves, you know, over the course of time.
Dara: How did that come about? I'm super curious. Did you always know that you wanted to be a midwife?
Casey: No, actually, when I think back on it, I grew up with two sisters and with a really strong, we have a really strong like matriarch dyad of sisterhood in our family history. And So kind of being with women is sort of how I always identified in the world and how I learned about, like, my body, my menstrual cycle, my identity, and sort of became like a natural advocate for those issues kind of throughout my life of being surrounded by strong women. But it wasn't until I met my first midwife that I really learned about what midwifery was. And I was taking a class about mothers and daughters. And a midwife came and spoke about her career and how, speaking of the journey of the work and the like the scope of midwifery, she talked about how she started out, she was older, and she talked about how she started her career in perinatal birth work, like really supporting young birthing families, and how as her career went on, she then went to support patients in the menopausal space, and eventually actually ended her career doing end of life transitional work with families. And I thought, wow. This is really profound. I need to learn more about this. And so that really sparked my curiosity. And I started meeting healthcare providers, nurses, midwives who kind of mentored me and said, there's a path here and we need you. We need your energy in this profession. Join us in the work. And that was it. The fate was sealed.
Rena: What an amazing path to your passion.
Casey: Yeah, it really is such a gift. And I think many people who are drawn to the work of midwifery, there's a social justice component to it, like an advocacy component. We're working for our patients and advocating within complex healthcare system of the United States and globally to really center our patients in everything that we do. And so it is a passion career in that way. And you really need to have that vision and that energy and that drive to really be able to kind of sustain the work. And I think the beauty of the profession is there's so many iterations of how midwives show up for patients in different spaces. And that allows us to evolve and, you know, explore the work, you know, as we go kind of through the career and through the profession.
Rena: Well, so tell us exactly what is a midwife. It sounds like a midwife can be many things?
Casey: And that is a question I have been answering my entire career, and I never tire of it because advocating for the profession alone is part of our advocacy for our patients, right? And so a midwife, and there's so many myths and misconceptions about who we are and what we do, and most people do not know. So thank you for starting with that question. So midwives are licensed, independent clinical providers. We are medical care providers in the United States. So we have a national accreditation organization. We have licensure within our state to practice full scope midwifery care. So meaning we can write prescriptions, we can admit patients to a hospital setting. So we have a pretty comprehensive scope as a professional organization. But I think, you know, because our core philosophy is and our expertise is really supporting holistic care, patient-centered care I've mentioned, and really thinking about normal physiologic life event that is this experience of going through pregnancy and birth and postpartum. Sometimes people ask us, are you a doula? Or what is the difference between a doula and a midwife? And so I think it's really important to understand that. I always sort of describe it as midwives and doulas have been working together for all of human existence. If you look at ancient drawings of birth, there's a patient in the middle, a midwife and a doula. And so we have that same goal of patient-centered care, but we have different roles, right? So the midwife is the clinical provider, whereas the doula provides that continuous emotional, physical, and educational support. And midwives do too, we work together, but we are navigating within these health systems, right? To make that clinical decision-making with you in a shared decision-making model. And the doula is supporting you directly in that way. So we work really beautifully together as a team, but we have a But I…
Dara: See it's interesting. You are also a registered nurse. So my assumption would be that midwifery is component under the umbrella of perhaps like a nurse, but are those two separate things? Or do you bring your RN roles and your midwifery roles together?
Casey: That's a great question. And one that our profession is really kind of struggling to navigate its identity around. So here in New York State, which is where I'm based, we have two pathways to midwifery here. We have certified nurse midwives, which is an advanced degree in midwifery after you have that underlying nursing degree, that RN, right? And that is what majority of midwives in the state have. But then we also have another pathway that's called a certified midwife. And this is where you just have that master's component. You have a bachelor's in something else and you bring your life experience to the work, and you really focus on the professional expertise in the midwifery only. So it's not actually required. And that is true across several states that there's this certified midwife pathway as well, that has equal privileges in terms of prescription, admitting patients to a healthcare setting, etc. So different pathways to the same scope as a clinician. And I think that there is a real movement to expand beyond nursing to allow more people to come in from diverse backgrounds. It's a more direct way into the profession. So I think we're like evolving in that space. So it's a great question. I would say we haven't totally, like, put a stake in the stand on our identity, but our organization is working towards kind of expanding that because we know we need more midwives in order to provide this type of care to more patients. So we want to make the profession as accessible as possible. But that said, I think nursing is a wonderful home for midwives in many ways because so much of the focus in excellent nursing care is on the patient, right? And on communication and really thinking holistically about, like, family health, complex social backgrounds, really meeting a patient where they're at and understanding kind of the nuance that in this moment, this one interaction with a patient is just one specific moment, right? But there's a whole history and all this wisdom that this person and this family and this culture that someone comes from brings to this moment of pregnancy, you know? And so we're really proud to be like part of the nursing profession, but it is its own distinct professional path which is pretty unique.
Rena: So if I were to be delivering and I specifically wanted a midwife, like how does that work? If I'm saying I'm delivering, you know, we're a New York based, right? So at Cornell Hospital, you know, mainstream hospital. Do I request a midwife or do I look for an OB practice that has a midwife or how might I access your services?
Casey: Yeah, that's a great question. So I think there has been, unfortunately, like a lot of siloing of the profession across like the birth landscape in the US. So I think the common perception is like, I'm either choosing home birth and like no medical intervention, very few medical interventions and a midwife in that way, or I'm on like a high risk pathway with an OB with like every medical intervention And I think my passion is about breaking down that binary and helping patients to understand that you shouldn't have to choose. You should actually have like the right expert at the right time available to you in your care model. That said, there's a lot of different models out there of ways that midwives work. So you might see, you know, majority of midwives across this country actually work in the public health settings in hospital systems, providing care within the system itself. But there are large sort of private practice models for midwifery as well that exist all around the country, where you might choose a private practice that is either midwifery only, or a collaborative care model like Oula, where I work now, where we have midwives leading the care but OBs part of our care model. Again, so you have both of those providers in your care team kind of going throughout the journey. So it depends on which institution, what state you're in, what the landscape looks like. And I always talk to so many sort of patients and friends, family, community members in the preconception phase or early pregnancy phase when they're asking that question about like, how do I find midwives or what should I be asking about? What do I need to know? And I think, you know, I always talk about early on, think about what is going to make you feel the most safe when you're giving birth. What are your core values when you envision your birth experience? And what is kind of the story you want to tell about your birth, right? To your unknown baby right down the road? And you know, we know that the evidence shows us that actually, there's this sort of the sphincter theory, right of like, that labor is a process where you need to feel safe, mentally, emotionally and physically in order to relax and allow for that normal physiologic process to continue. And that's, that's through the hormones of like oxytocin that that progress the normal labor course, right? And so where that is and what that looks like is really different for each person, right? There are some people that really do feel safer being at home and some that really do feel safer being in a hospital setting. And again, like centering the patient means like supporting you and giving choice and autonomy to be able to figure that out early on. So I always like ask people that question and it helps them reflect on kind of like, where should this end up in terms of the vision of the actual experience? And then that will help you work backwards to understand what are the questions to ask my care provider about like early on about what are your policies around like the labor and birth experience? Like, what does that look like? Like, how would I feel comfortable? Like, how would we communicate, right? Unpacking some of your core values. Helps you kind of align on what's the right fit in terms of the care provider and the birth location specifically. And we just do that too late as a society, you know, we spend a lot of, there's a lot of fear, there's a lot of like, real fear, there's a lot of ambiguous fear. emotional vulnerability in the first trimester. We know there's a risk of loss whether it is a planned pregnancy or unplanned pregnancy there is a sense of ambiguity like what is you don't know you're, you're siloed you're alone maybe you haven't told people in your network, in your community right? So there's a sense of feeling pretty isolated you don't know what questions to ask where to go. It's a lot. It's a difficult phase and so just making that more accessible to folks to help kind of guide the questions is something I feel really passionate about because I think we We have a culture of sort of waiting until we get through all the pregnancy stuff, right? We go through genetics testing. We make sure this is a viable pregnancy. We have our anatomy scan. We're like, okay, we're planning for the nursery. And then it's like, all of a sudden, it's like, wait a second. I don't even know anything about the birth experience with this provider or with this health system or this setting. And you start asking questions and then you find out, well, wait, maybe this isn't aligned with my core values? And you can make a change later on in pregnancy, of course, but there's a lot of transition going on. So if we can minimize transition, it's a little bit easier for folks, I think, from that just mental, emotional load.
Rena: Absolutely.
Dara: I was thinking, I was like, Casey, where were you? I wish like way back when, when I was going through things, I'm like, that would have been really helpful to get, even to get the information because, you know, especially when you're newly pregnant and it's, it's, you have no idea the questions to ask it, that there are options. So I would love to hear more about Oula Health and how you're involved and very interesting, the connection between yourself and OBGYNs and how that helps to, I'm sure that the people that you meet, how you're able to support them.
Casey: Yeah, absolutely. So Oula is setting out to kind of change the landscape, right, and make the experience of maternity care improved. We just think we can do better, and it's long overdue. And so we think that by centering the patient and the experience you have holistically of going through your pregnancy journey will improve clinical outcomes, and we're showing that through our care model. And so one of the ways to speak to your question about how we work with OB is that I think has been really successful at Ola and really resonates with our patients is that You don't have to choose. You come into care and a midwife greets you. And it's so fascinating to me. I thought when we started Oula, okay, here is an accessible care program where we have in network with all major insurance, midwifery access, which including Medicaid, which is in New York City, pretty unique and special. So I was already curious and excited when we started building this. And so of course, patients came to us who were looking for that type of accessible midwifery care. But as we mentioned earlier, What is a midwife is something many of us do not know, right? And so actually I find it fascinating that majority of our patients come to Oula abecause they're looking for something different. They don't know what that is exactly, what that solution is, but they know they've heard, maybe they had a bad experience in an earlier pregnancy experience or they hear stories from their friends on the Facebook group, whatever. And so I think that we're trying to be that landing pad where you can just arrive as you are and you knowing your own core values best, you can help guide us of how to best support you. And we really think of it as sort of a team model with the patient at the center. So it's like you, your family, your team, right? Your community, your culture, you arrive. And then a midwife is there to greet you. And I think when our patients meet our midwives, that's when they have their a-ha moment of like, oh, midwives can help unlock this type of experience I was looking for. And I didn't even know that. Basically, we will do that intake assessment with the midwife. And then we'll help to chat with you about, like, your pathway and your preferences. So if you have a more complex health history coming into the pregnancy journey, then we might recommend that you meet with our OB for the next visit and talk about like some of the more clinical aspects of the care plan for the pregnancy and birth implications. And then maybe you stay kind of like being cared for by that dyad throughout the journey. Or if a patient prefers to meet with an OB more, you actually can choose that, right? Like say, you know, I love meeting with the midwife, but I'd also like to have regular visits with the OB regardless of like the clinical kind of escalation pathway. And we really trust our patients again, to know what's best for them in terms of feeling safe, feeling seen and getting the resources that they need. So when we put the patient at the center, we're bringing the best that we can offer through all different allied health practitioners, right? So we have the midwife, who is an expert in physiologic birth and really viewing holistically this experience as fitting in the context of our life and a transformational life moment across all systems of health, right? And then we have our OB who is an expert in complex high-risk medical conditions and surgical birth, including procedures, coming to the table to make sure we have that kind of guardrail in terms of like the clinical expertise there in collaboration with midwifery. And then we also have like welcoming in a doula, right? To educate you, empower you, Make sure you're asking us the right questions during your prenatal visits. We have doulas come to visits with our patients. They join in in group classes that we offer, and they're part of the team on labor and delivery at Oula. And then everything else, right? Like we're talking about like mental health providers. We're making sure you have the referrals that fit your needs. PT, you name it, like whatever it might be that you need at that moment. We want to make sure that you have access to that specific need and that it really comes together in a way that really meets you where you're at. When we collaborate with our OBs on labor and delivery, it's also really, it's the same sort of like everything we do at Oula is sort of this dyad. There's a midwife and there's an OB working together to take care of our patients. When you come to labor and delivery, we have two midwives and one OBGYN on call 24/7 for our patients on labor and delivery. So again, you'll be greeted by a midwife in triage, and then the OB will come in and say, hey, I'm here if you have any questions for me. And if in the event that you were to need an unplanned cesarean birth, if that arises in the labor, That is your surgeon who's part of the care team midwife. stays for continuity of care to go through all the education and emotional support if the care plan evolves in that pathway. Otherwise, you stay with the midwife and the OB just pops in to say hi, and they're off to focus on more complex clinical cases if their expertise isn't needed in that particular patient case. So it works really well for our clinicians. Our OBs are just so mission-driven at Oula. It's really wonderful to see. They see this model as really something that is sustainable for the OBGYN community as a whole when they think about there aren't enough OBs either, right? There's burnout across both OB profession as well as midwifery. And so it allows for them to have like more of a team approach, which is really unique and different, I think, from a lot of backgrounds that clinicians are coming into or experiences that they've had. And so it works for our OBs. It works beautifully for our midwives because they feel really supported by our OB, but they also feel lifted up that they have their own clinical expertise and scope of practice where they really are the expert. So it works really nicely clinically. And then for the patient, you just feel like, wow, I have it all like I have everybody here that I need on my team, I can relax and let my body do the work of labor and birth. And so I see this as just like, such an exciting model that to me is kind of a no brainer, honestly. And I think as we have these conversations about growing at Oula and kind of bringing this model to more states, we're going to Connecticut this year, and new markets on the horizon, it's It's like, it's exciting to think about coming together to drive the clinical research, really study this model that's frankly been kind of understudied, right? We know that's an issue in women's health in general. And to really like push the needle on the conversation and say, patients are demanding this kind of care. It's time to deliver it, you know, pun intended, perhaps. But anyway.
Dara: I love it. I didn't realize, and this is like, I guess my own ignorance, which is great that you mentioned it, that you are part of the patients that you work with, they actually give birth in the labor and delivery floor. I guess my own, you know, I thought, oh, maybe it's a home birth. So it's definitely in a hospital?
Casey: A hundred percent. So, one of the reasons that we designed our care model that way at Oula is that that is where majority of people are giving birth. So again, it's like if you go back to the myth of like midwifery equals home birth, that's actually a very small minority. And it should exist. Like I support home birth midwifery. Again, I support autonomy and options and choices for birthing people. But it is such a small percentage of where people are giving birth. We want to transform the experience from within our health system because that is where majority of people are giving birth today. And it's the fastest way to improve health outcomes to close the health equity gap for black and brown patients and, and to reach the most people with this care model. So yes, Oula attends birth 100% in hospital settings, on traditional labor and delivery units, where we work together to kind of make sure we have the right protocols in place that are evidence based that support the physiologic labor pathway, things like intermittent monitoring, eating and drinking and labor, ability to have movements centered in your care, options for pain management, hydrotherapy, supporting that golden hour when the baby is born with skin to skin - things that are really central to our core tenants of midwifery and bring it in a collaborative way that supports and takes into consideration the needs of the system. Like, pediatrics, they have their own policy and protocol. Let’s come together to the table and talk about our goals here. And it turns out, the venn diagram is pretty vast. We're all pretty aligned on where we want to see this go. Great outcomes, happy patients, healthy patients. And so we're proposing that this is a way to do that. And so yes, we are meeting patients where majority of patients are giving birth currently, which is in the hospital. So yeah, thanks for clarifying that.
Rena: love Oula. I mean, obviously a big fan. I think it's such an amazing service and I wish everyone had access to that type of care, you know, just the holistic collaborative model, which I think is so necessary for women or families.
Casey: Yeah, it's been really fun. I mean, I love talking about this. And I, you know, I was one of the early architects of what we call like the patient journey kind of like how can we kind of create anticipatory guidance for patients so they kind of know what's going to come next, what their choices are, and give them tools to be able to have true informed consent, right? And that shared decision making along the way. And it's really exciting to hear the reactions to this. I was just, I was mentioning to Rena a little bit earlier, I was at ACOG conference in Minneapolis and the American College of OBGYN, their national conference in Minneapolis this weekend with our chief medical officer, Ila Dayananda, and it was just so exciting chatting with people, these OBs coming into the profession with curiosity, appetite for change. It's really resonating and aligning both with patients, with clinicians, and with health systems as a solution that should be available. And so again, back to like, it just makes logical sense, like when it all matches up, look around the world, right? Midwifery led care leads to better outcomes, the clinical evidence is very clear on that. So the US frankly, is behind in that way. And so I see this as a real solution for kind of how we can catch up and, and start moving that conversation forward.
Dara: I love the collaborative approach. I think it's great. And I even saw on your site that, you know, that you also offer at Oula preconception care. So opportunities- also prior to conceiving.
Casey: Yes, I know. And I think it's so interesting. I mean, so to zoom in on women's health in general, many of us do not have a primary care provider in this country. We do not have a regular GYN provider, right? Those people who do have a GYN provider and decide to go on a pregnancy journey or find out they have a pregnancy that is unplanned, you're just with whoever you're with, right? It's like you're just kind of trying to access healthcare. And I think the whole concept of this preconception visit it has gotten lost a little bit in that, in those systemic issues. And I think we've had a really huge, like positive reaction to our preconception program. We basically set up a really education heavy visit with our midwives. Anyone who's interested in just learning about this path, you don't have to be actively trying or planning at that time, but you want to learn more. This is a visit to come meet with one of our midwives and receive a lot of like preventative health information, and also like referrals that might be like really catered to you, right? So we might refer from there for like to our REI reproductive endocrinology colleagues to support in like more of a fertility space, if that's clinically appropriate that time, we might give referrals for mental health. You know, one of the challenges with mental health is that sometimes we are late to access, right? And we're late to diagnosis and support. And so we want to like build those structures and from a preventative health perspective, that really looks at holistically at the patient before the pregnancy journey even begins. And then we also offer an early pregnancy care program as well, because we know that's a huge gap. You know, many traditional OB offices, like you don't come in person until 8 to 10 weeks, right? By then you're already nauseous or you're having spotting, you're concerned, you don't know, is this viable? Like there's a lot that can go on in those early vulnerable weeks that we talked about. And so we know that's a real gap. And so we have a program set up where anyone in New York City who is eligible for our care just through our in-network coverage can meet with us virtually as soon as you find out you're pregnant and have a visit with a midwife, talk about what's going on, make a care plan of what comes next. And our OBs are part of that collaborative space. And we also offer sonography within Oula so you can kind of come in and have like this whole care plan created before you've even come to Oula as like an established, right? We don't have those rules and parameters of like a traditional model in that way. We really believe that if you're reaching out, like you should be seen, right? We kind of say everybody deserves a midwife. And some people also need an OBGYN, right? And it's like, again, just kind of being a landing pad for folks who maybe don't know where to go, who to reach out to, and need a safe space to arrive with questions and, you know, trusted referrals and clinical expertise. So yeah, that is part of our program. And we also developed last year, a gynecology program for well-person GYN. You know, we started out as a perinatal program, prenatal care, on-call for your birth, immediate postpartum. And then our patients were like, are you kidding? I'm not going somewhere else for GYN. And we literally were like, okay, you're right. So we built our well-person GYN program to kind of catch up to the patient demand. So that's been really awesome to have our patients be able to stay with us more long-term for comprehensive health and see our midwives and our OBs. And then whenever that, if they come back around for the perinatal care, great. If not, they can just stay on the GYN path since that's the rest of the story for some of us.
Rena: Amazing. Truly incredible what you built. I remember talking to the founders. It must have been how many years ago? It was fairly recent.
Casey: 2020 is when Ula started. We had our first birth in early 2021.
Rena: So I remember connecting with the founders. It must have been 2020 and five years. You've grown an incredible amount. It's amazing.
Casey: It's pretty exciting. Yeah. We have three clinics now, one in Brooklyn Heights, one in Soho, and one on the upper Upper West Side, Broadway and 112th. And all, you know, funnel in for birth at Mount Sinai West by Columbus Circle. And we are opening in Stanford, Connecticut with Stanford Health. We'll have a clinic in Norwalk, Connecticut by the end of this year. So really excited!
Dara: That's exciting. I love the idea of a collaborative approach. I know Rena and I are both big advocates of even the holistic space. You know, going to a place that can help you, support you, meet you where you're at and see things from different angles. I think that's, it's phenomenal. It's great that you guys have really taken something that was definitely a need that wasn't really there and have created, even what sounds like to me, it sounds like a spa in a way. Even though it's clinical, I don't know, it's, you could see, you could tell it caters to what females really want.
Casey: Yeah, well, you know, I mean, it's it's true. Like our clinics are ridiculously beautiful. And I mean, I’m bias. I've been in the clinics all the time. But the idea it goes back to that kind of like sphincter theory that I was talking about a feeling safe, right in a space. And we know like a typical clinic setting. It's not relaxing. Like you can feel your body is tensing up when you walk in. It's like bright fluorescent lights, sterile walls, like it's like, where am I? Am I in the hospital? Right? And you know, nine months of prenatal visits is it's a lot of time. You actually spend a lot more time in the outpatient part of your journey than actually the physical hospital where you're giving birth. And I think a lot of people think about the hospital rooms and what that looks like much more than they think about like the whole prenatal journey and the values of their care provider. And so we designed the clinic in that way. Yes, it's beautiful, but it's also serving our clinical outcomes in that it helps you to relax. And our theory is that helps to like lower the blood pressure, literally and metaphorically, to kind of allow for spaciousness for that trust and communication to really open up. The provider opens a visit with you and really is like, how are you today? Like, what is going on for you right now? And is just listening. And that's the start of your care. And you're in a space where you feel comfortable, where we have tea and goodies. And you know, our front desk associates are like incredible angels that just make everybody feel really good coming in and how we want to prove that that matters. You know, you deserve that. Our Medicaid patients, I mean, it's like night and day from like a typical clinic, right? Everybody deserves access to that level of care and to feel that they deserve a beautiful space, a safe experience, something that's personal and meaningful to you because this is what birth is all about. It's one of the most transformational life experiences. So I really, it is, it's luxurious. And then I think people forget that actually this is an accessible program that is in network with all major insurers, including Medicaid. So we want to bring this to as many people as we can.
Rena: So amazing. Well, we're so happy to have you on the podcast to spread the word and share with our listeners about Oula, what you do. I know it's such a necessary service. Really incredible.
Casey: Thank you so much for having me on. It’s great to chat and to be in conversation with other allied health. You’re part of the team! Right? You know, nutrition, therapy, these are things that matter and can actually define a patient’s experience and so I really appreciate you making the space to talk about midwifery and talk about collaborative care and Oula and we look forward just continuing the conversation and busting the myths and putting the clinical evidence and outcomes out there and just together, working together to improve the experience for birthing people. So, I'm excited.
Rena: Well, what a gift you are and Oula is. And thank you so much for coming on to share your wisdom and advice and knowledge with our listeners.
Casey: My total privilege and pleasure. Thank you.
Dara: So Casey, how we like to end our sessions are with words of gratitude. So what are you grateful for at this very moment?
Casey: I am so grateful for all the midwives who have come before me to mentor me in the work and all the midwives that do the work on the ground and center our patients in everything that we do.
Rena: That's beautiful. What about you, Dara?
Dara: I'm grateful for women. I had a really nice evening spent with friends who I haven't seen in a long time. We did a sound meditation and dinner, and it just made me realize the importance of connecting with community. So very grateful for that. What about you, Rena?
Rena: I'm going to say I'm really grateful for friends and people that really see you for who you are and love you no matter what.
Dara: A–woman to that. Beautiful.
Rena: Casey, thank you.
Casey: I'm going to go finish on this chilly day. I'll drink my birthing. I have my birthing mug. I don't know if listeners will get to see this, but I have my special midwifery birthing mug.
Rena: I love that.
Casey: I have my tea on this dreary day in New York, but thanks so much for having me.
Dara: Thank you so much for listening today. And always remember, practice gratitude, give a little love to someone else and yourself, and remember, you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.