Ep. 427: Sick Care vs Healthcare: Burnout, Insurance, ACOG Guidelines, and a Midwifery-Led Model with Tracy Burns AKA Modern Day Midwife

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In this episode of The Birth Lounge Podcast, HeHe is joined by Tracy aka Modern Day Midwife (a hospital-based midwife in Arizona with a NICU background) for a candid, behind-the-scenes conversation about the realities of modern healthcare.

Together, they unpack how the U.S. healthcare system is failing both patients and providers, from provider burnout and lack of mental health support to the pressures of hospital politics, insurance reimbursement, and productivity quotas.

They explore the difference between “Medicine 1.0” (acute care) and “Medicine 2.0” (preventative care, functional medicine, wellness), and how insurance-driven, fee-for-service models often prioritize sick care over true health. The result? Confusing medical bills, rushed care, poor patient experiences, and providers who are stretched thin despite doing deeply meaningful work.

HeHe and Tracy dive into the unique challenges facing women’s health, maternity care, and birth: over-medicalization, the cascade of interventions, the limits of 10-minute OB-GYN appointments, maternity care deserts, and the need for individualized care, informed consent, and continuity of care. From ACOG guidelines to ever changing evidence and research, they explore possible solutions including a midwifery-led model of care, better transfer systems for home birth and birth center patients, coverage for doulas and health coaching, and shifting consumer demand away from traditional insurance and towards alternatives like health shares.

Tracy shares her exciting vision for an integrated wellness hub that could include midwifery, obstetrics, pelvic floor PT, lactation, chiropractic care, and community-based health supports, and ends by sharing how to connect with her at Premier OB GYN in Phoenix and via Modern Day Midwife online and on Instagram.

00:00 Why Healthcare Breaks Providers

02:24 Burnout and Speaking Up

04:59 Fear and Privilege in Advocacy

07:18 Who Supports Clinicians

12:32 Medicine 1.0 vs Prevention

17:25 Billing Confusion and Fee for Service

19:06 Burn It Down or Reform It

23:55 Disrupting Insurance and Incentives

26:49 Birth Care Needs a New Model

29:36 Preeclampsia Prevention Debate

30:47 Rethinking Maternity Care Roles

32:04 Money in Wellness Care

34:55 Building a One Stop Birth Hub

37:43 Continuity Across Birth Settings

41:45 Evidence Based Medicine Reality Check

47:56 ACOG Guidelines vs Individual Choice

53:23 Demanding Individualized Care

55:11 Rebuilding Healthcare and Provider Support

56:59 Where to Find Tracy

58:15 Closing Thanks and Resources

Guest Bio:

Meet Tracy Burns, Board Certified Nurse Midwife. Tracy graduated from the University of Cincinnati in 2003 with her bachelor's degree in nursing. After graduation, Tracy spent a year in labor and delivery as a bedside RN and then took a job in the Neonatal Intensive Care Unit at Cincinnati Children’s Hospital. Tracy spent the first 13 years of her career taking care of premature infants and mothers before pursuing her advanced practice career in Women’s Health.

Tracy graduated from the University of Cincinnati in 2017 with her Master’s degree in Midwifery. With a big heart for women, Tracy is an advocate for midwifery care for women and the continuity of care model. Tracy has been an active team player in bringing midwifery services to Banner Estrella and Abrazo West. Tracy is passionate about health and wellness. She believes in using a functional/integrative approach to health promotion/disease prevention through an early introduction to nutrition, exercise, mindfulness, sleep, and community. Tracy is committed to caring for women by collaborating with other like-minded providers who are as committed to changing the way we care for women in America.

Tracy is married and has two teenage daughters. She enjoys Crossfit, hiking, and spending time with family and friends. She is a co-owner of Crossfit Fury, CrossFit Trainer, and BirthFit professional. Tracy and her husband are actively involved in changing maternal and neonatal outcomes globally through Helping Babies and Mothers Survive Campaign.

Connect with Tracy here: Www.moderndaymidwife.com

SOCIAL MEDIA:

Connect with HeHe on Instagram: https://www.instagram.com/tranquilitybyhehe/

Connect with Tracy on IG: https://www.instagram.com/moderndaymidwife/

BIRTH EDUCATION:

Learn how to stay in control of your birth and reduce the risk of unnecessary interventions in our Avoid a C-Section Webinar. HeHe breaks down the cascade of interventions, explains what’s really happening in the hospital, and shares practical strategies to protect your birth plan, advocate for yourself, and navigate labor with confidence. Perfect for anyone who wants a positive, informed hospital birth experience: https://www.thebirthlounge.com/csection

Feeling nervous about speaking up in labor? Our Scripts for Advocacy give you the exact words to handle the most common conversations that can make or break your birth experience. From declining unnecessary interventions to asking the right questions about procedures, these scripts empower you to stay in control, speak confidently, and protect your birth plan — even when the pressure is on. Think of it as your personal toolkit for advocating like a pro, so you can focus on your baby, not the stress: https://www.thebirthlounge.com/Scripts-for-Advocacy

And if you haven’t grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor: https://www.thebirthlounge.com/pitocin

Join The Birth Lounge for judgment-free, evidence-based childbirth education from HeHe that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way: https://www.thebirthlounge.com/

Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere: https://www.thebirthlounge.com/app-download-page