My First Birth Story

When life handed me the label "elderly primigravida," I didn't just recoil at the term—I redefined it. Embark on a profoundly candid chronicle where I lay bare the trials and triumphs of my journey into motherhood later in life. Coupling professional expertise as a labor and delivery nurse with my visceral personal experience, this episode is an intricate tapestry of the fears, the stigma, and the sheer joy that comes with pregnancy after 35. Recounts of battling persistent nausea and a petite frame's resistance to the rigors of childbirth paint a vivid picture of resilience.

Through the lens of my story, we traverse the peaks and valleys of natural childbirth preparation, the value of a trusted doula, and the stark reality of less-than-ideal hospital conditions. The narrative swells as I share the unexpected twists of labor, revealing how home strategies clashed with the hospital's austere environment, and how a traumatic delivery threatened to overshadow the birth of my child. This episode isn't just a playback of events; it's a rich exploration of emotional fortitude and the unanticipated paths labor can take.

The tapestry continues post-delivery as I navigate the postpartum world, with its potent mix of gratitude for nursing support and the struggle with breastfeeding challenges. I open up about the search for community and the advocacy for parents in the birth space following a move to a new city. This episode isn't just for expectant mothers; it's a testament to the collective wisdom and shared experiences that empower and guide all parents along their extraordinary journey into the transformative world of birth and parenting. Join me as we share, learn, and connect in the universal adventure that begins with the very first heartbeat.

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☑️identify the source of anxiety you have surrounding birth. 

☑️fill in knowledge gaps to make sure that you are fully informed and confident. 

☑️learn key phrases so you can better communicate with your medical team. 

☑️emotionally process your fears so that they don’t hold power over you

Go to kellyhof.com to book a free 30 minute birth vision call.

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Transcript

Speaker 1: 0:29

Hello, today I have with me myself. I have, at long last, decided to begin the journey of sharing my own birth stories. I have hesitated to do this for a while because, in my head, I thought that I needed somebody to interview me. However, I just realized that that was an excuse to avoid sharing my own story. So I've decided to accept my own challenge and share the stories that are the reason for me embarking on this journey. As a podcast host and birth advocate, I'm not sure really what my hang up was when it came to sharing my stories. I think that I wanted to be able to impart such deep wisdom and advice for new parents. I had such a standard that I didn't think that I could meet my own standards for sharing wisdom and advice. I realized that in seeking that perfection, I was holding back on sharing my story and helping others Without further ado. Today, I am not only sharing my birth story on my podcast for the first time, but I'm also attempting to record the podcast as a video for the first time, and I'm hoping to take the first steps to having my podcast on YouTube.

Speaker 1: 1:55

Here we are. Alright, here we go. I've printed off the questions that I send to each guest. So I think I'm just going to get started with those. First of all, you're going to get kind of an insider view because as I read my questions, I'll share them with you. When I send this email to guests, I say tell your story, including the following how many pregnancies have you had? How many children have you had? Was conception easy or challenging? And was pregnancy easy or difficult? Did you have any health conditions that affected your pregnancy? Did you have a birth plan? Did your birth go as planned? So let's start from the beginning and I'll answer those questions and then we'll move on.

Speaker 1: 2:34

I got married at the age of 34, so I was automatically terrified that I wouldn't be able to have kids because I knew that once I hit 35 that would be considered advanced maternal age, also known as elderly pregnancy, or I would have been an elderly primigravida, which is a horrifying term. Another term is geriatric pregnancy, all those things that just sound scary but don't necessarily mean anything. It does mean that you're past the age of 35 and statistically in human history that's when risks start to go up, essentially for complications in childbirth. But if you're essentially healthy, it may not mean anything. I remember expressing my concerns to my husband and he happened to be friends with a fertility specialist and got me on the phone with that person to have a conversation, and I shared all of the things that were scaring me, all of my fears about conception, pregnancy, birth and bringing a child into the world at the age of 35. My concern wasn't just my age. My concern was that I have asthma and I thought that that would make my pregnancy even more high risk. But my asthma hasn't been severe enough to really cause much of a problem and to date I have, as a labor and delivery nurse, 10 or so years later I have rarely seen asthma as a complication for pregnancy. The only thing that it's ever done has really been a contraindication for certain hemorrhagements, namely hemobate, which I don't like using anyway because it causes copious diarrhea, anyway. So our friend assured me that I didn't have a lot of relative risks and that the main risk was the age of 35 or older and that just meant that I was basically going to be followed more closely by my doctors and maternal fetal medicine specialists. So I got to see my baby more on ultrasound and I got to hear my baby's heart rate more when we did NSTs, which NST stands for non-stress test. So they listened to your baby's heart rate and analyzed your baby's heart rate while your baby is under no stress theoretically Okay. So I've had two pregnancies and I have two children.

Speaker 1: 5:01

Conception for us, surprisingly was super easy. Funny story In 2014, my daughter was conceived during what I believe was the ALDS championships, like the very beginning of October. This is important because in my head I knew exactly when her due date was and when we had the first ultrasound her due date was July 1st. Then later on they changed the due date and I was enraged by that. They changed it to July 3rd. I knew in my heart that that was wrong and I was right because my daughter was born before July 1st, so I felt very vindicated in that. So anyway, like I said, conception was easy. I'm pretty sure we conceived within the first attempt, within a month of going off birth control, and we were thrust into the potential of parenthood shockingly quickly. So a lot of regrouping there. We thought it would take six months to a year and that we would need fertility treatments and all that fun stuff. So it was like, wow, okay, here we go Now.

Speaker 1: 6:03

Pregnancy was not as easy as conception. I probably had low-key hyperemesis. Never got treated for it other than Zofran, but I was nauseous the entire pregnancy. I threw up the entire pregnancy Like clockwork. I was a night shift nurse at the time. Like clockwork, every morning, right before change of shift I would go running to the bathroom to throw up. My OB who I worked with that followed me during my pregnancy was not the same OB that delivered me, unfortunately, but he would come down. He worked Tuesday nights on call and so I usually worked Tuesday nights and he would come down Wednesday morning and see me running to the bathroom and he's like yep, it's that time of day, isn't it Just horrible? Nausea I also contracted during my entire pregnancy.

Speaker 1: 6:53

Probably had more to do with being a night shift nurse and being on my feet all night long than anything else, but, yeah, miserable. I'm also 5'2 and having another human growing inside a five foot two inch frame is just a challenge. I felt like there wasn't space for a normal sized baby in there and I had a normal sized baby. I envy people that are six feet and have babies the size of mine. I wish I had that much space, but I did not. Breathing was difficult, walking was difficult. I had tons of round ligament pain, like I said, I contracted all the time. It was just, it was hard. I ended up developing sleep apnea. I was told to go get a sleep study to see if I needed to go on CPAP. But at the time that it was recommended I was about 36 weeks pregnant and I was like no, I'm not going to go on CPAP for the last part of my pregnancy. I just won't sleep. That's fine. Not sure if that was the best choice not recommending that but it was just what I wanted. I did not want to have to go on CPAP during my pregnancy.

Speaker 1: 7:56

And CPAP, if you don't know, is like a pressurized breathing machine. It maintains a certain amount of pressure to keep your airway open. I can't remember what it stands for CPAP. Let's look that up. What does it mean? Continuous positive airway pressure. So it gives you a little bit of pressure constantly to prevent your airway from closing. And what happens? What happened to me is I had so much pressure on my chest and so much swelling that when I was falling asleep, everything relaxed and constricted my earway and then I would wake up when I was no longer breathing. It was horrible. I would wake up out of breath and terrified and realize that I have to, like, roll over to breathe. Awful, awful.

Speaker 1: 8:39

I was dumb and scheduled the glucose tolerance test after a 12 hour shift Right around Easter. It was also during, so, if you don't know, easter is around the time of nurse appreciation week, and so that night at the hospital all of the nurse appreciation treats were out, which basically is candy. I just was eating jelly beans all night, so do not recommend eating jelly beans all night before you do your glucose tolerance test. I almost didn't pass, but I did, and that is just a testament to my pancreas' ability to process sugar, which I mean. I think my pancreas could win awards for processing sugar, but I digress.

Speaker 1: 9:22

So, yeah, my pregnancy was challenging. It was uncomfortable, it wasn't fun. I didn't love being pregnant. I loved getting to know my daughter. During the pregnancy I felt her move. I remember the moment that I felt her move. It was about one o'clock in the morning. I was 13 weeks pregnant. I know it sounds ridiculous, but Same thing happened with my second pregnancy. About 13 weeks is when I felt my baby's move and it was spectacular. It was so amazing and I loved that part. I feel like I knew my children before they were born. I feel like finding a name for them and understanding their personalities was really easy for me. Bonding with them was really easy. But both pregnancies were very difficult.

Speaker 1: 10:05

Let's see health conditions that affected my pregnancy. I didn't have any specific health conditions other than being nauseous all the time, but that's not necessarily a health condition. I was on Zofran for that. I have mixed feelings about Zofran in pregnancy but I don't know how I would have made it through without it because I was just so super nauseous. Other conditions during pregnancy I had an anterior placenta, which again not a condition, just part of the pregnancy. My daughter had a two-vessel cord, so we were followed even more closely for that. And then also there was follow-up with pediatric cardiology to make sure. We did a specific echocardiogram test in pregnancy to test for any cardiac anomalies that could have been associated with the two-vessel cord, because having a two-vessel cord increases the risk of cardiac anomalies. Nothing was found during pregnancy but I was followed more closely because of that.

Speaker 1: 11:02

So during my pregnancy, to prepare for pregnancy, because I was terrified of getting a C-section, and the reason I was terrified was because I had my appendix out in the Dominican Republic when I was 21, and that was a horrific experience, basically because having my abdomen cut open was awful and, being somebody that was very physically active, that just basically took the wind out of my sails. I felt completely debilitated by that. I no longer felt that I had access to my abdominal muscles. Nerves didn't fire right after that, muscles didn't fire right after that. Nothing felt right after that, and so that experience made me not want to have any kind of abdominal surgery ever again, unless it was absolutely 100% necessary, and I wanted to make sure that it never became necessary.

Speaker 1: 11:54

So a C-section for me was definitely not something that I wanted to pursue and I wanted to prevent. If I could have a safe birth without a C-section, I absolutely wanted to exhaust all options for a safe birth without a C-section. So in order to prepare for that, I had a friend who was a doula at the time, who's now a midwife, and she encouraged me to take a class with another midwife who taught the Bradley Method. So I believe I took about a 12-hour birth class. We went every weekend for three to four hours and we went to the group of couples and we learned how to advocate for yourself, which I'm really, really glad that I did.

Speaker 1: 12:35

I learned about the options and the risks and benefits for interventions and tools that are used at the hospital. It was in New York City at the time. I was living in New York City and I learned about the options and hospitals and policies in the city at the time, which, if you don't know, there's not a lot of infrastructure for hospitals compared to where I was from In the Midwest. There's lots of spades, lots of rooms, lots of options. So there weren't a lot of rooms in New York City. A lot of people were doing home births because it's just, even if you do get to the hospital in time, there's not necessarily space for you, which was kind of my experience, but we'll get to that in a minute.

Speaker 1: 13:19

So my birth plan was to hopefully have a natural, unmedicated birth and I was taught some positions and some coping techniques in this class in order to achieve it and I was encouraged to get a doula, which I did, and I got a doula that I aligned with that she's a fairly newish doula. I could afford her, which was really huge. Probably the number one barrier to getting a doula was price, but she was affordable and I interviewed her and she was wonderful and I aligned with her on so many different levels and we both kind of wanted to treat birth as a marathon and we trained for the marathon and we know that it's going to take a long time. You have to conserve your energy and you have to take everything one step at a time. Just really loved her values. And Ashley Webb she's been on my podcast. Love her. Hi Hash she was a wonderful doula, wonderful advocate, wonderful friend. The birth and when she had to go back to her job at the New York Stock Exchange the next morning she had a second doula that came in as a backup doula. So I just felt really supported by her. So, yes, I had a birth plan.

Speaker 1: 14:29

I learned from the course that I took and felt like I was fully prepared. Most of you who have followed me and listened to my podcast know the end of the story and that I was not fully prepared. There's something that was missing and that was mental, emotional and mindset prep and I feel like that was lacking being able to emotionally go through some of the scenarios that you would go through during your labor and birth and some of the things that might come up for you and make it difficult for you to really advocate for yourself. I wasn't fully prepared for that. Another thing that I feel like I wasn't prepared for was or I'm not sure that I loved in my preparation was there was an emphasis on defensive advocacy. I'm not even sure if that's a term, but that's how I would describe it. It felt a lot like you're going to have to go into the hospital and defend yourself against these interventions and while that maybe true to some extent, I'm not sure if that is the mindset that was serving me the best at the time. I think being able to work as a team with your birth team is more important, and that's why I advocate for that now.

Speaker 1: 15:47

So my birth plan, as I said, was a natural labor, natural childbirth. I didn't want an epidural, I didn't want any interventions, I wanted to labor at home as long as possible, all of those things. So everything started out good. I went with my parents to see my friend Angel in Chicago the Musical she was playing Roxy Hart, and I didn't want to miss that. So, 39 weeks pregnant, I went to a Broadway musical and as soon as the curtain went up, contractions started.

Speaker 1: 16:23

I don't know if it was just the uncomfortable position that I was sitting in or what I mean. It probably was the fact that I was nearing my due date and was going into early labor. I just remember thinking, oh my goodness, first of all, I don't want to miss this. Where's the exit? And how can I position myself so that I don't break my water and squirt it all over the person in front of me? Those were my thoughts. So I believe I sat on the aisle seat because I wanted to be able to leave if necessary. But I was there with my parents and I just remember angling my knees toward the aisle because I really just didn't want to make a big mess on anybody if my water broke.

Speaker 1: 17:01

And I sat through the whole show contracting, and after every contraction my daughter would just kick and kick and kick, and I'm not sure if it was the music that she loved or if it was because I was in early labor, but it does hold true today that she is definitely a singer and a dancer and maybe that was just her first introduction to Broadway. So made it through that show, not sure how, because I was in pain and squished into teeny tiny seats. I mean when I say I was afraid that my water would break on the person in front of me. Literally his head was almost touching my knees. That's how packed you are. If you haven't been to a Broadway show, if you haven't been to the I think it's the Ambassador Theater, where Chicago the Musical has been for like decades If you haven't been, then just trust me that you were really packed in like sardines.

Speaker 1: 17:47

So after the show saw my friend Angel faked my way through contractions, pretended like I wasn't in early labor, got in a cab hardest well, not the hardest car drive of my life, but one of the hardest car drives of my life because I was super uncomfortable went home and just kind of while I was resting. It was hard to sleep that night but contractions did kind of slow down, so didn't go into the hospital, made it through the next day and then the next night I went out to dinner with my parents. We went to Cougans, which is no longer there, unfortunately. There is a documentary on Cougans restaurant in Washington Heights that was directed by Lin-Manuel Miranda before the restaurant shut down. It was a historic restaurant, loved it. It was right next to the hospital and saw a couple of friends on the way to work sitting outside eating my at the time. I love the steak Caesar salad there, so went out to dinner and then we walked home.

Speaker 1: 18:42

At the time we had a dog. He was a 100 pound Rottweiler German shepherd mix and we took him to the dog park every night so that he could hang out with his friends and run off his energy and go for a walk and all that fun stuff. And I went with my dad and my husband and as we walked my dog home actually no, in the dog park, this is the first significant thing I saw my friend, Michelle, who she'll probably remember this. She had a dog named Dexter and we were just hanging out talking and she has a son that's close to my daughter's age, who was born several months before, and her dog was like just circling me and like doing figure eights in between my legs, wouldn't leave me alone. And then other dogs started coming over and one teeny tiny dog came and peed on my dress and Michelle looked at me. She said are you in labor? And I was like I don't know. And she was like well, if you're not, you're about to be, because dogs never act like this. They know what's going on. And she was right.

Speaker 1: 19:38

I had been contracting for a while and things were starting to really pick up and the contractions were starting to feel different. For those of you that don't know, brexans, hicks contractions are kind of like just tightening of the sides of the uterus, but once you start having like real contractions, the top part of the uterus will contract and squeeze from the top down and the whole point is so that the baby will go down in your pelvis and out. And I started having those types of contractions and they started stopping me in my tracks and on the way home I was really really trying to work through contractions and it just it was harder and harder and harder. So my dad was staying at a hotel at the time in New York because they came to hang out and wait for my daughter to be born. She was the first grandchild and he went home that night and I tried to hide it from him, but I'm pretty sure you could tell and I went upstairs and about an hour later I started texting my doula. I needed to give her plenty of time to get there because, like I said, she worked at the New York Stock Exchange but she lived in Queens and so she needed to get home, get changed, get all her stuff done. I told her to eat and come whenever she could get there and she drove up to Washington Heights. Takes about an hour drive, even though New York is so close just hard to get places.

Speaker 1: 20:49

And after texting her, I told my husband that I thought I was actually didn't tell him I was in labor. I told him that I needed to do laundry and I started gathering up the laundry to do it and I said, well, part of it was because I needed to clean the pee off my dress. And he was like oh, we'll just do it tomorrow. I was like no, we're not gonna be able to do it tomorrow. He's like what are you talking about? I'm tired, I'm gonna do laundry. And I was like nope, we're doing laundry tonight. I don't want this sitting overnight and we're not gonna be able to do the laundry tomorrow. The whole house is gonna stink.

Speaker 1: 21:14

And he was like what are you talking about? I was like I'm in labor. He's like yeah, right, didn't believe me. And so I was like okay, cool, you don't believe me. Well, ashley's on her way over here, so get on board or don't.

Speaker 1: 21:25

And then he started seeing me sitting on the birthing ball like hands and knees on the couch All these weird things and kind of like, trying to talk to me, and during contractions I wasn't talking. He was like oh my God, this is serious and I have a video of him that I filmed in between contractions and I think I'm gonna post this because it's so funny. But when I told him, when he finally realized and accepted that I was in labor, there's this video of him going, oh my God, oh my God, oh my God, oh my God, back and forth in the house. It's just, he's such a goofball. If you know him, you totally understand this. But yeah, it took him a minute to get on board. He went and he finally did do my laundry and our Jula got there, I believe around nine o'clock and so this was like between seven and nine I believe close to seven, when I started really knowing that my contractions were serious and they were about five minutes apart, and I texted her and she got there on nine and she hung out with us like all night, like literally all night.

Speaker 1: 22:22

As soon as she got there, I asked her if she ate anything. She said no. My husband said do you want a roast beef sandwich. And guess what? She never got her roast beef sandwich. I didn't. My husband was so distracted. I still to this day. Oh, ashley, a roast beef sandwich. I think I might just like send her one through DoorDash or something like that. She doesn't even live anywhere close to me anymore, but yeah, so we labor there.

Speaker 1: 22:42

For a while, contractions got more and more intense. Basically, in my brain, I fast forward from sitting on the birthing ball kneeling on the couch texting my Dula telling my husband what was going on, to being in the bathtub. And in New York we have these shower heads that are like in the middle of the bathtub, which is completely the most convenient thing in the world, because I just turned the shower on as hot as I could and it was basically aimed on my belly. And what was wonderful about the bathtub is and I didn't know, I didn't understand this fully at the time and I wish that I had taken spinning babies before. I don't even think that 10 or eight years ago spinning babies was a thing, but I wish that I had this information.

Speaker 1: 23:29

But what I understand now is what was comfortable in the bathtub. I was laying on my back, which isn't necessarily recommended, but it isn't recommended actually. But that was what was comfortable for me because I wanted that hot water on my belly and I had an exercise ball Is it a Pilates ball or it's like a soft ball that has air in it and it was very squishy and it was about the size of a pumpkin and I put it behind me and leaned on it in the shower because it was waterproof, obviously, and when I leaned up against it or sorry, in the bathtub with the shower on, when I leaned up against it, my feet were able to touch the bottom of the bathtub and I'm short, so it gave me an affirm to do that and what I would do between contractions is push up from the bottom and do that. Basically, I was giving myself counter pressure on my pelvis. So because I was laying on my back and I was giving myself counter pressure from the hard bathtub bottom, it was pushing on that spot on my pelvis. That was painful and I labor like that for hours.

Speaker 1: 24:32

And then finally started, my doula noticed change in the vocalization pattern that I was having and she noticed that my uterus looked lower in my pelvis and that I had some bloody show and she suggested that we go to the hospital and our plan was to call our neighbor Lori. She had a car that was parked right up in front of our building, which in New York is just such a hard thing to find. She was so excited for my daughter to be born and to this day they just love each other so much. And she was ready. She didn't care what time I called her. So at three o'clock in the morning when my husband ran next door and started pounding on the door I have a feeling she was already up. I don't think she had gone to bed. I think I mean in New York apartments you can hear everything. So I'm pretty sure she heard me. The windows were open. It was New York in June. You don't have air conditioning, you just have the little window units, the. I'm sure the whole neighborhood knew I was having a baby, but she was ready.

Speaker 1: 25:29

She helped me walk downstairs, which was so hard. Actually I didn't walk downstairs, I walked out to the elevator and leaned on the elevator rails to stand up, and my doula and my husband helped me stand up. And then Lori went and got her car and I just remember now that was the worst car ride ever Short of when I had appendicitis and my car ride to the hospital that was pretty bad. But Lori just all smiles, driving the car. She's like you've got this, you've got this. Yes, scream as loud as you need to. I just remembered her tearing me on, my husband horrified in the front, and it was literally. The drive was four blocks. I mean I could have walked it. I couldn't have, but it was physically possible to walk if I weren't in labor. But I know in labor I would not have been able to. So it was so intense.

Speaker 1: 26:15

We got to the hospital. They remember they just came out with a wheelchair, like I was, oh my gosh, just vocalizing with each contraction. I don't know anybody that's seen Ace Ventura Pet Detective where the scene, where he screams and he opens the door with the sound barrier. So it was like when I got on the elevator the contraction started and I just started shouting and labor and delivery was on the 10th floor and I shouted until the doors closed and I was still shouting. But I'm just from the perspective of the people out in the lobby.

Speaker 1: 28:33

At three o'clock in the morning I'm sure I was just like and then screamed the whole way up to the 10th floor and his door's open, it was this crazy lady comes out the elevator and I don't know how long I spent in the waiting room. I mean, this is something that I just don't understand. Like how do you have somebody that's screaming and labor just hang out in a wheelchair in the waiting room? But there I was. There wasn't a seat for me in the waiting room, so I stayed in the wheelchair. It took a while I mean, like I feel like it was an hour, but maybe I'm exaggerating to get even registered. I was like how do you whatever, guess we're not triaging people. Then they didn't have a room for me, they didn't have a bed for me, so I just hung out there for a while and finally, when I got admitted, I was admitted To the PACU, which is the area where they do C-section recoveries. So it's basically a stretcher and with a curtain in between, and next to me was somebody that had just had a C-section and it was three o'clock in the morning, so she's recovering there with her baby and I'm next to her screaming obscenities.

Speaker 1: 29:40

And I labored on that stretcher for another couple of hours and let me just tell you the comparison of laboring on a stretcher and laboring at home in hot water is night and day. Whereas the contractions were manageable at home, it was absolutely not manageable on the stretcher and my poor husband and doula. We did not have a lot of resources in that little area. That was not a labor room. There was no labor equipment other than the monitor where and the reason they had the monitor? To listen to the heart. It was just so that they could prepare people for a C-section. So it was set up to prepare for a C-section and to recover from a C-section. It was definitely not set up for labor. So a flat stretcher on my back again not advisable, because that position not only is uncomfortable, it puts your baby in not the most optimal position for labor.

Speaker 1: 30:30

And so my labor became dysregulated. Additionally, as I mentioned, new York in the summer, with no air conditioning, I hadn't had anything to drink. For hours I had not had a sip of water or anything to drink because I just didn't feel like I could drink anything. My whole body was contracting, it felt like, and I didn't think that there was any space in my stomach for anything. So I'm sure I was intensely dehydrated and my contractions began to get very dysregulated. I remember at one point sitting there going. When is it going to stop? This hurts so bad. There's no relief in between contractions. I'm not able to rest between contractions. I feel like my uterus is not relaxing.

Speaker 1: 31:11

It was awful, but it was such a busy night that there was no one there that I could talk to about that. My nurse was busy. She was doing C-section recoveries. That's kind of a one-to-one thing. It is a one-to-one thing. So the person in natural labor whose baby is tolerating the natural labor wasn't the priority and I wasn't skilled in fetal monitoring then. So I have no idea whether they could tell if I was contracting that frequently or if, because I was moving around so much, they couldn't even really see my contractions. But nonetheless, they got to the point where my uterus was not relaxing between contractions and I was just in agony. So, not understanding what that meant, I just asked for an epidural because that was the only tool that I felt like I had at the moment. There was no peanut ball, there was no birthing ball, there was no other chair that I could sit in. Really, I got up to pee once. Normally I'm peeing every 10 minutes, so that's an indication that I'm dehydrated right there, and when you're dehydrated, your uterus can't relax, and so of course this was happening, of course my labor was getting regulated.

Speaker 1: 32:10

I didn't have an IV. I'm not sure why. I'm not sure why I wasn't even offered an IV, but that's usually the first thing is a labor and delivery nurse that I offer to a patient. If it's a natural laboring patient, they may not need it, but I would have gladly accepted an IV. I didn't walk in with a written birth plan. I didn't refuse an IV. I didn't ask for it but I didn't refuse it. And so I'm just kind of looking back on this kind of shock that I was never offered an IV, because I think that probably could have been the start to making my labor a little bit more regulated. So, anyway, no IV. I asked for an epidural. Took about an hour for the anesthesiologist to get there. Still no IV.

Speaker 1: 32:46

Did not get an IV bolus before my epidural, which I don't understand and when I got ready to go to the hospital, I put on the gown that I bought, because I knew that the gowns at the hospital were not really conducive to labor and breastfeeding. They weren't the gowns that unsnap. I don't know why they didn't have them, but for those of you that don't know, most of the time the gowns unsnap at the sleeves. So right here so you can undo them and breastfeed your baby. So pull down and put your baby skin to skin and do all that stuff and then snap it, mostly for convenience, and you can buy gowns on Amazon that do that too, and I bought one that came down easily, went up easily, had space in the back for an epidural and untied in the front so that the monitoring equipment could be put on the belly. So I thought I had everything covered.

Speaker 1: 33:35

Well, as soon as the anesthesiologist got there, the first thing he said is you're going to have to take off your gown. I was like what? That wasn't just a forearm, oh my god. So that was the first moment where I felt like I was no longer in control. The anesthesiology resident, not the anesthesiologist. So at that hospital it was a teaching hospital, so basically every medical provider that I saw during the night was a resident. So he made me take off my gown and put on the gown that I didn't like, not only because it's itchy, which at that point I didn't care, but I wanted to be able to do skin to skin with my baby and that really made it hard. So therefore, I didn't do skin to skin with my baby immediately after birth. It was a while after birth before I did it, I think it was at least an hour.

Speaker 1: 34:18

And then when I sat for the epidural in the past when I have helped patients get epidurals so before I was a postpartum nurse, I was a Spanish interpreter and I worked with a population in the obstetrics department and I would stand there and let moms lean on me so that they would be in the correct position for an epidural while the nurse did all of the safety checks and everything like that, because you just need a person to help with that process. Well, that wasn't offered to me. In fact, I was specifically told no, that my husband had to stand in the corner, my doula was not able to support me and my nurse refused to do that. So I felt I was in so much pain at that point, I was so exhausted and I felt like I had no control over my abdominal muscles, like it just felt like my whole body was contracting. I felt like I couldn't hold myself up. So that was really really hard for me to sit for the epidural. So strike one was well. Strike one was laboring on a stretcher, but I digress. Strike one was laboring on a stretcher. Strike two was not getting an IV beforehand. Strike three was telling me to take off my gown and put on the awful hospital gown. And then strike four is not assisting me into the proper position for an epidural.

Speaker 1: 35:33

Luckily, the epidural went in smoothly. It took effect immediately. However, and I have since talked to anesthesiologists about this next part, specifically an anesthesiologist that worked at the hospital that I delivered at, and my understanding at this point is that there are certain medications that are put in the epidural that can cause uterine tetany. And so that next moment, two things happened. I remember looking up at my blood pressure before the epidural and it was like 180 over 100, which my blood pressure is never that high, but I would imagine it was the amount of pain that I was in. And then after that, I remember it was like it was so super low. It was like 70 over 30 or something. That's the last thing I remember seeing as I passed out was the number on the blood pressure machine saying like 70 over 30. I know the bottom. The diastolic was 30 and I passed out Still didn't have an IV at that point.

Speaker 1: 36:26

As I came to, I remember seeing a resident come in who touched my belly and said that I was in uterine tetany, which means that I was having a really long contraction. At some point after that I remember him saying something like she's been contracted for 10 minutes straight. Get the turb, which turbulent is a medication that stops contractions. I remember the nurse putting turbulent in my arm while I'm going in and out of consciousness. And also I remember hearing my baby's heart rate was in like the 80s and going down. Normal heart rate for baby is 110 to 160. So hers was half of that.

Speaker 1: 37:04

And I remember getting my IV and then later I kind of came to and I couldn't feel anything from my waist down because I had the epidural. It was effective, but that was terrifying. I remember, as I passed out one of the times, looking at my doula saying what have I done? And she just said you know I'm here to support you. But that was terrifying. So after that I just felt completely out of control. Even though I was at the hospital that I worked at, even though I was a nurse in obstetrics in the hospital that I worked at among colleagues, I still felt out of control. So that all happened about 7 o'clock in the morning, right before shift change.

Speaker 1: 37:40

At about 8 o'clock in the morning I got moved to a room. Finally I was comfortable, but I was no longer contracting. Oh, when that resident came in and said I was in tetany, he also checked my cervix and it was. He said I was 8 centimeters. Prior to that, when I arrived at the hospital the first cervical check, I was 6 centimeters. So when I got to the room I wasn't contracting. My day shift nurse put me in thrown position to try to bring the baby's head down.

Speaker 1: 38:03

The attending came in and recommended a C-section. After checking me again and saying that I was only 7 centimeters and that my baby was low in the pelvis, but she had what's called capitis. So there was swelling in her head, not her brain, just like her scalp area, which is normal if your baby's been sitting in your pelvis for a while. She said that my labor had stopped progressing. But I made the argument that while it stopped progressing because you guys gave me medication to stop it. So maybe let's see if there's something we can do about that. So the option was given to me to start pitocin and I agreed. In the meantime, when the pitocin started, my nurse and my doctor were pulled into another birth and so I actually was allowed to labor for longer than they had anticipated. They said I'd have like an hour, but I got like 3 hours and luckily, by the time they came back I was complete and ready to push In.

Speaker 1: 39:01

Between those times when I believe when the pitocin had started or maybe actually no, before the pitocin started when the doctor left the room to have us discuss a C-section, my husband called our friend who had been the fertility specialist that I spoke to before I got pregnant and asked what he thought we should do, and we sent him a picture of our baby's heart rate at that moment and he said at this very second, it looks good, the variability is good. She's having exiles. At this very second, I don't see any indication, any urgent indication, for a C-section. She looks healthy. So if you want a little more time, I would advocate asking for a little bit more time, and he presented the option of maybe asking if we could start a little bit of pitocin to get the labor back. It started because it had stalled out after the turbulence was given, and so that's what we asked for and we started pitocin at one.

Speaker 1: 39:59

I remember looking at the pump to see what level of pitocin we were at, and over the next three hours we went from one to two to three and we landed on three. We stayed at three of the pitocin and I got to complete during that time Probably a little earlier than that time, honestly, because the doctor and the nurse were so busy with other patients that I don't think that they noticed that I was complete and they came in when my daughter started having D-cells, which is expected as your baby starts to crown. So, and the reason that I think that my baby was probably getting very low in my pelvis was because with the pitocin, there was a point where I just started pooping and could not stop, and that is an indication to me that my baby's head was pushing on my rectum. In my poor husband, I just told him to run out to the hall and ask for room spray and baby wipes. If they couldn't come in and deliver my baby, at least we could just, you know, clean up, and it was like he would hand me a baby wipe. I would wipe my own butt. I was turned out on my right side because that was my baby's favorite side, apparently and hand him the wipe with the poop in it, he would run over to the red he had a glove on and he would gag his way over to the red trash can in the corner and throw it away. And that was.

Speaker 1: 41:12

We did that for about an hour and then, finally, it was my turn and the doctor came in and was like well, you're complete and ready to push and let's get this baby out because her heart rate is super low. I don't know when the heart rate got low. I don't know what happened, but from what I know now, that tends to happen when babies are super low in your pelvis. Additionally, my baby had two vessels in her cord and also she had a cord around her neck, so she was not a happy camper when she was born. But I pushed for 20 minutes while I was pushing. I found it easier to push when I got counter pressure on my hips, on the bottom of my pelvis, from my doctor. It just felt like I was more stable and pushing up against something that was helpful.

Speaker 1: 41:53

At some point, I know, her heart rate went down and I was told this time I needed to push and get her out. And at the same time the doctor said I'm making more room for your baby and what I had learned in my birthing class was that there was ways that the provider could stretch your perineum so you can make more room for your baby. And I thought that's what she meant. What she actually meant was she was cutting it a pisiotomy. I didn't know this until later and I'll get to this, but I don't love how she approached the pisiotomy with me. But I don't disagree with the need and it took me a while to get to that point.

Speaker 1: 42:27

Anyway, my daughter was born after pushing for 20 minutes after the pisiotomy she came out. I was terrified. They had called the pediatrics team to the delivery because she was a known two-vessel cord, so that was standard, and also she'd been having D cells, so her heart rate had been going down. So they called the NICU team. They were there. The doctor handed her to me. She didn't ask, she just handed her to me. She actually had me put my hands down to try to help pull her out, but I didn't. I mean I was exhausted, it was.

Speaker 1: 42:59

The position was awkward. I was in the lethotomy position, it was. I couldn't reach her. I didn't have any abdominal strength to pull her towards me, and anybody that's taken a freshly born baby from someone knows that they're slippery and they're hard to hold onto. In addition, she was floppy and blue. The reason the doctor had me push towards the end to get her out was because she had the quarter on her neck and her heart rate had gone down and so she had no tone. She just felt like a blob Her head, her photos of her head flopped forward and her arms flopped forward and she's just this blue blob. And she handed her to me and I said take her over there to the NICU team so they can stimulate her and make sure she's okay.

Speaker 1: 43:40

Within a minute she had 9-9 apkars. Within a minute she was crying. I could hear her crying, she was okay, but those moments from when pushing started to when she was born really stuck with me as a trauma experience. It's something that I'm still processing. I'm still trying to understand. I can look back at it now and not experience it as a trauma, but I still can't 100% answer my own questions. I've gotten a lot closer to answering my own questions, but I wish I had felt more a part of the birth team during that process I felt like things were done to me instead of working with me. I feel like I was being told what to do rather than being involved in the teamwork. Nobody told me that I was getting an apesiaotomy. Nobody told me that they were just gonna what felt like throw my baby at me, throw a floppy blue baby at me. I feel like there was some opportunities for informed consent and inclusion that were missed. Now I said I was gonna get back to this.

Speaker 1: 44:37

I don't disagree with the decisions that the provider made. I believe that the apesiaotomy was warranted, and here's why I later found out that my daughter was. Not only did she have the cord around her neck, which could have limited her ability to come through the pelvis in an appropriate manner, she was also in a position called left occipit transverse, or actually no, I think she might have been right occipit transverse, I can't remember. Both my kids were. Their heads were transverse in the pelvis, which is harder to deliver. So they never did that nice rotation that they're supposed to do in order to deliver the head in the easier manner, and I don't know if that had to do with the cord. I don't know if that had to do with my position in labor or if it had to do more with my pelvis structure. But either way it's just a lot harder to get the baby through the pelvis and especially when your baby's heart rate is going down and you need to expedite delivery, an apesiaotomy can aid that process and theoretically prevent tears that could be more extensive. So all of those things combined, I don't disagree with the decision to cut an apesiaotomy. What I disagree with was the manner in which it was done. I wish that my provider had said your baby's heart rate's down. This looks like a tight fit. The baby's head looks like it's not in an optimal position. I believe it's necessary to cut an apesiaotomy to get her out quickly enough to maintain her oxygen level and prevent any negative effects that it might have on her. But that wasn't said to me. So back to the recovery. We'll get to the rest of that part of the story. So recovery I don't remember when I did skin to skin but I didn't know, I didn't do it for an hour, I didn't do it right away, and I know that the NICU team had my baby and a lot of this is just.

Speaker 1: 46:18

I wasn't fully educated the way that I am now. Now I know that babies should go on your chest immediately. Nurses should assist in that process so that the mom doesn't feel like her baby's being thrown at her. Most moms now know that the baby's going to go on your chest. We talk about skin to skin extensively, but that wasn't as much of a thing back then, I guess. So after the NICU team was done with her, I got eyes and thighs, so I got the erythromycin gel in her eyes and I had her get her vitamin K, which was a choice that I strongly aligned with. Not everybody does. I highly recommend vitamin K. I recommend that you do your research and you talk to your pediatrician about the erythromycin. There's controversy with both, but do your avidus-based research and make your decisions with your pediatrician before you just decide whether or not you're going to do that.

Speaker 1: 47:06

Anyway, it's a tangent. I got my baby. We got to bond. We have lots of nice, lovely pictures bonding with her. She breastfed right away.

Speaker 1: 47:14

My parents came to see her within about an hour of her birth because they're heading to a Broadway show, because I told them that I didn't want to be sat and watched until I went into labor. So I said make sure your itinerary is full because I am not a show and I don't want any audience in my labor. So they came and visited. We have fun pictures of that and then in that hospital at that time babies were taken upstairs to postpartum in the nursery to get their bath, to get their first assessment and to get ready for mom to transfer and, like I had said before, that was a very busy day. So I believe I was down in labor and delivery for about four hours before I got upstairs and now I know that's not optimal. At the time it wasn't concerning to me and here's why I was a postpartum nurse in a nursery nurse and I sent my baby to be up with all of her aunties on postpartum and my lovely co-worker, colleague, nurse that trained me, friend person that I just love. I was honored that she was the first person to give my baby a bath and she was able to spend the first, well, maybe the second couple hours with her while I was being prepared to go upstairs Again, not recommending it, but I know she was well taken care of and loved during that time.

Speaker 1: 48:23

I got upstairs to postpartum. It took several hours for transport to get there because, again, busy hospital. I was lucky enough to get a private room because I knew the charge nurse and told them I was in labor and they knew I was coming and they had the room ready for me and all of my colleagues were really excited to see me. I remember my nurse, cynthia, is the one who admitted me at the end of that shift. I didn't get up there until closer to six or seven, I believe. It was really really close to shift change and I remember feeling so bad about that because most people in obstetrics know that the closer to shift change that you get when you transfer, the less safe it is. But my friend Cynthia was happy to accept me.

Speaker 1: 49:07

I remember her helping me get up to go to the bathroom and I remember looking down and seeing how swollen I was. I look like the buns that you can get from Subway, I mean just hugely swollen. Some people say hot dog bun lady. They were way bigger than hot dog buns, like it was insane. And I remember her making a comment and she said wow, you had extensive tears, you had a second degree laceration internally and you also had an apesia. And I just remember being floored and the reason I was floored is because nobody told me about the apesia to me and I just want to say it's just real icky to find out about something like that after the fact from your colleague rather than from your OB. And that's all I'm going to say about that.

Speaker 1: 49:49

I don't disagree with the decision, I just don't love the way that it was handled. That brings me back to who repaired my apesia to me. It was a resident. It was a resident that I trusted. However, it took a really long time to heal and I don't know if it was the internal laceration or the apesiautomy or what, but at the six-week checkup it still wasn't healed. And I went back two weeks later. My doctor had said if it wasn't healed by the eight-week mark, that it needed to be treated. And it still wasn't fully healed. But he didn't think that it needed to be treated. So anyway, he just recommended pelvic rest for a few more weeks. I had pain for at least nine months, so it just it really didn't heal. Pain and scarring it didn't heal well. It wasn't until after my second delivery that I feel like everything healed appropriately, other than pelvic floor issues, which that's a whole other issue. After two apesiautomies You're gonna have pelvic floor issues. So apesiautomy healed way later than anticipated.

Speaker 1: 50:51

Postpartum I could not be happier with my postpartum nurses. I love them. They were some of the best humans that I've ever worked with. Everybody came and visited me. That was my colleague. I had such a great experience. They helped my husband learn how to feed her.

Speaker 1: 51:07

Yes, I was breastfeeding, but during my pregnancy, at about this 37-week mark, I started pumping colostrum because I knew that if I didn't have enough breast milk, that if she lost weight, then she would be given formula and I wanted to avoid that. So I wanted to have colostrum on hand in case I needed it. And again, we lived four blocks from the hospital, so it was just a matter of going and grabbing it from the freezer. So that wasn't a problem. And I also wanted my husband to learn how to feed her, so he brought some colostrum. I also pumped while I was at the hospital. Again, not all things that are necessary, it was just the choices that I made because I wanted my husband to be involved in feeding her. So my colleagues taught him to feed her while I pumped. For a couple feeds she latched pretty well, but later, after taking her to the dentist when she was younger I realized that she did have a lip tie and I think that really contributed to some nipple pain and some breastfeeding pain that I had. So I wish that I had gotten some lactation help ahead of time. But I thought I knew what I was doing because I helped mom's breastfeed all the time and I'd been to lactation conferences. I thought I knew everything, like how much do you really need to know as a new mom? Apparently I didn't know enough. So I definitely advocate for people getting a lactation consultant, even if you think you know it all.

Speaker 1: 52:15

Postpartum was difficult and enjoyable. There were really difficult times. Getting her to sleep was a chore. She stayed to sleep pretty well when I finally got her to sleep, but getting her to sleep took hours. Probably she was just a colicky baby, which that may or may not mean something to you and in the medical world that may or may not mean something to pediatricians. It's kind of a controversial topic, but I know that I was colicky and she had typical signs of what you would consider colic she would fuss, she would move around, she would cry for hours at night. It was just really, really hard to put her down. As soon as we put her down, she would wake back up and start screaming and lather, rinse, repeat. We would just be. We walked loops around the apartment every night trying to get her to sleep and I just remember being exhausted and then she would wake up screaming and being overwhelmed with all of that. But during the days I just loved hanging out with her and it was New York in the summer and going for walks with her. It was really enjoyable.

Speaker 1: 53:13

I went back to work the night shift three nights a week in October, I believe yeah, october, and I remember October 31st. I put in my 30 days notice because my husband got a job in the DC area and right after Thanksgiving is when we moved. Like the first week of December is when we moved. So that was a rough move, a rough turnaround, and then after that, postpartum became more challenging. And while I recognize that the 12 weeks was up and some people may consider that no longer postpartum, that first year of your baby's life is so life altering.

Speaker 1: 53:52

So to have to go from my safety net in New York where we had made friends we'd been there for two years, I learned to become a nurse to the outskirts of DC where I knew nobody, in the middle of winter, no opportunity to really meet anybody, because we didn't have any babysitter, we didn't have family. My husband had started a new career. It was encouraged that I not work for the first six months of his career, because it was a really intense program that he had to learn at the time. So I got to be alone for, let's say, we moved here when she was four months and then she went to daycare when she was 11 months and that's when I went back to work. So seven months I felt really alone and after that I started to meet people. I started meeting my neighbors, some of whom you've heard on this podcast Jen Burns, who is someone that makes frequent appearances on this podcast and was my neighbor across the street for a while. We have kids that are about the same age, and then my colleagues at work a lot of them You've also heard on this podcast.

Speaker 1: 54:51

So that first year was rough but things got better after that. Everything I took from my birth is something that I was finally able to process when I became a labor and delivery nurse. But during that first year I definitely wrestled with a lot of things that happened, trying to understand why I got in a pisciotomy. Trying to understand why my daughter's heart rate went down and I was handed a baby that was floppy and blue. Trying to understand why, when her heart rate was fine, I was being recommended for a C-section. Trying to understand why I didn't get an IV before my epidural. Trying to understand why I had to take my gown off and put on the stupid hospital gown, why there were small infractions on my autonomy, and so that's where I started trying to understand what happens to gestational parents, the birthing parent and the birth space in the hospitals, and how we can do better. I was lucky enough to process the interventions of my birth with the people that I was doing orientation with, with the midwife that was training us on orientation.

Speaker 1: 55:50

I chose to go to the hospital where I went because a wonderful nurse interviewed me and asked me how my first birth went and I told her the story and she said oh, darling, you don't need to do the next time, you need to do over Leah Martin, you know who you are. And she promised me. She said I'd drive past two hospitals to get to this hospital and I would never work at another hospital, and she convinced me to take the job that I took and she taught me how to be a nurse advocate and, yes, she was the nurse that delivered my son. She was one of them. There were several that were in there at the moment that he was born and I love all of them and I'm so grateful for them. I'm so grateful for the delivery team for my second pregnancy and I will share that story on another episode coming up. But I chose to go to this hospital because I knew that was a place that I would be supported. That place offered me a lot of healing from the experiences of my first birth and sent me on the way to advocacy for other parents.

Speaker 1: 56:50

Now, that has not been a perfect journey. There's been a lot of learning in the process, but that's why I am such a champion for education and emotional preparation and mindset work to prepare for pregnancy and birth and parenthood. If we are not emotionally ready, if we don't prepare for the process, we don't address our fears and we don't overcome certain emotional obstacles before we go into that space, it will not be an enjoyable experience If you don't know what's happening to you. A friend of mine said something that I thought was just so profound Trauma is what happens when your brain can't keep up with what's happening to your body, and that's exactly the trauma that I experienced in my first birth and, just spoiler alert, same interventions happened in my second birth, but I felt no trauma because I understood what was happening to my body. You'll hear about that story later if you stay tuned for the episode where I share that, but I just want to leave you today with the message that if you are pregnant, if you are planning to become pregnant and become a parent and you are the birthing person that is going to be delivering that baby, seek out as much education as possible.

Speaker 1: 57:58

Unfortunately, the medical system isn't set up to prepare moms through the medical system, through the hospital system.

Speaker 1: 58:04

It's not a great process across the board.

Speaker 1: 58:06

There are some that are probably better than others, but my experience is most moms come in not really knowing what they're in for and a lot of questions about the process and when you're about to go through labor and birth.

Speaker 1: 58:19

That's not the time for a crash course in labor and delivery, and so I really just want to advocate for moms to seek out education and support and emotional processing and mindset work and all of the things that you will need to prepare for labor and childbirth and motherhood before you go into the space. Take advantage of the time that you're pregnant and before you have kids to do that and to really prepare for that, because it will make your pregnancy and birth so much more enjoyable, and you deserve to have an enjoyable pregnancy and birth. This is probably the most important time of your life, probably the biggest milestone of your life. Other than the day that you were born, other than if you got married, if you're wedding, this is a day that you're going to remember forever, and what I want for you is for that to be a positive experience. So do the work that it takes to make sure that it is positive.