Perfect picture, since this episode is being posted on New Year’s Eve!
Today, Emily & Paul share the story of how their “spirited” son was in breech position, or head up, and how the many proactive things they tried to encourage him to flip didn’t work. Because the vast majority of OBs aren’t trained these days in vaginal breech birthing techniques, their practice included, their birth needed to be a scheduled c-section. While this wasn’t even close to their original vision for the way birth would go, they share how the overall compassionate and proactive care their family received made all the difference in the world toward a positive experience. Then things took an unexpected turn when their son needed to go to the NICU when his low blood sugar couldn’t be improved with skin-to-skin or supplementation. Almost simultaneously, Emily was diagnosed with the rare HELLP syndrome, which is a variant of preeclampsia and is fairly rare but very serious, in the hours after birth. Emily shares how she received (mostly) compassionate care both in the hospital as well as expert care both at the hospital and at home once discharged, with a few bumps along the way.
Episode Topics:
intros, explaining why they had to schedule a cesarean
attempts to get baby to turn from breech to vertex position & ways they prepped logistically for the cesarean
“good debt” of investing in a private postpartum room (if your hospital doesn’t offer that by default, which is usually the case in NYC hospitals)
Emily goes into labor spontaneously, nesting as a sign of impending labor
ordered Uber XL (highly recommends having the extra space)
rhythmic & breathing rituals helpful in the car transfer, Paul’s responsibilities
arrival at hospital, administration of spinal with several tries while Paul waits out in hall in scrubs
discussions with care provider about spontaneous labor protocol before scheduled cesarean, concern over increased risk of prolapsed cord with breech babies
gentle cesarean requests/plans out window due to spontaneous labor happening before she could make those requests
special requests/directives they made
Paul’s perspective on OR experience, birth of 9-pound baby, Paul cuts cord
Emily notices not feeling quite right, she’s moved to recovery room
Emily’s postpartum severe pre-eclampsia (HELLP syndrome); to prevent a stroke, they had to give her a magnesium solution
Teddy had low blood sugar when he was born due to being large; supplementation via cup feeding, lots of skin-to-skin; goes to NICU due to not stabilizing
finding out about HELLP diagnosis, what “drop mag” means, terrible side effects for days
mom and aunt arrive at hospital; some communication snags with one nurse
Paul’s perspective on what transpired after birth and his role, going back and forth between NICU and Emily
Emily pumping through all of this, milk took a long time to come in, learning to encourage Teddy to latch on after getting used to formula feeding
pain relievers that she could and couldn’t use, huge difference between 2 nurses on two back-to-back shifts (one great, one not so much)
packing tip: earplugs and/or earbuds; Teddy coming out of NICU; staying in hospital for 1 extra (optional) day, for a total of 4 days, they highly recommend Mt. Sinai West private rooms
instructions upon discharge, settling into home
Paul’s 2 podcasts - Dads on Dads on Dads parenting podcast & Red Sox podcast You May Be Right
Resources:
Spinning Babies - this links to lots of info on breech, or heads up, fetal position
C-section Are Best with a Little Labor (NYTimes)
Gentle Cesarean Techniques (Lamaze)
Family Centered Cesarean Birth (video)
Family Centered Cesareans (video)
Dilaudid - pain medication
Dads on Dads on Dads podcast (the episode on masculinity Lisa refers to is Ep. 11)
You May Be Right - (Paul’s podcast about the Red Sox on Elite Sports Network)
Heads Up: The Disappearing Art of Vaginal Breech Delivery* (documentary)
*Disclosure: Links on this page to products are affiliate links; I will receive a small commission on any products you purchase at no additional cost to you.
Transcript:
Lisa: 0:00
You're listening to the Birth Matters Podcast, episode 18.
Paul: 0:04
So he had to be cup fed. They did not cup feed him down there.
Emily: 0:06
That's true. They made a mistake and the nurse calls and says, "Look, I'm so sorry that that happened," and I'm like, "You know what? It was a really long road to get him. I'm trying to see the forest for the trees here. It happened, and let's just move forward. That's it."
Paul: 0:22
Right.
Lisa: 0:29
Hey there, and welcome to the Birth Matters Show. I'm your host, Lisa Greaves Taylor, founder of Birth Matters NYC Childbirth Education and Labor Support. This show is here to lessen your overwhelm on the journey into parenthood by equipping and encouraging you with current best evidence info and soulful interviews with parents and birth pros. Please keep in mind the information on this show is not intended as medical advice or to diagnose or treat any medical conditions. Did you know you can sign up to receive email updates whenever a new episode goes live? Visit birthmattersshow.com to join our podcast community.
Today, Emily & Paul share the story of how their “spirited” son was in breech position, or head up, and how the many proactive things they tried to encourage him to flip didn’t work. Because the vast majority of OBs aren’t trained these days in vaginal breech birthing techniques, their practice included, their birth needed to be a scheduled C-section. While this wasn’t even close to their original vision for the way birth would go, they’ll share how the overall compassionate and proactive care their family received made all the difference in the world toward a positive experience. Then things took an unexpected turn when their son needed to go to the NICU when his low blood sugar couldn’t be improved with skin-to-skin or supplementation. Almost simultaneously, Emily was diagnosed with the rare HELLP syndrome, which is a variant of preeclampsia and is fairly rare but very serious, in the hours after birth. Emily shares how she received mostly compassionate care both in the hospital as well as expert care both at the hospital and at home once discharged, with a few bumps along the way.
Lisa: 1:22
Before we get started on the birth story, today's episode is brought to you by the Birth Matters Complete Online Course. If you can't squeeze in an in-person group birth class series, or if you didn't feel like the one you took was comprehensive enough, or if you don't even have a quality class available in your area, I have the perfect solution for you. Birth Matters Complete Course is an online recorded version of my in-person full series. It covers not only prep for an amazing birth with self-advocacy tips, best current evidence and tips for partners, but also holistic postpartum wellness, breastfeeding and newborn care. And to top it off, you get lifetime access so that you can use it as a refresher later in this or a future pregnancies. Check it out at birthmattersonline.com. Now let's get started with today's birth story.
Lisa: 3:01
Hey you guys, welcome to the show. I'm so glad to have you here. Introduce yourselves, and maybe tell us where you are in your parenting journey, and then you can feel free to launch right into your birth story.
Paul: 3:13
Absolutely. My name is Paul Desena. It feels I think a little bit longer, but it's about seven months after our son Teddy was born and I'm really just happy to be here.
Emily: 3:25
I'm Emily and yes, I'm about seven months postpartum and have a very bouncing baby boy named Teddy.
Paul: 3:35
Spirited baby.
Emily: 3:35
Spirited baby.
Lisa: 3:41
I like that word.
Emily: 3:41
That's how we describe him, he's very spirited. He knows what he wants. Whom we love and adore. Yeah. So our birth story. I guess it starts with the fact that we did use fertility treatments to get pregnant. So I knew we would always have a hospital birth. That was 100% certain.
Paul: 4:03
It made planning almost more comfortable in certain ways because we knew, kind of knew what we'd have to do.
Emily: 4:09
Yeah.
Paul: 4:10
You know, and we knew that it would to some extent, I think, be scheduled.
Emily: 4:14
Yeah. And we didn't, we didn't force, it wasn't forced upon us. It was a choice we made, but it was the choice we were most comfortable with. So Teddy, being a spirited baby, never turned into the correct position.
Paul: 4:26
Because he was breech.
Emily: 4:27
He was breech. Yeah, he was breech. Supposed to turn the other way. And we did a whole bunch of holistic measures to try and get him to turn. I mean, I would constantly go, I went to prenatal yoga every week, did sitting baby exercises, watched the video.
Paul: 4:43
Did the ice thing.
Emily: 4:43
Oh gosh. Everybody thought I was a horrible, horrible...tell them what I did, Paul.
Paul: 4:49
What was it? A tepid bath?
Emily: 4:51
A warm bath, warm, not hot, but like warm.
Paul: 4:54
Warm bath. You take ice and you place it on your belly in such a way as to try to get him to turn.
Emily: 5:02
So he would go into the warm water that was on the bottom if I put the cold ice pack like on his head, essentially. I was part of a midwife practice that's run by a doctor. So Dr. Paka's midwives were the ones who suggested that to me. But—and I did it, but I remember my mom thought I was mean for doing it, like, "He's going to come out wanting to wear a hat." Paul thought I was mean. It didn't work.
Paul: 5:26
He doesn't love hats, but he doesn't hate them.
Emily: 5:28
That's true.
Paul: 5:29
Acupuncture.
Emily: 5:29
I did acupuncture and...
Paul: 5:31
Smudge.
Emily: 5:31
The take-home smudge stick that I made Paul—because I couldn't reach my pinky toe, we had like at-home acupuncture. Paul would put it to my pinky toe several times a day. The heated smudge stick that they give you.
Paul: 5:46
I must have done it wrong. I must've done it wrong because it didn't work.
Emily: 5:49
We did a lot of things.
Lisa: 5:52
That's it. Put all the blame on yourself because you didn't try enough.
Paul: 5:58
I'm not here to cast dispersions on Eastern medicine. I'm assuming I did it wrong.
Emily: 6:05
But you know, we approached I think like week 36 and they're like, and I think the—by that point the midwives in Dr. Paka were like, "Yeah, we're just gonna schedule the C-section, because that's where we're at." And we knew Teddy, you know, was on the bigger side, but they stopped really talking about him being very big towards the end. Like they weren't mentioning his weight or anything anymore.
Paul: 6:27
They probably thought it was too much, so it was rude. He was a big baby.
Emily: 6:29
My family has a history of very large babies. I was over eight pounds and I was born at 36 weeks.
Paul: 6:41
And we were tiny. Comparatively.
Emily: 6:41
So I was like, "Well, maybe we'll meet somewhere in the middle."
Paul: 6:45
I was one of the largest babies in my family at seven pounds one ounce.
Lisa: 6:51
Yeah. And that's a very average size. Yeah.
Emily: 6:54
Yeah. Wouldn't it be nice? So we did—our pregnancy was rather beautifully uneventful, no complications really. Right? It was normal, you know, pregnancy complaints.
Paul: 7:08
Backaches.
Emily: 7:08
Backaches. Tired. I got really tired toward the end of my pregnancy. Very, very tired. But the doctors were very unconcerned, and I stopped working I think around week 37. It was week 38. It was a Friday morning.
Paul: 7:22
I'd set my paternity leave by then.
Emily: 7:23
Yeah, you had.
Paul: 7:25
We actually planned it.
Emily: 7:26
Because we had the C-section date.
Paul: 7:27
We had the C-section date and I had planned my paternity leave at work and we planned the date and we'd worked it all out. And the date was the date and it was all set.
Emily: 7:38
And I'm, I'm very grateful that I actually watched your...so you, we did the fast course with you. It was done over, how many, how many days of the past
Lisa: 7:47
Three weekend days. Yeah, the four hour classes.
Emily: 7:50
So we had to do a, there were videos on C-section to watch at home, which I watched, thankfully. So I was starting to make my plan around like week 37, like having Paul have cotton balls with, you know, you know, essential oils on them in his pocket, playlist ready to go, should I want that in the delivery room, on his phone because that could also be in his pocket. What were other things that we were kind of...
Paul: 8:16
I got a contraction counter.
Emily: 8:17
You had a contraction counter ready to go. An app.
Paul: 8:19
There are a million of those apps. Yeah. There's like...wow. I mean, I didn't think this was a market that was so huge.
Lisa: 8:29
I know, right? It's kind of crazy because it's such a simple kind of thing. And yet why is there so much competition? I have no idea. That's why I don't pick one. I'm like, "Just, just pick any of them. They're fine."
Paul: 8:41
The one I picked, I can't remember the name, worked great.
Emily: 8:50
And we took one of the best-- a great piece of advice you gave, and we took, and I do not regret it, I think it was very important in my recovery, was you said "If you're going to have a C-section, or you end up having one, consider going into the good debt and get a private room in postpartum. And ...
Paul: 9:07
That was not a question, yeah.
Emily: 9:08
It became, yeah, we were going back and forth a little bit and we said, "You know what, being able to be--to heal, and to have the space to heal is important." Our friends had their baby two weeks before us, so we saw what a shared room looked like, and although, you know, it's doable, we, I also said, "You know, Lisa said...."
Paul: 9:31
It wasn't for us.
Emily: 9:31
So you know, we, we cleared out room on a credit card and we're like, we're going to go into good debt and we are okay with our decision on that. So all these things were kind of ready to go. Date was ready and then Friday morning, it was a Friday, right? It was..
Paul: 9:46
Thursday night, remember?
Emily: 9:48
Thursday night. That's right. Thursday night. I'm like, "Something feels weird. I feel weird. Something feels weird. I don't think he's moving as much. I feel so tired,"
Paul: 9:57
She was rushing around and cleaning a lot right before that.
Emily: 9:59
Was I? No.
Paul: 9:59
Yeah, you were. Like all day. Yeah. And then at night around seven o'clock, or it might have been 6:30 you said, "I feel really, really tired. I feel just really..." Then you felt, and then you told me and we called your mom about it, but you said that you, that you weren't sure if you were feeling him moving as much.
Emily: 10:21
As much. So we called the on -call doctor and they were like, well you have to go to labor and delivery, and I don't know if it's because I'm like--my mom was a labor and delivery postpartum nurse most of my life. She's a nurse practitioner. And I just felt so silly. I'm like, "Why? Why am I going in? It's not a big deal." And he was very like, "You know, no, it's not silly. You just go in and that's that. And just double check. Better safe than sorry." So we hopped in a cab, went over. I think I was having some very mild contractions at that point. Didn't know it. Very, very mild.
Paul: 10:54
Did you think they were Braxton-Hicks?
Emily: 10:56
I just thought they, well--a weird tightening, like weird feeling, like a weird feeling.
Paul: 11:00
Like you maybe had to go to the bathroom.
Emily: 11:02
Maybe like, I'm like, "This is a weird feeling." And they checked, my blood pressure was a little elevated, because I had been a very steady 110 over 70 my entire pregnancy. And basically they sent me home. I wasn't dilated, I wasn't effaced.
Paul: 11:17
They did confirm that you were having contractions.
Emily: 11:20
They were like "It's very mild. You can...it's nothing. It's nothing. Go home." And it didn't, it wasn't painful. It was not painful. So we went home and when I woke up I was, I was like, "Ooh, I think I," you know, TMI, people probably don't need to know this, I'm like "I have to go to the bathroom," and you know, I go to the bathroom. And I'm like, "Ooh, I still feel like I have to go to the bathroom." So I call my mom, the labor and delivery nurse. She's like, "Emily, you know, I've had a lot of women who were like, 'I think I have to go to the bathroom,' but they're actually in labor," and I'm like, "No, I'm not in labor. I'm at week 38."
Lisa: 12:01
Denial.
Emily: 12:01
"No, Mom." And then they started going and getting a little more intense and I'm like, "Okay." She's like, "Just call the doctor." So I called again. The on-call doctor--it was a different doctor than my OB, you know, on-call. And she was like, and then again, I'm doing the, "I feel silly. I was there last night. I, you know, I probably just have like, I ate something funny." She's like, "Well, you know what, just come on in. It's fine, just come on in, it's better just to check." And while we are... I said, "Okay, we're going to do this. Let's call an Uber." I don't know who told us, who gave us this advice, but we got an Uber XL, like one with lots of space.
Lisa: 12:39
Smart.
Paul: 12:42
That might've been the only one available.
Emily: 12:43
No, I asked for it. I asked for it.
Lisa: 12:46
Good to have that space.
Paul: 12:49
So at 8....
Emily: 12:51
I had some pain, but I didn't know if it was like late, I don't know, it was like serious denial.
Paul: 12:55
Early that--I had woken up purposely early that morning to get the entire house ready because I wanted to go into work because I wanted to leave work early, and I don't remember why, but that's, I was already up.
Emily: 13:08
You were up, yeah.
Paul: 13:08
I was dressed for work. And that's when you started having the pain. So we called the Uber, Uber XL, and we got in and I started off.
Emily: 13:17
It was so nice.
Paul: 13:18
I fired up the contraction counter.
Emily: 13:20
Yeah. I think by the time we hit the bridge from going into Queens into Manhattan, I was like this is labor.
Paul: 13:25
Four and a half minutes.
Emily: 13:26
I am having contractions and--oh my gosh.
Paul: 13:34
It was between five and six minutes apart. And then by the time we got to the hospital they were about four and a half, four minutes apart. The guy was so nice about it.
Emily: 13:39
This is also like 8:30, 8:45 AM on a Friday going from Queens into Manhattan, so cross town traffic, trying to get from the east side to 10th Avenue, which is where Mount Sinai is.
Paul: 13:55
In labor. In rush hour.
Emily: 13:57
Laboring in rush hour. So we went over--over an hour.
Paul: 14:01
He was really nice about it. He was like, "I've got three kids,"
Emily: 14:03
We had great Uber drivers to and from the hospital. We really did.
Paul: 14:05
A salute to the company, as far as that's concerned.
Emily: 14:12
And so he was very calm, very patient and you know, not, not concerned at all. He's like "Yeah, my wife's had lots of kids, we've seen this, you're good. We're gonna get to the hospital." And I knew, and I knew I was very much in labor by the, by the--before we left Queens. Like I said, no more denial. There was no way to deny it. And we get there and to my shock, because I'm in so much pain, even though I know a C-section's coming, I can tell where he is. Head still up in the rib cage, you know. They're like, "Well you're clearly effaced, but you, you're not even dilated." And I'm like, "What? This is what not dilated feels like?" He hadn't dropped yet because of his position. So all that was a factor in the dilation issue.
Lisa: 14:57
Oh yeah, yeah, yeah, yeah. Without the head there. Yeah, absolutely.
Emily: 15:01
Like it, like, apparently breech babies can drop, but like he was not dropped at all. He was just hanging out.
Lisa: 15:08
I just wanted to ask you, in the car transfer in the Uber, are there any coping techniques that you found to be helpful, or positions or anything?
Emily: 15:18
Oh yeah. I mean, we, we used...
Paul: 15:21
Ride-the-wave breathing.
Emily: 15:22
Yep. And and the ritual where you...Paul was the one that told me about it because it was in the Birth Partner book you recommended, Lisa.
Lisa: 15:31
Yeah. Yeah, the three Rs.
Emily: 15:34
Yes. And so ritual, like just saying like, "Huh-hummmm," or whatever...
Paul: 15:38
We tried to do the same thing through the contractions...
Emily: 15:42
And that really helped.
Paul: 15:42
And then kind of just keep, we tried to keep like a, a beat going.
Paul: 15:47
Paul would tap on me.
Paul: 15:49
Keep it rhythmic. Whatever it was, we tried to keep it rhythmic and regular. So if you're watching somebody have a contraction, you could actually see it physically happen, because the pain is, I'm assuming, having never felt one, it's really intense. So that's, so that's what we tried to do and we just--so we started that I think in the Uber ride over..
Emily: 16:13
Absolutely, yeah.
Paul: 16:13
And, and it continued.
Emily: 16:16
Very intensely in the, in the triage area.
Paul: 16:20
So we tried to do as much as we could in the triage area, and then we got back to it in earnest when she was in the room, not the birthing room or anything, but like the holding ....
Emily: 16:29
That's triage.
Paul: 16:32
Right, right. The triage. That's where we really got back into it. Then from there, you know, eventually from there they would bring her into to have a C-section.
Emily: 16:41
Yeah, so that was, yeah, we were definitely focusing on rituals, especially toward the end as it got a lot more intense. Luckily we were getting closer to the hospital.
Paul: 16:49
Right.
Emily: 16:50
Positions? You know, I remember I, before, you know, him being breach was becoming an issue toward the end of my pregnancy, I remember talking to my doctor and midwife and I'm like, "I don't want monitoring. I need space, I need to be able to move, and I need to be able to get on the floor. I need to be able to crawl on the bed. I just need to move, walk around, and I need you to support me in this." And like that was such a big deal for me. And I found during the contractions, I, I know I did not want to do anything except be right where I was, like seated on the bed. It was instinctual. I didn't, I was not, I was not up for standing and swaying my hips. So I was not up for anything. It was, I just wanted to be in that position and focus on doing the ritual with Paul making sound.
Paul: 17:38
You needed your back supported.
Emily: 17:38
I had a lot of, yeah, back pain, probably positioning of Teddy was a big part of that. But I remember when they accidentally gave me really hot towels, like out of the dryer almost and I put them on my back. I was like, "Oh my God, that's amazing. More!" That's one of the reasons I wanted the XL Uber is that if I needed the space, I wouldn't feel confined in, like, a Ford Focus.
Paul: 18:06
It was very spacious. Roomy.
Lisa: 18:06
That's such a good tip. I'm going to totally steal that tip, so thank you. Yeah, bigger is better and more space for sure. That makes sense.
Emily: 18:19
Worth that extra 20 bucks.
Paul: 18:20
A ton of room. I mean at rush hour it's expensive, but there was a ton of room, I mean, you could spread out in that thing. And then I was sitting there timing her contractions, helped doing the ritual, and just trying to give her any, any really anything she asked for, like if she needed a drink of water or something like that, just try to have.
Emily: 18:42
[inaudible] water. They kept offering me water. I remember that.
Paul: 18:45
But on the way over, you, you asked for like a tissue or something like that. Every once in a while she'd need something from the bag. And I just remember that I would have the bag ready. That was, those were pretty much my sole responsibilities.
Lisa: 19:00
Nice. Very important ones, too.
Emily: 19:02
We were in triage for a while. That was the thing that was unexpected for me, how long I was laboring before the C-section took place. I was asking for drugs at that point, I think because I knew, I'm like, "Look, I remember Ina May Gaskin--if I'm saying her name correctly, one of the, Ina May Gaskin, like a, which, I've read her books on giving birth and also on breastfeeding, which was really helpful--was like, "You're gonna feel the pain, you know, with a vaginal unmedicated birth, you're gonna feel the pain during it. But then afterwards, you know, the pain's over. If you're going to have a cesarean section, not that it's always a choice, you may not feel the pain before, but you're going to feel the pain. There's going to be pain after.
Emily: 19:44
And I was like, "Well s**t!"
Lisa: 19:46
Thanks a lot!
Emily: 19:46
"I'm feeling pain now and I know I'm going to have to deal with it later. When, when can I get my spinal? Is there any other drugs you can give me? Like their, my, my, contractions were coming very fast.
Paul: 19:57
Two minutes.
Emily: 19:58
Two minutes. And I, you know, and I was just like, "What's going on?" So we were there for a couple hours actually.
Paul: 20:04
In triage for a couple hours. There was a couple snafus when we first got there. The first one, they had trouble getting, getting her line in and she did ask repeatedly for an epidural.
Emily: 20:14
Spinal, yeah.
Paul: 20:14
Or spinal. Eventually we got pain medication, I believe.
Emily: 20:18
No, I got the spinal.
Paul: 20:22
The first thing you got was the spinal.
Emily: 20:22
Yeah.
Paul: 20:22
So they kept her there for about two hours with very...no relief.
Emily: 20:28
It got to the point where I was like, "You gotta give me a time so I can start counting down, so I can know I have to do 15 or 20 more of these," you know what I mean?
Lisa: 20:36
Yeah, of course.
Emily: 20:37
My nurse, he was like, "Yes. Okay, you have 30 minutes." I said, "Okay." And then I had, I said, "Okay, Paul, what's the number?" And he was like, "This is the number." I'm like, I'm like, "Okay, we can do this. One at a time. One at a time."
Lisa: 20:48
Yes.
Paul: 20:49
They did get the line at one point.
Emily: 20:52
Yeah, my IV. So they couldn't get my IV in. We didn't know it at the time, but I was becoming severely preeclamptic, even though I had no preeclampsia issues or high blood pressure issues during my pregnancies. So I was retaining a lot of water. They tried so many times. I didn't want it in my arm because I planned on breastfeeding and I knew that would be a problem. They tried multiple times to not do it in the crook of my arm, to not do it, to do it down by my wrist. And then they tried to do it in the crook of my arm with just many awful attempts, again, because of that.
Paul: 21:22
That's where they ended up getting.
Emily: 21:23
And eventually they, when my blood pressure kept going up, maybe it would have been there longer, I don't know. But they knocked me to the top of the list and I was the next—when my doctor was ready, I was the next C-section to go in.
Paul: 21:35
Right.
Emily: 21:35
So they took me and Paul had to wait, which is common and protocol across the board. While they did my final, they do spinal to first time moms instead of epidurals, is my understanding.
Paul: 21:46
Right.
Emily: 21:46
So they were.
Paul: 21:47
What hospital was this?
Emily: 21:47
We were at Mount Sinai.
Paul: 21:49
Right.
Emily: 21:49
So they took me back to my spinal. My doctor, I am so grateful for her. She was such a calming force in the OR for me. I felt so supported by her during and post op, her name was Dr. Chu. She's one of the doctors on my, on the rotation with my normal OB. So if my OB's not on-call, she's one of the doctors that takes my doctor's patients and she, I remember her being there with me.
Emily: 22:12
They had a hard time placing the spinal, too. It was not fun, and it did take multiple attempts—not to like freak other people out. It's not the end of the world, but it's not fun either. But, and she was just, she had her hands on my shoulders the whole time. She would talk to me. Her second, the person who was assisting her, was holding my hands while this was happening. Of course I'm having contractions during this process, right? And you're not supposed to move. So it's very intense, but they were really calming for it. I felt very taken care of by them. It took a minute for the pain to go away once, you know, I remember—laying back, going from the seated position and you have to lay back, essentially for the surgery on the table. That was the probably the worst part of the, before I gave birth.
Emily: 22:59
I don't know why, again, maybe the back thing, his position or something.
Paul: 23:03
How many times did they try to get the spinal on?
Emily: 23:05
I remember four.
Paul: 23:06
Okay. And so while this was going on and they were trying to get her spinal, I was waiting out there dressed for the OR for what felt like a very long time, and I did not feel as if I would be permitted to just kind of barge in, so I was sitting in the hallway. Eventually they came and got me.
Emily: 23:25
Yeah. I think that's protocol.
Lisa: 23:27
Thank you. Yeah. I was going to ask you if you were there, or at what point you were there. Great, thank you.
Emily: 23:33
So we had planned for my mom to be there during the birth, too, because she had a flexible ticket. So when they had made the call that my C-section was happening that day, she was basically catching a flight up. We knew Paul would be in the room for the C-section so that wasn't—we wanted a second person. That was another thing I wanted to go in with like gloves on to fight for, but, like she wasn't even there. So there was no point. Right?
Lisa: 23:54
Gotcha. Can I ask a question about the spinal? Usually that's a single injection that's good for about an hour.
Emily: 24:01
Yeah.
Lisa: 24:01
Was it, was it just a one-time injection or was it a—some kind of continuous feed?
Emily: 24:08
You mean the numbing agent, right?
Lisa: 24:09
Right.
Emily: 24:10
So the last time I felt it, and that was bad, that was the painful part of it, and they had to give me more and they—it was hard for me to communicate and they had to prompt me. They had said, "You have to tell us where you're feeling it." And you know, I'm like, "Upper right, upper right." I was able to finally get it out and then as soon as I said it, quickly they were able to relieve that pain. Because it is a teaching hospital, I could hear the attending working with the residents, you know, so that's, that's how I knew that it was not going well, with the attempt for the spinal place. So I, I didn't feel it until the final one. That was a successful one. And although I did feel the pain from that, they were able to alleviate it quickly.
Lisa: 24:49
Did you have some pain relief before you had to lie down on your back?
Emily: 24:53
No.
Lisa: 24:53
Not at all. It didn't sound like it when you said that was awful.
Emily: 24:59
It was awful. Quickly, everything went away. Quickly after that, everything went away. As soon as I was on the table, you know, and there's all this bustling going around and then all of a sudden I'm like, "Oh, hey, I don't feel any contractions." You know? And I know at one point my nurse was there and I was like, "Hey, have they started again?" I'm like, that's a great sign. They are very much started.
Lisa: 25:19
Yeah. And did you guys have, before you went into labor, in your prenatal visit as you were scheduling the surgery and everything, did you have any conversations about what the protocol would be if you were to go into labor spontaneously before the scheduled date?
Emily: 25:36
A little bit, yes. They—mainly because there's a, a small concern about the cord, what is it called? Prelapsed cord. Right?
Paul: 25:46
Prolapsed.
Lisa: 25:46
Prolapsed, yep.
Emily: 25:47
With a breech baby, because you're, the head isn't blocking the cervix, like, you know, his, his bottom isn't blocking the cervix like his head was. So, you know, I said, you know, like, "What, what are the, basically what are the protocols?" And they're like, "Immediately, you're in labor, you need to come in. It's not waiting until a certain amount of time or anything. If you're having contractions, you need to make your way to the hospital." They're like, "If you see the cord coming out of you, you go to the closest ER, otherwise you come to your labor and delivery unit." So I knew, and that was probably one of the reasons why when I would call it both times the night before on the day of when I called the doctors and I was like, "I feel funny. I don't know what this is," they're like, "Come in."
Paul: 26:29
We had, we had discussed the plans with the OB GYN, a meeting prior, I think at one of the last meetings prior to actually going into labor.
Emily: 26:42
That was—that was of our midwives.
Paul: 26:43
Yeah, I had them, I had them all in my phone.
Emily: 26:47
Oh, the numbers. Oh yeah, yeah.
Paul: 26:50
Who numbers do we call? All of the contingency plans that we can think of. We did actually kind of go through and we had everything straight. It just feels like though when it happens, everything's out the window. There's a baby coming, you got a train rolling at ya. There's a plane about to land. It just feels really like everything's happening all at once.
Emily: 27:15
We didn't even bring all our stuff with us.
Paul: 27:17
Nope.
Emily: 27:17
We only brought a small go-bag because again, the denial of, "Well, I don't want to bring all this stuff over there if I'm not actually..."
Lisa: 27:27
Yeah,
Paul: 27:29
"This is probably just another false alarm."
Emily: 27:31
I mean the important stuff was there, but like I think like we didn't bring like a car seat, you know, nothing like that. with us.
Paul: 27:39
Right.
Lisa: 27:40
And did you, I'm just curious if you had made any special requests along the lines of the gentle cesarean techniques.
Emily: 27:47
Again, this was like one of the things that we were prepping. I'm like, "We have the date, I want to have Paul with the aromatherapy cotton balls in his pocket. I want to ask for the clear screen. I want to see the placenta. I want to, I want, I want, I want, I want the baby right on me. Like as soon as the labor happened and I was in that, it just, yeah, it really did everything.
Paul: 28:08
Went out the window.
Emily: 28:08
Everything kind of just flew.
Paul: 28:10
And then you don't really feel like you're in a position to advocate.
Emily: 28:12
Is that how you felt?
Paul: 28:14
Definitely, at the hospital, because Emily's on the table screaming and the last thing I need to be doing...
Emily: 28:22
I wasn't screaming...
Paul: 28:23
Well, not screaming, but you were, you were, you were vocally going through your...
Emily: 28:28
Oh, you mean, oh, you mean when I was in labor and triage...
Paul: 28:33
When you were in the triage area, you were very vocal, so you don't really feel like you're in a position to, "Hey doc, let me pull you aside and let's, and let me harangue you for ten minutes about
Lisa: 28:42
Right.
Emily: 28:47
I was still supposed to see Dr. Paka one more time before I had my cesarean. She was going to be my doctor performing the cesarean. Yeah. So we had like a, we felt we had a little bit more time than we did. It's really kind of what it came down to. I thought I was going to have one more conversation and be like, "Can I get the clear screen? Can I get that..."
Lisa: 29:07
Ah, gotcha.
Emily: 29:07
"When can the baby be on me?"
Paul: 29:08
A lot the things we wanted we eventually would get.
Emily: 29:13
Yeah, they really were–there was a lot of great, you know, I feel like–you're kind of assigned a nurse. The mom is, and the baby. My nurse, he really was, I don't even know if I told them I was–maybe–that I wanted to breastfeed, and that was very important to me. Or that I wanted to have the baby as close to me as soon as possible. But he was, he was advocating and he'd be like, "Stand up, take pictures, go over there, and now, Paul, go take pictures of the baby as he gets weighed. The baby's being delivered now. Take a picture, stand up, take a picture."
Paul: 29:41
Did we bring in our printed sheet of directives into the hospital? I don't remember. I think we did.
Emily: 29:46
Maybe it was in the bag.
Paul: 29:49
I think I–either me or you told them it was there and they went and took it.
Emily: 29:53
Oh maybe. I don't remember.
Paul: 29:55
I think we did.
Emily: 29:57
What do you remember?
Paul: 29:58
I think we did that. I remember because we had...
Emily: 30:00
I know there were printouts of what you gave us. There were printouts that I had printed. I'm fuzzy on this.
Paul: 30:03
Right. But then we had a sheet, then we had like a sheet written out. I'm an attorney, so then we had a sheet written out of things that we wanted.
Lisa: 30:14
I like your word "directives." I haven't ever heard any expected parents saying "directives."
Paul: 30:19
I mean they're health care directives, this is what they are. These are our commands.
Lisa: 30:24
I certainly like directives more than the whole "birth plan" because people never receive that well.
Paul: 30:29
Yeah, there's no such thing as a plan.
Lisa: 30:32
Right? Totally.
Emily: 30:35
He was making sure Paul in all the crucial moments was being an active part, and documenting this for us. That was important.
Paul: 30:43
Yeah. It was great.
Emily: 30:43
Paul was able to get Teddy right away and there were some choices at the end, after like, within the first hour that I was able to be like, "Oh no. Delayed bath. Thank you for asking." Because I had some really great nurses around me in the beginning and was able to–you know, that kind of thing was able to happen.
Paul: 30:59
Do you want the blow by blow of the OR itself?
Lisa: 31:02
Yeah. If you're willing, if you'd like to share that.
Paul: 31:04
So from the husband's perspective, they brought me in and brought me around–the operating table was to my left. They brought me around that and they forbade me to look down at Emily and so they brought me around her and the screen was up and she's lying on her back. Both arms spread out. And her hands were really cold. That's one thing I did notice, but Emily was
Emily: 31:25
I wasn't tied down.
Paul: 31:25
No, she wasn't being tied down or being held down.
Emily: 31:29
Because that happens sometimes in hospitals. That did not happen with us. [inaudible]
Paul: 31:33
But she looked to be pain free, or as pain free as you can be.
Emily: 31:36
Yeah, I just felt a lot of tugging. He was a big baby. He was over 9 pounds . When he came out. All the nurses were like, "He's going to be a size one right off the bat!" meaning a size one diaper, like he's skipping the newborn diaper, which he definitely did.
Paul: 31:52
Right before he came out of an incision had been made or something was broken because there's a lot of fluid on the floor. Like a lot. There's way more than I expected and that's I think when we heard him cry for the first time.
Emily: 32:06
Oh yeah, that was awesome. That was amazing. Both of us immediately were crying with Teddy.
Paul: 32:12
Well he's–so he gets, he gets out, and he cries and I poked my head out, because you kinda gotta poke your head out to see ,and he's this kind of grey slimy little guy, just crying. And then the, and then that's when the nurse said, "Alright, you gotta go, you gotta go, you gotta go." And he hustled me around...
Emily: 32:26
To take pictures...
Paul: 32:26
...Back around the operating table and they brought him to the side table to weigh him. I cut the umbilical cord. He showed me exactly where to cut. So I cut the umbilical cord. We did not preserve cord blood, or anything of that nature.
Emily: 32:40
That was not even brought up about delayed clamping. We didn't–we weren't able to even discuss that.
Lisa: 32:48
Yeah, usually you can't delay it in the OR, at least, with most care providers, yeah.
Paul: 32:53
So then they brought me back, me back around to Emily while they, I guess cleaned him to a certain extent or...
Emily: 33:01
Swaddled him.
Paul: 33:01
Swaddled him up. Newborn babies smell amazing. They smell really good. They swaddled him up, and then they brought him back around behind the screen to where, where Emily's face was. And so we took pictures there with a swaddled Teddy.
Emily: 33:19
They did skin-to-skin by doing face-to-face at that point. I would say at that point, you know, I was wondering, "Is something...?" I'm like, "I don't feel great." I remember that was in my head. I was shaking a lot, which is very normal. But I remember like, "I don't feel, I don't feel great. Like my energy, something feels–doesn't feel right" and it just....
Paul: 33:40
There is one thing, as I was sitting there and we were waiting for him to come, her blood pressure kept dipping and they kept pushing...whatever they pushed, I guess...
Emily: 33:52
I don't know. That was never brought up to me.
Paul: 33:53
Whatever thing. I was just watching it because you know, I don't know.
Emily: 33:56
Again, I think, it was this teaching hospital, he was also hearing what the attending was telling.
Paul: 34:00
Right, right, right. He'd go, "I have to push more. I have to push more." So yeah, who knows what it was. But the blood pressure kept like dipping and then they'd push and it would come up. And then it'd dip again and then they'd push some more and then it'd come up. And so by the time we had Teddy, she was shaking.
Emily: 34:16
I was shaking a lot, which they, you know, knew to expect. There's morphine in the spinal, which is a good thing for the most part because most people when they take their first walk, it's very helpful to be in your system when you get out of bed the first time. And I think I knew at that point I'm like, "I just don't feel..." and I'm like, you know, I've never had any surgery. I've never had, obviously never had a baby or C-section. So I'm like, "Well, maybe this is just how you feel. Fine." And then got wheeled to the recovery room.
Paul: 34:48
So we were wheeled to a spot. This is actually relatively important to the story. She was wheeled to the spot right next to the entrance to the recovery room. So that means.
Emily: 34:57
The public entrance.
Paul: 34:57
The public entrance to the recovery room. So that means whenever anybody came in to visit anybody, the door would slam about two feet away from where her bed was. Of course there was a curtain, there was a curtain, yada, yada, yada. But it's the recovery room. The good thing about the recovery room–and I actually spoke to my, my mother about this, and she was a nurse way back when–good thing about the recovery room is that the nurses' station was right in front of Emily's bed.
Emily: 35:23
With the nurses' station, someone, someone has to manage–you have to be within, you're within eyesight of–every bed that's in there's within eyesight of the nurses in the station. So my, story, where I had some complications postpartum after an uneventful, beautiful uneventful pregnancy–I did have severe preeclampsia HELLP syndrome, which means my, I was having issues after–the solution to both of these things is to give birth. So my body had done half of its work already and maybe that's why Teddy came a little early, right? In order to keep me from having a seizure or from having a stroke. They had to give me a magnesium solution, and you know, I'm finding all this out. There was like an hour in between. All this epicness–they kept checking my blood pressure.
Paul: 36:09
It was pinging up and down. It was all over the place.
Emily: 36:10
And they're like, "We have to run some labs," trying to be nonchalant. We had him breastfeeding right away. That was amazing. They were very, very helpful. The nurse from recovery when I got there was one of the like all stars for me, I must say.
Paul: 36:27
She was great .
Emily: 36:27
She came and checked on me the next day. Ruining the story: I was still in recovery the next day. She was really great. She was really good at advocating for me. Teddy had issues also. He had, he was a very big baby, so when he came out, it's something that's common, is he had low blood sugar, so his blood sugar had a hard time stabilizing without me doing the work for him. So he came out, they're doing the pricks on the heel. His blood pressure's off, they're trying some sugar paste. Not working. They're like, "Well, we should–now we need to give him formula." I had just seen, my friend had given birth and I saw something in her hospital where they were using like a tube while they're breastfeeding to get them to get formula while you're breastfeeding. You get the tube in the side of their mouth and they would also be getting formula supplement. I asked for that, and I was lucky to even know it existed, and they were like, this one nurse who I liked a lot, she went away and she was talking, calling in. She's like, "Okay, we don't have that. So what we do have, we have a traveling nurse here. She is going to come over and work with you and baby and we can cup feed him."
Paul: 37:31
She was great, too.
Emily: 37:32
She was great, too. So you don't have to worry about, she's like, "We understand your, your concern for nipple confusion, like, right out of the womb. Absolutely. So we're going to cup feed him and we're going to show you how to do it." So they came over and were working. He's drinking out of a little cup just like an hour old. You know, and he's...
Paul: 37:51
And he smalls great.
Emily: 37:51
And we're getting lots of skin to skin. They're coming by very often, maybe 15-30 minutes, they're checking his blood sugar and they're not stabilizing. They're doing tests on me.
Paul: 38:01
Right.
Emily: 38:02
And unfortunately he did have to go to the NICU because his blood sugar did not stabilize.
Paul: 38:06
Now, did you know that you had preeclampsia HELLP before?
Emily: 38:12
No I did not.
Paul: 38:13
Okay. Right. So they...
Emily: 38:14
So they said, "He's going to go here, but as soon as you are discharged–you move to your postpartum room, you're free to go be with him as much as you want." I'm like, "Fine. Okay." So we're waiting and then we get, you know, my labs come back and basically with HELLP you have problems with your liver, your kidneys and your platelets. So, and again, like with severe preeclampsia HELLP you have to be careful of stroke and seizure. So I had to have 24 hours of this magnesium. They say "drop mag," you know, this magnesium bag. And they told me that she's like, you know, "This is going to, you know, a lot of people–this is pretty awful stuff. You know, you're not gonna feel good." And I was, you know, queen of denial. I'm like, "I just had a baby."
Lisa: 39:01
"I can do anything."
Emily: 39:03
"I just had a miracle baby. I am on cloud nine. What are you talking about? I'm going to be fine. We're going to get this over with. I'm going to go see my baby. It will be fine." No. Not what happened.
Lisa: 39:15
Oooh. I've heard the bag is awful.
Emily: 39:16
I felt awful. I felt awful for days. Yeah.
Lisa: 39:19
Did you feel weak? Because it relaxes your...
Emily: 39:23
Very. I couldn't keep my eyes open. When I finally was able, 36-plus hours later, able to leave that little recovery room, I remember the first time I saw Teddy after, I had to be very honest and look at the NICU nurse and be like, "I'm too tired. You need to take him from me. I don't want to drop him." And she was like, "Oh, okay. I'm taking him taking him." I'm like, "I'm sorry." And she's like, "No, no, don't be sorry."
Lisa: 39:52
No, good for you.
Emily: 39:52
Yeah. I'm like, "I feel too tired and I don't feel like I can–I want to hold him, but I know I shouldn't be holding him right now, you know?" So, so it really took a toll on my body. I had a hard time focusing. Like everyone's sending me all these messages like, "Oh my gosh, congrats!" I couldn't read any texts, I couldn't respond to anything like that. Paul had to be the lead for that.
Paul: 40:16
And eventually your mother and aunt got there.
Emily: 40:18
My mom and my aunt got there late, late that night. We gave birth in the afternoon and they got in like closer to midnight, 11 o'clock, and they were all able to go see–did they see Teddy at that point too? Everybody was able to go see Teddy. And it was hard to be, the hardest part was then, because I couldn't, he had to stay where he was. I had to stay where I was and we couldn't be together. And I remember going into it, that was what I considered the worst case scenario, but for better or worse, I was so sick, Lisa, that I didn't, that wasn't a fight in me at that point. Like I was like more–so the focus was like I guess I knew my body had to get better in order to move to the next step.
Lisa: 40:57
Yeah. Makes sense.
Emily: 40:57
It wasn't–I was constantly asking for updates, but other than that like I wasn't...
Paul: 41:04
At first they weren't great about updates.
Emily: 41:05
Well there was one particular, yes, a shift, because they do sevens to sevens there. 7:00 AM to 7:00 PM is the nursing shift. It was not great. That was my only...
Paul: 41:19
The overnight?
Emily: 41:21
No, she was 7:00 AM to 7:00 PM. I still remember.
Paul: 41:24
She was 7:00 AM to 7:00 PM?
Emily: 41:28
Mm-hmm.
Paul: 41:28
Oh, because they came in and gave you the update in the overnight.
Emily: 41:31
They did. They gave–one of the doctors came in at 4:00 AM and gave me an update on Teddy.
Paul: 41:35
Yeah, right.
Emily: 41:36
That was the last thing I heard at 4:00 AM and then I spent the rest of the day trying to get an update.
Paul: 41:40
Right.
Emily: 41:41
Unless Paul was going in there and like–that was the only time we would know what was going on.
Paul: 41:47
And Teddy's issues compared, to be quite frank, to some of the other babies in the NICU, are so minor.
Emily: 41:55
Very different.
Paul: 41:55
You had a sugar issue, you're gonna get an IV.
Lisa: 41:58
Yeah. It's fairly common. Where HELLP is not.
Emily: 42:02
No HELLP, it's not.
Paul: 42:04
You know, and he was a robust baby even in the NICU.
Emily: 42:08
Next to all the small NICU babies. So I think there might've been a little, I don't know...
Paul: 42:11
He chewed his own IV out of his arm.
Lisa: 42:11
What?
Emily: 42:11
He did. We told you he was spirited.
Paul: 42:20
He had chewed the IV out of his hand. Yeah, I was like, "What's with his hand?" She goes, "Well we had to tape it there." "Why'd you have to tape it there?" "Because he pulled it out."
Lisa: 42:30
Wow.
Paul: 42:33
With his mouth, with his mouth.
Lisa: 42:36
And so Paul, were you back and forth between the NICU and Emily or what were you doing during all this time?
Paul: 42:43
So we kept Teddy for as long as we could in the recovery room. So Emily had kind of been drifting in and out of sleep. I won't say "consciousness." She wasn't, you know, she wasn't passing out unconscious like a coma, but she was drifting in and out of sleep, so I was holding Teddy skin-to-skin. Teddy was sleeping for the most part. Occasionally he'd stir. I changed his diaper for the first time.
Emily: 43:06
I vaguely remember that.
Paul: 43:08
I saw the meconium, I saw that, that's something else.
Lisa: 43:14
It's tarry, right? Pretty sticky stuff.
Paul: 43:17
It looks, it looks like a, like a pudding, almost. Very strange. Very strange. It's not what I expected out of my little boy. But changed diapers a couple of times, but eventually, you know, we tried to latch him. He didn't want to latch. Because he had gone down to the NICU. He had taken a bottle and then they, he had come back.
Emily: 43:37
Okay, so that's 36 hours, 48 hours...
Paul: 43:41
About, between that, like 4 PM and eight, nine, 10:00 PM and where he had gone down and then I went down and got him and brought him back up. Because I'm only wanting to see him and we both wanted to be with them. So where he had no trouble latching at first, he suddenly started having trouble.
Emily: 43:59
Are you talking about when he was discharged from the NICU?
Paul: 44:02
No, he was back and forth and we said–right, from the nursery...
Emily: 44:06
Before he was in the NICU.
Paul: 44:08
Before he was in NICU, we said he had to be cup fed. They did not cup feed him down there.
Emily: 44:13
They made a mistake and the nurse called me and was like, "I'm so sorry that that happened." And I'm like, "You know what? It was a really long road to get him. I'm trying to see the forest for the trees here. It happened, and let's just move forward. That's it."
Paul: 44:26
Right. And so shortly after that he wasn't all that well off the breast after that happened.
Emily: 44:32
I don't remember this.
Paul: 44:32
So that's like, that's like six to eight or 9:00 PM. Eventually they came and they tested them again and they said, "Okay," that's when he had to go down to the NICU because just his blood sugar still wasn't stabilizing. So that's when that happened. Now in the overnight, I actually went back to the apartment at 2:00 AM.
Emily: 44:52
You can't, you can have 24 hour visitors technically in recovery.
Paul: 44:57
Because her mom and aunt were there.
Emily: 44:57
But there was no–we had opted to get a private room, but there's nowhere for Paul to sleep, and my mom and aunt were at the hotel nearby, and there's not even–maybe there was a chair?
Lisa: 45:08
Wait a minute. There's no place for him to sleep in a private room?
Emily: 45:12
No, no, no. In the, in the, when I was still in recovery.
Lisa: 45:15
Oh, I'm sorry. Okay. Oh sorry. I misunderstood. Gotcha.
Emily: 45:19
I hadn't been allowed yet. So I when they're still dropping the magnesium, my labs were still off. They were making me stay in that recovery room, which is basically like a turning door for women who had just given birth. And me.
Paul: 45:30
Right. And it's 2:00 AM. It was around two, 2:30 AM we decided that, her, Emily, me and her mom and her aunt decided that, "All right. Go back to the apartment, catch four or five hours of shuteye, and come back to the hospital." So that's what I did. I actually caught the end, the very, very, very end of game three of the World Series between the Red Sox and Dodgers when I went back.
Lisa: 45:58
Very important to you.
Paul: 46:01
Okay. I will say that, you know, I will say that Teddy was not born on a day that the Red Sox lost. So he is no jinx.
Lisa: 46:08
Ah. Yay.
Paul: 46:11
Very important. At any rate. But it was the next morning that I got back to the hospital and then that that morning Emily was a bit perturbed because she'd gotten updated only at one time, only at 4:00 AM and nothing, nothing since then. So I went onto...
Emily: 46:29
Even though I was asking.
Paul: 46:29
So I went to the NICU to rounds and they told me, well at that point they told me what the plan was with him, and it was a couple of days, it would be a couple of days probably before his blood sugar stabilized. But otherwise he was doing very well. So I sat in on rounds. I don't remember what questions I asked, but I was told that I could come back anytime that I wanted.
Emily: 46:49
24 hours a day.
Paul: 46:50
24 hours, I could come back and go visit him and go see him. Of course, my wife is also pretty sick, so you know, I wanted to make sure I spent enough time with, with Emily as well.
Emily: 47:00
And then during this time I was pumping in my somewhat delirious state. Trying to.
Paul: 47:14
Trying to.
Emily: 47:14
Because of how sick I was, my milk didn't come in for almost three weeks. Two and a half weeks. Yeah. It took a lot of elbow grease and dumb luck .
Paul: 47:27
And stick-to-ing it.
Emily: 47:27
And the lactation consultants at our hospital were amazing and they would come like track me down. Like they would go between NICU and postpartum looking for me to see how I was doing, to work on a plan. They knew that I really wanted to do this, I remember my doctor said I needed to pump every two hours. I just didn't have it in me. I just could not. So I just did what I could and that was kind of that. And I made a lot of small goals when we got home because he did not, after being on formula and used to getting two ounces every three hours, he did not have the patience for latching.
Paul: 48:00
No, so we bottle fed him for a while.
Emily: 48:03
But we had, we learned some really great techniques, which I'm also happy to share, to get him back on the breast basically. Which we were able to do by about week four or five.
Paul: 48:12
So from the first day that she was in recovery. The next day at 8:00 PM we're finally–she's, by this time she's eating and all the rest of it. This time we're told we're moving into our private room.
Emily: 48:24
Oh, my liquid diet. I was so excited to have that cold pea soup. One of the things that I wish I woulda or I didn't have great support at that point. The only real downside I would say is that I didn't have great pain management support. I was trying to understand what I should be...
Paul: 48:42
This is while she was in recovery.
Emily: 48:45
In recovery, not in postpartum. I'm trying to understand what my options are. I kind of knew that the morphine was no longer going to be enacting from the spinal, and I couldn't have Tylenol because of the issue with my liver. That happens with HELLP syndrome.
Paul: 48:58
But you could have ibuprofen.
Emily: 48:58
Ibuprofen. Which I didn't know I could have that again and the dilaudid, which is not great, but it's what it is. And so it made for a really, really awful first walk to the bathroom. And I wished that I would have known and been able to better advocate earlier to get something in my system for that before it happened. As soon as that, you know, they were ready and like, "Okay, we need to take care of you." But...
Paul: 49:24
We thought that the nurse would come over to administer pain medication at every point where it was possible.
Emily: 49:31
Like whenever it was like, "Oh, you're at your four-hour mark, you can take this"
Paul: 49:34
Every three with ibuprofen.
Emily: 49:34
Every three. Whatever it is, whatever the at-mark is, but you have to actually ask for it. And I remember at one point I did that, I'm like, "Yeah, what do I have available to me? Basically? Or like what am I going to do now for pain management?" Because I knew I had just had abdominal surgery and I'm like, she's like, "Well, what's your pain level?" I'm like, "Well, if I don't move, it's to this. But if I move, it's to this. And I'm like, "Am I just going to have pain no matter what?" And she's like, "Yeah, you're just going to be in pain." I'm like, and that was...
Paul: 50:04
That was the nurse that said–remember? She goes, "Pain is pain. You know, this is pain." I didn't do the accent.
Emily: 50:12
This is, that was not the highlight, the bottom light?
Paul: 50:16
The lowlight.
Emily: 50:18
The lowlight. This was the low light of our experience.
Paul: 50:21
That shift change was...
Emily: 50:23
When that, when the next nurse came in the next day, she was the one who was like, "Hi, Emily, what are you doing for your pain management?" I'm like, "My what?"
Lisa: 50:32
"There is such a thing?" Oh wow.
Emily: 50:35
I'm like, "Can you walk me through it? Exactly what do I have my–what are my options? What should, what do you recommend?" So that was the lowlight, that, yeah, that and the non-communication and that was kind of all the same shifts, the hard time communicating with NICU when I was not–when I was by myself.
Paul: 50:49
And never forget during recovery she's about two feet away from that door. All night that door's opening and closing. Cha-chunk, cha-chunk, cha-chunk. And it was like every 15-20 minutes.
Emily: 51:01
I did have my birth playlist that we did not use, that I put my, as long as my headphones lasted, I put them in and I listened to my birth playlist at night to kind of block out the people and the noise. Maybe earplugs. That was something I wish I would've packed.
Lisa: 51:20
Yeah, I need to add that to my list.
Emily: 51:24
Yeah. Because Paul and I are, like, hikers. You stay in, like, hostels and we've done a thing called the Camino de Santiago where you walk the pilgrimage route and there's like these, places where the pilgrims stay and you have like 40 smelly people.
Paul: 51:38
Yeah.
Emily: 51:39
We know how to sleep in a noisy environment. I don't know why I didn't think to bring earplugs. But we, you know, I, I did make it out of a the recovery room and into postpartum. Teddy did make it out of NICU and into my suite with me. The day before, 24 hours before we were discharged. Before he was discharged, he joined me.
Paul: 52:02
And one thing else I will say, the day before she was scheduled to be discharged, Doctor came in and examined her, and said, "Hey, how do you feel about another day?" And we took the extra day. Right?
Emily: 52:13
Oh, that's right. Yeah. Took an extra day.
Paul: 52:14
Which I think made a bit of difference.
Emily: 52:18
Yeah.
Lisa: 52:20
Good. So you were there what, like four days or so?
Paul: 52:23
Four days. Which was great. And the private rooms at Mount Sinai are really nice. It's as close to hotel service as I think I've ever seen in a hospital.
Lisa: 52:33
Yeah.
Paul: 52:33
That's really great.
Lisa: 52:34
Nice.
Paul: 52:35
They have a menu. You plan all your meals out. Rooms are spacious and quiet.
Emily: 52:40
Yeah. I felt that I just needed that level of privacy because of the, you know, you're in, I was in pain and walking was hard, especially with maybe the first handful of times, and having my own space and being able to do it in my own time and get to the bathroom and not have to worry about sharing it with anyone was just, that was nice, to not have that as a concern. Again, a lot of this is seasoned by the complications I had to, you know, so not every C-section is like this.
Paul: 53:09
And some of the medication you were on, too.
Emily: 53:11
Obviously medication made me feel how I felt, but I was very grateful we had made that–glad we made that choice.
Paul: 53:18
Regarding getting the private room.
Emily: 53:21
Yeah.
Lisa: 53:23
Well I know we're running short on time here, but I want to ask you, did they give you any instructions as they discharged you from the hospital? Any specific things to look out for given your, this diagnosis that you had?
Emily: 53:38
Yeah, yeah. I remember Paul's like, "Should we be doing her blood pressure like every whatever at home?" And they're like, "That might make her blood pressure raise even farther.
Paul: 53:47
So I split the difference and did my own.
Emily: 53:55
You know my mom, who's a nurse practitioner, was with us for a while in that timeframe back home. I think they didn't know that going into it. So that was a good thing. And then for Paul and I as well, by the time I left, my labs were better, they stabilized and then they got better. Like they never turned for the worst. Like you know, that happens in cases. I was very lucky that was not my case. So when I left I was already on the, the upswing of things, I suppose. There's like a laundry list of like what to look out for with your incision, if you don't feel well or you know to come back to labor and delivery. And to be very honest, I think, what was it, day two home? Paul, what was the bad day?
Paul: 54:33
The bad day was definitely...
Emily: 54:35
Going into day two?
Paul: 54:35
From day two the overnight into day three.
Emily: 54:38
And that's when I did feel so sick.
Paul: 54:42
Halloween.
Emily: 54:43
I don't remember the day.
Paul: 54:44
It was the 31st.
Emily: 54:46
Okay.
Paul: 54:47
No you're right. So it was going into day two.
Emily: 54:49
Day two. So like day two, being home, I did reach a point where I was like, "I feel..." I felt so awful, like worse than when I was in the hospital that I was, it was like a border of, if I don't get better in the next couple hours or after this next sleep or after this next, you know, chunk of time, we're going to have to go see a doctor or go back to the hospital.
Paul: 55:09
She looked green.
Emily: 55:09
I think I was passing off the dilaudid because I stopped taking it very close to being home, because I was able to finally be back on Tylenol. So that's one of the things, like them explaining how to use the pain medication. Since that was allowed Tylenol again, I could just alternate ibuprofen and Tylenol all day long. And as soon as I got through with the heavy stuff, it really was when my body started to feel better, and when it passed out of me, my body began to feel better. So I think there was an edge of where we were kind of like riding the line where it's like, you know, "We may need more medical attention," you know?
Paul: 55:44
So that night we sent Emily to bed about 9:00 PM, and said, "Okay, well we're going to put together, between me and her mom, we're going to, we're going to...
Emily: 55:55
And our friends at 6:00 AM.
Paul: 55:56
And our friends at 6:00 AM, we're going to piece together as long a sleep as Emily needs. So the mom helped out till midnight. I did the overnight 12 to 6 and then stayed up till about, I stayed up, ended up staying up till about nine, then Emily got up around nine, her mom was here from nine to noon. I think I went to sleep somewhere around 10:00 AM. Then I got up at like two and by that time–we were really on the upswing by the time of Teddy's first pediatric appointment, which was day three. At that, that time I noticed that Emily was starting to eat more normally. Her appetite was back, you know, she was hungry again, which was really a great sign and by that time the worst seemed to have cleared, and everything seemed a bit more manageable.
Emily: 56:45
Yeah, they didn't get very specific with the help. Like again though, the biggest way to treat it is to not be pregnant.
Paul: 56:52
Right.
Emily: 56:53
I feel like almost that one pain medication really did not work well with my system. You know, it's there for a reason. But.
Paul: 57:00
Yeah, it was a necessary...
Emily: 57:01
Yeah. As soon as I was able to be off of it–I was taking the maximum amount daily allowed of Tylenol and ibuprofen, mind you, like, I wasn't not medicated.
Lisa: 57:12
Yeah.
Emily: 57:13
Yeah. And all the stuff with Teddy to watch out, too, like, I felt the postpartum nurses, especially the one who discharged us, I really felt taken care of. Like I really understood like, you know, felt good leaving the hospital. I felt prepared if you can feel prepared. I don't know. She was very helpful.
Lisa: 57:30
Good.
Paul: 57:31
And I think it was that night. I think it was the overnight on day two where Teddy had his really bad...had his really rough night.
Emily: 57:36
So the night that Paul stayed up with him all night, he was really gassy. And he was otherwise a very chill baby those first couple of weeks but that was a hard night for Teddy.
Paul: 57:49
He kept waking himself up in his sleep. So it was, I mean it was good because it kept me on my toes, but it was a rough night for him and he couldn't get to sleep until about like 3:00 AM.
Emily: 58:04
Oh, those early days.
Paul: 58:08
Still the cutest little guy.
Emily: 58:08
You do round a corner. It's not like that always.
Lisa: 58:13
Yes. Yes. So true. Well, do you have any last, any wisdom, any important things that you would want to share with any expectant parents based on your, the way that your birth went or these first few months of parenthood?
Emily: 58:26
Flexibility. You know, things don't always go as planned. I think it's good to know what you want, and to advocate for yourself. So flexibility. And that includes when you get home too. I'd say yeah, just be kind to each other because there is a lot of often sleepless nights or, less sleep than you're used to. I personally had such bad sleep in my pregnancy that I was fine. I was sleeping in bigger chunks than I was after he was born, which is crazy, but I'm like, "Wow. I slept two and a half hours!" That was a lot for me
Paul: 59:03
He's not a phenomenal sleeper now. But he was okay at the start.
Emily: 59:06
He was, yeah, well we, we got, we got handed a NICU baby on a schedule. I'm not going to lie. Right?
Paul: 59:14
For a while it was like, "Who's doing the midnight? Who's doing the three?"
Emily: 59:16
He was kind of like a clock that way. So I don't know if everybody gets that, but I guess that's been .... But be easy on each other. Easy on your partner.
Paul: 59:26
And clear your decks, to the extent that you can, for work, for any other obligation. Clear them out.
Emily: 59:35
Make space.
Paul: 59:35
Because there's, you just need space.
Emily: 59:37
Make space for your new family member.
Lisa: 59:40
Yeah. Absolutely. Thank you. That's great wisdom. Great words. And finally, Paul, do you want to share about your, I know you have more than one, but the, especially the parenting related podcast? Because I'd love to share that and I'll post the link to it wherever this is posted. So go ahead and tell us about it.
Paul: 59:57
Yeah. So we do, me and a couple friends of ours or a couple friends of mine, one of them who became a dad really close to me. He became a dad two weeks before I did. We do a podcast called "Dads on Dads on Dads." And every episode we do a theme, you know, that's dad related and we talk about our experiences, talk about, you know, how we want to raise our sons, because we all have sons, or at least all the dads on it so far all have sons. And we talk about how those themes relate to our families and our futures, so yes, "Dads on Dads on Dads," it's available wherever you get your podcasts. It's also available at www.outrunthebearmedia.com. And yeah, give a listen and I'm on a second one, it's called "You May Be Right." It's about the Red Sox and the Yankees. As you can probably tell, I'm a big Red Sox fan. So that's through the Elite Sports New York network.
Lisa: 60:47
Nice. Yeah. And I, I've been listening to several of the "Dads on Dads on Dads" episodes. One that stood out to me today was you guys had watched a documentary about masculinity. Now I want to watch it with my husband. We need to check it out. But that was really just such fascinating stuff to think about. So everybody check out his podcasts.
Paul: 61:11
Thank you. Yeah, and especially the masculinity episode was especially trenchant. Again, we all, I mean all the guys on that podcast for that episode have sons, and that's something that's always going through our head, you know, you know, what does it, what does it mean to be a man with your boy? What does it mean to bring your boy up in a world where maybe certain things are expected of him that maybe you would not teach in the home? You know?
Lisa: 61:37
Yeah. Good stuff. All right. Thank you so much Paul and Emily, I've very much appreciate your taking the time to share your experiences. Give Teddy a big hug for me and I hope I can see you guys soon.
Emily: 61:52
Thank you, Lisa.
Paul: 61:53
Thanks so much.
Lisa: 61:54
All right, have a good one. Bye bye.
Paul: 61:56
You, too. Bye.
Emily: 61:56
Bye.
Lisa: 61:58
So that’s it for Emily’s & Paul’s story.
On the topic of breech birth, I wanted to mention that, in the NYC birth environment, and most of the birth environment in the U.S., cesarean birth will be the default if a baby is in breech, or heads up, position at full-term. This is because the vast majority of doctors in our country aren’t trained in how to safely catch a breech baby, as I mentioned in the intro. It can be done, but it requires different expertise than a vertex, or head down, baby, and does carry extra risk factors. It’s really unfortunate that care providers aren’t being trained these days and many of us hope that will change so that birthing families can feel like they have choices if they find themselves in this scenario. If you want to learn more, I recommend checking out the documentary HEADS UP. I’ve linked to several videos and an article about gentle cesarean techniques if you look up episode 18 at birthmattersshow.com. These are techniques that can help a cesarean birth to feel more like the beautiful birth it should feel like and to give you and your baby the best and healthiest start. In most of our U.S. hospitals, these techniques are NOT standard, so it’s a good idea to make your requests known in advance. I recommend framing it like this, “In the UNLIKELY event that my baby needs to be born via cesarean, could I request…” this or that.
Emily mentioned being diagnosed after birth with HELLP syndrome (that's spelled H-E-L-L-P), which is a type of preeclampsia that is a very serious complication. The name HELLP is an acronym that stands for the things that HELLP does to the body -- Hemolysis, which is the breaking down of red blood cells, Elevated liver enzymes, and Low Platelet Count. In the U.S., around 5 to 8% of pregnant women develop preeclampsia. It’s estimated, according to the Preeclampsia Foundation, that 15% of women diagnosed with preeclampsia will develop HELLP syndrome. As Emily mentioned, the cure for it is giving birth, but things do need to be monitored and treated with great care.
Meconium, which Paul mentioned, is “baby’s first poop” for the first day or two after birth. It’s black, sticky, and very tarry and is very hard to clean off baby’s bum in diaper changes, so I always recommend applying some olive oil to baby’s bum at each diaper change after cleaning them up so that, next time they poop, it’ll be SO much easier to clean. You only need to do that until the poop turns green and isn’t sticky anymore, but it’s a sanity saver.
One thing Emily mentioned is something I always teach about in birth class. That’s on the topic of staying flexible in this very unknowable process of giving birth. While it’s important for many of us to develop a birth vision and have strong intentions, it’s just as important to then surrender to the process and take heart that you can navigate the unknown, knowing that even if the labor doesn’t go exactly “according to plan”, so to speak, it still can be an overall positive life event. Now don’t hear me wrong here: in this, I’m NOT saying, “say yes to whatever your care provider recommends in the heat of the moment.” I simply mean that there are other variables in the organic process that are out of our control, and it will protect our mental health and wellness on the other side of birth, to a large extent, to remain flexible and adaptable.
If you’d like to learn more about any of these topics, visit this episode’s show notes page over at birthmattersshow.com Okay, here’s a sneak peek of what’s up next week!
Speaker 2: 65:40
This is really important when you get pregnant and I think it's really important for women to really listen to their bodies, and really listen to their heart, and any type of thing that you're feeling in your gut or intuition, go with it. You're going to be told so many different things from healthcare providers or girlfriends or family, your mother-in-law, your mother, everything. But I think it's really important. Everyone's first experience is so different. I think it's really important to just follow your heart and follow that gut.
Lisa: 66:05
See you next week. And remember that you can navigate the unexpected in giving birth. ---END---
