Birth Matters Podcast, Ep 10 - Singing Baby Down with a Midwife

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Today’s episode will be the shortest interview we’ve shared thus far. In this birth story, Dara describes her experience of giving birth as both “magical” and “frustrating”. This is the story of a first-time labor and vaginal birth working with a midwifery practice at Manhattan’s Metropolitan Hospital. She shares about using nitrous oxide (or laughing gas) for pain relief, very briefly, and then getting an epidural. Listen to hear the magical way mama Dara instinctively helps her baby come closer to being born. Here’s a hint: If you like music, you’ll enjoy this one! We had a musician dad featured on the last episode, and now we have a professional singer mom and massage therapist sharing her perspectives. You’ll also hear how a fever Dara developed led to baby having to go to the NICU (or neonatal intensive care unit), and how having a baby in the NICU can be challenging for new parents and baby.

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Episode Topics:

  • Switching from an OB practice where she felt like she wasn’t getting good care over to Village Maternity midwife practice  

  • Doula support

  • Birth story begins with water breaking in middle of night

  • Going into hospital, but not having contractions, almost goes home until doc says it’s too risky

  • Gets membranes stripped & contractions start right away 

  • Tries nitrous but gives her nausea, labors in shower w/ singing

  • Epidural administration

  • Singing with nurse

  • Develops a fever (which hospitals assume is and treat as an infection called chorioamnionitis), so baby has to immediately go into NICU for antibiotics. Due to high CRP level (C-Reactive Protein; high levels can lead to sepsis) ended up having a week long of antibiotics instead of just a couple of days.

  • Backing up to pushing stage and birth of baby & immediate skin-to-skin; had to be on her back for pushing or baby would go into distress

  • Golden tip: everyone should go for pelvic physical therapy!

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Resources:

Transcript:



Lisa: 0:00

You're listening to the Birth Matters Podcast, Episode 10

Dara: 0:03

The nurse comes up to me and she's like, "You can hold on to me." She takes me by the arms, and she said, "Hold onto my shoulders." I'd never seen or met this woman before, but she had heard me in the shower and she said, "Okay, so now we'll harmonize together." So basically like the midwife said to me, "Why don't you sing the song you wrote for her?" Because they assumed I had written a song for her. And then I did. And then her head came down and stayed there.

Lisa: 0:33

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 the show is not intended as medical advice or to diagnose or treat any medical conditions. Have you subscribed to the show yet? Please be sure to do that wherever you're listening to this so you don't miss on any episodes. Today’s episode will be the shortest interview we’ve shared thus far. In this birth story, Dara describes her experience of giving birth as “magical & frustrating.” This is the story of a first-time labor and vaginal birth working with a midwifery practice at Manhattan’s Metropolitan Hospital. She shares about using nitrous oxide (or laughing gas) for pain relief, very briefly, and then getting an epidural. Listen to hear the magical way mama Dara instinctively helps her baby come closer to being born. Here’s a hint: If you like music, you’ll enjoy this one! We had a musician dad featured a couple of episodes ago, and now we have a professional singer mom and medical massage therapist sharing her perspectives. You’ll also hear how a fever Dara developed led to baby having to go to the NICU (or neonatal intensive care unit), and how having a baby in the NICU can be challenging for new parents and baby. Before we jump in to the interview, I thought I’d share a little bit about my training and credentials in birth work so you can get to know me better. It might also be useful for any listeners who are interested in pursuing birth work and might wonder which certifications would be good ones to seek out. I began seeking dual certification in birth work back in the summer of 2009 both as a doula and as a childbirth educator. I'm certified with the largest doula certification organization, which is called DONA, or Doulas of North America International, and I began attending births as a doula in 2010. You can find out more about them or find a DONA-certified doula at DONA.org, and I'll link you to that in the shownotes at birthmattersshow.com. At the same time, I began studying with a local organization for childbirth educators called Childbirth Education Association of Metropolitan New York (that's a mouthful, isn't it?). CEA is the most thorough childbirth educator certification program that exists, which is one reason I chose them. Another reason I chose them is because they're local to where I live, and it's been incredibly valuable to connect with other perinatal professionals in order to develop a strong referral list for my students. CEA's program is so thorough that it took me nearly three years to complete while I was parenting my two little ones and working part-time at a Manhattan nonprofit called Hope for New York. I served on the board of directors for five years with CEA, and I was very honored to be presented with the Ellen Chuse Childbirth Educator of the Year award a couple of years ago. For any of you who might be interested in pursuing or are already pursuing birth work, CEA has a number of wonderful continuing ed classes that are open to not just the certification program members, but anyone who would like to attend. You can find out more about that at ceamny.org A few years later, I decided I wanted to also have the Lamaze credential to my name, both because Lamaze is a great organization, and because so many expectant parents call looking for "Lamaze" classes. It's similar to the word Kleenex being synonymous with tissue in that the brand name has come to be the household name for birth class over the years. So, I sat for the Lamaze exam and had no trouble easily passing it because CEA had so thoroughly prepared me. I've begun attending Lamaze's annual conferences and absolutely love their continuing education both at conferences and online. They also have fantastic resources online for both expectant parents and birth pros. Visit Lamaze.org for more info. I've loved being a part of all 3 of these organizations, particularly as they're aligned with my personal approach to birth. They all carry the philosophy that birth is a healthy, natural physiological process that we can trust, that we would benefit from having great support in labor and parenting, that there's no one right way to give birth, that learning self-advocacy strategies is very important in our current birthing environments (especially for persons of color, who unfortunately and unjustly have far worse outcomes), and that we should abide by best current evidence as much as possible. Before we jump into the story, I want to let you know that this episode is brought to you by Birth Matters NYC's Childbirth Education Classes. If you live in the New York City area, the best way to build your confidence and prep for an amazing birth and entry into parenthood and to connect with other expectant parents to build your very important support system is to attend group childbirth education classes. You'll spend quality time with your labor support partner in our comfy Astoria living room classroom, as you prepare for not only birth, but also for your best possible postpartum recover and wellness, as well as early parenting, with classes on breastfeeding and newborn care techniques. Classes often book up about one to two months in advance, so be sure to grab your spot on the early side. For more information and to sign up, visit birthmattersnyc.com.

Lisa: 6:03

Okay. I've kept you waiting long enough. Let's jump into the story.

Lisa: 6:07

Hi Dara. I'm so happy to be talking with you today and can't wait to hear everything you have to share. Can you tell us first a little bit about yourself and maybe how long ago you gave birth?

Dara: 6:17

Sure, so I am Dara Lazar. I am a medical massage therapist and I do have a history of a lot of prenatal massage, but that was a while ago and I also am a myofunctional—orofacial myofunctional therapist. I practice only on adults, but it is a, that is a sub profession of speech pathology that mostly pertains to babies, which has come in really handy in dealing with her. So should I just tell you about my birth experience?

Lisa: 6:41

Absolutely. Wait, did you say how long ago she was born?

Dara: 6:43

Sorry. Yes, she was born on January 17th, so she's almost four months. So I had signed up, I went through a midwife practice called Village Maternity and they'd basically repackaged the service that is publicly available at Metropolitan Hospital. So they give you your prenatal care downtown at a different office. They are the sister practice of an obstetrics practice called Village OB, which is very excellent but very expensive. So Village Maternity is an out of network provider or—they were until last week, which is—but they, the, you get the prenatal care downtown and then you get, you deliver at Metropolitan Hospital. So Metropolitan Hospital is, you get—as far as I know, everyone who goes in just it's primarily midwifery, midwife care. And the reason I wanted to be there is because of that and because their reputation and official reputation I guess I had, I used to say that but as a baby friendly hospital unquote, which has specific connotations legally I guess or I don't know, you know more about that. And also because they had nitrous oxide and I was like okay let's try this pain relief that they use all over Europe and see what happens. I came to Village Maternity and Metropolitan later in my pregnancy because first I went to a traditional obstetrics practice and—like in network—I thought, you know, I'll just like pay in network and not have to pay $1 million for my birthing experience like I do with all my other healthcare. But being who I am. I was completely ridiculous—it was ridiculous of me to believe that I could exist comfortably in a conventional space. Because that's just—my entire life is based around natural health care, you know? So there's no way I'm going to—.

Dara: 8:22

The woman who, who treated us, the doctor, she was I'm think quite intelligent, quite excellent. And she was always like, she was like doing squats all the time. Like she couldn't sit down. Just no—she had 30 seconds for us. Everything was in a, and even when she was actually listening, you could tell she was just used to having to hurry off. And that practice made so many mistakes. I won't even name them, they just didn't get anything right. So, so I, they did—like they were being bought. So you know, like, corporate buyouts, like horrible experience, if you want to talk about that too, that would be interesting. But maybe a different conversation. So the positive part is that then I went to Village Maternity. We wanted to look for a midwife practice that we would get to pay in network, but it was kind of an emergency. They don't, no one will take you after 28 weeks and I was at 27 weeks or something. And we're like, okay, we're just going to pay this thing and you know, see what happens. Basically when I got finally—so then I also hired a doula because at that point I was like so clueless and I just needed a lot of help. So we went through a doula service in Astoria, I can't remember the name of .

Lisa: 9:25

Astoria Doula Collective, yep. They're great.

Dara: 9:28

Yeah, so my friend Jada in Brooklyn had recommended them, and were referred to Caren and Caren was excellent. She was really, really helpful. She just knows she's taken tons of, she studied tons of things, taken lots of classes.

Lisa: 9:43

I'm actually mentoring her through a childbirth educator program right now.

Dara: 9:49

She seems to like not really be able to stop educating herself. She just enjoys it so much.

Lisa: 9:53

Yes. Totally.

Dara: 9:54

That's kind of what I do in my profession also. So it was like a meeting of the minds in a way and it was great. So the hospital experience itself—when I was at Village Maternity, I was told that I would, I would meet all of the midwives at the hospital before I gave birth. But that turned out to be, I don't know, a fib at best, really. But when I got to the hospital—Oh, sorry. So my water broke at four in the morning and called the midwife in charge. It's great. They have a midwife phone call at VM and she's awesome. She told me, you know, "Wait till the morning and go in, call me in the morning unless something else happens and then we'll try to keep you until noon. Plan on going in around noon."

Dara: 10:33

So basically like when my water broke, it was like television. It wasn't a, I wasn't in the grocery store or anything, but it was like my water broke like.

Lisa: 10:42

Big gush.

Dara: 10:42

Big gush, I was like, "Oh, here I am." But then of course not much was happening.

Lisa: 10:46

And were you sleeping when it happened, did it wake you up?

Dara: 10:49

I was just sound asleep. And it was like, Oh, that's definitely water. I know what water is. No question. And of course they don't know that that's your experience, so they can't tell for sure. But I'm like, yeah, yeah, definitely my water—but then there was like, you know, not really contractions, but like, I guess it was Braxton Hicks or something else was happening. Very like uncomfortable but not desperate for a while. And then she convinced me to going around noon to the hospital. She told me that to do that. And I was under the impression I was getting like pretty unconventional care. When I got to the hospital, the midwife there, she said, "I can tell by your face that you're not having contractions. This is not painful enough yet."

Dara: 11:30

Oh, sorry. Do you need to tell us something?

Dara: 11:33

Oh, it was not painful enough yet. And so she's like, "Honestly, if it was me, I wouldn't have even—I would have told you to stay home." And Caren, the doula had told me that she would recommend staying home, too, even though she said, you know, talk to the midwife, but personally I would just have you stay home because the hospital is where you get an infection and then you don't want—and then you get more interventions, like you and I when we spoke about it in the class and stuff and I was expecting Metropolitan to have less interventions because of the reputation as a baby-friendly hospital and because of all the stuff that I got from the mid, from interviewing with the midwives first. And with the midwives there, that was true. They were exceptional in that regard. But the rest of the hospital is set up differently. Right? Because it's a hospital.

Lisa: 12:14

Absolutely.

Dara: 12:15

[inaudible] So the midwife who I saw there was amazing and she was like, "Okay, well listen, the more—you know, if we strip your membranes, you know there's a chance that you, the more we intervene in your cervix the more chance of infection. If you want—the doctor's gonna want you to stay here, but I can't make you stay here legally. If you want to go home and labor at home, you can do that. If you want, I can strip your membranes and then maybe you'll go into labor sooner and then, you know..." So I was like, "Okay, let's do that." The doctor comes in ... really, really smart tactic. They look right at my husband and they're like—and they tell him the, the possible negative ramifications of laboring at home. Smart. Such a smart tack, you know, because obviously, well, yeah, I don't have to go into that. So she looks right at him and tells him all the things that can go wrong. Which pisses me off.

Lisa: 13:03

That's so frustrating.

Dara: 13:04

So then Crystal strips my membranes. I'm like, "Yeah, well, why don't you go ahead and strip my membranes? I'm going to go, we're going to go home." But then I go into labor like 10 minutes later anyway. So the hospital is like, they had space for me right away. They got me down to labor and delivery within like 20 minutes. Everyone that I encountered in labor and delivery and subsequently in—whatever—the postpartum care was exceptionally caring and exceptionally, exceptionally professional. Like I just had the most incredible experience. So I had they, they have a private room. I think you probably have to pay extra for that. The secret is though that like you can just go to that hospital and get this exceptional care in-network and they even treat a lot of Medicaid patients.

Lisa: 13:50

Yeah. It's a public hospital. So yeah.

Dara: 13:52

Public hospital, tons of Spanish speaking patients. A lot of patients that didn't seem to speak English or families who didn't speak seem to speak English as I'm walking down the hall and we're all getting this like exceptional nurse midwife care. Right. So like everyone, I would choose it over a private hospital a million times. So then like the basically like I try, they let me do whatever I needed to do. They let my husband put cloths over the monitors cause blue lights really bother me and wake me up. They made it a really nice warm, cozy experience. My doula put lights around and the baby monitors were covered with cloths and then the midwife would come in and just like take her finger and like look under the cloth to see the baby's vitals and then like go back and put them back and stuff. So they let me labor as long as I wanted. No one pressured me. I did get an epidural. I told the guy I was going to—the anesthesiologist came in and said you know "When do you want it?" And I was like, "Probably in an hour, but you know, we'll let you know." So I tried the nitrous, but what happened was, I got a fever so I got really nauseous and the nitrous just made me worse. Before the nitrous, I was in the, in the, I'm a singer, so I was trying, I was like, let me just try this, it's worked with pain relief before, but let me tell you, it doesn't work as well. Not a good enough relief. I was in the shower and it's not, it's helping a little bit, but not as well as it has for other things. And then when I, but the positive of that was that when I got out, the nurse had heard me and so when they came to, so I used the nitrous, it made me really nauseous. I was already a little nauseous, so I had to cut that out. And they called the, they called the anesthesiologist. I'm saying, I'm like, "How am I going to stay still at this point while I'm getting the epidural because it's painful enough to stay still." Like you had said in class, the nurse comes up to me and she's like, "You can hold on to me." She, she takes me by the arms and she said "Hold onto my shoulders." I'd never seen or met this woman before, but she had heard me in the shower and she said, "Okay, so now we'll harmonize together."

Lisa: 15:54

Oh that's kinda cool.

Dara: 15:56

It was really cool. So she—we sang together while they put the epidural in, and it really helped. And it was also this bonding moment.

Lisa: 16:03

Oh, that is so cool.

Dara: 16:06

There were lots of experiences like that throughout the night. I feel like I shouldn't name them because they kind of went outside of protocol a little bit for me. I'm not sure, you know, but that, that was really positive because, so basically I got chorio which is—I forget what the, the full name is for that, but you get an infection in your, in the uterine lining and you get a fever. And the reason that that matters is that in a lot of hospitals, including this one, when that happens, the baby automatically goes into the NICU and is under surveillance. So there are a few different protocols as I understand it. One is that the baby is just under surveillance for—what do you call that, observation? Not surveillance...

Dara: 16:50

Observation.

Dara: 16:50

Did have like an ankle monitor, so it felt like surveillance. She—in one, in one scenario you're just under observation for while they get the bacterial cultures back. But the way they do it at this hospital, which is another way that is done sometimes, is that she's automatically prophylactically given antibiotics for two days while they wait for the bacterial culture to come back.

Lisa: 17:14

Yeah, that's very common, whenever a fever develops.

Dara: 17:16

Right. So that's what happened. Yeah. So I'm trying to breastfeed from down the hall. The good thing about that hospital is the nurses. You press the call button and then you take them, they'll take the milk that you pumped down to the NICU part and feed it to your baby, which I didn't know until the second day, but it was really excellent. That's excellent. Right? They're very, very breastfeeding-friendly. As soon as you give birth, they've got this lactation consultant who comes into the room and tells you, kind of helps you figure, figure things out. Which was great, but you know, it's like anyway, you're exhausted. You just went through labor. You're up for 24 hours and then how are you going to advocate for yourself?

Lisa: 17:52

Right. Yeah.

Dara: 17:52

Since I was under the impression that I was at a baby-friendly hospital, I didn't try, I didn't even listen—no offense, you know, no offense—but during the class where you were like, "Here's what to do under intervention," when you're like, "I know with epidurals you get a fever sometimes. And then there are things like that leads to baby being under observation and getting more and more interventions." I wasn't worried about that happening, but I was wrong. So not only did she get the two days of antibiotics, but she also, the culture came back negative, but she came back with a high CRP level, which is like very, very general measure of inflammation. It was really high. So she was fighting something. So then they give it to her for a week, right. Antibiotics for a week.

Lisa: 18:41

Oh wow.

Dara: 18:42

So like she's just out of the womb, and I just like went through the trouble of a vaginal delivery and all the probiotics are wiped out.

Dara: 18:48

Oh wow.

Lisa: 18:49

We don't know what the longterm consequences of those antibiotics are.

Lisa: 18:52

I know, I wonder that too.

Dara: 18:55

It just really pissed me off. Not only, I mean it's like now what do I have to do to recover her from this intervention, at such a tiny age. And then she's getting Similac, like the first thing. So you get all this midwife care and then you're feeding the baby Similac. They'll help you breastfeed, and actually I will say about that NICU, is like, they talk to you and they say is it "It's supposed to be breastmilk or is..." whatever, whatever. Well, try doing exclusively breast milk when you're down the hall and then you're in another borough.

Dara: 19:21

Yeah. Oh wow. That's tough, right? Because you probably went home after a couple of days, right?

Dara: 19:26

Yeah, they let you stay and then the midwife was like, "Yeah, we'll just, we'll add an extra day onto your stay." That's another thing about the hospital though is that because they're not focused on money or something, certain things you can just, they'll just, I don't know, they're just more laid back about giving you actual care. It's, it was, that was pretty cool. But then with the NICU, the doctors, kept miscommunicating. So there were three different dates I was given that she was going home. So three different dates I arrived and thought she was coming home and I was done like pumping in the middle of the night and, and commuting to Queens, which is an hour away and three different times I had to like be told that she wasn't coming home yet and I had to keep doing it. It's not like she was in danger, but it was exhausting, you know, and it just felt, I felt so condescended to, you know what I mean? It made me really angry. Oh. And then another midwife there who was kind of an activist when she first came in to the room right after I was, I didn't know her, but soon as I gave birth, she came into the room and like stuck the baby on my breast to make sure that she could breastfeed before she was like, confiscated. And that midwife told me later that she had had a conversation with the head of the pediatrics unit about a similar related but different patient cohort. And he had said, well if we don't hospitalize those babies, there'll be no one in the NICU. But yeah, and that was about, they were hospitalizing babies whose—it was something where the water had broken, but there wasn't any chorio, something like that. And so she fought I guess long enough that those babies stopped being confined to the NICU. But of course when you have chorio they still do well. I would have really preferred a situation where she was under observation and then if she needs some medicine to give her medicine, but you don't...have a week of intravenous medicine when it's not, when there's no indication.

Lisa: 21:21

Yeah, yeah, absolutely. Agreed.

Dara: 21:24

So, yeah, so it was clearly about like keeping the NICU open, which by the way, the nurses there were incredible also and really bonded and had a great time. But that's not worth antibiotics.

Lisa: 21:32

No, no, definitely not. Now can you just clarify, when you said when she was in the NICU, you were having to pump, did you ever, were you ever able to get her to the breast in the NICU?

Dara: 21:45

Like I did it all day long.

Lisa: 21:47

Okay, good.

Dara: 21:47

For like eight to 10 hours, you know, like it's my first kid, so I'm like knocking myself out because I can. And like you don't want your baby to be born and then end up in a plastic container. She's a perfectly healthy baby in a plastic container. So, and they swaddle her and they, because there aren't that many babies in the NICU, I think they'd probably get a little more physical attention than other places. I think I have to think there were some positives for her in being in that environment, but I don't, it's just—who the hell knows. Like she, she's maybe less susceptible to noises or she's more—she might be more flexible in some ways. She's definitely flexible in terms of bottle versus breast. So when my husband puts her to bed, it's easy, things like that, but...

Lisa: 22:34

And then what caused them to start doing formula?

Dara: 22:39

I couldn't produce enough milk. And I think my mom had a lot of trouble at first producing enough milk, but it was like, how am I going to produce enough milk when I'm sleeping somewhere else?

Lisa: 22:48

You're separated, right. Yeah, yeah. You're not able to bring the baby to the breast frequently enough. Probably. So now backing up, right? Well, go ahead, you were about to say something.

Dara: 22:56

No, no. Tell me.

Lisa: 22:57

I was just going to say, did we skip over the pushing stage and a little bit more of labor?

Dara: 23:02

Yeah, so they let my, they let Caren try to breathe me out of my fever. The, the, the nurse is, she's like, you know, "As soon as you hit a fever, you're supposed to get Tylenol antibiotics, but I'm going to give you guys a while, a little bit. I'll give you like a little bit to figure this out. And then if it doesn't work, gonna have to give you medicine." So Caren successfully breathed me down out of my fever, but then it all came back immediately, and I was shaking like really, really shaking. So it became clear at some point it wasn't an epidural fever, it was, had to be something more than that. And then as if, to clarify that as soon as they gave me antibiotics, Tylenol, I felt fine. Within 10 minutes I was better. And then I pushed for two hours and she came out. But I labored in different positions. But I ended up laboring on my back because when I was on all fours, whatever reason, her position meant that she would go into distress when I was on all fours. So it's so funny, like all this planning and like the best laid plans and stuff. And then I ended up laboring on my back with an epidural. And I'm grateful for the epidural with the epidural. I don't know. I said this is still the most painful thing I've ever experienced. And Caren said, "I hope no one told you that labor was a pain-free experience." And I said, "Yeah, like I thought that epidural meant it was pain free," but she's like, "No way." I'm still surprised at how painful it was. I don't know if that's because my waters broke so early because her head was like just hanging out on the pelvis.

Lisa: 24:40

Actually that really can increase the intensity of what you're feeling, especially when it's a big gush. Like how you had it happen.

Dara: 24:47

Cool. Good to know. So it looked like there were still pockets of water, but they were not helping much. From my perspective. So I had trouble pushing her out. I had a tight band and it was kind of affirming to know that exactly where my physical therapist said I would have trouble is where I had trouble with this tight band. Wasn't letting her head out. Her head wasn't staying down and I was like, "Okay, so I just need to get psychological about this or else"—I just, I had just had this feeling where I'm terrified. Basically the whole time during labor, I'm thinking "This is an insurmountable task. There is no way out of this. It'll never end. Can't see how this is ever going to end. It's impossible." And sure enough, like I pushed and pushed and her head goes down and then pops back up and it pops back up and it pops back up. And so then I turned to Caren and I'm like, "Okay, listen." I was like, "I think I'm just really ambivalent about being a mother and that's why this isn't working." And I'm like, I'm not sure how these people are going to take this. Right. But this is where I have to go. And I don't know, she says something, you know, supportive. The midwife who didn't even know this, but assumed it, and we haven't brought her into the story yet so far, but she was like a magically calm, contented human being. Probably she couldn't have been more than like 27 so basically like she said, she, the midwife said to me, "Why don't you sing the song you wrote for her?" Because they assumed I had written a song for her. And then I did. And then her head came down and stayed there.

Lisa: 26:10

That's amazing.

Dara: 26:12

I said, "God, that woman is wise," you know.

Lisa: 26:14

Oh wow.

Dara: 26:16

And then the pushing started and that was another TV moment, because I was just like screaming at the top of my lungs and I looked down at the midwife and she's a foot from my vagina and I'm thinking I'm going to look at her and she's going to be like wincing in pain. There's no expression on her face at all. Just like this placid beatific calm that she always has and she says "That was good. Now give me 10% more." And then I just let, I just labored for, I pushed probably two hours total and then the baby—two and a half hours. And they actually delayed letting the pediatrician, pediatric unit know that she was born until after she was born, because they're supposed to like whisk her away and you'd give them a bath immediately but they gave me an hour to bond. Like they....She got to breastfeed immediately and I had four midwives like helping me breastfeed and Caren and my doula helping me breastfeed and like stitching me up. And they all stayed over time by like an hour to stitch me up. So it was really, it was really exceptional care.

Lisa: 27:22

Oh, I'm so glad.

Dara: 27:25

Yeah, and the reason they had tried to let Caren get my fever down was because they didn't want her to be, they knew that we didn't want her to be taken away. So that was great. Yeah. So that's the story kind of. I think. So. Look, of course we're lucky to have the baby that's alive, that didn't have a bacterial infection. Like it's not like, but it's not. But I don't think she had one. That's the thing, you know. But my husband also had only two weeks of paternity leave, so he missed the first one. He was at home cleaning the apartment, which might've been good actually. Because we probably should've done that stuff.

Lisa: 27:59

So wait, you're saying you're saying he was home? He used up one of his two weeks with her in the hospital.

Dara: 28:06

Oh yeah. So that was really hard for him. But the other thing, this might be a different conversation, but because of New York Paid Family Leave, I mean our lives have been transformed by that. It really allows us to spend a lot of time with her, allows me to spend time with her and allows me to get help because he comes home for a day and takes care of her. I usually go to work, but then I can go out and do what I need to do.

Lisa: 28:33

Yeah. I was curious when you said he had two weeks off. I thought, "I wonder if they, they, they're taking advantage of the family leave."

Dara: 28:40

Yeah. But he's just taking one day for the rest of the year that allow me to work part time. Not have to go back immediately and not have to get childcare because it's—putting your baby in someone else's hands immediately turns out to be really stressful.

Lisa: 28:54

Of course. Yeah. You're worried and...yeah, all the what-ifs and like is this person safe or is this daycare center safe? And do you want to share it all how the transition back to work has been for you?

Dara: 29:07

Well, I'm really lucky—slash—my life was already set up for this because I'm a singer and so I was only working part time anyway. So now I'm just going to gigs like I'm doing singing gigs. Easy ones, not that stuff that I have to plan for but stuff that's managed by somebody else. And then I have a couple of wealthy clients who come in part-time. Do you want to go to bed? They come from other countries or states to get work. So I'll get like one-off massage, give a massage and then—I'm not going back to work. In fact, I'm going to quit my job tomorrow, and just have my own private practice, so I can work whenever it's convenient for us.

Lisa: 29:45

Nice. That sounds good. I'd love to come hear you sing some time, if you do local gigs.

Dara: 29:53

All the time.

Lisa: 29:54

Do you have a website for either your massage therapy or your singing or both? We'll have to post those. Yeah.

Dara: 30:03

Oh, one thing we should talk about, which I think you already talked about. Everybody should go to a physical therapist, manual physical therapist after birth and get their pelvis reorganized and no one does it. And I see women all the time 16 years later, like, "I don't know, I have this back pain. It's been for so many years." I'm like, "Did you have a baby?" Like, "Yes," you know. "Okay. Well your pelvis is completely going three different directions."

Lisa: 30:26

Yes.

Dara: 30:27

Very easy to remedy, if...

Lisa: 30:29

Yes. I'm so glad you're bringing that up. So have you gone already, or...

Dara: 30:33

No, I haven't gone.

Lisa: 30:36

Do as I say, not as I do. I always say. I say that a lot, but yeah, I recommend that as a great idea. Right. And it's not like you have to do it—like you're, you're still in an intense, pretty intense time with your baby and everything. There's plenty of time to do that. But to do it at some point is such a smart thing.

Dara: 30:54

It's best to do it with the most oxytocin still available in your system. But breastfeeding took us a couple of months and all I could do all day was like do that. So I didn't really have the opportunity to take care of myself the way I would like to.

Lisa: 31:05

Sure.

Dara: 31:06

But I'll get there.

Lisa: 31:08

Yeah. All in good time. It's been so good to talk with you, Dara. Thank you for sharing all of this. Take care. Bye.

Lisa: 31:16

So that's Dara's story. I don't know about you, but I just adore the part where she sings her baby toward being born. Maybe it's just because I have a musical and singing background. I dunno. Before we wrap things up, here are a few of my followup thoughts. As Dara pointed out and as she experienced developing a fever in labor is very common. It all too frequently happens with epidurals. I recommend asking your care provider what their protocols are if you happen to develop a fever for any reason in labor. In most cases here in New York hospitals, if a person develops a fever in labor, it means separation of mom and baby, as in Dara's case, so that the baby goes to the NICU for administration for antibiotics. Sometimes the hospital can administer them while rooming in, meaning while the baby is in the room with the mother. This is a lot more ideal and you could absolutely advocate for this instead, if you find yourself in this scenario. Whether or not it's possible depends on your care provider and hospital. I wanted to point out that most babies only get one to three days of antibiotics and go home with the parents upon the mother's discharge. Dara's baby had them for additional days, I think due to the high CRP levels. C R P stands for C-reactive protein and is a general measurement of inflammation in the body. Some hospitals by contrast would just do some observation on the baby, as Dara mentioned—and would have preferred, to be sure that there's no sign of an infection. This is one of many examples of comparing the active management approach to the expectant management approach. Active management is the approach used in the majority of hospitals in general, in which they do things actively that might carry their own risk to prevent a problem. Active management is more necessary in high risk scenarios where problems are more likely but often is used across the board in hospitals. Expectant management is more appropriate for low risk situations and the approach is to only treat a problem in the unlikely event that it arises. In a hospital setting, if you prefer an expectant management approach, it more often than not requires some self advocacy or advocacy for your baby. When Dara shared about still feeling discomfort with the epidural, I wanted to point out that everyone responds to an epidural differently. For some. It does entirely remove the perception of pain, as you'll hear in episodes 12 and 13, although most people can still feel pressure. For others, as with Dara, the pain is not totally numbed and some don't get full relief, so as you consider your options for pain relief and labor, it's important to go into it with eyes open, understanding that it may or may not provide complete relief. It's also common for people to feel uneven numbing. An anesthesiologist or nurse anesthetist would do their best to tweak it as needed to achieve the level of relief that someone's seeking.

Lisa: 34:06

Before we give you a sneak peek into next week's episode, be sure to visit our show page at birthmattersshow.com where you can not only listen to all episodes, but you can find all kinds of goodies there like photos, transcripts, and links to mentioned resources and educational information for each episode. Here's a peek at next week story.

Speaker 3: 34:26

I think that was one of the things that the class that I took with you did for me, was empowered me more to ask questions and to push back and to say, "No, this doesn't seem right. Like there's something wrong here." And so I was, I was really happy that I was able to have that moment of like, "No, there's something wrong and I'm going to push back and I'm going to question it." And sure enough I was right.

Lisa: 34:44

Instead of playing our usual outro music today, Dara is going to sing us out with a song she wrote for her daughter. As she does, the thought I'll leave with you is this: what gifts do you have that might come into great use for labor, birth or parenting? I'm going to modify a quote from one of my mentors and say to you, your baby needs the gifts that only you can give. Thanks for listening to the Birth Matters Show and be well,

Dara: 35:10

She's my baby. My only baby. No other baby. Just one baby. No other baby. Only one baby. Just one baby. One baby will do. She's my baby. My only baby. No other baby. Just one baby. Only one baby. No other baby. Only one baby. One baby, not two. She's my baby. No other baby. Just one baby. Only one baby. No other baby. Only one baby. Just one baby. One baby. That's you. She's my baby. No other baby. Just one baby. Only one baby. No other baby. Just one baby. Only one baby. One baby will do. ---END---