Birth Matters Podcast, Ep 11 - Self-Advocacy in Induced Birth & Breastfeeding

Today Jennifer will share her story of an IVF-conceived pregnancy in which more than one doctor suggested scheduling a cesarean due to the size of her baby. She’ll share about her journey toward the decision to at least have what we call a “trial of labor” toward the vaginal birth that she desired. You'll hear how she impressed everyone by giving birth vaginally to an almost 9-pound baby. Listen to hear the smart ways she advocates for herself and makes the choices that were preferred and ideal for her & her baby along the way of her induced labor with an epidural at Long Island’s LIJ Katz Hospital. Jenn will also share a bit about how easy initial breastfeeding was, but then how things got a little trickier after that.

Episode Topics:

• PCOS-induced fertility challenges, conception via IVF

• Induction (for several reasons)

• Being told her pelvis is small and she was having a big baby and her OB gave her an option of a scheduled cesarean (due to these factors plus her additional risk factors of age, weight, etc.), sharing her journey of deciding to try for a vaginal birth

• On the day of the induction, she calls and finds she’s not on the schedule, so she has to just show up and go through triage

• Talks about the benefit of this hospital offering a private room by default (uncommon in NYC)

• Induction with Cytotec

• Using music, movement, hands-on techniques with partner for coping well

• Water breaking, bloody show

• Things get more intense, get epidural

• Jen progresses efficiently from 5cm to 10cm; pushing and birth of a fairly large baby

• Skin-to-skin after birth

• Early breastfeeding and exhaustion in hospital, almost supplementing with formula due to weight loss right after birth, but then Jen catching that hospital had miscalculated and that baby didn’t need supplementation at that point

• Going home from hospital, struggling with breastfeeding, going to ENT with her sister and her new baby to evaluate for tongue/lip tie

• Lying down breastfeeding goes much better and things improve from there

• Hand expressing breastmilk and syringe feeding helped Jen feel more at peace in the early days that baby was getting nourishment

• Community found in birth class -- the importance of supporting fellow parents

Resources:

Syringes for early feeding

• Free “Pack for Your Best Birth” Packing List

• Kellymom.com articles on syringe, cup, finger feeding as alternatives to bottle feeding in the early days/weeks

• Kellymom.com article on normal infant weight loss immediately after birth and healthy weight gain after that

Transcript:

Lisa: 0:00

You're listening to the Birth Matters Podcast, episode 11

Jennifer: 0:04

I think that was one of the things that the class that I took with you did for me, it was, it 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: 0:30

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 out on any episodes. Today, Jennifer will share her story of an IVF conceived pregnancy in which more than one doctor suggested scheduling a cesarean due to the size of her baby. She'll share about her journey toward the decision to at least have what we call a "trial of labor" toward the vaginal birth that she desired. You'll hear how she impressed everyone by giving birth vaginally to an almost nine pound baby. Listen to hear the smart ways she advocates for herself and makes the choices that were preferred and ideal for her and her baby along the way of her induced labor with an epidural at Long Island's LIJ Katz hospital. Jen will also share a bit about how easy initial breastfeeding was, but then how things got a little trickier after that. Before we get started, if you'd like to receive your free Pack for Your Best Birth Checklist and my free mini course with some expert tips for your best birth, please visit birthmattersonline.com/pack, which you can also find linked in the show notes. Okay, let's jump in.

Lisa: 2:04

Welcome to the Birth Matters Podcast, Jennifer, it's so good to see you. Today I have Jennifer on the show and she's going to share her experiences through birth and maybe a little bit of breastfeeding depending on what we have time for. How you doing today, Jen?

Jennifer: 2:18

I'm doing great, Lisa. Thanks for having me on your show.

Jennifer: 2:22

Tell us how long ago you gave birth. Not long ago, right?

Jennifer: 2:26

No. So it's a little over eight weeks now. I gave birth on July 21st. My little Emma Sophia came into the world at 12:51 PM. And she's my first, so it was very exciting for us.

Jennifer: 2:40

Awesome. Well thank you for being willing so early on when things are still fresh, but you're still also still exhausted, to come in.

Jennifer: 2:49

Yeah.

Jennifer: 2:50

All right. Well why don't you just tell us anything and everything you'd like to tell us about your birth.

Jennifer: 2:56

Sure.

Lisa: 2:57

And pregnancy, if you want to say anything about pregnancy, too.

Jennifer: 3:01

Yeah. So I guess I'll start with the beginning and kind of give a frame around how Emma came into the world and why I made some of the decisions that I made around my birth. But I have been with my husband for almost 10 years and we tried for many years to conceive and unfortunately we had some fertility issues. I do have polycystic ovarian syndrome (PCOS) and that was a big kind of deterrent in me being able to get pregnant. So we went through four rounds of IVF before we could have Emma and she was one of two embryos I had left and that were transferred into me and she's the one that made it. She's my, my surviving little embryo that became my beautiful baby girl. So it was quite the journey to get to finally becoming pregnant. And once I was pregnant I would say that I had a pretty good pregnancy. Yeah, I really didn't have any crazy complications. I, you know, I had the typical nausea in the beginning and feeling super tired and exhausted because you're creating this person, creating human life, as I used to tell my husband all the time when he'd be like, "Are you tired?" I'm like, "Yeah, yeah, I'm making a person. Pretty tiring." But nothing crazy. No preeclampsia, not, you know, my feet didn't swell up. My hands would swell up, which was strange. Every time I'd go out into the heat, especially, my hands would swell up, like just kind of annoying. And I had a little carpal tunnel for a couple of weeks and that went away. But overall I had a really healthy and happy pregnancy and no crazy complications. The one thing I will say I had to do, which wasn't the most pleasant but made sure that Emma was okay, was I have anticoagulant syndrome. So I had to take blood thinners on a daily basis. So everyday I had to have a little bit oxygen injection, which later turned into a Hepburn injection towards the end of my pregnancy. But as an IVF mom, that one little shot a day really, really wasn't too much for me because I wasn't, I'd been so used to so many injections and so many—so many kind of medical interventions to get pregnant in the first place so it wasn't too bad. but fast forward to my pregnancy went really well and she was very comfortable in there. She didn't want to come out. So I ended up having to have an induction. I made it to 41 weeks and I was considered high risk for several reasons. One, the PCOS; advanced maternal age because I am 38 years old, or I was 37 when I had her, but I just had a birthday and...

Lisa: 5:30

Happy Birthday!

Jennifer: 5:31

Oh, thank you. What are my other reasons? There was quite a few reasons I remember them calling me, saying I had a geriatric womb, which was really pleasant to hear. But and then the, the antiphospholipid, so the whole blood thinning disorder issue, and I'm, I'm somewhat overweight. So that was also a factor in them, considering me a high risk patient. So I saw many specialists and the pregnancy itself—as uneventful as it was—because of all of those factors, it was pretty monitored, especially towards the end of my pregnancy. So as I was going in for weekly monitoring with my primary OB GYN, the decision was made that we really shouldn't let this go too much further past my due date. So it went a week past and then that's when we decided to schedule the induction. There was definitely talk before the induction was scheduled about how big this baby was. So I was getting, you know, the weekly monitoring of her, but I also had quite a few scans done, and in one of the later scans in my pregnancy it was determined that she was over eight pounds already, and my doctor was concerned. I think at one point they mentioned that they thought I had small pelvic bones and my baby was over eight pounds and it's my first time having a child, and I have all these kinds of other high risk factors. So she actually mentioned the possibility of having a C-section. And I personally wanted to have a vaginal birth if at all possible.

Lisa: 7:03

Can I just ask for some clarification there?

Jennifer: 7:06

Yeah, sure.

Lisa: 7:06

Was she talking about a scheduled C-section or just the possibility of—you might need it in the middle of a, an induction.

Jennifer: 7:13

So, both. So she originally started the conversation with, you know, "I wouldn't be unsupportive if you wanted to schedule a C-section. I've seen people schedule a C-section with less risk factors and smaller babies. So if you felt that you needed to schedule a C-section, I would be able to be supportive of that. But I'm also supportive of you having a vaginal delivery." And I think part of it was she was—I really liked my doctor, because she was pretty practical and she wasn't pushing me either way, and there really wasn't necessarily a reason to have a C-section at that point, in my mind. But I think the experience that my sister had when she had her first child affected me somewhat. So my sister had a baby two years ago. Her birthday is next week actually. And my sister had a really tough labor and unfortunately she went through an induction, which turned into 18 hours of pushing, which turned into an emergency C-section because the baby just, she wouldn't drop low enough in her pelvic area. She just didn't go down low enough for them to even be able to use forceps or a vacuum. And she went from all of this, you know, very exhausting, painful, long lasting delivery into an emergency C section, which turned into her having a hemorrhaging issue. Which, you know, I left the hospital, my brother-in-law calls me, he's like, "You need to come back, your—your sister's surrounded by doctors, something's wrong." And it was really touch and go. She ended up with a really difficult recovery process and two blood transfusions, and all of that experience for me really scared me a bit. You know, it made me worry about the idea of going through a very long and intense labor only to end up having to have an emergency C-section anyway. And I think my doctor's concern was based on the baby's size at that point. If that was accurate, the baby could be over nine pounds, closer to 10 pounds. And at that point with all the other factors that I had, that emergency C-section was a very large possibility. Right. By the percentages, she thought that the possibility that that route was going to have to be taken was, was there and if I wanted to schedule a C-section in order to avoid kind of the unknown emergency C-section that she would be supportive of that. And you know, I started thinking about kind of all my options and then I also started thinking about kind of some of the things that I learned in your class and some of the things that, you know, we, we discussed about how sometimes interventions lead to more interventions and how many times in this, in this country in particular, you know, doctors and hospitals and the medical institutions will lean on C-sections and we have a much higher rate of C-sections than are necessary.

Jennifer: 10:10

And I also saw the recovery my sister went through after her C-section and I remember, you know, I swaddled my niece and I fed her and I helped my sister a lot those first couple of weeks because she was in so much pain and she really just, she couldn't hold her baby as much as she wanted to and it was hard for her to get up out of bed, and if I could avoid that I wanted to. So I went into it with an open mind in terms of "If I have to have a C-section I will, because I'm going to do what's best in terms of an emergency situation arising." You know, I went through a lot of medical intervention to just have my baby. So I wasn't trying to kind of at that point give up on medical intervention if that's what my doctor thought was needed. And I trusted her. I, she, she is a great doctor and she was always very transparent with me, and kind of talking to me about my options and what they were. And I, I said to her, "Well, let's, let's see what happens." And she's like, "Yeah, I agree." She's like, "At this point, let's schedule the induction and let's, let's hope that, that, that, that works and then if for any reason you have to have an emergency C-section, we'll, you know, we'll cross that bridge when we get to it." So we had that conversation I think about a week before my induction was scheduled, there—a few days before, and my induction was scheduled for a Saturday, the 20th, and the day didn't start off so well. So I had been told to call the hospital about two hours before my scheduled time, right, so I had to be there at 12:00 PM. So at 10:00 AM I call, and I was told it was just a formality to confirm that everything was on track. You know, on an occasional basis they would have a lot of emergent patients come in and they would maybe want me to push it a little bit. And so instead of waiting at the hospital, they recommend that you call ahead of time in case the schedule's been changed in any way and you might need to be bumped. But when I called, there was no record of my induction. They were not expecting me. And so I kind of, I flipped out a little bit. I was like, "What do you mean?" I was like, "This, this has been scheduled. I spoke to the receptionist." So at that point I'm calling the receptionist, I'm calling my doctor. And they're like, "No, they got the paperwork. Absolutely you should be on the schedule." But when I called the person at the hospital again, she's like, "You're not on the schedule, so you can come in, but, but you're going to be going through triage and you're going to be like a walk in." And I was like, "Whoa, that doesn't work. Like I'm not a walk-in, I'm scheduled. So it was just very, the first couple of hours were not, that day, were not great.

Lisa: 12:43

That sounds stressful.

Jennifer: 12:45

Yeah, it was actually really stressful because I woke up in like this great mood thinking, you know, "My baby's going to be here soon!" And we planned a brunch with my sister and my husband, which was going to be really relaxing and nice. And I spent like the time between me getting ready to get up the door and have a brunch, kind of just stressing out about "What's going to happen when I get to the hospital? Are they going to turn me away? Am I going to be made to wait longer than a regular patient because I'm not on their schedule. What's gonna happen here?" But you know, I ended up calling back and one of the people there was just like, "Just come in, you know, we're, we're going to take care of you. You're not going to get turned away. You do have to go through triage, which you wouldn't have done if you were on the schedule. But it's really not a big deal." And I just, at that point I, you know, I was having brunch with my sister and she knows all this is going on and she's just like, "Don't worry, it's going to be okay." And I was like, "I don't want to go into this day crying or being stressed out." So I was, I just kind of said, "It's going to be fine. Just show up and we'll see what happens." And that's exactly what I did. And my doctor unfortunately wasn't on call that weekend. So I ended up with another doctor that was part of the practice, which was another unknown because I hadn't met her before. But I had heard great things about her and I was a little nervous about that, about meeting this doctor for the first time.

Lisa: 14:01

That's understandable.

Jennifer: 14:04

Yeah, no, absolutely. It's, it's kind of strange that you work with someone for 10 months and then the day-of, it's someone different but, you know, I know that happens to a lot of women, so, you know, my doctor reassured me she was—apparently this other doctor was like kind of head of her practice. And she had been practicing for 30 years. So I went into Yelp and I'm like looking around like looking up information about this doctor and you know, there were some mixed reviews, some people really loved her and some people didn't. So I was just like, "Oh, let me stop reading." I was like, "This is probably not a good idea. Let me just go in there with an open mind and no preconceived ideas." And I actually really ended up liking her. I thought she was great. Fast forward 12 o'clock I check in, I probably got there around 12:15 and I go through triage just as I expected. So it was a few extra steps. But the nice thing was that my doctor, the, that was actually on call for—that would be delivering my baby, she came over pretty early. So it was probably before one o'clock or around one o'clock when she came in to introduce herself and she said she had gone through my file and my chart and one of her first questions was "Has anyone talked to you about a C-section?" And I was like, "Yeah, I know." And she's like, "Okay, I just want to make sure that your doctor prepared you for all the possibilities. I don't know that that's necessarily going to be the case, but you know, if you're in a situation where the baby's very large and you're not able to push her out, we may have to do an emergency C-section." And I was like, "I understand. We've had these conversations, like, I appreciate it, but I would like to try." And she's like, "Yeah, no, you know, we'll do that. I just want to, I want to kind of know what we're in for." She was like, "When was the last time you had an imaging done?" And you know, "What was the weight of the baby?" And I think I had been about a week and a half previous that my last scan was done at Carnegie Imaging and they had calculated a little over eight pounds. So at this point we were thinking, you know, this baby's going to be closer to nine pounds or at least eight and a half pounds. And she's like, "Well, I want to get a maternal fetal medical doctor in here to give us another scan today and give us kind of an updated idea of how big the baby is. So I was like, "Okay, yeah, that's fine."

Lisa: 16:05

And do you remember what we learned in class about the margin of error of those scans?

Jennifer: 16:11

Yeah. And, and that's why I kept saying to them, I was like, "This is at least 20% off in either direction and the doctor—is it more?

Lisa: 16:19

Up to one to two pounds in either direction. It's huge.

Jennifer: 16:25

Huge. Yeah. That's what I told her.

Lisa: 16:29

Yeah, it drives me crazy when they put such an emphasis on that, because it's so inaccurate. So I'm curious to know how accurate it was in your case.

Jennifer: 16:38

No, absolutely. And I think all of that information was, was so helpful to me at that point because that was one of the things I said to push back. I was like, "I know that these are guesstimates." I was like, "You know, the baby could be a small as seven pounds or as large as nine pounds." So I guess, I guess the nine to nine-and-a-half pounds range scared me, right? If they were off. But I also felt like they probably overestimate on the weight more than they underestimate. And I just, I had such a good pregnancy and she didn't, I don't know. I know it's kind of weird to say, but she didn't feel massive inside of me and I didn't gain an absurd amount of weight. Like I just didn't think she was going to be like that nine pound, nine-and-a-half pound baby. I was like, maybe she's, she's going to be on the bigger side, but I just, I wanted to try. Right. So if—I told her, I was like, "I get it. If we have to do that, we'll do that, but let's see what happens." And I was like, you know, "There's no, no harm, no foul having another MFM come in and scan me again and let's, let's see what happens." So another doctor came in and she scanned me and they do it in grams, right? So they said the weight in grams and I'm just like, "Okay. That means nothing to me. I'm, you know, a woman in the US, like, unfortunately we're the only country that doesn't use the metric system.

Lisa: 17:47

Really, right. Like why are—we're rebelling against Britain.

Jennifer: 17:50

Rebelling against, against the world basically. I was like, "I wish I thought that way, but I don't know what 3,500 grams means. So let's figure this out." I pull out my calculator, I'm like trying to figure out what she really weighed and so then, she actually calculated it behind of seven pounds, so she thought it was actually—she was actually smaller than Carnegie's last image had had confirmed for me. So I was like, "Okay." And then the doctor was like, "Okay, let's do this one more time." And she, she really took her time. She did it again. She was like, let's get the average of two scans to make sure. And then after the second scan, my OB GYN—she was actually there for both scans and she's like, "Okay," she's like, "I think we're in a better position than we originally thought in terms of the baby's size. I think it'll be fine. You know, we're, we're open to all possibilities, we'll see what happens and let's take it from there." And then the other thing that kind of encouraged me to really like say, you know, "I'm not going to listen to all of this kind of hearsay about the size of the baby and whether or not we should—like you know, how prepared I should be for an emergency C-section." I want, I really want to keep going and just do this as you know, progress to a vaginal birth if at all possible. Because when I checked in, I was at one-and-a-half centimeters, and so my body was already progressing and by the time I went from the triage up to the room where they checked me in, it was probably closer to like three 3:30-4 o'clock. And at that point when I first checked into the labor and delivery room, they did another quick check and I was at three centimeters. So I was already starting to move along. So I was like, "Okay, you know, we're okay". But I wasn't feeling contractions so to speak. I just, I felt fine. I didn't really feel much. So at this point I'm at labor and delivery. I'm with my husband. The nurse comes in, this really sweet but really young, really young-looking nurse. And the, for one of the first things she needed to do is put my IV in, and I'm not a big fan of needles, even though I've had to deal with needles for so long in so many different ways with the, the whole IVF process. But, for some reason the, the whole IV needle kind of freaks me out a little bit. I guess it's just because of the placement and it's going to stay in there. So she went to do that and for some reason she kind of doubted herself and she was just like, "Okay, if we don't get you on the first try, don't worry. I'll get someone else in here to take care of it." And I was like, "Ooh, let's not start the conversation this way." I was like, "Let's say that you're definitely going to get it on the first try. Let's stay positive."

Lisa: 20:24

Right? That is not what you want to hear.

Jennifer: 20:26

Not at all what I wanted to hear. I mean I was already a little bit hesitant and didn't want to kind of be judgemental, right, because she looked so young. Right? But then I was like, "So how long have you worked here?" And she was like, "Oh, I was at this other hospital for 10 years. I've been here for three years." So she obviously looked a lot younger than she than she was. And I was like, "Okay." I was like, "Don't worry, you got this, you're going to get this." Like I'm like cheering her on. I'm like, "Please don't stick me more than once." And she—sure—she got it the first try. So I was very relieved. She was really nice. And it was funny because she, she had opened up to me and she, she told me that she was having fertility issues and that she was kind of broke because she, her last two attempts didn't work, and that she was trying to pick up extra shifts for that. And so it was kind of crazy. Like it's—now that I have my daughter and I've gone through the whole fertility kind of issues and, and the whole IVF process, you really realize how, how common it is. Right? A lot of people don't talk about it but so many people are dealing with the same issues that you are. So by the time she put the IV in, it was probably closer to 4:30-5 o'clock and she says to me, "Have you eaten?" And I was like, "Yeah, well I ate before I came. But that was like 10:30-11 o'clock in the morning." She was like, "You must be hungry." She's like, "Let me see if I can get you cleared to eat again before we start the process." And I was like, "Yes, let's do that." Because I had no idea how long this would last. And I remember you telling me how long it could last, and learning in the class, how, you know they just, they, they cut you off from all types of food and you know I had some snacks that I had snuck in with me and I was kind of like "I will eat these if I really feel like I have to," but they get to your head, right? Because they tell you you can only have ice chips and you can only have water. And even that, like the water, they're just like, "Sip tiny amounts of water." But it was great because she's like, she went back to my OB GYN that was on call that would be delivering the baby for me that day. And she got the approval for me to have a full meal before I started the induction process. So I was like "Fine, go! Go downstairs, go get us, go get us dinner." So I had a sandwich, I had a soup, I had chips. I was like, I have like a full-on meal, like probably a much larger meal than I would have on a regular basis. But I was like, it was like my last meal, I didn't know when I was gonna get to eat again. So I took full advantage.

Lisa: 22:34

And I don't think you said mentioned where you were giving birth. Do you mind mentioning that for the benefit of local listeners?

Jennifer: 22:39

Yeah, absolutely. So I was at Long Island Jewish Medical Center, which is a really brand new facility, Katz's Women's Medical Center. And it was, I think it was constructed in 2012 so it's been around for less than 10 years. So it's a brand spanking new building. It's really a beautiful,

Lisa: 22:58

It was renovated.

Jennifer: 22:59

Kind of like, yeah, it was renovated. Okay.

Lisa: 23:02

I was just going to say I worked there as a doula before the renovation once, and then once after the renovation. Like, night and day difference. Like, yeah, it was like a brand new facility.

Jennifer: 23:17

Yeah, absolutely. So, and that was one of my deciding factors for, for giving birth in Long Island Jewish Medical Center because every patient gets a private recovery room. You can get that in Manhattan at Mount Sinai, NYU, some of the hospitals. But you're paying a premium for it. I know some of these hospitals charge anywhere from like $800 to $1,200 a night just for you to have your own room. And that was kind of out of our budget,

Lisa: 23:41

Sure, out of most people's budget.

Jennifer: 23:44

Yeah, exactly. I just, it's, it's a high price to pay for the comfort of being able to recover in a room on your own. And I remember, you know, my, my sister gave birth in Manhattan, in the hospital and she had a shared room and I remember, you know, it was just kind of uncomfortable. You know, the other patient has guests coming and you know, if you have the baby in the room and one baby starts crying it might wake up your baby if she's in the bassinet next to you. So there was a lot of reasons I wanted to go with a private room without the premium. And for me, I live in Queens, so it was a good fit. It wasn't too far away. It was probably an extra 10 minute drive from what one of the Manhattan hospitals would have been. So it worked out. So, back to...so I'm back in labor and delivery. I have my full meal and at this point it's almost 6:00 PM and they start the induction process and my OBG YN came in and started talking about how we were gonna start the induction process. And she actually, we opted for Cytotec and I wasn't familiar, very familiar with Cytotec. I knew it was one of the drugs we had talked about in our class, you know, Cytotec and—what's—Pitocin. And I think there's at least one other, but what I liked about Cytotec was it was just a small amount of liquid in a little shot glass. It was colorless, it was tasteless. And it did the trick. I was, I was very lucky because I started on Cytotec at 6:00 PM and every two hours I took a larger dose and they kept doubling doses. So I started with, let's call it 30 mls and then the next dose was 60 mls and the next dose was 120.

Lisa: 25:32

And it sounds like you were taking it orally.

Jennifer: 25:35

I was, it was orally. So they'd be like little shot glasses that you just, you just drank really quickly. And like I said, they were colorless, tasteless. It was, it just felt like I was drinking a little cups of water to be honest. And I kind of almost felt like, "Well, this isn't gonna do anything. Like this doesn't seem like it's going to do the trick." But, I would say by midnight, I started to feel something. I started to definitely feel the contractions. But they weren't, they weren't super strong. Like I was able to breathe through them and, and use some of the information that, I had kind of gathered myself and I had learned in class about how to work through the pain and find comfort. So what I was doing was—they have you hooked up to the IV and they have you hooked up to the monitors. And I had asked for both, I asked for wireless, if they had wireless monitoring, which they didn't. And I asked if they were willing to do the Hep lock so that I wouldn't have to be tied up to the IV and I probably could've pushed for it more, but they were like, "No, you have to have an IV, you have to have enough liquid. It's not something that we recommend." And I kind of just accepted it, but what I was able to do, and probably to my nurse's chagrin, is I got up quite a bit. I kept disconnecting myself and grabbing the pole and walking to the bathroom and walking around the room. And you know, Juan was so sweet—my husband, he had created a playlist and we had this really calming music in the background and music also that we just loved that we've always listened to together, kind of like the machaca from our wedding and slow music that we've always liked to listen to together and [inaudible], which was this artist that I love and I've always listened to when I want to relax. And I remember at one point they were starting to come and getting really painful and Juan came over and we were just looking at each other and I put my arms around him and I, and I started kind of just swaying back and forth and doing some of the moves that we had practiced in class together and it really did help me quite a bit. I will say that there was, they had the huge kind of gym ball, I forgot what it's called.

Lisa: 27:50

Exercise ball, or...

Jennifer: 27:51

Exercise ball, there you go...that I had bounced around quite a bit in the days upcoming to the induction that I was kind of using to like loosen my pelvic area. And just, you know, get kinks out of my back and feel comfortable at home. I didn't use it at the hospital, I felt a little, I guess because I was attached to the IV, I just kind of was worried. I was like, I feel like I'm so, it felt too cumbersome with these wires and stuff. Like I do see that if I, if I hadn't been hooked up to all of those things, how I would've felt more comfortable in my own skin and kind of like moving around more aggressively. But I just, I just did, I would lay down and then when my back started hurting or I started feeling uncomfortable or tired of being in the same position I would, I would unhook myself. I learned how to unhook myself. I 'd throw the, the wires over my shoulder and I just walked around and at one point one of the nurses came, and she's like, "Are you still in the bathroom?" And I was like, "Yeah, I am." And she's like, "Do you feel like you need to poop? Because if you feel like you need to poop, well we don't want to have any babies in the toilet, so please don't stay on the toilet and start pushing." And I was like, "No, no, I'm just kind of taking my time." I just, she was like, "Okay, you just want to kind of hang out outside of the bed." I was like, "Yeah." And she's like, "All right." So you know, they really didn't want you doing that because they want to constantly be looking at these monitors and know that you're okay and the baby's okay. But they didn't give me a hard time. Like I was able to get out of bed for at least five to 15 minutes at a clip and kind of like do my thing around the room and then go back into the bed. At certain points I wanted to lay down because I was, I was in pain and sometimes laying down and kind of curling up a little bit, felt good. So I...

Lisa: 29:28

It can slow things down. So sometimes if we're like not ready to lean into the pain, sometimes lying down can slow it down. And it makes it more tolerable sometimes. Not always, but sometimes that's what's going on.

Jennifer: 29:40

Yeah. So I definitely laid down a few times and, and felt like, "Okay, this is getting pretty painful." And so the Cytotec keeps coming and I got all the way from the 6:00 PM to the 2:00 AM dose and at that point the pain was, was bad enough and the contractions were coming strong enough that, you know, there was no way I was getting sleep or rest at that point. It was just okay. Like I'm definitely in labor and you know, the nurses kept coming in and checking on me and I was, I was doing the ice chips in the water and Juan was good and I was good, but we were still kind of in that space of, you know, "This is happening" but it's not got, the pain is not unbearable at this point. And I didn't know exactly how many centimeters I was at that point. Obviously when I had first gotten there I was at three centimeters. But I also remembered not necessarily getting those checks too often because I didn't want to feel like I hadn't progressed enough or—you know, it's been five hours. Why am I only at three and a half centimeters or four centimeters? So I didn't want to ask for more checks than they kind of were willing to offer and to my surprise and I was actually happily surprised that they weren't coming in constantly to like check, "Oh hey, how are you progressing? How are you progressing?" They were just coming in and seeing that I was having contractions on the monitor and they're like, "How are you feeling? How are you pain wise?" And I'm like, "It hurts, but I'm, I'm okay," like "I can deal." So I kept pushing through the pain and doing a lot of the breathing exercises too, that we, we reviewed in class, and the music was super helpful.

Jennifer: 31:19

But around, I think it was around 3:00 AM I felt water, just a gush. And I was like, "Okay, either I peed on myself, which I don't think is the case because I've been getting up every 20 minutes or so to pee"—even when I don't have to pee, just because I wanted to get up and walk around. I was like, "This, this feels different. Like I think my water might be breaking." And the nurse came in at that moment and I was like, "I'm thinking my water broke." And she, she's like, "Really?" And I was like, "Yeah." And she's like, "Okay." And I was like, "I want to get up." And she's like, "Okay." She's like, "Hold on before you get up." So she, she laid out this, this large, like, I don't know, like human size, weewee pad. It was like, like a medical waste kind of throw, I guess. Yeah. And so there's this huge square under me and she's like, "Okay, you can get up". And so I got up and I walked over and at that point was like, it was like in the movies, like, it was this huge gush. And I was like, "Whoa, like this..." And it was super warm. And when I looked down there was this bloody kind of clotty thing on the floor and I was like, "Ooh, is that my bloody show?" And she's like, "Yeah." And and it was, it was really kind of exciting actually because I was like, "Oh this is happening," you know, I was like, "Oh and I—and my water broke and they didn't have to break it for me which is another thing I didn't want to have happen, right, because I always knew like one, one intervention will lead to more interventions and the more things happen on their own the better. So I was, I was really happy about that and I kind of—but I kind of felt gross after that and I was just like, I kind of like, "I want to clean up." Like they're like, they're like, "It's going to get a lot worse." And I had bought my own labor gown and I was like, "Oh, should I put this on?" And they're like, "No, you shouldn't." Like, "Because you're going to have to like—it's going to be—like you can if you want to, but it's going to get really messy." And I was like, "Okay." I kept my hospital gown on. I'm glad I did actually because it really did get really bad and I think I cleaned myself up or I asked for stuff to clean up a little bit and I laid back down for a bit because the pain started to get really bad.

Jennifer: 33:31

And then I got up again and I was trying to push through it and breathing and doing a lot of like rocking back and forth. And Juan came over and at one point while I was laying down, he was putting his fist into my back and into like my lower spine area and doing some of those exercises that we had learned. Like he did a few things that are really helpful and at a certain point like he tried to do something and I was like, "Please don't." I was like, "Stop, like don't touch me, right now, it hurts. Like I just, I, like, nothing you're going to do right now is gonna help the situation" and I think he, I think I hurt his feelings a little bit, because he was like, "Oh okay," he walked away. I was like, "Thank you for trying, honey, but I'm going through a lot of pain.

Jennifer: 34:11

And at this point, I'm crying during the contractions and they started to come really fast and furious. They started to like, I wasn't getting a break to recover in between. And what had happened before was I was getting breaks, you know, as painful as it was, it would go away and I'd have at least a couple of minutes to breathe to be okay, and then be ready for the next one. And at this point I was getting a contraction. It would go away for, I don't know, 10 seconds maybe. And then back. And I was in the room and I—at that point, I'm laying down and I'm on my side and I'm crying and I'm shaking and Juan comes over, he's like, "Are you okay?" And I was like, "Not really." And the nurse comes in and she looks at me, she's like, "I can see on the monitor." She's like, "They're coming really strong and really fast." So the resident comes in and she says to me, "I'm going to speak—I'm going to call your doctor to have her come, you know, check your charts and check on your—and check on you. You know, if you haven't progressed to the point that they would expect, they may decide to put you on Pitocin. And once they put you on Pitocin, your contractions are going to most likely get worse and you're going to be in more pain." And I was like, "Okay, great." So I'm, I'm already in a lot of pain and I feel like I'm already progressing quite a bit. And they're like, "Do you want pain management?" And we had talked about the pain management options, a little bit beforehand in terms of the, the few different drugs they could offer me. And I was already in lot of pain. And at this point it's about 3:30 a little, a little after 3, right? Because my water broke at 3 and this all happens in like the next 20 to 30 minutes. And I just said, "I want to get ahead of the pain. I don't, I don't want to like, if it's gonna get worse than this, especially if they decide to put me on Pitocin. I don't want to feel like this for the unforeseeable future." Right. Because I, I can, she checked me at that point. I think I got checked at that point too. And I was at, I think it was at five centimeters, if I'm not mistaken. No, not yet. Not yet. No, I hadn't gotten checked yet. That was later on. That was after my epidural. So at that point they're like, "Would you like the epidural?" And I'm crying and I'm in pain. I was like, "Yes, please." So I ended up getting the epidural at about 3:50 in the morning. So it was kind of amazing actually how quickly it happened. And I think I was in some ways kind of lucky in that sense because I've heard of women asking for an epidural and then having to wait for a long time. I asked for an epidural and then it was no more than 20, 25 minutes by the time I asked for it and the time I was in bed and I was like, "Whoa, this feels great."

Lisa: 36:47

Great. Yeah. That's about the quickest it can happen. So I'm glad to hear that.

Jennifer: 36:52

Yeah. So the doctors, the anesthesiologists were called, it was a team of two people. They were actually really jovial and like they'd kept making all these jokes and they walk in and they're just like, "Hey, we're here to help. We're going to get rid of this pain really quickly." And they're like "Big"—they're like "Big pinch and a burn and then, and then it'll feel good." And I think I was really kind of scared of the epidural because I, you know, I did a lot of research about it and I knew all the kind of the side effects that were—could possibly happen and if it goes wrong and if they don't hit you in the right spot and then having to potentially do it again. And, I've heard some women that have a very painful epidural experience and I, I've, I have some friends, including my sister, have had to, they've had to go in more than once because they haven't gotten the—hit the right spot. And, and then even worse stories, right, about really long-term back issues and long-term pain and all of these other things. And at that point I was just in so much pain. I was just like, "I, yes, I want the epidural." And fortunately for me, it really was a great experience in the sense that it was really quick. It wasn't painful when it went in. I mean, like they said, it was a pinch and a burn. It wasn't any more painful really than my IV was. And I laid down and just within a few minutes that terrible pain that was making me cry had gone away.

Lisa: 38:13

Wow. That's the most ideal.

Jennifer: 38:17

Yeah. I mean, I was a bit of a, a critical decision, right. Because at that point I can't get out of bed anymore and they put the catheter in. So, you know, I, I can't go to the bathroom anymore on my own. And I did—I had in my head that I wanted to wait as long as I could before I got to that point. And you know, I did make it for, for a few hours, but I also had in my head that I didn't want to really suffer. I didn't want to be in a lot more pain than necessary. And at that point I felt a lot of pain. And I also wanted, I wanted to give myself a good shot to have the strength and I guess the reserves to push this kid out, especially after, you know, kind of everyone had freaked me out a little bit about how big she was and whether or not I would be able to push her out. I was like, "I'm going to take the pain medication and, and, and hopefully that will help me get to where I need to get to." So at the end of the day, I don't regret the decision and I think it was the right one for me at the time. So it worked. I was in no pain and then I just had, I kept having my contractions. I, I was in bed at that point. Like I said, I had the catheter and I couldn't walk.

Lisa: 39:33

Oh, can I ask you a question real quick before you move into...When the epidural was administered, I was just curious, did Juan stay with you or did they have him leave the room?

Jennifer: 39:44

Oh yes. So they did have him leave the room and I was expecting that because I remember that was one of the things we had talked about in our classes and I was like, "Why? Why does he have to leave the room?" And he was there and they gave me the same line that, you know, you told me to expect, which was like, "It's a sanitary issue or kind of control of..." I was just like, "Okay, that's fine." The nurse was really nice. When she sat in front of me, she's like, "You can grab me if you want." I was like, "I don't want to break your hand." I was like, "I'm pretty strong. Just pass me a pillow." So I was expecting like this, this terrible pain. So I, I braced for it. I grabbed the pillow and I put it in front of me and I actually bit it. I bit down on it while they were, while they told me when they told me they were gonna give me a shot and it was just, like I said, it was just so much less painful than I had imagined it would be. So in that respect, I was lucky. I felt like, you know, that it was smooth, it did the job and everything worked out well from the epidural perspective.

Lisa: 40:42

And did you find it hard to curl into the C? I've had students who've said that was so hard to curl into a C like you have to do with your back.

Jennifer: 40:51

Yeah, I mean it was, it definitely wasn't pleasant, but I wasn't in that position for very long. And I think for me the bigger thing was "I don't want to move. Like I don't want to move and mess this thing up for these guys." Right. So I was just like, "Tell me what to do and how to do it and I'm just going to do it." And, and yeah, it was definitely that whole curl curling into yourself. It wasn't a pleasant situation, but it was, it was over pretty quickly. So it wasn't too bad.

Lisa: 41:16

And were you sitting up or were you laying down on your side for that?

Jennifer: 41:20

I was sitting up, so I was sitting on the edge of the bed and I curled over and, I think what really helped too was the attitude of the anesthesiologists because they really were, I mean, they were just, I don't remember the jokes. Oh, they asked me what I did and I said I worked at a bank and one of them was like, "Oh, can we go, you know, we can go rob the bank after this, and all be rich, and can do something else." Like he made a couple of jokes and like, really kind of lightened the whole mood. And they were also very, like, she explained everything, like very like step-by-step. She's like, "This is what we're going to do. This is how we're gonna do it. This is how it's going to feel. This is what you can expect." And so it didn't, it took the fear out of it and then I kind of just, I braced for the pain and the pain didn't really come. It was like they said, a pinch and a burn. Yeah, and the pain went away. So, so I was overall I was, I, I left kind of being the believer of epidural. I was like, "Okay."

Lisa: 42:15

Sure.

Jennifer: 42:17

I know other people have had bad experiences, but

Lisa: 42:19

Yeah, plenty of people have good ones. Sorry to have made you backtrack. Proceed.

Jennifer: 42:26

No, not at all. So epidural's in, and I'm feeling much better. I'm laying down. Catheter's working. I'd say within about an hour, an hour and a half, I was like, "Something's wrong, something feels wrong. I feel a lot of pressure, but it wasn't pain." And so I called the nurse and I was like, "Is something wrong with my catheter?" Because it felt like I had to pee really badly and it didn't make sense because they had the catheter in. So the catheter is releasing any fluids in my bladder and I just felt—like not even during the whole pregnancy where I constantly had these sensations of having to pee and I always had like, it was just such a strange amount of pressure and I thought that that was it, but it wasn't. It was the baby. It was like the baby. It was the baby trying to get out of me. And that pressure, because it was masked by the epidural, I couldn't differentiate that this was not pain coming from your need to pee it was pain or pressure—it was not even pain because it was, you know, it didn't cause me to to cry or to have any real pain. Like I said, it was just really uncomfortable and a lot of pressure and I kept associating it with my bladder for some reason, but it was it just the act of giving birth, it was this baby trying to come out of me, but I didn't, I couldn't accept that for some reason because I guess the epidural had masked that sensation for me so quickly for an amount of time that when I started to feel that pressure again, I was like, "This is just weird." But it was the epidural wearing off and me starting to feel some of the sensations of giving birth again, but because those sensations are now masked by this very strong drug, your body can no longer really tell you where it's coming from and, and that I found to be strange. Right? So the nurse came in and she's just like, "No, your catheter is fine. I think I made her check like two or three times and this poor woman must be like, "Okay, crazy woman, like, your catheter is fine. I can see the fluids." And I'm like, "Okay, okay."

Lisa: 44:25

I thought the nurse would have gone to get your OB to see if maybe you were fully dilated. But that's not what she did?

Jennifer: 44:32

No, no, I, I, you know, I, I think that I almost was avoiding the checks because I was like, "Once the baby's here, the baby's here. Like they'll, I'm sure they'll catch on." When, you know, I'm fully dilated like someone will check at some point. Right? But I think it was just me further dilating. Right. I don't know. I don't think I was in transition yet at that point. I was definitely just kind of in the thick of it. But again, you're, you're masked by the epidural so you know, it's, I'm sure if I had not had the epidural at that point, they probably would've called the OB GYN because I probably would have been like hollering because I would have been in pain. But at that point Juan lays down, he's trying to sleep and I just found it really amusing because he's trying to sleep and I kinda, I think I was like, "How are you honey?" Or I asked him something and he just said, "Oh my back hurts" because it's like, I guess that the pull out bed that was there wasn't very comfortable and I was like, "Huh, really? Your back hurts? Cry me a river. Like, really? You're back hurts? I'm in labor, I'm giving birth to your child. Don't tell me your back hurts. Like it's really funny. Yeah, it was just really funny because I don't even think he thought about it when he said it like, he was just like...I was just like checking in on him, and I was talking to him and he was just like, "Oh yeah, no, my back hurts. This bed is uncomfortable." I was like, "Really?"

Lisa: 45:48

Oh, honey, do you need an epidural?

Jennifer: 45:52

Seriously, I was just like, "Let's not make those comments here in the labor and delivery room as your wife is giving birth." So that was really fun. So he's trying to sleep, I'm trying to get some rest, I'm on my left side. I'm constantly throwing this monitor off my belly. It's because they don't have a wireless one. I wish they had wireless, but as I'm moving, it's constantly getting out of position and then they can't find the heartbeat. And so then I'm moving it for them at this point because I don't want them to have to keep coming back into the room. And then like I just kept wanting to move. I didn't want to be in the same position for too long because it got uncomfortable. So I will say that that part of the whole process was pretty annoying because it was just constantly making sure that those monitors were in the right place so that the powers that can be outside could, could watch screens and tell me everything was okay or, or be able to tell that everything was okay. And that was kind of frustrating. But just, I kind of just relaxed for a while as much as I could with that pressure feeling and tried to sleep. I'm very sensitive to light. So my husband had bought me one of those kind of covers that you use when you sleep. So I was trying to use that. That was really somewhat helpful in just relaxing me then because it kind of let me kind of tune out all of the things around me and, but getting any real sleep, even if I hadn't been in pain I think would've been difficult just because of the noises. The noises coming from the machines and the beeps. And then when the monitor falls off where it's supposed to be, something starts beeping and the IV bag runs out and then that starts beeping. And you know, if I got up and I went to the bathroom and before that, but know before the epidural, like that was—a lot of noises.

Lisa: 47:33

Yeah. That beeping can be so, so annoying. And it's very, very common. Yeah.

Jennifer: 47:39

Yeah. Which is why like I, when I think of like a home birth or a more natural birth versus kind of the birth with all of these kind of apparatuses and medical devices and everything, like, I could see kind of the, the huge advantage to that. Right. But at that point when I had the epidural, I also saw the huge advantage to that. Happy to have access to that.

Lisa: 47:59

Yeah, sure. And, and you had an induction which often is harder to tolerate, too. Yeah.

Jennifer: 48:05

So at this point, like I said, while I was laying down, I was fulfilling that really tough pressure and then it just escalated from there. I'd say it was probably at this point around between 6:00 AM to 8:00 AM I'm back to "Wow, this is very painful." And breathing through contractions and expecting them and at a certain point they were still manageable because I was getting a little time in between them again. I'd say by, I think it was by, by 9:00 AM I was again on my side shaking and pushing because I felt the need to push. I mean the pain was such that Juan came over, the nurse came back in and was like, "They're coming really hard and really, really close together again." And he came over and he looked scared cause I was, I guess I looked, looked like I was in a lot of pain obviously. And he's just like, and he looked at me and I could tell like he was getting emotional because I mean I think it's hard for you to see the person you love in so much pain and not being able to do anything to help really. I'm sure there's a sense of helplessness there and, and I felt bad for him in that moment. I was like, "It's okay." And he was like, "No, I'm fine. You're fine and we're going to be fine." I was just like, "I know. It's just...it hurts." And that's where I was. I was struggling not to push. Like I remember at that point the resident came in and they did a check and I think I was between five and six centimeters and they're like, "You can't push. It's too early." And I was like, "Well, my body is making me push." Like I felt the need to push and I think I must have gone from probably six centimeters to nine, like really quickly because that hour got really intense. I would say it was, again, between nine and ten in the morning and I was just in so much pain again and it was so strange to me because I was even in more pain than I had been in before I got the epidural, which makes me think mentally like how bad would it have been if I had not gotten the epidural?

Lisa: 50:10

Well, or did it—was it a continuous feed, I wonder? And if it—had it started to wear off because I think you said a few minutes ago that you thought it was kind of wearing off some.

Jennifer: 50:21

Yeah, so it had definitely started to wear off, and there was a button, right?

Lisa: 50:25

Okay. I was going to ask you if you had that.

Jennifer: 50:28

So I start pressing this button like there's no tomorrow. At one point the button falls and I can't get to the button. I'm like, "Press the button, Juan, press the button." So he grabs the button. The nurse walks in and she's like, "You can't press the button. Only she can press the button," and I'm just like, "Someone press the button, just press the button please, because I'm in pain." And then she's like, "Okay, it's gotten really bad again." She's like, "Do you want me to call the anesthesiologist and increase your dose?" And I was like, "Yes, please. I didn't know that was an option." Like I like, I guess it was mis.... I guess like any medicine, right, it wears off or if the dose isn't high enough, you're not going to feel the effects. And in my mind, like once I had the epidural, like you're done, especially if you have the button and you can give yourself some, but I don't know if the protocol is for them to use a smaller amount, the smallest amount that they deem necessary, and over a certain amount of time it kind of wears off or whatever the case may be. But she's just like, "Yeah, no, we can call the anesthesiologist and have them increase your dose." I was like, "Yes, please." So at this point it's close to 10 o'clock, the anesthesiologist is called, he comes in, he reprimands Juan for pressing the button, and he's like, "You can't press a button for her because it's kind of the fail-safe for making sure that the patient has enough strength to press the button, because if the patient doesn't have enough strength to press the button then they've taken too much medication and they shouldn't, someone else shouldn't be doing it for them. So make sure that she's the only one that has access to the button" and I was like, "Yes, okay, thank you. Point taken, we'll be careful with the button." He came in and he was just like, "Okay, I'm going to increase the dosage and the frequency of the epidural." I'm like "Okay, please, thank you." Because at that point I was like I said in the worst pain I had been in and it wasn't going anywhere. Like it was really like on top of each other, these contractions, and you can watch the monitor, too, which kind of psyches you out because you start seeing huge peaks and they're just one right after the other. And I was like, "Whoa, no wonder I feel the way I do." And he increased the dosage, and then all of a sudden I'm back to, "Wow, I can do this for another 12 hours. Like easy, like I don't feel bad anymore." But it was a strange thing because I stopped feeling the pain. I went pretty numb pretty quickly. And you know, you feel relief, you feel relieved because you went from feeling this really, really excruciating pain to, "Okay, I can breathe again. I feel pressure, but not pain.

Jennifer: 52:58

And so I'm laying there. And even the pressure was very minimal. And they call the OB GYN and the, the resident comes, no, the resident comes in with a nurse and was like, "We're going to check you again because you were in a lot of pain just now." At that point they're like, "Oh wow, she has really dark hair." And I was like, "Whoa." I was like, "So you can see her head?" And they're like, "Yeah, you're 10 centimeters, you're gonna, we're going to start pushing."And it was like, "Wait, what do you mean we're gonna start pushing?" I was like, "I feel fine." Like, "Let's not rush this." Like, because I didn't feel pain anymore. I was like, "Why are we going to push now? Like I feel good, like I, we have time now," and they're like, "No, you're, you're 10 centimeters. You need to start pushing." And I'm just like, "But can we let the—" so this was my issue, right? Right before I got epidural, I was in so much pain, but my body was naturally pushing on its own. Like I just, I felt the urge and I felt the need and I knew how to push because my body was just doing it for me because that's what you do when you're in that kind of pain and you're in the labor process. Now that I had this epidural, I didn't feel that and I didn't know how to push or what to push. And I knew that—and I knew from, from the class that we took with you, Lisa, that, that, that lack of feeling of, of having to push can lead to a larger tear can, you know, create more stress and kind of physical trauma on you because you're pushing kind of, you know, in a fake manner, in a, in a, in an artificial way because you're being told when to push as opposed to feeling the need to push. And, and I felt that so distinctly before I got that increase in the epidural. And once I had the increase and I just felt the pressure and I was like, "Okay, you know, I know it's a contraction, but it's not forcing my body to push. It's not forcing me to feel like I need to push." And they're like, "Well, it's time. So this is what's gonna happen. And so at that point the doctor, the nurse and the resident go, you know, "We're going to show you how you need to push." And so they put me up in the stirrups. I go down to—or not, I guess it's not stirrups—like these contraptions to hold your legs and they show me how to hold my own legs. And they say, "Well, when you, when you start to push, you're going to push in three consecutive pushes, and you're gonna you know, breathe in and push out.

Jennifer: 55:16

And I remember that he said to me, "Imagine"—and this analogy actually really worked well for me because I'm kind of a visual person—and they said to me, "Imagine a tube of toothpaste kind of curling into itself. Like you need to put your chin down and curl upwards a little bit and push that way, and make sure that your put that your, you're breathing from your stomach and not just—not pushing from your face." They're like "You're pushing from your face, push through your body, like push through your bottom." And I also knew that if I started pushing and the pushes weren't effective, that I was going to just be using up all this energy and it wasn't gonna progress, it wasn't gonna help. And I also knew that if I didn't go through those three pushes progressively and really continue to make progress that the kid could basically start to come out and then get sucked back up again. And I remembered, you know, kind of learning all of these different things and saying like, "I'm gonna, I'm gonna push like I've never pushed. Like I'm going to do exactly what they told me to do." And I remember being super laser focused about just bearing down and counting when I was supposed to and breathing how I was supposed to, and the minute I felt myself pushing from my face I would stop and make sure I was bearing down and pushing from my bottom. And they were kind of impressed with me, I would say. I would say that the nurse and the resident kept looking and they're like, "Oh good progress, you're doing great." And it's still kind of surreal because you have these two people at the end of the bed and they're staring at your vagina and like giving you words of encouragement and telling you like, "Oh, good job." Like "Awesome." And I was like, okay,

Lisa: 56:53

This is new...

Jennifer: 56:55

Yeah, exactly. Like it was just so crazy and Juan is I, you know, I didn't want Juan to have like a front row seat to that. So he's to my left side standing by my head and he's just like holding my, was he holding my, he was holding my hand at one point or like just holding my hand. He bought actually what he did that was really great was cold water compresses. He was putting it on my forehead because I was really hot and just like I just, I was like burning up and he was just like, he was like wiping my head and getting rid of the sweat for me and like saying really sweet things. But I wasn't really listening to him because I was just trying to push. And they're—they just kept coaching me through it. And I will say that both the residents and the one nurse, I wish I remembered her name, I think it was Natalie, I don't remember. But she was great but she was just really encouraging and she kept telling me what I was doing right and what I was doing wrong. And things I could be doing better. And they were both just like, "Oh wow, you're doing a great job." Like this is, you know "You're progressing really well." So I started pushing at 11:50 approximately and probably around 12:30 the two of them just look at at each other and they're like, "Okay, where's the doctor? Where's the doctor? Did you page Dr. Ostroff? Did you page Dr. Ostroff?" And it was like a comedy of like—I was like, what's going on here? I was like, "Could someone page the doctor?" because they realized in that moment, like, I think because they had all been under the impression like "This is a really big baby, like, she might not be able to push him out." And my doctor, when I, when I first—I forgot to mention this, when I got into the L and D room or maybe even before in triage, she, she kind of prepared me. She's like, "I'm going to have some extra people in the room with with me. When you get to the point of having the baby and we're going to use the stairs that are going to be over the bed. So in case you need help in pushing the baby out or I need an extra set of hands to help, you know, twist the baby out of you if the baby's too big. I had someone there, so don't worry if you see like a lot of people around you" and I'm just like, "All right, well you know, thanks for the heads up."

Jennifer: 59:00

But I think kind of the expectation was like "She's going to have a hard time pushing this kid out." So when I started pushing at 10:50 and by you know, 11-11:45 or whatever and I was, the baby was born at 12:50 so it was 11:50 when I started pushing. So after 12 they see I'm making really good progress and they're like "This kid—this kid's almost here." And they finally get in touch with the doctor and as soon as—like right when they're about to like be like, "Where is she?" She walks in like a superhero all of a sudden, like she was just like, "Hey!" she was like, "I'm here." She's like, "Oh." She's like, "Oh wow, great. Look, look at you, like, she's almost here." She's like, just, and I literally did one or two more pushes at that point and she just flew out of me. He just came right out there, like, and, and it was just, it was amazing. Like it was amazing. I looked at Juan and he just instantly started crying because he saw her and she cried. She cried right away. Which was great because you know, you hear the crying and you know she's okay, you know she's breathing, she's alive. And so they did the delayed clamping. So they waited a little bit and they asked if he wanted to cut the cord and he did. So he cut the cord and I remember they took her to the side, just—couldn't have been more than five to seven minutes. But I remember saying, like, "Give me my baby, where's my baby? Like, do whatever you need to do, like, with her on top of me, but I want her now. Like I, I, I need her back. So they had taken her to I guess, see the, what's, what are the, what's that test? The AG-GAR?

Lisa: 60:41

APGAR. Usually they do that with the baby on you though.

Jennifer: 60:44

No, they didn't. So, so they took her to, to measure and weigh her and they did the footprint because I could look over and they were putting her little footprints on a piece of paper and I was just insistent, and it couldn't have kind of been more than, like I said, like five to seven minutes or something. But I was like, "Give her back to me. Give her back to me."

Lisa: 61:02

Yeah, yeah. Good for you.

Jennifer: 61:06

They're like, "We need to do the vitamin K injection and the eye ointment," and I was like, "Can't you do that while she's on top of me?" And they were like, "Yeah, of course." And it really wasn't a lot of time, but there was amount of time that she was taken away before I had her. And then they brought her right to me and I opened up my gown and I put her directly on my chest and it was amazing. It was this she, she was, she was, she was so chunky. Like, and that was a thing, like the minute they weighed her, where like everyone knows like the big question is, like, how much did she weigh? How much does she weigh? They thought she was going to be this massive baby and she ended up being eight pounds and 14 ounces. So she was, she was big. She was almost nine pounds. She was two ounces off from being nine pounds. But interestingly enough, MFM that had scanned her twice that same day thought she was closer to eight pounds or closer to a high seven pounds. So it just goes to show how inaccurate these scans are and how you really, you can't, you can't make decisions based on that because it's a guesstimate, and just like she was nine pounds—she could have been closer to eight. So who knows? She was 22 inches. So what saved me and my vagina was that the kid was big, but she's long. She wasn't, she didn't have this massive head. She wasn't like super wide. She was, she was longer than, she was wide. So I did end up with a tear, a second degree tear. And you know, they, that's what it was. I think she didn't, she was stitching me up before they passed the baby back to me. She wanted to finish stitching me up. So she stitched me up. Maybe had— she was weighed, measured, little footprints. She came back to me, she's on my chest, Juan is crying, I'm crying. And she was perfect. And she laid there for a little while and then I let her get closer to my breast and she latched on. And it was crazy how, how she did like how awake she was and how quickly she latched onto me. Like I didn't think that that would happen at all. Like I was just like, wow. And I remember watching the video that you had recommended in your class and it was just that, it was kind of this baby that was laying on her mom and just kind of crawled over and found her way to the breast. And you know, I remember being like, that's, that's some like magical, special stuff that doesn't happen for every woman, right? And she did though, like, I mean, I definitely assisted in terms of getting her closer to my breast and, and knowing how kind of important that, that, that time was right after and making sure I had the skin-to-skin moment, but I didn't, you know, I didn't have the expectation that she would latch on, but she did.

Jennifer: 63:47

So we had that moment and then, I can't remember how long we were there and she was with me before we got moved to the recovery room, but I think it was a little under an hour, that I just held her and it was really great. So she was perfect. She was super healthy. She passed all her tests with flying colors, but at that point they had that, once they had put on, I remember that ointment, like being kind of the, the ointment they put on the eyes like I remember being like, "Oh, that seems aggressive and unnecessary," but I guess it's one of those non-negotiables. So let's go with it. And then the vitamin K—she did cry a little bit when they, when they put that injection in right away, but she calmed down pretty quickly after it and yeah, that was, that's, that's how little Emma Sophia came into the world. It was pretty awesome.

Lisa: 64:43

Oh, thank you for sharing. And did she go for a delayed bath? Around the time you were transferring to postpartum unit?

Jennifer: 64:53

So I didn't want to have her bathed that first day, so I asked them to wait until the next day. And I remember you had told us, you know, you can have them be bathed as soon or as late as you want them to. And I was like, I was like, I want all that little stuff, all of the different...

Lisa: 65:09

The vernix.

Jennifer: 65:11

Yes, the vernix. I was like, I want it all rubbed into her little skin well, and she was just so little and warm and comfortable. I was like, I don't want, I don't want to put her through that. And I think I was also a little biased, because I remember seeing them bathe my niece and I remember her just crying so hard and like I just think like, "Oh no, I want to wait as long as possible." And I ended up having her bathed the next day and it's like 24 hours later and I had them come to the room, and bathe her in front of me.

Lisa: 65:42

Oh good. What a great idea.

Jennifer: 65:45

They gave us—yeah—they gave us the option, like "We'll take her to the nursery," and I was like,"Can, can, can someone come do this here?" And they're like, "Yeah, we can actually do it in the room for you." So it was much nicer because it wasn't me doing it, but I was standing right there. Dad was standing right there. We got to take a little video and you know, she cried but it wasn't as traumatic as I think as a, as it would have been if she had been taken to another room. And...

Lisa: 66:09

When you're out of her line of sight, she doesn't know that you still exist. So it's pretty upsetting for these little babies so that's wonderful. I'm glad they were able to do it in the room with you.

Jennifer: 66:21

Yeah, absolutely. And everything else really. So they wanted me, they wanted her to go to the nursery for the hearing test, and I, and every time they wanted to take her somewhere I was like, "Can they come here?" and they accommodated. And I, I was, I think I was only separated from her once while we were there and Juan went with her to the nursery. I think it was for her TB shot, if I'm not mistaken. Or, no, her HEP-B, her head. The shot was, definitely her HEP-B, but the, the heel stick, the hearing tests, those things, they came to the room and they did them there because they, they came to do the heel stick and they were going to take her. And I was like, "Well, my husband's not here to go with you. So either come back later when my husband could go, or you do it here."

Jennifer: 67:08

She's like, "Okay, I'll bring the stuff. We can do it here." And she was so good during the heel stick test. She didn't even cry. She didn't even, it was like she didn't feel it. She totally just, she was like, "Wow!" She's like, "What a calm baby." And she was a little champ. But I will say that those first few days were exhausting. I definitely never felt as tired as I did that first week I would say. And breastfeeding was really hard for me, figuring out how to make it work and not have anxiety around her not getting enough. I was induced on a Saturday. She was born on Sunday morning and then she came home on Tuesday and I had a lactation consultant come in on Wednesday, which was great. Having that happen sooner rather than later. And I did have lactation consultants that I met with at the hospital.

Jennifer: 68:01

I will say that the level of care I received at Long Island Jewish Medical was, was really great during the labor and delivery part of the portion of the experience. And afterwards, not as much. Some of the nurses I really liked. And then some of them just didn't seem like they were going an extra—kind of taking that extra step to make you feel really cared for. It was, you know, and some of the nurses aides were really, kind of the bare minimum, you know, you'd ask for something and they just kinda like drop it off. And then one night I remember was really struggling and I felt like we really needed to get some sleep. And I called in one of the nurses aides and I said to her, I called the nurse and the nurse didn't come, the nurse aides, the nurses aide came in and I said to her, "You know, we haven't slept at all and she's waking up every, every two to three hours and I'm latching her on and I'm trying to get her to feed, but I don't know that she's getting enough because she seems hungry constantly and I just need to sleep a little bit, but I don't want to give her formula because I want to exclusively breastfeed. You know. What would happen if we sent her to the nursery so we could try to get some rest?" She said, "Well the minute she starts crying, we're just gonna bring her back to you because she needs to eat and we're going to give her formula otherwise." And I'm just like, "Okay." And I guess in that moment, logically I knew that she had to stay in the room with me, right. If I was going to exclusively breastfeed and it's what I wanted, but I was just so exhausted and I was just looking for support or some kind of words of encouragement or her to say, you know, "Let me help you in some way." And, and I was crying as I'm having this conversation with her and she's like, "Yeah, that's all we can do." And she—and she walked out of the room and didn't,

Speaker 5:

69:48

[inaudible]

Jennifer: 69:50

Yeah, it was really, it felt super callous in that moment. And I remember feeling really just kind of lost. Like I was like, "Well, what do I do?" Like, and it was just like, "Okay, like push through." And we did and, and I'm—oh, and that was the other thing that they did that was pretty awful actually when I was getting discharged, they had weighed her again and they came over and maybe it was one of the pediatricians or one of one of the doctors, it was like, "Well, she's lost 10 and a half percent of her body weight. So we're very concerned and you know, if she's lost this much, you may need to supplement if you can't continue, if she doesn't continue to gain in the next few days." And I remember, you know, again, learning about how much weight the baby can lose.

Lisa: 70:34

And that's so borderline what they're saying because up to 10% is completely normal. So that's barely—so barely it could go either way.

Jennifer: 70:44

But the other thing is, Lisa, is that I remembered the weight that she was when she was born obviously and then I remembered the weight that she was the day before when they came and weighed her. And I had actually kind of ran the numbers a bit in my head and I remember thinking like, "Oh she's good." Like, "She hasn't lost that much." And so when they came back and they were like "10 and a half percent," I was like, "That doesn't sound right." I was like, "Can you double-check your numbers?" I was like, "How much did she weigh when you weighed her last night, and how much did she weigh originally?" I was like, "Because when I run the numbers I don't get 10 and a half percent." And I was like, "And I have—I haven't slept more than four hours in the last two days.

Lisa: 71:17

You're amazing.

Jennifer: 71:21

I was like, I need to know that this is what you're talking about. And so the same woman comes back with her tail between her legs and she's just like, "I'm so sorry. They inverted two of the numbers."

Lisa: 71:34

Oh my gosh.

Jennifer: 71:36

They switched them when they entered them into the computer, and they were like, "She's only lost—" you know, I think it was—"eight and a half percent" or something and she's just like, you know, "It's still, it's within the range of normal. So you know, you know, we're so sorry," like, "She didn't lose as much as we originally thought." And I was just like, "Okay, that's a really big mistake." And I was like, "And you really scared me. Especially as a first time mom." And I was like, "If someone else—if you had told that to someone else and that person hadn't run the numbers themselves or didn't have the presence of mind to push back on you, they would've gone home really freaking out that their kid was underweight. And—and would be that much more likely to turn to formula right away, out of a sense of fear. And I was already worried, right? So when she told me that...and I think that was one of the things that the class that I took with you did for me, it 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 at least have that moment of like, no, like, there's something wrong and I'm going to push back and I'm gonna question it. And sure enough I was right.

Lisa: 72:41

Good for you.

Jennifer: 72:43

Yeah, no, definitely. But when I went back, so she had her first pediatrician's appointment the next day, she had lost more weight and at that point she was above the 10%, and we were having a really hard time, like I said, breastfeeding, I didn't feel like—we were having a hard time latching at certain points. And when she latched, I didn't feel like she was getting, she was transferring milk efficiently. Like she would be on me for half an hour, I'd come off and she was still hungry and I was in, I had kind of the the lipstick-shaped nipple when she came off of me. I was seeing a lot of different signs of—something's wrong or just—the latch is not working well. So we just kept working on it. And you know, I worked with that lactation consultant that came to my house and then I did a virtual lactation consultant call with someone a week later.

Jennifer: 73:32

And my sister had her baby three weeks later, and a couple of weeks ago she was concerned about her baby's latch and she made an appointment to an ENT and my insurance covered it as well. So she's just like, I made us two appointments. Why not? Why not get it checked out and make sure she doesn't have a lip tie or tongue tie. And when I looked at her, I felt like she did have a bit of a lip tie. Most, you know, most people do have a lip tie, whether or not it's severe enough to actually affect the way they eat. And we went to see, a great ENT in the city who had actually seen my niece two years earlier and had told my sister, "She's perfectly fine, there's no need to do anything." So I felt confident going to see him because I knew that he was the kind of doctor that wouldn't intervene if it weren't necessary, that would say this isn't needed.

Jennifer: 74:21

And unfortunately my niece, she did end up having a tongue tie and so they clipped it and it was great because it was caught really early. And my sister's having a better experience now. And for me, baby Emma was fine. No, no severe lip tie or tongue tie. And he's like, "I do see the lip tie like you saw, but I really don't think it's, it's something that's affecting your breastfeeding experience because it's, it's very mild, not a severe lip tie." So, so yeah. So I kind of did all those things and then I just started working on my latch with her. Just being really purposeful around the steps of, you know, bringing the baby to the breast, and the way she was latching and having her face me, and the way I hold her and you know, I tried football and then I tried cross-body, and one morning I remember I was just so exhausted and so like scared of the whole co-sleeping thing and, and I was just like, "I'm fine. Juan is here." Like my husband was home that morning and I was like, "Honey, just make sure I don't fall asleep and like roll over on the baby, but I'm going to bring her to bed with me and see if I can get her to nurse that way." And she just latched on right away and she fed for like 20 minutes and she just passed out, like, she was so full, and I remember that moment, and, and also when you're laying down, like and they're feeding that way, like you can just look right into their little face and you're so close. And it was just such a sweet moment. I was like, "Aw." Like she, this was so easy. Like it just came so naturally, like in that position, like I didn't have to like move her or like flex or like it was just, she just found my breast and she just, like a little baby sharks she just attacked and she was on there and, and it was, it was great and it's kind of been all uphill since then. She's gaining like a champ. Her last appointment, she was 11 pounds and two ounces, so she's at the 75th percentile of weight, and she's still super tall for her age. She, she's 95 percentile for her height, so she's, she's a big baby and she's doing well. I think that was the other reason too that you know, she dropped so much weight to begin with, right? Because she was a bigger baby and fortunately I didn't have the Pitocin or some of the type of induction liquids that would cause her to be even more kind of swollen or inflamed. But you know, they do, they, she was a lot more swollen like when she was born. And I think they use a lot of liquids and all of those things in the beginning.

Jennifer: 76:48

So their weight's inflated to begin with. So just like the whole birth weight that they scanned her and that's a guesstimate, like that whole weight of—you know, what they're born at and how much weight they're losing in that first week. Like what I would just say is don't be scared to question that and, and push through, like, work with lactation consultants, you keep trying. What really helped me was hand expression. So those first couple of days when I was really psychologically worried about her not getting enough, I started hand expressing and putting it into syringes and giving her the milk in syringes and visually I can see that I was producing colostrum and that she was getting it, especially during that time that I had the latching issues. So that really helped us kind of push through those first few days until my milk came in to establish a healthy breastfeeding relationship. So

Lisa: 77:39

That's great. I just wanted to mention for listeners who might be like, "A syringe? What are you talking about?" I love that you knew to do that because it's recommended if we do need to supplement in the early days or weeks before breastfeeding is going well to use a syringe or to use a cup for feeding instead of a bottle to avoid nipple confusion. So it's really wonderful that you knew to do that and that you also learned how to hand express, which is often much more effective for a lot of women. We, we get a lot more milk a lot of times with hand expression than with a mechanical pump.

Jennifer: 78:15

Yeah, definitely I tried to pump in the early days and I didn't get much out and you know, psychologically like you look and you're just like, "I have no Milk, I'm dried up. I'm not, I can't produce for my baby." And that's not true. You know, it's, once I was able to hand express, I saw that I definitely had colostrum and I just had to wait for my milk to come in. And because I had PCOS, because I was induced and that, you know, there was a certain amount of medication and intervention in the epidural. You know, it's very common for your milk to be delayed by a few days and, and that, that's, you know, that 24 hours or 48 hours is, is a lifetime when when you feel like your kid's not getting enough food and you hear them cry, and you're exhausted and you're so tired and you know, that combination is really dangerous because it's, I think what pushes so many moms to just say, "Let's, let's give this kid formula because they're not getting enough."

Jennifer: 79:09

And I would just say stick to it if you can, like, just push through and you know, I don't blame women that do supplement and feel the need to, I mean it happens and, and fortunately there are some women that can supplement for some time and then build up their supply and go back to just, you know, exclusively breastfeeding. So, I mean there's many different ways to feed your baby, but I'm very, I'm very grateful that I've been able to stick to the breastfeeding and I haven't had to supplement, and I got sent home with formula and—I asked for it, you know, the, the hospital definitely didn't push it on me, but you know, I was nervous that I wouldn't have enough. And I just said, "You know, just in case, you know, it's the middle of the night and I don't have anything. I want to be sure I have something." So I'm very happy to say that formula is still in my cabinet towards the back and I hope to never have to use it. So, we'll see how our journey continues.

Lisa: 80:04

Great. Well, thank you so much, Jen. This has been so wonderful and I just want to applaud you for all the self-advocacy that you did across your whole birth and early postpartum journey. It takes a lot of courage to speak up for yourself and to say, you know, to question the, the weight loss. And I just can't, I'm like so impressed by that, because you were so, I know how exhausted you were. I've been there too, and I—most of us just wouldn't even have that wherewithal to speak up and, you know, advocate for our babies. But you did and you advocated for yourself and I love how you got up out of the bed and you know, went to the bathroom regularly without asking permission, I think. It sounded like...

Jennifer: 80:50

I unhooked myself.

Lisa: 80:54

That's what, yes, yes, yes. Listen to her, everybody. Because in class I always say, "Better to ask for forgiveness than permission." Just do. And they will absolutely tell you if they have a problem with it, but don't—if you ask them, it's just asking for a "no." So, good for you. That is awesome. I am, I'm so, so thankful to hear that great birth story.

Jennifer: 81:16

Yeah, no, well I, it really—your class was so helpful because I, you know, I'm a first time mom and I've never gone through this process and it's a lot. There's so many different aspects and things that, that come along and decisions you have to make and you know, decisions people try to make for you. And I think one of the things that I really took away from your class was, was that just, you know, ask the questions and they can't force you to do anything you don't want to do. Right? And so you really have to advocate for yourself and make sure you're comfortable with what's happening, right? And so I'm very happy. I feel like I had a good experience and most—more than anything I, I felt in control and I felt like I, I had a, the experience that I wanted to have and you know, there were bumps along the road and you know, such as not having me on the schedule, and you know, a little bit of callousness from that nurse's aide in the middle of the night. But overall it was a really great experience and I think your class and all of the knowledge and all of the things I learned during that time were really helpful. And now I'm keeping in touch with all of my classmates, which is also really helpful. I've been able to, to kind of learn from their stories. And then we had our first baby play date a couple of weeks ago and I'm really excited to, to keep in touch with, with everyone. And one of, my classmates, unfortunately, you know, the baby ended up in the NICU, she had a really tough time and she was just texting me the other day and I could tell she was, you know, struggling and I was like, "Can I call you?" And I called her and we chatted. And so it's been a really nice source of just support and kind of connecting to people that are going through the same thing that I just went through. So I'm looking forward to staying in touch with, with every one else in the class, too. So. And you too, Lisa. So thanks!

Lisa: 83:05

Yes. And I hope your whole cohort will come to the next reunion and I will thank you again and please give Juan my love and I hope to come cuddle your baby, to meet your baby at some point.

Jennifer: 83:22

I'm so excited. I think she's, she's been good. I think she probably had her bottle and she's, she's good because I haven't heard her cry, so she's doing well with my mother-in-law. She's great.

Lisa: 83:33

Awesome. Okay, well thanks again.

Jennifer: 83:35

Sending you a hug.

Lisa: 83:35

You too. Bye-bye.

Jennifer: 83:38

Take care.

Lisa: 83:39

So there is Jen's birth story. I hope you enjoyed it as much as I did. It's been a long episode so I won't do my usual commentary, but we'll leave you with one thought to daydream about what if we had a cultural narrative surrounding birth that built our confidence and trust in our body's ability to birth our babies even if they are big. Why are we surprised in the U.S. (more than in other countries) when a mother can push out a big baby through her pelvis and vagina? Okay, here's a sneak peek of what's up next week.

Speaker 5:

84:14

For all intents and purposes, having done, you know, the birth class where I, like, knew what all these things were, at least I had like the working knowledge of, as these things come up, like, okay, so when they say "Foley balloon" to me, I'm like, "Okay, I know what this is. I'm not scared. We don't have to like stop, you know, kind of be stressed about it in any way." Like I, I knew what was going to happen.

Lisa: 84:35

Until next time. Remember that your body has the ability to birth your baby, whatever the size. Thanks for listening to the Birth Matters Podcast and be well. —-END—-