Today’s birth story, which will be broken up into two consecutive episodes, will be especially helpful for expectant parents whose baby gets a clubfoot diagnosis. Joe & Beckie share their journey of their son, Elliot, getting this diagnosis early in pregnancy. They also detail their birth story of a long, 30-hour induction several weeks before their due date due to low amniotic fluid. Beckie shares lots of details about the ways that her OB helped her feel involved and informed in the decision-making process every step of the way. Because she was not even quite 37 weeks when the induction took place, there are particular challenges to the induction that Beckie shares.
Episode Topics:
introductions, conception on babymoon and early pregnancy
suspicion of clubfoot and subsequent testing, resources for this diagnosis they found helpful
late pregnancy diagnosis of low amniotic fluid, they miss their last birth class (which would have been newborn care) due to overnight observation
checking in to hospital for induction (due to low fluid) - cytotec used, also try foley balloon, doesn’t work first time, advocated for herself to postpone IV fluids for a few hours
start pitocin after the other things weren’t helping progress much; she lets doula know but says don’t come yet; instinctive coping techniques; start IV fluids
AROM (breaking the waters artificially) took 2 tries (and unusually painful due to a posterior cervix)
doula recommendations of positional changes; Beckie requests epidural and Joe stays in room for administration
Resources:
Clubfoot information (symptoms, causes, testing, diagnosis, types, etc.)
Dr. Raeka Talati, OB/GYN (NY Presbyterian Columbia, Manhattan)
Dr. Joshua Hyman (NY Presbyterian Columbia, Manhattan) - Orthopedist
Audrey Jessup - Doula
Andrea Scannell/Momally - Mom’s group in Astoria, Queens
Written Birth Story
On the day of our last Birth Matters class, during our week 35 ultrasound, we found out that Beckie's amniotic fluid was very low, less than 3 centimeters. They advised us to check into our hospital (Columbia / Morgan Stanley Children's Hospital) for overnight observation. We were told we could either be discharged after 24 hrs and treated outpatient, be induced that weekend, or that she'd be kept in the hospital for a week until being induced. Baby and Beckie passed all their stress tests so they sent us home the next day and went in for two more outpatient ultrasounds and and non-stress tests that week.
A week later, our doctor advised us to begin induction the following Monday because the fluid was still low, and there was no benefit to waiting longer, it was best to begin labor while baby was healthy vs waiting for something to go wrong. Monday was also her full day scheduled in the hospital so we would be able to have our doctor there. We were just on the cusp of 37 weeks so we were considered in the safe birth range. On Sunday, March 24, our doc called and said she got us a labor room early. So we got our stuff together and went off to the hospital in an uber on Sunday night. On the way we practiced installing our car seat in the back of the uber.
They began inducing Sunday evening, with two rounds of cidatec. They tried to do the foley balloon overnight but it didn't work, then successfully used the foley balloon early Monday. After several hours, Beckie was dilated to about 3. Our doula arrived in early afternoon with the beginning of pitocen and more intense contractions. I would describe mid-day Monday as what would be like early labor. Beckie enjoyed sitting on her big ball and moving into some different positions including all 4's on the bed. She did not want the epidural for a long time because she did not want to be relegated to the bed.
Beckie was talkative and in good spirits most of the day but then our doc manually broke her water around 7pm increasing intenseness of contractions, and by 10pm, after nearly 24 hours already, Beckie opted for the epidural. They had our doula leave the room, I put on the funny hat and mask, and stayed to observe and hold her hand. The epidural did not help right away, they had to adjust a 2nd time it before she was finally pain free. The epidural allowed all of us to sleep for a couple hours. By 2 or 3am it was determined that Beckie had developed a low grade fever, and started antibiotic. Things moved quickly when by 4am Beckie was dilated to 9! They said by 5am our doc would come in to deliver. We started pushing at 4:30am. I held one leg, a nurse held the other. The resident came in and coached Beckie to push. She didn't feel much of the pushing due to the epidural, but she was a great pusher. She only pushed for 1 hour. Our doc successfully delivered our baby, a baby boy at 5:39am, after 30 hours. Elliot Joseph Sommo was born 5lb 6oz and 19.5 inches.
The nurses put him right on Beckie's chest for skin to skin. I announced that it was a boy and cut the cord. They showed us the placenta and gave us a tour of it (spoiler: it's so gross, just kidding so beautiful). Prepare for a steady stream of nurses coming in and out at all hours of the day and night to check your vitals, check the baby, check a million things. Beckie found the IV fluid (and continued antibiotics) to be very uncomfortable the whole time. We brought baby home on Thursday morning.
We had our first pediatrician appointment the following day, Friday March 29th. He lost about 13% of his birth weight, more than the 10% threshold. To get his weight up (and help jaundice) they advised us to supplement breastfeeding with formula to top off each feed. After several days of this Elliot was back up to 5lb 3oz (only 4% off birth weight) and his skin was much improved. It was a bit scary but just be patient and don't freak out and trust your doctors!
Transcript:
Lisa: 0:01
You're listening to the Birth Matters Podcast, Episode 12.
Becky: 0:04
We're interviewing doulas at that time because I knew I wanted a doula. Just because I understood—like I love my doctor and she's great and she's wonderful but you know, she's in charge of baby. And for me having that doula is like having like a day-of coordinator for your wedding, right like there for you on that day.
Lisa: 0:33
Hey, there. And welcome to the Birth Matters Show. I'm your host, Lisa Greaves Taylor, founder of Birth Matters NYC Childbirth Education and Labor Support. This show is here to lessen your overwhelm on the journey into parenthood by equipping and encouraging you with current best evidence info and soulful interviews with parents and birth pros. Please keep in mind the information on the show is not intended as medical advice, or to diagnose or treat any medical conditions. Have you subscribed to the show yet? Please be sure to do that wherever you're listening to this so you don't miss out on any episodes.
Lisa: 1:08
Today's birth story, which will be broken up into two consecutive episodes, will be especially helpful for expectant parents whose baby gets a club foot diagnosis. Joe and Becky share their journey of their son Elliott getting this diagnosis early in pregnancy. They also detail their birth story of a long 30-hour induction several weeks before their due date due to low amniotic fluid. Becky shares lots of details about the ways that her OB helped her feel involved and informed in the decision making process every step of the way. Because she was not even quite 37 weeks when the induction took place, there are particular challenges to the induction that Becky shares.
Lisa: 1:48
Before we get started on the birth story, today's episode is brought to you by The Birth Matters Complete Online Course. If you can't squeeze in an in-person group birth class series or if you didn't feel like the one you took was comprehensive enough, or if you don't even have a quality class available in your area, I have the perfect solution for you. Birth Matters Complete Course is an online recorded version of my in-person full series. It covers not only prep for an amazing birth with self-advocacy tips, best current evidence and tips for partners, but also holistic postpartum wellness, breastfeeding, and newborn care. And to top it off, you get lifetime access so that you can use it as a refresher later in this or future pregnancies. How awesome is that? For New York city locals, you have an option to add to the course an in-person one evening hands-on comfort measures workshop, which is a really ideal option for the more tactile parts of the course. Check it out at birthmattersonline.com. Now let's get started with today's birth story.
Lisa: 2:51
Hey guys, thanks so much for being willing to talk today. I can't wait to hear even maybe more details than you wrote to me. Why don't you just start out by introducing yourselves and sharing how, how old your little baby is, whose name is Elliot, yes?
Becky: 3:09
My name is Becky and this is my husband, Joe.
Joe: 3:13
Hello.
Becky: 3:13
Elliot is now seven weeks. He'll be eight weeks tomorrow. So we're coming up on almost two months. Right now he is growing really fast. He's kind of having a little bit of a growth spurt, he's in the middle of that first, like, leap—mental leap they call it. So he just wants to eat all the time and be snorgled. So that's what we're doing. But yeah, we can talk a little bit about our pregnancy and our kind of birth story from there. So we found out we were pregnant in August, so just shortly after we had been on vacation for a friend's wedding, which was really nice. And somewhere in the middle of the Midwest we made a baby, which my mother loves. And so then I had a very good pregnancy the whole first trimester. I felt tired, but fine. I never had a lot of nausea, anything like that. I was able to stay really active. my doctor was Dr. Talati with Columbia at New York Presbyterian. She's fantastic. She was really great all the way through. We had all of the normal ultrasounds...
Joe: 4:20
And you first got in to see her in what week?
Becky: 4:23
They saw us week nine. So I was nine weeks when we confirmed the pregnancy and all of that stuff.
Joe: 4:28
So that was the first time in to the doctor's office and we proceeded to have regular ultrasounds thereafter.
Becky: 4:35
And then when we went in for our anatomy scan around 18 weeks, they had said she thought that he might be either pigeon toed or they said "Oh, or he might have this diagnosis of clubfoot. Don't worry about it, go away for three weeks"—because it was like over the Thanksgiving holidays—"Come back in and we'll do another ultrasound to confirm and have a better look." What's nice about Columbia Presbyterian, so my doctor is not like a high-risk doctor. She doesn't see a lot of that kind of stuff, but they were able to send us uptown to all the amazing fetal maternal medicine folks that are also part of Columbia. It was really wonderful. They took care of scheduling everything. At that time we also had a fetal heart echo because Joe has a family history of some heart problems. And then it's also something that they check whenever they are kind of looking for genetic markers and things that could be associated with something structural. Like they were just seeing like a clubfoot, but they're also checking for all of like the super scary things that could be associated.
Joe: 5:38
His fetal echo turned out fine. Everything was fine. In terms of the clubfoot, when they originally weren't sure about it, the reason why is because they couldn't see it in the ultrasound. So that made them, extra cautious—or they couldn't see the feet rather, in the ultrasound. So it made them extra cautious about, "Well, let's make sure we check on this the next time." And then when we went in for the next ultrasound, that's when they confirmed that the, the, the feet did look clubbed, and they speculated that it was bilateral, which means both feet. So, after that point we went uptown to Columbia hospital, 168th street to do the kind of genetic, further testing and, or a more thorough ultrasound followed by a decision to either do an amniocentesis or not. And the amniocentesis was very, it was a little, you know, stressful. Just, we didn't know if we wanted to do it. We, we consulted with the doctors, they said that it's the best way to kind of rule a lot of things out. So we talked about it and we said, you know, "It's the best way to go forward, because if the club foot is related to anything else, we should know about it now." And so we went ahead with it and they, you know, they assured us that their success rate with this is, is better than—like the success rate is already good. But then at that hospital in particular, it's even better because they're, they just deal with it so often and they're just very professional and a great hospital.
Lisa: 7:01
So Morgan Stanley Children's Hospital is a high risk hospital. So they see everything, right? So as we were kind of going in there, again, like the doctor had set up first our consult, like first the kind of super duper ultra sound with the 3D and all of this stuff with the fetal and maternal medicine folks, two lovely women. So after we kind of had that, she said, "Well, the same day we'll set you up with a meeting with the genetics counselor." She said, "It's just a meeting, you can talk through what an amnio is. If you decide that you want to have one, you can then and you can do it that day." So, and we had had in that first trimester 12—at like 12 weeks we had had the NIPT screenings. So we had had just the screening portion of that and she said, "You can feel really confident that this is likely just a structural clubfoot diagnosis because your screening was all clear. But the only way to know for sure is to then do the amnio." So I went into that, you know, kind of day just being like, "Well, I'll kind of see where we are." I think when we kind of first got the diagnosis, we had like four or five days in between kind of having then that, that kind of secondary thing and it just kind of, we kind of had a moment to kind of deal with it, like kind of do our like research around like, "What does this mean?
Joe: 8:15
Research it, mentally process, "What does it mean to have a clubfoot baby?"
Becky: 8:17
Understanding that like treatment is like intense and kind of a duration but noninvasive, you know, nothing that's going to affect the rest of his life. All of those kinds of things. Nothing super scary as long as we could rule those things out. So essentially that day, once we kind of got through the morning and the ultrasound, yeah, we went ahead and had the amnio. I felt very safe. I felt really in good hands and it was the only way for me to be able to say, like, nothing else scary was gonna pop up. So I think that was important for us just to be like, "Okay, let's rule out everything that's really scary. And then all we have is a structural thing, which is very treatable." And we moved on from there.
Joe: 8:56
And the results of that amniocentesis allowed us to have a good mental pregnancy the rest of the way, you know, we, we felt good about it. We said, "Okay, well we know how to treat this once he's born. So, and there's no other issues that have popped up so we can now go on and enjoy this." So we even went on vacation in December.
Becky: 9:15
We went on our baby-moon.
Lisa: 9:16
Baby-moon. Yeah. May I ask where you went?
Becky: 9:19
We went to San Diego.
Lisa: 9:21
Oh, nice.
Becky: 9:22
Between Christmas and New Year.
Joe: 9:25
It was very beautiful.
Becky: 9:25
I had a cold the entire time.
Lisa: 9:27
Oh no.
Joe: 9:28
So, so yes, we were able to enjoy the rest of the pregnancy and then fast forward to, I guess week 34.
Lisa: 9:37
Can I pause just one second there and ask a quick question before we go onto a different topic. Were there any resources, any websites or any books on this topic that you found helpful?
Becky: 9:47
Yeah, so we did a couple of things. So after we've kind of got the diagnosis and then all of the results of the amnio came back, they also said "We'll set you up with a consult with a pediatric orthopedist that's there at Columbia for—that would be like in charge of treatment." So we had first that kind of doctor's—that doctor's consult, which was nice. It was good to meet him, it was out of pocket. Insurance does not cover that. So luckily we were able to, you know, we were like, " Okay, we'll swing that." But I also, I think it was good because I think one of the challenging things, or at least for me right away was just like the like, "Oh God, do I type this into Google and what am I going to see?" Right? So wanting to throw out all the information that was incoming, to be level-headed and you know, coming from the right sources and people and just kind of that kind of thing.
Lisa: 10:42
Sure, yeah.
Becky: 10:43
Having the consult with him, it was okay. It was fine. At that point we had had like about a week and a half to kind of process. And do some light Googling...
Lisa: 10:52
I like that, "light Googling."
Becky: 10:57
...around treatment and things. I think like medically, once I understood like, "Okay, like it's not surgical, like we're not like replacing a lung or a heart, or you know, something really scary." I like, I was like, "Okay, I understand what this is." And my mind immediately flipped to, "Okay," like, "this changes everything about like, what do I do about childcare?" And you know, I don't know, "The car seat that I have is, is it the right one?"
Lisa: 11:26
Wow, you're like rethinking everything.
Joe: 11:29
But, you know, those items and even the treatment and all that stuff, before we went into the orthopedist for that consult, we got a lot of feedback from Facebook groups, like a clubfoot Facebook group and an Astoria mom's group—Astoria's where we live—and those networks and communities are, you know, they're filled with people that have gone through this with their children and are, you know, eager to share advice, your own experience. And that's extremely helpful, you know? And, now we're kind of a part of that, too. So maybe we can pass it forward at some point. But yeah, that was extremely helpful. And I would recommend other people to use Facebook as a resource. Facebook isn't always great, but for stuff like that...
Lisa: 12:10
For that it's great.
Joe: 12:11
Yeah.
Becky: 12:12
Because I think like the difference between like seeing the doctor and having that medical consult is they're going to treat the medical issue. Right? But like then like you have to also like live your life and they're not gonna like have the recommendation for, "Oh yeah, this daycare is going to be fine for you." Or "Here's a car seat that's wide enough at the bottom that when they go into boots and bars it's gonna still work for you when you won't have to like redo everything." So that was, that was helpful. Again, it's a Facebook group so you have to do similar like sorting of like—this is hysteria; this is not. Just like you do with the internet, but.
Joe: 12:50
Do your own vetting.
:
12:50
And that's fine. Right? So like even to be able to have like simple solutions, like , "Great, when they're in casts, it's really great to have little baby legwarmers because it can make the cast less scratchy. And then also you don't have poop explosions everywhere on casts that you can't change." Like just things like that was like, "Oh, okay." Like, "Okay." Those are like functional everyday things that people are going to be able to share with you versus a doctor who is just like, "Okay, the casts are done; go away. See you."
Joe: 13:22
Also really helpful that my Aunt Valerie sent me an email that said, "Listen, you know who had clubfoot? Olympic skater Kristi Yamaguchi. And Super Bowl champion Troy Aikman.
Lisa: 13:35
That's so cool to know.
Joe: 13:37
It's kind of a very reassuring comment because it tells you that, it's a condition that of course we knew it was treatable, but also something that, you know, as Becky said, is not something that will affect longterm life things. So he could go on to win the Super Bowl. I know he probably won't because he's our kid and we're small people.
Lisa: 13:59
You never know. That's really encouraging.
Joe: 14:02
You never know. I would expect him more to be a writer, but who knows. Yeah, it could be. It could be.
Becky: 14:09
Yeah that basically got us to the beginning of the third trimester. So third trimester started and I kind of immediately felt like behind because like December and January was when I was going to do all of my like, interview my doula, find my birth class. Like, get all that taken care of. This kind of threw us for a loop. Like, it's February. And I was like, "Oh shoot, I gotta get it together."
Joe: 14:34
Right. We basically had nothing together by like week 34, week 35, which is fine because they say be ready by week 36, but unfortunately things like, you know, change quickly. So we were in our Birth Matters class for the first five classes and we were getting ready to attend our sixth and final class, which would have been extremely helpful.
Lisa: 15:01
You figured it out though. I'm quite sure.
Joe: 15:04
That same day we went in for our week, 35 or 36, 35, ultrasound.
Becky: 15:11
It was 35 weeks.
Joe: 15:11
Yeah, 35 ultrasound. And it was determined that Becky's amniotic fluid level was very low and they even asked her if her water broke or like if she noticed anything.
Becky: 15:21
If I was leaking or anything, I was like, "No, I sweat a lot. Is that leaking?"
Joe: 15:29
We asked about the scale of amniotic fluid and how they measure that. And they said, "Well, the high end would be like in the twenties and ours was like two and a half.
Lisa: 15:36
Yeah. They get concerned below five usually in terms of like, "Maybe we need to induce."
Joe: 15:41
Right. So it was extremely low and so they put Becky down for a stress test on the baby. So they strapped the outside, what do they call it? I'm sorry.
Becky: 15:53
The monitor.
Joe: 15:54
Yeah. So they, they did a stress test and then after that our doctor said, "Okay, we're going to send you up to the hospital to be observed overnight." And there was basically no clarity on what was gonna happen because they said, "Well, you could be in overnight and go home tomorrow or you could have this baby this weekend. You could be in the hospital for a week until you have the baby." So basically they had no idea. So then I emailed you, saying we couldn't make it to Birth Matters.
Lisa: 16:19
That's amazing that you had the presence of mind to think, "Oh, I need to get in touch with her."
Joe: 16:27
So, so I went home—we split up, I went home to—what's the matter?
Becky: 16:33
Nothing.
Joe: 16:33
She squeezed my leg. I went home to grab a go-bag and pack some clothes and things, and she went up to the hospital on her own to check in. So I met, I came up, I met her, I went into the room. She, you know, they, and they monitor her overnight and put an IV in. They gave her lots and lots of fluids. And, by the next day, I think her amniotic fluid went up to three from two and a half. So, but they had given the baby more stress tests and Becky tests and they determined that, you know, he was passing with flying colors. He was in great health. She was in good health. So they said, "Okay, well, we're going to send you home this afternoon," which was the next day. So we were overnight and they sent us home the next day. And, but they said that we would do two ultrasounds this week to be sure. And so we went in on Tuesday for the first one and then again on the Friday.
Becky: 17:22
Yeah. I think something that was really helpful again with Dr. Talati and this kind of group is like when I went in for my 30 week ultrasound, that was right before we started birth classes. And like our biggest, you know, that's the kind of the first check they do where they're like looking at baby's position. Baby still has plenty of time to turn around. You know, we went in for that one and that was when we thought our biggest problem was he was breech, get the baby to turn around.
Lisa: 17:46
Oh, that's right. Yeah. Yeah.
Joe: 17:49
He was breech for a very long time. And then turned around probably right around the time...
Becky: 17:51
When we went in for the 35 weeks scan. Then it was like, "Great! Baby has turned around. It was head down. Excellent." And then...
Lisa: 17:59
Different issue.
Becky: 17:59
You have very low amniotic fluid.
Lisa: 18:02
Oh, come on!
Becky: 18:05
She was, I mean like the doctor, I mean, she was great. She was like, "Well, the good news is, like, baby has turned around. Bad news: you have low fluid. Other good news is he's unlikely to turn back around because he has no room, very likely to stay head down. So I think that was great. Again, like they're just very calm and I really appreciate all of the doctors and the team there just kind of, I think really communicating with us around what this meant. Like she was very clear like "Listen," like Joe said, "You could go up there and you could have this baby tomorrow, you could stay there for a week, we could release you." Like you know what I mean? Like we're looking through all these things and she was just like, "Listen, but don't be fooled, like, your amniotic fluid is so low, it's never going to go up to the ten." Right? Like ten—5 to 10 is what they want to see. During that timeframe we were at a two and a half.
Joe: 18:58
And there was also some speculation that it was like a, like a placenta issue, but they couldn't determine for sure what it was.
Becky: 19:04
So yeah, she said, "Listen, like, the goal now is to get you as close to 37 weeks as we can. Right?" So she said, "Listen, like, here's what we're going to do. Let's go, let's monitor you for overnight. Put a bunch of fluid in. See if it is, like, dehydration"—it wasn't, right? Like it's not dehydration if it's only gonna move that level kind of overnight. So that's where the doctor that was seeing us then that next day was just saying, "Oh yeah, it's likely like the placenta is just kicking out and not really regulating the fluid back and forth here at the end. So go away, you feel fine. The baby is doing great, keep doing what you're doing. But then we'll just check you twice a week and then every week and see how we go." The other thing we did, it gave us the opportunity while we were hospitalized to do—that 24 hours, we did two shots for what's it called? Steroids. Two steroids just in that last week, that kind of like pushes all of that final lung development. And she said, "We'll go ahead and we'll do that and you know you'll be set." She said, "But don't be afraid." She was like, "If your baby is born tomorrow"—we were at like 35 and five or something at that point, and she was like, "Your baby will be fine. Even if you have the baby, you go up there, baby's dah, dah, dah, dah, we got to go get it. Your baby's going to be fine. May not even need NICU." So we left.
Becky: 20:22
Then you know we got discharged that Saturday. Everything was fine. They said, "Go away, check in with your doctor on Monday." So then I went back in Monday, had another fetal non-stress test, had another ultrasound. Like everything was still the same. They said "Go, continue, come back," and on Friday. In the middle of that was when all of a sudden I went into like work hyperdrive. We went in the weekend of St. Patrick's Day, which was for my, my biggest client at work is Guinness. So that was like our [inaudible] whatever, like, they were done. I said, "Okay, see you later." And I was planning on—like we had already started some of my hand over a little bit for maternity leave. But yeah, like we're, we were about four weeks ahead of schedule. So that kind of week I worked from home a couple of days. The doctor wasn't like, "You're on bedrest." She was like, "Just take it easy" and you're, I don't know. So that's what I did. I've worked from home mainly because everyone—I felt like my presence at work made people nervous. Their stress would make me stressed.
Lisa: 21:27
Sure.
Becky: 21:27
It was more just about like making sure that I was just like pushing things off and handing over as many things as possible. I'm very lucky. My boss, my department head like was really wonderful, super supportive. They were like, "We don't want to see you. We'll take everything, do what you need to do."
Joe: 21:46
So we went in on that Friday for that second ultrasound that week and that's when the, you know, the situation was the same, but our doctor came in and said, "How do you feel about having—giving birth on Monday?" Because that's the day that she's in the hospital all day. That's her day. And so I think both of us feel it was important to have her there because she was with us the whole pregnancy. So, you know, the prospect of having the baby delivered by somebody else wasn't as appealing as having her there with us. So we looked at it. I, my response was like, "Next Monday, or..?" "No," she said, "This Monday." So I said, "Okay, well, you know, we, we trust you." And that's the thing, as I would recommend to others that, you know, trust your doctor.
Lisa: 22:30
It sounds like you guys felt like you really could trust your doctors. Yeah.
Joe: 22:34
Yeah. I mean, we fortunately had great doctors, especially at, you know, Columbia New York Pres, and Dr. Talati, as I said, amazing. So we trusted her and we decided—there he is!
Lisa: 22:50
Hi, Elliot! What a cutie.
Joe: 22:53
So we, actually, planned to go in on Monday, but then she was able to get us a room on Sunday night. So we went up to the hospital Sunday night, checked in, went into the labor room and they almost immediately started the inducing process, which they began with the the pill.
Becky: 23:13
Yeah. Let's talk about a couple of other things as it pertains to, like, birth plans and things like that. Yeah, let's talk about that a little bit. So yeah, about the time we were starting our birth classes, all of that stuff, I think like when we like wrote on the form, like, "What do you want most out of your birth? Like what's your birth like...
Lisa: 23:32
I have it right here in front of me.
Becky: 23:36
I think it was like "have a good team," right?
Lisa: 23:39
A strong support team. Yup.
Becky: 23:41
We were interviewing doulas at that time because I knew I wanted a doula. Just because I understand—like, I love my doctor and she's great and she's wonderful, but you know, she's in charge of baby and for me having that doula is like having like a day-of coordinator for your wedding, right? Like there they're for you, on that day, you know. I think up until all of this everything was happening, my kind of intent for birth and all of that kind of stuff was go as natural as possible. Again, for me, my priority as far as that was just, I wanted to be as involved as possible. So for me when I handle stressful situations and pain management and all of that stuff, like being active and involved is how I, how I cope. So, you know, trying to go do a natural birth—like, yes, in a hospital setting, but whatever—as much as possible. It was really just about, for me being involved, having a doula there, someone to tell me what to do because I would immediately forget. Like we did all of the practice coping mechanisms and all of that kind of stuff, but like, I'm never going to remember that. So having that person in the room to say like, "Hey, do this one" and I can be like, "Oh yeah, I remember that. Okay, here we go" was really helpful and she was wonderful. We did actually wind up finding a birth doula off chance that had actually had a client with clubfoot before as well. It doesn't matter for birth at all, but we had a couple of postpartum visits with her. So it was kind of nice to have someone who had working language and knowledge of, you know, some of the other stuff that would be like post-birth. So the weekend before we had the visit where I was diagnosed with the low amniotic fluid, we had had, you know, the kind of pre-birth meeting where we talk about like, "What do you want in your birth plan" and dah dah, dah, dah, all that kind of stuff. "What are your preferences?" She was really great, you know, like, "What are the most important things to you? What moments matter the most?" Talking through all of that kind of stuff.
Becky: 25:45
So I was like, great, like "Send me a copy." She was like, "I'll send you a copy of like a sample birth plan and you can, we can do it for your next visit." So we were in between these two visits. I'm like, "You know what? Like, I have like a kind of a busy weekend coming up with St. Patrick's Day. Like let me get through that and then we'll do our like second visit. Because like I just, I can't focus on that. Like, we'll we'll go through here. Like she, I think she was out of town for like a training or something. This was all pre 37 weeks when they're kind of like fully on call for, so I was like, you know, "No problem. Like let's do this after..." Yeah. Like we just kind of left it at that and then yeah. Then the whole week happened and all this kind of stuff and she—we were messaging back and forth like updates. She was like, "Great, keep me in the loop. Let's talk about it. If you have questions, do you want to like hop on a phone call?" She was so great. Once we shared with her that we were going to be induced, she was like, "Well, do you want to have like a meeting Saturday or Sunday before you go in, to kind of like go through and like talk through your birth, like a different birth plan for you. And I said "No. I just, you know what, at this point like I have no birth plan. Like I'm done. I'm done planning. I feel great. Like I have you, you're amazing. I feel fine about my doctors. Like, it is what it is at this point. Like I'm just going to go in and I'm going to do what people tell me to do to have this baby." Right? So I was like, "I'm not doing a birth plan."
Lisa: 27:10
Too much extra work.
Becky: 27:10
I was like, "I'm done with that. My birth plan is have a baby and feel great."
Lisa: 27:19
Sounds good. Keep it simple.
Becky: 27:23
So, yeah. I mean like Joe said, like one of the things I do appreciate about Dr. Talati, I don't know how you, like—I got lucky with her. I didn't interview like lots of different, you know, OBs in the city. I got like a recommendation from a moms Facebook group of someone that they liked and her office was in Midtown next to my office. That was it. Arguably, I got lucky with her. But yeah, like I call her a "quiet pusher." Just fantastic. Someone to have on your side who's going to advocate for you, who's going to explain things to you, who's going to take you into account again, like she—yes, like, she wanted us to come in and be induced on Monday because that's her 24-hour shift in the hospital uptown. But I think she was kind of invested in this baby too. Like we had been through the clubfoot diagnosis. We had, you know, kind of come in here and had a couple of, I mean like arguably the complications we had were not life threatening in any way. You know what I mean? It's nothing, you know, kind of went down that path. But I think for her, she was a little bit invested in this baby. She said, she said, "Listen," she's like, "I can get you an appointment for Monday, 8:00 AM show up if you don't hear from me." But she was like, "I'm going to try and get you in Sunday night because inductions take forever." Coming in Sunday night was really key to like up the chances of her actually delivering our baby because if we had gone to Monday morning, she would, we wouldn't have, she wouldn't have delivered the baby because the likelihood of it taking more than 24 hours is a lot is—especially when you're starting from zero. Like I went in on that Friday, she was like, "Let me just check and see if you're dilated at all." And she was like, "No."
Lisa: 29:11
And that's probably why the Foley balloon didn't work. I'm kind of jumping ahead. But the first time.
Becky: 29:17
I was starting from zero, nothing, nada.
Lisa: 29:20
Yeah. Got it.
Becky: 29:20
My body was not preparing to give birth in anyway at 35 weeks and five days. We were fine.
Joe: 29:27
Once we checked in, that's when they basically started right away within a half an hour. And they started with the pill. I can't recall the name of it.
Lisa: 29:35
Cytotec, I'm guessing.
Becky: 29:37
Yeah. And I think, and like I had had—so she called on Sunday and she said, "Do you want to talk through what happens with induction?" And I was like, "Yeah, okay." Right? So I'm sitting there with like literally like my notes from class and like, so I'm seeing like, okay, there's Cytotec and then there's like the gel and you had said, like, if you can do the gel, it's more gentle.
Lisa: 30:01
I noticed that in the birth story when you wrote it, Joe, that you said "we didn't use the gentle gel."
Becky: 30:08
Yeah, because it takes longer, right? And whatever.
Joe: 30:10
They wanted to speed it up. Especially because as, as Becky said, Dr. Talati [inaudible].
Becky: 30:15
So yeah. So I can talk through kind of the timeline of events of actual birth.
Joe: 30:24
Take it away.
Becky: 30:24
Okay. Yeah. So we had talked to Dr. Talati, she called me Friday night. We talked through what induction means. She confirmed the timing, all of that stuff. This is like Friday at like seven o'clock at night. She's like calling me to like talk me through like what, what inducement meant. And like, again, like some of my preferences because we hadn't even really had a visit where I had said like, "Okay, here is my list of preferences and birth plan type of things" with my OB, we hadn't really had that meeting because the meeting that we were going to have that all of a sudden turned into us going uptown and being admitted to a hospital. So yeah. So it was really nice to have that conversation with her, kind of talk through all those different preferences. have her talk through, you know, like how they approach inducing and all of that kind of good stuff. So then Sunday afternoon I hadn't heard from her and I was like, "Okay, well I guess we're not going in and like we'll just prepare for Monday morning." I was like futzing around the house, like keeping myself busy and distracted, like making lactation cookies and like pasta bake that I could put in the freezer. Like the things you're supposed to be doing before you give birth. I did it in like a day. I don't know.
Lisa: 31:43
Let's cram it all in.
Becky: 31:43
I ordered like a bunch of crazy stuff from Amazon cause we had nothing, whatever. It was fine. So yeah. And then she called us around eight o'clock, and she was like, "Okay." She was like, "So show up to the hospital at 10. They'll take you tonight." And I was like, "Oh, I guess I hadn't heard from you." She was like, "Oh, I called and left a voicemail this afternoon," and I was like, "Oh, nope. Didn't get it.
Lisa: 32:15
Oh no.
Becky: 32:15
My phone is like weird. It didn't notify me, whatever. So at least I keep joking. I was joking with Joe like at least we like still had like somewhat the, like, "Surprise! Go to the hospital in two hours" kind of like thing. We sat down, ate dinner and then like took an Uber to the hospital. Put the car seat in there, took it with us. So we got there around like 10:30, got admitted. It was quiet. It's a Sunday night. Like that's kind of nice to kind of go in through an admin process that isn't, you know, super crazy and a bunch of people all around.
Lisa: 32:53
Yeah. And that hospital has a smaller labor and delivery unit than a lot of our other ones.
Becky: 32:58
Yeah. So yeah, like just said, like they, then they started with the pill right away. I did successfully advocate for four hours, no IV fluids. I remember talking about that, right, like you're on IV and you've retained so much water and do you really need it when you're in such early labor? And so she was like, "Well," she was like, "I'll get it approved." And we were talking with the nurse and she said, "Okay, well, I'll go and have it approved with the doctor." And so yeah, she was like, "Okay, well, we'll start this first round without it and we'll see how we go." And I was like, "Okay, great, thanks." I mean, I had everything on me though. Like it's like at that point, like it was still moot. Like I had, I had both the fetal monitor and you know, the heart monitor, I had a blood pressure cuff, which was one of the most annoying things.
Lisa: 33:47
Yeah.
Becky: 33:47
Like it was all constantly on. I was hooked up to everything. They had a heart monitor for me, so they could tell the difference between baby and my heartbeat. But yeah, so they started with, with the pill for dilation and softening and all that stuff.
Joe: 34:04
And they did two administerings.
Lisa: 34:05
Vaginal administration or oral?
Becky: 34:06
Vaginal.
Joe: 34:08
Two times.
Becky: 34:09
Yeah. So after, after about, yeah, the four hours or whatever, they come in, they check, nothing's happening. They're like, "Okay, we're going to do another one." But like contractions started. So once they, once they inserted the pill, like contractions kind of naturally started, but just kind of very, you know, like we were just, they were just like, "Rest, try to sleep if you can, we'll be back, you know, kind of periodically to check." So yeah, when they came in at four hours they were like, "Well, we'll try to get to one centimeter so we can insert the Foley balloon. So we'll come back after this first round and see how that goes." I mean, I think it was really helpful, I think. And 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 gonna happen.
Joe: 35:10
Thank you, Lisa.
Lisa: 35:10
You're so welcome. Glad I could help.
Becky: 35:13
...be informed and then make decisions. So yeah, they came in after that first round they were like, "Nope, not even a centimeter. We'll do another one. Try again. See you in the morning." So yeah. Then they came back in around like eight. I was about eight in the morning, got the centimeter. They said, "Okay, we're going to do the Foley balloon," which took two tries.
Lisa: 35:37
Did that hurt? How did that feel?
Becky: 35:39
It hurt a lot and I think a lot of, I think a lot of the challenges with both the Foley balloon and then also later when they were breaking my water is: not only were we trying to dilate and soften at the same time, because I was so far out from giving birth, my cervix was all still like in the back position. Like it hadn't really.
Lisa: 36:00
Yeah, posterior.
Becky: 36:00
So I think some of those—because I know when she said when she broke my water and she was like, "This is, this is a little bit hard because of the angle, that's why you're kind of feeling like really uncomfortable." So yeah, it took them two tries to get that Foley balloon in there.
Joe: 36:17
It did work. Second time.
Becky: 36:17
So yeah, then I mean that—the insertion was, that was painful for me. I think some people it is or it isn't, it just kind of varies. But you know that that was short. Once it was in, it didn't hurt. But then I started, you know, by that time I was starting, contractions were kind of starting to pick up. They said, "We'll do the Foley balloon and then we'll wait to do Pitocin towards more like late morning, mid-afternoon. So we'll see how far the Foley balloon can bring you." They didn't want to start the Pitocin right away, so everything up till there was all cervical dilation and softening and stuff. So yeah. Then you have the Foley balloon, like strapped to your leg. That was just, it was just like more like deeply uncomfortable. Again, like I was trying to stay as active and like I had my birth ball and you know what I mean? Just like being in bed for 30 hours was gonna be the worst thing. Right? I can't just lay here for 30 hours I guess the worst. So yeah, it was just kind of this like contraption of like navigating like the IV stand and...
Lisa: 37:17
All the connections.
Becky: 37:19
...all the stuff. Every time I got on the birth ball they had to come reposition the monitors.
Lisa: 37:23
Because it flips. Yeah.
Becky: 37:26
Which they were wonderful about. Like they were very encouraging like, "Do what you need to do." Like they were really wonderful about like, "Lay down so we don't have to readjust things." You know what I mean? Like they were really wonderful about just like coming in, readjusting it, doing all that kind of.
Joe: 37:43
The baby also kept kicking it. He hated it.
Lisa: 37:50
And did you have to be lying down in the bed at first when you got the Cytotec?
Becky: 37:56
I don't know if I had to, I was, because it was overnight I think. I think, that just kind of like went together. I don't know if...
Lisa: 38:04
That makes sense.
Becky: 38:04
That didn't even occur to me.
Lisa: 38:07
I've done a couple of birth story interviews recently where two more than one of my students said that they got either Cervidil or Cytotec and at their particular hospital they said, "You have to stay lying down so that the gravity doesn't pull it out. So it's really in there on the cervix." So I'm just interested in hearing how common standard that is across all of our hospitals.
Becky: 38:30
Our focus was like lay down and rest anyway.
Lisa: 38:32
And go to sleep. Yeah. No that's great. That's, that's a nice confluence of events.
Joe: 38:36
You were laying down for most of whatever they gave you minus the epidural. But we'll get to that.
Becky: 38:41
Yeah, because it was, yeah we were overnight. Yeah. Because I didn't really feel like I needed to like be up and out and kind of moving and kind of coping until, you know, they kind of put in the Foley balloon and I was like, "Let's kind of like move around and just kind of get active." You know what I mean? Sun's up. Morning was there. I ate breakfast. I threw it up. Right? Like they were like, "You can eat until"—I think they said untilPitocin. I can't remember. You want to take him?
Joe: 39:12
Sure.
Becky: 39:12
Daddy time. So, yeah. Yeah, I had breakfast. Yeah. I think the contractions were starting to get, I don't know, stronger or like maybe it was just like I didn't react well to breakfast and then the Foley balloon, like they came, they kept checking like they're just waiting for it to kind of come out. That came out like maybe like it was later in the afternoon. Yeah, because they had said, "We'll just, we'll wait to start the Pitocin to see what the Foley balloon does." So then around like 10 or 11, like the Foley balloon wasn't coming out. Not even close. She was like, "I'll give it a tug. We'll just see." No. Right? Like not going anywhere. Nothing's happening. So they said, "Okay, we're gonna go ahead and start, start the Pitocin." So then I was like, "Okay, let me text my doula and be like, 'Hey, they're starting Pitocin, time for you to come.'" Because I had told her like, "We're going to be there overnight," like, "No reason for you to be there. It's gonna be fine. Like, you be rested for, like, the actual stuff later and then you know, we'll kind of go from there." So that was great. She came up. Yeah. Yeah. They started the Pitocin like late morning. So then I think the Foley balloon kind of came out maybe like one or two in the afternoon. So we had been in it for awhile. That was, yeah, so starting at around midnight until around noon. So yeah, that first 12 hours was all just trying to get to three centimeters.
Lisa: 40:46
That's often the case with these inductions.
Becky: 40:50
That was delightful. Doing fine. Like once, once the doula got there, I sent Joe away for lunch. I said, "You go eat," right, like, "Take care of you." Oh good job, Daddy. We're going to do some bottle, too, we're still supplementing. We'll get to that. So yeah. Once the Pitocin started, contractions were manageable, doing all of the things. I spent most of the time on the birth ball because I just felt more comfortable kind of just bouncing basically. Leaning, doing some of the compression stuff. One of the things that—but this time I was on IV fluid because what they were having to monitor a lot of was, like once they started the Pitocin my contractions were very close together and pretty strong like right off the bat. So they were like, "One of the ways we can manage this is increase the fluid and help space out contractions. So they would like give it like a boost of like a bunch of fluid and then kind of back it off to help kind of like space out those contractions. So that's what we were doing. That's basically what most of the afternoon looked like while they were like slowly up up upping the Pitocin throughout the day. We got to like middle, like early evening and they were kind of like checking, checking in along the way.
Lisa: 42:17
Yeah. So like middle, early evening contractions were getting stronger but like not a lot of like progress was happening. So they said, "We'll see where we are and then we'll let you know when we're going to break your water." And they said, "Be prepared. Once we break your water, your contractions are going to get a lot, a lot harder and a lot tougher because the combination of those two things will make for a more painful contraction, but also a more productive contraction."
Lisa: 42:42
Yup.
Becky: 42:42
Okay, cool. I'm in it. I'm ready.
Lisa: 42:45
Bring it on.
Becky: 42:47
My doula's like, "You should eat something." You know, like they're telling me at this point, the doctors are saying, "You can't eat." But my doula's like, "Do you want to eat something? I have like a granola bar?" I mean I just like, I honestly was just like not really hungry after throwing up breakfast. So I was kind of eating small things and like the not-eating thing was not an issue for me, but I had a very good doula that was like, "Do you want a cheeseburger? I'll go get you one." I was like, "No, I don't need that." So yeah. So they broke water around seven.
Joe: 43:20
Seven PM.
Lisa: 43:20
He has it firmly in his head.
Becky: 43:22
Early evening. Again, that took two tries.
Joe: 43:27
Yeah, I could tell from her reaction that was very painful.
Becky: 43:29
Well, the first time, the first time it like it was really painful and again like she was, she was like, yeah, that's when she told me she was like, "We're working with the angle of your cervix. That hasn't really come all the way forward."
Joe: 43:43
Yeah. And then when they did it, obviously there was not much that came out because of our low level.
Becky: 43:48
I said if we break this water and there's like gushing fluid down there, we need to have a conversation.
Lisa: 43:55
It better not.
Becky: 43:56
If I have two and a half centimeters of fluid it'd better be a trickle.
Joe: 44:04
It was a trickle. It was not much.
:
44:05
Did it cause a big escalation in the intensity or or not?
Becky: 44:09
I don't know. I don't know if that is based on...
Joe: 44:12
Escalation of what?
Becky: 44:12
The intensity of the contractions.
Joe: 44:14
Oh yes, I remember specifically. Yeah. As soon as they did that your contractions got very strong and she lasted I think about until 10:00 PM which is when she opted for the epidural,
Lisa: 44:25
Which is a very long time to labor without it.
Becky: 44:29
Yeah. After that, like we were doing the more intense contractions like Audrey our doula was fantastic. She's like, you know, "Do the—stand up," like, "Lean on the bed," you know, kind of all these things. She was like, "Do you want to go take contractions on the toilet?" Like we did that. That was very good.
Lisa: 44:48
Love that toilet.
:
44:49
Yeah, we got to like 10-11 and then I was like doing the math of like, "Okay, I've been at this for 24 hours, I've been in labor for 24 hours, this baby is not coming anytime soon. I know this is going to be an overnight situation at this point." And I was like, "Nope, I'm calling it. Like, good job, team. Good job, good job. Like, I'm ready for this epidural. Plan B," which was, which was fine and Audrey is, you know the doula is doing the like, "Do you want to be checked?" And like all of those kinds of nice prompts and I was like "We could be checked but we're not going to be anywhere. Like we're not going to be anywhere." And it was really more about like knowing that I wanted to have that energy for the end of labor and the pushing and not—protecting that part of my strength and my wits and like honestly like my mental energy, too—like, it's physical but it's a lot mental, right? Like constantly saying like, "Okay, keep going, keep going, keep going." So yeah, we did the epidural.
Lisa: 45:54
Did—Joe stayed in the room with you?
Becky: 45:56
Joe stayed in the room.
Joe: 45:58
Yes, the doula left. I had to put the mask and hat on.
Becky: 45:58
They only let one person.
Lisa: 45:59
Did you have to ask for permission for that or was that a default where you were?
Becky: 46:08
That was default. They said, yeah, they're like, "Daddy can stay, or doula can stay, you pick, and the other person leaves the room." Again, it was, I guess it might've been quiet. Like, there wasn't like a like a "Do you want"—like no one had asked me up until that point, no one had asked me about an epidural except for when the nurses kind of changed. Every nurse that came in, right, was saying like, "What's your birth plan?" I said, "I just want to be, have communication. Here's my doula, here's my husband. We're trying to go as natural as we can for as long as we can."
Joe: 46:44
The male doctor in the morning had mentioned that "If you want an epidural, let us know and we'll come in and do it asap."
Becky: 46:48
When we checked—well they do the epidural sign off when you check-in, they bring in the anesthesiologist, so that we had all done. So yeah, like by the time I said I want the epidural, it was probably like maybe 20 minutes, half an hour or maybe. Went in. They said, "Okay." Did the epidural, they were like, "In about a half an hour you should feel, you know, numb. Let us know if that's not true, here's the little button if you need a boost, whatever."
Lisa: 47:14
So yeah, but like by that half an hour that came and went like I was still having like really strong vocal contractions. The doula was like, "Yeah, you might need topped off. Like, I shouldn't be hearing you have a contraction at this point." Yeah. So I was like laying in bed. So yeah, which was fine. They said "Totally normal, come back and top you off. It's a guesstimate, like, at best." So they came back in, gave me that kind of like second boost. Then everything kind of went away and they were like, "Just try to sleep." I slept for a couple of hours.
Lisa: 47:44
Did Joe sleep?
Becky: 47:45
Joe slept.
Lisa: 47:46
Great.
Becky: 47:48
What's nice about Morgan Stanley is, we did have like a beautiful private birthing suite. Like we had like a corner, like we checked in and they were like, "Oh you're getting like the best room. And so it was a corner room so it faced East and South. So we saw downtown and then East across the city, like at night, like who cares? Blinds open like whatever. So it's huge. It's bigger than our apartment.
Joe: 48:12
Nice. Nice atmosphere for sleeping.
Becky: 48:16
So yeah, like the husband, like you know, your partner can be with you. They have the little bed, like all of that. It's like a little couch that pulls out.
Joe: 48:24
But the epidural, you know, it was really, really key to getting us the rest we needed in those hours because everything would escalate by like 3:00 AM.
Becky: 48:37
Yeah. Everything escalated really quickly after that.
Lisa: 48:40
So that's the end of the first half of Becky and Joe sharing Elliot's birth story. I left you hanging a bit there. So tune in next week to hear what happens. I'm betting there is a baby at the end of this. For anyone who might benefit from some informational resources on clubfoot, please visit the show notes for this episode at birthmattersshow.com where I have linked some of the things Becky and Joe shared. I'll save my commentary for next week's episode, but here's a sneak peek into part two of Becky and Joe's story.
Joe: 49:11
It was hard for me in the first few days after we brought him home because I could tell that he wasn't as soothed by me as he was by his mom. The doula was helpful in that regard too because she kind of taught me to do some different movements, including like squats. So I'm getting some exercise. So we bounce him. I bounce him a lot and to me getting comfortable with him on my own when mom is sleeping—I feel like for moms it's so instinctual, they just go into mom mode—and then for dads it's like, "Whoa, what the hell am I supposed to do?"
Lisa: 49:40
Thanks for listening to the Birth Matters podcast. And remember, you got this. ---END---
